EHR_DEERS_ICD

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Implementation, maintenance, training, technical and help desk support of an ambulatory Electronic Health Record (EHR) commercial off-the-shelf (COTS) product solution for the United States Coast Guard (USCG)
Solicitation number
HSCG23-10-R-PCI104
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From the source

Additional file to Attachment VII - EHR Deers ICD

Text of this file

Interface Control Document (Draft)

DEERS -- EHR

USCG

Electronic Health Record (EHR)

Draft

Prepared in support of the EHR acquisition for the USCG. This Interface Control Document (ICD) is a draft to allow the bidders to evaluate their solution in the context of their system interfacing to DEERS.

Table of Contents

1.Scope1-1
1.1System Identification1-1
1.2Document Overview1-1
2.Concept of Operations2-1
2.1System Overview2-1
2.1.1EHR2-1
2.1.2DEERS2-2
2.2Functional Allocation2-2
2.2.2Interface Transactions2-4
2.3Data Transfer2-7
2.4Security and Integrity2-7
2.5C2 Requirements2-7
2.6Privacy Requirements2-7
3.Message Specifications3-1
3.1EHR/DEERS Message Structure3-3
3.1.1Encoding Rules3-3
3.1.2Conventions3-4
3.2EHR Messages3-6
3.2.1Address/Log/Organ Donor Update Message3-6
3.2.2Eligibility/Registration Message3-9
3.2.3Enrollment/Disenrollment (0) – Cancel Message3-11
3.2.4Enrollment/Disenrollment (1) – Enrollment Message3-13
3.2.5Enrollment/Disenrollment (2) – Disenrollment Message3-14
3.2.6Enrollment/Disenrollment (3) – Reciprocal Disenrollment Message3-16
3.2.7Enrollment/Disenrollment (4) – Reciprocal Disenrollment/Enrollment Msg3-18
3.2.8Enrollment/Disenrollment (5) Message3-19
3.2.9Enrollment/Disenrollment (6) Message3-21
3.2.10Enrollment/Disenrollment (7) Message3-23
3.2.11Enrollment/Disenrollment (8) Message3-24
3.2.12Enrollment/Disenrollment (P) Message3-26
3.2.13Reciprocal Disenrollment Message3-28
3.2.14NAS Routine (I) Message3-29
3.2.15NAS Conditional (J) Message3-32
3.2.16NAS Conditional (K) Message3-35
3.2.17NAS Candidate List Message3-38
3.2.18NAS Cancel Message3-40
3.2.19NAS Monthly Report Message3-41
3.2.20NAS Statistical Report Message3-42
3.3DEERS Response Messages3-43
3.3.1Address/Log/Organ Donor Update (X) Response3-43
3.3.2Eligibility/Registration (S) Response3-45
3.3.3Eligibility Family (K) Response3-51
3.3.4Eligibility/Registration Discrepancy (X) Response3-54
3.3.5Enrollment/Disenrollment (X) Response3-56
3.3.6Reciprocal Disenrollment (D) Response3-58
3.3.7NAS (I) Response3-60
3.3.8NAS (K) Response3-61
3.3.9NAS Candidate (L) Response3-62
3.3.10NAS Candidate (Q) Response3-64
3.3.11NAS Monthly Report (R) Response3-69
3.3.12NAS Statistical Report (S) Response3-82
3.3.13NAS (X) Response3-84
3.3.14NAS Discrepancy (X) Response3-85
3.3.15NAS Discrepancy Report (X) Response3-86
4.Communication Requirements4-1
4.1Interface Initiation4-1
4.2Flow Control4-2
4.3Error Management4-2
4.4SECURITY FEATURES4-8

LIST OF TABLES

Table 21 EHR/DEERS Events and Messages2-4
Table 31 EHR/DEERS Messages/Responses3-1
Table 32 Legend -- Data Field Padding Nomenclature3-4
Table 33 Data Field Attribute Table Format for EHR Messages3-5
Table 34 Data Field Attribute Table Format for DEERS Messages3-5
Table 35 Address/Log/Organ Donor Update Message3-7
Table 36 Eligibility/Registration Message3-10
Table 37 Enrollment/Disenrollment (0) -- Cancel Message3-12
Table 38 Enrollment/Disenrollment (1) -- Enrollment Message3-13
Table 39 Enrollment/Disenrollment (2) -- Disenrollment Message3-15
Table 310 Enrollment/Disenrollment (3) -- Reciprocal Disenrollment Message3-17
Table 311 Enrollment/Disenrollment (4) -- Reciprocal Disenrollment/Enrollment Message3-18
Table 312 Enrollment/Disenrollment (5) Message3-20
Table 313 Enrollment/Disenrollment (6) Message3-21
Table 314 Enrollment/Disenrollment (7) Message3-23
Table 315 Enrollment/Disenrollment (8) -- Disenrollment Cancellation Message3-25
Table 316 Enrollment/Disenrollment (P) Message3-27
Table 317 Reciprocal Disenrollment Message3-29
Table 318 NAS Routine (I) Message3-30
Table 319 NAS Conditional (J) Message3-33
Table 320 NAS Conditional (K) Message3-36
Table 321 NAS Candidate List Message3-38
Table 322 NAS Cancel Message3-40
Table 323 NAS Monthly Report Message3-42
Table 324 NAS Statistical Report Message3-43
Table 325 Address/Log/Organ Donor Update Response (X)3-44
Table 326 Eligibility/Registration (S) Response3-46
Table 327 Eligibility Family (K) Response3-52
Table 328 Eligibility/Registration Discrepancy (X) Response3-55
Table 329 Enrollment/Disenrollment (X) Response3-56
Table 330 Reciprocal Disenrollment (D) Response3-58
Table 331 NAS (I) Response3-60
Table 332 NAS (K) Response3-61
Table 333 NAS Candidate (L) Response3-63
Table 334 NAS Candidate (Q) Response3-65
Table 335 R-Facility Temporarily Not Available for Report Type = 13-70
Table 336 Professional Capability Temporarily Not Available for Report Type = 23-72
Table 337 Medically Inappropriate for Report Type = 33-73
Table 338 Summary Report by Branch of Service for Report Type = 43-74
Table 339 Summary Report by Major Diagnostic Category for Report Type = 53-76
Table 340 Facility/Professional Capability Permanently Not Available for Report Type = 63-80
Table 341 NAS Statistical Report (S) Response3-82
Table 342 NAS (X) Response3-85
Table 343 NAS Discrepancy (X) Response3-86
Table 344 NAS Discrepancy Report (X) Response3-87
Table 41 Discrepancy Code Description4-3

DEERS – EHR ICD (draft) v

Scope This Interface Control Document (ICD) specifies the interface between the United States Coast Guard (USCG) Electronic Health Record (EHR) system and the Defense Eligibility and Enrollment Reporting System (DEERS).

System Identification DEERS is a computerized information service. DEERS data is used to verify the eligibility of individuals to receive Uniformed Services benefits. It is development by Electronic Data Systems (EDS) in support of the:

DEERS Program Office 1600 N. Wilson Blvd.

Suite 400 Arlington, VA 22091

EHR is a Commercial Off-the-Shelve (COTS) software package that supports the USCG Health Care system through its USCG healthcare clinics and deployed forces. It integrates the management of all health care services under a single system.

Document Overview The purpose of this document is to describe the interface between EHR and DEERS. It is not to be used as a requirement documents. It serves as a resource for understanding this interface as it is envisioned to exist in the future EHR.

This document describes the concept of operations for the interface, defines the message structure and protocols which govern the interchange of data, and identifies the communication paths that the data is expected to flow. The document contains message specifications and communication requirements.

1-1

Concept of Operations The operational objective of the interface between EHR and DEERS is to provide USCG healthcare clinics with accurate and timely patient’s eligibility, enrollment and Non-Availability Status (NAS) information. The EHR on deployed forces does not directly interface with DEERS but rather with the EHR central system located in Martinsburg, WV during periods that sufficient connectivity exists between the ship and the central system.

System Overview The functionality and architecture of the participating systems is described in the following paragraphs. They briefly summarize each system; place special emphases on functionality related to the interface and identify key hardware and software components of the DEERS. The EHR system components will be identified once the system has been acquired.

EHR

EHR is a Commercial Off-the-Shelve (COTS) software package that supports the USCG healthcare system throughout its USCG healthcare clinics and deployed forces. It integrates the management of all USCG health care services under a single system.

The USCG healthcare clinics include medical and dental clinics and provide integrated information services in support of patient care. The system supports application modules, patient care and documentation, administrative and management functions, and other infrastructure to support the USCG health care program.

Application Modules include:

· Ambulatory Care

· Urgent Care

· Dental

· Physical Therapy

· Optometry

· Behavioral Health

· Immunization

· Audiology

· Radiology

· Ambulatory Pharmacy

· Laboratory

· Patient Portal

Patient Care and Documentation include:

· Clinical Content and Decision Support

· Patient Problems, History and Laboratory Tests

· Charting and Drawing

· Medications

· Sick Call / Triage Center

· Ophthalmology

Administrative and Management include:

· Billing

· Health Care Management

· Scheduling

· Worklists

· End User Dashboard

· Reporting and Forms

· Health Information Management (HIMS)/ Medical Records

Other Infrastructure includes:

· Remote Access to Patient Clinical Information for USCG Physicians and Staff

· Remote Access to Patient Clinical Information for Affiliates/ Contract/ Network Providers

· Remote Access to Patient Clinical Information for Ships

· Kiosks

· User Interface

· User Roles/ Security

EHR will be implemented as a COTS package in a CITRIX environment with server hosting in Martinsburg, WV and clients at USCG healthcare clinics. Remote stations will be used with deployed forces and will synchronize with the server when connectivity is sufficient or when the ship returns to port.

DEERS

DEERS is a reporting system designed to aid the Department of Defense (DoD) in improving distribution of personnel and health benefits to entitled beneficiaries by providing interfacing systems with patient’s medical benefits eligibility information. The system also supports the Health Care Management, Research, and Liaison activities. DEERS data provides information for eligibility verification and identification (ID) card issuance for individuals entitled to Uniformed Services Benefits.

DEERS operates as two systems: Enrollment and Eligibility. The Enrollment System represents the past, present, and potentially eligible beneficiaries of the system. The Eligibility System provides an Online Inquiry function to determine the benefit eligibility of sponsors and their dependents that are entered in DEERS.

Functional Allocation The interface between EHR and DEERS provides EHR with access to data held by DEERS:

· Patient’s eligibility to receive uniformed services medical benefits

· Patient’s demographic and organ donor information

· Reciprocal disenrollment information

· Non-Availability Statement information

· Non-Availability Statement information The interface between EHR and DEERS provides DEERS with data held by EHR:

· Patient’s demographic, organ donor status and blood type

· Patients MCP enrollment information

· Non-Availability Statement information Eligibility for Care Patient data related to eligibility for medical care as a uniformed service's benefit is collected and maintained in DEERS. EHR requests eligibility data from DEERS as needed. EHR does not collect eligibility data locally and does not modify eligibility data in DEERS. When DEERS responds with a patient's eligibility, it also sends selected information they hold relative to the patient's demographic data, sponsor identification and enrollment information. EHR notifies DEERS when a decision is made to provide patient care to an individual whom DEERS classifies as ineligible.

Patient Demographics When patients are registered at an USCG healthcare clinic, EHR collects the following patient information, which may be updated during subsequent encounters:

1. Patient Name and FMP/SSN

2. Sponsor Name, Rank, and SSN

3. Patient Gender and DOB

4. Patient Address and Phone number

5. Patient Blood Type

6. Organ Donor information.

EHR notifies DEERS when any of the above information is modified (added, changed or deleted) during registration or subsequent editing.

Managed Care Enrollment Patient enrollment in and disenrollment from an MCP is performed on EHR. EHR notifies DEERS of patient enrollments, disenrollments and other changes to enrollment information. On request, DEERS forwards to the requesting EHR site the identity of its patients who were reciprocally disenrolled by a remote EHR site. The requesting EHR site will use this information to update its database.

Non-Availability Statements EHR generates non-Availability Statements (NAS) to document the authorization for non-military treatment facilities to provide services for patients who are eligible to receive treatment at an USCG healthcare clinic. EHR notifies DEERS when issuing or updating a NAS on EHR. DEERS maintains this information and provides EHR with NAS Reports, upon request.

Interface Transactions Table 21 shows the transactions/events on EHR that trigger the messages sent to DEERS. The paragraph, in this document, where each message’s format and content are defined is also listed. All messages received from DEERS are triggered upon DEERS receipt of a message from EHR; these are also listed in Table 21. For additional information on the specific transaction see the paragraph of this document referenced in the last column of this table.

Table 21 EHR/DEERS Events and Messages

Transaction
Originator
Message
Ref
Update Patient Demographic data
EHR
Address/ Log/Organ Donor Update AQC4H
3.2.1
Update Patient Organ Donor Status
EHR
Address/ Log/Organ Donor Update AQC4H
3.2.1
Update Patient Blood Type
EHR
Address/ Log/Organ Donor Update AQC4H
3.2.1
Log EHR' Access of Patient Data in DEERS
EHR
Address/ Log/Organ Donor Update AQC4H
3.2.1
Override Patient's Ineligibility on DEERS
EHR
Address/ Log/Organ Donor Update AQC4H
3.2.1
Register patient / Admit patient
EHR
Eligibility/Registration AQC4Q
3.2.1
Cancel Patient MCP enrollment
EHR
Enroll/Disenroll- Cancel AQC40
3.2.3
Enroll Patient in MCP Plan
EHR
Enroll/Disenroll – Enrollment AQC41
3.2.4
Disenroll Patient from MCP Plan
EHR
Enroll/Disenroll – Disenrollment AQC42
3.2.5
Reciprocally Disenroll Patient from another EHR site (losing site).
EHR
Enroll/Disenroll – Reciprocal Disenrollment AQC43
3.2.6
Enroll patient at gaining EHR site.
EHR
Enroll/Disenroll – Reciprocal Disenrollment/Enrollment AQC44
3.2.7
Modify patient's MCP plan start date.
EHR
Enroll/Disenroll - Update Start Date AQC45
3.2.8
Modify patient's MCP plan end date.
EHR
Enroll/Disenroll – Disenrollment Date Correction AQC46
3.2.9
Modify patient's other MCP plan enrollment data.
EHR
Enroll/Disenroll - Update Other Enrollment Data AQC47
3.2.10
Cancel Disenrollment
EHR
Enroll/Disenroll –Disenrollment Cancellation AQC48
3.2.11
Enroll patient in MCP plan that is not recorded in DEERS (e.g. – new spouse or newborn).
EHR
Enroll/Disenroll – Conditional Enrollment AQC4P
3.2.12
Query DEERS for all patients who have been reciprocally disenrolled for a particular site.
EHR
Reciprocal Disenrollment AQC5J
3.2.13
Issue Routine NAS for a patient.
EHR
NAS Routine (I) AQHNI
3.2.14
Issue Conditional NAS (first part)
EHR
NAS Conditional (J) AQHNJ
3.2.15
Issue Conditional NAS (second part)
EHR
NAS Conditional (K) AQHNK
3.2.16
Query DEERS for a previously issued NAS. Used to determine if new NAS should be filed.
EHR
NAS Candidate List AQHNQ
3.2.17
Cancel NAS for a patient.
EHR
NAS Cancel AQHNC
3.2.18
Request a report on NAS.
EHR
NAS Monthly Report AQNHR
3.2.19
Request statistical NAS information
EHR
NAS Statistical Report AQNHS
3.2.20
Receipt of valid AQC4Q message from DEERS.
DEERS
Address/Log/Organ Donor Update Response type (X)
3.3.1
Upon receipt of Eligibility /Registration
DEERS
Eligibility / Registration Discrepancy Response type (X)
3.3.4
Receipt of a valid AQC4Q message from EHR, where the individual requested is identified.
DEERS
Eligibility / Registration – Response type (S)
3.3.2
Receipt of a valid AQC4Q message from EHR, where the family group (via sponsor SSN) but not the individual requested is identified.
DEERS
Eligibility Family – Response type (K)
3.3.3
Upon receipt of Enrollment /Disenrollment
DEERS
Enrollment / Disenrollment -Response type (X)
3.3.5
Upon receipt of NAS Candidate List
DEERS
NAS Candidate Response - type (L)
3.3.9
Upon receipt of NAS Candidate List
DEERS
NAS Candidate Response -type (Q)
3.3.10
Upon receipt of NAS Cancel
DEERS
NAS Discrepancy – Response type (X)
3.3.14
Upon receipt of NAS Candidate List
DEERS
NAS Discrepancy – Response type (X)
3.3.14
Upon receipt of NAS Conditional (J)
DEERS
NAS Response type (X)
3.3.13
Upon receipt of NAS Conditional (J)
DEERS
NAS Discrepancy – Response type (X)
3.3.14
Upon receipt of NAS Conditional (K)
DEERS
NAS Discrepancy – Response type (X)
3.3.14
Upon receipt of NAS Routine
DEERS
NAS Discrepancy –Response type (X)
3.3.14
Upon receipt of NAS Monthly Report
DEERS
NAS Monthly Report –Response type (R)
3.3.11
Upon receipt of NAS Routine
DEERS
NAS Response type (I)
3.3.7
Upon receipt of NAS Conditional (K)
DEERS
NAS Response type (K)
3.3.8
Upon receipt of NAS Monthly Report
DEERS
NAS Report Discrepancy - Response type (X)
3.3.15
Upon receipt of NAS Statistical Report
DEERS
NAS Report Discrepancy - Response type (X)
3.3.15
Upon receipt of NAS Statistical Report
DEERS
NAS Statistical Report –Response type (S)
3.3.12
Upon receipt of Reciprocal /Disenrollment
DEERS
Reciprocal / Disenrollment -Response type (D)
3.3.6

Data Transfer EHR and DEERS exchange patient data via custom messages, which are transmitted as triggering events occur. EHR and DEERS exchange patient data via custom messages, which are transmitted as triggering events occur. Computer connectivity between EHR and DEERS occurs in two ways. Most EHR sites connect via communications processes using the Defense Information Systems Network (DISN) Wide Area Network (WAN) and based on the Internet Protocol (IP) network address of the DEERS McData gateway. A few EHR sites connect using the Defense Medical Systems Support Center (DMSSC) network with leased telephone lines and modems. Specific communications requirements are itemized in Section 4 of this document.

Security and Integrity Existing security protocols will continue to be used. Currently the network performs validations of IP address of remote systems are performed.

C2 Requirements All participating systems shall adhere to the security requirements as defined for division C (discretionary protection), class C2 systems (controlled access protection) in the Department of Defense Trusted Computer System Evaluation Criteria (TCSEC), DoD 5200.28-STD (also known as the Orange Book).

Privacy Requirements Participating systems of the CDI interface send and receive Sensitive But Unclassified (SBU) administrative, personal, and medical data. Examples of such information include patient name, social security number, and benefit information. This data is subject to the provisions of the Privacy Act of 1974 and DoD Privacy Program, DoD 5400.11-R. Additionally, its personal and medical data fall within the content of Exemption Number 6 of the DoD FOIA Program, DoD 5400.7-R. Both the DoD Privacy and FOIA programs mandate adequate data protection.

2-7

Message Specifications EHR and DEERS communicate via messages conforming to a fixed length message format, which provides a general framework for communication. This Interface Control Document explicitly specifies the required content of each message and the circumstances under which it is sent. Refer to Table 31.

Table 31 EHR/DEERS Messages/Responses

Transaction Name
Table #
Response Type
Table #
AQC4H - Address /Log/Organ Donor Update
3-5
X - Address/Log/Organ Donor
3-25
AQC4Q - Eligibility/Registration (Q)
3-6
Eligibility/Registration

S – Single K – Family X - Discrepancy

3-26 3-27 3-28

AQC40 - Enrollment/Disenrollment (0)
3-7
X - Enrollment/Disenrollment
3-29
AQC41 - Enrollment/Disenrollment (1)
3-8
X - Enrollment/Disenrollment
3-29
AQC42 - Enrollment/Disenrollment (2)
3-9
X - Enrollment/Disenrollment
3-29
AQC43 - Enrollment/Disenrollment (3)
3-10
X - Enrollment/Disenrollment
3-29
AQC44 - Enrollment/Disenrollment (4)
3-11
X - Enrollment/Disenrollment
3-29
AQC45 - Enrollment/Disenrollment (5)
3-12
X - Enrollment/Disenrollment
3-29
AQC46 - Enrollment/Disenrollment (6)
3-13
X - Enrollment/Disenrollment
3-29
AQC47 - Enrollment/Disenrollment (7)
3-14
X - Enrollment/Disenrollment
3-29
AQC48 - Enrollment/Disenrollment (8)
3-15
X - Enrollment/Disenrollment
3-29
AQC4P - Enrollment/Disenrollment (P)
3-16
X - Enrollment/Disenrollment
3-29
AQC5J - Reciprocal Disenrollment
3-17
D - Reciprocal Disenrollment
3-30
AQHNI - NAS Routine (I)
3-18
I – NAS

X - NAS Discrepancy 3-31 3-43

AQHNJ - NAS Conditional (J)
3-19
X – NAS

X - NAS Discrepancy 3-42 3-43

AQHNK - NAS Conditional (K)
3-20
K – NAS

X - NAS Discrepancy 3-32 3-43

AQHNQ - NAS Candidate List
3-21
L - Partial List NAS Candidate

Q - Full List NAS Candidate X - NAS Discrepancy 3-33 3-34 3-43

AQHNC - NAS Cancel
3-22
X – NAS

X - NAS Discrepancy 3-42 3-43

AQHNR - NAS Monthly Report
3-23
NAS Monthly Reports

R - Facility Temporarily Not Available for Report Type=1 R - Professional Capability Temporarily Not Available for Report Type=2 R - Medically Inappropriate for Report Type=3 R - Summary Report by Branch of Service for Report Type=4 R - Summary Report by Major Diagnostic Category for Report Type=5 R - Facility/Professional Capability Permanently Not Available for Report Type=6 X - NAS Discrepancy Report

3-35

3-36

3-37

3-38

3-39

3-40

3-43

AQHNS - NAS Statistical Report
3-24
S - NAS Statistical Report

X - NAS Discrepancy Report 3-41 3-44

EHR/DEERS Message Structure The following sections describe the basic rules that are followed for all messages sent and received by EHR.

Encoding Rules EHR and DEERS exchange patient data via a custom set of messages. Each message is composed of a defined set of data fields of fixed length. Padding must be used to maintain the fixed field and message length. The fields are organized in a specified sequence with no delimiters. The data fields are of two data types: string and numeric. Fields are found within the message by employing an offset scheme. The required padding scheme for each data field is specified in its associated message description in Section 3.2 and 3.3 of this document. Table 32 defines the nomenclature used to specify the padding scheme for each data field.

Table 32 Legend -- Data Field Padding Nomenclature

DD
DEERS Date
PS
Preceding Spaces
PZ
Preceding Zeros
TS
Trailing Spaces
TZ
Trailing Zeros
NUMBER
NUMBER

A message requires all specified data fields. If there are no available data or applicable business rules directing that the information associated with the data field not be transmitted, the field must be padded as indicated in the associated message description. Any unexpected fields will be treated as an error. See Section 4.3 for error management rules.

All data must be represented as displayable ASCII characters (hexadecimal values between 20 and 7E, inclusive). All special separator and other special characters must also be displayable ASCII characters, except the message terminator, which must be the ASCII Carriage Return character.

Conventions This section describes the layout of the tables used to depict the messages and responses exchanged by EHR and DEERS.

As applicable, the following items of information are listed as part of each message description:

Transaction ID: The EHR message identification. The value contained in this field tells DEERS what type of message this is. (See Section 3.2 – Many messages have the same Transaction ID; the value in the Transaction Type differentiates them.)

Transaction Type: The value contained in this field tells DEERS what type of transaction this is and, accordingly, the purpose of the message.

Source: The originator of the message.

Target: The receiver of the message.

Repeat at Element Name: Name of the data element in the message that identifies the beginning of a repeat segment. (This applies only to some DEERS messages).

Repeat Value: The maximum number of times the data stream can be repeated in a message. The value can contain an actual numerical value or a data element name (value by reference). This only applies to some DEERS messages.

Repeat Condition: A numerical value that identifies the type of report and thereby the data content of the report. (This only applies to the NAS Monthly Report response message from DEERS.)

Each column header used in the message layouts shown in Sections 3.2 and 3.3 represents an attribute of the data fields listed for each EHR and DEERS message. The table format in Table 33 depicts EHR messages. The table format in Table 34 depicts DEERS messages.

Table 33 Data Field Attribute Table Format for EHR Messages

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range

Table 34 Data Field Attribute Table Format for DEERS Messages

Seq
Element Name
R/O
Len
Format
RP
Description

A description of the type of information provided under each column heading follows:

SEQ – Position (sequence within the message) - Ordinal position of the data field within the message.

ELEMENT NAME - Descriptive name for the field.

R/O – Optionally - Whether a data field is required or optional. The designations are:

· R – required

· - optional LEN – Required length of the data field.

FORMAT - The padding scheme for a data field (See Table 31).

RP – Repetition - Whether a data field may repeat. An asterisk under this heading indicates that the identified data field and all data fields that follow it repeat as a segment.

FILE - The EHR database ID Number for the EHR File that is the source of value in the data field. For example, File = 2 - Patient File.

Note: Where File = API - The EHR Application Software is the source of the value in the data field.

FIELD - The EHR database ID Number for the EHR Field that is the source of the value in the data field.

VALID RANGE - The range of valid values for the data field.

DESCRIPTION – A high-level description of the contents of the data field.

EHR Messages EHR sends unsolicited update messages to DEERS and queries (requests) DEERS for information when triggered by an event initiated by an authorized EHR user.

Paragraphs 3.2.1 through 3.2.20 describe the EHR messages transmitted to DEERS.

Table 35 provides the triggering events for these messages.

Address/Log/Organ Donor Update Message This unsolicited message will notify DEERS when EHR updates a patient's demographic information, organ donor status or blood type information. Additionally, this message will notify (log) DEERS when EHR accesses patient information via a request for patient eligibility.

The specification for this message is provided in Table 35.

Transaction ID:
AQC4
Transaction Type:
H
Source:
EHR
Target:
DEERS
Triggers:
Patient demographic data updated.

Patient organ donor status updated.

Patient blood type updated.

Patient eligibility request sent to DEERS - override patient's ineligibility on DEERS.

Table 35 Address/Log/Organ Donor Update Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2

H

3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SOCIAL SECURITY NUMBER
R
9
TS
2
8000
9 digit numbers
7
DATE OF BIRTH
R
8
DD
2
.03
YYYYMMDD
8
FAMILY MEMBER PREFIX
R
2
PZ
2
8000
20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest- Youngest)
9
FAMILY SEQUENCE NUMBER
R
1
TS

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
2
9029
20 (Sponsor), 30 -39 (Spouse), 01-19 (Children)
11
UCA
R
2
TS
API

AA (Inpatient) BA (Outpatient) AA or BA (apply for PAD team) Blank (apply for MCP team & Pharmacy team)

12
ADDRESS UPDATE SWITCH
R
1
TS

Y = Yes and Blank = No

13
STREET
R
28
TS
2
.111, .112, .113
Free Text
14
CITY
R
18
TS
2
.114
Free Text
15
STATE
R
2
TS
2
.115
Require a valid State code (see file 5) If State is not defined , then STATE = “XX”
16
COUNTRY
R
2
TS
2
.117
Require a valid Country code (see file 5) If Country is not defined, then COUNTRY = “US”
17
ZIP CODE
R
9
TZ
2
.116
Require a valid Zip Code
18
PHONE
R
10
PZ
2
.131
10 digit numbers If Area Code is not defined, then Area Code = “001”
19
ELIGIBILITY CODE
R
2
PZ
2
9015
2 characters
20
ELIGIBILITY OVERRIDE CODE
R
2
PZ
2
9030
2 digit numbers (00-99) (see file 8900.4)
21
ELIGIBILITY START DATE
R
8
DD
2
9011
YYYYMMDD
22
ELIGIBILITY END DATE
R
8
DD
2
9012
YYYYMMDD
23
ELIGIBILITY END REASON
R
1
PZ
2
9016
1 Character (see file 8900.3)
24
ORGAN DONOR FLAG
R
1
TS
API

Y= Want, N= Don't want, Blank = Undecided

25
ORGAN DONOR DATE
R
8
DD
API

YYYYMMDD

26
BLOOD TYPE
R
3
TS
API

A+, A-, B+, B-, AB-, AB+, O+, O-. NULL (“ “) if not updated

27
BLOOD TYPE DATA SOURCE
O
4
TS
API

EHR, DBSS, NULL (“ “) if not updated

Eligibility/Registration Message The eligibility and registration transmission are identical. This message will request eligibility information for a patient from DEERS. Table 36 lists the specification for this message.

Transaction ID:
AQC4
Transaction Type:
Q
Source:
EHR
Target:
DEERS
Triggers:
Patient registered.

Patient admitted.

Eligibility requested.

Table 36 Eligibility/Registration Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2

Q

3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SPONSOR SSN
R
9
TS
API

9 digit numbers

7
DATE OF BIRTH
R
8
DD
API

YYYYMMDD

8
FAMILY MEMBER PREFIX
R
2
PZ
API

20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest-Youngest)

9
FAMILY SEQUENCE NUMBER
R
1
TS
API

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30 -39 (Spouse), 01-19 (Children)

11
UCA
R
2
TS
API

AA or BA (apply for PAD team) DA (apply for Pharmacy team) Blank (apply for MCP team)

12
TREATMENT START DATE
R
8
DD
API

YYYYMMDD

13
TREATMENT END DATE
R
8
DD
API

YYYYMMDD

Enrollment/Disenrollment (0) – Cancel Message This message will notify DEERS that EHR cancelled a valid patient MCP plan Enrollment. An enrollment end date being changed to be the same date as the enrollment start date identifies a cancelled enrollment.

Table 37 lists the specification for this message.

Transaction ID:
AQC4
Transaction Type:
0
Source:
EHR
Target:
DEERS
Trigger:
Enrollment end date = enrollment start date.

Table 37 Enrollment/Disenrollment (0) -- Cancel Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2
3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SPONSOR SSN
R
9
TS
API

9 digit numbers

7
DATE OF BIRTH
R
8
DD
API

YYYYMMDD

8
FAMILY MEMBER PREFIX
R
2
PZ
API

20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest-Youngest)

9
FAMILY SEQUENCE NUMBER
R
1
TS
API

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30 -39 (Spouse), 01-19 (Children)

11
UCA
R
2
TS
API

FN

12
MCP ENROLLMENT DATE
R
8
DD
API

YYYYMMDD

13
MCP DISENROLLMENT DATE
R
8
DD
API

YYYYMMDD

14
MCP PLAN TYPE
R
1
TS
API

1 letter

15
DMI[footnoteRef:1]S ID [1: DMIS - Defense Medical Information System]
R
4
TS
API

4 characters

16
PCM CONTRACTOR CODE
R
2
TS
API

4 digit numbers

Enrollment/Disenrollment (1) – Enrollment Message This message will notify DEERS that a patient has been enrolled in a MCP plan. An enrollment is identified when a new enrolment is filed.

The specification for this message is listed in Table 38.

Transaction ID:
AQC4
Transaction Type:
1
Source:
EHR
Target:
DEERS
Trigger:
New enrollment filed.

Invalid enrollment refilled.

Table 38 Enrollment/Disenrollment (1) -- Enrollment Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2
3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SPONSOR SSN
R
9
TS
API

9 digit numbers

7
DATE OF BIRTH
R
8
DD
API

YYYYMMDD

8
FAMILY MEMBER PREFIX
R
2
PZ
API

20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest- Youngest)

9
FAMILY SEQUENCE NUMBER
R
1
TS
API

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30-39 (Spouse), 01-19 (Children)

11
UCA
R
2
TS
API

FN

12
MCP ENROLLMENT DATE
R
8
DD
API

YYYYMMDD

13
MCP DISENROLLMENT DATE
R
8
DD
API

YYYYMMDD

14
MCP PLAN TYPE
R
1
TS
API

1 letter

15
DMIS ID
R
4
TS
API

4 characters

16
PCM CONTRACTOR CODE
R
2
TS
API

4 digit numbers

Enrollment/Disenrollment (2) – Disenrollment Message This message will notify DEERS that a patient has been disenrolled from an MCP plan. A EHR user’s updating a disenrollment date and reason or refiling an ‘invalid disenrollment’ identifies a disenrollment. In addition, this message will be sent to DEERS when the CP Enrollment Bulletin task job identifies ‘expired’ enrollments.

Table 39 lists the specification for this message.

Transaction ID:
AQC4
Transaction Type:
2
Source:
EHR
Target:
DEERS
Trigger:
Disenrollment date and disenrollment reason entered into EHR.

Enrollment period expired.

Table 39 Enrollment/Disenrollment (2) -- Disenrollment Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2
3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SPONSOR SSN
R
9
TS
API

9 digit numbers

7
DATE OF BIRTH
R
8
DD
API

YYYYMMDD

8
FAMILY MEMBER PREFIX
R
2
PZ
API

20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest- Youngest)

9
FAMILY SEQUENCE NUMBER
R
1
TS
API

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30-39 (Spouse), 01-19 (Children)

11
UCA
R
2
TS
API

FN

12
MCP ENROLLMENT DATE
R
8
DD
API

YYYYMMDD

13
MCP DISENROLLMENT DATE
R
8
DD
API

YYYYMMDD

14
MCP PLAN TYPE
R
1
TS
API

1 letter

15
DMIS ID
R
4
TS
API

4 characters

16
PCM CONTRACTOR CODE
R
2
TS
API

4 digit numbers

Enrollment/Disenrollment (3) – Reciprocal Disenrollment Message This message notifies DEERS that a patient was reciprocally disenrolled from an MCP Plan. Reciprocal disenrollment occurs when a patient with a valid enrollment at one EHR site goes to a different EHR site and requests to be disenrolled.

The specification for this message is listed in Table 310.

Transaction ID:
AQC4
Transaction Type:
3
Source:
EHR
Target:
DEERS
Trigger:
Patient reciprocally disenrolled.

Table 310 Enrollment/Disenrollment (3) -- Reciprocal Disenrollment Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2
3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled.

Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SPONSOR SSN
R
9
TS
API

9 digit numbers

7
DATE OF BIRTH
R
8
DD
API

YYYYMMDD

8
FAMILY MEMBER PREFIX
R
2
PZ
API

20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest- Youngest)

9
FAMILY SEQUENCE NUMBER
R
1
TS
API

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30-39 (Spouse), 01-19 (Children)

11
UCA
R
2
TS
API

FN

12
MCP ENROLLMENT DATE
R
8
DD
API

YYYYMMDD

13
MCP DISENROLLMENT DATE
R
8
DD
API

YYYYMMDD

14
MCP PLAN TYPE
R
1
TS
API

1 letter

15
DMIS ID
R
4
TS
API

4 characters

16
PCM CONTRACTOR CODE
R
2
TS
API

4 digit numbers

Enrollment/Disenrollment (4) – Reciprocal Disenrollment/Enrollment Message This message notifies DEERS that a patient was:

1. Reciprocally disenrolled from an MCP Plan.

2. The EHR site (gaining site) sending this message is enrolling the patient in an MCP Plan.

Reciprocal disenrollment occurs when a patient with a valid enrollment at one EHR site goes to a different EHR site and requests to be disenrolled.

The specification for this message is listed in Table 311.

Transaction ID:
AQC4
Transaction Type:
4
Source:
EHR
Target:
DEERS
Trigger:
Patient reciprocally disenrolled and then reenrolled.

Table 311 Enrollment/Disenrollment (4) -- Reciprocal Disenrollment/Enrollment Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2
3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SPONSOR SSN
R
9
TS
API

9 digit numbers

7
DATE OF BIRTH
R
8
DD
API

YYYYMMDD

8
FAMILY MEMBER PREFIX
R
2
PZ
API

20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest- Youngest)

9
FAMILY SEQUENCE NUMBER
R
1
TS
API

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30-39 (Spouse), 01-19 (Children)

11
UCA
R
2
TS
API

FN

12
MCP ENROLLMENT DATE
R
8
DD
API

YYYYMMDD

13
MCP DISENROLLMENT DATE
R
8
DD
API

YYYYMMDD

14
MCP PLAN TYPE
R
1
TS
API

1 letter

15
DMIS ID
R
4
TS
API

4 characters

16
PCM CONTRACTOR CODE
R
2
TS
API

4 digit numbers

Enrollment/Disenrollment (5) Message This message will notify DEERS that a patient’s MCP plan enrollment start date is modified in EHR.

Table 312 lists the specification for this message.

Transaction ID:
AQC4
Transaction Type:
5
Source:
EHR
Target:
DEERS
Trigger:
Patient’s MCP plan start date modified.

Table 312 Enrollment/Disenrollment (5) Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2
3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SPONSOR SSN
R
9
TS
API

9 digit numbers

7
DATE OF BIRTH
R
8
DD
API

YYYYMMDD

8
FAMILY MEMBER PREFIX
R
2
PZ
API

20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest- Youngest)

9
FAMILY SEQUENCE NUMBER
R
1
TS
API

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30-39 (Spouse), 01-19 (Children)

11
UCA
R
2
TS
API

FN

12
MCP ENROLLMENT DATE
R
8
DD
API

YYYYMMDD

13
MCP DISENROLLMENT DATE
R
8
DD
API

YYYYMMDD

14
MCP PLAN TYPE
R
1
TS
API

1 letter

15
DMIS ID
R
4
TS
API

4 characters

16
PCM CONTRACTOR CODE
R
2
TS
API

4 digit numbers

Enrollment/Disenrollment (6) Message This message will notify DEERS that a patient’s MCP plan enrollment end date is modified in EHR.

Table 313 lists the specification for this message.

Transaction ID:
AQC4
Transaction Type:
6
Source:
EHR
Target:
DEERS
Trigger:
Patient’s MCP plan end date modified.

Table 313 Enrollment/Disenrollment (6) Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2
3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SPONSOR SSN
R
9
TS
API

9 digit numbers

7
DATE OF BIRTH
R
8
DD
API

YYYYMMDD

8
FAMILY MEMBER PREFIX
R
2
PZ
API

20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest- Youngest)

9
FAMILY SEQUENCE NUMBER
R
1
TS
API

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30-39 (Spouse), 01-19 (Children)

11
UCA
R
2
TS
API

FN

12
MCP ENROLLMENT DATE
R
8
DD
API

YYYYMMDD

13
MCP DISENROLLMENT DATE
R
8
DD
API

YYYYMMDD

14
MCP PLAN TYPE
R
1
TS
API

1 letter

15
DMIS ID
R
4
TS
API

4 characters

16
PCM CONTRACTOR CODE
R
2
TS
API

4 digit numbers

Enrollment/Disenrollment (7) Message This message will notify DEERS that specific information related to a MCP enrollment is modified in EHR.

Table 314 lists the specification for this message.

Transaction ID:
AQC4
Transaction Type:
7
Source:
EHR
Target:
DEERS
Trigger:
DMIS ID modified.

Enrolling divisions modified.

Patient type modified.

Alternate Care Value modified.

PCM modified.

Note: PCM is considered modified when a selected new PCM has a Place of Care type different from the one specified for the previous PCM.

Table 314 Enrollment/Disenrollment (7) Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2
3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SPONSOR SSN
R
9
TS
API

9 digit numbers

7
DATE OF BIRTH
R
8
DD
API

YYYYMMDD

8
FAMILY MEMBER PREFIX
R
2
PZ
API

20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest- Youngest)

9
FAMILY SEQUENCE NUMBER
R
1
TS
API

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30-39 (Spouse), 01-19 (Children)

11
UCA
R
2
TS
API

FN

12
MCP ENROLLMENT DATE
R
8
DD
API

YYYYMMDD

13
MCP DISENROLLMENT DATE
R
8
DD
API

YYYYMMDD

14
MCP PLAN TYPE
R
1
TS
API

1 letter

15
DMIS ID
R
4
TS
API

4 characters

16
PCM CONTRACTOR CODE
R
2
TS
API

4 digit numbers

Enrollment/Disenrollment (8) Message This message notifies DEERS that a patient's MCP status on EHR, relative to their most current enrollment record (MCP plan), is changed from 'disenrolled' to 'enrolled'.

Upon successful receipt of this message, DEERS will change the patient's DEERS current enrollment record to 'enrolled' status, if the following are true:

· Patient's enrollment status on DEERS = 'disenrolled'

· MCP Enrollment Date in the AQC48 message matches the one on DEERS

· MCP Disenrollment Date in the AQC48 message = current or future date If any one of these is not true, DEERS will return one of the following Discrepancy Codes: A3, A4, or A5. Upon receipt of any Discrepancy Code, EHR will restore the patient's enrollment status to 'disenrolled' and the Enrollment End Date to the date it contained prior to the Cancel Disenrollment process.

The specification for this message is listed in Table 315.

Transaction ID:
AQC4
Transaction Type:
8
Source:
EHR
Target:
DEERS
Trigger:
Patient’s MCP status changed to ‘enrolled’.

Table 315 Enrollment/Disenrollment (8) -- Disenrollment Cancellation Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2
3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SPONSOR SSN
R
9
TS
API
8000
9 digit numbers
7
DATE OF BIRTH
R
8
DD
API
.03
YYYYMMDD
8
FAMILY MEMBER PREFIX
R
2
PZ
API
8000
20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest- Youngest)
9
FAMILY SEQUENCE NUMBER
R
1
TS
API

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
2
9029
20 (Sponsor), 30-39 (Spouse), 01-19 (Children)
11
UCA
R
2
TS
API

FN

12
MCP ENROLLMENT DATE
R
8
DD
API

YYYYMMDD – (must match the one on DEERS or message will be rejected)

13
MCP DISENROLLMENT DATE
R
8
DD
API

YYYYMMDD 00 – (must be current or future date or message will be rejected)

14
MCP PLAN TYPE
R
1
TS
API

1 letter

15
DMIS ID
R
4
TS
API

(must match the DMIS code held on DEERS for the patient or the message will be rejected)

16
PCM CONTRACTOR CODE
O
2
TS
API

(Only need to provide if this information has changed on EHR)

Enrollment/Disenrollment (P) Message This message will notify DEERS that a patient, who is not currently in the DEERS Database, is conditionally enrolled in an MCP plan in EHR. A 'conditional patient' is a patient whose eligibility is not recorded on the DEERS database, is expected to be recorded there in the near future, and for whom a 'DEERS override code' was entered during registration. A newborn or new spouse is an example of a patient who may be defined as a 'conditional patient'.

The specification for this message is listed in Table 316.

Transaction ID:
AQC4
Transaction Type:
P
Source:
EHR
Target:
DEERS
Trigger:
Enroll patient in MCP Plan who is not recorded in DEERS.

Table 316 Enrollment/Disenrollment (P) Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC4

2
TRANSACTION TYPE
R
1
PZ
8907.2

P

3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
SPONSOR SSN
R
9
TS
API

9 digit numbers

7
DATE OF BIRTH
R
8
DD
API

YYYYMMDD

8
FAMILY MEMBER PREFIX
R
2
PZ
API

20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest- Youngest)

9
FAMILY SEQUENCE NUMBER
R
1
TS
API

Almost always equals 1

10
DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30-39 (Spouse), 01-19 (Children)

11
UCA
R
2
TS
API

FN

12
MCP ENROLLMENT DATE
R
8
DD
API

YYYYMMDD

13
MCP PLAN TYPE
R
1
TS
API

1 letter

14
PATIENT NAME
R
27
TS
API

Free Text

15
DMIS ID
R
4
TS
API

4 characters

16
PCM CONTRACTOR CODE
R
2
TS
API

4 digit numbers

Reciprocal Disenrollment Message This message queries DEERS for all the requesting EHR site's patients who are reciprocally disenrolled. A EHR site can reciprocally disenroll a patient from the EHR site where they are currently enrolled by sending DEERS an AQC43 or AQC44 message. DEERS stores the reciprocal disenrollment for the patient relative to the patient's current DMIS (Defense Medical Information System). A patient's current EHR site cannot reciprocally disenroll them.

When DEERS receives an AQC5J message from a EHR site, DEERS provides that site with all its patients who have been reciprocally disenrolled.

The specification for this message is listed in Table 317.

Transaction ID:
AQC5
Transaction Type:
J
Source:
EHR
Target:
DEERS
Trigger:
Periodic task: XDWRED.

Table 317 Reciprocal Disenrollment Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQC5

2
TRANSACTION TYPE
R
1
PZ
8907.2

J

3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
BLOCK ID
R
4
PZ
API

1-9999

7
FLAG
R
1
PZ
API

Either 0, 1, or 2 0: Initial block 1: Processing (multiple blocks) 2: Processing complete

8
LOSING DMIS
R
4
PZ
API

Code for Defense Medical Information System

9
FILLER
R
10
PS
API

Blank

NAS Routine (I) Message This message will notify DEERS that a routine NAS is issued for a patient in EHR. A routine NAS must meet all of the following three conditions:

1. Is a Non-Conditional Patient

2. Issue reason is 4 through 9

3. Issue type is “C” (Non-Retroactive/Chronic) or “N” (Non-Retroactive/Non-Chronic).

The specification for this message is listed in Table 318.

Transaction ID:
AQHN
Transaction Type:
I
Source:
EHR
Target:
DEERS
Trigger:
A routine NAS is issued for a patient.

Table 318 NAS Routine (I) Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQHN

2
TRANSACTION TYPE
R
1
PZ
8907.2

I

3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
DMIS NUMBER
R
4
TS
API

4 digit numbers

7
RETRANSMISSION FLAG
O
1
TS
API

Always Blank

8
SPONSOR SSN
R
9
TS
API

9 digit numbers

9
SPONSOR FAMILY SEQUENCE NUMBER
R
1
TS
API

From 1 to 9

10
PATIENT DATE OF BIRTH
R
8
DD
API

YYYYMMDD

11
PATIENT DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30-39 (Spouse), 01-19 (Children)

12
CONDITIONAL FLAG
R
1
TS
API

Y (if not DEERS Eligible) or Blank

13
RETROACTIVE FLAG
R
1
TS
API

Can be any letter but “R” or “Y”

14
PATIENT CATEGORY
R
1
TS
API

Indicate the service affiliation and relationship of the patient to the service.

Either 1, 2, 3, 4, or 5

15
REASON FOR ISSUE
R
1
TS
API

Reason for issuance of the NAS. Can be any code in file 8582 but code 3

16
MAJOR DIAGNOSTIC CAT
R
2
TS
API

Either a Major Diagnostic Code or a valid Outpatient Procedure Code (See file 8584)

17
SIGN DATE
R
8
DD
API

YYYYMMDD

18
ISSUING OFFICER LAST NAME
R
16
TS
API

Officer who is authorized to issue a NAS Free Text (See file 8104)

19
ISSUING OFFICER FIRST NAME
R
10
TS
API

Free Text

20
ISSUING OFFICER MIDDLE INITIAL
R
1
TS
API

Free Text

21
ISSUING OFFICER GRADE
R
6
TS
API

See file 8104

22
ISSUING OFFICER TITLE
R
24
TS
API

See file 3.1

23
OTHER INSURANCE
R
1
TS
API

Y or Blank

24
OTHER INSURANCE POLICY
R
15
TS
API

See file 8064

25
OTHER INSURANCE COMPANY
R
27
TS
API

See file 8064

26
REMARKS
R
90
TS
API

Issue by user, every particular comments

NAS Conditional (J) Message This message is the first part of a 2-part NAS conditional issuance (the second part is AQHNK). A conditional NAS is issued when all of the following conditions are met:

1. Patient is a Conditional Patient (patient is not registered on DEERS but sponsor is registered, such as a newborn or new spouse)

2. Issue reason is "3" (Medically Inappropriate)

3. Issue type is "R" (Retroactive/Chronic) or "Y" (Retroactive/Non-Chronic).

4. The NAS is being issued retroactively (after the fact).

The specification for this message is listed in Table 319.

Transaction ID:
AQHN
Transaction Type:
J
Source:
EHR
Target:
DEERS
Trigger:
Conditional NAS is issued.

Table 319 NAS Conditional (J) Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQHN

2
TRANSACTION TYPE
R
1
PZ
8907.2

J

3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
DMIS NUMBER
R
4
TS
API

4 digit numbers

7
RETRANSMISSION FLAG
O
1
TS
API

Always Blank

8
SPONSOR SSN
R
9
TS
API

9 digit numbers

9
SPONSOR FAMILY SEQUENCE NUMBER
R
1
TS
API

From 1 to 9

10
PATIENT DATE OF BIRTH
R
8
DD
API

YYYYMMDD

11
PATIENT DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30-39 (Spouse), 01-19 (Children)

12
CONDITIONAL FLAG
R
1
TS
API

Y (if not DEERS Eligible) or Blank

13
RETROACTIVE FLAG
R
1
TS
API

Can be any letter but “R” or “Y”

14
PATIENT CATEGORY
R
1
TS
API

Indicate the service affiliation and relationship of the patient to the service.

Either 1, 2, 3, 4, or 5

15
REASON FOR ISSUE
R
1
TS
API

Reason for issuance of the NAS. Can be any code in file 8582 but code 3

16
MAJOR DIAGNOSTIC CAT
R
2
TS
API

Either a Major Diagnostic Code or a valid Outpatient Procedure Code (See file 8584)

17
SIGN DATE
R
8
DD
API

YYYYMMDD

18
ISSUING OFFICER LAST NAME
R
16
TS
API

Officer who is authorized to issue a NAS Free Text (See file 8104)

19
ISSUING OFFICER FIRST NAME
R
10
TS
API

Free Text

20
ISSUING OFFICER MIDDLE INITIAL
R
1
TS
API

Free Text

21
ISSUING OFFICER GRADE
R
6
TS
API

See file 8104

22
ISSUING OFFICER TITLE
R
24
TS
API

See file 3.1

23
OTHER INSURANCE
R
1
TS
API

Y or Blank

24
OTHER INSURANCE POLICY
R
15
TS
API

See file 8064

25
OTHER INSURANCE COMPANY
R
27
TS
API

See file 8064

26
REMARKS
R
90
TS
API

Issue by user, every particular comments

NAS Conditional (K) Message This message is the second part of a NAS conditional issuance (the first part is AQHNJ). It provides DEERS with additional NAS information that includes the NAS number.

The specification for this message is listed in Table 320.

Transaction ID:
AQHN
Transaction Type:
K
Source:
EHR
Target:
DEERS
Trigger:
Response type = X99 for AQHNJ message.

Table 320 NAS Conditional (K) Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQHN

2
TRANSACTION TYPE
R
1
PZ
8907.2

K

3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
DMIS NUMBER
R
4
TS
API

4 digit numbers

7
RETRANSMISSION FLAG
O
1
TS
API

Always Blank

8
SPONSOR SSN
R
9
TS
API

9 digit numbers

9
SPONSOR FAMILY SEQUENCE NUMBER
R
1
TS
API

From 1 to 9

10
PATIENT DATE OF BIRTH
R
8
DD
API

YYYYMMDD

11
PATIENT DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30-39 (Spouse), 01-19 (Children)

12
CONDITIONAL FLAG
R
1
TS
API

Y (if not DEERS Eligible) or Blank

13
RETROACTIVE FLAG
R
1
TS
API

Can be any letter but “R” or “Y”

14
PATIENT CATEGORY
R
1
TS
API

Indicate the service affiliation and relationship of the patient to the service.

Either 1, 2, 3, 4, or 5

15
REASON FOR ISSUE
R
1
TS
API

Reason for issuance of the NAS. Can be any code in file 8582 but code 3

16
MAJOR DIAGNOSTIC CAT
R
2
TS
API

Either a Major Diagnostic Code or a valid Outpatient Procedure Code (See file 8584)

17
SIGN DATE
R
8
DD
API

YYYYMMDD

18
ISSUING OFFICER LAST NAME
R
16
TS
API

Officer who is authorized to issue a NAS Free Text (See file 8104)

19
ISSUING OFFICER FIRST NAME
R
10
TS
API

Free Text

20
ISSUING OFFICER MIDDLE INITIAL
R
1
TS
API

Free Text

21
ISSUING OFFICER GRADE
R
6
TS
API

See file 8104

22
ISSUING OFFICER TITLE
R
24
TS
API

See file 3.1

23
OTHER INSURANCE
R
1
TS
API

Y or Blank

24
OTHER INSURANCE POLICY
R
15
TS
API

See file 8064

25
OTHER INSURANCE COMPANY
R
27
TS
API

See file 8064

26
REMARKS
R
90
TS
API

Issue by user, every particular comments

NAS Candidate List Message This message queries DEERS for a patient's previously issued NAS. Receipt of this information allows EHR users to view all previously issued NAS and determine if they need to file a new NAS for the patient.

The specification for this message is listed in Table 321.

Transaction ID:
AQHN
Transaction Type:
Q
Source:
EHR
Target:
DEERS
Trigger:
Users attempt to issue, cancel, or print an NAS.

Table 321 NAS Candidate List Message

Seq
Element Name
R/O
Len
Format
File
Field
Valid Range
1
TRANSACTION ID
R
4
PZ
8907.2

AQHN

2
TRANSACTION TYPE
R
1
PZ
8907.2

Q

3
SITE ID
R
6
PZ
8907

000001-999999

4
TERMINAL ID
R
3
PZ

EHR controlled. Value = #$%

5
USER ID
R
8
TS
3

8 digit numbers

6
DMIS NUMBER
O
4
TS
API

4 digit numbers

7
ISSUE DATE
O
4
TS
API

4 digit numbers (first digit = year, last three digit = the number of days from Jan 1 for example, 5020 = Jan 20,1995)

8
NAS SEQUENCE NUMBER
O
3
TS
API

3 digit numbers (000 - 999)

9
SPONSOR SSN
R
9
TS
API

9 digit numbers

10
DATE OF BIRTH
R
8
DD
API

YYYYMMDD

11
FAMILY MEMBER PREFIX
R
2
PZ
API

20 (Sponsor), 30 (Spouse), 01-19 (Children: Oldest- Youngest)

12
FAMILY SEQUENCE NUMBER
R
1
TS
API

From 1 to 9

13
DEERS DEPENDENT SUFFIX
R
2
PZ
API

20 (Sponsor), 30 -39 (Spouse), 01-19 (Children)

NAS Cancel Message This message will notify DEERS that an NAS previously filed for a patient has been cancelled in EHR.

The specification for this message is listed in Table 322.

Transaction ID:
AQHN
Transaction Type:
C
Source:
EHR
Target:
DEERS
Trigger:
Previously filed NAS cancelled for a patient.

Table 322 NAS Cancel Message

Seq
Element Name
R/O
Len

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