This page (revision-15) was last changed on 26-Nov-2021 10:22 by Kevin Higgs

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Page References

Incoming links Outgoing links
RBINTERFACE
RBINTERFACE

Version management

Difference between version and

At line 3 changed one line
The RBINTERFACE program creates a HIPPA ANSI 834 File layout for reporting benefit information to carriers.
!!Purpse
At line 5 changed 5 lines
!!Required Set Up
1) Report Parameters \\
2) IDIF\\
2) IMUF\\
The RBINTERFACE program creates a HIPPA ANSI 834(ANSI X12N 005010X220A1 (834) standard) File layout for reporting benefit information to carriers.
Interchange file segment ordering example\\
At line 11 changed 19 lines
!Report Parameters
||Report Parameters||Description
|__Entity__ |Mandatory, LOV Available\\You must enter one entity|
|__Interface Format Code__ |Mandatory, LOV Available\\You must select an interface code defined on IDIF (Sample ‘HL$ANSI-X12N834’)|
|__ASK Partner Number__ |Used to populate Segment ‘ISA’ element ‘06’; and Segment ‘GS’ element ’02’.
|__ISA Control Number__ |Used to populate Segment ‘ISA’ element ‘13’; and Segment ‘IEA’ element ‘02’.
|__GS Control Number__ |Used to populate Segment ‘GS’ element ’06’; and Segment ‘GE’ element ‘02’..
|__Master Policy Number__ |Used to populate Segment ‘REF’ element ’02’.
|__From Date__ |The starting date used for records to be included in the file|
|__To Date__ |The ending date used for records to be included in the file|
|__Plan Type__ |Mandatory, LOV Available\\You must select a Benefit plan type to process (Sample Dental,Medical, Vision,Health)|
|__This is a Test File__ |Value of ‘Y’ or ‘N’. Used to populate Segment ‘ISA’ element ’15’ (populate with ‘T’ for test file; and ‘P’ for production file).|
|__This is an Update File__|Value of ‘Y’ or ‘N’. Used to populate Segment ‘BGN’ element ’08’ (populate with ‘RX’ for replace action).|
|__Create File__ |Value of ‘Y’ or ‘N’. If set to 'N' no file will be created.|
|__Directory Name__ |Enter a valid directory name (Directory must be found on the database server)|
|__File Name__ |Enter a file name|
|__Include Exception__ |Value of ‘Y’ or ‘N’ (to include exception messages on the report)|
|__Exception Level__ |Values of ‘0’ to ‘9’ (more exception messages are displayed when a higher level number is used). Use Level-2 if you want to see all the records created (or will be created) on the file listed on the report.
!!Segment Ordering Sample
Interchange file segment ordering example:
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!Interface File Definition (IDIF) Set Up
*ISA\\
*GS\\
*ST\\
*BGN\\
*REF\\(employee and dependent details following)
**DTP ...
**1000A N1
**1000B N1
**1000C N1 (situational/optional)
***2000 INS ...
***2000 REF (0F)
***2000 REF (1L)
***2000 REF (F6) (situational/optional)
***2000 DTP ...
****2100 NM1
****2100A PER
****2100A N3 (required for subscriber)
****2100A N4 (required if 2100A N3 is included)
****2100A DMG
****2100C NM1 (situational/optional)
****2100C N3 (situational/optional)
****2100C N4 (situaional/optional)
****2200 DSB
****2200 DTP ...
*****2300 HD ...
*****2300 DTP ...
*****2300 REF (situational/optional)
*SE
*GE
*IEA
!!Required Set Up
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High Line supplies a standard IDIF file definition, __‘HL$ANSI-X12N834’__, for use with this process.
!1) Interface File Definition ([IDIF]) Set Up
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High Line supplies a standard IDIF file definition, __‘HL$ANSI-X12N834’__, for use with this process.\\
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Use IDIF to modify the file definition to contain the required value for the vendor.\\
Use IDIF to modify the IDIF file definition to contain the required value for the vendor.\\
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- The Beginning Position may always be defined as `1`\\
- The Ending Position must be defined in order for the program to know how many characters are required for each column.\\
- The Field Type must be defined as ‘Char’\\
- Constant Value, client must define the element value in this column as it is applicable to their own installation.\\
*The Beginning Position may always be defined as `1`\\
*The Ending Position must be defined in order for the program to know how many characters are required for each column.\\
*The Field Type must be defined as ‘Char’\\
*Constant Value, client must define the element value in this column as it is applicable to their own installation.\\
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| | | | | | | |
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- The following User Defined Feld (UDF) is required.  Setup on IMUF.
!2) The following User Defined Feld (UDF) is required on [IMUF].
At line 94 added 21 lines
!Report Parameters
||Report Parameters||Description
|__Entity__ |Mandatory, LOV Available\\You must enter one entity|
|__Interface Format Code__ |Mandatory, LOV Available\\You must select an interface code defined on IDIF (Sample ‘HL$ANSI-X12N834’)|
|__ASK Partner Number__ |Used to populate Segment ‘ISA’ element ‘06’; and Segment ‘GS’ element ’02’.
|__ISA Control Number__ |Used to populate Segment ‘ISA’ element ‘13’; and Segment ‘IEA’ element ‘02’.
|__GS Control Number__ |Used to populate Segment ‘GS’ element ’06’; and Segment ‘GE’ element ‘02’..
|__Master Policy Number__ |Used to populate Segment ‘REF’ element ’02’.
|__From Date__ |The starting date used for records to be included in the file|
|__To Date__ |The ending date used for records to be included in the file|
|__Plan Type__ |Mandatory, LOV Available\\You must select a Benefit plan type to process (Sample Dental,Medical, Vision,Health)|
|__This is a Test File__ |Value of ‘Y’ or ‘N’. Used to populate Segment ‘ISA’ element ’15’ (populate with ‘T’ for test file; and ‘P’ for production file).|
|__This is an Update File__|Value of ‘Y’ or ‘N’. Used to populate Segment ‘BGN’ element ’08’ (populate with ‘RX’ for replace action).|
|__Create File__ |Value of ‘Y’ or ‘N’. If set to 'N' no file will be created.|
|__Directory Name__ |Enter a valid directory name (Directory must be found on the database server)|
|__File Name__ |Enter a file name|
|__Include Exception__ |Value of ‘Y’ or ‘N’ (to include exception messages on the report)|
|__Exception Level__ |Values of ‘0’ to ‘9’ (more exception messages are displayed when a higher level number is used). Use Level-2 if you want to see all the records created (or will be created) on the file listed on the report.
\\
This page (revision-15) was last changed on 26-Nov-2021 10:22 by Kevin HiggsTop