Certification Test

Certification Test Program (Test Case Activities For CMS A/B MACs, CEDI and other contractors)

Certification Test Program requires CMS trading partners to perform certification testing using the CTP and produce reports based on the test results. A test case describes each task that will insure ASC X12 data elements, qualifiers, and data values conform to the TR3 and the transactions edit spreadsheet. Each valid value, invalid value, and edit as listed in the ASC X12edits spreadsheet has an associated test case. Each test case includes the purpose of the test case, steps (and prerequisites) required to execute the test case, what the expected results are, and any necessary comments to clarify the test case. The modifications and enhancements resulting from changes to the Edit Spreadsheets and deviations resulting from the CTP will be used as part of the annual recertification.

The contractors will utilize the Recertification Test Package (RTP) that is updated annually to perform self certification annually. The CMS will provide detailed instructions to the A/B MACs, CEDI or other contractors if designated by CMS to be used to perform the recertification testing. These instructions will be revised as needed and communicated to the A/B MACs, CEDI, or other contractors if designated by CMS. The CMS/MAC ReCertification Instruction Guide will be used as guidance to set up the execution of the Front End system to certify compliance with the standards.

As part of recertification, contractors will use template supplied by the STC for reporting of Re-Certification status, re-certification Checklists Reports, and Deviation Reports. In addition, weekly meetings with the contractors will be established by CMS during the recertification process for gathering status and other reporting activities. The CMS, utilizing existing processes and guidelines, will continue to provide ongoing administrative support for the ASC X12 5010 certification/recertification including building the master RTP, review of certification/recertification deviations to ensure the chosen recertification use cases and test cases are in sync with the current edit spreadsheets and complete the final sync (occurring immediately prior to the distribution of the Recertification test package) of the recertification Test Package with the most recent edit spreadsheet.

To learn more about HIPAA EDI and become a certified EDI Professional please visit our course schedule page.

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