Batch 276 Sample Profile Overview

When you submit a Claim Status Inquiry (276) to an Insurance Company, you receive a response (277) as soon as the claim status has been verified. You can also submit batches of 276 requests to optimize the data processing flow. This sample profile shows you how to process a batch of 276 EDI transactions, generates a 277 response for each transaction, and batches the responses into a single EDI document.

Profile Location

Edifecs Library / Best Practices / HIPAA Interactions / Batch 276 Sample

Requirements

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

Prerequisites

  • In Edifecs Application Manager, add the profile 276-277 Batch Sample from the Edifecs Library. For more information, see XEServer Help Center.
  • Copy the file merger_hipaa277x212cs.properties from the folder ${XESProfileConfig}/artifacts/Merger to the folder ${XESRoot}/features/route-engine/components/aggregator-hipaa/config.

The profile receives all five 277 Claim Status Responses from the back-end system.

  1. Start the profile. Verify that all the required routes have been started.
  2. Copy the sample 276x212_good.dat file from the directory ${XESProfileConfig}/data to the directory ${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 directory ${XESWorkspace}/test-data/Outbound/Acks/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/.
    • Five individual 276 transactions are available in the directory ${XESWorkspace}/test-data/Outbound/Split/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/.
    • A batch with 277 responses is available in the directory ${XESWorkspace}/test-data/Outbound/BatchedResponse/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/. None of the individual responses contain the E2:0*YYYYMMDD segment as all the five 277 transactions were received.

The profile receives only four 277 Claim Status Responses from the back-end system.

  1. Stop the profile.
  2. Open the Back End Emulation route.
  3. Set the value of 271_Resp_Quantity environment variable to 4.
  4. Start the profile. Verify that all the required routes have been started.
  5. Copy the sample file 276x212_good.dat from the folder ${XESProfileConfig}/data 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 directory ${XESWorkspace}/test-data/Outbound/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/.
    • Five individual 276 transactions are available in the directory ${XESWorkspace}/test-data/Outbound/Split/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/.
    • A batch of 277 responses is available in the directory ${XESWorkspace}/test-data/Outbound/BatchedResponse/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/. One of the responses contains the STC*E2:0*YYYYMMDD segment as one of the five 277 responses was not received.

The profile receives an invalid 276 request.

  1. Copy the sample file 276x212_bad.dat from the directory ${XESProfileConfig}/data to the directory ${XESWorkspace}/test-data/Inbound.
  2. Go to the folder ${XESWorkspace}/test-data/Outbound to view the processing results:
    • One data file is available in ${XESWorkspace}/test-data/Outbound/Bad.
    • A TA1 acknowledgement is available in the directory ${XESWorkspace}/test-data/Outbound/Acks/XXXXXXXX-XXXX-XXXX-XXXX-XXXXXXXXXXX/.
    • An LDNS report is available in ${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 '000031039'. The expected value is '000031033'. .