Case Study: CCHP achieves 98% EDI approval and over $100,000 in reimbursements with Astera Software

CCHP used EDI Connect to ensure accuracy and quality in their Encounters

CCHP, a nonprofit health plan affiliated with Children’s Wisconsin, was struggling to meet state Medicaid EDI acceptance requirements because its Encounter files were full of errors and required time-consuming manual corrections. The team needed a way to improve data quality, avoid penalties, and keep reimbursement status secure, so they turned to Astera Software and its EDI automation capabilities.

Astera Software implemented an end-to-end EDI correction process that automated file cleaning, validation, and submission to the state. As a result, CCHP raised its approval rate to 97–98% and even 99% in some cases, cut file changes from three hours to five minutes, saved about $26,000 a year in labor, and retained over $100,000 in reimbursements.

CCHP

Amanda Moede

Health Plan Data Analyst