Xerox EDI Direct Testing Requirements And Guidelines
Xerox EDI Direct testing is required in order to submit claims in the X12 standard format. A majority of payers have additional business requirements in addition to the X12 standard. The business requirements could be due to system limitations or utilized to properly adjudicate a claim. Therefore, Xerox EDI Direct testing requires trading partners to engage in two phases of testing for each payer/transaction type.
Phase one testing is Edifecs validation and phase two is parallel testing. Xerox EDI Direct will process test files through Edifecs-SpecBuilder to ensure X12 transactions meet the WEDI-SNIP validation levels one through four. The WEDI-SNIP levels may vary by payer.
- Level One—EDI Syntax Error
- Level Two—HIPAA Syntax Error
- Level Three—Balancing Error
- Level Four—Situational Error
Once all Syntax Errors have been resolved in the Trading Partners test file and the file passes phase one of testing, phase two of testing will be begin. Phase two of testing is performed between the trading partner and a Analyst at Xerox EDI Direct. The Xerox EDI Direct Commercial Support Team is available to assist you throughout this process. Testing is conducted to verify the integrity of the format, not the integrity of the data. The number of test transmissions required depends on the number of format errors on a transmission and the relative severity of these errors. Xerox may require additional testing to verify any changes made to the Xerox EDI Direct Clearinghouse system or the X12 formats.
The Trading Partners first test file will be validated against Edifecs by a Xerox EDI Direct analyst. Edifecs is a testing tool used to validate a test file against the base HIPAA implementation guidelines.
- Test all 7 WEDI/SNIP Types. Edifecs provides all 7 Types of WEDI/SNIP Testing for HIPAA including integrity testing, requirement testing, balancing testing, situational testing, code set testing, product or services testing, and guide-specific testing. Xerox EDI Direct, in most cases when applicable, will validate the test file against WEDI/SNIP types one through four.
- Test the HIPAA Code Sets. Validate over 40 industry code tables and databases.
One you have submitted your test file please contact Xeros EDI Commercial Support Team. Pilot Submitters must use this application to validate their test files for HIPAA compliancy before submitting for Communication and Client Integration testing.