FOX HIPAA Clearinghouse Services

EDI Clearinghouse Capabilities

As part of our commitment to assisting our clients with full HIPAA compliance, FOX Systems, Inc. (FOX) offers EDI Clearinghouse capabilities that include the implementation, operations, and ongoing support of an EDI transactions clearinghouse.

Transactions serviced by the FOX Clearinghouse include:

NSF-formatted Batch or Real-Time Transmission, Receipt, and Translation for:
- ANSI X12 837 P/I/D – Healthcare Professional/Institutional/Dental Claim or Encounter Transactions
- ANSI X12 835 – Claims Payment and Remittance Advice Transaction
- ANSI X12 278 – Referral Certification and Prior Authorization Requests Transaction
- ANSI X12 276/277 – Healthcare Claims Status Request and Response Transaction
- ANSI X12 270/271 – Healthcare Eligibility Benefit Inquiry and Response Transaction
Technical Support Capabilities, including:
- Communications hub to support transmission, routing, and receipt of transactions
- Transmittal of all batch transactions to appropriate recipient(s) within 24 business hours after receipt
- Transmittal of all real-time transactions to appropriate recipient(s) within 20 seconds of receipt, excluding non-business hours
- 24-hour x 7 days/week continuous processing and maintenance
- Help Desk support from 7:00 a.m. to 7:00 p.m. CT, excluding holidays
- Tracking logs for all transactions

FOX is continuing to expand its clearinghouse services to encompass the remaining HIPAA transactions. These services will be available in the coming months.

Future HIPAA transactions serviced by FOX will include:
- ANSI X12 820 – Premium Payment Transaction
- ANSI X12 834 – HMO Enrollment and Disenrollment Transaction
- ANSI X12 275 – Claims Attachment Transaction (yet to be finalized and incorporated into the final HIPAA rule)
- ANSI X12 997 – Functional Acknowledgment Transaction