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WTX Compliance Checking

Showing 19

Compliance map not generating valid XML message on edi_log.xml

edi_log.xml generated output compliance maps are not valid XML for both EDIFACT and X12. They are missing closing tag for EDIFACT & root opening/closing tags for X12.

ITX 277CA Processing

Allow for detection of syntactical error in claim by STC0101, and also including an Entity code so that resultant 277CA is valid per use of the STC0102 value of 19: At each HL level in the 277, there could be rejected claim(s) due to invalid synta...

Including 277DRA transaction in Compliance Check

Our clients are seeking to check compliance on 277DRA transactions as well . Version - 5010

Bypass SNIP 3 and 4 to Allow Denied Claims to Flow Through

We have a client use case where we need to relax validations in order to allow denied claims to flow through that requires us to validate on SNIP 1, 2 and 7 (i.e. bypass SNIP 3 and 4). This is because denied claims might fail on SNIP 3 and 4 and h...

We need the Compliance Checker augmented to validate 275 transactions related to Prior Authorizations

You already supplied us with a version that accomodates 275s related to claims. This would make the enhancement complete from a processing perspective.
over 2 years ago in Sterling Transformation Extender / WTX Compliance Checking 1 Delivered

NCPDP Compliance Check Enhancement

Enhance the NCPDP compliance checker to provide situational compliance checking for the entire transaction. Some examples are: We would expect a transaction to fail compliance when the Compound segment (AM10) is sent and field 436-E1 in the Claim ...
almost 3 years ago in Sterling Transformation Extender / WTX Compliance Checking 0 Delivered

Remove Write Access Requirement from Install Dir

As per the below , https://www.ibm.com/support/pages/logged-user-must-have-write-permission-websphere-transformation-extender-installation-directory-windows-operating-systems Write permission is required in the installation directory. This raises ...
about 3 years ago in Sterling Transformation Extender / WTX Compliance Checking 1 Delivered

999 ISA Control Number

Currently the ISA control number (ISA) always has a value of 000000001 in every 999 transaction that is generated out of compliance. X12.5 Interchange Control Structure section 5.1.2 requires a unique number within a reasonably extended time frame...
over 3 years ago in Sterling Transformation Extender / WTX Compliance Checking 1 Delivered

Develop a compliance check for the 277CA

It is common for claims processor to do pre-adjudication business editing in addition to doing transaction compliance checking. The results of the pre-adjudicated processing are reported on the 277CA. Currently there is not a compliance map for th...
over 3 years ago in Sterling Transformation Extender / WTX Compliance Checking 0 Delivered

Type 5 editing based on date of service for medical code sets

Currently type 5 editing is based on processing. Medical codes are based on the date of service and not processing date. We are requesting an enhancement for at least all of the 837 transactions to include the PACDR to edit medical codes sets (ICD...
over 3 years ago in Sterling Transformation Extender / WTX Compliance Checking 0 Delivered