Resources

Export citation:

Statistics

  • Views: 386
  • Aggregate Downloads: 21

Information

  • Type: Software
  • Categories:
  • Keywords: EDI
  • License: Public Domain

Share


VA Code in Flight Submission - HAC EDI Claims System Enhancements v.01 Client Solution Source Code
Revision: 2
Please use this identifier to cite or link to this publication: http://hdl.handle.net/10909/11071
The HAPE EDI portfolio delivers IT products and services to CBO. This PC enhancement project is intended to deliver a range of updates, extensions, and modifications to various financial and administrative systems, processes, files, and reporting mechanisms, including:

1. PC System Enhancements: Harris will modify vendor data storage and claims processing functionality so payments to small businesses are made in a timely manner per the Prompt Payment Act. Harris will develop reports to verify compliance and data integrity.

2. Health Administration Center (HAC) EDI Claims System Enhancements: Harris will provide EDI functionality related to referral requests and authorizations in preparation for rules effective January 2016.

3. Electronic Remittance Advice (ERA) 835 Compliance: To comply with CORE Level III Electronic Funds Transfer (EFT) standards, we will modify vendor file and vendor maintenance functionality, Veterans Health Information Systems and Technology Architecture (VistA) Fee, and Claims Processing and Eligibility (CP&E) for beneficiary-related transactions.

4. Health Plan Identifier (HPID) Compliance: To comply with rules effective Fall 2016, we will modify claim transaction functionality related to incoming HPID validation and generation of outgoing EDI transactions to populate the VA HPID.

5. Claims Attachments Compliance: We create systems to manage the receipt, processing, and storage of claims attachments in preparation for rules effective January 2016.

6. Healthcare Claims 837 Compliance: We will review and modify the 837 transaction flow within VA systems.

7. Caregiver Stipend Payments System (optional task): We will create a rules-based system to calculate stipend payments for caregivers, and create an interface to VA’s vendor database and maintenance process, CBOPC Veterans files, and Financial Management System (FMS) payment system.
Revision Version
Submitted By
Submission Date
Certified
Notes
2OI&T EPMO Lean Systems Engineering Open Source Coordination Office12-09-2015
1OI&T EPMO Lean Systems Engineering Open Source Coordination Office04-22-2015

Reviews (Phase: Peer)

There is no review at this time.
To submit one, please log in.

Comments

COMMENTS

Powered by Midas