As healthcare entered the 21st Century, The SSI Group began making its commitment to broaden the focus of the company’s core business model. In part, this was the result of SSI’s never-ending quest to better serve its provider client base by seeking to eliminate costly and time consuming steps in getting data to and from the payers. This initiative fostered a burgeoning roster of “direct connect” relationships between The SSI Group and leading commercial payers. As well, we deemed it a logical expansion of what SSI does best--transferring data between systems and exporting to destinations with security and confidentiality. Indeed, these are the very heart of SSI’s mission and vision. We are well positioned with greatly expanded connectivity within the payer community; and we’ve been equally busy developing and marketing products and services customized specifically for the Payer community.

SSI’s Commercial Payer Gateway
Today, The SSI Group offers healthcare commercial payers the advantage of a single convenient conduit to more than 35% of the U.S. hospital market. Accordingly, SSI has direct connect relationships with nearly 370 payers, representing hundreds of insurance plans with payers such as Aetna, Cigna, United HealthCare, Pacificare and Kaiser. We work hand in hand with these companies to assist them in achieving their EDI initiatives. Facilitating greater electronic claim throughput is a perennial objective. Supplying physician practices with software that enables electronic claim submission is also a common imperative. We even supplement IT infrastructure through data distribution, be it back to the providers or claims forwarding for the PPO marketplace. Ultimately, SSI's Commercial Payer Gateway serves to process data and continually inform all parties involved in a HIPAA compliant and user friendly manner.

Transaction Tool Kit
SSI’s in-depth healthcare EDI expertise translates into powerful software that enables the payer to manage incoming and outgoing files with ease, and process 837 and 835 files as well as the response reports. Add SSI’s OCR (Optical Character Recognition) capability to scan hard copy claims as they come through the door and generate an 837 claim that routes to your electronic process.

Payers may access SSI’s existing integration engine and appropriate templates to import/export files based on the ANSI X12 4010A1 specs. This is applicable to any ODBC environment.

Data Warehousing
The SSI Group’s heritage of EDI safety, security and confidentiality lends great credence to why the payer community is turning to us as a trusted data repository resource. One example: SSI is the ideal choice to host eligibility rosters. This online eligibility integration gives providers access to key information, without consuming a payer’s human resources in fielding answers to simple benefit questions.

SSI’s solid optical storage technology furthers this notion...retain all your information, be it electronic or scanned, for use within the processing of claims. Electronic File folders can be implemented to expedite case management.

Summation
SSI's depth of expertise in enabling payers to process and manage all distribution of data to the provider community is unparalleled. Whether it's connectivity issues, data warehousing, distribution of data such as electronic remittance distribution, or simply looking for a company to foster a HIPAA compliant method of operation, SSI is your single source solution.

Our industry and transaction experts conduct a detailed analysis of each payer to determine exactly what your organization needs to compete in today’s marketplace. We further leverage the results to anticipate future needs as your business grows and expands. Contact us at PayerLink@ssigroup.com to determine just how SSI can help you succeed in this challenging and competitive marketplace.