A certain exchange of information occurs during each communication between a patient and a health care provider. In addition to the basics of patient demographics, symptoms, diagnoses, and treatments,a common Health Insurance Portability and Accountability Act (HIPAA) trading scenario requires the exchange of claims and payment data as well as associated payer,subscriber,eligibility, and authorization information. A single encountercan involve the transmission of large volumes of information among several participants.
The exchange of health care information can generally be viewed as a transaction between the sender and receiver participants.
Health care transactions include(but are not limited to):
this shows an example of a transaction that includes a health care claim and the claimpayment between two partners.
Health care claim processing
These transactions can be transmitted electronically in compliance with health care transaction standards. Health care data exchange standards allow the accurate and timely exchange of information between health care organizations.For example,a simple benefits inquiry can take 20 minutes on the phone. Using Electronic Data Interchange (EDI), his type of request can be processed almost immediately,without the need for a call to the insurers customer service center.
WebSphere Transformation Extender and its HIPAA EDI Pack provide predefined functionality that supports tactical HIPAA compliance, reduces the risks associated with complex compliance, provides standard-checking, cuts programming time and cost, and minimizes the need for back-end system reengineering.WebSphere DataPower B2B Appliance XB60 provides, at the network edge, B2B governance and high performance for full end-to-end processing with validation and functional acknowledgments,together with B2B Governance by enforcing Trading Partner Agreement policy and AS2/AS3 Standards compliance.
WTX with Launcher and WebSphere DataPower B2B Appliance XB60 provide a full end-to-end solution, covering all the requirements for a robust, scalable, and maintainable B2B infrastructure for partner trading. These requirements include:
Secure Sockets Layer (SSL) is not included in this scenario in the interest of brevity.
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B2b Technologies And Standards
B2b Deployment Methodology
Aspects Of B2b Security
Websphere Datapower B2b Appliance Xb60
Device Setup And Administrative Tasks
B2b Configuration Options
Troubleshooting The Appliance
Xb60 And Wtx Integration For Hipaa
Xb60 With Transformation
Trading Outbound Binary Documents Using The B2b Gateway Service
Trading Binary Documents Using A Multi-protocol Gateway Service
Handling Soap Messages With Attachments In A B2b Environment
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