NEHENEDI
Proven, Reliable Data Exchange
NEHEN’s X12 EDI services have been the backbone of healthcare data exchange in New England for over two decades. Trusted by both large and small healthcare organizations, NEHEN’s EDI platform ensures secure, efficient transactions for payers and providers alike.
Payers
Payers avoid clearinghouse costs by directly connecting with their exchange partners and working together to promote and implement common standards.
A Collaborative Community
- Collaboration with healthcare leaders and technologists working on your behalf
- NEHEN is a non-profit community of trading partners with a common goal of decreasing costs and improving healthcare
Advanced Claims Adjudication Features
- Real time integrated eligibility inquiry and response
- Submit a single real-time eligibility inquiry to multiple payers at once
- Improved claims operations/reduced resubmission and duplication.
- Greater adoption of electronic transactions, increased % of electronic submission
- Reduced call center volume
Competitive, Customer-Friendly Fee Structure
- No transaction fees
- One fixed flat fee per month (paid quarterly)
- No long-term contracts
- Free training and technical support
Ease Of Use
- Access to technology used and refined for over 15 years
- Opportunity to align organizational and exchange technology strategies with the community
Workflow Support
- Simplified HIPAA and EDI testing
- Fewer proprietary interfaces to support
- Reduced total cost of operations
Participating Payers
In addition, Trizetto/Cognizant offers access to other payers across the United States via its expanded national network services.
Providers
Providers benefit from lower cost, higher value EDI services across an array of transactions including eligibility, discovery, claims, remittance, claim status inquiry, referrals, and authorizations.
A Collaborative Community
- Collaboration with healthcare leaders and technologists working on your behalf
- NEHEN is a non-profit community of trading partners with a common goal of decreasing costs and improving healthcare
Extensive Regional and National Network
- Unlimited access to NEHEN payers - no per-click charges!
- Access to thousands of payer plans via the TriZetto Provider Solutions (TPS) network (a small transaction fee may apply for national payers, depending on the payer)
- Medicare & Medicaid (MassHealth) included in NEHEN payer network
Competitive, Customer-Friendly Fee Structure
- Flat membership-based fee includes all transactions and no per-transaction fees within the NEHEN payer network
- Flexible terms to allow for changing business needs
Advanced Revenue Cycle Features
- Automation tools and capabilities included/available such as claim denial analytics and automated actions
- Our unique discovery feature allows for searching multiple payers (up to 12) with a single inquiry for any coverage or benefits
Ease of Use
- No cost setup of real time (2 second) standardized eligibility inquiry and response integrated within the EHR
- Single point of access for all transactions with online portal access self-administered by your organization
- Discovery available via secure portal or batch transactions
- Online onboarding of services including self-directed training for all staff
Workflow Support
- Integration with all EHRs (Epic, Cerner, eCW, NextGen, Allscripts, etc.) using industry standard EDI transactions
- Multiple modes of interaction including integrated real-time, batch via secure FTP, online via a secure portal
Participating Providers
Below is just a sample of the 200+ providers who trust and use NEHEN services:
- Atrius Health
- Beth Israel Deaconess Medical Center
- Beth Israel Lahey Health
- Boston Children's Hospital
- Boston Medical Center
- Mass General Hospital
- Trinity Health New England
- RiverBend Medical Group
