Editing a HIPAA X12 document

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The selections that you make in the HIPAA Validation Types area of the Edit X12 Inbound Trade Link window are used by Message Manager to determine the validation level of incoming HIPAA data.

Note: These fields are enabled only when the Inbound Group is for a HIPAA Version with a Functional ID code other than FA. Additionally, to enable these drop-down menus, at least one Structure Validation record must be imported, or manually added for levels 1 and 2 and at least one HIPAA Type Qualifiers Import (hipaa_x12_4010_qualifier.dat), or maintenance must be performed for levels 3; 4; 6; and 7, with one exception. In this exception, type 5 will be enabled if type 2, 3, or 4 is enabled and a HIPAA Type Qualifiers Import was run. For details related to the HIPAA Type Qualifiers Import, see the Chapter 3 of the Trading Manager Installation and User Guide.

You may select one of the following values for these fields:

  • Type1: Disabled; Enabled; or Reported in 997
  • Type 2: Disabled; Enabled; Enabled, Reported in 997; or Enabled, Reported in 999
  • Type 3: Disabled; Enabled; Enabled; Reported in 824; Enabled; Reported in 999; or Enabled, Execute Map
    Note: If Enabled, Execute Map is specified in Type 3, the Type 3 Map field must contain a value.
  • Type 4: Disabled; Enabled; Enabled, Reported in 824; Enabled, Reported in 999
  • Type 5: Disabled; Enabled; Enabled, Reported in 997; Enabled, Reported in 999
  • Type 6: Disabled; Enabled; Enabled, Reported in 824; Enabled, Reported in 999
  • Type 7: Disabled; Enabled; Enabled, Reported in 824; Enabled, Reported in 999

    You can only specify Type 7 if the External Application Partner for this link has a "HIPAA Institution" set.

    If any 824 reporting was selected, a box will be enabled to allow you to specify the version for the 824 transaction. The default version is 4050, but it can be changed to a value in the drop down list (currently versions 4050 and 4010 are available).

    For tradelinks for HIPAA version V4050X151 and functional ID "PI", if a type 4 824 or 999 report was selected, another check box in the HIPAA validation window is enabled to allow you to define how to perform validation for the BIN segments that might be present in those transactions. The default value is to perform no validation (Value=NEVER), but you can also specify the values "X" to perform only format validation, or "S" to perform validation against a Schema for both version and content. It is important in the last two cases to have the required schema file located in the same directory as the Message Manager maps.