EdiLogic Overview

EDILogic fully automates the processing of edi healthcare 837 professional and institutional transactions for payers by automatically downloading the edi files from the trading partner sites, transforming the EDI files to XML and generating corresponding UB-92 or HCFA-1500 forms. It also creates outgoing EDI files and submits them to trading partners via ftp.

Incoming edi files:

EDILogic receives the edi file from the trading partner through FTP or web (FTP Transfer Service Component or WebDirect Claim Submission Component )

Captures the content of the files

Submits it to BizTalk Server engine and transforms the content to XML format.

Parses the XML file for all UB92 or HCFA-1500 data elements and all other most commonly used data elements.

Stores the parsed data to EDILOgic SQL Server database

Generates a PDF presentation of the UB92 or HCFA-1500.

Stores both XML and PDF files in the SQL Server database.

Allows user to view and print the UB92 and HCFA-1500 forms

Depending on the type of the healthcare file (837I or 837P)

Outgoing edi files:

Retrieves all adjudicated claims from the database and creates XML presentations of the respective files

Submits the generated XML content to the BizTalk Server engine and transforms it to EDI format.

Uploads the generated EDI file to the trading partner site.