Setting Up HIPAA Tables

EDI Trading Partners Page

BN_EDI_PARTNERS

Define the information needed for the EDI Interchange Control segments for each partner receiving 834 transaction transmissions.

EDI 834 Transaction Map Table Page

BN_834_MAP_TBL

View the delivered code maps or set up new code maps for any new codes you have added to the system.

Name

Enter the name of the EDI trading partner.

A trading partner can be one of your health care providers but doesn't have to be.

External Partner ID

Identify the receiving partner.

This ID must be agreed upon by both the sender and receiver.

Internal Partner ID

Identify the sending partner.

This ID must be agreed upon by both the sender and receiver.

Application Receiver's Code

Enter a value.

Application Sender's Code

Enter a value.

Use Alternate Group Number for Trans Set Identifier Code

Select to enter a value in the Alternate Group Number field.

Alternate Group Number

If you selected the Use Alternate Group Number for Trans Set Indenitfier Code field, then you must enter a value. The system uses the alternate group number in place of the external partner ID when creating the concatenated transaction set identifier code.

Security Password Required

Select to enter a value in the Password field. This indicates there is security information associated with the HIPAA file.

Password

If you selected the Security Password Required field, then you must enter a 10-character password. The systems sets the ISA03 value to 01 in the ISA segment and then sends the password value in position ISA04.

Master Policy Number

Enter a value.

In the header of the HIPAAA file, the system includes a new REF segment (Transaction Set Policy Number) with a reference ID qualifier of 38 along with the master policy number that you entered in this field.

Subscriber Number

Select from the following values:

EmplID: The HIPAA process uses the emplID of the subscriber as the REF02 value in the REF*0F segment in loop 2000.

SSN The HIPAA process uses the social security or national ID number of the subscriber instead of the emplID. The records for dependents also use the subscriber's ID number for the REF02 value.

Last Control Number

The system increments this number with each transmission to the partner.

Initially the control number is set to 0. You can manually reset the control number, if necessary.

Field Separator

Enter the character to use to separate fields in each segment of the EDI file.

The default value is an asterisk (*), which is the value suggested by the reporting standard.

Segment Terminator

Enter the character to use to mark the end of each segment of the EDI file.

The default value is a tilde (~), which is the value suggested by the standard.

Subelement Separator

Enter the character to use to separate component data elements within a composite data structure of the EDI file.

The default value is a colon (:), which is the value suggested by the standard.

Repetition Separator

Enter the character to use to separate repeated data in the EDI file.

The default value is a carat (^). You can change this, but you must not enter any character used as a delimiter or terminator by another field.

File Name

Enter the name for the EDI file.

File Directory

Enter the directory where the file will be created.

If this field is left blank, the file will be created in the directory PS_SERVDIR.

Default EDI Code (default electronic data interchange code)

Each plan type has one default EDI code used in the HIPAA file, for example, HLT for Plan Type 10.

Original Description

The description of the code that is being mapped.

EDI 834 Value

The ASC X12.834 value corresponding to the PeopleSoft code or customer-defined code.

EDI 834 Description

The ASC X12.834 code description.