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What is Redix RMAP module?

RMAP is the shorthand term for “Redix Map for HIPAA”. The RMAP module consists of a collection of HIPAA maps. These maps convert to and from the HIPAA healthcare standards and Redix internal formats. The Redix internal formats are CSV (Comma Separated Value) formats that encapsulate HIPAA data into a more concise, usable, and readable format.

What is the purpose for Redix to develop the RMAP module?

Many healthcare companies have been using the UB92 or NSF standards in the past for healthcare claims. Unfortunately, both the UB92 and NSF standards do not have all of the data that HIPAA requires. Therefore, when converting a HIPAA message into a UB92 message, some HIPAA data will not be passed. On the other hand, some healthcare users do not support the X12 or HIPAA standards, and neither do they support the NSF or UB92 standards. Instead, they use some proprietary file format for healthcare claims or eligibility checking. Their claim data are stored in databases, and they need to generate HIPAA messages out of their databases.

RMAP was developed to streamline the process and remain completely HIPAA compliant. RMAP is a much simpler data format that preserves all of the HIPAA-mandated data.

What are the advantages of using the RMAP module?

Advantages of using the RMAP module are:

  • smaller size files; fewer records and fields and much easier to develop
  • easier to understand from a business perspective
  • quicker translation time
  • an easier way to query to and from databases
  • a provided crosswalk shows how each RMAP element maps to a HIPAA element

As a result, many clients have adopted the Redix RMAP formats as their own internal database format for storing healthcare data.

Can the Redix RMAP module be licensed alone?

No, the RMAP module is an add-on module on the Redix AnyToAny Format Converter Engine. The user will need to license the Redix AnyToAny Format Converter Engine as well.

What does RMAP module include?

The RMAP module consists of the maps of each HIPAA transaction. Also, the maps are divided into two categories: HIPAA to RMAP and RMAP to HIPAA.

HIPAA to RMAP:

Map Name Source Message Type Target Message Type
HIPAA_A1_NPI_270_to_RMAP_4 HIPAA 4010A1 (NPI) 270 Eligibility Request Redix RMAP Version 4 270
HIPAA_A1_NPI_271_to_RMAP_4 HIPAA 4010A1 (NPI) 271 Eligibility Response Redix RMAP Version 4 271
HIPAA_A1_NPI_276_to_RMAP_4 HIPAA 4010A1 (NPI) 276 Claim Status Request Redix RMAP Version 4 276
HIPAA_A1_NPI_277_to_RMAP_4 HIPAA 4010A1 (NPI) 277 Claim Status Response Redix RMAP Version 4 277
HIPAA_A1_NPI_278_REQ_to_RMAP_4 HIPAA 4010A1 (NPI) 278 Services Review Request Redix RMAP Version 4 278REQ
HIPAA_A1_NPI_278_RES_to_RMAP_4 HIPAA 4010A1 (NPI) 278 Services Review Response Redix RMAP Version 4 278RES
HIPAA_A1_NPI_820_to_RMAP_4 HIPAA 4010A1 (NPI) 820 Group Payment Remittance Redix RMAP Version 4 820
HIPAA_A1_NPI_834_to_RMAP_4 HIPAA 4010A1 (NPI) 834 Eligibility Audit Report Redix RMAP Version 4 834
HIPAA_A1_NPI_835_to_RMAP_4 HIPAA 4010A1 (NPI) 835 Claim Remittance Advice Redix RMAP Version 4 835
HIPAA_A1_NPI_837_Inst_to_RMAP_4 HIPAA 4010A1 (NPI) 837 Institutional Claim Payment Request Redix RMAP Version 4 837I
HIPAA_A1_NPI_837_Dent_to_RMAP_4 HIPAA 4010A1 (NPI) 837 Dental Claim Payment Request Redix RMAP Version 4 837D
HIPAA_A1_NPI_837_Prof_to_RMAP_4 HIPAA 4010A1 (NPI) 837 Professional Claim Payment Request Redix RMAP Version 4 837P

RMAP to HIPAA:

Map Name Source Message Type
Target Message Type
RMAP_4_270_to_HIPAA_A1_NPI Redix RMAP Version 4 270
HIPAA 4010A1 (NPI) 270 Eligibility Request
RMAP_4_271_to_HIPAA_A1_NPI
Redix RMAP Version 4 271
HIPAA 4010A1 (NPI) 271 Eligibility Response
RMAP_4_276_to_HIPAA_A1_NPI
Redix RMAP Version 4 276
HIPAA 4010A1 (NPI) 276 Claim Status Request
RMAP_4_277_to_HIPAA_A1_NPI
Redix RMAP Version 4 277
HIPAA 4010A1 (NPI) 277 Claim Status Response
RMAP_4_278REQ_to_HIPAA_A1_NPI
Redix RMAP Version 4 278REQ
HIPAA 4010A1 (NPI) 278 Services Review Request
RMAP_4_278RES_to_HIPAA_A1_NPI
Redix RMAP Version 4 278RES
HIPAA 4010A1 (NPI) 278 Services
RMAP_4_820_to_HIPAA_A1_NPI
Redix RMAP Version 4 820
HIPAA 4010A1 (NPI) 820 Group Payment Remittance
RMAP_4_834_to_HIPAA_A1_NPI
Redix RMAP Version 4 834
HIPAA 4010A1 (NPI) 834 Eligibility Audit Report
RMAP_4_835_to_HIPAA_A1_NPI
Redix RMAP Version 4 835
HIPAA 4010A1 (NPI) 835 Claim Remittance Advice
RMAP_4_837D_to_HIPAA_A1_NPI
Redix RMAP Version 4 837D
HIPAA 4010A1 (NPI) 837 Dental Claim Payment Request
RMAP_4_837P_to_HIPAA_A1_NPI
Redix RMAP Version 4 837P
HIPAA 4010A1 (NPI) 837 Professional Claim Payment Request
RMAP_4_837I_to_HIPAA_A1_NPI
Redix RMAP Version 4 837I
HIPAA 4010A1 (NPI) 837 Institutional Claim Payment Request

 

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