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Status Submitted
Categories Standards
Created by Guest
Created on Mar 19, 2024


To Support EDI 27x transactions and follow X12 HIPAA Guidelines.

My company Prolifics Inc is working with the client who is BlueShield of California (Health Insurance provider). We are working in a project where we have to deal with the EDI 27x (270/271 Eligiblity & Benefit Inquiry (Request/Response) Transaction.

We are using the ITX/ITXA production to process the EDI transaction. We found a potential discrepancy in the ISA and GS loop of the X12 EDI transaction where ITXA is not returning TA1 (Acknowledgement) to the partner when the incorrect data element is sent in the EDI 270, 276, or 278 request. As per the X12 guideline, when the incorrect data element is sent in the EDI request, the request will be rejected and the reason code of the rejection needs to be returned in the TA1 (Acknowledgement). However, this in scenario, ITXA is returning "No Envelope Found" error code which is incorrect.

Therefore, we would like to discuss with the IBMs respective team to discuss this scenario and a solution of this issue. Due to the urgency of this issue, anything you could do to resolve this issue would be highly appreciated.

What is your industry? Healthcare
How will this idea be used?

To improve the EDI X12 27x transaction