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At what point in the validation process might the entire batch of claims be rejected?

April 26, 2017batch entire point process validation

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At what point in the validation process might the entire batch of claims be rejected?

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BCBSNC invokes security validation edits to ensure that only authorized trading partners and providers are exchanging data with BCBSNC. Security validation takes place at both the ISA (Interchange) and GS (Functional Group) Levels of the transmission, as well as the ST (Transaction Set) Level of the transmission. What portion of the transmission gets rejected depends upon where the violation occurs. If the violation is in the ISA, the entire transmission fails. If it is in the GS portion, the entire Functional Group fails. If a security violation occurs within the Transaction Set, all claims/inquiries associated with the same Provider Identifier that could not be validated fail. See individual chapters of the BCBSNC Companion Guide to EDI Transactions for more information.