WEDI Papers & Fact Sheets

Knowledge Center Reporting Tiered Benefits June 5, 2023 Tiered benefits can have different meanings or be defined differently by payers and providers. They may interpret the data they exchange differently, as well as how that information could be applied when delivering patient care. Both traditional and more complex benefit plan designs have been introduced into…

Knowledge Center No Surprises Act – Good Faith Estimate Use Cases May 5, 2023 Claims Subworkgroup & No Surprises Act Task Group These use cases describe common scenarios for which the Good Faith Estimate would be used. The purpose is to illustrate the business workflow steps required to obtain the necessary information to populate and…

Knowledge Center Fact Sheet: Medicare Telehealth Changes After the PHE April 24, 2023 Since the public health emergency (PHE) related to the COVID-19 pandemic began in 2020, the Centers for Medicare & Medicaid Services (CMS) issued a series of waivers and flexibilities for telehealth services for Medicare beneficiaries. Some of these waivers and flexibilities were…

Knowledge Center Health Equity Terminology Level Setting March 15, 2023 To focus this work so we are all “rowing in the same direction,” we need to have a mutual understanding of the terms and their definitions that make up the language of health equity. Download the Paper Back to Knowledge Center Categories Comments & Letters…

Knowledge Center Best Practices for Health Plans that Sub-Contract Creation of the Remittance Advice September 29, 2022 Providers are experiencing challenges in situations where they have a relationship/contract with a specific health plan (and submit their claims to that health plan), but that health plan then sub- contracts some or all services to a business…

Knowledge Center Integrating Telehealth Data from Standalone Platforms into EHRs September 21, 2022 As the use of telehealth services through standalone platforms becomes more prevalent, there will be an increased need to integrate health data from those platforms into patients’ electronic health records (EHR). This paper will provide an overview of the need to integrate…

Knowledge Center Fact Sheet: Data issues in Clinical Genomics March 17, 2022 What can EHR systems do now to support genomics in clinical practice In general, the health care industry struggles to understand how to better incorporate genomics into patient care. Some of these challenges are attributed to the lack of genomic capabilities of electronic…

Knowledge Center NACHA Data Security Requirement Updates for Healthcare Entities November 17, 2021 This paper outlines updates made to the NACHA Operating Rules (Article 1, section 1.6 Security Requirements) regarding security requirements for account numbers used in healthcare claim payments and other electronic payments made by healthcare entities. NACHA Data Security Requirement Updates for Healthcare…