NetworX event codes
The NetworX pricer includes in the XML response file greater than 130 routing codes. Several of the NetworX routing codes have been mapped to discrete Smart Claims Engine event codes. The remaining NetworX outing codes may be mapped to existing or newly created event and/or action codes, which may then be configured to meet the customer’s specific event management needs.
The following routing codes have been mapped to Smart Claims Engine event codes for use
in the pricing module. The MapSANPErrorResponseToEvent decision table manages
this conversion:
NetworX routing code | SCE event code | SCE event code name |
6 | SSP-0001 | The claim was re-priced correctly, but is a duplicate of another claim. |
23 | SSP-0003 | The ICD procedure code on the claim line is missing or is not found in the pricing system. |
24 | SSP-0004 | The procedure code on the claim line is missing or is not found in the pricing system. |
402 | SSP-0005 | The diagnosis code is missing or is not found in the pricing system. |
403 | SSP-0006 | The ICD procedure code on the claim line is missing or is not found in the pricing system. |
404 | SSP-0007 | The procedure code on the claim line is missing or is not found in the pricing system. |
405 | SSP-0008 | The HCPCS code on the claim line is missing or is not found in the pricing system. |
413 | SSP-0009 | No allowed amount is populated on the claim line; manual entry required. |
145 | SSP-0011 | No valid provider contract was found due to missing mandatory fields on the response. |
152 | SSP-0012 | No provider could be identified. |
154 | SSP-0013 | The custom identification code assigned to the provider is not valid. |
161 | SSP-0014 | Multiple matching or conflicting rate sheets was found. |
162 | SSP-0015 | No rate sheet matching the claim line date of service was found. |
The NetworX pricer application also includes NetworXErrors level error codes to indicate when the XML request file contains formatting errors. These errors are categorized into (a) data format errors, (b) missing data errors, and (c) authorization errors. These NetworXError level errors have been mapped to the following event codes:
SCE event code | SCE event code name |
SSP-0016 | One or more data format errors exist on the claim. |
SSP-0017 | One or more data errors were found, or the claim is missing required data. |
SSP-0018 | One or more errors related to the claim authorization were found. |
SSP-0019 | The Networx Pricer pricing system was not found. |
SSP-0020 | The Networx Pricer pricing system did not respond. |
The application validates the presence of several properties in the NetworX XML response file and uses the following single event code when one or several of those properties are missing from the response.
SCE event code | SCE event code name |
SSP-0010 | One or more properties that are required on the external pricer response are missing |
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