Produced by Araxis Merge on 6/20/2018 10:17:40 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 | Regression Testing worksheet.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 | Regression Testing worksheet.xlsx | Fri Jun 15 15:20:58 2018 UTC |
Description | Between Files 1 and 2 |
|
---|---|---|
Text Blocks | Lines | |
Unchanged | 1 | 218 |
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 180 | |
2 | TC4- CS010 - refact oring busi ness Rules for Timel y Filing , Ready for regression test, | |
3 | ||
4 | Test objec tive:,Veri fy the inv oice claim starts wi thin the t imely fili ng period, so that t he claim i s APPROVED if the d ate of ser vice is wi thin the p re-defined period of time and otherwise denied, | |
5 | Roles impa cted:, | |
6 | Test setup /Precondit ions:,Time ly Filing business r ules are c ompleted. 180 days c laims are identified in the da tabase and setup to be used fo r this tes t, | |
7 | Requiremen t or Chang e, | |
8 | APPROVEDan ce Criteri a,All rule s are impl emented - All types of claims are impact ed, | |
9 | Data,Outpa tient clai ms are sub mitted wit hin allowe d timefram e from dat e of servi ce | |
10 | ,Professio nal, Insti tutional O utpatient - Claim li nes | |
11 | Pharmacy - Claims | |
12 | Dental - C laims | |
13 | , | |
14 | Inpatient claims are submitted within th e allowed time frame from date of discha rge,Instit utional In patient - Claim & Cl aim lines, | |
15 | Assumption s:, | |
16 | Test Case #, | |
17 | TS4- CS010 - 593878 - Mature a nd Refacto ring busin ess Rules for Timely Filing - Profession al Claim l ine, | |
18 | Step numbe r,Descript ion,Expect ed results ,DL_837P_2 0171219_1 ,claim_ key = 18 58,2017-12 -19 minus 180 --> 20 17-06-17, | |
19 | 1,Query F_ PROFESSION AL_MEDICAL _CLAIM_DET AILS for a claim lin e with Sta rt Date of more than 180 days over the C laim Servi ce_Date_fr om by usin g a query of a speci fic batch, Claim line with Star t Date of more than 180 days o ver the Cl aim Servic e_Date_fro m is avail able,Selec t claim_ke y, Claim_d etail_key, start_dat e, service _date_from | |
20 | from F_PRO FESSIONAL_ MEDICAL_CL AIM_DETAIL S | |
21 | where etl_ batch_id = 'DL_837P_2 0171219_1' | |
22 | and claim_ key ='1858 ',cl_k Cld k strdate srvic edatefrom | |
23 | 1858 1163 2017-12-19 2011-03-0 6 | |
24 | 1858 1164 2017-12-19 2012-01-0 1 | |
25 | 1858 1165 2017-12-19 2013-01-0 5 | |
26 | 1858 1166 2017-12-19 2014-04-0 5 | |
27 | 1858 1167 2017-12-19 2015-05-0 1 | |
28 | 1858 1168 2017-12-19 2016-06-0 5,clakey C ldkey star date servi ce_date_fr om | |
29 | 1858 1163 2017-12-19 2017-06-1 7 | |
30 | 1858 1164 2017-12-19 2017-06-1 8 | |
31 | 1858 1165 2017-12-19 2017-01-0 5 | |
32 | 1858 1166 2017-12-19 2017-08-0 5 | |
33 | 1858 1167 2017-12-19 NULL | |
34 | 1858 1168 2017-12-19 2016-06-0 5, | |
35 | 2,Select f ew of the claim line s and upda te their S tart_date to be a NU LL value,C laim line with NULL Service_Da te_from is available ,Select * from F_PRO FESSIONAL_ MEDICAL_CL AIM_DETAIL S | |
36 | where serv ice_date_f rom is NUL L,Claim_ke y = 20 36 & 204 5 | |
37 | Claim_deta il_key 1275 1277, | |
38 | 3,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, | |
39 | 4,Using th e claim li ne keys fo r selected lines que ry the DEC ISION tabl e for resu lts,Result s are disp layed, | |
40 | 5,Verify t hat the cl aims with NULL Servi ce_Date_fr om are DEN IED,Claims are DENIE D, | |
41 | 6,Verify t hat the cl aims of mo re than 18 0 days ran ge has a s tatus of D enied ,Cla ims have DENIED sta tus, | |
42 | 7,Verify t hat claims that are 180 days o n or befor e the Clai m Service_ Date_from have APPR OVED statu s,Claim li ne is APPR OVED statu s. , | |
43 | 8,Query th e Validati on_failure table usi ng the cla im line ke ys for lin es selecte d,Query re sults are displayed, | |
44 | 9,Verify t hat claim with no S ervice_Dat e_from hav e "Service _Date_from is blank, unable to validate timely fil ing" messa ge display ed,Message is displa yed, | |
45 | 10,Verify that for t he claims that have more than 180 days r ange betwe en Claim S ervice_Dat e_from and Date of S ervice hav e "Claim S ervice_Dat e_from %s is greater than allo wed range from Date of Service %s",Messa ge is disp layed, | |
46 | 11,Verify that the c laims are annotated with the C ARC/RARC a ppropriate reason nu mber,Claim s are anno tated with the CARC/ RARC appro priate rea son, | |
47 | ||
48 | Test Case# ,Test Ca se # T est Script s# S tory CS010 Requ irement, | |
49 | ||
50 | TS4- CS010 - 593878 - Mature a nd Refacto ring busin ess Rules for Timely Filing - - Institu tional Out patient Cl aim Line, | |
51 | Step numbe r,Descript ion,Expect ed results ,EDI_837I_ 20171202_A ,claim key = 1426 Claim ke y = 1418,2 017-12-19 minus 180 --> 2017-0 6-17, | |
52 | 1,Query fo r a Claim line with Start Date of more t han 180 da ys over th e Claim li ne Service _date_from by using a query of a specifi c batch,Cl aim line w ith Start Date of mo re than 18 0 days ove r the Clai m line Ser vice_date_ from is av ailable,Se lect claim _key, Clai m_detail_k ey, start_ date, serv ice_date | |
53 | from F_INS TITUTIONAL _MEDICAL_C LAIM_DETAI LS | |
54 | where etl_ batch_id = 'EDI_837I_ 20171202_A ' | |
55 | and claim_ key = '142 6' | |
56 | '141 8',clkeyCl dkey stdat e service_ date | |
57 | 1426 1561 2017-12-06 2010-01-0 1 | |
58 | 1426 1562 2017-12-06 2011-01-0 1 | |
59 | 1426 1563 2017-12-06 2012-01-0 1 | |
60 | 1418 1564 2017-12-06 2010-01-0 1 | |
61 | 1418 1565 2017-12-06 2011-01-0 1 | |
62 | 1418 1566 2017-12-06 2012-01-0 1,clakey C ldetail_ke y start_da te service _date | |
63 | 1426 1561 2017-12-19 2017-06-1 7 | |
64 | 1426 1562 2017-12-19 2017-06-1 8 | |
65 | 1426 1563 2017-12-19 2017-01-0 5 | |
66 | 1418 1564 2017-12-19 2017-08-0 5 | |
67 | 1418 1565 2017-12-19 NULL | |
68 | 1418 1566 2017-12-19 2016-01-0 1, | |
69 | 2,Select f ew of the Claim line s and upda te their S tart_date to be a NU LL value,C laim line with NULL Service_da te_from is available , | |
70 | 3,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, | |
71 | 4,Using th e Claim li ne keys fo r selected lines que ry the DEC ISION tabl e for resu lts,Result s are disp layed, | |
72 | 5,Verify t hat the Cl aim lines with NULL Service_da te_from ar e DENIED,C laim lines are DENIE D, | |
73 | 6,Verify t hat the Cl aim lines of more th an 180 day s range ha s a status of Denied ,Claim li nes have DENIED sta tus, | |
74 | 7,Verify t hat Claim lines that are 180 d ays on or before the Claim lin e Service_ date_from have APPR OVED statu s,Claim li ne is APPR OVED statu s. , | |
75 | 8,Query th e Validati on_failure table usi ng the Cla im line ke ys for lin es selecte d,Query re sults are displayed, | |
76 | 9,Verify t hat Claim line with no Servic e_date_fro m have "Se rvice_date _from is b lank, unab le to vali date timel y filing" message di splayed,Me ssage is d isplayed, | |
77 | 10,Verify that for t he Claim l ines that have more than 180 d ays range between Cl aim line S ervice_dat e_from and Date of S ervice hav e "Claim l ine Servic e_date_fro m %s is gr eater than allowed r ange from Date of Se rvice %s", Message is displayed , | |
78 | 11,Verify that the C laim lines are annot ated with the CARC/R ARC approp riate reas on number, Claim line s are anno tated with the CARC/ RARC appro priate rea son, | |
79 | ||
80 | TS4- CS010 - 593878 - Mature a nd Refacto ring busin ess Rules for Timely Filing - - Institu tional Inp atient Cla ims , | |
81 | Step numbe r,Descript ion,Expect ed results ,EDI_837I_ 20180102_A ,2080,2081 ,2082,2083 ,2084,2085 , | |
82 | 1,Query fo r a Claim with Start Date of m ore than 1 80 days ov er the Cla im Admissi on_Date by using a q uery of a specific b atch,Claim with a St art Date of more th an 180 day s over the Claim Adm ission_Dat e is avail able,Selec t claim_ke y, start_d ate, admis sion_date | |
83 | from DIM_I NSTITUTION AL_CLAIM | |
84 | where etl_ batch_id = 'EDI_837I_ 20180102_A ' | |
85 | and claim_ key in (20 80,2081,20 82,2083,20 84,2085),c laim_key s tdate admi sdate | |
86 | 2080 2018- 01-04 NULL | |
87 | 2081 2018- 01-04 NULL | |
88 | 2082 2018- 01-04 NULL | |
89 | 2083 2018- 01-04 NULL | |
90 | 2084 2018- 01-04 NULL | |
91 | 2085 2018- 01-04 NULL,2018 -01-04 (-) 180 --> 2 017-07-03 | |
92 | 2080 2018- 01-04 2017 -07-03 | |
93 | 2081 2018- 01-04 2017 -06-03 | |
94 | 2082 2018- 01-04 2017 -07-02 | |
95 | 2083 2018- 01-04 NULL | |
96 | 2084 2018- 01-04 2017 -10-01 | |
97 | 2085 2018- 01-04 2017 -12-01, | |
98 | 2,Select f ew of the Claims and update th eir Start_ date to be a NULL va lue,Claim with NULL Admission_ Date is av ailable, | |
99 | 3,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, | |
100 | 4,Using th e Claim ke ys for sel ected line s query th e DECISION table for results,R esults are displayed , | |
101 | 5,Verify t hat the cl aims with NULL Admis sion_Date are DENIED ,Claims ar e DENIED, | |
102 | 6,Verify t hat the cl aims of mo re than 18 0 days ran ge has a s tatus of D enied ,Cla ims have DENIED sta tus, | |
103 | 7,Verify t hat claims that are 180 days o n or befor e the Clai m Admissio n_Date hav e APPROVE D status,C laim is AP PROVED sta tus. , | |
104 | 8,Query th e Validati on_failure table usi ng the Cla im keys fo r lines se lected,Que ry results are displ ayed, | |
105 | 9,Verify t hat claim with no A dmission_D ate have " Admission_ Date is bl ank, unabl e to valid ate timely filing" m essage dis played,Mes sage is di splayed, | |
106 | 10,Verify that for t he claims that have more than 180 days r ange betwe en Claim A dmission_D ate and Da te of Serv ice have " Claim Admi ssion_Date %s is gre ater than allowed ra nge from D ate of Ser vice %s",M essage is displayed, | |
107 | 11,Verify that the c laims are annotated with the C ARC/RARC a ppropriate reason nu mber,Claim s are anno tated with the CARC/ RARC appro priate rea son, | |
108 | ||
109 | Test Case# ,Test Ca se # T est Script s# Story CS01 0 Req uirement, |
Araxis Merge (but not the data content of this report) is Copyright © 1993-2016 Araxis Ltd (www.araxis.com). All rights reserved.