Transaction Configuration Files

To configure a HIPAA transaction in the Operations Editor, the following files are needed for each transaction:

HIPAA Transaction Guideline
HIPAA Transaction Schema
HIPAA Transaction Map File for EDI to XML or EDI to Text Conversion
HIPAA Transaction Map File for XML to EDI Conversion

The HIPAA transaction guidelines contain rules that are used to validate HIPAA X12 transactions according to the HIPAA Implementation Guides (IGs) or Type 3 Technical Reports (TR3s). The HIPAA transaction guidelines provided with BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream are located in multiple locations:

  • BCCE-1.3.0_Home/images/services/cms/bcce-cms/config and BCCE-1.3.0_Home/images/services/is/bcce-is/config

  • Fsrest mount path

  • bcce-edihipaa-1.0.0_InstallerFolder>/samples/sampleDocs/guidelines

The HIPAA transaction schemas contain the definition of the XML that can be used by the backend process for handling HIPAA transaction data. The schemas associated with the HIPAA transaction guidelines provided with BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream are in the directory: bcce-edihipaa-1.0.0_InstallerFolder>/samples/sampleDocs/schemas

The HIPAA transaction map files are used by the EDI conversion engine to convert HIPAA transaction EDI data into XML and the reverse. The HIPAA transaction map files can also be used to convert HIPAA transaction EDI data into textual data.

The map files associated with the HIPAA transaction schemas provided with BusinessConnect Container Edition - EDI Protocol HIPAA Edition powered by Instream are in the directory: bcce-edihipaa-1.0.0_InstallerFolder>/samples/sampleDocs/maps.

The map files, which contain the mapping for converting from XML to EDI data have file names of the form schema_name_XE.map. The map files used for converting inbound EDI data into XML data have file names of the form schema_name_EX.map.

Notice that the names of the HIPAA transaction schemas and maps files are similar to each other but they are not similar to the names of the HIPAA transaction guidelines. This is because the HIPAA transaction schemas and maps files are created using TIBCO EDISIM Standards Editor, which cannot read the HIPAA transaction guidelines because the rules in the guidelines are encrypted. So to create the HIPAA transaction schemas and maps files, you must use the unencrypted guideline from TIBCO EDISIM, which only contains level 1 and 2 syntax checks but not the level 3 and above HIPAA validation rules.

The following table lists the TIBCO EDISIM guideline used to generate the schemas and map files for each HIPAA transaction.

TIBCO EDISIM Guidelines

HIPAA Transaction

HIPAA Guideline

EDISIM Guideline

00307/003070X070A1/277

PDSA3070277UX070A1.std

277-X070A1

00401/004010X092A1/270

PDSA270.std

270AA120

00401/004010X092A1/271

PDSA271.std

271AA120

00401/004010X093A1/276

PDSA276 .std

276AA120

00401/004010X093A1/277

PDSA277.std

277AA120

00401/004010X094A1/278 (RQ)

PDA278RQ.std

278AREQ

00401/004010X094A1/278 (RSP)

PDA278RP.std

278ARES

00401/004010X061A1/820

PDSA820.std

820AA120

00401/004010X095A1/834

PDSA834.std

834AA120

00401/004010X096A1/837 (I)

PDSA837I.std

837AQ320

00401/004010X097A1/837 (D)

PDSA837D.std

837AQ220

00401/004010X098A1/837 (P)

PDSA837P.std

837AQ120

00404/004040X167/277

PDSA4040277UX167.std

277-X167

00405/004050X150/277

PDSA4050277X150.std

277-X150

00405/004050X151/275

PDSA4050275X151.std

275-X151

00405/004050X166/824

PDSA4050824X166.std

824-X166

00501/005010X279A1/270

PDSA5010270X279.std

270-X279

00501/005010X279A1/271

PDSA5010271X279.std

271-X279

00501/005010X212/276

PDSA5010276X212.std

276-X212

00501/005010X212/277

PDSA5010277X212.std

277-X212

00501/005010X217/278 (RQ)

PDSA5010278X217Q.std

278X217Q

00501/005010X217/278 (RSP)

PDSA5010278X217R.std

278X217

00501/005010X218/820

PDSA5010820.std

820-X218

00501/005010X220A1/834

PDSA5010834.std

834-X220

00501/005010X221A1/835

PDSA5010835.std

835-X221

00501/005010X222A1/837 (P)

PDSA5010837P.std

837-X222

00501/005010X223A2/837 (I)

PDSA5010837I.std

837-X223

00501/005010X224A2/837 (D)

PDSA5010837D.std

837-X224

00501/005010X214/277

PDSA5010277CAX214.std

277CA-X214

00501/005010X186A1/824

PDSA5010824X186.std

824-X186

00501/005010X210/275

PDSA5010275X210.std

275-X210

00501/005010X213/277

PDSA5010277X213.std

277-X213