Errors captured by the Sybase HIPAA Accelerator compliance maps are reported to ECMap’s Trans Log. This error logging identifies noncompliant data and lets you build business processes around the event, such as the submission of a 997 functional acknowledgement.
The following list represents situations that the HIPAA compliance maps trap:
Missing mandatory data segment or data element
Unexpected segment or loop – invalid map flow
Invalid internal code value
Data length exceeds maximum or less than minimum
Maximum use exceeded for segment or loop
Invalid data format for date or time
Not used element contains data
Invalid data type, such as alphanumeric or numeric only
Violation of reasonable conditional edits (gray box rules)
Violation of semantics contained in the front matter of the Implementation Guide that can be reasonably quantified
You can also enhance the HIPAA compliance maps to validate external code values, such as ZIP codes, country codes, and the like.
The HIPAA compliance maps do not trap the following situations:
Invalid crosswalk, such as application data, subscriber’s last name mapped to X12 transaction, or a subscriber’s first name
Conditional edits that cannot be reasonably verified, such as if the presence of a person’s middle name is required, if known. It would be unreasonable to determine whether the submitting trading partner knew the patient’s middle name.
Error trapping gives you enough information to either modify the EDI data to create valid compliance information or notify senders so they can quickly correct the data. See Chapter 4, “Troubleshooting Map Errors” for more information.
