New England Health Exchange Network (NEHEN)
From MAHealthIT
NEHEN (New England Healthcare Exchange Network)
Overview:
The New England Healthcare Exchange Network (NEHEN) is a consortium of regional payers and providers who have designed and implemented a secure and innovative electronic solution for the electronic exchange of healthcare information. NEHEN was formed in July 2009 as a result of the merger of MA-SHARE, the largest clinical health information exchange organization in Massachusetts, and the New England Healthcare EDI Network, a mature healthcare administrative transaction exchange formed in 1998, which handles over 80 percent of the inpatient administrative transactions in the state (about 60 million transactions per year).
NEHEN is a collaborative, payer- and provider-owned solution for connectivity and administrative simplification that: transports HIPAA-compliant transactions; has a low-cost of ownership; delivers an "any payer" solution to connectivity; makes the most of the participating organizations' investment in technology; can be integrated on each organization's terms into claims payment and provider service processes (on the payer side) or into patient access and revenue cycle processes (on the provider side); reduces bad debts and other financial exposures by improving administrative efficiencies; and shortens the elapsed time to achieve electronic data interchange at an appropriate transaction volume level.
The primary success factor for NEHEN has been the collaboration between health plans and providers. All intellectual property created for NEHEN is shared among the members. Also, if a member individually develops a solution that might benefit the group, that solution is donated to NEHEN. Collaboration has enabled the members to share costs, leverage experience gained by other participants, and accelerate the benefits of administrative simplification. This collaboration is in fact what makes NEHEN different from a typically competitive environment. Its features and benefits are designed to be balanced in their value to payers and providers alike.
Current projects:
- NEHEN is working with its members to meet the industry-wide deadline of January 1 2012 for compliance with the new HIPAA 5010 transaction standard. NEHEN is not only developing the software to make the transmission possible, but also coordinating the massive testing effort necessary to ensure interoperability across the membership.
- NEHEN is leading in the cross-enterprise exchange of clinical information in the region through its work with interconnecting providers, payers, and public agencies through federal standards for messaging and routing. Members now exchange clinical information with providers for continuity of care and improved clinical outcomes; with insurance payers for risk and case management; with MAeHC for standardized quality reporting; and with public health agencies to monitor population health and meet Meaningul Use requirements set out in the Patient Protection and Affordable Care Act.
- NEHEN has made a web portal available to unaffiliated providers and other allied health professionals. This portal, called NEHENNet, went live in 2007 and brings the same tools available to institutional-sized NEHEN members for a small monthly subscription fee. Now any provider can use the same software used by the "big guys" to verify patient eligibility, submit electronic claims, and perform other health insurance-related transactions.
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