HIPAA support in BizTalk has always required the purchase, installation and use of the HIPAA accelerator. I've recently learned that the upcoming release of BizTalk 2006 R2 (scheduled sometime in the June 2007 timeframe) will bundle HIPAA support out of box. A main feature of BizTalk 2006 R2 is to provide native EDI support for transaction sets such as X12. HIPAA is simply a collection of specific X12 transaction sets. As such, its a natural enhancement to support HIPAA out of the box. The following is the current list of transaction sets to be supported as described in the Biztalk b2b blog on msdn located at: (http://blogs.msdn.com/biztalkb2b/archive/2006/12/31/hipaa-support-in-biztalk-server-2006-r2.aspx).
- key HIPAA 4010A transaction set schemas:
- 270/271 - Eligibility
- 276/277 - Claim Status
- 278 - Services Review Request/Response
- 820 - Payroll Deduction
- 834 - Benefit Enrollment
- 835 - Claim Payment
- 837D - Claim Dental
- 837I - Claim Institutional
- 837P - Claim Professional - ten other non-HIPAA standard schemas that are widely used in the HIPAA realm, including but not limited to:
- v3070 277 Healthcare Payer Unsolicited Claim Status
- v4010 148 Doctor's First Report of Injury
- v4040 277 Healthcare Claim Acknowledgement
- v4050 274 Healthcare Provider Information - a schema annotation which enables splitting a multiple part document (e.g. a 837 Claim that has many individual claims) into separate transactions, one for each individual document. This feature is enabled by an annotation called 'subdocument_break'. When assigned a value of "yes" it will split an inbound transaction into individual transaction sets based on the number of documents included in the original transaction set. For example, an inbound 837D with three separate claims in it would be split into three separate 837D transaction sets with all of the appropriate header information included in each.
- WEDI/SNIP level 2 validation which includes basic X12 syntax integrity as well as validation of loops, segments, elements and code values.
