2. EPMO Open Source Coordination Office Redaction File Detail Report

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2.1 Files compared

#	Location	File	Last Modified
1	PSE_v22_PRCA4.5307.zip\PSE_v22_PRCA4.5307\CIF_VistA_Feb_2017	PSE RSD Phase 01 Incr01 v1.19.docx	Thu Feb 23 20:48:18 2017 UTC
2	PSE_v22_PRCA4.5307.zip\PSE_v22_PRCA4.5307\CIF_VistA_Feb_2017	PSE RSD Phase 01 Incr01 v1.19.docx	Tue Feb 28 14:50:36 2017 UTC

2.2 Comparison summary

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Changed	6	34
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2.3 Comparison options

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2.5 Comparison detail

	1	Patient St atement En hancements (PSE) Dis crepancies (Incremen t 1, Phase 1) Requir ements Spe cification Document
	2
	3
	4
	5
	6
	7	December 2 016
	8
	9	Version 1. 18
	10
	11
	12
	13	Department of Vetera ns Affairs
	14
	15	Revision H istory
	16
	17	Note: The revision h istory cyc le begins once chang es or enha ncements a re request ed after t he
	18	Requiremen ts Specifi cation Doc ument has been base- lined.
	19
	20	Date
	21	Version
	22	Descriptio n
	23	Author
	24	12/12/2016
	25	1.18
	26	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. (C R #429994)
	27
	28
	29	Updated se ction 2.6. 1 and requ irements A CJ001, ACJ 010, ACR00 1, and rem oved ACJ00 7 to exclu de Missing Amount Di screpancie s fixes. ( CR #432565 )
	30	Ray Mattes on
	31	11/29/2016
	32	1.17
	33	Updated re quirement ACJ006 to exclude Re fund Revie ws from Au to-Correct ion. (CR # 425119)
	34	Ray Mattes on
	35	10/31/2016
	36	1.16
	37	Added requ irements A CJ014 and ACR014 to account fo r and repo rt on inde terminate bill discr epancies. (CR #42999 4)
	38	Ray Mattes on
	39	10/20/2016
	40	1.15
	41	Added user stories U S005, US00 6, and US0 07 to expl icitly sta te the tra nsaction d iscrepancy remediati on require ments.
	42	Ray Mattes on
	43	10/3/2016
	44	1.14
	45	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 )
	46
	47
	48	Added requ irements A CJ012 and ACJ013 to handle Aut o-Correcti on batch j ob failure reporting . (CR #385 933)
	49
	50
	51	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)
	52	Ray Mattes on
	53	8/1/2016
	54	1.13
	55	Added Vist A AR Patie nt Stateme nt run dat e change f unctional requiremen ts.
	56	Ray Mattes on
	57	05/27/2016
	58	1.12
	59	Updated in troduction
	60	Shawnee Bl air
	61	4/13/2016
	62	1.11
	63	Updated AC J002 to re flect the initial sc hedule of the Auto-C orrection Job.
	64	Diana Coll ins
	65
	66
	67
	68
	69
	70
	71	Patient St atement En hancements (Phase 1)
	72	Requiremen ts Specifi cation Doc umentiDece mber 2016
	73
	74
	75	Date
	76	Version
	77	Descriptio n
	78	Author
	79	3/29/2016
	80	1.10
	81	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.
	82	Updated co ver sheet title.
	83	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.)
	84	Randy Maje wski
	85	3/17/2016
	86	1.09
	87	Update sec tion 2.6.3 “duplicat e flag” is now “inco mplete fla g (INCOMPL ETE TRANSA CTION FLAG . 433, 10) ”.
	88	Renumbered requireme nt ACR012 to ACR013 at the bot tom of tab le 2.6.
	89	Updated AC J003 per R TC task 29 0807,
	90	276150.
	91	Randy Maje wski
	92	3/9/2016
	93	1.08
	94	Updated th e screen c aptures in Appendix A as follo ws:
	95	-the Auto- Correction Report to show the
	96	Continue p rompt
	97	-the Auto- Correction Report to show the Patient St atement Au to-Correct ion Progra m option
	98	Diana Coll ins
	99	3/3/2016
	100	1.07
	101	Added the new Securi ty Key Nam e to ACJ00 4.
	102	Diana Coll ins
	103	2/4/2016
	104	1.06
	105	Updated AC R003 to in clude the status of
	106	‘Other’.
	107	VA confirm ed that a new securi ty key is needed; Up dated ACJ0 04 accordi ngly.
	108	Added requ irement AC J011. Adde d requirem ent ACR012 .
	109	Refreshed screen moc k-ups to s how the fo ur new Aut o-Correcti on Reasons .
	110	Added Over view of th e PSE proj ect phases .
	111	Diana Coll ins
	112	10/30/2015
	113	1.05
	114	Updated ve rbiage in sections 2 .6.1, 2.6. 2, and
	115	2.6.3 per Ray Pietrz ak.
	116	Heather Ch atwin
	117
	118
	119	Date
	120	Version
	121	Descriptio n
	122	Author
	123	10/18/2015
	124	1.04
	125	Updates ma de per cus tomer revi ew. Update s include:
	126	Section 1. 2 added no te regardi ng root ca use analys is, and re moved refe rences of TBD.
	127	Section 1. 3: include d referenc e to BRD a nd include d PSE PWS.
	128	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.
	129	Section 2. 6.4 added and provid ed updated specifica tions to s how tracea bility to PWS requir ements.
	130	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.
	131	Section 2. 12: remove d scope in tegration specificat ions as th ey are not applicabl e to Phase 1.
	132	Updated co ver page, and footer s.
	133	Heather Ch atwin
	134	9/28/2015
	135	1.03
	136	Removed re ference to My Health eVet (MHV) in sectio n 2.3. Des ign Constr aints Spec ification (Out of sc ope)
	137	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.”
	138	Removed re ferences t o the uniq ue patient identifie r and stat ement form in sectio n 2.12.1. CCPC.
	139	Removed th e “To Be D etermined” statement from sect ion 2.15. Usability Specificat ions.
	140	Added Figu re 17 To B e PSE Auto -Correctio n
	141	Diagram.
	142	Tony Nixon
	143
	144
	145	Date
	146	Version
	147	Descriptio n
	148	Author
	149
	150	1.02
	151	Removed RT C ID.
	152	Added requ irements f or the Aut o-Correcti on
	153	Job to res olve the f ollowing d iscrepanci es:
	154	•Missing t ransaction amount
	155	•Duplicate transacti on
	156	•Incomplet e transact ion status
	157	Updates to Appendix A:
	158	•Added Aut o-Correcti on Report examples
	159	•Added exa mples of t he followi ng 3 discr epancies
	160	oMissing t ransaction amount
	161	oDuplicate transacti on
	162	oIncomplet e transact ion status Addition of Appendi x B: Manua l Steps To Resolve A ny Discrep ancy.
	163	Tony Nixon
	164	9/09/2015
	165	1.01
	166	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).
	167	Removed se ction four as this s ection is not applic able to th e PSE proj ect.
	168	Updated co ver page, and table of content s to inclu de list of figures a nd list of tables.
	169	Heather Ch atwin
	170	Tony Nixon
	171	8/26/2015
	172	1.00
	173	Initial dr aft of PSE Phase I.
	174	Heather Ch atwin
	175	Tony Nixon
	176
	177	Artifact R ationale
	178
	179	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.
	180
	181	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
	182	large proj ect should be acknow ledged and clearly r eflected i n project schedules. Do not du plicate da ta that is already d efined in another do cument or a section in this do cument; no te in the section wh ere the in formation can be fou nd.
	183
	184	Table of C ontents
	185	1.Introduc tion ..... .......... .......... .......... .......... .......... .......... .......... .......... ... 7
	186	1.1. Pur pose...... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... . 7
	187	1.2. Sco pe ....... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ... 7
	188	1.2.1.Out of Scope.. .......... .......... .......... .......... .......... .......... .......... .......... ......... 8
	189	1.3. Ref erences... .......... .......... .......... .......... .......... .......... .......... .......... .......... ......... 8
	190	2.Overall Descriptio n......... .......... .......... .......... .......... .......... .......... .......... 8
	191	2.1. Acc essibility Specifica tions .... .......... .......... .......... .......... .......... .......... .......... 9
	192	2.2. Bus iness Rule s Specific ation .... .......... .......... .......... .......... .......... .......... ....... 9
	193	2.3. Des ign Constr aints Spec ification .......... .......... .......... .......... .......... .......... ... 10
	194	2.4. Dis aster Reco very Speci fication . .......... .......... .......... .......... .......... .......... .... 11
	195	2.5. Doc umentation Specifica tions .... .......... .......... .......... .......... .......... .......... .... 11
	196	2.6. Fun ctional Sp ecificatio ns ....... .......... .......... .......... .......... .......... .......... ......... 11
	197	2.6.1.Miss ing Transa ction Amou nt Discrep ancy Fixes ......... .......... .......... ... 12
	198	2.6.2.To-B e Auto-Cor rection Jo b: Incompl ete Transa ction Proc ess ...... .... 13
	199	2.6.3.To B e Auto-Cor rection Jo b: Duplica te Transac tion Proce ss ....... ...... 13
	200	2.6.4.To B e Schedule for VistA AR Patien t Statemen t Run Date s......... ...... 13
	201	2.6.5.Func tional Req uirements .......... .......... .......... .......... .......... .......... ........ 1 4
	202	2.7. Gra phical Use r Interfac e (GUI) Sp ecificatio ns ....... .......... .......... .......... ...... 20
	203	2.8. Mul ti-divisio nal Specif ications . .......... .......... .......... .......... .......... .......... ....... 20
	204	2.9. Per formance S pecificati ons ...... .......... .......... .......... .......... .......... .......... ...... 20
	205	2.10. Qual ity Attrib utes Speci fication . .......... .......... .......... .......... .......... .......... ..... 21
	206	2.11. Reli ability Sp ecificatio ns ....... .......... .......... .......... .......... .......... .......... .......... 21
	207	2.12. Scop e Integrat ion ...... .......... .......... .......... .......... .......... .......... .......... .......... ... 21
	208	2.12.1.Sec urity Spec ifications .......... .......... .......... .......... .......... .......... .......... .. 21
	209	2.13. Syst em Feature s ........ .......... .......... .......... .......... .......... .......... .......... .......... .. 22
	210	2.14. Usab ility Spec ifications ......... .......... .......... .......... .......... .......... .......... .......... 22
	211	3.Purchase d Componen ts ....... .......... .......... .......... .......... .......... .......... . 22
	212	4.Approval Signature s ........ .......... .......... .......... .......... .......... .......... .... 23
	213
	214	List of Fi gures
	215
	216
	217	Figure 1: To-Be Auto -Correctio n Batch Pr ocess..... .......... .......... .......... .......... .......... .......... .......... .......... .... 12
	218	Figure 2: Auto-Corre ction Job and Report Menu Opti ons ...... .......... .......... .......... .......... .......... .......... ........ 2 4
	219	Figure 3: Notificati on to AR U ser when j ob is stil l actively running . .......... .......... .......... .......... .......... ....... 25
	220	Figure 4: MailMan no tification when Auto -Correctio n job is s till activ ely runnin g ........ .......... .......... ....... 25
	221	Figure 5: Auto-Corre ction Repo rt Options ......... .......... .......... .......... .......... .......... .......... .......... .......... ......... 26
	222	Figure 6: Auto-Corre ction Repo rt Option Selection Example... .......... .......... .......... .......... .......... .......... ...... 26
	223	Figure 7: Auto-Corre ction Repo rt: Sorted by Bill N umber .... .......... .......... .......... .......... .......... .......... ......... 26
	224	Figure 8: Auto-Corre ction Repo rt: Sorted by Debtor Name .... .......... .......... .......... .......... .......... .......... .......... .27
	225	Figure 9: Auto-Corre ction Repo rt: Sorted by Auto C orrection Date...... .......... .......... .......... .......... .......... ... 27
	226	Figure 10: Auto-Corr ection Rep ort: Sorte d by Trans action Num ber ...... .......... .......... .......... .......... .......... .. 27
	227	Figure 11: Missing T ransaction Amount – Screen 1 . .......... .......... .......... .......... .......... .......... .......... .......... .. 28
	228	Figure 12: Missing T ransaction Amount – Screen 2 . .......... .......... .......... .......... .......... .......... .......... .......... .. 29
	229	Figure 13: Missing T ransaction Amount – Screen 3 . .......... .......... .......... .......... .......... .......... .......... .......... .. 30
	230	Figure 14: Duplicate Transacti on – Scree n 1 ...... .......... .......... .......... .......... .......... .......... .......... .......... ........ 3 0
	231	Figure 15: Duplicate Transacti on – Scree n 2 ...... .......... .......... .......... .......... .......... .......... .......... .......... ........ 3 1
	232	Figure 16: Duplicate Transacti on – Scree n 3 ...... .......... .......... .......... .......... .......... .......... .......... .......... ........ 3 2
	233	Figure 17: Incomplet e Status – Screen 1 .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... . 33
	234	Figure 18: Incomplet e Status – Screen 2 .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... . 34
	235	Figure 19: Incomplet e Status-S creen 3... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... . 34
	236	Figure 20: Patient S tatement D eficiency Resolution To-Be Pro cess Diagr am ....... .......... .......... .......... ....... 36
	237
	238
	239	List of Ta bles
	240
	241	Table 2-1: Access Le vels for V istA AR Pa ckage .... .......... .......... .......... .......... .......... .......... .......... .......... ...... 9
	242	Table 2-2: Patient S tatement R ules ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .... 10
	243	Table 2-3: To Be sch edule of V istA Patie nt Stateme nt run dat es........ .......... .......... .......... .......... .......... ...... 14
	244	Table 2-4: Descripti on of Requ irement Sp ecificatio n Table .. .......... .......... .......... .......... .......... .......... ......... 15
	245	Table 2-5: Auto-Corr ection Job (ACJ) Req uirements .......... .......... .......... .......... .......... .......... .......... .......... . 15
	246	Table 2-6: Busines R ules for B alancing A ccounts (B R) ....... .......... .......... .......... .......... .......... .......... .......... ....17
	247	Table 2-7: Auto-Corr ection Rep ort (ACR) Requiremen ts........ .......... .......... .......... .......... .......... .......... ....... 17
	248	Table 2-8: Patient S tatement C hange Date Requireme nts ...... .......... .......... .......... .......... .......... .......... ......... 19
	249	Table 2-9: Transacti on Discrep ancy Root Cause Reme diation Re quirements .......... .......... .......... .......... ..... 20
	250	Table 2-10 : Performa nce Specif ications.. .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 20
	251
	252	1. Introdu ction
	253
	254	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.
	255
	256	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.
	257
	258	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.
	259
	260	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.
	261
	262	1.1.Purpos e
	263
	264	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.
	265
	266	1.2. Scope
	267
	268	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:
	269
	270	1. As-Is analysis of the Vis tA AR Pati ent Statem ent proces s for defi ciency res olution an d
	271	To-Be of t he process which inc ludes the resolved d efects and automatio n.
	272	2. Root- cause anal ysis of th e followin g 3 accoun t balance discrepanc ies within the AR
	273	applicatio n:
	274	a. Trans action amo unt missin g b. Dup licate tra nsaction
	275	c. Incom plete stat us
	276
	277	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
	278
	279	incorrectl y to ‘1’ b y end user s. The Aut o-Correcti on Job wil l remedy t his issue by setting the incom plete stat us to ‘0’ when an ac count is o ut of bala nce. The d evelopment team cont inues to w ork closel y with the business to determi ne scenari os that ca use duplic ate transa ctions and missing t ransaction s amounts.
	280
	281	3. Requi rement ela boration o f Phase I business r equirement s defined in the Pat ient
	282	Statement Enhancemen t (PSE) Pr oject Work Scope (PW S) documen t (section 5.5).
	283	4. Devel opment and installat ion of an automated process fo r the dete ction and tracking o f discrepa ncies that prevent a patient s tatement f rom proces sing.
	284	5. Devel opment of an automat ed process for remed iation of discrepanc ies that p revent a p atient sta tement fro m processi ng.
	285	6. Updat e the bill ing statem ent run da te for any VA sites that build and trans mit statem ent data t o AITC on or after t he 26th ca lendar day of each m onth.
	286
	287	1.2.1.Out of Scope
	288
	289	The follow ing items are consid ered out o f scope fo r Phase I developmen t:
	290
	291	1. Requi rement ana lysis and elaboratio n for Phas e II and P hase III r equirement s.
	292
	293	1.3. Refer ences
	294
	295	The follow ing docume nt was use d as refer ence mater ial for th is RSD:
	296
	297	•Patient S tatement E nhancement s (PSE) Pr oject Work Scope, Se ction 5.5.
	298	•NSR 20100 716 (CCPC) Patient S tatement E nhancement s and Cons olidation BRD-3-18-
	299	15. http:/ /URL.DNSAc tive
	300
	301	2. Overall Descripti on
	302
	303	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.
	304
	305	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 .
	306
	307	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.
	308
	309	2.1. Acce ssibility Specificat ions
	310
	311	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,
	312	1194.31, a nd 1194.41 ) located at 508 Res ources Lin k1 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.
	313
	314	The table below defi nes the di fferent le vels of ac cess to th e VistA AR package.
	315
	316	Table 2-1: Access Le vels for V istA AR Pa ckage
	317
	318	User Level
	319	Role
	320	Responsibi lities
	321	Access Lev el
	322	Primary
	323	VA Medical Center ag ent cashie rs
	324	•Applying payments
	325	•Effecting other var ious chang es to the AR record (increases and decre ases)
	326	Full Acces s
	327	Primary
	328	Customer S ervice Sta ff (facili ties and C onsolidate d Patient Account Ce nters [CPA C])
	329	Effecting other vari ous change s to the
	330	AR record (increases and decre ases)
	331	Full Acces s
	332	Primary
	333	Health Res ource
	334	Center (HR C) Staff
	335	Effecting other vari ous change s to the
	336	AR record (increases and decre ases)
	337	Full Acces s
	338	Secondary
	339	Austin Inf ormation T echnology Center (AI TC) staff
	340	•Receive s tatement d ata in a f lat file
	341	•Format da ta for sta tement mai ling
	342	•Send data file to p rint contr actor
	343	Full Acces s
	344	Secondary
	345	Administra tors
	346	Run FileMa n routines for repor ting purpo ses or ext racting in formation for other reasons.
	347	Full Acces s
	348
	349	2.2. Busin ess Rules Specificat ion
	350
	351	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 :
	352
	353
	354
	355
	356
	357
	358
	359
	360
	361
	362
	363
	364
	365	1http://UR L.DNS.html
	366
	367	Table 2-2: Patient S tatement R ules
	368
	369	Event
	370	A patient statement will not p rint when the outsta nding bala nce of the AR bills and the Pa tient
	371	Statement balance ar e unequal.
	372	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).
	373	A patient statement will not p rint when it has an Open or Ac tive bill and unproc essed. A p atient sta tement wil l not prin t when a p repayment bill is in Refund Re view statu s.
	374	A patient statement will not p rint when it has a z ero balanc e and the site param eter “Supp ress
	375	Zero Balan ce” field is set to “Yes”.
	376	A patient statement will not p rint when there is n o amount d ue and no new activi ty.
	377	A patient statement will not p rint when the accoun t has a cr edit balan ce and no new activi ty.
	378	A patient statement will not p rint when it has a c redit/prep ayment bal ance amoun t of less than
	379	$1.00 (one dollar).
	380	A patient statement will not p rint when it only ha s interest and admin istrative charges.
	381	A patient statement will not p rint when the next s tatement d ate has no t yet occu rred.
	382	A patient statement will not p rint when the statem ent date i s unknown.
	383	A patient statement will not p rint when the third (3rd) lett er has alr eady print ed.
	384
	385	2.3. Desig n Constrai nts Specif ication
	386
	387	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.
	388
	389	•Technical Subject M atter Expe rt (SME) s hortage, d ue to the complexity of the ex isting sof tware, and the parti cipation o f experien ced VistA AR applica tion devel opers is e ssential t o the succ essful des ign and de velopment of the sys tem.
	390	•Any propo sed soluti on must me et all VHA Security, Privacy, and Identi ty Managem ent requir ements and Non-Funct ional requ irements a ddresses i n this doc ument.
	391	•Integrate d testing environmen ts that in clude all upstream a nd downstr eam applic ations, i. e., Lockbo x, must be available .
	392	•Constrain ts on func tionality of this in itiative e xist relat ed to reve nue polici es and bus iness rule s.
	393	•Statement s will not print if the AR Deb tor file i s set to ‘ Unknown’ o r has an i nvalid ent ry/incompl ete addres s. Address es used fo r billing purposes a re stored in the AR Debtor fil e (#340). First Part y (patient ) debtor a ddresses a re stored in the Vis tA Patient file (#2) .
	394	•Other con straints w ill be add ed as disc overed dur ing requir ements ela boration.
	395
	396	2.4. Disas ter Recove ry Specifi cation
	397
	398	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.
	399
	400	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
	401
	402	2.5. Docum entation S pecificati ons
	403
	404	The PSE pr oject will conform t o the docu mentation specificat ions as ma ndated by Program
	405	Management Accountab ility Syst em (PMAS), ProPath, and the In tegrated P roject Tea m (IPT).
	406
	407	2.6. Funct ional Spec ifications
	408
	409	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.
	410
	411	The diagra m in Figur e 1 illust rates the To-Be Auto -Correctio n Batch Jo b for Miss ing Amount
	412	Transactio n, Incompl ete Transa ction, and Duplicate Transacti on discrep ancies.
	413
	414	NOTE: Mis sing Amoun t Transact ion discre pancies fi xes will b e a future enhanceme nt to the
	415	Auto-Corre ction Batc h Job.
	416
	417
	418
	419	Figure 1: To-Be Auto -Correctio n Batch Pr ocess
	420
	421
	422
	423	2.6.1. Mis sing Trans action Amo unt Discre pancy Fixe s
	424
	425	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.
	426
	427	2.6.2.To-B e Auto-Cor rection Jo b: Incompl ete Transa ction Proc ess
	428
	429	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.
	430
	431	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.
	432
	433	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 an 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).
	434
	435	2.6.3.To B e Auto-Cor rection Jo b: Duplica te Transac tion Proce ss Changes will be m ade in the VistA AR module to ensure dup licate tra nsactions do not res ult when s pecific au tomatic de creases ar e processe d. Changes will elim inate the second tra nsaction w ith a uniq ue interna l identifi cation so that dupli cates are no longer written to the AR TR ANSACTION file (#433 ). Revised processin g will del iver accur ate amount s in the f ile to ens ure proble m-free pat ient state ment print ing.
	436
	437	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.
	438
	439	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.
	440
	441	2.6.4. To Be Schedul e for Vist A AR Patie nt Stateme nt Run Dat es
	442
	443	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
	444	26th calen dar day of the month immediate ly prior t o the oper ational de ployment o f the cons olidated b illing sta tement fun ctionality implement ation (i.e . PSE Phas e 2). The need to
	445	move all s ite patien t billing processing to before the 26th day of the month is to accommo date the f irst month in which the new PS E ‘consoli dated pati ent billin g statemen t’ process es are imp lemented. Seventeen VistA site s have bee n identifi ed (see Ta ble 2-3) t hat curren tly have a Patient S tatement d ate on or after the 26th of th e month.
	446
	447	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).
	448
	449	The adjust ed Patient Statement run date schedule f or the 17 VistA AR s ites is in dicated in Table
	450	2-3.
	451
	452
	453
	454	Table 2-3: To Be sch edule of V istA Patie nt Stateme nt run dat es
	455
	456	Station
	457	#
	458	Station na me
	459	Current bu ild Date
	460	Current Pa tient Stat ement Date
	461	New build
	462	Date
	463	New Patien t
	464	Statement Date
	465	438
	466	SIOUX FALL S,SD
	467	24
	468	26
	469	19
	470	21
	471	501
	472	ALBUQUERQU E,NM
	473	24
	474	26
	475	19
	476	21
	477	504
	478	AMARILLO,T X
	479	24
	480	26
	481	19
	482	21
	483	542
	484	COATESVILL E,PA
	485	24
	486	26
	487	19
	488	21
	489	562
	490	ERIE,PA
	491	24
	492	26
	493	19
	494	21
	495	568
	496	FORT MEADE ,SD
	497	24
	498	26
	499	19
	500	21
	501	649
	502	PRESCOTT,A Z
	503	24
	504	26
	505	19
	506	21
	507	656
	508	ST. CLOUD, MN
	509	24
	510	26
	511	19
	512	21
	513	688
	514	WASHINGTON ,DC
	515	24
	516	26
	517	19
	518	21
	519	756
	520	EL PASO,TX
	521	24
	522	26
	523	19
	524	21
	525	565
	526	FAYETTEVIL LE,NC
	527	26
	528	28
	529	20
	530	22
	531	621
	532	MOUNTAIN H OME,TN
	533	26
	534	28
	535	20
	536	22
	537	658
	538	SALEM,VA
	539	26
	540	28
	541	20
	542	22
	543	664
	544	SAN DIEGO, CA
	545	26
	546	28
	547	20
	548	22
	549	671
	550	SAN ANTONI O,TX
	551	26
	552	28
	553	20
	554	22
	555	689
	556	WEST HAVEN ,CT
	557	26
	558	28
	559	20
	560	22
	561	740
	562	TEXAS VALL EY COASTAL ,TX
	563	26
	564	28
	565	20
	566	22
	567
	568	2.6.5. Fun ctional Re quirements
	569
	570	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- Cor rection Jo b, Auto-Co rrection R eport, and Statement Run Date Changes.
	571
	572	Table 2-4: Descripti on of Requ irement Sp ecificatio n Table
	573
	574	Req. Type
	575	Requiremen t Type Des cription
	576	Req. ID
	577	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- Corr ection Rep ort).
	578	Primary Te xt
	579	This is th e requirem ent or use r story te xt.
	580	Priority
	581	This is th e priority of the re quirement as indicat ed in the PWS.
	582
	583	Table 2-5: Auto-Corr ection Job (ACJ) Req uirements
	584
	585	Req. ID
	586	Primary Te xt
	587	RDNG #
	588	BN1
	589	Manage Vis tA A/R dis crepancies .
	590	866640
	591	BN 1.1
	592	The system shall det ect discre pancies th at prevent the patie nt stateme nt process es from su ccessful c ompletion.
	593	616504
	594	US001
	595	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.
	596	866634
	597	ACJ001
	598	The AR app lication s hall execu te Auto-Co rrection f unctionali ty that de tects and fixes the following 2 types of discrepan cies:
	599	•Duplicate transacti on
	600	•Incomplet e Transact ion status
	601	616518
	602	BN 1.4
	603	The system shall cor rect the d iscrepancy as part o f normal o perations.
	604	616509
	605	ACJ002
	606	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 .
	607	Note: The scheduling may chang e based on how long the job ru ns during site testi ng.
	608	616519
	609	BN 1.6
	610	The system shall cre ate and ex ecute tran sactions r equired to correct
	611	First Part y AR trans action dis crepancies .
	612	616510
	613	ACJ003
	614	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.
	615	616520
	616	ACJ004
	617	The AR app lication s hall provi de a new s ecurity ke y to run t he Auto- C orrection job by an option. Th e new secu rity key n ame will b e PRCA
	618	AUTOCRCT P GM.
	619	616521
	620	ACJ005
	621	The Auto-C orrection job shall run after patch inst allation, so that au to- correc tion of di screpancie s begins i mmediately .
	622	616522
	623
	624
	625	Req. ID
	626	Primary Te xt
	627	RDNG #
	628	ACJ006
	629	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. If an accoun t includes a bill th at is curr ently in R efund Revi ew, the a ccount is excluded f rom the Au to-Correct ion job pr ocessing.
	630
	631
	632	See Table 2-6: Busin es Rules f or Balanci ng Account s (BR)
	633	616523
	634	ACJ008
	635	If a dupli cate “DECR EASE ADJUS TMENT” tra nsaction e xists for an
	636	‘Active, ‘ Open’, or “Cancellat ion’ bill in the AR TRANSACTIO N file
	637	(#433) cau sing a pat ient’s acc ount to be out-of-ba lance, the n the Auto - Correcti on Job sha ll correct the out-o f-balance condition by setting the INCOM PLETE TRAN SACTION FL AG field ( #10) to a value of 1 on the du plicate tr ansaction record.
	638
	639
	640	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.
	641	See Append ix A - Dup licate Tra nsaction e xample
	642	616525
	643	ACJ009
	644	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- balan ce conditi on by repl acing the value of 1 with a va lue of 0 i n the INCO MPLETE TRA NSACTION F LAG field on the inc omplete tr ansaction record.
	645	See Append ix A - Inc omplete St atus examp le
	646	616526
	647	ACJ010
	648	The Auto-C orrection job shall execute bu siness rul es based
	649	on Manual Steps To R esolve Any Discrepan cy to reme diate the following 2 types of discrepan cies:
	650	•Duplicate transacti on
	651	•Incomplet e status
	652
	653
	654	If multipl e discrepa ncies exis t within a n out-of-b alance bil l, the Aut o- Correct ion job do es not att empt to ba lance the bill but i nstead mar ks all tra nsaction r ecords tha t have a d iscrepancy with a re ason of “N ot Fixable ”.
	655	See Append ix B – Man ual Steps To Resolve Any Discr epancy
	656	616527
	657	ACJ014
	658	When an AR billing a ccount is out of bal ance and t he exact t ransaction (s) within an accoun t that cau se the out of balanc e discrepa ncy is ind eterminate , the Auto -Correctio n job does not attem pt to bala nce the st atement bu t instead marks the last trans action rec ord in the account a s “Not Fix able”.
	659	Note: This “indeterm inate” out -of-balanc e account will be re ported on within the Auto-Corr ection rep ort. See R equirement ACR014.
	660	866635
	661
	662
	663	Req. ID
	664	Primary Te xt
	665	RDNG #
	666	ACJ011
	667	The Auto-C orrection job shall send a Mai lman Notif ication to the
	668	‘PRCACPS’ Mail group when the job has co mpleted.
	669	703792
	670	ACJ012
	671	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
	672	process or quit from starting the job ag ain.
	673	866636
	674	ACJ013
	675	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’
	676	Mail group that job did not ye t complete from the last run o f the proc ess.
	677	866637
	678
	679	Table 2-6: Busines R ules for B alancing A ccounts (B R)
	680
	681	Req. ID
	682	Primary Te xt
	683	RDNG #
	684	BR001
	685	All transa ctions mus t add up t o the Curr ent Balanc e.
	686	616539
	687	BR002
	688	The balanc e for all bills must add up to Current B alance.
	689	616540
	690	BR003
	691	All transa ctions for a bill mu st add up to the Bil l Balance.
	692	616541
	693	BR004
	694	All transa ctions bef ore the la st stateme nt must ad d up to th e Last
	695	Statement Balance.
	696	616542
	697	BR005
	698	All transa ctions aft er the las t statemen t must add up to the New Activ ate
	699	Total.
	700	616543
	701	BR006
	702	The Last s tatement B alance + t he New Act ivate Tota l = Curren t Balance.
	703	616544
	704
	705
	706
	707	Table 2-7: Auto-Corr ection Rep ort (ACR) Requiremen ts
	708
	709	Req. IDPri mary TextR DNG #
	710
	711
	712	Req. ID
	713	Primary Te xt
	714	RDNG #
	715	BN 1.2
	716	The system shall tra ck identif ied discre pancies.
	717	616511
	718	US002
	719
	720	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.
	721	868638
	722	ACR001
	723	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:
	724	•Duplicate transacti on
	725	•Incomplet e status
	726	616528
	727	BN 1.3
	728	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.
	729	616512
	730	ACR002
	731	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- correctio n.
	732	616529
	733	US003
	734	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-
	735	Correction Job with an explana tion so th at the fou nd discrep ancies can be viewed and manua lly correc ted.
	736	866639
	737	BN 1.5
	738	The system shall ide ntify and catalog an y discrepa ncies not corrected
	739	for viewin g and manu al correct ive action .
	740	616513
	741	ACR003
	742	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 .
	743	616530
	744	BN 1.7
	745	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).
	746	616514
	747	ACR012
	748	The Auto-C orrection report sha ll record audit valu es associa ted with r emediating the discr epancy.
	749	703793
	750	BN 1.8
	751	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.
	752	616515
	753	ACR004
	754	The Auto-C orrection Report sha ll display only the last 4 dig its of the
	755	Social Sec urity Numb er (SSN).
	756	616531
	757	ACR005
	758	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.
	759	616533
	760	ACR006
	761	The Auto-C orrection Report sha ll provide a default FROM date value of
	762	“T-7”.
	763	616534
	764	ACR007
	765	The Auto-C orrection Report sha ll provide a default TO date v alue of
	766	“T”.
	767	616535
	768
	769
	770	Req. ID
	771	Primary Te xt
	772	RDNG #
	773	ACR008
	774	The AR app lication s hall promp t the user to sort t he Auto-Co rrection
	775	Report by the follow ing parame ters:
	776	•Bill numb er
	777	•Debtor na me
	778	•Transacti on number
	779	•Auto Corr ection Dat e
	780	See Append ix A – Aut o-Correcti on Report
	781	616536
	782	ACR009
	783	The Auto-C orrection report sha ll display the follo wing infor mation wit h correspo nding head ers:
	784	•BILL NO.
	785	•DEBTOR
	786	•SSN
	787	•TRANS NUM
	788	•AUTO-CORC T DATE
	789	•AUTO-CORC T REASON
	790	See Append ix A – Aut o-Correcti on Report
	791	616532
	792	ACR010
	793	The Auto-C orrection report mai n header s hall read: “BILLS TH AT HAVE BE EN AUTO-CO RRECTED” S ee Appendi x A – Auto -Correctio n Report
	794	616537
	795	ACR011
	796	The Auto-C orrection report wil l have the following menu path :
	797
	798
	799	Clerk’s AR Menu:
	800	Account Ma nagement
	801	Auto-Corre ct Patient Discrepan cy
	802	Report Se e Appendix A – Auto- Correction
	803	616538
	804	ACR013
	805	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.
	806	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.
	807	703794
	808	ACR014
	809	When the A uto-Correc tion job f inds an ac count that is out-of -balance, but the ex act transa ction (or transactio ns) that a re the cau se of the discrepanc y within t he account cannot be determine d, the Aut o- Correct ion Report will incl ude the la st bill nu mber of th e account in the rep ort, displ ay the rea son as “No t Fixable” and leave the trans action num ber blank for the ou t-of-balan ce account .
	810	866641
	811
	812	Table 2-8: Patient S tatement C hange Date Requireme nts
	813
	814	Req. IDPri mary TextR DNG #
	815
	816
	817	Req. ID
	818	Primary Te xt
	819	RDNG #
	820	BN2
	821	Create the foundatio n of the c onsolidate d patient statement
	822	866642
	823	BN 2.1
	824	Analyze an d design t he foundat ion softwa re and pro cesses for the creat ion of a c onsolidate d patient statement.
	825	866643
	826	US004
	827	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.
	828
	829
	830	Refer to T able 2-3 f or the 17 Station nu mbers to b e modified for state ment run d ates.
	831	866644
	832
	833	Table 2-9: Transacti on Discrep ancy Root Cause Reme diation Re quirements
	834
	835	Req. ID
	836	Primary Te xt
	837	RDNG #
	838	US005
	839	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
	840	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.
	841	866645
	842	US006
	843	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.
	844	866646
	845
	846
	847	2.7. Graph ical User Interface (GUI) Spec ifications
	848	Not applic able.
	849
	850	2.8. Multi -divisiona l Specific ations
	851
	852	No new mul ti-divisio nal specif ications a re being i ntroduced in PSE Pha se 1.
	853
	854	2.9. Perfo rmance Spe cification s
	855	The follow ing specif ications w ere provid ed in the NSR 201007 16 (CCPC) Patient St atement
	856	Enhancemen ts and Con solidation BRD-3-18-
	857	15: http:/ /URL.DNSAc tive
	858
	859	Table 2-10 : Performa nce Specif ications
	860
	861	If this is a system modificati on, how ma ny users d oes the cu rrent syst em support ?
	862
	863
	864	If this is a system modificati on, how ma ny users d oes the cu rrent syst em support ?
	865	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.
	866	In the cur rent syste m:
	867	•Accounts receivable data is u ploaded to the VistA AR packag e for char ges for Ve teran medi cal care f or each Ve teran who receives c are.
	868	•Customer service re presentati ves access the VistA AR module when a Ve teran call s in with a question about the ir account . The esti mated numb er of cust omer servi ce represe ntatives u sing the V istA AR mo dule is 1, 200.
	869	•Once a mo nth, billi ng data is sent from each of t he 100+ Vi stA system s for each Veteran
	870	who has in curred cha rges at th at site. T he stateme nts are th en created , printed and sent o ut. Many V eterans ge t bills fr om more th an one sit e. Approxi mately 2 m illion sta tements ar e mailed e ach month.
	871	How many u sers will the new sy stem (or s ystem modi fication) support?
	872	The number of curren t system u sers will be the sam e for the modified s ystem.
	873	What is th e predicte d annual g rowth in t he number of system users?
	874	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.
	875	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.
	876
	877	2.10. Qual ity Attrib utes Speci fication
	878
	879	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.
	880
	881	2.11. Reli ability Sp ecificatio ns
	882
	883	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.
	884
	885	2.12. Scop e Integrat ion
	886
	887	Additional scope spe cification s and inte gration ar e not appl icable to Phase I de velopment.
	888
	889	2.12.1.Sec urity Spec ifications
	890
	891	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:
	892
	893	•Complianc e with sta ndards and regulator y requirem ents publi shed in VA Handbook and
	894	Directive 6500: Vete rans Affai rs Directi ves > VA H andbook an d Directiv e 6500.
	895	•Complianc e with FIP S PUB 140- 2, Securit y Requirem ents for C ryptograph ic Modules , and for all voice and data t raffic enc ryption: C omputer Se curity Div ision > Pu blications > Federal Informati on Process ing Standa rds > FIPS PUB 140-2 .
	896
	897	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.
	898
	899	2.13. Syst em Feature s
	900
	901	Refer to S ection 2.6 .5 for the details o f all incl uded funct ionality.
	902
	903	2.14. Usab ility Spec ifications
	904
	905	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.
	906
	907	3. Purchas ed Compone nts
	908
	909	The PSE pr oject does not have purchased components for Phase 1.
	910
	911
	912
	913	4. Approva l Signatur es
	914
	915
	916
	917	REVIEW DAT E: 02/07/2 017
	918
	919	SCRIBE:
	920	1







	921	Date: 2017 .02.07 15: 29:27 -05' 00'02/07/2 017
	922
	923
	924	Integrated Project T eam (IPT) ChairDate
	925
	926
	927	PII





	928
	929	Business S ponsorDate
	930
	931
	932	PII 02/09/201 7 IT Program Manager D ate








	933
	934
	935
	936
	937	02/09/201 7_ Projec t Manager Date
	938
	939
	940
	941	A. Appendi x A:Discre pancy Exam ples
	942
	943	Appendix A provides examples o f the new menu optio ns, report s and sort ing capabi lities, an d
	944	MailMan No tification s.
	945
	946	MENU LOCA TION AND N AVIGATION
	947
	948	Select OPT ION NAME: RCA CLERK MENU Cler k's AR Men u
	949
	950
	951
	952
	953
	954
	955
	956
	957
	958
	959
	960
	961
	962
	963	TPJI
	964	Audit/Set up a New A ccounts Re ceivable
	965	New Bill Forms Print ... Profil e of Accou nts Receiv able Updat e Accounts Receivabl e ... Adju stment to Accounts R eceivable Report Men u for Acco unts Recei vable Foll ow-up Lett er Menu oo o Estab lish/Edit Old Bills o o o Transactio n Profile
	966	Third Part y Joint In quiry
	967	SP9}U!t Management n Agent Ca shier Menu EDI Lockb ox o o o
	968	FMS Utilit ies Menu
	969	Refund Rev iew and Ap prove
	970
	971
	972	Select Cle rk's kMenu <TEST ACC OUNT> Opti on:ccount Managemen t
	973
	974	NEW >>>>i !Auto Corr ect Patien t Discrepa ncy Report
	975	NEW >>>>1 1Patient Statement Auto-Corr ection Pr ograT!l
	976	Account I nformation Address D isplay/Edi t Bill Com ment Log
	977	Brief Acco unt Profi le
	978	Check Pati ent Accoun t Balance
	979	Debtor Com ment Log F ollow-up R eports Ful l Account Profile
	980	List of Pa tients wit h ADDRESS UNKNOWN ( AR) Remove /Add Comme nt Patient Statement Statement Discrepan cy Listing
	981	Transactio n History for a Pati ent
	982	Transactio n Patient Statement History
	983
	984
	985	Figure 2:A uto-Correc tion Job a nd Report Menu Optio ns
	986
	987
	988
	989	Figure 3: Notificati on to AR U ser when j ob is stil l actively running
	990
	991
	992
	993
	994
	995	Figure 4: MailMan no tification when Auto -Correctio n job is s till activ ely runnin g
	996
	997
	998
	999
	1000
	1001
	1002
	1003
	1004
	1005
	1006
	1007
	1008
	1009
	1010
	1011
	1012
	1013
	1014
	1015	Figure 5: Auto-Corre ction Repo rt Options
	1016
	1017
	1018
	1019
	1020
	1021
	1022
	1023	Figure 6: Auto-Corre ction Repo rt Option Selection Example
	1024
	1025
	1026
	1027	Figure 7: Auto-Corre ction Repo rt: Sorted by Bill N umber
	1028
	1029
	1030
	1031	Figure 8: Auto-Corre ction Repo rt: Sorted by Debtor Name
	1032
	1033
	1034
	1035	Figure 9: Auto-Corre ction Repo rt: Sorted by Auto C orrection Date
	1036
	1037
	1038
	1039	Figure 10: Auto-Corr ection Rep ort: Sorte d by Trans action Num ber
	1040
	1041
	1042
	1043
	1044
	1045
	1046
	1047
	1048
	1049
	1050
	1051
	1052
	1053
	1054
	1055
	1056
	1057
	1058
	1059
	1060
	1061
	1062
	1063
	1064
	1065
	1066
	1067
	1068
	1069
	1070
	1071	Figure 11: Missing T ransaction Amount – Screen 1
	1072
	1073
	1074
	1075
	1076
	1077
	1078
	1079
	1080
	1081
	1082
	1083
	1084
	1085
	1086
	1087
	1088
	1089
	1090
	1091
	1092
	1093
	1094
	1095
	1096
	1097
	1098
	1099
	1100
	1101
	1102
	1103
	1104
	1105
	1106
	1107
	1108
	1109
	1110
	1111
	1112
	1113
	1114
	1115	Figure 12: Missing T ransaction Amount – Screen 2
	1116
	1117
	1118
	1119
	1120
	1121
	1122
	1123
	1124
	1125
	1126
	1127
	1128
	1129
	1130
	1131
	1132
	1133
	1134
	1135
	1136
	1137
	1138
	1139
	1140
	1141
	1142
	1143	Figure 13: Missing T ransaction Amount – Screen 3
	1144
	1145
	1146
	1147
	1148
	1149
	1150
	1151
	1152
	1153
	1154
	1155
	1156
	1157
	1158
	1159
	1160
	1161
	1162
	1163
	1164
	1165
	1166
	1167
	1168
	1169
	1170
	1171
	1172
	1173
	1174	Figure 14: Duplicate Transacti on – Scree n 1
	1175
	1176
	1177
	1178
	1179
	1180
	1181
	1182
	1183
	1184
	1185
	1186
	1187
	1188
	1189
	1190
	1191
	1192
	1193
	1194
	1195
	1196
	1197
	1198
	1199
	1200
	1201
	1202
	1203
	1204
	1205
	1206
	1207
	1208
	1209	Figure 15: Duplicate Transacti on – Scree n 2
	1210
	1211
	1212
	1213
	1214
	1215
	1216
	1217
	1218
	1219
	1220
	1221
	1222
	1223
	1224
	1225
	1226
	1227
	1228
	1229
	1230
	1231
	1232
	1233
	1234
	1235
	1236
	1237
	1238
	1239	Figure 16: Duplicate Transacti on – Scree n 3
	1240
	1241
	1242
	1243
	1244
	1245
	1246
	1247
	1248
	1249
	1250
	1251
	1252
	1253
	1254
	1255
	1256
	1257
	1258
	1259
	1260
	1261
	1262
	1263
	1264
	1265
	1266
	1267
	1268
	1269
	1270
	1271
	1272
	1273	Figure 17: Incomplet e Status – Screen 1
	1274
	1275
	1276
	1277
	1278
	1279
	1280
	1281
	1282
	1283
	1284
	1285
	1286	Figure 18: Incomplet e Status – Screen 2
	1287
	1288
	1289
	1290
	1291
	1292
	1293
	1294
	1295
	1296
	1297
	1298
	1299
	1300
	1301
	1302
	1303
	1304
	1305
	1306
	1307
	1308
	1309
	1310
	1311
	1312
	1313
	1314
	1315
	1316
	1317
	1318
	1319
	1320
	1321
	1322
	1323
	1324
	1325
	1326
	1327
	1328
	1329
	1330
	1331
	1332
	1333	Figure 19: Incomplet e Status-S creen 3
	1334
	1335	B. Appendi x B – Manu al Steps t o Resolve Any
	1336	Discrepanc y
	1337
	1338
	1339	1. Check Patient A ccount Bal ance.
	1340	2. Run T ransaction Patient S tatement H istory.
	1341	a.Discrepa ncies occu r since la st stateme nt? Statem ent printe d in previ ous month. b. Look for the a mount that is out of balance.
	1342	c.Look at the type o f transact ion.
	1343	3. Look at the Bil l Transact ions.
	1344	4. Reconc ile the ne w activity .
	1345	5. Recon cile the s tatement d ata.
	1346	6. Prefo rm the cor rections.
	1347	7. For d uplicate t ransaction s, set the INCOMPLET E TRANSACT ION FLAG i n file
	1348	433,10.
	1349	8. For a missing t ransaction amount, s et the Tra nsaction a mount if i n file 433 .
	1350	9. For I NCOMPLETE TRANSACTIO N FLAG tha t are caus ing the di screpancy, remove th e flag in file 433,1 0.
	1351	10. Verify by Check Patient ac count Bala nce.
	1352
	1353	C. Appendi x C – TO B E Diagram for Auto-C orrection
	1354
	1355
	1356
	1357	Figure 20: Patient S tatement D eficiency Resolution To-Be Pro cess Diagr am