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999 Acknowledgement Specification v1-1

UHIN STANDARDS COMMITTEE

Approved

 

UHIN STANDARDS COMMITTEE

Version 1.1

999 Acknowledgement Specification

 

 

UHIN 999 Acknowledgement Specification is compatible with all HIPAA Requirements.

 

Purpose:  The purpose of this Specification is to outline the UHIN role and the responsibilities for the 999 Acknowledgement transaction. This Specification adopts the use of the ASC X12 999 transaction. 

 

Applicability: This Specification applies to UHIN and its processes for generating 999 Acknowledgements sent to entities. A 999 could be sent by payers, providers, and UHIN to acknowledge receipt of batch transactions.

 

Trading partners outside of the UHIN community may choose to use a 997 as an acknowledgement response.  It is not intent of the UHIN Community to require the 999 and the 997. 

 

Basic Concepts:  UHIN generates a 999 as part of the validation process. UHIN must notify entities of rejected transactions due to payer validation desires. UHIN uses a generic sender ID (UHIN3) for all UHIN generated 999’s. To differentiate a UHIN 999 from a payer 999, UHIN moved to a generic UHIN sender ID.

 

Definitions:

 

999 – Implementation Acknowledgement for Health Care Insurance

 

ASC X12 – is chartered by the American National Standards Institute (ANSI). They develop and maintain EDI standards that facilitate electronic interchange relating to business transactions.

 

Validation – UHIN’s default validation level is SNIP type 2.

 

Details:

 

  • UHIN only validates provider batch transactions (837, 270, 276). These are the only transactions for which UHIN has generated a 999.
  • UHIN must notify entities of rejected transactions
  • UHIN uses a generic sender ID, UHIN3, for all UHIN generated 999’s.  While some payers are using UHIN as their front end system and are not creating a second 999, other payers are generating their own 999.  To differentiate a UHIN 999 and payer generated 999, we moved to a generic UHIN sender ID.
  • 999’s are not a part of the real time transaction exchange
  • UHIN will pass all control numbers sent in the original transaction (837, 270, 276) back in the 999. This should allow senders to match the 999 back to the original transaction in their system.
  • UHIN’s default validation level is SNIP type 2.
  • UHIN will pass through all ISA, GS, and ST control numbers from the original transaction. This will allow members receiving 999’s to match it back to their original transaction.
  • UHIN plans to validate all provider batch transactions and return a 999.
  • UHIN will send back in the 999 Functional Group Acknowledge Codes, “A” for accepted, “R” for rejected or “E” for accepted, but errors were noted.

 

Unique Global Tracking Number:

 

The GS06 will be used as the unique global number for 999 tracking purposes.  This means the GS06 values are unique within an ISA/IEA and the GS06 values are also unique across interchanges.  It is required UHIN users maintain unique GS06 values over a minimum of a 60-day period, but a year is recommended.

 

 

IMPLEMENTATION ISSUES

 

  1. All endpoints on the network must be able to accept and generate 999s.

 

  1. Payers must understand when and why they may receive multiple 999’s for a single transaction.

 

  1. Validation level of 999’s may be different and the 999 that passed through UHIN’s validation is not guaranteed to pass through each payer’s edits.

 

  1. UHIN does not assign a unique control number in UHIN3 999’s. UHIN 999’s pass through all ISA, GS, and ST control numbers from the original transaction. This allows members receiving 999’s to match it back to their original transaction.

 

 

 

 

History: (MM/DD/YY)

 

Original

A* 1

A* 2

A* 3

A* 4

A* 5

A* 6

ORIGINATION DATE

7/2/13

5/6/2014

 

 

 

 

 

APPROVAL DATE

9/11/13

7/9/2014

 

 

 

 

 

EFFECTIVE DATE

11/6/2013

8/4/2014

 

 

 

 

 

* A = Amendment

1

 

 

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