Description

When an EDI 835 Project is created in GenRocket, the entire Transaction Set is enabled. Of course, when you are testing a Transaction Set, not every Segment, Loop, and Element will be needed to complete each test or to achieve a specific Business Case Scenario.


This is where Test Data Cases can be extremely beneficial because they make it possible to fully customize what Transaction Set Segments, Loops, and Elements will be used to generate data. Additionally, you can add Segments (i.e. Domains), add Attributes, and make Generator Configuration changes that are specific to the Test Data Case, but do not effect the Project as a whole. 


When should Test Data Cases be used for EDI 835 Projects?

Test Data Cases can be used to perform specific types of testing (Negative, Integration, Beta, etc.) and for testing Business Case Scenarios., such as: 

  • Governmental institutional environment. One or more Depository Financial Institutions is involved in transferring information from the sender to the receiver.

  • Managed care environment. Funds are sent by EFT to the provider’s account, and the remittance data is transmitted directly to the provider. 

  • Report secondary or tertiary payments back to the provider.


Business Case Scenario 1

This EDI 835 Business Case Scenario will show how to set up Test Data Cases for a Governmental institutional environment. One or more Depository Financial Institutions is involved in transferring information from the sender to the receiver.

Important: Please note that this is a sample for tutorial purposes and has been designed to show how Test Data Cases can be used to accomplish your EDI 835 Business Case objectives. The provided EDI Test Data Case samples can be copied and modified to meet your specific testing needs. 


The instructions in this tutorial will show how to configure a Test Data Case to achieve the X12 Syntax displayed below:


Recommended Action

The example below shows how the provided Business Case Scenario was created and modified to achieve a specified testing goal. 


It is recommended to copy one of the provided Test Data Case Business Case Scenarios and modify it using the same methods below to meet your specific testing needs.


Story

This Story demonstrates a test data case for a Governmental institutional environment. One or more Depository Financial Institutions is involved in transferring information from the sender to the receiver. This can be accomplished by configuring an EDI Test Data Case based on the Business Case Scenario Syntax above. 


Step 1: Create a Test Data Case (or Copy an Existing Case to Modify)

  • Access the Test Data Cases (G-Case) Dashboard and select the Test Data Case Suite.
  • Select the Test Data Category within the Dashboard.
  • Click the Create New G-Case button.

  • Enter a Name and Description.

  • Click the Save button.


Note: To copy a Business Scenario Test Data Case, click the Copy icon within the Actions column for the appropriate Test Data Case. 


Step 2: Disable Segments and Loops for the Segment

The EDI Project will be created with all Headers, Segments, and Trailers that make up an EDI 835 Transaction. By default, every Segment and Loop will be enabled for the EDI 835 Project.


Segments and Loops can be disabled or turned "off" directly within the G-Case Dashboard. To do so, complete the following steps: 

  • Click the drop-down menu in the top left corner of the  Dashboard and choose EDI View.


  • Click on the EDI Tree icon on the G-Case Editor tab.



  • Use each checkbox to enable or disable a Segment, Loop, or Element. A checkmark means the item is currently enabled.



  • Expand Segments and Loops within the EDI Tree View to make additional changes. In this example, Loop_1000A has been expanded. 

     
  • Click OK once finished.


Note: When Segments, Loops, and Elements are disabled within the Tree View, specific Segments will be added automatically and enabled or disabled depending on your selections. 


These items have been disabled within the EDI Tree View:

EDI Segments

  • CUR_ForeignCurrencyInformation
  • REF_ReceiverIdentification
  • REF_VersionIdentification


Loop_1000A

  • PER_PayerBusinessContactInformation_1000A
  • PER_PayerTechnicalContactInformation_1000A
  • PER_PayerWEBSite_1000A



Loop_1000B

  • N3_PayerAddress_1000B
  • N4_PayerCityStateZIPCode_1000B
  • REF_PayerAdditionalIdentification_1000B
  • RDM_RemittanceDeliveryMethod_1000B


Loop_2000 > Loop_2100

  • NM1_InsuredName_2100
  • NM1_CorrectedPatientInsuredName_2100
  • NM1_ServiceProviderName_2100
  • NM1_CrossoverCarrierName_2100
  • NM1_CorrectedPriorityPayername_2100
  • NM1_ OtherSubscriberName_2100
  • MOA_OutpatientAdjudicationInformation_2100
  • REF_OtherClaimRelatedIdentification_2100
  • REF_RenderingProviderIdentification_2100
  • DTM_CoverageExpirationDate_2100
  • DTM_ClaimReceivedDate_2100
  • PER_ClaimContactInformation_2100


  • AMT_ClaimSupplementalInformation_2100
  • Loop_2110


Step 3: Add Additional Required Segments to the Test Data Case

Depending on what has been disabled within the Tree View, you may need to add additional Segments or Loops to the Test Data Case. The Tree View is designed to make this process easier; however, sometimes you will need to add one or more Segments or Loops to test a specific Business Case Scenario. 


For this example, only one segment will need to be added and modified: BPR_FinancialInformation. Complete the following steps to add this segment: 

  • Use the Filter to locate each needed Segment. For this example "BPR" has been entered to find this Segment: BPR_FinancialInformation.

  • Next, click the Plus (+) icon located to the right of the Segment within the G-Case Editor tab. 


  • Once finished, the added Segments will appear in the table located on the right of the G-Case Editor tab. Segments added this way are automatically enabled and will appear at the bottom of the list.  

     

Note: You can click, drag, and drop a Segment into another location within the list to better organize enabled Segments. 


Step 4: Add and Configure Attributes for BPR_FinancialInformation

In some instances, you may need to make changes to the generated data for a specific Test Data Case to match the Business Case Scenario. This can be done by adding a Attribute to the Test Data Case Domain for the Segment.


For this example, the BPR_FinancialInformation test data configuration will need to match the following X12 Syntax:


Based on the syntax above, the following Attributes will need to be added and modified to generate this test data: 

  • handlingCode01 = C
  • flagCode03 = C
  • methodCode04 = ACH
  • formatCode05 = CTX
  • numberQualifier06 = 01
  • payerIdentifier10 = Automatically Generated (Optional)
  • supplementalCode11 = 999999999
  • numberQualifier12 = 01
  • numberQualifier14 = DA


Step 4a: Add Attributes to the BPR_FinancialInformation Test Data Case Domain

Complete the following steps to view the Test Data Case Domain for the Segment and add Attributes with the required test data:

  • Click the Edit Test Data Case Domain icon in the Actions column.


  • Click the Plus (+) button to add one or more Attributes to the Test Data Case Domain.


  • In the dialog window, tick the checkbox for each Attribute that needs to be added.

  • Click the Save button once finished.



  • Each Attribute will be added to the Test Data Case Domain, as shown below:



Step 4b: Modify the handlingCode01 Attribute Generator Configuration

The handlingCode01 Attribute Generator, by default, has 7 codes: C, D, H, I, P, U and X. For this sample, only C is needed. You will need to modify the Generator configuration so that only C is generated. Complete the steps below: 

  • Click on the handlingCode01 Attribute.


  • Click on each value within the list to select it and then click the Remove button. This step will need to be completed 6 times for each of the codes that are not needed. 



  • The configuration will appear as shown below. Click the Save Generator button.


Step 4c: Modify the flagCode03 Attribute Generator Configuration

The flagCode03 Attribute Generator, by default, has 2 codes: C and D. For this sample, only C is needed. You will need to modify the Generator configuration so that only C is generated. Complete the steps below: 

  • Click on the flagCode03 Attribute.


  • Click on D within the list to select it and then click the Remove button. 


  • The configuration will appear as shown below. Click the Save Generator button.


Step 4d: Modify the methodCode04 Attribute Generator Configuration

The methodCode04 Attribute Generator, by default, has 5 codes: ACH, BOP, CHK, FWT, and NON. For this sample, only ACH is needed. You will need to modify the Generator configuration so that only ACH is generated. Complete the steps below: 

  • Click on the methodCode04 Attribute.


  • Click on each value within the list to select it and then click the Remove button. This step will need to be performed several times.


  • The configuration will appear as shown below. Click the Save Generator button.


Step 4e: Modify the formatCode05 Attribute Generator Configuration

The formatCode05 Attribute Generator, by default, has 2 codes: CCP and CTX. For this sample, only CTX is needed. You will need to modify the Generator configuration so that only CTX is generated. Complete the steps below: 

  • Click on the formatCode05 Attribute.


  • Select the gen1 (ListGen) Generator underneath Linked Generators.



  • Click on CCP within the list to select it and then click the Remove button. 



  • The configuration will appear as shown below. Click the Save Generator button.


Step 4f: Modify the numberQualifier06 Attribute Generator Configuration

The numberQualifier06 Attribute Generator, by default, has 2 qualifiers: 01 and 04. For this sample, only 01 is needed. You will need to modify the Generator configuration so that only 01 is generated. Complete the steps below: 

  • Click on the numberQualifier06 Attribute.


  • Select the gen1 (ListGen) Generator underneath Linked Generators.



  • Click on 04 within the list to select it and then click the Remove button. 



  • The configuration will appear as shown below. Click the Save Generator button.


Step 4g: Modify the numberQualifier12 Attribute Generator Configuration

The numberQualifier12 Attribute Generator, by default, has 2 qualifiers: 01 and 04. For this sample, only 01 is needed. You will need to modify the Generator configuration so that only 01 is generated. Complete the steps below: 

  • Click on the numberQualifier12 Attribute.


  • Select the gen1 (ListGen) Generator underneath Linked Generators.



  • Click on 04 within the list to select it and then click the Remove button. 


  • The configuration will appear as shown below. Click the Save Generator button.

     


Step 4h: Modify the numberQualifier14 Attribute Generator Configuration

The numberQualifier14 Attribute Generator, by default, has 2 qualifiers: DA and SG. For this sample, only DA is needed. You will need to modify the Generator configuration so that only DA is generated. Complete the steps below: 

  • Click on the numberQualifier14 Attribute.


  • Select the gen1 (ListGen) Generator underneath Linked Generators.


  • Click on SG within the list to select it and then click the Remove button. 



  • The configuration will appear as shown below. Click the Save Generator button.


Completed Test Data for BPR_FinancialInformation Segment