ProvidersPayor Solutions

Tesia Clearinghouse, LLC offers a comprehensive and flexible clearinghouse service that address HIPAA transaction requirements, delivers flexible capabiltiies along with robust solutions for the provider community to actively increase EDI volumes and enhance drop to pay rates.

As the industry's only proven end-to-end Real-Time Claims processing clearinghouse, Tesia brings 18 years of EDI know-how to a customer, enhancing the opportunity for them to avoid typical pitfalls.

To help reduce future costs, Tesia simplifies connectivity with other parties on behalf of customers through Tesia's "Managed Gateway" offering. Anyone can connect to a Tesia customer (without limitation or additional cost to the customer), reducing a Payor's need to supply resources and increase costs to increase EDI volumes. Whether it be individual providers, other clearinghouses, practice management software Vendors, or other third parties, Tesia provides a single connection point, allowing a subimtter to use an array of formats and connectivity methods.

Implement varying levels of complex edits, validation processes and routing are readily available for any customer. These additional pre-adjudication steps help enhance EDI processing, and increase drop-to-pay rates. Some sample edits used today by key customers include (but not limited to):

  • simple or complex eligibility validation
  • provider network matching / scrubbing
  • code-specific conversions
  • bundling & unbundling
  • repricing of claims
  • multi-system rules processing
  • .....and more!

All Tesia clearinghouse clients are also able to offer ancillary transaction connectivity at no extra cost, including (but no limited to):

  • 837 - claims, prior auths & utilization
  • 270/271 - eligibility &benefits
  • 276/277 - claim status
  • 278 - referrals
  • 275 - attachments
  • .....and more!

Non-standard solutions for providers give Tesia an enhanced opportunity to increase the value of a Tesia relationship, delivering flexible methods for submitters to exchange EDI with a Payor customer.

  • No Computer solutions (PCI-Terminal™)
  • Computer, no PMS software and no internet (WorkStation™)
  • Computer, no PMS software with broadband (NetStation™)
  • PMS software (with or without internet) (TesiaBridge™)
  • No technology knowledge or desire (TesiaFax™)
  • Large IT department desiring flat file exchanges (TesiaLink™)
  • .....and more!

Implement expeditiously with minimal intrusion upon existing administrative work processes. An average implementation with a new customer takes 2-4 weeks, including end-to-end testing. Tesia handles as much of the "customization" to simplify connectivty.

Business Process Outsource (BPO) solutions provide complimentary services to EDI customers, focused on aligning corporate goals and initiatives of lowering costs and increasing efficiencies through a paperless environemnt.

  • Paper-to-EDI / OCR Services
  • Printing Services
  • Custom EDI conversion / mapping / development
  • ....and more!

Call Tesia today to learn how you can join hundreds of Payors, tens of thousands of Providers and leading vendors who are already linked with the industry's only organization dedicated to the pursuit of Electronic Data Intelligence.

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