In your EMR/PMS software, if you need to parse the EDI 271 Response, You can use our API Service which will parse and returns as Human Readable Text. Please contact me via email vbsenthilinnet@gmail.com for more details
I’ve developed Web API in which you can pass the EDI 271 Message and API will return the Human Readable Text.
These RESTful Web Services are developed using Spring Boot.
The following video demo explain how to Make restful web service API for the service.
Parse 271 Message to Text
In order to test all the RESTful Web Services , an testing tool also developed and here is the video demo for the same.
Parse 271 Message to JSON Format
Parse 271 Message to HTML
Workflow
1) Patient Books an appointment.
2) Billing team before the appointment date, check the Patient Insurance Eligibility.
3) Software prepares the EDI 270 Message and send to the Payer via Clearing House entity, Payer in turn returns the Response in EDI 271 Message. Here clearing house is the middle man between Health care Organization and Payer
4) Software parse EDI 271 Message and convert into Human Human Readable Text and show to application End User
Another Example for EDI 270 and 271
1. Provider Smith uses ABC Billing Software.
2. Provider Smith already signed up with XYZ Clearing House and an ID has been assigned to Provider Smith by the clearing house.
3. ABC Billing software has the option of generating EDI 270 message and through web service call, it will send the message to the clearing house.
4. XYZ receives message within few seconds and then identify the message for Payer GOLD. Since XYZ already enrolled with the Payer Gold, so it just forward the message to Payer Gold via web service.
5. Payer Gold receives the message and prepare the response 271 and send back to the clearing house. Immediately clearing house forward the response to the Provider Smith’s ABC billing software.
270, 271 healthcare transactions background information
The eligibility 270 Request and 271 Response is the third most utilized transactions in the healthcare industry, after claims submission and remittance advice transactions. Mandates from the Department of Health and Human Services requiring claim and remittance adoption were contributing factors to claim and remit transaction levels less the 270/271 could be the predominate healthcare EDI transaction. Before the 270/271 transactions were adopted, most eligibility verification was handled over the phone. Since the Healthcare 270/271 has been made a standard industry wide, Providers of Service can send the 270 Request to all Insurance Companies and expect to receive the same uniformed 271 Response format across the board.