Six Levels Testing

1.

 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."

2.

 Requirement
 Testing

Testing for HIPAA implementation-guide-specific requirements, 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.

3.

 Balancing Testing

Testing the transaction for balanced field totals, record or segment counts, financial balancing of claims or remittance advice, and balancing of summary fields.

4.

 Situation Testing

Testing of specific inter-segment situations described in the HIPAA implementation guides such that: If A occurs then B must be populated. 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.

5.

 Code Set Testing

Testing for valid implementation-guide-specific code set values.

6.

 Line-of-
 Business Testing

Specialized testing required by certain healthcare specialties. For example Hospice Care, Home Oxygen Treatment, and Ambulance Service all have unique data requirements when submitting health care claims to a payor.