Health Policy

Download BizTalk 2013 EDI for Health Care: HIPAA-Compliant 834 by Mark Beckner PDF

By Mark Beckner

BizTalk 2013 EDI for Healthcare – EDI 834Enrollment Solutions removes the complexity anddemonstrates easy methods to construct either inbound and outbound EDI 834 procedures inBizTalk server that keep on with the mandatory styles for integrations with theseexchanges.  Archiving, mapping,reconstituting EDI 837 info, exception dealing with and complicated logging andreporting (without the necessity for BAM!) are all coated in adequate element to allowyou to enforce your individual totally useful answer.

The cheap CareAct and the necessities to combine with kingdom Exchanges have securedBizTalk’s position with integrations in the healthcare industry.  EDI 834 files are the center to allintegrations, facing enrollment and the upkeep of enrollments.  so one can effectively combine with theexchanges, businesses are required to enforce a couple of architectural componentsthat will be daunting and complicated to paintings via. high quality assets for IT specialist to address those demanding situations are sorely wanted, and this source has been designed to supply concise solutions.

What you’ll learn

  • examine how you can increase whole finish to finish EDI 834 ideas, either inbound and outbound
  • Create a resolution that demonstrates how you can combine with kingdom Exchanges
  • Explore suggestions for customized pipeline elements, archiving styles, lookups
  • Detailed info for complicated 834 EDI mapping

Who this publication is for

BizTalk directors and builders, in addition to administration body of workers hooked up with those positions.

Table of Contents

1.  Architectural Patterns

2.  Solution: Receiving 837P Data

3.  Solution: Sending 837P Data

4.  Mapping Data

5.  Adapters, AS2 and Acks

6.  Solution: Receiving 834 Data

7.  Pipelines for 834 Processing

8.  Custom company Rules

9.  Advanced 834 Mapping

10.  Solution: Sending 834 Data

11.  Solution: Sending 834 info, Simplified

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Extra resources for BizTalk 2013 EDI for Health Care: HIPAA-Compliant 834

Example text

The 834 is ubiquitous within health care back-end systems, and knowledge of it is critical to an IT professional’s ability to operate successfully within this industry. BizTalk provides an obvious integration platform and EDI engine for these types of integrations. Specifically as it relates to 837s, there is an immense need within the claims management industry to build highly efficient EDI processing systems that are cost effective and easy to maintain and extend. BizTalk is emerging as the leading technology applied in this space due to its low initial cost and the relative ease with which it can be adopted into infrastructures that are Microsoft based.

Make it of type SQL. Click on Configure next to the SQL Type, and set the following properties: Poll While Data Found should be False Polling Interval and Polling Unit of Measure should be values that represent how often you want to pull the data from SQL. Connection String is the connection to the database where you stored procedure sits. Document Root Element Name is a wrapped element that is used ONLY to allow for the adapter to pull the results. It will need to be the root node of your schema that you have created for the stored procedure results.

On the Envelopes tab, set the following values: Transaction Type should be 837_P - Health Care Claim: Professional. com/BizTalk/EDI/X12/2006 GS1 should be HC-Health Care Claim (837) GS2, GS3, GS4, and GS5 should be set based on what your trading partner requires (again, see the trading partner implementation guide or a sample 837P instance from them) GS7 should be X-Accredited Standards Committee X12 GS8 should be 005010X222. Š NoteŠŠ The GS8 property value can be tricky to get right. If you are batching, or you have a trading partner that requires a certain value here, you may find that you have to create a custom pipeline to override this value right before it is sent to the trading partner.

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