Perhaps the biggest challenge you will have with the 835 is balancing. The total payment must balance with the remittance details for that payment. The amounts also have to balance at three different levels: the transaction level, the claim level and the service level. For example, at the claim level, the Total Claim Charge Amount (CLP03) minus the sum of all the Adjustment Amounts (CAS segments) must equal the Claim Payment Amount (CLP04). Balancing at the different levels is explained in detail in the 835 X12 standards.
For the most part, X12 is loop driven, so, at a minimum, you might want to start with creating tables that match up with each loop. Think about what keys you'll want to use, perhaps based on your internal claim numbers and sequence numbers. It will be important for traceability and, simply, to keep things straight.
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也许 835 面临的最大挑战是平衡。总付款必须与该付款的汇款详细信息平衡。这些金额还必须在三个不同级别上保持平衡:交易级别、索赔级别和服务级别。例如,在索赔级别,索赔费用总额 (CLP03) 减去所有调整金额(CAS 段)的总和必须等于索赔付款金额 (CLP04)。 835 X12 标准中详细解释了不同级别的平衡。
在大多数情况下,X12 是循环驱动的,因此,至少,您可能希望从创建与每个循环匹配的表开始。考虑您要使用哪些密钥,也许根据您的内部索赔号和序列号。这对于可追溯性非常重要,简单来说,就是保持事情的顺利进行。
Perhaps the biggest challenge you will have with the 835 is balancing. The total payment must balance with the remittance details for that payment. The amounts also have to balance at three different levels: the transaction level, the claim level and the service level. For example, at the claim level, the Total Claim Charge Amount (CLP03) minus the sum of all the Adjustment Amounts (CAS segments) must equal the Claim Payment Amount (CLP04). Balancing at the different levels is explained in detail in the 835 X12 standards.
For the most part, X12 is loop driven, so, at a minimum, you might want to start with creating tables that match up with each loop. Think about what keys you'll want to use, perhaps based on your internal claim numbers and sequence numbers. It will be important for traceability and, simply, to keep things straight.
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