Question

#25-1 use the screenshot to answer the following questions.

benefit filing mappings for emergency services 86
match action: file to service - ed 2
msg segment handling: custom msg logic | no msg segment

match action: file to service - urgent care 6
msg segment handling: custom msg logic | no msg segment
urgent care
defined msg search logic: \urgent care\

match action: do not file
msg segment handling: custom msg logic | no msg segment
ancillaries or anesthesia
defined msg search logic: \ancillaries\ or \anesthesia\

part 1 of 3
what does the second mapping mean?
select one of the following (1 pt)
a. if the service type is emergency services 86, file to ecd urgent care 6 when there is no msg segment.
b. if the service type is emergency services 86, file to ecd urgent care 6 when the msg segment contains urgent care.
c. if the service type is urgent care 6, file to ecd emergency services 86 when the msg segment contains urgent care.
d. if the service type is urgent care 6, file to ecd emergency services 86 when there is no msg segment.

Explanation:

Analyze the screenshot configuration

The screenshot shows "Benefit filing mappings for Emergency Services [86]". This indicates that the base service type being mapped is Emergency Services [86].

Evaluate the second mapping block

The second mapping block (labeled with a circled 2) has:

• Match action: File to service - Urgent Care [6]
• MSG segment handling: Custom MSG Logic
• Defined MSG search logic: "URGENT CARE"

This means if the incoming service type is Emergency Services [86], the system will file it to the Epic benefit service type (ECD) Urgent Care [6] if the MSG segment contains the text "URGENT CARE".

Compare with the multiple-choice options

• Option A: Incorrect. It claims this happens when there is "No MSG Segment".
• Option B: Correct. It states: "If the service type is Emergency Services [86], file to ECD Urgent Care [6] when the MSG segment contains URGENT CARE."
• Option C: Incorrect. It reverses the source and target service types.
• Option D: Incorrect. It reverses the source and target service types and mentions "No MSG Segment".

Answer:

• (A) If the service type is Emergency Services [86], file to ECD Urgent Care [6] when there is No MSG Segment.
• (B) If the service type is Emergency Services [86], file to ECD Urgent Care [6] when the MSG segement contains URGENT CARE. (Correct answer)
• (C) If the service type is Urgent Care [6], file to ECD Emergency Services [86] when the MSG segement contains URGENT CARE.
• (D) If the service type is Urgent Care [6], file to ECD Emergency Services [86] when there is No MSG Segment.