How to Generate a Batch of Claims
This lesson shows how to generate a batch of Claims for an EDI 837I Document. For this example, we will generate a single EDI 837I Document that contains:
- Fifteen Claims
- One to five Service Lines per Claim
Step 1: Select or Create a G-Case within the G-Cases Management Dashboard
A G-Case will need to be selected or created within the G-Cases Management Dashboard to set up a batch of Claims.
Step 2: Add Loop_2300V1 and Loop_2400V1 to the G-Case
Click on the EDI Tree View icon within the G-Case Editor Tab.
Locate Loop_2300V1 and add the Domain to the G-Case by clicking on the Plus (+) icon.
Locate Loop_2400V1 and add the Domain to the G-Case by clicking on the Plus (+) icon. Then click on the OK button to finish.
The two added Loops will appear within the G-Case Editor Tab.
Step 3: Set the Loop Count for Loop_2300V1
The Loop Count for Loop_2300V1 will need to be set to a constant value of 15 to generate fifteen Claims within the EDI 837I Document.
Within the G-Case Editor Tab, click on the Update Loop Count icon within the Loop Count Column.
Select the “Constant” Loop Type and enter 15 for the Loop Count value. Then click the Save button.
Step 4: Set the Loop Count for Loop_2400V1
The Loop Count for Loop_2400V1 will need to be set to a random value of 1 to 5 to generate one to five Service Lines per Claim within the EDI 837I Document.
Within the G-Cases Editor Tab, click on the Update Loop Count icon within the Loop Count Column.
Select the “Random” Loop Type. Then enter 1 for the Min Range value and 5 for the Max Range value. Click the Save button once finished.
If no other changes are made within the G-Case, it will generate one EDI 837I Document containing fifteen Claims. Each Claim will have 1 to 5 Service Lines.
By default, a different synthetic Payer Name and Receiver Name is generated for each Claim. If the Payer Name or Receiver Name should be the same name for each Claim, additional steps will need to be completed and are provided below.
Step 5: Add the NM1_PayerName_2010BB Segment to the G-Case and Modify Its Parameters
Add the NM1_PayerName_2010BB Segment to the G-Case through the EDI Tree View.
Click on the Pencil icon within the EDI Tree View.
Next, add the payerName103 Element/Attribute to the Test Case Domain by clicking on the Plus (+) icon.
Click on the checkbox for the payerName103 Element/Attribute and click the Save button.
Select the payerName103 Element/Attribute.
Select the gen1 Generator and then type ConstantGen within the Quick Generator Replacement Menu.
Select the ConstantGen Generator and click the Replace button.
Then enter the desired Payer Name for the value Parameter and click the Save Generator button.
Note: To generate specific Payer Names for each Claim, users can also assign the ListGen Generator or assign a Query Generator.
Step 6: Add the NM1_ReceiverName_1000B Segment and Modify Its Parameters
The same steps in Step 5 can be performed for the NM1_ReceiverName_2000B Segment to generate Claims for a single Receiver Name. By default, multiple synthetic Receiver Names will be generated for the Claims within an EDI Document.
To use one Receiver Name for each Claim or a list of specific Receiver Names, the Domain for this segment will need to be added to the G-Case.
Add the ReceiverName_1000B1 Element/Attribute to the Test Case Domain and then select it to view the assigned Generators.
Assign the ConstantGen Generator to the ReceiverName_1000B1 Element/Attribute by using the Quick Generator Replacement Menu.
Enter the Receiver Name for the value Parameter and click the Save Generator button.
Note: To generate specific Receiver Names for each Claim, users can also assign the ListGen Generator or assign a Query Generator.
Note: The steps shown in Steps 5 and 6 can be used to assign different Generators for an Element/Attribute and to change a Generator’s Parameter values prior to using a G-Case to generate EDI Documents.