Question
KCI USA Inc
US
Last activity: 25 Mar 2020 8:26 EDT
270 5010 verssion in x12 format
Is there any OOTB way to generate 270 5010 verssion in x12 format ? I can see only X125010N270GeneralBenefitRequest text file , how this can be generated dynamically based on request paramerters like group id , subscriber id etc
***Edited by Moderator Marissa to update SR Details***
Pegasystems Inc.
US
HI Sourabh,
The OOTB configuration handles inbound 270 Request and generates a 271 Response Message using the inbound transaction clipboard page as a template.
You could essentially reverse engineer a workflow using the OOTB process and use either the 270 or 271 clipboard pages as your base templates. We have a rich membership and coverage information data model in the Healthcare Foundation as well as screen layouts for Group, Policy, Membership object models that your could reference.
You can find the X12 Messaging Technical Specification document under Pega Foundation for Healthcare on Pega Community. It provides a nice summary of the key rules used in the X12 270-271 message processing, available in the Foundation.
Salil.