Claims (EDI Channel)

The 837 to FHIR XEServer route implements the HIPAA claims mapping to the FHIR format. XES Module for FHIR uses segments of EDI claim transactions to create FHIR resources. The XEServer route that processes claims does the following:

• Receives an EDI professional claim file, the version 5010A 837x222A1 (the File System Inbound component).

You can submit the EDI 837 transaction to the following folder: ${XESModuleForFHIRRoot}/workspace/Runtime/Claims/EDItoFHIR/Inbound837 or change this path on the Common tab of the File System Inbound component. To do this, in Source folder, enter the required path. If you do not want to use the file system data transport and you need to receive data through another channel, for example, JMS, FTP, HDFS, and so on, you can create a route with data re-drop from the inbound endpoints to the file system endpoints. For more information, see Endpoints in the XEServer documentation. You can also use the XES Module for FHIR web portal to submit data.

• Splits EDI 837 to separate claims (the XE Native component).
• Converts EDI 837 data to a FHIR bundle using the mapping rules (XE Translator component).
• Submits the FHIR bundle to the FHIR server (the FHIR Action component).