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We need a Tool to Identify the Cause of HIPAA X12 Compliance Exceptions

Tool to Identify the Cause of HIPAA X12 Compliance Exceptions

NASCO routinely receives very large HIPAA X12 transmissions from their business / trading partners. (Very large meaning millions of segments and tens of thousands of transactions.) Only a very small percentage of the transaction content is expected to fail compliance checking. Occasionally, however, we find that there are situations where the majority of the transactions end up getting rejected because one or more instances of non-compliance recurs throughout the transmission. When this happens, the standard acknowledgement processes are likely to generate lots of output without necessarily providing the insight needed to resolve the problem.  


It would be helpful to have an application that could to identify the root cause of compliance exceptions that recur throughout the HIPAA X12 transmission. This information could then be used to request changes on the part of the trading partner that has sent the data or to provide guidance on rules that need to be disabled using configurable rules.

  • Avatar32.5fb70cce7410889e661286fd7f1897de Guest
  • Aug 31 2018
  • Declined
How will this idea be used?

Identifies the Cause of HIPAA X12 Compliance Exceptions when NASCO receives huge files from their Trading Partners / Plans with NON-HIPAA Compliant errors.

What is your industry? Healthcare
What is the idea priority? Medium
DeveloperWorks ID
Link to original RFE
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    Luke Raiano commented
    30 Jul, 2019 05:46pm

    Better geared to a services engagement. LIkely a good use case for machine learning, but no current (18mos) plans to productize