Standardizing Electronic Information Exchange and Reducing Costs
Mission
Linxus strives to be the premier regional innovator in the New York health care market for payer-provider transaction processing. It does so by identifying best practices along with business and technical solutions and by promoting increased utilization of the administrative transaction code sets under the Health Insurance Portability and Accountability Act (HIPAA).
As a participant sponsored program, Linxus emphasizes collaboration in developing requirements for standards-based electronic healthcare data exchange, while preserving the option for all Information Technology purchasing decisions to remain with individual participating organizations.
Linxus emphasizes collaboration as the means for all participants to realize full business value from the implementation of transactions.
History
In 2004, Greater New York Hospital Association (GNYHA) and a group of health professionals from the health plan and provider communities began an initiative to demonstrate that, by working together, common misunderstandings between providers and health plans could be resolved, and that standard operating procedures—based on the framework provided by HIPAA—could be reached through consensus. This group, which is now called Linxus, began to develop standard operating rules for improving reimbursement transactions and the quality of electronic information exchange used for those transactions. The participants shared the understanding that standards, if developed collaboratively and with an eye toward creating mutual value for providers and health plans, would deliver significantly improved returns on health information technology (HIT) investments. To prove the feasibility of this model, the founding participants agreed to pilot the claim status transaction in 2005.
Future
With its ever-expanding broader membership base, Linxus continues to work on developing standard operating rules now beyond claim status, and has plans to produce customized “implementation guides” for HIPAA transactions. These guides will aim to promote interoperability and standardization by reflecting the broadest needs of the health care marketplace, in contrast with the various individual formats for transactions now used by different health plans. This approach follows the lead of other industries, like financial services, that have successfully established interoperability between and among systems, and adheres to the spirit of the HIPAA legislation, which aimed to encourage the widespread adoption of electronic data exchange.