20216. EPMO Open Source Coordination Office Redaction File Detail Report

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20216.1 Files compared

# Location File Last Modified
1 CCRS.zip\CCRS\CCRS-BUSRULES-v1.5.3.zip\CCRS-BUSRULES-v1.5.3-436e6fff1115001d614ccd45b469ad60a9bdb27b\docs\Rule_Specification\word_format payment_authority_rule_specification.docx Tue Apr 10 06:18:41 2018 UTC
2 CCRS.zip\CCRS\CCRS-BUSRULES-v1.5.3.zip\CCRS-BUSRULES-v1.5.3-436e6fff1115001d614ccd45b469ad60a9bdb27b\docs\Rule_Specification\word_format payment_authority_rule_specification.docx Fri Jun 15 14:52:30 2018 UTC

20216.2 Comparison summary

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Files 1 and 2
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20216.3 Comparison options

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20216.4 Active regular expressions

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20216.5 Comparison detail

  1   PaymentAut hority Rul es
  2   Automatica lly evalua te line it ems on the  invoice t o ensure t he payment  authority  in the 83 7COB has a  matching  obligation  number in  the Payme ntAuthorit yObligatio n Table.
  3   Logic
  4   PAYMENT_AU THORITY_WI TH_FLU_SHO T - Applie s to INST- IO, DENT:
  5   IF the Cla im.referra lNumber do es NOT mat ch a Refer ral    THE N FOREACH  ClaimLine  related to  the Claim         IF  ClaimLine .Procedure .code does  NOT match  'G0008' O R '90658'  OR '90656'  OR '90662 '             THEN cr eate Valid ationFailu re with CA RC: RARC:  for ClaimL ine         OTHERWISE  IF ClaimL ine.servic eDate is N OT within  CptObligat ion.startD ate AND Cp tObligatio n.endDate              THEN crea te Validat ionFailure  with CARC : RARC: fo r ClaimLin eOTHERWISE  IF Referr al.payment AuthorityO bligationI d does not  exist     THEN creat e Validati onFailure  with CARC:  RARC: for  ClaimOTHE RWISE FORE ACH ClaimL ine relate d to the C laim    IF  ClaimLine .serviceDa te is NOT  within Pay mentAuthor ityObligat ion.startD ate AND Pa ymentAutho rityObliga tion.endDa te         THEN creat e Validati onFailure  with CARC:  RARC: for  ClaimLine
  6   PAYMENT_AU THORITY_WI TH_FLU_SHO T - Applie s to PROF:
  7   IF the Cla im.referra lNumber do es NOT mat ch a Refer ral    THE N FOREACH  Profession alClaimLin e related  to the Cla im         IF Profess ionalClaim Line.Proce dure.code  does NOT m atch 'G000 8' OR '906 58' OR '90 656' OR '9 0662'             THE N create V alidationF ailure wit h CARC: RA RC: for Pr ofessional ClaimLine         OTH ERWISE IF  Profession alClaimLin e.serviceD ateTo is N OT within  CptObligat ion.startD ate AND Cp tObligatio n.endDate              THEN crea te Validat ionFailure  with CARC : RARC: fo r Professi onalClaimL ineOTHERWI SE IF Refe rral.payme ntAuthorit yObligatio nId does n ot exist     THEN cre ate Valida tionFailur e with CAR C: RARC: f or ClaimOT HERWISE FO REACH Prof essionalCl aimLine re lated to t he Claim     IF Profe ssionalCla imLine.ser viceDateTo  is NOT wi thin Payme ntAuthorit yObligatio n.startDat e AND Paym entAuthori tyObligati on.endDate         TH EN create  Validation Failure wi th CARC: R ARC: for P rofessiona lClaimLine
  8   Data Eleme nts
  9   BRENGINE
  10   CCRSDB
  11   Claim.clai mLines**
  12   F_*_CLAIM_ DETAILS
  13   Claim.refe rralNumber
  14   DIM_VA_CLA IM.referra l_number
  15   ClaimLine. isFluShot* *
  16   F_*_CLAIM_ DETAILS
  17   ClaimLine. serviceDat e
  18   F_*_CLAIM_ DETAILS.se rvice_date
  19   Profession alClaimLin e.procedur e.id
  20   DIM_PROCED URE_CODE.p rocedure_k ey
  21   Profession alClaimLin e.serviceD ateTo
  22   F_PROFESSI ONAL_MEDIC AL_CLAIM_D ETAILS.ser vice_date_ to
  23   BRENGINE
  24   CCRSDB
  25   Referral.p aymentAuth orityOblig ationId
  26   ccra.REFER RAL.Paymen tAuthority Obligation Id
  27   CptObligat ion.startD ate
  28   ccra.CPT_O BLIGATION. start_date
  29   CptObligat ion.endDat e
  30   ccra.CPT_O BLIGATION. end_date
  31   PaymentAut horityObli gation.sta rtDate
  32   ccra.PAYME NT_AUTHORI TY_OBLIGAT ION.start_ date
  33   PaymentAut horityObli gation.end Date
  34   ccra.PAYME NT_AUTHORI TY_OBLIGAT ION.end_da te