Section_5_Central_Mailroom_Legacy_version_20140106.doc

Requirements Specification Document (LEGACY DRAFT)

Central Mailroom (Section 5)

Central Bill Process

Central Mailroom (PWS Section 5) Requirements Specifications Document

(LEGACY DRAFT)

Prepared for:

U.S. Department of Labor Office of Worker’s Compensation Programs

Revision History:

SPECIAL NOTICE: This document is a legacy draft requirements specification document developed between 2011 and 2012. As outlined in the Performance Work Statement, the Contractor will be required to review this RSD and make appropriate updates wherever necessary. (Please refer to PWS R0052 for more details.)

Table of Contents Central Mailroom – DFEC

51.1 Central Mailroom Overview – DFEC

71.2 Central Mailroom Business Process Description-DFEC

71.2.1 Receive Mail from PO Boxes, 3rd Party Delivery Services

71.2.2 Sort and open mail by program

71.2.3 Document Preparation

71.2.4 Document Scan

81.3 Central Mailroom Business Process Flow – DFEC

81.3.1

Central Mailroom – DEEOIC

92.1 Central Mailroom Overview – DEEOIC

112.2 Central Mailroom Business Process Description – DEEOIC

112.2.1

112.2.2

112.2.3

112.2.4

122.3 Central Mailroom Business Process Flow- DEEOIC

122.3.1

Central Mailroom – DCMWC

133.1 Central Mailroom Overview – DCMWC

153.2 Central Mailroom Business Process Description – DCMWC

153.2.1

153.2.2

153.2.3

153.2.4

163.3 Central Mailroom Business Process Flow- DCMWC

163.3.1

Central Mailroom Business Requirements

174.1 Functional Requirements

194.2 Business Rules

Central Mailroom Supporting Functional Components

255.1 Initial Data Migration

255.2 Interfaces

265.3 Reports

285.4 Letters

Constraints

296.1 Assumptions

296.2 Dependencies

296.3 Issues/Open Items

Appendices

307.1 Terms & Definitions

327.2 DEEOIC Other Types of Inbound Correspondence

337.3 DCMWC Other Types of Inbound Correspondence

1 Central Mailroom – DFEC

1.1 Central Mailroom Overview – DFEC

The 'front-end' process of Central Bill Process consists of the following functional areas: Central Mailroom, DFEC Imaging, Claimant Bill Development, Bill Scan/Data Entry, and Return to Provider. The narrative of this section is focused on the Central Mailroom, but because the functional areas of the front-end process are closely related, references to these other areas are mentioned to provide a complete picture of the functionality. Details of the other front-end functional areas will be covered in their respective RSD sections.

The CBP Central Mailroom is a critical component of the CBP solution, integrating all of the functions related to paper document processing, both inbound and outbound.

The Contractor will configure its Central Mailroom solution to accommodate the workflows and unique requirements of the DOL. The mailroom automation software will be installed and configured to achieve the maximum throughput, efficiency, and accuracy. All standard bills are considered ‘recognized forms’, (e.g., CMS/OWCP 1500, UB04, ADA, etc.), and are automatically classified out-of-the-box along with many standard types of correspondence. The mailroom automation software will use common elements found on the forms and will include the ability to look for specific types of data elements on forms with ‘drop out ink’ and specific word elements on standard black and white forms. The classification logic will allow for development of complex rules for document and page classification that will be used to identify program-specific forms. The logic will be configured to evaluate various data elements on a page, query the manual classification operators about elements, and redefine the page identification based on the elements or answers from the operator.

The Contractor’s mailroom facility, augmented by the mailroom automation software, will provide the infrastructure necessary to process all incoming mail, parcels, and DFEC correspondence. To ensure continuity of processing, The Contractor will arrange for all United States Postal Service (USPS) post office boxes currently in use by the incumbent to be transferred and the mail redirected to its facility. The Contractor’s solution will incorporate the appropriate level of hardware, software, and staff to meet all of the Performance Work Statement (PWS) requirements for incoming mail and parcel processing.

The Contractor will provide dedicated, program-specific USPS post office boxes for receipt of standard mail and will also accept mail delivered by standard third-party mail services such as FedEx and UPS as well as mail from courier services.

The Contractor’s Central Mailroom will receive, classify, and image the various paper forms and form sets that will comprise the bulk of the inputs to the Central Mailroom solution. This responsibility results in a complex set of operations by the various groups within the unit to properly organize these forms, screen them for acceptance as both acceptable and legible documents, process the forms to create images and transactions, and to submit both images and transactions to the respective back-end components for processing. Using the mailroom automation software the Contractor will plan to reduce the amount of traditionally labor intensive handling and provide a higher level of control and accuracy, as well as a faster turnaround. And combined with all components of the mailroom automation software, the to the Contractor will track each document via the document control number (DCN), allowing for transparency throughout the mailroom processing.

The Contractor will process to completion all incoming mail to the Central Mailroom facility within two business days of receipt. This includes document preparation, scanning, identifying, indexing, data capture, and electronic routing of the incoming documents to their proper destination for further processing - whether the incoming mail is a medical bill, correspondence, or other document that requires further research. The Contractor’s mailroom automation software will aid in identifying each document type, (e.g., bills, attachments, or other DFEC documents). All document types will be identified and processed as required, including envelopes returned as undelivered. The Contractor will process all DFEC correspondence, medical records, etc. as specified in Section 6 of the PWS. Documents will be checked for presence and validity of an approved case number, routed to specified District Office (DO) case numbers if unable to determine one, imaged, indexed (including but not limited to category and author date), and delivered to the appropriate DO for further processing within a monthly average of two business days. Image and index files will be compressed in a .zip file format prior to delivery. Any bill documents will be routed to the appropriate workflow for processing. Authorizations will be imaged, indexed as category code ‘Medical and SOAF’ with a subject code of ‘request for authorization’, and will also be routed to the appropriate capture workflow. Hardcopy documents will be stored for 90 days and then disposed of per federal guidelines.

The basic flow of the Central Mailroom process will be to open the envelope, extract the contents, and manually perform the minimum required screening (e.g., verify there is a case number on the document), perform general cleanup (e.g., remove staples, etc.), insert a separator sheet, and then scan. The integrity of the document will be maintained throughout its entire lifecycle. Additionally, documents will be scanned at the earliest possible time to ensure all documents are imaged and indexed, the data is captured, and the images are transmitted and viewable within a monthly average of two business days of receipt.

The CBP Central Mailroom will return unacceptable and illegible documents back to submitting providers and claimants, maintain statistical counts of forms received and processed, and perform other processes to maintain image index integrity.

The Central Mailroom is part of the overall front-end process supporting DFEC document imaging, claimant bill development, bill scan/data entry and return to provider processes.

1.2 Central Mailroom Business Process Description-DFEC

1.2.1 Receive Mail from PO Boxes, 3rd Party Delivery Services

The Contractor provides nine dedicated, program-specific USPS post office (PO) boxes for receipt of standard mail and will also accept mail delivered by standard third-party mail services such as FedEx and UPS, as well as mail from courier services. There are three PO boxes per program: Provider Enrollment, Prompt Pay Submissions, and General Bills Submissions.

1.2.2 Sort and open mail by program

The bulk of the mail is expected to be received from the USPS. The PO boxes will be used as a natural sort for each program. Mail for each program and individual PO box will be staged in a dedicated area on shelving units in order of receipt. Standard sized envelopes will be processed using automated mail opening equipment and automatically counted. Oversized envelopes and packages will be manually opened and counted. A report will be created with counts for each program broken down by PO box.

1.2.3 Document Preparation

The contents of each envelope will be extracted and sorted into three categories: general bills, Prompt Pay bills, and DFEC mail documents. Standard document preparation will then take place, (e.g., staples/clips removed and torn pages repaired). Any items smaller than 8.5 x 11 inches will be taped to a blank, white sheet of paper to minimize jams in the scanner. If necessary, separator pages will be inserted to segregate multiple documents received in one envelope or package.

1.2.4 Document Scan

All prepared documents will be scanned using scanners and submitted to the Mailroom automation software pipeline for document classification and processing.

Note: The following table was updated after the Build 1 RSD was finalized.

Prompt Pay bills will be scanned using the program-specific bill form ID but will have a priority indicator applied to them.

1.3 Central Mailroom Business Process Flow – DFEC

1.3.1 Central Mailroom

The following diagram captures the DFEC Central Mailroom Business Process flow.

2 Central Mailroom – DEEOIC

2.1 Central Mailroom Overview – DEEOIC

The 'front-end' process of Central Bill Process consists of the following functional areas: Central Mailroom, Claimant Bill Development, Bill Scan/Data Entry, and Return to Provider. The narrative of this section is focused on the Central Mailroom, but because the functional areas of the front-end process are closely related, references to these other areas are mentioned to provide a complete picture of the functionality. Details of the other front-end functional areas will be covered in their respective RSD sections.

The CBP Central Mailroom is a critical component of the CBP solution, integrating all of the functions related to paper document processing, both inbound and outbound.

The Contractor will configure its Central Mailroom solution to accommodate the workflows and unique requirements of the DOL. The mailroom automation software will be installed and configured to achieve the maximum throughput, efficiency, and accuracy. All standard bills will be considered ‘recognized forms’, (e.g., CMS/OWCP 1500, UB04, ADA, etc.), and are automatically classified out-of-the-box along with many standard types of correspondence. The Mailroom automation software will use common elements found on the forms, and will include the ability to look for specific types of data elements on forms with ‘drop out ink’ and specific word elements on standard black and white forms. The document classification logic will allow for development of complex rules for document and page classification that will be used to identify program-specific forms. The logic will be configured to evaluate various data elements on a page, query the manual classification operators about elements, and redefine the page identification based on the elements or answers from the operator.

The Contractor’s mailroom facility will provide the infrastructure necessary to process all incoming mail, parcels, and DEEOIC correspondence. To ensure continuity of processing, The Contractor will arrange for all United States Postal Service (USPS) post office boxes currently in use by the incumbent to be transferred and the mail redirected to the Contractor’s facility. The Contractor’s solution will incorporate the appropriate level of hardware, software, and staff to meet all of the Performance Work Statement (PWS) requirements for incoming mail and parcel processing.

The Contractor will provide dedicated, program-specific USPS post office boxes for receipt of standard mail and will also accept mail delivered by standard third-party mail services such as FedEx and UPS as well as mail from courier services.

The Contractor’s Central Mailroom will receive, classify, and image the various paper forms and form sets that will comprise the bulk of the inputs to the Central Mailroom solution. This responsibility will result in a set of operations by the various groups within the unit to properly organize these forms, screen them for acceptance as both acceptable and legible documents, process the forms to create images and transactions, and submit both images and transactions to the respective back-end components for processing. The Contractor should plan to reduce the amount of traditionally labor intensive handling and provide a higher level of control and accuracy, as well as a faster turnaround. And combined with all components of the Mailroom automation software package, the Contractor will track each document via the document control number (DCN), allowing for transparency throughout the mailroom processing.

The Contractor will process to completion all incoming mail to the Central Mailroom facility within two business days of receipt. This includes document preparation, scanning, identifying, indexing, data capture, and electronic routing of the incoming documents to their proper destination for further processing - whether the incoming mail is a medical bill, correspondence, or other document that requires further research. The Contractor’s mailroom automation software will aid in identifying each document type, (e.g., bills, attachments, or other DEEOIC documents). All document types will be identified and processed as required, including envelopes returned as undelivered. The Contractor will process all DEEOIC correspondence, medical records, etc. Expected DEEOIC correspondence/document types will be provided in Appendix 7.2, along with the expected processing for each. Documents will be checked for the presence of a valid SSN or provider number and routed through the workflow tool for proper processing. Documents identified as medical documentation, death or birth notices/certificates, or claimant change of address will be routed to the appropriate District Office for further processing within a monthly average of two business days. Any bill documents will be routed to the appropriate workflow for processing. Authorizations will be imaged, indexed and routed to the appropriate capture workflow. DEEOIC hardcopy documents will be stored for 2 years and then shipped to the Federal Record Center (FRC).

The basic flow of the Central Mailroom process will be to open the envelope, extract the contents, and manually perform the minimum required screening (e.g., verify there is a case number on the document), perform general cleanup (e.g., remove staples, etc.), insert a separator sheet, and then scan. The integrity of the document will be maintained throughout its entire lifecycle. Additionally, documents will be scanned at the earliest possible time to ensure all documents are imaged and indexed, the data is captured, and the images are transmitted and viewable within a monthly average of two business days of receipt.

The CBP Central Mailroom will return unacceptable and illegible documents back to submitting providers and claimants, maintain statistical counts of forms received and processed, and perform other processes to maintain image index integrity.

The Central Mailroom is part of the overall front-end process supporting DEEOIC document imaging, claimant bill development, bill scan/data entry and return to provider processes.

2.2 Central Mailroom Business Process Description – DEEOIC

2.2.1 Receive Mail from PO Boxes, 3rd Party Delivery Services

The Contractor will provide nine dedicated program-specific USPS post office (PO) boxes for receipt of standard mail and will also accept mail delivered by standard third-party mail services such as FedEx and UPS, as well as mail from courier services. There are three PO boxes per program: Provider Enrollment, Prompt Pay Submissions, and General Bills Submissions.

2.2.2 Sort and open mail by program

The bulk of the mail is expected to be received from the USPS. The PO boxes will be used as an initial sort for each program. Standard sized envelopes will be processed using automated mail opening equipment and automatically counted. Oversized envelopes and packages will be manually opened and counted. A report will be created with counts for each program broken down by PO Box.

2.2.3 Document Preparation

The contents of each envelope will be extracted and sorted into three categories: general bills, Prompt Pay bills, and DEEOIC mail documents. Standard document preparation will then take place, (e.g., staples/clips removed and torn pages repaired). Any items smaller than 8.5 x 11 inches will be taped to a blank, white sheet of paper to minimize jams in the scanner. If necessary, separator pages will be inserted to segregate multiple documents received in one envelope or package.

2.2.4 Document Scan

All prepared documents will be scanned and submitted to the mailroom automation software pipeline for document classification and processing.

Prompt Pay bills will be scanned using the program-specific bill form ID but will have a priority indicator applied to them.

2.3 Central Mailroom Business Process Flow- DEEOIC

2.3.1 Central Mailroom

The following diagram captures the DEEOIC Central Mailroom Business Process flow.

3 Central Mailroom – DCMWC

3.1 Central Mailroom Overview – DCMWC

The 'front-end' process of Central Bill Process consists of the following functional areas: Central Mailroom, Claimant Bill Development, Bill Scan/Data Entry, and Return to Provider. The narrative of this section is focused on the Central Mailroom, but because the functional areas of the front-end process are closely related, references to these other areas are mentioned to provide a complete picture of the functionality. Details of the other front-end functional areas will be covered in their respective RSD sections.

The CBP Central Mailroom is a critical component of the CBP solution, integrating all of the functions related to paper document processing, both inbound and outbound.

The Contractor will configure its Central Mailroom solution to accommodate the workflows and unique requirements of the DOL. The mailroom automation software will be installed and configured to achieve the maximum throughput, efficiency, and accuracy. All standard bills will be considered ‘recognized forms’, (e.g., CMS/OWCP 1500, UB04, etc.), and will be automatically classified out-of-the-box along with many standard types of correspondence. The Mailroom automation software will use common elements found on the forms, and will include the ability to look for specific types of data elements on forms with ‘drop out ink’ and specific word elements on standard black and white forms. The document classification logic will allow for development of complex rules for document and page classification that will be used to identify program-specific forms. The logic will be configured to evaluate various data elements on a page, query the manual classification operators about elements, and redefine the page identification based on the elements or answers from the operator.

The Contractor’s mailroom facility will provide the infrastructure necessary to process all incoming mail, parcels, and DCMWC correspondence. To ensure continuity of processing, the Contractor will arrange for all United States Postal Service (USPS) post office boxes currently in use by the incumbent to be transferred and the mail redirected to the Contractor’s facility. The Contractor’s solution will incorporate the appropriate level of hardware, software, and staff to meet all of the Performance Work Statement (PWS) requirements for incoming mail and parcel processing.

The Contractor will provide dedicated, program-specific USPS post office boxes for receipt of standard mail and will also accept mail delivered by standard third-party mail services such as FedEx and UPS as well as mail from courier services.

The Contractor’s Central Mailroom will receive, classify, and image the various paper forms and form sets that will comprise the bulk of the inputs to the Central Mailroom solution. This responsibility will results in a set of operations by the various groups within the unit to properly organize these forms, screen them for acceptance as both acceptable and legible documents, process the forms to create images and transactions, and to submit both images and transactions to the respective back-end components for processing. The Contractor should plan to reduce the amount of traditionally labor intensive handling and provide a higher level of control and accuracy, as well as a faster turnaround. The Contractor track each document via the document control number (DCN), allowing for transparency throughout the mailroom processing.

The Contractor will process to completion all incoming mail to the Central Mailroom facility within two business days of receipt. This includes document preparation, scanning, identifying, indexing, data capture, and electronic routing of the incoming documents to their proper destination for further processing - whether the incoming mail is a medical bill, correspondence, or other document that requires further research. The Contractor’s mailroom automation software will aid in identifying each document type, (e.g., bills, attachments, or other DCMWC documents). All document types will be identified and processed as required, including envelopes returned as undelivered The Contractor will process all DCMWC correspondence, medical records, etc. Expected DCMWC correspondence/document types will be provided in Appendix 7.3, along with the expected processing for each. Documents will be checked for the presence of a valid SSN or provider number and routed through the workflow for proper processing. Documents identified as medical documentation, death or birth notices/certificates, or claimant change of address will be routed to the appropriate District Office for further processing within a monthly average of two business days. Any bill documents will be routed to the appropriate workflow for processing. DCMWC Hardcopy documents will be stored for 90 days and then prepared for destruction.

The basic flow of the Central Mailroom process will be to open the envelope, extract the contents, and manually perform the minimum required screening (e.g., verify there is an SSN on the document), perform general cleanup (e.g., remove staples, etc.), insert a separator sheet, and then scan. The integrity of the document will be maintained throughout its entire lifecycle. Additionally, documents will be scanned at the earliest possible time to ensure all documents are imaged and indexed, the data is captured, and the images are transmitted and viewable within a monthly average of two business days of receipt.

The Contractor will maintain a check log to record information about all checks received in the Central Mailroom, including the date received, and the date sent to the P.O. Box 979067 (see Appendix 7.3).

The CBP Central Mailroom will return unacceptable and illegible documents back to submitting providers and claimants, maintain statistical counts of forms received and processed, and perform other processes to maintain image index integrity.

The Central Mailroom is part of the overall front-end process supporting DCMWC document imaging, claimant bill development, bill scan/data entry and return to provider processes.

3.2 Central Mailroom Business Process Description – DCMWC

3.2.1 Receive Mail from PO Boxes, 3rd Party Delivery Services

The Contractor provides nine dedicated program-specific USPS post office (PO) boxes for receipt of standard mail and will also accept mail delivered by standard third-party mail services such as FedEx and UPS, as well as mail from courier services. There are three PO boxes per program: Provider Enrollment, Prompt Pay Submissions, and General Bills Submissions.

3.2.2 Sort and open mail by program

The bulk of the mail is expected to be received from the USPS. The PO boxes will be used as an initial sort for each program. Mail for each program and individual PO box will be staged in order of receipt. Standard sized envelopes will be processed using automated mail opening equipment and automatically counted. Oversized envelopes and packages will be manually opened and counted. A report will be created with counts for each program broken down by PO Box.

3.2.3 Document Preparation

The contents of each envelope will be extracted and sorted into three categories: general bills, Prompt Pay bills, and DCMWC mail documents. Standard document preparation will then take place, (e.g., staples/clips removed and torn pages repaired). Any items smaller than 8.5 x 11 inches will be taped to a blank, white sheet of paper to minimize jams in the scanner. If necessary, separator pages will be inserted to segregate multiple documents received in one envelope or package.

3.2.4 Document Scan

All prepared documents will be scanned and submitted to the Mailroom automation software pipeline for document classification and processing.

Prompt Pay bills will be scanned using the program-specific bill form ID but will have a priority indicator applied to them.

3.3 Central Mailroom Business Process Flow- DCMWC

3.3.1 Central Mailroom

The following diagram captures the DCMWC Central Mailroom Business Process flow.

4 Central Mailroom Business Requirements

The following section documents the functional requirements and business rules needed to implement the requirements outlined in Section 5 – Central Mailroom of the PWS. For requirements traceability purposes, IDs have been assigned to each functional requirement and business rule. The first two characters of each ID represent the related Program, (B1 (Core/DFEC), B2 (DEEOIC), B3 (DCMWC), followed by PWS Section, followed by a 3 digit sequentially assigned number within each Build/PWS Section. The Program column indicates whether the requirement/rule is Core (i.e., applies to all programs) or if it is DFEC, DEEOIC, and/or DCMWC specific.

4.1 Functional Requirements

PWS

Req # Functional

Req ID

R0236

R0237 R0238

R0247

B1-05-FR001

B1-05-BR002

B1-05-BR019

B1-05-BR020

Core

R0235 R0237

R0244

R0245

R0246

B1-05-FR003

DFEC

R0235

R0237

R0244

R0245

B2-05-FR003

DEEOIC

R0235

R0237

R0244

R0245

B3-05-FR003

DCMWC

R0243

R1011

R1012

B3-05-BR009

Core

R0237 R0239 R0240 R0241

R0242

R0015

B1-05-FR005

B1-05-BR004

B1-05-BR005

B1-05-BR006

B1-05-BR008

DFEC

R0237

R0239

R0240

R0241

R0242 R0015

B2-05-FR005

B1-05-BR004

B2-05-BR005

B1-05-BR006

B1-05-BR008

DEEOIC

R0237

R0239

R0240

R0241

R0242 R0015

B3-05-FR005

B1-05-BR004

B3-05-BR005

B1-05-BR006

B1-05-BR008

DCMWC

R0241 R0015

B1-05-BR021

B3-05-BR021

Core

R0237

R0240

B1-05-FR007

R0237

R0239

R0242

R0243

B1-05-FR008

B1-05-BR007

B3-05-BR007

B1-05-BR008

B1-05-BR009

B1-05-BR010

B2-05-BR010

B3-05-BR010

B1-05-BR011

B1-05-BR012

B1-05-BR014

Core

B2-05-BR013

B3-05-BR013

B1-05-BR014

Core

B2-05-BR018

B3-05-BR018

Core

4.2 Business Rules

· As an added benefit, utilize the Contractor courier to pick up mail received in the various designated PO Boxes between the regular USPS morning delivery schedule.

Core

· PO Boxes will be used as the natural sort for each program: General Bills; Prompt Pay Bills; Provider Enrollments and Index Only Documents.

· Standard sized envelopes will be processed using automated mail opening equipment and automatically counted.

· Oversized envelopes and packages will be manually opened and counted.

Core

Misdirected mail is defined as either mail received at the Contractor facility in error or inadvertently sent to the Contractor facility. Any mail forwarded to the Contractor facility in error by the USPS will be returned to the USPS on a daily basis. Mail addressed to the Contractor facility but is obviously not related to the OWCP i.e. a credit card or electric bill payment that was put in the wrong envelope and was not intended to be sent to the Contractor facility will be returned to the sender with a form letter stating that the mail was misdirected. Mail received at the Contractor facility that is addressed to the attention of an individual that is not a known employee will be researched and processed if the correct flow can be determined, i.e. it is a valid bill or valid DFEC correspondence, otherwise it will be returned to the sender.

DFEC

B2-05-BR005

Misdirected mail is defined as either mail received at the Contractor facility in error or inadvertently sent to the Contractor facility. Any mail forwarded to the Contractor facility in error by the USPS will be returned to the USPS on a daily basis. Mail addressed to the Contractor facility but is obviously not related to the OWCP i.e. a credit card or electric bill payment that was put in the wrong envelope and was not intended to be sent to the Contractor facility will be returned to the sender with a form letter stating that the mail was misdirected. Mail received at the Contractor facility that is addressed to the attention of an individual that is not a known employee will be researched and processed if the correct flow can be determined, i.e. it is a valid bill or valid correspondence, otherwise it will be returned to the sender.

DEEOIC

B3-05-BR005

Misdirected mail is defined as either mail received at the Contractor facility in error or inadvertently sent to the Contractor facility. Any mail forwarded to the Contractor facility in error by the USPS will be returned to the USPS on a daily basis. Mail addressed to the Contractor facility but is obviously not related to the OWCP i.e. a credit card or electric bill payment that was put in the wrong envelope and was not intended to be sent to the Contractor facility will be returned to the sender with a form letter stating that the mail was misdirected. Mail received at the Contractor facility that is addressed to the attention of an individual that is not a known employee will be researched and processed if the correct flow can be determined, i.e. it is a valid bill or valid correspondence, otherwise it will be returned to the sender.

DCMWC

· Remove staples/clips

· Repair torn pages

· Tape any items smaller than 8.5 x 11 to a blank white sheet to minimize jams in the scanner

· Use a “Separator Sheet” to maintain the integrity of the document and its associated pages within an envelope.

· For multiple claimants documents received in one envelope or package, use a “Patch Sheet” to segregate each claimant’s set of documents from another.

Core

· Copies of bills within bills will be identified and an Indicator Sheet placed in front of each bill copy

· Bills with legal size attachments are separated from other bills that will go through document processing software

· Dental bills with X-rays are separated from other bills that will go through document processing software

· Red Dental bills are separated from other claims that will go through document processing software Core

B3-05-BR007

· Copies of bills within bills will be identified and an Indicator Sheet placed in front of each bill copy

· Bills with legal size attachments are separated from other bills that will go through document processing software

DCMWC

· Not prepped nor scanned Core

· Both the envelope and its contents will be prepped and processed for scanning

· Will be categorized during scanning as Miscellaneous

· Both front and back of the envelope and contents will be scanned and any blank pages deleted Core

For DFEC, undelivered and returned Provider Mail will be imaged and then processed by the Contractor Provider Enrollment Unit. Claimant undelivered returned mail will be imaged, categorized in the IFECs system as miscellaneous, and the appropriate District Office Representative will be notified via the workflow. The District Office will then provide final processing instructions to the Contractor.

Core

B1-05-BR010

B2-05-BR010

B3-05-BR010

B1-05-BR013

B3-05-BR013

· 3 label stickers with matching assigned numbers will be used to associate the “Non-scannable Routing Sheet” to the original item (i.e., 1 to be affixed to the routing sheet; 1 to affixed to the non-scannable item; 1 to be affixed to the envelope/packaging of the item)

· Non-scannable items (e.g., x-rays, three-dimensional objects, etc) will be held for one week

· A shipping log detailing the items and control numbers will be prepared for shipping of the items to the appropriate District Office via Third Party Mail Service Core

· SLA is within 2 days of receipt in the Central Mailroom Core

· Outgoing parcels will be detailed on a log, along with sender and recipient information. A report will be created detailing delivery costs.

Core

5 Central Mailroom Supporting Functional Components The following functional components serve as inputs or outputs to the Central Mailroom process.

5.1 Initial Data Migration

The following table identifies the initial data migration required by the Central Mailroom. Specific details (i.e., file layout, business rules, etc.) of each data migration will be outlined under a separate document, Detailed Design Specifications. For requirements traceability purposes, Initial Data Migration IDs have been assigned to each Initial Data Migration requirement. The first two digits represent the PWS Section, followed by a system component identifier (IDM01=DFEC; IDM02=DEEOIC; IDM03=DCMWC; IDM99=Misc/Global), followed by a 3 digit sequentially assigned number within each PWS Section and system identifier.

Data Migration

ID

Source

System Target

System Description

05-IDM01_001

05-IDM02_001

05-IDM03_001

5.2 Interfaces

The following table identifies the interfaces required by the Central Mailroom. Specific details (i.e., file layout, business rules, etc.) of each interface will be outlined under a separate document, Detailed Design Specifications. For requirements traceability purposes, Interface IDs have been assigned to each interface requirement. The first two digits represent the PWS Section, followed by a system component identifier (INTF01=DFEC; INTF02=DEEOIC; INTF03=DCMWC; INTF99=Misc/Global), followed by a 3 digit sequentially assigned number.

Future State Interface ID Source

System Target

System

05-INTF01-001

05-INTF02-001

05-INTF03-001

05-INTF01-002

05-INTF02-002

05-INTF03-002

05-INTF01-003

05-INTF02-003

05-INTF03-003

5.3 Reports

The following table identifies the reports required by the Central Mailroom. Specific details (i.e., report templates, data elements, business rules, etc.) of each report will be outlined under a separate document, Detailed Design Specifications. . For requirements traceability purposes, Report IDs have been assigned to each report requirement. The first two digits represent the PWS Section, followed by a system component identifier (RPT01=DFEC; RPT02=DEEOIC; RPT03=DCMWC; RPT99=Misc/Global), followed by a 3 digit sequentially assigned number within each PWS Section and system identifier.

Future State

Report ID Current State

Report ID

05-RPT01_001

05-RPT02_001

05-RPT03_001

Data Elements:

Provider Number

OWCP Program Enrollment ID

Provider Name

Date Welcome Letter Mailed

Provider Status (New Provider, Re-enrolled Provider)

05-RPT99_002

Daily counts of all mail received for each program, broken down by PO Box as well as 3rd party courier.

Data Elements:

Date

Julian Date

Program

PO Box Number and Description

3rd Party Courier

Count Total

Clerk ID

05-RPT01_003

05-RPT02_003

05-RPT03_003

Data Elements:

Date

Program

Total Envelopes Received

Total Documents Processed

Total Pages Scanned

Total Images Created

Total Images Deleted

05-RPT01_004

05-RPT02_004

05-RPT03_004

Data Elements:

Date

Month Ending

Job/Batch Number

Program Name

Letter Type

Total Volume

Mailed Date

Mailed Volume

05-RPT01_005

05-RPT02_005

05-RPT03_005

Data Elements:

Date

Account Name/Number(Program) Opening Balance

Funds Added

Amount Spent

Closing Balance

05-RPT01-006

05-RPT02-006

05-RPT03-006

Data Elements:

Date

Account Number/Name(Program)

Postage Account Type (Meter/Permit/BRM)

Letter Category

TotalPostage

Total Pieces

5.4 Letters

The following table identifies the letters required by the Central Mailroom. Specific details (e.g., letter templates, data elements, business rules, etc.) of each letter will be outlined under a separate document, Detailed Design Specifications. For requirements traceability purposes, Letter IDs have been assigned to each letter requirement. The first two digits represent the PWS Section, followed by a system component identifier (LTR01=DFEC; LTR02=DEEOIC; LTR03=DCMWC; LTR99=Misc/Global), followed by a 3 digit sequentially assigned number within each PWS Section and system identifier.

**NOTE: All Letters will be distributed electronically or through the Central Mailroom. Each respective letter will be listed in its respective RSD (e.g., DOL Prior Authorization Letter will be captured in the Authorization RSD.

Future State

Letter ID Current State

Rpt ID

05-LTR01_001

05-LTR02_001

05-LTR03_001

6 Constraints

6.1 Assumptions

· N/A

6.2 Dependencies

· Timely receipt of mail from incumbent during the Bill Hold period.

6.3 Issues/Open Items

7 Appendices

7.1 Terms & Definitions

Program administered by the Division of Coal Mine Workers’ Compensation (DCMWC) that provides compensation benefits to eligible coal miners and their families and medical benefits to eligible coal miners in the event of total disability or death due to pneumoconiosis. These benefits are financed through direct Federal appropriations, earmarked tax revenues, and legislatively mandated private sector liability insurance arrangements.

A medical bill processing operation that processes bills for three OWCP programs: FECA under DFEC; BLBA under DCMWC; EEOICPA under DEEOIC using one centralized process, but with customized business rules for each program.