24_TCRS_Sec_J_Atch_J-16_TA_User_Guide.pdf

TED Auditing (TA)

User Guide v5.12.00.0

For questions or concerns regarding this user guide, contact the MHS Help Desk 1-800-600-9332, or Email EIDS@mhs-helpdesk.com

Attachment J-16, TA User Guide

Table of Contents

1 TED AUDITING (TA) SYSTEM OVERVIEW

DETAILED SYSTEM OVERVIEW

ABOUT THIS USER GUIDE

CONVENTIONS

2 USING THE TA SYSTEM

2.1 SATELLITE WELCOME SCREEN

2.2 TA MAIN SCREEN

2.3 BROWSE/UPDATE AUDIT ERRORS

2.4 AUDIT/REBUTTAL REPORT REQUEST -AUDIT

2.5 AUDITOR MAINTENANCE

2.6 BROWSE CLOSED AUDIT ERRORS

2.7 LOCK/CLOSE AUDIT RESULTS

2.8 PROJECTION REPORT REQUEST

2.9 CLAIMS AUDIT REQUEST

2.10 VARIABLE MANAGEMENT

2.11 OPENING EXTRACT FILES IN MS EXCEL

2.12 TRI-LISTING

2.13 SANITIZE UNIVERSE AND SAMPLE

2.14 TA BUSINESS OBJECTS (BOXI)

2.14.1 TA BOXI Navigation

2.15 TA HELP

3 HELP – MHS HELP DESK

4 ABBREVIATION LIST

1 TED Auditing (TA) System Overview

The purpose of this audit system is to provide a mechanism for the Claims Audit Review Services (CARS) contractor and TRICARE Management Activity (TMA) to track and monitor the claim-processing performance of Managed Care Support Contractor (MCSC), Managed Care Support Services (MCSS) and TRICARE Dual Eligibility Fiscal Intermediary (TDEFIC) contractors. It allows the client to retain an audit trail with the appropriate error code, facilitates the input of detailed explanations for assessing errors and error amounts, and determines the contractor payment error and occurrence error performance standard. These standards are included in the contractor incentive provisions contained in each of the MCSC, MCSS and TDEFIC contracts.

Detailed System Overview TED Auditing System consists of both batch and online processing. The batch portion of the system extracts, determines sample sizes, selects statistically valid random samples, and loads TED sampled records into the TA database. It also produces a five percent sub-sample for internal auditing.

The system allows the CARS contractor and TRICARE Management Activity (TMA) to audit at the claim-related record and line item levels. It provides interfaces for auditors to enter audit errors, and trigger report generation. The application also has ad-hoc reporting available through the Cognos Query application.

On the Main Menu, menu and sub-menu options are available to an auditor based on their user permissions.

a) If the auditor is TMA/COO personnel, then all screens, menu and sub-menu options are available to the auditor. The auditor will also have permission to trigger report generations.

In addition this user will also have the authority to add/update/delete/change permissions for other users.

b) If the auditor is a CARS contractor, sub-sample menu options as well as “Claims Audit Request”, “Lock/Close Audit Results”, “Auditor Maintenance” (except selected CARS auditors) and “Projection Report Request” screens will not available for the auditor.

c) If the auditor is an authorized CARS auditor, then the auditor will additionally have access to “Auditor Maintenance” screen.

The following figure illustrates the functional/data flow diagram of the HA–TA application.

Figure 1.1 TA W/V Functional Diagram

About this User guide This user guide provides step-by-step instructions to access the TRICARE Patient Encounter Processing and Reporting (PEPR) TED Auditing (TA) system using an internet accessible computer system.

This user guide can be used in two ways: as a new user’s learning tutorial and as a reference guide for experienced users.

Conventions The following conventions will be used to indicate buttons and identify field names and toolbar instructions within the application.

• Underlined and Bold text represents user action, ex. Click <Submit>

• “< >” indicates buttons are to be selected; ex. Click <Submit>

• Bold text indicates fields or toolbar instructions; ex. Type your name in the User ID field.

• “|” indicates a selection sequence; ex. Select File | OpenLook inMy DocumentsSelect desired Word document

• An asterisk (*) indicates a required field

• You can go back to a previous screen by clicking on its link at the top of the screen. Do not use your browser’s back arrow

NOTE: The screenshots used within this document were taken from the QA node PEPR Portal and may not reflect more recent changes. However, the functionality of the application remains the same.

2 Using the TA System

2.1 Satellite Welcome Screen

Click the Satellite link on the top of the PEPR Main Menu Bar and the Welcome to the Satellite Applications screen will be displayed.

Scroll down and select the TED Audit System (TA) link.

2.2 TA Main Screen

The Welcome to TED Auditing main screen will display.

Step Action Result

1 From the Main screen Click Enter

The Main TA menu screen is displayed

From here you select the activity you wish to perform

2 The Main TA menu screen is shown here

Select one of the following:

Browse/Update Audit Errors

Audit/Rebuttal Report Request

Claims Audit Request

Projection Report Request

TRI Listing and scrolling down…

Sanitization Processing and Reporting

Variable and Contract Management

Auditor Maintenance

Browse Closed Audit Errors

Lock/Close Audit Results

The selections on the TA main menu screen are described in the table below and will be discussed in more detail in the sections that follow.

Browse/Update Audit Errors

This screen allows the user to add/update/delete/browse errors and comments for the selected audit. The user can also browse for duplicate records (i.e. TED Record Indicator but with different sample types). The sample, and sub-sample, types for an audit are occurrence, payment, and annual Health Care Cost (HCC).

Audit/Rebuttal Report Request On this screen, the user requests a series of audit/rebuttal reports online for the following sample and sub sample types: Occurrence, Combined Payment, Non-Denied Payment and Denied Payment for both active and closed audits. Additionally this screen will allow requests for audit/rebuttal reports for Annual Health Care Cost sample and sub sample.

An e-mail can be sent to an auditor ID indicating that a request for audit/rebuttal report was received and the status of the reports.

Auditor Maintenance The screen is used to identify the person who can audit the sampled claim-related records. The TMA–COO personnel and authorized CARS auditors have the administrative rights to add/delete/modify auditor’s IDs. The authorized user can add an auditor, delete an existing auditor, modify the details of an existing auditor, and change the authorization of existing auditors and browse to the list of auditors.

Browse Closed Audit Errors Once an audit (per contract, per audit period) has been completed and the rebuttal process is finalized the audit records can be locked/closed which moves that contract audit results to read-only tables. This screen allows the user to browse locked/closed audit errors and their comments.

Lock/Close Audit Results The functionality of this screen is to allow the TMA Auditors to submit a request to lock/close all the samples and sub-samples for a Contract Number and Audit Period combination after the audit has been completed and the rebuttal is resolved.

Projection Report Request This screen triggers Annual Target Health Care Cost reports, which provides summarized information on claim-related records strata, error rate and cost projection for ”Annual Target Health Care Cost” sample.

Claims Audit Request Only TMA Auditors can access this screen. TMA Auditors can browse the audit requests of quarterly and annual sampling of HCSR and TED contracts. Users can also request for HCSR/TED Audit Detail reports and ICN listing reports for any sub-sample and audit period through this screen.

Sanitization Processing and Reporting

Only TMA Auditors and PEPR Operations staff can access this screen. This process is used when TMA negotiates with Manage Care Support Contractors on the final set of health claim records that will be included in the audit. Any record removed from the audit is performed here.

Variable and Contract Management Only TMA Auditors and PEPR Operations staff can access this screen. This process is used to set variables used during Universe Build processing, as well as Universe/Strata definitions for T3 Contracts.

2.3 Browse/Update Audit Errors

1 Click on the Browse/Update Audit Errors link and the following page is displayed where you can select the:

Contract number Audit period Sample type

TRI.

Click the TRI that error entries are desired and the page is displayed.

Enter Error Codes for this record and click <Update> (note the 01A Error Code)

A screen Error message will display if an incorrect Error Code is entered, as is shown for the 01D code

Click

<CANCEL>

to return to the previous Browse Audit Screen

Enter Auditors Comments by selecting this option from the Options menu or clicking the icon

On the prior screen, clicking on the menu option Options | Auditor's Comment or on the icon in the Comments field on this screen will display the screen Browse Auditor's Comments.

Click on the menu option Options | Browse Duplicate Records. If duplicate record exists for the HCSR Number/TED Record Indicator, the Browse Duplicate HCSR/TED Sample screen will open up and display all duplicate samples. If no duplicates are found, a message box will be displayed with the text No duplicates found for selected sample.

The Auditor’s Comments page is shown next (Options | Auditor’s Comments).

The Auditor’s Comments screen is displayed

Click on the

<ERROR

LOOKUP>

button to display a list of error codes (see next page)

Clicking an error code will put it into the central Auditor’s Comments window where an explanation can be typed. (see next page)

Click

<UPDATE>

to save the comment

The error code 01A was selected in the Error Codes List and the text ‘(add auditor comment for this error)’ was typed in the Comments widow.

Here you would actually input a detailed explanation of why the error was assessed, enter the payment amount (which is the difference between the actual payment and the correct payment) and enter the correct billed amount

Click the <BACK> button (hidden behind the Error Codes List) to return to the Update Audit Errors screen (see step 8 above)

2.4 Audit/Rebuttal Report Request -Audit

1 Click the

Audit/Rebuttal Report Request Link and this page is presented.

Select the Contract number, audit period, category, Sample or SubSample and sample type

Then, select the report you’d like to execute Optionally, Click the email ID in the Notify dropdown list of the TMA-A auditor to be notified that the reports are available for viewing

Selecting an auditor to notify and clicking

<SUBMIT>WI

LL FREEZE

ALL

RECORDS for this period and contract number. A warning dialog box will be displayed for your OK to continue and submit

The status screen will indicate that the report is running

All Audit/ Rebuttal reports are produced using the above steps and have the same paging controls

Click the <browse arrows> to page through the report

Each report runs in a separate browser window, so

Click the Close button, [X], to return to the report menu

2.5 Auditor Maintenance

This web page gives a list of auditors and allows the maintenance of auditors. It allows an authorized user to do the following tasks:

• Add a new auditor to the list of existing auditors. For adding a new auditor the user can enter the details of the following fields; ID, last name, first name, initial, authorization, auditor type and status

• Update the details for an existing auditor by editing the last name, first name, middle initial, authorization, auditor type and status fields

• Delete the record of any existing auditor from the table

• Change the authorization of existing auditors

1 Click on the Auditor Maintenance menu selection

To search, enter at least one or more selection criteria

Clicking <Search> will display the auditors matching the criteria

Click the <Add> button to add a new auditor (no selection criteria is needed)

The <Back> button returns you to the TA main screen

2 3

Auditors with a Status of Active were selected to be displayed in this screen

Maintain an existing auditor by Clicking the selection radio button for that auditor and Click <Update> or <Delete>

The <Back> button returns you to the TA main screen

Page through the report using the <browse arrows>

2.6 Browse Closed Audit Errors

1 The main

TA menu selection Browse Closed Audit Errors provides the ability to browse closed Occurrence, Payment, or Annual

HCC

samples

All the samples display in a similar manner so only the Occurrence Sample screens will be shown

Enter selection criteria and click the

<SEARCH>

button or exit the screen by clicking the <Home> button to return to the main TA screen

The detail Error Codes for the selected record are displayed

To display the Auditor’s Comments for the error codes, move your mouse pointer over the Options menu item and click Auditor’s Comments or click on the Comments icon

The comments will display (see the next screen)

On the prior screen, clicking on the menu option Options | Auditor's Comments or on the icon in the Comments field on this screen will display the screen Browse Auditor's Comments.

Click on the menu option Options | Browse Duplicate Records show duplicate records. If duplicate record exists for the HCSR Number/TED Record Indicator, the Browse Duplicate HCSR/TED Sample screen will open up and display all duplicate samples. If no duplicates are found, a message box will be displayed with the text "No duplicates found for selected sample".

The Auditor’s Comments page is shown next (Options | Auditor’s Comments).

7 The comments for the error codes will display

Click the

<BACK>

button to return to the previous browse page

The steps described in the above screens are the same for browsing any of the Closed Audit Error samples

2.7 Lock/Close Audit Results

1 This menu option allows the

TMA

Auditors to submit a request to lock/close all the samples and sub-samples for a Contract Number and Audit Period combination after the audit has been completed and the rebuttal is resolved

2 Enter the Audit Period and Contract Number to be locked/closed

Click

<SUBMIT>

to send the lock request

Click

<CANCEL>

to return to the prior screen and abort sending the lock request

2.8 Projection Report Request

1 The Projection Report Request menu selection is used to submit a request to trigger the generation of an Annual Target Health Care Cost projection report, which provides summarized information on claim-related records strata, error rate and cost projection for "Annual Target Health Care Cost" sample

2 Enter the Audit Period And Select the Contract Number for the desired report.

Click

<SUBMIT>

to run the report in the background or

<CANCEL>

to return to the main TA

2.9 Claims Audit Request

Clicking the Claims Audit Request menu selection displays all the records processed in the current month with their contract number, contractor information, audit period information, request type, audit type and completion date

Clicking a contract number will open the screen “Browse Audit Request for Combined Payment and Occurrence Sampling” that displays download links of the files/reports that were created during the sampling process for the selected contract and audit period

Enter values for Audit Period, Contract Number and Request Type and Click the <SEARCH> button for claim-related audit /sub sample listing records

4 Click on a

Link, if present, under the column Reports/Files to review those items

2.10 Variable Management

1 Click on a Link, if present, for Audit Variable Management.

This service is used to set variables for the backend Universe creation and sampling process.

2 Select the contract number and search for results.

Select the contract radio button and then select update to update variables for this contract.

Otherwise, you can add new variables or delete variables.

The back button takes you back to the previous page.

Variables required for an annual T3 audit are the

ADMIN OR

CARE END

DATE must be set to “M” and the Collection period set to the number of months that are used to collect claims that fit into the audit window.

The only variable needed for quarterly T3 audits is the

ADMIN OR

CARE END

DATE

variable and it is set to “B”.

Select Contractor Management to maintain data about contractors.

contract number radio button and select the update or delete button.

Selecting the Add button allows you to add new contractors to this table.

Select Contract Management to manage data about the contract.

contract number radio button and then select the update or delete button.

Strata Definition Management link to maintain strata definitions and counts.

This information is used by T3 Universe build and random sampling.

search criteria information that minimizes the results list on the right. Then select the contract number on the right to maintain this information.

Here you add/delete strata definitions with their respective counts. The

“ALL”

keyword is typically used in the high dollar strata to instruct the sampling process to select all records from that strata.

The ‘back’ link takes you to the previous page; the ‘Home’ link takes you back to the TA Portal page; and the ‘Exit’ link takes you back to the PEPR Portal page.

Universe Definitions Management link to maintain information used by the Universe Build process.

This link should only be used by

PEPR

Operations staff.

2.11 Opening Extract Files in MS Excel

A report or data that is downloaded for use in Microsoft tools is saved as a text file with the values separated by commas. The file name will end with the extension .csv. After the extract has completed, use the following steps to find the files, move them to a location and import the .csv files into MS Excel or Access.

1 To find these files within MS

Excel, perform the following steps:

a. Open Excel.

b. Click on the

File|Open link.

c. From the Open dialog box, browse to the folder containing the file

Once the folder is located, Click the Files of Type drop down box and select All Files (*.*) so that all files are displayed

Click the .csv file you wish to open

4 The file will be opened in Excel

2.12 TRI-Listing

Clicking the TRI- Listings menu selection displays the TRI-Listings of annual audits available from the TA Application for download. These listings can be viewed or saved in a new location.

Clicking one of the rows (a blue underlined report listing) under the Report Files column heading will display a popup window to allow the user to choose between “Open,” “Save” or “Cancel.”

Clicking the Back button at the bottom of the screen, center, will return the user to the previous screen.

From the popup window, the user can click “Open” to download the file to view, “Save” to save the file in a new location or “Cancel” to return to the previous screen.

Each Report file includes the following fields in .txt format:

- Filing Date

- Filing State Country Code

- Sequence Number

- Time Stamp

- Adjustment Key

- Government Paid Amount

- Sample Flag

2.13 Sanitize Universe and Sample

Clicking the Sanitize Universe and Sample menu selection displays two dropdown selections.

Preliminary Sanitation must be completed before Final Sanitation can proceed.

Click Preliminary Sanitation.

After clicking on the “Submit” button (previous page), a popup message displays after the file has been successfully uploaded.

Click the “OK” button.

Once the upload is complete, an email message will automatically be sent to the requestor indentifying the Audit period and the Contract Number and listing the statistical results of the upload.

If the all the TRIs in the input file match the TRIs in the TA Universe, (match not found = 0) this message will include “The Process is ready for Final Sanitation.” The requestor can return to the PEPR TA screen to begin Final Sanitation.

After Preliminary Sanitation has been completed, and the message “The Process is ready for Final Sanitation” is received (previous page) Final Sanitation can proceed.

Click Final Sanitation

The TED Sanitation Report can be viewed by selecting the Audit Period from the dropdown menu, selecting the Contract Number from the Contract Number dropdown menu, and clicking the “View Report”

The “TED Sanitation Report” lists the TRIs for the Audit Period and Contract Number selected in the previous screen.

It lists those TRIs from the input file that were not found in the TA Universe as well as those that were found.

After viewing the TED Sanitation Report, the Final Sanitation process can be initiated by again selecting the Audit Period from the dropdown menu, selecting the Contract Number from the Contract Number dropdown menu, and clicking the

“SUBMIT”

A Popup “Reminder – Web Page Dialog” will appear with details of the TA Sanitation Process.

A second Popup titled “Message – Web Page Dialog” will appear with “Record approval successful.”

Once the Final- Sanitation process is complete, an email message will automatically be sent to the requestor indentifying the Audit period and the Contract Number with a message that “Projection and other reports are ready for further analysis.”

The requestor can return to the PEPR TA screen to view these reports.

2.14 TA Business Objects (BOXI)

The reports within the TA system have been converted from Cognos to Business Objects XI (BOXI) technology. TA Users will have the option to run an existing report in Cognos (Sections 2.4) as well as in BOXI. The BCS environment will be accessible from the PEPR Portal via a hyperlink which will redirect the user to the BOXI InfoView interface. The BOXI hyperlink will only be available to TA users that have been granted the PEPR BOXI Portal role.

The following reports have been converted:

1. 220-001 (addp_occ)-Summary of Claim Information by Provider, Tax Identification Number

2. 220-001 (addp_pymt)-Audit Error Report

3. 220-001 (occ)-Audit Error Report

4. 220-001 (pymt)-Audit Error Report

5. 240-001 (addp_occ)-Audit Error Report

6. 240-001 (addp_pymt)-Audit Listing

7. 240-001 (occ)-Audit Listing

8. 240-001 (pymt)-Audit Listing

9. 260-001 (addp_occ)-Audit Listing

10. 260-001 (addp_pymt)-Audit Analysis of Errors Report

11. 260-001 (occ)-Audit Analysis of Errors Report

12. 260-001 (pymt)-Audit Analysis of Errors Report

13. 280-001 (addp_occ)-Audit Analysis of Errors Report

14. 280-001 (addp_pymt)-Contractor Audit Summary Report

15. 280-001 (occ)-Contractor Audit Summary Report

16. 280-001 (pymt)-Contractor Audit Summary Report

17. 340-001 (addp_occ)-Contractor Audit Summary Report

18. 340-001 (addp_pymt)-Audit Error Code Analysis Report

19. 340-001 (occ)-Audit Error Code Analysis Report

20. 340-001 (pymt)-Audit Error Code Analysis Report

21. TA Audit Sanitization Report

The following are known differences between the Cognos and BOXI TA reports:

1. There is a difference in the way BOXI and Cognos sorts spaces and special characters. BOXI sorts blanks/spaces at the end, Cognos Sorts blanks/spaces at the beginning of a list. As a result, blank or missing ERROR CD/Auditor's Comments will display in different order than Cognos. This is internal sort behavior that the development team cannot control.

2. Report Prompts: When requesting a report in Cognos, the Filter Criteria boxes are related and display a list of values (LOV) to select from. The BOXI prompts are not linked and users must manually type filter values into the BOXI prompts. Developing LOV options for the BOXI reports will be addressed in a future PEPR Portal Integration release.

3. To compare Cognos to BOXI results, users will need to pull up the PEPR Portal report interface and select the report filter criteria to execute the Cognos report. Then after selecting all of the prompt values, the user will manually type the same values into the BOXI prompts. Some of the Cognos values will have to be translated to internal codes for the BOXI report. Below shows the prompt items and corresponding conversion value to be entered into the BOXI prompts:

Prompts:

(Cognos Prompts Screen)

BOXI Prompts Screen

1. Contract Number: Type in 13 digit Contract number; use uppercase for alpha characters.

2. Audit Period: Type in Audit Period using YYYYMM format.

3. Category: Not a prompt in BOXI; users will select individual Occurrence or Payment report.

4. Sample or Subsample: Not a prompt In BOXI; users will select specific Sample type.

5. Sample Type: Use the table below to determine valid BOXI value:

Cognos Prompt Value BOXI Prompt Value Annual Sample A Annual Subsample AS Denied Sample D Denied Subsample DS Electronic Retail Occurrence Sample B Electronic Retail Occurrence Subsample BS Electronic Retail Sample R Electronic Retail Subsample RS High Dollar Sample H High Dollar Subsample HS

Cognos Prompt Value BOXI Prompt Value Mail Order Occurrence Sample C Mail Order Occurrence Subsample CS Mail Order Sample M Mail Order Subsample MS Non-Denied Sample N Non-Denied Subsample NS Occurrence Sample O Occurrence Subsample OS Paper Occurrence Sample E Paper Occurrence Subsample ES Paper Sample P Paper Subsample PS Specialty Occurrence Sample F Specialty Occurrence Subsample FS Specialty Sample S Specialty Subsample SS

6. Report Type: Not a prompt in BOXI; users will select individual reports.

7. Sort Order: Use the table below to determine the prompt value:

Cognos Prompt Value BOXI Prompt Value Error Code ERROR CD TED Record Indicator TRI

8. Additional BOXI Prompts (these do not affect filter criteria; they are for display purposes only):

a. Contractor: Enter the contractor name or description to be displayed in the report header.

b. Audit Period: Enter the report period to be displayed in the report header.

c. Sample Desc: Enter the description for the sample type to be displayed in the report header.

2.14.1 TA BOXI Navigation

The BCS/BOXI hyperlink will be part of the header of the main PEPR Portal screen (a.k.a Welcome to the PEPR Portal). It will appear between the Satellite and Help links. The BOXi link will only be available to TA users that have been granted the PEPR_BOXI Portal role.

Once the user clicks on the ‘BOXI’ link the user will be redirected to the

BCS BOXI

InfoView user interface via new web browser window.

To access reports, Click on the <Document List> Menu option or the <Document List> folder.

Expand “Public Folders” and then “TA” folder to see the list of TA BOXI canned reports.

Double Click on the Report Title to proceed to the report form.

Clicking on the Report link launches a blank report template.

Click on the <Refresh All> button to launch the Report Prompts Screen to set filter criteria for the report.

The Prompts Screen allows the user to select parameters for filtering report results.

A red arrow indicates a required field.

Green check mark indicates a value has been set.

The <Run Query> button is disabled until all prompts are set.

Click on the Prompts to open the text field to enter values:

Audit Period:

Enter value for Audit Period using YYYYMM format.

12 Contract Number: Enter value using 13 digit Contract number; Must use uppercase for alpha characters for data to be returned.

Sample Type:

This prompt allows for multiple values.

(See section 2.14 for list of valid codes.) Must use uppercase for alpha characters for data to be returned.

Enter code for Sample Type, then click the (>) arrow button to add the value.

To remove a value, select the code and then click the (<) arrow button.

16 Contractor:

Enter the Contractor Name or description to be displayed in the report header.

17 Period: Enter the report period to

18 Sample Desc:

Enter the description for the Sample Type to

19 Sort Order:

Enter the Sort Order for the report and then click the (>) arrow button to add the value.

Valid values are:

• TRI,

• ERROR CD

To remove a value, select the code and then click the (<) arrow button.

Use the Scroll Bar to see all available prompts

Once all values are set, click the “Run Query” button to execute the report

The report will display.

To re-run the report, click the ‘Refresh All’ button to return to the prompts and click the ‘Run Query’ button.

Users have the option to save the report Click on “Document”

Select “Save to my computer as” option to save report in PDF, CSV or Excel format on local machine.

Select “Save as” option to save report into “My Favorites” folder within BCS.

Click on <Document List> menu option or close the report to return to the Main

25 To create Ad-Hoc reports in BOXI click and select “Web Intelligence Document” from drop down list under “New.”

This function is limited to users with the FCT Reporter and FCT Publisher roles.

26 To open TA Universe, click on “TA” link.

27 After selecting the TA universe, various TA ad hoc objects are displayed.

Double click on desired objects or drag and drop objects to “Result Objects” area on the right. Select “Run Query” when all desired objects are selected.

28 Ad-Hoc report is created.

29 Click the dropdown arrow next to the “Save” button icon and save the ad hoc report to the desired location

2.15 TA Help

There are Help links on ever page within the TA application that provides more information about the certain screen that you are on.

For example, clicking Help on the Browse TED Audit Errors screen displays the following help screen.

3 Help – MHS Help Desk

At any time you are using any of the PEPR applications and need assistance, you can contact the MHS Help Desk via the following methods:

By Phone – 1-800-600-9332

By email – help@mhs-helpdesk.com

By internet – http://www.mhs-helpdesk.com

4 Abbreviation List

Abbreviation Description ACAT Acquisition Category ADD Active Duty Dependent ADFM Active Duty Family Member ADSM Active Duty Service Member AHA American Hospital Association AISS Automated Information Security System Alpha Alphabetic ATO Authority to Operate BCS BOXI Common Services BOS Branch of Service BOXI Business Objects XI BRAC Base Realignment and Closure C&A Certification and Accreditation CCB Configuration Control Board CDIS Care Detail Information System CDR Critical Design Review CES Cost Element Structure CFC ColdFusion Components CFM ColdFusion Modules CFMX ColdFusion MX CHCBP Continued Health Care Benefit Program CI Claims Information System CMAC CHAMPUS Maximum Allowable Charge CMIS CHAMPUS/TRICARE Medical Information System COBOL Common Business Oriented Language COMS Contract Management Systems COTS Commercial Off-the-Shelf CPT Current Procedural Terminology CQ COGNOS Query CRDM Common Reporting Data Mart CRIS CHAMPUS Regional Intermediary System - Provides user access to information about TRICARE claims, beneficiaries, providers, diagnosis and procedure codes, and other data.

CSS Cascading Style Sheets CURES CHAMPUS Utilization Reporting and Evaluation System DAA Designated Approving Authority DCIS Defense Criminal Investigation Services DDS DEERS Dependent Suffix Code DEERS Defense Enrollment Eligibility Reporting System

DHSS Defense Health Services Systems DITSCAP DoD Information Technology Security Certification and Accreditation Process DMIS Defense Medical Information System DoD Department of Defense DQ&FP Data Quality and Functional Proponency DRG Diagnosis Related Group DT&E Development Test and Evaluation ECHO Extended Care Health Option EI/DS Executive Information and Decision Support [Replaced by DHSS 2008] EIN Employer Identification Number ELIPS Estimated Line Item Prorated System - Calculates Common Costs at a line-item level for non-institutional providers for HCSR’s ETL Extract, Transform and Load FCA Functional Configuration Audit FI Fiscal Intermediary FOUO For Official Use Only FY Fiscal Year GIAT Government Installation Acceptance Testing GSUE Active Duty Member Claims-Europe GUI Graphical User Interface HA HCSR Audit HCPR Health Care Provider Record HCSRI Health Care Service Record Indicator HCSR Health Care Service Record HIPAA Health Insurance Portability and Accountability Act of 1996 HSR Health Service Region HSRA Health Service Region Area HSSC Health Services and Support Contractor HTML Hyper Text Markup Language HTTP Hyper Text Transfer Protocol IATO Interim Information Assurance to Operate IAVA Information Assurance Vulnerability Alert ICD International Classification for Diseases ICD-9-CM International Classification for Diseases, Ninth Revision, Clinical Modification ICN Internal Control Number ICT Integrated Contractor Team ID Identification Code IDME Indirect Medical Education IDMS Integrated Database Management System IMD Information Management Directorate INST Institutional IQD Impromptu Query Definition

ISSO Information System Security Officer IWR Impromptu Web Report MB&RS Medical Benefits & Reimbursement Systems MCSC Managed Care Support Contractors MDC Major Diagnostic Code MHS Military Health System MTF Military Treatment Facility MVS Multiple Virtual Storage NADD Non Active Duty Dependent NAS Non Availability Statement NON INST Non Institutional NQ National Quality Monitoring ODS Operational Data Stores OHI Other Health Insurance OLAP On-Line Analytical Processing OT&E Operational Test and Evaluation PCA Physical Configuration Audit PCDIS Purchased Care Detail Information System PCDW Purchased Care Data Warehouse PCMIS Purchased Care Medical Information System PCURES Purchased Care Utilization Reporting and Evaluation System [decommissioned 12/23/2008] PDF Portable Document Format PDR Preliminary Design Review PEPR Patient Encounter Processing and Reporting PHI Protected Health Information PMB Performance Measurement Baseline PP Provider Participation System PRISM Provider Requirements Integrated Specialty Model QA Quality Assurance RAD Rapid Application Development RAMS Resource Accounting Management System SCM Software Configuration Management SDCS Source Data Collection System SDK Software Development Kit SDS System Design Specification SI Sensitive Information SIT System Integration Test SNF Skilled Nursing Facilities SOAP Simple Object Access Protocol SOP Standard Operating Procedure SPC Special Processing Code SQL Structured Query Language

SQT System Qualification Test SRB Schedule Review Board SRS System Requirements Specifications SSAA System Security Authorization Agreement ST & E Security Testing & Evaluation STS Specialized Treatment Services TA TED Audit TCB Trusted Computing Base TDEFIC TRICARE Dual Eligibility Fiscal Intermediary TED TRICARE Encounter Data TFL TRICARE For Life TIN Taxpayer Identification Number TMA TRICARE Management Activity TPL Third Party Liability TPR TRICARE Prime Remote Active Duty Claims-USA TRI Ted Record Indicator URL Uniform Resource Locator UT Unit Testing UTP Unit Test Plan VIT Vendor Integration Test VPN Virtual Private Network WBS Work Breakdown Structure XSLT Extensible Style Sheets Language for Transformations XML Extensible Markup Language XSLT Extensible Style Sheets Language for Transformations ZIP Zip Code (United States Postal Code)

DOCUMENT REVISION LIST

Client: Defense Health Services Systems (DHSS) and TRICARE Management Activity (TMA)

Rev No

Date;

Author

Revision and Description Release number if applicable

Page Numbers

Action Taken, CR number if applicable

1 3/27/2009 Sheila Hutchison

Maintenance: Updated DHSS for EIDS, added revision list and updated for PCURES decommission.

1, 48-50, 52 Maintenance: Updated DHSS for EIDS, added rev history and removed references to PCURES, changed glossary to i PCURES as decommissioned.

2 6/32009 Sheila Hutchison

2.15.00.0 New applications added to PEPR TA:

“TRI Testing,” “Annual Audit Analysis Cubes” an “Sanitize Universe and Sample.”

45-48

49-64

A. CRS03849:Added Annual Audit Analysis Cubes and drill-thru reports screens.

B. CRS04691: Added Automate Annual Universe and Sample Sanitation screens.

3 2/26/2010 2.15.01.0

4 2/26/2010 2.15.02.0

5 6/6/2013 Craig Owens

5.02.00.0 T3 Annual Audit Suppor

to the application

All CRS13249

6 6/14/2013 Craig Owens

Response to DT&E SIT review All CRS13249

2.15 TA Help