UiPath Healthcare SMART EDI Conversion Suite

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Summary

UiPath SMART EDI Conversion Suite (270/271, 276/277 and 835/837) is a bi-directional EDI files conversion solution. It can un-spool the EDI files to DataTable & can spool an EDI file from claim forms

Overview

UiPath Healthcare EDI convertor is a bi-directional solution with below listed features
This solution converts the EDI 270/271 transaction the eligibility and benefit information request & response files, EDI 276/277 for Claim Status Inquiry and response, & EDI 835/837 for electronic transaction for claims submissions and claim payment information into meaningful DataTables/DataSet for automated data validations, verification and data entries to different healthcare systems. This real time converted data can also be utilized for reporting & analysis purpose.
This solution has the capability to generate the EDI files from different data sources like Claim Forms, excel data source, health information systems and backend data bases like SQL bases on defines configuration files.
Use Cases
EDI files conversion to dataset for data analysis & Reporting
Benefit & eligibility data verification and validation
Healthcare Claim data validation & Edits (Ex. CMS 1500)
Payment Posting data validations & Automated data entry
Eligibility mismatch
Cash and Credit adjustments
Real time EDI file updates
Advanced Analytics/Machine Learning/ BI Extraction