HIPAA X12
When customizing HIPAA X12 config files, note the following points:
•HL segments are generated automatically and do not need to be mapped manually.
•Field instances can have a built-in code list that can be used for validation and auto-completion (see code snippet below). Values can be manually added or removed.
•Segments are identified by a condition with a specific value. A condition is tied to a Data element via the Data element's ref attribute. A value within the referenced Data element identifies the segment (see code snippet below). If no value can be referenced for the condition, then the condition is not fulfilled and the segment will not be found. Condition codes are auto-generated in the target component if they contain a single value. If you need to edit conditions or their values, you must ensure that condition values are unique.
<Group name="Loop1000A" info="Submitter Name">
<Segment name="NM1" info="Submitter Name">
<Condition path="F98" />
<Data ref="F98" info="Entity Identifier Code">
<Values>
<Value Code="41" />
</Values>
</Data>
...
<Data ref="F365" info="Communication Number Qualifier">
<Values>
<Value Code="EM" />
<Value Code="EX" />
</Values>
</Data>
...
</Group>
•Auto-completion can be configured via three attributes of the Completion element (see code snippet below): (i) singleConditions auto-completes single conditions for all fields in the target component; (ii) singleValues auto-completes single values for all fields in the target component; (iii) HL generates appropriate fields in all HL segments of the target component.
<Message>
<MessageType>837-Q2</MessageType>
<Completion singleConditions="1" singleValues="1" HL="1" />
<Description>Health Care Claim: Dental</Description>
...
</Message>
•HIPAA omits several optional elements that are present in standard X12 transactions. These optional elements are hidden in MapForce components. This being the case, these elements cannot be mapped to target components and will not appear in target output files. In the configuration files, the absence of these elements is defined by setting their respective maxOccurs to 0. You can manually modify this setting.