SW-31415 - USA (New Jersey) - RFI for Health Insurance Portability and Accountability Act Compliance Tool - Deadline February 19,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: SW-31415

Government Authority located in New Jersey; USA based organization looking for expert vendor for health insurance portability and accountability act compliance tool.

[A] Budget: Looking for proposal

[B] Scope of Service:

Vendor needs to provide health insurance portability and accountability act compliance tool HIPAA compliance tool is a Payer Electronic Data Interchange commercial off-the-shelf software solution to validate payer claims in accordance with the HIPAA compliance regulations for Community Care claims reimbursement to VA EDI partners per HIPAA regulations.
- Workgroup for Electronic Data Interchange (WEDI) Strategic National Implementation Process (SNIP) defined levels 1-7 for electronic data interchange (EDI) transactions.
- Testing "for valid segments, segment order, element attributes, testing for numeric values in numeric data elements, validation of X12 syntax and compliance with X12 rules."
- Testing for HIPAA implementation-guide-specific requirements, such as repeat counts, used and not used codes, elements and segments, required or intra-segment situational data elements, nonmedical code sets as laid out in the Implementation Guide. Tests the code value specified in the guide for that transaction (as opposed to external code sets).
- Testing for balanced field totals, record or segment counts, financial balancing of summary fields.
- Testing of specific inter-segment situations described in the HIPAA Implementation Guides, including the validation of situational fields given values or situations present elsewhere in the file.
- Testing for valid implementation-guide-specific code set values, makes sure the usage is appropriate for any particular transaction. Validates external code sets, e.g. CPT, HCPCS, ICD9, NCPDP, HL7 Version 2 and 3, HL7 FHIR, CDT, NDC, remittance advice codes, etc., and their appropriate use within the transaction.  

[C] Eligibility:

Onshore (USA Only)

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office premises.

Expiry Date : Wednesday, 19 February, 2020

Category : Software, System and Application

Country : USA

State : New Jersey

RFP Expired

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