Frequently Asked Questions (HIPAA Package)
- What does the Redix HIPAA Package include?
- What is the difference between HIPAA_A1_837_Prof and HIPAA_A1_837_Prof_Outbound messages?
What does the Redix HIPAA Package include?
The Redix HIPAA Package bundles everything you need to build, test, and deploy HIPAA-compliant data exchanges and comprehensive EDI solutions for healthcare. It contains:
Redix AnyToAny Format Converter Engine: A high-performance runtime engine for versatile data transformations across formats.
GUI Mapper with EDI Authoring Tools: A point-and-click map designer and tester for intuitive EDI mapping.
HIPAA database: Incorporates all essential HIPAA EDI transaction sets, ensuring full HIPAA compliance.
Supported HIPAA transaction sets:
270/271: Health Care Eligibility/Benefit Inquiry and Information Response
276/277:Claim Status Request and Response
278: Health-care Service Review – Request for Review and Response
834: Benefit Enrollment and Maintenance
835: Claim Payment/Advice (**EDI 835 remittance**)
837: Claim (Institutional, Professional, Dental) (**EDI 837 claim**)
What is the difference between HIPAA_A1_837_Prof and HIPAA_A1_837_Prof_Outbound messages?
The HIPAA_A1_837_Prof message is the generic 837 professional definition defined in X12 4010. However, the HIPAA_A1_837_Prof_Outbound is a specific form of the 837 professional standard, based on HIPAA usage. The HIPAA_A1_837_Prof_Outbound has been rigorously defined in the usage of various segments and loops, and therefore, eliminates the possibility of vagueness in HIPAA data exchange.
It is highly recommended that users utilize the HIPAA_A1_837_Prof_Outbound as the target message definition to generate a HIPAA 837 message. Conversely, use the HIPAA_A1_837_Prof as the source message definition to convert a HIPAA 837 file.