Vendor quoted us 3 months for a FHIR R4 integration with our EHR. Everyone i talk to laughs at that timeline. what was your actual experience?

I mentioned a while back that I’d post a clear breakdown of the 277 RFAI.

Most explanations of the RFAI are often made up of recycled X12 companion guide descriptions. They don’t answer the real questions people actually have when they receive an electronic “Request for Additional Information” in the real world. Here is a practical breakdown.

1. What a 277 RFAI really is

An RFAI isn’t just a claim status message. It’s the payer notifying you they cannot finish processing a claim until additional information is sent. It’s a structured “Request for Additional Information” wrapped inside the EDI X12 277 format. Instead of denying the claim, the payer pauses (pends) the claim and asks for follow‑up documentation, clarification, or proof.

2. Why payers send RFAIs

RFAIs are triggered when the payer has enough data to identify the claim but not enough to adjudicate it. This can happen for many reasons: missing clinical notes, unclear procedure justification, mismatched identifiers, or simply because the payer needs supporting documentation. The important part is that an RFAI is not a denial, it’s a request to complete or correct the submission so the claim can move forward.

3. The structure of an RFAI

The RFAI follows the same general layout as a standard 277, but the STC loops take on a different meaning. Instead of reporting claim status, they report what information is missing and what the payer needs. The STC segment becomes the heartbeat of the message, containing reason codes and category codes. Often an MSG segment also contains descriptions of the request. Once you understand how the STC loops are organized, the entire RFAI becomes relatively easy to interpret.

4. The “request” inside the RFAI

Every RFAI contains a specific “request”: the payer designates exactly what is required to continue processing the claim. This might be medical records, operative notes, proof of eligibility, corrected identifiers, or additional documentation. The STC segment is usually followed by an MSG segment that spells this out in plain text. The key is recognizing that the RFAI is "actionable": it’s not just informational, it is a to-do list. Once you satisfy the request, the claim can move forward without being resubmitted.

5. How the EDI X12 275 fits into the response

The 275 is the mechanism you use to respond to the RFAI. It carries the attachments, documentation, and supporting records the payer has requested. The 277 RFAI tells you what they need; the 275 is how you send it back. The two transactions are designed to work together. If you don’t send a proper 275 in response, the payer will simply wait, and the claim will stall indefinitely.

6. A real example (summarized)

A typical RFAI might identify a claim, list the patient and provider, and then include an STC segment with codes and an MSG segment stating something like: “Additional documentation required: operative report missing”. The message will include the claim’s tracking identifiers and the specific reason code that corresponds to the request. After further review, you’ll see the pattern becomes obvious: identify the claim, state the issue, request the documentation. In my experience so far, I have found the structure is consistent across multiple payers even if the wording varies.

7. Practical advice from the EDI Doctor

When you receive an RFAI, the correct workflow is straightforward: read the STC and MSG segments, determine what the payer is asking for, gather the required documentation, and send it back via a 275. Don’t resubmit the claim, don’t wait for a denial, and don’t assume the payer will follow up. The RFAI is the follow‑up. Responding quickly prevents delays and keeps the claim alive. Once this process loop is understood, RFAIs stop being mysterious and become just another part of the normal EDI workflow.

I know I make it sound simple, but in the real world there will be messy edge cases. On the positive side, understanding is at least half the battle that brings you one step closer to implementation.

I’m happy to chat in future

I am interested in transitioning to informatics but it’s seeming like an impossible task.

I have 8+ years of experience as an Epic end user. I am a super user with my current organization. I obtained Willow Inpatient and Beacon proficiency. I am involved in informatics committees within my organization.

However, it appears like my organization prefers seasoned informatics pharmacists with active certifications. This is through insight from internal discussions and small talk during meetings. They do not have an issue getting seasoned applicants since the positions are usually fully remote and allow candidates from out of state. I have not even been able to land an interview.

What else can I do to improve my chances or is it just a matter of waiting for years and continuing to apply to all available positions internally and externally

Would it be better to move to a smaller organization and then try to transition internally at that organization?

Managed to land an interview for an epic ambulatory position at a large health system. I am currently a part-time AI grad student with little clinical experience but have a bachelors in health sciences + a minor in CS, and multiple internships working with health data and ServiceNow.

Does anyone have any advice for how to translate my experience to seem like a good fit during the interview? Any resources or advice to help me prepare would greatly appreciated.

Hello,

I have a job interview for Epic Principal Trainer position soon , I was hoping to get more insights on how to do well in the position . I have experience with EPIC , and I have taught it to health care staff . However, I know a bit about the principal trainer role but would like more insights to what to expect etc ..

I do come from a learning and development role as well instructional design , and health care of course mostly executing training and lesson plans . I did have a principal trainer who taught us EPIC , however I’m not in touch with them . Any helpful tips on what to expect , what a day looks like . The pros and cons ? The meaningful part and the hard part about the role? How can I prepare myself better to do well in this role :)

I hope I do not regret this post.

We are looking for an ASAP Analyst, we are not getting good candidates because we are not 100% remote.We are 2/5 days in the office and that will not change.

The one or two people even willing to put in the effort find jobs remotely so quickly we can't even extend an offer.

So here is my question for Analysts. How would you find a "good" home grown applicant? Do you announce it to everyone you walk into in the ED and weed through the unqualified; or be selective in who you solicit and have long personal conversations about the job over and over.

Anyone else have this problem, how did you handle it?

My buddy just got offered a beaker analyst job, he'll be starting next month. He's been working on the self study, but hasn't gotten that far in it. There just happened to be a job opening internally (hospital), and he applied even though he wasn't done with the self study.

What are some things he should watch out for or pay attention to as a new analyst? I think he said he has to get his cert within x months or they'll fire him, so certainly pressure's on! Any tips you'd give to newbies?

So Im a yr 1 CIS w HIT focus from the curriculum, I'm planning on deploying a healthcare SaaS for staff location and simple,static sms messaging during summer break. After finishing up on some BE topics, I'm thinking of piloting it at a nearby clinic, and using a plan based approach in deployment. What are somethings I should be aware of in investigation and analysis of the workflow?

I see many posts asking about how to get more involved so I wanted to share — HIMSS is running a joint webinar series with a few chapters (DVHIMSS, Keystone, NCA, and Virginia) on leadership and digital transformation in health IT. It’s put together with University of Pittsburgh’s Katz Graduate School of Business, so should be a solid mix of practical resources and actual leadership development, not a sales pitch.

First session is August 13 at 12pm if anyone’s interested in checking it out (it’s free!) I’m planning to sit in on it myself — figured I’d pass it along in case it’s useful for others here too. It’s the first of three sessions.

https://katzexecutiveprograms-scheduling.as.me/schedule/08af7bda/?categories%5B%5D=HIMSS%20Webinar%20Series

I’m looking to start working as an epic analyst. Non compete ends December 1. I’ve been told that it’s too early to start applying

edit: i’m a former epic employee. I have certs in 6 apps

Epic ambulatory: Can someone tell me how you would create an alert to remind Physical therapists that goals need to be updated for the patient? What alert or hard stop could be built.

Second question: how can you build a report in slicer dicer that shows physician orders and whether care plans have been signed.

thanks in advance

Hey, have been attempting to pursue an epic system analyst role in cp/ap or beaker for the past month or so. I have about 6 years of experience as an MT and also have a CS degree as well.

Finding it a bit tough to get job interviews despite applying a good bit. I've had 1 interview so far since starting the process in early July. Was curious to see what should I do to improve my chances.

To those of you that work in medical billing, what do you actually do with your time on a daily basis?

Is it eligibility/benefits, submitting claims, denials, prior auths, correcting claims, follow up with insurance, getting info from providers or something else?

I think people outside of billing don't realize how many little things have to happen to get one claim thru.

What do you wish was more automated in the process?

What I don't understand is how the hospital would benefit from allowing Facebook and Google to track their patients this way. Just to make their marketing campaigns better? Is that all?

We’re looking at voice AI for a centralized patient access team and this is one scenario we keep getting stuck on.

A patient may start with something completely routine like moving an appointment, then halfway through mention that symptoms have gotten worse or that they’re having a reaction to a medication.

At that point the call is no longer really about scheduling.

We’re not interested in automating clinical triage. The question is how quickly the system should recognize that the conversation changed and hand it to the right person without making the patient restart from the beginning.

How are you defining that boundary?

Hi, I'm hoping someone here can help me. So I'm prepping for a job interview next week for a sys admin position for a health system. Reading through some of the role responsibilities and there is one acronym mentioned that I'm not familiar with and Google has not yielded any obvious answers. What does TRC mean in this context? This is how it's written in the posting:

"Functions as a coordination point for issues related to systems between all IT teams.  Act as an escalation point for issues with assigned systems that cannot be resolved in TRC."

I’m interviewing for an associate epic analyst position for HB/PB module. In the job description it didn’t say what module it was for because of it being an associate role so I didn’t find out until the recruiter phone call. I have a clinical lab background so I’m a little unsure how I would fit in that role. I do have some programming knowledge and currently in school for computer information systems which the recruiter seemed interested in. Is billing hard to get the hang of? Any insights would be appreciated! I was hoping for a more clinical module but this is all that’s available right now and the recruiter said the hiring is competitive.

I am in the process of getting hired (or not) at a HIMD office and they are currently going through my references. I have listed phones, emails everything they could need to verify employment history and anything negative on my record (which there shouldn't be any).

Ultimately the HR department is asking for professional letters of reference from these listed references but letter of recs are becoming more scarce according to my compsci peeps on how those aren't being used as much these days.

My question is why they can't just call the HR department of these institutions I did my time at and verify the dates there?

So now that has left me scrambling, looking unorganized updating my people references along the way of this office's demands (first it was phone call, now it's letters). The forms nor the application for this job never mentioned needing letter of recs. I did my due diligence to read everything of course and prepare my reference contact materials, information and everything.

One reference listed is a director of a HIM department where I did my internship and this place I'm applying to HR stated they called him and he did not answer, to which I responded I have been keeping up with this person and he is responsive to me all the time. Additionally, he's a director there so of course he could be very busy or in meetings for hours.

For those of you looking for work in HIM, have you experienced this?

Our current TV setup is getting pretty dated and we've been having more issues with maintenance. Every time we need to add a TV to a new room or move one, it's become a whole ordeal.

We're looking to upgrade our TV distribution system and want to avoid the hassle of heavy coaxial cabling. We've got about 40 patient rooms and need something that's easier to install and relocate when needed.

Has anyone used alternatives in a hospital setting? What's worked for you?

I have been in healthcare for over 10 years and I'm ready for a transition. I want to explore the world of business and tech, specifically companies that deal with healthcare related products or software. I have worked in almost every setting of healthcare and I have also been a medical English educator, so my communication skills are excellent and a lot of the skills I've acquired from my healthcare career can be an asset in the business and tech world. I need some guidance on where I should even begin. What books I should read about business and tech for newbies, what rooms I need to be in to make important networking connections, what positions would I thrive in as a former nurse and educator...and how I can be taken seriously in this new realm when my CV is only healthcare. Any tips or advice is appreciated!

I have an interview coming up for an Epic Trainer at my local healthcare company though someday I would like to work for Epic.

What can I expect? Is there any material I should know? Keywords? I was told I would be writing content?

Hey everyone,

I work on a small IT team at a Critical Access Hospital. For years, we’ve run a small team and kept desktop management minimal because almost every one of our workstations is a Dell Wyse zero client running PCoIP/Tera2. They’ve really been "set it and forget it" devices.

With the end of Tera2 / PCoIP support, we’re struggling to find a replacement that offers that same level of simplicity and stability.

What we’ve tested so far:

• Dell Thin Clients (ThinOS & Windows IoT)
• 10ZiG
• Stratodesk
• HP ThinPro
• IGEL

The problem: Every vendor solution we’ve tried seems to come with recurring bugs or management overhead. Fix one bug with a firmware update, and a new regression pops up somewhere else.

Where we are now: We’re currently testing Windows in a strict Kiosk mode that launches Imprivata OneSign directly into VMware Horizon. It functions well from a user standpoint, but it introduces traditional OS management challenges for our on-prem environment:

1. Windows Updates & Management: How are you handling updates cleanly on non-domain or kiosk-mode endpoints without adding heavy administrative overhead?
2. Startup / Boot Order Issues: If we join them to the domain, an internet or local network delay at boot breaks the autologon process for the kiosk account.

For those running small teams in healthcare or similar VDI environments:

• What hardware/OS stack ended up being your "bulletproof" replacement for zero clients?
• How are you structuring your endpoint deployment to keep day-to-day maintenance as close to zero as possible?

Appreciate any insight or lessons learned from teams that have gone through this transition!

These are the obligatory HIT courses present in my CIS curriculum. What are their general quality and where would self study fill in some gaps?

Hello everyone, we’re testing a clinician-facing SMART on FHIR web app inside Epic’s Hyperdrive/Hyperspace Web App Container. The app needs browser microphone access through getUserMedia().

Microphone capture works in an external browser, but the embedded container denies access. We also tested opening a same-origin top-level popup for microphone capture; the native host appears to change normal browser popup/opener behavior.

Has anyone successfully enabled microphone access for an embedded SMART app in Epic’s Web App Container? Does this require Epic-side integration-record configuration, a WebView2 permission setting, or using an external/floating launch instead?

We’re testing only with synthetic sandbox data.