834 to DFF with Sorting Profile Workflow

This profile picks up a batch of 834 transactions, validates the data, splits the file into individual enrollments. Then, the corresponding route converts individual enrollment documents to a custom DFF format and stores the result in XEServer Data Storage. The profile uses the Balance Counters feature to activate the Reorder route after all enrollments are processed. The corresponding route extracts the DFF enrollments from the data storage and sorts the enrollments firstly by Suscriber ID, and then by Maintenance Type.

This profile has the following routes:

This route receives a file with multiple 834 Benefit Enrollment and Maintenance EDI documents, validates and splits the file into individual enrollments using the Native Processing component. All the accepted enrollments are converted to a custom DFF format using XE Translator, and are stored in XEServer Data Storage.

The Balance Counters outbound components (Accepted Counter and Stored Counter) track the number of enrollments after the splitting and mapping respectively to verify that the number of accepted individual enrollments received as input matches the number of individual enrollments stored in XEServer Data Storage.

Route structure

Enrollment Route

Route Components Description

Component Name Component Type Description
834 File Inbound FS Inbound Picks up a batch with 834 transactions from the file system.
Native Processing XE Native Validates the batch and splits individual transactions into good and bad. The component sets two properties on the output split.good: MaintenanceType and SubscriberID. These properties are later user for sorting the enrollments after the mapping.
834 to DFF XE Translator Converts enrollments from the HIPAA format to a custom DFF format using the map file ${XESProfileConfig}/artifacts/guidelineAndMaps/834-DFF_Map.ems.
Data Storage Data Storage Outbound Stores DFF enrollments in XEServer Data Storage. The location for each enrollment is identified by a unique combination of properties Task ID, Subscriber ID and Maintenance Type.
Stored Counter BCounter Outbound Updates the number of DFF enrollments stored in the data storage (counter field Completed).
Rejected Enrollments FS Outbound Stores individual enrollments that did not pass the XEngine validation.
LDNS Report FS Outbound Stores the LDNS report on the file system.
Accepted Counter BCounter Outbound Updates the counter (Total) representing the number of individual enrollments in the original 834 batch. This happens after all individual enrollments are processed. Once the number of processed enrollments matches the number of enrollments in the original batch, the route Reorder starts.

This route starts once the Balance Counter Completion Expression (Completed==Total) is met which means that the number of HIPAA-formatted enrollments in the input batch is the same as the number of DFF enrollments stored in the data storage. The route extracts DFF enrollments from the data storage and sorts them by Suscriber ID and Maintenance Type.

Route structure

Reorder Route

Route Components Description

Component Name Component Type Description
Activation Counter BCounter Inbound Initiates the route processing once the number of enrollments received in the input batch is the same as the number of DFF enrollments stored in the data storage.
Data Storage Data Storage Inbound Extracts the enrollments from the data storage using the path /{Prp[CounterID]}. The property CounterID uses the macro {MD_BCNT_ID} which returns the Balance Counter ID.
Sorter Sorter Sorts the DFF enrollments firstly by SubscriberID and then by MaintenanceType. The sort order is ascending.
Aggregation Aggregation Aggregates sorted enrollments into a single file.
Result FS Outbound Stores the result DFF file with sorted enrollments on the file system.