Overview

In this tutorial, you use TIBCO ActiveMatrix BusinessWorks™ and BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream running on the host machine to send a HIPAA 270 Eligibility, Coverage or Benefit Inquiry transaction to the trading partner machine running BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream.

A simple private process on the receiving machine is configured to send the HIPAA 271 Eligibility, Coverage or Benefit Information transaction through BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream in response to the 270 transaction. The transaction set identifier information is as follows:

• The initiator machine:
— Transaction set - 270
— Group version - 4010X092A1
— Interchange version - 00401
• The responder machine:
— Transaction set - 271
— Group version - 4010X092A1
— Interchange version - 00401

As you run the tutorial, the TIBCO software applications perform the following tasks on the host machine:

  1. TIBCO Business Studio reads the XML file that contains the data for the 270 transaction.

  2. TIBCO Business Studio parses the XML data and sends the XML data to BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream.

  3. BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream converts the XML data to X12 data.

  4. BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream validates the X12 data against the 270 guideline.

  5. The validated X12 data is bundled into an interchange for sending to the trading partner.

  6. The software uses HTTP transport to send the interchange to the trading partner.

The TIBCO software applications perform the following tasks on the trading partner machine:

  1. BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream receives the X12 interchange.

  2. BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream validates the X12 data against the 270 transaction guideline.

  3. The software converts validated 270 X12 data to XML data.

  4. The software sends the converted 270 XML data to the private process.

  5. The private process returns statically configured 271 XML data to BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream.

  6. BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream takes the 271 XML data that it receives from the private process and converts the XML data to X12 data.

  7. BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream validates the X12 data against the 271 guideline.

  8. The software bundles the validated 271 data into an interchange.

  9. BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream takes the interchange containing the 271 data and returns it as part of the 200 OK HTTP response to the original HTTP request.

The following steps occur on the host machine:

  • BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream validates the X12 data against the 271 transaction guideline.

  • The software converts the validated 271 X12 data to XML data.

  • The software sends the converted 271 XML data to the private process.

  • The private process logs data from the 271 response.

The following sections describe how to set up and run the tutorial. The steps required in setting up BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream to run the tutorial are the same steps that are discussed in the “Managing EDI Guidelines” and “Exchanging Documents” topics in the TIBCO BusinessConnect™ Container Edition - EDI Protocol powered by Instream® User Guide.