Understanding EDI Structure
Introduction
Before diving into the EDI (Electronic Data Interchange) structure, let's first understand how data is typically structured in a book or a Word document.
Structure of a Page
- Word: A single unit of language separated by space.
- Sentence: A group of words forming a meaningful statement.
- Paragraph: A collection of sentences expressing a complete idea.
Example of Address Representation
Subscriber Information
Carrie J. Brown, DOB 01/13/1953, Male 3360 Lynn Street Woburn, MA 01801
Company Information
Healthservices LLC, Tax ID: xx1234512 2550 Adamsville Road Harlingen, TX 78550
Page vs. EDI Structure
| Traditional Document | EDI Structure |
|---|---|
| Words are separated by spaces | Elements are separated by a delimiter (usually *) |
| Sentences are separated by lines | Segments are separated by a terminator (usually ~) |
| Paragraphs are separated by line breaks | Loops do not have defined separators |
Converting Data to EDI Format
Using EDI formatting, the above address example is converted into:
Carrie*J*Brown*01/13/1953*Male~ 3360*Lynn Street~ Woburn*MA*01801~ Healthservices LLC*xx1234512~ 2550*Adamsville Road~ Harlingen*TX*78550~
Note: In real-world EDI, this appears as:
Carrie*J*Brown*01/13/1953*Male~3360*Lynn Street~Woburn*MA*01801~Healthservices LLC*xx1234512~2550*Adamsville Road~Harlingen*TX*78550~
How Computers Process EDI Data
Computers do not inherently understand the meaning of raw EDI data. To structure it properly, we use:
- Segment Name - Identifies the type of data.
- Type Qualifier (Optional) - Specifies what the segment represents.
Rewriting the Example with Proper EDI Segments
NM1*IL*Carrie*J*Brown*01/13/1953*Male~ N3*3360*Lynn Street~ N4*Woburn*MA*01801~ NM1*85*Healthservices LLC*xx1234512~ N3*2550*Adamsville Road~ N4*Harlingen*TX*78550~
Key Points
- ✅ Each segment starts with a segment name (e.g., NM1, N3, N4).
- ✅ Type qualifiers (e.g., IL, 85) differentiate data types.
- ✅ Address segments (N3, N4) do not require a type qualifier.
Additional Notes on EDI Messages
- If you need to send a number (NPI, Tax ID, SSN), it must be prefixed with an identifier.
NM1*85*2*Demo Clinic*XX*1215099528
Since segments are groups of elements, some elements may be optional.
- With a middle name:
NM1*IL*Carrie*J*Brown
- Without a middle name:
NM1*IL*Carrie**Brown
Conclusion
EDI structures transform unstructured text into computer-readable formats. By using segments, delimiters, and type qualifiers, we create a standardized way to exchange data efficiently.