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Technical Interview Questions and Answers :: EDI


    Electronic Data Interchange

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    How does EDI Work?

    Purchase Ordering Example
    1. The buyer enters order information into the production database, which generates a purchase order on the computer. The order information is then channeled through a number of interface programs.
    2. The interface software programs perform edits and checks on the document and direct the order data into predefined EDI intermediate files.
    3. The EDI intermediate files contain information in a form that the EDI translation software can read.
    4. The translation software is a set of programs that translates the interface file data into a document formatted according to EDI standards that the supplier's computer can recognize.
    5. The electronic document now consists of a file that contains the order data in a predefined, recognizable order.
    6. The communications software adds appropriate communications protocols to the EDI document in preparation for transmission via telephone lines.
    7. Using a modem and telephone line, the buyer transmits the EDI purchase order to a VAN (Value added network). Think of this as a mailbox.
    8. The communications software on the supplier's computer picks up the document from the VAN, interprets and/or converts the communications protocols to open the electronic document.
    9. The purchase order is now in a standard, recognizable format in a file and is available to the supplier's computer.
    10. The supplier's translation software interprets the documents from the EDI format and places the order information in EDI intermediate file(s).
    11. The EDI intermediate files contain the translated purchase order information.
    12. The interface programs perform edits and checks before the data is integrated with the supplier's production database.
    13. The application software on the supplier's computer can now process the buyer's order.

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    What are EDI Benefits?

    Builds closer business partnerships * Reduces/eliminates manual handling of data, errors and rework * Transfers information faster and more accurately * Automates routine transactions * Improves productivity and business controls * Reduces costs * Shortens transaction processing cycles * Enhances data accuracy * Lowers inventory levels * Contributes to better in-stock positions * Lowers freight costs * Provides Quick Response capability * Improves cash-flow management * Creates a competitive advantage

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    What are EDI Drivers?

    * Ability to strengthen partnerships
    * Improve business processes
    * A communication tool to allow new ways to do business
    * A preferred way of doing business among Fortune 500 companies
    * A business basic for the industry

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    What is IDES?

    International Demonstration and Education System. A sample application provided for faster learning and implementation.

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    What is the most common EDI cycle?

    Subscriber or Sponsor or Member will Enroll the individual or Group EDI 834 ( Enrollment) *With 834 transaction Subscriber information will be stored at Payers data base * Subscriber starts paying Premium payment EDI821 * Provider sends EDI270 for Eligibility Inquiry* Payer responds with Eligibility Response EDI271* Some times Provider request for prior authorization for Patient ( subscriber) EDI278* Payer responds with review response EDI278 * Provider submits the Claim to Payer EDI837 * Payer some times request Additional information EDI277 * Provider request for Claim status by sending EDI276 * Payer replies with Status Response EDI277 * Provider response with attachment EDI275/HL7 * Payer process remittance advice EDI835 * 


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    Why move to EDI?

    * Allow machines to process business transactions while people develop and enhance business relationships
    * Strengthen internal and external business relationships through "information partnering"
    * Promote Electronic Commerce through EDI and other information solutions
    * Improve the supply chain by making accurate information available quickly and inexpensively
    * Reduce operating costs by re-designing business processes and automating routine tasks

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    What is required for enrollment with EDISS?

    To begin enrollment, EDISS requires providers create an online profile in EDISS ‘Connect’. Creating a profile in Connect provides EDISS with all the necessary information for setup completion in our system. All demographic, facility, line of business, electronic transaction, and method of submission information is captured immediately during online registration.

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    Is there downtime for submitting claims to EDISS?

    EDISS phone lines are available for submission of production files 24/7, with the exception of every Sunday from 6:00 a.m. to 12:00 p.m. (CT) when the lines are
    unavailable for scheduled maintenance.

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    What is a companion guide and how can I get one?

    The companion guide is specific to a client (BCBSNC, AETNAGA, UPS Etc) and implementation Guide is a standard guide like 837, 835 Implementation guides.

    Every client prepares their own companion guides with the help of Implementation Guide, with this companion guide System Analysts, Developers, Architects works to develop their system to integrate the EDI Transaction flow.

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