X12 messaging standard
X12 is a standard for EDI trading in commercial and non-commercial sectors. X12 has an underlying syntax, which is an ANSI standard.
Within that syntax, there are directories of data elements,
composite data elements, segments, and messages. There are conventions
for placing messages in an envelope
which identifies the
sender and receiver and other attributes of a transmission. For more
information on the X12 messaging standard, see the ASC X12 website.
X12 messages can be modeled using DFDL or MRM Tagged/Delimited String Format (TDS).
If you choose to use MRM, you can use the mandatory Interchange Control Header element to define the delimiters that are used in the message itself. To enable this element to be recognized as an X12 Service String, you must set the element property Interpret Element Value to X12 Service String. You must also set the delimiter values to the mnemonic values defaulted by setting the Message Standard property to X12.
HIPAA 5010 messaging standard
HIPAA X12 is a set of X12 transactions used within the Healthcare industry to exchange data about health insurance claims and payments. Support for reading, processing and writing all of the legally mandated HIPAA transactions is provided as part of the IBM® Integration Bus Healthcare Pack .
- 270: Eligibility Benefit Inquiry
- 271: Eligibility Information Response
- 276: Claim Status Request
- 277: Care Claim Status Response
- 278: Services Review Request
- 278: Services Review Response
- 820: Premium Payment
- 834: Benefit Enrollment
- 835: Claim Payment/Advice
- 837: Professional Claim
- 837: Institutional Claim
- 837: Dental Claim
- 277: Claim Acknowledgment
- 999: Implementation Acknowledgment