AHCCCS EDI Test Data and Privacy Requirements

EDI real-life production data enhances the overall value of the compliance testing process. If a covered entity elects to use production data in testing, it must ensure that it remains in compliance with all federal and state privacy regulations. Data (e.g., names and identification numbers) that would make it possible to identify particular individuals should be removed or encrypted. AHCCCS expects that patient identifiable information will be encrypted or eliminated from test data submitted to the certification testing system unless the testing system is in compliance with all HIPAA regulations concerning security, privacy, and business associate specifications.

There are two separate processes for testing with AHCCCS: Foresight Community Manager and file submissions using the Trading Partner’s TEST/EDI-IN (SFTP/EFT) directory.

Community Manager Testing

The Foresight Community Manager test site is a platform for trading partners to conduct EDI testing and validation of electronic data.

  • All 837 trading partners must satisfy the Community Manager scenario profile/test scenarios assigned to them prior to conducting end to end testing phase.
  • All 270/271 and 276/277 trading partners must successfully validate at least two 270/276 files in Community Manager prior to conducting end to end processing.
  • All test files uploaded to Community Manager should be 1MB or less.
  • There are no Community Manager test requirements for 835 and 275 Web Upload Attachment/275 Transaction trading partners.

Trading Partner’s file submission at SFTP/FTP TEST/EDI-IN

SFTP/FTP TEST/EDI-IN testing will be provided for the following EDI transactions:

  • 270/271
  • 276
  • 820
  • 835
  • 837 Claims
  • 837 Encounters
  • NCPDP PAH 2.2

File size limitation – Testing files cannot exceed 500 KB.

To learn more about HIPAA EDI testing and become a certified  EDI Professional please visit our course schedule page.

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