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1 | C:\AraxisMergeCompare\Pub_un | 0008AG_CPE Build 7 Sprint 19 Plan_Updated.docx | Thu Jul 26 17:18:05 2018 UTC |
2 | C:\AraxisMergeCompare\Pub_re | 0008AG_CPE Build 7 Sprint 19 Plan_Updated.docx | Fri Jul 27 15:23:41 2018 UTC |
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1 | Claims Pro cessing El igibility (CP&E) | |
2 | Teams 1 an d 2 | |
3 | Build 7 Pl an | |
4 | ||
5 | CLIN 0008A C (include s | |
6 | CLIN 0008A F Build Re lease Plan ning Packa ge and | |
7 | CLIN 0008A G Sprint P lan) | |
8 | Department of Vetera ns Affairs (VA) | |
9 | Office of Informatio n and Tech nology (OI T) | |
10 | May 2018 | |
11 | Version 0. 9 | |
12 | ||
13 | Revision H istory | |
14 | NOTE: The revision h istory cyc le begins once chang es or enha ncements a re request ed after t he documen t has been baselined . | |
15 | Date | |
16 | Version | |
17 | Descriptio n | |
18 | Author | |
19 | 5/11/2018 | |
20 | 0.9 | |
21 | Updated Sp rints and returned d ocument to PM for ap proval | |
22 | Michael Sy nakiewicz | |
23 | 5/8/2018 | |
24 | 0.8 | |
25 | Updated Sp rint 19 an d returned document to COR app roved vers ion | |
26 | Richard Ma rble | |
27 | 5/3/2018 | |
28 | 0.7 | |
29 | Added Spri nt 19 | |
30 | Michael Sy nakiewicz | |
31 | 4/6/2018 | |
32 | 0.6 | |
33 | Added Spri nt 18 to a ddress JRu le issues and ASC | |
34 | Michael Sy nakiewicz | |
35 | 3/23/2018 | |
36 | 0.5 | |
37 | Removed Us er Story 0 01-116 for data need ed and add ed ATO Doc umentation for Evide nce | |
38 | Michael Sy nakiewicz | |
39 | 3/14/2018 | |
40 | 0.4 | |
41 | Updated Sp rint 15 Us er Stories due to de pendencies | |
42 | Chris Vanz o Michae l Synakiew icz | |
43 | 3/06/2018 | |
44 | 0.3 | |
45 | Added Spri nt 16, upd ated Sprin t 15, upda ted Team O rganizatio n table | |
46 | Chris Vanz o Michael S ynakiewicz | |
47 | 2/27/2018 | |
48 | 0.2 | |
49 | Updated Sp rint 14 | |
50 | Michael Sy nakiewicz | |
51 | 2/09/2018 | |
52 | 0.1 | |
53 | Initial Dr aft | |
54 | Michael Sy nakiewicz | |
55 | ||
56 | Table of C ontents | |
57 | 1.Build Ex ecution1 | |
58 | 2.Scrum Te ams1 | |
59 | 2.1.Veloci ty1 | |
60 | 2.2.Capaci ty vs. Pla n2 | |
61 | 2.3.Organi zatial Cha rt2 | |
62 | 3.Function al Specifi cations3 | |
63 | 3.1.Epics/ Sub-Epics/ User Stori es3 | |
64 | 4.User Sto ries/Backl og10 | |
65 | 5.Testing Responsibi lities10 | |
66 | 6.Acceptan ce Criteri a10 | |
67 | 7.Schedule 11 | |
68 | 7.1.Build 7 Sprint 1 411 | |
69 | 7.2.Build 7 Sprint 1 512 | |
70 | 7.3.Build 7 Sprint 1 614 | |
71 | 7.4.Build 7 Sprint 1 716 | |
72 | 7.5.Build 7 Sprint 1 818 | |
73 | 7.6.Build 7 Sprint 1 920 | |
74 | 7.7.Sprint Ceremonie s20 | |
75 | 7.8.Build 7 Planning 21 | |
76 | 8.Dependen cies21 | |
77 | 9.Risk & I ssues22 | |
78 | 9.1.Identi fied Risks 22 | |
79 | 9.2.Identi fied Issue s22 | |
80 | 10.Constra ints22 | |
81 | 11.Assumpt ions22 | |
82 | 12.Definit ion of Don e22 | |
83 | 13.Build 7 Deliverab les22 | |
84 | ||
85 | ||
86 | Build Exec ution | |
87 | This docum ent descri bes the Bu ild 7 Plan for the C laims Proc essing and Eligibili ty (CP&E) project. T he Build i ncludes 6- Sprints fo r approxim ately two (2) weeks each that run from F ebruary 28 , 2018, th rough May 31, 2018. Throughout the build , the scru m teams wi ll elabora te, analyz e, program , validate , test, an d build us er stories supportin g the busi ness owner ’s priorit ies. Subse quently, r eleased pr ioritized items in t he backlog are captu red in the Rational product ba cklog. | |
88 | Sprint tea ms collabo rate to pr oduce and deliver co de to the VA for Qua lity Assur ance (QA) and User A cceptance Testing (U AT). Defec ts found d uring spri nts will b e evaluate d immediat ely by the scrum tea m. Defects that can be resolve d within t he sprint will be ta sked and r esolved. F TC will ca ll defects “bugs”. | |
89 | Defects th at cannot be resolve d within t he sprint will be pl aced on th e Build Ba cklog to b e resolved based upo n the busi ness prior ities. The se defects will be e valuated b y the scru m team and estimates will be l isted in R ational, t hen priori tized, and approved by the bus iness. At the end of the sprin t, a build is create d and demo nstrated. Stories wi th High an d Very Hig h defects will not b e consider ed complet e and will not be de monstrated at the en d of a spr int. Stori es without defects a nd stories with Low or Medium defects wi ll be demo nstrated f or accepta nce. | |
90 | During the two-week sprint per iod, FTC i s preparin g for buil ding and d emonstrati ng the pro duct. FTC has contin uous deplo yment jobs that help sustain o ur builds, packaging fixes, an d promotin g the code from one environmen t to the n ext. FTC k eeps contr ol of its versioning and confi gurations, including preparing test data for testi ng and fix es. | |
91 | A retrospe ctive cere mony is us ed to revi ew and app rove the w ork produc t complete d during t he two-wee k sprint. | |
92 | Scrum Team s | |
93 | FTC will a ccomplish sprint pla nning base d on the f ollowing v elocity an d capacity . Velocity is based upon the t eam averag e over pre vious spri nts and wi ll adjust based upon that aver age throug hout the b uild. Capa city is de termined b y the team members a ssigned an d their av ailability during th e sprint t o accompli sh tasks; this is a fixed amou nt based o n the COR expectatio n that man ning will not affect build res ults and c apacity wi ll be fixe d. The fin al sprint in the bui ld will be for defec t repair a nd hardeni ng. | |
94 | Velocity | |
95 | The Veloci ty from Bu ild 6 is u sed to pla n for Buil d 7. Table 1, illust rates Spri nt 13 tota l number o f points c ompleted b y each tea m and the average po ints per s print: | |
96 | Table 1: V elocity Da ta | |
97 | CP&E | |
98 | Build 6 Po ints Compl eted | |
99 | Average Pe r Sprint P oints | |
100 | Team 1 | |
101 | 155 | |
102 | 31 | |
103 | Team 2 | |
104 | 143 | |
105 | 29 | |
106 | Capacity v s. Plan | |
107 | The follow ing table represents the full team capac ity (in ho urs) vs. t he planned work per sprint/per team (in hours). Le vel of Eff ort (LOE) roles, suc h as Proje ct Manager and Busin ess Analys t, are spr ead evenly per user story. Cap acity is b ased upon four devel opers and one and on e third te ster per t eam per di rection fr om the COR . | |
108 | Table 2: C apacity Da ta | |
109 | Sprint 14 (10 days) | |
110 | Team 1 | |
111 | Team 2 | |
112 | Capacity | |
113 | 235 | |
114 | 235 | |
115 | Planned | |
116 | 235 | |
117 | 235 | |
118 | Sprint 15 (10 days) | |
119 | Team 1 | |
120 | Team 2 | |
121 | Capacity | |
122 | 235 | |
123 | 235 | |
124 | Planned | |
125 | 234 | |
126 | 234 | |
127 | Sprint 16 (10 days) | |
128 | Team 1 | |
129 | Team 2 | |
130 | Capacity | |
131 | 235 | |
132 | 235 | |
133 | Planned | |
134 | 220 | |
135 | 220 | |
136 | Sprint 17 (10 days) | |
137 | Team 1 | |
138 | Team 2 | |
139 | Capacity | |
140 | 240 | |
141 | 240 | |
142 | Planned | |
143 | 240 | |
144 | 240 | |
145 | Sprint 18 (10 days) | |
146 | Team 1 | |
147 | Team 2 | |
148 | Capacity | |
149 | 240 | |
150 | 240 | |
151 | Planned | |
152 | 240 | |
153 | 240 | |
154 | Sprint 19 (14 days) | |
155 | Team 1 | |
156 | Team 2 | |
157 | Capacity | |
158 | 336 | |
159 | 336 | |
160 | Planned | |
161 | 336 | |
162 | 337 | |
163 | ||
164 | Organizati al Chart | |
165 | The organi zation dep icted incl udes co-lo cated cros s-function al feature d teams wi th a Scrum Master. T his is whe re the ite rative spr ints and d evelopment cycle sta rts. | |
166 | Table 3 il lustration features CP&E teams that defi ne and del iver the p roduct: | |
167 | Table 3: C CSE CP&E T eams | |
168 | Name | |
169 | Team | |
170 | Roles | |
171 | Michael Sy nakiewicz | |
172 | (All Teams ) | |
173 | Product Ma nager | |
174 | Joseph Kob rosky | |
175 | (All Teams ) | |
176 | Scrum Mast er, Techni cal Lead | |
177 | Angel K. | |
178 | (All Teams ) | |
179 | Technical Analyst, B usiness An alyst | |
180 | Bharati M. | |
181 | (All Teams ) | |
182 | Senior Con figuration Manager | |
183 | Diane S. | |
184 | (All Teams ) | |
185 | Senior Tes ter | |
186 | Faith D. | |
187 | (All Teams ) | |
188 | Senior Tes ter | |
189 | ||
190 | Team 1 | |
191 | ||
192 | Cindy S. | |
193 | Team 1 | |
194 | Senior MUM PS Develop er | |
195 | Subba B. | |
196 | Team 1 | |
197 | Senior MUM PS Develop er | |
198 | Barry J. | |
199 | Team 1 | |
200 | Senior MUM PS Develop er | |
201 | Yeou D. | |
202 | Team 1 | |
203 | Senior MUM PS Develop er | |
204 | ||
205 | Team 2 | |
206 | ||
207 | Dennis B. | |
208 | Team 2 | |
209 | Senior MUM PS Develop er | |
210 | Tom H. | |
211 | Team 2 | |
212 | Senior MUM PS Develop er | |
213 | Chau D. | |
214 | Team 2 | |
215 | MUMPS Deve loper | |
216 | Oliver W. | |
217 | Team 2 | |
218 | MUMPS Deve loper | |
219 | Functional Specifica tions | |
220 | Epics/Sub- Epics/User Stories | |
221 | The overal l specific ations des cribe Epic s, Sub-Epi cs, and Us er Stories that will be addres sed in Bui ld 7. Spri nts 14, 15 , 16, 17 a nd 18 User Stories h ave been a ssigned. S upplementa ry, detail for the r emaining B uild 7 Spr ints will be planned within th e sprint p lanning fo r each spr int. | |
222 | Table 4 Us er Stories are defin ed and ela borated ac cording to the table below: | |
223 | Table 4: O verall Epi cs, Sub-Ep ics, and U ser Storie s | |
224 | Epic | |
225 | Story # | |
226 | Rational | |
227 | Descriptio n | |
228 | 001 | |
229 | Epic 001 | |
230 | 951406 | |
231 | As a VE, I want to u se the Phy sical Loca tion Zip F ield in th e Bene Cal c routine for approp riate bene fit calcul ation. | |
232 | 001 | |
233 | CPE001-013 | |
234 | 958201 | |
235 | As the HCR Group, I would like a report I can eith er print o r export t o Excel fr om CP&E th at display s the info rmation ba sed on the report sp ecificatio ns on dupl icate vend or records that have been inac tivated. | |
236 | 001 | |
237 | CPE001-018 | |
238 | 951231 | |
239 | As an HCR PA, I want the label in the IP vendor sc reen to be changed f rom "Remit -to Inform ation" to "Billing/R emit-to In formation" . | |
240 | 001 | |
241 | CPE001-019 | |
242 | 951234 | |
243 | As an HCR PA, I want the syste m to displ ay the pro vider's bi lling addr ess (Stree t Address, City, Sta te, and Zi p Code) on the IP Ve ndor searc h result s creen in t he field t hat is lab elled "BIL LING/REMIT -TO ADDRES S", when t he billing address i s present in the Ven dor File. | |
244 | 001 | |
245 | CPE001-100 | |
246 | 972772 | |
247 | As a VE, I want the system to use the PL Zip in th e Prospect ive Paymen t System ( PPS) payme nt methodo logy in al l correspo nding Type s of Cover age for th e Coordina tion of Be nefit of P rimary, Se condary an d Tertiary for CHAMP VA\SB manu al and EDI Inpatient claims. | |
248 | 001 | |
249 | CPE001-101 | |
250 | 972773 | |
251 | As a VE, I want the system to use the PL Zip in th e Low Volu me Mental Health (LV MH) paymen t methodol ogy in all correspon ding Types of Covera ge for the Coordinat ion of Ben efit of Pr imary, Sec ondary and Tertiary for CHAMPV A\SB manua l and EDI Inpatient claims. | |
252 | 001 | |
253 | CPE001-102 | |
254 | 972774 | |
255 | As a VE, I want the system to use the PL Zip in th e High Vol ume Mental Health (H VMH) payme nt methodo logy claim s in all c orrespondi ng Types o f Coverage for the C oordinatio n of Benef it of Prim ary, Secon dary and T ertiary fo r CHAMPVA\ SB manual and EDI In patient. | |
256 | 001 | |
257 | CPE001-103 | |
258 | 972775 | |
259 | As a VE, I want the system to use the PL Zip in th e Medicare Hospice P er Diem Ra tes paymen t methodol ogy for Ho spice Gene ral Inpati ent Care i n all corr esponding Types of C overage fo r the Coor dination o f Benefit of Primary , Secondar y and Tert iary for C HAMPVA\SB manual and EDI Inpat ient claim s. | |
260 | 001 | |
261 | CPE001-105 | |
262 | 702571 | |
263 | PL Zip in the Medica re SNF Pri cer paymen t methodol ogy for Sk illed Nurs ing Facili ty (SNF) | |
264 | 001 | |
265 | CPE001-106 | |
266 | 702572 | |
267 | PL Zip in the DRG pa yment meth odology fo r Substanc e Use Diso rder Rehab ilitation Facility ( SUDRF) | |
268 | 001 | |
269 | CPE001-107 | |
270 | 702573 | |
271 | PL Zip in the Half D ay Per Die m payment methodolog y for Part ial Hospit alization program cl aims | |
272 | 001 | |
273 | CPE001-109 | |
274 | 972781 | |
275 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Facility and Profes sional Fee services in all cor responding Types of Coverage f or the Coo rdination of Benefit of Primar y, Seconda ry and Ter tiary for CHAMPVA\SB manual an d EDI Outp atient cla ims. | |
276 | 001 | |
277 | CPE001-110 | |
278 | 972782 | |
279 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Mental He alth in al l correspo nding Type s of Cover age for th e Coordina tion of Be nefit of P rimary, Se condary an d Tertiary for CHAMP VA\SB manu al and EDI Outpatien t claims. | |
280 | 001 | |
281 | CPE001-111 | |
282 | 972783 | |
283 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for ASC Profe ssional Fe e services claims in all corre sponding T ypes of Co verage for the Coord ination of Benefit o f Primary, Secondary and Terti ary for CH AMPVA\SB m anual and EDI Outpat ient. | |
284 | 001 | |
285 | CPE001-112 | |
286 | 972784 | |
287 | As a VE, I want the system to use the PL Zip in th e PPS paym ent method ology for ASC Hospit al Based F acility in all corre sponding T ypes of Co verage for the Coord ination of Benefit o f Primary, Secondary and Terti ary for CH AMPVA\SB m anual and EDI Outpat ient claim s. | |
288 | 001 | |
289 | CPE001-113 | |
290 | 972785 | |
291 | As a VE, I want the system to use the PL Zip in th e PPS paym ent method ology for ASC Freest anding Fac ility in a ll corresp onding Typ es of Cove rage for t he Coordin ation of B enefit of Primary, S econdary a nd Tertiar y for CHAM PVA\SB man ual and ED I Outpatie nt claims. | |
292 | 001 | |
293 | CPE001-114 | |
294 | 972786 | |
295 | As a VE, I want the system to use the PL Zip in th e CMAC Ane sthesia Ra te payment methodolo gy in all correspond ing Types of Coverag e for the Coordinati on of Bene fit of Pri mary, Seco ndary and Tertiary f or Anesthe sia for CH AMPVA\SB m anual and EDI Outpat ient claim s. | |
296 | 001 | |
297 | CPE001-115 | |
298 | 972787 | |
299 | As a VE, I want the system to use the PL Zip in th e Medicare Hospice P er Diem Ra tes paymen t methodol ogy for Ho spice Rout ine Home C are in all correspon ding Types of Covera ge for the Coordinat ion of Ben efit of Pr imary, Sec ondary and Tertiary for CHAMPV A\SB manua l and EDI Outpatient claims. | |
300 | 001 | |
301 | CPE001-117 | |
302 | 972789 | |
303 | As a VE, I want the system to use the PL Zip in th e CMAC Inj ectable Ra te payment methodolo gy for Inj ectable Dr ugs in all correspon ding Types of Covera ge for the Coordinat ion of Ben efit of Pr imary, Sec ondary and Tertiary for CHAMPV A\SB manua l and EDI Outpatient claims. | |
304 | 001 | |
305 | CPE001-119 | |
306 | 972791 | |
307 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Multiple Surgery in all corre sponding T ypes of Co verage for the Coord ination of Benefit o f Primary, Secondary and Terti ary for CH AMPVA\SB m anual and EDI Outpat ient claim s. | |
308 | 001 | |
309 | CPE001-120 | |
310 | 972792 | |
311 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Multiple Surgery Fi ngers or T oes in all correspon ding Types of Covera ge for the Coordinat ion of Ben efit of Pr imary, Sec ondary and Tertiary for CHAMPV A\SB manua l and EDI Outpatient claims. | |
312 | 001 | |
313 | CPE001-121 | |
314 | 972793 | |
315 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Assistant -At-Surger y in all c orrespondi ng Types o f Coverage for the C oordinatio n of Benef it of Prim ary, Secon dary and T ertiary fo r CHAMPVA\ SB manual and EDI Ou tpatient c laims. | |
316 | 001 | |
317 | CPE001-122 | |
318 | 972794 | |
319 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Other tha n Assistan t-At-Surge ry in all correspond ing Types of Coverag e for the Coordinati on of Bene fit of Pri mary, Seco ndary and Tertiary f or CHAMPVA \SB manual and EDI O utpatient claims. | |
320 | 001 | |
321 | CPE001-123 | |
322 | 972795 | |
323 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology in all corres ponding Ty pes of Cov erage for the Coordi nation of Benefit of Primary, Secondary and Tertia ry for CHA MPVA\SB ED I Manual a nd EDI cla ims with a Type of S ervice of Dental. | |
324 | 001 | |
325 | CPE001-124 | |
326 | 983056 | |
327 | As a VE, I want the system to use the PL Zip in th e CMAC Pay ment Metho dology for PA or NP as an Assi stant-at-S urgery in all Corres ponding Ty pes of Cov erage for the Coordi nation of Benefit of Primary, Secondary and Tertia ry for CHA MPVA\SB Ma nual and E DI Outpati ent Claims . | |
328 | 001 | |
329 | CPE001-125 | |
330 | 988070 | |
331 | As a Commu nity Care Specialist , I requir e a capabi lity for t he CPE sys tem to aut omatically queue SNF claims wi th missing data, so I correct SNF claims with data errors. | |
332 | 001 | |
333 | CPE001-126 | |
334 | 988109 | |
335 | As a Nurse Reviewer, I require the syste m to queue SNF claim s for bene ficiaries who have M edicare A and/or Med icare B Ty pe of OHI Coverage, so I can m anually re view if th ey have ex hausted Me dicare SNF benefits and submit ted a Medi care denia l EOB. Rul es associa ted with t his sectio n run afte r the bene fit calcul ation has been compl eted. | |
336 | 001 | |
337 | CPE001-127 | |
338 | 988061 | |
339 | As a Commu nity Care Specialist , I requir e a capabi lity for t he CPE sys tem to aut omatically run a dat a conflict check whe n the syst em selects to sort a submissio n into cla ims, so I am prompte d that the claim is missing a Units for HIPPS code . | |
340 | 001 | |
341 | CPE001-128 | |
342 | 988063 | |
343 | As a Commu nity Care Specialist , I requir e a capabi lity for t he CPE sys tem to aut omatically run a dat a conflict check whe n the user selects t o sort a s ubmission into claim s, so I am prompted that the c laim is mi ssing an D ischarge S tatus. | |
344 | 001 | |
345 | CPE001-129 | |
346 | 988110 | |
347 | As a Nurse Reviewer, I require the syste m to queue SNF claim s for bene ficiaries who are un der age 65 , so I can manually review med ical neces sity for t he SNF ser vices prov ided. | |
348 | ||
349 | PR-1 | |
350 | 705844 | |
351 | If the PR is entered at the li ne level, it should pay the le ss of the billed amo unt or the PR for th at line it em. | |
352 | ||
353 | NDC | |
354 | 705845 | |
355 | When and N DC is ente red on an outpatient claim, it should pa y the less er of the billed amo unt or the allowed a mount (ave rage whole sale price (AWP) fou nd in ^MDI in VistA. | |
356 | ||
357 | HB ASC | |
358 | 705849 | |
359 | The Hospit al based A SC issue h as always occurred i n VISTA an d it was o nly recogn ized after the 11/01 /17 load b ecause the re was a s ignificant number of codes add ed to TRIC ARE’s ASC list in th is update. When a VE receives a hospital based ASC claim, th ey check t o see if t he surgica l codes on the claim are on TR ICARE’s AS C list. If even one code is on the list, they proc ess the cl aim as ASC (pick the ASC vendo r and use POS 24). A 196 denia l is occur ring only when there is a code that is o n the list on the da te of serv ice, and a code that was added to the li st after t he date of service. The code o n the clai m that was not added to TRICAR E’s ASC li st until a fter the d ate of ser vice is de nying for 196 in err or when it should pa y CTC. Thi s error is not effec ting very many claim s because if the onl y surgical code on t he claim i s not on t he list on that date of servic e, the cla im is proc essed as o utpatient and the pr ovider is paid CMAC. | |
360 | ||
361 | AC Impleme ntation Ev idence upl oaded | |
362 | 714053 | |
363 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
364 | ||
365 | CA Impleme ntation Ev idence upl oaded | |
366 | 714060 | |
367 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
368 | ||
369 | AT Impleme ntation Ev idence upl oaded | |
370 | 714063 | |
371 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
372 | ||
373 | PL Impleme ntation Ev idence upl oaded | |
374 | 714066 | |
375 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
376 | ||
377 | CM Impleme ntation Ev idence upl oaded | |
378 | 714067 | |
379 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
380 | ||
381 | AU Impleme ntation Ev idence upl oaded | |
382 | 714068 | |
383 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
384 | ||
385 | SC Impleme ntation Ev idence upl oaded | |
386 | 714355 | |
387 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
388 | ||
389 | RA Impleme ntation Ev idence upl oaded | |
390 | 714356 | |
391 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
392 | ||
393 | MP Impleme ntation Ev idence upl oaded | |
394 | 714357 | |
395 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
396 | ||
397 | MA Impleme ntation Ev idence upl oaded | |
398 | 714358 | |
399 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
400 | ||
401 | IA Impleme ntation Ev idence upl oaded | |
402 | 714359 | |
403 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
404 | ||
405 | PE Impleme ntation Ev idence upl oaded | |
406 | 714360 | |
407 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
408 | ||
409 | CP Impleme ntation Ev idence upl oaded | |
410 | 714361 | |
411 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
412 | ||
413 | PS Impleme ntation Ev idence upl oaded | |
414 | 720572 | |
415 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
416 | ||
417 | Security C ontrol Ass essment | |
418 | 694167 | |
419 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
420 | ||
421 | MP Impleme ntation Ev idence upl oaded | |
422 | 714357 | |
423 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
424 | ||
425 | AP Impleme ntation Ev idence Upl oad | |
426 | 725141 | |
427 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
428 | ||
429 | UL Impleme ntation Ev idence Upl oad | |
430 | 725142 | |
431 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
432 | ||
433 | AR Impleme ntation Ev idence Upl oad | |
434 | 725143 | |
435 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
436 | ||
437 | DM Impleme ntation Ev idence Upl oad | |
438 | 725144 | |
439 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
440 | ||
441 | DI Impleme ntation Ev idence Upl oad | |
442 | 725145 | |
443 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
444 | ||
445 | SC Impleme ntation Ev idence Upl oad | |
446 | 726551 | |
447 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
448 | ||
449 | SE Impleme ntation Ev idence Upl oad | |
450 | 726552 | |
451 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
452 | ||
453 | IP Impleme ntation Ev idence Upl oad | |
454 | 726614 | |
455 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
456 | ||
457 | Prepare CD 2 Paperwor k | |
458 | 727825 | |
459 | Documentat ion will b e place in Risk Visi on under t he applica ble sectio n for ATO audit. | |
460 | ||
461 | Retired Re servist Do cumentatio n for CD2 | |
462 | 734724 | |
463 | Documentat ion for RR CD2 | |
464 | 001 | |
465 | SNF034 | |
466 | 736135 | |
467 | Process Sk illed Nurs ing Data E ntry Confl icts Unit - HIPPS Co de | |
468 | 001 | |
469 | SNF035 | |
470 | 736136 | |
471 | Process Sk illed Nurs ing Data E ntry Confl ict - Reve nue Code | |
472 | 001 | |
473 | SNF036 | |
474 | 736138 | |
475 | Process Sk illed Nurs ing Data E ntry Confl ict - HIPP S Code | |
476 | 001 | |
477 | SNF038 | |
478 | 736139 | |
479 | Process Sk illed Nurs ing Data E ntry Confl ict - From Date | |
480 | 001 | |
481 | SNF039 | |
482 | 736140 | |
483 | Process Sk illed Nurs ing Data E ntry Confl ict - Thro ugh Date | |
484 | 001 | |
485 | SNF053 | |
486 | 736141 | |
487 | Send SNF C laim to Mi ssing Data Queue - U nits for H IPPS Code (RUG Group 1-4) | |
488 | 001 | |
489 | SNF054 | |
490 | 736142 | |
491 | Send SNF C laim to Mi ssing Data Queue - R evenue Cod e 0022 for HIPPS Cod e | |
492 | 001 | |
493 | SNF055 | |
494 | 736143 | |
495 | Send SNF C laim to Mi ssing Data Queue - N o HIPPS Co de Status | |
496 | 001 | |
497 | SNF057 | |
498 | 736144 | |
499 | Send SNF C laim to Mi ssing Data Queue - " From Date" | |
500 | 001 | |
501 | SNF058 | |
502 | 736145 | |
503 | CRU__SNF05 8 - Send S NF Claim t o Missing Data Queue - "Throug h Date" | |
504 | User Stori es/Backlog | |
505 | The Ration al Product backlogs contain al l prioriti zed and ac cepted use r stories ready for developmen t. Backlog items can be reprio ritized by the VA at any time. The curre nt backlog is mainta ined and a vailable w ithin Rati onal. | |
506 | Table 5 de picts the location w here the a rtifacts a re identif ied as bas elined, gr ouped, and managed: | |
507 | Table 5: R ational Pr oduct Back log Docume nts | |
508 | Document N ame | |
509 | Document L ink | |
510 | CP&E Backl og | |
511 | https:// URL /ccm/web/p rojects/HA C_CPE%20(C M)#action= com.ibm.te am.apt.vie wPlan&page =com.ibm.t eam.apt.we b.ui.plann edItems&id =_RxBG8Gfa Eee9Yp9RON nEjA&planM ode=com.ib m.team.apt .viewmodes .internal. productBac klog.workB reakdown | |
512 | Testing Re sponsibili ties | |
513 | Table 6: F TC Test Ta sks | |
514 | FTC (Devel oper) | |
515 | Party Resp onsible | |
516 | Unit/Produ ct/Compone nt Testing | |
517 | FTC System Quality A ssurance ( SQA) | |
518 | Build Veri fication T esting | |
519 | FTC SQA | |
520 | Functional Testing | |
521 | FTC SQA | |
522 | Performanc e/Load Tes ting | |
523 | FTC SQA | |
524 | Integratio n/System T esting | |
525 | FTC SQA | |
526 | Regression Testing | |
527 | FTC SQA | |
528 | Section 50 8 Complian ce Testing | |
529 | FTC SQA | |
530 | Security T esting | |
531 | FTC SQA | |
532 | Installati on Testing /Build Ver ification | |
533 | FTC SQA | |
534 | Security T esting | |
535 | FTC SQA | |
536 | Performanc e/Load Tes ting | |
537 | FTC SQA | |
538 | Acceptance Criteria | |
539 | Final Deve lopment Co de Files, Compiled C ode, and s upporting documentat ion are ch ecked into the proje cts Ration al Reposit ory. | |
540 | 100% trace ability in Rational. | |
541 | Updated as per plan in Rationa l, Require ments Trac eability M atrix (RTM ) and exec uted Test Scripts is in Ration al. | |
542 | 508 Compli ant Checkl ists. | |
543 | Schedule | |
544 | The Build schedule i s describe d in the s ections be low. Story Points ar e estimate d prior to elaborati on using s tandard Ag ile princi pals and m ay not ref lect actua l hours es timated du ring sprin t planning . | |
545 | Build 7 Sp rint 14 | |
546 | Table 7: B uild 7 Spr int 14 Sch edule | |
547 | CP&E Build 7 | |
548 | 46 Days | |
549 | Wednesday 2/28/18 | |
550 | Tuesday 5/ 31/18 | |
551 | Task Name | |
552 | Duration | |
553 | Start | |
554 | Finish | |
555 | Build 7 - Sprint 14 | |
556 | 9 Days | |
557 | Wednesday 2/28/18 | |
558 | Tuesday 3 /13/18 | |
559 | Team | |
560 | Descriptio n | |
561 | Epic | |
562 | Sub Epic | |
563 | User Story | |
564 | Story Poin ts | |
565 | Hours | |
566 | Team 1 | |
567 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Facility and Profes sional Fee services in all cor responding Types of Coverage f or the Coo rdination of Benefit of Primar y, Seconda ry and Ter tiary for CHAMPVA\SB manual an d EDI Outp atient cla ims. | |
568 | 001 | |
569 | N/A | |
570 | 001-109 | |
571 | 13 | |
572 | 90 | |
573 | ||
574 | As a VE, I want the system to use the PL Zip in th e CMAC Ane sthesia Ra te payment methodolo gy in all correspond ing Types of Coverag e for the Coordinati on of Bene fit of Pri mary, Seco ndary and Tertiary f or Anesthe sia for CH AMPVA\SB m anual and EDI Outpat ient claim s. | |
575 | 001 | |
576 | N/A | |
577 | 001-114 | |
578 | 13 | |
579 | 95 | |
580 | ||
581 | As an HCR PA I want the label in the IP vendor scr een to be changed fr om "Remit- to Informa tion" to " Billing/Re mit-to Inf ormation". | |
582 | 001 | |
583 | N/A | |
584 | 001-018 | |
585 | 8 | |
586 | 50 | |
587 | Team 2 | |
588 | As a VE, I want the system to use the P L Zip in t he CMAC In jectable R ate paymen t methodol ogy for In jectable D rugs in al l correspo nding Type s of Cover age for th e Coordina tion of Be nefit of P rimary, Se condary an d Tertiary for CHAMP VA\SB manu al and EDI Outpatien t claims. | |
589 | 001 | |
590 | N/A | |
591 | 001-117 | |
592 | 13 | |
593 | 95 | |
594 | ||
595 | As the HCR Group I w ould like a report I can eithe r print or export to Excel fro m CP&E tha t displays the infor mation bas ed on the report spe cification s on dupli cate vendo r records that have been inact ivated. | |
596 | 001 | |
597 | N/A | |
598 | 001-013 | |
599 | 13 | |
600 | 90 | |
601 | ||
602 | As an HCR PA I want the system to displa y the prov ider's bil ling addre ss (Street Address, City, Stat e, and Zip Code) on the IP Ven dor search result sc reen in th e field th at is labe lled "BILL ING/REMIT- TO ADDRESS ", when th e billing address is present i n the Vend or File. | |
603 | 001 | |
604 | N/A | |
605 | 001-019 | |
606 | 8 | |
607 | 50 | |
608 | D: Sprint Plan | |
609 | Monday: 2/ 12/18 | |
610 | Sprint Kic koff/Plann ing | |
611 | (All Teams ) | |
612 | 4-6 Hours | |
613 | ||
614 | Wednesday: 2/28/18 | |
615 | Sprint 14 Backlog Gr ooming | |
616 | (All Teams ) | |
617 | 1 Hour | |
618 | ||
619 | Thursday: 3/8/18 | |
620 | Sprint 14 Sprint Rev iew | |
621 | (All Teams ) | |
622 | 1 Hour | |
623 | ||
624 | Tuesday: 3/13/18 | |
625 | Build 7 Sp rint 15 | |
626 | Table 8: B uild 7 Spr int 15 Sch edule | |
627 | Build 7 - Sprint 15 | |
628 | 10 Days | |
629 | Wednesday 3/14/18 | |
630 | Tuesday 3 /27/18 | |
631 | Team | |
632 | Descriptio n | |
633 | Epic | |
634 | Sub Epic | |
635 | User Story | |
636 | Story Poin ts | |
637 | Hours | |
638 | Team 1 | |
639 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Mental He alth in al l correspo nding Type s of Cover age for th e Coordina tion of Be nefit of P rimary, Se condary an d Tertiary for CHAMP VA\SB manu al and EDI Outpatien t claims. | |
640 | 001 | |
641 | N/A | |
642 | 001-110 | |
643 | 8 | |
644 | 48 | |
645 | ||
646 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for ASC Profe ssional Fe e services claims in all corre sponding T ypes of Co verage for the Coord ination of Benefit o f Primary, Secondary and Terti ary for CH AMPVA\SB m anual and EDI Outpat ient. | |
647 | 001 | |
648 | N/A | |
649 | 001-111 | |
650 | 8 | |
651 | 48 | |
652 | ||
653 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Multiple Surgery Fi ngers or T oes in all correspon ding Types of Covera ge for the Coordinat ion of Ben efit of Pr imary, Sec ondary and Tertiary for CHAMPV A\SB manua l and EDI Outpatient claims. | |
654 | 001 | |
655 | N/A | |
656 | 001-120 | |
657 | 8 | |
658 | 72 | |
659 | ||
660 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Multiple Surgery in all corre sponding T ypes of Co verage for the Coord ination of Benefit o f Primary, Secondary and Terti ary for CH AMPVA\SB m anual and EDI Outpat ient claim s. | |
661 | 001 | |
662 | N/A | |
663 | 001-119 | |
664 | 8 | |
665 | 66 | |
666 | Team 2 | |
667 | As a VE, I want the system to use the PL Zip in th e CMAC Pay ment Metho dology for PA or NP as an Assi stant-at-S urgery in all Corres ponding Ty pes of Cov erage for the Coordi nation of Benefit of Primary, Secondary and Tertia ry for CHA MPVA\SB Ma nual and E DI Outpati ent Claims . | |
668 | 001 | |
669 | N/A | |
670 | 001-124 | |
671 | 5 | |
672 | 48 | |
673 | ||
674 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Assistant -At-Surger y in all c orrespondi ng Types o f Coverage for the C oordinatio n of Benef it of Prim ary, Secon dary and T ertiary fo r CHAMPVA\ SB manual and EDI Ou tpatient c laims. | |
675 | 001 | |
676 | N/A | |
677 | 001-121 | |
678 | 8 | |
679 | 48 | |
680 | ||
681 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology for Other tha n Assistan t-At-Surge ry in all correspond ing Types of Coverag e for the Coordinati on of Bene fit of Pri mary, Seco ndary and Tertiary f or CHAMPVA \SB manual and EDI O utpatient claims. | |
682 | 001 | |
683 | N/A | |
684 | 001-122 | |
685 | 8 | |
686 | 60 | |
687 | ||
688 | As a VE, I want the system to use the PL Zip in th e CMAC pay ment metho dology in all corres ponding Ty pes of Cov erage for the Coordi nation of Benefit of Primary, Secondary and Tertia ry for CHA MPVA\SB ED I Manual a nd EDI cla ims with a Type of S ervice of Dental. | |
689 | 001 | |
690 | N/A | |
691 | 001-123 | |
692 | 8 | |
693 | 78 | |
694 | D: Sprint Plan | |
695 | Monday: 2/ 12/18 | |
696 | Sprint Kic koff/Plann ing | |
697 | (All Teams ) | |
698 | 4-6 Hours | |
699 | ||
700 | Wednesday: 3/14/18 | |
701 | Sprint 15 Backlog Gr ooming | |
702 | (All Teams ) | |
703 | 1 Hour | |
704 | ||
705 | Thursday: 3/22/18 | |
706 | Sprint 15 Sprint Rev iew | |
707 | (All Teams ) | |
708 | 1 Hour | |
709 | ||
710 | Tuesday: 3/27/18 | |
711 | Build 7 Sp rint 16 | |
712 | Table 9: B uild 7 Spr int 16 Sch edule | |
713 | Build 7 - Sprint 16 | |
714 | 10 Days | |
715 | Wednesday 3/28/18 | |
716 | Tuesday 4 /10/18 | |
717 | Team | |
718 | Descriptio n | |
719 | Epic | |
720 | Sub Epic | |
721 | User Story | |
722 | Story Poin ts | |
723 | Hours | |
724 | Team 1 | |
725 | As a VE, I want the system to use the PL Zip in th e PPS paym ent method ology for ASC Hospit al Based F acility in all corre sponding T ypes of Co verage for the Coord ination of Benefit o f Primary, Secondary and Terti ary for CH AMPVA\SB m anual and EDI Outpat ient claim s. | |
726 | 001 | |
727 | N/A | |
728 | 001-112 | |
729 | 8 | |
730 | 50 | |
731 | ||
732 | As a VE, I want the system to use the PL Zip in th e PPS paym ent method ology for ASC Freest anding Fac ility in a ll corresp onding Typ es of Cove rage for t he Coordin ation of B enefit of Primary, S econdary a nd Tertiar y for CHAM PVA\SB man ual and ED I Outpatie nt claims. | |
733 | 001 | |
734 | N/A | |
735 | 001-113 | |
736 | 8 | |
737 | 50 | |
738 | ||
739 | As a VE, I want the system to use the PL Zip in th e Medicare Hospice P er Diem Ra tes paymen t methodol ogy for Ho spice Rout ine Home C are in all correspon ding Types of Covera ge for the Coordinat ion of Ben efit of Pr imary, Sec ondary and Tertiary for CHAMPV A\SB manua l and EDI Outpatient claims. | |
740 | 001 | |
741 | N/A | |
742 | 001-115 | |
743 | 8 | |
744 | 60 | |
745 | ||
746 | Documentat ion for AT O Evidence | |
747 | 001 | |
748 | N/A | |
749 | ATO | |
750 | 8 | |
751 | 60 | |
752 | Team 2 | |
753 | As a VE, I want the system to use the PL Zip in th e Prospect ive Paymen t System ( PPS) payme nt methodo logy in al l correspo nding Type s of Cover age for th e Coordina tion of Be nefit of P rimary, Se condary an d Tertiary for CHAMP VA\SB manu al and EDI Inpatient claims. | |
754 | 001 | |
755 | N/A | |
756 | 001-100 | |
757 | 8 | |
758 | 60 | |
759 | ||
760 | As a VE, I want the system to use the PL Zip in th e Low Volu me Mental Health (LV MH) paymen t methodol ogy in all correspon ding Types of Covera ge for the Coordinat ion of Ben efit of Pr imary, Sec ondary and Tertiary for CHAMPV A\SB manua l and EDI Inpatient claims. | |
761 | 001 | |
762 | N/A | |
763 | 001-101 | |
764 | 8 | |
765 | 50 | |
766 | ||
767 | As a VE, I want the system to use the PL Zip in th e High Vol ume Mental Health (H VMH) payme nt methodo logy claim s in all c orrespondi ng Types o f Coverage for the C oordinatio n of Benef it of Prim ary, Secon dary and T ertiary fo r CHAMPVA\ SB manual and EDI In patient. | |
768 | 001 | |
769 | N/A | |
770 | 001-102 | |
771 | 8 | |
772 | 50 | |
773 | ||
774 | As a VE, I want the system to use the PL Zip in th e Medicare Hospice P er Diem Ra tes paymen t methodol ogy for Ho spice Gene ral Inpati ent Care i n all corr esponding Types of C overage fo r the Coor dination o f Benefit of Primary , Secondar y and Tert iary for C HAMPVA\SB manual and EDI Inpat ient claim s. | |
775 | 001 | |
776 | N/A | |
777 | 001-103 | |
778 | 8 | |
779 | 60 | |
780 | D: Sprint Plan | |
781 | Monday: 2/ 12/18 | |
782 | Sprint Kic koff/Plann ing | |
783 | (All Teams ) | |
784 | 4-6 Hours | |
785 | ||
786 | Wednesday: 3/28/18 | |
787 | Sprint 16 Backlog Gr ooming | |
788 | (All Teams ) | |
789 | 1 Hour | |
790 | ||
791 | Thursday: 3/28/18 | |
792 | Sprint 16 Sprint Rev iew | |
793 | (All Teams ) | |
794 | 1 Hour | |
795 | ||
796 | Tuesday: 4/10/18 | |
797 | Build 7 Sp rint 17 | |
798 | Table 10: Build 7 Sp rint 17 Sc hedule | |
799 | Build 7 - Sprint 17 | |
800 | 10 Days | |
801 | Wednesday 4/11/18 | |
802 | Tuesday 4 /24/18 | |
803 | Team | |
804 | Descriptio n | |
805 | Epic | |
806 | Sub Epic | |
807 | User Story | |
808 | Story Poin ts | |
809 | Hours | |
810 | Team 1 | |
811 | AC Impleme ntation Ev idence upl oaded | |
812 | ATO | |
813 | N/A | |
814 | 714053 | |
815 | 5 | |
816 | 30 | |
817 | ||
818 | CA Impleme ntation Ev idence upl oaded | |
819 | ATO | |
820 | N/A | |
821 | 714060 | |
822 | 3 | |
823 | 15 | |
824 | ||
825 | AT Impleme ntation Ev idence upl oaded | |
826 | ATO | |
827 | N/A | |
828 | 714063 | |
829 | 3 | |
830 | 15 | |
831 | ||
832 | PL Impleme ntation Ev idence upl oaded | |
833 | ATO | |
834 | N/A | |
835 | 714066 | |
836 | 3 | |
837 | 15 | |
838 | ||
839 | CM Impleme ntation Ev idence upl oaded | |
840 | ATO | |
841 | N/A | |
842 | 714067 | |
843 | 3 | |
844 | 15 | |
845 | ||
846 | AU Impleme ntation Ev idence upl oaded | |
847 | ATO | |
848 | N/A | |
849 | 714068 | |
850 | 3 | |
851 | 15 | |
852 | ||
853 | SC Impleme ntation Ev idence upl oaded | |
854 | ATO | |
855 | N/A | |
856 | 714355 | |
857 | 3 | |
858 | 15 | |
859 | ||
860 | RA Impleme ntation Ev idence upl oaded | |
861 | ATO | |
862 | N/A | |
863 | 714356 | |
864 | 3 | |
865 | 15 | |
866 | ||
867 | MP Impleme ntation Ev idence upl oaded | |
868 | ATO | |
869 | N/A | |
870 | 714357 | |
871 | 3 | |
872 | 15 | |
873 | ||
874 | MA Impleme ntation Ev idence upl oaded | |
875 | ATO | |
876 | N/A | |
877 | 714358 | |
878 | 3 | |
879 | 15 | |
880 | ||
881 | IA Impleme ntation Ev idence upl oaded | |
882 | ATO | |
883 | N/A | |
884 | 714359 | |
885 | 3 | |
886 | 15 | |
887 | ||
888 | PE Impleme ntation Ev idence upl oaded | |
889 | ATO | |
890 | N/A | |
891 | 714360 | |
892 | 3 | |
893 | 15 | |
894 | ||
895 | CP Impleme ntation Ev idence upl oaded | |
896 | ATO | |
897 | N/A | |
898 | 714361 | |
899 | 3 | |
900 | 15 | |
901 | ||
902 | PS Impleme ntation Ev idence upl oaded | |
903 | ATO | |
904 | N/A | |
905 | 720572 | |
906 | 3 | |
907 | 15 | |
908 | ||
909 | Security C ontrol Ass essment | |
910 | ATO | |
911 | N/A | |
912 | 694167 | |
913 | 3 | |
914 | 15 | |
915 | Team 2 | |
916 | If the PR is entered at the li ne level, it should pay the le ss of the billed amo unt or the PR for th at line it em. | |
917 | ATO | |
918 | N/A | |
919 | 705844 | |
920 | 8 | |
921 | 80 | |
922 | ||
923 | When and N DC is ente red on an outpatient claim, it should pa y the less er of the billed amo unt or the allowed a mount (ave rage whole sale price (AWP) fou nd in ^MDI in VistA. | |
924 | ATO | |
925 | N/A | |
926 | 705845 | |
927 | 8 | |
928 | 80 | |
929 | ||
930 | The Hospit al based A SC issue h as always occurred i n VISTA an d it was o nly recogn ized after the 11/01 /17 load b ecause the re was a s ignificant number of codes add ed to TRIC ARE’s ASC list in th is update. When a VE receives a hospital based ASC claim, th ey check t o see if t he surgica l codes on the claim are on TR ICARE’s AS C list. If even one code is on the list, they proc ess the cl aim as ASC (pick the ASC vendo r and use POS 24). A 196 denia l is occur ring only when there is a code that is o n the list on the da te of serv ice, and a code that was added to the li st after t he date of service. The code o n the clai m that was not added to TRICAR E’s ASC li st until a fter the d ate of ser vice is de nying for 196 in err or when it should pa y CTC. Thi s error is not effec ting very many claim s because if the onl y surgical code on t he claim i s not on t he list on that date of servic e, the cla im is proc essed as o utpatient and the pr ovider is paid CMAC. | |
931 | ATO | |
932 | N/A | |
933 | 705849 | |
934 | 8 | |
935 | 80 | |
936 | D: Sprint Plan | |
937 | Monday: 2/ 12/18 | |
938 | Sprint Kic koff/Plann ing | |
939 | (All Teams ) | |
940 | 4-6 Hours | |
941 | ||
942 | Wednesday: 3/28/18 | |
943 | Sprint 17 Backlog Gr ooming | |
944 | (All Teams ) | |
945 | 1 Hour | |
946 | ||
947 | Thursday: 3/28/18 | |
948 | Sprint 17 Sprint Rev iew | |
949 | (All Teams ) | |
950 | 1 Hour | |
951 | ||
952 | Tuesday: 4/10/18 | |
953 | Build 7 Sp rint 18 | |
954 | Table 11: Build 7 Sp rint 18 Sc hedule | |
955 | Build 7 - Sprint 18 | |
956 | 9 Days | |
957 | Wednesday 4/25/18 | |
958 | Tuesday 4 /08/18 | |
959 | Team | |
960 | Descriptio n | |
961 | Epic | |
962 | Sub Epic | |
963 | User Story | |
964 | Story Poin ts | |
965 | Hours | |
966 | Team 1 | |
967 | MP Impleme ntation Ev idence upl oaded | |
968 | ATO | |
969 | N/A | |
970 | 714357 | |
971 | 3 | |
972 | 30 | |
973 | ||
974 | AP Impleme ntation Ev idence Upl oad | |
975 | ATO | |
976 | N/A | |
977 | 725141 | |
978 | 3 | |
979 | 15 | |
980 | ||
981 | UL Impleme ntation Ev idence Upl oad | |
982 | ATO | |
983 | N/A | |
984 | 725142 | |
985 | 3 | |
986 | 15 | |
987 | ||
988 | AR Impleme ntation Ev idence Upl oad | |
989 | ATO | |
990 | N/A | |
991 | 725143 | |
992 | 3 | |
993 | 30 | |
994 | ||
995 | DM Impleme ntation Ev idence Upl oad | |
996 | ATO | |
997 | N/A | |
998 | 725144 | |
999 | 3 | |
1000 | 15 | |
1001 | ||
1002 | DI Impleme ntation Ev idence Upl oad | |
1003 | ATO | |
1004 | N/A | |
1005 | 725145 | |
1006 | 3 | |
1007 | 15 | |
1008 | ||
1009 | SC Impleme ntation Ev idence Upl oad | |
1010 | ATO | |
1011 | N/A | |
1012 | 726551 | |
1013 | 3 | |
1014 | 15 | |
1015 | ||
1016 | SE Impleme ntation Ev idence Upl oad | |
1017 | ATO | |
1018 | N/A | |
1019 | 726552 | |
1020 | 3 | |
1021 | 15 | |
1022 | ||
1023 | IP Impleme ntation Ev idence Upl oad | |
1024 | ATO | |
1025 | N/A | |
1026 | 726614 | |
1027 | 3 | |
1028 | 30 | |
1029 | ||
1030 | Prepare CD 2 Paperwor k | |
1031 | ATO | |
1032 | N/A | |
1033 | 727825 | |
1034 | 5 | |
1035 | 50 | |
1036 | Team 2 | |
1037 | PL Zip in the Medica re SNF Pri cer paymen t methodol ogy for Sk illed Nurs ing Facili ty (SNF) | |
1038 | 001 | |
1039 | N/A | |
1040 | 001-105 | |
1041 | 5 | |
1042 | 50 | |
1043 | ||
1044 | PL Zip in the DRG pa yment meth odology fo r Substanc e Use Diso rder Rehab ilitation Facility ( SUDRF) | |
1045 | 001 | |
1046 | N/A | |
1047 | 001-106 | |
1048 | 5 | |
1049 | 50 | |
1050 | ||
1051 | PL Zip in the Half D ay Per Die m payment methodolog y for Part ial Hospit alization program cl aims | |
1052 | 001 | |
1053 | N/A | |
1054 | 001-107 | |
1055 | 5 | |
1056 | 50 | |
1057 | ||
1058 | Payment Me thodology for Full D ay Per Die m for | |
1059 | Partial Ho spitalizat ion Progra m Claims. | |
1060 | 001 | |
1061 | N/A | |
1062 | 001-108 | |
1063 | 8 | |
1064 | 60 | |
1065 | D: Sprint Plan | |
1066 | Monday: 3/ 26/18 | |
1067 | Sprint Kic koff/Plann ing | |
1068 | (All Teams ) | |
1069 | 4-6 Hours | |
1070 | ||
1071 | Wednesday: 4/25/18 | |
1072 | Sprint 18 Backlog Gr ooming | |
1073 | (All Teams ) | |
1074 | 1 Hour | |
1075 | ||
1076 | Thursday: 4/19/18 | |
1077 | Sprint 18 Sprint Rev iew | |
1078 | (All Teams ) | |
1079 | 1 Hour | |
1080 | ||
1081 | Tuesday: 5/08/18 | |
1082 | ||
1083 | ||
1084 | ||
1085 | Build 7 Sp rint 19 | |
1086 | Table 12: Build 7 S print 19 S chedule | |
1087 | Build 7 - Sprint 19 | |
1088 | 14 Days | |
1089 | Wednesday 5/9/18 | |
1090 | Tuesday 5 /29/18 | |
1091 | Team | |
1092 | Descriptio n | |
1093 | Epic | |
1094 | Sub Epic | |
1095 | User Story | |
1096 | Story Poin ts | |
1097 | Hours | |
1098 | Team 1 | |
1099 | Retired Re servist Do cumentatio n for CD2 | |
1100 | CD2 | |
1101 | ||
1102 | 734724 | |
1103 | 21 | |
1104 | 336 | |
1105 | Team 2 | |
1106 | Process Sk illed Nurs ing Data E ntry Confl icts Unit - HIPPS Co de | |
1107 | 001 | |
1108 | N/A | |
1109 | SNF034 | |
1110 | 5 | |
1111 | 50 | |
1112 | ||
1113 | Process Sk illed Nurs ing Data E ntry Confl ict - Reve nue Code | |
1114 | 001 | |
1115 | N/A | |
1116 | SNF035 | |
1117 | 3 | |
1118 | 35 | |
1119 | ||
1120 | Process Sk illed Nurs ing Data E ntry Confl ict - HIPP S Code | |
1121 | 001 | |
1122 | N/A | |
1123 | SNF036 | |
1124 | 3 | |
1125 | 35 | |
1126 | ||
1127 | Process Sk illed Nurs ing Data E ntry Confl ict - From Date | |
1128 | 001 | |
1129 | N/A | |
1130 | SNF038 | |
1131 | 3 | |
1132 | 35 | |
1133 | ||
1134 | Process Sk illed Nurs ing Data E ntry Confl ict - Thro ugh Date | |
1135 | 001 | |
1136 | N/A | |
1137 | SNF039 | |
1138 | 3 | |
1139 | 35 | |
1140 | ||
1141 | Send SNF C laim to Mi ssing Data Queue - U nits for H IPPS Code (RUG Group 1-4) | |
1142 | 001 | |
1143 | N/A | |
1144 | SNF053 | |
1145 | 3 | |
1146 | 35 | |
1147 | ||
1148 | Send SNF C laim to Mi ssing Data Queue - R evenue Cod e 0022 for HIPPS Cod e | |
1149 | 001 | |
1150 | N/A | |
1151 | SNF054 | |
1152 | 3 | |
1153 | 35 | |
1154 | ||
1155 | Send SNF C laim to Mi ssing Data Queue - N o HIPPS Co de Status | |
1156 | 001 | |
1157 | N/A | |
1158 | SNF055 | |
1159 | 3 | |
1160 | 35 | |
1161 | ||
1162 | Send SNF C laim to Mi ssing Data Queue - " From Date" | |
1163 | 001 | |
1164 | N/A | |
1165 | SNF057 | |
1166 | 3 | |
1167 | 21 | |
1168 | ||
1169 | CRU__SNF05 8 - Send S NF Claim t o Missing Data Queue - "Throug h Date" | |
1170 | 001 | |
1171 | N/A | |
1172 | SNF058 | |
1173 | 3 | |
1174 | 21 | |
1175 | D: Sprint Plan | |
1176 | Monday: 4/ 30/18 | |
1177 | Sprint Kic koff/Plann ing | |
1178 | (All Teams ) | |
1179 | 4-6 Hours | |
1180 | ||
1181 | Wednesday: 5/9/18 | |
1182 | Sprint 19 Backlog Gr ooming | |
1183 | (All Teams ) | |
1184 | 1 Hour | |
1185 | ||
1186 | Thursday: 5/3/18 | |
1187 | Sprint 19 Sprint Rev iew | |
1188 | (All Teams ) | |
1189 | 1 Hour | |
1190 | ||
1191 | Tuesday: 5/29/18 | |
1192 | Sprint Cer emonies | |
1193 | Table 10: Sprint Cer emonies an d Meeting Orientatio n | |
1194 | Meeting Na me | |
1195 | Date | |
1196 | Time | |
1197 | Duration | |
1198 | Attendees | |
1199 | Standing S print Cere monies and Meetings | |
1200 | Sprint Kic koffVetera n-focused Integratio n Process (VIP) Spri nt Plannin g | |
1201 | First Day of Sprint | |
1202 | VariousWed nesday | |
1203 | 1 Hourper Team | |
1204 | FTC Team R epsVA PMVA PO | |
1205 | Daily Scru m | |
1206 | Daily | |
1207 | Mornings | |
1208 | 10 Minutes | |
1209 | FTC Team M embersVA R epresentat ives Welco me | |
1210 | Scrum of S crums | |
1211 | Daily | |
1212 | 11:30 AM | |
1213 | 30 Minutes | |
1214 | FTC Team R epsVA PMVA PO | |
1215 | Sprint Bac klog Groom ing/Planni ng | |
1216 | Bi-Weekly | |
1217 | 3:00 PM Th ursday | |
1218 | 1 Hour | |
1219 | FTC Team R epsVA PMVA POVA BA | |
1220 | Sprint | |
1221 | Review | |
1222 | At Sprint End | |
1223 | 2:00 PMTue sday | |
1224 | 1 Hour | |
1225 | FTC Team R epsVA PMVA PO | |
1226 | Build 7 Pl anning | |
1227 | Table 11: Build 7 Pl anning and Meeting O rientation | |
1228 | Standing B uild Plann ing Sessio ns, Meetin gs, and De liverables | |
1229 | Build 7 Pl anning | |
1230 | Timeframe | |
1231 | Date | |
1232 | Duration | |
1233 | Attendees | |
1234 | Build Plan 7 Backlog Review | |
1235 | Within 3-W eeks | |
1236 | Prior to B uild Start | |
1237 | 1/31/18 | |
1238 | 1 Hour | |
1239 | FTC Team R epsVA PMVA POVA BA | |
1240 | Build Plan 7 Plannin g Session | |
1241 | Within 3-W eeks Prior to Build Start | |
1242 | 1/31/18 | |
1243 | 1 Hour | |
1244 | FTC Team R epsVA PMVA POVA BA | |
1245 | Build Plan 7 | |
1246 | Review | |
1247 | Within 2-W eeks Prior to Build Start | |
1248 | 2/09/18 | |
1249 | 1 Hour | |
1250 | FTC Team R epsVA PMVA POVA BA | |
1251 | Dependenci es | |
1252 | None | |
1253 | Risk & Iss ues | |
1254 | Identified Risks | |
1255 | IF: Multip le develop ers work o n the same code modu le and pus h their ch anges into productio n. THEN: T he last de veloper to push a ch ange into production will over write the work of th e other de velopers. | |
1256 | Identified Issues | |
1257 | There is n o relevant data for this secti on. | |
1258 | Constraint s | |
1259 | None at th is time. | |
1260 | Assumption s | |
1261 | Defects, f unctionali ty, and us er satisfa ction norm ally ident ified and resolved d uring a sp rint or re solved in the follow ing sprint will accu mulate thr oughout th e build if VA is una ble to acc omplish sp rint by sp rint SQA/U AT testing . | |
1262 | Defects fo und during SQA and U AT will im pact the v olume of w ork to be accomplish ed during Build 7 or when the VA is able to perfor m SQA/UAT testing. T his dynami c must be anticipate d and plan ned. | |
1263 | In followi ng the Agi le process defects f ound durin g a sprint that cann ot be reso lved withi n the spri nt are pla ced in the build bac klog and w ill be wor ked in the next spri nt. Subseq uently, th e technica l reasons why the Us er Story w ith defect s could no t be finis hed within the sprin t will be explained during the Sprint Re trospectiv e. | |
1264 | Definition of Done | |
1265 | The Sprint work prod uct delive rables are shown in Section 3. 1 and Sect ions 7.1 t hrough 7.2 . | |
1266 | Final Deve lopment Co de Files, Compiled C ode, and s upporting documentat ion are ch ecked into the proje ct’s Ratio nal reposi tory (0008 AM). | |
1267 | 100% trace ability in Rational. | |
1268 | Creation o f all the iterative Release Pa ckage (008 AP) docume ntation as sociated w ith Build 7 required for a fut ure releas e to produ ction (e.g . Installa tion Guide and User Manual.) | |
1269 | Updated RT M and exec uted test scripts as per plan in Rationa l. | |
1270 | Build 7 De liverables | |
1271 | The Sprint Work Prod uct delive rables com pleted are checked i nto the pr ojects, Ra tional Rep ository fo r updates and subseq uently rel eased main tenance as the proje ct continu es forward . | |
1272 | Build 7 Re lease Plan ning Packa ge (0008AF ) | |
1273 | Build 7 Sp rint Plans (0008AG) | |
1274 | Build 7 Sp rint Burnd own and Ve locity cha rts (0008A H) | |
1275 | Build 7 50 8 Certific ation (000 8AK) | |
1276 | Build 7 Ac ceptance F orm (0008A N) | |
1277 | Build 7 Re lease Pack age (0008A P) |
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