Ana test result negative with cut off rate 1.117 and sample rate 0.198. what does that mean? low/moderate positive? is there any confirmatory test?

ANA negative: ANA is not a substance to be measured but an activity in the blood produced by a variety of molecules at different intensity. Everybody has some and only when a cutoff level is assigned is the test meaningful. If done properly (and the test has its pitfalls), your physicians will have to look for something other than lupus as the cause of your joint pain.

Not by itself: This is a non-standard assay. Rheumatology evaluation is the confirmatory test in this case.