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Need help to resolve a hard edit


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Jala Sandhya

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Joined: 27 Apr 2023
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PostPosted: Thu Apr 27, 2023 6:07 pm
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11a edit Description type of treatment.

Sample production claim which triggered 11 edit. # 23097EP6629

Output I want claims should no longer trigger 11 edit after making the code changes to validate type of treatment on claims and systematically update type of treatment code(TT) code.





As a WGS user,I want system yo validate the type of teatment (TT) within the claim and systematically update the claim with valid type of treatment and no longer trigger 11 edit such that claims can be systematically adjudicated according to member benefits.

Please do help me with the Cobol code logic for the above scenario.

Please do mention the module list and logic required for to resolve 11 edit from system and automatically populate the valid type of treatment.

Expectation

Claims should no longer trigger 11 edit once logic is automated.


Wgs-Wellpoint group systems
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Joerg.Findeisen

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PostPosted: Thu Apr 27, 2023 6:12 pm
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Please, do not use screenshots, use the Code button instead. Thank you!
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Jala Sandhya

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PostPosted: Thu Apr 27, 2023 6:20 pm
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Sure will not use screenshots from next time
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sergeyken

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PostPosted: Thu Apr 27, 2023 6:37 pm
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Jala Sandhya wrote:
Sure will not use screenshots from next time

Also, posting the same question twice would not speed-up the resolution of the issue!
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Jala Sandhya

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PostPosted: Thu Apr 27, 2023 6:43 pm
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gncveds and gncpveds both the modules are having this 11 edit.


PostPosted: Thu Apr 27, 2023 6:07 pm
Post subject: Need help to resolve a hard edit
11a edit Description type of treatment.

Sample production claim which triggered 11 edit. # 23097EP6629

Output I want claims should no longer trigger 11 edit after making the code changes to validate type of treatment on claims and systematically update type of treatment code(TT) code.





As a WGS user,I want system yo validate the type of teatment (TT) within the claim and systematically update the claim with valid type of treatment and no longer trigger 11 edit such that claims can be systematically adjudicated according to member benefits.

Please do help me with the Cobol code logic for the above scenario.

Please do mention the module list and logic required for to resolve 11 edit from system and automatically populate the valid type of treatment.

Expectation

Claims should no longer trigger 11 edit once logic is automated.


Wgs-Wellpoint group systems

Please provide me the update as soon as possible
[/code]
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dneufarth

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Joined: 27 Apr 2005
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PostPosted: Thu Apr 27, 2023 7:06 pm
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You may understand how these programs work, but we do not.

Understanding how your code invokes these edits and under what circumstances is unclear.

What code/changes have you tried?
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Jala Sandhya

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PostPosted: Thu Apr 27, 2023 7:19 pm
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Tried to populate the first occurrence of type of treatment before the edit is getting triggered.


It was working but not sure weather my coding is correct or not

If MPRREVC -TYPE-TRTMT-CDE(WS-NUM1) >SPACES
MOVE MPRREVC -TYPE-TRTMT-CDE(WS-NUM1) TO DDC-DTL-TT-CDE(DDC-DTL-NDX)
END-IF
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Jala Sandhya

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PostPosted: Thu Apr 27, 2023 10:54 pm
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Any update on the above ask?

Please reply
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Robert Sample

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Joined: 06 Jun 2008
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Location: Dubuque, Iowa, USA

PostPosted: Thu Apr 27, 2023 11:54 pm
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Quote:
Any update on the above ask?

Please reply
It is considered rude to prompt for replies to an earlier query on a forum. Since people respond when they have the knowledge, time, and interest in responding it can easily be hours ... days ... weeks ... years even without a response. And this is all normal.

If you need an immediate response, persuade your management to hire a consultant to help you. Otherwise, don't expect replies in any given amount of time. And based upon the near-total lack of information you have provided, it is EXTREMELY unlikely you will get any responses that address your issue(s).
Code:
If MPRREVC -TYPE-TRTMT-CDE(WS-NUM1) >SPACES
MOVE MPRREVC -TYPE-TRTMT-CDE(WS-NUM1) TO DDC-DTL-TT-CDE(DDC-DTL-NDX)
END-IF
You did not provide ANYTHING to help us here -- what are the PICTURE clauses for each of the variable mentioned in this code excerpt? Why are you asking if the coding is correct? I can tell by inspection that the code you posted will not even compile since COBOL does not allow spaces in variable names and you have them.

Questions you might want to think about answering to get some help:
    What is a "hard edit"?
    What is an "11 edit"?
    Is there a software vendor for this software, and have you contacted them for help yet?
    Do you even know COBOL?
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