hipaa_to_hix.mms example map

This example shows how a HIX 834 is created. The map takes an initial enrollment structure and transforms it into an FFE compliance 834 for transmission to a qualified health plan (init_enroll_ffe_to_qhp).

There are two inputs to this map.

Input 1 - HIPAA 834 enrollment message. This is the same HIPAA message that is used to enroll members into private payer plans. Although the HIPAA 834 and the HIX 834 are similar (and based on the same transaction) there are some differences. This example map shows one possible way to fill in the gaps.
Input 2 - This input is a proprietary file that is used for lookup and data embellishment. This case uses a set of Member Reporting Categories with 'Maintenance Reason Codes'. The reason codes equate to the reason that this message is created, such as for a new enrollment, or to modify an existing enrollment.

There are two outputs from this map:

Output 1 - Temporary card output designed for interim results.
Output 2 - Manipulates the output 1, and is the final transformed product.