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# | Location | File | Last Modified |
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1 | CCRS.zip\CCRS\CCRS-BUSRULES-v1.5.3.zip\CCRS-BUSRULES-v1.5.3-436e6fff1115001d614ccd45b469ad60a9bdb27b\docs\Rule_Specification\word_format | dollar_threshold_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 | dollar_threshold_rule_specification.docx | Fri Jun 15 14:50:11 2018 UTC |
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1 | DollarThre shold | |
2 | Descriptio n | |
3 | Verify the invoice t otal does not exceed a customi zable thre shold, so that the c laim is ac cepted if the invoic e total do es not exc eed the th reshold an d suspende d for manu al review if it exce eds the th reshold fo r 24 hours . If no ac tion is ta ken within 24 hours, then acce pt invoice . If an in voice exam iner revie ws and det ermines th e invoice should not be paid, then proce ss the inv oice as de nied. | |
4 | Validation Descripti on | |
5 | Dollar Thr eshold Exc eeded | |
6 | Claims mus t not exce ed a defin ed dollar amount | |
7 | Validation Logic | |
8 | Dollar Thr eshold Exc eeded - Ap plies to I NST-IO, PR OF, DENT: | |
9 | FOREACH Cl aimLine re lated to t he Claim { IF (t he ClaimLi ne.chargeA mount does not exist ) THEN { create Val idationFai lure: blan kChargeAmo unt, CARC: N/A, RARC : N/A for ClaimLine } O THERWISE I F (the Cla imLine.cha rgeAmount exceeds th e defined threshold) THEN { create Validatio nFailure: dollarThre sholdExcee ded, CARC: N/A, RARC : N/A for ClaimLine }} | |
10 | 24 Hour Re view - App lies to IN ST-IO, PRO F, DENT: | |
11 | IF (no fur ther actio n is taken within 24 hours ) T HEN { change the ClaimLine .decision to 'Approv ed'} | |
12 | Notes | |
13 | No CARC an d RARC cod es are nee ded for th e Dollar T hreshold E xceeded va lidation | |
14 | Data Eleme nts | |
15 | BRENGINE | |
16 | CCRSDB | |
17 | Claim.clai mLines | |
18 | F_*_CLAIM_ DETAILS | |
19 | ClaimLine. chargeAmou nt | |
20 | F_*_CLAIM_ DETAILS.ch arge_amoun t |
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