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.
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,…
The Dell Boomi AtomSphere provides users with the ability to create and configure trading partners for EDI transactions. Users can create trading partners to be used with the X12 Interchange format.
The X12 Interchange Format is a standard used for the sending and receiving of EDI files, it allows us to define different pieces of information about the file and communicate information about what is expected of the file between the respective trading partners. It uses the ISA and GS segment definition headers within sent EDI messages to set this information.
This post will cover how to create a basic X12 Trading Partner and the different configuration options available for them.
First we can create our trading partner by creating a new component and selecting “Trading Partner”, we can configure items such as the name and whether or not this is our company…