20215. EPMO Open Source Coordination Office Redaction File Detail Report

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20215.1 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 leie_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 leie_rule_specification.docx Fri Jun 15 14:52:05 2018 UTC

20215.2 Comparison summary

Description Between
Files 1 and 2
Text Blocks Lines
Unchanged 1 66
Changed 0 0
Inserted 0 0
Removed 0 0

20215.3 Comparison options

Whitespace
Character case Differences in character case are significant
Line endings Differences in line endings (CR and LF characters) are ignored
CR/LF characters Not shown in the comparison detail

20215.4 Active regular expressions

No regular expressions were active.

20215.5 Comparison detail

  1   LeieRules
  2   Descriptio n
  3   Verify the  provider  is not on  the LEIE,  so that th e claim is  accepted  if the pro vider of s ervice is  not includ ed in the  LEIE and d enied if t he provide r of servi ce is incl uded in th e LEIE.
  4   In process  of furthe r elaborat ion to ide ntify if t he LEIE ed iting rule  will be v alidating  if the pro vider was  on the LEI E at the d ate of ref erral or i f the prov ider was o n the LEIE  at the da te of serv ice
  5   Validation  Descripti on
  6   Sanctioned  Provider
  7   Provider o f service  must not h ave been s anctioned  during the  Claimline  date of s ervice.
  8   Logic
  9   Applies to  INST-IO,  PROF, DENT :
  10   FOREACH (C laimLine r elated to  the Claim)  {      IF  (the Clai mLine.prov iderOfInte rest exist s in Table  LKUP_PROV IDER_SANCT ION) THEN  {            IF (the  ClaimLine. serviceDat e is after  the Provi derSanctio n.exclusio nDate) THE N {               IF  (the Claim Line.servi ceDate is  before the  ProviderS anction.re instateDat e) THEN {                  creat e Validati onFailure:  sanctione dProvider,  CARC: B7,  RARC: N13 2 for Clai mLine             }         }     }}
  11   Data Eleme nts
  12   BRENGINE
  13   CCRSDB
  14   Claim.clai mLines
  15   F_*_CLAIM_ DETAILS
  16   ClaimLine. providerOf Interest**
  17   DIM_PROVID ER
  18   ClaimLine. serviceDat e
  19   F_*_CLAIM_ DETAILS.se rvice_date
  20   ProviderSa nction**
  21   LKUP_PROVI DER_SANCTI ON
  22   ProviderSa nction.npi OrTaxId**
  23   LKUP_PROVI DER_SANCTI ON
  24   ProviderSa nction.exc lusionDate
  25   LKUP_PROVI DER_SANCTI ON.exclusi on_date
  26   ProviderSa nction.rei nstateDate
  27   LKUP_PROVI DER_SANCTI ON.reinsta te_date
  28   Provider.n piOrTaxId* *
  29   DIM_PROVID ER
  30   Provider.n pi
  31   DIM_PROVID ER.npi
  32   Provider.t axId
  33   DIM_PROVID ER.tax_id