I TA1/999 Generation on Error for HIPAA Documents

This appendix discusses the Interchange Acknowledgment (TA1) and document type 999 Functional Acknowledgment (FA) generation on error features of HIPAA documents.

HIPAA messages are used for information exchange. These messages are required to send the TA1 and 999.

The appendix contains the following sections:

I.1 Introduction

There are many kinds of acknowledgments for a HIPAA document that are exchanged between payer and receiver.

When an initiator sends a message, following are the different types of the acknowledgments in the order of precedence:

  • TA1 – Interchange level acknowledgment

  • 999 – Functional acknowledgment for 5010 versions and higher

The message flow is completed when TA1 or 999 is sent for inbound business message as shown in Figure I-1:

Figure I-1 TA1 Acknowledgment

Description of Figure I-1 follows
Description of "Figure I-1 TA1 Acknowledgment"

I.2 Creating TA1 Documents

You must create TA1 document type or document definition and trading partner agreement to generate and process TA1 messages. You must create TA1 document type/definition based on Interchange version of X12/HIPAA.

For example, if the Interchange is for "00501" version, TA1 should be created as follows:

  1. Open Oracle B2B console by accessing:

    http://<hostname>:<port>/b2b

    Where <hostname> is the name of the computer running Oracle B2B and <port> is the port number where Oracle B2B listens, typically 8001.

  2. Click the Administration link on top right corner and then click the Documents tab.
  3. Create Protocol Version 5010 under EDI_X12 interchange version as document protocol version.
  4. Create Protocol Document Type TA1 under 5010 version.
  5. Create Protocol Document Definition TA1Def (user defined name). When creating the TA1 document definition, TA1.xsd and TA1.ecs are automatically added by Oracle B2B console.

Figure I-2 displays the creation of a TA1 document.

Figure I-2 TA1 Document Creation

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Description of "Figure I-2 TA1 Document Creation"

After creating the TA1 document type and definition, you must add the TA1 document definition usage to the required Trading Partner and create the agreement for TA1.

Figure I-3 displays a sample TA1 agreement.

Figure I-3 A Sample TA1 Agreement

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Description of "Figure I-3 A Sample TA1 Agreement"

I.3 Configuring TA1

There are two ways to generate TA1 for inbound HIPAA messages.

You can either set it at Protocol Version as global or at the Trading Partner level. However, the value set at the Trading Partner level overrides the one set at the Protocol Version level.

The following are the values for TA1:

  • Always: TA1 is always generated.

  • OnError: A negative TA1 is generated if an invalid Interchange message is received.

  • None: No TA1 is generated regardless of valid/invalid Interchange content.

I.3.1 Configuring TA1 at the Protocol Version Level

You can configure TA1 at the Protocol Version level. To configure TA1, open the Protocol Version, such as EDI_X12-5010. In the Interchange tab, set the option for TA1 as shown in Figure I-4.

Figure I-4 Configuring TA1 at Protocol Version Level

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Description of "Figure I-4 Configuring TA1 at Protocol Version Level"

I.3.2 Configuring TA1 at the Trading Partner Level

You can also configure TA1 at the Trading Partner level. The value set at this level overrides the value set at the global level.

To configure TA1, select the Trading Partner, click the Documents tab, and click the HIPAA document such as EDI_X12-5010-TA1. Under the Version tab, click the Interchange tab, and set the value of TA1 as shown in Figure I-5.

Figure I-5 Configuring TA1 at the Trading Partner Level

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Description of "Figure I-5 Configuring TA1 at the Trading Partner Level"

I.3.3 Outbound and Inbound TA1

In the case of an inbound HIPAA message, an outbound TA1 acknowledgement is sent based on the following conditions:

  • If the value of the ISA14 segment of a HIPAA message is 0, then no TA1 is generated regardless of valid/invalid Interchange content or if TA1 is set to Always or OnError.

  • If the value of the ISA14 segment of a HIPAA message is 1 and if TA1 is set to Always, then a TA1 (positive/negative) is generated.

  • If the value of the ISA14 segment of a HIPAA message is 1 and TA1 is set to OnError, then a TA1 is generated for invalid Inbound Interchange content.

When an outbound HIPAA message is sent out with ISA14 = 1 (Interchange Acknowledgement Requested field in the Interchange tab is set to 1 in Figure I-4 or Figure I-5), the outbound message will be in MSG_WAIT_TA1 state until Oracle B2B receives an inbound TA1. However, the MSG_WAIT_TA1 state is overridden when a 999 acknowledgement is received.

I.4 Configuring 999 Acknowledgement on Error

Typically, a 999 Functional acknowledgment is sent when HIPAA messages with version 5010 and higher are received.

For this, you must select the Functional Ack check box under the Agreement parameters section in an agreement as shown in Figure I-6.

Figure I-6 Configuring Functional Acknowledgement in the Agreement level

Description of Figure I-6 follows
Description of "Figure I-6 Configuring Functional Acknowledgement in the Agreement level"

Functional Acknowledgement can be further configured in Document Type tab in the Documents page of the Trading Partner to select whether Functional Acknowledgement should be sent only in case of an error as shown in Figure I-7.

Figure I-7 Configuring Functional Acknowledgement on Error Only

Description of Figure I-7 follows
Description of "Figure I-7 Configuring Functional Acknowledgement on Error Only"

The value of the Functional Acknowledgement on Error Only check box is evaluated only if the Functional Ack check box is selected at the agreement level. If Functional Acknowledgement on Error Only is selected, then Functional Acknowledgement with only reject response is generated for invalid incoming messages; else no Functional Acknowledgement is generated.