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How HealthTranslate works

HealthTranslate streamlines Medicaid encounter processing with configurable business rules, enables HIPAA compliance, and supports what-if analyses—adapting validations as contracts or requirements evolve. It automates X12 837 and NCPDP processing, generates TA1/999/277CA responses, and delivers near real-time analytics to reduce manual rework, improve consistency, and strengthen managed care organization (MCO) oversight.

HealthTranslate highlights

HealthTranslate is built to analyze X12 837 and NCPDP encounter files to drive intelligent actionable data, validate compliance, and provide quality data outcomes.

~4M

claims processed biweekly

500+

attributes captured for insights

3600

view of claim processing

250+

out-of-the-box business rules

HealthTranslate market differentiators

HealthTranslate delivers out-of-the-box rules, reports, AI-enabled insights, and scalable processing to simplify encounter operations.

HealthTranslate: Enabling state managed care administration

HealthTranslate enables state managed care administration by streamlining encounter intake and validation, surfacing data issues early, and giving teams searchable visibility and dashboards to efficiently manage compliance and reporting.

HealthTranslate portal

HealthTranslate portal provides encounter search and GenAI chatbot support, enabling faster lookup and guided assistance.

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Configurable rules engine

HealthTranslate lets states (MCOs) define custom encounter rules by trading partner and transaction.

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Reports and dashboards

HealthTranslate turns encounter data into actionable insights with regulatory-aligned reporting and dashboards.

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HealthTranslate: Streamlining client operations

HealthTranslate improves data quality, compliance, organization onboarding, and overall operational efficiency.

HealthTranslate’s claims management solution for government simplifies trading partner onboarding through a standardized portal-based experience for registration, approval, setup, transfer options, and processing with clear visibility into status and exceptions. This reduces manual coordination, speeds issue resolution, and helps trading partners onboard faster.

Our encounter processing engine helps states manage changes to encounter requirements via configurable business rules tailored to state policies, contract requirements, and trading partner needs. This gives states greater control over validations, reduces manual rework when rules change, and supports what-if analysis to assess the impact of rule changes before deployment.

HealthTranslate provides a consolidated view of encounter validation outcomes, edit trends, and geographic distribution of claims. It helps states quickly identify where encounters are passing or failing, surface recurring edit issues, and analyze performance patterns by state or region to improve operational oversight and data quality.

Get in touch

Cheri Riddle

Cheri Riddle

Managing Director | Government & Public Services | Deloitte Consulting LLP
Arvind Dubey

Arvind Dubey

Managing Director | Government & Public Services | Deloitte Consulting LLP
Don Hoag

Don Hoag

Principal | Government & Public Services | Deloitte Consulting LLP
+1 412 402 5292