270/271

Talend Data Mapper - X12 HIPAA Specifications User Guide

EnrichVersion
6.4
EnrichProdName
Talend Real-Time Big Data Platform
Talend Data Fabric
Talend MDM Platform
Talend Data Services Platform
Talend Data Management Platform
Talend Big Data Platform
task
Data Quality and Preparation > Third-party systems > Processing components (Integration) > Data mapping
Data Governance > Third-party systems > Processing components (Integration) > Data mapping
Design and Development > Third-party systems > Processing components (Integration) > Data mapping
EnrichPlatform
Talend Studio

The following table provides details on the 270/271 transaction pair.

Transaction type

X12 EDI

Sample Map Version 50 Release 10 (5010)

No

Description

Direction

Map Name

XML Structure Name

Eligibility Request

270

Health Care Benefit Eligibility Inquiry

Inbound EDI to XML

270-EligibilityRequest

EligibilityRequest

Outbound XML to EDI

EligibilityRequest-270

Eligibility Response

271

Health Care Benefit Eligibility Response

Inbound EDI to XML

271-EligibilityResponse

EligibilityResponse

Outbound XML to EDI

EligibilityResponse-271

The following table shows the mapping cases demonstrated in the examples for the 271 inbound transaction.

#

Condition

Description

Example

Mapping Method

1

Looping

X12 to XML with multiple occurrences of looping

loop of one Info Source Name (NM1 segment with ABC Insurance), one Receiver (NM1 with Marcus A Jones), one Subscriber (NMI with John L Smith) and two Dependents (NM1's with Jim Smith and Kathy Smith)

Output structure

Occurs max of -1

loop of multiple contact information (Information Source PER segment with MEMBER SERVICES and BILLING DEPT)

3

Output Format

X12 to XML date format as YYMMDDY

Transaction set creation date (BHT04)

Output structure's Field Data Format YYMMDD

X12 to XML date format as CCYYMMDDY

Subscriber date (DTP)

Output structure's Field Data Format default

X12 to XML code mapping value from code to description

Info Source NM1 loop with Communication Contact (PER03) from Telephone Number Qualifier TE maps to Telephone

Output element Telephone type set to value. Drag PER03 to Telephone to contact qualifier1 and a popup appears to map input code to output value.

4

Code Value

X12 to XML with output field conditional on code value

Subscriber Plan Begin Date qualifier (DTP01) selects specific date type (346) and output to PlanIssueDate

AgConcat function loop searching on constant

5

Function

X12 to XML concatenate fields

Name (NM1 in receiver loop) to concatenate Subscriber's first name, middle initial and last name

Map output field using concat function by dragging input structure fields to loop expression. Drag constant function to insert a value between fields (space)