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WTX Compliance Checking

Showing 15

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.
about 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 ...
over 2 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 ...
over 2 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 2 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 2 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 2 years ago in Sterling Transformation Extender / WTX Compliance Checking 0 Delivered

Claim level reject enhancement

Currently with claim level rejection if there are duplicate CLM01 values, claim level rejection is not possible. We would like the recommend an enhancement to check the entire CLM segment for duplication which may eliminate the duplication of the ...
almost 3 years ago in Sterling Transformation Extender / WTX Compliance Checking 0 Delivered

Reactivate 824 ACK creation from HIPAA data compliance map

Reactivate 824 ACK creation from HIPAA data compliance map as this is still being used by one of our major clients: 1. Updating the hipaa_data_compliance_parameter.JSON file to include 824 ACK 2. Uncommenting the 824 creation logic from the rules....
almost 3 years ago in Sterling Transformation Extender / WTX Compliance Checking 1 Delivered

HIPAA Pack Compliance Check – stop compliance when error threshold is reached.

IBM ITX HIPAA Compliance Check has a parameter that limits the number of Errors reported on the x12 999, but compliance continues to execute even when the 999 reporting limit has been reached. The result is that Compliance can run for more than an...
about 3 years ago in Sterling Transformation Extender / WTX Compliance Checking 0 Delivered

Claim Level Reject at the Provider, Subscriber or Patient Level

We have received the explanation that claim level rejection works as designed in the 2300 Loop of the 837 and does NOT have rejection capability in the Provider, Subscriber and Patient Loops. Based on our competitors’ capabilities and our client n...
about 4 years ago in Sterling Transformation Extender / WTX Compliance Checking 1 Delivered