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| # | Location | File | Last Modified |
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| 1 | eInsurance_Build_17_IB_2_601.zip | TAS+eIns+USIN-062+Processing+MAD+and+MUP+Messages.docx | Wed Nov 8 18:20:10 2017 UTC |
| 2 | eInsurance_Build_17_IB_2_601.zip | TAS+eIns+USIN-062+Processing+MAD+and+MUP+Messages.docx | Wed Dec 6 21:35:07 2017 UTC |
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| 1 | User Story Number: U SIN-62 | |
| 2 | User Story Name: Pro cessing MA D & MUP Me ssages (FS C Developm ent) | |
| 3 | Product Ba cklog ID: 62 | |
| 4 | Backlog Pr iority: (H igh, Mediu m, Low) Hi gh Sizing 8 | |
| 5 | Initial Si zing Estim ate: | |
| 6 | Rational I D: | |
| 7 | Author: eI nsurance T eam | |
| 8 | Background | |
| 9 | When the F inancial S ervices Ce nter (FSC) sends an Electronic Insurance Verificat ion (eIV) table upda te to Vist A, FSC is not notifi ed if Vist A is unava ilable or is unable to process the table update. The ePharm acy packag e sends ac knowledgem ent messag es to FSC when table updates a re receive d. The eIV package s hould foll ow this sa me process to ensure communica tion with FSC. | |
| 10 | If FSC sen ds an eIV ADD messag e that isn ’t process ed by the eIV packag e, a subse quent upda te message cannot be processed either. | |
| 11 | Currently the FSC sy stem does not resend eIV table updates t o VistA un less reque sted by th e eInsuran ce team. T he eIV pac kage does not acknow ledge FSC table mess ages at al l. | |
| 12 | This lack of communi cation bet ween the e IV package and FSC h as caused a long sta nding issu e. We wan t to imple ment stand ard HL7 ac knowledgem ents. | |
| 13 | Story | |
| 14 | As the eIV VistA pac kage, I wa nt to ackn owledge eI V table up dates from FSC so FS C can rese nd updates as needed to keep e IV tables in synch w ith FSC’s master dat a source. | |
| 15 | Conversati on | |
| 16 | ePharmacy is sending HL7 ackno wledgement s (ACK), b oth Applic ation ACK and Commit ACK. The acknowled gements se rve differ ent purpos es. The C ommit ACK indicates that VistA received the HL7 me ssage. Th e Applicat ion ACK co nfirms ePh armacy pro cessing wi th a respo nse to ind icate succ ess (ACK) or failure (NAK) in processing . For ePh armacy, ta ble update s are put into a seq uential qu eue. When the sendi ng system gets a suc cessful Ap plication ACK, the n ext messag e in queue is sent f rom FSC. Multiple e rror codes and corre ctive acti ons were i mplemented for ePhar macy. ePh armacy als o has a ma ximum numb er of retr ies. If th e maximum number of retries is hit for a n ePharmac y update, then FSC s kips the m essage. | |
| 17 | Technical note: ple ase see wh at max is set to for ePharmacy and mimic . | |
| 18 | ||
| 19 | eIV wants to impleme nt the sam e flow tha t ePharmac y has impl emented. There are no sequent ial depend encies in eIV. Sinc e there is no depend ency, mult iple error codes and correctiv e actions may not be necessary . | |
| 20 | ||
| 21 | The eInsur ance team is comfort able with skipping m essage if applicatio n ACK is n ot receive d in 3 day s. The nu mber of at tempts wil l be a par ameter for FSC. | |
| 22 | ||
| 23 | Technical Note: For the eBilli ng patch 5 17, they d o applicat ion acks. | |
| 24 | Technical Note: Deve loper: loo k at ibcne hlt (from Darlene), Make sure that we on ly send AC K for Succ essful tra nsactions | |
| 25 | Initially, error cod es will no t be neces sary. Err or codes w ill only b e included for this user story if determ ined neces sary durin g tech ana lysis. If error cod es are nec essary, th is user st ory will b e revised. | |
| 26 | FSC will n ot take an y action b ased on co mmit ACK b ut will mo nitor for applicatio n ACK. FS C will kee p the mess age in que ue until t he applica tion ACK i s received or until the maximu m days and attempts are hit, a s defined by paramet ers. | |
| 27 | There is s pecific di scussion a bout the P ayer Table in this u ser story because th e Payer Ta ble is mos t often im pacted. T his user s tory appli es to all VistA tabl es maintai ned by FSC . The fol lowing ema il contain s informat ion on the tables th at are aff ected. | |
| 28 | ||
| 29 | Discussion : Payer Ta ble | |
| 30 | As part of the curre nt process , a user m ust ask FS C to resen d files wh en VistA i s out of s ynch with FSC. There isn’t a g ood way to know the eIV tables are out o f synch. Only FSC k nows if ta ble update s are not accepted b y a VistA site. | |
| 31 | Implement the follow ing change s: | |
| 32 | ||
| 33 | VistA will send an H L7 acknowl edgement t o FSC to i ndicate th e message has been r eceived in VistA (Co mmit ACK). | |
| 34 | The eIV pa ckage will send ackn owledgemen t when the message i s processe d successf ully (Appl ication AC K). A NAK will be s ent if the message i s not proc essed succ essfully. | |
| 35 | If the ack nowledgmen t indicate s failure (NAK) | |
| 36 | FSC should resend th e message, stopping after a ma ximum numb er of retr ies. | |
| 37 | The maximu m number o f tries wi ll be stor ed in a pa rameter by FSC. | |
| 38 | After the maximum nu mber of re tries, FSC removes t he message from queu e and send s an email notificat ion to the eInsuranc e team usi ng an Outl ook mail g roup: VHAE INSURANCER R@VA.GOV. | |
| 39 | If FSC doe s not rece ive a resp onse from eIV within a specifi ed number of days, F SC will tr eat lack o f response as NAK. The number of days w ill be sto red in a p arameter b y FSC. | |
| 40 | During pat ch install ation, inc rement the Interface version n umber; coo rdinate wi th FSC to implement. | |
| 41 | Detailed L isting of Acceptance Criteria | |
| 42 | Requiremen t ID | |
| 43 | Descriptio n | |
| 44 | External D ependency | |
| 45 | (Y/N) | |
| 46 | If Y, prov ide organi zation and descripti on | |
| 47 | USIN-1.01 | |
| 48 | FSC sends table upda te to Vist A. | |
| 49 | ||
| 50 | USIN-1.02 | |
| 51 | VistA gene rates a co mmit ACK a nd sends t o FSC. | |
| 52 | ||
| 53 | USIN-1.03 | |
| 54 | VistA proc esses the transactio n table up date and g enerates a n Applicat ion ACK an d sends to FSC | |
| 55 | ||
| 56 | USIN-1.04 | |
| 57 | FSC sends a table up date to Vi stA and Vi stA is not available to respon d. No comm it ACK is sent to FS C. Verify that FSC will treat lack of r esponse as a NAK wit hin specif ied number of days. | |
| 58 | ||
| 59 | USIN-1.05 | |
| 60 | FSC Sends table upda te to Vist A and Vist A generate s Commit A CK, but se nds an app lication N AK. FSC w ill try se veral time s accordin g to the s ystem para meter, the n move to next recor d in queue . After ma x number o f retries, failed re cord is te rminated a nd notific ation is s ent to eIn surance te am via Out look email . | |
| 61 | ||
| 62 | USIN-1.06 | |
| 63 | FSC Sends table upda te to Vist A and Vist A generate s Commit A CK, but Vi stA cannot successfu lly proces s the reco rd change and sends NAK to FSC . FSC pro ceeds with processin g next tra nsaction i n queue. | |
| 64 | ||
| 65 | Tester Not es: | |
| 66 | This chang e can only be tested between F SC and Vis tA (standa rd end use r tester c annot do i t). | |
| 67 | During IOC , this cha nge can on ly be test ed in a pr oduction a ccount. F SC does no t communic ate with M IRROR acco unts. | |
| 68 | This chang e can be t ested in t est lab en vironment such as Ba y Pines (C IT, SQA, U AT). | |
| 69 | To see the results o f a MAD or MUP messa ge in a Vi stA table, assistanc e is neede d from a V istA devel oper. | |
| 70 | Constraint s | |
| 71 | FSC and Vi stA develo pment is r equired. | |
| 72 | This user story shou ld go into the same build as u ser story USIN-359: Treat MUP messages as MAD mes sages. | |
| 73 | Risks | |
| 74 | If we don’ t do this work, cert ain sites will have multiple t ables with different values th at can cau se transac tion issue s. | |
| 75 | Assumption s | |
| 76 | This chang e also req uires a co de change at FSC. | |
| 77 | This user story appl ies to all FSC updat es pertain ing to eIV . | |
| 78 | Clearingho uses and p ayers are not involv ed in this process. | |
| 79 | Table entr y missing from VistA is only o ccurring w hen VistA does not r eceive the message f rom FSC. | |
| 80 | Table upda te is not successful ly process ed in Vist A only occ urs when V istA does not receiv e the mess age from F SC. | |
| 81 | After init ial testin g, this ca pability o f continuo usly resen ding a mes sage that was not ac knowledged will only occur for FSC’s Eli gibility C ommunicato ry (EC) pr oduction a ccount. | |
| 82 | This user story is r elated to user story USIN-359: Treat MUP messages as MAD mes sages. | |
| 83 | Approval S ignatures | |
| 84 | ||
| 85 | ||
| 86 | ||
| 87 | ||
| 88 | Revision H istory | |
| 89 | Date | |
| 90 | Version | |
| 91 | ||
| 92 | Descriptio n | |
| 93 | Author | |
| 94 | 09/22/2016 | |
| 95 | V0.1 | |
| 96 | ||
| 97 | Original | |
| 98 | PII | |
| 99 | 09/22/2016 | |
| 100 | V0.2 | |
| 101 | ||
| 102 | Developer elaboratio n | |
| 103 | PII | |
| 104 | 09/27/2016 | |
| 105 | V0.3 | |
| 106 | ||
| 107 | eInsurance finalizat ion | |
| 108 | PII | |
| 109 | 10/25/2016 | |
| 110 | V0.4 | |
| 111 | ||
| 112 | Edits from meeting r eview | |
| 113 | PII | |
| 114 | 11/4/2016 | |
| 115 | V0.5 | |
| 116 | ||
| 117 | Incorporat e changes from USD&P review | |
| 118 | PII |
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