REDMOND, Wash. — June 9, 2010 — Microsoft Corp. today announced that multiple payer, provider and partner organizations, including Molina Healthcare Inc., EmblemHealth, Edifecs, Evolute, Neudesic LLC, The TriZetto Group Inc. and Washington Publishing Company are standardizing on Microsoft’s integrated, standards-based platform, with Microsoft BizTalk Server 2009 at the core, to support HIPAA 5010 and ICD-10 compliance. The platform also enables health plans to reduce costs and accelerate and automate processes and work flows to achieve administrative simplification.
BizTalk Server 2009 is a scalable electronic data interchange and messaging solution that helps payer and provider organizations meet the challenges of integrating diverse systems. It provides out-of-the-box support for HIPAA 5010 messaging schemas, trading partner management and integration components, while also enabling payer and providers to make better use of existing technology to support growth and reduce costs.
Microsoft and leading partners, including The TriZetto Group Inc., Neudesic LLC, Evolute, Washington Publishing Company and Edifecs, are collaborating to help payers and providers embrace a service-oriented approach to HIPAA 5010 while creating a longer term IT strategy to support administrative simplification, health reform, ICD-10 adoption and new health IT models.
Furthermore, to meet the new medical loss ratio minimums that, under health reform, compete directly with profit margins, health plans must find innovative ways to quickly drive down administrative costs, fraud, process waste, and the complexities of doing business. By using BizTalk Server to convert HIPAA 5010 transactions into electronic documents that are human- and machine-readable, health plans can redesign and automate labor intense and error-prone processes by tightly coupling administrative transactions with customer service, medical management and financial processes — including claims auditing, investigations, authorizations, referrals, fraud and abuse, utilization management, appeals/grievances, online sales, enrollment, and customer service.
Coupled with platform technologies, such as Microsoft SQL Server 2008 and Microsoft Office SharePoint Server 2007, the Microsoft platform provides straightforward ICD-10 compliance so that it can be sent and received in time for the October 2013 deadline. It also integrates with the entire suite of Microsoft tools and interoperates with legacy applications and Java-based platforms, so the organization’s legacy systems can be integrated into the platform.
