NEHEN is a full service online administrative solution offering claims, eligibility, referrals, claim statuses, and remittances for a single, flat membership rate (usually lower than a traditional clearinghouse). It currently uses EDI and X12, making it fully compliant with HIPAA transaction standards.
NEHEN offers utility-level savings and efficiencies to organizations for more strategic uses of their limited human and financial capital.
NEHEN today offers a cornerstone HIE service for payer and provider trading partners wishing to exchange industry-standard X12, HIPAA-compliant API transactions in real-time or via an integrated portal or using batch processing. NEHEN is exploring adding support for HL7 Fast Healthcare Interoperability Resources (FHIR) API data exchange for clinical transactions and attachments which can be used within an automated prior authorization process as well as for many other purposes.
Payer organizations avoid clearinghouse costs by directly connecting with their exchange partners and working together to promote and implement common standards.
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.
NEHEN emphasizes collaboration among its members while using and advancing standards-based electronic data exchange directly with your trading partners.
NEHEN works from within your electronic medical record system or claims management system, enabling you to optimize information exchange.
Fees are adjusted to reflect actual use during the subscription period.
In development: clinical information exchange, including FHIR-based, USCDI/US Core-compliant, and regulation-minded API transactions and business processes.
Exchange services (discover, transact, validate/verify, report)
X12 Electronic Data Interchange, including eligibility, claim status inquiry (CSI), specialist referrals, claim submission, remittance
NEHEN will be a complete interoperability smart hub supporting clinical and administrative transactions.
NEHEN will take the complexity out of prior authorization, surprise billing, and price transparency enabling payers and providers to:
Automate transactions using industry standard, open-platform methods such as those developed by HL7’s DaVinci FHIR accelerator
Use a community-based, collaborative, and member-driven service to facilitate the exchange of clinical and administrative data
Use innovative tools and practices to support automation and advanced applications of clinical data exchange