CONSULTING SERVICES

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AEG CONSULTING SPECIALIZES IN EDI AUTOMATION & EDI MODERNIZATION

AEG’s consulting team has more than 179 years’ experience supporting the workers’ compensation industry, EDI projects, EDI systems, and the IAIABC EDI reporting standards.  We have a proven track record of successful EDI implementations with multiple state jurisdictions and hundreds of claim administrators.  AEG staff are and have been active leaders and members of the IAIABC EDI Council, Claims, POC, Systems Committees and trainers since 1993 and have been instrumental in developing the national standards. 

CLAIM ADMINISTRATOR EDI AUTOMATION CONSULTING


Today’s claims administrators are faced with difficult choices as it relates to “EDI Triggers and Sequencing” automation. Develop in-house or contract with a third-party vendor?  For many, the answer isn’t so simple.  


Vendor solutions create some unique challenges including but not limited to higher recurring costs, increased risks revolving around data quality and security, and the internal development resources and time required to integrate with a vendor’s system.  Additionally, if a vendor change is necessary, or a decision is made to develop internally, the associated costs and technical hurdles can be prohibitive.  


Internal development of automated triggers and sequencing is often challenging due to a lack of EDI specific expertise. AEG's consulting team has the in-depth knowledge and experience in EDI automation that can remove the knowledge and resource barriers for those who choose internal development. AEG can assist your team in developing a fully automated EDI system.  We specialize in analyzing, defining and delivering trigger rules and sequencing rules to reviewing data storage requirements, workflow processes and everything in-between:


  •  Environment Review/Analysis: Provide analysis showing future EDI impact, gaps, considerations.  
  • Event/MTC Trigger & Sequencing/Hold & Release: Recommend workflow including events that impact execution of trigger rules, sequencing/hold and release logic. Document Trigger Rules by Type (FROI/SROI) and MTC including identification of data elements required to be examined by each rule.
  • Transaction Population by state, document type and MTC.
  • Transaction Editing can be documented for internal development or using software solutions.
  • Acknowledgment Processing – recommend and document workflows, technical considerations, error analysis, correction process, storage, and correlation with triggers and sequencing.
  • Transaction Archiving - Recommend and document transaction archiving strategy and define potential usage of data.
  • Internal EDI Audit Reporting - Provide data content and usage/value of each report.
  • Develop, document and assist in executing an EDI test plan.

 

Although AEG’s focus is on automation, our consulting services includes all areas of EDI. Our consulting services will save you money, time and eliminate many of risks associated with vendor provided software solutions. 

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JURISDICTION EDI MODERNIZATION CONSULTING

AEG Consulting assists Jurisdictions’ modernization efforts for Claims, Proof of Coverage and Adjudication.   We provide expertise in all areas of Electronic Data Interchange (EDI) using International Association of Industrial Accident Boards and Commissions (IAIABC) EDI standards for First Reports of Injury (FROI), Subsequent Reports of Injury (SROI) and Proof of Coverage (POC).


  • Provide consulting services for Claims and POC EDI reporting projects and implementations.    
  • Support states in all EDI areas to include developing R3.1 EDI reporting requirements, implementation guides, requirement tables, edits, Trading Partner documentation, mapping data elements, training, etc.
  • Provide Trading Partner (TP) education, training, and creating TP work groups.
  • Analyze Statute/Rules/Forms and provide documentation specifying EDI business requirements. 
  • Conversion analysis to move from IAIABC Releases R1 or R3.0 to R3.1.
  • Provide training and transfer of EDI knowledge to EDI teams to develop and maintain EDI reporting going forward.
  • Review Vendor proposals and assist with selection process.