36C10G20R0014-015.xls

XLS spreadsheet Posted May 11, 2020

Attached to: Community Care Network Region 5 - Alaska Pre-Solicitation Notice
Solicitation number: 36C10G20R0014
Issued by: Department of Veterans Affairs Headquarters

About this file

Written by GovTribe AI · Dec 30, 2023

This document contains a pre-solicitation notice and description for solicitation number 36C10G20R0014 to establish a Community Care Network region in Alaska. The Department of Veterans Affairs intends to issue a request for proposal for a single-award firm fixed price indefinite delivery indefinite quantity contract with a nine-month base period and seven one-year options. The contractor will be responsible for establishing and maintaining a network of licensed healthcare providers to deliver medical, surgical, complementary and integrative services, durable medical equipment, pharmacy, and dental care to eligible Veterans throughout Alaska. Additional responsibilities include providing exemplary customer service, monitoring quality outcomes, using data and performance metrics to improve services, and processing and paying claims. The anticipated period of performance is nine months for the base period followed by seven one-year options. Offers are due on or around June 1, 2020.

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36C10G20R0014 CN Region 5 Attachment W - Data Repository Schema.xls

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Other files

File	Type	Posted
CCN Region 5 Alaska Conformed RFP 36C10G20R0014 Amendment 0003 (changes highlighted in green) 6.3.20.pdf	PDF	Jun 4, 2020
CCN Region 5 Alaska SF30 36C10G20R0014 Amendment 0003 .pdf	PDF	Jun 4, 2020
CCN Region 5 Alaska - Attachment 1 PWS Terms and Definitions 0001.pdf	PDF	May 29, 2020
CCN Region 5 Alaska Consolidated Responses to Questions from Industry for A0002.pdf	PDF	May 29, 2020
CCN Region 5 Alaska Conformed RFP 36C10G20R0014 Amendment 0002 (changes highlighted in green).pdf	PDF	May 29, 2020
CCN Region 5 Alaska 36C10G20R0014 SF30 Amendment 0002.pdf	PDF	May 29, 2020
36C10G20R0014-0001002.xlsx	XLSX spreadsheet	May 13, 2020
36C10G20R0014-0001001.pdf	PDF	May 13, 2020
36C10G20R0014-0001000.pdf	PDF	May 13, 2020
36C10G20R0014-041.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-035.pdf	PDF	May 11, 2020
36C10G20R0014-003.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-018.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-005.docx	DOCX document	May 11, 2020
36C10G20R0014-009.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-029.docx	DOCX document	May 11, 2020
36C10G20R0014-036.docx	DOCX document	May 11, 2020
36C10G20R0014-034.docx	DOCX document	May 11, 2020
36C10G20R0014-028.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-017.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-039.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-011.docx	DOCX document	May 11, 2020
36C10G20R0014-013.pptx	PPTX presentation	May 11, 2020
36C10G20R0014-030.docx	DOCX document	May 11, 2020
36C10G20R0014-012.docx	DOCX document	May 11, 2020
36C10G20R0014-038.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-033.docx	DOCX document	May 11, 2020
36C10G20R0014-014.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-021.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-022.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-016.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-020.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-040.docx	DOCX document	May 11, 2020
36C10G20R0014-032.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-037.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-010.docx	DOCX document	May 11, 2020
36C10G20R0014-004.docx	DOCX document	May 11, 2020
36C10G20R0014-002.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-019.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-001.pdf	PDF	May 11, 2020
36C10G20R0014-031.docx	DOCX document	May 11, 2020
36C10G20R0014-024.docx	DOCX document	May 11, 2020
36C10G20R0014-006.docx	DOCX document	May 11, 2020
36C10G20R0014-008.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-023.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-027.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-026.xlsx	XLSX spreadsheet	May 11, 2020
36C10G20R0014-025.docx	DOCX document	May 11, 2020
36C10G20R0014-007.xlsx	XLSX spreadsheet	May 11, 2020

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Attachment W - Relational Database Schema

Date last modified: 7/9/19

Data Description

This document serves as the Attachment W data dictionary and schema for data elements requested to be stored and reported. Below is a pdf file of the visual view of Attachment W

Data Disclosure

This data derived from the contract and through collaboration sessions between VA and Contractor

Data is submitted through VA DAS in a nightly extract, transform, load (ETL)

Attachment managed by:

OCC Informatics & Data Analytics, PI&R

If modifications are needed, please submit requests to the Contracting Office.

Attachment W - Database Schema

Table Name	Column Name	Column Datatype	Column Null Option	Attribute Definition
VA_Model_Claim_Aged	aged	varchar(20)	Null	Calculated value to determine the age of a claim.
VA_Model_Claim_Aged	aged_description	varchar(255)	Null	Calculated value to determine the aging category a claim is associated to.
VA_Model_Claim_Aged	aged_key	bigint	Not Null	System generated auto-incrementing identity column. One logical claim will have a maximum of 1 loaded record to the VA_Model_Claim_Aged table per initially submitted claim. Subsequently received adjustment claim transactions will not result in a record loaded to the VA_Model_Claim_Aged table.
VA_Model_Claim_Aged	claim_id	varchar(38)	Not Null	Identifier used to track a claim from creation by the health care provider through payment.
VA_Model_Claim_Aged	claim_key	bigint	Not Null	FK to join back to VA_Model_VA_Claims.claim_key. System generated auto-incrementing identity column.
VA_Model_Claim_Aged	last_updated_date	datetime2	Not Null	System generated ETL field. Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Claim_Aged	last_updated_user	varchar(128)	Not Null	System generated ETL field.
VA_Model_Claim_Aged	load_file_detail_id	int	Not Null	System generated ETL field.
VA_Model_Claims_Details	adjusted	char(1)	Null	Indicator field to capture whether or not a claim service line transaction has been adjusted.
VA_Model_Claims_Details	adjustment_date	date	Null	Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Claims_Details	allowable_type	varchar(20)	Null	Qualifies the 3 allowable amount fields in the 'VA_Model_Claims_Details' table; 'other_allowable_amount', 'vista_allowable_amount', 'CMS_allowable_amount'.
VA_Model_Claims_Details	charge_amt	decimal (10, 2)	Null	Monetary amount.
VA_Model_Claims_Details	claim_detail_key	bigint	Not Null	System generated auto-incrementing identity column.
VA_Model_Claims_Details	claim_key	bigint	Not Null	FK to join back to VA_Model_VA_Claims.claim_key. System generated auto-incrementing identity column.
VA_Model_Claims_Details	cms_allowable_amount	decimal (10,2)	Null	Monetary amount.
VA_Model_Claims_Details	date_paid	date	Null	Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Claims_Details	denial_reason_key	char(3)	Null	Code assigned by issuer to define reason for rejection.
VA_Model_Claims_Details	drug_code	varchar(48)	Null	Identifying number for a product or service.
VA_Model_Claims_Details	invoice_number	varchar(50)	Null	Identifying control number that must be unique within te transaction set functional group assigned by the originator for a transaction set.
VA_Model_Claims_Details	last_updated_date	datetime2	Not Null	System generated ETL field. Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Claims_Details	last_updated_user	varchar(128)	Not Null	System generated ETL field.
VA_Model_Claims_Details	load_file_detail_id	int	Not Null	System generated ETL field.
VA_Model_Claims_Details	minutes	decimal (15,3)	Null	Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken.
VA_Model_Claims_Details	other_allowable_amount	decimal (10,2)	Null	Monetary amount.
VA_Model_Claims_Details	paid_amt	decimal(10,2)	Null	Monetary amount.
VA_Model_Claims_Details	pay_flag	char(1)	Null	Indicator field to capture whether or not a processed claim has resulted in a payment being issued to a provider.
VA_Model_Claims_Details	pos_key	char(2)	Null	Facility ID of the matched location.
VA_Model_Claims_Details	procedure_key	varchar(48)	Null	Identifying number for a product or service.
VA_Model_Claims_Details	rendering_provider_key	bigint	Null	FK to join back to VA_Model_Provider.provider_key. System generated auto-incrementing identity column.
VA_Model_Claims_Details	rendering_provider_qualifier	char(2)	Null	Code designating the system/method of code structure used for identification code (67).
VA_Model_Claims_Details	rendering_provider_taxonomy	varchar(50)	Null	Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier.
VA_Model_Claims_Details	service_date_from	date	Null	Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Claims_Details	service_date_to	date	Null	Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Claims_Details	service_line_number	char(6)	Null	Number assigned for differentiation within a transaction set
VA_Model_Claims_Details	source_claim_line_id	varchar(50)	Null	Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier.
VA_Model_Claims_Details	unit	varchar(15)	Null	Numeric value of quantity.
VA_Model_Claims_Details	unit_label	char(2)	Null	Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken
VA_Model_Claims_Details	vista_allowable_amount	decimal (10,2)	Null	Monetary amount.
VA_Model_Claims_Details_Adjustments	adjusted_amount	decimal(10,2)	Null	Monetary amount.
VA_Model_Claims_Details_Adjustments	adjustment_reason_key	char(5)	Null	Code identifying the detailed reason the adjustment was made.
VA_Model_Claims_Details_Adjustments	claim_detail_adjustments_key	bigint	Not Null	System generated auto-incrementing identity column.
VA_Model_Claims_Details_Adjustments	claim_detail_key	bigint	Not Null	FK to join back to VA_Model_Claims_Details.claim_detail_key. System generated auto-incrementing identity column.
VA_Model_Claims_Details_Adjustments	last_updated_date	datetime2	Not Null	System generated ETL field. Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Claims_Details_Adjustments	last_updated_user	varchar(128)	Not Null	System generated ETL field.
VA_Model_Claims_Details_Adjustments	load_file_detail_id	int	Not Null	System generated ETL field.
VA_Model_Claims_Details_Adjustments	modifier_code	varchar(30)	Null	This identifies special circumstances related to the performance of the service, as defined by trading partners.
VA_Model_Patient	is_dependent	char(1)	Null	Indicator field to capture whether or not the record is for a dependent to a Veteran subscriber.
VA_Model_Patient	is_veteran	char(1)	Null	Indicator field to capture whether or not the record is for a Veteran subscriber.
VA_Model_Patient	last_updated_date	datetime2	Not Null	System generated ETL field. Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Patient	last_updated_user	varchar(128)	Not Null	System generated ETL field.
VA_Model_Patient	load_file_detail_id	int	Not Null	System generated ETL field.
VA_Model_Patient	patient_key	bigint	Not Null	System generated auto-incrementing identity column. Patient data loaded to VA_Model_Patient is sourced from the claim transaction. No de-duplication occurs.
VA_Model_Patient	source_claim_info_seq	bigint	Null	System generated ETL field.
VA_Model_Patient	vista_patient_id	varchar(29)	Null	Code identifying a party or other code.
VA_Model_Provider	certified_medicaid	char(1)	Null	Indicator field to capture if the provider is certified Medicaid.
VA_Model_Provider	certified_medicare	char(1)	Null	Indicator field to capture if the provider is certified Medicare.
VA_Model_Provider	etl_sequence_key	int	Null	System generated ETL field.
VA_Model_Provider	in_oig_list	char(1)	Null	Indicator field to capture whether or not a claim submitted was by an active LEIE / OIG list provider (List of Excluded Individuals/Entities, Office of Inspector General).
VA_Model_Provider	last_updated_date	datetime2	Not Null	System generated ETL field. Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Provider	last_updated_user	varchar(128)	Not Null	System generated ETL field.
VA_Model_Provider	line_item_control_nbr	varcahr(50)	Null	System generated ETL field.
VA_Model_Provider	load_file_detail_id	int	Not Null	System generated ETL field.
VA_Model_Provider	medicare_id	varchar(80)	Null	Code identifying a party or other code.
VA_Model_Provider	npi	varchar(80)	Null	Code identifying a party or other code.
VA_Model_Provider	npi_deactivation_date	date	Null	Date expressed as CCYYMMDD-CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Provider	npi_deactivation_reason_code	char(2)	Null	Code identifying the detailed reason the deactivation was made.
VA_Model_Provider	npi_reactivation_date	date	Null	Date expressed as CCYYMMDD-CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Provider	provider_first_name	varchar(50)	Null	Individual first name.
VA_Model_Provider	provider_key	bigint	Not Null	System generated auto-incrementing identity column. Provider data loaded to VA_Model_Provider is sourced from the Claim transaction.No de-duplication occurs.
VA_Model_Provider	provider_last_name	varchar(60)	Null	Individual last name or organizational name.
VA_Model_Provider	provider_last_update_date	date	Null	Date expressed as CCYYMMDD-CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_Provider	provider_middle_name	varchar(50)	Null	Individual middle name or initial.
VA_Model_Provider	provider_name	varchar(162)	Null	Concatenation of the provider [Last Name, First Name, Middle Name].
VA_Model_Provider	provider_other_org_name	varchar(70)	Null	Individual last name or organizational name.
VA_Model_Provider	provider_type_description	varchar(50)	Null	Description designating the system/method of code structure used for Identification Code (67).
VA_Model_Provider	provider_type_name	char(3)	Null	Code designating the system/method of code structure used for Identification Code (67).
VA_Model_Provider	replacement_npi	varchar(80)	Null	Code identifying a party or other code.
VA_Model_Provider	source_claim_info_seq	bigint	Null	System generated ETL field.
VA_Model_Provider	tax_id	varchar(50)	Null	Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier.
VA_Model_Provider	upin_id	varchar(50)	Null	Code identifying a party or other code.
VA_Model_VA_Claims	AuthStation_ifn	varchar(110)	Null	Concatenated value of 'Station Number/ID' + 'Consult IEN'.
VA_Model_VA_Claims	Consult_ien	varchar(50)	Null	Veteran referral number sourced from claims data.
VA_Model_VA_Claims	billing_id_qualifier	char(3)	Null	Code qualifying the Reference Identification.
VA_Model_VA_Claims	billing_provider_key	bigint	Null	FK to join back to VA_Model_Provider.provider_key. System generated auto-incrementing identity column.
VA_Model_VA_Claims	billing_provider_taxonomy	varchar(50)	Null	Code identifying a party or other code.
VA_Model_VA_Claims	billing_provider_tin	varchar(50)	Null	Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier.
VA_Model_VA_Claims	check_number	varchar(50)	Null	Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier.
VA_Model_VA_Claims	claim_id	varchar(38)	Not Null	Identifier used to track a claim from creation by the health care provider through payment.
VA_Model_VA_Claims	claim_key	bigint	Not Null	System generated auto-incrementing identity column. One logical claim will have minimally loaded 3 records to the VA_Model_VA_Claims table (i.e., pre-adj 837, post-adj 837 COB, 835).
VA_Model_VA_Claims	claim_type	char(1)	Null	Identification of the claim form type. Valid values include: 'M'-Medical, 'D'-Dental, 'P'-Pharmacy.
VA_Model_VA_Claims	completed_date	date	Null	Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_VA_Claims	created_date	date	Null	Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_VA_Claims	date_of_service	varchar(50)	Null	Date expressed as CCYYMMDD-CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_VA_Claims	etl_sequence_key	int	Null	System generated ETL field.
VA_Model_VA_Claims	form_type_key	varchar(20)	Null	Identification of the claim form type. Valid values include the following; 'Professional', 'Institutional', 'Dental'.
VA_Model_VA_Claims	insured_id	varchar(29)	Null	Code identifying a party or other code.
VA_Model_VA_Claims	invoice_number	varchar(50)	Null	Identifying control number that must be unique within te transaction set functional group assigned by the originator for a transaction set.
VA_Model_VA_Claims	last_updated_date	datetime2	Not Null	System generated ETL field. Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_VA_Claims	last_updated_user	varchar(128)	Not Null	System generated ETL field.
VA_Model_VA_Claims	load_file_detail_id	int	Not Null	System generated ETL field.
VA_Model_VA_Claims	other_insurance	varchar(60)	Null	Free-form name.
VA_Model_VA_Claims	patient_account_number	varchar(50)	Null	Identifier used to track a claim from creation by the health care provider through payment.
VA_Model_VA_Claims	patient_key	bigint	Null	FK to join back to VA_Model_Patient.patient_key. System generated auto-incrementing identity column.
VA_Model_VA_Claims	received_date	date	Null	Date expressed as CCYYMMDD-CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_VA_Claims	referring_provider_key	bigint	Null	FK to join back to VA_Model_Provider.provider_key. System generated auto-incrementing identity column.
VA_Model_VA_Claims	referring_provider_taxonomy	varchar(50)	Null	Code identifying a party or other code.
VA_Model_VA_Claims	reopen_date	date	Null	Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_VA_Claims	reopen_reason	varchar(50)	Null	Identification of the claim reopen reason.
VA_Model_VA_Claims	signature_date	date	Null	Date expressed as CCYYMMDD-CCYYMMDD where CC represents the first two digits of the calendar year.
VA_Model_VA_Claims	source_claim_info_seq	bigint	Null	System generated ETL field.
VA_Model_VA_Claims	station_key	varchar(80)	Null	Code identifying a party or other code.
VA_Model_VA_Claims	status	varchar(30)	Null	Identification of the claim status. 837 will default a value of 'Submitted'. 835 will populate a final disposition description.
VA_Model_VA_Claims	status_reason_key	varchar(30)	Null	Identification of the claim status reason. 837 will default a value of 'In-Progress'. 835 will populate a final disposition description.
VA_Model_VA_Claims	taxonomy	varchar(50)	Null	Code identifying a party or other code.
VA_Model_VA_Claims	transaction_type	char(3)	Null	Code uniquely identifying a Transaction Set.

MBD00AAA81D.pdf aged_key claim_id aged aged_description claim_key (FK) load_file_detail_id last_updated_user last_updated_date patient_key source_claim_info_seq is_veteran is_dependent vista_patient_id load_file_detail_id claim_detail_key claim_key (FK) procedure_key pos_key denial_reason_key adjusted adjustment_date charge_amt unit unit_label rendering_provider_key (FK) rendering_provider_qualifier paid_amt date_paid service_date_from source_claim_line_id service_date_to allowable_type other_allowable_amount vista_allowable_amount cms_allowable_amount pay_flag service_line_number drug_code rendering_provider_taxonomy invoice_number minutes load_file_detail_id claim_key claim_id etl_sequence_key form_type_key billing_provider_key (FK) referring_provider_key (FK) station_key patient_key (FK) insured_id billing_id_qualifier transaction_type patient_account_number status_reason_key status invoice_number check_number date_of_service signature_date received_date other_insurance created_date claim_type completed_date taxonomy billing_provider_taxonomy referring_provider_taxonomy reopen_date reopen_reason Consult_ien AuthStation_ifn billing_provider_tin source_claim_info_seq load_file_detail_id provider_key source_claim_info_seq etl_sequence_key in_oig_list tax_id npi certified_medicaid certified_medicare medicare_id provider_name provider_type_name provider_type_description provider_first_name provider_last_name provider_middle_name upin_id replacement_npi provider_other_org_name provider_last_update_date npi_deactivation_reason_code npi_deactivation_date npi_reactivation_date line_item_control_nbr load_file_detail_id claim_detail_adjustments_key adjustment_reason_key adjusted_amount modifier_code claim_detail_key (FK) load_file_detail_id

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