System and method for the cascading definition and enforcement of EDI rules

• US 7,475,051 B1
• Filed: 09/22/2005
• Issued: 01/06/2009
• Est. Priority Date: 09/22/2004
• Status: Expired due to Fees

• Current Assignee: International Business Machines Corporation
• Original Assignee: International Business Machines Corporation
• Inventors: Francis, Sanjay, Krishnan, Gopal, Laxminarayan, Chaitanya
• Primary Examiner(s): Vincent; David
• Assistant Examiner(s): Berman; Melissa J
• Application Number:
  US11/232,839
• Time in Patent Office: 1,202 Days
• Field of Search: 705/18, 706/47
• US Class Current: 706/47
• CPC Class Codes: G06N 5/02 Knowledge representation; Symbolic representation
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 20/14 specially adapted for billing systems

Abstract

An efficient organizer of companion guide rules is created by a validation application from the common set of rules among an industry'"'"'s implementation guide and the rulebooks, such as companion guides of one or more entities, such as payers. The organizer of companion guide rules creates an inventory of all rules and a profile for each companion guide and stores each profile in metadata storage. Each profile contains pointers to code in the inventory for all the rules employed by the corresponding companion guide. After an EDI document reaches the validation application, a runtime checker engine checks metadata storage for a current rule set for the payer. A rule set is created the first time a profile is accessed during the validation process and whenever the profile is updated. The runtime checker engine attempts to validate the EDI document by comparing it to the current rule set for a payer'"'"'s companion guide.

Claims

1. A method of validating a plurality of electronic data interchange (EDI) documents, where EDI documents, each EDI document associated with at least one of a plurality of entities, the method comprising

creating an inventory of all rules, the inventory including a common set of rules for the plurality of entities dynamically adjusting said inventory of all rules based upon the entity-specific rules where the entity specific rules are derived from a plurality of companion guides, each companion guide associated with one of the plurality of entities;

determining a profile containing pointers to select rules in the inventory of all rules for each companion guide,

storing the profile for each companion guide in a storage;

receiving a first document associated with a first entity;

checking the first EDI document associated with the first entity by

employing a runtime checker engine to check the storage for a first current rule set for the first entity, where the first current rule set comprises rules from the inventory of rules required by the companion guide associated with the first entity

comparing the first EDI document with the first current rule set;

forwarding the first EDI document to the first entity if the first EDI document matches the first current rule set, wherein the first EDI document is validated; and

returning the first EDI document to the sender if the first EDI document does not match the first current rule set, wherein the first EDI document is invalidated;

receiving a second document associated with a second entity

checking the second EDI document associated with entity the second entity by

employing the runtime checker engine to check the storage for a second current rule set for the second entity, where the second current rule set comprises rules from the inventory of rules required by the companion guide associated with the second entity

comparing the second EDI document with the second current rule set;

forwarding the second EDI document to the second entity if the second EDI document matches the second current rule set, wherein the second EDI document is validated; and

returning the second EDI document to the sender if the second EDI document does not match the second current rule set, wherein the second EDI document is invalidated.

2. A method of enforcing EDI rules comprising determining entity-specific rules from corresponding companion guides for each of a plurality of entities;

expressing each rule in a neutral and machine readable format;

classifying the rules by determining for each rule

whether the rule is common with at least one other rule, or

whether the rule is similar to at least one other rule, or

whether the rule is unique;

conveying the results of classifying the rules by;

creating an inventory of all rules, the inventory including a common set of rules for the plurality of entities dynamically adjusting said inventory of all rules based upon the entity-specific rules where the entity specific rules are derived from a plurality of companion guides, each companion guide associated with one of the plurality of entities;

storing the set of rules in a storage according to the classification of each rule as common, similar, or unique;

creating pointers to the entity-specific rules associated with at least one of the plurality of entities; and

storing the pointers in a storage for use in retrieving the appropriate current rule set when validating an EDI document.

3. The method of claim 2 further comprising

determining a current rule set for a first one of the plurality of entities comprising at least one of the entity-specific rules;

validating an EDI document associated with the first one of the plurality of entities by;

comparing the EDI document to the current rule set;

forwarding the EDI document to the first one of the plurality of entities if the EDI document matches the current rule set, wherein the EDI document is validated; and

returning the EDI document to the sender if the EDI document does not match the current rule set, wherein the second EDI document is invalidated.

4. The method of claim 2 further comprising

updating the inventory of rules and the pointers in response to a change in the rules.

5. A method of validating EDI documents comprising:

providing an inventory of all rules, the inventory including a common set of rules for the plurality of entities dynamically adjusting said inventory of all rules based upon the entity specific rules where the entity specific rules are derived from a plurality of companion guides, each companion guide associated with one of the plurality of entities;

creating a rules analyzer to analyze the content of companion guides and to build an organizer of companion guide rules where each companion guide is associated with one of the plurality of entities;

employing the organizer of companion guide rules to add companion guide rules to the inventory of rules;

creating a profiles engine to create a current rule set for each of said plurality of entities;

creating a companion guide profile for each of the plurality of entities where each companion guide profile indicates that entity'"'"'s companion guide rules and provides pointers to the rules in the inventory of rules that are associated with the current rule set of that entity, and

creating a runtime checker engine to validate EDI documents by comparing each EDI document to the current rule set associated with a corresponding one of the plurality of entities, by forwarding the EDI document to the corresponding one of the plurality of entities if the EDI document matches its current rule set, wherein the EDI document is validated and by returning the EDI document to the sender if the EDI document does not match the current rule set, wherein the EDI document is invalidated.

6. The method of claim 5 further comprising

setting up a portal Web page to permit an entity to access, to review and to modify its companion guide profiles.

7. The method of claim 5 further comprising

setting up a metadata storage to store companion guide profiles and an inventory of rules.

8. The method of claim 5 wherein creating a rules analyzer to analyze the content of companion guides and to build an organizer of companion guide rules further comprises

employing a companion guide analyzer that utilizes the organizer of companion guide rules to analyze companion guides for common and different rules and uses this information to create and update the entries in the inventory of rules.

9. The method of claim 8 wherein building an organizer of companion guide rules further comprises

creating human-readable hierarchies of rules from companion guides.

10. The method of claim 8 wherein employing a companion guide analyzer further comprises

manually analyzing companion guides for common and different rules to create and update the entries in the inventory of rules.

11. The method of claim 8 wherein employing a companion guide analyzer further comprises analyzing the companion guides with an automated software program.

12. The method of claim 5 further comprising

employing an implementation guide for a set of standard rules for EDI documents to determine the set of common validation rules that are common to a plurality of entities;

and employing a controller that controls data transfers for validation application.

13. The method of claim 5 wherein creating a profiles engine to create a current rule set for each of said plurality of entities further comprises

creating the current rule set for each of said plurality of entities the first time a corresponding companion guide profile is accessed during validating the EDI document associated with that entity, wherein the current rule set is used subsequently each additional time that the corresponding companion guide profile is accessed.

14. The method of claim 5 further comprising

creating a new rule set when the entity'"'"'s companion guide profile is updated.

15. The method of claim 5 wherein using the organizer of companion guide rules to create companion guide profiles further comprises

updating the rules stored in the inventory of rules without having to update individual companion guide profiles, whose pointers remain accurate.

16. The method of claim 5 wherein adding the set of common validation rules to the inventory of rules further comprises

downloading an implementation guide;

and

utilizing the organizer of companion guide rules to add implementation guide rules to the inventory of rules.

17. The method of claim 5 further comprising

using the rules analyzer and a companion guide analyzer to analyze the contents of each rule in the companion guide to determine whether the content of a companion rule is

identical to another rule in the inventory of rules, or

similar to another rule in the inventory of rules, or

not found in another rule in the inventory of rules.

18. The method of claim 5 wherein validating the EDI Document further comprises

checking an entity identification code with the runtime checker engine to determine whether the document matches the entity'"'"'s rule set.