Insurance Company chooses WebSphere Message Broker and TransformaTech X12 Message Sets over WebSphere Transformation Extender (WTX) to replace unsupported WebSphere Data Interchange (WDI) to support electronic claims processing
Key Challenges:
- Need to migrate from 4010 to 5010 837 X12 standard to stay in compliance
- Current Solution using WDI going out of support
- Significant licensing and maintenance costs of switching from WDI to IBM’s proposed solution of WTX
- Limited knowledge of existing WDI interfaces
- No prior experience with handling X12 / EDI in WMB
Solution Overview:
- No purchase of new IBM software
- Use TransformaTech’s pre-built X12 Message Sets for 837 and 997
- Engage TransformaTech to assist in migration of WDI EDI translations to WMB EDI Translations
Key Results and Benefits:
- Successful and transparent migration from WDI to WMB for EDI translations
- Saved over $175K + ongoing maintenance costs
- Become compliant by being able to receive 837 5010 and support new ICD10 codes
- Continue to leverage on investment made with WMB
Background
An insurance company responsible for processing thousands of workman’s compensation claims per day was faced with their former EDI translation product (WDI) going out of support by IBM and their regulatory requirement to be able to support EDI X12 837 5010 version for their electronic medical bill processing.
Figure 1: WebSphere Message Broker Environment before
IBM had proposed that the company purchase WebSphere Transformation Extender (WTX). While this would have been a technically acceptable solution, it brought about a significant cost to the company. The costs associated included license fees of over $175K plus ongoing maintenance costs. Significant services were also required to migrate their existing WDI EDI translations to WTX. This was a new technology and the company’s staff would require significant training and experience. This lead the company to evaluating the following options:
Solution
After extensive evaluation and review, the company decided to go with option 3 – a 100% WMB solution. The company engaged with TransformaTech to help them with their critical project to migrate off of WDI and because compliant with their Medbill processing by supporting 837 5010 standard and new ICD10 codes. The solution consisted on the following:
- Successful and transparent migration from WDI to WMB for EDI translations
- Saved over $175K + ongoing maintenance costs
- Become compliant by being able to receive 837 5010 and support new ICD10 codes
- Continue to leverage on investment made in WMB
- Staff fully trained and able to take on support and future development
Figure 2: WebSphere Message Broker after
Outcome
With the assistance of TransformaTech, the company made a seamless transition from WDI to a 100% WMB solution. This solution resulted in the following:
- Use TransformaTech’s pre-built Message Sets for 837I, 837P, and 997 5010 standards
- Replicate WDI EDI Translations (mapping to XML) and update to make 5010 compliant and support new ICD10 codes
- Extensive Regression testing to ensure old and new process produced same results
- Assist company to migrate from DEV to TEST to PROD environments
- Knowledge transfer and mentoring to company staff on new process
Additional Information
>>Read more about TransformaTech’s WMB/IIB X12 Message Sets and DFDL
>>Read more about IIB/MQ Monitoring and Support Outsourcing
>>Read more about TransformaTech Monitor
>>Read more about TransformaTech’s history working with IIB
