36C77619R0003-016.docx

ATTACHMENT 15

TOOLKIT TASK DETAILS TEMPLATE

Source: Received from TK POT DUP TASK # xxxxxx. (If received via email, copy and paste the portions of the email specifically pertaining to your case only into the Toolkit Task.)

(When documenting verification data enter the data used to complete the request followed by the data returned.)

SSA via SHARE: Use Entered Data: Name-abcdefg, SSN-xxxxxxxxx verified, DOB – mm/dd/yyyy

BIRLS: Use Entered Data: Name-abcdefg, SSN-xxxxxxxxx verified, DOB – mm/dd/yyyy

VIS: Use Entered Data: Name-abcdefg, SSN-xxxxxxxxx verified, DOB – mm/dd/yyyy As needed

ESR: Document using same format as above if needed. As needed

HEC: Document using same format as above if needed. As needed

SSDI: Document using same format as above if needed. As needed

Accurint: Document using same format as above if needed. As needed

CAPRI: Document any pertinent data referencing site name and record specifics. As needed

For Privacy Act-ID trait change cases: include statement of documents received from requestor/site. ie: Birth Certificate, Marriage Certificate, Divorce Decree, etc.

TK & MVI data discrepancies: (This statement is only documented if the answer is Yes. If yes, provide details) As needed

Audit: (Copy and paste any overwrites of the patient’s identity traits from the audit.)

All audits have been thoroughly reviewed to ensure data has not been overwritten.

Assessment: (Document all data discrepancies noted during review of case as well as how you determined the information being retained. Example: Per SSA verified last name is Smith and spelling of first name is Roberto. Per BIRLS verified middle name is Michael. Finish assessment with “All other data matches”.)

Permanent ICN:

(Copy and paste Permanent PDAT with AS’s documented and Treating Facilities showing)

Update the Aliases:

(Be sure all updates and messaging have cleared at the site by checking the EDAT, RDAT and the CHK option prior to updating the Alias field. If messaging has not cleared, any updates to the Alias field will repopulate.)

Verified all updates completed and Treating Facility list is complete in both the MVI & TK.

(Once you’ve double checked your Toolkit Task Template to ensure all necessary documentation has been included select Resolved in the Toolkit Task. Please note this is not to be selected until you are actually resolving the case.

Updated 04/24/13 Georgann Cox