Introduction: AMISYS is a global claims processing system which is used frequently by many health care companies.
Problem: All claims data that is processed in AMISYS needs to be sent to other systems to convert them to EDI formats and to share them to partners through B2B communication channels
Description:
- AMISYS has a provision to write all claim information in flat files with tab delimitation. Those files are called Header, Detail and Trailer files
- It can also read the claims information/updates from partners in flat file formats mentioned above
- Integration system is required to read, understand, transform, and translate into the destination systems
Solution:
- Client chose TIBCO Integration platform to establish the needed connections
- TIBCO has a palette for operations on Files that can read and parse files with tab delimited content.
- When AMISYS completes the claims processing, it would send them to certain folder location on the system, at a scheduled time of the day
- TIBCO would poll the folders, read the data and then process claim information into required EDI XML format.
- This data would be sent to TIBCO BusinessConnect which is a B2B solution from TIBCO that creates EDI 837 files and sends to partners over VAN or AS2.
Tools Used: TIBCO BW, TIBCO BC
