Process Overview
To process HIPAA messages, use the facilities provided by:
Module for HIPAA which provides the HIPAA-related services such as validate for all the mandated HIPAA transactions and responds with the appropriate acknowledgments.
Trading Networks which handles the routing of messages to trading partners.
Additionally, you must add your own processing to do the following:
Send HIPAA messages to your trading partners. If you are acting as a sender, you can use a
Trading Networks delivery service to send a valid standard HIPAA message to your trading partner (acting as the receiver).
Send the appropriate acknowledgments to the HIPAA messages. Module for HIPAA can be configured to send acknowledgments using TPA parameters. To send acknowledgments, use
Trading Networks delivery features. For more information, see the
webMethods Trading Networks Administrator’s Guide for your release.
Process the HIPAA transactions to meet your specific needs. For example, you might want to map the data from a
835 Health Care Claim Payment/Advice transaction to an external system document and send that document to the downstream system.
The Module for HIPAA sample illustrates how to map data to IS document types for processing by external systems.
To add your own processing, use either Trading Networks processing rules or Designer to define custom process models and business processes.