Mark Beckner's BizTalk 2013 EDI for Health Care: HIPAA-Compliant 834 PDF

By Mark Beckner

ISBN-10: 1430266074

ISBN-13: 9781430266075

ISBN-10: 1430266082

ISBN-13: 9781430266082

BizTalk 2013 EDI for Healthcare – EDI 834Enrollment Solutions removes the complexity anddemonstrates how one can construct either inbound and outbound EDI 834 methods inBizTalk server that stick to the mandatory styles for integrations with theseexchanges. Archiving, mapping,reconstituting EDI 837 facts, exception dealing with and complex logging andreporting (without the necessity for BAM!) are all lined in adequate aspect to allowyou to enforce your personal totally practical answer.

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

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Extra info for BizTalk 2013 EDI for Health Care: HIPAA-Compliant 834 (Enrollment) and 837 (Claims) Solutions

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In Listing 4-8, you will see a method that returns the maintenance reason based on the reason code that is passed in as a parameter. =''"> Listing 4-8. Maintenance Reason public string GetMaintenanceReason(string reasonCode) { string reason=""; switch (reasonCode) 57 Chapter 4 Mapping Data { case "01":reason case "02":reason case "03":reason case "05":reason case "07":reason case "08":reason case "14":reason case "22":reason case "25":reason case "28":reason case "EC":reason case "32":reason case "41":reason case "43":reason case "59":reason case "AI":reason case "33":reason case "XN":reason case "XT":reason default:reason = } return reason; } = "Divorce"; break; = "Birth"; break; = "Death"; break; = "Adoption"; break; = "TermOfBenefits"; break; = "TermOfEmployment"; break; = "VoluntaryCancel"; break; = "PlanChange"; break; = "ChangeOfInformation"; break; = "Effectuation"; break; = "BenefitSelection"; break; = "Marriage"; break; = "Re-enrollment"; break; = "LocationChange"; break; = "NonPayment"; break; = "NoReason"; break; = "PersonnelData"; break; = "NotificationOnly"; break; = "Transfer"; break; "N/A"; break; Mapping the Transaction Type for SHOP and Individual SHOP and Individual 834 files will often be processed through the same maps.

File Receive Port The second receive port in this pattern is the File Receive Port which picks up the individual 837P documents that are getting created each time the SQL Receive Port executes and returns data. When this File Receive Port picks up the data, the batching settings on the BizTalk Party Agreement will cause the document to queue up and not be delivered until the batch executes. ToBeBatched. • Set the Type to File and point it to the directory where the File Send Port is writing out the individual 837P files.

You can use the same solution you used for the project in Chapter 2. • Schemas. There are two schemas that will be used in this solution, as follows: °° The 837P Schema which will be contained in its own project. X837P °° The schema that matches the source SQL data result set. SQLData. • Maps. Outbound The Schema Projects Two schemas are required for this project. The first is the 837P 5010 schema that ships with BizTalk, which was discussed in Chapter 2, “Solution: Receiving 837P Data”. The second schema project will contain the schema which matches how data will be pulled from SQL Server.

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BizTalk 2013 EDI for Health Care: HIPAA-Compliant 834 (Enrollment) and 837 (Claims) Solutions by Mark Beckner


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