Crosscheck Networks Ensures HIPAA Compliance for Health-care IT Organizations

Health-care simulation and test suite enables version 5010 conformance.

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Crosscheck Networks, Inc. has released a simulation and testing solution to help health-care IT organizations ensure compliance with the latest Health Insurance Portability and Accountability Act (HIPAA) mandates. The company’s new SOAPSonar and CloudPort Health-care Suite empowers health-care entities to conform to Version 5010 and seamlessly migrate to ICD-10 code sets.

As of January 1, 2012, all health-care providers, payers, and clearinghouses that conduct business electronically must transition from the prior HIPAA standard, Version 4010/4010A, to Version 5010. Moreover, this upgrade is a prerequisite to accommodate the conversion from ICD-9 to ICD-10-CM and ICD-10-PCS code sets, which allow for greater diagnostic and procedural coding flexibility.

The Health-care Information and Management Systems Society noted when it was first introduced that HIPAA 5010 represented “an opportunity to substantially reduce administrative costs and increase efficiency. In fact, the net financial benefits to the industry could reach $33.8 billion, according to the Department of Health and Human Services (HHS). However, realizing these benefits is dependent on fully implementing the standard and increasing provider usage of electronic transactions.”

“It’s clear from the Centers for Medicare & Medicaid Services introducing a ‘90-day period of enforcement discretion for compliance with new HIPAA transaction standards,’ as well as the HHS announcing its ‘intent to delay ICD-10 compliance date’ that many health-care providers are increasingly challenged with meeting 5010 compliance, and preparing for the ICD-10 transition,” said Mamoon Yunus, CEO of Crosscheck Networks.

EDI-, SOA-, XML-, and REST-based services are the foundation of today’s high-transaction-oriented health-care organizations. As such, real-world, intensive testing of these services -- ensuring trading partners can conduct business transactions concurrently and without issues -- is essential.

SOAPSonar provides modes for functional, multi-client performance, compliance, and security testing of EDI-, SOAP-, XML-, and REST-based services. New capabilities now allow health-care IT entities to validate that their underlying service infrastructures comply with exacting HIPAA regulations prior to deployment.

CloudPort, a simulation tool, enables development and QA teams to test/mimic services in the cloud and data centers prior to implementation. Enterprises benefit by never having to touch production code, while eliminating the substantial time, capital and IT staff resource expenses related to building a distinct cloud test environment.

Building upon these industry-leading capabilities, CloudPort’s health-care functionality allows it to simulate the behavior of a managed file transfer (MFT) gateway. Developers can dynamically emulate all EDI transactions -- including claim submissions, claim status requests and responses, referral/authorization requests and responses, eligibility/benefit requests and responses, and claim remittances -- prior to implementation. With CloudPort, test teams can validate -- independent of protocol -- that integration partner documents are formatted and exchanged in accordance with Version 5010 and ICD-10 standards.

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