Edi testing 834 filr testing forum5/24/2023 Using them in conjunction with SSIS, I'm passing raw EDI files through the parser via a ExecProcess task, and then using the resulting flat file in the data flows. Not sure where you're at in your progress, but in our processing of 834/835 files, we use home-grown parser apps to break the files down into more of a flat-file layout, which makes them easier for actual data processing (they're each slightly modified/tweaked from the x12 specs in order to be better used from what our partners send us and for what our business needs are). None of my searches have come up with anything worthwhile. I'm just wondering if anyone has published anything on this topic that would give me some new options to consider. I know at least one way to accomplish this. It turns out that accomplishing this is not as easy as it looked at first. For example, if I'm processing purchase orders (X12-850 format), I'd like to have the SSIS package writing the header and detail records directly to the DB tables without having to temporarily storing the individual segment then having a separate process creating the header and detail records from the temporary storage. I'm trying to develop a methodology that would keep most, if not all, of the processing inside a SSIS DataFlow. When I first started thinking about this it sounded pretty simple. I’m wondering if anyone has found a good (or any) reference for doing EDI with SSIS using X12 format files. I'm looking to improve my knowledge of how to do thing using SSIS, and I'm hoping to turn this into a PASS Chapter presentation, and possibly into an article also. The test system is secure and HIPAA privacy compliant.Let me start by saying that I'm not looking for assistance in solving a work problem. Your claims will deny in the test adjudication system if invalid data is used such as a dummy MassHealth member ID number. You must use real patient data to ensure proper editing during the testing process. Can I use test data in my test or do I need to use real patient data? At this point, it is strongly encouraged that all submitters begin using the 837 format as soon as possible.ġ2. If I pass compliance testing, do I need to begin billing in the 837 format right away? Yes, when you receive your test results back from the EDI testing team, the 999 will be be available for you to download from the test environment within 2 hours after submitting a file that passes pre-compliance.ġ1. Will I receive a 999 acknowledgement from my test file? All compliance and adjudication errors will be reported back to you.ġ0. If you are set up for 835s, you may download the 835 from the test environment. Test claims will not process nor will they appear on any MassHealth remittance advice or 835 files received from the production environment. Will my test file be run through MassHealth editing or just a compliance check?Įach test file will be validated for format and content compliance including MassHealth claims adjudication edit testing. On average it takes two - three tests for a submitter to be approved for production.ĩ. How many test files does it take the average submitter to become HIPAA compliant for the 837 transaction? Who do I contact if I am having trouble submitting my test file or to check on test results?Ĭontact MassHealth Customer Service at 1-80 or email: Is there a limit to the number of claims I can submit in my test file?Ĩ. Please check the MassHealth website periodically for updates: Ħ. To request a copy of any of the MassHealth Companion Guides please contact MassHealth Customer Service at 1-80. "Test" claims will not be submitted for production adjudication processing.ĥ. The claims sample should contain valid claims data and be representative of the types of service and scenarios that your facility typically bills to MassHealth. If you are planning to submit void and replace and COB claims, you should include those claims in your test file. How many claims should I submit in my test file?īetween 10 and 15 claims are sufficient for testing. Yes, if you are still using your previous version of software or have not yet implemented changes to your system, you may test and submit Production EDI claims to the test environment at the same time.Ĥ. To ensure successful claims processing, it is strongly suggested that you retest after any software or system change.ģ. Yes, any software or system change can affect the outputted claim. Do I need to retest after making software or system changes? They can access this information by going to the Vendor List page.Ģ. MassHealth provides a list of approved software vendors. What software vendors are authorized to submit EDI claims to MassHealth?
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