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XML HIPAA Package

The Redix XML HIPAA Package contains:

  • Redix AnyToAny Format Converter Engine
  • XML Module
  • XML GUI Mapper with EDI Authoring Tools
  • Predefined maps (see below)
  • HIPAA data structure and definitions, which incorporates all the HIPAA transaction sets:
    • 270/271: Health Care Eligibility/Benefit Inquiry and Information Response
    • 276/277: Health Care Claim Status Request and Response
    • 278 request/278 response: Health Care Services Review – Request for Review and Response
    • 834: Benefit Enrollment and Maintenance
    • 835: Health Care Claim Payment/Advice
    • 837: Health Care Claim: Institutional
    • 837: Health Care Claim: Dental
    • 837: Health Care Claim: Professional
  • Support of the following XML standards:
    • Open Applications Group (OAG) 7.0
    • RosettaNet 1.1, 2.0
    • Open Travel Alliance (OTA) 1.0
    • CommerceOne's xCBL Version 2.0, 3.5
    • Petroleum Industry Data Exchange (PIDX) 1.0
    • Chemical Industry Data Exchange (CIDX) 2.0
    • Mortgage Industry Standards Maintenance Organization (MISMO) 1.0
    • cXML 1.1

Features of the Redix XML HIPAA Package:

  • Supports Six Levels of Testing recommended by WEDI/SNIP.
  • Various X12 databases, including the X12 standard Version 4010, 4020, 4030, 5010, 5020, 5030, 5040, and 5050.
  • HCFA (Health Care Financing Administration) database, which includes the NSF Version 2.0, 3.1 and the UB92 standard Version 5.0 and 6.0
  • Predefined maps between the HIPAA Professional Transaction Set and the HCFA standards:

Map NameSource Message TypeTarget Message Type
HCFA_NSF_20_to_HIPAA_837_Prof_Outbound HCFA NSF Version 2.0 HIPAA 837 Professional 4010
HCFA_NSF_20_to_HIPAA_A1_837_Prof_Outbound HCFA NSF Version 2.0 HIPAA 837 Professional 4010A1
HCFA_NSF_31_to_HIPAA_837_Prof_Outbound HCFA NSF Version 3.1 HIPAA 837 Professional 4010
HCFA_NSF_31_to_HIPAA_837_Prof_Outbound HCFA NSF Version 3.1 HIPAA 837 Professional 4010A1
HCFA_WebMD_NSF_20_to_HIPAA_837_Prof_Outbound WebMD NSF Version 2.0 HIPAA 837 Professional 4010
HCFA_WebMD_NSF_20_to_HIPAA_A1_837_Prof_Outbound WebMD NSF Version 2.0 HIPAA 837 Professional 4010A1
HCFA_UB92_50_to_HIPAA_837_Inst_Outbound HCFA UB92 Version 5.0 HIPAA 837 Institutional 4010
HCFA_UB92_50_to_HIPAA_A1_837_Inst_Outbound HCFA UB92 Version 5.0 HIPAA 837 Institutional 4010A1
HCFA_UB92_50_OP_to_HIPAA_837_Inst_Outbound HCFA UB92 Version 5.0 (using Signed overpunch) HIPAA 837 Institutional 4010
HCFA_UB92_50_OP_to_HIPAA_A1_837_Inst_Outbound Outbound
HCFA UB92 Version 5.0 (using Signed overpunch)
HIPAA 837 Institutional 4010A1
HCFA_UB92_60_to_HIPAA_837_Inst_Outbound HCFA UB92 Version 6.0 HIPAA 837 Institutional 4010
HCFA_UB92_60_to_HIPAA_A1_837_Inst_Outbound HCFA UB92 Version 6.0 HIPAA 837 Institutional 4010A1
HIPAA_837_Prof_to_HCFA_NSF_20_Outbound HIPAA 837 Professional 4010 HCFA NSF Version 2.0
HIPAA_A1_837_Prof_to_HCFA_NSF_20_Outbound HIPAA 837 Professional 4010A1 HCFA NSF Version 2.0
HIPAA_837_Prof_to_HCFA_NSF_31_Outbound HIPAA 837 Professional 4010 HCFA NSF Version 3.1
HIPAA_A1_837_Inst_to_HCFA_NSF_31_Outbound HIPAA 837 Professional 4010A1 HCFA NSF Version 2.0
HIPAA_837_Inst_to_HCFA_UB92_50_Outbound HIPAA 837 Institutional 4010 HCFA UB92 Version 5.0
HIPAA_837_Inst_to_HCFA_UB92_50_Outbound HIPAA 837 Institutional 4010A1 HCFA UB92 Version 5.0
HIPAA_837_Inst_to_HCFA_UB92_60_Outbound HIPAA 837 Institutional 4010 HCFA UB92 Version 6.0
HIPAA_837_Inst_to_HCFA_UB92_60_Outbound HIPAA 837 Institutional 4010A1 HCFA UB92 Version 6.0
HIPAA_837_Inst_to_HCFA_UB92_50_OP_Outbound HIPAA 837 Institutional 4010 HCFA UB92 Version 5.0 (Using Singed overpunch)
HIPAA_837_Inst_to_HCFA_UB92_50_OP_Outbound Outbound
HIPAA 837 Institutional 4010A1
HCFA UB92 Version 5.0 (Using Signed overpunch)

Additional Information:

  • All the predefined maps can be cloned and modified to accommodate the user’s requirements.
  • Users can view the translations simultaneously, while performing drag-and-drop operations between two tree structures.
  • The package consists of complete map reports with sorting capabilities.
  • The package automatically generates Interface statements to integrate with the Redix AnyToAny software engine. The statements can be in one of the programming languages: Visual Basic, C++/C#, or JAVA.

Add-on Modules

Redix modules are optional software add-ons to the Redix XML HIPAA Package that add additional functionality. Multiple software modules may be added onto a single engine, and the modules do not have to be installed during the initial XML HIPAA Package installation.

The Redix XML HIPAA Package includes an AnyToAny Format Converter Engine and XML Module, so users do not have to purchase separate engine and XML licenses in order to use the XML HIPAA package. The XML HIPAA package is fully compatible with all Redix modules.

Depending on the enterprise’s needs, the enterprise can purchase separate module licenses in addition to the XML HIPAAP Package. For example, if the enterprise needs to convert NCPDP files to any other format, then the enterprise should purchase a separate NCPDP Module license. Similarly, if the enterprise wishes to convert HL7 files to any other format, then the enterprise should purchase an HL7 Module license. The following is a list of possible modules that can be added onto the XML HIPAA Package.

ModuleDescription
RMAP Enables the AnyToAny Format Converter Engine to work with all Redix RMAP predefined maps
Database Enables the AnyToAny Format Converter Engine to access any ODBC-compliant database, e.g. Oracle, SQL Server, MySQL, etc.
NCPDP Enables the AnyToAny Format Converter Engine to handle all NCPDP files
HL7 Enables the AnyToAny Format Converter Engine to handle all HL7 files
WPC-XML Enables the AnyToAny Format Converter Engine to work with all Redix XML-HIPAA predefined maps
PDF Enables the AnyToAny Format Converter Engine to generate PDF files from any input file. Also enables the engine to work with all Redix HIPAA-PDF predefined maps.

 

  • Windows 2000 / XP / Server 2003 / Vista / 7 / Server 2008 / Server 2008 R2
  • XML Schema
  • X12
  • UN/EDIFACT
  • RosettaNet
  • PIDX
  • OAG
  • MISMO
  • HIPAA
  • HCFA NSF UB92
  • cXML
  • CIDX

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