Produced by Araxis Merge on 6/20/2018 10:17:54 AM Central Daylight Time. See www.araxis.com for information about Merge. This report uses XHTML and CSS2, and is best viewed with a modern standards-compliant browser. For optimum results when printing this report, use landscape orientation and enable printing of background images and colours in your browser.
# | Location | File | Last Modified |
---|---|---|---|
1 | CCRS.zip\CCRS\CCRS-BUSRULES-v1.5.3.zip\CCRS-BUSRULES-v1.5.3-436e6fff1115001d614ccd45b469ad60a9bdb27b\testing\Test Cases | Team 4 rational input cases 11082017 temp...xlsx | Tue Apr 10 06:18:41 2018 UTC |
2 | CCRS.zip\CCRS\CCRS-BUSRULES-v1.5.3.zip\CCRS-BUSRULES-v1.5.3-436e6fff1115001d614ccd45b469ad60a9bdb27b\testing\Test Cases | Team 4 rational input cases 11082017 temp...xlsx | Fri Jun 15 15:25:17 2018 UTC |
Description | Between Files 1 and 2 |
|
---|---|---|
Text Blocks | Lines | |
Unchanged | 1 | 176 |
Changed | 0 | 0 |
Inserted | 0 | 0 |
Removed | 0 | 0 |
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 |
No regular expressions were active.
1 | SHEET: Tim ely Filing Rule | |
2 | TC4- CS010 - 592744 Code busin ess Rules for Timely Filing, | |
3 | ||
4 | Test objec tive:,Veri fy the inv oice claim is receiv ed within the timely filing pe riod, so t hat the cl aim is acc epted if t he date of service i s within t he pre-def ined perio d of time and otherw ise denied , | |
5 | Roles impa cted:, | |
6 | Test setup /Precondit ions:,Time ly Filing business r ules are c ompleted. 180 and 30 days clai ms are ide ntified in the datab ase and se tup to use d for this test, | |
7 | Requiremen t or Chang e, | |
8 | Acceptance criteria, All rules are implem ented - Al l types of claims ar e impacted , | |
9 | ||
10 | Assumption s:, | |
11 | ||
12 | TC4- CS010 - 592744 - Claim Li ne Verific ation of C ode busine ss Rules f or Timely Filing - P rofessiona l Claims, | |
13 | Step numbe r,Descript ion,Expect ed results , | |
14 | 1,Query fo r a claim line with First Date of Servic e of more than 180 d ays over t he Claim R eceived Da te by usin g a query of a speci fic batch, Claim line with Firs t Date of Service o f more tha n 180 days over the Claim Rece ived Date is availab le, | |
15 | 2,Run batc h rule pro cessing jo b using th e same bat ch ID as p revious st ep,Batch p rocessing job is com pleted, | |
16 | 3,Query th e RULE_OUT COME table ,Query re sults are displayed, | |
17 | 4,verify t hat claim lines with no receiv ed date ha ve "Receiv ed date is blank, un able to va lidate tim ely filing " message displayed, Message is displayed , | |
18 | 5,Verify t hat for th e claims t hat have m ore than 1 80 days ra nge betwee n Claim re ceived Dat e and Date of Servic e have "Cl aim Receiv ed Date %s is greate r than all owed range from Date of Servic e %s",Mess age is dis played, | |
19 | 6,Verify t hat the cl aim has a status of Denied ,Cl aim has a status of Denied , | |
20 | 7,Verify t hat the cl aim is ann otated wit h the CARC /RARC appr opriate re ason numbe r,claim is annotated with the CARC/RARC appropriat e reason, | |
21 | 8,Query fo r a claim that has a First Dat e of Servi ce of more than 30 d ays after the Claim Received d ate,First Date of Se rvice of m ore than 9 0 days aft er the Cla im Receive d date, | |
22 | 9,Verify t hat claim has a DENI ED status, Claim has Denied sta tus, | |
23 | 10,Verify that the c laim is an notated wi th the CAR C/RARC app ropriate r eason,clai m is annot ated with the CARC/R ARC approp riate reas on, | |
24 | 11,Using a query loc ate claim with First Date of S ervice is 180 days o n or befor e the Clai m Received Date,Invo ice claim line with First Date of Servic e of more than 180 days over the Claim Received D ate is ava ilable, | |
25 | 12,Verify that the c laim is in ACCEPT st atus,Claim is in ACC EPT status , | |
26 | 13,Query f or a claim that has a First Da te of Serv ice is 90 days on or before C laim Recei ved date,c laim that has a Firs t Date of Service is 90 days o n or befor e Claim R eceived da te, | |
27 | 14,Verify that claim sataus is ACCEPTED, Claim has been accep ted, | |
28 | ||
29 | ||
30 | Test Case# ,Test Ca se # T est Script s# Story C S010 Requiremen t, | |
31 | ||
32 | TC4- CS010 - 592744 -Claim Ver ification of Code bu siness Rul es for Tim ely Filing - Institu tional Cla ims, | |
33 | Step numbe r,Descript ion,Expect ed results , | |
34 | 1,Query fo r a claim line with First Date of Servic e of more than 180 d ays over t he Claim R eceived Da te by usin g a query of a speci fic batch, Claim line with Firs t Date of Service o f more tha n 180 days over the Claim Rece ived Date is availab le, | |
35 | 2,Run batc h rule pro cessing jo b using th e same bat ch ID as p revious st ep,Batch p rocessing job is com pleted, | |
36 | 3,Query th e RULE_OUT COME table ,Query re sults are displayed, | |
37 | 4,verify t hat claim lines with no receiv ed date ha ve "Receiv ed date is blank, un able to va lidate tim ely filing " message displayed, Message is displayed , | |
38 | 5,Verify t hat for th e claims t hat have m ore than 1 80 days ra nge betwee n Claim re ceived Dat e and Date of Servic e have "Cl aim Receiv ed Date %s is greate r than all owed range from Date of Servic e %s",Mess age is dis played, | |
39 | 6,Verify t hat the cl aim has a status of Denied ,Cl aim has a status of Denied , | |
40 | 7,Verify t hat the cl aim is ann otated wit h the CARC /RARC appr opriate re ason numbe r,claim is annotated with the CARC/RARC appropriat e reason, | |
41 | 8,Query fo r a claim that has a First Dat e of Servi ce of more than 30 d ays after the Claim Received d ate,First Date of Se rvice of m ore than 9 0 days aft er the Cla im Receive d date, | |
42 | 9,Verify t hat claim has a DENI ED status, Claim has Denied sta tus, | |
43 | 10,Verify that the c laim is an notated wi th the CAR C/RARC app ropriate r eason,clai m is annot ated with the CARC/R ARC approp riate reas on, | |
44 | 11,Using a query loc ate claim with First Date of S ervice is 180 days o n or befor e the Clai m Received Date,Invo ice claim line with First Date of Servic e of more than 180 days over the Claim Received D ate is ava ilable, | |
45 | 12,Verify that the c laim is in ACCEPT st atus,Claim is in ACC EPT status , | |
46 | 13,Query f or a claim that has a First Da te of Serv ice is 90 days on or before C laim Recei ved date,c laim that has a Firs t Date of Service is 90 days o n or befor e Claim R eceived da te, | |
47 | 14,Verify that claim sataus is ACCEPTED, Claim has been accep ted, | |
48 | ||
49 | ||
50 | Test Case# ,Test Ca se # T est Script s# Story C S010 Requiremen t, | |
51 | ||
52 | ||
53 | SHEET: ref erral # Ru le | |
54 | TC4- CS014 - 592739 Code Busi ness rules for refer ral number s, | |
55 | ||
56 | Test objec tive:,Auto matically match invo ices to ex isting ref errals wit hin CCRS, so only ma tched invo ices are p rocessed. Deny invo ices that have no ma tching ref erral, so that denia ls can be stored and communica ted., | |
57 | Roles impa cted:, | |
58 | Test setup /Precondit ions:,1) C laim lines that do n ot match a referral should be annotated as denied. Validatio n name: VA LID_REFERR AL , | |
59 | Requiremen t or Chang e, | |
60 | Acceptance criteria, | |
61 | ||
62 | Assumption s:, | |
63 | ||
64 | TC4- CS014 - 592739 Code Busi ness rules for refer ral number s 837P, | |
65 | Step numbe r,Descript ion,Expect ed results , | |
66 | 1,In a new incoming claim batc h select f ew claim l ines and l ist their referral n umbers. , Referral n umbers are listed an d saved, | |
67 | 2,Query CC RS DB and find match es for ref erral numb ers from s tep 1,Refe rral numbe rs have a match in C CRS, | |
68 | 3,In the n ew batch i nsert few referral n umbers ,Re ferral num bers are l isted and saved, | |
69 | 4,Assure t hat the re ferral num bers from step 3 do not have a match in CCRS,Refer ral number s do not h ave a matc h in CCRS, | |
70 | 5,Run the rule batch job,Job i s complete d, | |
71 | 6,Verify t hat Claim lines tha t do not m atch a ref erral are annotated as denied, Claim line s are deni ed, | |
72 | 7,Verify t hat Claim lines tha t have ama tch in CCR S are proc essed,Clai m lines ar e processe d, | |
73 | ||
74 | Test Case # Test Scripts# Story Requirem ent, | |
75 | ||
76 | ||
77 | ||
78 | TC4- CS014 - 592739 Code Busi ness rules for refer ral number s 837I, | |
79 | Step numbe r,Descript ion,Expect ed results , | |
80 | 1,In a new incoming claim batc h select f ew claim l ines and l ist their referral n umbers. , Referral n umbers are listed an d saved, | |
81 | 2,Query CC RS DB and find match es for ref erral numb ers from s tep 1,Refe rral numbe rs have a match in C CRS, | |
82 | 3,In the n ew batch i nsert few referral n umbers ,Re ferral num bers are l isted and saved, | |
83 | 4,Assure t hat the re ferral num bers from step 3 do not have a match in CCRS,Refer ral number s do not h ave a matc h in CCRS, | |
84 | 5,Run the rule batch job,Job i s complete d, | |
85 | 6,Verify t hat Claim lines tha t do not m atch a ref erral are annotated as denied, Claim line s are deni ed, | |
86 | 7,Verify t hat Claim lines tha t have ama tch in CCR S are proc essed,Clai m lines ar e processe d, | |
87 | ||
88 | Test Case # Test Scripts# Story Requirem ent, |
Araxis Merge (but not the data content of this report) is Copyright © 1993-2016 Araxis Ltd (www.araxis.com). All rights reserved.