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TIBCO BusinessConnect™ Container Edition - EDI Protocol HIPAA Edition powered by Instream® 1.0.0

# Business Application Acknowledgements

The following is a list of the versions of business application acknowledgements that are supported by BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream:

| • | 00405/004050X166/824 - generated for 4010 HIPAA transactions

| • | 00501/005010X186A1/824 - generated for 5010 HIPAA transactions

| • | 00307/003070X070A1/277 - generated for 4010 HIPAA transactions

| • | 00404/004040X167/277 - generated for 4010 HIPAA transactions

| • | 00501/005010X214/277 - generated for 5010 HIPAA transactions

BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream can automatically generate the following business application acknowledgements:

| • | Application advice (824)

| • | Unsolicited Health Care Claim Status Notification (277U)

| • | Health Care Claim Acknowledgement (277CA)

The 824 application advice reports the results of an application system's data content edits on a transaction set. The results of editing transaction sets can be reported at the functional group and transaction set level, in either coded or free-form format.

The 824 is designed to report the following for a transaction set:

| • | Acceptance

| • | Rejection

| • | Acceptance with change

The unsolicited health care claim status notification (277U) reports the results of an application system's data content edits on the claims in a transaction set.

The 277 Claim Acknowledgement (277CA) has replaced the usage of the 277U Unsolicited Health Care Claim Status Notification. The 277 Claim Acknowledgement reports the results of an application system's data content edits on the claims in a HIPAA 837 transaction.

Use the HIPAA Acknowledgement tab to specify settings to use in composing these business application acknowledgements for documents sent by this trading partner. These settings take effect only if transaction level acknowledgements have been enabled in the Acknowledgement tab.

The 997 or 999 is generated, when the 824 application advice acknowledgements are also generated, the results contain the X12 and HIPAA syntax validation edits for the transaction.

## 999 Acknowledgements

In accordance with the 5010 transaction TR3s, BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream can be configured to generate version 005010X231A1 999s for all HIPAA 5010 transactions.

Use the HIPAA Acknowledgement tab to enable the option for generating version 005010X231A1 999s. This setting overrides any other 997 or 999 acknowledgement generation settings for 00501 interchanges, which contain HIPAA 5010 transactions.

See the following table for details.

HIPAA Acknowledgement Fields

Field | Description
824 Application Advice Creation | Defines when 824 acknowledgements are created for this partner by the host. The possible acknowledgement creation options are:
| • | None No acknowledgement is created (default).
| • | Always The acknowledgement is created whether there are validation errors to be reported or not. The acknowledgement contains all validation edit info other than that which is related to syntax checking for X12 and HIPAA.
| • | Only on Errors The acknowledgement is created only if there are errors in validation that are not related to X12 syntax or HIPAA syntax.
824 Application Advice Version | Select the version of the 824 Application Advice that should be generated:
| • | 004050X166 This version of 824 application advice is generated only for version 4010 HIPAA transactions (default)
| • | 005010X186 This version of 824 application advice is generated only for version 5010 HIPAA transactions.
| • | 004050X166 & 005010X186 Generate 824 application advice for both version 4010 and 5010 HIPAA transactions.
277 Health Care Notification Creation | Defines when a 277U or 277CA acknowledgement is created for this partner by the host. 277U or 277CA acknowledgements are only created for 837 transactions. The possible acknowledgement creation options are:
| • | None No acknowledgement is created (default).
| • | Always The acknowledgement is created whether there are validation errors to be reported or not. The acknowledgement contains all validation edit info including that which is related to syntax checking for X12 and HIPAA.
277 Health Care Notification Version | Select the version of the 277U or 277CA that should be generated:
| • | 003070X070A1 - Unsolicited Claim Status. A 277U is generated only for version 4010 HIPAA transactions. (Default)
| • | 004040X167 - Claim Acknowledgement. A 277CA is generated only for version 4010 HIPAA transactions.
| • | 005010X214 - Claim Acknowledgement. A 277CA is generated only for version 5010 HIPAA transactions.
| • | 004040X167 & 005010X214 - Claim Acknowledgement. A 277C is generated for both version 4010 and 5010 HIPAA transactions.
| • | 003070X070A1 & 005010X214 - Claim Acknowledgement. A 277U is generated for 4010 HIPAA transactions and a 277CA is generated for 5010 HIPAA transactions.
005010X231A1 999 Ack Creation | Enable generation of version 005010X231A1 999 acknowledgements for HIPAA 5010 transactions.
| • | Off - 997 and 999 acknowledgement settings from the Acknowledgement tab applied to all transactions.
| • | 5010 HIPAA Transactions - Version 005010X231A1 999s is generated for 00501 interchanges, which contain HIPAA 5010 transactions. The 'Inbound Ack Creation Option' setting, from the Acknowledgement tab, is still applied (for example, Interchange, Group, and Txn).

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TIBCO BusinessConnect™ Container Edition - EDI Protocol HIPAA Edition powered by Instream®

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