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HIPAA Testing
Testing process plays a major role in HIPAA
implementation. It is where trading partners find errors, omissions,
and conflicts in their systems and correct them before the actual
standard transactions are used. Health plans, clearinghouses and
vendors should be in the testing stage of HIPAA implementation for
October 16, 2003 compliance. This includes active testing with their
providers.
We at HPS
Clearinghouse, take the lead in testing your Electronic Data Interchange
(EDI) transactions for HIPAA compliance. Our testing services includes
all the seven levels of HIPAA testing methodology.
HPS Clearinghouse
HPS clearinghouse provides a variety of ways to test a computer system’s
ability to create, send, or receive HIPAA compliant transactions.
According to guidelines developed by WEDI SNIP, there are seven
different ways to assure compliance. |
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Integrity Testing
According to the WEDI/SNIP White Paper, this involves testing for
valid segments, segment order, element attributes, testing for numeric
values in numeric data elements, validation of X12 syntax and compliance
with X12 rules. In short, it tests for valid EDI syntax for each
type of transaction.
Requirement Testing
This tests that the transaction sets adhere to the implementation
guides. Testing for HIPAA implementation guide-specific requirements,
HIPAA-specific syntax such as repeat counts, used and not
used codes, elements and segments, required or intra-segment
situational data elements, non-medical code sets as laid out in
the implementation guide and values noted in the implementation
guide via an X12 code list or table.
Balancing
Testing of the transaction for balanced field totals, financial
balancing of claims or remittance advice and balancing of summary
fields.
Situation Testing
Testing of specific inter-segment situations as defined in the implementation
guide where if A occurs then B must be present. This is considered
to include the validation of situational fields given values or
situations present elsewhere in the file. A typical situation testing:
there is a dependent loop but no subscriber loop in a transaction.
Code Set Testing
Testing of correct use of external code sets whether valid values
of external data elements are used.
Speciality or Line of Service Testing
Specialized testing required for certain health care specialties.
For example, Hospice Care, Home Oxygen Treatment, and Ambulance
Service have unique data requirements when submitting health care
claims to a payer.
Trading Partner Testing
Testing of trading partners’ ability to transmit and receive
HIPAA-compliant data.
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