Preview Draft 80X0
The ASC X12 Insurance Subcommittee, called X12N, is currently managing a series of public review periods to define new implementation guides for the healthcare insurance industry. These implementation guides will eventually replace the HIPAA adopted TR3s.
Because of the current status of the final versions of the implementation guides, the Pack for Healthcare includes examples that provide a preview based on the
current draft versions. These examples include a X12 8010 based schema with transactions covered by the implementation
guides under review, to allow for validation in accordance with WEDI/SNIP Type 1 EDI Standard
Integrity Testing. Also included are two schema to
allow for validation in accordance with the Type 2 HIPAA Implementation Guide Requirement Testing
for the Draft 8010 TR3 for these transactions:
- HP – Health Care Claim Payment/Advice – 835, Version 008010X322
- BE – Benefit Enrollment and Maintenance - 834, Version 008010X333
- HS – Eligibility, Coverage, or Benefit Inquiry – 270, Version 008010X332
- HB – Eligibility, Coverage, or Benefit Information - 271, Version 008010X332
For these transactions, step-up and step-down example maps are provided to demonstrate one way to transform data conforming to the HIPAA adopted version 5010 TR3’s to the draft TR3 requirements based on X12 8010.
The step-up maps also demonstrate one possible way to enrich the data with new information that is specified in the Draft 8010 TR3’s through JSON input.
The example files install within the imported project.