Copyright © TIBCO Software Inc. All Rights Reserved
Copyright © TIBCO Software Inc. All Rights Reserved


Chapter 1 X12 Overview : HIPAA Acknowledgment Properties

HIPAA Acknowledgment Properties
Business Application Acknowledgments
The following information is a list of the versions of business application acknowledgments that TIBCO BusinessConnect EDI Protocol powered by Instream supports:
TIBCO BusinessConnect EDI Protocol powered by Instream can automatically generate the following business application acknowledgments:
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 information for a transaction set:
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 Acknowledgment (277CA) has replaced the usage of the 277U Unsolicited Health Care Claim Status Notification. The 277 Claim Acknowledgment reports the results of an application system data content edits on the claims in a HIPAA 837 transaction.
You can use the HIPAA Acknowledgement tab to specify settings to be used in composing these business application acknowledgments for documents sent by this trading partner. These settings only take effect if you have enabled transaction level acknowledgments in the Acknowledgement tab.
The 997 or 999 acknowledgment that is generated when 824 application advice acknowledgments are also generated, only contains the results of the X12 and HIPAA syntax validation edits for the transaction.
999 Acknowledgments
In accordance with the 5010 transaction TR3s, TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream can be configured to generate version 005010X231A1 999s for all HIPAA 5010 transactions.
You can use the HIPAA Acknowledgement tab to enable the option for generating version 005010X231A1 999s. This setting overrides any other 997 or 999 acknowledgment generation settings for 00501 interchanges, which contain HIPAA 5010 transactions.
See Table 2 for details.
None   No acknowledgment is created. By default, None is selected.
Always   The acknowledgment is created whether there are validation errors to be reported or not. The acknowledgment contains all validation edit information other than that which is related to syntax checking for X12 and HIPAA.
Only on Errors   The acknowledgment is only created if errors that are not related to X12 syntax or HIPAA syntax occur in validation.
004050X166    This version of 824 application advice is only generated for version 4010 HIPAA transactions. By default, 004050X166 is selected.
005010X186   This version of 824 application advice is only generated for version 5010 HIPAA transactions.
004050X166 & 005010X186     These versions of 824 application advice are generated for both version 4010 and 5010 HIPAA transactions.
None   No acknowledgment is created (default).
Always   The acknowledgment is created whether validation errors are reported or not. The acknowledgment contains all validation edit info including that which is related to syntax checking for X12 and HIPAA.
003070X070A1 - Unsolicited Claim Status   A 277U is only generated for version 4010 HIPAA transactions. (default)
004040X167 - Claim Acknowledgement   A 277CA is only generated for version 4010 HIPAA transactions.
005010X214 - Claim Acknowledgement   A 277CA is only generated 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.
Off   997 and 999 acknowledgment settings from the Acknowledgement tab apply to all transactions.
5010 HIPAA Transactions   Version 005010X231A1 999s are 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.
 
 

Copyright © TIBCO Software Inc. All Rights Reserved
Copyright © TIBCO Software Inc. All Rights Reserved