The Workgroup for Electronic Data Interchange (WEDI) published a Strategic National Implementation Process (SNIP) Testing recommendations on the levels of testing that need to comply with the HIPAA transaction sets.
1. | Integrity Testing | According to the WEDI/SNIP White Paper, this involves testing "for valid segments, segment order, element attributes, testing for numeric values in numeric data elements, validation of X12 syntax and compliance with X12 rules." |
2. | Requirement | Testing for HIPAA implementation-guide-specific requirements, such as repeat counts, used and not used codes, elements and segments, required or intra-segment situational data elements- non-medical code sets as laid out in the implementation guide - and values noted in the implementation guide via an X12 code list or table. |
3. | Balancing Testing | Testing the transaction for balanced field totals, record or segment counts, financial balancing of claims or remittance advice, and balancing of summary fields. |
4. | Situation Testing | Testing of specific inter-segment situations described in the HIPAA implementation guides such that: If A occurs then B must be populated. This is considered to include the validation of situational fields given values or situations present elsewhere in the file. A typical situation testing: there is a dependent loop but no subscriber loop in a transaction. |
5. | Code Set Testing | Testing for valid implementation-guide-specific code set values. |
6. | Line-of- | Specialized testing required by certain healthcare specialties. For example Hospice Care, Home Oxygen Treatment, and Ambulance Service all have unique data requirements when submitting health care claims to a payor. |
src="http://pagead2.googlesyndication.com/pagead/show_ads.js">
No comments:
Post a Comment