Validating a Non-Coverge Gap Submission

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About Non-Coverage Gap Submission

After importing the files into the Validata application, the lines in the file are ready to be validated against a validation set. The validation set tells Validata which validations, called Rule Sets, to perform on the data and how to handle any validation errors that are encountered. You can run any Rule Set validation on the lines in the Submission. Validata records the results and uses them to assign each line an overall status of either Included or Excluded. To learn more about validation, see the Validation documentation.

When creating a new Submission, if the analyst has opted to automate validation within the submission creation wizard, the Submission validation begins automatically without any manual actions. For more information about automatically initiating validation for Submission, see Validation Automation. The analyst can view the validation status within the Submission in the Process and results overview section. For more information about validation progress, see Validation Progress Status Details.

When the analyst has not opted for the automated validation within the submission creation wizard, the validation must be initiated manually for the Submission.

Run Validation Manually

This section describes how to initiate the validation for a Submission manually.

In the Validata application, navigate to the Submission menu.
On the Submissions page, from the list table, click the Submission Name link to open the Submission.
The Submission details page is displayed.
Click the Run Validations card.
Note: The Run Validations button remains inactive when the file upload is in progress. When an error occurs during file upload, the Run Validations remains inactive.
The Run Validations is activated when at least one file upload to the Submission is completed.
Click Run Validations. The Validation Options window is displayed.
The Analyst can also open the Validation Options window from the Submission header section.
Click the ellipses (three dots icon) on the Submission header section. Select Validate & Options.
Specify the required validation options.
- Type of validation: Whether to perform the validation using a Single Validation or a Chained Validation. The default is Single Validation.
- The Run validation on lines with status indicates to the application’s validation execution which transactions, based on the Line Status, will be considered. The user input contains the following selectable options matching the Submissions workflow:
  - New: When the user input is selected as ‘New’, the lines with a Line Status value of New will be considered when validating the lines. The ‘New’ value was formerly known as Imported in the previous Transaction File workflow.
  - Included: When the user input is selected as ‘Included’, the lines with a Line Status value of Included will be considered when validating the lines. The ‘Included’ value matches the value of the same name in the previous Transaction File workflow.
  - Excluded: When the user input is selected as ‘Excluded’, the lines with a Line Status value of Excluded will be considered when validating the lines. The ‘Excluded’ value matches the value of the same name in the previous Transaction File workflow.
- Validation set: Select the name of the Validation Set that will be used for validating the Submission. The list includes only Validation Sets or Chained Validation Sets based on the input for the Type of validation.
- Duplicate check indicator: Specify the duplicate check status that will be considered while validating the Lines:
  - Processed: To validate the Submission Lines that were checked for duplicates previously.
  - Not Processed: To validate the Submission Lines were not checked for duplicates previously.
  - All: To validate all the Submission Lines irrespective of whether they were checked duplicates previously. This is the default value.
- Publish status: Specify the publish status of the lines that will be considered while validating the lines:
  - Published: To validate the Submission Lines with Published status.
  - Not Published: To validate the Submission Lines with Not Published status.
  - All: To validate all the Submission Lines irrespective of whether they were Published or not.
- Include all dates of service: By default, the Include all dates of service is set to Yes; this means all the utilization lines, irrespective of their Date of Service, will be validated.
  When the Include all dates of service is set to No, you can specify the Date of Service period. That means all the utilization lines whose Date of Service falls under the specified start and end date will be validated. The utilization lines in the Submission whose Date of Service does not fall under the provided start date and end date period will be ignored during the validation of the Submission.
  Select the Start date and End date of the Date of service period using the calendar widget or enter manually in the MMDDYYYY format.
To start the validation, click Run Validations.

Effective Fall 2023 RP2 HF9, when running validation from the Validation Options drawer, when the Validation Set name does not include a base validation Rule Set name, the following warning message is displayed on the user interface:
The following validations must be run before the <validation name> validation set can be run successfully: <validation names>
In the warning popup message, the user has given the following two options to choose from:
Yes: On clicking Yes, the user can run validation on the Submission without making any changes.
No: On clicking No, the user will stay in the Validation Options drawer and choose a different Validation Set.

Validation Progress Status Details

Irrespective of automated or manual initiation of the validation process, the progress of the validation process is the same. You can verify the progress or validation status within the Submission in the Run Validations card.

: This icon specifies that the file upload has been completed and validation can be initiated; user input is required to start the validation.
: This icon specifies that the system is running Submission validation.
: This icon specifies that the Submission Validation has been completed. After the validation is completed, the Re-Validate and Mark Complete option is populated on the screen.
- Using the Re-Validate option, the Analyst can revalidate a Submission. For more information about Submission revalidation, see Re-run the Validation Process.
- Using the Mark Complete option, the Analyst can notify the Validata application validation result review and analysis has been completed. For more information about marking a Submission as complete, see Mark Submission Validation Complete.

Viewing Validation Results Within Submission

When the Submission validation is completed, you can view the validation result overview within the Submission.

Lines with error: The count of lines with error after validation completion.
Units with errors: The count of units with errors after validation completion.

In the Line Level Details tab, you can review the detailed result for each line and make changes like overriding the error severity and manually changing the line status from Excluded to Included and vice-versa as required.

For more information about Line Level details, see Viewing Submission Line Level Details.
For more information about overriding Submission Line's validation result, see Overriding Submission Line's Validation Result.

Once the validated lines are reviewed and the necessary changes are done, notify the Validata application by marking the Submission Analysis as completed. For more information, see Mark Submission Analysis Complete.

Re-Validate a Non-Coverage Gap Submission

The Validation Analyst can validate a Submission using different Validation Sets. Once a Submission is validated using a Validation Set, the Analyst can re-validate the Submission by choosing another Validation Set under the Validation Options section.

When the Validation Analyst makes some changes to the Submission once the first validation has been processed, the Analyst has to rerun the validation for the respective Submission. The Analyst has to re-validate a Submission when the following changes are made to the Submission after the first validation has been processed:

Including additional files to the Submission.
Changing the existing Mapping Set of any included files in the Submission.
Change the Contract Details for the Submission at the header level or at the line level.

When the Analyst makes any one of the above changes and proceeds to save changes, the following confirmation message is displayed on the page:

Click Yes to proceed with saving the changes.

How to Re-Validate a Submission

Note: Irrespective of the user selection for auto-start validation after Submission creation, the analyst has to run the re-validation manually when any changes have been made to the Submission. Validation automation only dictates the first validation that occurs after Submission creation.

To Re-Validate a Submission:

Navigate to Submissions > Submission Name (link) > Overview (tab) > Run Validations card.
Click the Re-Validate button.
The Validation Option window is displayed.
Specify the Validation Options.

When a Submission is Re-Validated, the user can view the validation progress status details within the Run Validations card. For more information, see Validation Progress Status Details.

Mark Submission Analysis Complete

When the Submission validation is completed, the Analyst can view the Submission Line Level details and make required overrides and status changes in the Line Level Details tab. Once the Submission validation result analysis and review are completed, the Analyst has to mark the Submission Analysis as complete to indicate to the application that the Submission validation analysis and review have been completed and the Submission is ready to be published. When Submission is marked as Analysis Completed, the Publish card action will be activated for user action.

Click the Mark Complete button. When the Analysis is marked as completed, the Mark Complete button becomes inactive, and the completed status is displayed for Analysis.

Note: When an error occurs during the validation process in the validation card, the status is displayed as Error, and the Run Validations button is displayed.