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1 | PSE Patch PRCA_45_307 CIF submission.zip | PSE RSD Phase 01 Incr01 v1.18.docx | Wed Jan 4 15:53:34 2017 UTC |
2 | PSE Patch PRCA_45_307 CIF submission.zip | PSE RSD Phase 01 Incr01 v1.18.docx | Thu Feb 2 18:52:23 2017 UTC |
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1 | Patient St atement En hancements (PSE) | |
2 | Discrepanc ies (Incre ment 1, Ph ase 1) | |
3 | Requiremen ts Specifi cation Doc ument | |
4 | ||
5 | ||
6 | ||
7 | December 2 016 | |
8 | Version 1. 18 | |
9 | ||
10 | Department of Vetera ns Affairs | |
11 | ||
12 | Revision H istory | |
13 | Note: The revision h istory cyc le begins once chang es or enha ncements a re request ed after t he Require ments Spec ification Document h as been ba se-lined. | |
14 | Date | |
15 | Version | |
16 | Descriptio n | |
17 | Author | |
18 | 12/12/2016 | |
19 | 1.18 | |
20 | Updated re quirement ACJ009 and ACJ008 to explicitl y state th at out of balance bi lls not in specific status wil l not be r emediated by the Aut o-Correcti on job (CR #429994) | |
21 | ||
22 | Updated se ction 2.6. 1 and requ irements A CJ001, ACJ 010, ACR00 1 and remo ved requir ement ACJ0 07 to excl ude Missin g Amount D iscrepanci es fixes. (CR #43256 5) | |
23 | Ray Mattes on | |
24 | 11/29/2016 | |
25 | 1.17 | |
26 | Updated re quirement ACJ006 to exclude Re fund Revie ws from Au to-Correct ion. (CR # 425119) | |
27 | Ray Mattes on | |
28 | 10/31/2016 | |
29 | 1.16 | |
30 | Added requ irements A CJ014 and ACR014 to account fo r and repo rt on inde terminate bill discr epancies. (CR #38592 6) | |
31 | Ray Mattes on | |
32 | 10/20/2016 | |
33 | 1.15 | |
34 | Added user stories U S005, US00 6, and US0 07 to expl icitly sta te the tra nsaction d iscrepancy remediati on require ments. | |
35 | Ray Mattes on | |
36 | 10/3/2016 | |
37 | 1.14 | |
38 | Updated Au to-Correct ion flow d iagram in 2.61; upda ted Requir ements ACJ 007, ACJ00 8, ACJ009, ACR003 to update AR transacti on types t hat are co rrected. ( CR #386662 ) | |
39 | ||
40 | Added requ irements A CJ012 and ACJ013 to handle Aut o-Correcti on batch j ob failure reporting . (CR #385 933) | |
41 | ||
42 | Updated re quirement ACJ010 to explicitly state tha t out of b alance bil ls with mu ltiple dis crepancies will not be remedia ted by the Auto-Corr ection job . (CR #385 926) | |
43 | Ray Mattes on | |
44 | 8/1/2016 | |
45 | 1.13 | |
46 | Added Vist A AR Patie nt Stateme nt run dat e change f unctional requiremen ts. | |
47 | Ray Mattes on | |
48 | 05/27/2016 | |
49 | 1.12 | |
50 | Updated in troduction | |
51 | Shawnee Bl air | |
52 | 4/13/2016 | |
53 | 1.11 | |
54 | Updated AC J002 to re flect the initial sc hedule of the Auto-C orrection Job. | |
55 | Diana Coll ins | |
56 | 3/29/2016 | |
57 | 1.10 | |
58 | Updated se ction 2.6. 3 with cla rification of what “ If the Aut o-Correcti on job fai ls to laun ch or is u nable to c orrect the transacti on, HPS wi ll be noti fied” mean s, and “by producing an error in the Vis tA error l og file” w as added. | |
59 | Updated co ver sheet title. | |
60 | Updated AC R003 per d efect 2917 10 (Missin g or null transactio n discrepa ncies for decrease, increase, and paymen ts in part are marke d as OTHER ERROR.) | |
61 | Randy Maje wski | |
62 | 3/17/2016 | |
63 | 1.09 | |
64 | Update sec tion 2.6.3 “duplicat e flag” is now “inco mplete fla g (INCOMPL ETE TRANSA CTION FLAG . 433, 10) ”. | |
65 | Renumbered requireme nt ACR012 to ACR013 at the bot tom of tab le 2.6. | |
66 | Updated AC J003 per R TC task 29 0807, 2761 50. | |
67 | Randy Maje wski | |
68 | 3/9/2016 | |
69 | 1.08 | |
70 | Updated th e screen c aptures in Appendix A as follo ws: | |
71 | the Auto-C orrection Report to show the C ontinue pr ompt | |
72 | the Auto-C orrection Report to show the P atient Sta tement Aut o-Correcti on Program option | |
73 | Diana Coll ins | |
74 | 3/3/2016 | |
75 | 1.07 | |
76 | Added the new Securi ty Key Nam e to ACJ00 4. | |
77 | Diana Coll ins | |
78 | 2/4/2016 | |
79 | 1.06 | |
80 | Updated AC R003 to in clude the status of ‘Other’. | |
81 | VA confirm ed that a new securi ty key is needed; Up dated ACJ0 04 accordi ngly. | |
82 | Added requ irement AC J011. | |
83 | Added requ irement AC R012. | |
84 | Refreshed screen moc k-ups to s how the fo ur new Aut o-Correcti on Reasons . | |
85 | Added Over view of th e PSE proj ect phases . | |
86 | Diana Coll ins | |
87 | 10/30/2015 | |
88 | 1.05 | |
89 | Updated ve rbiage in sections 2 .6.1, 2.6. 2, and 2.6 .3 per Ray Pietrzak. | |
90 | Heather Ch atwin | |
91 | 10/18/2015 | |
92 | 1.04 | |
93 | Updates ma de per cus tomer revi ew. | |
94 | Updates in clude: | |
95 | Section 1. 2 added no te regardi ng root ca use analys is, and re moved refe rences of TBD. | |
96 | Section 1. 3: include d referenc e to BRD a nd include d PSE PWS. | |
97 | Section 2. 6: removed agile fig ures, and added subs ections 2. 6.1, 2.6.2 , and 2.6. 3 to cover business process of the Auto- Correction Job. Upda ted requir ement ACJ0 08. | |
98 | Section 2. 6.4 added and provid ed updated specifica tions to s how tracea bility to PWS requir ements. | |
99 | Section 2. 9: accepte d changes made to th e performa nce table, and inclu ded a sent ence indic ating the table was inserted f rom the BR D. | |
100 | Section 2. 12: remove d scope in tegration specificat ions as th ey are not applicabl e to Phase 1. | |
101 | Updated co ver page, and footer s. | |
102 | Heather Ch atwin | |
103 | 9/28/2015 | |
104 | 1.03 | |
105 | Removed re ference to My Health eVet (MHV) in sectio n 2.3. Des ign Constr aints Spec ification (Out of sc ope) | |
106 | The follow ing note w as added t o ACJ007, ACJ008, an d ACJ009: “This requ irement ma y be modif ied as wor k on the A uto-Correc tion conti nues.” | |
107 | Removed re ferences t o the uniq ue patient identifie r and stat ement form in sectio n 2.12.1. CCPC. | |
108 | Removed th e “To Be D etermined” statement from sect ion 2.15. Usability Specificat ions. | |
109 | Added Figu re 17 To B e PSE Auto -Correctio n Diagram. | |
110 | Tony Nixon | |
111 | ||
112 | 1.02 | |
113 | Removed RT C ID. | |
114 | Added requ irements f or the Aut o-Correcti on Job to resolve th e followin g discrepa ncies: | |
115 | Missing tr ansaction amount | |
116 | Duplicate transactio n | |
117 | Incomplete transacti on status | |
118 | Updates to Appendix A: | |
119 | Added Auto -Correctio n Report e xamples | |
120 | Added exam ples of th e followin g 3 discre pancies | |
121 | Missing tr ansaction amount | |
122 | Duplicate transactio n | |
123 | Incomplete transacti on status | |
124 | Addition o f Appendix B: Manual Steps To Resolve An y Discrepa ncy. | |
125 | Tony Nixon | |
126 | 9/09/2015 | |
127 | 1.01 | |
128 | Interim dr aft; revie wed Append ix A (incl uded in te mplate) wi th HP PSE team and d etermined these requ irements w ere not ap plicable f or Phase I . removed appendix A from the interim ve rsion, but kept the appendix a s a place holder (if needed fo r the fina l). | |
129 | Removed se ction four as this s ection is not applic able to th e PSE proj ect. | |
130 | Updated co ver page, and table of content s to inclu de list of figures a nd list of tables. | |
131 | Heather Ch atwin | |
132 | Tony Nixon | |
133 | 8/26/2015 | |
134 | 1.00 | |
135 | Initial dr aft of PSE Phase I. | |
136 | Heather Ch atwin | |
137 | Tony Nixon | |
138 | ||
139 | Artifact R ationale | |
140 | The Requir ements Spe cification Document (RSD) reco rds the re sults of t he specifi cation gat hering pro cesses car ried out d uring the Requiremen ts phase. The RSD is generally written b y the func tional ana lyst(s) an d should p rovide the bulk of t he informa tion used to create the test p lan and te st scripts . It shoul d be updat ed for eac h incremen t. | |
141 | The level of detail contained in this RS D should b e consiste nt with th e size and scope of the projec t. It is n ot necessa ry to fill out any s ections of this docu ment that do not app ly to the project. T he resourc es necessa ry to crea te and mai ntain this document during the life cycl e of a lar ge project should be acknowled ged and cl early refl ected in p roject sch edules. Do not dupli cate data that is al ready defi ned in ano ther docum ent or a s ection in this docum ent; note in the sec tion where the infor mation can be found. | |
142 | ||
143 | Table of C ontents | |
144 | 1.Introduc tion7 | |
145 | 1.1.Purpos e7 | |
146 | 1.2.Scope7 | |
147 | 1.2.1.Out of Scope8 | |
148 | 1.3.Refere nces8 | |
149 | 2.Overall Descriptio n8 | |
150 | 2.1.Access ibility Sp ecificatio ns9 | |
151 | 2.2.Busine ss Rules S pecificati on9 | |
152 | 2.3.Design Constrain ts Specifi cation10 | |
153 | 2.4.Disast er Recover y Specific ation11 | |
154 | 2.5.Docume ntation Sp ecificatio ns11 | |
155 | 2.6.Functi onal Speci fications1 1 | |
156 | 2.6.1.To-B e Auto-Cor rection Jo b: Missing Transacti on Process 11 | |
157 | 2.6.2.To-B e Auto-Cor rection Jo b: Incompl ete Transa ction Proc ess13 | |
158 | 2.6.3.To B e Auto-Cor rection Jo b: Duplica te Transac tion Proce ss14 | |
159 | 2.6.4.To B e Schedule for VistA AR Patien t Statemen t Run Date s14 | |
160 | 2.6.5.Func tional Req uirements1 5 | |
161 | 2.7.Graphi cal User I nterface ( GUI) Speci fications2 1 | |
162 | 2.8.Multi- divisional Specifica tions21 | |
163 | 2.9.Perfor mance Spec ifications 21 | |
164 | 2.10.Quali ty Attribu tes Specif ication22 | |
165 | 2.11.Relia bility Spe cification s22 | |
166 | 2.12.Scope Integrati on22 | |
167 | 2.12.1.Sec urity Spec ifications 22 | |
168 | 2.13.Syste m Features 23 | |
169 | 2.14.Usabi lity Speci fications2 3 | |
170 | 3.Purchase d Componen ts23 | |
171 | 4.Approval Signature s24 | |
172 | ||
173 | List of Fi gures | |
174 | ||
175 | Figure 1: To-Be Auto -Correctio n Batch Pr ocess13 | |
176 | Figure 2: Auto-Corre ction Job and Report Menu Opti ons25 | |
177 | Figure 3: Notificati on to AR U ser when j ob is stil l actively running26 | |
178 | Figure 4: MailMan no tification when Auto -Correctio n job is s till activ ely runnin g26 | |
179 | Figure 5: Auto-Corre ction Repo rt Options 27 | |
180 | Figure 6: Auto-Corre ction Repo rt Option Selection Example27 | |
181 | Figure 7: Auto-Corre ction Repo rt: Sorted by Bill N umber27 | |
182 | Figure 8: Auto-Corre ction Repo rt: Sorted by Debtor Name28 | |
183 | Figure 9: Auto-Corre ction Repo rt: Sorted by Auto C orrection Date28 | |
184 | Figure 10: Auto-Corr ection Rep ort: Sorte d by Trans action Num ber28 | |
185 | Figure 11: Missing T ransaction Amount – Screen 129 | |
186 | Figure 12: Missing T ransaction Amount – Screen 230 | |
187 | Figure 13: Missing T ransaction Amount – Screen 331 | |
188 | Figure 14: Duplicate Transacti on – Scree n 131 | |
189 | Figure 15: Duplicate Transacti on – Scree n 232 | |
190 | Figure 16: Duplicate Transacti on – Scree n 333 | |
191 | Figure 17: Incomplet e Status – Screen 13 4 | |
192 | Figure 18: Incomplet e Status – Screen 23 5 | |
193 | Figure 19: Incomplet e Status-S creen 335 | |
194 | Figure 20: Patient S tatement D eficiency Resolution To-Be Pro cess Diagr am37 | |
195 | ||
196 | List of Ta bles | |
197 | Table 21: Access Lev els for Vi stA AR Pac kage9 | |
198 | Table 22: Patient St atement Ru les10 | |
199 | Table 23: To Be sche dule of Vi stA Patien t Statemen t run date s15 | |
200 | Table 24: Descriptio n of Requi rement Spe cification Table15 | |
201 | Table 25:A uto-Correc tion Job ( ACJ) Requi rements16 | |
202 | Table 26: Busines Ru les for Ba lancing Ac counts (BR )18 | |
203 | Table 27: Auto-Corre ction Repo rt (ACR) R equirement s18 | |
204 | Table 28: Patient St atement Ch ange Date Requiremen ts20 | |
205 | Table 29: Transactio n Discrepa ncy Root C ause Remed iation Req uirements2 1 | |
206 | Table 210: Perfomanc e Specific ations21 | |
207 | ||
208 | Introducti on | |
209 | The remedi ation of t he Veteran s Health I nformation Systems T echnology Architectu re (VistA) Accounts Receivable (AR) proc ess is req uired to p rovide a c onsolidate d and easi ly readabl e patient statement from multi ple treatm ent facili ties durin g a monthl y cycle. E nhancement s to the A R system w ill increa se Veteran satisfact ion by mit igating co ncerns rai sed by Vet erans Serv ice Organi zations (V SO) and in dividual V eterans, w ho have pr ovided fee dback to t he Departm ent of Vet erans Affa irs (VA) r egarding p oor custom er service and poor business p ractices. Future dev elopment a ctivities are depend ent on Pha se 1 and P hase 2 enh ancements, as these enhancemen ts will de ploy best practices in financi al and bus iness proc esses, and align wit h the VA i nitiative to build V eterans Re cord Manag ement (VRM ) capabili ty to enab le conveni ent and se amless int eractions. | |
210 | The PSE pr oject incl udes 3 dev elopment p hases acro ss 5 incre ments. Pha se 1 will remediate existing p ayment cyc le deficie ncies and include an Auto-Corr ection job . Phase 1 will be co ded and in itial SQA testing wi ll be perf ormed in I ncrement 1 . Phase 1 final Soft ware Quali ty Assuran ce (SQA), User Funct ionality T esting (UF T), Initia l Operabil ity Capabi lity (IOC) , and depl oyment wil l be in In crement 3. | |
211 | Phase 2 in cludes the creation of the con solidated billing st atement. P hase 2 wil l be coded and initi al SQA tes ting will be perform ed in Incr ement 2. P hase 2 fin al SQA, UF T, IOC, an d deployme nt will be in Increm ent 3. | |
212 | Phase 3 in cludes mak ing the bi lling stat ements ava ilable on- line throu gh the My HealtheVet (MHV) por tal and fo r the gene ration of the Annual Patient P ayment Sum mary (APPS ) statemen t. Phase 3 will be c oded and i nitial SQA testing w ill be per formed in Increment 4. Phase 3 final SQA , UFT, IOC , and depl oyment wil l be in In crement 5. | |
213 | Purpose | |
214 | The purpos e of this RSD is to introduce the functi onal and t echnical r equirement s for Pati ent Statem ent Enhanc ements (PS E) for Pha se I. The intended a udience fo r this doc ument are PSE Office of Inform ation and Technology (OI&T), t he PSE Bus iness Requ irements O ffice, and other PSE stakehold ers. | |
215 | Scope | |
216 | This RSD f ocuses on the busine ss rules a nd require ments for Phase 1 de velopment. Items con sidered in scope for Phase 1 a re listed below: | |
217 | As-Is anal ysis of th e VistA AR Patient S tatement p rocess for deficienc y resoluti on and To- Be of the process wh ich includ es the res olved defe cts and au tomation. | |
218 | Root-cause analysis of the fol lowing 3 a ccount bal ance discr epancies w ithin the AR applica tion: | |
219 | Transactio n amount m issing | |
220 | Duplicate transactio n | |
221 | Incomplete status | |
222 | Note: Root cause ana lysis of I ncomplete Status is complete. Analysis c onfirmed t he incompl ete status flag (INC OMPLETE TR ANSACTION FLAG, 433, 10) is se t incorrec tly to ‘1’ by end us ers. The A uto-Correc tion Job w ill remedy this issu e by setti ng the inc omplete st atus to ‘0 ’ when an account is out of ba lance. The developme nt team co ntinues to work clos ely with t he busines s to deter mine scena rios that cause dupl icate tran sactions a nd missing transacti ons amount s. | |
223 | Requiremen t elaborat ion of Pha se I busin ess requir ements def ined in th e Patient Statement Enhancemen t (PSE) Pr oject Work Scope (PW S) documen t (section 5.5). | |
224 | Developmen t and inst allation o f an autom ated proce ss for the detection and track ing of dis crepancies that prev ent a pati ent statem ent from p rocessing. | |
225 | Developmen t of an au tomated pr ocess for remediatio n of discr epancies t hat preven t a patien t statemen t from pro cessing. | |
226 | Update the billing s tatement r un date fo r any VA s ites that build and transmit s tatement d ata to AIT C on or af ter the 26 th calenda r day of e ach month. | |
227 | Out of Sco pe | |
228 | The follow ing items are consid ered out o f scope fo r Phase I developmen t: | |
229 | Requiremen t analysis and elabo ration for Phase II and Phase III requir ements. | |
230 | References | |
231 | The follow ing docume nt was use d as refer ence mater ial for th is RSD: | |
232 | Patient St atement En hancements (PSE) Pro ject Work Scope, Sec tion 5.5. | |
233 | NSR 201007 16 (CCPC) Patient St atement En hancements and Conso lidation B RD-3-18-15 .http:// DNS /warboard/ anotebk.as p?proj=179 0&Type=Act ive | |
234 | Overall De scription | |
235 | The Vetera ns Health Administra tion (VHA) Chief Bus iness Offi ce (CBO) i s requesti ng softwar e enhancem ents to re medy defic iencies id entified w ith patien t statemen ts. These requested enhancemen ts will re quire chan ges to the VistA AR package. | |
236 | The enhanc ement iden tifies Vis tA AR acco unt balanc e discrepa ncies and other know n discrepa ncies that interrupt the norma l patient statement printing p rocess and prevents successful completio n. Three t ypes of ma jor discre pancies ha ve been id entified t hrough a s earch of h elp desk t ickets sub mitted. Th e existing work-arou nd process requires submission of a Nati onal Remed y Ticket s ubmitted b y the fiel d to Produ ct Support . Product Support pe rsonnel ac cess the V istA AR pa ckage and complete t he onerous manual ad justments to the dat a in order to correc t the disc repancies on Veteran accounts before the Consolida ted Co-Pay ment Proce ssing Cent er (CCPC) patient st atements c an be sent . | |
237 | In additio n, and in preparatio n for PSE Phase 2 so ftware ins tallation, any site that curre ntly build s and tran smits stat ement data to AITC o n or after the 26th date of ea ch calenda r month, m ust be cha nged to tr ansmit sta tement dat a to a dat e earlier in the mon th. | |
238 | Accessibil ity Specif ications | |
239 | The PSE pr oject will adhere to all Secti on 508 req uirements, which inc lude compl iance with the appli cable requ irements i n the VHA Section 50 8 checklis ts (1194.2 1, 1194.22 , 1194.24, 1194.31, and 1194.4 1) located at 508 Re sources Li nk or as o therwise s pecified. Establishe d checkpoi nts will e nsure that accessibi lity is in corporated from the earliest p ossible de sign or ac quisition phase and successful ly impleme nted throu ghout the project. | |
240 | The table below defi nes the di fferent le vels of ac cess to th e VistA AR package. | |
241 | Table 21: Access Lev els for Vi stA AR Pac kage | |
242 | User Level | |
243 | Role | |
244 | Responsibi lities | |
245 | Access Lev el | |
246 | Primary | |
247 | VA Medical Center ag ent cashie rs | |
248 | Applying p ayments | |
249 | Effecting other vari ous change s to the A R record ( increases and decrea ses) | |
250 | Full Acces s | |
251 | Primary | |
252 | Customer S ervice Sta ff (facili ties and C onsolidate d Patient Account Ce nters [CPA C]) | |
253 | Effecting other vari ous change s to the A R record ( increases and decrea ses) | |
254 | Full Acces s | |
255 | Primary | |
256 | Health Res ource Cent er (HRC) S taff | |
257 | Effecting other vari ous change s to the A R record ( increases and decrea ses) | |
258 | Full Acces s | |
259 | Secondary | |
260 | Austin Inf ormation T echnology Center (AI TC) staff | |
261 | Receive st atement da ta in a fl at file | |
262 | Format dat a for stat ement mail ing | |
263 | Send data file to pr int contra ctor | |
264 | Full Acces s | |
265 | Secondary | |
266 | Administra tors | |
267 | Run FileMa n routines for repor ting purpo ses or ext racting in formation for other reasons. | |
268 | Full Acces s | |
269 | Business R ules Speci fication | |
270 | The table below iden tifies kno wn conditi ons that p revent the patient s tatement p rocess fro m completi ng. If a p atient sta tement mee ts one of the follow ing criter ia, the pa tient stat ement will not print . The AR u ser manual will be u pdated wit h the foll owing busi ness rules : | |
271 | Table 22: Patient St atement Ru les | |
272 | Event | |
273 | A patient statement will not p rint when the outsta nding bala nce of the AR bills and the Pa tient Stat ement bala nce are un equal. | |
274 | A patient statement will not p rint when the outsta nding amou nt of the account is in an unp rocessed s tatus (i.e ., Refund Review, Pe nding Calm Code). | |
275 | A patient statement will not p rint when it has an Open or Ac tive bill and unproc essed. | |
276 | A patient statement will not p rint when a prepayme nt bill is in Refund Review st atus. | |
277 | A patient statement will not p rint when it has a z ero balanc e and the site param eter “Supp ress Zero Balance” f ield is se t to “Yes” . | |
278 | A patient statement will not p rint when there is n o amount d ue and no new activi ty. | |
279 | A patient statement will not p rint when the accoun t has a cr edit balan ce and no new activi ty. | |
280 | A patient statement will not p rint when it has a c redit/prep ayment bal ance amoun t of less than $1.00 (one doll ar). | |
281 | A patient statement will not p rint when it only ha s interest and admin istrative charges. | |
282 | A patient statement will not p rint when the next s tatement d ate has no t yet occu rred. | |
283 | A patient statement will not p rint when the statem ent date i s unknown. | |
284 | A patient statement will not p rint when the third (3rd) lett er has alr eady print ed. | |
285 | Design Con straints S pecificati on | |
286 | PSE will a dhere to a ll technic al standar ds publish ed in VA H andbook 61 02, as wel l as all s ecurity st andards de scribed un der the Se ction 2.13 of this d ocument. F or develop ment, codi ng standar ds follow the Standa rds and Co nventions document. | |
287 | Technical Subject Ma tter Exper t (SME) sh ortage, du e to the c omplexity of the exi sting soft ware, and the partic ipation of experienc ed VistA A R applicat ion develo pers is es sential to the succe ssful desi gn and dev elopment o f the syst em. | |
288 | Any propos ed solutio n must mee t all VHA Security, Privacy, a nd Identit y Manageme nt require ments and Non-Functi onal requi rements ad dresses in this docu ment. | |
289 | Integrated testing e nvironment s that inc lude all u pstream an d downstre am applica tions, i.e ., Lockbox , must be available. | |
290 | Constraint s on funct ionality o f this ini tiative ex ist relate d to reven ue policie s and busi ness rules . | |
291 | Statements will not print if t he AR Debt or file is set to ‘U nknown’ or has an in valid entr y/incomple te address . Addresse s used for billing p urposes ar e stored i n the AR D ebtor file (#340). F irst Party (patient) debtor ad dresses ar e stored i n the Vist A Patient file (#2). | |
292 | Other cons traints wi ll be adde d as disco vered duri ng require ments elab oration. | |
293 | Disaster R ecovery Sp ecificatio n | |
294 | A continge ncy plan w ill addres s PSE disa ster recov ery needs. The emerg ency manag ement staf f of syste m sites wi ll coordin ate with d eveloping the contin gency plan and the f acility di rector or program ma nager will approve i t. The con tingency p lan will d efine the overall ob jectives a nd establi sh the fra mework, ro les, and r esponsibil ities of t he plan. T he plan wi ll address the scope , resource requireme nts, proce ssing prio rities, tr aining, te sting, pla n maintena nce, and b ackup requ irements o f the cont ingency re covery pla n. The con tingency p lan will i nclude rem ote sites. Activitie s involved in creati ng this pl an include conductin g an impac t analysis , identify ing preven tive measu res, devel oping a re covery str ategy, doc umenting t he disaste r plan, di stributing the plan to appropr iate indiv iduals, tr aining the staff, an d testing the plan. | |
295 | The PSE co ntingency plan will identify t he activit ies that a re necessa ry to exec ute tempor ary inform ation syst em process ing capabi lities, re pair damag e to the o riginal sy stem, and restore op erational capabiliti es at the original o r new faci lity. The informatio n system c ontingency recovery plan will also docum ent the fo llowing re sources re quired for supportin g critical functions . Recovery strategie s will inc lude the s equence of activitie s as well as detaile d procedur es for the technical recovery of operati ons until the system can be re constitute d | |
296 | Documentat ion Specif ications | |
297 | The PSE pr oject will conform t o the docu mentation specificat ions as ma ndated by Program Ma nagement A ccountabil ity System (PMAS), P roPath, an d the Inte grated Pro ject Team (IPT). | |
298 | Functional Specifica tions | |
299 | This secti on introdu ces the Vi stA AR sys tem proces ses, funct ional and non-functi onal requi rements th at support the Auto- Correction job (ACJ) and the A uto-Correc tion repor t (ACR) fo r the top three disc repancies: Incomplet e Transact ions, Miss ing Transa ctions, an d Duplicat e Transact ions. This section a lso introd uces the a djustment of the mon thly VistA AR patien t statemen t run date s. | |
300 | The diagra m in Figur e 1 illust rates the To-Be Auto -Correctio n Batch Jo b for Miss ing Amount Transacti on, Incomp lete Trans action, an d Duplicat e Transact ion discre pancies. | |
301 | NOTE: Mis sing Amoun t Transact ion discre pancies fi xes will b e a future enhanceme nt to the Auto-Corre ction Batc h Job. | |
302 | ||
303 | Figure 1: To-Be Auto -Correctio n Batch Pr ocess | |
304 | ||
305 | Missing T ransaction Amount Di screpancy Fixes | |
306 | Changes wi ll correct infrequen t erroneou s data com binations and transa ction sequ ences that result in missing t ransaction amounts i n the AR T RANSACTION file (#43 3). Revise d processi ng will de liver accu rate amoun ts in the file to en sure probl em-free pa tient stat ement prin ting. | |
307 | To-Be Auto -Correctio n Job: Inc omplete Tr ansaction Process | |
308 | Changes wi ll be made in the Vi stA AR mod ule to ens ure user-a djusted tr ansactions no longer result in “incomple te” status es (INCOMP LETE TRANS ACTION FLA G, 433, 10 ). Changes will rese t flags te mporarily set by use rs when pr ocessing i ncreases a nd decreas es to bala nce accoun ts. Revise d processi ng will de liver “com plete” sta tuses in F ileMan Fil e #433 to ensure pro blem-free patient st atement pr inting. | |
309 | When other unidentif ied proces sing condi tions resu lt in “inc omplete” s tatuses (I NCOMPLETE TRANSACTIO N FLAG, 43 3, 10), th e Auto-Cor rection pr ocess outl ined in Se ction 2.6. 5 will ame nd process ing result s to make the overal l account balance eq ual the Pa tient Stat ement bala nce. | |
310 | The Auto-C orrection Batch Job process fo r correcti ng incompl ete transa ctions is illustrate d in Figur e 1. When the Auto-C orrection Batch Prog ram determ ines the a ccount is out of bal ance due t o a single transacti on marked as incompl ete (INCOM PLETE TRAN SACTION FL AG, 433,10 ), in a A ctive or O pen bill a nd the AR transactio n is anyth ing other than a “CO MMENT TRAN SACTION”, the job co rrects the incomplet e flag wit hin the AR TRANSACTI ON file (# 433). | |
311 | To Be Auto -Correctio n Job: Dup licate Tra nsaction P rocess | |
312 | Changes wi ll be made in the Vi stA AR mod ule to ens ure duplic ate transa ctions do not result when spec ific autom atic decre ases are p rocessed. Changes wi ll elimina te the sec ond transa ction with a unique internal i dentificat ion so tha t duplicat es are no longer wri tten to th e AR TRANS ACTION fil e (#433). Revised pr ocessing w ill delive r accurate amounts i n the file to ensure problem-f ree patien t statemen t printing . | |
313 | ||
314 | When other unidentif ied proces sing condi tions resu lt in dupl icate tran sactions f or Decreas e Adjustme nt transac tions, the Auto-Corr ection pro cess outli ned in Sec tion 2.6.5 will amen d processi ng results to make t he overall account b alance equ al the Pat ient State ment balan ce. | |
315 | ||
316 | The Auto-C orrection Batch Job process fo r correcti ng duplica te transac tions is i llustrated in Figure 1. When t he auto-co rrect job determines an accoun t is out o f balance in the AR TRANSACTIO N file (#4 33) due to a single duplicate Decrease A djustment transactio n for an O pen, Activ e, or Canc ellation b ill, the A uto-Correc tion job c orrects th e duplicat e discrepa ncy by set ting the i ncomplete flag on th e duplicat e transact ion. | |
317 | To Be Sch edule for VistA AR P atient Sta tement Run Dates | |
318 | All VistA AR sites w ill need t o create a nd transmi t to AITC all Patien t Statemen t data bef ore the 26 th calenda r day of t he month i mmediately prior to the operat ional depl oyment of the consol idated bil ling state ment funct ionality i mplementat ion (i.e. PSE Phase 2). The ne ed to move all site patient bi lling proc essing to before the 26th day of the mon th is to a ccommodate the first month in which the new PSE ‘c onsolidate d patient billing st atement’ p rocesses a re impleme nted. Seve nteen Vist A sites ha ve been id entified ( see Table 23) that c urrently h ave a Pati ent Statem ent date o n or after the 26th of the mon th. | |
319 | Moving the Patient S tatement R un date fo r these 17 sites wil l ensure a window at the end o f the imme diate prio r month in which all statement data has been proce ssed for b illing bef ore the ne w consolid ated Patie nt Stateme nt process es are imp lemented ( i.e., PSE Phase 2). | |
320 | The adjust ed Patient Statement run date schedule f or the 17 VistA AR s ites is in dicated in Table 23. | |
321 | ||
322 | Table 23: To Be sche dule of Vi stA Patien t Statemen t run date s | |
323 | Station # | |
324 | Station na me | |
325 | Current bu ild Date | |
326 | Current Pa tient Stat ement Date | |
327 | New build Date | |
328 | New Patien t Statemen t Date | |
329 | 438 | |
330 | SIOUX FALL S,SD | |
331 | 24 | |
332 | 26 | |
333 | 19 | |
334 | 21 | |
335 | 501 | |
336 | ALBUQUERQU E,NM | |
337 | 24 | |
338 | 26 | |
339 | 19 | |
340 | 21 | |
341 | 504 | |
342 | AMARILLO,T X | |
343 | 24 | |
344 | 26 | |
345 | 19 | |
346 | 21 | |
347 | 542 | |
348 | COATESVILL E,PA | |
349 | 24 | |
350 | 26 | |
351 | 19 | |
352 | 21 | |
353 | 562 | |
354 | ERIE,PA | |
355 | 24 | |
356 | 26 | |
357 | 19 | |
358 | 21 | |
359 | 568 | |
360 | FORT MEADE ,SD | |
361 | 24 | |
362 | 26 | |
363 | 19 | |
364 | 21 | |
365 | 649 | |
366 | PRESCOTT,A Z | |
367 | 24 | |
368 | 26 | |
369 | 19 | |
370 | 21 | |
371 | 656 | |
372 | ST. CLOUD, MN | |
373 | 24 | |
374 | 26 | |
375 | 19 | |
376 | 21 | |
377 | 688 | |
378 | WASHINGTON ,DC | |
379 | 24 | |
380 | 26 | |
381 | 19 | |
382 | 21 | |
383 | 756 | |
384 | EL PASO,TX | |
385 | 24 | |
386 | 26 | |
387 | 19 | |
388 | 21 | |
389 | 565 | |
390 | FAYETTEVIL LE,NC | |
391 | 26 | |
392 | 28 | |
393 | 20 | |
394 | 22 | |
395 | 621 | |
396 | MOUNTAIN H OME,TN | |
397 | 26 | |
398 | 28 | |
399 | 20 | |
400 | 22 | |
401 | 658 | |
402 | SALEM,VA | |
403 | 26 | |
404 | 28 | |
405 | 20 | |
406 | 22 | |
407 | 664 | |
408 | SAN DIEGO, CA | |
409 | 26 | |
410 | 28 | |
411 | 20 | |
412 | 22 | |
413 | 671 | |
414 | SAN ANTONI O,TX | |
415 | 26 | |
416 | 28 | |
417 | 20 | |
418 | 22 | |
419 | 689 | |
420 | WEST HAVEN ,CT | |
421 | 26 | |
422 | 28 | |
423 | 20 | |
424 | 22 | |
425 | 740 | |
426 | TEXAS VALL EY COASTAL ,TX | |
427 | 26 | |
428 | 28 | |
429 | 20 | |
430 | 22 | |
431 | Functiona l Requirem ents | |
432 | This secti on identif ies the fe atures and functiona l requirem ents for t he PSE pro ject – Pha se 1. For traceabili ty across project ar tifacts an d the rati onal tools , the foll owing tabl e structur e along wi th a brief descripti on of the fields is identified below. Ta bles are o rganized b y feature: Auto-Corr ection Job , Auto-Cor rection Re port, and Statement Run Date C hanges. | |
433 | Table 24: Descriptio n of Requi rement Spe cification Table | |
434 | Req. Type | |
435 | Requireme nt Type De scription | |
436 | Req. ID | |
437 | This is th e BN, PWS, RSD, or U ser Story (US) uniqu e identifi er. RSD id entifiers begin with an acrony m of ACJ ( Auto-Corre ction Job) , or ACR ( Auto-Corre ction Repo rt). | |
438 | Primary Te xt | |
439 | This is th e requirem ent or use r story te xt. | |
440 | Priority | |
441 | This is th e priority of the re quirement as indicat ed in the PWS. | |
442 | Table 25: Auto-Corre ction Job (ACJ) Requ irements | |
443 | Req. ID | |
444 | Primary Te xt | |
445 | Priority | |
446 | BN1 | |
447 | Manage Vis tA A/R dis crepancies . | |
448 | ||
449 | BN 1.1 | |
450 | The system shall det ect discre pancies th at prevent the patie nt stateme nt process es from su ccessful c ompletion. | |
451 | High | |
452 | US001 | |
453 | As a user, I want th e Accounts Receivabl e applicat ion to det ect and co rrect acco unt balanc e discrepa ncies as p art of nor mal operat ions, so t hat I do n ot have to perform t he task ma nually. | |
454 | ||
455 | ACJ001 | |
456 | The AR app lication s hall execu te Auto-Co rrection f unctionali ty that de tects and remediates the follo wing 2 typ es of disc repancies: | |
457 | Duplicate transactio n | |
458 | Incomplete Transacti on status | |
459 | High | |
460 | BN 1.4 | |
461 | The system shall cor rect the d iscrepancy as part o f normal o perations. | |
462 | ||
463 | ACJ002 | |
464 | The Auto-C orrection functional ity shall be a taske d job that runs in t he backgro und of the Accounts Receivable applicati on. The jo b will be initially scheduled to run eve ry Wednesd ay at 1:00 AM local time, befo re the CCP C job runs . | |
465 | Note: The scheduling may chang e based on how long the job ru ns during site testi ng. | |
466 | High | |
467 | BN 1.6 | |
468 | The system shall cre ate and ex ecute tran sactions r equired to correct F irst Pary AR transac tion discr epancies. | |
469 | High | |
470 | ACJ003 | |
471 | The AR app lication s hall inclu de a VistA menu opti on to exec ute the Au to-Correct ion job, s o that it can be run on demand . There sh all be a u ser prompt indicatin g "Request ed Time To Run: NOW/ " so the u ser can ru n the job immediatel y (NOW) or queue the job to ru n at a fut ure date a nd time. | |
472 | High | |
473 | ACJ004 | |
474 | The AR app lication s hall provi de a new s ecurity ke y to run t he Auto-Co rrection j ob by an o ption. The new secur ity key na me will be PRCA AUTO CRCT PGM. | |
475 | High | |
476 | ACJ005 | |
477 | The Auto-C orrection job shall run after patch inst allation, so that au to-correct ion of dis crepancies begins im mediately. | |
478 | High | |
479 | ACJ006 | |
480 | The Auto-C orrection job shall execute Bu siness Rul es for Bal ancing Acc ounts to d etermine i f an accou nt is in b alance. I f an accou nt include s a bill t hat is cur rently in Refund Rev iew, the account is excluded from the A uto-Correc tion job p rocessing. | |
481 | ||
482 | See Table 26: Busine s Rules fo r Balancin g Accounts (BR) | |
483 | High | |
484 | ACJ008 | |
485 | ||
486 | If a dupli cate “DECR EASE ADJUS TMENT” tra nsaction e xists for an ‘Acitve , ‘Open’, or “Cancel lation’ bi ll in the AR TRANSAC TION file (#433) cau sing a pat ient’s acc ount to be out-of-ba lance, the n the Auto -Correctio n Job shal l correct the out-of -balance c ondition b y setting the INCOMP LETE TRANS ACTION FLA G field (# 10) to a v alue of 1 on the dup licate tra nsaction r ecord. | |
487 | ||
488 | Note: If a transacti on in AR f ile (#433) contains data that is identic al to that of a prev ious trans action, ex cept for t he transac tion numbe r, then th e transact ion is a d uplicate. | |
489 | See Append ix A - Dup licate Tra nsaction e xample | |
490 | High | |
491 | ACJ009 | |
492 | ||
493 | If a trans action in the AR TRA NSACTION f ile (#433) has the I NCOMPLETE TRANSACTIO N FLAG fie ld (#10) s et to 1 fo r any tran saction ty pe other t han a “COM MENT TRANS ACTION” fo r a bill t hat is cur rently ‘Ac tive’ or ‘ Open’, and causes a patient’s account to be out-of -balance, then the A uto-Correc tion Job s hall corre ct the out -of-balanc e conditio n by repla cing the v alue of 1 with a val ue of 0 in the INCOM PLETE TRAN SACTION FL AG field o n the inco mplete tra nsaction r ecord. | |
494 | See Append ix A - Inc omplete St atus examp le | |
495 | High | |
496 | ACJ010 | |
497 | The Auto-C orrection job shall execute bu siness rul es based o n Manual S teps To Re solve Any Discrepanc y to remed iate the f ollowing 2 types of discrepanc ies: | |
498 | Duplicate transactio n | |
499 | Incomplete status | |
500 | ||
501 | If multipl e discrepa ncies exis t within a n out-of-b alance bil l, the Aut o-Correcti on job doe s not atte mpt to bal ance the b ill but in stead mark s all tran saction re cords that have a di screpancy with a rea son of “No t Fixable” . | |
502 | See Append ix B – Man ual Steps To Resolve Any Discr epancy | |
503 | High | |
504 | ACJ014 | |
505 | When an AR billing a ccount is out of bal ance and t he exact t ransaction s within a bill that cause the out of ba lance disc repancy is indetermi nate, the Auto-Corre ction job does not a ttempt to balance th e statemen t but inst ead marks the first transactio n record i n the bill as “Not F ixable”. | |
506 | Note: This “indeterm inate” out -of-balanc e bill wil l be repor ted on wit hin the Au to-Correct ion report . See Requ irement AC R014. | |
507 | High | |
508 | ACJ011 | |
509 | The Auto-C orrection job shall send a Mai lman Notif ication to the ‘PRCA CPS’ Mail group when the job h as complet ed. | |
510 | High | |
511 | ACJ012 | |
512 | When an au thorized A R User ini tiates the Auto-Corr ection job from the VistA menu option, b ut the job is still actively r unning or failed to complete f rom the la st time it was ran, the system shall inf orm the AR user and send a Mai lman Notif ication to the ‘PRCA CPS’ Mail group that the job d id not yet complete from the l ast run of the proce ss. The AR user will be provid ed the cho ice to sta rt another Auto-Corr ection pro cess or qu it from st arting the job again . | |
513 | High | |
514 | ACJ013 | |
515 | When the A uto-Correc tion job i s started from VistA TaskMan, but the jo b is still actively running or failed to complete from the l ast time i t was ran, the syste m shall se nd a Mailm an Notific ation to t he ‘PRCACP S’ Mail gr oup that j ob did not yet compl ete from t he last ru n of the p rocess. | |
516 | High | |
517 | Table 26: Busines Ru les for Ba lancing Ac counts (BR ) | |
518 | Req. ID | |
519 | Primary Te xt | |
520 | Priority | |
521 | BR001 | |
522 | All transa ctions mus t add up t o the Curr ent Balanc e. | |
523 | High | |
524 | BR002 | |
525 | The balanc e for all bills must add up to Current B alance. | |
526 | High | |
527 | BR003 | |
528 | All transa ctions for a bill mu st add up to the Bil l Balance. | |
529 | High | |
530 | BR004 | |
531 | All transa ctions bef ore the la st stateme nt must ad d up to th e Last Sta tement Bal ance. | |
532 | High | |
533 | BR005 | |
534 | All transa ctions aft er the las t statemen t must add up to the New Activ ate Total. | |
535 | High | |
536 | BR006 | |
537 | The Last s tatement B alance + t he New Act ivate Tota l = Curren t Balance. | |
538 | High | |
539 | Table 27: Auto-Corre ction Repo rt (ACR) R equirement s | |
540 | Req. ID | |
541 | Primary Te xt | |
542 | Priority | |
543 | PWS 1.2 | |
544 | The system shall tra ck identif ied discre pancies. | |
545 | High | |
546 | US002 | |
547 | As a VistA user, I w ant to tra ck the 2 m ajor types of accoun t balance discrepanc ies in the Accounts Receivable applicati on, so tha t the corr ect patien t statemen t data are transmitt ed to the AITC. | |
548 | High | |
549 | ACR001 | |
550 | The AR app lication s hall creat e an Auto- Correction report th at tracks the follow ing 2 type s of balan ce discrep ancies: | |
551 | Duplicate transactio n | |
552 | Incomplete status | |
553 | High | |
554 | BN 1.3 | |
555 | Ensure tha t the proc ess to cre ate the ‘S tatement D iscrepancy Listing’ remains an d any enha ncements a re perform ed to this report. | |
556 | High | |
557 | ACR002 | |
558 | The Auto-C orrection Report sha ll list th e discrepa ncy detail s that wer e remediat ed by the Auto-corre ction job and displa y a reason for auto- correction . | |
559 | High | |
560 | US003 | |
561 | As a VistA user, I w ant the Vi stA System to identi fy and cat alog accou nt balance discrepan cies that could not be remedia ted by the Auto-Corr ection Job with an e xplanation so that t he found d iscrepanci es can be viewed and manually corrected. | |
562 | High | |
563 | BN 1.5 | |
564 | The system shall ide ntify and catalog an y discrepa ncies not corrected for viewin g and manu al correct ive action . | |
565 | ||
566 | ACR003 | |
567 | The Auto-C orrection Report sha ll list th e discrepa ncy detail s that cou ld not be remediated by the Au to-Correct ion job an d display “Not Fixab le” as the reason wh y the disc repancy (o r discrepa ncies) cou ld not be resolved t hrough the auto corr ection bat ch process . | |
568 | High | |
569 | BN 1.7 | |
570 | The system shall rec ord all va lues assoc iated to t he discrep ancy for u se in root cause ana lysis (aud iting). | |
571 | ||
572 | ACR012 | |
573 | The Auto-C orrection report sha ll record audit valu es associa ted with r emediating the discr epancy. | |
574 | ||
575 | BN 1.8 | |
576 | Provide a Post Initi alization Utility th at shall r ecord all balance di screpancie s that req uire manua l remediat ion as wel l as discr epancies t hat were b alanced au tomaticall y to an ou tcome repo rt. The ab ility to r un the rep ort via an option mu st be prov ided. | |
577 | ||
578 | ACR004 | |
579 | The Auto-C orrection Report sha ll display only the last 4 dig its of the Social Se curity Num ber (SSN). | |
580 | High | |
581 | ACR005 | |
582 | The AR app lication s hall promp t the user to enter a FROM and TO date f or the Aut o-Correcti on Report. | |
583 | High | |
584 | ACR006 | |
585 | The Auto-C orrection Report sha ll provide a default FROM date value of “T-7”. | |
586 | High | |
587 | ACR007 | |
588 | The Auto-C orrection Report sha ll provide a default TO date v alue of “T ”. | |
589 | High | |
590 | ACR008 | |
591 | The AR app lication s hall promp t the user to sort t he Auto-Co rrection R eport by t he followi ng paramet ers: | |
592 | Bill numbe r | |
593 | Debtor nam e | |
594 | Transactio n number | |
595 | Auto Corre ction Date | |
596 | See Append ix A – Aut o-Correcti on Report | |
597 | High | |
598 | ACR009 | |
599 | The Auto-C orrection report sha ll display the follo wing infor mation wit h correspo nding head ers: | |
600 | BILL NO. | |
601 | DEBTOR | |
602 | SSN | |
603 | TRANS NUM | |
604 | AUTO-CORCT DATE | |
605 | AUTO-CORCT REASON | |
606 | See Append ix A – Aut o-Correcti on Report | |
607 | High | |
608 | ACR010 | |
609 | The Auto-C orrection report mai n header s hall read: | |
610 | “BILLS THA T HAVE BEE N AUTO-COR RECTED” | |
611 | See Append ix A – Aut o-Correcti on Report | |
612 | High | |
613 | ACR011 | |
614 | The Auto-C orrection report wil l have the following menu path : | |
615 | ||
616 | Clerk’s AR Menu: | |
617 | Account Ma nagement | |
618 | Auto-Corre ct Patient Discrepan cy Report | |
619 | See Append ix A – Aut o-Correcti on Report | |
620 | High | |
621 | ACR013 | |
622 | The Auto-C orrection Report sha ll pause a nd display a “Contin ue” prompt at the en d of the r eport page if the re port needs to span t o another screen on the VistA user inter face. | |
623 | Note: The output of the Auto- Correction Repot def aults to d isplay on the user’s screen, b ut can be queued to a network printer or to VistA MailMan. | |
624 | High | |
625 | ACR014 | |
626 | When the A uto-Correc tion job f inds a bil l that is out-of-bal ance, but the exact transactio n (or tran sactions) that are t he cause o f the disc repancy wi thin the b ill cannot be determ ined, the Auto-Corre ction Repo rt will in clude the bill numbe r in the r eport, dis play the r eason as “ Not Fixabl e” and lea ve the tra nsaction n umber blan k for the out-of-bal ance bill. | |
627 | High | |
628 | Table 28: Patient St atement Ch ange Date Requiremen ts | |
629 | Req. ID | |
630 | Primary Te xt | |
631 | Priority | |
632 | BN3 | |
633 | Consolidat e patient statement( s) within a single b illing cyc le | |
634 | High | |
635 | BN 3.3 | |
636 | The system shall gen erate a co nsolidated statement combining all activ e outstand ing accoun t charges (regardles s of the V A facility ) based on the Veter an's billi ng cycle. | |
637 | High | |
638 | US004 | |
639 | As a VistA user, I w ant my Vis tA site to build and transmit patient bi lling stat ement file s that are sent to A ITC prior to the 26t h of each month so t hat when c onsolidate d patient statement functional ity is imp lemented t here is a window at the end of the prior month whe n all stat ement data has been processed for billin g. | |
640 | ||
641 | Refer to T able 23 fo r the 17 S tation num bers to be modified for statem ent run da tes. | |
642 | High | |
643 | Table 29: Transactio n Discrepa ncy Root C ause Remed iation Req uirements | |
644 | Req. ID | |
645 | Primary Te xt | |
646 | Priority | |
647 | US005 | |
648 | As a VistA user, I w ant the Vi stA AR sys tem to rem ediate the identifie d root cau se of crea ting dupli cate trans action dis crepancies in First Party bill ing so tha t the Vete ran’s mont hly billin g statemen ts are not delayed i n the norm al monthly printing process. | |
649 | High | |
650 | US006 | |
651 | As a VistA user, I w ant the Vi stA AR sys tem to rem ediate the identifie d root cau se of crea ting Missi ng (NULL) transactio n amount d iscrepanci es in Firs t Party bi lling so t hat the Ve teran’s mo nthly bill ing statem ents are n ot delayed in the no rmal month ly printin g process. | |
652 | High | |
653 | US007 | |
654 | As a VistA user, I w ant the Vi stA AR sys tem to rem ediate the identifie d root cau se of crea ting Incom plete tran saction di screpancie s in First Party bil ling so th at the Vet eran’s mon thly billi ng stateme nts are no t delayed in the nor mal monthl y printing process. | |
655 | High | |
656 | ||
657 | Graphical User Inter face (GUI) Specifica tions | |
658 | Not appli cable. | |
659 | Multi-divi sional Spe cification s | |
660 | No new mu lti-divisi onal speci fications are being introduced in PSE Ph ase 1. | |
661 | Performanc e Specific ations | |
662 | The follow ing specif ications w ere provid ed in the NSR 201007 16 (CCPC) Patient St atement En hancements and Conso lidation B RD-3-18-15 : DNS | |
663 | Table 210: Performan ce Specifi cations | |
664 | If this is a system modificati on, how ma ny users d oes the cu rrent syst em support ? | |
665 | The curren t system i s used by Customer S ervice Rep resentativ es and CPA C Staff in the suppo rt of Vete ran. | |
666 | In the cur rent syste m: | |
667 | Accounts r eceivable data is up loaded to the VistA AR package for charg es for Vet eran medic al care fo r each Vet eran who r eceives ca re. | |
668 | Customer s ervice rep resentativ es access the VistA AR module when a Vet eran calls in with a question about thei r account. The estim ated numbe r of custo mer servic e represen tatives us ing the Vi stA AR mod ule is 1,2 00. | |
669 | Once a mon th, billin g data is sent from each of th e 100+ Vis tA systems for each Veteran wh o has incu rred charg es at that site. The statement s are then created, printed an d sent out . Many Vet erans get bills from more than one site. Approxima tely 2 mil lion state ments are mailed eac h month. | |
670 | How many u sers will the new sy stem (or s ystem modi fication) support? | |
671 | The number of curren t system u sers will be the sam e for the modified s ystem. | |
672 | What is th e predicte d annual g rowth in t he number of system users? | |
673 | It is esti mated that the trans action vol ume may gr ow an addi tional 5-1 0% in the first year , but the number of users will not grow. | |
674 | Actual dat a provided for the n umber of U nique SSN / First Pa rty Collec tions (Pre scription, Inpatient /Outpatien t, and Lon g Term Car e) by Fisc al Year (F Y): Approx imately 20 0K get mul tiple stat ements per month. | |
675 | Quality At tributes S pecificati on | |
676 | Quality at tribute sp ecificatio ns will en hance the supportabi lity, main tainabilit y, portabi lity, test ability, a nd reusabi lity of th e PSE proj ect. This includes a pplicable coding sta ndards, na ming conve ntions, cl ass librar ies, maint enance acc ess, and m aintenance utilities . The qual ity attrib utes speci fications are achiev ed by the accepted d esign of t he Patient Statement enhanceme nts. | |
677 | Reliabilit y Specific ations | |
678 | VistA AR s hould be a vailable 2 4 hours pe r day, 365 days per year, exce pt during periods of scheduled maintenan ce. | |
679 | Scope Inte gration | |
680 | Additional scope spe cification s and inte gration ar e not appl icable to Phase I de velopment. | |
681 | Security S pecificati ons | |
682 | VA require s that app lication e nhancement s address standards, procedure s, and tec hnical asp ects of th e solution required for achiev ing system certifica tion and a ccreditati on. These should add ress contr ols listed in Federa l Informat ion Proces sing Stand ards (FIPS ) PUB 200, Minimum S ecurity Re quirements for Feder al Informa tion and I nformation Systems. Additional security specificat ions inclu de: | |
683 | Compliance with stan dards and regulatory requireme nts publis hed in VA Handbook a nd Directi ve 6500: V eterans Af fairs Dire ctives > V A Handbook and Direc tive 6500. | |
684 | Compliance with FIPS PUB 140-2 , Security Requireme nts for Cr yptographi c Modules, and for a ll voice a nd data tr affic encr yption: Co mputer Sec urity Divi sion > Pub lications > Federal Informatio n Processi ng Standar ds > FIPS PUB 140-2. | |
685 | Additional ly, due to patient s afety cons iderations , data pro tection me asures suc h as backu p interval s and redu ndancy sha ll be cons istent wit h systems categorize d as criti cal. | |
686 | System Fea tures | |
687 | Refer to S ection 2.6 .5 for the details o f all incl uded funct ionality. | |
688 | Usability Specificat ions | |
689 | There are no enhance ments bein g made to the VistA applicatio n during P hase 1 tha t affect h ow the sys tem is acc essed or o perated by users. PS E shall ut ilize As-I s componen ts and exi sting func tionality for user a ccess, sec urity and usability. | |
690 | Purchased Components | |
691 | The PSE p roject doe s not have purchased component s for Phas e 1. | |
692 | ||
693 | ||
694 | Approval S ignatures | |
695 | ||
696 | REVIEW DAT E: <date> | |
697 | SCRIBE: <n ame> | |
698 | ||
699 | Signed: __ __________ __________ __________ __________ __________ __________ __________ ______ | |
700 | Integrated Project T eam (IPT) ChairDate | |
701 | ||
702 | ||
703 | __________ __________ __________ __________ __________ __________ __________ ________ | |
704 | Business S ponsorDate | |
705 | ||
706 | __________ __________ __________ __________ __________ __________ __________ ________ | |
707 | IT Program ManagerDa te | |
708 | ||
709 | ||
710 | __________ __________ __________ __________ __________ __________ __________ ________ | |
711 | Project Ma nagerDate | |
712 | ||
713 | ||
714 | ||
715 | Appendix A : Discrepa ncy Exampl es | |
716 | Appendix A provides examples o f the new menu optio ns, report s and sort ing capabi lities, an d MailMan Notificati ons. | |
717 | ||
718 | Figure 2: Auto-Corre ction Job and Report Menu Opti ons | |
719 | ||
720 | ||
721 | Figure 3: Notificati on to AR U ser when j ob is stil l actively running | |
722 | ||
723 | ||
724 | Figure 4: MailMan no tification when Auto -Correctio n job is s till activ ely runnin g | |
725 | ||
726 | ||
727 | Figure 5: Auto-Corre ction Repo rt Options | |
728 | ||
729 | Figure 6: Auto-Corre ction Repo rt Option Selection Example | |
730 | ||
731 | Figure 7: Auto-Corre ction Repo rt: Sorted by Bill N umber | |
732 | ||
733 | ||
734 | Figure 8: Auto-Corre ction Repo rt: Sorted by Debtor Name | |
735 | ||
736 | Figure 9: Auto-Corre ction Repo rt: Sorted by Auto C orrection Date | |
737 | ||
738 | Figure 10: Auto-Corr ection Rep ort: Sorte d by Trans action Num ber | |
739 | ||
740 | Figure 11: Missing T ransaction Amount – Screen 1 | |
741 | ||
742 | Figure 12: Missing T ransaction Amount – Screen 2 | |
743 | ||
744 | Figure 13: Missing T ransaction Amount – Screen 3 | |
745 | ||
746 | ||
747 | Figure 14: Duplicate Transacti on – Scree n 1 | |
748 | ||
749 | ||
750 | Figure 15: Duplicate Transacti on – Scree n 2 | |
751 | ||
752 | ||
753 | Figure 16: Duplicate Transacti on – Scree n 3 | |
754 | ||
755 | ||
756 | ||
757 | Figure 17: Incomplet e Status – Screen 1 | |
758 | ||
759 | ||
760 | ||
761 | Figure 18: Incomplet e Status – Screen 2 | |
762 | ||
763 | ||
764 | Figure 19: Incomplet e Status-S creen 3 | |
765 | ||
766 | Appendix B – Manual Steps to R esolve Any Discrepan cy | |
767 | ||
768 | Check Pati ent Accoun t Balance. | |
769 | Run Transa ction Pati ent Statem ent Histor y. | |
770 | Discrepanc ies occur since last statement ? Statemen t printed in previou s month. | |
771 | Look for t he amount that is ou t of balan ce. | |
772 | Look at th e type of transactio n. | |
773 | Look at th e Bill Tra nsactions. | |
774 | Reconcile the new ac tivity. | |
775 | Reconcile the statem ent data. | |
776 | Preform th e correcti ons. | |
777 | For duplic ate transa ctions, se t the INCO MPLETE TRA NSACTION F LAG in fil e 433,10. | |
778 | For a miss ing transa ction amou nt, set th e Transact ion amount if in fil e 433. | |
779 | For INCOMP LETE TRANS ACTION FLA G that are causing t he discrep ancy, remo ve the fla g in file 433,10. | |
780 | Verify by Check Pati ent accoun t Balance. | |
781 | ||
782 | Appendix C – TO BE D iagram for Auto-Corr ection | |
783 | ||
784 | ||
785 | Figure 20: Patient S tatement D eficiency Resolution To-Be Pro cess Diagr am | |
786 |
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