franz400@xxxxxxxxxxxx wrote:
What does it take to translate files (for Medicare CMS) to x12 on an iSeries?
Anything in the OS or does it take a product?
Jim Franz
I wrote a parser for 4010 835s in RPG, but that was a lot of work, and
with version 5010 coming down the pipe, I'm thinking about converting
them to XML with BizTalk first and then using DOM to get at the data. We
also use GE EDI Desktop for some payers, but I don't think it's really
any easier, and it's yet another potential point of failure.
837s are pretty easy to write with RPG and the stream file APIs. I did
that for Medicaid. The hard part is developing the data. You can also
use PC-Ace, which (I think) is available for free through your MAC.
There's also a paid version from the vendor (
http://system-designs.com/)
which has (I guess) more flexibility. We use it for Medicare, but we're
really too big for it, and it's abysmally slow if you have more than
10000 claims in the database.
I use an awk script to convert 997s to a text report for the users.
They're absolutely standard, regardless of payer, so that works pretty
well. It's a simple document. Haven't gotten around to the others yet,
but they're less important, and nobody seems to care all that much.
BizTalk does have predefined document templates to handle all the HIPAA
transactions. It's not cheap though, and IMHO, rather poorly documented
and difficult to work with unless you know it really well and are
proficient with .NET programming. I needed consulting help to make it
work when we went from version 2002 to 2006 R2. In typical Microsoft
fashion, the parsing templates were not backward compatible, and
Microsoft doesn't seem to know it well enough to give solid advice. That
said, there are some excellent consultants out there, and the good ones
can make it sing.
<rant>Soon as you get things working though, count on our helpful
government to change all the rules. I think it should be illegal for
lawyers in committee to design systems. Maybe single payer will clean up
some of the mess.</rant>
midrange.com
