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Audit type logic

Updated on October 9, 2020
  1. The system would parse the outbound XML response.
  2. If the response did have errors on, it would map the errors to the appropriate event codes.
  3. The system would calculate the audit type based on rule acronym and claim line action on the current claim line and other lines within the same case. Audit type would be calculated for each line. Case action might be used to determine the audit type as well.
  4. Once the audit type is determined the system would refer to the CXTResponsetoSCECode table. Event codes would be mapped based on certainty, current claim line action, rule acronym, rule type, case action, audit type and customer adjustment code.

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