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BizTalk 2013 EDI for Health Care

HIPAA-Compliant 834 (Enrollment) and 837 (Claims) Solutions

Mark Beckner

Computers / Enterprise Applications / Collaboration Software

BizTalk 2013 EDI for Healthcare – EDI 834Enrollment Solutions eliminates the complexity anddemonstrates how to build both inbound and outbound EDI 834 processes inBizTalk server that follow the required patterns for integrations with theseexchanges. Archiving, mapping,reconstituting EDI 837 data, exception handling and advanced logging andreporting (without the need for BAM!) are all covered in enough detail to allowyou to implement your own fully functional solution.

The Affordable CareAct and the requirements to integrate with state Exchanges have securedBizTalk’s role with integrations within the healthcare industry. EDI 834 documents are the heart to allintegrations, dealing with enrollment and the maintenance of enrollments. In order to successfully integrate with theexchanges, companies are required to implement a number of architectural componentsthat can be daunting and complex to work through. High-quality resources for IT professional to handle these challenges are sorely needed, and this resource has been designed to provide concise solutions.

What you’ll learn Learn how to develop complete end to end EDI 834 solutions, both inbound and outbound Create a solution that demonstrates how to integrate with state Exchanges Explore options for custom pipeline components, archiving patterns, lookups Detailed information for advanced 834 EDI mapping Who this book is for

BizTalk administrators and developers, as well as management personnel connected with these positions.

Table of Contents

1. Architectural Patterns

2. Solution: Receiving 837P Data

3. Solution: Sending 837P Data

4. Mapping Data

5. Adapters, AS2 and Acks

6. Solution: Receiving 834 Data

7. Pipelines for 834 Processing

8. Custom Business Rules

9. Advanced 834 Mapping

10. Solution: Sending 834 Data

11. Solution: Sending 834 Data, Simplified

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