EDI/Clearinghouse

OneStream Managed Gateway

Smart Data Solutions’ OneStream Managed Gateway simplifies paper and EDI transaction processing for healthcare payers and providers, creating a centralized stream of all inbound transactions to improve EDI adoption and auto-adjudication rates with full transparency and reconciliation. Our solution ensures HIPAA X12 compliance with enhanced data quality and improved turn-around-time.

Smart Data Solutions’ OneStream Managed Gateway offers payers and providers the following benefits:

Financial Benefits

  • Consolidation of both Paper and EDI processing
  • Reduction in direct labor and operational costs
  • Reduction in overall cost per transaction
  • Remediation of HIPAA violations

Direct Labor Reduction

  • Remediation of expensive IT system implementation and fixes
  • Reduction in IT resources and expensive onboarding/training costs
  • Reduction in manual processing and reviewing of paper documents

System Automation

  • Custom logic capabilities to automate pends and rejections
  • Improvements in auto adjudication rates
  • Establish multi-vendor connectivity with ease
  • Full transparency of transaction processing and reconciliation

Services Include:

  • QuickScan – Scanning Solution
  • Paper to EDI – Mailroom / DataCapture Services
  • EDI Transaction Processing
  • File Conversion – Proprietary, Flat File and Standard
  • Claims Management Institutional / Professional / Dental / Vision / Work Comp and Auto eBills with Attachments
  • Rejection Handling
  • Network Repricing and Hosted Fee Schedules
  • Remittance Advice
  • Real-Time Eligibility and Claims Status
  • Provider Direct Data Entry Portal
  • 834 Enrollment

Payer Solutions

Smart Data Solutions offers payers a wide array of services designed to increase, simply, and expand EDI transaction capabilities, while reducing cost and improving control. Credibility and experience has allowed Smart Data Solutions to leverage its vast and continually growing network of direct connections and our automated, real-time transaction capabilities to help lower EDI transaction costs and reduce paper submission for our clients while providing unparalleled personalized services and support.

EDI Solutions include:

  • 837 Claims Processing
  • CORE 270/271 and 276/277
  • 835 Remittance Advice
  • Provider Direct Data Entry
  • Provider Outreach, Support and Education
  • WC eBills Processing
  • Medicare Crossover Services
  • eAttachments Handling
  • Network and PPO Routing
  • 834 Enrollment Processing
  • Advanced Claims Management and Rules Engine

Provider Solutions

Smart Data Solutions offers automated, real-time transaction capabilities to connect to over 1000+ payers, including Medicare and Medicaid. Our process will help reduce payment turn-around-time and provide full transparency and tracking on submitted transactions.

Provider Solutions Include:

  • Electronic Claims Submission (Professional / Institutional / Dental / Vision / Work Comp)
  • Real-Time/Batch Eligibility and Claims Status
  • 835 ERA Delivery
  • Provider Portal Access
  • Direct Data Entry Capabilities
  • Seamless Vendor System Integration

Provider Portal

All of the above services are supported by Smart Data’s extensive reporting and easy-to-use portal interfaces that provide automated, real-time tracking and control of all forms. You can locate a claim in your process and view the claim at any time. This system includes detailed error reporting to detect fraudulent, excessive or repetitive claims. In addition, Smart Data Solutions provides a dedicated developer support with an unparalleled level of service 24/7. This fully integrated system can be configured to meet your organizations’ needs.

Step-By-Step Guide

Payer List

To view a current listing of our payers please click here.

Video Overview