Buy vs. Build: Humana’s Perspective on Operating Rules – An Edifecs Webinar

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Health Plans to Learn About Challenges and Benefits of Operating Rules and How to Develop a Strategy for a Successful Implementation

The Affordable Care Act of 2010 established a set of ‘Operating Rules’ to enable administrative simplification by augmenting existing HIPAA transactions. Health plans have limited time to implement these rules before facing significant penalties starting in April 2014.

Edifecs, a compliance solution provider and CORE testing partner, is hosting a webinar with Humana, a Fortune 100 company and leading health plan which has planned for a successful transition to Operating Rules. The webinar will offer lessons learned, best practices and key considerations for buying versus building for Operating Rules compliance.

WHEN: Wednesday, April 18, 2012 at 10:00 AM PDT / 1:00 PM EDT

WHAT: A webinar discussing key challenges for health plans in meeting Operating Rules compliance objectives with a discussion of options and opportunities for operational efficiency gains through commercial off-the-shelf technology solutions. Specifically, attendees will learn:

  • How to identify systems and departments needing remediation as part of Operating Rules compliance planning
  • How to use technology and tools to achieve Operating Rules compliance while gaining operational and financial efficiencies, including ROI
  • Why health plans need a plan to avoid penalties for non-compliance and to avoid costly in-house build scenarios

WHO: Kim Peters, HIPAA EDI Program Manager, Humana
John McCandlish, Principal - Healthcare Solutions, Edifecs
Alison Schambach, Sr. Healthcare Business Consultant, Edifecs


About Edifecs, Inc.
An industry leader since 1996, Edifecs provides healthcare software solutions that improve operational performance by streamlining the exchange of information among health plans, hospitals, and other healthcare organizations, while enabling compliance with current mandates such as HIPAA 5010, Operating Rules and ICD-10.

Today, more than 250 healthcare customers use Edifecs technology to unify transactions from any information channel source and input mechanism, while automating manual business processes such as enrollment, claims and payments management.

Edifecs is currently recognized as one of the 100 Fastest Growing Private Companies in the state of Washington, 100 Best Places to Work in the state of Washington, an Inc. 5000 fastest-growing private company and one of the 500 Fastest Growing Companies in North America by Deloitte. Edifecs is headquartered in Bellevue, WA. For more information, please visit

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Robin Rees
Edifecs, Inc.
(425) 452-0630 606
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Michael Ann Thomas
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