X12 translation question

[Mark McDaid]

Hello clovertechers,

I have a question.  I don’t know anything about the X12 format, I have only been working with HL7.  I’m trying to find out if it is possible to translate an 837 claims message to an HL7 DFT message.  Has anyone ever done anything like this, or is it even possible?

Thanks,

Topic

[Jim Kosloskey]

Mike,

This is possible. I have never done this exact integration but going to HL/7 fro X12 is doable.

Some things of which to be aware:

The X12 message will come with an envelope. The envelope needs to be removed to reference the message in an Xlate. Clovelreaf provides a package and a proc to do this. However, the provided proc (hcisplitinterchange is the name I think) has a flaw (at least up to Cloverleaf 5.6). I have a replacement proc that eliminates that flaw – let me know if you want that. You would use this proc at the inbound TPS most likely.

You should get the Implementation Guide for the 837 Transaction Set. You may be able to get that from the X12 organization if this is NOT 004010 or later otherwise you may need to get the Implemenation Guide from Washington Publishing (there could be a charge).

You should also have an 837 (possibly 835/837 pair) Companion Guide from the trading partner who is sending you the 837.

The Implementation Guide tells you the standard, the Companion Guide tells you how the Trading Partner is deploying the standard.

Ideally you should have a detailed HL/7 specification from the receiving Trading Partner.

You will need to determine (hopefully with the assistance of the two trading partners) what gets mapped from the X12 837 to the HL/7 DFT.

Take some time to gt familiar with the X12 837 Transaction Set by reading the Implementatikon and Companion Guides. X12 is generally steeped in ‘Levels’ and ‘loops’ which can be a challenge initially to get your head around. In the Xlate it can mean lots of ITERATEs.

email: jim.kosloskey@jim-kosloskey.com 29+ years Cloverleaf, 59 years IT - old fart.

[Mark McDaid]

Thanks for the quick reply, Jim.  I do have the implementation guide for the 837.  It’s a whopping 742 pages, so it’s a bit difficult to digest, that’s why I wanted to check and make sure what we are trying to do is even possible before I spend a lot of time working on this.  Thank you for the insight.  Sounds like this is going to be quite a challenge.  🙂

Thanks,

[Jim Kosloskey]

Mark,

That is why you could use the Companion Guide.

The Implementation Guide covers the total use of the Transaction Set.

One generally finds the Companion Guide to be more succinct. Moreover there are the particulars like what codes to use where which are only identified as existing in the Implementation Guide but specifically addressed in the Companion Guide.

As to whether this is doable – mechanically it is.

But everything depends on what is provided by the source Trading Partner and what is expected by the receiving Trading Partner. You won’t know for sure until you have discussions about  what is wanted and what is provided.

email: jim.kosloskey@jim-kosloskey.com 29+ years Cloverleaf, 59 years IT - old fart.

[Mark McDaid]

Jim,

Could you post the replacement hcisplitinterchange proc that you mentioned that fixes the flaw?

Thanks,

[Jim Kosloskey]

Mark,

email me and I will send it to you.

email: jim.kosloskey@jim-kosloskey.com 29+ years Cloverleaf, 59 years IT - old fart.

[Mark McDaid]

Ok, I’ve sent you an email to the address you have listed.

Thanks,

[Author]

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