CHICAGO, April 8, 2008 /PRNewswire/ -- Rising Medical Solutions, Inc. (Rising), a national medical cost containment organization, and WorkCompEDI, an electronic transaction clearinghouse company, recently established a relationship to process electronic billing transactions between healthcare Providers and Payers of Workers' Compensation claims.
Rising initially contracted with WorkCompEDI to implement a national clearinghouse solution in compliance with the eBilling requirements mandated by the Texas Department of Insurance. This mandate, effective January 2008, requires Texas healthcare Providers to submit electronic Workers' Compensation bills and attachments to insurance Payers in a state-approved ANSI 837 format. In return, Payers are required to electronically submit remittance advices to Providers in an ANSI 835 format.
Subsequent to January, Rising and WorkCompEDI have deployed connectivity to Rising's Payer clients in additional states. As eBill protocols are increasingly being standardized and adopted by various states, this alliance ensures Rising clients will have access to fully compliant and fully integrated electronic transaction services that meet the regulatory standards adopted in these new jurisdictions.
Addressing Payers' complete workflow needs, Rising's eBilling solution includes receipt of electronic medical bill submissions, review and repricing of medical charges, provision of electronic explanation of reviews, processing of corresponding Electronic Remittance Advices (ERAs), and satisfying other mandated state reporting requirements. Additionally, Rising's capabilities include processing Provider payments on behalf of its Payer clients should they so choose.
Rising COO Cecil Pickens states, "For numerous reasons, the Workers' Compensation industry has been slow to initiate electronic billing and payment between Providers and Payers -- a practice that is commonplace in other healthcare segments. We are excited that, in conjunction with our relationship with WorkCompEDI, our Payer clients are able to access electronic processing capabilities through a single integration point with Rising." He adds, "With technological advancements where they are today, we are able to leverage our own technology innovation and investments while limiting additional capital outlays required by our clients and allow them to focus on core business competencies."
Comments WorkCompEDI President/CEO Marc Menendez, "We are very pleased to have been chosen as Rising's eBilling clearinghouse partner for the Texas mandate and we are excited to increase the depth of our partnership to other states. Both companies have worked hard to ensure that Rising clients experience a quick and smooth transition to the eBill solution. By combining WorkCompEDI's advanced EDI clearinghouse capabilities with Rising's leading bill review programs, Rising is able to deliver an end-to-end electronic medical bill processing, auditing, and payment solution to the Workers' Compensation marketplace."
About Rising Medical Solutions, Inc.
Headquartered in Chicago, Illinois, Rising is a leading medical-financial solutions organization that services the auto, workers' compensation, and liability markets. Through its comprehensive medical cost containment and care management programs, Rising provides compelling business outcomes to clients nationwide, including insurance carriers, self-insured employers, government organizations, third party administrators, and attorneys.
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|SOURCE Rising Medical Solutions, Inc.|
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