Intelligent Enterprise

Informatica on Monday launched a healthcare claims processing platform that's designed to help insurance companies process claims more efficiently while meeting new standards for data privacy and portability.

Informatica's B2B Data Exchange for Healthcare Payers meets healthcare payer requirements for compliance with HIPAA (Health Insurance Portability and Accountability Act) 5010 data standards. It's also designed to allow healthcare enterprises to fully validate HIPAA messages and increase first-pass adjudication rates, according to Informatica.

The system provides an electronic claims data exchange and HIPAA compliance infrastructure, which includes HIPAA validation functions from Informatica partner Edifecs.

"Customers can now leverage a unified platform for automating the entire electronic claims data exchange process, and avoid having to weave together an assemblage of niche solutions," said Girish Pancha, general manager for Data Integration at Informatica, in a statement.

The B2B Data Exchange for Healthcare Payers also features Universal Data Transformation that transforms and integrates any data format, including traditional EDI, XML, and proprietary mainframe data, in real time and batch modes.

Additionally, it provides users with the ability to automate the entire electronic claims data exchange process and identify bad data events on-the-fly.

"The Informatica B2B Data Exchange solution for Healthcare Payers is a comprehensive and economical offering for optimizing the electronic claims process, while ensuring HIPAA compliance," said Girish.

Informatica's healthcare industry customers include Dean Health Plan, Israel's Clalit Health Services Group, and the Cancer Council of New South Wales, in Australia.

The company last week reported third-quarter earnings of $16.2 million, or 17 cents per share, compared with earnings of $13.4 million, or 14 cents per share, in the same period a year ago. Third-quarter revenue was $123.4 million, compared to $113.8 million a year earlier.

Blue Cross of Northeast Pennsylvania, the University of Louisville School of Medicine, and a range of large and small healthcare providers are using mobile apps to improve care and help patients manage their health. Find out how. Download the report here (registration required).