Overview
The SPE Pack for Healthcare Payer is a healthcare industry accelerator that provides Business-to-Business (B2B) enablement for use with the IBM Standards Processing Engine (SPE).
The SPE Pack for Healthcare Payer facilitates
processing for organizations that exchange healthcare data that must
comply to the standards established by the Health Insurance Portability
and Accountability Act of 1996 (HIPAA). This solution provides general
B2B capabilities and the functionality needed for HIPAA-specific transaction
sets and related data standards.
- Ability to perform general B2B enablement functionality for HIPAA
ASC X12 based data and related transactions, as described here:
- Partner-specific configuration of B2B transaction processing options.
These processing options include the following options:
- Establish processing steps for inbound and outbound data based on trading partner relationships.
- Establish acknowledgement and reporting preferences.
- Establish compliance check requirements, including expected types of validation.
- External code set enablement utilities for establishing the allowable values for fields to be validated against lists that are provided by external sources.
- Inbound data processing flows determined by partner requirements that are based on configuration. These flows might include steps to remove envelope segments, validate incoming data, and report results.
- Outbound data processing flows determined by partner requirements that are based on configuration. These flows might include steps to remove envelope segments, validate data and report results.
- Enable data transformation by use of either the IBM B2Bi mapper, or the WebSphere Transformation Extender engine.
- Partner-specific configuration of B2B transaction processing options.
These processing options include the following options:
- Ability to perform healthcare-specific data processing in support
of HIPAA and related data formats:
- Components in support of WEDI/SNIP type 1 through 7 compliance check and reports
- WebSphere Transformation Extender type trees that are organized by WEDI/SNIP types.
- Subsystem to enable and disable specific WEDI/SNIP type 3, 4, 5, 6 and 7 rules.
- Example WEDI/SNIP type 5 External Code Set data and pattern based validation.
- Artifacts that are provided to support transformation of HIPAA and related data.
- Components in support of WEDI/SNIP type 1 through 7 compliance check and reports
- Example industry standard data files and transformations are provided.