Case Study: Home Medical Equipment (HME/DME) company automates claims processing and boosts productivity with Radley, LLC's hosted iR*EDI

Processing Healthcare Claims with Radley Hosted EDI

Home Medical Equipment Company, a fast-growing provider of HME/DME business management solutions, struggled with a manually intensive EDI claims process: operators had to log into each of four DMERCs or a clearinghouse, contend with slow asynchronous dial-up connections and frequent reconnects, and push out new software releases for payor-specific edits. To address this, they selected a hosted version of Radley, LLC’s B2B EDI solution, iR*EDI.

Radley, LLC implemented the hosted iR*EDI platform (including iR*EDI Mapper and Scheduler) so claims are generated from the in‑house application via web service, queued for immediate transmission, and received on a scheduled basis with process statuses and reports returned automatically. The solution automated DMERC dial/re-dial, removed the need to hard-code carrier-specific edits, and leveraged Radley’s SOA for easier integration—resulting in a significant reduction in manual processing, fewer dropped-connection reconnects, faster claim throughput, and quicker response to changing payor requirements.