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Introduction -
HIPAA 835 to HCFA ERA (Electronic
Remittance Advice) 2.0
| A full map from the
HIPAA 835 HealthCare Payment format
to the HCFA ERA Version 2.0 format is available to Redix XML
HIPAA Package users. This ready-to-go map is intended to help users
quickly generate the HIPAA compliance message for healthcare claims.
The user can use the map as a template, and modify the user data (such as
ISA or GS elements) using the Redix Mapper.
An in-depth map document from the
HIPAA 835 format to the ERA 2.0
format is also available to Redix XML
HIPAA Package
users.
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Input - Before Translation
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Output - After Translation
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| This map is fully operational with the Redix
XML HIPAA Package. The map definition allows users to translate
a file from the HIPAA 835 format
to the ERA Version 2.0 format, while also validating
the input for completeness, as well as syntax and code validation.
Additional effort has been made to provide a 1:1 mapping ratio of the
ERA fields to
HIPAA 835 elements. |
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| The image above demonstrates a user using the Redix Drag
and Drop GUI to perform a 1:1 mapping of a 835 SVC
segment element to an ERA 2.0 450 Record. |
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| In addition to a straight-forward translation,
the userdata() function can also be used to allow users to pass real time data, such as ISA and GS segment information, a necessity for any HIPAA X12 translation. |
Documentation
| A spreadsheet (ERA_to_HIPAA_835.xls) is provided
to document the map definition on an element level. Every element is
marked as a mapped, unused, constant, or conditional map. In
addition, the userdata() function used to customize a map is also presented in the document. |
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Modifying the Current Map Definition
| There are many ways to modify the current map definition. One
specific way in the ERA to HIPAA map is to use the userdata() function.
The userdata() function in this map is used to pass the separators, ISA, GS, and
GE, and IEA information. The user can use the "Userdata"
text box in the configuration tab of the Redix XML HIPAA Package to enter
the userdata() strings. If the following information is passed: |
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| Input Test 1 |
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| the resulting ISA segment will have the following data: |
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| Output Test 1 |
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| If the userdata() function was altered, as such: |
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| Input Test 2 |
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| then the ISA segment would look like this: |
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| Output Test 2 |
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| The examples above demonstrate how the output may be
altered at translation time. Within this map, only data that is specific to the
client and processing is passed.
For more information about the usage of the userdata() function, the user
should refer to the Redix AnyToAny XML Engine Reference Guide. |
Integrating the Map Definition into the Project Environment
| Once the map files (IFD and OFD) are
generated, the user may then add the IFD and OFD files to the production environment. |
| Redix offers the ability to add a translation
file to the production environment through the use of the Application Programming Interface (API). The API is supported in C/C++, Visual C++, Visual Basic, JAVA™,
and command-line formats, e.g., redix. If the user uses the Redix Automation
Processor (RAP), then the user can also use the RAP's API with the above
programming languages. |
| Redix provides a GUI to automatically generate API
statements or JAVA classes that can be copied and pasted into the user's
existing application environment. |
| Direct Engine Interface
redix_app_ext(String input_filename, String ifd_filename, String ofd_filename, String ack_filename, String error_filename, String output_filename, char conversion_flag, char segment_terminator, char element_separator, char composite_separator, char release_char, String
userdata);
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| Redix Automation Processor Interface
redix_process(String
input_filename, String configuration_filename, String log_filename, String
userdata, String last_event_log, String last_filename, String
summary_filename);
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| Redix also provides
a similar set of API's for those who would
prefer to do the conversion using the memory approach. |
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