NPI Validation Profile Workflow
This profile handles the processing of NPI validation through an external validation service. The route NPI Data Processing picks up an incoming 837 Professional transaction, validates and splits the good data into separate files, one for each Provider. The corresponding route component extracts the NPI number from each file and passes the resulting data as a query parameter. The route sends a request to an external service to check whether the passed NPI number is registered with the NPPES NPI Registry. Based on the response, the route saves claims to the file system in either one of the folders Valid or Not Valid.
This profile contains the route NPI Data Processing.
Route structure
Route Components Description
| 837 In
|
FS Inbound |
Picks up a batch of 837 Professional claims from the file system. |
| Native Processing
|
XE Native |
Validates and splits the batch by Provider and extracts the NPI number for each Provider. |
| Check NPI
|
REST Client |
Makes a GET request to https://npiregistry.cms.hhs.gov/api passing the NPI number as a query parameter. The JSON response from the service contains information on whether the passed NPI number is registered with the NPPES NPI Registry (for example, "result_count":1) or not ("result_count":0). |
| Extract data from JSON
|
JSON Value Extractor |
Extracts the value of the field result_count from the JSON response and sets this value as an XEServer message property NPIValidationResult. |
| Is NPI Valid
|
Router |
Directs claims to either the Valid or the Not Valid destination folder depending on the property NPIValidationResult. |
| Not Valid
|
FS Outbound |
Stores transactions with Providers that have failed to pass the NPI validation. |
| Valid
|
FS Outbound |
Stores transactions with Providers that have passed the NPI validation. |
