Xpress Claimtest Pro
Claims Regression Testing Software for Migrations
and Upgrades of Healthcare Payment Systems
In today's competitive health care management environment, the ability to pay claims accurately and timely are two of the most important factors affecting cash flow. With complex benefit plans and billing procedures, fully testing your claim billing scenarios when upgrading and/or migrating your claims management system was never possible.
Xpress Claim Test Pro is designed to take existing client claims data to test a target environment and ensure claims are paying as expected. TriZetto has already mapped Xpress Claim Test Pro to most major claims payment systems.
How it Works
- Your testing team creates test "suites" by querying current claims data directly from your claims payment system (source).
- Users edit the claims to create specific claim scenarios or negative test cases.
- Export test "suites" as HIPAA 837's, Adobe Acrobat PDF's or NCPDP files for loading on the target system.
- Once the file is loaded on the target and the claims are adjudicated, results can be reconciled 100% to the service line level directly against the target system or an 835/277. Reconciliation fields are fully customizable.
- Review results and troubleshoot configuration issues on the target. Re-test the suite if necessary.
Uses
- Migrating from one claims payment system to another
- Upgrading claims payment system to new release
- Configuring a new line of business
- Major system configuration modifications
Benefits
- Save hundreds of hours building and documenting test cases
- Test an unlimited number of claims and claim scenarios
- End user can quickly build broad or complex testing scenarios
- Creates complete audit trail to document all testing
- Easily customize reporting for audit team
- Users can effortlessly customize existing data to fit testing needs
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