An EDI software’s ability to identify and respond to invalid X12 HIPAA EDI transactions is a major contributor to the effectiveness of EDI dependent organizations. Many healthcare companies appoint a business unit as stewards of the tens of thousands of transactions that are transmitted between payers, providers, and trading partners providing auxiliary services. These business units are often hard-pressed to respond to the quantity of incorrect claims, enrollments and payments received within their current EDI solutions or products.
The T-Connect EDI Management Suite is Tallan’s healthcare EDI product, providing actionable insight, alerting, and painless mechanisms to respond to invalid X12 EDI transactions flowing in and out of the organization. The following is a brief introduction into some of these capabilities.
The EDI solution consists of several components working in unison to introduce, augment or replace an EDI processing system.
· The T-Connect Management Portal,…
All of us who have worked on EDI integration know the pain of maintaining the integrity of the EDI messages coming into the system, as well as the value of validating them right from the pipeline-gate. To aid in this, Microsoft BizTalk Server supports out of the box verification of structural integrity with extended schema validation settings. The great part about this is that it allows us to reject any incoming EDI transactions right out of the gate and return those results in the generated ACK file. This way, we ensure that we don’t let invalid data into the system, while also making the sender aware of our “bad data” rejection.
However, as great as this feature is, it still leaves a major validation pain point.
Let’s consider following scenario.
Let’s say in the case of EDI 837 transactions, we consider REF*D9 as…