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
Alignment with Canadian Standards
PCS Release Management
PCS Support
Phase 1 - MVP Scope - Fields & Functionality
Phase 1 Overview - MVP
01-Claim Request - Medication - New and Updated Fields
02 - Claim Request - Professional Services - New Transaction
11 - Reversal Request
61 - Reversal Response
51 & 52 -Claim Responses - New and Updated Fields
30 & 31 - Daily Totals & Adjudication Details
80 - Daily Totals Response Details
81 - Adjudication Details Response
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
CPHA3 - FHIR Field Level Mappings
Claim Request & Reversal Messages
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
FHIR: Claim and Reversal 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
FHIR: GET Totals and Details 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 - Field Values
Overview and Maintenance
Alert Codes
Adjudication Category
Coverage 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 /Message ID FINAL
Gender RR Ready for REview
Healthcare Role
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?
Therapeutic Substitution Code
Unlisted Compound FINAL
Terminology Mappings CPHA-FHIR
System Identifiers
FHIR Home
Link FHIR Home Page
61 - Reversal Response
Under Construction
