Advanced Health Information Network
Empowering Health-Care Professionals with Information at the Point of Service
Several years ago, representatives from a number of Arkansas health-care systems
and Arkansas Blue Cross and Blue Shield envisioned a statewide, seamlessly integrated
health-care delivery and claims processing and communication transaction system;
wherein, the hospitals of the state would be connected to physicians practicing
in their facilities, and the various facilities and individual physicians would
be connected to each other, to major employers in their regions and to payers by
way of a health-data network. AHIN is the communications tool created to implement
this vision.
What Is AHIN?
AHIN is an online system that provides advanced functionality, which allows physicians
and hospitals to manage their business functions more efficiently. It was one of
the first health-information networks in the United States to offer advanced real-time
functionality and continues to offer capabilities that are unique within the industry.
This functionality is the primary reason that Hospitals and Health Networks
magazine identified Arkansas Blue Cross as one of the "10 Most Wired Health Plans"
in the country.
How AHIN Works
Links to Arkansas Blue Cross information systems provide access to eligibility,
claims and claim-status information. Links to other Blue Cross and Blue Shield plans
provide similar access to this information nationwide. A unique feature allows claim
submission and online, real-time correction of erroneous claims regardless of how
they were submitted. An interface with the Arkansas Medicaid system allows access
to eligibility for this program.
AHIN is a browser-based system — Netscape Navigator or Internet Explorer —
which simplifies installation and maintenance. Everything necessary to access the
system is already present on most personal computers.
Security
Security of data is always a major concern, and AHIN's developers went to great
lengths to limit access to patient or other data to a need-to-know basis. The system
operates as an extranet and uses both hardware and software controls to limit data
access to users with the proper authorization. Access to data stored on the network
is through a security system, which is addressable down to the object level; and
individuals who have security clearance to view patient or other data are limited
to viewing information specific to their organization.
Data
AHIN functions as a repository for demographic, insurance eligibility, claims and
related information. In addition, AHIN serves as a conduit through which information
— such as referral/precertification processing, claims submission, claim status,
remittance advice and claims error notification/correction/resubmission —
may be sent from one point to another.
The primary functions provided by AHIN include:
- Demographics: Available for more than a million Arkansas Blue Cross, Health
Advantage, BlueAdvantage and USAble Administrators members
and former members; updated nightly.
- Eligibility: Available for Arkansas Blue Cross and Blue Shield and out-of-state
Blue Cross and Blue Shield plans, Health Advantage, BlueAdvantage Administrators,
USAble Administrators and Medicaid Texas and Arkansas). Eligibility information
for the Arkansas Blue Cross and Blue Shield family of companies is updated nightly.
All other eligibility uses real-time interfaces to the host system.
- Claims: Received and processed for all payers, including those that do not
accept electronic claims. Claims processing includes electronic error notification
to submitters, with the ability to perform online error correction and claims re-submission.
Information related to claims processed through AHIN is on a real-time basis.
- Claims Status: Available for all Arkansas Blue Cross and Blue Shield and
out-of-state Blue Cross and Blue Shield plans, Health Advantage and USAble Administrators.
Arkansas Blue Cross and Blue Shield claim status is updated nightly. Information
from out-of-state Blue Cross and Blue Shield plans is via real-time interfaces to
the host system.
- Remittance Advice: Presented in conjunction with the claim status described
above, remittance advice is provided for finalized Arkansas Blue Cross and Blue
Shield, Health Advantage, BlueAdvantage Administrators and USAble Administrators
claims.
- Medical Edit Research: The Edit/Coverage function provides users with procedure-code-specific
member coverage and licensed prepayment edit information.
How Do I Get AHIN?
AHIN access is free of charge. To gain access to
the system, complete the following:
Download the
AHIN Setup Document and Agreements (92 KB PDF)
— Complete, sign and mail the documents to:
Advanced Health Information Network
601 S. Gaines Street
P.O. Box 1489
Little Rock, Arkansas 72203-1489
An AHIN Customer Support Representative will notify the contact person listed on
the AHIN setup document when all testing is complete and provide the assigned user
names and password.
If you have questions regarding the AHIN documents you may contact your local Network Development Representative or call AHIN Customer
Support at 501-378-2336.
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