Proper Names
The guide that introduces ClaimsXten's clinical auditing capabilities.
What is the Auditing Logic & Rules Guide (AL&R)?
Collection of data or content referenced by a rule.
What is a Category?
Responsible for maintaining the data map.
Who is Business Analyst?
Users can access product documentation, including user instructions and release notes.
What is the Knowledge Center?
The certainty that indicates the rule recommendation should automatically applied.
What is APPLY?
Provides detailed information about default rules at the rule level.
What is the Rules Configuration and Criteria Questionnaire (RCCQ)?
The name of the environment every client MUST have.
What is PROD?
Responsible for creating and maintaining default rules.
Who is Clinical Team?
A web-based issue tracking product, developed by Atlassian.
What is Jira
A collection of CXT rules grouped together that focus on industry sourced, traditional reimbursement, and health plan policy.
What is a KnowledgePack?
Provides a clear understanding of how the rules work in a logical form.
What is the Rules Specification?
Contain the clinical rationale or justification for rule behavior.
What is an Edit Clarification?
Responsible for gathering and documenting business requirements.
Who is Payment Accuracy Advisor?
Used to house, maintain, and customize rule content referenced in CXT for rule adjudication.
What is Content Manager?
Controls the rule firing order, set the rule level action, certainty, and other claim processing parameters.
What is the Rules Flag?
The library that contains the rule code and used by the rules engine to invoke the rule logic.
What is the Dynamic Link Library?
The category used to exclude data criteria.
What is ALL_EXCLUSIONS?
Responsible for the development of business logic.
Who is the Rules Center of Excellence (RCE)?
A browser-based application used by providers to test "what if" scenarios by submitting mock claim information.
What is Clear Claim Connection (C3)?
Describes the name of a rule in text form.
What is the rule acronym?