The Edifecs Operating Rules Solution will help Bluegrass achieve rapid cost savings, enhanced productivity and increased member and provider satisfaction by complying with Operating Rules. As the health insurance arm of the
“As a regional organization, we were looking for a partner to help us with a solution that would ease transaction management and increase satisfaction among our members,” said
Health plans have limited time to test and implement technology for Operating Rules compliance, and many are overwhelmed by additional healthcare mandates on the agenda such as ICD-10 and Health Insurance Exchanges. For smaller payers, including Bluegrass, it is also difficult to hire and train enough IT staff for a project that will require dedicated resources over future updates as well as consistent monitoring and maintenance of IT systems.
The Edifecs solution allows health plans to save time while achieving cost-efficient and scalable compliance with Operating Rules, with future-proofing for new mandates down the road. With an easy-to-use interface and modern front-end infrastructure, health plans look to Edifecs to improve business processes and gain faster access to detailed information about member benefits, deductibles and expected costs, which providers can share at the point of care.
“Bluegrass Family Health is a wonderful example of how payers of any size can simplify their administrative processes and maintain compliance with the latest mandates,” said
An industry leader since 1996, Edifecs provides healthcare software solutions that improve operational performance by streamlining the exchange of information among health plans, hospitals, and other healthcare organizations, while enabling compliance with current mandates such as HIPAA 5010 and ICD-10.
Today, more than 250 healthcare customers use Edifecs technology to unify transactions from any information channel source and input mechanism, while automating manual business processes such as enrollment, claims and payments management.
Edifecs is currently recognized as one of the 100 Fastest Growing Private Companies in the state of
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