HL7 Integration and COVID-19 Testing Claims: A Case Study

To help clinics eliminate their efforts in billing COVID-19 tests, we have fully integrated with HL7 and are in collaboration with a laboratory in Utah. Through this partnership, we aim to help automate the billing process more, reducing billing-related work for healthcare professionals and staff. This is our most recent change, and we are looking forward to this new direction, providing better services for our clients.

The Current Situation

When healthcare providers administer and send COVID-19 tests to a lab, that means there will be new claims needing to eventually be submitted. What many times happens is the claims needing to be submitted are documented and sent to a billing company by the healthcare providers. The billing company then takes the information and enters them into individual claims to be billed. This is a more manual approach and requires the healthcare facilities to tell the billing team what services need to be submitted for billing. HL7 integration and our processes will allow our team to know what needs to billed without healthcare facilities needing to send the information to us.

What is HL7?

HL7 is a standard for the exchange and use of electronic healthcare information. What this means is that once systems are integrated with HL7, the different systems can seamlessly communicate healthcare information between each other. It is a standard that is used by many providers such as hospitals, clinics, primary care physicians, labs, etc. It is an American National Standards Institute accredited standard, and the HL7 organization has been around since 1987.

For users this means the ability to share and have access to patients’ health information in an easier way. When both the lab and Americare Network have integrated with HL7, it means we can now exchange information more efficiently, and we can bill in a more automated manner for healthcare facilities who use this laboratory.

HL7 Integration and Reducing Billing Efforts by Healthcare Facilities

When a healthcare provider administers a COVID-19 test, the sample is sent off to the laboratory. This information will be in the lab’s information system. In our case, it is a different software than Americare Network’s system. Before, the individual healthcare providers using the lab will need to send the information in a format that our system can interpret and use. Now, when the lab integrates with HL7, it allows our HL7-integrated software to exchange information easily and directly with the lab.

This means our team can bill claims for the COVID-19 tests without the individual healthcare providers having to send us the information manually. Our system can communicate with the lab’s system directly, get information on which claims need to be submitted, and then submit claims accordingly.

This can be done because the lab has the information from healthcare providers. Moreover, the lab and Americare Network, having integrated with HL7, can communicate in a standardized format with each other, even though our systems are different. Since the lab works with different healthcare providers who administer COVID-19 tests, we can now help those providers with their medical billing, through the lab.

HL7 Is Not Complicated

This format of information exchange is not something healthcare providers need to worry about. HL7 works in the background and will help cut down on time and costs associated with a non-integrated approach. Think of it as our system and the laboratory’s system now having the ability to communicate in the same language and interpret the information in the same way. This information will then help us submit claims for healthcare providers. Through integrating with HL7 and working with the lab, our team will be able to manage the billing of claims safely and more efficiently, so you as healthcare providers do not have to. For more information on this new process, contact us today.