BizTalk 2013 EDI for Health Care: HIPAA-Compliant 834 - download pdf or read online

By Mark Beckner

ISBN-10: 1430266074

ISBN-13: 9781430266075

BizTalk 2013 EDI for Healthcare – EDI 834Enrollment Solutions removes the complexity anddemonstrates the right way to construct either inbound and outbound EDI 834 strategies inBizTalk server that stick with the necessary styles for integrations with theseexchanges.  Archiving, mapping,reconstituting EDI 837 information, exception dealing with and complex logging andreporting (without the necessity for BAM!) are all lined in adequate element to allowyou to enforce your personal totally useful resolution.

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

What you’ll learn

  • research the best way to enhance entire finish to finish EDI 834 options, either inbound and outbound
  • Create a answer that demonstrates tips to combine with kingdom Exchanges
  • Explore strategies for customized pipeline elements, archiving styles, lookups
  • Detailed info for complex 834 EDI mapping

Who this booklet is for

BizTalk directors and builders, in addition to administration group of workers attached with those positions.

Table of Contents

1.  Architectural Patterns

2.  Solution: Receiving 837P Data

3.  Solution: Sending 837P Data

4.  Mapping Data

5.  Adapters, AS2 and Acks

6.  Solution: Receiving 834 Data

7.  Pipelines for 834 Processing

8.  Custom company Rules

9.  Advanced 834 Mapping

10.  Solution: Sending 834 Data

11.  Solution: Sending 834 facts, Simplified

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Additional info for BizTalk 2013 EDI for Health Care: HIPAA-Compliant 834

Example text

Some trading partners have very lax standards, while others have extremely rigid requirements. Š NoteŠŠ There are seven levels of HIPAA EDI Compliance. BizTalk handles level one and two. In general, all trading partners have their own unique map from whatever internal format you have within your environment to their specific format. Even trading partners that have virtually identical EDI format requirements should have a separate map within BizTalk. The pattern for outbound maps based on an internal flat file format is shown in Figure 1-9.

Sending Acknowledgements Receiving Data that Requires an Orchestration In many cases, there is no need for an orchestration in order to handle inbound 837P data - the data simply needs to be received, mapped, and dropped in an appropriate format for another subscribing system. In many other cases, it is not enough to map and deliver - actual workflow steps must take place in order to handle the data appropriately. In cases where workflow is required, an orchestration must be developed. Examples of implementing orchestrations for common requirements are shown in Chapter 2.

You are not required to make it look the same, but the less effort you spend on creating a solid source structure that patterns your claim data properly, the more effort you will spend in mapping and creating code to get this claim data into the target EDI document. In order to be able to define the schema for the source data coming from SQL, you'll want to work through the creation of a result set. The approach that allows for the most extensive flexibility around retrieving data, performing some level of data validation or cleansing, and formatting it in a “BizTalk friendly” way is through the use of a stored procedure.

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BizTalk 2013 EDI for Health Care: HIPAA-Compliant 834 by Mark Beckner


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