90265. EPMO Open Source Coordination Office Redaction File Detail Report

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1	v2.0_Sprint_15_Build_5.zip\v2.0_Sprint_15_Build_5\Unredacted	Attachements Retrieval System SDD v1.0.docx	Tue Apr 24 14:38:02 2018 UTC
2	v2.0_Sprint_15_Build_5..zip\v2.0_Sprint_15_Build_5\Unredacted	Attachements Retrieval System SDD v1.0.docx	Thu Apr 26 19:49:21 2018 UTC

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	1	Community Care Syste m Enhancem ents (CCSE )
	2	Electronic Data Inte rchange (E DI)
	3	Purchased Care (PC) Enhancemen ts
	4
	5	System Des ign Docume nt
	6	for
	7	Attachment s Retrieva l System ( ARS)
	8
	9
	10
	11	Department of Vetera ns Affairs
	12
	13	March 2018
	14	Version 1. 0
	15
	16
	17
	18
	19	Revision H istory
	20	Creation D ate
	21	Version No .
	22	Descriptio n/Comments
	23	Author(s)
	24	03/27/2018
	25	1.0
	26	Created
	27	Lew Pearso n (FTC)
	28
	29
	30
	31
	32
	33
	34
	35	Table of C ontents
	36	1Introduct ion1
	37	1.1Purpose of the SD D1
	38	1.2Identif ication2
	39	1.3Scope3
	40	1.4Constra ining Poli cies, Dire ctives and Procedure s4
	41	1.5User Ch aracterist ics5
	42	1.5.1User Objectives 5
	43	1.6Definit ions, Acro nyms, and Abbreviati ons5
	44	1.6.1Acron yms5
	45	1.6.2Defin itions7
	46	1.7Referen ces8
	47	2Backgroun d10
	48	2.1Overvie w of the S ystem10
	49	2.2Overvie w of the B usiness Pr ocess11
	50	2.2.1Claim Attachmen t Request Business P rocess11
	51	2.2.2Autho rization A ttachment Request Bu siness Pro cess12
	52	2.3Busines s Benefits 13
	53	2.4Assumpt ions and C onstraints 13
	54	2.4.1Desig n Assumpti ons13
	55	2.4.2Desig n Constrai nts13
	56	2.4.3Desig n Trade-of fs14
	57	2.5Overvie w of the S ignificant Requireme nts14
	58	2.5.1Overv iew of Sig nificant F unctional Requiremen ts14
	59	2.5.2Overv iew of Fun ctional Wo rkload / P erformance Requireme nts14
	60	2.5.3Overv iew of Ope rational R equirement s14
	61	2.5.4Overv iew of the Technical Requireme nts14
	62	2.5.5Overv iew of the Security or Privacy Requireme nts15
	63	2.5.5.1Aud iting15
	64	2.5.5.2Ide ntity Acce ss Managem ent (IAM)1 5
	65	2.5.5.3Sin gle Sign O n (SSO)15
	66	2.5.5.4Use r Roles an d Permissi ons15
	67	2.5.6Overv iew of Sys tem Critic ality and High Avail ability Re quirements 15
	68	2.5.7Stora ge16
	69	3Conceptua l Design17
	70	3.1Concept ual Applic ation Desi gn17
	71	3.1.1Appli cation Con text18
	72	3.2Concept ual Data D esign18
	73	3.2.1Datab ase Inform ation18
	74	3.3Concept ual Infras tructure D esign19
	75	3.3.1Syste m Critical ity and Hi gh Availab ility19
	76	4System Ar chitecture 19
	77	4.1Softwar e Architec ture19
	78	4.2Service Oriented Architectu re / Elect ronic Safe ty and Sec urity (ESS )19
	79	5Data Desi gn19
	80	5.1DBMS Fi les19
	81	5.2Data Vi ew1
	82	5.3ARS Dat a Descript ion Langua ge (DDL)1
	83	6Detailed Design4
	84	6.1Softwar e Detailed Design5
	85	6.1.1Conce ptual Desi gn5
	86	6.1.1.1Pro duct Persp ective5
	87	6.1.1.1.1U ser Interf aces5
	88	6.1.1.1.2C ommunicati ons Interf aces6
	89	6.1.1.2Pro duct Featu res6
	90	6.1.1.3Use r Characte ristics6
	91	6.1.2Speci fic Requir ements6
	92	6.1.2.1Dat abase Repo sitory6
	93	6.1.2.2Sys tem Featur es6
	94	6.1.2.2.1V iew Solici ted Claim Attachment s6
	95	6.1.2.2.2V iew Author ization At tachments7
	96	6.1.2.2.3C reate and Send Reque sts for Cl aim Attach ments9
	97	6.1.2.2.4C reate and Send Reque sts for Au thorizatio n Request Attachment s16
	98	6.1.2.2.5C reate Requ est for In formation Letters21
	99	7External System Int erface Des ign23
	100	7.1Interfa ce Archite cture23
	101	7.2Interfa ce Detaile d Design23
	102	8Human-Mac hine Inter face24
	103	8.1Interfa ce Design Rules24
	104	8.2Inputs2 4
	105	8.3Outputs 24
	106	9Security and Privac y24
	107	9.1Securit y24
	108	9.2Privacy 24
	109	A.Attachme nt Storage Capacity Analysis25
	110	B.Attachme nt Metadat a Storage Capacity A nalysis (f or Oracle) 31
	111
	112
	113	List of Ta bles
	114	Table 1 – Business T hemes, Epi cs, and Us er Storys3
	115	Table 2 – Scope Excl usions4
	116	Table 4 – Acronyms a nd Abbrevi ations5
	117	Table 5 – Definition s7
	118	Table 6 – Claim Atta chment Req uest Busin ess Proces s Identifi ers11
	119	Table 7 – Authorizat ion Attach ment Reque st Busines s Process Identifier s12
	120	Table 8 – Security R equirement s15
	121	Table 9 – Databases1 8
	122	Table 10 – 277_RFAI1 9
	123	Table 11 – 278_RFAI2 0
	124	Table 12 – Design El ements for Solicited Attachmen ts23
	125	Table 13 – Design El ements for Unsolicit ed Authori zation Att achments24
	126	Table 14 – Design El ements for Requestin g Claim At tachments2 5
	127	Table 15 – Design El ements for Requestin g Authoriz ation Atta chments34
	128	Table 16 – Design El ements for Printed R FAIs38
	129
	130	List of Fi gures
	131	Figure 1 – Claim Att achment Re quest Busi ness Proce ss Diagram 12
	132	Figure 2 – Authoriza tion Attac hment Requ est Busine ss Process Diagram13
	133	Figure 3 – Claim Att achment Re quest Conc eptual App lication D esign17
	134	Figure 4 – Authoriza tion Attac hment Requ est Concep tual Appli cation Des ign18
	135	Figure 5 – Claim Att achment Re quest Desi gn23
	136	Figure 6 – Authoriza tion Attac hment Requ est Design 24
	137
	138	Introducti on
	139	The missio n of the D epartment of Veteran s Affairs (VA), Offi ce of Info rmation an d Technolo gy (OI&T), Community Care Syst em Enhance ments (CCS E) is to p rovide Inf ormation T echnology (IT) produ cts and se rvices to the Vetera ns Health Administra tion (VHA) which in turn provi des benefi ts and ser vices to V eterans of the Unite d States. In meeting these goa ls, OI&T s trives to provide hi gh quality , effectiv e, and eff icient IT services t o those re sponsible for provid ing care t o the Vete rans at th e point of -care as w ell as thr oughout al l the poin ts of the Veterans’ health car e in an ef fective, t imely and compassion ate manner . VA depen ds on Info rmation Ma nagement/I nformation Technolog y (IM/IT) systems to meet miss ion goals.
	140	The Chief Business O ffice (CBO ) Purchase d Care (PC ) assesses the impac t of healt hcare regu latory req uirements on VHA Ele ctronic Da ta Interch ange (EDI) revenue o perations and design s the use cases to i llustrate the reengi neered bus iness proc ess flows associated with tech nology cha nges. The office con tinuously monitors a nd partici pates in m eetings of industry EDI standa rds-settin g organiza tions. As the busine ss process owner and subject m atter expe rt (SME) f or industr y health c are EDI ma ndates, PC defines b usiness ne eds that n ecessitate revenue s ystem soft ware devel opment. Th e office d esigns the maintenan ce and ite rative upd ates to th e EDI ente rprise too l used to pay health care provi ders for s ervice con nected car e provided to Vetera ns. PC dev elops part nerships w ith other Federal ag encies and trading p artners to support E DI process ing and ve rify compl iance; the y test sof tware, tra in users o n the use of revised software, and provi de help de sk support for end u sers. The EDI transa ctions pro cesses are utilized to pay nea rly $6B in projected claims an nually. Th e developm ent work d one under the scope of PC is i nextricabl y linked t o providin g Veterans the medic al care th ey have ea rned and d eserve.
	141	ARS will c reate a me chanism fo r requesti ng support ing docume ntation fo r claims a nd service s via EDI transactio ns. In add ition, thi s enhancem ent will d evelop the necessary systems f or receivi ng, storin g and retr ieving Hea lthcare Cl aim and se rvices att achments, whether su bmitted in response to a Reque st for Inf ormation ( RFI) or un solicited.
	142	Purpose of the SDD
	143	This Syste m Design D ocument (S DD) transl ates the r equirement s listed i n the corr esponding Requiremen ts Specifi cation Doc ument (RSD ) into tec hnical des ign specif ications. It identif ies the sy stem archi tecture, a nd describ es hardwar e, softwar e, communi cation, an d interfac e.
	144	The intend ed audienc e of this document i ncludes th e Product Developmen t (PD), So ftware Qua lity Assur ance (SQA) , the CBO, and staff at the OI &T at the Health Adm inistratio n Center ( HAC).
	145	This SDD f or the Att achements Retrieval System det ails the n ecessary f unctionali ty for rec eiving ele ctronic at tachments for health care servi ces review requests (authoriza tion reque sts), as w ell as req uesting el ectronic a ttachments for claim s and auth orizations .
	146	This docum ent is org anized as follows:
	147	Section 1: Presents introducti on, scope, definitio n and acro nyms, and references .
	148	Section 2: Presents a conceptu al design and analys is of the External I nterfaces.
	149	Section 3: Documents the speci fic techni cal and de sign requi rements fo r each sof tware elem ent releva nt to ARS.
	150	Section 4: Presents details re garding th e system a rchitectur e.
	151	Section 5: Presents details re garding da ta design, including Database Management System (D BMS) and d ata view.
	152	Section 6: Discusses the syste m’s detail ed hardwar e and soft ware desig n as appli cable.
	153	Section 7: Presents details of the exter nal interf ace design to the sy stem.
	154	Section 8: Presents details of the inter face betwe en the use r and the PC system.
	155	Section 9: Presents details of system se curity mec hanisms an d privacy design con sideration s at the a pplication level.
	156	Identifica tion
	157	The system s impacted by this p roject are EDI Gatew ay, Automa ted Author ization To ol (AAT), Fee Paymen t Processi ng System (FPPS), ED I Web View er (EWV), and Attach ment Retri eval Syste m (ARS).
	158	Listed bel ow are VA reference and guidan ce documen tation and standards applicabl e to or ta ilored for the CCSE EDI PC Pro ject. CCSE EDI PC wi ll use thi s guidance to fulfil l the perf ormance re quirements of this c ontract.
	159	44 U.S.C. § 3541, “F ederal Inf ormation S ecurity Ma nagement A ct (FISMA) of 2002”
	160	Federal In formation Processing Standards (FIPS) Pu blication 140-2, “Se curity Req uirements For Crypto graphic Mo dules”
	161	Software E ngineering Institute (SEI), So ftware Acq uisition-C apability Maturity M odeling (S A-CMM) Lev el 3 proce dures and processes
	162	VA Directi ve 6102, “ Internet/I ntranet Se rvices,” J uly 15, 20 08
	163	36 C.F.R. Part 1194 “Electroni c and IT A ccessibili ty Standar ds,” July 1, 2003
	164	Office of Management and Budge t (OMB) Ci rcular A-1 30, “Manag ement of F ederal Inf ormation R esources,” November 28, 2000
	165	32 C.F.R. Part 199, “Civilian Health and Medical P rogram of the Unifor med Servic es (CHAMPU S)”
	166	An Introdu ctory Reso urce Guide for Imple menting th e Health I nsurance P ortability and Accou ntability Act (HIPAA ) Security Rule, Mar ch 2005
	167	Sections 5 04 and 508 of the Re habilitati on Act (29 U.S.C. § 794d), as amended by the Workf orce Inves tment Act of 1998 (P .L. 105-22 0), August 7, 1998
	168	Homeland S ecurity Pr esidential Directive (12) (HSP D-12)
	169	VA Directi ve 6500, “ Informatio n Security Program,” August 4, 2006
	170	VA Handboo k 6500, “I nformation Security Program,” September 18, 2007
	171	VA Handboo k, 6500.5, Incorpora ting Secur ity and Pr ivacy in S ystem Deve lopment Li fecycle.
	172	VA Handboo k 6500.6, “Contract Security,” March 12, 2010
	173	Project Ma nagement A ccountabil ity System (PMAS) po rtal (refe rence Perf ormance Wo rk Stateme nt (PWS) R eferences - Technica l Library at https:/ / URL /)
	174	Office of Enterprise Developme nt (OED) P roPath Pro cess Metho dology (re ference PW S Referenc es -Techni cal Librar y and ProP ath Librar y links at https:// URL /). Note: In the eve nt of a co nflict, OE D ProPath takes prec edence ove r other pr ocesses or methodolo gies.
	175	Technical Reference Model (TRM ) (referen ce at http ://www.va. gov/TRM)
	176	National I nstitute S tandards a nd Technol ogy (NIST) Special P ublication s SP 800-6 0 and 800- 53
	177	IT Asset M anagement (ITAM) and Enterpris e Manageme nt Foundat ion (EMF) BR-0006, v ersion 002 .1-1405200 8, dated 1 0/30/2007
	178	HIPAA of 1 996; Pub.L 104-191.
	179	Patient Pr otection a nd Afforda ble Care A ct (PPACA) , Pub. L. 111-148, 1 24 Stat. 1 19, H.R. 3 590, enact ed March 2 3, 2010
	180	5 CFR 1315 , Final Ru le, Prompt Payment ( http://fms .treas.gov /prompt/re gulations. html) (for merly OMB Circular A -125),
	181	The aim of this proj ect is to ensure tha t the CCSE EDI PC sy stems are compliant with the C ORE Rules as publish ed by Coun cil for Af fordable Q uality Hea lthcare (C AQH), and found here http://ww w.caqh.org /CORE_oper at_rules.p hp
	182	Scope
	183	This docum ent addres ses the so ftware des ign that w ill satisf y the tech nical requ irements t he ARS RSD which wer e derived from the A RS Busines s Requirem ents Docum ent (BRD.
	184	Table 1 li sts the sc ope inclus ions for A RS.
	185	Table 1 – Business T hemes, Epi cs, and Us er Storys
	186	Identifier
	187	Descriptio n
	188	Theme 001
	189	View healt hcare atta chments (A ligns to G oal 2)
	190	Epic 001
	191	As Claims Processing team, I w ant to be able to vi ew 275 hea lthcare cl aim attach ments so I can proce ss a claim .
	192	Epic 002
	193	As Claims Processing team, I w ant to be able to vi ew 275 hea lthcare se rvices att achments s o I can pr ocess an a uthorizati on.
	194	Epic 003
	195	As Claims Processing team, I w ant to be able to vi ew submitt ed Request for Infor mation (RF I) so I ca n confirm that the r equest has been sent .
	196	User Story 001
	197	As a Claim s Processo r Clerk, I want the system to record tha t an RFI w as submitt ed for a V eterans Fa mily Servi ces (VFS) claim so I can view the health care claim attachmen t request that was s ent.
	198	User Story 002
	199	As a Claim s Processo r Clerk, I want the system to record tha t an RFI w as submitt ed for a N on-VA Care claim so I can view the healt hcare clai m attachme nt request that was sent.
	200	User Story 004
	201	As a Claim s Processo r Clerk, I want the system to record tha t an RFI w as submitt ed for a N on-VA Care claim so I can view the healt hcare serv ice reques t that was sent.
	202	Theme 002
	203	Send healt hcare clai m attachme nt request (Aligns t o Goal 1)
	204	Epic 004
	205	As Claims Processing team, I w ant to be able to re quest 277 RFI so I c an receive an attach ment with additional informati on (275).
	206	User Story 005
	207	As a Claim s Processo r Clerk, I want to i nput pre-d efined ide ntificatio n informat ion so tha t I can re quest addi tional cla im informa tion.
	208	User Story 006
	209	As a Claim s Processo r Clerk, I want to b e able to select fro m a standa rdized lis t of items so that I can reque st additio nal inform ation.
	210	User Story 007
	211	As a Claim s Processo r Administ rator, I w ant to be able to ed it the sta ndardized list of it ems so tha t I can up date the i tems that are needed to reques t addition al informa tion.
	212	User Story 008
	213	As a Claim s Processo r Clerk, I want the system to require da ta points to be popu lated for a RFI so t hat I can submit an accurate R FI.
	214	User Story 009
	215	As a Claim s Processo r Clerk, I want the system to display a message wh en require d data poi nts are no t populate d so that I can inpu t the requ ired data to submit an accurat e RFI.
	216	User Story 010
	217	As a Claim s Processo r Clerk, I want the system to create a c ompliant 2 77 RFI so that I can request a dditional documentat ion.
	218	Theme 003
	219	Print RFI (Aligns to Goal 2)
	220	Epic 005
	221	As Claims Processing team, I w ant to be able to pr int a stan dardized l etter that is equiva lent to an electroni c RFI so I can provi de a hard copy of th e healthca re claim r equest to the provid er.
	222	Epic 006
	223	As Claims Processing team, I w ant to be able to pr int a stan dardized l etter that is equiva lent to an electroni c RFI so I can provi de a hard copy of th e healthca re service request t o the prov ider.
	224	Theme 004
	225	Send healt hcare serv ice reques t (Aligns to Goal 1)
	226	Epic 007
	227	As Claims Processing team, I w ant to be able to se nd 278 RFI so I can receive he althcare a dditional informatio n to suppo rt a healt hcare serv ice review response 275.
	228	User Story 011
	229	As a Claim s Processo r Clerk, I want to i nput pre-d efined ide ntificatio n informat ion so tha t I can re quest addi tional inf ormation f or the hea lthcare se rvices rev iew.
	230	User Story 012
	231	As a Claim s Processo r Clerk, I want to b e able to select fro m a standa rdized lis t of items so that I can reque st additio nal inform ation for the health care servi ces review .
	232	User Story 013
	233	As a Claim s Processo r Clerk, I want to b e able to edit the s tandardize d list of items so t hat I can update the items tha t are need ed to requ est additi onal infor mation for the healt hcare serv ices revie w.
	234	User Story 014
	235	As a Claim s Processo r Clerk, I want the system to require da ta points to be popu lated for a request for additi onal claim informati on so that I can sub mit an acc urate RFI for the he althcare s ervices re view.
	236	User Story 015
	237	As a Claim s Processo r Clerk, I want the system to display a message wh en require d data poi nts are no t populate d so that I can inpu t the requ ired data to submit an accurat e Request for additi onal infor mation (RF AI) for th e healthca re service s review.
	238	User Story 016
	239	As a Claim s Processo r Clerk, I want the system to create a c ompliant 2 77 RFI so that I can request a dditional informatio n for the healthcare services review.
	240
	241	The busine ss need li sted below was exclu ded from t he scope o f this dev elopment, as support ing health care servi ces (autho rization) requests f or Veteran Family Se rvices (VF S) had bee n deemed o ut of scop e.
	242	Table 2 – Scope Excl usions
	243	Identifier
	244	Descriptio n
	245	User Story 003
	246	As a Claim s Processo r Clerk, I want the system to record tha t an RFI w as submitt ed for a V FS claim s o I can vi ew the hea lthcare se rvice requ est that w as sent.
	247	Constraini ng Policie s, Directi ves and Pr ocedures
	248	This SDD i s constrai ned by the following policies, directive s, artifac ts, and pr ocedures.
	249	Policies a nd Directi ves
	250	The Accred ited Stand ards Commi ttee X12 ( ASC X12) N 005010X21 0 Addition al Informa tion to Su pport a He alth Care Claim or E ncounter ( 275)
	251	ASC X12N/0 05010X211 Additional Informati on to Supp ort a Heal th Care Se rvices Rev iew (275)
	252	ASC X12N/0 05010X213 Health Car e Claim RF AI (277)
	253	ASC X12N/0 05010X217 Health Car e Services Review – Request fo r Review a nd Respons e (278)
	254	VA-generat ed Artifac ts
	255	PC X12 Att achments C ompliance Phase 3 BR D, version 1.0, May 2015(http: // URL /pm/hape/i pt_5010/ED I_Portfoli o/Program% 20Level%20 Documentat ion/PC/FY% 202015/BRD /08-023%20 PC%20X12%2 0Attach%20 Compl%20BR D%20v1.0.p df)
	256	VA Standar d Procedur es
	257	VA Section 508 polic ies and pr ocedures 6 221 Access ible Elect ronic and IT, Direct ive/Handbo ok, publis hed by the VA’s Sect ion 508 PD Product A ssessment Competency Division (reference at http:/ /www1.va.g ov/vapubs/ viewPublic ation.asp? Pub_ID=435 &FType=2)
	258	508 compli ance testi ng certifi cations fo r each enh ancement t hat requir es any cha nge to the Graphical User Inte rface (GUI ) (http:// www.sectio n508.va.go v/Standard s_Checklis t.asp)
	259	User Chara cteristics
	260	This devel opment wil l affect c laims adju dicators a nd their s upervisors for Non-V A Care and VFS, as w ell as rev iew nurses , clerks, and superv isors who manage aut horization s for Non- VA Care. F or claims processing , an adjud icator can request c linical do cumentatio n to suppo rt the cla im in eith er EWV or FPPS. Like wise, user s of AAT w ill be abl e to reque st documen tation for authoriza tions or a uthorizati on request s. In addi tion, medi cal record s personne l could us e ARS to d ownload co pies of at tachments into Veter ans’ medic al records in their VistA Imag ing system .
	261	All affect ed systems currently exist and their sup port struc ture will remain unc hanged.
	262	User Objec tives
	263	ARS will a llow users to view s olicited a nd unsolic ited attac hments for claims, a uthorizati ons, and a uthorizati on request s. It will also allo w them to solicit at tachments for claims , authoriz ations, an d authoriz ation requ ests.
	264	Definition s, Acronym s, and Abb reviations
	265	Acronyms
	266	The table below list s acronyms and abbre viations a pplicable to ARS.
	267	Table 4 – Acronyms a nd Abbrevi ations
	268	Term
	269	Definition
	270	AAT
	271	Automated Authorizat ion Tool
	272	AERB
	273	Architectu re and Eng ineering R eview Boar d
	274	ANSI
	275	American N ational St andards In stitute
	276	ARS
	277	Attachment Retrieval System
	278	ASC X12
	279	The Accred ited Stand ards Commi ttee X12
	280	BRD
	281	Business R equirement s Document
	282	CAQH
	283	Council fo r Affordab le Quality Healthcar e
	284	CBO
	285	Chief Busi ness Offic e
	286	CBOPC
	287	Chief Busi ness Offic e Purchase d Care
	288	CCD
	289	Continuity of Care D ocument
	290	CDW
	291	Corporate Data Wareh ouse
	292	CHAMPUS
	293	Civilian H ealth and Medical Pr ogram of t he Uniform ed Service s
	294	CM
	295	Configurat ion Manage ment
	296	CMP
	297	Configurat ion Manage ment Plan
	298	CORE®
	299	Committee on Operati ng Rules f or Informa tion Excha nge
	300	COTS
	301	Commercial Off-the-S helf
	302	CPRS
	303	Computeriz ed Patient Record Sy stem
	304	CVS
	305	Conformanc e Validati on Stateme nt
	306	DBMS
	307	Database M anagement System
	308	DD
	309	Data Dicti onary
	310	DIR
	311	Diagnostic Imaging R eport
	312	EDI
	313	Electronic Data Inte rchange
	314	EFT
	315	Electronic Funds Tra nsfer
	316	EMF
	317	Enterprise Managemen t Foundati on
	318	ERA
	319	Electronic Remittanc e Advice
	320	ERD
	321	Entity Rel ationship Diagram
	322	ESS
	323	Electronic Safety an d Security
	324	EWV
	325	EDI Web Vi ewer
	326	FIPS
	327	Federal In formation Processing Standards
	328	FISMA
	329	Federal In formation Security M anagement Act
	330	FPPS
	331	Fee Paymen t Processi ng System
	332	FSAM
	333	Federal Se gment Arch itecture M ethodology
	334	GUI
	335	Graphical User Inter face
	336	HAC
	337	Health Adm inistratio n Center
	338	HAPE
	339	Health Adm inistratio n Product Enhancemen ts
	340	HCCH
	341	Health Car e Clearing House
	342	HIPAA
	343	Health Ins urance Por tability a nd Account ability Ac t
	344	HSPD-12
	345	Homeland S ecurity Pr esidential Directive (12)
	346	ICN
	347	Internal C ontrol Num ber
	348	IM
	349	Informatio n Manageme nt
	350	IPT
	351	Integrated Project T eam
	352	IT
	353	Informatio n Technolo gy
	354	ITAM
	355	IT Asset M anagement
	356	LOINC
	357	Logical Ob servation Identifier s Names an d Codes
	358	NIST
	359	National I nstitute S tandards a nd Technol ogy
	360	NPI
	361	National P rovider Id entifier
	362	OED
	363	Office of Enterprise Developme nt
	364	OI&T
	365	Office of Informatio n and Tech nology
	366	OMB
	367	Office of Management and Budge t
	368	PC
	369	Purchased Care
	370	PCN
	371	Patient Co ntrol Numb er
	372	PD
	373	Product De velopment
	374	PHI
	375	Protected Health Inf ormation
	376	PII
	377	Personally Identifia ble Inform ation
	378	PjM
	379	Project Ma nager
	380	PM
	381	Program Ma nager
	382	PMAS
	383	Project Ma nagement A ccountabil ity System
	384	PMP
	385	Project Ma nagement P lan
	386	POC
	387	Point of C ontact
	388	PPACA
	389	Patient Pr otection a nd Afforda ble Care A ct
	390	PWS
	391	Performanc e Work Sta tement
	392	QASP
	393	Quality As surance Su rveillance Plan
	394	RFAI
	395	Request fo r Addition al Informa tion
	396	RFI
	397	Request fo r Informat ion
	398	RPC
	399	Remote Pro cedure Cal l
	400	RSD
	401	Requiremen ts Specifi cation Doc ument
	402	RTM
	403	Requiremen ts Traceab ility Matr ix
	404	SA-CMM
	405	Software A cquisition -Capabilit y Maturity Modeling
	406	SDD
	407	System Des ign Docume nt
	408	SDE
	409	Service De livery and Engineeri ng
	410	SEI
	411	Software E ngineering Institute
	412	SFTP
	413	Secure Fil e Transfer Protocol
	414	SME
	415	Subject Ma tter Exper t
	416	SOA
	417	Service Or iented Arc hitecture
	418	SQA
	419	Software Q uality Ass urance
	420	T4
	421	Transforma tion Twent y-One Tota l Technolo gy
	422	TIN
	423	Tax Identi fication N umber
	424	TO
	425	Task Order
	426	TRM
	427	Technical Reference Model
	428	UAK
	429	Unique Aut horization Key
	430	VA
	431	Department of Vetera ns Affairs
	432	VAMC
	433	VA Medical Center
	434	VFS
	435	Veterans F amily Serv ices
	436	VHA
	437	Veterans H ealth Admi nistration
	438	VistA
	439	Veterans H ealth Info rmation Sy stems and Technology Architect ure
	440	VPN
	441	Virtual Pr ivate Netw ork
	442	Definition s
	443	The table below list s terms an d definiti ons applic able to AR S.
	444	Table 5 – Definition s
	445	Term
	446	Definition
	447	275 Additi onal Infor mation to Support a Health Car e Claim or Encounter
	448	A transact ion for de livering a n attachme nt for a c laim
	449	275 Additi onal Infor mation to Support a Health Car e Services Review
	450	A transact ion for de livering a n attachme nt for an authorizat ion or aut horization request
	451	277 Health Care Clai m RFAI
	452	A transact ion for re questing a n attachme nt for a c laim
	453	278 Health Care Serv ices Revie w – Reques t for Revi ew
	454	A transact ion for re questing a n attachme nt for an authorizat ion or aut horization request
	455	ASC X12
	456	The ASC X1 2 – is an American N ational St andards In stitute (A NSI)-accre dited stan dards deve lopment or ganization and the e ntity resp onsible fo r the HIPA A transact ion standa rds for el ectronic h ealth care , eligibil ity, claim s processi ng, claims status, a uthorizati ons and re mittance t ransaction s named by the HIPAA of 1996. The VA is currently operating to version 5010 stan dards.
	457	CORE
	458	CORE, is a n multi-st akeholder initiative created, organized and facili tated by C AQH that i s working to make it easier fo r physicia ns and hos pitals to access eli gibility, benefits a nd claim i nformation for their patients at the poi nt of care
	459	HIPAA v. 5 010
	460	HIPAA vers ion 5010 i s the newe st set of standards related to the elect ronic tran smission o f specific health ca re transac tions such as Health Care Clai ms, Eligib ility Inqu iry/Respon se, and He alth Care Claim Remi ttance Adv ice.
	461	Payer
	462	An insuran ce company , fiscal i ntermediar y, governm ent agency , other ag ency, or i ndividual responsibl e for the payment of health ca re claims
	463	References
	464	PC X12 Att achments C ompliance Phase 3 BR D, version 1.0, May 2015(http: // URL /pm/hape/i pt_5010/ED I_Portfoli o/Program% 20Level%20 Documentat ion/PC/FY% 202015/BRD /08-023%20 PC%20X12%2 0Attach%20 Compl%20BR D%20v1.0.p df)
	465	PC X12 Att achments C ompliance RSD, versi on 1.1, Ju ly 2015
	466	(http:// URL /pm/hape/i pt_5010/ED I_Portfoli o/Program% 20Level%20 Documentat ion/Forms/ AllItems.a spx?RootFo lder=%2Fpm %2Fhape%2F ipt%5F5010 %2FEDI%5FP ortfolio%2 FProgram%2 0Level%20D ocumentati on%2FPC%2F FY%202015% 2FVendor%2 0Deliverab les%20%28V A%2D118%2D 11%2DD%2D1 009%29%2F0 002AC%20%2 D%20Purcha sed%20Care %20Authori zations%20 Compliance %20Phase%2 03%20Requi rements%20 Specificat ion%20Docu ment)
	467	PC X12 Att achments C ompliance Entity Rel ationship Diagram (E RD), versi on 0.01, J uly 2015(h ttp:// URL /pm/hape/i pt_5010/ED I_Portfoli o/Program% 20Level%20 Documentat ion/Forms/ AllItems.a spx?RootFo lder=%2Fpm %2Fhape%2F ipt%5F5010 %2FEDI%5FP ortfolio%2 FProgram%2 0Level%20D ocumentati on%2FPC%2F FY%202015% 2FVendor%2 0Deliverab les%20%28V A%2D118%2D 11%2DD%2D1 009%29%2F0 005AC%20%2 D%20Purcha sed%20Care %20X%2D12% 20Attachme nts%20Comp liance%20P hase%203%2 0Requireme nts%20Spec ification% 20Document )
	468	CORE Level III EFT s tandards.
	469	44 U.S.C. § 3541, “F ISMA of 20 02”
	470	FIPS Publi cation 140 -2, “Secur ity Requir ements For Cryptogra phic Modul es”
	471	SEI, SA-CM M Level 3 procedures and proce sses
	472	VA Directi ve 6102, “ Internet/I ntranet Se rvices,” J uly 15, 20 08
	473	36 C.F.R. Part 1194 “Electroni c and IT A ccessibili ty Standar ds,” July 1, 2003
	474	OMB Circul ar A-130, “Managemen t of Feder al Informa tion Resou rces,” Nov ember 28, 2000
	475	32 C.F.R. Part 199, “CHAMPUS”
	476	An Introdu ctory Reso urce Guide for Imple menting th e HIPAA Se curity Rul e, March 2 005
	477	Sections 5 04 and 508 of the Re habilitati on Act (29 U.S.C. § 794d), as amended by the Workf orce Inves tment Act of 1998 (P .L. 105-22 0), August 7, 1998
	478	HSPD-12
	479	VA Directi ve 6500, “ Informatio n Security Program,” August 4, 2006
	480	VA Handboo k 6500, “I nformation Security Program,” September 18, 2007
	481	VA Handboo k, 6500.5, Incorpora ting Secur ity and Pr ivacy in S ystem Deve lopment Li fecycle.
	482	VA Handboo k 6500.6, “Contract Security,” March 12, 2010
	483	PMAS porta l (referen ce PWS Ref erences - Technical Library at https:// URL /)
	484	OED ProPat h Process Methodolog y (referen ce PWS Ref erences -T echnical L ibrary and ProPath L ibrary lin ks at http s:// URL /). Note: In the eve nt of a co nflict, OE D ProPath takes prec edence ove r other pr ocesses or methodolo gies.
	485	TRM (refer ence at ht tp://www.v a.gov/TRM)
	486	NIST Speci al Publica tions SP 8 00-60 and 800-53
	487	ITAM and E MF BR-0006 , version 002.1-1405 2008, date d 10/30/20 07
	488	HIPAA of 1 996; Pub.L 104-191.
	489	PPACA, Pub . L. 111-1 48, 124 St at. 119, H .R. 3590, enacted Ma rch 23, 20 10
	490	5 CFR 1315 , Final Ru le, Prompt Payment ( http://fms .treas.gov /prompt/re gulations. html) (for merly OMB Circular A -125),
	491	The aim of this proj ect is to ensure tha t the HAPE EDI PC sy stems are compliant with the C ORE Rules as publish ed by the CAQH, and found here : http://w ww.caqh.or g/CORE_ope rat_rules. php.
	492	ASC X12N 0 05010X210 Additional Informati on to Supp ort a Heal th Care Cl aim or Enc ounter (27 5)
	493	ASC X12N/0 05010X211 Additional Informati on to Supp ort a Heal th Care Se rvices Rev iew (275)
	494	ASC X12N/0 05010X213 Health Car e Claim RF AI (277)
	495	ASC X12N/0 05010X217 Health Car e Services Review – Request fo r Review a nd Respons e (278)
	496	ProPath Ve rsion 23, PRP-2.3, C reate SDD
	497	PMAS Readi ness Check list
	498	VA Section 508 polic ies and pr ocedures 6 221 Access ible Elect ronic and IT, Direct ive/Handbo ok, publis hed by the VA’s Sect ion 508 PD Product A ssessment Competency Division (reference at http:/ /www1.va.g ov/vapubs/ viewPublic ation.asp? Pub_ID=435 &FType=2)
	499	508 compli ance testi ng certifi cations fo r each enh ancement t hat requir es any cha nge to the GUI (http ://www.sec tion508.va .gov/Stand ards_Check list.asp)
	500
	501	Background
	502	Overview o f the Syst em
	503	A number o f systems used by th e VA will be modifie d by this project so that soli cited and unsolicite d electron ic attachm ents can b e integrat ed into th e claims a djudicatio n and outs ide care a uthorizati on process es.
	504	EDI Gatewa y is the s ystem that receives batch tran sactions f rom the He alth Care Clearing H ouse (HCCH ), parses them, and distribute s them to other syst ems. Attac hments for authoriza tions, req uests for attachment s for auth orizations , and requ ests for a ttachments for claim s, represe nt new tra nsaction t ypes that the EDI Ga teway did not previo usly proce ss. The at tachments will need to be funn eled into the ARS, a nd the req uests will pass from ARS to th e EDI Gate way so the y can be t ransmitted to the HC CH.
	505	ARS is a c entral rep ository fo r electron ic attachm ents. It w ill allow searching and viewin g of attac hments in its own sy stem and a llow those attachmen ts to be i dentified and linked to and fr om inside EWV, FPPS, and AAT.
	506	FPPS is a web-based system tha t interfac es with ot her VA sys tems to pr ocess and adjudicate Veteran c laims. Lin ks will be added all owing clai ms adjudic ators to c reate and view reque sts for su pporting d ocumentati on for a c laim.
	507	EWV is a w eb-based s ystem that allows VF S claims a djudicator s to view electronic ally recei ved claims to assist in claims adjudicat ion. Links will be a dded allow ing claims adjudicat ors to cre ate and vi ew request s for supp orting doc umentation for a cla im.
	508	AAT is a c entral rep ository fo r electron ic authori zations an d authoriz ation requ ests. It w ill receiv e necessar y attachme nt-related informati on from AR S.
	509	Overview o f the Busi ness Proce ss
	510	Claim Atta chment Req uest Busin ess Proces s
	511
	512	Figure 1 – Claim Att achment Re quest Busi ness Proce ss Diagram
	513	Table 6 – Claim Atta chment Req uest Busin ess Proces s Identifi ers
	514	Step #
	515	Process St ep
	516	Automated/
	517	Manual
	518	Current or
	519	Future Pro cess
	520	Owner of P rocess
	521	1
	522	Claim adju dicator ne eds to req uest addit ional info rmation fr om the pro vider in t he form of medical d ocumentati on to supp ort the ad judication of a heal th care cl aim
	523	Manual
	524	Current
	525	Claim adju dicator
	526	2
	527	The reques t will be initiated by a user viewing cl aim data i n EWV or F PPS, or di rectly fro m a blank request in ARS.
	528	Automated
	529	Future
	530	EWV, FPPS, ARS
	531	3
	532	The ARS Gr aphical Us er Interfa ce (GUI) w ill pull i n claim da ta to crea te the req uest (in c ases where a request was initi ated from EWV or FPP S).
	533	Automated
	534	Future
	535	ARS
	536	4
	537	Upon submi ssion, the ARS will generate t he 277 RFA I EDI tran saction.
	538	Automated
	539	Future
	540	ARS
	541	5
	542	The 277 RF AI data wi ll be sent to the At tachment R epository to allow v iewing and storing o f the requ est.
	543	Automated
	544	Future
	545	Attachment Repositor y
	546	6
	547	The 277 RF AI transac tion will be stored in the EDI Gateway u ntil it is batched w ith other transactio ns of the same type.
	548	Automated
	549	Future
	550	EDI Gatewa y
	551	7
	552	During a n ightly pro cess, the 277 RFAI w ill be tra nsmitted t o the HCCH .
	553	Automated
	554	Future
	555	EDI Gatewa y
	556	8
	557	The 277 RF AI will be sent elec tronically to the pr ovider to request ad ditional i nformation about the claim or service li ne.
	558	Automated
	559	Future
	560	HCCH
	561	Authorizat ion Attach ment Reque st Busines s Process
	562
	563	Figure 2 – Authoriza tion Attac hment Requ est Busine ss Process Diagram
	564
	565	Table 7 – Authorizat ion Attach ment Reque st Busines s Process Identifier s
	566	Step #
	567	Process St ep
	568	Automated/
	569	Manual
	570	Current or
	571	Future Pro cess
	572	Owner of P rocess
	573	1
	574	Review Nur se needs t o respond to the hea lthcare se rvice revi ew inquiry requestin g addition al informa tion to su pport an a uthorizati on for a s ervice.
	575	Manual
	576	Current
	577	Review Nur se
	578	2
	579	The reques t will be initiated by a user viewing au thorizatio n data in the AAT.
	580	Automated
	581	Future
	582	AAT
	583	3
	584	The AAT GU I will pul l in autho rization r equest dat a to creat e the tran saction.
	585	Automated
	586	Future
	587	AAT
	588	4
	589	Upon submi ssion, the AAT will generate t he 278 RFA I EDI tran saction.
	590	Automated
	591	Future
	592	AAT
	593	5
	594	A copy of the 278 RF AI will be saved in the 278 Re pository
	595	Automated
	596	Future
	597	AAT
	598	6
	599	The 278 RF AI data wi ll be sent to the AR S to allow cross-ref erencing a ny 275 res ponses.
	600	Automated
	601	Future
	602	AAT
	603	7
	604	The 278 RF AI will be transmitt ed to the HCCH in re al time.
	605	Automated
	606	Future
	607	AAT
	608	8
	609	The 278 RF AI will be sent elec tronically to the pr ovider.
	610	Automated
	611	Future
	612	HCCH
	613	Business B enefits
	614	This devel opment is necessary to avoid t he potenti al for sub stantial p enalties a nd fees as sessed for non-compl iance with EDI requi rements se t forth in PPACA. No n-complian ce with th e regulato ry timelin e will res ult in the inability for VHA t o exchange data with providers according to the st andards fo r data exc hange, the reby resul ting in a loss of re venue. Fur thermore, the inabil ity to exc hange data according to the st andards wi ll result in a loss of busines s efficien cy and ult imately a considerab le failure to serve the Vetera n populati on.
	615	Assumption s and Cons traints
	616	Design Ass umptions
	617	This desig n assumes that the c urrently c ontracted HCCH will support bo th the 277 RFAI and 278 transa ctions and that they will be h andled as batches si milar to t he 277 tra nsactions currently used for c laim statu s.
	618	Design Con straints
	619	ARS has th e followin g constrai nts:
	620	The soluti on will ne ed to meet VA Enterp rise Stand ards for d evelopment language, security, 508 compl iance, web framework , applicat ion framew ork, and i ntegration with othe r VA syste ms.
	621	Developmen t of the a pplication s are cons trained by the avail ability of programmi ng resourc es and VHA resources for advic e and test ing.
	622	Timely acq uisition o f all new or allocat ed hardwar e resource s approved by the Go vernment f or project developme nt.
	623	Design Tra de-offs
	624	ARS databa se tables will be cr eated in t he FPPS_OW NER databa se within an existin g instance of Oracle instead o f SQL Serv er. This w ill reduce the SQL S erver data base licen se count a nd remove the need t o use Tale nd, an ext ract, tran sform and load (ETL) utility t o move ARS data from SQL Serve r to Oracl e. Modific ations to existing P L/SQL will move data from ARS tables to PROGRAM TR ACKING tab les in Ora cle, impro ving overa ll perform ance.
	625	Overview o f the Sign ificant Re quirements
	626	Overview o f Signific ant Functi onal Requi rements
	627	The ARS wi ll accept, store, pr ocess, and allow vie wing and d ownloading of solici ted and un solicited attachment s for auth orization requests.
	628	The ARS wi ll accept, store, pr ocess, and allow vie wing and d ownloading of solici ted and un solicited attachment s for auth orization requests i n the same way it cu rrently do es for cla im attachm ents.
	629	The ARS wi ll allow t he solicit ation of a ttachments for claim s.
	630	The ARS wi ll allow t he solicit ation of a ttachments for autho rization r equests.
	631	The ARS wi ll allow a physical letter to be printed that can be sent to request t he same in formation as the att achment re quest.
	632	Overview o f Function al Workloa d / Perfor mance Requ irements
	633	All attach ments, as well as at tachment r equests fo r claims w ill be sen t, receive d, and tra nsferred b etween sys tems in ba tch mode w ith no str ingent req uirements in regards to respon se time. A ttachment requests f or authori zations wi ll be sent in real-t ime, and a confirmat ion from t he HCCH is expected within 20 seconds. T he request ed attachm ent will l ater be re turned via batch. It is estima ted that t here will be approxi mately 5,0 00 attachm ents recei ved per da y once pro viders hav e transiti oned from the paper process th e new EDI process.
	634	Overview o f Operatio nal Requir ements
	635	ARS S/W wi ll be depl oyed in th e HAC. ARS metadata and attach ments will remain in the HAC.
	636	The nature and size and retent ion period of (1) at tachment m etadata st ored in Or acle, (2) attachemen t images a nd (3) ret ention of original X 12 275 doc uments req uire devel opment of one or mor e administ rative das hboards fo r capacity status an d planning .
	637	Overview o f the Tech nical Requ irements
	638	ARS will u se the inf rastructur e and grap hical user interface (GUI) tec hnologies developed for FPPS 2 .0. The in frastructu re uses RE ST-based s ervice ori ented arch itecture. Business l ogic and d ata access will be e ncapsulate d as servi ces and de ployed to WebLogic. The GUI wi ll adhere to a Singl e-Page App lication ( SPA) archi tecture wh ereby a si ngle HTML page will be loaded into the b rowser and client-si de Javascr ipt will b e used to render cha nges to th e display, alleviat ing the ne ed to load multiple static pag es or dyna mically cr eating pag es in the back-end ( WebLogic).
	639	Overview o f the Secu rity or Pr ivacy Requ irements
	640	Auditing
	641	Audit trai lswill be kept for v iewing and downloadi ng attachm ents. In a ddition, a n audit tr ail will b e kept whe n users ge nerate RFA I letters for claims , authoriz ations, an d authoriz ation requ ests. Fina lly, only users with appropria te securit y keys wil l be able to edit th e list of Logical Ob servation Identifier s Names an d Codes (L OINC) code s used whe n requesti ng attachm ents.
	642	Identity A ccess Mana gement (IA M)
	643	Before a u ser can ac cess ARS t hey must b e authenti cated as b eing a kno wn user. P hase 1 del ivery of A RS will us e existing HAC mecha nisms to a uthenticat e. In phas e 2 ARS wi ll integra te with IA M SSOi for user auth entication .
	644	Single Sig n On (SSO)
	645	SSO allows a user to logon onc e and acce ss applica tions with out going thru the l og on proc ess again. The user’ s permissi ons, deriv ed from th eir user r oles, will determine which app lications are allowe d. Phase 1 will use existing H AC SSO. Ph ase 2 will use SSO p rovided by IAM SSOi.
	646	User Roles and Permi ssions
	647	ARS will u se Attribu te Based A ccess Cont rol (ABAC) , a form o f Role Bas ed Access Control (R BAC), to l imit acce ss to scre ens and in formation displayed. The benef it of ABAC over RBAC is the re duction of the proli fteration of roles f or cases w here a use r needs on e or more permissio ns outside of their current ro le(s).
	648	Table 8 – Security R equirement s
	649
	650	Theme/Epic /Narrative
	651	Requiremen t Number
	652	Descriptio n
	653	User Story 007
	654	FS-UN007-0 03
	655	The LOINC Code Modif ier list f or claims shall be a ble to be edited by a user wit h super us er/admin r ights in t he ARS.
	656	User Story 013
	657	FS-UN013-0 03
	658	The LOINC Code Modif ier list f or authori zations sh all be abl e to be ed ited by a user with super user /admin rig hts.
	659	Epic 005
	660	FS-EP005-0 05
	661	An audit t rail shall be create d with a l ink to the previousl y printed claim RFAI letter, d ate the le tter was p rinted, an d user nam e/ID.
	662	Epic 006
	663	FS-EP006-0 05
	664	An audit t rail shall be create d with a l ink to the previousl y printed authorizat ion RFAI l etter, dat e the lett er was pri nted, and user name/ ID.
	665	Overview o f System C riticality and High Availabili ty Require ments
	666	No new sys tems are i ntroduced by this pr oject, and the exist ing availa bility and disaster recovery p lans will be suffici ent for th e affected systems. As stated in the BRD , the syst ems involv ed are to be availab le no less than 86% of the cal endar week , and shou ld recover from any outage wit h a mean t ime of 30 minutes. A dditional details sh ould be av ailable fr om the HAC CIO.
	667	Storage
	668	Based on t he size, f requency a nd retenti on period requiremen ts for raw and proce ssed 275 E DI documen ts, has de termined t hat storag e capacity needs be increased in the fol lowing are as:
	669	Storage of extracted attachmen t metadata in Oracle
	670	Storage of extracted attachmen t images t o local or network a ttached st orage (NAS )
	671	Storage of raw 275 E DI documen ts
	672	Storage ca pacity ana lysis for ARS attach ments can be found i n Appendix A. Storag e capacity analysis for attach ment metad ata in Ora cle can be found in Appendix B .
	673
	674
	675	Conceptual Design
	676	Conceptual Applicati on Design
	677	The follow ing figure s illustra te the con ceptual ap plication design of the change s and addi tions desc ribed in t his SDD.
	678
	679	Figure 3 – Claim Att achment Re quest Conc eptual App lication D esign
	680
	681
	682	Figure 4 – Authoriza tion Attac hment Requ est Concep tual Appli cation Des ign
	683	Applicatio n Context
	684	Users will continue using the applicatio ns that th ey’re alre ady using to do thei r job, but new funct ions will be added. Where user s currentl y view cla ims, they’ ll be able to reques t document ation to s upport tho se claims. The PC Au thorizatio ns project , concurre nt with th is one, wi ll add the ability t o process authorizat ion reques ts and aut horization s, and use rs will be able to u se that sy stem to vi ew attachm ents and r equest doc umentation to suppor t those au thorizatio n requests and autho rizations. When crea ting such a request, users wil l be able to generat e letters to send to providers in additi on to the EDI transa ction that will be g enerated.
	685	Conceptual Data Desi gn
	686	Database I nformation
	687	Table 9 – Databases
	688	Database N ame
	689	Descriptio n
	690	Type
	691	Steward
	692	ARS
	693	Attachment Retrieval System
	694	Create/Mod ify
	695	HAC
	696	FPPS
	697	Fee Paymen t Prcoessi ng System
	698	Create/Mod ify
	699	HAC
	700	EWV
	701	EDI Web Vi ewer
	702	Create/Mod ify
	703	HAC
	704	EDI Gatewa y
	705	Electronic Data Inte rchage Gat eway
	706	Back-end p ackages
	707	HAC
	708	E_REPOS
	709	Claims dat abase used by EWV
	710	Create/Mod ify
	711	HAC
	712	Conceptual Infrastru cture Desi gn
	713	System Cri ticality a nd High Av ailability
	714	This proje ct modifie s existing systems a nd will no t change t heir syste m critical ity or ava ilability requiremen ts. As sta ted in the BRD, the systems in volved are to be ava ilable no less than 86% of the calendar week, and should rec over from any outage with a me an time of 30 minute s.
	715	System Arc hitecture
	716	ARS is hos ted at the HAC. The other affe cted syste ms hosted at the HAC include E DI Gateway , FPPS, an d EWV.
	717	Software A rchitectur e
	718	The EDI Ga teway is a collectio n of Java routines a nd databas e jobs tha t move and transform data betw een the HC CH and the various H AC systems .
	719	FPPS and E WV are web -based sys tems hoste d at the H AC for man aging Non- VA and VFS claims, r espectivel y.
	720	ARS is a w eb-based s ystem host ed at the HAC for ma naging ele ctronic at tachments for claims and autho rizations, including storing, viewing, a nd request ing attach ments.
	721	Service Or iented Arc hitecture / Electron ic Safety and Securi ty (ESS)
	722	ARS will u se the FPP S 2.0 serv ice orient ed archite cture cons isting of Node.js fo r the fron t-end UI s erver and WebLogic a pplication server to host busi ness and d ata access logic.
	723	Data Desi gn
	724	DBMS Files
	725	The ARS da tabase wil l contain records of the 277 a nd 278 tra nsactions that it se nds to req uest attac hments.
	726	Table 10 – 277_RFAI
	727	Column
	728	Type
	729	Notes
	730	RFAI_ID
	731	Numeric
	732	Automatica lly assign ed to each request
	733	EREPOS_ID
	734	Numeric
	735	ID of matc hing claim from E_RE POS (or bl ank if lin ked to FPP S)
	736	FPPS_ID
	737	Numeric
	738	ID of matc hing claim from FPPS (or blank if linked to E_REPO S)
	739	SERVICE_LI NE
	740	Numeric
	741	ID of the service li ne on the original c laims (or blank if t he RFAI is for the e ntire clai m and not a particul ar service line)
	742	REQUEST_SE NT
	743	Date/Time
	744	When the r equest was sent
	745	REQUEST_TE XT
	746	Text
	747	The entire ty of the outgoing r equest
	748	RECIPIENT_ ID
	749	Numeric
	750	ID of the provider t he request is being sent to
	751	STATUS_COD E
	752	Text
	753	Claims Sta tus Type C ode
	754	LOINC_CODE
	755	Text
	756	LOINC code describin g desired document t ype
	757	LOINC_MOD
	758	Text
	759	LOINC code modifier
	760	STATUS
	761	Text
	762	“O”=Open, “C”=Closed
	763	ATCHMNT_ID
	764	Numeric
	765	ID of atta chment rec eived in r esponse to this requ est
	766
	767	Table 11 – 278_RFAI
	768	Column
	769	Type
	770	Notes
	771	RFAI_ID
	772	Numeric
	773	Automatica lly assign ed to each request
	774	REQUEST_SE NT
	775	Date/Time
	776	When the r equest was sent
	777	REQUEST_TE XT
	778	Text
	779	The entire ty of the outgoing r equest
	780	RECIPIENT_ ID
	781	Numeric
	782	ID of the provider t he request is being sent to
	783	STATUS_COD E
	784	Text
	785	Claims Sta tus Type C ode
	786	LOINC_CODE
	787	Text
	788	LOINC code describin g desired document t ype
	789	LOINC_MOD
	790	Text
	791	LOINC code modifier
	792	STATUS
	793	Text
	794	“O”=Open, “C”=Closed
	795	ATCHMNT_ID
	796	Numeric
	797	ID of atta chment rec eived in r esponse to this requ est
	798
	799	Data View
	800
	801	Figure 5 A RS Entity Relationsh ip Diagram (ERD)
	802	Figure 5 A RS Entity Relationsh ip Diagram (ERD)The following entity rel ationship diagram de scribes th e tables a nd table r elationshi ps for ARS .
	803
	804	ARS Data D escription Language (DDL)
	805	The follow ing ARS DD L will be used to cr eate the A RS tables defined in Figure 5.
	806
	807	CREATE TAB LE claim_c ontact (
	808	contac tuserid NUMBER NOT NULL,
	809	contac temail VARCHAR2(3 50 BYTE),
	810	datecr eated DATE,
	811	datemo dified DATE
	812	);
	813
	814	ALTER TABL E claim_co ntact ADD CONSTRAINT claim_con tact_pk PR IMARY KEY ( contactu serid );
	815
	816	CREATE TAB LE claim_s ubmission (
	817	submis sionid NU MBER NOT N ULL,
	818	contac tuserid NU MBER NOT N ULL,
	819	trn02c pe_pdi VA RCHAR2(15 CHAR),
	820	trn02f pps_claim_ id NU MBER,
	821	hl1nm1 03pyr_nm VA RCHAR2(250 BYTE),
	822	hl1nm1 09pyr_id VA RCHAR2(350 BYTE),
	823	hl2nm1 03inf_rcvr VA RCHAR2(250 BYTE),
	824	hl1per 04vamccnte m VA RCHAR2(250 BYTE),
	825	hl3nm1 03svcbillp rvnm VA RCHAR2(250 BYTE),
	826	hl3nm1 09prvnpi VA RCHAR2(350 BYTE),
	827	hl2nm1 09svcprvti n VA RCHAR2(350 BYTE),
	828	hl4nm1 03ptlstnm VA RCHAR2(250 BYTE),
	829	hl4nm1 04ptftnm VA RCHAR2(150 BYTE),
	830	hl4nm1 05ptmdnm VA RCHAR2(150 BYTE),
	831	hl4nm1 07ptsfxnm VA RCHAR2(100 BYTE),
	832	hl4nm1 09ptid VA RCHAR2(350 BYTE),
	833	ref102 ptctrlnmbr VA RCHAR2(200 BYTE),
	834	trn02p yrclmctrln mbr VA RCHAR2(250 BYTE),
	835	ref202 billtype VA RCHAR2(250 BYTE),
	836	ref402 clrnghsid VA RCHAR2(250 BYTE),
	837	ref302 medrecnmbr VA RCHAR2(250 BYTE),
	838	dtp203 responsedu edate DA TE,
	839	dtp103 svcfrmdt DA TE,
	840	dtp103 svctodt DA TE,
	841	submis sion_statu s VA RCHAR2(50 BYTE),
	842	"277Ge nerate_Sta tus" VA RCHAR2(50 BYTE),
	843	datecr eated DA TE,
	844	datesu bmitted DA TE,
	845	datemo dified DA TE
	846	);
	847
	848	ALTER TABL E claim_su bmission A DD CONSTRA INT claim_ submission _pk PRIMAR Y KEY ( su bmissionid );
	849
	850	CREATE TAB LE claim_s vc_lines (
	851	submis sionsvclin eid NUMB ER NOT NUL L,
	852	submis sionid NUMB ER NOT NUL L,
	853	ref02s vclnnmbr VARC HAR2(200 B YTE),
	854	dtp03s vcfrmdt DATE ,
	855	dtp03s vctodt DATE ,
	856	svc01r evcd VARC HAR2(200 B YTE),
	857	svc01p roccd VARC HAR2(200 B YTE),
	858	svc01m od VARC HAR2(10 BY TE),
	859	svc02c hrgamt NUMB ER(19,4),
	860	datecr eated DATE ,
	861	datemo dified DATE
	862	);
	863
	864	ALTER TABL E claim_sv c_lines AD D CONSTRAI NT claim_s vc_lines_p k PRIMARY KEY ( subm issionsvcl ineid );
	865
	866	CREATE TAB LE hccs_cd (
	867	hccs_i d NUMBER NOT NULL,
	868	stchcc statuscat_ cd VARCHAR2(3 5 BYTE) NO T NULL,
	869	stchcc statuscat_ cd_desc VARCHAR2(2 000 BYTE) NOT NULL,
	870	isacti ve CHAR(1 BYT E) DEFAULT '1' NOT N ULL,
	871	datecr eated DATE,
	872	datemo dified DATE
	873	);
	874
	875	ALTER TABL E hccs_cd ADD CONSTR AINT hccs_ cd_pk PRIM ARY KEY ( hccs_id );
	876
	877	CREATE TAB LE loinc_c d (
	878	loinc_ id NUMBER NOT NULL,
	879	stcloi nc_cd VARCHAR 2(35 BYTE) NOT NULL,
	880	stcloi nc_cd_desc VARCHAR 2(2000 BYT E) NOT NUL L,
	881	isacti ve CHAR(1 BYTE) DEFA ULT '1' NO T NULL,
	882	datecr eated DATE,
	883	datemo dified DATE
	884	);
	885
	886	ALTER TABL E loinc_cd ADD CONST RAINT loin c_cd_pk PR IMARY KEY ( loinc_id );
	887
	888	CREATE TAB LE loinc_c d_mod (
	889	loinc_ cd_mod_id NUM BER NOT NU LL,
	890	stcloi nc_mod_cd VAR CHAR2(35 B YTE) NOT N ULL,
	891	stcloi nc_mod_cd_ desc VAR CHAR2(2000 BYTE) NOT NULL,
	892	isacti ve CHA R(1 BYTE) DEFAULT '1 ' NOT NULL ,
	893	datecr eated DAT E,
	894	datemo dified DAT E
	895	);
	896
	897	ALTER TABL E loinc_cd _mod ADD C ONSTRAINT loinc_mod_ cd_pk PRIM ARY KEY ( loinc_cd_m od_id );
	898
	899	CREATE TAB LE submiss ion_codes_ bridge (
	900	submis sion_codes id NUMBE R NOT NULL ,
	901	submis sionid NUMBE R NOT NULL ,
	902	servic elinenumbe r NUMBE R,
	903	hccs_i d NUMBE R NOT NULL ,
	904	loinc_ id NUMBE R NOT NULL ,
	905	loinc_ cd_mod_id1 NUMBE R,
	906	loinc_ cd_mod_id2 NUMBE R
	907	);
	908
	909	ALTER TABL E submissi on_codes_b ridge ADD CONSTRAINT submissio n_codes_br idge_pk PR IMARY KEY ( submissi on_codesid );
	910
	911	ALTER TABL E claim_su bmission
	912	ADD CO NSTRAINT c laim_conta ct_fk FORE IGN KEY ( contactuse rid )
	913	RE FERENCES c laim_conta ct ( conta ctuserid ) ;
	914
	915	ALTER TABL E claim_sv c_lines
	916	ADD CO NSTRAINT c laim_svc_c laim_fk FO REIGN KEY ( submissi onid )
	917	RE FERENCES c laim_submi ssion ( su bmissionid );
	918
	919	ALTER TABL E submissi on_codes_b ridge
	920	ADD CO NSTRAINT s ubm_cd_cla im_svc_lin es_fk FORE IGN KEY ( servicelin enumber )
	921	RE FERENCES c laim_svc_l ines ( sub missionsvc lineid );
	922
	923	ALTER TABL E submissi on_codes_b ridge
	924	ADD CO NSTRAINT s ubm_cd_hcc s_cd_fk FO REIGN KEY ( hccs_id )
	925	RE FERENCES h ccs_cd ( h ccs_id );
	926
	927	ALTER TABL E submissi on_codes_b ridge
	928	ADD CO NSTRAINT s ubm_cd_loi nc_cd_fk F OREIGN KEY ( loinc_i d )
	929	RE FERENCES l oinc_cd ( loinc_id ) ;
	930
	931	ALTER TABL E submissi on_codes_b ridge
	932	ADD CO NSTRAINT s ubm_cd_loi nc_mod_cd1 _fk FOREIG N KEY ( lo inc_cd_mod _id1 )
	933	RE FERENCES l oinc_cd_mo d ( loinc_ cd_mod_id );
	934
	935	ALTER TABL E submissi on_codes_b ridge
	936	ADD CO NSTRAINT s ubm_cd_loi nc_mod_cd2 _fk FOREIG N KEY ( lo inc_cd_mod _id2 )
	937	RE FERENCES l oinc_cd_mo d ( loinc_ cd_mod_id );
	938
	939	ALTER TABL E submissi on_codes_b ridge
	940	ADD CO NSTRAINT s ubm_cd_sub m_fk FOREI GN KEY ( s ubmissioni d )
	941	RE FERENCES c laim_submi ssion ( su bmissionid );
	942
	943	CREATE SEQ UENCE clai m_subm_sub missionid_ seq START WITH 1 NOC ACHE ORDER ;
	944
	945	CREATE OR REPLACE TR IGGER clai m_submissi on_submiss ionid BEFO RE
	946	INSERT ON claim_ submission
	947	FOR EA CH ROW
	948	WHEN ( new.submi ssionid IS NULL )
	949	BEGIN
	950	:new.s ubmissioni d := claim _submissio n_submissi onid.nextv al;
	951	END;
	952	/
	953
	954	CREATE SEQ UENCE clai m_svc_line s_subm_svc l_seq STAR T WITH 1 N OCACHE ORD ER;
	955
	956	CREATE OR REPLACE TR IGGER clai m_svc_line s_submissi onsvcl BEF ORE
	957	INSERT ON claim_ svc_lines
	958	FOR EA CH ROW
	959	WHEN ( new.submi ssionsvcli neid IS NU LL )
	960	BEGIN
	961	:new.s ubmissions vclineid : = claim_sv c_lines_su bmissionsv cl.nextval ;
	962	END;
	963	/
	964
	965
	966
	967
	968
	969	Detailed D esign
	970
	971
	972	Section 6. 1.2 detail s the chan ges that w ill be mad e to the c laims adju dication a nd Non-VA Care autho rization p rocess. Th ese change s are refl ected in t he diagram s below.
	973	Figure 6 – Claim Att achment Re quest Desi gn
	974	Software D etailed De sign
	975	Conceptual Design
	976	Product Pe rspective
	977	The change s describe d in this document w ill allow the VA to electronic ally reque st support ing docume ntation fo r claims a nd to acce pt solicit ed electro nic claims attachmen ts and use them duri ng claims adjudicati on. Additi onally, th e changes will allow the VA to electroni cally requ est suppor ting docum entation f or authori zations an d authoriz ation requ ests and t o access s olicited a nd unsolic ited attac hments to authorizat ions and a uthorizati on request s. Finally , when the se attachm ents are b eing solic ited elect ronically, the user will have the abilit y to gener ate and pr int a pape r letter t hat can be sent to t he provide r.
	978	User Inter faces
	979	The user i nterfaces of the var ious exist ing system s will be mostly una ffected. E xisting sc reens in A AT, EWV, a nd FPPS wi ll have li nks to req uest attac hments add ed to them , and exis ting scree ns in AAT will have links to v iew attach ments adde d.
	980	The ARS wi ll be upda ted to all ow users t o search f or attachm ents to au thorizatio n requests via their attachmen t IDs, or using addi tional inf ormation s uch as pat ient demog raphics. A dditionall y, attachm ents for N on-VA Care authoriza tions may be sent to the VistA Imaging s ystem at t he user’s local VAMC .
	981	Communicat ions Inter faces
	982	All involv ed systems will use the existi ng VA netw ork.
	983	Attachment s will be transferre d via Secu re File Tr ansfer Pro tocol (SFT P) from th e HCCH to the EDI Ga teway at t he HAC in the same f ashion tha t claims c urrently w ork. Reque sts for at tachments will be tr ansferred to the HCC H via SFTP in a mann er similar to how cl aims statu s updates currently work. Atta chment dat a will be imported f rom the ED I Gateway into the A RS, and at tachment m etadata wi ll be tran smitted to AAT as ne cessary.
	984	Product Fe atures
	985	The ARS wi ll accept, store, an d process solicited attachment s for clai ms just li ke it curr ently does for unsol icited cla im attachm ents.
	986	The ARS wi ll accept, store, pr ocess, and allow vie wing and d ownloading of solici ted and un solicited attachment s for auth orizations in the sa me way it currently does for c laim attac hments.
	987	The ARS wi ll allow t he solicit ation of a ttachments for claim s, authori zation req uests, and authoriza tions.
	988	The ARS wi ll store r equests fo r attachme nts and al low users to search for and vi ew them.
	989	The ARS wi ll allow a physical letter to be printed that can be sent to request t he same in formation as the att achment re quest.
	990	User Chara cteristics
	991	This devel opment wil l affect c laims adju dicators a nd their s upervisors for Non-V A Care and VFS, as w ell as rev iew nurses , clerks, and superv isors who manage aut horization s for Non- VA Care. F or claims processing , an adjud icator can request c linical do cumentatio n to suppo rt the cla im in ARS, EWV, or F PPS. Likew ise, users of AAT wi ll be able to reques t document ation for authorizat ion reques ts. In add ition, med ical recor ds personn el could u se ARS to download c opies of a ttachments into Vete rans’ medi cal record s in their VistA Ima ging syste m.
	992	Specific R equirement s
	993	Database R epository
	994	ARS tables will be c reated in the FPPS D B for stor age of ARS attacheme nt metadat a. ARS att achements will be sa ve to loca l or netwo rk attache d storage to be dete rmine by t he HAC
	995	System Fea tures
	996	View Solic ited Claim Attachmen ts
	997	Few change s will be needed in order to v iew solici ted claim attachment s. After t he deploym ent from t he FY14 Cl aims Attac hments pro ject, the system wil l already distribute metadata on claims attachment s to all r elevant sy stems allo wing eithe r direct v iewing via ARS or pr oviding at tachment I Ds to sear ch on in A RS.
	998	Table 12 – Design El ements for Solicited Attachmen ts
	999	Requiremen t Number
	1000	Design Ele ment
	1001	Descriptio n
	1002	FS-EP001-0 01
	1003	FS-EP001-0 02
	1004	FS-EP001-0 04
	1005	FS-EP001-0 05
	1006	FS-EP001-0 06
	1007	FS-EP001-0 07
	1008	FS-EP001-0 08
	1009	FS-EP001-0 09
	1010	FS-EP001-0 10
	1011	FS-EP001-0 11
	1012	FS-EP001-0 12
	1013	FS-EP001-0 13
	1014	FS-EP001-0 14
	1015	FS-EP001-0 15
	1016	FS-EP001-0 16
	1017	FS-EP001-0 17
	1018	FS-EP001-0 18
	1019	FS-EP001-0 19
	1020	SD-EP001-0 01
	1021	Solicited claims att achments w ill behave in every way, inclu ding searc hing, view ing, visib ility and hyperlinki ng in down stream sys tems, and downloadin g to VistA Imaging w here appro priate, as unsolicit ed claims as develop ed in the FY14 Claim s Attachme nts Compli ance proje ct.
	1022
	1023	The ARS wi ll update the data u sed by dow nstream sy stems (FPP S and E_RE POS) so th at they ca n link to received a ttachments (or provi de attachm ent IDs fo r searchin g), which, to the do wnstream s ystems, wi ll functio n identica lly to uns olicited a ttachments . Also, th e ARS will update th e data tha t FPPS and EWV use t o display the status of an att achment re quest.
	1024	FS-EP001-0 03
	1025	SD-EP001-0 03
	1026	The user w ill be all owed to en ter any co mbination of the fol lowing fie lds from t he ASC X12 275 EDI T ransaction as the se arch crite ria to vie w electron ic attachm ents.
	1027	Patient Co ntrol Numb er (REF*EJ segment a t the 1000 D loop)
	1028	Medical Re cord Ident ification Number (RE F*EA segme nt at the 1000D loop )
	1029	Patient La st Name (N M103 of th e NM1 segm ent at the 1000D loo p)
	1030	Patient Fi rst Name ( NM104 of t he NM1 seg ment at th e 1000D lo op)
	1031	Patient Id entifier ( ID) (NM109 of the NM 1 segment at the 100 0D loop)
	1032	Provider N PI (NM109 of the NM1 segment a t the 1000 C loop)
	1033	Date of Se rvice – si ngle date or a date range (If not presen t in the D TP472 seg ment of th e 2100A lo op, then D TP472 of the 1000D loop will be used. F ormat Qual ifier can be D8 or R D8)
	1034	Payer Clai m Control Number (TR N segment at the 200 0A loop)
	1035	Attachment Control N umber (TRN segment a t the 2000 A loop)
	1036	VA Unique Attachment ID (Creat ed when th e electron ic attachm ent is sto red in the Attachmen t Reposito ry)
	1037	View Autho rization A ttachments
	1038	ARS will a dd support for solic ited and u nsolicited attachmen ts for aut horization requests. A link al lowing vie wing of th e attachme nt will be available in the AA T GUI for authorizat ion reques ts.
	1039	Table 13 – Design El ements for Unsolicit ed Authori zation Att achments
	1040	Requiremen t Number
	1041	Design Ele ment
	1042	Descriptio n
	1043	FS-EP002-0 01
	1044	SD-EP002-0 01
	1045	For solici ted author ization re sponses, u sers will be able to view 275 healthcare service a ttachments by search ing using the ARS. L inks will also be ad ded to the AAT GUI a llowing vi ewing of a ttachments .
	1046	FS-EP002-0 02
	1047	SD- EP002- 002
	1048	Authorizat ion attach ments will only be v iewable fo r Non-VA C are.
	1049	FS-EP002-0 03
	1050	SD- EP002- 003
	1051	Attachment ID will b e created in the ARS database.
	1052	FS-EP002-0 04
	1053	SD- EP002- 004
	1054	Attachment ID will b e stored i n the AAT database.
	1055	FS-EP002-0 05
	1056	SD- EP002- 005
	1057	A solicite d attachme nt for an authorizat ion respon se will be linked to the origi nal author ization re quest in t he AAT dat abase. ARS will send this info rmation to AAT using a web ser vice.
	1058	FS-EP002-0 06
	1059	SD- EP002- 006
	1060	A solicite d attachme nt for an authorizat ion reques t will be able to be viewed in the ARS v ia a hyper link in th e AAT GUI.
	1061	FS-EP002-0 07
	1062	SD- EP002- 007
	1063	A solicite d attachme nt for an authorizat ion respon se will be linked to the 10-70 78 or 10-7 079 in the AAT datab ase. ARS w ill send t his inform ation to A AT using a web servi ce.
	1064	FS-EP002-0 08
	1065	SD- EP002- 008
	1066	The VistA Imaging us ers will b e allowed to view an d download attachmen ts using t he ARS for healthcar e service attachment s.
	1067	FS-EP002-0 09
	1068	SD- EP002- 009
	1069	The ARS se arch scree n will lis t the stor ed healthc are servic e attachme nts for he althcare s ervice req uests.
	1070	FS-EP002-0 10
	1071	SD- EP002- 010
	1072	The user w ill be all owed to en ter any co mbination of the fol lowing fie lds from t he ASC X12 275 EDI T ransaction as the se arch crite ria to vie w electron ic attachm ents.
	1073	278 Reques t Date
	1074	Patient Co ntrol Numb er (REF*EJ segment a t the 1000 D loop)
	1075	Medical Re cord Ident ification Number (RE F*EA segme nt at the 1000D loop )
	1076	Patient La st Name (N M103 of th e NM1 segm ent at the 1000D loo p)
	1077	Patient Fi rst Name ( NM104 of t he NM1 seg ment at th e 1000D lo op)
	1078	Patient Id entifier ( ID) (NM109 of the NM 1 segment at the 100 0D loop)
	1079	Provider N PI (NM109 of the NM1 segment a t the 1000 C loop)
	1080	Date of Se rvice – si ngle date or a date range (If not presen t in the D TP472 seg ment of th e 2100A lo op, then D TP472 of the 1000D loop will be used. F ormat Qual ifier can be D8 or R D8)
	1081	Payer Clai m Control Number (TR N segment at the 200 0A loop)
	1082	Attachment Control N umber (TRN segment a t the 2000 A loop)
	1083	VA Unique Authorizat ion ID (Cr eated when the elect ronic atta chment is stored in the Attach ment Repos itory)
	1084	FS-EP002-0 11
	1085	SD- EP002- 011
	1086	The search result wi ll display the list of attachm ent IDs wi th links t o the elec tronic att achments b ased on th e search c riteria.
	1087	FS-EP002-0 12
	1088	SD- EP002- 012
	1089	User will be allowed to select and view the attach ments by c licking on the attac hment ID l ink.
	1090	FS-EP002-0 13
	1091	SD- EP002- 013
	1092	When the h yperlink i s clicked, a new ARS window wi ll open to display t he attachm ents.
	1093	FS-EP002-0 14
	1094	SD- EP002- 014
	1095	Healthcare service r equest att achments f or Non-VA Care will be able to be viewed in ARS vi a a hyperl ink in the AAT GUI.
	1096
	1097	Create and Send Requ ests for C laim Attac hments
	1098	This proje ct will ad d the abil ity to FPP S and EWV to request attachmen ts for a c laim. Link s in the c laim detai l view of both tools will allo w the user to open a new activ ity where they speci fy the inf ormation i n the RFAI in order to send it to the pr ovider. Th e status o f an attac hment requ est can al so be chec ked from t he same lo cation. At tachment r equests wi ll be held and trans mitted in a daily ba tch from t he EDI Gat eway to th e HCCH. Th e ARS itse lf will ha ve an adde d activity to fill o ut a blank RFAI, whi ch FBCS us ers can fi ll out usi ng data fr om FBCS.
	1099	Table 14 – Design El ements for Requestin g Claim At tachments
	1100	Requiremen t Number
	1101	Design Ele ment
	1102	Descriptio n
	1103	FS-UN001-0 01
	1104	SD-UN001-0 01
	1105	277 RFAIs will be ab le to be v iewed in A RS.
	1106	FS-UN001-0 02
	1107	SD-UN001-0 02
	1108	For a VFS claim, a c laim will be “flagge d” in EWV when a 277 RFAI has been sent.
	1109	FS-UN001-0 03
	1110	SD-UN001-0 03
	1111	A VFS 277 RFAI that has not be en fulfill ed with an associate d 275 atta chment res ponse will be record ed as havi ng an Open /Pending s tatus in A RS.
	1112	FS-UN001-0 04
	1113	SD-UN001-0 04
	1114	A VFS 277 RFAI will be flagged as closed when an a ssociated 275 respon se is rece ived by th e ARS.
	1115	FS-UN001-0 05
	1116	SD-UN001-0 05
	1117	A user wil l have the ability t o flag the 277 RFAI as closed in ARS or EWV, if th e response is receiv ed in a me ans other than elect ronically (i.e. pape r).
	1118	FS-UN001-0 06
	1119	SD-UN001-0 06
	1120	The ARS se arch scree n will lis t the stor ed healthc are claim requests.
	1121	FS-UN001-0 07
	1122	SD-UN001-0 07
	1123	The user w ill be all owed to en ter any co mbination of the fol lowing fie lds from t he ASC X12 277 EDI T ransaction as the se arch crite ria to vie w healthca re claim r equests.
	1124	Service Pr ovider/Bil ling Provi der Name – 2100C loo p
	1125	Service Pr ovider/NPI – 2100C l oop
	1126	Service Pr ovider/Bil ling Provi der Name – 2100C loo p
	1127	Service Pr ovider/Tax Identific ation Numb er(TIN) – 2100C loop
	1128	Patient La st Name – 2100D loop
	1129	Patient Fi rst Name – 2100D loo p
	1130	Patient Id entifier – 2100D loo p
	1131	Payer Clai m Control Number – T RN02 in th e 2200D lo op
	1132	Patient Co ntrol Numb er (PCN) – REF*EJ at the 2200D loop
	1133	Claim Numb er (CP&E o r FPPS) – REF*D9 at the 2200D loop
	1134	Line Item Control Nu mber – REF *FJ at the 2220D loo p
	1135	Medical Re cord Numbe r – REF *E A at the 2 200D loop
	1136	Internal C ontrol Num ber (ICN) – TRN02 at the 2200D loop
	1137	Date of Se rvice – si ngle date or a date range (DTP 472 segme nt of the 2200D loop at the cl aim level, or DTP47 2 of the 2 220D loop at the ser vice line level will be used. Format Qua lifier can be D8 or RD8) – DTP segment a t the 2200 D loop
	1138	FS-UN002-0 01
	1139	SD-UN002-0 01
	1140	For a Non- VA Care cl aim, a 277 RFAI will be able t o be viewe d in FPPS.
	1141	FS-UN002-0 02
	1142	SD-UN002-0 02
	1143	A new tab “Requests” will be a dded to th e Claims S earch, Awa iting Proc ess, and I n Process screens in FPPS to d isplay all 277 RFAI requests t hat are ma de from FP PS.
	1144	FS-UN002-0 03
	1145	SD-UN002-0 03
	1146	A Non-VA C are 277 RF AI that ha s not been fulfilled with an a ssociated 275 attach ment respo nse will b e recorded as having an Open/P ending sta tus in ARS .
	1147	FS-UN002-0 04
	1148	SD-UN002-0 04
	1149	A Non-VA C are 277 RF AI will be flagged a s closed w hen an ass ociated 27 5 response is receiv ed by the ARS.
	1150	FS-UN002-0 05
	1151	SD-UN002-0 05
	1152	A 277 RFAI will have the abili ty to flag the reque st as clos ed in FPPS , if the r esponse is received in a means other tha n electron ically (i. e. paper).
	1153	FS-UN002-0 06
	1154	SD-UN002-0 06
	1155	For a Non- VA Care cl aim, a 277 RFAI will be able t o be viewe d in ARS.
	1156	FS-EP004-0 01
	1157	SD-EP004-0 01
	1158	A new butt on will be added to the Detail View/Bill ing Misc. screen in EWV to ena ble a user to create a RFAI fo r a VFS cl aim. (Figu re 1)
	1159	FS-EP004-0 02
	1160	SD-EP004-0 02
	1161	The ‘reque st’ button will dire ct a user to ARS to fulfill al l criteria to create and gener ate the 27 7 RFAI.
	1162	FS-EP004-0 03
	1163	SD-EP004-0 03
	1164	A new butt on will be added to the Detail View/Serv ice Line(s ) screen i n EWV to e nable a us er to crea te a RFAI at each li ne of serv ice for VF S.
	1165	FS-EP004-0 04
	1166	SD-EP004-0 04
	1167	The ‘reque st’ button will dire ct a user to ARS to fulfill al l criteria to create and gener ate the 27 7 RFAI.
	1168	FS-EP004-0 05
	1169	SD-EP004-0 05
	1170	A new butt on will be added to the Claims Menu/ Det ail Claim section of the Claim s Search, Awaiting P rocess, an d In Proce ss screens in FPPS t o enable a user to c reate a RF AI (pertai ning to a claim or s ervice lin e for Non- VA Care). (Figure 2)
	1171	FS-EP004-0 06
	1172	SD-EP004-0 06
	1173	The ‘reque st’ button will dire ct a user to ARS to fulfill al l criteria to create and gener ate the 27 7 RFAI.
	1174	FS-EP004-0 07
	1175	FS-EP004-0 08
	1176	SD-EP004-0 07
	1177	A new butt on, design ed with FB CS users i n mind, wi ll be adde d to the A RS to enab le the use r to creat e a 277 RF AI.The “re quest” but ton will p resent the user with a blank r equest for m. The use r will be able to fi ll out all applicabl e fields t o create a nd generat e the 277 RFAI.
	1178	FS-UN005-0 01
	1179	SD-UN005-0 01
	1180	The new RF AI screen in ARS wil l input da ta into th e followin g pre-popu lated fiel ds:
	1181	Payer Name : Veteran’ s Affairs
	1182	Payer ID: 12115 (for Blank For m, or matc hing the s ource clai m when ope ned from F PPS [alway s 12115] o r EWV [841 46 or 8021 4])
	1183	Informatio n Receiver : HCCH, ET IN
	1184	Response D ue Date – the date 3 0 days in the future from the date of th e request
	1185	Contact In formation – this wil l be the g roup email of the lo cal VAMC
	1186	FS-UN005-0 02
	1187	SD-UN005-0 02
	1188	The new Re quest for Additional Informati on screen in ARS wil l pre-popu late data from the a ssociated claim line s (or with the infor mation pro vided) int o the foll owing fiel ds:
	1189	Service Pr ovider/Bil ling Provi der Name – 2010AA lo op from th e 837 Prov ider Name - 2100C lo op of the 277RFAI
	1190	Service Pr ovider/NPI – 2010AA loop from the 837 P rovider NP I - 2100C loop of th e 277RFAI
	1191	Service Pr ovider/TIN – 2010AA loop from the 837 Provide r TIN - 21 00C loop o f the 277R FAI, if NP I not avai lable
	1192	Patient La st Name –2 010BA loop from the 837 Pat ient Last Name - 210 0D loop of the 277RF AI
	1193	Patient Fi rst Name – 2010BA loo p from the 837 Pat ient First Name- 210 0D loop of the 277RF AI
	1194	Patient Id entifier 2 010BA (SSN with a MI qualifier ) Patie nt Identif ier Name - 2100D loo p of the 2 77RFAI
	1195	Payer Clai m Control Number – C HAMPVA cla im ID or F PPS claim index numb er Payer C laim Contr ol Number - TRN02 at the 2200D loop of t he 277RFAI
	1196	PCN - CLM0 1 at the 2 300 loop Patient C ontrol Num ber - REF* EJ at the 2200D loop of the 27 7RFAI
	1197	Bill Type (for 837I claims) – CLM05 at t he 2300 lo op Bill Type - RE F*BLT at t he 2200D l oop of the 277RFAI
	1198	Clearingho use ID – R EFD9 at t he 2300 lo op C learinghou se ID – RE FD9 at th e 2200D lo op of the 277RFAI
	1199	Medical Re cord Numbe r – REF E A at the 2 300 loop Medical R ecord Numb er - REFE A at the 2 200D loop of the 277 RFAI
	1200	Date(s) of Service – single da te or a da te range ( DTP472 s egment of the 2400 l oop at the Service l ine level of the 837 P. Format Qualifier can be D8 or RD8) (D TP434 seg ment of th e 2300 loo p at the C laim level of the 83 7I. Format Qualifier can be D8 or RD8); Date(s) of Service - DTP03 at the 2200D loop of th e 277RFAI (will be r equired in the insta nce when a claim lev el only re quest is m ade)
	1201	FS-UN005-0 03
	1202	SD-UN005-0 03
	1203	The new RF AI screen in ARS wil l pre-popu late data from the a ssociated claim/serv ice lines (or with t he informa tion provi ded) into the follow ing fields when the request is generated at the se rvice line level:
	1204	Service Pr ovider/Bil ling Provi der Name – 2010AA lo op from th e 837 Prov ider Name - 2100C lo op of the 277RFAI
	1205	Service Pr ovider/NPI – 2010AA loop from the 837 Pr ovider NPI - 2100C l oop of the 277RFAI
	1206	Service Pr ovider/TIN – 2010AA loop from the 837 P rovider TI N - 2100C loop of th e 277RFAI, if NPI no t availabl e
	1207	Patient La st Name –2 010BA loop from the 837 Patient L ast Name - 2100D loo p of the 2 77RFAI
	1208	Patient Fi rst Name – 2010BA loo p from the 837 Patient F irst Name- 2100D loo p of the 2 77RFAI
	1209	Patient Id entifier 2 010BA (SSN with a MI qualifier ) P atient Ide ntifier Na me - 2100D loop of t he 277RFAI
	1210	Payer Clai m Control Number –CH AMPVA clai m ID or FP PS claim i ndex numbe r Payer Cl aim Contro l Number - TRN02 at the 2200D loop of th e 277RFAI
	1211	PCN - CLM0 1 at the 2 300 loop Patie nt Control Number - REF*EJ at the 2200D loop of th e 277RFAI
	1212	Bill Type (for 837I claims) – CLM05 at t he 2300 lo op Bill Type - REF*BLT at the 220 0D loop of the 277RF AI
	1213	Clearingho use ID – R EFD9 at t he 2300 lo op Clearin ghouse ID – REFD9 a t the 2200 D loop of the 277RFA I
	1214	Medical Re cord Numbe r – REF E A at the 2 300 loop Medic al Record Number - R EFEA at t he 2200D l oop of the 277RFAI
	1215	Service Li ne Informa tion/Reven ue Code - SVC201 at the 2400 l oop from t he 837I; S ervice Lin e Informat ion/Proced ure Code - SVC01 – 2 at the 22 20D loop o f the 277R FAI if Pro cedure cod e not pres ent, else SVC04 at t he 2220D l oop of the 277RFAI
	1216	Service Li ne Informa tion/Proce dure Code – SVC202 – 2 at the 2400 loop from the 8 37I; Servi ce Line In formation/ Procedure Code – SVC 01 – 2 at the 2220D loop of th e 277RFAI, if presen t
	1217	Service Li ne Informa tion/Proce dure Code – SVC101 – 2 at the 2400 loop from the 8 37P or – S VC301 – 2 at the 240 0 loop fro m the 837D Service L ine; Infor mation/Pro cedure Cod e – SVC01 – 2 at the 2220D loo p of the 2 77RFAI
	1218	Service Li ne Informa tion/Modif iers
	1219	(4 occurre nces) –
	1220	SVC101 – 3 , SVC101 – 4, SVC101 – 5, SVC1 01 – 6 of 2400 loop of 837P/D and SVC201 – 3, SVC2 01 – 4, SV C201 – 5, SVC201 – 6 of the 83 7I Service Line Info rmation/Mo difiers
	1221	(4 occurre nces) –
	1222	SVC01 – 3, SVC01 – 4 , SVC01 – 5, SVC01 – 6 at the 2220D loop of the 27 7RFAI
	1223	Service Li ne Informa tion/Charg e Amount – SVC102 at the 2400 loop from the 837P/D and SVC20 3 from the 837I; Ser vice Line Informatio n/Charge A mount – SV C02 at the 2220D loo p of the 2 77RFAI
	1224	Date(s) of Service – single da te or a da te range ( DTP472 se gment of t he 2220D l oop at the service l ine level will be us ed. Format Qualifier can be D8 or RD8) – DTP segme nt at the 2220D loop . (This fi eld can al so be calc ulated fro m the firs t and last dates of service at the line level for 837P/D cla ims.); Dat e(s) of Se rvice – si ngle date or a date range (DTP 472 segme nt of the 2220D loop at the se rvice line level wil l be used. Format Qu alifier ca n be D8 or RD8) – DT P*472 segm ent at the 2220D loo p.
	1225	Line Item Control Nu mber – REF 02 at the 2400 loop on the ori ginal clai m. (If a L ine Item C ontrol Num ber is not submitted , this wil l be the l ine sequen ce number of the ser vice line. ) Line Ite m Control Number – R EF02 at th e 2400 loo p on the o riginal cl aim. (If a Line Item Control N umber is n ot submitt ed, this w ill be the line sequ ence numbe r of the s ervice lin e.)
	1226	FS-UN005-0 04
	1227	SD-UN005-0 04
	1228	The 837 cl aim data u sed to pre -populate the fields above whe n creating the RFAI from EWV w ill be pul led from t he e-Repos itory.
	1229	FS-UN005-0 05
	1230	SD-UN005-0 05
	1231	The 837 cl aim data u sed to pre -populate the fields above whe n creating the RFAI from FPPS will be pu lled from FPPS_Owner .
	1232	FS-UN005-0 06
	1233	SD-UN005-0 06
	1234	The pre-po pulated fi elds will not be edi table by t he ARS use r for a RF AI request generated from EWV or FPPS.
	1235	FS-UN005-0 07
	1236	SD-UN005-0 07
	1237	The pre-po pulated fi elds will not be val idated dur ing the va lidation p rocess upo n submissi on of the request.
	1238	FS-UN005-0 08
	1239	SD-UN005-0 08
	1240	The fields will be a ble to be edited by the user f or a blank RFAI requ est genera ted in the ARS.
	1241	FS-UN006-0 01
	1242	SD-UN006-0 01
	1243	The follow ing fields will be m arked as * Required w hen creati ng the 277 RFAI in t he ARS:
	1244	Health Car e Claim St atus Categ ory Code
	1245	LOINC Code
	1246	LOINC Code Modifier
	1247	FS-UN006-0 02
	1248	SD-UN006-0 02
	1249	The Health Care Clai m Status C ategory Co de field w ill list t he Descrip tions of t he valid v alues for a user to choose fro m and map to the val id Health Care Claim Status Ca tegory cod e upon cre ating the 277 RFAI t ransaction .
	1250
	1251	STC01-1 va lue
	1252	Descriptio n
	1253	R0
	1254	RFAIs/Gene ral Reques ts-Request s that don 't fall in to other R -type cate gories.
	1255	R1
	1256	RFAIs/Enti ty Request s-Requests for infor mation abo ut specifi c entities (subscrib ers, patie nts, vario us provide rs).
	1257	R3
	1258	RFAIs/Clai m/Line-Req uests for informatio n that cou ld normall y be submi tted on a claim.
	1259	R4
	1260	RFAIs/Docu mentation- Requests f or additio nal suppor ting docum entation. Examples: certificat ion, x-ray , notes.
	1261	R5
	1262	RFAI/more specific d etail-Addi tional inf ormation a s a follow up to a p revious re quest is n eeded. The original informatio n was rece ived but i s inadequa te. More s pecific/de tailed inf ormation i s requeste d.
	1263	R6
	1264	RFAIs – Re gulatory r equirement s
	1265	R7
	1266	RFAIs – Co nfirm care is consis tent with Health Pla n policy c overage
	1267	R8
	1268	RFAIs – Co nfirm care is consis tent with health pla n coverage exception s
	1269	R9
	1270	RFAIs – De terminatio n of medic al necessi ty
	1271	R10
	1272	RFAIs – Su pport a fi led grieva nce or app eal
	1273	R11
	1274	RFAIs – Pr e-payment review of claims
	1275	R12
	1276	RFAIs – Cl arificatio n or justi fication o f use for specified procedure code
	1277	R13
	1278	RFAIs – Or iginal doc uments sub mitted are not reada ble. Used only for s ubsequent request(s) .
	1279	R14
	1280	RFAIs – Or iginal doc uments rec eived are not what w as request ed. Used o nly for su bsequent r equest(s).
	1281	R15
	1282	RFAIs – Wo rkers Comp ensation c overage de terminatio n.
	1283	R16
	1284	RFAIs – El igibility determinat ion
	1285	R17
	1286	Replacemen t of a Pri or Request . Used to indicate t hat the cu rrent atta chment req uest repla ces a prio r attachme nt request .
	1287
	1288	FS-UN006-0 03
	1289	SD-UN006-0 03
	1290	The Health Care Clai m Status C ategory Co de field w ill be req uired for a valid va lue and ca nnot be bl ank.
	1291	FS-UN006-0 04
	1292	SD-UN006-0 04
	1293	The LOINC Code field will list the Descr iptions of the valid values fo r a user t o choose f rom and ma p to the v alid LOINC Code upon creating the 277 RF AI transac tion.
	1294	Clinical d ocument Ty pe
	1295	Position i n STC,
	1296	Descriptio n/selectio n term
	1297
	1298	LOINC code s for STC0 1-4
	1299
	1300
	1301	19016-5
	1302	All reques ts for inf ormation t hat are in cluded in this trans action are implicit to individ ual servic es.
	1303	Continuity of Care D ocument (C CD)
	1304	34133-9
	1305	Summarizat ion of epi sode note
	1306	Consultati on Note
	1307	11488-4
	1308	Consult no te
	1309	Diagnostic Imaging R eport (DIR )
	1310	18748-4
	1311	Diagnostic imaging s tudy
	1312	Discharge Summary
	1313	18842-5
	1314	Discharge summary
	1315	History an d Physical
	1316	34117-2
	1317	History an d physical note
	1318	Operative Note
	1319	11504-8
	1320	Provider-u nspecified Operation note
	1321	Procedure Note
	1322	28570-0
	1323	Provider-u nspecified Procedure note
	1324	Progress N ote
	1325	11506-3
	1326	Provider-u nspecified Progress note
	1327
	1328	FS-UN006-0 05
	1329	SD-UN006-0 05
	1330	The LOINC Code field will be r equired fo r a valid value and cannot be blank.
	1331	FS-UN006-0 06
	1332	SD-UN006-0 06
	1333	LOINC Code 19016-5 w ill be val idated to not appear on a 277 RFAI at th e service line level .
	1334	FS-UN006-0 07
	1335	SD-UN006-0 07
	1336	The LOINC Code Modif ier field will list the Descri ptions of the valid values for a user to choose fr om and map to the va lid LOINC Code Modif ier code u pon creati ng the 277 RFAI tran saction.
	1337
	1338	MODIFIER L OINC codes for STC10 -4 and STC 11-4
	1339	Selection descriptio n dealing with time
	1340	18789-8
	1341	Include al l data of the select ed type wi thin the d ate window associate d with the service
	1342	18790-6
	1343	Include al l data of the select ed type on or before the date of service
	1344	18791-4
	1345	Include al l data of the select ed type wi thin or al igned to a service
	1346	18792-2
	1347	Include al l data of the select ed type on or after the date o f service
	1348	18803-7
	1349	Include al l data of the select ed type th at represe nts observ ations mad e 30 days or fewer b efore the starting d ate of ser vice
	1350	18804-5
	1351	Include al l data of the select ed type th at represe nts observ ations mad e three mo nths or fe wer before the start ing date o f service
	1352	18805-2
	1353	Include al l data of the select ed type th at represe nts observ ations mad e six mont hs or fewe r before t he startin g date of service
	1354	18806-0
	1355	Include al l data of the select ed type th at represe nts observ ations mad e nine mon ths or few er before the starti ng date of service
	1356	18807-8
	1357	Include al l data of the select ed type th at represe nts observ ations mad e one year or less b efore the starting d ate of ser vice
	1358	53033-7
	1359	Include al l data of the select ed type th at represe nts observ ations mad e two year s or less before the starting date of se rvice
	1360	18793-0
	1361	Use no fix ed time li mit on dat a—any of t he selecte d type are relevant no matter when obtai ned
	1362
	1363	Selection descriptio n dealing with Item
	1364	18794-8
	1365	Send all i tems of th e specifie d type wit hin the ti me window
	1366	18795-5
	1367	Send all i tems of th e specifie d type wit hin the ti me window relevant t o the serv ice
	1368	18796-3
	1369	Send all a bnormals w ithin the time windo w
	1370	18797-1
	1371	Send the f irst abnor mals withi n the time window
	1372	18798-9
	1373	Send the l ast abnorm als within the time window
	1374	18800-3
	1375	Send the w orst abnor mal result for each kind of ob servation in the tim e window
	1376	18799-7
	1377	Send the f irst (i.e. , oldest) result for each kind of observ ation in t he time wi ndow
	1378	18802-9
	1379	Send the l ast (most recent) wi thin the t ime window
	1380
	1381	FS-UN006-0 08
	1382	SD-UN006-0 08
	1383	The LOINC Code Modif ier field will be re quired for a valid v alue and c annot be b lank.
	1384	FS-UN007-0 01
	1385	SD-UN007-0 01
	1386	The Health Care Clai m Status C ategory Co de list wi ll be able to be edi ted by a u ser with s uper user/ admin righ ts in the ARS.
	1387	FS-UN007-0 02
	1388	SD-UN007-0 02
	1389	The LOINC Code list will be ab le to be e dited by a user with super use r/admin ri ghts in th e ARS.
	1390	FS-UN007-0 03
	1391	SD-UN007-0 03
	1392	The LOINC Code Modif ier list w ill be abl e to be ed ited by a user with super user /admin rig hts in the ARS.
	1393	FS-UN008-0 01
	1394	SD-UN008-0 01
	1395	A new butt on will be added to the RFAI s creen in t he ARS to ‘submit’ t he request .
	1396	FS-UN008-0 02
	1397	SD-UN008-0 02
	1398	Upon submi ssion of t he 277 RFA I the ‘req uired’ fie lds will b e validate d in the A RS.
	1399	FS-UN008-0 03
	1400	SD-UN008-0 03
	1401	Fields fou nd with in correct en tries duri ng the val idation pr ocess will be marked for the u ser to cor rect.
	1402	FS-UN009-0 01
	1403	SD-UN009-0 01
	1404	Required f ields foun d with bla nk entries during th e validati on process will be m arked for the user t o enter a valid valu e.
	1405	FS-UN010-0 01
	1406	SD-UN010-0 01
	1407	A solicite d 277 RFAI will be l inked to t he associa ted claim using the TRN segmen t.
	1408	FS-UN010-0 02
	1409	SD-UN010-0 02
	1410	The ARS wi ll create the 277 RF AI transac tion.
	1411	FS-UN010-0 03
	1412	SD-UN010-0 03
	1413	The 277 RF AI transac tion will be stored in the arc hive datab ase awaiti ng transmi ssion to t he HCCH.
	1414	FS-UN010-0 04
	1415	SD-UN010-0 04
	1416	A batch of 277 RFAI transactio ns in the archive da tabase wil l be creat ed nightly .
	1417	FS-UN010-0 05
	1418	SD-UN010-0 05
	1419	The batch file will have no ma ximum file size othe r than tha t mandated by the fi le system of the ser ver.
	1420	FS-UN010-0 06
	1421	SD-UN010-0 06
	1422	The batch transmissi on from ED I Gateway to the HCC H will occ ur nightly .
	1423	FS-UN010-0 07
	1424	SD-UN010-0 07
	1425	The 277 RF AI will be stored in the Attac hment Repo sitory for viewing p urposes.
	1426	Create and Send Requ ests for A uthorizati on Request Attachmen ts
	1427	This proje ct will ad d the abil ity to AAT GUI to re quest atta chments fo r an autho rization r equest. Th e user wil l be able to search for an aut horization request u sing Veter an informa tion and p rovider in formation. While vie wing an au thorizatio n request, a link wi ll allow t he user to open a ne w activity where the y specify the inform ation in t he RFAI in order to send it to the provi der. The s tatus of a n attachme nt request can also be checked from the same locat ion. Attac hment requ ests will be transmi tted in re al time fr om the AAT .
	1428	Table 15 – Design El ements for Requestin g Authoriz ation Atta chments
	1429	Requiremen t Number
	1430	Design Ele ment
	1431	Descriptio n
	1432	FS-UN004-0 01
	1433	SD-UN004-0 01
	1434	For a heal thcare ser vice reque st, a 278 RFAI will be able to be viewed in ARS.
	1435	FS-UN004-0 02
	1436	SD-UN004-0 02
	1437	A Non-VA C are 278 RF AI that ha s not been fulfilled with an a ssociated 275 attach ment respo nse will b e recorded as having an Open/P ending sta tus in ARS .
	1438	FS-UN004-0 03
	1439	SD-UN004-0 03
	1440	A 278 RFAI will be f lagged as closed whe n a 275 re sponse is received.
	1441	FS-UN004-0 04
	1442	SD-UN004-0 04
	1443	An AAT use r will hav e the abil ity to fla g the requ est as clo sed, if th e response is receiv ed in a me ans other than elect ronically (i.e. pape r).
	1444	FS-EP007-0 01
	1445	SD-EP007-0 01
	1446	A new butt on will be added to the AAT GU I to enabl e a user t o create a RFAI for a Non-VA C are author ization re quest.
	1447	FS-EP007-0 02
	1448	FS-EP007-0 03
	1449	SD-EP007-0 02
	1450	The “reque st” button will dire ct a user to a new a ctivity in the AAT G UI to fulf ill all cr iteria to create and generate the 278 RF AI.
	1451	FS-UN011-0 01
	1452	SD-UN011-0 01
	1453	The new RF AI screen in AAT GUI will inpu t data int o the foll owing pre- populated fields:
	1454	Payer Name : Veteran’ s Affairs
	1455	Payer ID: 12115
	1456	Informatio n Receiver : HCCH, ET IN
	1457	Contact In formation – this wil l be the g roup email of the lo cal VAMC
	1458	FS-UN011-0 02
	1459	SD-UN011-0 02
	1460	The new RF AI screen in AAT GUI will pre- populate d ata from t he associa ted author ization re quest (or with the i nformation provided) into the following fields:
	1461	*Field inf ormation t o be provi ded.
	1462	FS-UN011-0 03
	1463	SD-UN011-0 03
	1464	The 278 He althcare S ervices Re view Reque st data us ed to pre- populate t he fields above when creating the RFAI f rom AAT GU I will be pulled fro m the AAT database.
	1465	FS-UN011-0 04
	1466	SD-UN011-0 04
	1467	The pre-po pulated fi elds will not be edi table by t he user.
	1468	FS-UN011-0 05
	1469	SD-UN011-0 05
	1470	The pre-po pulated fi elds will not be val idated dur ing the va lidation p rocess upo n submissi on of the request.
	1471	FS-UN012-0 01
	1472	SD-UN012-0 01
	1473	The follow ing fields will be m arked as * Required w hen creati ng the 278 RFAI:
	1474	Health Car e Claim St atus Categ ory Code
	1475	LOINC Code
	1476	LOINC Code Modifier
	1477	FS-UN012-0 02
	1478	SD-UN012-0 02
	1479	The Health Care Clai m Status C ategory Co de field w ill list t he Descrip tions of t he valid v alues for a user to choose fro m and map to the val id Health Care Claim Status Ca tegory cod e upon cre ating the 278 RFAI t ransaction .
	1480	STC01-1 va lue
	1481	Descriptio n
	1482	R0
	1483	RFAIs/Gene ral Reques ts-Request s that don 't fall in to other R -type cate gories.
	1484	R1
	1485	RFAIs/Enti ty Request s-Requests for infor mation abo ut specifi c entities (subscrib ers, patie nts, vario us provide rs).
	1486	R3
	1487	RFAIs/Clai m/Line-Req uests for informatio n that cou ld normall y be submi tted on a claim.
	1488	R4
	1489	RFAIs/Docu mentation- Requests f or additio nal suppor ting docum entation. Examples: certificat ion, x-ray , notes.
	1490	R5
	1491	RFAI/more specific d etail-Addi tional inf ormation a s a follow up to a p revious re quest is n eeded. The original informatio n was rece ived but i s inadequa te. More s pecific/de tailed inf ormation i s requeste d.
	1492	R6
	1493	RFAIs – Re gulatory r equirement s
	1494	R7
	1495	RFAIs – Co nfirm care is consis tent with Health Pla n policy c overage
	1496	R8
	1497	RFAIs – Co nfirm care is consis tent with health pla n coverage exception s
	1498	R9
	1499	RFAIs – De terminatio n of medic al necessi ty
	1500	R10
	1501	RFAIs – Su pport a fi led grieva nce or app eal
	1502	R11
	1503	RFAIs – Pr e-payment review of claims
	1504	R12
	1505	RFAIs – Cl arificatio n or justi fication o f use for specified procedure code
	1506	R13
	1507	RFAIs – Or iginal doc uments sub mitted are not reada ble. Used only for s ubsequent request(s) .
	1508	R14
	1509	RFAIs – Or iginal doc uments rec eived are not what w as request ed. Used o nly for su bsequent r equest(s).
	1510	R15
	1511	RFAIs – Wo rkers Comp ensation c overage de terminatio n.
	1512	R16
	1513	RFAIs – El igibility determinat ion
	1514	R17
	1515	Replacemen t of a Pri or Request . Used to indicate t hat the cu rrent atta chment req uest repla ces a prio r attachme nt request .
	1516
	1517	FS-UN012-0 03
	1518	SD-UN012-0 03
	1519	The Health Care Clai m Status C ategory Co de field w ill be req uired for a valid va lue and ca nnot be bl ank.
	1520	FS-UN012-0 04
	1521	SD-UN012-0 04
	1522	The LOINC Code field will list the Descr iptions of the valid values fo r a user t o choose f rom and ma p to the v alid LOINC Code upon creating the 278 RF AI transac tion.
	1523	19016-5 Al l requests for infor mation tha t are incl uded in th is transac tion are i mplicit to individua l services . (Used at claim lev el only.)
	1524	Clinical d ocument Ty pe
	1525	Position i n STC,
	1526	Descriptio n/selectio n term
	1527
	1528	LOINC code s for STC0 1-4
	1529
	1530
	1531	19016-5
	1532	All reques ts for inf ormation t hat are in cluded in this trans action are implicit to individ ual servic es.
	1533	CCD
	1534	34133-9
	1535	Summarizat ion of epi sode note
	1536	Consultati on Note
	1537	11488-4
	1538	Consult no te
	1539	DIR
	1540	18748-4
	1541	Diagnostic imaging s tudy
	1542	Discharge Summary
	1543	18842-5
	1544	Discharge summary
	1545	History an d Physical
	1546	34117-2
	1547	History an d physical note
	1548	Operative Note
	1549	11504-8
	1550	Provider-u nspecified Operation note
	1551	Procedure Note
	1552	28570-0
	1553	Provider-u nspecified Procedure note
	1554	Progress N ote
	1555	11506-3
	1556	Provider-u nspecified Progress note
	1557
	1558	FS-UN012-0 05
	1559	SD-UN012-0 05
	1560	The LOINC Code field will be r equired fo r a valid value and cannot be blank.
	1561	FS-UN012-0 06
	1562	SD-UN012-0 06
	1563	LOINC Code 19016-5 w ill be val idated to not appear on a 278 RFAI at th e service line level .
	1564	FS-UN012-0 07
	1565	SD-UN012-0 07
	1566	The LOINC Code Modif ier field will list the Descri ptions of the valid values for a user to choose fr om and map to the va lid LOINC Code Modif ier code u pon creati ng the 278 RFAI tran saction.
	1567	MODIFIER L OINC codes for STC10 -4 and STC 11-4
	1568	Selection descriptio n dealing with time
	1569	18789-8
	1570	Include al l data of the select ed type wi thin the d ate window associate d with the service
	1571	18790-6
	1572	Include al l data of the select ed type on or before the date of service
	1573	18791-4
	1574	Include al l data of the select ed type wi thin or al igned to a service
	1575	18792-2
	1576	Include al l data of the select ed type on or after the date o f service
	1577	18803-7
	1578	Include al l data of the select ed type th at represe nts observ ations mad e 30 days or fewer b efore the starting d ate of ser vice
	1579	18804-5
	1580	Include al l data of the select ed type th at represe nts observ ations mad e three mo nths or fe wer before the start ing date o f service
	1581	18805-2
	1582	Include al l data of the select ed type th at represe nts observ ations mad e six mont hs or fewe r before t he startin g date of service
	1583	18806-0
	1584	Include al l data of the select ed type th at represe nts observ ations mad e nine mon ths or few er before the starti ng date of service
	1585	18807-8
	1586	Include al l data of the select ed type th at represe nts observ ations mad e one year or less b efore the starting d ate of ser vice
	1587	53033-7
	1588	Include al l data of the select ed type th at represe nts observ ations mad e two year s or less before the starting date of se rvice
	1589	18793-0
	1590	Use no fix ed time li mit on dat a—any of t he selecte d type are relevant no matter when obtai ned
	1591
	1592	Selection descriptio n dealing with Item
	1593	18794-8
	1594	Send all i tems of th e specifie d type wit hin the ti me window
	1595	18795-5
	1596	Send all i tems of th e specifie d type wit hin the ti me window relevant t o the serv ice
	1597	18796-3
	1598	Send all a bnormals w ithin the time windo w
	1599	18797-1
	1600	Send the f irst abnor mals withi n the time window
	1601	18798-9
	1602	Send the l ast abnorm als within the time window
	1603	18800-3
	1604	Send the w orst abnor mal result for each kind of ob servation in the tim e window
	1605	18799-7
	1606	Send the f irst (i.e. , oldest) result for each kind of observ ation in t he time wi ndow
	1607	18802-9
	1608	Send the l ast (most recent) wi thin the t ime window
	1609
	1610	FS-UN012-0 08
	1611	SD-UN012-0 08
	1612	The LOINC Code Modif ier field will be re quired for a valid v alue and c annot be b lank.
	1613	FS-UN013-0 01
	1614	SD-UN013-0 01
	1615	The Health Care Clai m Status C ategory Co de list wi ll be able to be edi ted by a u ser with s uper user/ admin righ ts.
	1616	FS-UN013-0 02
	1617	SD-UN013-0 02
	1618	The LOINC Code list will be ab le to be e dited by a user with super use r/admin ri ghts.
	1619	FS-UN013-0 03
	1620	SD-UN013-0 03
	1621	The LOINC Code Modif ier list w ill be abl e to be ed ited by a user with super user /admin rig hts.
	1622	FS-UN014-0 01
	1623	SD-UN014-0 01
	1624	A new butt on will be added to the RFAI s creen to ‘ submit’ th e request.
	1625	FS-UN014-0 02
	1626	SD-UN014-0 02
	1627	Upon submi ssion of t he 278 RFA I the ‘req uired’ fie lds will b e validate d.
	1628	FS-UN014-0 03
	1629	SD-UN014-0 03
	1630	Fields fou nd with in correct en tries duri ng the val idation pr ocess will be marked for the u ser to cor rect.
	1631	FS-UN015-0 01
	1632	SD-UN015-0 01
	1633	Required f ields foun d with bla nk entries during th e validati on process will be m arked for the user t o enter a valid valu e.
	1634	FS-UN016-0 01
	1635	SD-UN016-0 01
	1636	A solicite d 278 RFAI will be l inked to t he associa ted author ization us ing the TR N segment and master Authoriza tion ID nu mber.
	1637	FS-UN016-0 02
	1638	SD-UN016-0 02
	1639	The AAT wi ll create the 278 RF AI transac tion.
	1640	FS-UN016-0 03
	1641	SD-UN016-0 03
	1642	The 278 RF AI transac tion will be sent to the HCCH as a real- time trans action.
	1643	FS-UN016-0 04
	1644	SD-UN016-0 04
	1645	The 278 RF AI will be stored in the Autho rization R epository for viewin g purposes .
	1646	Create Req uest for I nformation Letters
	1647	Wherever a user can generate a n RFAI in order to r equest inf ormation f rom a prov ider, they will have an option to additi onally gen erate a le tter that can be pri nted to ph ysically s end to the provider. The exact text of t he letter will be de termined b y the Chie f Business Office Pu rchased Ca re (CBOPC) team and will be ad ded to thi s document once it h as been co mpleted.
	1648	Table 16 – Design El ements for Printed R FAIs
	1649	Requiremen t Number
	1650	Design Ele ment
	1651	Descriptio n
	1652	FS-EP005-0 01
	1653	SD-EP005-0 01
	1654	The user w ill have t he ability to print the newly created 27 7 RFAI upo n submissi on.
	1655	FS-EP005-0 02
	1656	SD-EP005-0 02
	1657	The user w ill have t he ability to print the standa rdized let ter upon d isplaying the RFAI f rom the as sociated l ink into A RS from EW V, FPPS, o r AAT, or directly f rom ARS. T he link fr om all of these syst ems will l ead to a n ew activit y in ARS t hat does t he actual letter gen eration an d printing .
	1658	FS-EP005-0 03
	1659	SD-EP005-0 03
	1660	When the l etter is p rinted fro m the RFAI view in A RS, it wil l be gener ated with the curren t date.
	1661	FS-EP005-0 04
	1662	SD-EP005-0 04
	1663	The letter will be d ynamically generated to displa y the rema ining numb er of days a provide r has to r espond to the RFAI ( i.e. 45-T) .
	1664	FS-EP005-0 05
	1665	SD-EP005-0 05
	1666	An audit t rail will be created with a li nk to the previously printed l etter, dat e the lett er was pri nted, and user name/ ID.
	1667	FS-EP005-0 06
	1668	SD-EP005-0 06
	1669	The user w ill have t he ability to reprin t any of t he previou sly create d letters.
	1670	FS-EP006-0 01
	1671	SD-EP006-0 01
	1672	The user w ill have t he ability to print the newly created 27 8 RFAI upo n submissi on.
	1673	FS-EP006-0 02
	1674	SD-EP006-0 02
	1675	The user w ill have t he ability to print the standa rdized let ter upon d isplaying the RFAI f rom the as sociated l ink in EWV , FPPS, AA T, and/or ARS.
	1676	FS-EP006-0 03
	1677	SD-EP006-0 03
	1678	When the l etter is p rinted fro m the RFAI link in E WV, FPPS, AAT, and/o r ARS, it will be ge nerated wi th the cur rent date.
	1679	FS-EP006-0 04
	1680	SD-EP006-0 04
	1681	An audit t rail will be created in ARS wi th a link to the pre viously pr inted lett er, date t he letter was printe d, and use r name/ID.
	1682	FS-EP006-0 05
	1683	SD-EP006-0 05
	1684	The user w ill have t he ability to reprin t any of t he previou sly create d letters.
	1685
	1686
	1687	External S ystem Inte rface Desi gn
	1688	Interface Architectu re
	1689	All involv ed systems will use the existi ng VA netw ork.
	1690	Attachment s will be transferre d via SFTP from the HCCH to th e EDI Gate way at the HAC in th e same fas hion that claims cur rently wor k. Attachm ent data w ill be imp orted from the EDI G ateway int o the ARS, and attac hment meta data will be transmi tted to AA T as neces sary.
	1691	Interface Detailed D esign
	1692	The EDI Ga teway curr ently uses a system of scripts to receiv e files vi a SFTP fro m HCCH, th en parse t hem and re package th em for imp orting int o other sy stems. Thi s project will also use the ED I Gateway to send fi les contai ning reque sts for at tachments to the HCC H, as well . As of th is writing , exact fi le format specificat ions for f iles to an d from the HCCH for supporting attachmen ts and req uests are in progres s. The ARS repositor y will imp ort and ex port the f iles relev ant to man aging elec tronic att achments.
	1693
	1694	Human-Mach ine Interf ace
	1695	Interface Design Rul es
	1696	ARS will f ollow FPPS 2.0 singl e page app lication g uide lines using HTM L5, CSS3, JavaScript and Angul ar 2. All screens wi ll be 508 compliant.
	1697	Inputs
	1698	ARS
	1699	ASC X12 27 5 Addition al Informa tion to Su pport a He alth Care Services R eview tran sactions f rom EDI Ga teway
	1700	Access aud it trail i nformation when atta chments ar e accessed
	1701	AAT
	1702	Authorizat ion attach ment metad ata from A RS
	1703	Outputs
	1704	ARS
	1705	ASC X12 27 7 Health C are Claim RFAI trans actions to EDI Gatew ay
	1706	ASC X12 27 8 Health C are Servic es Review – Request for Review and Respo nse transa ctions to EDI Gatewa y
	1707	Authorizat ion attach ment metad ata to ARS
	1708	Security a nd Privacy
	1709	Security
	1710	EWV and F PPS will c ontinue to restrict access to only autho rized user s via a lo gin proces s. The AAT GUI will also restr ict access based on login to o nly author ized users . Attachme nt request s will be audited.
	1711	The ARS wi ll maintai n a record of all vi ews and do wnloads of attachmen ts, and on ly users w ho are exp licitly gi ven access to the sy stem will be able to access or request a ttachments .
	1712	Privacy
	1713	Protected Health Inf ormation ( PHI) and P ersonally Identifiab le Informa tion (PII) will be s ecured in the approp riate data bases with controls to ensure that only those with a need to access th e data wil l be able to do so.
	1714
	1715	Attachment Storage C apacity An alysis
	1716	Station
	1717	Claims (Ye arly)
	1718	Attachment s (Yearly)
	1719	% of paper claims wi th attachm ents (Yea rly)
	1720	Range of p ages (min of 12 page s)/attachm ent and (m ax of 200 pages)/att achment (Y early)
	1721
	1722
	1723	ROM (20kb per page) Yearly
	1724	ROM (170kb per page) Yearly
	1725
	1726
	1727
	1728
	1729
	1730	Lower Page Count
	1731	Upper Page Count
	1732	Calculatio n: 20 kb * Page Coun t / 1,000, 000 (1 Mil lion KB in a GB)
	1733	Calculatio n: 170 kb * Page Cou nt / 1,000 ,000 (1 Mi llion KB i n a GB)
	1734	Danville ( 550)
	1735	71,254
	1736	34,610
	1737	48.50%
	1738	415K-6.9M
	1739	415,000
	1740	6,900,000
	1741	8.3Gb - 13 8 Gb
	1742	70.55Gb - 1173 Gb
	1743	Hines (578 )
	1744	50,502
	1745	22,600
	1746	44.70%
	1747	272K-4.52M (est)
	1748	272,000
	1749	4,520,000
	1750	5.44Gb - 9 0.4 Gb
	1751	46.24Gb - 768.4 Gb
	1752	Iron Mount ain (585)
	1753	72,813
	1754	11,610
	1755	15.90%
	1756	140K-2.3M
	1757	140,000
	1758	2,300,000
	1759	2.8Gb - 46 Gb
	1760	23.8Gb - 3 91 Gb
	1761	Jesse Brow n (537)
	1762	60,348
	1763	21,980
	1764	36.40%
	1765	264K-4.4M
	1766	264,000
	1767	4,400,000
	1768	5.28Gb - 8 8 Gb
	1769	44.88Gb - 748 Gb
	1770	Lovell (55 6)
	1771	42,747
	1772	28,455
	1773	66.50%
	1774	342K-5.7M
	1775	342,000
	1776	5,700,000
	1777	6.84Gb - 1 14 Gb
	1778	58.14Gb - 969 Gb
	1779	Madison (6 07)
	1780	78,991
	1781	22,600
	1782	44.70%
	1783	272K-4.52M (est)
	1784	272,000
	1785	4,520,000
	1786	5.44Gb - 9 0.4 Gb
	1787	46.24Gb - 768.4 Gb
	1788	MKE (695)
	1789	103,399
	1790	15,078
	1791	14.50%
	1792	181K-3.1M
	1793	181,000
	1794	3,100,000
	1795	3.62Gb - 6 2 Gb
	1796	30.77Gb - 527 Gb
	1797	Tomah (676 )
	1798	53,734
	1799	24,008
	1800	44.60%
	1801	288K-4.8M
	1802	288,000
	1803	4,800,000
	1804	5.76Gb - 9 6 Gb
	1805	48.96Gb - 816 Gb
	1806	Totals:
	1807	533,788
	1808	180,941
	1809
	1810
	1811	2,174,000
	1812	36,240,000
	1813	43.48Gb - 724.8 Gb Y early
	1814	369.58Gb - 6160.8 Gb Yearly
	1815	Average:
	1816	66,724
	1817	22,618
	1818	39.48%
	1819
	1820	271,750
	1821	4,530,000
	1822
	1823
	1824
	1825
	1826
	1827
	1828
	1829
	1830
	1831
	1832
	1833	Extrapolat ion out to 150 Sites
	1834	Average Pa ge Count
	1835	Average At tachment C ount
	1836	Average At tachment R atio
	1837
	1838	Average Lo wer Page C ount
	1839	Average Up per Page C ount
	1840	ROM (20kb per page) Yearly
	1841	ROM (170kb per page) Yearly
	1842
	1843	66,724
	1844	22,618
	1845	39.48%
	1846
	1847	271,750
	1848	4,530,000
	1849
	1850
	1851	Multiple o f 150
	1852	10,008,525
	1853	3,392,644
	1854
	1855
	1856	40,762,500
	1857	679,500,00 0
	1858	815.25Gb - 13590 Gb
	1859	6929.625Gb - 115515 Gb
	1860
	1861
	1862
	1863
	1864
	1865
	1866
	1867	13.5 Tb Ye arly
	1868	115.5 Tb Y early
	1869
	1870
	1871
	1872
	1873	20kb/page/ month AVG LOW(Gb)
	1874	20kb/page/ month AVG HIGH (Gb)
	1875	170kb/page /month AVG LOW (Gb)
	1876	170kb/page /month AVG HIGH (Gb)
	1877
	1878	Monthly Br eakdown
	1879	Monthly Sp ace:
	1880	67.94
	1881	1,132.50
	1882	577.47
	1883	9,626.25
	1884
	1885	Daily Brea kdown
	1886	Daily Band width:
	1887	3.40
	1888	56.63
	1889	28.87
	1890	481.31
	1891
	1892	Daily 275 File Size:
	1893
	1894	4.42
	1895	73.61
	1896	37.54
	1897	625.71
	1898
	1899
	1900
	1901
	1902
	1903
	1904
	1905
	1906	Month
	1907
	1908	Size @ 20k b/page (Gb )
	1909	Size @ 170 kb/page (G b)
	1910	P2E Median (95kb/pag e)
	1911	200 Gb/wee k Estimati on
	1912	320 Gb/day Estimatio n (1.6 Tb/ week)
	1913	1
	1914
	1915	68
	1916	9,626
	1917	4,847
	1918	800
	1919	6,400
	1920	2
	1921
	1922	136
	1923	19,253
	1924	9,694
	1925	1,600
	1926	12,800
	1927	3
	1928
	1929	204
	1930	28,879
	1931	14,541
	1932	2,400
	1933	19,200
	1934	4
	1935
	1936	272
	1937	38,505
	1938	19,388
	1939	3,200
	1940	25,600
	1941	5
	1942
	1943	340
	1944	48,131
	1945	24,235
	1946	4,000
	1947	32,000
	1948	6
	1949
	1950	408
	1951	57,758
	1952	29,083
	1953	4,800
	1954	38,400
	1955	7
	1956
	1957	476
	1958	67,384
	1959	33,930
	1960	5,600
	1961	44,800
	1962	8
	1963
	1964	544
	1965	77,010
	1966	38,777
	1967	6,400
	1968	51,200
	1969	9
	1970
	1971	611
	1972	86,636
	1973	43,624
	1974	7,200
	1975	57,600
	1976	10
	1977
	1978	679
	1979	96,263
	1980	48,471
	1981	8,000
	1982	64,000
	1983	11
	1984
	1985	747
	1986	105,889
	1987	53,318
	1988	8,800
	1989	70,400
	1990	12
	1991
	1992	815
	1993	115,515
	1994	58,165
	1995	9,600
	1996	76,800
	1997	13
	1998
	1999	883
	2000	125,141
	2001	63,012
	2002	10,400
	2003	83,200
	2004	14
	2005
	2006	951
	2007	134,768
	2008	67,859
	2009	11,200
	2010	89,600
	2011	15
	2012
	2013	1,019
	2014	144,394
	2015	72,706
	2016	12,000
	2017	96,000
	2018	16
	2019
	2020	1,087
	2021	154,020
	2022	77,554
	2023	12,800
	2024	102,400
	2025	17
	2026
	2027	1,155
	2028	163,646
	2029	82,401
	2030	13,600
	2031	108,800
	2032	18
	2033
	2034	1,223
	2035	173,273
	2036	87,248
	2037	14,400
	2038	115,200
	2039	19
	2040
	2041	1,291
	2042	182,899
	2043	92,095
	2044	15,200
	2045	121,600
	2046	20
	2047
	2048	1,359
	2049	192,525
	2050	96,942
	2051	16,000
	2052	128,000
	2053	21
	2054
	2055	1,427
	2056	202,151
	2057	101,789
	2058	16,800
	2059	134,400
	2060	22
	2061
	2062	1,495
	2063	211,778
	2064	106,636
	2065	17,600
	2066	140,800
	2067	23
	2068
	2069	1,563
	2070	221,404
	2071	111,483
	2072	18,400
	2073	147,200
	2074	24
	2075
	2076	1,631
	2077	231,030
	2078	116,330
	2079	19,200
	2080	153,600
	2081
	2082
	2083
	2084	Veteran Fa mily Servi ces Number s
	2085
	2086
	2087
	2088	Claim Coun t (Yearly)
	2089	7,000,000
	2090
	2091
	2092	Ratio of A ttachments
	2093	39.48%
	2094
	2095
	2096	Count of A ttachments
	2097	2,763,250
	2098	Low (12 pa ges) High (200 pages )
	2099
	2100	Count of P ages (Low)
	2101	33,159,000
	2102
	2103	3200
	2104	Count of P ages (High )
	2105	552,650,00 0
	2106
	2107	376.470588 2
	2108	Median Pag es
	2109	292,904,50 0
	2110
	2111
	2112	Low Estima te (20 Kb) Gb
	2113	663
	2114	.6 Tb
	2115
	2116	High Estim ate (20 Kb ) Gb
	2117	11,053
	2118	11 Tb
	2119
	2120	Low Estima te (170 Kb ) Gb
	2121	5,637
	2122	5.6 Tb
	2123
	2124	High Estim ate (170 K b) Gb
	2125	93,951
	2126	93.9 Tb
	2127
	2128	Monthly:
	2129
	2130
	2131
	2132	Low Estima te (20 Kb) Gb
	2133	55
	2134	55 Gb
	2135
	2136	High Estim ate (20 Kb ) Gb
	2137	921
	2138	.9 Tb
	2139
	2140	Low Estima te (170 Kb ) Gb
	2141	470
	2142	.4 Tb
	2143
	2144	High Estim ate (170 K b) Gb
	2145	7,829
	2146	7.8 Tb
	2147
	2148	Daily:
	2149
	2150
	2151
	2152	Low Estima te (20 Kb) Gb
	2153	3
	2154	3 Gb
	2155
	2156	High Estim ate (20 Kb ) Gb
	2157	46
	2158	46 Gb
	2159
	2160	Low Estima te (170 Kb ) Gb
	2161	23
	2162	23 Gb
	2163
	2164	High Estim ate (170 K b) Gb
	2165	391
	2166	391 Gb
	2167
	2168
	2169
	2170	Six Month Conservati ve Estimat e:
	2171	46,975
	2172	46 Tb
	2173
	2174
	2175
	2176
	2177
	2178
	2179
	2180
	2181
	2182	Additional Numbers ( May 2016)
	2183
	2184
	2185
	2186
	2187
	2188	Veteran Fa mily Servi ces Number s
	2189
	2190
	2191	Fee Number s
	2192
	2193
	2194	Claim Coun t (Yearly)
	2195	12,000,000
	2196	(1 M Month ly)
	2197	Claim Coun t (Yearly)
	2198	15,000,000
	2199	(1.25 M Mo nthly)
	2200	Ratio of A ttachments
	2201	40.00%
	2202
	2203	Ratio of A ttachments
	2204	40.00%
	2205
	2206	Count of A ttachments
	2207	4,800,000
	2208	Low (12 pa ges) High (200 pages )
	2209	Count of A ttachments
	2210	6,000,000
	2211	Low (12 pa ges) High (200 pages )
	2212	Count of P ages (Low)
	2213	57,600,000
	2214
	2215	Count of P ages (Low)
	2216	72,000,000
	2217
	2218	Count of P ages (High )
	2219	960,000,00 0
	2220
	2221	Count of P ages (High )
	2222	1,200,000, 000
	2223
	2224	Median Pag es
	2225	508,800,00 0
	2226
	2227	Median Pag es
	2228	636,000,00 0
	2229
	2230	Low Estima te (20 Kb) Gb
	2231	1,152
	2232
	2233	Low Estima te (20 Kb) Gb
	2234	1,440
	2235
	2236	High Estim ate (20 Kb ) Gb
	2237	19,200
	2238
	2239	High Estim ate (20 Kb ) Gb
	2240	24,000
	2241
	2242	Low Estima te (170 Kb ) Gb
	2243	9,792
	2244
	2245	Low Estima te (170 Kb ) Gb
	2246	12,240
	2247
	2248	High Estim ate (170 K b) Gb
	2249	163,200
	2250
	2251	High Estim ate (170 K b) Gb
	2252	204,000
	2253
	2254	Monthly:
	2255
	2256
	2257	Monthly:
	2258
	2259
	2260	Low Estima te (20 Kb) Gb
	2261	96
	2262
	2263	Low Estima te (20 Kb) Gb
	2264	120
	2265
	2266	High Estim ate (20 Kb ) Gb
	2267	1,600
	2268
	2269	High Estim ate (20 Kb ) Gb
	2270	2,000
	2271
	2272	Low Estima te (170 Kb ) Gb
	2273	816
	2274
	2275	Low Estima te (170 Kb ) Gb
	2276	1,020
	2277
	2278	High Estim ate (170 K b) Gb
	2279	13,600
	2280
	2281	High Estim ate (170 K b) Gb
	2282	17,000
	2283
	2284	Daily:
	2285
	2286
	2287	Daily:
	2288
	2289
	2290	Low Estima te (20 Kb) Gb
	2291	5
	2292
	2293	Low Estima te (20 Kb) Gb
	2294	6
	2295
	2296	High Estim ate (20 Kb ) Gb
	2297	80
	2298
	2299	High Estim ate (20 Kb ) Gb
	2300	100
	2301
	2302	Low Estima te (170 Kb ) Gb
	2303	41
	2304
	2305	Low Estima te (170 Kb ) Gb
	2306	51
	2307
	2308	High Estim ate (170 K b) Gb
	2309	680
	2310
	2311	High Estim ate (170 K b) Gb
	2312	850
	2313
	2314
	2315
	2316
	2317
	2318
	2319
	2320	Six Month Conservati ve Estimat e:
	2321	81,600
	2322	81 Tb
	2323	Six Month Conservati ve Estimat e:
	2324	102,000
	2325	102 Tb
	2326
	2327
	2328	Attachment Metadata Storage Ca pacity Ana lysis (for Oracle)
	2329	Oracle 275 Metadata Database S izing
	2330
	2331
	2332
	2333	Size Per 1 000 Record s
	2334	100 MB
	2335
	2336
	2337
	2338
	2339
	2340
	2341	Station
	2342	Claims (Ye arly)
	2343	Attachment s (Yearly)
	2344	Yearly Met adata Size (Gb)
	2345
	2346
	2347
	2348
	2349	Danville ( 550)
	2350	71,254
	2351	34,610
	2352	3.5
	2353	Hines (578 )
	2354	50,502
	2355	22,600
	2356	2.3
	2357	Iron Mount ain (585)
	2358	72,813
	2359	11,610
	2360	1.2
	2361	Jesse Brow n (537)
	2362	60,348
	2363	21,980
	2364	2.2
	2365	Lovell (55 6)
	2366	42,747
	2367	28,455
	2368	2.8
	2369	Madison (6 07)
	2370	78,991
	2371	22,600
	2372	2.3
	2373	MKE (695)
	2374	103,399
	2375	15,078
	2376	1.5
	2377	Tomah (676 )
	2378	53,734
	2379	24,008
	2380	2.4
	2381	Totals:
	2382	533,788
	2383	180,941
	2384	18.1
	2385	Average:
	2386	66,724
	2387	22,618
	2388	2.3
	2389	Average Mu ltiple of 150
	2390	10,008,525
	2391	3,392,644
	2392	339.3
	2393
	2394
	2395
	2396
	2397	Veteran Fa mily Servi ces Number s
	2398
	2399
	2400
	2401	Claim Coun t (Yearly)
	2402	7,000,000
	2403
	2404
	2405	Ratio of A ttachments
	2406	39.48%
	2407
	2408
	2409	Count of A ttachments
	2410	2,763,250
	2411
	2412
	2413	Yearly Met adata Size (Gb)
	2414	276.325
	2415	Total Year ly Size
	2416	615.6
	2417
	2418
	2419	Six Month Plan
	2420	102.6
	2421