4. EPMO Open Source Coordination Office Redaction File Detail Report

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4.1 Files compared

#	Location	File	Last Modified
1	ES5.6_docs.zip\ESCC	TS - VCE and HBP Updates.docx	Wed Mar 27 20:26:44 2019 UTC
2	ES5.6_docs.zip\ESCC	TS - VCE and HBP Updates.docx	Thu Apr 11 16:42:57 2019 UTC

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	1	Enrollment System (E S)
	2	Community Care Progr am - Eligi bility and Health Be nefit Plan Updates
	3	Technical Specificat ion
	4
	5	Department of Vetera ns Affairs
	6	Office of Informatio n and Tech nology (OI T)
	7	Product De velopment
	8	Documentat ion Versio n 1.1
	9	Revision H istory
	10	Date
	11	Revision
	12	Descriptio n
	13	Author
	14	02/21/2019
	15	1.1
	16	Updates to TPA and C CN File Ex tracts sec tion.
	17	Dennis Dou ssan
	18	02/2019
	19	1.0
	20	Initial do cument
	21	Dennis Dou ssan
	22
	23	Table of C ontents
	24	1.Introduc tion1
	25	1.1.Purpos e1
	26	2.System C omponents and Proces ses2
	27	2.1.Databa se Changes 2
	28	2.1.1.Tabl e STD_HEAL THBENEFITP LAN2
	29	2.1.2.Tabl e VCESTATU STYPE2
	30	2.2.UI Cha nges3
	31	2.2.1.Heal th Benefit Plan Scre en3
	32	2.2.2.Comm unity Care Determina tion Histo ry Screen4
	33	3.TPA and CCN File E xtracts5
	34	4.Referenc e Document s6
	35
	36
	37
	38
	39
	40
	41	Introducti on
	42	Due to Mis sion Act, new Commun ity Care P rogram (CC P) eligibi lities and Health Be nefit Plan s (HBPs) a re being a dded.
	43	Purpose
	44	The purpos e of this document i s to descr ibe the da tabase and User Inte rface (UI) changes n eeded to s upport the new eligi bilities a nd Health Benefit Pl ans for Mi ssion Act.
	45	System Com ponents an d Processe s
	46	Database Changes
	47	Table STD_ HEALTHBENE FITPLAN
	48	The table below hold s HBPs tha t can be a ssigned to a Veteran . The foll owing data will be a dded:
	49
	50	Code
	51	Name
	52	200
	53	Veteran Pl an - Veter ans Choice Basic
	54	201
	55	Veteran Pl an - Veter ans Choice Mileage
	56	202
	57	Veteran Pl an - Veter ans Choice Wait-Time
	58	203
	59	Veteran Pl an - VC Un usual or E xcessive B urden
	60	204
	61	Veteran Pl an - Veter ans Choice Air, Boat , or Ferry
	62	206
	63	Veteran Pl an - CCP U nusual or Excessive Burden
	64	207
	65	Veteran Pl an - CCP A ir, Boat, or Ferry
	66	208
	67	Veteran Pl an - CCP B asic
	68	209
	69	Veteran Pl an - CCP S tate with no Full Se rvice Medi cal Facili ty
	70	210
	71	Veteran Pl an - CCP U rgent Care
	72	211
	73	Veteran Pl an – CCP G randfather
	74
	75	Table VCES TATUSTYPE
	76	This table holds the CC Progra m Eligibil ities and all valid combinatio ns. The fo llowing da ta will be changed o r added:
	77	Code
	78	Name
	79	Descriptio n
	80	ND
	81	Not determ ined
	82	Community Care Eligi bility not determine d.
	83	B
	84	Basic
	85	Basic.
	86	M
	87	Mileage
	88	Mileage el igibility for the Ve terans Cho ice Progra m.
	89	WT
	90	Wait-Time
	91	Wait-Time eligibilit y for the Veterans C hoice Prog ram.
	92	H
	93	Hardship
	94	Hardship.
	95	MWT
	96	Mileage an d Wait-Tim e
	97	Eligible f or the Vet erans Choi ce Program based on both Milea ge and Wai t-Time.
	98	HWT
	99	Hardship a nd Wait-Ti me
	100	Eligible f or the Vet erans Choi ce Program based on both Hards hip and Wa it-Time.
	101	X
	102	Ineligible
	103	Not eligib le.
	104	G
	105	Grandfathe red
	106	Grandfathe red.
	107	N
	108	State with No Full-S ervice VA
	109	State No F ull-Servic e VA.
	110	U
	111	Urgent Car e
	112	Urgent Car e.
	113
	114	Grandfathe red, State with No F ull-Servic e VA and U rgent Care codes wil l be added and the d escription will chan ge on Basi c, Hardshi p and No L onger Elig ible.
	115	The logic for the Co mmunity Ca re Determi nation His tory scree n will cha nge to dis play the o ld descrip tions for pre-Missio n Act elig ibilities assignment s.
	116	Multiple e ligibiliti es will be handled b y creating separate instances in the VCE LIGIBILITY table. Th is table a lso captur es the eff ective dat e each eli gibility w as applied .
	117	UI Changes
	118	Health Ben efit Plan Screen
	119	ES will co ntinue to display th e pre-Miss ion Act He alth Benef it Plans u ntil 6/6/2 019.
	120
	121
	122	Figure 1: Pre-Missio n Act Heal th Benefit Plans
	123
	124	ES will on ly display the follo wing HBPs associated with the Mission Ac t on 6/6/2 019:
	125
	126	HBPs Assoc iated with the Missi on Act on 6/6/2019
	127	Veteran Pl an - CCP U nusual or Excessive Burden
	128	Veteran Pl an - CCP A ir, Boat, or Ferry
	129	Veteran Pl an - CCP B asic
	130	Veteran Pl an - CCP S tate with no Full Se rvice Medi cal Facili ty
	131	Veteran Pl an - CCP U rgent Care
	132	Veteran Pl an – CCP G randfather
	133	Community Care Deter mination H istory Scr een
	134	The Commun ity Care D eterminati on - Histo ry screen will need to change to accommo date the m ultiple el igibilitie s and effe ctive date s.
	135
	136
	137	Figure 2: Community Care Deter mination - History s creen
	138
	139	TPA and CC N File Ext racts
	140	The file f ormats wil l change f rom sendin g the comb ined code to sending each elig ibility wi th its eff ective dat e. See th e TPA and CCN ICDs.
	141
	142
	143	Reference Documents
	144	ESCC Missi on Act RSD
	145
	146
	147