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EDI Parsing and Validation FAQ

EDI Parsing and Validation Questions

1. What is HIPAA SNIP validation?

HIPAA SNIP validation is applied to X12 EDI documents to ensure the EDI data is HIPAA-compliant. Each succeeding WEDI-SNIP Type 1-7 increases the strictness of data constraints. Support of the higher SNIP levels (SNIP Types 4-7) in an EDI solution helps to ensure robust validation and HIPAA EDI compliance checks.

2. How are EDI X12 files validated?

Several parts of an EDI message can have problems that corrupt or invalidate the message contents. The EDI specification includes SNIP Types 1-7 (SNIP Levels) that define checks to make sure a given EDI message is EDI compliant and passes specific criteria for being well-formed. PilotFish provides SNIP validation out-of-the-box for Types 1-3 and Types 4-7 as an add-on. An additional EDI SNIP Validation Processor provides a preliminary overall sanity check.

3. Does PilotFish offer a comprehensive rules engine for HIPAA-compliant EDI file validation and error reporting?

Absolutely. PilotFish expertly conducts SNIP validations, ensuring both integrity and compliance. For example, EDI 835 files that are generated from EDI 837 files. This meticulous validation process not only identifies errors but also presents the findings in a user-friendly XML format. Additionally, users have the flexibility to either generate detailed reports or opt for exceptions based on these validation outcomes.

4. Does PilotFish provide comprehensive SNIP Levels 1 to 3 validation?

Yes, PilotFish’s base products include a thorough validation that spans the entire spectrum of SNIP standards, ensuring a detailed and complete verification process, far beyond mere surface-level checks. SNIP 1-3 is included automatically and SNIP 4-7 are optional add-ons.

5. How do you map and validate EDI 837 claim transactions to a database using an integration engine?

An Integration engine, or interface engine, allows you to send and receive messages, convert them to XML or another common format, validate them and map the contents of the EDI 837 transaction to a database. You can also create and generate the EDI 999 acknowledgment. To see this process in action with PilotFish’s Integration Engine watch the EDI 837 Claims Processing Integration video.

EDI 837 Data Integration with the eiConsole

EDI 837 Claim Data Integration

6. What tool parses EDI 837 and EDI 835 data to an SQL database?

Pilotfish’s eiConsole Interface Engine can configure interfaces to parse EDI 835 and EDI 837 messages and transform them into SQL inserts. Read more about X12 EDI Parsing.

7. How do you build EDI 270 transactions?

In the PilotFish Data Mapper, EDI messages can be graphically constructed into specific XML representations that the EDI Transformation Module can then convert into properly structured EDI messages.

8. Can the eiConsole for X12 by PilotFish map EDI 837, EDI 278 and other transactions to FHIR resources?

Yes, the PilotFish Mapper in the eiConsole for X12 can map any X12 or EDI transaction to any target transaction, resources such as FHIR, and API’s. The Data Mapper can also connect and map directly to SQL database tables.

9. Can PilotFish utilize a simple code script for universal file type validation and feedback?

Certainly. PilotFish’s versatile validation capabilities allow for a straightforward script to manage the validation of any file type. This efficient code extracts key details such as the X12 version and transaction type from EDI documents to ensure accurate SNIP validation.

10. How can I validate an EDI X12 270 without transforming it in PilotFish software?

To validate an EDI X12 270, or any other X12 transaction within PilotFish, it’s necessary to convert the EDI to XML because the validation is performed in XML format. This transformation is achieved effortlessly using the EDI transformation module.

11. Does PilotFish offer validation at both the file and transaction set or claim level?

Yes, with PilotFish, you’re able to perform validation not just at the file level but also at specific levels such as transaction set or claim level. You can customize the validation rules and use data mapping to achieve this.

12. Can I bypass specific validation rules in PilotFish?

Certainly. PilotFish offers the flexibility to omit select validation rules as per your requirements. We offer SNIP validation 1-7.

13. Can I perform validation at a particular repeating element level within a transaction set in PilotFish?

Absolutely! With PilotFish, you can not only validate at specific repeating element levels within a transaction set but also segment transactions based on the outcomes of these validations.

14. Is there a way to create a real-time EDI validation service using an API?

Yes, you can create a real-time EDI validation service using the software’s API capabilities. You can set up a RESTful Web Service Listener to receive EDI messages, initiate validations and return error diagnostics in JSON format seamlessly.

15. How does EDI integration work?

Interface engines integrate EDI data formats to target systems by transforming them first into a common format. EDI mapping is how the EDI source data is mapped from a common form to related target data fields, converted and output as XML, Excel, JSON, other EDI formats and other specified formats.

16. Can I create EDI inquiry file (270/271) from Excel data?

Yes, as long as the XLS file has all the data needed to generate X12 EDI 270/271 transactions you can use PilotFish to map the Excel fields to the 270/271 fields using XML and XSLT. Then you can transform the XML to EDI. You can do this for any X12 transaction.

17. What tool will validate EDI SNIP 1 and 2 files and debug exceptions in those files coming from our customers?

We recommend the eiConsole with the X12 EDI bundle (the bundle can be selected when you download the software or a free trial). The eiConsole can handle SNIP Type 1-7 (SNIP Level 1-7) validations.

18. Why is EDI healthcare parsing, mapping, and validation important?

It ensures accurate and efficient exchange of healthcare information, reduces errors and rework, and improves patient care and outcomes.

19. What are some challenges in EDI healthcare parsing and validation?

Complexity, varying standards, changing regulations, and manual errors are some common challenges in EDI healthcare parsing and validation.

20. How can EDI parsing and validation improve revenue cycle management?

It can help streamline claims processing, reduce denials and rejections, and improve cash flow by reducing the time and effort required for manual data entry and reconciliation. Read our Healthcare Revenue Recovery Solution case study.

21. How can EDI parsing and validation improve patient safety?

It can help ensure accurate and complete patient information, reduce medication errors, and improve care coordination and communication among healthcare providers.

22. What are some best practices for EDI healthcare parsing and validation?

Standardization, automation, continuous monitoring, and regular updates are some best practices for EDI healthcare parsing and validation.

23. What role does technology play in EDI healthcare parsing and validation?

Technology such as EDI software or middleware, artificial intelligence, and machine learning can help automate and improve the accuracy and efficiency of EDI healthcare parsing and validation processes.

24. What are some common errors that can occur during EDI parsing and validation?

Missing data, incorrect data formats, and invalid codes or values are some common errors that can occur during EDI parsing and validation.

25. How can EDI parsing and validation help with supply chain management in healthcare?

It can help streamline ordering, delivery, and payment processes, reduce errors, and improve visibility and transparency in the healthcare supply chain.

26. What is the role of HIPAA in EDI healthcare parsing and validation?

HIPAA sets standards for the secure and confidential exchange of healthcare information and requires compliance with specific rules and regulations for EDI data exchange.

27. How can EDI parsing and validation help with population health management?

It can help identify and analyze healthcare data at the population level, track outcomes and trends, and support preventive care and disease management initiatives.

If you have any additional questions or require further assistance, please don’t hesitate to contact our customer support team. Click on the button or jump into a chat.

X12, chartered by the American National Standards Institute for more than 35 years, develops and maintains EDI standards and XML schemas.

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