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| # | Location | File | Last Modified |
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| 1 | eInsurance_Build_17_IB_2_601.zip | TAS+USIN-040+Transmit+Source+of+Information+Codes.docx | Wed Nov 8 18:21:08 2017 UTC |
| 2 | eInsurance_Build_17_IB_2_601.zip | TAS+USIN-040+Transmit+Source+of+Information+Codes.docx | Wed Dec 6 21:35:59 2017 UTC |
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| 1 | User Story Number: U SIN-040 | |
| 2 | User Story Name: Tra nsmitting Source of Informatio n Codes | |
| 3 | Priority: (High, Med ium, Low) High | |
| 4 | Rational I D: (to be added late r) | |
| 5 | (Product B acklog ID: 73) | |
| 6 | Service Re quest Numb er: | |
| 7 | Author: eI nsurance | |
| 8 | ||
| 9 | Background (If helpf ul, otherw ise delete ) | |
| 10 | The electr onic insur ance verif ication (e IV) softwa re obtains informati on from th e VistA Bu ffer File, sends HL7 messages to Financi al Service s Center ( FSC) to cr eate eligi bility ben efits inqu iries, and receives HL7 messag es in retu rn carryin g eligibil ity benefi ts respons es. (aka: HIPAA 270 /271 trans actions). Each “buf fer” entry created i n file 355 .33 (the t emporary h olding tan k of data) has a Sou rce of Inf ormation ( SOI) code associated with it. This code tells the user comm unity how the inform ation was obtained. | |
| 11 | ||
| 12 | FSC conduc ts data an alysis but has no kn owledge of originati on. Since there is a SOI code on each e ntry, we w ant to sen d that SOI code to F SC. This code will be used by FSC for d ata analys is and wil l NOT be s ent forwar d to the c learinghou se. | |
| 13 | ||
| 14 | Story | |
| 15 | As the eIV business owner, I w ant the ou tbound HL7 message c arry the ‘ Source of Informatio n’ code fr om each bu ffer entry to FSC so that bett er data an alysis can occur. | |
| 16 | ||
| 17 | Conversati on | |
| 18 | There are many sourc es from wh ich a buff er file ca n be creat ed. Many times we h ave had th e need to trace entr ies made f rom proble matic sour ces; howev er, we do not have t hat capabi lity in th e current VistA soft ware. We need to cr eate and u se a new s egment/ele ment in th e HL7 mess age to sen d the SOI code on ea ch buffer entry to F SC. Even though thi s element is not req uired by t he HIPAA g uides, not only woul d FSC be a ble to com plete addi tional dat a analysis , but also would hav e increase d data rep orting so that sites , VISNs, a nd CPACs m ay identif y any buff er file en try issues that coul d be the f ault of th e ‘Source of Informa tion’. | |
| 19 | ||
| 20 | The busine ss flow wi ll not cha nge based on this us er story. FSC will need a lis t of SOI c odes to co nduct addi tional dat a analysis . The ema il below p rovides a complete l ist. | |
| 21 | ||
| 22 | Technical Note: Sour ce of Info rmation fi le is #355 .12, Buffe r pointer is #355.33 ,.03 | |
| 23 | The develo pment team will rese arch the f ield that will be us ed for the SOI code. A ZSEGME NT may nee d to be ad ded or the re may be an existin g field in a standar d HL7 mess age. The details wi ll be addr essed duri ng design. The SOI needs to b e included on the 27 0 inquiry but not th e 271 resp onse. | |
| 24 | It is poss ible that some sites may have added code s. The te am is not concerned about the potential additions. | |
| 25 | ||
| 26 | During pat ch install ation, inc rement the Interface version n umber; coo rdinate wi th FSC to implement. | |
| 27 | ||
| 28 | After Patc h deployme nt, we wil l need to go through patch reg istration process an d the eIns urance tea m would li ke to cont inue the u se of auto mated regi stration a s part of the patch install. | |
| 29 | ||
| 30 | ||
| 31 | Detailed L isting of Acceptance Criteria | |
| 32 | Requiremen t ID | |
| 33 | Descriptio n | |
| 34 | External D ependency | |
| 35 | (Y/N) | |
| 36 | If Y, prov ide organi zation and descripti on | |
| 37 | USIN-040.0 1 | |
| 38 | VistA tran smits the appropriat e source o f informat ion code o n the outb ound HL7 i nquiry | |
| 39 | ||
| 40 | USIN-040.0 2 | |
| 41 | FSC receiv es the sou rce of inf ormation c ode in the HL7 inqui ry | |
| 42 | ||
| 43 | USIN-040.0 3 | |
| 44 | FSC saves the source of inform ation code in the st atistical database ( along with other dat a from mes sages) | |
| 45 | Yes, FSC | |
| 46 | USIN-040.0 4 | |
| 47 | Source of Informatio n is not i ncluded in the trans action tha t goes in the X12 me ssage to C learinghou se from FS C | |
| 48 | Yes, FSC | |
| 49 | ||
| 50 | Tester Not es | |
| 51 | Buffer ent ries with any source of inform ation can be manuall y generate d using Pr ocess Insu rance Buff er menu; a dd entry o ption. | |
| 52 | User will need the I B INSURANC E SUPERVIS OR securit y key for testing. | |
| 53 | Use a pati ent that i s transmit ted to FSC during Ba y Pines te sting. | |
| 54 | The appoin tment extr act (IBCNE IIV NIGHT LY PROCESS ) doesn’t make buffe r entries prior to t ransmissio n to FSC; the entrie s SOI defa ult to “eI V”. | |
| 55 | ||
| 56 | Constraint s | |
| 57 | Requires F SC coding change, da tabase cha nge, and t esting. | |
| 58 | Requires V istA HL7 t eam approv al. | |
| 59 | ICD will n eed to be updated. | |
| 60 | Implement this user story at t he same ti me or afte r USIN-71. | |
| 61 | ||
| 62 | Assumption s | |
| 63 | FSC is ava ilable to receive ne w informat ion. | |
| 64 | FSC can sa ve new inf ormation. | |
| 65 | FSC will n ot change the proces s of trans action pro cessing at this time , but may make futur e changes based on n ew informa tion. | |
| 66 | The eIV HL 7 transact ion versio n number w ill need t o be chang ed. | |
| 67 | Will need to go thro ugh patch registrati on process . | |
| 68 | HL7 approv es use of generic se gment to c arry propr ietary dat a. | |
| 69 | Assure tha t multiple version o f HL7 can run concur rently (Re fer to IB5 49 patch). | |
| 70 | Every Vist A database has the s ame Source of Inform ation code s with the same IEN numbers as signed to values. | |
| 71 | ||
| 72 | Risks | |
| 73 | By not imp lementing this featu re, FSC an d eInsuran ce will be unable to perform s ource of i nformation analysis. | |
| 74 | Dependent on HL7 tea m approval . | |
| 75 | An individ ual site m ay have ad ded to the Source of Informati on codes; although s ites shoul d not chan ge this di ctionary. | |
| 76 | ||
| 77 | Approval S ignatures | |
| 78 | ||
| 79 | ||
| 80 | ||
| 81 | ||
| 82 | Revision H istory | |
| 83 | Date | |
| 84 | Version | |
| 85 | Descriptio n | |
| 86 | Author | |
| 87 | CM Version | |
| 88 | 10/18/2016 | |
| 89 | v0.01 | |
| 90 | Original | |
| 91 | eInsurance | |
| 92 | 1.0 | |
| 93 | 10/18/2016 | |
| 94 | V0.02 | |
| 95 | Edits by e Insurance | |
| 96 | eInsurance | |
| 97 | 2.0 | |
| 98 | 10/19/2016 | |
| 99 | V0.03 | |
| 100 | Group Edit in Elabor ation Sess ion | |
| 101 | Julie Mann | |
| 102 | 3.0 | |
| 103 | 11/4/2016 | |
| 104 | V.0.04 | |
| 105 | Changes pe r USD&P me eting | |
| 106 | Cindy Fawc ett | |
| 107 | 4.0 | |
| 108 | 11/9/2016 | |
| 109 | V1.0 | |
| 110 | Final vers ion for su bmission | |
| 111 | Team Leido s | |
| 112 | 5.0 | |
| 113 | 11/21/2016 | |
| 114 | V2.0 | |
| 115 | Incorporat e edits fr om rejecti on | |
| 116 | Cindy Fawc ett | |
| 117 | 6.0 |
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