Multitech | MT2834BA | Communications—Sending & Receiving Files

Communications—Sending & Receiving Files
Chapter
IV
Communications—Sending & Receiving Files
This chapter provides information to establish an electronic communications session with Georgia
Medicare and to submit and receive files.
For additional assistance, call EDI Services at (888) 883-2720, Option 3.
Modem Requirements
To communicate electronically with Georgia Medicare, you need a dial-up asynchronous modem.
The required modem specifications are:
Use any asynchronous modem with a DCE (Data Communications Equipment) and DTE (Data
Terminal Equipment) speed up to 33,600 baud.
Setup requirements are:
−
Data/Stop Bits: 8/1
−
Parity: None
−
Full duplex
−
Set Flow Control to Xon/Xoff
−
Preferred Baud Rate: 9600
Turn data compression off.
You will login and logout using an ASCII file transfer protocol, and you will send and receive files
using either Xmodem or Zmodem. The remaining sections of this chapter explain the sending
and receiving procedures.
©Blue Cross Blue Shield of Georgia
Georgia - Medicare
Page 1 of 7
Release 1 (January 2008)
Section A-EDI User Guide
IV - Communications-Sending & Receiving Files
Communication Protocols—XModem and ZModem
You may use either Zmodem or Xmodem to send and receive transactions. Using either protocol,
you may send and receive the following transactions:
Xmodem: You may use Xmodem to transfer the following files to and from Georgia Medicare:
−
−
Send X12N Transactions (837 Institutional and 276 Claim Status Request)
Receive the following:
−
X12N Responses (277 Claim Status Response)
−
X12 997 Functional Acknowledgment
−
Medicare Reports (Medicare Accepted Report, Medicare Error Report, and Medicare
Letters)
−
Transmission Acknowledgments
−
X12N 835 Payment Advice
Note: The procedure to receive the 835 Payment Advice using Xmodem is
different from the procedure to receive other files.
Zmodem: You may use Zmodem to transfer files to and from Georgia Medicare:
−
−
Send X12N Transactions (837 Institutional and 276 Claim Status Request)
Receive the following:
−
X12N 277 Claim Status Response
−
X12 997 Functional Acknowledgment
−
Medicare Reports (Medicare Accepted Report, Medicare Error Report, and Medicare
Letters)
−
Transmission Acknowledgments
Note: You cannot receive the 835 Payment Advice with Zmodem.
This chapter provides instructions to send and receive files using Xmodem and Zmodem. The
instructions target trading partners who are proficient in the use of the protocol(s) they choose.
For additional assistance, call EDI Services at (888) 883-2720, Option 3.
©Blue Cross Blue Shield of Georgia
Georgia - Medicare
Page 2 of 7
Release 1 (January 2008)
Section A-EDI User Guide
IV - Communications-Sending & Receiving Files
Sending X12N Transactions to Georgia Medicare
Both communications protocols (Xmodem and Zmodem) will send X12N transactions to Georgia
Medicare. The basic sending procedure for Xmodem and Zmodem is the same for both protocols.
Use the following procedure to login and send X12N transactions, with Xmodem or Zmodem.
1. Using an asynchronous modem, dial into the Georgia Medicare transaction line.
2. After the modem connects, pause for three seconds.
3. Example initialization string for a MultiTech Model MT2834BA modem:
(The initialization string will differ with different modems.)
1
2
1234567890123456789012345
ATV1E0M1Q0&C1&D3&E14S7=60
AT
V1
E0
M1
Q0
&C1
&D3
Value identifies the modem and may differ with different modems
Verbose result codes
Echo Off
Monitor speaker on until carrier detect
Result codes will be sent
Carrier detect normal
Causes modem to reset to default parameters when CD drops
&E14
S7=60
Data compression off
Time to wait for CD
4. Create and send the Submitter Login Record in ASCII format as defined in the chart below.
The login must not exceed 64 bytes including a carriage return (013 decimal, 0D hex) and line
feed (010 decimal, 0A hex).
Submitter Login Record Specification—Sending Files
Record
Indicator
Submitter
Identifier
Submitter
Password
Assembly
Method
Transmission
Identifier
1
Data Format
7
Length
Field Name
Position
All fields are left justified with blanks filled. Fill blanks with a space (032 decimal, 20 hex).
Value / Description
6
/SLRON Submitter login
/SLRON indicates this event is a submitter login.
12 (12 Character Submitter ID)
EDI Services assigns this value. Submitter ID also
populates ISA06 in the X12N interchange.
Authenticates the Submitter ID.
19
8
(assigned by EDI Services)
27
3
30
8
NAT is the only valid value. This value identifies the
method to reassemble the file if necessary.
(8-byte
The submitter assigns this value to identify the transmission. This field may
Transmission not be blank or contain leading or imbedded spaces.
Identifier)
Must have a unique value and may repeat within 2 years of transmission.
Suggestions for Transmission Identifier:
38
NAT
ƒ Configure your system to increment an original value automatically.
ƒ Configure your system to assign this value by month, day, minute, and
second (MMDDMMSS); or month, day, hour, second (MMDDHHSS).
Identifies the data contained in the transmission
15 One of the following values:
1
Value
Report Type
ANSI837I 1
ANSI837I 1 - ANSI X12N 837 Institutional Claims
ANSI276
ANSI276 1 - ANSI X12N 276 Claim Status Requests
1
Protocol
Indicator
53
X Xmodem
Transaction ID
54
4
Claim ID
58
3
Filler
61
2
0
End of File
63
2
(Carriage Return and Line Feed)
Z Zmodem
This value sets the communications protocol for
transmission.
ANSI American National Standards ANSI is the only valid value.
Institute
MDA Identifies Medicare Part A
Carriage Return is 013 decimal, 0D hex.
Line Feed is 010 decimal, 0A hex.
Medicare Part A Sample
Submitter Login Record
©Blue Cross Blue Shield of Georgia
Georgia - Medicare
1
2
3
4
5
6
1234567890123456789012345678901234567890123456789012345678901
/SLRONSUBMITTER_IDPASSWORDNATTRANS_IDANSI837I 1
Page 3 of 7
Release 1 (January 2008)
Section A-EDI User Guide
IV - Communications-Sending & Receiving Files
5. We will return one of the following values:
Y (089 decimal, 59 hex): Your Submitter Login Record was accepted.
Proceed to Step 6.
N (078 decimal, 4E hex): Your Submitter Login Record was not accepted.
A Transmission Acknowledgment will follow with an error message (see below).
The system automatically disconnects.
Submitter Login Not Accepted—Transmission Acknowledgment
with Error Messages
Transmission Acknowledgment heading:
ACKNOWLEDGMENT OF X SUBMITTER_ID.TRANS_ID ON yy-mm-dd AT hh:mm:ss
TRANSMISSION FAILED
Error Message
Invalid Submitter ID or pass-word
in the Submitter Login
Invalid assembly method in the
Submitter Login
The Assembly Method value in your Submitter Login Record is not
valid. The Assembly Method value must be NAT.
Invalid format name in the
Submitter Login
The Data Format value in your Submitter Login Record is not valid.
See the Submitter Login Record Specification on the next page for
Data Format values.
The Transmission ID value in your Submitter Login Record is not
valid.
Invalid Transmission ID in the
Submitter Login
The Transmission ID in the
Submitter Login is a duplicate
Host not responding
6.
7.
8.
9.
Explanation
The Submitter ID or password in the Submitter Login Record is not
valid. The values in these fields must match the Submitter ID and
password assigned by EDI Services.
An earlier transmission included the same Submitter ID and
Transmission ID from your Submitter Login Record.
The Georgia Medicare computer system is not available. Please call
EDI Services at 888-883-2720, Option 3 to report this problem.
Once your Submitter Login Record is accepted, pause for one second.
Send your transmission using either Xmodem or Zmodem.
After sending your transmission, pause for one second.
Log out: To log out, create and send the Submitter Logout Record in ASCII format. See the
chart below.
Submitter Logout Record Specification
The Submitter Logout Record must not exceed 30 bytes, including the carriage return and line feed.
All fields are left justified and blank-filled. The blank filler is a space (032 decimal, 20 hex).
Field Name
Position
Record
Indicator
Submitter
Identifier
Transmission
Identifier
End of File
1
Length
7
8
12
20
8
28
2
Sample Submitter Logout
Record
©Blue Cross Blue Shield of Georgia
Georgia - Medicare
Value
Description
/SLROFF Submitter
logout
(12 Character
Submitter ID)
(Transmission
Identifier)
(Carriage Return
and Line Feed)
/SLROFF indicates this event.
This is the same value as in the corresponding field from
the Submitter Login Record.
This is the same value as in the corresponding field from
the Submitter Login Record.
Carriage Return is 013 decimal, 0D hex.
Line Feed is 010 decimal, 0A hex.
1
2
123456789012345678901234567
/SLROFFSUBMITTER_IDTRANS_ID
Page 4 of 7
Release 1 (January 2008)
Section A-EDI User Guide
IV - Communications-Sending & Receiving Files
Receiving Transmissions from Georgia Medicare
Georgia Medicare may send the following transactions or files to trading partners:
X12 997 Functional Acknowledgment
Transmission Acknowledgments
Medicare Reports to include:
−
Medicare Accepted Report
−
Medicare Error Report
−
Medicare Letters
X12N 835 Payment Advice
X12N 277 Claim Status Response
Trading partners can use Xmodem or Zmodem to receive transactions from Georgia Medicare. You
can use Xmodem to receive all of the transactions from Georgia Medicare. You can use Zmodem to
receive all except the X12N 835 Payment Advice.
*The procedure to receive the 835 Payment Advice with Xmodem is explained in the next section.
1. Using an asynchronous modem, dial into the Georgia Medicare transaction line.
2. After the modem connects, pause for three seconds.
3. Example initialization string for a MultiTech Model MT2834BA modem:
(The initialization string will differ with different modems.)
1
2
1234567890123456789012345
ATV1E0M1Q0&C1&D3&E14S7=60
AT
V1
E0
M1
Q0
&C1
&D3
Value identifies the modem and may differ with different modems
Verbose result codes
Echo Off
Monitor speaker on until carrier detect
Result codes will be sent
Carrier detect normal
Causes modem to reset to default parameters when CD drops
&E14
S7=60
Data compression off
Time to wait for CD
Repeat the remaining steps for each transaction you want to receive.
4. Create and send the Transmission Request Login Record in ASCII format as defined in the
chart on the next page.
The login must not exceed 64 bytes including a carriage return (013 decimal, 0D hex) and line
feed (010 decimal, 0A hex).
©Blue Cross Blue Shield of Georgia
Georgia - Medicare
Page 5 of 7
Release 1 (January 2008)
Section A-EDI User Guide
IV - Communications-Sending & Receiving Files
Transmission Request Submitter Login Record Specification—Receiving Files
Position
Length
All fields are left justified with blanks filled. Fill blanks with a space (032 decimal, 20 hex).
Field Name
Record
Indicator
Submitter
Identifier
Submitter
Password
Reserved
1
6 /SLRON Submitter login
Transmission
Identifier
Data Format
Value / Description
/SLRON indicates this event is a submitter login.
7
12 (12 Character Submitter ID)
19
8 (assigned by EDI Services)
EDI Services assigns this value. Submitter ID also
populates ISA06 in the X12N interchange.
Authenticates the Submitter ID.
27
3 (3 spaces)
This 3-spaces value is not used.
30
8 (8-byte
The submitter assigns this value to identify the transmission. This field may
Transmission not be blank or contain leading or imbedded spaces.
Identifier)
Must have a unique value and may repeat within 2 years of transmission.
Suggestions for Transmission Identifier:
38
15 One of the
following
values:
Value
Protocol
Indicator
53
Transaction ID
Vendor ID
54
58
Software ID
61
End of File
63
ƒ Configure your system to increment an original value automatically.
ƒ Configure your system to assign this value by month, day, minute, and
second (MMDDMMSS); or month, day, hour, second (MMDDHHSS).
Identifies the data contained in the transmission
Note: value list does not include Medicare Reports (Medicare Accepted
Report, Medicare Error Report, and Medicare Letters) or Transmission
Acknowledgments. To receive Medicare Reports, Transmission
Acknowledgments, and all other available reports, enter either MF- or *
Report Type
MF-ANSI-997
MF-ANSI-997 - Medicare 997 Report
MF-
MF- - All available Medicare Reports
TR-277
TR-277 - ANSI X12N 277 Claim Status Response
*
* - Entire mailbox contents
1 X Xmodem
This value sets the communications protocol for
transmission.
Z Zmodem
4 MDD Medical Data Delivery
3 (Vendor ID)
MDD is the only valid value.
This field may identify the entity sending the transaction.
Specific data is not required in this field, and you may
insert any 3-byte entry, including 3 spaces.
2 (Software ID)
This value identifies the vendor software version. Each
vendor assigns the value for this field. We use this field
as a troubleshooting aid only.
2 (Carriage Return and Line Feed) Carriage Return is 013 decimal, 0D hex.
Line Feed is 010 decimal, 0A hex.
Medicare Part A
Sample Submitter
Login Record
1
2
3
4
5
6
12345678901234567890123456789012345678901234567890123456789012
/SLRONSUBMITTER_IDPASSWORD
TRANS_IDDATA_FORMAT
XMDD VND00
5. We will return one of the following values:
Y (089 decimal, 59 hex), followed by a filename and a 32-character subject: Your login was
accepted and you have files. Go to Step 6.
Z (090 decimal, 5A hex): Your login was accepted, but you have no files. The system will
disconnect.
N (078, 4E hex) Your Submitter Login was not accepted. The following Transmission
Acknowledgment will display:
Unable to Authenticate User Login—This rejection message indicates that the Submitter
ID or password was not valid. These values must match the Submitter ID and password
assigned by EDI Services. The system will automatically disconnect.
6. If you receive a Y (089 decimal, 59 hex):
a.
Pause for one second.
b.
Begin receiving the file using either Xmodem or Zmodem.
c.
Repeat this procedure from Step 3 to create a new Submitter
Login Record until you receive a Z (090 decimal, 5A hex)
(Submitter Login Record was accepted, but you have no files).
Then, you may disconnect.
©Blue Cross Blue Shield of Georgia
Georgia - Medicare
Page 6 of 7
Release 1 (January 2008)
Section A-EDI User Guide
IV - Communications-Sending & Receiving Files
Receiving the 835 Health Care Payment / Advice
1. Using an asynchronous modem, dial into the Georgia Medicare transaction line.
2. After the modem connects, pause for three seconds.
3. Example initialization string for a MultiTech Model MT2834BA modem:
(The initialization string will differ with different modems.)
1
2
1234567890123456789012345
ATV1E0M1Q0&C1&D3&E14S7=60
AT
V1
E0
M1
Q0
&C1
&D3
Value identifies the modem and may differ with different modems
Verbose result codes
Echo Off
Monitor speaker on until carrier detect
Result codes will be sent
Carrier detect normal
Causes modem to reset to default parameters when CD drops
&E14
S7=60
Data compression off
Time to wait for CD
4. Create and send the Submitter Login Record in ASCII format as defined in the following
chart.
The login must not exceed 27 bytes including a carriage return (013 decimal, 0D hex) and line
feed (010 decimal, 0A hex).
Submitter Login Record Specification—Request the 835 Payment Advice
All fields are left justified with blanks filled. Fill blanks with a space (032 decimal, 20 hex).
Field Name
Record
Indicator
Submitter
Identifier
Data Format
End of File
Sample
Position
Length
1
6
7
12
19
26
7
2
Value
Description
sx –f Submitter
login
(12 Character
Submitter ID)
!REPORT
(Carriage Return
and Line Feed)
sx –f indicates this event is a transmission
request.
EDI Services assigns this value.
!REPORT is the only acceptable value.
Carriage Return is 013 decimal, 0D hex.
Line Feed is 010 decimal, 0A hex.
1
2
123456789012345678901234567
sx –f SUBMITTER_ID!REPORT
5. If your Submitter Login Record was not accepted, the system will disconnect. If your
Submitter Login Record was accepted, and if you have files available, we will send the 835
Payment Advice.
6. Begin receiving the 835 Payment Advice using the Xmodem protocol. Upon completion, the
system will disconnect.
If you have questions regarding these instructions, call EDI Services at (888) 883-2720, Option 3.
©Blue Cross Blue Shield of Georgia
Georgia - Medicare
Page 7 of 7
Release 1 (January 2008)
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