e-referral initiative · 2014-11-10 · referral. the initiative will facilitate better control on...

e-Referral Initiative Technical Specifications Version 1.0

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Table of Contents

OVERVIEW 2

SCOPE 2

WHY E-REFERRAL 2

ABBREVIATIONS 2

EREFERRAL INITIATIVE CYCLE 3

INVOLVED TRANSACTION 3

EREFERRAL TRANSACTIONS 3

EREFERRAL CYCLE 4

EREFERRAL TRANSACTION STATUS 4

EREFERRAL ACCESS 5

CONNECTING TO EREFERRALHUB 5

CREDENTIALS TO UTILIZE EREFERRALHUB 5

EREFERRAL BUSINESS PROCESS 6

PROCESS 1: UPLOAD EREFERRAL 6

PROCESS 2: CANCEL EREFERRAL 9

PROCESS 3: DOWNLOAD AND DISPENSE EREFERRAL 10

PROCESS 4: RELEASE EREFERRAL 11

PROCESS 5: DISCHARGE EREFERRAL 11

EREFERRAL SCENARIO EXCEPTIONS 12

REFERRAL FROM CLINICIANS OUTSIDE DUBAI 12

REFERRAL TO CLINICIANS OUTSIDE DUBAI 12

EREFERRAL TRANSACTION TRACKING 12

EREFERRAL STATUS UPDATES 13

REFERRING CLINICIAN 13

DOWNLOADING CLINICIAN 13

EREFERRAL WEB SERVICE DOCUMENTATION 14

UPLOAD EREFERRAL (PROVIDER) 14

GET MISSING EREFERRAL REFERENCE NO. (PROVIDER) 15

GET REFERRAL DETAILS (PROVIDER) 16

DOWNLOAD EREFERRAL FILE (PROVIDER & PAYER) 17

LOCK EREFERRAL (PROVIDER) 18

RELEASE EREFERRAL (PROVIDER) 19

DISCHARGE EREFERRAL (PROVIDER) 20

GET NEW EREFERRAL (PAYER) 21

SEARCH EREFERRAL HISTORY (PROVIDER & PAYER) 22

SET EREFERRAL AS DOWNLOADED (PAYER) 24

WEB SERVICES RETURNED VALUES 25

EREFERRAL WEB SERVICES ADDRESS \ WSDL 25

WEB SERVICES WSDL 25

EREFERRAL INITIATIVE IMPLEMENTATION ERROR! BOOKMARK NOT DEFINED.

IMPLEMENTATION IN DUBAI ERROR! BOOKMARK NOT DEFINED.

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Overview

Scope As the insurance sector in the emirate of Dubai is expanding rapidly with the introduction of the new

mandatory insurance law, the Dubai Health Authority is introducing a new gate keeping initiative called e-

Referral. The initiative will facilitate better control on the insurance spending towards a more cost effective

insurance market.

eReferral initiative is a computer based referral system between General and specialist clinicians within the

same as well as different healthcare facilities. The system will enable a clinician to transfer a patient to a

different clinician based on their specialty or specialty group through the eReferralHub (Part of the DHPO).

eReferral will provide insurance companies with tracking evidence of the referral rout taken by the patient.

Dubai is the first to implement such an electronic gate keeping solution in the region.

This document will discuss and outline the business and processing aspects of the eReferral initiative to

help all involved parties configure the technical connections and establish the business requirements

through the involved transactions’ schemas.

Why e-Referral Dubai Mandatory Insurance Law (11) is anticipated to increase the insured population in the emirate of

Dubai up to three folds the existing market size by the end of 2016. Dubai Health Authority is keen on

introducing smart electronic systems to facilitate easy transactions, gain visibility and maintain controls to

guarantee a cost effective Healthcare Insurance sector. Moreover, it is being a supportive decision-making

tool by making patient transfer history available now of referring the patient from the clinician side, as well

as adjudicating the claim on the payer side.

eReferral will play an important role in enabling the DHA to achieve the goals mentioned below:

Track patient referrals and transfers form one clinician to another.

Implement a Cost Containment model through a gate keeping routing process for clinician visits.

Reduce doctor-shopping habits performed by patients.

Abbreviations Below is a list of the abbreviations that may be used within the document body:

Abbreviation Description

DHA Dubai Health Authority

eReferral Electronic Referral Transaction

DHD Dubai Health DataDictrionary

DHPO Dubai Health Post Office

eReferralHub Component of the DHPO managing the eReferral transactions

Payer Healthcare Service Payer

Provider Healthcare Service Provider

Receiver Transaction receiver

Referring Clinician Clinician that is referring the patient to a given specialty

Specialty Clinician’s specialty as provided by the licensing authority

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eReferral Initiative Cycle Below is a diagram representing the high-level cycle covered within the eReferral initiative.

Figure 1: eReferral Cycle

Involved Transaction

eReferral Transactions eReferral cycle consists of the transactions shown below:

Transaction Description

Upload eReferral Transaction of submitting an eReferral from the referring clinician to the eReferral Hub

Download eReferral Summary Transaction of downloading an eReferral Summary by the Healthcare Facility from the eReferralHub.

Download eReferral File Transaction of downloading the full eReferral details by the Clinician from the eReferralHub.

Lock eReferral Transaction of setting the eReferral as Locked. The transaction can’t be downloaded by another clinician any more.

Release eReferral Transaction of releasing an eReferral transaction if it is not used by the downloading clinician.

Cancel eReferral Transaction of cancelling an eReferral transaction by the referring clinician.

Forward eReferral Transaction of forwarding a downloaded eReferral to another specialty. (Same as upload eReferral)

Discharge eReferral Transaction of discharging a patient once the referral cycle is completed by the downloading clinician.

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eReferral Cycle

Below is a transaction flow for the eReferral cycle performed on the system. Each line provides the

transaction source, destination, name, content and status as per the cycle diagram provided above.

No. Source Destination Action Input DHPO output

1 Referring Clinician

eReferralHub Upload eReferral

eReferral XML file Upload Result; eReferral Reference No.; Error Report;

2 eReferralHub Downloading Clinician

Download eReferral Summary

eReferral reference No. Member ID

eReferral General Info; Error Report;

3 eReferralHub Downloading Clinician

Download eReferral Full


eReferral XML File; Error Report;

4 Downloading Clinician

eReferralHub Lock eReferral


Lock Result; Error Report;


eReferralHub Release eReferral


Release Result; Error Report;

6 Referring Clinician

eReferralHub (Forward) Upload eReferral

eReferral XML file Upload Result; eReferral Reference No.; Error Report;


eReferralHub Discharge eReferral


Discharge Result; Error Report;

eReferral Transaction Status eReferral transaction will undergo several different statuses throughout its journey in the eReferral system

as shown below (Status list below is related to the eClaimLink eReferral System and may not apply to

other legacy systems developed by providers):

No. Transaction Status Description

1 Upload eReferral Posted eReferral is uploaded and available for download.

2 Cancel eReferral Canceled eReferral is cancelled and cannot be downloaded anymore.

3 Lock eReferral Locked eReferral is downloaded and locked from the eReferralHub. Transaction cannot be downloaded anymore.

4 Release eReferral Released eReferral is available for download

5 Forward eReferral Forwarded eReferral is forwarded\uploaded and available for download.

6 eReferral Expired (internal)

Expired eReferral is expired after passing the period defined by the DHA (1 month), without being downloaded by any clinician.

7 eReferral Discharged

Discharged eReferral is discharged after the last visit at the specialist.

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eReferral Access As eReferralHub will be managing the eReferral transactions, certain access and rules need to be set to manage the cycle.

Connecting to eReferralHub eClaimLink solution provides two channels for connecting to the eReferralHub:

An online portal for all the licensed Clinicians utilizing the eClaimLink portal in order to serve the Dubai population, to submit and download electronic referrals through the regulatory eReferralHub under their registered facilities.

A direct link to the eReferralHub though web services. (Details provided later in this document)

Credentials to utilize eReferralHub eReferralHub will manage eReferrals based on the Facility Credentials.

Access will be granted for all facilities registered on eClaimLink.

eReferrals will be allowed only for Clinicians that are listed under a given facility through the Settings Page.

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eReferral Business Process Below is a business process description of the eReferral processes:

Process 1: Upload eReferral

Uploading an eReferral by the referring Clinician to the eReferralHub will be utilized in two cases: 1.

Uploading a new eReferral Transaction, 2. Forwarding a downloaded eReferral Transaction.

Figure 2: Upload eReferral

1. Fill in eReferral Details: A minimum set of mandatory fields are requested to complete the transaction (defined the table below). Providing additional information will facilitate higher quality services and record keeping for the patient. Provider\Clinician has the option to utilize their internal HIS systems to communicate directly to the DHPO through web services, or to utilize the free of charge eReferral System provided by the DHA through the eClaimLink system.

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Table 2.2 eReferral Data Elements

A full list of elements with their definitions, types and restrictions is available at the DHD \ Schema section

on the eClaimLink Portal (Direct Link)

No. Element Description Mandatory

1 Header Header element of the eReferral transaction Yes

1.1 SenderID ID of the facility sending the eReferral Yes

1.2 ReceiverID ID of the facility receiving the eReferral Yes

1.3 TransactionDate Date of the transaction Possible values: DD/MM/YYYY

Yes

1.4 DispositionFlag To indicate the file type (TEST or PRODUCTION) Yes

2 Referral Prescription element of the eReferral transaction Yes

2.1 ID Unique Identifier to track the eReferral Yes

2.2 Type Type of the Electronic.Referral being submitted Possible values: Referral, Cancellation, Discharge

Yes

2.3 PayerID Represents the ID of the eReferral payer Possible values: Insurance License, SelfPay (cash patient)

Yes

2.4 Start Referral start date and time Possible values: dd/mm/yyyy HH:MM

Yes

2.5 End Referral end date and time Possible values: dd/mm/yyyy HH:MM

Yes

2.6 Clinician eClaimLink ID of the referring clinician Yes

2.7 Specialty eClaimLink ID of the destination specialty of the eReferral Yes

2.8 PreviousReferral ReferenceID

Reference Number of the pervious eReferral in the case of the transaction being a second referral

No

2.9 Member Member element of the eReferral transaction Yes

2.9.1 MemberID Unique reference ID of the patient receiving the eReferral Possible Values: Insurance Member ID, or other unique identifier of the member.

Yes

2.9.2 EmiratesIDNumber Number of the patient’s Emirates ID Possible values: Emirates ID Number, or Default values for members that do not have an ID.

Yes

2.9.3 DateOfBirth Birth Date of the patient Possible values: DD/MM/YYYY

No

2.9.4 Email Valid patient email account No

2.10 Diagnosis Diagnosis element of the Electronic.Referral Yes

2.10.1 Type Principal, Secondary, Admitting Yes

2.10.2 Code ICD code of the diagnosis (Predefined list) Yes

2.11.1 Observation Observation element within the Activity Yes

2.11.1 Type Type of the observation Yes

https://eclaimlink.ae/dhd_schemas.aspx

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Possible values: Predefined list

2.11.2 Code

Code of the observation Possible values: Predefined list

If you are using the eClaimLink eReferral system, this field will be auto filled in the background.

Yes

2.11.3 Value

Value of the observation

if you are using the eClaimLink eReferral system this field will be called: o If Type= Text “Reason for Referral” to enter the

referral reason. o If Type= File “file” to upload the needed

document

No

2.11.4 ValueType Type of the detail entered in the value field

If you are using the eClaimLink eReferral system, this field will be auto filled in the background.

No

2. Upload eReferral: Clinician generates and uploads the eReferral to the eReferralHub using the free of charge eReferral System provided by the DHA through the eClaimLink Portal \ Applications. Or utilizing the direct web-services method UploadReferral (documentation provided in a separate section below). Forward eReferral: if the clinician has received the patient through an electronic referral, and would like to further refer this patient to a new clinician specialty for a valid reason then aside from the eReferral details, the clinician should enter the eReferral Reference ID of the original downloaded eReferral within the field (PreviousReferralReferenceID) of the new eReferral. (This link will enable the providers and payers from tracking the chain of referrals). eReferral Transaction Status upon upload

Transaction is valid Status = Posted (available, and can be downloaded)

Transaction is expired Status = Expired (locked, and can’t be downloaded)(validity period to be decided by DHA as part of the Business rules on eClaimLink DHD)

`

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Process 2: Cancel eReferral

Cancellation of the eReferral is utilized in case the referring clinician needs to cancel or modify a successfully

uploaded eReferral. Cancellation is allowed only for posted eReferrals. Expired, Locked, Dispensed and

already cancelled transactions cannot be cancelled another time.

Figure 3: Cancel eReferral

1. Cancel eReferral: the referring clinician can cancel an eReferral in the eReferralHub using the free of charge eReferral System provided by the DHA through the eClaimLink Portal \ Applications. Or utilizing the direct web-services method UploadReferral (documentation provided in a separate section below), with the Referral Type = Cancellation. eReferral Transaction Status

Transaction is cancelled status = Canceled (available, and can be downloaded)

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Process 3: Download and Discharge

Once the eReferral is available at the eReferralHub, facilities and clinicians are able to download and dispense the eReferral (As long as it is valid and not Expired, Locked or Canceled)

Figure 4: Download and Process eReferral

1. Download eReferral Summary: Facility downloads the eReferral summary (only) using the free of charge eReferral System provided by the DHA through the eClaimLink Portal \ Applications. Or by utilizing the direct web-services method GetReferralDetails to validate if the specialty is available at the facility, and then direct the patient to the right clinician. (documentation provided in a separate section below)

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2. Lock eReferral: Facility or clinician confirms accepting the eReferral using the free of charge eReferral System provided by the DHA through the eClaimLink Portal \ Applications. Or by utilizing the direct web-services methods:

DownloadReferralFile to download the eReferral XML file from the eRferralHub.

LockeReferral to lock the eReferral and ensure it is not downloaded by a different facility or clinician.

eReferral Transaction Status

Transaction is Downloaded status = Locked (locked, and can’t be downloaded)

Process 4: Release eReferral

If a clinician evaluates an eReferral transaction after locking it and decides to release it so it can be downloaded by another clinician within the needed specialty:

1. In the case of deciding to reject the eReferral transaction, the clinician must release the eReferral using the free of charge eReferral System provided by the DHA through the eClaimLink Portal \ Applications. Or by utilizing the direct web-services method ReleaseReferral. (documentation provided in a separate section below) eReferral Transaction Status

Transaction is Released status = Released (Posted, and can be downloaded)

Process 5: Discharge eReferral

If a clinician evaluates an eReferral transaction after locking it, completes the needed services and decides to discharge the patient:

1. In the case of deciding to discharge the patient, the clinician must discharge the eReferral using the free of charge eReferral System provided by the DHA through the eClaimLink Portal \ Applications. Or by utilizing the direct web-services method dischargeReferral. (documentation provided in a separate section below) eReferral Transaction Status

Transaction is Discharged status = Discharged (Inactive, and can’t be downloaded)

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eReferral Scenario Exceptions

Referral From Clinicians outside Dubai

DHA advises to have the referring facility and clinician register on the eClaimLink system and send

the eReferral transaction electronically.

In case the referring clinician and facility are not registered on the eClaimLink, then the receiving

facility will submit a ClaimSubmission to the Payer and fill in the reference source using the

Encounter.TransferSource the name and licenses of the referring clinician and facility. (Field details

can be found in the eClaimLink Portal \ Dubai Health Data-Dictionary (DHD) page under the Schema

section).

Referral To Clinicians outside Dubai

Facilities and clinicians utilizing the eReferral system must be registered and activated on the

eClaimLink system.

In case the receiving clinician and facility are not registered on the eClaimLink, then the sending

facility will submit an eReferral transaction on the eReferralHub, and print out an eReferral form to

be provided to the patient in the out of Dubai facility or clinician.

eReferral Transaction Tracking Below is a brief demonstration of the logic and IDs utilized within the eReferral and eClaim process to link the transactions.

No Source Destination Transaction File Link ID

1 Referring Clinician eReferralHub eReferral.Request eReferral.Request ID, eReferral Reference No.

2 eReferralHub Downloading Clinician eReferral.Request eReferral.Request ID, eReferral Reference No.

3 Discharging Clinician

eReferralHub eReferral.Request eReferral Reference No.

3 Claim.Submission DHPO Claim.Submission eReferral Reference No., ClaimID

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eReferral Status Updates

Referring Clinician

Initial Status Action Final Status

Upload eReferral Posted

Posted Download eReferral Summary Posted

Posted Download eReferral XML File Posted

Posted Lock eReferral Locked

Posted Cancel eReferral Cancelled

Posted Edit eReferral Existing eReferral: Cancelled New eReferral: Posted

Posted Request eReferral Again New eReferral: Posted

Posted Expire Expired

Released Cancel eReferral Cancelled

Released Modify Existing eReferral: Cancelled New eReferral: Posted

Released Request Again New eReferral: Posted

Downloading Clinician

Initial Status Action Final Status

Download eReferral Summary Posted

Posted Download eReferral XML File Posted

Posted Lock eReferral Locked

Locked Release eReferral Released

Locked Forward eReferral Posted

Locked Discharge eReferral Discharged

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eReferral Web Service Documentation

Upload eReferral (Provider) Web service method: UploadReferral

Description: Web service method used to upload transaction content in xml format to post office. Validation rules will be applied to make sure that uploaded files are in good shape.

Signature: int UploadReferral (

string facilityLogin, string facilityPwd, string clinicianLogin, string clinicianPwd, base64Binary fileContent, string fileName, out int UploadReferralResult, out string eReferalReferenceNo, out string errorMessage, out base64Binary errorReport)

Element Description

facilityLogin Facility user login name to connect to the DHPO\eReferralHub

facilityPwd Facility user password to connect to the DHPO\eReferralHub

clinicianLogin Clinician user login name to connect to the DHPO\eReferralHub. (Allowed to be Null)

clinicianPwd Clinician user password to connect to the DHPO\eReferralHub (Allowed to be Null)

fileContent content of the file to upload (must be base 64 Binary encoded)

fileName original file name; this file name will be used later to show users the available files for download

UploadReferralResult Result of the upload method. Value Table provided in a separate section below

eReferalReferenceNo Unique Reference Number for the eReferral Generated by the DHPO\eReferralHub for tracking purposes.

errorMessage

output parameter that contains the transaction status: Error: error message if something goes wrong; web service can also send warnings using this parameter; the parameter may be null or empty string if the web service returns zero, otherwise the error message is expected Successful: empty

errorReport output parameter that contains byte array with the content of error report eventually generated by DHPO\eReferralHub Validation during file upload; the parameter may be null

Return value: The web service may return values described in the section Web Services Returned Values.

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Get Missing eReferral Reference No. (Provider) Web service method: GetReferralReferenceNo

Description: web service used to get the most recent eReferral Reference Number on DHPO\eReferralHub for this member.

Signature:

int GetRecentReferralReferenceNo (

string facilityLogin,

string facilityPwd,

string memberID,

out int GetReferralReferenceNoResult,

out string eReferalReferenceNo,

out string errorMessage)

Element Description

facilityLogin user login name to connect to the DHPO\eReferralHub

facilityPwd user password to connect to the DHPO\eReferralHub

memberID ID for a given member (member insurance card number).

GetReferralReferenceNoResult Result of the GetReferralReferenceNo. Value Table provided in a separate section below.

eReferalReferenceNo eReferalReferenceNo of the missing eReferral transaction.

errorMessage

output parameter that contains eventual error message if something goes wrong; web service can also send warnings using this parameter; the parameter may be null or empty string if the web service returns zero, otherwise the error message is expected


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Get Referral Details (Provider) Web service method: GetReferralDetails

Description: web service used to get a summary of a given eReferral transaction available on the DHPO\eReferralHub. The service returns back an XML containing the Referral transactions details.

Signature:

int GetRreferralDetails (


string facilityPwd,

string eReferalReferenceNo,

string memberID,

out int GetReferralDetailsResult,

out string xmlReferralDetailsMessage,


Element Description

login user login name to connect to the DHPO\eReferralHub

Pwd user password to connect to the DHPO\eReferralHub

eReferalReferenceNo eReferalReferenceNo reference of a given eReferral.


GetReferralDetailsResult Result of the GetReferralDetails. Value Table provided in a separate section below.

xmlReferralDetailsMessage output parameter that contains xml with description of the eReferral details including File ID.

errorMessage



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Download eReferral File (Provider & Payer) Web service method: DownloadReferralFile

Description: web-service used to download the new eReferral requests from the DHPO\eReferralHub.

Signature:

int DownloadReferralFile (

string Login,

string Pwd,

string clinicianLogin,

string clinicianPwd,

string fileId,

out int DownloadReferralFileResult,

out string fileName,

out base64Binary file,


Element Description

Login user login name to connect to the DHPO\eReferralHub




fileId id of the file to receive the downloading link for; this id is received from xml file returned by GetNewReferral web services

DownloadReferralFileResult Result of the DownloadReferralFileResult. Value Table provided in a separate section below.

filename XML file name that is being downloaded

File file content as byte array returned by the web server to the caller

errorMessage



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Lock eReferral (Provider) Web service method: LockeReferral

Description: web service used to get report that an eReferral transaction is locked for a given facility and clinician on the DHPO\eReferralHub.

Signature:

int LockeReferral (


string facilityPwd,




string memberID,

out int LockReferralResult,


Element Description







LockReferralResult Result of the LockReferralResult. Value Table provided in a separate section below.

errorMessage



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Release eReferral (Provider) Web service method: ReleaseReferral

Description: web service used to get report that an eReferral transaction is released for a given facility and clinician on the DHPO\eReferralHub.

Signature:

int ReleaseReferral (


string facilityPwd,




string memberID,

out int ReleaseReferralResult,


Element Description







ReleaseReferralResult Result of the ReleaseReferral. Value Table provided in a separate section below.

errorMessage



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Discharge eReferral (Provider) Web service method: dischargeReferral

Description: web service used to confirm the discharge of the patient for a given facility and clinician (Specialist) on the DHPO\eReferralHub.. The report will be accessible by the referring GP.

Signature:

int dischargeReferral (


string facilityPwd,




string memberID,

out int dischargeReferralResult,


Element Description





MemberID ID for a given member (member insurance card number).


dischargeReferralResult Result of the dischargeReferral. Value Table provided in a separate section below.

errorMessage



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Get New eReferral (Payer) Web service method: GetNewReferral

Description: web service used to get a list of new eReferral transactions available on the DHPO\eReferralHub. The service returns back a list of transactions that haven’t yet been flagged as downloaded.

Signature:

int GetNewReferral (

string PayerLogin,

string PayerPwd,

out int GetNewReferralResult,

out string xmlTransactions,


Element Description

Payerlogin user login name to connect to the DHPO\eReferralHub

PayerPwd user password to connect to the DHPO\eReferralHub

GetNewReferralResult Result of the GetNewReferral. Value Table provided in a separate section below.

xmlTransactions output parameter that contains xml with description of the eReferral files

errorMessage



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Search eReferral History (Provider & Payer) Web service method: SearchReferralHistory

Description: The web service performs advanced search for uploaded eReferral transactions.

Signature:

int SearchReferralHistory (


string facilityPwd,

int direction,

sting clinicianLicense,

sting memberID,


int transactionStatus,

string transactionFromDate,

string transactionToDate,

int minRecordCount,

int maxRecordCount,

out int SearchReferralHistoryResult,

out string foundTransactions,


Element Description Mandatory

facilityLogin user login name to connect to the DHPO\eReferralHub Yes

facilityPwd user password to connect to the DHPO\eReferralHub Yes

direction

flag to indicate if function will search for sent or received transactions; the parameter may have values 1 (sent only) or 2 (received only);

Yes

clinicianLicense

License of the clinician on the e-Prescription; if the parameter is NULL, it is not used as search criteria; otherwise the parameter value must be in the list of licenses your DHPO login is associated with. Restrictions:

If Null: consider all

Yes

memberID

ID of the patient on the e-Prescription Restrictions:

Provider\Pharmacy the field is mandatory

Provider\Clinician\Facility the field is optional

Payer the field is optional

If Null: consider all

No

eReferalReferenceNo Reference number generated for the eReferral by the DHPO\eReferralHub.

If Null: consider all No

transactionStatus

flag to indicate if function will search for new transactions or transactions already downloaded from the DHPO\eReferralHub; the parameter may have values 1 (new only) or 2 (already downloaded only);

Yes

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transactionFromDate

transaction date from which the e-claim files will be found; the parameter may not be in the future;

date must be provided as a string in a format 'dd/MM/yyyy HH:mm:ss';

if time is missed, the zero is used by default;

if the parameter is NULL, it is not used as search criteria

If Null: consider 3 months data up to current date

No

transactionToDate

transaction date until which the e-claim files will be found;

the parameter may not be in the future;

date must be provided as a string in a format 'dd/MM/yyyy HH:mm:ss';

if time is missed, the zero is used by default;

if the parameter is NULL, it is not used as search criteria

If Null: consider 3 months data up to current date

No

minRecordCount

minimum number of records in the transaction file to search for.

If the parameter is greater than zero, it must be less or equal to the value in the parameter maxRecordCount;

Restrictions:

if the parameter is -1, it is not used as search criteria

If Null: consider 1

minRecordCount has to be < maxRecordCount

No

maxRecordCount

maximum number of records in the transaction file to search for; if the parameter is greater than zero, it must be greater or equal to the value in the parameter minRecordCount; Restrictions:

if the parameter is -1, it is not used as search criteria

If Null: consider 50 latest records

maxRecordCount < 500

No

SearchReferralHistoryResult Result of the SearchReferralHistory. Value Table provided in a separate section below.

foundTransactions

output parameter that contains xml with description of the found eReferral files;

note that this web service will return maximum 500 records

errorMessage

output parameter that contains eventual error message if something goes wrong;

web service can also send warnings using this parameter; the parameter may be null or empty string if the web service returns zero, otherwise the error message is expected.


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Set eReferral as Downloaded (Payer) Web service method: SetReferralDownloaded

Description: web service is used to report the eReferral file as downloaded. User is supposed to call this we service to avoid receiving the same eReferral file using GetNewReferral web service.

Signature:

int SetReferralDownloaded (

string PayerLogin,

string PayerPwd,

string fileId,

out int SetReferralDownloadedResult,


Element Description

PayerLogin user login name to connect to the DHPO\eReferralHub

PayeryPwd user password to connect to the DHPO\eReferralHub

fileId id of the file to receive the downloading link for; this id is received from xml file returned by GetNewReferral web services

SetReferralDownloadedResult Result of the SetReferralDownloaded. Value Table provided in a separate section below.

errorMessage



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Web Services Returned Values All DHPO\eReferralHub web services share the return value, so that client application can implement one handler to process the result of web service execution and share it with all web service calls. The supported returned values are shown below:

Element Description


3 Member has no approved trade drugs, hence Prescription transaction is not returned.

2 No new prior authorization transactions are available for download.

1 E-claim transaction validation succeeded with warnings.

0 Operation is successful.

-1 Login failed for the user.

-2 E-claim transaction validation is failed with errors.

-3 Required input parameter for the web service is empty, or null, or contains invalid value.

-4 Unexpected error occurred.

-5 If difference between date from and date to parameters is longer than 100 days.

-6 The specified file is not found.

-7 Transaction is not supported.

-10 If no search criteria is found.

eReferral Web Services Address \ WSDL eReferral web services are available on this Address:

https://www.eclaimlink.ae/DHPO/eReferralTransactions.asmx

Web Services WSDL eReferral web services WSDL are available on this Address:

https://www.eclaimlink.ae/DHPO/eReferralTransactions.asmx?wsdl

https://www.eclaimlink.ae/DHPO/eReferralTransactions.asmx

https://www.eclaimlink.ae/DHPO/eReferralTransactions.asmx?wsdl

e-referral initiative · 2014-11-10 · referral. the initiative will facilitate better control on...

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