/ISHFR/RN_MCO_ORDER_CREATE - IS-H FR: Manual Dispatch Order Creation for Various MCO Procedures

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Title

IS-H FR: Manual message generation for various MCO communication procedures

Purpose

This report allows you to trigger communication events manually even if you have changed no data in the system.

This means that you can send messages even when the events are not automatically registered by SAP for message processing.

Prerequisites

The following criteria must be met if the report is to be able to write the order to the database:

• The communication procedure must be active for the institution specified.

• You must define a communication partner (data collection point).

• Customizing must be set up correctly.

Features

RSS: Standardized Discharge Message (PMSI MCO)

Message creation does not depend on the insurance provider.

The system selects all inpatient and day care cases that fit the selection criteria (selection by discharge date).

Clinical studies are treated like normal inpatient stays.

The system only creates messages for the following situations:

• Inpatient and day care stays on an Organizational Unit (OU) for which the value M,C or O is entered in the specialty category (=7).

• Inpatient and daycare dialysis cases (the Dialysis indicator is set in the case category.)

• Inpatient and daycare radiotherapy cases (the Radiotherapy indicator is set in the case category.)

The system generates a new RUM message for each different movement on an MCO unit (departmental OU of admission/transfer).

The system uses specialty category B to fill the RSS field ORGUNIT (unité medicale). This category should also be specified for the PDG-MCO grouper in the file UM.txt.

Absences with the movement type Transfer to ext. hospital are consideredin the previous stay's RUM. If the patient returns to the same MCO unit after an absence, only one RUM message is generated.

If the patient changes specialty after an absence, the period of the absence is treated as a part of the previous stay, and the system generates a new RUM for the time following the absence.

Dialysis and radiotherapy cases are also selected. During a normal MCO stay, these treatments should be documented as outpatient visits in an inpatient/daycare stay.

RSP: Standardized Message for Radiotherapy Preparation (PMSI MCO)

Message creation does not depend on the insurance provider.

The system selects all outpatient cases (for which the Radiotherapy indicatoris set in the case category) that are assigned to an inpatient or daycare case for which the RSS procedure is relevant.

The outpatient case must have a case-to-case assignment with the internal category R to these cases.

Clinical studies are treated like normal inpatient stays.

Dialysis cases are treated as daycare cases.

Preparation for radiotherapy (outpatient case) must be assigned to the last of the daycare cases or to the inpatient case.

UCD: FICHCOMP File Data Exchange for Drugs (PMSI MCO)

Message creation does not depend on the insurance provider.

The system selects all inpatient and daycare cases that fit the criteria (selection by discharge date) and have at least one movement (admission/transfer) on an MCO department.

Clinical studies are treated like normal inpatient stays.

The following conditions apply to message generation:

• The stay is treated as an inpatient or daycare stay on an OU that has the value M,C or O entered for the specialty category (=7). (The system considers the departmental OU (NBEW_ORGFA) of the transfer).

• At least one RSS message (EDI procedure FRRSS) with a status >=2 must exist for the case. If thisis not the case, the message is stopped (NC301S-SESTA = 02 and NC301S-HOLDD = '99991231'). The systemissues a corresponding warning message. The system always checks for an incomplete FRUCD message duringthe EDI procedure FRRSS whenever a new message with status =02 is generated. In this case, the system releases the stopped message.

• The system takes into account all billable UCD services (charge type = F8) for which the indicatorT2A is set in the service master. It does not matter whether the service has already been billed or not. The system also ignores the insurance provider.

• If the service price cannot be determined, or has a value of zero, the message is assigned the status "incomplete" (NC301S-SESTA =02).,,,,

LPP: FICHCOMP File Data Exchange for Medical Products (PMSI MCO)

Message creation does not depend on the insurance provider.

The system selects all inpatient and daycare cases that fit the criteria (selection by discharge date) and have at least one movement (admission/transfer) on an MCO department.

Clinical studies are treated like normal inpatient stays.

The following conditions apply to message generation:

• The stay is treated as an inpatient or daycare stay on an OU that has the value M,C or O entered for the specialty category (=7). (The system considers the departmental OU (NBEW_ORGFA) of the transfer).

• At least one RSS message (EDI procedure FRRSS) with a status >=2 must exist for the case. If thisis not the case, the message is stopped (NC301S-SESTA = 02 and NC301S-HOLDD = '99991231'). The systemissues a corresponding warning message. The system always checks for an incomplete FRUCD message duringthe EDI procedure FRRSS whenever a new message with status =02 is generated. In this case, the system releases the stopped message.

• The system takes into account all billable UCD services (charge type = F4) for which the indicatorT2A is set in the service master. It does not matter whether the service has already been billed or not. The system also ignores the insurance provider.

• If the service price cannot be determined, or has a value of zero, the message is assigned the status "incomplete" (NC301S-SESTA =02).,,,,

VIDHOSP: File for inpatient and home treatment

Message generation does not depend on the insurance provider.

The report selects all inpatient and day care cases that fit the selection criteria (selection by discharge date).

The system only creates messages for the following situations:

• Inpatient and day care stays on an Organizational Unit (OU) for which the value M,C, O or HAD is entered in the specialty category (=7).

The system selects all invoices for all insurance providers and self-payers that have not been canceled for the selected cases.

Selection

EDI procedure

Then choose the relevant EDI procedure.

General

• Institution

Choose the appropriate institution from the value help (F4).

• Discharge date from/to

Enter a period for the discharge movement, so that the system selects the case. If the period comprises only a single day, it is sufficient to enter only Discharge date from.

You must provide both criteria.

Additional criteria

• Case Number From/To

You can further restrict the selected cases by specifying case numbers.

• Selection parameters (for case selection)

If you have already executed the case selection program, you can use the same selection criteria here. The system only processes cases that have been assigned these selection criteria by the case selection.

• Med. Doc. Status Key

• Med. Doc. Status Profile

Further options

• Log

When you select this option, the system generates a log of the processed cases.

• Layout (Display Variant)

You can use this option to control the log layout. To use this option, you must also select the Log option.

• Test

When you select this option, the system only displays the processed cases - it does not actually generate real dispatch orders.

• Create messages directly

If you select this option, the system automatically triggers the message formatting relevant to the data exchange at the end of the run.

Output

The report writes a data record to dispatch order table NC301. This is used as a trigger to generate a new message during the next message formatting (program RNC30100).

If you have selected log, the system displays all available information about dispatch orders in the standard layout:

• Case

• Patient

• Patient Name

You can create your own layout as well.

If you have not selected log, the system displays the number of processed cases and created dispatch orders in a message.

If you have selected create messages directly, the system always displays a log of the executed message generation.

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