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Processing EDI batch files RRS feed

  • Question

  • We process claims where I work and we have always let the EDI disassembler do what it does, break the batch apart and process all claims in the file one at a time. However, because of our new back-end system we are required to break our information gathering down into a header/detail schema. We need to capture some batch file data for the header table and then just send each set of individual claim data to the detail table. How do I implement this within an orchestration so that we only capture the ISA/GS info once and don't recapture it every time a claim is processed from the file? Thanks.

    G

    Tuesday, July 30, 2013 4:20 PM

Answers

  • Yes, unfortunately, this is a notable gap in the EDI batching functionality.  Ideally, you could set 1000 transactions or (21:00 or 120 minutes).

    There are several ways to solve this.  One of the easier methods is to use a Windows Scheduled Task to copy Release Trigger messages to a File Receive Location as needed.  Such as daily at 11:30 or every 3 hours.

    • Marked as answer by Pengzhen Song Wednesday, August 7, 2013 12:29 PM
    Wednesday, July 31, 2013 7:18 PM

All replies

  • You would use a Sequential Convoy to process all the Transactions from a single Interchange.

    So, the first 'claim' would activate the Orchestration when you can create the header in the target system, then each subsequent claim would be processed with that header already existing.

    You can still split on the claim level so any ancillary processing in BizTalk won't be affected much if at all.

    Start here: http://msdn.microsoft.com/en-us/library/aa561843.aspx

    Tuesday, July 30, 2013 4:36 PM
  • Thanks for the input. I had looked a little at the Aggregator project in the SDK. It does look like it might fit the bill. The only other big issue I'm facing is this....I have to batch up all of the messages on the way out. The outgoing batch file needs to have all of the claims that were in the incoming batch file, minus any that error out. I know how to set up parties for batching, but I don't need these batches set to be released at any certain time or when a certain number of messages is reached. I need the batch released when each particular file is finished. Again, I need the outgoing file to look like the incoming one, minus the bad claims.

    Thanks.

    G

    Tuesday, July 30, 2013 8:23 PM
  • I think that sample is a Convoy example.

    Double and triple check that requirement.  I've been told such in the past just because it's how it was 'always done' but later found out that the adjudication system really couldn't care less about how the incoming claims were batched.

    If it really does care, investigate a bit, you might be able to fake it by overwriting some ISA values to match.  Did that once too.

    Tuesday, July 30, 2013 9:10 PM
  • I think the biggest thing I worry about with the automatic batch release threshold is this....what happens if you set it so that batches are released every time 2000 claims back up? Well, if all of the batches go out for the day and there are 1000 left over will they just sit there until 1000 more are added tomorrow? We need all claims processed the day they come in. I can't remember as I would have to look at the configuration on the party settings for batching, but is there a final release where you can have what's left go out by like 7pm?

    G

    Wednesday, July 31, 2013 6:12 PM
  • Yes, unfortunately, this is a notable gap in the EDI batching functionality.  Ideally, you could set 1000 transactions or (21:00 or 120 minutes).

    There are several ways to solve this.  One of the easier methods is to use a Windows Scheduled Task to copy Release Trigger messages to a File Receive Location as needed.  Such as daily at 11:30 or every 3 hours.

    • Marked as answer by Pengzhen Song Wednesday, August 7, 2013 12:29 PM
    Wednesday, July 31, 2013 7:18 PM