Course: EDI Fundamentals and Best Practices - General
Designed for all industries.
Course Description
This course provides both an overview of EDI, and an in-depth understanding of the technology's strategic and operational
components. This is an excellent training opportunity for anyone whose work involves EDI, or who anticipates future
involvement in an aspect of their company's EDI efforts. What makes the EDI Academy's course unique is the application
of real world examples from a wide variety of companies and industries. You acquire a thorough understanding of EDI
fundamentals, know how best to overcome major EDI challenges, and the correct application of current best practices.
All the scenarios, case studies, examples and best practices are from real world EDI professionals.
Detailed Course Content
Course: Health Care (HIPAA) EDI Training Fundamentals and Best Practices
Designed specifically for the Health Care Industry 
Course Description
This intensive two-day class covers all 9 Health Care EDI Transactions. The course instructors have at least 10 years of
Health Care EDI experience and are typically EDI managers at insurance companies, hospitals, clearinghouses and other
health care organizations. This course also has section on 4010A1 vs. 5010 and contains everything you need to know about
5010 migration. The target audience for this class ranges from the novice to the seasoned professional. The novice will
be able to gain knowledge about Health Care fundamentals while the seasoned professional will gain best practices knowledge.
The course deciphers all 9 Health Care EDI transactions; every single segment and element of each of the 9 health care EDI
transactions will be analyzed and explained. For the most popular transactions there will be a mapping exercise conducted.
There will be an implementation best practices section for each of the 9 transactions which will discuss the advantages to
be gained and the pitfalls to avoid for each transaction. All the scenarios, case studies, examples and best practices are
from real world Health Care EDI professionals.
Detailed Course Content
Detailed Course Content - EDI Fundamentals and Best Practices - General
Session One: Introduction to EDI
This session defines EDI-its origin, history, and common terminology. It also describes how EDI has
evolved over the years to become a globally recognized standard for doing business electronically.
You learn the roles of different organizations that define and govern the EDI industry, including DISA,
VICS, and EIDX. Introduction of EDI standards such as ANSI X12, EDIFACT, and HIPAA is a key part of this
session. How EDI is used to compose business solutions in different industries (retail, automotive,
transportation, etc.) is explained, as well.
The second portion of this session is an overview of the personnel, software, and hardware components of a typical EDI setup.
Session Two: EDI Communication Methods
Communications is a critical area in any EDI implementation. This session emphasizes different
options (value-added networks, Internet EDI-AS1, AS2, FTP, etc.) available for moving vital
data from one place to another. It also focuses on EDI enveloping and provides a sample scenario
of setting up EDI communications with an EDI trading partner. Examples help you gain an in-depth
understanding of how an EDI implementation should be integrated with a company's internal network,
hardware, security, and software.
Session Three: Business Analysis and Mapping
EDI mapping requirements, and applying them from within an EDI translator. A detailed overview
and examples are provided on how the most common EDI transformations such as EDI-to-flat-file,
EDI-to-XML, EDI-to-CSV occur and how they can be integrated into a company's accounting, purchasing
and logistics software interfaces. This session also focuses on the most popular EDI transactions
such as the purchase order (850), invoice (810), payment file (820), advanced ship notice (856),
and common HIPPA transactions such as the 837 (claim) and 835 (claim payment/advice). Common mapping
and EDI translation barriers are covered, as well. A portion of this session describes what is involved
in creating EDI implementation guidelines.
Session Four: Strategies for Successful EDI Implementation
This session covers various real world examples of successful EDI implementation solutions.
It focuses on best practices for EDI partner communications, rollout programs, and chargeback
issues. It also includes information about frequently used barcodes, such as UCC labels, UPC codes,
and the use of GTIN. You also learn how EDI plays a key role in compliance-related environments such
as Sarbanes-Oxley and HIPAA.
Detailed Course Content - EDI Fundamentals and Best Practices – Health Care
Session One: Introduction to EDI
This session defines EDI-its origin, history, and common terminology. It also describes how EDI has evolved
over the years to become a globally recognized standard for doing business electronically. You learn the roles
of different organizations that define and govern the EDI industry, including DISA, VICS, and EIDX. Introduction
of EDI standards such as ANSI X12, EDIFACT, and HIPAA is a key part of this session. How EDI is used to compose
business solutions in different industries (retail, automotive, transportation, etc.) is explained, as well.
Session Two: Components of an EDI Environment and EDI Communication Methods
Communications is a critical area in any EDI implementation. This session emphasizes different options (value-added
networks, Internet EDI-AS1, AS2, FTP, etc.) available for moving vital data from one place to another. It also focuses
on EDI enveloping and provides a sample scenario of setting up EDI communications with an EDI trading partner. Examples
help you gain an in-depth understanding of how an EDI implementation should be integrated with a company's internal network,
hardware, security, and software. The second portion of this session is an overview of the personnel, software, and hardware
components of a typical EDI setup.
Session Three: Business Analysis and Mapping – Deciphering Health Care EDI Transactions
This session is the bulk of the course and it focuses on the nine Health Care EDI transactions:
270 - Health Care Eligibility Benefit Inquiry and Response
271 - Health Care Eligibility Response
276 - Health Care Claim Status Request
277 - Health Care Claim Status Response
278 - Health Care Services Review - Request for Review and Response
837 - Health Care Claim Institutional, Dental, Professional
835 - Health Care Claim Payment / Advice
834 - Benefit Enrollment and Maintenance
820 - Payroll Deducted and Other Group Premium Payment for Insurance Products
There will be an implementation best practices section for each of the 9 transactions which will discuss the
advantages to be gained and the pitfalls to avoid for each transaction. For the most popular transactions there
will be a mapping exercise conducted. All the scenarios, case studies, examples and best practices are from real
world Health Care EDI professionals.
Session Four: 5010 Migration
This session covers everything you need to know about migrating from 4010A1 to version 5010.
|