Envelope parameters list

In the following table, the * (asterisk) indicates the default value

SPE UI label / Parameter tag name Values Description
Generate an Acknowledgment when this Group is Received sets the HIPAA_997_Enabled parameter No - Never generate a HIPAA-specific 997 transaction even if the results of the compliance check indicate the presence of Type 1 errors.

Yes* - Always generate a HIPAA-specific 997 transaction for all interchanges even if compliance check does not indicate the presence of Type 1 errors.		 Indicates whether the results from the WEDI/SNIP Type 1 checks are reported by the HIPAA-specific 997 transaction set. This parameter is only available to be set when the highest level of HIPAA Validation selected is Type 1. If higher levels of HIPAA validations are selected, this parameter is not used.
HIPAA_Type_n_Checks_Enabled Note: Where n is an integer 1-7.

Yes - Perform Type n checks on the data.

No - Do not perform Type n checks on the data.

 Used to indicate whether WEDI/SNIP Type n checks should be performed on the input data. See the HIPAA_Type_n_Checks_Enabled details documentation for more information about this parameter.
Validate XML Data in BIN Segmentssets the XML_Validation parameter Never* - Never validate the contents of the BIN segment.

XML - Validates the contents of the BIN segment for proper XML formatting.

Schema - Validate the contents of the BIN segment for proper XML formatting and against the schema.

 Indicates the validation level for XML BIN/BDS segment content. The parameter is used to indicate whether the data in the BIN segment of the 4050 275 transaction set is to be validated, and to which level it is to be validated.
HIPAA Claim Level Rejection sets the HIPAA_Claim_Level_Rejection parameter Yes - Enable health care claims.

No*

 Indicates whether the transaction set is still accepted with an AK501=E (errors accepted), and the claim, or claims, in error are removed from the valid data. This parameter is only available when the input HIPAA EDI data is a Claim 837. Claim Level Rejection is not available for other HIPAA transactions, including the non-mandated Post-Adjudicated Claims.
HIPAA Claim Level 277CA Reporting Never* - Never generate a 277CA even if the results of compliance check indicate the presence of errors in 837 Claims input data.

Exceptions - Generate a 277CA for the interchange only when the results of compliance check indicate the presence of errors in the 837 Claims input data.

Always - Always generate a 277CA for all interchanges even if compliance check does not indicate the presence of errors in the 837 Claims input data.

 Indicates whether the results from the Claim Level Rejection process are reported using the 5010 277CA transaction set.
Splitting Level for Claim Level Rejection sets the HIPAA_Claim_Rejection_Level parameter Provider* - This option is recommended for performance. The 277CA reports details at the Provider level. This option does not provide specific details on each claim, only on the totals that are accepted and rejected for each Provider.

Claim - The 277CA reports details at the Claim level. This option provides specific details on each claim within the transaction. This option might impact performance if there are a large number of claims in the data.

 Indicates the level at which the HIPAA 277 Claims Acknowledgment reports. It can show detail at the Provider level, or it can show details down to the Patient/Claim level.

This parameter has an impact only when the HIPAA Claim Level Rejection envelope parameter is set to Yes, and the input HIPAA EDI data is a Claim (transaction set 837). The default setting is Provider. If there are no errors in the HIPAA EDI 837 data, then reporting goes to the Provider level regardless of the setting.

Generate the Translated Acknowledgment Report sets the HIPAA_Tack_Enabled parameter Yes - Generate

No* - Do not generate.

 Determines whether the Translated Acknowledgment Report is produced. This report transforms the acknowledgments into a readable report.
Translated Acknowledgment Trigger sets the HIPAA_Tack_Accepted parameter Always - Generate accepted error report.

Exceptions* - Generate error report only.

 Determines what level of reporting appears on the Translated Acknowledgment Report. The options are to produce the report for all data (accepted and rejected), or to only generate the report that is based on the data in error.
Unique File Names for Translated Acknowledgement sets the TAck_EDI_Unique_ID Yes

No*

 If unique Tack documents are requested, then SPE generates a unique id and passes it to the compliance checking map to be appended to the Tack EDI link in the translated acknowledgment document. The names of the output files do not change. Only the link to the EDI data in the translated acknowledgment report changes.
Validation Method sets the Validation_Method parameter Map* - Can only be used when validating Types 1- 4.

Compliance - Used to validate Types 5, 6 and 7.

Both

 Map - This default setting sends all data through the pass through validation maps and only the invalid data goes through the subsequent processing. This is the recommended, and the default setting.

Compliance - This setting causes all data to be passed to the detailed processing done by the Compliance Check application.

Both - This setting causes all data to be processed both by the pass through validation maps and the detailed compliance check validation. If there is a large amount of data, this option can slow the process. This option is used for troubleshooting purposes, logic module, or both.
Allow Relaxed Type 2 Structure Checking sets the HIPAA_Relaxed_T2_Structure_Check_Enabled parameter Yes - Perform relaxed Type 2 structure checks if WEDI/SNIP Level 2 structure checking fails.

No* - Do not perform relaxed Type 2 structure checks on the data.

 This parameter is used to indicate whether relaxed structure is to be performed on the input data if the data fails WEDI/SNIP Type 2 structure checking.

This new processing is performed only if there are errors found during Type 2 structure checking.

If errors are not present, this processing is bypassed. Also, this new processing is only executed when Type 2 checks are enabled. If only Type 1 checking is enabled, the setting is ignored.
Companion Guide Rule Group None Use Global Rules. Use Envelope Name Assign Rule Group Identifier This is not a typical parameter. It is instead, a link between the business rule and the envelope that determines when a particular Type 7 rule should trigger.
Companion Guide Rule Book Identifier Freeform Value Passed from SPE to compliance check and placed in the compliance summary file for debugging.
Type 7 Customer User Exit Language sets the T7_Exit_Type parameter None* - No custom user exit.

C Program - Custom User Exit is C Program.

Java Program - Custom user exit is Java Program.

 The type of validation utility that contains the user extended rules. This value is used to determine if a JEXIT or an EXIT function is required by the compliance check application.
Type 7 Exit Class Name or T7 Exit Library Name sets the T7_Exit_Name parameter Free form Value (user entered) The Exit name is a free form field with no further editing where you enter the library, or program name for a C program, or the Class Name for a Java program.
Type 7 Exit Method name or Type 7 Exit Function Name sets the T7_Exit_Function parameter Free form Value (user entered) The Exit Function is a free form field with no editing where you enter the Function name for a C Program, or the Method name for a Java program.
Exception Handling for Type 7 sets the T7_Reject_Level parameter Error - Report exceptions as errors and reject the data.

Warning* - Report exceptions as warnings and accept the data.

 This parameter lets you to flag Type 7 validation results as warnings, or errors.

Warnings - This default setting reports the results of the Type 7 validations on both the 5010X186A1 824 Application Advice and the Translated Acknowledgment report, but does not reject the data. The 999 acknowledgment does not report on any warnings that are found.

In order to review any warnings generated, the 824 Application Advice is generated and the Translated Acknowledgment report can also be enabled by setting the Generate the Translated Acknowledgment Report parameter to Yes.

Error - This setting causes data to be rejected when Type 7 validation errors occur and the errors are reported on the 999 acknowledgment. The errors are not reported on the 824 Application Advice when this parameter is set to Error.
Exception Handling for Type 6 sets the T6_Reject_Level parameter Error - Report exceptions as errors and reject the data.

Warning* - Report exceptions as warnings and accept the data.

 This parameter lets you flag Type 6 validation results as warnings, or errors.

Warning - This default setting reports the results of the Type 6 validations on both the 5010X186A1 824 Application Advice and the Translated Acknowledgment report but does not reject the data.

The 999 acknowledgment does not report on any warnings that are found. In order to review any warnings generated, the 824 Application Advice is generated and the Translated Acknowledgment Report can also be enabled by setting the Generate Translated Acknowledgment Report parameter to Yes.

Compliance Check Page Count sets the Paging_Parameter 8* This parameter specifies the page count used for the execution of most run maps from within the compliance check.

The page count might be an integer 1 - 9999. The default is 8 pages.
Compliance Check Page Size sets the Paging_Parameter 64* This parameter specifies the page size (in Kb) to be used for execution of run maps from within compliance check. The page size might be an even integer 2 - 1024. The default setting is 64 Kb. In general, larger page size and count settings improve overall compliance check performance when the transaction sets being processed are large.