36C77619R0003-0003010.docx
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36C77619R0003 0003 36C77619R0003_S02 - ATTACHMENT 15 - TOOLKIT TEMPLATE.docx
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TEMPLATE - TOOLKIT TASK DETAILS
TOOLKIT TASK TEMPLATE DETAILS & INSTRUCTIONS
Template
Source:
Below options have been reviewed:
| Checked for existing assigned/unassigned open Requests, Tasks, RJCs, and Exceptions |
| PDAT |
| EDAT or Correlation Comparison |
| Remote Patient Data |
SSA via SHARE:
BIRLS:
ESR:
ACCURINT:
SSDI:
CAPRI:
DOCUMENTATION:
Audit: All audits have been thoroughly reviewed to ensure data has not been overwritten.
Below options have been reviewed:
| Remote Patient Data |
| ADR MPI PV Compare |
| Verified no additional Tasks and/or Exceptions were generated |
Permanent ICN:
Template Instructions
Source: e.g., Received from TK POT DUP TASK #xxxxxx. Note, if received via e-mail, copy and paste the portions of the email specifically pertaining to your case only. If received via Toolkit Request, copy and paste the Request Notes from the POC, if present.
Below options have been reviewed: (indicate “Y” for Yes or “N/A” for Not Applicable)
| Checked for existing assigned/unassigned open Requests, Tasks, RJCs, and Exceptions |
| PDAT |
| EDAT or Correlation Comparison |
| Remote Patient Data |
(On cases where you may have multiple searches for discrepant data, enter the data used to complete the request followed by the data returned. The data entered isn’t required, if it’s the same as the returned data. If you are required to “trick” the SSN in SSA to obtain search results, please include the SSN used.)
SSA via SHARE: Use Entered Data: Name-abcdefg, SSN-xxxxxxxxx(verified), DOB-mm/dd/yyyy (documentation type for age verification from the Proof of Age field), Gender-M or F, DOD (if applicable)-mm/dd/yyyy
BIRLS: Use Entered Data: Name-abcdefg, SSN-xxxxxxxxx (verified), DOB-mm/dd/yyyy, Gender-M or F, DOD (if applicable)-mm/dd/yyyy), Alias Name (if applicable)-abcdefg, Claim or Service Number (if applicable)-xxxxxxxxx
ESR: If needed, use above format. If not needed, remove from the Toolkit Task Details Template.
ACCURINT: If needed, use above format. If not needed, remove from the Toolkit Task Details Template.
SSDI (www.genealogybank.com/gbnk/ssdi/ and/or www.death-record.com): If needed, use above format. If not needed, remove from the Toolkit Task Details Template.
CAPRI: Document any pertinent data and reference the site name and record specifics. If not needed, remove from the Toolkit Task Details Template.
*Documentation:
*For Privacy Act-ID trait change cases: List types of documents received from requestor/site. (i.e.: Birth Certificate, Divorce Decree, etc.) If not needed, remove from the Toolkit Task Details Template.
Audit: Add any audit data that is significant to your case. If, after reviewing the audit, no data needs to be included, indicate “All audits have been reviewed to ensure data has not been overwritten.”
**Assessment:
**Assessment statements are not required for Identity Trait Edits that are simple and straight forward, for example name changes. The statement(s) are still required for unusual Identity Trait Edits such as gender changes and SSN changes.
Document all data discrepancies noted during review of case as well as how you determined the information being retained. The correct data will be documented first followed by the incorrect data. Also, include an explanation/justification for any other information that you have determined should not be retained in the record (other LNs, other SSNs, etc.). Include only what is relevant to your case.
Example #1: LN discrepancy (Smith vs. Smiith), MN discrepancy (Michael vs. M), SSN discrepancy (123456789 vs. 333333333). The LN of Smith will be retained as verified by SSA. Smiith was a typographical error. MN of Michael will be retained as verified by BIRLS as it matches the MI of M. SSN 123456789 will be retained as verified by SSA. My research showed that SSN 33333333 belongs to another person and was entered in error. A record for the other person was created at this site the same day with a pseudo SSN. (VistA does not allow the entry of 2 records with the same SSN at the site.) With this information, I will also correct the other record to the proper SSN of 333333333 as verified by SSA. Once all discrepancies, etc., have been noted, finish assessment with “All other data matches”.
Example #2: LN discrepancy (Smith vs. Smiith), MN discrepancy (Michael vs. M), and SSN discrepancy (123456789 vs. 333333333). The LN of Smith will be retained as verified by SSA. Smiith was a typographical error. The MN of Michael will be retained as verified by BIRLS as it matches the MI of M. SSN 123456789 will be retained as verified by SSA. A letter from SSA was submitted from the site that states SSN 333333333 was originally assigned to this person. However, due to identity theft, the new SSN of 123456789 was assigned in June 2008. Once all discrepancies, etc., have been noted, finish assessment with “All other data matches”.
Below options reviewed: (indicate “Y” for Yes)
| Remote Patient Data |
| ADR MPI PV Compare |
| Verified no additional Tasks and/or Exceptions were generated |
Permanent ICN: Paste Permanent PDAT which includes the documented AS’s and the Treating Facilities list.
10/1/2014 (AMH)
04/04/2017 KJW
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