The technical glitches of healthcare.gov, America’s new insurance marketplace have been widely reported in the news. Some of the problems stem from the EDI transmissions used by healthcare.gov to communicate enrolment data to health insurance providers. In this post, I’ll describe the EDI transmissions used by the new marketplace and summarize a few of the problems that cropped up.
There are two types of EDI documents in use with the new marketplace: 834s and 999s. “834” is an EDI code that refers to a benefit enrolment and maintenance document. When a shopper on healthcare.gov chooses an insurance plan, the marketplace is designed to send an 834 to the insurance provider selling the user’s selected plan. This document contains information like the user’s name, their address, their phone number, their spouses or children on the plan and other details that the insurer needs to complete the enrolment.
Once an insurer receives an 834 from healthcare.gov, they respond with another document called a 999. 999s are an acknowledgement that the provider received the 834. The 999 tells healthcare.gov that the 834 was accepted by the insurance provider, that it was rejected or that it was accepted with errors. When the user pays their first premiums, the healthcare provider sends an 834 to healthcare.gov to confirm that the customer completed their enrolment. The marketplace responds with a 999 to acknowledge the insurer’s 834.
These EDI transmissions are backed up by an translator that converts the data into XML, a format that the marketplace’s systems can read. The Center for Medicare & Medicaid Services (CMS) has published an diagram that shows how this all works:
Healthcare.gov went live on October 1. At first, there were technical problems unrelated to EDI and very few people were able to enrol in plans. However, meeting minutes show that EDI problems quickly became apparent as the marketplace began to work properly. In a meeting on October 8th, administrators noted that “Issuers are not receiving 834s when they should be.”
An EDI dashboard was created to monitor the success rate of transactions, however the dashboard did not provide cumulative data. Again, this is described in the meeting notes from October 8th:
“News websites are reporting issuers who say they are receiving flawed 834s; because we use a daily dashboard, it is hard to see the cumulative number of 834s sent out that we don’t have a response back for.”
They added that: “There were 700+ enrollments last night. There are 300+ failed 999s”.
Other EDI problems that were reported after go-live included duplicate 834s, 834s with incorrect relationships — for example, one man was reportedly recorded as having three spouses — and 834s that lacked important information, like county codes. In some cases, the minutes show that issues that were identified through EDI may have been rooted in upstream components of the marketplace, like the XML provided to the EDI translator.
In hindsight it is easy to say that extra testing would have been beneficial for healthcare.gov before it went live on October 1. It seems like it was especially challenging for administrators and insurers to resolve EDI problems after the website had already been launched. You can read more about the EDI issues with healthcare.gov on the Washington Post blog and here at CNN.com.
Right now most eCommerce store are focusing on the upcoming holiday season and trying to make sure everything runs smoothly. For most businesses this is the busiest time of the year and a lot of this years preparations all come down to the last couple of months in 2013. But what about 2014? Have you started planning for next year yet?
Judith Wolst (@judithw) from SIME wrote a very interesting post giving readers Five Trends In eCommerce For 2014. It is a great read for eCommerce merchants who haven’t exactly started thinking about 2014 and want to know what will be trending for the upcoming year.
1) Big data
In general, companies are stressed out about not using the potential of “big data”. For e-tailers, data-centric customer analyses have for many been a given, since data is the beating heart of e-commerce. 2014 will be the year that e-retailers and other businesses will fight for talent that know their way around data. The good ones are not easy to find – being a mix of a merchandiser, a marketeer and a data geek is not a common combination.
High-quality, SEO-friendly and highly engaging content for enhanced user experience will be what matters for e-commerce websites in 2014. The relationship between exclusive quality content and ROI will become increasingly clear. E-retailers will in 2014 invest more in quality text, images and video.
Cross-channel is not a buzz-word anymore. Seamless browsing, saving and shopping across platforms is a no-brainer. Market growth will further drive investment in platforms and solutions, but mainly for brands with large budgets. The gap in user experience will increase between large and small e-tailers. It has become increasingly easy to start an e-commerce store front. Nevertheless, it will become harder to get the big picture to dance together. I also think we will see more M-commerce in 2014
4) Mobile POS in stores
Mobile point-of-sale devices are no longer just a tool for small merchants to accept card payments, eg. via solutions such as Square and iZettle. Today, more and more retailers equip their staff with POS devices that enable payments without going to the tills – a trend that was initiated the Apple stores. I think we will see lots of POS devices during this year’s holiday rush. Presumably, these will live on and become a permanent solution in a lot of stores in 2014
5) Significant increase in number of e-stores
With lowered barriers of entry we will see lots of smaller companies are entering into the fray. Solutions such as Shopify, WooCommerce and Tictail are enabling this. The difficulty for smaller merchants will not be in the technical are but in acquiring customers at a reasonable cost.
Bonus thought on Facebook commerce
In 2014, I think Facebook will still be struggling to get F-commerce to take off. Most recently, with Facebook Autofill. Will they find an angle that works?
Thanks for the great info Judith!
eBridge Connections is your ERP Integration expert – but before you’re able to integrate your ERP with your eCommerce Webstore(s), EDI Trading Partner(s) or CRM software, you have to have your ERP system implemented. There are many great choices when you’re trying to decide which ERP or Accounting Software to choose, many of which we Integrate with, so here are a few tips we have to help the process run a little smoother. We’ve worked with many customers in different stages of the ERP Integration process and some of our Customers come to us looking for integration before they’ve implemented an ERP system so here are a few helpful tips we give before they get started:
1. Construct A Budget And A Schedule
- This should be done at the beginning of your ERP implementation project. Making a budget and sticking to it will be one of the more difficult things you’ll have to do during the process but it should always the center point for all of your ERP goals. Remember to refer back to your budget and timeline to ensure everything is on track. If there are any major hiccups along the way be sure to reevaluate the budget and timeline to keep your project accurate.
2. Leave The Tech Stuff To The Tech People
- Even though this is a huge project that will impact your whole company, be sure to leave the tech changes with your IT team. They handle your company’s software on a daily basis so they will be the ones who are affected most by the change. Giving them time to test and understand the new software will help make them feel empowered and eager to embrace the change.
3. Do Not Underestimate The Project
- The problem we see most often is that companies don’t allocate enough time and resources for their implementation. The scope of this project is huge, affecting your whole company, so overestimating is always better than underestimating. Remember, implementing an ERP system not only shifts your company’s overall goals and tasks but your simple day-to-day tasks as well so you must give it the respect it deserves when it comes to estimating.
4. Train Employees To Help Manage The Change
- Implementing an ERP system or accounting software throughout your company will have implications for almost everyone and sometimes people don’t deal well with change. Training your employees will help ensure a more straight-forward and comfortable transition. Remember that the company who has implemented your ERP system or accounting package can be used as a knowledge tool. They come with years of experience working with implementations so be sure to ask them for advice when needed.
If you have any more helpful tips for us please post them in the comments below. We would love to hear advice you have if you’ve been part of an ERP Implementation project! If you’re looking for more information on integrating your ERP system with a webstore, EDI Trading Partner or CRM software, be sure to email me email@example.com .
There has been a lot of change to the eBridge Webinar series from 2012-2013. Since the release of eBridge On The Cloud we’ve primarily focused on ‘Cloud’ integration projects. We’ve received excellent feedback from our attendees and will continue to produce and post our latest webinars.
Our most recent webinar series has concentrated on our Sage 100ERP Cloud integration. We’ve held numerous webinars this summer focusing on the new features of our Sage 100ERP cloud integration and how it is different from our previous on-premise version. If you happened to miss the webinar and are interested in learning more, follow the link below! If you have any feedback or questions about our Cloud Sage integration, please comment below!
At eBridge Connections we know that our customers rely on our infrastructure as an important part of their business processes and data transmission. We take this responsibility very seriously, and the security and reliability of our software, systems and data are our top priority.
Our security consists of using 256-bit SSL encryption/certificates for all information travelling between your browser and eBridge Connections. The ‘Lock’ icon in your browser will verify that the site and all data is secure. It’s very similar to what banks or financial institutions are using. Other than that we have hardware and software in place to ensure a high level of security as well as redundancy in our facility. Everything at eBridge is done in-house at our Burlington Headquarters, we build, maintain and support all of our products. We don’t rely on any third party software which can assure customers that everything that is sent to eBridge stays within your eBridge Integration.
We want our customer and potential customers to know that all data transferred using our Cloud Integration is secure. If you have anymore questions or any concerns please contact us so we can set up a call with one of our Integration Specialists if you would like more information.
eBridge has scheduled a few hours for maintenance and upgrades to our ePortal system on Tuesday July 10th from 9:00PM EST until 1:00AM EST Wednesday July 11th. If you have any questions or concerns please contact our Support Team. Their information is listed below.
Please read through the ePortal Notification for more information:
|ePortal Planned Maintenance Notification
Thank you for selecting eBridge as your provider of business-to-business solutions.
Toll Free: 1-800-755-6921
eBridge Connections was sent information from the Costco Wholesale EDI Department regarding required upcoming EDI Changes. eBridge is contacting all customers who will be affected by the changes so they can become compliant by the July 1st implementation date. If you have any questions/concerns or would like more information on an EDI integration project with Costco, please don’t hesitate to contact us.
Here is a summary of the Costco email:
UPDATED INFORMATION – EFFECTIVE DATE JULY 1, 2013
**COSTCO’S ANNOUNCING NEW EDI REQUIREMENTS**
Costco Wholesale is currently involved in a project to implement an ERP software solution provided by SAP. Because you are currently an EDI partner with Costco this will impact you as our EDI requirements must change to accommodate the SAP model.
Costco’s new requirements:
- Product identification number transmitted on Costco’s 850/860 Purchase Order/Change must be used on your 810 Invoice. You will receive an 824 error rejection if this information is not supplied.
- All Item level discounts (excluding rebates) transmitted on Costco’s 850/860 Purchase Order/Change must be included on your 810 Invoice.
What Costco will need from you:
All information transmitted to you on the 850/860 Purchase Order/Change must be included on the 810 Invoice you transmit to Costco Wholesale. This includes the PO number, PO date, PO terms, quantity, price, product identification number (Costco item number, Supplier item number, UPC, GTIN, etc.) and all item level discounts (excluding rebates).
Your compliance is required by July 1, 2013. If you are already in compliance, we thank you and no action is required.
If you would like more information please email me firstname.lastname@example.org or comment below.
Home Depot has launched a new connection hub called Home Depot Special Order Program which will require its own new ePortal connection. Customers currently trading HD special products using Home Depot EDI will need to add a new trading partner. This is because it requires new mapping which may involve additional implementation costs. The cost will be different for every customer and is dependent on how may maps are necessary.
Home Depot sent eBridge three different implementation PDF’s with information outlining the changes that need to be made. If anyone would like a copy of the Home Depot Special Order Program EDI information, please contact your eBridge representative or email me email@example.com and I’ll be sure to forward the information to you. Below are the introductory paragraphs to the EDI maps that need to be changed:
856 Ship Notice/Manifest:
This Draft Standard for Trial Use contains the format and establishes the data contents of the Ship Notice/Manifest Transaction Set (856) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to list the contents of a shipment of goods as well as additional information relating to the shipment, such as order information, product description, physical characteristics, type of packaging, marking, carrier information, and configuration of goods within the transportation equipment. The transaction set enables the sender to describe the contents and configuration of a shipment in various levels of detail and provides an ordered flexibility to convey information. The sender of this transaction is the organization responsible for detailing and communicating the contents of a shipment, or shipments, to one or more receivers of the transaction set. The receiver of this transaction set can be any organization having an interest in the contents of a shipment or information about the contents of a shipment.
This Draft Standard for Trial Use contains the format and establishes the data contents of the Invoice Transaction Set (810) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to provide for customary and established business and industry practice relative to the billing for goods and services provided.
855 Purchase Order Acknowledgement:
This Draft Standard for Trial Use contains the format and establishes the data contents of the Purchase Order Acknowledgment Transaction Set (855) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to provide for customary and established business and industry practice relative to a seller’s acknowledgment of a buyer’s purchase order. This transaction set can also be used as notification of a vendor generated order. This usage advises a buyer that a vendor has or will ship merchandise as prearranged in their partnership.
|ePortal Scheduled Maintenance Notification
ePortal may be unavailable between 9:00am and 3:00pm EDT for planned maintenance.
During this time documents will be received but not processed. Once the maintenance is
Thank you for selecting eBridge as your provider of business-to-business solutions.