WPC © 2003 Functional Acknowledgments and Reponses Lisa S Miller COO Washington Publishing Company

WPC © 2003 Acknowledgement –The act of admitting or owning to something. –Recognition of another's existence, validity, authority, or right. –An answer or response in return for something done. –An expression of thanks or a token of appreciation. –A formal declaration made to authoritative witnesses to ensure legal validity.

WPC © 2003 Acknowledgements and HIPAA Acknowledgement References –Located in Appendix B –EDI Control Directory Includes the TA1 and the 997 Acknowledgements may also be business level responses –Example: Request for Eligibility Request and Response The HIPAA documentation (IG) is based on information that was available with version 4010 years ago.

WPC © Thousand Foot View Transaction A Transaction B Organization B Organization A

WPC © 2003 Acknowledgement? –The act of admitting or owning to something. –Recognition of another's existence, validity, authority, or right. –An answer or response in return for something done. –An expression of thanks or a token of appreciation. –A formal declaration made to authoritative witnesses to ensure legal validity.

WPC © 2003 X12 Acknowledgements Trading Partner Agreements Not required but strongly recommended Have specific intended use

WPC © 2003 X12 Acknowledgements Delivery Acknowledgements –TA1 – Basic Interchange Acknowledgment –TA3 – Interchange Delivery Notice Syntactic Response Acknowledgements –997 – Functional Acknowledgment –999 – Implementation Acknowledgment Business Application Acknowledgements –824 – Application Advice –Response Transaction Example 270/271

WPC © 2003 X12 Acknowledgements Transaction A TA1 Organization B Organization A

WPC © 2003 X12 Acknowledgements Organization B Organization A EDI Gateway 997 Transaction A

WPC © 2003 Implementation Guide (TR3) Acknowledgements Organization B Organization A EDI Gateway With IG ‘Edits’ 999 Transaction A

WPC © 2003 Application Advice Organization B Organization A EDI Gateway With IG ‘Edits’ 824 Transaction A Business Application

WPC © 2003 Response Transaction Organization B Organization A EDI Gateway With IG ‘Edits’ Transaction B Transaction A Business Application – Work completed

WPC © 2003 Other information * Image from the WEDI Whitepaper Front End Edits Whitepaper Version 1.0 ( currently being revised)

WPC © 2003 X12 Sequence Diagram

WPC © 2003 HIPAA Examples 270/271 Realtime Example 270/271 Batch Example TA1 270 bad

WPC © 2003 HIPAA Examples 837 Example TA

WPC © 2003 Technical choices interact with Business issues –Trading partner agreements –‘Batch’ verses ‘single’ –‘Positive’ and ‘negative’ acknowledgement handling – Choices

WPC © 2003 Conclusions Business needs and technical requirements intersect at the point of acknowledgment communication. The Healthcare industry needs to define specific implementation guides (TR3) for the purpose of defining the business needs within the X12 acknowledgement framework.