Once AdminisTEP has your data, it can be sorted, reported and workflowed any way you want it. These business rules are quickly customized to your specific needs. Get the results you want via automation and superior business rule logic.
This fundamental type of business rule validates that the EDI transaction structure complies with current standards (e.g., 4010A1, 5010, D.0., etc.) and that data fields are populated with the right data types in terms of character length, character type (alpha vs. numeric), etc. Syntax rules validate X12 file formats, including data elements, segments and functional groups (e.g. ISA, GS, ST, SE, GE, IEA, UNA, UNB, UNG, UNZ, UNH, UNT, UNE).
Validate that required data elements are present and properly formatted. These elements include national provider identifiers (NPIs), member number and information, provider physical and billing addresses, claim type information, and much more.
Custom Complex Rules
This is where AdminisTEP is differentiated from other vendors. Once AdminisTEP has your claim data, it can be sorted, reported and workflowed any way you want it. These business rules are quickly customized to your specific needs. AdminisTEP delivers the results you want, from automating the handling and reporting of claims inventories, to creating rules that help manage chronic conditions and population health.