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Functional Acknowledgments and Reponses

Functional Acknowledgments and Reponses. Lisa S Miller COO Washington Publishing Company. Acknowledgement. The act of admitting or owning to something. Recognition of another's existence, validity, authority, or right. An answer or response in return for something done.

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Functional Acknowledgments and Reponses

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  1. Functional Acknowledgments and Reponses Lisa S Miller COO Washington Publishing Company

  2. Acknowledgement • The act of admitting or owning to something. • Recognition of another's existence, validity, authority, or right. • An answer or response in return for something done. • An expression of thanks or a token of appreciation. • A formal declaration made to authoritative witnesses to ensure legal validity.

  3. Acknowledgements and HIPAA • Acknowledgement References • Located in Appendix B • EDI Control Directory • Includes the TA1 and the 997 • Acknowledgements may also be business level responses • Example: Request for Eligibility Request and Response • The HIPAA documentation (IG) is based on information that was available with version 4010 years ago.

  4. 40 Thousand Foot View Organization A Organization B Transaction A Transaction B

  5. Acknowledgement? • The act of admitting or owning to something. • Recognition of another's existence, validity, authority, or right. • An answer or response in return for something done. • An expression of thanks or a token of appreciation. • A formal declaration made to authoritative witnesses to ensure legal validity.

  6. X12 Acknowledgements • Trading Partner Agreements • Not required but strongly recommended • Have specific intended use

  7. X12 Acknowledgements • Delivery Acknowledgements • TA1 – Basic Interchange Acknowledgment • TA3 – Interchange Delivery Notice • Syntactic Response Acknowledgements • 997 – Functional Acknowledgment • 999 – Implementation Acknowledgment • Business Application Acknowledgements • 824 – Application Advice • Response Transaction • Example 270/271

  8. X12 Acknowledgements Organization A Organization B Transaction A TA1

  9. X12 Acknowledgements Organization B Organization A EDI Gateway Transaction A 997

  10. Implementation Guide (TR3) Acknowledgements Organization B Organization A EDI Gateway With IG ‘Edits’ Transaction A 999

  11. Application Advice Organization A Organization B EDI Gateway With IG ‘Edits’ Transaction A Business Application 824

  12. Response Transaction Organization A Organization B EDI Gateway With IG ‘Edits’ Transaction A Business Application – Work completed Transaction B

  13. Other information * Image from the WEDI Whitepaper Front End Edits Whitepaper Version 1.0 ( currently being revised)

  14. X12 Sequence Diagram

  15. HIPAA Examples • 270/271 Realtime Example • 270/271 Batch Example 271 270 TA1 270 bad 270 997 270

  16. HIPAA Examples • 837 Example 837 TA1 997 999 824 277 835

  17. Technical choices interact with Business issues • Trading partner agreements • ‘Batch’ verses ‘single’ • ‘Positive’ and ‘negative’ acknowledgement handling • Choices

  18. Conclusions Business needs and technical requirements intersect at the point of acknowledgment communication. The Healthcare industry needs to define specific implementation guides (TR3) for the purpose of defining the business needs within the X12 acknowledgement framework.

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