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RMAP Module

The RMAP (Redix Map for HIPAA) Module is an optional add-on to the Redix AnyToAny and Network Server-Based AnyToAny Format Converter Engines. The RMAP Module consists of a collection of HIPAA maps. These maps convert a file in the Redix internal format into a HIPAA file, and vice versa. Files in the Redix internal format are CSV (Comma Separated Value) files that encapsulate HIPAA data into a more concise and readable format. Many businesspeople find the Redix internal format easier to understand, while many programmers/system engineers find the format easier to program with because of the fewer number of records and fields. As a result, many Redix clients have adopted the Redix internal format as their own internal format for storing healthcare data.

Enterprises can use the RMAP Module to create HIPAA files. For example, if an enterprise wishes to create a HIPAA 837 Professional file, then the enterprise should first create a file in the Redix internal format instead of in the HIPAA 837 Professional format. After creating the file, the enterprise can simply plug the file into the Redix HIPAA map in the RMAP Module to generate the corresponding HIPAA 837 Professional file.

Enterprises can also use the HIPAA maps in the RMAP Module to validate and convert HIPAA files into files in the Redix internal format. The Redix HIPAA map will first validate the incoming HIPAA file. Only after the HIPAA file has been validated and deemed HIPAA-compliant will the file in the Redix internal format be generated.

The Redix internal format is a logical alternative to the complicated HIPAA format. Because the Redix internal format encapsulates the same data as the latest HIPAA formats, if an enterprise is able to store his healthcare data in the Redix internal format, then it does not have to worry about whether or not its data is HIPAA-compliant.

If an enterprise were to continue using his proprietary internal format alone, it would likely encounter future non-compliance issues. Non-compliance issues often involve resubmitting claims and wasting time and money. Redix is committed to ensuring that the RMAP Module and all other Redix products remain in total compliance with the latest HIPAA standards.

The following table compares the Redix internal format with the HIPAA format. Note that HIPAA segments are equivalent to records in the Redix internal format.

Redix Internal Format (RMAP)HIPAA Format
Complexity
  • Related data are grouped together in a single record, e.g.
    • One record for a single Billing Provider
    • One record for a single Subscriber
  • Does not use complicated Hierarchical Level (HL) segments
  • Minimum use of code qualifiers
  • Does not require any component element separators
  • Related data are split into multiple segments, e.g.
    • Seven segments for a single Billing Provider
    • Nine segments for a single Subscriber
  • Uses complicated Hierarchical Level (HL) segments
  • Extensive use of code qualifiers
  • Requires component element separators
Total Number of Segments or Records Has fewer records, e.g. an RMAP 837 Professional file has 35 records. Has more segments, e.g. a single HIPAA 837 Professional file has a total of 226 segments.
File Size Smaller file sizes, e.g. a typical RMAP 834 file is 76KB in size, smaller than the equivalent HIPAA 834 file, which is 94 KB. Both files contain the same information. Larger file sizes, e.g. if a HIPAA 834 file is 94KB in size, then the equivalent Redix RMAP file is around 76 KB. Both files contain the same information.
HIPAA Compliance Yes. Redix ensures that all generated files are 100% HIPAA-compliant. Yes
Backward Compatibility – Will new versions of the format support older versions? 100%

No, based on past history.

 

With Additional Database Module


With the optional Redix Database Module, data stored in the Redix internal format can be written to an ODBC-compliant database or generated from an ODBC-compliant database. Please refer to the Redix Database Module for more information.

The RMAP Module includes maps for each HIPAA transaction. The maps are divided into two categories: HIPAA to RMAP for users that receive HIPAA files, and RMAP to HIPAA for users that submit HIPAA files.

HIPAA to RMAP (Inbound Process):

Map NameSource Message TypeTarget 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 (Outbound Process):

Map NameSource Message TypeTarget 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 Review Response
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

 

  • Windows 2000 / XP / Server 2003 / Vista / 7 / Server 2008 / Server 2008 R2
  • UNIX (AIX 5.1+, Solaris 8/9/10, HP-UX 10+)
  • Linux (Red Hat, SUSE, etc.)
  • HIPAA

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