Provider-Payer Transactions

Author(s):  
Roy Rada

The key financial transactions in U.S. healthcare occur when the provider sends a claim to the payer and the payer adjudicates the claim. This chapter first explains the history of electronic data interchange (EDI) and then shows the powerful, costsaving impact that it can have on healthcare. One bottleneck to EDI in healthcare has been the lack of standardization. This problem was addressed with a law passed in 1996, with which the healthcare industry was still grappling a decade later. The standardization of these transactions will be explored in detail in this chapter. After that, a different aspect of provider-payer transactions is examined, namely, the temptation to cheat and the role of software in combating fraud.

2017 ◽  
Vol 6 (2) ◽  
pp. 66-77
Author(s):  
Alla Sirotinska ◽  
Oleksan Sirotinsky

The development tendencies of the information services market and electronic data interchange between enterprisesin Ukraine are studied. Functioning features of electronic data interchange systems and information systems of the enterprises are considered. The stages of work when choosing an information system for an enterprise and its introductionare proposed. The role of analytical accounting of economic activity in enterprise management is disclosed. The main prospects for the development of information technologies in enterprise managementare determined.


Author(s):  
Durga Patel ◽  
Sachin Goyal ◽  
Ratish Agarwal

This chapter provides an overview of the e-commerce business model, the history of e-commerce, the scope of e-commerce, the difference between e-commerce and traditional commerce, issues related to e-commerce, electronic data interchange, value chain, and supply chain, and the pros and cons and limitations of e-commerce.


1999 ◽  
Vol 3 (2) ◽  
pp. 133-146 ◽  
Author(s):  
Emma Jane Riddle ◽  
David A. Bradbard ◽  
Jane Boyd Thomas ◽  
Doris H. Kincade

Author(s):  
Durga Patel ◽  
Sachin Goyal ◽  
Ratish Agarwal

This chapter provides an overview of the e-commerce business model, the history of e-commerce, the scope of e-commerce, the difference between e-commerce and traditional commerce, issues related to e-commerce, electronic data interchange, value chain, and supply chain, and the pros and cons and limitations of e-commerce.


2021 ◽  
Vol 17 (23) ◽  
pp. 163
Author(s):  
Bahija Jardini

The bullwhip effect is a phenomenon of curious amplification of variations in demand as one moves away from the final customer. Popularized by Lee and al., (1997), the bullwhip effect has negative consequences on all actors in the supply chain because it generates considerable loss of profits: Too much stock, loss of sales, poor customer service, insufficient quality and multiple disruptions of flow and organization. To prevent and reduce the bullwhip effect, various tools are recommended. The Electronic Data Interchange (EDI) is among the most important given its impact on accelerating information sharing throughout the supply chain. This paper aims to shed light on the role of EDI, VMI (Vendor-managed inventory) and CPFR (collaborative planning forecasting and replenishment) in the prevention and reduction of the bullwhip effect in the supply chain.


Author(s):  
O. V. Voronova ◽  
V. A. Khareva

This article considers the features of electronic document management at retail trade enterprises of the FMCG-segment. The paper observes the types of document flow at chain companies and examines the process of implementation of electronic document management system. The notions of “electronic document management” and “electronic data interchange” are also distinguished in the article.The paper explores positive changes caused by the introduction of electronic document management and the complexity of its implementation. The study reveals that in the Russian Federation the process of mass introduction of electronic document management in the chain retail companies of the FMCG segment has been ongoing for about ten years, though has reached the highest level of its activity in the last two years. At present day, the major part of chain retail companies in the FMCG-segment has already started to actively work with the Electronic Data Interchange system. Moreover, in recent years the number of partner-enterprises that join this system has been steadily increasing.The results of the study show that introduction of electronic document management in chain companies of the FMCG-segment allows to reduce the time spent for processing documents and to track all stages of the core business processes more effectively. It also ensures information security, improves staff discipline and the quality of service, which in its turn significantly improves management efficiency of the company in general.


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