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AXIOM Systems: Simplifying HIPAA Ecommerce

 Richard Howe, Founder & CEO
In 1996, AXIOM Systems was launched as a single person Healthcare IT consulting company by Richard Howe. The company quickly grew to be a 60-person boutique consulting firm known for deep healthcare domain expertise that also had a specialty practice in HIPPA electronic data exchange (EDI). After leading multiple HIPAA transaction gap analysis initiatives and subsequent HIPAA EDI remediation and build out initiatives, AXIOM Systems launched a software division in 2001 in an ambitious bid to ‘simplify HIPAA ecommerce’ for both physicians and payer organizations.

Backed by Howe’s 30 years of experience in the industry, AXIOM Systems has developed a suite of products and services predominantly aimed at untangling the complexities associated with HIPAA ecommerce. By delivering advanced application architectures and system integration capabilities, the company also helps healthcare organizations overcome several other ecommerce challenges from an implementation as well as an operational standpoint. AXIOM Systems continues to provide IT consulting services for software selection, business and technical analysis, custom programming, data management and conversion, system implementations, project management, quality analysis, and more. All these services are based on a strong foundation of the company’s deep knowledge of healthcare business coupled with an extensive understanding of various technical and regulatory issues in the industry.

Demystify HIPAA EDI

HIPAA EDI transactions are characterized by extreme syntactical and situational complexity which is reflective of the industry we operate in. An implementation guide for a single EDI claim transaction identifies thousands of data elements, their definitions and attributes and situational requirements and each data element or combination of data elements has a business impact to both the sending and receiving organization. Being able to implement and support the ongoing maintenance of these transaction sets in the context of business information that can be configured, inspected and viewed as such allows business stakeholders the ability to define and validate their processing rules in a manner, they control and minimize their dependency on archaic and indecipherable technical specifications and the tools required to program those rules. “From an operational standpoint, the same business transparency provides insights into the data stream and any problems that might arise without having to involve technical staff that may not understand the business context of an issue,” says Richard Howe, founder and CEO of AXIOM Systems.

The company operates a software division each for providers and payers—that automate, generate, and exchange HIPAA EDI in the healthcare space. AXIOM Systems’ payer and provider product offerings have all been built with a common goal of simplifying HIPAA ecommerce and include TransSend, TransShuttle, ClaimShuttle, and SolAce EMC. TransSend enables payers to leverage their HIPAA investment by deploying a cost-effective solution that allows the configuration, integration, and storage of transactions while providing an operational view of all the processes from the file level to the transaction level including the logic execution paths and data transformations.

AXIOM Systems’ payer as well as provider product offerings have all been built with a common goal of simplifying HIPAA ecommerce

“We provide complete support for all the HIPAA EDI requirements of a health plan including particularly strong enrollment (834) processing features as well as proprietary flat files,” adds Howe.

TransShuttle—AXIOM Systems’ another payer offering— simplifies the process of managing EDI data exchanges with trading partners while complying with federal requirements and best practices in the industry, including HIPAA and the CAQH CORE operating rules up through CAQH CORE IV. On the Provider side, Solace EMC supports the generation of claim EDI transactions and ClaimShuttle supports the management and exchange of those transactions. As with the payer applications AXIOM supports the ability to view EDI data as easily readable business documents.

Gateway for Coexistence with Multiple Backend Systems

AXIOM Systems serves various regional and national payer organizations with 40,000 to a million members, hospitals, specialty firms, preferred provider organizations (PPO), billing services, and software vendors. The company’s success and effectiveness in serving such a wide range of healthcare organizations can be illustrated by how it helped a client with the migration process of their backend systems. The client went through three backend systems implementations using TransSend as their EDI gateway for all the migrations that otherwise would have required them to rebuild the architecture every time a new implementation was to be done. TransSend allowed the client to easily rip out their backend administration systems and at the same time seamlessly continue to operate and accommodate complete round trip data exchanges to multiple backend systems.

“When an organization implements a new backend system or is in the midst of a major upgrade of their existing system, it is oftentimes required to simultaneously deploy multiple systems, because migration is a complex long-term process that can take years. We refer to this a ‘coexistence scenario’ where the EDI gateway has to coexist with multiple backend systems,” explains Howe. AXIOM Systems’ gateway effectively enables such coexistence scenarios without the need for clients to shut down and rebuild all their systems, as the gateway handles all the incoming and outgoing traffic including managing different logic and integrations.

By constantly evaluating the industry trends and the evolving client needs, AXIOM Systems develops products and services that are ahead of the curve. What sets the company apart is its vast experience as a system integrator and an expertise in all aspects of the clients’ businesses. Most vendors provide a toolkit that includes compliance checking and mapping tools that clients use to build and orchestrate their own system integration capabilities. However, AXIOM Systems provides an application for the same, which has a browser-based UI that allows organizations to create scenarios, specify actions, and more. The company also supports several backend system vendors with pre-built application programming interfaces (APIs) and routines that optimally utilize data from backend systems. Clients can specify the business logic they require, and AXIOM Systems assists them to configure a transparent application that can be inspected, audited, and validated.

A dedicated engineering group at AXIOM Systems is continually involved in innovation, constantly prototyping, building, and testing advanced solutions, templates, as well as best practices that are ahead of the game and provide more value to clients. The company continues to add more features to the existing applications including real time operational dashboards and is now offering enhanced operational support capabilities and remote hosting options.