GTESS Corporation, a provider of technology-based claims processing services to the healthcare industry, announced today it is extending its eClaims Gateway™ services to include clearinghouse services to help payers improve the management of clearinghouse relationships and lower their cost-per-claim by providing an alternative to high-cost, low-quality EDI solutions.

Accordingly, GTESS also announced that its first Partner Clearinghouse is Florida-based Availity, LLC, a leading provider of e-health transaction services. GTESS and Availity are partnering for the receipt of HIPAA-compliant electronic claims and to jointly bring GTESS and Availity services to payer clients.

“GTESS has long been recognized for our mailroom and claim conversion business process outsourcing services that are differentiated from labor arbitrage models by our proprietary ASP technologies that incorporate powerful clean-claim applications, network management functions, over-payment protection services, and document management solutions. In combination, these advanced applications drive auto-adjudication, lower overall cost-per-claim and improve customer service quality,” said GTESS CEO and President, Deborah M. Gage. “Now, with expanded Clearinghouse services available through preferred partners such as Availity, the benefits of the GTESS eClaims Gateway™ are extended to all claims, paper and EDI.”

An Important Choice for Payers Many payers find it difficult or cost-prohibitive to connect with multiple clearinghouses, and may settle for low quality and poor customer service from a single EDI provider. With access to the eClaims Gateway™ and GTESS Partner Clearinghouses, payers gain a clean, homogenous stream of EDI claims, customized to auto-adjudicate, and all the accrued benefits of a single operational portal for quick, efficient customer service.

“Electronic claims are more cost effective than paper claims, because of their dramatically higher first-pass adjudication rates.” said GTESS Chief Technology Officer John Olsen. “A pended claim can cost more than ten times that of a first-pass-cleared claim. So, we have focused our technology innovation on our gateway solutions that level the playing field for paper and edi. Our clients experience similar costs and performance regardless of the claim source (paper or edi).”

In fact, GTESS’ fully integrated products are built upon a connective architecture that provides a single, streamlined workflow for all claims processing operations, creating new levels of cost savings and efficiency and opening the door for future applications. Within the GTESS solution, GTESS’ document management product, DocControl™, will now contain 100% of clients’ claims and the network management services component, PPO Connect™, can route and track all claims through primary, secondary/wrap, and fee negotiation partnerships.

A Growing Benefit for Providers“Availity is pleased to have the opportunity to work with GTESS to offer a comprehensive, proven capability that will be equally prized by providers and payers. Combining flexible, easy to access claims capabilities with outstanding customer support, the partnership delivers increased value for all constituents involved,” said Julie Klapstein, Chief Executive Officer for Availity. “By combining what we believe to be two best-in-class solutions, we’re able to offer a more robust product and service offering to our customers.”

About Availity, LLC Availity optimizes the flow of information between health care professionals, health plans, and other healthcare stakeholders through a secure internet-based exchange. The Availity® Gateway encompasses administrative and clinical services, supports both real-time and batch transactions via the Web and electronic data interchange (EDI), and is HIPAA compliant. Availity is the recipient of several national and regional awards, including Consumer Directed Health Care, A.S.A.P. Alliance Innovation, eHealthcare Leadership, Northeast Florida Excellence in IT Leadership, E-Fusion, Emerging Technologies and Healthcare Innovations Excellence (TETHIE), and AstraZeneca-NMHCC Partnership. For more information, visit www.availity.com or call 1.800.AVAILITY(282.4548).

About GTESS Corporation GTESS Corporation provides customers with a total pre-adjudication medical claims processing solution called the Claims Gateway Solution — a hybrid ASP software and service solution with five client-customized applications:

Mailroom and EDI claim receipt,

Clean-claim technologies,

Network management solutions,

Workflow systems for claim edit resolution, and

Document management technology.

The Claims Gateway Solution uses business process management (BPM) technologies to create new efficiencies and offer process transparency throughout the claim process. Our ‘clean-claim’ HIPAA-compliant electronic data interchange (EDI) delivery systems go beyond what can be achieved by automating parts of the process, or outsourcing operations off-shore.