We have included a new X12 claim status property to check how the claims in the files are processed.

Whenever the file is ingested it will be in In Progress status. Based on the claims in the files processed the status will vary as shown below.

The file statuses are:

• Success
• Failed
• Completed with errors
• Partially completed with errors

The following is the DSS and status information:

• If all the claims in the file are processed without any errors, the file is considered successful.
• If any of the claims in the file are errored-out, the file status is considered failed if the DSS setting is selected as Fail.
• If any of the claims in the file are errored-out, the file status is considered Completed with errors, if the DSS setting is selected as Ignore.
• If the claims within a file are still processing, the file status will be In Progress. Consider there are 500 claims in a file and the file is picked by the file listener; the file status is then In Progress.

Dynamic system settings: 2 DSS have been created:

Ignore: If the DSS is selected as Ignore, then even if a single file is errored-out the file status will be selected as Completed with errors.

Fail: If the DSS is selected as Fail, then even if a single file is errored-out the file status will be selected as Failed.

We have included the file status properties which include:

• Success- All the claims in the files were processed
• Failure- None of the files were processed
• Skipped

X12 claim status codes:

In the data base, there are database tables where the user can observe the status of files processed as well as exception tables where exceptions will be captured whenever anything fails during the process of file ingestion until the point of work object creation and adjudication.

The database tables for displaying the file status is PegaX12-Data-Filestatus.

The file status clearly displays how many claims are processed as part of a file, including different claim types.

The file status table tracks the number of P claims processed, the number errored-out or failed, and the number skipped (considering as duplicate claims).

The database table for showing all the exceptions is PegaX12-Data-Exception.

The exception table will show the exact exception message, as well as the X12 string where the actual exception occurred. The actual record within the entire file, where the exception occurred will also be displayed.

The database table for displaying all N837 transactions is PegaX12-Data-N837.

• De-Batch functionality