HIPPO - Internet Repricing Engine HIPPO is an exclusive Internet Repricing system. The system enables the client to reprice claims and receive discounts instantly via our Internet repricing portal. HIPPO also offers superior claims analytics and reporting capabilities.
Implementation Timeline: 1 day
Repricing Turnaround: Real-time
EDI - EDI
This type of EDI can be set-up in two [2] business days using The Covenant flat file format. The client extracts the claims out of their system and uses our flat file/HCFA in/out, UB in/out file layout. This is then returned to the client in the same layout.
Implementation Timeline: 2 days
Repricing Turnaround: Turnaround time of 90% the same day and the remainder within our normal 2-day turnaround time.
Paper to EDI
If a client decides to use The Covenant as a "mailroom" and wants the claims returned by The Covenant EDI, we recommend the ANSI 837/3041 format. UB-92 and HCFA 1500 claim form data is converted into an electronic file and repriced. All claims, in-network and out-of-network, are electronically forwarded directly into client's claim system.
Implementation Timeline: 250 claim files depending on the layout and the response time of the client.
Repricing Turnaround: The turnaround time for the conversion of paper to EDI and processing is 2 days from the paper being received by The Covenant.
Paper to Paper
The Covenant accepts paper claims and remits them back to the client with an adjudication page reflecting repriced amounts.
Implementation Timeline: Immediate
Repricing Turnaround: 1 day
Web Service - XML
The latest in B2B technology, Web Service Repricing. Web Service Repricing allows the claim application to communicate directly with our repricing engine to provide an integrated real time repricing solution. There are no files to manage or additional data entry. Systems and applications interface, completely transparent for users.
XML requires no data entry or files to send. XML technology is not tied to any operating system or computer language. Requires client's IT support to install code to the claims application system. Clients have secure internet access to all reporting features online facilities and system utilities.
Technology Workflow:
Claims are selected for repricing in the client's claims application system. As claims are selected, they are sent securely across the network via internet to The Covenant for repricing. As a claim is repriced and completed, it is immediately available to the client's claims application system. Client's claim application system retrieves the repriced claim data and discount.
