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EDI Problem RRS feed

  • Question

  • Hi,

    I am working on HIPAA 835 map. I have a requirement where I have to map repeating records of a single patient when it occurs multiple times.

    This is the flat file structure I have.

     

    9163.47|843892|20110328|0| |133056250|10288|28498118218|PAID|445.00|177.60|5.00|11070E04689||11|||||||||Name|NameI||15873546| |133056250|10288||20110214|20110214||99213||||0.00|0.00||2||20110214|20110214|0.00||||F|1||0|B20|0||0|ADEM_ADEM-One E&M/Day/Spec/Dx||0|0|1972581122|1972581122

    9163.47|843892|20110328|0||133056250|10288||10475||28498118218|PAID|445.00|177.60|5.00|11070E04689||11|||||||||Name|Name||15873546|Name|Name|J|133056250|10288||20110214|20110214||76519|RT|||225.00|76.60||1||20110214|20110214|0.00||||F|2||148.40|45|0||0|||76.60|0|1972581122|1972581122

    9163.47|843892|20110328| |133056250|10288|||28498118218|PAID|445.00|177.60|5.00|11070E04689||11|||||||||Name|Name||15873546|Name|AName|J|133056250|10288||20110214|20110214||||76519|RT|||225.00|76.60||1||20110214|20110214|0.00||||F|2||148.40|45|0||0|||76.60|0|1972581122|1972581122

    In the above all the records belong to the same customer. How can map this so the customer name will be same and I have to combine certain parts of the three records. What I want th output to be is this

    9163.47|843892|20110328|0| |133056250|10288|28498118218|PAID|445.00|177.60|5.00|11070E04689||11|||||||||Name|NameI||15873546| |133056250|10288||20110214|20110214||99213||||0.00|0.00||2||20110214|20110214|0.00||||F|1||0|B20|0||0|ADEM_ADEM-One E&M/Day/Spec/Dx||0|0|1972581122|1972581122 ||76519|RT|||225.00|76.60||1||20110214|20110214|0.00||||F|2||148.40|45|0||0|||76.60|0|1972581122|1972581122|||76519|RT|||225.00|76.60||1||20110214|20110214|0.00||||F|2||148.40|45|0||0|||76.60|0|1972581122|1972581122

    What happens is I need t combine the underlined parts of the records in to a single record and map against HIPAA 835 map. How can I do this? Thanks

    • Moved by Ben Cline1Moderator Monday, April 25, 2011 4:52 AM Related to EDI (From:BizTalk Server General)
    Sunday, April 24, 2011 10:48 PM

Answers

  • I ended up doing it by SQL. Now it's working. I guess getting the XML sorted from the database is easier than trying to write custom XSTL. Thanks
    • Marked as answer by Rosh_Biz Thursday, April 28, 2011 8:30 PM
    Thursday, April 28, 2011 8:27 PM

All replies

  • Those claim numbers almost look like they are comming from Trizetto. At any rate, you would nee to combine them somehow when you feed them to biztalk. It looks like you are breaking the messages appart by name, which is why you are getting two messages. When you insert them into the table or when you do your select statement, make sure your xml is ready for biztalk grouped and all. That is the easiest way to have the informaiton together. otherwise you will spend a lot of time with the looping functoid. I group my message and have the information ready for biztak.


    Please Indicate "Mark as Answer" if this Post has Answered the Question
    Monday, April 25, 2011 3:10 PM
  • Thanks for the reply Carlos T.

    Right now I have the information in a SQL table. Which has repeating records for a customer (simmilar to what I have given above).

    I grab everything as a single XML file and I map it against the 835 HIPAA map. As above, I have three repeating records for the same customer.

    Evertyhing works fine. But I get three seperate claim files for the single customer. But the requirement is to combine them together so that I have all the information in a single claim.

    What your suggestion is to select them all together from the sql datatable? I was thinking of having inline XSLT call template to combine these repeating records in to one record. In the sql table, All the information is same for a given customer and (lets say we have three records for this customer) only few table rows differ for the three records.

    Thanks

    Monday, April 25, 2011 3:25 PM
  • When you say claim, are your refering to 837? Because an 835 is not a claim.

    What I have learned is that it is best to group evertying and feed it to biztalk ready to go. You can do the other and group on biztalk, but I have found that to be very dificult and more complicated than just feeding the message to biztalk ready to go. It is MUCH easier to work with SQL and manipulate the record. What you are refering to I would just have one table with the member information and another table with all the records. Basically do a select joining both tables and the output will be the xml. Feed it to biztalk and away you go. That is my personal prefernece. I tried to do it the other way and spent more time troubleshooting than antying. Ended up abandoning it and manipulated the data on slq and I spent probably a few hours and I was up and running.


    Please Indicate "Mark as Answer" if this Post has Answered the Question
    • Proposed as answer by Carlos T. _ Tuesday, April 26, 2011 12:14 PM
    Monday, April 25, 2011 4:54 PM
  • I ended up doing it by SQL. Now it's working. I guess getting the XML sorted from the database is easier than trying to write custom XSTL. Thanks
    • Marked as answer by Rosh_Biz Thursday, April 28, 2011 8:30 PM
    Thursday, April 28, 2011 8:27 PM