Advanced Health Information Network
Empowering Health-Care Professionals with Information at the Point of Service
Several years ago, representatives from a number of Arkansas health-care systems
and the state's largest health insurer envisioned a statewide, seamlessly integrated
health-care delivery and claims processing and communication transaction system;
wherein, the hospitals of the state would be connected
to physicians practicing in their facilities, and the various facilities and individual
physicians would be connected to each other, to major employers in their regions
and to payers by way of a health-data network. AHIN is the communications tool created
to implement this vision.
What Is AHIN?
AHIN is an online system that provides advanced functionality, which allows physicians
and hospitals to manage their business functions more efficiently. It was one of
the first health-information networks in the U.S. to offer advanced real-time functionality
and continues to offer capabilities that are unique within the industry.
How AHIN Works
Links to the insurer's information systems provide access to eligibility, claims
and claim-status information. A unique feature allows claim submission and online,
real-time correction of erroneous claims regardless of how they were submitted. An interface
with the Arkansas Medicaid system allows access to eligibility for this program.
AHIN is a browser based system — Netscape Navigator or Internet Explorer — which
simplifies installation and maintenance. Everything necessary to access the system
is already present on most personal computers.
Security
Security of data is always a major concern, and AHIN's developers went to great
lengths to limit access to patient or other data to a need-to-know basis.
The system operates as an extranet and uses both hardware and software controls
to limit data access to users with the proper authorization. Access
to data stored on the network is through a security system, which is addressable
down to the object level; and individuals who have security clearance to view patient
or other data are limited to viewing information specific to their organization.
Data
AHIN functions as a repository for
demographic, insurance eligibility, claims and related information. In addition,
AHIN serves as a conduit through which information —
such as referral/precertification processing, claims submission, claim status, remittance
advice and claims error notification/correction/resubmission
— may be sent from one point to another.
The primary functions provided by AHIN include:
- Demographics: Available for more than a million Arkansas Blue Cross, Health
Advantage, BlueAdvantage Administrators and USAble Administrators members and former
members; updated nightly.
- Eligibility: Available for Arkansas Blue Cross and out-of-state Blue Cross
and Blue Shield plans, Health Advantage, BlueAdvantage Administrators, USAble Administrators
and Medicaid (Texas and Arkansas). Eligibility information for the Arkansas Blue
Cross family of companies is updated nightly. All other eligibility uses real-time
interfaces to the host system.
- Claims: Received and processed for all payers, including those that do not
accept electronic claims. Claims processing includes electronic error notification
to submitters, with the ability to perform online error correction and claims re-submission.
Information related to claims processed through AHIN is on a real-time basis.
- Claims Status: Available for all Arkansas Blue Cross and out-of-state Blue
Cross and Blue Shield plans, Health Advantage and USAble Administrators. Arkansas
Blue Cross claim status is updated nightly. Information from out-of-state Blue Cross
and Blue Shield plans is via real-time interfaces to the host system.
- Remittance Advice: Presented in conjunction with the claim status described
above, remittance advice is provided for finalized Arkansas Blue Cross, Health Advantage,
BlueAdvantage Administrators and USAble Administrators claims.
- Medical Edit Research: The Edit/Coverage function provides users with procedure-code-specific
member coverage and licensed prepayment edit information.
How Do I Get AHIN?
The best news of all is that AHIN access is free of charge. To gain access to the
system, please complete the following:
Download the
AHIN Setup Document and Agreements (82 KB PDF)
— Complete, sign and mail the documents to:
Advanced Health Information Network
601 S. Gaines Street
P.O. Box 1489
Little Rock, Arkansas 72203-1489
An AHIN Customer Support Representative will notify the contact
person listed on the AHIN setup document when all testing is
complete and provide the assigned user names and password.
If you have questions regarding the AHIN documents you may contact your local Network Development Representative or call AHIN Customer Support at (501)378-2336.
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