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Posts Tagged "HIPAA X12 EDI"

SNIP 5 – HIPAA External Code Set Testing

The HIPAA X12 EDI specification allows for the inclusion of code values that may be pertinent to the transaction set, such as a claim or encounter. These code values can represent a data point as widespread as a postal or zip code, or as complex as diagnosis and procedure codes.
WEDI describes seven types of validation, referred to as SNIP 1-7, as covered in some of our previous blog posts on SNIP 3 Balancing of Claims and Payments. SNIP 5 – HIPAA External Code Set Testing is the validation of code values against the external code sets they represent.
SNIP 5
As previously stated, SNIP 5 validates that code value exists within an external code list. For example, if a postal (zip) code is present in a subscriber’s address, then it should align with an actual postal code in as determined by the USPS, the…

Rapid EDI Trading Partner Onboarding with T-Connect

HIPAA X12 EDI transmission between the many entities in the HealthCare industry is performed using files conforming to ANSI X12 specifications. These Claim, Premium Payment and Remittance Advice EDI files may originate from payers, providers, clearinghouses, or third party administrators (TPAs). One prevalent hurdle in sending or receiving these EDI transactions is the often complex onboarding process of new trading partners.
HIPAA EDI files in X12 format may typically look similar to the sample below.

X12 Studio – Validate and Retrieve 999 Acknowledgements

Overview
X12 Studio provides validation capabilities that can be used to validate claims, enrollments, and other HIPAA X12 EDI file types.  X12 Studio can be used to test those files by reading, validating, and producing an X12 999 Acknowledgement (ACK).  The 5010 999 ACK replaced the previous version – 4010 997 ACK.  The 999 ACK informs the submitter that the EDI submitted is validated according to the receiver’s implementation guide.  This validation includes the results describing the quality of the functional group’s syntax.  Sometimes this validation is referred to as WEDI SNIP level edits 1 and 2.
Steps to Generate the 999 ACK

To start, download X12 Studio and install the application:

Launch the application and open an existing 837I, 837P, 834, or any of the HIPAA X12 EDI files:

Click on the Generate ACK 999 icon in the top menu:

View the Output tab at…

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