Unnecessary processing

To increase performance, avoid all unnecessary processing of data.

For example, the WEDI/SNIP type 5 capabilities in the HIPAA Compliance Check module can be set to check the values of external code set values that are stored in a database, against the qualified values in the data. Depending on your business requirements, this higher level checking might not be necessary.

Due to the large amount of resources that are required to perform the type 5 check, do not perform the check unless your intention is to reject such data.

Similarly, if you want to process all data with correct HIPAA structure (WEDI/SNIP type 2) do not perform the more costly type 4 validation. Type 4 validation includes cross segment summing and other cross segment checks. The rules that are involved in these levels of checks require the build-up of multiple pieces of information across more than one segment of data. Therefore, these checks require more resources than the type 2 checks require.

Another way to increase performance is to use Claim Level Rejection processing only when it is necessary to meet the business requirement.

The ability to process a subset of a batch of 837 claims is important in some environments, but not in all. If there is a business requirement to process all valid claim loops and report on all invalid claim loops within a single transaction set then Claim Level Rejection is necessary. However, the processing necessary to accomplish that task is complex and care must be taken to use Claim Level Rejection only when the business requirement demands this level of processing.