HL7 Financial Claims and Reimbursements (FICR) .NET Adjudication
Welcome to the Open Source HL7 Financial Claims and Reimbursement (FICR) .NET Adjudication Framework. This framework allows a claims processor / payor to easily integrate HL7 messaging into existing adjudications systems or to rapidly build next generation adjudication capabilities.
Released as an Open Source project, an implementer can build claims adjudication engines secure in the knowledge they are building on an open solution that insulates them from changes in the FICR messages and processing rules but gives them complete knowledge of how the system was built and how it can be customized. As the framework is built using Microsoft .NET technologies a variety of development platforms can be incorporated to build adjudication solutions, including Java, Visual Basic, Delphi, C++ and C#.
With a minimal investment in hardware and software, adjudication systems can be built to fully process eligibility requests, authorizations, treatment plans, coverage extension requests, invoice claims, SOFA queries, and payment reconciliation messages.
All of the FICR Special Interest Group (SIG) message sets are supported within the framework; a uniform object model / Application Programming Interface (API) allows different SIG messages to be processed with common routines.
Continovation Services has announced it will be providing support and consulting services
to use this framework to help support the rapid and efficient incorporation of the framework into processor / payor adjudication systems.
The Framework has been made available to HL7 or affiliate members and
is governed by HL7 licensing requirements as well as the GNU General Public License (GPL) agreement.
Please note the Intellectual Property Requirements required by HL7
in section 18 of the HL7
Policy and Procedure Manual.
This project is currently in an
Alpha state. We are currently looking for feedback on it's
usefulness and feature set as well as undergoing a documentation