Base VEE Rule 'Final Measurement Replacement' Is Accepting New IMD Instead Of Creating Issue (Doc ID 2606135.1)

Last updated on OCTOBER 10, 2022

Applies to:

Symptoms

On : 2.2.0.2.0 version, Common

Base VEE Rule 'Final Measurement Replacement' is accepting new IMD instead of creating Issue.

In MDM v2.2.0.2, base VEE Rule 'Final Measurement Replacement' is accepting new IMD instead of creating Issue when said VEE Rule require this IMD to raise an Issue, Instead the new IMD has been accepted and created a new Measurement triggering possible Cancel/Rebill.

Final Replacement Measurement Code:
If the 'Replacement Method' is "Reject Based on Configuration", a number of factors are analyzed:
1. If the 'Replace Manually Edited Data?' is set to "No", validation will prevent any existing manually-edited measurement from being replaced by new measurements.Setting this to NULL will allow manually edited data to be overlaid with replacements.
2. If 'Replacement Evaluation Type' is NULL, then all no comparison is done between the new and old measurements.
3. If the 'Replacement Evaluation Type' = "Compare Value Change", value difference between the new measurement in the IMD and the existing measurement must be greater than the
configured value. If greater than the 'Value Change Tolerance', then the measurement can be replaced.
4. If the 'Replacement Evaluation Type' = "Compare Percentage Change", percentage difference between the new measurement in the IMD and the existing measurement must be
greater than the configured percentage. If greater than the configured 'Percentage Change Tolerance', then the measurement can be replaced.
5. If the 'Replacement Evaluation Type' = "Both Value And Percentage Change", If both the value difference and the percentage difference are greater than the configured values, then the
measurement can be replaced.
6. If the 'Replacement Evaluation Type' = "Either Value Or Percentage Change", If either the value difference or the percentage difference are greater than the configured values, then the
measurement can be replaced.
7. The 'Condition Code Prioritization by Group' section allows a user to define a ranking of condition codes by group for replacement purposes. Any codes within a group can replace one
another. However, no lower sequence group (i.e. sequence 20) can replace a condition code in a higher sequence group (i.e. sequence 10). The Condition Code Group configuration
supersedes the 'Replace Manually Edited Data?' configuration when the new measurement is in a higher Condition Code Group that the old measurement.

Changes

Cause

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