Flexible and scalable data integration

Flexible and scalable data integration

Our data exchange capabilities

ProgenyHealth’s information exchange capabilities are extensive and include both proprietary and standard healthcare industry transaction protocols. We can connect with you to share data in a variety of ways—meeting you where you are today with your own systems, and partnering with you to support future enhancements.

ProgenyHealth Data Exchange Capabilities

Health Level 7 (HL7)

(ADT) Admit, Discharge & Transfer Notifications

ProgenyHealth can receive admit, discharge, and transfer information via HL7 transactions from any source. This notification makes the ProgenyHealth utilization management team aware of one of your newest members’ admission to the NICU or special care nursery. It also notifies us of the baby’s discharge to home or non-acute setting, as well as transfers to other locations of care. This method of notification to ProgenyHealth is ideal for both parties given that it is an industry standard and easy to implement per the HL7 ADT implementation guides.

HL7 (C-CDA) – Consolidated Clinical Document Architecture 

C-CDA is a document markup standard that specifies the structure and semantics of “clinical documents” for the purpose of exchange between healthcare providers from a hospital’s EMR or from a health plan’s medical management system. The Continuity of Care Document (CCD) represents a core data set of the most relevant administrative, demographic, and clinical information facts about a patient’s healthcare, covering one or more healthcare encounters. It provides a means for one healthcare practitioner, system, or setting to aggregate all pertinent data about a patient and forward it to another to support the continuity of care.

ProgenyHealth can receive a record transmission from any submitter, whether it is a hospital, health plan, or third-party vendor. Our internal nursing teams use this medical record information to support the babies we care for from birth all the way through 15 months of life (program dependent).

ASC X12

ProgenyHealth can support various ASC X12 transactions – the standard across much of healthcare for administrative data exchange:

  • 270 Health Care Eligibility Benefit Inquiry
  • 271 Health Care Eligibility Benefit Response
  • 278 Health Care Services Review Notification 
  • 837 Health Care Claim — Institutional 
  • 837 Health Care Claim — Professional
  • 275 Personal Health Record
  • 277 Health Care Claim Status Response
  • 834 Benefit Enrollment and Eligibility
  • 999 Response Files 

Proprietary

ProgenyHealth has integrated with our partners in the following ways:

Proprietary Prior Authorizations

ProgenyHealth can support proprietary authorization information transfer. Sometimes, our health plan partners’ medical management systems require more information than is supported by the ASC-ANSI X12 278 transaction. Proprietary files can overcome this issue and assure complete information exchange between ProgenyHealth and our health plan partners.

Census File

ProgenyHealth can accept a census file from you in various formats to notify us of the babies from your health plan under our care. Simply discuss your needs with our sales team and be assured we will provide you with options to meet them.

Medical Management System Interface

ProgenyHealth can develop an interface to ensure seamless data transmission between our integration-friendly, EHR-like platform BabyTrax®, and your Medical Management System. This enables our utilization management and case management teams to add appropriate information needed to administer claims. If additional information is needed, further discussion will be required to evaluate options. For additional data elements or functionality outside of standard EDI or HL7 requirements, custom options are available for additional cost.

Secure Fax & Email

ProgenyHealth can also do things the old-fashioned way, if needed. We accept secure faxes and secure e-mails today from our current hospitals and health plan clients.

Questions? Email us at:
edisupport@progenyhealth.com