METHOD AND APPARATUS FOR INTEGRATING HEALTH CARE PAYERS AND PROVIDER SYSTEMS WITH HEALTH CARE TRANSACTION SYSTEMS USING A SINGLE HIPAA EDI RESPONSE GENERATION COMPONENT
First Claim
1. In a data processing system, a method comprising:
- integrating software endpoint applications with a single transaction facility to enable transactions between a first endpoint and a second endpoint, wherein the first endpoint and the second endpoint are respectively represented by at least one of a service provider facility and a service payer facility and said integrating supports operations of one or more payer facilities and one or more provider facilities;
providing a testing facility to enable a test of a variety of transactions;
automating a clearinghouse test procedure via the testing facility;
providing an application plug-in facility to enable a simultaneous testing of multiple EDI exchanges;
receiving a Electronic Data Interchange (EDI) request message from the first endpoint;
generating an EDI response message in response to the EDI request message; and
when the EDI response message is generated, transmitting the EDI response message to the first endpoint.
2 Assignments
0 Petitions
Accused Products
Abstract
A method, system, and computer program product for integrating Health Care Payers and Providers with a health care transaction system. The health care transaction (HCT) utility solves the problem of integration between these two parties by providing the developer with an application that is capable of automatically generating an Electronic Data Interchange (EDI) response message to a request. The HCT utility mainly consists of a servlet (associated with the Hypertext Transfer Protocol (HTTP) or other data communication protocol) that forwards an EDI request from a sending party to applications that may act as either a payer or provider. These applications may automatically process and respond to request EDI messages sent from other applications using an EDI processor application. The HCT utility provides the advantage of providing an infrastructure for testing healthcare transactions. Furthermore, the infrastructure enables testing of a variety of transactions from multiple sources. Additionally, clearinghouse testing may now be automated.
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Citations
24 Claims
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1. In a data processing system, a method comprising:
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integrating software endpoint applications with a single transaction facility to enable transactions between a first endpoint and a second endpoint, wherein the first endpoint and the second endpoint are respectively represented by at least one of a service provider facility and a service payer facility and said integrating supports operations of one or more payer facilities and one or more provider facilities; providing a testing facility to enable a test of a variety of transactions; automating a clearinghouse test procedure via the testing facility; providing an application plug-in facility to enable a simultaneous testing of multiple EDI exchanges; receiving a Electronic Data Interchange (EDI) request message from the first endpoint; generating an EDI response message in response to the EDI request message; and when the EDI response message is generated, transmitting the EDI response message to the first endpoint. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A computer program product comprising:
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a computer readable medium; and program code on said computer readable medium that when executed within a data communication device generating application data, said program code provides the functionality of; integrating software endpoint applications with a single transaction facility to enable transactions between a first endpoint and a second endpoint, wherein the first endpoint and the second endpoint are respectively represented by at least one of a service provider facility and a service payer facility and said integrating supports operations of one or more payer facilities and one or more provider facilities; providing a testing facility to enable a test of a variety of transactions; automating a clearinghouse test procedure via the testing facility; providing an application plug-in facility to enable a simultaneous testing of multiple EDI exchanges; receiving a Electronic Data Interchange (EDI) request message from the first endpoint; generating an EDI response message in response to the EDI request message; and when the EDI response message is generated, transmitting the EDI response message to the first endpoint. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16)
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17. A data processing system comprising:
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a processor executing a servlet application; a memory system; a network mechanism that enables connecting of data processing systems; a utility which when executed in said data processing system provides functions for; integrating software endpoint applications with a single transaction facility to enable transactions between a first endpoint and a second endpoint, wherein the first endpoint and the second endpoint are respectively represented by at least one of a service provider facility and a service payer facility and said integrating supports operations of one or more payer facilities and one or more provider facilities; providing a testing facility to enable a test of a variety of transactions; automating a clearinghouse test procedure via the testing facility; providing an application plug-in facility to enable a simultaneous testing of multiple EDI exchanges; receiving a Electronic Data Interchange (EDI) request message from the first endpoint; generating an EDI response message in response to the EDI request message; and when the EDI response message is generated, transmitting the EDI response message to the first endpoint. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24)
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Specification