Batch 270 Sample Profile Overview

When you submit an Eligibility and Benefits Inquiry (270) to an Insurance Company, you receive a response (271) as soon as the eligibility has been verified. You can also submit batches of 270 requests to optimize the data processing flow. This sample profile shows you how to split an incoming batch of 270 transactions, generate a 271 response for each individual transaction, and batch all the response files into a single EDI document.

Profile Location

Edifecs Library / Best Practices / HIPAA Interactions / Batch 270 Sample

Requirements

  • Edifecs XEngine 9.0 or later
  • Edifecs XEServer 9.0 or later
  • Edifecs Application Manager (EAM) 9.0 or later
  • Edifecs HIPAA Standards 8.8.14
  • Edifecs External Code Lists for HIPAA 8.8.13

Prerequisites

  1. In Edifecs Application Manager, add the profile 270-271 Batch Sample from the Edifecs Library. For more information, see Edifecs Library Help Center.
  2. Go to the folder ${XESProfileConfig}/libs and copy the files PaddingTool.class and PaddingTool.java to the folder ${XESRoot}/platform/lib.user/shared.

Scenario 1: The route receives all four 271 responses from the beck-end system.

  1. Go to ${XESProfile}/bin and run start.bat to start the profile.
  2. Go to the folder ${XESProfileConfig}/data and copy the sample file 270x279A1_good.dat to the folder ${XESWorkspace}/test-data/Inbound.
  3. Go to the folder ${XESWorkspace}/test-data/Outbound to view the processing results:
    • A 999 acknowledgement file is available in the folder ${XESWorkspace}/test-data/Outbound/Acks/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/.
    • Four individual 270 transactions are available in the folder ${XESWorkspace}/test-data/Outbound/Split/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/.
    • A batch with 271 responses is available in the folder ${XESWorkspace}/test-data/Outbound/BatchedResponse/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/. None of the individual responses contain the AAA*Y**42*R segment as all the four 271 responses were received.

Scenario 2: The route receives only three 271 responses from the beck-end system.

  1. Go to ${XESProfile}/bin and run stop.bat to stop the profile.
  2. In Edifecs Application Manager, go to the route Back End Emulation.
  3. Set the value of 271_Resp_Quantity environment variable to 3 and save the configuration.
  4. Start the profile.
  5. Go to the folder ${XESProfileConfig}/data and copy the sample file 270x279A1_good.dat to the folder ${XESWorkspace}/test-data/Inbound.
  6. Go to the folder ${XESWorkspace}/test-data/Outbound to view the processing results:
    • An acknowledgement is available in the folder ${XESWorkspace}/test-data/Outbound/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/.
    • Four individual 270 transactions are available in the folder ${XESWorkspace}/test-data/Outbound/Split/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/.
    • A batch of 271 responses is available in the folder ${XESWorkspace}/test-data/Outbound/BatchedResponse/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/. One of the responses contains the AAA*Y**42*R segment as one of the four 271 responses was not received.

Scenario 3: The route receives an invalid 270 inquiry.

  1. Go to the folder ${XESProfileConfig}/data and copy the sample file 270x279A1_bad.dat to the folder ${XESWorkspace}/test-data/Inbound.
  2. Go to the folder ${XESWorkspace}/test-data/Outbound to view the processing results:
    • One data file is available in the folder ${XESWorkspace}/test-data/Outbound/Bad.
    • A TA1 acknowledgement is available in the folder ${XESWorkspace}/test-data/Outbound/Acks/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/.
    • An LDNS report is available in the folder ${XESWorkspace}/test-data/Outbound/Reports/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/. The report contains the following error: "Element IEA02" (Interchange Control Number) has a value of '000031033'. The expected value is '000031039'. .