The Military Medical Support Office (MMSO) provides medical and dental claims processing and customer service for eligible United States Department of Defense Active Duty Military and Reserve Service Members.
MMSO needed to enhance its its Claims Processing (CPSII) system to send and receive electronic transactions to comply with HIPAA (Health Insurance Portability and Accountability Act) requirements.
QFlow enhanced CPSII to support automated processing of the following HIPAA electronic transactions:
- 270/271 Eligibility Inquiry and Response
- 837/835 Claims Submission and Payment
- 276/277 Claims Status Inquiry and Response
The CPSII HIPAA-compliant application was successfully implemented in September 2003 prior to the mandated HIPAA implementation deadline.