WEDI Papers & Fact Sheets

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…

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…

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…

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…

Fact Sheet: Privacy and Security in Telehealth November 10, 2021 The Health Insurance Portability and Accountability Act (HIPAA) requires covered entities (e.g., health care provider, payer, or clearinghouse) to protect PHI they maintain or transmit to other covered entities or business associates. The requirement is to protect PHI in any format, including electronic,…

Prior Authorization Workflow Barriers and Guiding Principles October 4, 2021 Based on its discussions, the Prior Authorization Subworkgroup developed a set of guiding principles that will support optimal industry implementation of the X12 278 transactions and help stakeholders achieve increased benefits and cost savings associated with prior authorization automation. If you would like…

Best Practices for Secondary EDI Claim Submissions September 27, 2021 Mitigation steps that providers, software vendors, clearinghouses, and health plans can take to reduce consumption of resources at all levels, eliminate questions and confusion, reduce errors, and result in faster and more accurate payments to providers. If you would like to join the…