 |
|
|
|
|
 |
Healthcare |
|
|
|
|
HIPAA-EDI Translator
WING provided
Software Engineering
support for the acquisition
of an Electronic Data
Interchange (EDI)
Translator. The Translator
is used to achieve
HIPAA compliance,
while minimizing the
impact to the Department
of Health and Mental
Hygiene (DHMH) internal
system. The Translator
acts as an intermediary
to accept and send
HIPAA compliant data
to external systems
while sending proprietary
formatted data to
the Medicaid Management
Information System
(MMIS). The benefit
of this architecture
is that it limits
the modifications
to the current processing
logic on the internal
systems; thus allowing
interfaces for outside
organizations to be
left intact. This
also allows outside
organizations to adopt
support for HIPAA
on different schedules
and still be able
to integrate with
MMIS.
The Translator
integrates commercial
off-the-shelf software
(COTS) for EDI processing,
custom developed
processing software,
custom communications
software, and enterprise-class
servers and storage
devices.
Built on an Active/Active
Clustered Microsoft
SQL Server foundation,
the system is interfaced
via a BizTalk Server
group and BizTalk
Accelerator for
HIPAA. By using
BizTalk Accelerator
for HIPAA, which
provided the schemas
for the HIPAA transaction
development and
testing time, was
minimized. Several
organizations are
current implementing
BizTalk with BizTalk
Accelerator for
HIPAA for conducting
HIPAA-compliant
transactions. With
the added feature
of Microsoft Cluster
Services and SQL
Server in an Active/Active
Clustered environment,
the Translator has
proven to be a scaleable,
reliable and highly
available solution.
With the collaboration
of DHMH who provided
requirements from
its Claims and Eligibility
divisions, the WING
team developed a
conceptual design
and architecture
for the Translator
and basic mapping
for each of the
HIPAA transaction
to be implemented.
The requirement
spelled out the
implementation of
several HIPAA transactions
to include:
the 820, 837 Professional,
837 Dental, 837
Institutional, 835,
997, 270/271, 276/277,
278 and a Non-X12.
|
|
|
|
|
|
|
|
