X12 EDI Examples
EDI 5010 Documentation – 837 Institutional - Loop 2300 Prior Authorization or Referral Number
All My Healthcare Domain stuffs
1. Medical Billing concepts
2. Medical Billing Terminology
3. Health care Introduction documents
4. EMR Appointment Features
5. EMR SOAP Note
6. EMR History of Present Illness
7. EMR Use cases
8. EMR Test visit (Lab) workflow
9. Most commonly Used Lab Test Panels
10. EMR Most Commonly Used Vital Signs
11. Physician Quality Reporting System – PQRS
Healthcare Technical
1 EDI 5010 Documentation 837 Health care claim: Professional with Sample Files
2 EDI 5010 Documentation 837 Health care claim: Institutional with sample Files
3 EDI 5010 Documentation 835 Health Care Claim Payment/Advice with sample Files and Parsing Tool
4. EDI 5010 Documentation 270 Health Care Eligibility/Benefit Inquiry
5. EDI 5010 Documentation 271 Health Care Eligibility Benefit Response
6. SQL Server Stored Procedure for EDI 837 P 5010 Version
7. MYSQL Stored Procedure for EDI 837 P 5010 Version
8. Apply Insurance Payment (EOB Posting) Use cases.
9. Difference Between 837 Institutional and 837 Professional
10. Sample HL7 Files
11. HL7 Parsing
12. My Own HL7 Parser in java
13. MSH Message Header Segment
14. OBX Observation/result Segment
EDI RESTful Web Service API
Many Healthcare software development company needs Subject Matter Expert to complete their Medical Billing Component. In order to develop the Medical Billing Application, X12 EDI plays a major role. For example, from the Medical Billing software, they need to send the bill (claim) to the Insurance via Clearing House and the format should be X12 EDI 837. So i decided to provide a Latest Spring Boot Restful web services API Calls for all the major transactions that are needed in the Medical Billing Application. Here is the List of transactions available and please connect with me to use these API Service calls.
3. JSON to EDI 837 Professional Claims
4. Parse EDI 837p Message into JSON
Meaningful use Public Health Surveillance
About Me
LinkedIn Profile : https://www.linkedin.com/in/senthil-muthiah-16693857/
Email : vbsenthilinnet@gmail.com
Location: Bengaluru (Bangalore), India.
Skills : US Medical Billing, US Health care, Revenue Cycle Management,
Practice Management System, EDI Transactions such as EDI 837I, EDI837P, EDI270, EDI271, EDI835, ETC and EMR, HL7, etc. Also E-Prescription certification via Sure scripts, MU Stage 1 certification,etc
- Strong knowledge in Medical Billing (aka) Practice Management systems and published self-learning Chapters. You can check here
- Developed own EDI 835 Parser. Please check here
- Solid knowledge in Java EE and still hands on writing Complex business logic.
- Solid knowledge in ZKOSS RIA Framework and has been awarded from their team as one of the contributors. You can check here.
- Good Knowledge in the Latest MVVM Design pattern and created several examples to help developers. You can check here.
- As an independent developer, recently completed the Independent Practice Management software (PMS), you can see some screens in the following link
Link 1 , Link 2, Link 3 - Recently completed Meaningful stage 1 Certification for the current product. Helped the developers to understand the requirements for MU Stage 1.
- Involved in creating complete documentation for EDI 5010. Please check here
- Strong knowledge in Crystal reports and created numerous of Reports for Practice management application
- Conducted interviews with key business users to collect requirement and business process information.
- Interacting with the developers on resolving the reported bugs and various technical issues.
- Gathered Business Requirements and wrote Business Requirements documents (BRD) by working with the client's IT staff, project managers.
- Received numerous letters of recommendation, and appreciation from customers, and management.
- Conducted various meeting with Billing End users and come up with an Exclusive Tool called MedAZ Billing Tool, which takes care most part of their Follow-up activities. Actively involved in database design, user interface design, coding and implementation activities in that.
- Provided HIPAA integration and applied ANSI ASC X12 standards for 837 (P, I, D), 270/271, 276/277, 278, and 835 transactions
- Developed HL7 interfaces for Orders (ORMs) and Results (ORUs)
- Played Billing Revenue cycle Collection manager for some time and understood the complete billing process which helps to build an independent system called Billing Tool.
Summary
A technology-driven professional with over 16 years of experience including nearly 9 years in Software Development and Business Analysis. Thorough understanding of the SDLC with proficiency in mapping Business Requirements, Technical Documentation, Application Design, Development, Integration, Testing, and Troubleshooting for Information Systems Management. Adept in business process analysis and design, and application-based process reengineering.
Well-versed with US Healthcare Domain – Electronic Medical Record (EMR) & Medical Billing. Exposure in design, creation, testing and documentation of new and amended programs from supplied specifications in accordance with agreed standards. Deftness in monitoring delivery of high-quality customer experience. Strong communication, interpersonal, analytical & team-building skills with proficiency at grasping new concepts quickly and utilizing the same in a productive manner.
Well versed with Health care certification such as CCHIT, Meaningful use Stage 1, Sure scripts e-prescription, and HL7 Both inward and outward lab modules.
Core Competencies
Project Management | Software Development | Business Analysis |
Requirement Gathering | Technical Support | Troubleshooting |
Client Servicing | Software Testing | Gap Analysis |
MU Stage I Certification | CCHIT Certification | E-Prescription Certification |
IT Skills
Visual Basic 6.0, VB.NET 2005 |
Microsoft SQL server 2000/2005/2008 |
Crystal Report 8.5, 11.5 |
VBA (Word and Excel macros), Windows NT Service, Web service in VB.NET |
Java 1.6 |
Hibernate 4.x |
Spring Security 3.x |
Maven 3 |
MySQL Server 5.x |
Jasper Reports 4.x |
Dynamic Reports 3.x |
Dynamic Jasper 4.x |
MyBatis 3 |
Zkoss Framework 6.x |
Angular 9 |
Spring Boot |
and Many more………… |
and whatever current and future Technology…… |
Knowledge Purview
- Sound knowledge in ZKOSS RIA Framework and has been awarded from their team as one of the contributor
- Possess good knowledge in the Latest MVVM Design pattern and created several examples to help developers
- Well versed with Crystal reports and created numerous of Reports for Practice management application
- Proficient in the following Modules:
- HPI, ROS, and EXAM Templates
- Patient Encounter or SOAP
- Screen-based permission user security
- Sure scripts E-Prescription Certification
- Lab inward and outward Modules
- Encounter – Current Medication and Prescription
- Billing – Charges and Payments
- EDI 4010 and 5010
- Billing Reports
Employment Details
Aug’10 – June 2013 e-Cosmos Solutions India Pvt., Bangalore as Senior Business Analyst/Product Owner
Highlights
- Involved in creating complete documentation for EDI 5010
- Involved in Meaningful Use stage 1 Certification.
- Involved in UI Mockup for the web-based product.
- Successfully completed the Independent Practice Management software (PMS)
Jan'05 - Aug'10: Koni Ameri Tech Services India Pvt. Ltd., Chennai
Highlights
- Conducted interviews with key business users to collect requirement and business process information
- Coordinated with the developers on resolving the reported bugs and various technical issues
- Gathered business requirements and wrote Business Requirements Document (BRD) by working with the client IT staff and Project Managers
- Obtained numerous letters of recommendation, and appreciation from customers and management.
- Organized various meetings with Billing End users and came up with an Exclusive Tool called MedAZ Billing Tool, which takes care most part of their Follow-up activities
- Actively involved in database design, user interface design, coding, and implementation activities
- Provided HIPAA integration and applied ANSI ASC X12 standards for 837 (P, I, D), 270/271, 276/277, 278, & 835 transactions
- Developed HL7 interfaces for Orders (ORMs) and Results (ORUs)
- Managed responsibilities of Billing Revenue cycle Collection Manager for some time and understood the complete billing process which helps to build an independent system called Billing Tool
- Functioned as a Subject Matter Expert in US Health care outpatient domain.
Actively involved in:
- CCHIT 2008 Certification
- Superscript E-Prescription Certification
- Integrating Lab services from the quest, Lab Corp, etc.
Growth Path:
- Jan'05 - Apr'05 Senior Programmer
- Apr'05 - Apr'06 Programmer Analyst
- Apr'06 - Apr'08 Senior Business Analyst
- Apr'08 - Aug'10 Chief Technical Officer
Highlights
- Organized various meetings with Billing End users and came up with an Exclusive Tool called MedAZ Billing Tool which takes care of most part of their Follow-up activities
- Actively involved in database design, user interface design, coding, and implementation activities
- Successfully completed the migration of patient demographics, procedure rates, locations, referring physicians from Lytec/Medisoft/Medical Manager, etc. database to Medaz database
Previous Experience (Non Healthcare Domain Experience)
- Mar'02 - Dec'04: Mice Computer Center, Madurai as Senior Programmer
- Sep'00 - Feb'02: Soft Solutions Pvt. Ltd., Chennai as Programmer
- Dec'99 - Aug'00: Laconic Software India Pvt. Ltd., Dindigul as Programmer
- Oct'96 - Nov'99: Lakhotia Computer Center Dindigul as Senior Faculty
Client Testimonials