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Tier | 3.0 |
---|---|
Tier Description | Relational error |
Error Category | E3002 |
Error Category Message | Values inconsistently specified (multiple record types, multi file) |
Rule Type | Three Record Type Rule |
File Segment Number | ELG00002 |
Data Element Name | PRIMARY-DEMOGRAPHICS-ELIGIBILITY.DATE-OF-DEATH • CLAIM-HEADER-RECORD-IP.DATE-OF-BIRTH |
Validation Logic | 'if CLAIM-HEADER-RECORD-IP has a valid, non-null value for DATE-OF-BIRTH and PRIMARY-DEMOGRAPHICS-ELIGIBILITY has a valid, non-null value for DATE-OF-DEATH and ELIGIBILITY-DETERMINANTS.CONCEPTION-TO-BIRTH-IND does not equal '1' and ELIGIBILITY-DETERMINANTS.ELIGIBILITY-GROUP does not equal '64' and CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2', then CLAIM-HEADER-RECORD-IP.DATE-OF-BIRTH is less than or equal to PRIMARY-DEMOGRAPHICS-ELIGIBILITY.DATE-OF-DEATH' |
Rule Definition | If a non-denied IP claim has a value populated for date of birth and the primary demographics eligibility segment has a value populated for date of death and the claim is not for a conception to birth eligible, then the date of death value is equal to or after the date of birth. |
Denominator Logic | # of IP claim headers with CLAIM-HEADER-RECORD-IP.DATE-OF-BIRTH equal to a valid, non-null value and with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY not equal to 'F2' and with PRIMARY-DEMOGRAPHICS-ELIGIBILITY.DATE-OF-DEATH equal to a valid, non-null value and with ELIGIBILITY-DETERMINANTS.CONCEPTION-TO-BIRTH-IND not equal to '1' and with ELIGIBILITY-DETERMINANTS.ELIGIBILITY-GROUP not equal to '64' |