SNIP Type 1: EDI Standard Integrity Testing
This type validates the basic syntactical integrity of the EDI submission. This includes (but is not limited to) things like:
- Are the segments in the right order?
- Do fields meant for numbers contain numbers?
- Are the segments included valid segment types?
SNIP Type 2: HIPAA Implementation Guide Requirement Testing
Type 2 testing involves testing for HIPAA implementation guide-specific syntax requirements. This includes (but is not limited to) things like:
- Are the qualifiers used valid qualifiers?
- Are the right elements in the right types of segments?
- Are the sequencing segments (which count sequences of information) totaling correctly?
- Are situational segments (only needed under certain conditions) being used correctly?
SNIP Type 3: HIPAA Balance Testing
Balance testing involves ensuring that amounts reported in different places add up correctly. This includes (but is not limited to) things like:
- Do billed amounts listed on individual line items add up to the total billed amount listed for the whole claim?
- When Coordination of Benefit (COB) claims are involved, do the amounts listed for paid, adjusted, and patient responsibility add up to the amount originally billed?
Type 3 balance testing tests, for example, make certain that claim line item amounts are equal to the total claim amount.
SNIP Type 4: HIPAA Inter-Segment Situation Testing
Type 4 involves testing of specific inter-segment situations described in the HIPAA implementation guides (e.g. if A occurs, then B must be populated). This is considered to include the validation of situational fields. Situational values, or situational elements, need to be present or absent depending on other data segments. For example:
- If the claim is for an accident, is an accident date present?
- If the group number is present, the group name may not be included.
SNIP Type 5: HIPAA External Code Set Testing
Type 5 involves testing for valid implementation guide-specific code set values, as well as other code sets adopted as HIPAA standards (such as ICD-9-CM or NDC code sets). This involves comparing the values given to a database of correct options, such as comparing ICD-9-CM codes in the file to a database of valid ICD-9-CM codes.
SNIP Type 6: Product Type/Type of Service Testing
Type 6 testing ensures that the segments (records) of data that differ based on certain healthcare services are properly created and processed into claims data formats.
SNIP Type 7: Trading Partner-Specific Testing
The Implementation Guides contain some HIPAA requirements that are specific to Medicare, Medicaid, and Indian Health. Compliance or testing with these payer specific requirements is not required from all trading partners. If the trading partner candidate intends to exchange transactions with one of these Implementation Guide special payers, Type 7 testing is required.