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Search results: WTX Compliance Checking

Showing 7 of 107

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 4 years ago in Sterling Transformation Extender / WTX Compliance Checking 0 Delivered

Include ISA information in either the data passed to the hcsvu exit for implementing a type 7 rule in the qualifier file or in the data passed to a type 7 custom user exit

We currently have a requirement to compare one of ISA value to 1000A NM1 values to ensure they are same and it is currently no doable in ITX. We received this as a suggestion from support ticket TS005672303
over 4 years ago in Sterling Transformation Extender / WTX Compliance Checking 0 Not under consideration

Compliance Check map to include the CTX segments in the 999 Negative Acknowledgement

the usage of the CTX segment in the 999 would utilized in the LOOP ID - 2100 - AK2/IK3 ERROR IDENTIFICATION. where the Business Unit Identifier can correctly show the transaction error. TR3 rules state "Required when the error reported in this IK3...
almost 7 years ago in Sterling Transformation Extender / WTX Compliance Checking 5 Not under consideration

Using DB2 for performing SNIP Type 5 (External Code Set) validation in compliance check map

We have requirements for performing SNIP Type 5 validation and we use DB2 for our client. But we understand from ITX support team that the hipaa_data_compliance map is designed to use MONGO DB for performing SNIP Type 5 validation (External Code S...
over 4 years ago in Sterling Transformation Extender / WTX Compliance Checking 0 Not under consideration

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 4 years ago in Sterling Transformation Extender / WTX Compliance Checking 1 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 4 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 ...
over 4 years ago in Sterling Transformation Extender / WTX Compliance Checking 0 Delivered