With EDI Exchange you can keep track of your trading partners. You can set up their identifiers to send them EDI files or 999 acknowledgment, send email notifications and compliance check results, encryption keys and file transport mechanisms.
Once you have created the trading partner table (see Creating Database Tables) and initialized EDI Exchange (see Initializing EDI Exchange), you can set up the relationships with your trading partner. Follow the instructions below.
|1.||Select "Trading Partners" under the "EDI Exchange" menu.|
The "Trading Partners" menu item
|2.||The following screen will appear.|
The "Trading Partners" window
|3.||Click the "New" button to start entering the trading partner information.|
|4.||Define the necessary options. They are described further.|
|5.||Click on "Save."|
The "Save" button
|6.||The newly added Trading Partner's name will appear in the right pane.|
Trading Partner Options
The company information of a trading partner can be specified on the top of the form.
Top area of the "Trading Partners" window
Name and Type
|•||Name — Trading partner's company name. Required field.|
|•||Address — Trading partner's company address.|
|•||Status — Trading partner's status. Choose one of the available options:|
|•||Inactive — No upload into a database system through ODBC will be done.|
|•||Test Only — All outgoing EDI messages will be stamped with "Test" (ISA_15). Records will only be exported to the test environment.|
|•||Approved — All outgoing EDI messages will be stamped with "Production" (ISA_15). Records will be exported to the Live system with ODBC.|
|•||Type — There are five types of trading partners, select the necessary one: |
|•||Providers — Hospitals, doctors or other health care providers.|
|•||VANs — Value Added Networks like clearing houses or EDI Networks.|
|•||Service bureaus — Third party entities such as repricing organizations.|
|•||Sponsors — Entities that sponsor the benefits of subscribers such as MedicAid, government agencies or large employers.|
|•||Payers — Entities that pay for health care benefits such as health insurers.|
The next block on the form lists the communication methods and preferences.
|•||EDI File Exchange Method — Obligatory setting. HIPAAsuite supports three communication methods. Choose a preferred mode of sending EDI communications to the trading partner:|
|•||FTP — Allows you to transmit files actively to the Trading Partner or his Clearinghouse.|
|•||Outbox — All files for Trading Partner are stored locally. The Trading Partner is responsible for picking up files in his special directory of the local FTP or HTTP server. |
|•||SOAP - Allows you to transmit files to the Trading Partner or his Clearinghouse using SOAP 1.2 (CORE) by default. |
|o||SOAP Version - Defaults to CAQH CORE "SOAP 1.2". "SOAP 1.1" is also provided as a compatibility option for Trading Partners that are not yet CORE-Certified but use SOAP services.|
|•||MIME - Allows you to transmit files to the Trading Partner or his Clearinghouse using MIME (CORE). This is one of two CORE options.|
|•||Email Addresses — Enter the email address(es) into the text field.|
EDI Identifiers Tab
This tab relates to the EDI identifiers and EDI Version.
The "EDI Identifiers" tab
|•||EDI Version — There are two standards for HIPAA:|
|•||4010 — This standard was introduced in the original transaction from 2003 to 2011.|
|•||5010 — From 2012 on all HIPAA transactions must be conducted in the 5010 version.|
|•||EDI Identifiers and Qualifier |
|•||ISA Identifier and Qualifier (Record Key) — The ISA Identifier and Qualifier are the unique key to the trading partner database file. The ISA identifier can be up to 15 bytes long, the qualifier has to be 2 bytes. Approved qualifiers are:|
|•||01 — Duns (Dun and Bradstreet)|
|•||20 — Health Industry Number (HIN)|
|•||27 — Carrier Identification Number as assigned by HCFA|
|•||28 — Fiscal Intermediary Identification Number as assigned by HCFA|
|•||29 — Medicare Provider and Supplier Identification Number as assigned by HCFA|
|•||30 — U.S. Federal Tax Identification Number|
|•||33 — National Association of Insurance Commissioners Company Code (NAIC)|
|•||ZZ — Mutually Defined. Many organizations use the ZZ qualifier with their name as the ID, for example ZZ and HIPAASUITE.|
|•||ETIN number — The Electronic Transmitter Identification Number established by a Trading Partner Agreement. This number occurs only in the 837 transactions. Often, the ETIN is same as the ISA ID.|
|•||Application Receiver Code (GS_02) — A code identifying a part that sends a transmission or the specific application within the sender's organization. Codes are agreed by Trading Partners. Again, usually this code is same as the ISA ID. This code is placed in the GS_02 element in the Functional Group Header (GS). Some Trading Partners want to send a specific code in GS_03, the application receiver code. You can enter it into the corresponding field. Most of the time it is not necessary.|
|•||Assigned ID - Some trading partners, like health insurance exchanges will give a plan an ID that is different from the ISA identifier defined in the Company Setup screen of the application. Especially in the creation of filenames is this Assigned ID important.|
The "Options" Tab
You can choose one of the following options:
|•||Send EDI Acknowledgment (997 or 999) — This check-box allows sending Functional Acknowledgment transactions to the Trading Partner.|
|•||Send e-mail with compliance check and process results — This option allows sending the compliance check results back to your contact at the Trading Partner via email. No PMI will be transmitted. Adding an email address is important, even when the Communication method is not "Email."|
|•||Send e-mail notification when receiving files — This option allows sending an acknowledgment email of EDI files. This option is not necessary when you choose 997 or 999 acknowledgments.|
|•||Send e-mail notification when sending files — This option allows sending a file to the Trading Partner notifying them that a file has been created for them.|
|•||Reject Files with Compliance Errors - This option will reject files that have compliance warnings and move them into the suspended files directory. It also determines whether the TA1 and 999 indicate acceptance or the 999 lists all the errors and warning.|
|•||Create a 277CA for 837 claims — This option only applies to 837 Claims. Checking this option will produce a 277CA Claims Acknowledgment report for received 837 Claim files.|
|•||One ST-SE loop per claim - This option separates all claims into individual transactions enclosed by their own ST and SE segments.|
Remote FTP Tab
If your trading partner has an FTP Server, then you can set up here the connection information. Read more in Using Built-in FTP Client.
The "Remote FTP" tab
The file transfer protocol (FTP) is one of the first internet protocols and goes back to the 1960's. Transporting electronic files was one of the great achievements of the internet. During the last 50 years a lot of improvements to this protocol have been made, mainly to increase the security of the transfer.
|•||FTP — For security reasons, EDI Exchange supports secure FTP or FTPs.|
|•||Explicit FTPS Connection — The explicit method is a legacy compatible implementation where FTPS aware clients can invoke security with an FTPS aware server without breaking overall FTP functionality with non-FTPS aware clients. In explicit mode (also known as FTPS), an FTPS client must "explicitly request" security from an FTPS server and then step-up to a mutually agreed encryption method. If a client does not request security, the FTPS server can either allow the client to continue insecure or refuse/limit the connection.|
|•||Implicit FTPS Connection — The implicit method requires that all clients of the FTPS server be aware that SSL is to be used on the session, and thus is incompatible with non-FTPS-aware clients. Negotiation is not allowed with implicit FTPS configurations. A client is immediately expected to challenge the FTPS server with a TLS/SSL ClientHello message. If such a message is not received by the FTPS server, the server should drop the connection. In order to maintain compatibility with existing non-TLS/SSL aware FTP clients, implicit FTPS was expected to listen on the IANA Well Known Port 990/TCP for the FTPS control channel and 989/TCP for the FTPS data channel. This allowed administrators to retain legacy compatible services on the original 21/TCP FTP control channel.|
|•||SFTP — also known as FTP over SSH is deemed the most secure form of FTP and uses encryption certificates. There are 3 different ways to authenticate a SFTP connection, |
|▪||With user name and password, just like a regular FTP connection,|
|▪||User name and a certificate|
|▪||User name, certificate and password|
Remote Connection and Directories
You need the FTP address, the user name and password to establish the connection and the directory information where files are picked up and where dropped off. Fill in the following fields:
|•||FTP Address - This is usually the IP address of the server|
|•||Put Directory - This is the directory where you drop off files|
|•||Get Directory - This is the directory where you download files from|
It is possible that a trading partner has two FTP servers, one for 'put' and another one for 'get'. If so, check "Different Download Server" and additional fields will become visible so you can specify the those connection parameters.
After Download: You have two choices. Files on the server will be either deleted or moved to another folder of your choice .
The Contact Tab stores contact information for your selected Trading Partner.
The "Contact" tab
Enter the name and the number into the corresponding fields and select the communication type from the drop-down list.
|•||Communication Numbers — Valid Communication number qualifiers are: |
|•||TE — Stands for Telephone.|
|•||EX — Stands for Extension.|
Click the "Add" button and the contact will appear in the "Communication Numbers" table.
Note: The information that you fill in goes also into EDI files in the "PER" segment.
Local Access for FTP and HIPAAsuite Web
To register a user, enter the user name and the password into the corresponding fields and click the "Add" button. The user will appear in the "Registered Users" table.
EDI Exchange supports PKI encryption. Encryption keys are defined by the email address of the owner. Both supported products, PGP and GnuGP use this logic. Read more in Using Encryption.
You can set up the encryption parameters for a Trading Partner on the "Encryption" tab.
The "Encryption" tab
|•||Private Key Infrastructure (PGP)|
Key (email address of key owner)
Within the HIPAAsuite Communications Directory, each Trading Partner has his own folder. This keeps files finely separated and in order. Here is where you can set this up. Read more in Defining Communications Directory.
The "Folders" tab
|•||Outgoing Files Root — This field has a pre-generated path. You can change this path by changing the EDI Root Directory. |
|•||Trading Partner's Outbox — Mandatory setting. Click on the three-dots button to access the "Select Folder" window. There you choose an existing folder or create a new one. |
|•||Processed Files Root — This field has a pre-generated path. You can change this path by changing the EDI Root Directory. |
|•||Trading Partner's Repository — Mandatory setting. Click on the three-dots button to access the "Select Folder" window. There you choose an existing folder or create a new one. |
Once you have specified the directory settings, click on the "Create Folders Using Trading Partner ID."
The "Create Folders Using Trading Partner ID" button
|•||File Naming Convention - Health Insurance Exchanges (HIX) demand that a carrier adheres to more or less complex File naming conventions. Since these conventions are often really complicated we decided to hard code several schemes. California, Maryland, DC and the CMS scheme are among those currently configured and we will add other schemes if needed.|
Filenaming dropdown menu options
The Custom File Naming Convention option requires some additional setup. This is covered in Custom File Naming Conventions.
This tab stores settings for the use of CORE-Compliant SOAP- and MIME-enveloped transactions. When using a Requester or similar application, these settings apply to the information source. When using a Responder or similar application, these settings apply to the information requester/receiver. Soap 1.2 or 1.1 will use the same options.
CORE settings tab
|•||UserName - UserName portion of the username authentication token. Used to verify a Trading Partner's Username token's Username or in your own Username token authenticate yourself to a Trading Partner's CORE-compliant servi e.|
|•||Password - Password portion of the username authentication token. Used to verify a Trading Partner's Username token's Password or in your own Username token to authenticate yourself to a Trading Partner's CORE-compliant service.|
|•||SSL Certificate - Instead of Username tokens, use an SSL certificate to verify a Trading Partner's identity or access a Trading Partner's CORE-compliant service. Not currently implemented.|
|o||MIME Address - Trading Partner's web address for MIME Real-Time transactions.|
|o||SOAP Address - Trading Pertner's web address for SOAP Real-Time transactions.|
|o||MIME Submission Address - Trading Partner's web address for MIME Batch transactions.|
|o||MIME Retrieval Address - Some Trading Partners may use a different address to submit or retrieve batch transactions. Use this field for a retrieval-specific address.|
|o||SOAP Submission Address - Trading Partner's web address for SOAP Batch transactions.|
|o||SOAP Retrieval Address - Some Trading Partners may use a different address to submit or retrieve batch transactions. Use this field for a retrieval-specific address.|