Question

I've got a project I took over from someone that requires data to be exported in the EDI X12 Standard (837P) format. Although I have been able to find some samples that are useful I haven't been able to find anything that defines what the possible "segments" are and what they mean. The previous developer has quite a bit of work done, but I have no way of knowing if it's correct.

Is this something I should take on, or should I look for some 3rd part EDI plug-in?

Finally, if so, does anyone know of any good ones that will work with .net or COM? The application is actually built in access, so that would be the easiest and cheapest way to go.

Was it helpful?

Solution

The X12 standards are published by the Washington Publishing Company. The implementation guides used to be subsidized by CMS, but that came to an end in April of 2006. A pdf version of the implementation guide is $175. If you decide to download it, make sure you get the combined version, which includes the original standards and the addenda. The current version is 4010A. Version 5010 will be required as of January 1, 2012.

I don't know what your situation is, but I have found the health care claim to be one of the more complex EDI transactions. I have always used specific mapping tools, such as Gentran or ECMap, that are specifically designed to facilitate the translation of X12 files into a variety of other formats and vice-versa. Another important capability of EDI translators is that most can do a compliance check on your X12 files.

Outbound files are a little more forgiving, since you have control over the data. I recall creating test files with C programs on a UNIX box when none of our trading partners were ready to send us test data. I wouldn't recommend that as a long term solution, though. You might consider a clearinghouse, but, if you decide to do it yourself, you really need the standards and an implementation guide from each of your trading partners.

Good luck!

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