iWay HIPAA eBusiness Adapter

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The Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191 – known as HIPAA) includes provisions for Administrative Simplification, which require the Secretary of Department of Health and Human Services to adopt standards to support the electronic exchange of administrative and financial healthcare transactions primarily between health care providers and plans. HIPAA directs the Secretary to adopt standards for transactions to enable health information to be exchanged electronically and to adopt specifications for implementing each standard. This iWay HIPAA Adapter is based on the October 1998 ASC X12 standards, referred to as Version 4, Release 1, Sub-release 0, (004010).

Maximum Flexibility

The iWay HIPAA Adapter is integrated into the enterprise through the iWay Service Manager. This provides the ability to parse, format, and transform HIPAA X12N transactions into any other format – XML, non-XML, EDI, SQL, SAP IDoc, RPC, and J2EE – and interface to legacy applications and databases. The iWay HIPAA Adapter is used in conjunction with application servers, message brokers, and other iWay Adapters (e.g CICS, VSAM, SAP R/3, or MUMPS) to integrate HIPAA transactions with internal applications using standard formatted XML. iWay XML Transformation Workbench can be used to map the transformation and workflows for HIPAA integration with internal (enterprise) systems and external EDI or B2B networks. Supported environments include IBM WebSphere, IBM WebSphere MQ Integrator, Microsoft BizTalk Server, Microsoft Commerce Server, Oracle 9iAS, and Oracle 9iAS InterConnect.

Accelerate HIPAA Compliance

Auditing and compliance testing tools are provided for the HIPAA messages and for the 200+ environments that iWay can integrate into HIPAA workflows. The tools are based on standards defined by the WEDI SNIP Testing and Certification Sub Workgroup.

The iWay HIPAA Adapter provides support for all of the HIPAA ANSI X12N 4010 transactions:

835 Claim Payment
270 Eligibility Enquiry
271 Eligibility Response
276 Claim Request
277 Claim Response
278 Service Review
834 Enrollment
837(I) Claim (Institutional)
837(D) Claim (Dental)
837 (P) Claim (Professional)
Embedded HL7 Documents

iWay HIPAA Adapter provides full integration across the enterprise systems since HIPAA EDI documents (and associated workflow) can be integrated with over 200 enterprise data and application systems. The integration with back-end systems is a key requirement.

Accelerate Legacy Integration

HIPAA impacts across business processes and internal systems for healthcare providers and payers. These systems are in the most part mainframe applications running "legacy" applications such as CICS, VSAM, IMS, and Model204. The move to distributed computing has resulted in disparate applications based on AS/400, HP3000, and UNIX systems with applications such as MUMPS, Ingres, and Informix. The real cost of HIPAA compliance is in the integration of the back-end systems across heterogeneous platforms, databases, and TP systems.

Achieve Greater Efficiencies

Gartner has researched this issue and project that the back-end costs equate to as much as $10 for every $1 spent on the front-end HIPAA interfaces. This is the real value of the iWay HIPAA Adapter.

"It is essential to regard HIPAA as an opportunity. A sure path to loss of competitive standing is to find the least-cost methods of compliance with the opportunistic HIPAA requirements without finding a way to capture the cost savings." Gartner, "A Common Sense Approach to HIPAA," Matthew Duncan, Jim Klein, Kenneth Kleinberg, Wes Rishel, March 2001.

Adapter Benefits

The iWay adapter technologies offer developers these advantages:
- Extend packaged and e-business applications systems based on Java, XML, SOAP, and Web Services without requiring any custom coding
- Reduce the cost in extending packaged applications into a B2B trading partner management based on standards such as ebXML and Web Services
- Provide a common development environment integrated inside of multiple message brokers and application servers
- Uniform XML Interface for all packaged applications thus reducing the requirement for specific packaged applications native API knowledge
- Bidirectional adapter functionality to automate integrated event-driven input capability to integrate real-time transactions
- Document conversion from proprietary XML to standard XML, EDI formats, SQL, and RPCs to other application systems
- Protects investment in legacy database, ERP, CRM, SCM, and homegrown "legacy" applications modules
  
  iWay HIPAA Adapter in Action
  
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  No other company provides the kind of sophisticated data integration and SOA-based integration technology that iWay Software does. To find out more, call toll-free (866) 297-4929 or e-mail us at info@iwaysoftware.com.