Sample: BizTalk 2006 R2 - Hospital HIPAA Accelerator. Contains claim cube example
Note: This is Biztalk project example. This sample project contains SSAS claim cube for claim trending and analysis. I thought readers might be interested in this claim cube example.
Project Purpose
This project provides a basis for understanding how BizTalk Server 2006 R2 handles HIPAA processing. This solution also demonstrates the capability for hospitals to achieve a faster adjudication on thier claims and a reduction in thier processing times by using a 3rd party claims processor called Availity http://www.availity.com. The following messaging patterns are demonstrated:
- 837 Institutional Claim Submission in Batch and Realtime
- 835 Payment
- 270 Eligibility Request
- 271 Eligibility Response
- Ability to use a HIPAA Preprocessor for workign with non validating Claims (http://www.edifecs.com)
Reporting for the claim submission can be accomplished in 2 ways:
- Realtime reporting using a ROLAP Cube and SQL 2005 Reporting Services
- Trend reporting using a MOLAP Cube and Excel or SQL 2005 Reporting Services
Project Description
This sample application demonstrates the ability to use BizTalk Server 2006 R2 for processing HIPAA Claims from a provider perspective. In this sample an 837 Institutional claim is processed by BizTalk and sent to either Availity (www.availity.com) or to an existing clearinghouse via batch.
Tags: sample