Pharmacy Claim Standard - Canada
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Business Overview
PCS Overview
Current State
New Features & Functions High Level View
Quebec Legislative Requirements - Priority
COB - General Guidance
01-Claim Dispensed Med Request - New and Updated Fields
02 - Proff Services - New Transaction
51 & 52 -Claim Responses - New and Updated Fields
30 & 31 - Daily Totals & Adjudication Details
80 & 81 - Daily Totals Response Details
PCS MVP Implementation Scope
Alignment with Canadian Standards
PCS Release Management
PCS Support
Message Samples
01-Claim Request - Dispense
02-Professional Service Claim
11-Reversal Request
61-Reversal Response Accepted
51-Claim Response - Dispense
52-Professional Service Response
30-Daily Totals Request
80-Daily Totals Response
31-Adjudication Details Request
81-Adjudication Details Response
Under Construction - template
CPHA - FHIR Field Level Mappings
Claim Request & Reversal Messages - FHIR-CPHA
Response Messages FHIR-CPHA
Get Totals and Details Request FHIR-CPHA3
Daily Totals Response
Adjudication Details Response
Complex Mapping Rules FHIR-CPHA
Event Codes /CPHA Transaction Codes
Deprecated CPHA Fields & codes
FHIR Profiles & Extensions
Profile Summary
Claim and Reversal Messages & Profiles
Claims - Operations Overview
Claim Request - Dispensed Product
Claim Response - Dispense
Claim Response - Errors - TWG review
Claim Request - Professional Services
Claim Response - Professional Services
Claim Reversal
Claim Reversal Response
GET Totals and Details Messages & Profiles
Operation Overview
Daily Totals and Details Request
Totals and Details Responses
Technical Overview
Technical Overview, FHIR RESTful API
Operations Overview
API Definition & Example
Error Handling
Guaranteed Delivery & Key Message Identifiers
Key Identifiers
FHIR Tooling
Outstanding Technical Work
Digital Signature - Prior Claim Results
Capability Statements, Capability Tracking
Outstanding Implementation Work Items
Change Log
Terminology
Overview and Maintenance
Alert Codes
Adjudication Category
Claim Response Plan Type
Coverage Program Type
Claim Response Outcome Code
Pharmacist Assigning Authority - missing some
Daily Totals Response Status Anne DEPRECATE
Dispense Type - CPHA New/Refill Code FINAL
Dispense.status FINAL
Diagnosis System - FINAL
Dispense PharmaService Codes Final
Dispensed Quantity Unit Codes
Error Messages FINAL
DUR Codes
Event /Transaction Code FINAL
Gender RR Ready for REview
Intervention & Exception Codes
Intervention Result "U" codes Outcomes Table 4
Intervention "C" codes, Refusal to Fill Table 2 FEEDBACK
Intervention Codes - Code Systems
Identifier Type
Jurisdictional Healthcare Identifier Type
Message Version
Note Type
Note Language
New Refill Code - Final
National Pharmacy ID Code
Not Performed Reason HL7/Intervention C AS ABOVE
Level of Service Codes, SSC TWG Table 5 DISCUSS/DEPRECATE
Medication Code DIN / GP# / PIN FEEDBACK
Medication Dispense Type
Message Protocol/Assigning Authority TWG review
Payee Type Code - NEW FHIR
Program Type
Provider Software ID - Issued later
Professional Service Codes
Product Selection
Relationship Codes TWG
Response and Error Codes IMPL
Response Code - Code System Values
Response Status - Claim TWG when final
Special Service Codes Table 3
SubType Claim Response
Substitution Reason Code FINAL
SupportingInformationCategoryCodes
Software Vendors - Certified FHIR
Reversal Response Codes start here with LL
Reversal Response Status Redundant?
Unlisted Compound FINAL
Terminology Mappings CPHA-FHIR
System Identifiers
FHIR Home
Link FHIR Home Page
52-Professional Service Response
##Under Construction
