Question

1. the screenshot displays the search configuration for your medicare replacement query chaining data pull:

a response returns with the following benefit information:

ebu30hm
refnq739584763
nm1pr*medicare advantage plus
ref18h3525 839

based on the response, which search lines evaluate to true? choose all that apply.

a. line 1
b. line 2
c. line 3
d. line 4
e. line 5

Explanation:

Analyze the EDI response segments and fields

The response contains the following segments:

• EBU30HM
• Segment: EB
• Field 1 (separated by *): U
• Field 2: empty
• Field 3: 30
• Field 4: HM
• REFNQ739584763
• Segment: REF
• Field 1: NQ
• Field 2: 739584763
• NM1PR*MEDICARE ADVANTAGE PLUS
• Segment: NM1
• Field 1: PR
• REF18H3525 839
• Segment: REF
• Field 1: 18
• Field 2: H3525 839

Evaluate each search configuration line

• Line 1: Segment EB, Field 1, Operator InSet, Value R,U.
• In the response, EB Field 1 is U. Since U is in {R, U}, Line 1 evaluates to True.
• Line 2: Segment EB, Field 4, Operator InSet, Value HM,HN,IN,PR,PS, Attribute Same Segment As Above.
• In the same EB segment where Field 1 is U, Field 4 is HM. Since HM is in the set, Line 2 evaluates to True.
• Line 3: Segment NM1, Field 1, Operator InSet, Value PRP,PR.
• In the response, NM1 Field 1 is PR. Since PR is in {PRP, PR}, Line 3 evaluates to True.
• Line 4: Segment REF, Field 1, Operator Equals, Value 18.
• In the response, there is a segment REF18H3525 839 where Field 1 is 18. Thus, Line 4 evaluates to True.
• Line 5: Segment REF, Field 1, Operator Equals, Value 1W.
• In the response, the REF segments have Field 1 values of NQ and 18. Neither equals 1W. Thus, Line 5 evaluates to False.

Determine the correct options

Lines 1, 2, 3, and 4 evaluate to true.

Answer:

• (A) Line 1 (Correct answer)
• (B) Line 2 (Correct answer)
• (C) Line 3 (Correct answer)
• (D) Line 4 (Correct answer)
• (E) Line 5