Performing Bulk Actions for the Submissions

Overview

The analyst can perform bulk actions for the selected Submission on the Submissions grid, like publishing/exporting or validating. The selected Submission must meet the defined conditions to execute the bulk Submission actions. For example, to view the Line-Level Details, more than one Submission should be of the same type and not have a Status value of Processing. To view the minimum condition the selected should meet for performing bulk action, hover on the action button. The conditions for the respective action are listed on the page.

Bulk Submission Update

To perform bulk submission updates:

1. On the Submissions grid, select the Submissions.

2. The following Action buttons are displayed:

   1. Validate

   2. Publish/Export

   3. Reversal Action

   4. Publish Reversals

   5. View Lines

Note:

• If an action cannot be performed on one of the selected Submission (s), the actions button remains inactive when the respective Submission (s) is chosen.

3. Click one of the required action buttons. The respective functionality drawer is opened.

Note: When the bulk action is executed for the selected Submissions, the history is stamped for the bulk action for the respective Submission. For more information, see Viewing Submission History.

Bulk Submissions Validation Executions

The Validation Analyst can initiate validation execution for more than one selected Submission on the Submissions grid. Validation can be triggered if multiple submissions have unique submission types and Customer IDs.

Note: To perform bulk Submission validation, all the selected Submissions must meet the following conditions:

• The same Payer must be selected

• The same Submission Type must be selected

• The Submission can't be in 'Processing' status

• The submission should include successfully uploaded file(s)

To perform bulk Submissions validation execution:

1. On the Submissions grid, select the Submissions.
   The Actions buttons are populated.
   Note: The Validate button will be disable state when:

   1. When the Submission Type of the selected Submissions is not the same.

   2. When the Customer ID for the selected Submissions is not the same.

   3. When one of the selected Submission Status is ‘Processing.’

2. Choose the Validate button.

3. The Validation options drawer is displayed.
   The number of selected Submissions is shown in the drawer.

4. Provide the Validation options and click Run Validations. For more information, see the Validation Options documentation.

Bulk Submissions Publish/Export

The validation analyst can perform Publish/Export for the selected Submission on the Submissions grid. Publish/export across multiple submissions can be initiated when all the submissions meet the required conditions. The Publish/Export button will not be enabled when all the selected Submissions do not meet the following defined conditions:

• The same Payer must be selected

• The same Submission Type must be selected

• The Submission status should be 'In Progress' or 'Published/Completed'

• The submission should include the results of the successful validation analysis.

To perform bulk Publish/Export across Submissions:

1. On the Submissions grid, select the Submissions.
   The Actions buttons are populated.
   Note: The Publish/Export button will be disabled when selected Submissions do not meet the required conditions.

2. Choose the Publish/Export button.
   The Publish options drawer is displayed. It shows the number of Submissions selected for this action.

   1. To publish the Submissions to the downstream Payer application:

      1. Fill in the Publish option details in the drawer.
         For detailed documentation about the Publish options, see Publish/Export Non-Coverage Gap Submission.
         Note: The Publish submission name user-input value is not auto-populated in the Publish options drawer. The user has to enter a unique Publish submission name.

         Note: When publishing the Submission to the PbyN Payer Management application, Validata checks that the same contracts exist across all selected Submissions and Submission Lines. The lines can be published for one contract at a time. In the Contract filter section, select the contract desired to be part of this publish action.

      2. Click the Publish button.

      3. When bulk submissions are successful, the publish process creates a single utilization submission in the Payer application.

      4. When at least one of the lines in a Submission is published, its status is updated to Published.

   2. To export the Submissions lines:

      1. Fill in the details in the Publish options drawer.

      2. Click the Export Button.

      3. A single exported file is generated for download. The analyst can view the exported file by clicking the Export button on the Submission List grid or selecting the Available Exports option within the Submission Details overflow menu.
         Note: When exporting the Coverage Gap Submission lines, if one of the selected Submission(s) does not contain Invoice File Lines, then when export is performed, an alert message is displayed:
         The invoice file is missing for the following submission(s): <submissionID1>, <submissionID2>, ..., <submissionIDn>

Bulk Submissions Reversal Action

On the Submission list grid, the analyst can review the Submissions requiring action on the Reversal line available within the Submission. When one or more Submissions are selected on the Submission Grid, which contains Reversal lines that need action, the Reversal Action button is displayed and clickable. The Reversal Action button remains disabled when the selected Submission on the Submissions grid does not meet the following condition:

• The Selected Submission does not contain Reversals, i.e., the 'Contains Reversals' column is empty.

• The Selected Submission should not be a Type of Coverage Gap.

• The submission can't be in status: New, Review, or Processing.

• The same Payer must be selected.

To perform bulk Reversal Action across Submissions:

1. On the Submissions grid, select the Submissions.
   The Actions buttons are populated.
   Note: The Reversal Action button will be disabled when selected Submissions do not meet the required conditions.

2. Choose the Reversal Action button.
   The Reversal action drawer is displayed. It shows the number of Submissions selected for this action. Fill the below details:

   1. Reversal status: Specify the Reversal Status, such as New, In Progress, or Skipped. You can select more than one Status. The Reversal Action will be done to the Reversal Lines with the specified Reversal Status.

   2. Reversal type: Specify the Reversal Type, such as COB or 340B. You can select more than one Type. The Reversal Action will be done to the Reversal Lines with the specified Reversal Type.

   3. Date filter type: Select the Date filter type option. Reversal Action will be executed on the lines whose a date of service falls in the selected date filter type option.

      1. All dates: By default, the selection is All dates. Filtering with All dates considers the reversal lines with all Dates of service.

      2. Single date: To execute the Reversal Action on the Lines that match a defined date, choose the Single date option. When the Single date option is selected, the following two options are displayed:

         • Service date condition: This has operator values Less than, Less than or equal to, Equal to, Greater than, and Greater than or equal to.

         • Service date: Select the service date using the calendar chooser.
           For example, if the Service date condition is chosen as Less than and the Service date is selected as 09-05-2024, a Reversal Action will be executed on all the Reversal Lines that have a Date of Service value less than 09-05-2024.

         • Date range: Select the date range to execute Reversal Action on the Reversal Lines whose Date of Service matches the specified date range. When the Date range option is selected, the Service date range field is displayed in the drawer. In the Service date range field, choose the start and end date of the date range. Reversal action will be executed on all the Reversal Lines that match the specified service date range.

   4. Contracts: By default, the Contracts toggle is set to No. When it is set to Yes, a list of Contracts that all the Reversal Lines across the selected Submissions contain is displayed in the grid. Choose the required Contract on the grid. A reversal action will be executed on the lines containing the chosen Contract.

   5. Plans: By default, the Plans toggle is set to No. When it is set to Yes, a list of plans that all the Reversal Lines across the selected Submissions contain is displayed in the grid. Choose the required Plan Name on the grid. A reversal action will be executed on the lines containing the chosen Plan Name.

   6. Products: By default, the Products toggle is set to No. When it is set to Yes, a list of plans that all the Reversal Lines across the selected Submissions contain is displayed in the grid. Choose the required Products on the grid. A reversal action will be executed on the lines containing the chosen Products.

   7. Reversal Action: Choose the action that will be taken on the filtered reversal lines. Choose one of the following options:

      1. Accept: Choose Accept to accept the reversal lines for the next action. When the Accept option is selected, the Analyst can create the Reversal Publishing for the accepted lines.

      2. Skip: Choose Skip to skip the reversal lines for the following action. When the Skip option is selected, reversal lines are omitted from the publishing process.

   8. Click Save to save the changes done in the Reversal action drawer. Click Cancel to close the Reversal action drawer without saving the changes.

3. When the user saves the changes done in the Reversal action drawer, a job is initiated in the monitor list with the process name Bulk Reversal. The following confirmation message is displayed on the page to notify users that the Reversal has been initiated:

Bulk Submissions Reversals Publish/Export

The Validation analyst can initiate bulk Submissions Reversal Lines Publish or Export action on the Submissions grid. Bulk Submissions Publish/Export reversals can be initiated when the Submission meets the following conditions:

• The Submission contains the same Submission Type value.

• The Submissions has a unique Payer.

• The Submission has a value as Pending Publish in the Reversal Summary column.

• The Submission Status is not in Processing.

When one or more Submissions are selected on the Submission Grid containing Reversal Pending Publish, the Publish/Export Reversal Action button is displayed and clickable. The Publish/Export Reversal action button remains disabled when the selected Submission on the Submissions grid does not meet the following condition:

• The Selected Submissions are not of the same Type.

• The selected Submission is a Coverage Gap Submission.

• The selected Submissions do not contain a unique Payer value.

• The selected Submissions do not contain ‘Pending Publish’ in the Reversal Summary column.

• The Submission Status is Processing.

To perform bulk Submissions Publish/Export Reversals:

1. On the Submissions grid, select the Submissions.
   The Actions buttons are populated.
   Note: The Publish/Export Reversal button will be disabled when selected Submissions do not meet the required conditions.

2. Choose the Publish/Export Reversal action button.
   The Publish Reversals drawer is displayed. It shows the number of Submissions selected for this action. Fill in the below details:

   • Submission type: The selected Submission Type is displayed by default. This is a read-only value that cannot be altered.

   • Publish submission name: The Publish submission name user-input value is not auto-populated in the Publish options drawer. The user has to enter a unique Publish submission name.

   • Mapping set: Select the Mapping Set to export/publish the reversal Submission line. The drop-down list includes only Mapping Sets of the appropriate type, depending on the type of Submission.

   • Transaction period: This is a mandatory user input. Specify a start and end date for the Transaction period. Only reversals with a Date of Service falling within this range will be included in the publish/export actions. By default, the system automatically populates the Transaction period:

     • Start Date: Earliest submission-selected Rebate period start date.

     • End Date: Latest submission-selected Rebate period end date.

   • Include previously published reversals: This toggle is set to No by default. This means all the reversal lines with a Reversal status value InProgress will be published/exported. When the toggle is set to Yes, all the previously published lines will also be considered for reversal publish/export action.

   • Revenue manager mapping set: Select the Model N Revenue Manager mapping set that you want to use to map the export file to the Model N Revenue Manager submission tables.

     Note: The system compares the selected Model N Validata export mapping set and the import mapping set selected for Model N Revenue Manager when you click the Export button. An error appears if both mapping sets are not compatible.

   • Revenue manager severity set: Select the severity set for Model N Revenue Manager to use to process the imported utilization submission.

   • Reversal Type: Specify the type of reversal that will be considered for Publish/Export reversals. By default, no value is selected for this user input. You can select one of the following values:

     • 340B: Select this option to publish/export the reversal lines resulted from 340B reprocessing.

     • COB: Select this option to publish/export the reversal lines resulted from the Coordination of Benefit Validation Rule Set.

   • Publish options: The Publish options dictate to the Validata application how the Submission Lines will be summarized during the Export/Publish process. Choose the Publish option.

   • Backbill details: The Submission often includes lines with the Date of Service value before the Transaction Start Date. Using the Backbill details, you can set whether you want to include the lines containing a Date of Service before the specified Transaction Start Date.

     • Include backbills: This user input allows you to opt in or opt out of the Submission's backbill configuration. By default, the Include backbills toggle is set to Yes.

       • You can set the Include backbills toggle to No if you do not want to consider the backbill Date of Service lines from the Submission for Publish/Export. Backbill-related user inputs will be hidden on the user interface.

       • When the Include backbills toggle is set to Yes, the Analyst can specify the backbill period details, and those lines whose Date of Service falls within the defined backbill period will be considered for the Publish/Export.

     • Number of backbill periods: Specify the number of backbill periods in the text box. Lines with the Date of Service within the number of periods you specify before the Transaction Start Date are considered from the Submission for publish/export.

     • Backbill export period: When the Number of backbill periods is entered, you can specify the export period to use in relation to backbills.
       Include backbills in summary: The Include backbills in summary toggle is set to No by default.

       • When Include backbills in summary is set to Yes, the lines with Dates of service within the specified Backbill export period before the Transaction period start date are summarized in the same line.

       • When Include backbills in summary is set to No, the lines with Dates of service within the specified Backbill export period before the Transaction period start date are summarized in a separate line.

   • Contracts: Choose the Contract ID desired to be part of this publish action. When Validata is integrated with RC, only one Contract can be published at a time.

   • Plans: Choose the Plans that will be part of this publish action.

   • Products: Choose the products that will be part of this publish action.

3. Click the Publish button to auto-create a Reversal Submission in the downstream Payer application. When the publish Reversal is completed successfully, a single utilization submission is created in the downstream Payer application.
   
   or
   
   Click the Export button to export the reversal lines to a .txt file, which you can use later to process in the Payer application. When the export reversal lines are completed successfully, a single export file is generated.

4. Click Cancel to close the Publish reversals drawer.

Bulk Submissions Line Level Details View and Perform Override Action

For Non-Coverage Gap Submissions, the validation analyst can view all the transaction lines included within the selected Submissions on the Submissions grid and take action on individual lines, such as overriding errors, overriding line statuses, or changing contracts. It is enabled when Submissions meet the defined conditions and contain utilization lines. The Analyst can view all the Coverage Gap Data File lines for Coverage Gap Submissions included within the selected Submissions on the Submissions grid.

Note: To perform bulk Line Level Override action, all the selected Submissions must meet the following conditions:

• The same Submission Type must be selected

To perform bulk Submissions Line Level Override Action:

1. On the Submissions grid, select the Submissions.
   The Actions buttons are populated.
   Note: The View Lines button will be disabled when selected Submissions are not from the same Type.

2. Choose the View Lines button.

3. The Submission Lines page is displayed.
   For Non-Coverage Gap Submissions, the Line Level Details from the selected Submissions are listed on the Submission Lines grid.
   For Coverage Gap Submissions, the Data Lines from the selected Submissions are listed on the Submission Lines grid.
   Note: In Processing status, Submissions are also listed in the Submission Lines grid. The user can only view the Lines from Submissions in Processing status. The user cannot take any action on the Submission lines.

4. On the Submission Lines grids, the columns and values displayed are the same as those of the Submission Line Level Details tab grid. For detailed documentation, see Submission Line Level Details. The following table only lists the additional columns that are listed in the Submission Lines grids:

Column Name	Description
Submission Name	Displays the name of the selected Submission.
Submission ID	Displays the ID of the selected Submission.
Submission Status	Displays the current status of the Submission.

5. The validation analyst can perform the following actions for the Non-Coverage Gap Submissions on individual transaction lines.

   • View Error Overrides

     The Analyst can view all the errors associated with the selected lines and override the severity of the error from a severity level of Major to Warning for the selected lines in the Submission Lines grid. For detailed documentation, see Override Error Severity Level.

   • Override Line Status:

     The Validation Analyst can override the Line Status of the selected utilization Lines. 

 

1. Click the Override Line Status button. The override line status option is displayed.

2. Select one of the following line status options from the drop-down list.

   • Include

   • Exclude

3. Choose the reason for line status override in the Override reason text box. The Analyst can either select one of the pre-configured reasons that are populated on clicking the text or can add a new reason text. Multiple reasons can be selected and added by the Analyst.  This is an optional field.

4. Enter the comment if any in the Override comment text box.

• Change Contract:

  The Validation Analyst can change the Contract for the selected Submissions lines. On clicking the Change Contract button, the Change Contract drawer is displayed. The grid displays the Contract associated with the selected lines and the count of lines that are associated with the Contracts.