270/271
The following table provides details on the 270/271 transaction pair.
|
Transaction type |
X12 EDI |
Sample Map Version 50 Release 10 (5010) |
|||
|---|---|---|---|---|---|
|
No |
Description |
Direction |
Map Name |
XML Structure Name |
|
|
Eligibility Request |
270 |
Health Care Benefit Eligibility Inquiry |
Inbound EDI to XML |
270-EligibilityRequest |
EligibilityRequest |
|
Outbound XML to EDI |
EligibilityRequest-270 |
||||
|
Eligibility Response |
271 |
Health Care Benefit Eligibility Response |
Inbound EDI to XML |
271-EligibilityResponse |
EligibilityResponse |
|
Outbound XML to EDI |
EligibilityResponse-271 |
||||
The following table shows the mapping cases demonstrated in the examples for the 271 inbound transaction.
|
# |
Condition |
Description |
Example |
Mapping Method |
|---|---|---|---|---|
|
1 |
Looping |
X12 to XML with multiple occurrences of looping |
loop of one Info Source Name (NM1 segment with ABC Insurance), one Receiver (NM1 with Marcus A Jones), one Subscriber (NMI with John L Smith) and two Dependents (NM1's with Jim Smith and Kathy Smith) |
Output structure Occurs max of -1 |
|
loop of multiple contact information (Information Source PER segment with MEMBER SERVICES and BILLING DEPT) |
||||
|
3 |
Output Format |
X12 to XML date format as YYMMDDY |
Transaction set creation date (BHT04) |
Output structure's Field Data Format YYMMDD |
|
X12 to XML date format as CCYYMMDDY |
Subscriber date (DTP) |
Output structure's Field Data Format default |
||
|
X12 to XML code mapping value from code to description |
Info Source NM1 loop with Communication Contact (PER03) from Telephone Number Qualifier TE maps to Telephone |
Output element Telephone type set to value. Drag PER03 to Telephone to contact qualifier1 and a popup appears to map input code to output value. |
||
|
4 |
Code Value |
X12 to XML with output field conditional on code value |
Subscriber Plan Begin Date qualifier (DTP01) selects specific date type (346) and output to PlanIssueDate |
AgConcat function loop searching on constant |
|
5 |
Function |
X12 to XML concatenate fields |
Name (NM1 in receiver loop) to concatenate Subscriber's first name, middle initial and last name |
Map output field using concat function by dragging input structure fields to loop expression. Drag constant function to insert a value between fields (space) |