And now that the CAQH CORE Eligibility and Claim Status Operating Rules have been mandated by ACA Section 1104 as HIPAA Operating Rules you'll also need to consider the requirements in these rules. These rules can be downloaded from www.caqh.org.
Rachel Foerster 847-872-8070 From: [email protected] [mailto:[email protected]] On Behalf Of edi_guy2003 Sent: Wednesday, March 28, 2012 12:15 PM To: [email protected] Subject: [EDI-L] Re: EDI X12 to X12 Mapping in IBM Sterling Integrator I agree completely with Brian and Michael Mattias. There are way too many business process differences, 5010 upgrade is not just about EDI syntax and loop structures. For example, in 5010 if a patient is a dependent, the patient can still be treated as a subscriber on the subscriber loop if that patient has a unique member ID, if the payer can accept this then you would have to eliminate the patient loop. Have you considered this and dozens of other differences when you did a *business* gap analysis between the two versions. Be careful if you think that this is a just an EDI mapping project. EDI Academy has posted a little snipped with details about this: http://ediacademy.com/edi_training_5010_837.pdf Also, if you have not done so already, I recommend you thoroughly read your trading partner's companion guide in addition to the TR3. They may treat some of the 5010 rules differently. However, there are dozens of other such business gap examples to consider in the other transactions. Good Luck! Mike --- In [email protected] <mailto:EDI-L%40yahoogroups.com> , "vijaychandrak07" <vijaychandrak07@...> wrote: > > Hi All, > > Has anyone worked on X12 to X12 mapping? I have this requirement for mapping Health Care Claim transaction (837) from 4010 to 5010. My platform is IBM Sterling Integrator5.2 . > > My client needs to get it done by outbound process only. I am clueless on how to run an outbound process for x12-x12 transactions. I'm quite aware of outbound for positional to X12 / XML to X12 using header maps where I write select/update statements to recognize the correct partnerID's. Can we use the same process of header maps for X12-X12 outbound mapping too? > Asking this because when I tried to create a header map for the X12 elements' standard rules, I couldn't find select and update. Please advice. > > Regards, > Chandra > [Non-text portions of this message have been removed] ------------------------------------ ... Please use the following Message Identifiers as your subject prefix: <SALES>, <JOBS>, <LIST>, <TECH>, <MISC>, <EVENT>, <OFF-TOPIC> Job postings are welcome, but for job postings or requests for work: <JOBS> IS REQUIRED in the subject line as a prefix.Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/EDI-L/ <*> Your email settings: Individual Email | Traditional <*> To change settings online go to: http://groups.yahoo.com/group/EDI-L/join (Yahoo! ID required) <*> To change settings via email: [email protected] [email protected] <*> To unsubscribe from this group, send an email to: [email protected] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
