Kepa,

While it would nice to get an interpretation from X12C Communications &
Controls Subcommittee, my personal opinion is that this guidance would come
much too late to be of use to those who are implementing now. Rather, I
would strongly encourage the WEDi SNIP Transactions Work Group to take the
lead and offer guidance. Further, my recommendations would be that the
preferred or recommended sequencing and grouping be as the various HL loops
are currently presented in the various HIPAA IGs. That is, that the various
high-level context start followed by the next logical contextual level. For
example, in the 837 Institutional the several contextual levels are:

Billing/Pay-to Provider
Subscriber
Patient

These contextual levels provide a logical grouping and nesting. I further
believe that this is the logical grouping or linking that would be found in
most application systems as well. I do not think that it would be logical to
create an 837 Institutional containing multiple Billing/Pay-to Providers,
multiple subscribers, and multiple patients to sequence all of the HL loops
for all Billing/Pay-to Providers first followed by all of the HL loops for
all subscribers (and then have to logically link the subscriber HL to the
correct Billing/Pay-to Provider HL, and then to sequence all of the HL loops
for all Patients and have to logically link each Patient HL to its logical
Subscriber parent HL. While technically this is achievable, it is
counterintuitive.

While the X12 standards are silent on how to actually sequence multiple HL
loops with their various contextual levels, I think that the logical
grouping and sequencing is more consistent with today's application systems
logical grouping and linking, whether in today's relational database
management systems or in the old IBM IMS parent/child dbms. Taking the
logical grouping approach is also preferable in my opinion since not all
commercially available EDI translators have the flexible mapping
capabilities to manage the appropriate HL01 Hierarchical ID number
assignment **and** the logical linking and assignment of parent Hierarchical
IDs to subsequent child HL loops in HL02  that do not immediately follow the
parent HL loop construct. I also agree with William that the **top/down,
left/right** hierarchical concept does lend guidance to implementers.

So, my strong recommendation is for the WEDi SNIP Transactions Work Group to
bite the bullet and make this implementation recommendation **now** to the
industry. Personally, even if an interpretation of sequencing and grouping
was requested of X12C, that request could only first be presented to X12C at
the February 2002 meeting in Seattle. And even in the most optimistic of
timelines and assuming that X12C could write and approve such an
interpretation at the February trimester meeting, the dissemination of that
guidance would come much too late for implementers. The industry needs
guidance now and I think it's very appropriate for the Transactions WG to
provide this guidance.

Also, one minor correction, my good friend William Kammerer, while an
enormous fount of X12 knowledge, was never the chair of X12C. However, both
William and I have been long time members of X12C - my participation
starting in 1988.

Hope this helps.

Rachel Foerster

-----Original Message-----
From: Kepa Zubeldia [mailto:[EMAIL PROTECTED]]
Sent: Saturday, October 27, 2001 9:20 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; HIPAAlive; X12N
Subject: TCS: HL structure clarification


There has been some debate on the proper structuring of HL loops for the
HIPAA transactions.  This is very important, as it could make the HIPAA
transactions totally unprocessable by the receiver.

The X12 standard is somewhat subject to interpretation as to what is a
"top-down/left-right" ordered structure.  So I asked William Kammerer,
past X12C chair.  His response is below.

I think that X12N, SNIP, or DHHS ought to submit a "Request for
interpretation" to X12C as soon as possible on this topic. In the
meantime, maybe X12N, SNIP, or DHHS can address this topic.

Comments?

Kepa Zubeldia
Claredi


"William J. Kammerer" wrote:

I looked at both X12.6 Application Control Structure and 12.59
Implementation of EDI Structures - Semantic Impact, and though the
latter mentions the HL, there is no mention that subordinate HL loops
must be contiguous to their parent in a top-down left-to-right manner.
But there is a segment comment associated with the HL that says "The HL
segment defines a top-down/left-right ordered structure," for whatever
that's worth.  I realize that doesn't definitively mean the HLs have to
be physically in that order in the data.

"Does in order mean that all the children HL must immediately follow
their parent HL before there is another parent HL?"  I would maintain
that, yes, in-order means top-down, left to right ordering.

"Is that stated somewhere in X12?" Not explicitly in X12.6, X12.59 nor
in the HL dictionary itself, as I indicated above.  I think this calls
for a Request for Interpretation.  If I had still been "chair" of X12C
TG2, I would have been the one to write the response.

Actually, even if X12 doesn't address the issue, shouldn't the HIPAA IGs
explicitly lay down this rule once and for all?

William J. Kammerer
Novannet, LLC.
+1 (614) 487-9286
+1 (614) 638-4384 (c)
+1 (520) 396-6310 (FAX)

----- Original Message -----
From: "Kepa Zubeldia" <[EMAIL PROTECTED]>
To: "William J. Kammerer" <[EMAIL PROTECTED]>
Subject: Re: TCS: Hierarchical Level Structure

William,

What does "in order" mean?  If someone sends all the "insured HL" in
order first and then all the "patient HL" in order also, but from a
patient HL is pointing to an insured HL that is many levels above as
being the parent, is that out of order?

Does in order mean that all the children HL must immediately follow
their parent HL before there is another parent HL?  Is that stated
somewhere in X12?

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