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Status Submitted
Workspace Sterling Transformation Extender
Created by Guest
Created on Mar 8, 2024

RELATED IDEAS

Claim Level Rejction

ITX-I-210 was an enhancement to claim level rejection to change from looking at only CLM01 to look at the entire CLM segment when checking for duplicates. This enhance was released in 10.2.1. We have found that we are still having issues with entire transaction set getting rejected because duplicate CLM segments are included in the transaction. We have found that this occurs even if the claims with the duplicate CLM segments contain no compliance failure. We are requesting a solution be investigated to only reject the claim(s) that have compliance failures.

What is your industry? Healthcare
How will this idea be used?

It will prevent the entire transaction set that may contain hundreds of claims from being rejected when there are compliance failures only on a subset of the claims.

  • Admin
    Mike Lamb
    Reply
    |     Mar 19, 2024

    Hi Stacey,


    Are you running ITXA 10.0.1.8 where ITX 10.2.1 packs are supported?

    3 replies

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