Sun B2B Suite HIPAA Protocol Manager User's Guide

HIPAA PM Overview

Because HIPAA PM integrates with eGate, eInsight, eXchange, and the HIPAA OTD Library, the product enables you to design Java CAPS Projects that process HIPAA messages. Message validation is handled through a third-party service.

For more information about eGate, eXchange, and the HIPAA OTD Library, see the corresponding user’s guides.

Note –

As you use this document, refer to the eXchange Integrator User’s Guide for information relating directly to eXchange operation.

Basic Operation

HIPAA PM allows you to test and validate your HIPAA transactions by performing calls to a third-party validation service. The HIPAA PM’s validation features allow you to do this operation. HIPAA PM validation supports HIPAA validation, which may consist of any certified HIPAA validation solution.

HIPAA PM and eXchange

eGate and eXchange enable you to build Java CAPS Projects that process standard B2B business protocols and enveloping protocols, such as HIPAA.

HIPAA PM works with eXchange to provide the following features during message processing:

Message transport
Message tracking
Error handling

HIPAA PM and the HIPAA OTD Library

HIPAA messages within eGate are called HIPAA OTDs. The Java CAPS provides packaged HIPAA OTDs for eGate as part of the HIPAA OTD Library.

Note –

For more information on these OTDs, see the HIPAA OTD Library User’s Guide.

You can also build your own OTDs using the SEF OTD wizard supplied with Java CAPS. HIPAA PM provides packaged BP rules to handle HIPAA OTDs.

Third-party Validation

HIPAA PM allows your system to validate data using third-party services such as EDIFECS and Foresight.

When you import the xengine.jar and xe_extensions.jar files (see Initializing and Running Enterprise Designer) into your Logical Host directories, you enable validation through the EDIFECS XEngine.

For complete instructions on how to set up EDIFECS to validate HIPAA data, as well as how to use the EDIFECS XEngine, see the following Web site:

http://www.edifecs.com

From this Web site, search under EDIFECS XEngine for information on how to enable and use this feature to validate HIPAA data.

You need to create an environment variable XEROOTthat will contain the installation path of the EDIFECS XEngine.

Note –

HIPAA PM allows you to set outbound messages to be sent without Business Message Syntax validation, to speed up message processing. However, inbound message validation is always required.

To Set Up Foresight to Validate HIPAA Data

For complete instructions on how to set up Foresight to validate HIPAA data, see the following Web site:

http://www.foresightcorp.com

After you have installed the Foresight engine, do the following:

Create a new file,TI.csv using the SamplePartnerAutomation.csv file.

For more information about the SamplePartnerAutomation.csv file, refer to the Foresight documentation.

Copy the TI.csv file to the HIPAAValidatorInstream/Bin directory.

Open the fsdir.ini file in an editor and modify the parameter PARTNERAUTOMATION.
1. Remove the colon that is present before the parameter PARTNERAUTOMATION.
2. Replace the SamplePartnerAutomation.csv file with the TI.csv file.
  
  PARTNERAUTOMATION="C:\ProgramFiles\HIPAA Validator Instream\Bin\TI.csv"

To start the application server on UNIX, you need to set the following Environment variables:
1. Add the following path to the environment variable FSINSTREAMINI.
  
  ...ForesightInstallDir/Bin
2. The LIBPATH(AIX), LD_LIBRARY_PATH(Sun OS), or SHLIB_PATH(HP-UX) needs to contain the value of the FSINSTREAMINI variable.

How HIPAA PM Messaging Works

HIPAA PM operates using the following basic functional layers:

View: eInsight provides the ability to create and view the structure of HIPAA eXchange Projects, and the eXchange Message Tracking feature allows the searching and viewing of sent and received HIPAA messages. HIPAA PM Message Tracking includes interleaved error reports to allow pinpoint tracking of system messaging errors.
Services Orchestration: You use the eXchange Partner Manager (ePM) to design HIPAA Transaction Sets; then the appropriate HIPAA Projects prepare and return the interchange and functional acknowledgments (TA1 and 997) to the TP. HIPAA Projects also perform message correlation to associate business responses to the related requests. A HIPAA B2B Host Project manages and coordinates the HIPAA messaging operations.
Integration Services: The HIPAA Project handles Interchange Envelope (ISA) and Functional Group (GS) enveloping from incoming messages, prepares these envelopes for outgoing messages, batches together documents to be delivered as a single transaction (ISA), and records the activity in Message Tracking. You may configure these enveloping parameters using ePM.

Key Parts of EDI Processing Logic

The key parts of EDI processing logic are listed in Table 2–2.

Table 2–2 Key Parts of EDI Processing


Term	Description	Language Analogy	Java CAPS Component
Structures	Format, segments, loops	Syntax rules	OTD elements and fields
Validations	Data contents “edit” rules	Semantic rules	Not supported by HIPAA PM; handled by a third-party service
Translations (also called mappings)	Reformatting or conversion	Translation	Collaborations, Java Collaboration Definitions (JCDs)
Enveloping	Header and trailer segments	Envelope for a written letter	Special “envelope” OTDs: FunctionalGroupEnv and InterchangeEnv
Acks	Acknowledgments	Return receipt	Specific acknowledgment elements in the OTD

Java CAPS uses structures, translations, enveloping, and acknowledgments, as listed in Table 2–2 to support the HIPAA standard. The remainder of this section explains these terms in greater detail.

OTD Message Structures

The HIPAA OTD Library includes pre-built OTDs for messaging in all supported HIPAA versions. These OTDs can be viewed in the eGate OTD Editor but cannot be modified.

To customize an OTD structure , for example, in order to add a segment or loop , you must first create a .sef file (generally using a third-party application). You then use the SEF OTD wizard to generate the appropriate OTD from a given .sef file.

Translations, Enveloping, and Acknowledgments

Within each HIPAA OTD are Java methods and Java bean nodes for handling translations, enveloping, and acknowledgments. The marshal and unmarshal methods of the two envelope OTDs handle enveloping and de-enveloping.

No prebuilt translations are supplied with the HIPAA OTD Library. You build data translations with an eGate Enterprise Designer user interface called the Java Collaboration Editor (JCE).

Note –

In eGate, HIPAA translations are called Java Collaboration Definitions (JCDs).

You may also construct eGate XSLT Collaborations and/or eInsight BPs to perform translations.

Message Information Levels

The levels of information that guide the final format of a specific transaction are:

HIPAA Protocol : The HIPAA Act mandates a standard structure for each HIPAA TP transaction. Specifically, since HIPAA regulations are law, it is important to follow the guidelines for these transactions as strictly as possible.
TP Agreements : It is normal for TPs to have individual agreements that supplement the standard guidelines. The specific processing of the transactions in each TP’s individual system can vary from one site to another. As a result, additional documentation providing information about the differences is helpful to the site’s TPs and simplifies implementation. For example, although a certain code might be valid in an implementation guide, a specific TP might not use that code in transactions. In such a case, it is important to include that information in the TP agreement.

Using the SEF Wizard

You can use this product with custom SEF OTDs built with the SEF OTD wizard. The wizard supports the most current SEF versions.

The SEF OTD wizard does not handle the following information and sections:

In the .SEMREFS section, semantic rules with its type of the “exit routine” are ignored as per SEF specification. An exit routine specifies an external routine (such as a COM-enabled server program supporting OLE automation) to run for translators or EDI data analyzers.
The .TEXT sections (including subsections such as .TEXT,SETS, .TEXT,SEGS, .TEXT,COMS, and .TEXT,ELMS) are ignored, because these sections store information about changes in a standard’s text, such as notes, comments, names, purposes, descriptions, titles, semantic notes, explanations, and definitions.