Notes
Slide Show
Outline
1
A Repository Approach
to
HIPAA EDI Compliance
  • Presented by
  • Management Systems Consulting, Inc.
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Electronic Data Interchange
  • EDI - provides the ability to exchange business documents between trading partners without the laborious, time consuming, and error prone movement and handling of paper.


3
Healthcare Network
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Translation
  • The Rosetta Stone led to the modern understanding of hieroglyphs.
  • EDI leads to the formatting and translation of business documents.


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EDI Standard
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EDI Translation
  • ISA*00*          *00*          *30*999003060      *30*999756858     *010625*1133*U*00401*000000001*0*T*>~GS*BE*999003060*999756858*20010625*113309*1*X*004010X095~ST*834*1001~BGN*00*113309*20010625*113309*ET***2~N1*P5*CHIPSTERS*FI*236003060~N1*IN*HealthPlan*FI*299759958~INS*Y*18*021*28*A***FT*N~REF*0F*10000607209~REF*1L*35S1~REF*3H*10000607208~REF*6M*162991010~NM1*IL*1*George*Dallas*J***34*189783830~N3*144222 South Sixth Ave~N4*Scranton*GA*19904**CY*35~DMG*D8*19990324*M*I*C*1~LUI*LE*EN~NM1*QD*1*Maleta*Lisa*S***34*994648539~PER*RP**TE*5703416671~HD*021**HLT*Subsidized*IND~DTP*348*D8*20010701~REF*1L*35S1~INS*Y*18*021*28*A***FT*F~REF*0F*99000607213~REF*1L*43N1~REF*3H*99900607211~REF*6M*169911012~NM1*IL*1*Wyman*Sylvia*M***34*995784904~N3*PO Box 143~N4*West Middlesex*GA*16159**CY*43~DMG*D8*19980116*F*I*C*1~LUI*LE*EN~NM1*QD*1*Wyman*Sam*J***34*004681782~PER*RP**TE*5558138028~HD*021**HLT*Free*IND~DTP*348*D8*20010701~REF*1L*43N1~SE*35*1001~GE*1*1~IEA*1*000000001~
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EDI Segment Analysis
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Cost Reduction Potential
  • Full implementation of EDI capabilities provide the basic framework for substantial cost reduction.
  • Leverage existing workforce in more profitable activities.
  • Reduce/Eliminate paperwork, forms, filing and filing cabinets.


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Benefits
  • Improve Accuracy.
  • Reduce Data Entry Time & Staffing.
  • Reduce Operational Costs (office supplies, postal costs & telephone charges.
  • Efficient Information Delivery.
  • Improved relations with other organizations.
  • Create ‘Partnership’ relationships.
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Technology
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EDI Translator
  • An EDI Translator is a software tool that provides the ability to translate application data to/from standard formatted EDI transactions.
  • Translation codification is based on standards developed by Industry committee groups under the auspices of the American National Standards Institute (ANSI).
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Translator Components
  • Most EDI Translator tools are comprised of these sub-components:
  • Core EDI Standards translation engine.
  • Data Mapping Utility – map EDI data to application data base or files.
  • Mailbox (inbound/outbound) repositories for Trading Partner Transactions.
  • Communications Gateway
  • Proprietary Language/Scripting Dialogues
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Enterprise Accessible
  • Single Translator can serve multiple departmental entities.
  • Single Workstation or Server based implementation options.
  • Common Standards Repository.
  • Shared Resource Pool.
  • Increased Span of Control
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Component View
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EDI Integration
  • Synchronous Interaction
  • Asynchronous Interaction
  • Routing & Distribution
  • Rules-based Transformation
  • Application Integration
  • Rapid Implementation
  • Security, Audit Trails and Tracking
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Translator/Translation
  • Translator Functions
  • Software Tool
  • EDI Segment Processing according to ANSI Standards
  • Component Data Organization, Routing and Transport



  • Translation Functions
  • Application Data Base Integration
  • Business Rules and Application Data Flow
  • Security, Privacy, Audit & Control
  • Localized/Integrated Data Management
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EDI Resources
  • Complete business process support.
  • Pre-existing transaction sets defined for virtually any business process including HIPAA.
  • Open standards make communications between different systems and technologies possible.
  • Tested and Proven methodology.
  • With lower entry costs, available to even the smallest business enterprise today.


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EDI Repository
  • Translated EDI data stored in localized common data base tables.
  • Governed by Business Rules
  • Common SQL Data Base Access
  • Choice of Application Language Structures
  • Expandable to future use.
  • Auditable, Controllable & Secure
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Repository Features
  • Store EDI Data Elements required by Trading Partner or HIPAA exchange without defined storage in applications systems structure.
  • Gain control of inbound data in open and accessible format.
  • Provide staging area for outbound EDI data.
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EDI Translation Process
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Benefits
  • Reduced dependency on an outside vendor.
  • Broadened use of existing open data structures and coding standards.
  • Limit use of specialized expertise in proprietary/closed language and scripting.
  • Faster time to deployment of the EDI translation process.
  • Simplification of the overall translation process.
  • Future flexibility by broadening the access points into and out from the MMIS system.
  • Open systems accessibility to the gateway enabling easier Internet or web based application integration in the future.
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Thank You
  • Please call MSC, Inc.
  • 407-856-1691
  • or visit
  • http://www.msc-inc.net
  • For additional Information