Real-time data exchange with the health plans
Trade eligibility, claim status, encounters, and remittances with payors in real time. It's built on current X12 ANSI EDI standards, with the same automation as the rest of Claims-Flow.
Talk to our team →The transactions health plans expect
Real-time 270/271
Member, benefits, and accumulator lookups during processing.
Real-time 276/277
Claim status lookups on demand.
Encounter generation
Encounter file generation for CAP plans.
837I/P for markup plans
Institutional and professional claim submission.
835 for markup plans
Remittance handling for markup arrangements.
ODAG reporting
Claims reporting that meets ODAG requirements.
Standards-compliant exchange
From 270/271 eligibility to 837/835 claim and remittance files, every exchange is built on current X12 specifications, so you stay compliant with Medicare and payor requirements without manual rework.
Real-time, not batch processing
Eligibility, accumulators, and claim status are pulled in real time during processing, so decisions are made on current data rather than an overnight batch.
Connect your plans in real time
We'll map out which exchanges your operation needs.