System and method for interactive EDI transactions

Electrical computers and digital processing systems: multicomput – Computer-to-computer data routing – Least weight routing

Reexamination Certificate

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Details

C709S246000

Reexamination Certificate

active

06516353

ABSTRACT:

BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates generally to communications platforms for performing EDI transactions and more particularly, an Internet/Web communications platform that supports interactive EDI transactions.
2. Description of Related Art
Electronic Data Interchange (EDI) facilitates the transfer of machine-readable information between computer systems. EDI standards were developed to streamline communications between business organizations. For example, healthcare service organizations such as providers, payers, managed care organizations, etc. often exchange documents that conform to EDI standards. For healthcare service organizations, EDI and other automation techniques reduce overhead by using technology to speed communications related to eligibility and benefit information, claims processing, referrals, authorizations, and remittance. Usually, an organization purchases special software that provides the functionality needed to translate data to an EDI format for further processing at another computer system. The actual formats required at various computer systems may vary so data formatting or mappings/translations specific to each of the computer systems with which an organization communicates may be required to complete all of its EDI transactions. Commercially available products such as PaperFree's WinMap Translator and WinMap Development products may be used to perform mapping and translation functions.
In many cases, an administrator manually performs the tasks that are required to prepare a data set or file for transfer and processing at another computer system. An administrator at the receiving computer system may also perform many tasks to process the received data. Whether at the sending or receiving computer system, an administrator may first perform file manipulation tasks that may be required by the receiving computer system. For example, the administrator may copy files, append files together, create empty files to receive data from another source, delete processed files, etc. The administrator may also encrypt, compress, or translate the data to another format. Commercially available software products may be used to perform some of the administrative functions. For example, Xceed Zip Compression Library may be used to perform compression and decompression functions.
The administrator may also perform mapping functions such that data is translated between or mapped from one format to another. Next, the administrator may perform tasks to complete the transfer of the data set or file to another computer system. For example, the administrator may perform an FTP process. Some administrators may create scripts or instruction sets to assist them in performing the required tasks. The scripts then perform many of the manual file and other manipulations that might otherwise be required for two computer systems to communicate and complete an EDI transaction.
Although EDI is widely used, organizations that use EDI for the exchange of information often need additional software to support the transmission and translation of data between internal and external computer systems. EDI standards relate to the format of data and are independent of underlying transport protocols that may be used to transmit data between computer systems. One problem with EDI, therefore, is a common communications platform for performing the data interchange. Typically, data is exchanged using a Value Added Network (VAN) with mailboxes. A requestor sends data to a mailbox and a responder looks for the data, processes it, and sends a response to the same mailbox. This process works well if timely responses to the requestor are not critical. This process does not work well for interactive communications or other situations in which a timely response is critical. For example, healthcare providers often require an immediate and timely response to questions regarding a patient's eligibility or benefits coverage.
The Internet and more specifically, the World Wide Web (Web) are platforms that are well suited for interactive communications. A Web page provides a common delivery platform between computer systems. However, the Internet/Web and the Hypertext-Transfer Protocol (HTTP) of the Web do not directly support EDI transactions. Therefore, there is a need for a system and a method of data transfer to support EDI transactions in an interactive Internet/Web based environment.
SUMMARY OF THE INVENTION
The present invention is a system and method for performing interactive EDI transactions across an Internet/Web based communications platform. The present invention is a Web-based system and method that facilitates the entry, transfer, and communication of data between organizations that use EDI standards. EDI transactions in the interactive environment of the Internet and Web are supported. The present invention comprises a plurality of software modules or components that communicate with one another to accomplish the features and functionality of the present invention. The software modules or components may be co-located on one computer or in some cases, may be distributed across computers that communicate, preferably, in accordance with Internet/Web protocols. Each computer involved in an EDI transaction in accordance with the present invention, in a preferred embodiment, executes a script for processing EDI data associated with a transaction. A script or instruction set operating on a first computer collects or obtains data for processing. One or more file manipulation, data formatting, compression/decompression, etc. tasks may be performed by the script. The unprocessed transaction/EDI data is transmitted from the first computer to a second computer (preferably, a Web server) for further processing in accordance with another script or instruction set operating at the Web server. Once again, one or more file manipulation, data formatting, compression/decompression, etc. tasks may be performed by the script. A script execution component associated with the URL or Web page of the Web server runs or executes the script. The script executing or running at the Web server may process the EDI data at the Web server in accordance with a business function or application also at the Web server. The processed transaction/EDI data is then transmitted from the Web server to the first computer. The EDI transaction is then complete.
Another component of the present invention is used to develop scripts for execution in accordance with the present invention. A graphical user interface tool for building scripts allows for a lot of functions that would require extensive programming otherwise. This type of programming is out of the capabilities for small- and medium-sized companies and therefore, represents a significant advantage for small- and medium-sized companies that would like to automate the process of performing EDI transactions.


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