Employee Navigator built a tool that allows users to schedule file creation and transmission to the carrier. Transmission details are typically coordinated early in the process, and identify the method and security credentials to establish the secure data transfer.
One of the first steps in the EDI process involves letting the carrier know you are interested in moving a client to EDI feeds. The carrier will typically break that request internally up into two channels:
- File Structure: What type of file and what needs to be included on it (companion guide and group structure)
- Transmission: How is the data getting to the carrier
This article is addressing how the data gets to the carrier, and everything included in that process. From the naming convention on the file, to the method the file is transmitted, those details are all very specifically coordinated. For security of the data, it has to be!
Request and complete carrier paperwork to initiate EDI transmission
Determine transmission methodology
Carrier assigns transmission protocols and user credentials to licensee
Licensee configures the transfer protocol details on EDI configuration
Licensee provides PGP encryption key to Employee Navigator
Test Transmission Connection
Generate and transmit a test file
Update Settings and turn on scheduled files
- Upon initial request to move a client to EDI feeds, the carrier begins to initiate the processes internally for EDI transmission. Carrier will ask for technical contact. This contact should be the licensee. Employee Navigator will support the licensee when needed for transmission, but should not be listed as a direct contact with the carrier
- Carriers will either have specific transfer protocols, or will ask the licensee how they would like to transmit. If carriers have specific protocols, they will provide those details to the technical contact identified in Step 1
- If a carrier gives you an option, you need to know a little about what options may be available. In a nutshell, there are two components:
- Data can be transmitted via various transmission methods. FTP allows you to transfer files between two computer on the internet. SFTP is a secure version of FTP, which facilitates the transfer over a secure shell (SSH). Some carriers have build in file transfer processes from their secure websites (HTTPS://).
- Securing the data is another optional layer of protection. Typically, data is secured through PGP( Pretty Good Privacy). Carriers will have a unique public key they provide to all their clients transmitting data. This key is not unique to the client sending data, so if a PGP key is received, it needs to be provided to Employee Navigator to configure at the carrier level.
- IP Addresses:
- Another level of security some carriers implement involves configuring valid IP addresses authorized to connect to FTP/STFP to validate EDI files are coming from approved senders. The automated files Employee Navigator creates and transmits will be from the following IP Addresses of 220.127.116.11, 18.104.22.168, 22.214.171.124
- Employee Navigator offers a tool to test connection to an FTP/SFTP, which is 126.96.36.199 . Note, test files aren't generated off this IP address. This tool is only used to validate configured transmission protocols (see Step 6). If carrier needs IP addresses, you need to give this address if using the Test tool.
- Important! In the event that a file needs to be transmitted to the carrier outside of the Employee Navigator transmission tool, it is recommended that licensees also establish backup processes. You may also create a file and load directly to the carrier (outside of the automated transmission tool), you will need to provide the carrier with those IP addresses who may be responsible/authorized to transmit a file to the carrier.
- Carriers known to require specific IP addresses include the list below. If you find that one a carrier restricts access by IP address and it is not listed below, please let us know so we can update appropriately.
- Blue Shield of California
- Blue Cross Blue Shield of Tennessee
- Delta Dental of Kansas
- Delta Dental of Massachusetts
- HealthNet of California
- Reliance Standard
- Meritain Health
- Transmission methodology
- Securing the data
- NOTE! We highly recommend our licensees to subscribe to this article because IP address can and will change and we will update this article immediately upon any changes.
- When given the choice, Employee Navigator recommends using SFTP with PGP, because that offers 2 levels of protection. If transmitting via FTP, you should ALWAYS secure your data with PGP.
- Carrier will send the transmission protocols to the technical contact
- FAQ: My carrier has indicated that Employee Navigator already has a transmission credentials established and would like to re-use it, is that ok?
- The carrier is referring to the secure method in which an 834 EDI file is transmitted to them. While Employee Navigator may have secure transmission protocols established for our own direct clients, for security purposes, it is imperative that each licensee establishes their own protocol with the carrier directly. If a carrier attempts to require all files originating from Employee Navigator's server to use the same credentials/protocols, please send in a support ticket so we can assist.
- Licensee configures transmission details under the File Settings tab. By selecting the "Transmitting" box, more configure fields will appear
- File naming Convention- Carrier will specify the exact name they need to process the file.This is configured under the File Settings Tab, in "Filename" field. Date/Time stamp can be configured by placing codes within brackets.
YY: 2 Digit Year (2014 would be 14)
YYYY: 4 Digit Year
Example: TestFile_1234_[YYYYMMDD].txt will turn into TestFile_1234_20140101.txt
- Tips: Type in any extensions needed (with the exception of PGP) such as .txt, .dat, .834
- If file is PGP encrypted, do not type in ‘.PGP’ to the naming convention. The extension automatically gets added when encrypted.
- Transmission Details- Add transmission details by checking the Transmitting box on the file settings tab.
- Protocol: Select transmission protocol
- Transfer Mode: Active or Passive (leave at default unless asked to change)
- FTP Server: Can be address or IP. Example: ftp.carriername or 188.8.131.52
- FTP Server Port: FTP is port 21 and SFTP is port 22. If other port is the carrier will provide the #
- Username/Password: Unique to client/carrier (dependent on carrier)
- FTP Directory: Optional Sub directory where file is placed on carrier server (/in, Prod, Test, etc)
- Scheduling: Employee Navigator recommends to leave scheduling unset during testing
- The PGP key is saved at the carrier level. Please contact your Employee Navigator technical contact with the PGP key provided if you are setting up a new carrier
- This is optional only and not needed to transmit a file.
- If EDI configuration is completed and ypu are ready to send a test file just navigate to the Generation tab and select RUN. (check the reminders under RUN prior to hitting transmit. It lists the transmission options that you have enabled)
- Setup tab- change the "Transmission Status for Reporting" field to production. This will automatically change the ISA 15 value to a P indicating to the carrier the data is for production
- Update file naming convention if necessary
- Add email addresses of users that wish to receive a copy of an email when a file is generated/sent to the notification list in the file settings tab
- Select the preferred day for the scheduler and check a box and save the page in the file settings tab. The file will be generated overnight on the day selected. (If Tuesday is selected, file generation starts at 3:00 A.M Eastern time on Tuesday
- Review the email received after the file is sent for errors and report any errors to Employee Navigator that you may not understand. Some common transmission errors are : incorrect user id/password, file generation timeout, unable to communicate with carrier’s server