Supplement Partner:

A Supplemental partner, in this context, refers to a partner with an extended provider network. This expansion enables the Client to offer provider discounts on a wider range of bills. Paradigm forwards bills to the Supplemental partner for pricing evaluation and subsequently receives the pricing outcomes.

Within this system, Adeptia handles JSON formatting, transforming it into EDI 837I/P, and dispatches it to the Supplement Partner. The Supplement Partner then reviews the file, incorporates Price information into the EDI file, and returns it to Adeptia. Subsequently, Adeptia processes the price details, converts them into JSON format, and transmits them back to Adva-Pro.

Partner creation

Click Partners > Partners > Add Partner.
Provide Partner Details such as Partner Name and Network name Here Network is created as “Supplement Network”.

Image 2.1

Image 2.2

Maximize the Configure Supplement Network Parameters.
Update the value of parameters for a PartnerID and Partner Type.
In order to send or receive EDI data from/to the Partner, select Configure EDI Settings checkbox to configure EDI settings and parameters for the Partner. Three groups - EDI Configuration, Inbound Global Control Numbers, and Outbound Global Control Numbers appear.

EDI Configuration

Click to expand EDI Configuration.
Provide the Partner email.
Provide the Partner ID. Host ID of the company is populated automatically. You can change the Host ID, if required.

The values in the fields of the group - Inbound Global Control Numbers and Outbound Global Control Numbers are populated automatically. If you want to change the values, click to expand Inbound Group Control Numbers and Outbound Group Control Numbers and provide the values corresponding to the fields. The values defined in the fields will serve as global defined values while creating EDI Transactions.
Click Add to add the partner for your company.
Activate the Partner as shown below-

Transactions Creation and Execution

Supplemental Inbound Transaction

You can create an Inbound EDI Transaction by using a prebuilt EDI Template bundled with Connect. Use this template to create an EDI Inbound Transaction.

To create an Inbound EDI Transaction:

Click Transactions > Templates.
On the Templates screen, search EDI Inbound in the Search bar.
Click “Use this” for the EDI Inbound Template to create an EDI Transaction.
Connect automatically populates the name and description for the Transaction, you can edit the name and description, if necessary.
Click Continue to define the Network and Partner.

Click Next to define the EDI Configuration.

On the EDI Configuration window, do the following-

Select the EDI standard as HIPPA from the EDI Standard drop-down list.
Select the appropriate 837 version based on the filetype 005010X222A1 for P / HCFA or 005010X223A2 for I / UB version from the EDI Standard Version drop-down list. This list will have all the EDI versions you have created in the Data Dictionary
On the basis of the selected EDI version, the list of transaction set codes is populated in the Transaction Set Code drop-down list. Select the 837 code from the drop-down list.

Select the indicator from the Test/Production Indicator drop-down list. The available options are T-Test and P-Production.
Select the ”Yes - With error detail” option from the Generate Acknowledgement to generate acknowledgment for the inbound messages sent.

Select Compliance Check checkbox, if required.

Expand Translation Properties and Select the number of translation(s) as 2.

Click Next to define the Source.

Select/Create the File Event.

Select On File Archive Option and provide Archive path..

Select the First Destination as LAN File.

Click Next and select LAN File Target or create a new LAN File Target based on the requirement.

Provide the File Name as mentioned in the below-

For HCFA: $$PARTNER_NAME$$_$$TransactionPID$$_HCFA_Intermediate

For UB: $$PARTNER_NAME$$_$$TransactionPID$$_UB_Intermediate

Provide File extension.

Select target schema.

Create a Mapping. Click on and Provide the name of the data mapping. The name should follow the Paradigm naming convention policy.

Click on the Import option in the mapping.

Search in the search bar as “BaseMap” , list of mapping will be visible and select the appropriate standard base mapping.

Save the Mapping once import has done.
Implement the rules of provided data mapping and save the mapping.
Choose Target Destination 2.

Select Advance Database Target.
Select Second Mapping.
Click Sava & Exit.

Supplemental Outbound Transaction

To create an Outbound EDI Transaction:

Click Transactions > Templates.
On the Templates screen, search EDI Outbound in the Search bar.
Click “Use this” for the EDI Outbound Template to create an EDI Transaction.
Connect automatically populates the name and description for the Transaction, you can edit the name and description, if necessary.

Click Continue to define the Network and Partner.
Click Next to define the EDI Configuration.
On the EDI Configuration window, do the following-
Select the EDI standard as HIPPA from the EDI Standard drop-down list.
Select the 005010X222A1 version from the EDI Standard Version drop-down list. This list will have all the EDI versions you have created in the Data Dictionary
On the basis of the selected EDI version, the list of transaction set codes is populated in the Transaction Set Code drop-down list. Select the 837 code from the drop-down list.
Select the indicator from the Test/Production Indicator drop-down list. The available options are T-Test and P-Production.
Select the ”No” option from the Expect Acknowledgement.
Scroll down and expand ISA Envelope Properties. Refer below image for reference.

To Create an ISA Envelope and fill the required information. Refer Fig 1 and 2 for reference.

Select source as LAN File
Select the appropriate File event from the drop-down or create new one by clicking button and click on Next.
Select your Source Data Format.

Choose Destination as LAN.
Select/Create LAN File Target
Enter temp in File Extension.

Check File Archival file if required and provide appropriate details.
Select Appropriate mapping or create a new one using .
Click on Save & Exit.

Data Mapping

Configure Value Map

Go to Configure>Data Transformation>Value Map.

Edit the TargetConfigurationMap Value Map.
Provide File Path and File Name. These are intermediate File Name and File Path for Outbound after merging Price JSON and EDI files.

Note: Please if you are onboarding a new partner then a new entry needs to be created in the above Value map and the File Name and File Path should match with the File Event selected in Outbound Transaction. Separate entries need to be created for the Professional and Institutional files.

Configure Calendar Events

Configure Calendar event for Consume ADVA process to pick messages from ASB and store into SupplimentalData table.

Go to Configure>Event>Calendar Event
.Click on create Calendar event and enter information as required. Event Name should end with _partnerId. For Example 181is partner id in this case.

Go to Configure>Event>Event Registry
Create Event registry as required.
Bind the event with consume Event with PC_PF_ConsumeAdvaProResponse_ASB_Supplimental

Create a Calendar event to bind merge flow with event.

Go to Configure>Event>Calendar Event
Click on create Calendar event and enter information as required. Event Name should end with _BillType_partnerId. For Example 181is partnerId and HCFA is BillType in this case.

Go to Configure>Event>Event Registry
Create an Event registry as required.

Bind the event with consume Event with PC_PF_MergeJSON_DB_Suppliment

Adeptia Implementation Service Knowledge Base

Implementation: Supplemental Partner