Payment Hub End-to-End

1. Payment Hub End-to-End • Hub workflow is updated for web portal viewing by all counterparties Flow Chart: To optimize payment tracking, improve reimbursement transparency, and accelerate payment delivery. Use Case Scenario: • Through NextGen Practice Management System, the provider’s office will generate and submit the 837 claim file to the payment hub • The Hub receives and acknowleges claim EDI, the 837 is routed to the payer, and the payer adjudicates the claim. • The 835 file is sent to the hub in standard EFT/ERA format • Hub parses the file into Financial portion for bank and supporting claim data • A NACHA format file will be sent to the payer's bank on behalf of payer via SWIFT FileAct • The payer’s bank will initiate debits to payer account and credit to the providers accounts via SWIFT FileAct in NACHA • Providers bank will send complete achtjnl to hub for forward to provider • The 835 file data and achtjnl is sent to provider for load into NextGen PMS • A contract analysis is done for expected reimbursement. • All workflow history is updated at each step into the hub for web portal tracking by all counterparties Provider Payer Payment Hub 837 835 835 835 837 Provider’s Bank Payment Data EFT NACHA Claim Info Payer’s Bank