HIPAA Accelerator Guide

HIPAA Accelerator Guide

Inbound Authorization

Inbound Authorization

The authorization process verifies that the partner that sent the specific HIPAA message is, indeed, authorized to send this HIPAA message.
The authorization process is performed as part of the GS level processing. This process is done by comparing the HIPAA message type received in the GS01 and ST01 elements to the DX workflow parameters defined in the "Transactions" section of the partner's profile. To allow a partner to send a specific HIPAA message, you must check the relevant HIPAA Transaction.
Workflow Parameters
If a particular message type is not authorized:
  1. The DX event status is updated to "Authorization Error"
  2. If 999 Acknowledgment profile parameter is set to 'Enabled' (default), an HIPAA ACK (999) is generated with the appropriate error message and sent back to the partner
  3. If 999 Acknowledgment profile parameter is set to 'Enabled' (default), an HIPAA ACK is added to the DX Event
  4. The Accelerator splits the input into files with one ISA segment, one GS segment, and one ST segment, and attributes are extracted. For 837I, 837P, 837D, 277CA, and 835, each transaction is split to claims. Information is extracted and added to the event.
as shown in the following image.

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