EDI GLN Account

EDI GLN Account Hierarchies (Parties and Locations) GLNs are designed to support unique and unambiguous identification of parties/locations in business processes, which is essential for efficient communication between trading partners. The GLN can be used to identify a functional entity (like a hospital pharmacy or accounting department), a physical location (like a warehouse or hospital Read More →

EDI Packing

EDI Packing Product Hierarchy (GTIN Implementation) GTINs are globally unique identifiers for “trade items” (i.e., any item that may be priced, ordered, or invoiced at any point in any supply chain). When goods are traded between trading partners, various packaging levels can be involved depending on the type of product and the extent of exchange. Read More →

GLN

GTINs and GLNs Prepare for Implementation Prior to GTINs and GLNs implementation, it is essential to assess the effort needed to implement GTINs and GLNs in current systems and transactions. Key aspects of this effort include assessing internal systems, engaging with trading partners about readiness, and determining the transactions in which GTINs and GLNs are Read More →

HIPAA EDI

EDI Product and Location Identification In Transactions EDI transaction standards support numerous types of identifiers for products and parties/locations, including both GS1 identifiers and Non-GS1 identifiers. The following tables list product identifiers and party/location identifiers that are commonly used in U.S. healthcare EDI transactions today. Product identifiers commonly used in U.S. healthcare EDI transactions Party/location Read More →

EDI Order-to-Cash Transactions

EDI Order-to-Cash Transactions in U.S. Healthcare Using GTINs and GLNs in EDI business messaging instead of proprietary identifiers can help improve transaction accuracy and efficiency, and more fully support traceability from the manufacturer to the patient / end user. GS1 guidelines describe key aspects of Order-to-Cash transactions in U.S. healthcare. 850 Purchase Order Used by the Read More →

Implementing GLNs

Implementing GLNs and GTINs in Order-to-Cash Transactions (GS1 Healthcare US) When identification standards are not widely used across an industry, trading partners often use nonstandard and proprietary identifiers. This practice can result in multiple identifiers for the same product (e.g., buyer’s part number; supplier’s catalog number; vendor’s item number; etc.) or party/location (e.g., DUNS Number; Read More →

EDI Transmission Security

  EDI Transmission Security Protocols Prevea360 Health Plan requires 834 files to be PGP encrypted with its public key. Prevea360 requires PGP encryption, in addition to transmission via the SSH security protocol, to achieve a defense-in-depth/layered security posture for the protection of member/customer confidentiality. SFTP (SSH file transfer protocol) provides protection of the data in transit from the Read More →

834 Test File Validation

834 Test File Validation Prevea360 will review and test all trading partner files with Optum Transaction Testing Service to perform SNIP level validations to ensure that transactions are valid using the following testing categories. Integrity Testing Requirement Testing Balancing Testing Situation Testing Code Set Testing Product Types/Types of Service Testing. The EDI team will work Read More →

834 Transaction Scenarios

834 HIPAA Transaction Scenarios (Prevea360 Health Plan) In today’s post we offer four 834 Transaction Scenarios. Find below the description and mapping. Adding a Subscriber Scenario John Doe is enrolling into the plan as a new-hire. His coverage is effective 4/1/17. His employment begin date is 4/1/17. Changes include transactions such as address, name, phone Read More →

835 5010 Mapping

EDI 835 5010 Mapping Excersise Try your HIPAA EDI skills in EDI 835 5010 Mapping Excersise. Find the scenario below. The Outbound 837P, completed in Exercise 1, was sent on to Blue Cross the payer. The Claim was adjudicated and Blue Cross has transmitted the 835 5010A1 transaction directly to the receiving billing provider, Abuncha Physicians. Within Read More →