EDI Converter 2.14.5 — Support for Pay-to Billing Provider Address, Related Cause Code, and Contract Info

We’re pleased to announce version 2.14.5 of our EDI Converter.

This is a maintenance release that adds support for the “pay-to” billing provider’s address and a few other fields in 837 transactions.

This release also includes a bug fix for incorrect parsing of the provider’s taxonomy.

New JSON Objects and Fields

“Pay-to” Billing Provider Address

A billing provider can have a second address on 837, denoted by NM*85 segment. There is now a new claim field ““payToAddress” containing this address.

Example (fragment; full JSON here):

  "payToAddress" : {
    "entityRole" : "PAY_TO_PROVIDER",
    "entityType" : "BUSINESS",
    "address" : {
    "line" : "235 SEAWAY ST",
    "city" : "MAIMI",
    "stateCode" : "FL",
    "zipCode" : "33111"
  }

We’ve added support for the Related Causes Code (CLM11) segment in 837P transactions:

Example:

"relatedCause" : {
  "relatedCauseCode" : "OA",
  "relatedCauseCode2" : "AA",
  "stateCode" : "FL",
  "countryCode" : "US"
}

Object schema

Contract Info Object (CN1 Segment)

We’ve added support for the CN1 segment (contract or contract line item for post-adjudicated claims) for 837I/P/D transactions:

Example:

  "contractInfo" : {
    "contractTypeCode": "02",
    "amount": 550.00,
    "percentage" : 99.90,
    "contractCode": "XX",
    "termDiscountPercentage": 2.20,
    "versionIdentifier": "V5"
  },

Object schema

Other JSON Changes

  • New “patientSignatureSourceCode” field (CML10) field for 837p transactions
  • New “ambulancePatientCount” field (QTY*PT) for 837P transactions (line-level)

Bug Fixes

We’ve fixed a bug related to parsing billing/rendering providers’ taxonomy when multiple taxonomies are present in the same transaction.

API Server

If you don’t need code descriptions in your API responses, you can disable it by supplying codeset_enrichcodes=false environment variable.

This will reduce the size of the response and improve the startup time for the API server.

How to Upgrade

API Docker container

If using docker compose, update the image tag to repo.datainsight.health/ediconvert:2.14 and pull the new image:

docker compose pull

The latest docker-compose file is always available in our GitHub repo.

Without docker compose:

docker pull repo.datainsight.health/ediconvert:2.14

Check the version via the API:

curl http://localhost:5080/api/about

CLI tool

  1. Download the new version.
  2. Unzip and replace your existing installation files (including lib and conf folders).
  3. Do not delete your license file.
  4. Run: 
    ediconvert -V
    The output should include ediconvert 2.14.5.

EDI Parser for Java

Update your Gradle or Maven dependency:

implementation "hdi:edi:2.14.5"

AWS Lambda Function

Update the Lambda deployment:

aws lambda update-function-code --function-name <your function name> --zip-file fileb://./edi/build/distributions/ediconvert-lambda-2.14.zip

You can also use this Terraform file to update the function.