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Translator 101

What is a translator?
Simply put, a translator is a software program that converts an originating data file into a structure that a destination system can understand. It is similar to using a person to translate a foreign language into one you understand.

What exactly does it do?
A translator uses templates, or stored instructions related to the structure of a data file, to create a map between the originating and destination file formats. It translates data so that the receiving system can use it. However, that is not all a translator can accomplish. It is capable of doing all these tasks:

  • Create format templates and maps.
  • Convert standard or non-standard outbound data to standard or non-standard formats.
  • Convert standard or non-standard inbound data to standard or non-standard formats.
  • Generate a data element based on a combination of data values.
  • Generate a data element based on a formula applied to data values.
  • Create email notification of job and error logs.
  • Support multiple versions of standard transaction data sets.
  • Convert single or multi-record formats.
  • Convert fixed-width or delimited files.
  • Handle looping or hierarchical criteria.
  • Support linkage to ODBC databases. (DB2, Informix, Oracle, SQL, Sybase, etc.)
  • Handle file conversions and database, or data warehouse loads.

Ok Great, why do we need it for HIPAA compliance?
Healthcare transactions have traditionally required healthcare organizations to exchange thousands of dissimilar file formats. In order to complete these exchanges, one of the companies usually performs the task of developing custom conversion software to take the originating data file and convert it, or "map it", to another file format. The HIPAA regulations mandate that healthcare organizations exchange information using standard ANSI X12 formats. The task of modifying existing systems and or developing custom conversion software is a costly, time consuming and cumbersome process. A translator can accomplish this task and much more.

What are our other options?

1. Custom Software Development.

Custom software development for the translation or conversion of the HIPAA .

Transaction data sets can be a very involved and complex task. Organizations that have not historically undertaken major development initiatives may want to avoid this option in lieu of obtaining a translator or outsourcing to a clearinghouse. Consideration should be given to available business and information technology resources, application architecture, the cost for the initial and ongoing development, maintenance, and the time to market.

If you have the available resources to develop the custom software solution you benefit by:

  • Control of future development.
  • A customized solution specific to business requirements.
  • Cost predictability

Available resource determination for custom software development should include the following considerations.

Initial review of custom software development may exclude features such as:

  • The need for logic to replace data values

  • The need to create calculated fields, or add data via a formula for the output file

  • The limitation associated with a one-to-one solution, which does not allow a change in either the source format, or the destination format without the corresponding software development

  • Market and consumer pressures necessitate the ability to support the exchange of data and information, often the difference between profit and loss.

Designing and developing custom conversion software is costly, time consuming and cumbersome. The information Technology and business resources needed to complete the creation; development, testing, and deployment for a single file-to-file translation can easily cost tens of thousands of dollars!

2. Outsourcing to a Clearinghouse

The translation of the HIPAA formats can be outsourced to a clearinghouse. Most clearinghouses offer a suite of services, many including connectivity, a communications package, and trading partner interfaces. After the implementation and training is complete, the clearinghouse takes responsibility for the majority of the day-to-day operations. Costs are ongoing and typically charged on a transaction basis. Fluctuations in transaction volumes can cause variances in the month-to-month expenses with unpredictability an issue in budgeting.

To sum it up the options for achieving HIPAA Data Transaction set compliance are:

Internal Software Development
DataBridge Integration Solution
Outsourced to Clearinghouse
Cost Cost confined to resources allocated to the creation, development , testing, training, deployment, and maintenance.

Software pricing is very predictable. Usually a one-time expenditure for license and implementation plus minimal ongoing fees for maintenance.
Cost unpredictable since is pricing based on the number of transactions.

Implementation and training fees . Ongoing costs indefinitely.

Functionality Most often will lack features contained in other options. Includes more features than other options.
Tailored specifically to your current requirements, but little flexibility for other needs.
Maintenance Internal to your organization Provided as part of the Package pricing or as an Option.
Provided as part of the service.
Provided within your Organization by your resources.

Provided as part of the Package pricing or as an Option

Provided as part of the service.
Changes in standards necessitate additional development.
Usually offered as part of the Package pricing or as an Option
Provided as part of the service.
Ownership Your Oraganization

Software vendor

Domain Your data center

Your data Center Ciearinghouse

Your organization controls use and development.

You have control within your Organization

Time to Market Most lengthy Very short, depending on the vendor and your requirements. Very short, depending on the vendor and your requirements.
Scope of Tasks Usually limited to specific format-to-format mapping.
Should enable other file conversions and data warehouse loads.
Specific to contracted services.

The end result of a translator specific to the administrative simplification portion of HIPAA, will be a single communication language to use in data exchanges that creates a paper-free environment, speeds up transmissions, streamlines exchange of information, and creates a national pool of comparable data. The by-products of the process will be increased operational efficiency, a reduction in the transaction cycle time and a higher level of consumer satisfaction.
Clavib provides HIPAA compliant software and services to all healthcare entities that are affected by the HIPAA Act of 1996. The DataBridge Integration solution enables these entities to effectively transmit and receive healthcare EDI information by converting proprietary formats to ANSI X12 formats and vice versa, reducing custom programming costs by delivering pre-defined standard layouts and the ability to map transaction sets.

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