Compliance Checking

EDI Compliance Checking For X12, EDIFACT And HIPAA Standard Requirements

EDI Compliance Checking is the process of incoming and outgoing X12/EDIFACT/HIPAA documents validation. The documents are being checked for compliance with the established and agreed formats.

There exist EDI Compliance Checking packs – frameworks that check incoming documents for compliance before they are transformed. After EDI documents are checked for compliance they are considered compliant and satisfy the established demands of trading partners. Usually frameworks check the document for envelope validity. Frameworks that check X12 standard compliance can log errors in the data and even create partner-neutral TA1 acknowledgement and 997 functional acknowledgements.

HIPAA compliance demands EDI file analysis based on the HIPAA standards and is a basic rule for the exchange of Medicare and health care insurance EDI documents. It is a well-known fact that HIPAA EDI files are difficult to check for compliance. Many of them often have errors (syntax errors, omitted loops, missing elements, wrongly formatted elements etc.). Speaking about HIPAA files we can say that all EDI files should be check very carefully before they come into receiver’s system.

Many modern EDI applications have in-built compliance systems that analyze both incoming and outgoing EDI transactions. The quality of the incoming and outgoing HIPAA EDI files is checked line by line, element by element, and after this error report is being provided.

There can be different types of compliance checking systems with various packs for detecting definite errors or analyzing special processes or files.

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