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


Chapter 2 HIPAA Transaction Configuration : Configuring Acknowledgements

Configuring Acknowledgements
In addition to 997 Functional Acknowledgements, 999 Implementation Acknowledgements, and TA1 Interchange Acknowledgement Segments, the following business application acknowledgements can be automatically generated for HIPAA transactions received from your trading partners:
The 824, 277U, and 277CA acknowledgements are treated as regular transactions and acknowledgements will be returned for them just as they would be returned for a normal HIPAA transaction. For example, if the system is configured to return 997s and TA1s, then a 997 and TA1 will be returned when an 824, 277U or 277CA acknowledgement is received.
The 824, 277U, and 277CA acknowledgements are not supported for use in synchronous request/response HIPAA transactions. For information on configuring 999 Implementation Acknowledgements, see Configuring 999 Implementation Acknowledgements.
Configuring 824 Application Advice Acknowledgements
The 824 Application Advice reports the results of an application system's data content edits on a transaction set. The 824 Application Advice can report on validation errors that are beyond the syntax errors that are normally reported by the 997 or it can report the receipt of a transaction that passed validation without any errors. TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream supports the following versions of the 824 Application Advice:
TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream can be configured to automatically generate an 824 Application Advice for HIPAA transactions. The 824 Application Advice will contain information on the validation results when a transaction was validated against the validation rules contained in the HIPAA Implementation Guides or Type 3 Technical Reports (TR3')s. For more information on configuring TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream to automatically generate an 824 Application Advice for a trading partner, see HIPAA Acknowledgement Properties.
To use the 824 Application Advice, you must also configure the transaction properties in the Operations Editor. Example interfaces containing the configurations for the supported versions of the 824 can be found in the directory: BC_HOME/protocols/tibedi/samples/interfaces.
The example interfaces are named as follows: HIPAA-Ack-<interchange version>-824.csx
To explain how to configure the 824 Application Advice, the example interface HIPAA-Ack-00405-824.csx will be used. Importing this interface in the Operations Editor will result in the following:
Once this interface is imported and your trading partner is configured for automatic generation of this version of the 824 Application Advice, TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream will automatically generate this version of an 824 Application Advice whenever a 4010 HIPAA transaction is validated.
You could also manually configure the 824 Application Advice in the Operations Editor just as you would configure any other X12 interchange, group and transaction set. However for the 824 Application Advice, it is not necessary to upload the guidelines to use for validation. TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream knows which guidelines should be used when the interchange, group and transaction are configured as follows:
When configured as above, the following guidelines will be used:
These guidelines can be found in the following directory:
BC_HOME/protocols/tibedi/samples/sampleDocs/guidelines
Configuring 277U Unsolicited Health Care Claim Status Notifications
The 277U unsolicited health care claim status notification reports the results of an application system’s data content edits on the claims in a HIPAA version 4010 837 transaction set. The example interface HIPAA-Ack-00307-277.csx contains the configuration for this acknowledgement. This interface can be found in the directory BC_HOME/protocols/tibedi/samples/interfaces
Importing this interface in the Operations Editor will result in the following:
You could also manually configure the 277U acknowledgement in the Operations Editor just as you would configure any other X12 interchange, group and transaction set. However for the 277U acknowledgement, it is not necessary to upload the guidelines to use for validation. TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream knows which guidelines should be used when the interchange, group and transaction are configured as follows:
When configured as above, the following guideline will be used:
This guideline can be found in the following directory:
BC_HOME/protocols/tibedi/samples/sampleDocs/guidelines.
Configuring 277 Claim Acknowledgement
The 277 Claim Acknowledgement 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. TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream supports two versions of the 277 Claim Acknowledgement:
Version 5010X214 277 Claim Acknowledgements can be generated for version 5010 HIPAA 837 transactions only.
Version 4040X167 277 Claim Acknowledgements can only be generated for version 4010A1 HIPAA 837 transactions.
TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream can be configured to automatically generate 277 Claim Acknowledgements for the claims inside a HIPAA 837 transaction. Generation of both 277 Claim Acknowledgements and 277U Unsolicited Health Care Claim Status Notifications cannot be done.
The 277 Claim Acknowledgement contains information on the validation results when a claim is validated against the validation rules contained in the HIPAA Implementation Guides or Type 3 Technical Reports (TR3')s. For more information on configuring TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream to automatically generate 277 Claim Acknowledgements for a trading partner, see HIPAA Acknowledgement Properties.
To use the 277 Claim Acknowledgement, you must also configure the transaction properties in the Operations Editor. Example interfaces containing the configurations for the supported versions of the 277 Claim Acknowledgement can be found in the directory: BC_HOME/protocols/tibedi/samples/interfaces
The example interfaces are named HIPAA-Ack-interchange version -277.csx.
Configuring 999 Implementation Acknowledgements
TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream supports the automatic generation of version 005010X231A1 999 Implementation Acknowledgements for HIPAA version 5010 transactions.
For more information on configuring TIBCO BusinessConnect EDI Protocol HIPAA Edition powered by Instream to generate version 005010X231A1 999 Implementation Acknowledgements in response to HIPAA 5010 transactions, see HIPAA Acknowledgement Properties.
Non-HIPAA 999 Implementation Acknowledgements are explained in detail in TIBCO BusinessConnect EDI Protocol powered by Instream, X12 Configuration, Configuring Acknowledgements.

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