Hello all!

Please allow me to introduce myself, my name is Tony Bernard and I am a Senior Program Manager on the BizTalk Server team. I am taking over for Suren Machiraju who, as relayed in his final post, has moved on to new and exciting opportunities elsewhere within Microsoft.

I want to take this opportunity to thank Suren for his many years of dedication and leadership on the B2B team!

In my inaugural post, I thought I would discuss a lesser known dimension of the R2 EDI feature set, but one that we have received several questions about – HIPAA support.

Beginning with the R2 release of BizTalk Server 2006 you will no longer need to purchase or install a separate accelerator to get HIPAA support in BizTalk. HIPAA support will be integrated into the EDI engine that installs with R2. In addition to the all the great features that you get with R2 EDI such as partner agreement management, batching, schema extensibility, and interchange/ack reporting you will also get:

  • key HIPAA 4010A transaction set schemas:
    – 270/271 – Eligibility
    – 276/277 – Claim Status
    – 278 – Services Review Request/Response
    – 820 – Payroll Deduction
    – 834 – Benefit Enrollment
    – 835 – Claim Payment
    – 837D – Claim Dental
    – 837I – Claim Institutional
    – 837P – Claim Professional

  • ten other non-HIPAA standard schemas that are widely used in the HIPAA realm, including but not limited to:
     – v3070 277 Healthcare Payer Unsolicited Claim Status
     – v4010 148 Doctor’s First Report of Injury
     – v4040 277 Healthcare Claim Acknowledgement
     – v4050 274 Healthcare Provider Information

  • a schema annotation which enables splitting a multiple part document (e.g. a 837 Claim that has many individual claims) into separate transactions, one for each individual document. This feature is enabled by an annotation called ‘subdocument_break’. When assigned a value of “yes” it will split an inbound transaction into individual transaction sets based on the number of documents included in the original transaction set. For example, an inbound 837D with three separate claims in it would be split into three separate 837D transaction sets with all of the appropriate header information included in each.

  • WEDI/SNIP level 2 validation which includes basic X12 syntax integrity as well as validation of loops, segments, elements and code values.

If there are other HIPAA specific features that you would like to see or you have any specific questions regarding HIPAA functionality let us know.

Happy New Year!