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Processing Large EDI Files in QNXT using T-Connect

The Challenge
TriZetto QNXT is an end-to-end solution for health plan administration across multiple lines of business. QNXT uses a Microsoft BizTalk Server application called QNXT Connect to intake EDI and translate it into XML for processing; however, transforming an EDI file expands the size significantly. Large files can create a bottleneck causing BizTalk to slow or halt processing.  For instance, a 10 MB EDI file can expand to 100 MB after BizTalk translates it into XML.  For redundancy, BizTalk also stores that large message repeatedly within BizTalk Server’s database.
There are a few options to resolve performance issues encountered within BizTalk and QNXT system:

Scaling – Upgrading the system by adding additional servers (scaling out) or upgrading existing servers (scaling up). This may solve the problem temporarily but will quickly hit a period of diminished returns as the sheer size of the…

Splitting 835 Healthcare Claim Payment

The Electronic Data Interchange (EDI) consists of a file in a specific format that represents data exchanged in a transaction from supply chain to healthcare. EDI 835 Claim Payment transaction provides payments information in reference to claims in EDI 837 Healthcare Claim format. The details include transactions such as charges, deductible, copay, payers, payee, etc. The information is stored a hierarchical structure. The standard of EDI format is well defined and the complexity can be very overwhelming. Additionally, we do not want this high degree of detail slowing our processing time.
One of the problems that enterprise systems face with EDI is file size. A single EDI 835 may contain multiple claim records and the quantity of claims in a single file can make it very difficult to process the file. Systems are often bogged down when dealing with a very…

Publishing Schemas and Orchestrations as WCF Services in BizTalk

If there’s one problem that an integration system needs to address, it’s standardizing the format of all data being exchanged. Before any type of data can be processed or transformed, the system handling it must be aware of its format and structure. Using a service, at the client endpoint, forces the user to provide proper data that is agreed upon. This acts as a contract between the service and the client. Given a certain format of data, the client will receive another format of data in return. Anything that happens behind the curtain is the responsibility of the service; the client simply waits for the returned data set.
BizTalk WCF Service Publishing Wizard
One of the more popular tools offered by BizTalk 2010 is the WCF Service Publishing Wizard. This handy tool can automatically create a WCF service, and fully configures the…