System Integration

Many IT projects require multiple interfaces yet in our experience vendors and healthcare organizations are not always equipped to build them.  In fact, integration is a common failure point of large system implementations and poorly designed integrations are frequently the root cause of delayed go live dates and increased project costs. 

Healthcare Frontier’s experienced team can help you avoid costly re-work associated with poorly designed integrations.  We are software and system integration experts.  We’ve designed and implemented hundreds of successful integrations. 

Claim System Integrations

We have vast experience developing Member, Provider, Claims, Financial/GL, Authorization, and Case Management interfaces for software vendors and healthcare organizations.

Clinical System Integrations

Our team has successfully integrated clinical HIE, EMR, and Portal systems for patient registration, clinical data, messaging and work-flow.

Examples of Our Work

  • Claims systems with referral management systems
  • Claims systems with financial systems
  • Physician portals with clinical hubs
  • EMR portals with clinical hubs
  • Claims systems with payment portals (PaySpan®)
  • Referral management system (Access Express™) with NextGen® including messaging and referral automation
  • Legacy systems with data warehouses
  • Legacy systems with clearinghouses, lab providers, hospitals, etc.
  • Enrollment systems with Claims systems

Our Approach

Working with both industry standard as well as proprietary formats, our approach is to first gather requirements and document a functional design. Once approved we advance to technical design and development.

Our technical designs include audit trail features, checks and balances, alerts, and code that monitor its own health. We make every effort to isolate common aspects of the interface so components are easily repeatable. Key aspects of our integrations are documented and packaged for smooth knowledge transfer to our clients.

Interface Standards Expertise

Our development team experts bring solid healthcare system integration experience with all HIPAA mandated ANSI X12 standards for healthcare:

  • Claims/Encounters (837P, 837I)
  • Enrollment (834)
  • Payment/Advice (835)
  • Eligibility Inquiry/Response (270/271)
  • Claim Status Inquiry/Response (276/277)
  • Services Review Request (278)
  • Acknowledgment (997)

As well as clinical EDI standards

  • Clinical standards (HL7, CALINX)

In addition to standard integration projects, we design and develop data archiving solutions for our clients. One example is a claims system archive project where we took all data out of our client’s claims system, scrubbed it, and passed it off to a vendor who hosted it in a cloud. Another example is an extensive EMR system archiving project where we were responsible for all aspects of design, development and testing of the archive approach.