Case Study: Chorus Community Health Plans achieves 98% EDI approval and over $100,000 in reimbursements with Astera Software

Chorus Community Health Plans Uses Astera to Ensure Accuracy and Quality in Their Encounters

Chorus Community Health Plans, a nonprofit HMO affiliated with Children’s Wisconsin, needed a better way to manage EDI encounter files from TPAs. Its data reporting team was spending hours manually correcting files that often failed state approval requirements, putting Medicaid reimbursement status at risk.

Astera Software provided an EDI solution that automated file correction and validation end to end. With Astera, CCHP raised its state approval rate to 98% and even 99% in one year, cut file changes from up to three hours to five minutes, saved about five weeks of manual coding and reviewing work worth roughly $26,000 a year, and retained over $100,000 in reimbursements.

Chorus Community Health Plans

Amanda Moede

Health Plan Data Analyst