SAN MATEO, Calif.--(BUSINESS WIRE)--PokitDok announced today that 152 insurers were added to its growing list of trading partner connections that will dramatically improve the delivery of health-related business services. In an industry heavily reliant on spreadsheets, processes, paperwork and landline fax and telephones, PokitDok allows health information technology professionals, health systems, employer groups, insurers and the state and federal exchanges to seamlessly and securely:

• exchange data for health plan enrollment management
• determine a patient’s eligibility for health services based on their insurance plan
• pre-authorize specialist referrals and;
• submit claims and ascertain their status

PokitDok is the first to establish a new, powerful model for exchanging data using Application Programming Interfaces, available on the PokitDok Platform and leveraging established Electronic Data Interchange (EDI) agreements with insurers that represent 75 percent of the covered American population.

"New regulations introduced by the Patient Protection and Affordable Care Act inject huge interoperability challenges within the technology layers of the health system," said Allen Byerly, CTO, Grouphub.io. "PokitDok gives us the tools to help our customers minimize costs and prepare for HIPAA electronic compliance mandates that will be effective in 2016. Insurance brokers can start to eliminate paperwork, prevent manual errors and automate data exchange now as they, for example, adhere to new 834 file formats for benefit enrollment and maintenance.”

The industry standard for electronic transmission of health information, from enrollment to claims submission, is called HIPAA ASC X12 5010. The Health Insurance Portability & Accountability Act (HIPAA) of 1996 was intended to make the healthcare system in the United States more efficient by standardizing healthcare transactions like eligibility requests and health plan enrollment. The 2010 Patient Protection and Affordable Care Act has established additional operating rules aimed at requiring standardization for health transactions. PokitDok introduces a centralized, advanced method for the transmission and reception of healthcare information that improves care coordination, prevents delays, reduces administrative costs and helps the industry conform to new governing rules, including 834 EDI transmission for Benefit Enrollment and Maintenance and 278 Pre-Authorization and Referral (aka Medical Referral and Response) Information file standards.

Historically, after consumers submit their insurance card for their medical visit, the provider’s back office will call the insurance company to verify and assess coverage and eligibility. Once medical services have been provided, a claim is mailed to the insurance company seeking reimbursement and much of the process is tracked and stored on flat files. Using the PokitDok Platform, this manual process is automated through Software as a Service and can be integrated into the provider’s technology network through Application Programming Interfaces. To sign up, go to platform.pokitdok.com and request an API key. To become an insurance trading partner, email X12info@PokitDok.com.

“Beginning with Aetna, PokitDok brought the necessary industry relationships together, coupled with a technical architecture, to solve real integration and data integrity issues faced by nearly every healthcare institution,” said Lisa Maki, co-founder and CEO, PokitDok. “Companies don’t have to rip and replace their IT systems to conform to legislative mandates and support higher volumes of data exchange. Because of PokitDok’s trading partner relationships, data exchange can take place flawlessly, at an accelerated pace, driving costs down and helping companies adapt to the new consumer-driven healthcare system.”

About PokitDok

Founded in 2011, PokitDok is a HIPAA-compliant cloud-based platform for healthcare purchases, connecting consumers directly with practitioners in a transparent, e-commerce experience. PokitDok provides Enterprise access to market-driven provider, treatment and pricing information for Employers, Payers and Health networks seeking to reduce expenses and capture lost reimbursements. PokitDok also provides an e-commerce storefront for practitioners seeking to market their services and enable consumers to pay for treatment up front at PokitDok.com or via downloadable app on the Apple App Store or Google Play Store. PokitDok is based in San Mateo, CA and Charleston, SC and backed by New Atlantic Ventures, Rogers Venture Partners, and Subtraction Capital.