Skip to content

EFT and ERA Enrollment Process White Paper

Knowledge Center Episode 195- “You Can’t Pour from an Empty Cup.” Forward-Thinking Solutions to Improve Interoperability with Mike O’Neill, Medicasoft February 2, 2024 The enrollment process for EFT and ERA varies widely throughout the industry today.  This document was previously published in 2013 and has been updated to include an overview of enrollment processes for…

Read More

WEDI Prior Authorization Electronic Inquiry: Guiding Principles

Knowledge Center Episode 195- “You Can’t Pour from an Empty Cup.” Forward-Thinking Solutions to Improve Interoperability with Mike O’Neill, Medicasoft October 16, 2023 The purpose of this document is to offer guidance across stakeholder groups to support the increased utilization and maximal efficiency of electronic prior authorization (PA) inquiry transactions. Download Paper Back to Knowledge…

Read More

Reporting Tiered Benefits

Knowledge Center Episode 195- “You Can’t Pour from an Empty Cup.” Forward-Thinking Solutions to Improve Interoperability with Mike O’Neill, Medicasoft 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…

Read More

No Surprises Act – Good Faith Estimate Use Cases

Knowledge Center Episode 195- “You Can’t Pour from an Empty Cup.” Forward-Thinking Solutions to Improve Interoperability with Mike O’Neill, Medicasoft 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…

Read More

Fact Sheet: Medicare Telehealth Changes After the PHE

Knowledge Center Episode 195- “You Can’t Pour from an Empty Cup.” Forward-Thinking Solutions to Improve Interoperability with Mike O’Neill, Medicasoft 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…

Read More

Health Equity Terminology Level Setting

Knowledge Center Episode 195- “You Can’t Pour from an Empty Cup.” Forward-Thinking Solutions to Improve Interoperability with Mike O’Neill, Medicasoft 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…

Read More

2022 WEDI Annual Report

Knowledge Center Episode 195- “You Can’t Pour from an Empty Cup.” Forward-Thinking Solutions to Improve Interoperability with Mike O’Neill, Medicasoft January 5, 2023 WEDI was formed in 1991 by then-Secretary of Health and Human Services (HHS) Dr. Louis Sullivan to be a national, multi-stakeholder organization to serve as a voice for the health care industry…

Read More

Electronic Payments: Guiding Principles

Knowledge Center Episode 195- “You Can’t Pour from an Empty Cup.” Forward-Thinking Solutions to Improve Interoperability with Mike O’Neill, Medicasoft December 16, 2022 The opportunities for improved efficiency and cost-savings associated with industry adoption of the Automated Clearing House (ACH) Electronic Funds Transfer (EFT) transaction are well established. However, despite having a national standard and…

Read More

Best Practices for Health Plans that Sub-Contract Creation of the Remittance Advice

Knowledge Center Episode 195- “You Can’t Pour from an Empty Cup.” Forward-Thinking Solutions to Improve Interoperability with Mike O’Neill, Medicasoft 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…

Read More
Scroll To Top