EDI Code Generation
For Healtchare Claims

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EDI Code Generation For Healtchare Claims

Moogilu designed, architected, and delivered an Electronic Data Interchange (“EDI”) encoding and decoding services for Healthcare Claims submission. Here below are the project specifics:

Healthcare Compliance Rules Engine

Healthcare Compliance Rules Engine includes:

  • Design and Architecture of EDI Claims generation engine in Ruby and Java
  • EDI XML Claims Schema for validation
  • XML Schema Validation
  • EDI Code generation for Claims Submission
  • Decoding EDI signal from the Governement
  • Extensive reporting on encoded and decoded EDI signals
  • Automated QA system to compare EDI signals
  • Automated un-bundling of EDI files from one master files for multiple customers
  • Realtime verification or EDI signal using XML for readability
With EDI encoding and decoding for Claims:
  • Generate EDI Claims Signals from any charge capture system
  • Decode EDI Paid Signals from Government
  • Real-time EDI parsing for readability
  • Extensive EDI signals payment Reporting