Q: I had someone develop a medical software, but they don't know how to create the EDI submission part of it. Or they created the EDI, but don't know how to intergrade it so that the medical claims can be sent via the web-based application. It's a web based software and needs the ability to be able to submit the cms 1500 claims to insurance carriers. Again, the EDI portion is done, but they have reached a wall in terms of how to connect it all and be able to send claims to various carriers. Please be as specific in your explanation if you assist with this. Thank you.

A: I guess you hired the wrong programmer to the the EDI part then? Also, it seems like you're not even sure which part is missing. In any case, you need to talk to the person who developed what you already have and find out, exactly, what parts are missing to do the EDI exchange. From there, if the only thing missing is the actual "send the data to the carrier", then I guess the first step would be to contact the carrier and get their specs. If other parts are missing, you'll need to get us more info before we can help you further. On the other hand, it may be better in the long run to hire someone who does this for a living. Check out TriMed Solution's "FastEMC" product. It's HIPAA-compliant and handles CMS 1500 forms along with others. - kb -

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