WebSphere Data Interchange HIPAA Downloads

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What is HIPAA?
In 1996, in an effort to reduce Health Care costs, Congress passed the Health Insurance Portability and Accountability Act of 1996, commonly known as HIPAA. One part of this legislation requires health plans and providers to use a common format when electronically communicating health information. The Secretary of the Department of Health and Human Services (HHS) was put in charge of determining a standard that could accommodate this requirement. ASC X12 Insurance Subcommittee developed a set of implementation guides to meet these requirements and were ultimately approved by HHS as the common format to meet the electronic data requirements. These implementation guides were based off the Version 4 Release 1 of the ASC X12 North American Standards for Electronic Data Interchange. HIPAA legislation required compliance of these standards by October 16, 2002, for large providers and payers. In December 2001, the President signed into law the Administrative Simplification Compliance Act (ASCA). This act allowed a one year extension to the mandatory compliance date making compliance mandatory by October 16, 2003.

• HIPAA Support in WebSphere Data Interchange V3.2
• Download the Support Pack for HIPAA
• HIPAA Support in WebSphere Data Interchange V3.1
• WDI 3.1 Sample Maps for HIPAA Validation and Standards

WebSphere Data Interchange v3.2

How does IBM support these electronic standards?
IBM’s WebSphere Data Interchange supports ASC X12 standards and compliance as base function. Understanding that the HIPAA electronic data requirements are a subset of these standards, and realizing the number of customers that will need to implement quickly, IBM created the Support Pack for HIPAA for WDI 3.2, which supports the HIPAA Addenda 1 (4010A1) message format.

What is the Support Pack for HIPAA
The Support Pack for HIPAA enables customers to send and receive HIPAA transactions. It validates the inbound or outbound transmission and then transforms the transaction from X12 to XML. The Support Pack for HIPAA includes collaborations for HIPAA transactions that enable integration with customers’ existing back end data processing systems using the IBM WebSphere InterChange Server V4.2.2 and the IBM WebSphere Business Integration Collaborations for HIPAA Transactions V1.1.1. The IBM WebSphere InterChange Server provides a distributed infrastructure to process and route business information among disparate applications in the enterprise environment.

The Support Pack for HIPAA is supported on Microsoft Windows systems and AIX operating systems. It contains the following components:

• Standards - The definition files for each X12 HIPAA transaction. The standards contain a subset of the loops, segments, and code lists in the X12 4010A1 standards needed for compliance with the HIPAA Implementation Guides.
• Code Lists - The tables that provide the acceptable values for a HIPAA data element. Code Lists are provided for all elements except Snip Type 5 and 6. Snip Type 5 and 6 code lists must be obtained from an external source and imported into WebSphere Data Interchange.
• Validation Maps - The Validation Maps validate outbound and inbound X12 HIPAA transactions for implementation guide compliance and can issue 997 Functional Acknowledgements back to the trading partner to indicate non-compliance with the appropriate implementation guide.
• Transformation Maps - The Transformation Maps are a set of mapping instructions that describe how to translate the outbound and inbound X12 HIPAA transactions into XML using the HIPAA DTDs provided with this package.
• DTDs - The XML definitions for the X12 HIPAA transactions.
• Configuration Files - The files to configure the Support Pack for HIPAA on WebSphere Data Interchange and the WebSphere InterChange Server.
• Bridge Collaborations - The custom collaborations that connect the WebSphere Interchange server with WDI. The Bridge Collaborations split a single HIPAA transaction with multiple loops into multiple transactions with single loops so the WebSphere Business Integration Collaborations for HIPAA Transactions can process the message.
• CodeSetHandler Utility - A utility that converts externally-obtained code sets for SNIP level 5 and 6 validation from comma separated value (CSV) file format to the EIF file format supported by WDI.

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Download the Support Pack for HIPAA

1. To download the HIPAA Support Pack, click the package for your operating system.
2. Specify the drive and directory for the .zip or .tar file.
3. Use either an unzip utility on a Windows system or the tar command on an AIX system to unpack the file.
4. Read the HIPAA readme.txt file for important installation information.
5. Read the Support Pack for HIPAA PDF file located in the doc subdirectory for installation and configuration information.

License information
The Programs listed below are licensed under the following terms and conditions in addition to those of the International Program License Agreement.
Program Name: WebSphere Data Interchange Support Pack for HIPAA V1.0
Program Number: N/A
Authorization for Use on Home/Portable Computer: 2

Explanation of terms
Authorization for Use on Home/Portable Computer:
"1" means that the Program may be stored on the primary machine and another machine, provided that the Program is not in active use on both machines at the same time.
"2" means that you may not copy and use this Program on another computer without paying additional license fees.

Specified Operating Environment
The Program's specifications and specified operating environment information may be found in documentation accompanying the Program, if available, such as a read-me file, or other information published by IBM, such as an announcement letter.

Program-unique Terms

1. HIPAA Compliance Disclaimer: Customers are responsible for ensuring their own compliance with the Health Insurance Portability and Accountability Act. It is the customer's sole responsibility to obtain advice of competent legal counsel as to the identification and interpretation of any relevant laws, including but not limited to, the Health Insurance Portability and Accountability Act, that may affect the customer's business and any actions the customer may need to take to comply with such laws. IBM does not warrant or represent that its services or products will ensure that customer is in compliance with any law
2. WDI Support Pack for HIPAA product usage: The WDI Support Pack for HIPAA may only be used in conjunction with the WebSphere Data Interchange Server and WebSphere Data Interchange Client product(s) for the purposes of preprocess validation and transformation of Health Insurance Portability and Accountability Act of 1996(HIPAA) messages that comply with the established October 1997 ASC X12 Standards, referred to as Version 4, Release 1, Sub-release 0 (004010), Addenda 1 (aka 4010A1) message format. A copy of the Websphere Data Interchange product license may be located in \\license\wdilicense.txt, where is defined by the customer when they download the WDI Support Pack for HIPAA.

Technical support
Category 3 SupportPacs are supplied under the standard terms and conditions provided by the International Program License Agreement (IPLA) and thus, carry program defect service.

If you encounter what you believe to be a defect with the SupportPac you may request Program Services, by reporting the problem via the same defect reporting channel you use for the WebSphere Data Interchange product with which you are using the SupportPac. This product must itself have service support.

Please read the license files that accompany the SupportPac to determine if you want to download and use it. No proof of Entitlement or License Information is required to use this SupportPac.

Service is available for this SupportPac for as long as the WebSphere Data Interchange product specified as pre-requisite has service support.

HIPAA Support Pack for AIX:



HIPAA Support Pack for W2K:

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WebSphere Data Interchange v3.1
IBM WebSphere Data Interchange version 3.1 provides limited HIPAA validation. This validation is for inbound processing only, and includes the following as defined in each implementation guide:

• Segment usage
• Element usage
• Intersegment dependency
• Segment to segment dependency
• Loop dependency

The WebSphere 3.1 HIPAA receive map solution uses the MAPCHAIN, MAPSWITCH, and global variable features to perform HIPAA validation to the original HIPAA standards as published in May 2000. The following maps for 3.1 are provided as samples to accelerate HIPAA implementation. There is a separate file which includes the standards addenda as published in October 2002. The associated README.TXT file identifies the appropriate commands that must be added to the first element of the appropriate translation maps to activate the validation for receive processing. This validation process requires that the appropriate edits be placed on the next mandatory element in the transaction, as defined in the standard, for that reason the 997 Functional Acknowledgment will produce the proper error codes, however, the segment and element identified may not be accurate for most situations.

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Maps for HIPAA validation and Standards
HIPAA Standards and readme.txt:  hipaastds.zip
HIPAA 270 - Health Care Eligibility Inquiry:  hipaa270.zip
HIPAA 271 - Health Care Eligibility Response:  hipaa271.zip
HIPAA 276 - Health Care Claim Status Request:  hipaa276.zip
HIPAA 277 - Health Care Claim Status Response:  hipaa277.zip
HIPAA 278 - Health Care Services Review Request:  hipaa278req.zip
HIPAA 278 - Health Care Services Review Response:  hipaa278resp.zip
HIPAA 820 - Payroll Deducted and Other Group Premium Payment
  for Insurance Products: hipaa820.zip
HIPAA 834 - Benefit Enrollment and Maintenance: hipaa834.zip
HIPAA 835 - Health Care Claim Payment/Advice: hipaa835.zip
HIPAA 837 - Health Care Claim: Institutional: hipaa837-i.zip
HIPAA 837 - Health Care Claim: Dental: hipaa837-d.zip
HIPAA 837 - Health Care Claim: Professional: hipaa837-p.zip

1. To download the HIPAA file of your choice to your PC, click on the above.
2. Specify the drive and directory for the zipped file.
3. Unzip the file using an unzip utility.
4. Read the HIPAA Readme File.txt file.
5. Import the file (.eif) into DataInterchange Client using the Import facility.

Standards for Addenda Level
Addenda Standards: addenda-wdi31.zip

For outbound processing, it is suggested that the appropriate data checks be included in the appropriate application programs before the data enters WebSphere Data Interchange for translation.

Note: These files are provided as sample to help accelerate a HIPAA implementation. These maps were generated at the base level of the HIPAA Implementation Guidelines.

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