EDI Implementation Process

Here you can find detailed information on Maxwell’s EDI process once an EDI connection is requested by your broker. The below chart explains the lifecycle statuses of an EDI ticket, along with definitions of those statuses and estimated time to go live once that status is reached.

  • Please note: the “time to go live” are estimates only. Definitive times generally depend on how quickly carriers respond and how promptly brokers and employers are able to clarify issues as they arise throughout the process.  

Status

Definition of Status

Estimated Time to Go Live

Initiation

Maxwell creates EDI ticket and assigns it to an EDI analyst to begin work.

4-12 Weeks

Initial Info Required from Broker/Employer

In order to move forward with the file creation process, some carriers/vendors require that the broker reach out to the carrier first and/or fill out carrier specific forms or questionnaires.

Depends on Broker Turnaround Time

Data Gathering

Maxwell Health has reached out to the carrier/vendor in order to retrieve all file specification needed to begin implementation.

Depends on Carrier Turnaround Time

Data Gathering - 2nd Attempt

Once 7 calendar days pass after the first carrier/vendor reach out, Maxwell Health follows up with the carrier/vendor once.

Depends on Carrier Turnaround Time

Data Gathering - 3rd and Final Attempt

Once 7 calendar days pass after the second carrier/vendor reach out, Maxwell Health follows up with the carrier/vendor again.


If 7 additional days pass without a carrier/vendor response, this will be escalated to the broker partner in order to get assistance in obtaining the required information.

Depends on Carrier Turnaround Time

Secure Credentials Pending From Carrier

Maxwell Health has requested and is waiting for secure credentials from the carrier/vendor so that we can transmit a test file and eventually a production file in a secure manner.

Depends on Carrier Turnaround Time

Info Required from Broker/Employer

This status will occur when we need information from a broker or an employer before we can proceed, which generally has to do with account structures (at the beginning of the project) or data discrepancies within the client’s Maxwell portal. Until these are responded to, we cannot move forward with creating a test file.

Depends on Broker Turnaround Time

File Spec Creation

Maxwell Health codes the file to the specifications of the carrier and maps any account structures that the carrier has provided for the employer group.  

  • Please note: This step and the steps below can only begin once a portal is live.

8-10 Weeks

Data Review

Maxwell Health reviews all data in the employer portal to make sure it is accurate and there are no gaps (ex. missing DOB, SSNs, addresses, etc.).

6-8 Weeks

Testing - Internal Prep

Maxwell Health has created a test file and is going through our internal multi-layered quality assurance process prior to sending the test file to the carrier/vendor.  

4-6 Weeks

Testing with Carrier

Maxwell Health will send test files and receive discrepancy reports from the carrier/vendor. Maxwell will clear those discrepancies up (with the help of the broker) and re-send test files until sign off is given by the carrier/vendor.

1-4 Weeks

Live File

Carrier/vendor provides sign off on test file and the file is "turned on."


Once this occurs, your Account Manager will notify the contact with instructions on when the file will be sent and at what frequency.

N/A



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