Advisory Board Company

A Few Parser
Enhancement
Parser Enhancement

Jegadhesan Murugesan
9/21/2013

Table of Contents
DMV2 ........................................................................................................................................................ 2
HCFA: File similar to HCFA..................................................................................................................... 2
CSV: File similar to CSV. ......................................................................................................................... 2
NSF: File Similar to NSF. ........................................................................................................................ 2
ERROR MSG: Log table must have claimid instead of error message. .................................................. 2
Drop Visitid Logic. ................................................................................................................................. 2
CLAIM ........................................................................................................................................................ 3
Claim File ID: Temp table should have claimfileid................................................................................. 3
Account number Validation: ................................................................................................................. 3
Service Date Validation: ........................................................................................................................ 3
Delete: NPI character. ........................................................................................................................... 3

DMV2
HCFA: File similar to HCFA.
The parser is identifying the 837, NSF, CSV format files. All the unidentified claim files
are instinctively marked as File similar to HCFA but in fact 80% files are not HCFA. We need to
mark them as Unidentified Files format.
CSV: File similar to CSV.
The parser is validating the claim file and it has been marked as File similar to CSV but
really 80% files are not CSV.
Best Way: First Line should contain at least 5/7 delimiter (comma ,, Pipe |, cap ^, tilde ~).
Only then we should mark that as File similar to CSV. Rest of all need to marked as
Unidentified Files format.
NSF: File Similar to NSF.
Yes, Parser is validating the NSF files with the element code AAO and just marking as
File similar to NSF. So during this validation, we need to fetch the NSF version number from
the segment Prod and provide the version number for each file.
ERROR MSG: Log table must have claimid instead of error message.
The table cirunlogfilecstat contains historical claim data. In case of invalid/Missing vital
the claimid will append the text Invalid/Missing vital. Instead of the text, we need to have the
original visit/claimid in the column of table cirunlogfilecstat.
Drop Visitid Logic.
Visit-id generation could be in the form of fileid+claimid. This visit id is nowhere used in
the parser or Ambulatory.
Earlier it has been used for de-duplication logic. Now the de-duplication is totally
different and not based on this visit-id.

CLAIM
Claim File ID: Temp table should have claimfileid.
Temp table should contail we need to add the file claimid in the temp table.

Ease to verify the claim data and compare with the claim files.
Reduced Dmv2 traffic.
It helps out with more analysis case.
Joining the raw table to retrieve the claim file id is costly.

Account number Validation:

We are processing demographic information with one table and Diagnostics codes with another
table. Yes the claim id validation is done, along with that we need to validate the subscriber id.
Service Date Validation:
We are processing demographic information with one table and Diagnostics codes with another
table. Yes the claim id validation is done along with that we need to validate the service date.
Delete: NPI character.
The NPI value must be numeric type and we need to delete the rest.

Invalid claim analysis.

Easy to fix in case of any template error.
Saves more manual Effort. Avoids file by file validation.
Useful for file analysis.
Reduce repeated parser run.

Question to Development Team?

How we are validating the Delimiter from the CSV files?
Are we able to convert any date format?
How De-Duplication logic works with CPT/ICD Hash?
We can generate the visit id with concatenating Claim-id + claim fileid.
Post de-duplication can be verified with file Claim-id.
Question to Expert?
How to identify HCFA files. Generic CSV template. Existing template modification.

Customized 837 documents. Actual Service date to be considered.