Type 4 HIPAA Inter-segment Situation Testing

Type 4 involves testing of specific inter-segment situations described in the HIPAA implementation guides, such that, if A occurs, then Be must be populated. This is considered to include the validation of situational fields given values, or situational elements, present in other data segments. For example, if the claim is for an accident, the accident date must be present.

If the XML_Validation parameter is set to X or S, validation of the XML data in the BIN segment of the 4050 or 5010 275 (Additional Information to Support a Health Care Claim), is supported under Type 4 testing.

The options for reporting Type 4 exceptions identified by the SPE HIPAA Compliance Checker include the HIPAA 999 implementation acknowledgment and the Translated Acknowledgment report.