HIPAA EDI Development Suite

Typed Document

Remove All Complexities From Creating HIPAA EDI Documents

The developer can now spend more of their time on the business rules and not on intricacies of dealing with EDI”

Typed Documents removes all complexities from creating HIPAA EDI documents by making it truly object-oriented

EDIFileStructure

Main Features

  • Cut EDI development in half
  • Use feature-rich HIPAA objects like X125010Document
  • Use high level segment objects like ISA, GS, ST, CLM, IEA
  • Easily create loops and segments with a truly Object-Oriented paradigm
  • Extensible model allows the creation of custom Typed EDI documents and segments
  • Supports all 5010 HIPAA transactions sets
  • Code is cleaner, more understandable and maintainable

Details

If you’ve ever created an object and set its properties then you can create HIPAA EDI documents.  Typed Documents (X125010Document) enables developers to quickly create HIPAA EDI documents without any complexity.

X125010Document supports all HIPAA Implementation Guides.  HIPAA EDI document creation is intuitive and follows a simple loop structure.  There is an object for each 5010 segment like ISA, GS, ST, PAT, HI etc.  Just set properties on the objects and they will be translated into the HIPAA format when document generation occurs.

Avoid the Details of EDI formats

Typed Documents takes care of annoying things like empty trailing elements and empty trailing composite elements.  These can actually result in EDI files errors and file rejections.  Element, composite and segment separators are automatically added at the correct places resulting in a flawless EDI document.

Avoid Worrying about ISA Segment Minimum and Maximum Length Requirements

The ISA segment is special in the X12 standard.  It has a fixed length and contains metadata.  EDI parsers use this metadata to correctly parse EDI data.  If this segment is not created correctly parsing failure will occur.  Typed Documents will correctly pad or trim ISA element data to conform to the X12 5010 HIPAA standard.

Auto Placement of Number of Segments, Transactions and Functional Headers

SE segments must contain the total amount of segments used within that specific transaction.  Typed Documents will automatically keep a count of the number of segments used and goes as far as to actually enter that data in the SE segment.  Additionally the number of ST Transactions and GS Functional Groups are also tracked and added to the GE and IEA segments respectively.

Typed Documents takes care of the following counting scenarios:

  1. Adding the correct number of segments in SE segments
  2. Adding the correct number of transactions in GE segments
  3. Adding the correct number of functional groups in IEA segments

The Code

Code: Creating a Typed HIPAA Document

Generated HIPAA EDI Document

Code is Easier To Read, Understand and Maintain

public void DisplayAllClaims(List<DocumentLoop> claims)
{
   int rowNumber = 1;
   foreach (DocumentLoop claimSection in claims)
   {
      SBR subscriber = claimSection.GetSegment<SBR>();
      DocumentLoop subscriberInfo = claimSection.GetLoop("2010BA");
      NM1 subName = subscriberInfo.GetSegment<NM1>();

      DocumentLoop insuranceInfoSection = claimSection.GetLoop("2010BB");
      NM1 insuranceName = insuranceInfoSection.GetSegment<NM1>();

      DataRow subInfoRow = subscriberTable.NewRow();
      subInfoRow[0] = rowNumber;
      subInfoRow[1] = subName.NameLastOrOrganizationName + " " + subName.FirstName;
      subInfoRow[2] = insuranceName.NameLastOrOrganizationName;
      subInfoRow[3] = subscriber.IndividualRelationshipCode;
      subInfoRow[4] = subscriber.ClaimFilingIndicatorCode;

      subscriberTable.Rows.Add(subInfoRow);

      List<DocumentLoop> claimLoopSections = claimSection.GetLoops("2300");
      foreach (DocumentLoop cl in claimLoopSections)
      {
         CLM clm = cl.GetSegment<CLM>();

         DataRow claimInfoRow = claimsTable.NewRow();
         claimInfoRow[0] = rowNumber;
         claimInfoRow[1] = clm.ClaimSubmitterIdentifier;
         claimInfoRow[2] = clm.MonetaryAmount;

         claimsTable.Rows.Add(claimInfoRow);

         List<DocumentLoop> serviceLineSections = cl.GetLoops("2400");
         foreach (DocumentLoop sl in serviceLineSections)
         {
            //Get the service line segment
            SV1 sv1 = sl.GetSegment<SV1>();

            DataRow serviceLineInfoRow = serviceLineTable.NewRow();
            serviceLineInfoRow[0] = rowNumber;
            serviceLineInfoRow[1] = sv1.CompositeMedicalProcedureIdentifier.ProductServiceID1;
            serviceLineInfoRow[2] = sv1.MonetaryAmount1;

            serviceLineTable.Rows.Add(serviceLineInfoRow);
          }
      }
     rowNumber++;
  }
}

Easily Extendable

Typed Documents have a simple architecture that makes it easy to extend.  Custom typed documents and segments can easily be created to support any X12 standard.  For example, 4010 typed documents can be created and automatically integrate with the Typed Documents infrastructure.

Example – Create a custom Typed Document with 3 custom segments /p>

public class MyTypedDocument : TypedEDIDocument
{
   public MyTypedDocument()
   {
   }     

   protected override DocumentSegment GetDocumentSegment(string segmentName)
   {
     switch (segmentName)
     {
       case "CS1":
            {
                return new CustomSegment1();
            }
       case "CS2":
            {
                return new CustomSegment2();
            }
       case "ABC":
            {
                return new CustomSegment3();
            }
      }
     return null;
    }
 }

Currently Supported HIPAA Implementation Guides

  1. (837P)  Health Care Claim: Professional
  2. (837I)  Health Care Claim: Institutional
  3. (837D) Health Care Claim: Dental
  4. (820)   Payroll Deducted/Group Premium Payment Ins. Products
  5. (820)   Health Insurance Related Payments
  6. (834)   Benefit Enrollment and Maintenance
  7. (835)   Health Care Claim Advice
  8. (276)   Health Care Claim Status Request
  9. (277)   Health Care Claim Status Response
  10. (270)   Health Care Claim Eligibility Request
  11. (271)   Health Care Claim Eligibility Response
  12. (999)   Implementation Acknowledgement
  13. (277 CA) Health Care Claim Acknowledgment

Related Tutorials

 

Take Charge Of HIPAA

RDPCrystal EDI Library

trial2