EDI
Education Seminar – Mastering HIPAA EDI Implementation Guides
(Two Days)
Designed
for Health Care Professionals
ALL
seminars start at 8:00 a.m.
Day
One:
- Session
One: Introduction to Health Care EDI
This session introduces the basic concepts, components and definitions
of EDI and its usage within the health care industry. The session
identifies the benefits of implementation, and the requirements
of the Health Insurance Portability and Accountability Act of
1996 (HIPAA).
- Session
Two: Introduction to ANSI X12 Standards
This session introduces the basic syntax on ANSI X12 standards.
The discussion then focuses on how the ANSI X12 standards form
the basis of the Health Care Implementation guidelines. The discussion
focuses on examples of EDI documentation utilized by the health
care industry.
- Session
Three: Getting Ready for Mapping
This session helps develop an understanding of the logic process
required to master Healthcare EDI implementation. This session
steps attendee through a comprehensive example using the (837)
health care industry professional claim.
- Session
Four: Continuation of 837 Claim Exercise
This session completes the example that was started during Session
Three.
- Session
Five: ANSI X12 Envelopes
This session identifies the detailed content of the EDI envelopes,
which are currently in use. It identifies how these envelopes
are used in different EDI environments. It also stresses how the
envelopes assist the EDI user address audit and control requirements.
It includes an exercise in which the participants create an envelope
consistent with the claim exercise. The topic will be presented
on Day One. The exercise will be completed at the beginning of
Day Two.
Day
Two:
- Session
Six: Envelope Exercise
This session will utilize the 837 claim exercise and the envelope
instruction developed on Day One as the basis of an example of
the various layers of ANSI X12 envelopes.
- Session
Seven: ANSI X12 Acknowledgments
This session provides a detailed description of the documentation
of the functional acknowledgment and the interchange acknowledgment.
Several examples of each are discussed. The session also provides
discussion of how the acknowledgment provides a valuable audit
tool.
- Session
Eight: Introduction to Financial EDI
The concepts and definitions used in financial EDI are reviewed,
and distinguished from electronic funds transfer. The concept
of PATH is stressed in this session. Several examples of PATH
variations are discussed. This discussion concludes with a discussion
of the barriers to implementation of financial EDI.
- Session
Nine: Remittance Advice for Health Care
This session is a working session. Attendees are lead through
an exercise using Health Care Implementation Guidelines, to develop
the structure of the 835 transaction set.
- Session
Ten: Advanced Health Care EDI Topics
This session will covers three advanced topics on Health Care
EDI. First we will discuss how to request changes or enhancements
to the HIPAA implementation guides. Second we will review the
Electronic Healthcare Network Accreditation Commission’s
(EHNAC) Standard Transaction Format Compliance System, which you
can use to test your transaction to see if they are compliant
with the HIPAA implementation guides. Lastly we will discuss technologies
you can use to secure your transmissions over the Internet.
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