Exhibit_8_-_Technical_Overview_-_BWE_Fee_Gateway.pdf

DoD Defense Manpower Data Center

Defense Enrollment Eligibility Reporting

System/Military Health System

(DEERS)/(MHS)

Technical Overview

For the Beneficiary Web Enrollment (BWE) Fee

Authorization Interface

July 10, 2007 Version 2.0 ii

Table of Contents DoD Table of Contents................................................................................................................ ii

1.0 Document Purpose

2.0 Referenced Documents

3.0 Technical Process Flow

3.1 Capture of Charge Card Information- BWE Interface

3.2 Interface Provided by MCSC/DP

3.3 Conclusion of Enrollment

4.0 Security

5.0 Organizational Responsibilities

5.1 DMDC Responsibilities

5.2 Contractor Responsibilities

6.0 Identification

7.0 Transaction Messages

7.1 Fee Transaction

7.1.1 Output to MCSC/DP

7.1.2 Response from MCSC/DP

7.3 Assumptions

7.4 Request and Response Examples

7.4.1 Fee Transaction

Deleted: 4

Deleted: 7

Deleted: 8

1.0 Document Purpose

The purpose of this document is to detail the interface that will exist between DMDC and the TNEX Managed Care Support Contractors (MCSC) and Designated Providers (DPs) to process either a charge to a beneficiary or a charge card authorization.

2.0 Referenced Documents

The following document was utilized and/or referenced in writing this technical specification:

• TRICARE Systems Manual (TSM) Chapter 3

3.0 Technical Process Flow

3.1 Capture of Charge Card Information- BWE Interface

When a beneficiary chooses to participate in a health care program an enrollment fee may be required. The Beneficiary Web Enrollment (BWE) application will provide a user interface for collecting the information needed to charge the beneficiary’s credit card.

The user interface will be part of the web enrollment application and operate within the same process flow as the enrollment. The user will be given an indication that the authorization has occurred before the final summary is displayed. The operator also has the ability to indicate whether they would like an EFT or allotment set up after the initial credit card payment is received. In the case of EFTs, BWE will collect bank account information for the MCSC and submit it through the fee gateway. Bank account information will not be stored in DEERS, and will not be retained in BWE once the fee gateway data is submitted to the MCSC.

The information collected will use an HTTPS connection protocol and share the same session as the user’s enrollment session. The enrollment application will determine the contractor to which the payment is to be sent based on the residential zip code of the sponsor enrolled or enrolling (for USFHP enrollment, the provider type code and in some cases a facility selection will also be used). If the sponsor is not enrolled or enrolling, BWE shall submit fee data to the spouse’s contactor, else to the oldest child.

The process will require a successful credit card transaction in order to submit a complete enrollment.

MCSCs should be aware that during the course of enrollment, Fee data is submitted prior to the enrollment being posted to DEERS. Should the enrollment not post to DEERS, a charge posted via the fee gateway would not have a corresponding PNT. MCSCs should design appropriately for such a scenario.

3.2 Interface Provided by MCSC/DP

The enrollment application will make the call to an interface provided by the MCSC/DP.

The DMDC/DEERS system will create the transaction and send it to the MCSC/DP over the VPN. The MCSC/DP interface will accept the request parameters and process the credit card information within the framework of the architecture developed. The MCSC/DP will return a value to the requesting application, as to whether a successful transaction was accomplished or if the user needs to retry the charge authorization. The response from the contractor system should be a real-time automated process. The interface will operate on a HTTP protocol in synchronous mode.

Note. This diagram is for general context. Should other requirements conflict with the interpretation of this diagram, all other rules and requirements take precedence.

3.3 Conclusion of Enrollment

Once the Fee transaction response from the MCSC/DP is received by BWE, the user will be presented a summary of the actions that have transpired during the enrollment process and an option to print a completed enrollment form. The process will continue as detailed in the Tricare Systems Manual (TSM) Chapter 3, Section: Beneficiary Self- Service.

4.0 Security

Users will be performing enrollment activity on a Secured Socket Layer (SSL) connection. The user will authenticate through a DMDC security API before being given access to the BWE application. . The DMDC/DEERS system will create fee gateway request and send it to the MCSC/DP over the existing B2BVPN gateway.

5.0 Organizational Responsibilities

5.1 DMDC Responsibilities

o DMDC will provide the interface to capture the necessary data from the person performing the enrollment, to facilitate the credit card authorization.

o DMDC will use an agreed upon set of return codes to respond to the person performing the enrollment and perform the necessary decisions on performing the enrollment activity.

o DMDC will attach the necessary data to the notification message needed to match the enrollment to the credit card authorization transaction.

o DMDC will accept only credit cards from MasterCard, Visa, American Express, and Discover. The North and West MCSCs, and Johns Hopkins Healthcare, Brighton Marine Healthcare, Christus Healthcare DPs will accept Visa and MasterCard. The South MCSC, and Martin’s Point Healthcare and St. Vincent’s Catholic Medical Center DPs will accept all credit card types previously listed.

Pacific Medical Clinic DP will accept MasterCard, Visa, and Discover.

o DMDC/BWE will accept Annual or Quarterly payments. Fees are required for the initial enrollments. For example: Bene A & B enroll into a Family Plan, they will be required to make Fee payments in accordance with TRICARE requirements. If Bene C wishes to enroll say after 3 months, no Fees will be collected during the enrollment.

o DEERS will not update enrollment fee information for the policy as part of this process.

5.2 Contractor Responsibilities

o The interface will provide a real-time processing that will perform the operation and respond to the DMDC system with an agreed set of values.

o The MCSC/DP will provide the system which will match processed credit transactions with the notification of enrollment transactions sent by DEERS.

o The MCSC shall account for fee gateway transactions that do not receive a corresponding PNT and take appropriate action.

o The MCSC system will respond to the DMDC system within a thirty second time period.

o The MCSC/DP will ascertain that the fee payment amount be deducted/credited properly from the beneficiary’s credit card.

o The MCSC/DP will send DEERS a fee update transaction through the batch fee interface reflecting any fees that are collected as part of this process.

o The MCSC/DP will be responsible for adjusting the Paid through dates based on changes made to the initial policy dates as a result of new enrollments. For example, if the policy started 2006-Jul-01 and the Fee Paid through date was 2006-Sep-30, and if there were enrollments (retro) added to this policy starting 2006-Jun-01, the MCSC/DP will need to update the Fee Paid through date accordingly.

o The MCSC will contact beneficiaries indicating that they wish to setup and electronic funds transfer (EFT) or retired pay allotment.

o Note: During a family enrollment, if the family is split (ex: one in North, one in South), since there will be one Policy created, the fee transaction for this policy be sent to the contractor where the sponsor resides if the sponsor is enrolled, otherwise the contractor will be determined according to the billing hierarchy (Sponsor, Spouse, or Oldest Child)

6.0 Identification

BWE will send the DEERS ID, HCDP_PLN_CVG_CD, and policy begin date for the contractor to identify the family the policy for which fees are due. This data is based on the billing hierarchy of sponsor, spouse, and then eldest child. This information may or may not be for the same person enrolling.

In addition to the above information which should identify the policy to which fee information should be applied, BWE will post the sponsor PN_ID and Sponsor DOD_EDI_PN_ID. These values will always be for the sponsor, whether or not the sponsor is enrolled in a plan.

In certain split enrollments cases (i.e. sponsor in one region, child goes to college in another region and is enrolling there), the fee transaction may be sent to one contractor, but the corresponding PNT could be sent to another contractor.

7.0 Transaction Messages

DMDC expects every message to have begin and end tags. The begin tag is ‘<BEGIN>’.

The end tag is ‘<END>’ (Without quotation marks).

7.1 Fee Transaction

The inputs will be the data entered by the user within the BWE site. These fields include:

7.1.1 Output to MCSC/DP

Field Length Note Enrollment Specific input parameters (example)

APP_VRSN_ID 2 ‘01’

HCDP_PLN_CVG_CD 3 The coverage code of the enrolling plan.

HCDP_PLCY_BGN_DT 8 This Date will be the Begin Date of the policy. The contractors will be required to split the Fee based on the Fee amount, the policy dates and the fiscal year dates.

Example: If the Enrollment starts on Aug 01, and the Payment Plan is Quarterly, BWE will set the Policy date to Aug 01 and add the Fee amount as $115.00 (for Family Plan). The Contractors will need to determine the amounts that will be applied to the Fiscal years, which in this example for a Family Plan would be (460/12) * 2 paid thru Sep 30, and (460/12) * 1 paid thru Oct 31 of the next fiscal year.

YYYYMMDD

DEERS_FAM_ID 9 DEERS family ID. Zero-padded on the left

DEERS_BNFRY_ID

2 DEERS beneficiary ID Zero padded on the left (Beneficiary is based on hierarchy used to determine which contractor to send fee information to.

If sponsor is enrolled, this is always sponsor, else it’s a dependent)

SPN_PN_ID 9

SPN_PN_ID_TYP_CD 1

SPN_LST_NM 26 Sponsor last name

SPN_1ST_NM 20 Sponsor first name

TXN_DT_TM 14 Transaction Date and Time Stamp.

YYYYMMDDHHMMSS

DOD_EDI_PN_ID 10 Sponsor’s DOD_EDI_PN_ID (aka patient ID)

Length Subtotal 104

Vendor specific input parameters

PMT_ID

20 Credit Card Number. No white space is allowed

SEC_CD 4 3-digit code on the back of the card 4 digits (on the front) for American Express

This is optional.

CCRD_TYP_CD

1 One of the following values that indicates the credit card type.

1 – MasterCard 2 – Visa 3 – Discover 4 – American Express

CCRD_PN_LST_NM

Cardholder last name

CCRD_PN_FIRST_NM 20

Cardholder first name

CCRD_PN_MID_NM

20 Cardholder middle name

CCRD_EXP_MONTH 2 A two-digit field that is right justified and padded with a zero if necessary representing the card expiration month. Ex. ‘01’, ‘12’

CCRD_EXP_YEAR 4 A four-digit field that represents the year the credit card expires

CCRD_BILLING_ADDRESS_LINE1 35 Credit card billing address street

CCRD_BILLING_ADDRESS_LINE2 35 Credit card billing address street

CCRD_BILLING_ADDRESS_CITY 35 Credit card billing address city

CCRD_BILLING_ADDRESS_STATE 2 Credit card billing address state

CCRD_BILLING_ADDRESS_ZIP 5 Credit card billing address postal code

CCRD_BILLING_ADDRESS_COUNTRY 2 Credit card billing address country code

HCDP_FPMT_PLN_TYP_CD 1 ‘A’ – indicating annual payment ‘Q’ – indicating quarterly payment ‘R’ – indicates 3 month payment and desire to setup EFT/allotment

HCDP_EY_FPMT_AM 8 The amount that is to be charged or amount that is to be verified for a charge.

$240.00 $9999.00

HCDP_FPMT_TYP_CD 1 A – Allotment

E – EFT

If ‘R’ is submitted as

HCDP_FPMT_PLN_TYP_CD,

this value is populated, else it’s blank

EFT_FIN_INST_NAME 40 Required when

HCDP_FPMT_TYP_CD = ‘E’

EFT_FIN_INST_TELEPHONE 20 Required when

HCDP_FPMT_TYP_CD = ‘E’

EFT_FIN_INST_ADDRESS_LINE1 40 Required when

HCDP_FPMT_TYP_CD = ‘E’

EFT_FIN_INST_ADDRESS_LINE2 40 Required when

HCDP_FPMT_TYP_CD = ‘E’

EFT_FIN_INST_CITY 20 Required when

HCDP_FPMT_TYP_CD = ‘E’

EFT_FIN_INST_STATE 2 Required when

HCDP_FPMT_TYP_CD = ‘E’

EFT_FIN_INST_POSTAL_CODE 10 Required when

HCDP_FPMT_TYP_CD = ‘E’

EFT_FIN_INST_COUNTRY 2 Required when

HCDP_FPMT_TYP_CD = ‘E’

EFT_FIN_INST_ACCOUNT_TYPE 1 “C” – Checking “S” – Saving

Required when

HCDP_FPMT_TYP_CD = ‘E’

EFT_FIN_INST_ACCOUNT_NUMBER 20 Required when

HCDP_FPMT_TYP_CD = ‘E’

EFT_FIN_INST_ROUTING_NUMBER 20 Required when

HCDP_FPMT_TYP_CD = ‘E’ BWE

will restrict to 9 digits

EFT_FIN_INST_NAME_ON_ACCOUNT

40 Required when

HCDP_FPMT_TYP_CD = ‘E’

Length Subtotal 476

Length Total 580

7.1.2 Response from MCSC/DP

The MCSC/DP will respond by modifying the response object and returning the authorization value. The list below is a list of authorization codes that communicate the information results of the transaction. This is needed for DMDC to respond to the person performing the enrollment. The error, authorization codes and messages description will be obtained from the lists provided by the MCSC contractors and DPs.

Field Length Note DEERS_FAM_ID 9 9 digits. Right justified filled with zeroes

DEERS_BNFRY_ID 2 2 digits. Right justified filled with zeroes.

AUTH_CD 2 AC – Accepted Charge DEERS will process enrollment as pending and notify user that a charge was applied.

AA – Accepted Authorized – DEERS will process enrollment as pending and notify user that a charge will be applied after the enrollment is accepted by the contractor.

DN – Denied – Card was denied. These could be extended to indicate multiple denied reasons.

TR – Timeout Retry – This error is returned when the transmission was received in error and the contractor would like the enrollment application to resubmit the information.

TN – Timeout No Retry – This code will be returned when the contractor is unable to establish a connection with their payment gateway.

CCRD_AUTH_CD 12 Credit card authorization code returned by the card processor.

Total Length 25

Deleted: sample list of possible

An example message would look like this:

<BEGIN>

DEERS_FAM_ID (9 digits. Right justified filled with zeros) DEERS_BNFRY_ID (2 digits. Right justified filled with zeros) AUTH_CD (2 char.)

CCRD_AUTH_CD (12 char.)

<END>

7.3 Assumptions

1. Timeouts may also occur between the established connection of the DEERS web server and the contractor’s web server. This will be handled using standard server responses.

2. DMDC will reserve the right to modify, add, or remove codes as necessary to facilitate communication with the beneficiary.

3. The MCSC/DP will also provide the codes and definitions returned from their payment gateway provider, which may be necessary to communicate to the beneficiary performing the enrollment activity.

4. There will be no Code-1 check on the billing address

5. When there is a country code other than ‘US’, the

CCRD_BILLING_ADDRESS_STATE and CCRD_BILLING_ADDRESS_ZIP fields in the request will be blanked out.

6. When there is a country code other than ‘US’, the EFT_FIN_INST_STATE and EFT_FIN_INST_POSTAL_CODE fields in the request will be blanked out.

7. If BWE is unable to establish a connection to the contractor server, a message will be displayed to the user to try the enrollment later. BWE will not store the enrollment request state and the beneficiary will have to go through the entire enrollment process again.

7.4 Request and Response Examples

7.4.1 Fee Transaction

Output to MCSC/DP:

The attached file includes various sample strings of BWE fee gateway transactions.

feeGatewayMsg.txt