Need clarification on C-CDA USCDI v4 Receiver testing workflow and test documents

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Rajkumar P

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Aug 5, 2026, 8:14:57 AM (8 days ago) Aug 5
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Hi everyone,

I am currently working on C-CDA USCDI v4 Receiver testing and need some clarification regarding the complete Receiver testing workflow.

In my application, I currently have an XML import option for CIRI (Clinical Information Reconciliation). The workflow allows us to import a C-CDA XML, match the patient, review medications/problems/allergies, reconcile the information, and save it.

However, for the other Receiver scenarios, such as:

  • 170.315_b1_ToC_Amb
  • 170.315_b1_ToC_Inp
  • 170.315_b2_CIRI_Amb
  • 170.315_b2_CIRI_Inp
  • 170.315_b8_DS4P_Amb
  • 170.315_b8_DS4P_Inp
  • 170.315_b9_CP_Amb
  • 170.315_b9_CP_Inp

I am not clear about how the Receiver testing is supposed to be performed.

For example, for 170.315_b1_ToC_Inp:

  1. Where/how do we initially receive the C-CDA XML?
  2. Are we expected to manually upload/import the test C-CDA XML into our application, or is the test document sent to our application through another mechanism?
  3. After receiving the C-CDA, what exactly needs to be demonstrated in the EHR?
  4. What are the required Receiver workflows for ToC, CIRI, DS4P, and Care Plan?
  5. How should we perform the negative testing?
  6. Are there specific ONC/SITE test C-CDA XML files that should be used for each scenario?
  7. Is there a Receiver testing guide, test procedure, PDF, sample XML, or step-by-step documentation that explains the complete process from beginning to end?

At the moment, I understand the CIRI import/reconciliation workflow, but I am not clear on the complete Receiver testing process for the other scenarios.

If anyone has completed C-CDA USCDI v4 Receiver testing, could you please share the recommended workflow and any relevant ONC/SITE documentation, PDFs, test procedures, or sample C-CDA files?

Any guidance would be greatly appreciated.

Thanks!
Rajkumar.P
MettlerHealthCare.

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Nagesh Bashyam

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Aug 5, 2026, 8:43:00 AM (8 days ago) Aug 5
to Rajkumar P, Edge Test Tool (ETT)
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Rajkumar P

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Aug 5, 2026, 8:47:53 AM (8 days ago) Aug 5
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Hi Dragon,

Thanks for pointing me to the CIRI test procedure. I understand the CIRI Receiver testing now.

I have a similar question regarding TOC Receiver testing. For CIRI, I can see the XML import/reconciliation workflow in my application. For the other TOC scenarios, I’m not sure what the expected Receiver-side workflow is.

Could you please confirm whether I should follow the ONC §170.315(b)(1) Transitions of Care Test Procedure in the same way as the CIRI procedure, specifically the Receiver part?

Also, could you please point me to the relevant TOC Receiver test procedure/document/PDF that explains:

  • How the TOC C-CDA is received by the application
  • What we need to implement on the Receiver side
  • Which test XML/files should be used
  • How the Receiver testing should be started
  • What needs to be demonstrated for 170.315_b1_ToC_Amb and 170.315_b1_ToC_Inp

I want to make sure we are following the correct ONC Receiver testing workflow before implementing the TOC side.

Thanks!

Nagesh Bashyam

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Aug 5, 2026, 9:23:01 AM (8 days ago) Aug 5
to Rajkumar P, Edge Test Tool (ETT)

Yes , follow ONC §170.315(b)(1) Transitions of Care Test Procedure 



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