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


Chapter 3 Setting Up Trading Hosts and Partners : HIPAA Acknowledgement Properties

HIPAA Acknowledgement Properties
Business Application Acknowledgements
The following is a list of the versions of business application acknowledgements that are supported by TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream:
TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream can automatically generate the following business application acknowledgements:
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:
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 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 will only take effect if transaction level acknowledgements have been enabled in the Acknowledgement tab.
The 997 or 999 that will be generated, when 824 application advice acknowledgements are also generated, will only contain the results of the X12 and HIPAA syntax validation edits for the transaction.
999 Acknowledgements
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.
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 Table 6 for details.
None   No acknowledgement is created (default).
Always   The acknowledgement is created whether there are validation errors to be reported or not. The acknowledgement will contain all validation edit info other than that which is related to syntax checking for X12 and HIPAA.
Only on Errors   The acknowledgement will only be created if there are errors in validation which are not related to X12 syntax or HIPAA syntax.
004050X166    This version of 824 application advice will only be generated for version 4010 HIPAA transactions (default)
005010X186   This version of 824 application advice will only be generated for version 5010 HIPAA transactions.
004050X166 & 005010X186    Generate 824 application advice for both version 4010 and 5010 HIPAA transactions.
None   No acknowledgement is created (default).
Always   The acknowledgement is created whether there are validation errors to be reported or not. The acknowledgement will contain all validation edit info including that which is related to syntax checking for X12 and HIPAA.
003070X070A1 - Unsolicited Claim Status. A 277U will only be generated for version 4010 HIPAA transactions. (default)
004040X167 - Claim Acknowledgement. A 277CA will only be generated for version 4010 HIPAA transactions.
005010X214 - Claim Acknowledgement. A 277CA will only be generated for version 5010 HIPAA transactions.
004040X167 & 005010X214 - Claim Acknowledgement. A 277C will be generated for both version 4010 and 5010 HIPAA transactions.
003070X070A1 & 005010X214 - Claim Acknowledgement. A 277U will be generated for 4010 HIPAA transactions and a 277CA will be generated for 5010 HIPAA transactions.
Off - 997 and 999 acknowledgement settings from the Acknowledgement tab applied to all transactions.
5010 HIPAA Transactions - Version 005010X231A1 999s will be generated for 00501 interchanges which contain HIPAA 5010 transactions. The 'Inbound Ack Creation Option' setting, from the Acknowledgement tab, will still be applied (e.g. Interchange, Group and Txn).

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