Change Log

Trial Use, Version **** Target Q4 2025

The following changes have been made to the DRAFT version of PCS, and will be reflected in the forthcoming Trial Use PCS Version

Date Change Description Notes
Nov 2024 Added a change Log
Nov 2024 Added a page for PCS Implementation Roadmap
Nov 2024 Added section for Outstanding Implementation Work
Nov 2024 Added new page for Legislative Changes - Priority
Nov 2024 Updated mappings, SSC was not in dispense msg and is now
Nov 2024 Update refills remaining - clearly state it supports up to 3
Nov 2024 Update Quebec Proff Fee Info Definition - in profile to be reviewed with AQPP before profiles are moved to simplifier
Nov 2024 Quebec - changes made to profiles, field names must be confirmed, and definitions/usage notes, etc - review with AQPP before moving profiles into simplifier
Dec 7 New page for Capability Statements
Dec 18 Implementation Product Roadmap document for Review
Jan 3 Added a section on current state
Jan 3 Insert link to HL7 operation to submit claims, Operations Overview
Jan 3 Added HL7 link to Trial Use Standard, Release Management Overview
Jan 3 Added page for Claims, Operations Overview
Jan 3 Added Claim Request over 10k - Proposal - To be reviewed by implementation commit - also added to Outstanding Work Items
Jan 3 Clarifications on Reversal and Reversal Response. Added outstanding work item to create FHIR profiles and new work item to update event codes once profiles are created
Jan 3 Created new Operation for Claim Reversal; updated Operation Overview sections of the doc in Technical section and Claim Reversal section of the guide
Jan 3 Moved deprecated transactions for adjudication details to CPHA mapping se
Jan 3 Added page for support
Jan 26 Updated active device ID mapping CPHA FHIR Field Mappings page
Jan 26 Updated current state - target date - still TBD
Jan 26 Updated mapping current RX number to Dispense.identifier CPHA Mappings page
Jan 26 Update and replace Med Profile to remove Current & original RX; change to PrescribeITRX ID
Jan 26 Updated mapping on Cardholder Identity to be Coverage.subscriber.display
Jan 26 updated mapping on Provincial Health Care ID Code to both Patient.identifier with JursidictionalHealthNumber. value AND Coverage.subscriber.identifier
Jan 26 Vaidated section A B and C and D of CPHA claim mappings Dispense message only
Jan26 Added a few outstanding items for review by implementation committee
Jan 26 Added claim.related to the Mapping section - New fields for proff services
Jan 26 Confirm what to do with refusal to fill. Proff services? field mapping?
Jan 26 Updated MedicationDispense Profile and mappings to remove current rX (claim.identifier) and original rx - they are accurate but there is no point in duplicating within the message
Feb 2 Updates to CPHA mapping on Daily Totals
Feb 2 Clariications on Operation Definitons for Daily Totals & Adjudication Details including link updates
Feb 3 Define Parameters OUT - underway - https://simplifier.net/editguide/pharmacy-claims-standard/editor?filepath=Home/CPHA-FHIR-Field-Level-Mappings/Adjudication-Details-Response.page.md
Feb 23 Added scnearios table to Quebec section
Mar 15 Added a new folder and page to summarize all profile and extension links
Mar 15 Removed extensions that are not currently used (trace number, language indicator) as they are not required
Mar 15 Updated profile links that were not working, reported via email
Mar 15 Added extension links in the Dispense Request overview page
Mar 15 Terminology pages - removed links for value sets and code systems. Code systems are all in the overview page; value sets are not required
Mar 15 Banner identifier extension not required; may use sender id
Mar 15 No extension required to point to Dispense; using supporting information
Mar 27 Message example - complete, based on compounds
April 11 Continuing work message example, Dispense request
April 13 Updated claim request message mappings; validated against message sample
April 26 Completed dispense message sample; validated all mappings in the request; added some technical updates as a result of validation
May 6 FHIR Profile Summary added
May 16 Added a placeholder for FHIR PCS Software vendors
May 16 Updated Prescription profile remove medication reference; it is a mandatory code; reference is not required twice in the message
May 16 Update Claim profile removed facility from scope; not in the message sample and only an identifier is required
May 16 Update profile Claim.provider.identifier Now in scope; maps to B.21.03 Pharmacy ID Code. Reference s optional and identifier is mandatory for dispense and proff profil
May 16 Update Coverage profile Dependent now in scope, maps to C.33.01 - Patient code. Note this is a code in CPHA that maps to string
May 19 Message Header Request Profile Response details are out of scope, 0..0
May 19 Message Header Response Profile Mandatory response details, 1..1
May 19 Prior Coverage Added usage note regarding a display value of "not permitted" when it is inappropriate to share the identity of the prior insurer"
May 19 Prior Coverage Profile Expanded coverage type to allow for multiple codes which may be useful for specifying the type of coverage used in adjudication.
May 19 Message Request Profile added target profile for totals and adjudication results
May 19 Claim Proff Services Profile Moved prescription out of scope 0..0 to create clear differentiation in this profile and dispense, to ensure accurate validation of the message instances against the correct profile
May 19 Created package-preview 1.0.1-review
May 19 Message Header request profile update removed target references on destination.receiver to fix validation error; only identifier is supported
May 19 Message header request profile update removed target reference on MH.responsible
May 19 Message header request profile update removed target reference on MH.sender to fix validation error on request message
May 19 Claim Dispense profile removed reference to claim resource on profile as we only use identifiers
May 19 Claim Professional services profile removed reference to claim resource on profile as we only use identifiers
May 19 Claim Dispense profile removed reference to original prescription on profile as we only use identifiers
May 19 Claim Dispense profile removed reference to performer.actor on profile as we only use identifier
May 19 Coverage Profile update removed references on subscriber as we only use identifier, to fix validator issue with request
May 19 Coverage Profile update removed references on payor as we only use identifier, to fix validator issue with request
May 19 Coverage Profile update removed references on contract as we only use identifier, to fix validator issue with request
May 19 Claim profile - update claim.type to set fixed values for system and code and remove support for text.
May 19 Prior Claim Response.type update profile to use a system and code instead of text
May 19 Prior Claim REsponse.request removed reference to claim as we are only using the identifiers
May 19 Prior Claim REsponse.request removed reference to insurer as we are only using the identifiers
May 19 Prior Claim REsponse.subtype mandatory fixed value for text = prior
May 19 Status Dispense request validated with legacy validator in Simplifier; 15 errors still to resolve using new validator & package
June 2 Resolved all errors in sample,validated using legacy validator; uploaded Dispense Claim Request in JSON
June 13 Updated Message Response, Dispense Profile; when creating Claim Response sample creation; found some minor issues that are corrected
June 13 Validated response bundle and mh bundle
June 13 Creating Claim Response Dispense Instance
June 13 Moved claims over 10K separate message from outstanding to resolved Outstanding Implementation Work Items page
June 13 Added JHN to the terminology section
June 13 Added Claim.subType to terminology section
June 13 Created new section for System Identifiers in this specification
June 21 Updated Page, New functionality under Business section
June 21 Claim response profile; updated order on items, to have response codes be last
June 21 Claim Response profile, updated SA category codes to include "SA" in the code so it is clearer
June 21 Claim response profile, updated to include support for insurance
June 21 Added mandatory meta.profile to Prior Claim Response profile; and made it 0..0/forbidden in the claim response profile to differentiate
June 28 Message response, claim response profile, updated to move from E.16.03 to a value of "deductible" in the category.code
June 28 Coverage Program Type extension added to the Prior Claim Response profile.
June 28 Terminology for Program Type - added page and description
June 28 Added usage rule for inclusion of prior claim results
July 2 Updates to claim response & mappings to align with the message examples and profiles
July 11 Updates to claim response & profile updates as per my notes on required changes
July 14 Updated professional services claim request page
July 28 Removed Dispense quantity remaining from Request Sample message; however, this will not render further work to be done
July 28 Updated Claim Request Dispense profile, after removing dispense quantity remaining from the profile
July 28 Updated Outstanding Implementation work items page
July 28 Updated MVP log file for next meeting; added a few items for discussion next meeting
Aug 2 Updated Claim Response profile to add usage note and pull Coverage.type into support. Used to specify "plan type" in the adjudicaiton response
Aug 2 Continued work on Claim response sample; it is validated in xml using Simplifier
Aug 2 Uploaded claim response sample; it only rendered the table view **Further work to be done
Aug 7 email to Simplifer re the validation, where reference expects a reference value, and will not allow an identifier only TBD - awaiting response
Aug 8 Updated response to remove patient and org resources; retain references only
Aug 8 Updated event id's in terminology
Aug 8 Updated mappings for reversal request; use MH.Responsible to identify pharmacy in reversal request
Aug 8 Updated MH Request profile to bring Responsible into scope; added usage notes and fixed value for MH.Responsible.identifier.system
Aug 8 Created message instance for reversal request
Aug 8 Updated System identifier overview
Aug 8 Updated MH.Tag to include usage notes re the tag for message version
Aug 8 Removed "bundled" indicator on MH.Responsible as we do want to mandate use an org resource, eg in the claim reversal
Aug 9 Created, validated and updated Claim Reversal Sample message
Aug 9 Created, validated and updated Claim Reversal Response Successful message
Aug 17 Totals message - draft
Sept 1 Updated terminology wording based on Aug meeting notes
Sept 8 Removed diagrams - they were draft and out of date as the spec progressed
Oct 23 updated reference to original verison; confirmed not in scope for MVP; may be supported at a later time
Oct 25 Support for Program type has been removed. COB group determined this is not required. The extension has been amended to be "additional Coverage type" which allows more than one coverage type to be submitted. Note subType is limited to one code.
Oct 25 Updated prior details Profile and also the Coverage Extension profile. This has been added to the Claims Response -Dispense page
Oct 26 Updated Totals and Details section of the document to streamline content and to add more specific information about the variances between CPHA and FHIR
Oct 26 Response code page - added details regarding the systems
Oct 27 Key Identifiers - updated content on this page
Oct 27 Event codes - clarified deprecated transactions - added content to this page
Oct 28 Added note to New Detailed Functionality page re the extension of all cost fields; added Special Service Fee as an example.
Nov 5 Bundle profile update - added support for link which could be used in paging. New profile uploaded
Nov 5 Updated profile for DailyTotalsDetails IN - to remove "group" from the criteria being submitted. After impl group met in October - reviewed and agreed this functionality is not required. New profile uploaded
Nov 5 Updated profile for TotalParametersOUT based on the review from the October Implementation group. New profile uploaded
Nov 5 Began work on expanding Business Overview in prep for next Implmentation meeeting; added section for Claim Request and moved Business Overview section
Nov 8 Created sample message for Daily Totals response to match updated profile. Uploaded to IG after passing validation. One issue with validation (error 1012) which is apparently a known simplifier issue. (Issue=Invariant : Instance failed constraint inv-1 "A parameter must have one and only one of (value, resource, part)". The sample uploaded so I suspect there is no issue with this sample.
Nov 8 Did some profile updates on Adjudication Details response - still a few questions so did not upload to Simplifer. Did not yet update sample response. Nov 26 review required in order to complete
Nov 9 Added page for Daily Totals & Adjudication Details in Business OverviewNov 26 review required in order to complete
Nov 9 Created and uploaded a Daily Total Request sample
Nov 10 Updated Daily Total IN to remove group parameter/part Uploaded new profile for Daily Total Request
Nov 10 removed Program type extension from Claim Response profile and Claim Proff response profile as Implementers determined this is not required; only coverage type is needed
Nov 10 Response profiles - disposition is now mandatory
Nov 10 Response profile - updated special quantity remaining to support text as well as a decimal, where further explanation is required
Nov 11 Updated Adjudication details profile - technical correction
Nov 11 Uploaded to Simplifier
Nov 11 Created Adjudication details sample
Nov 11 After successful validation, uploaded to Simplifer
Nov 23 Updated business definitions
Nov 23 Continued udpate of business section after feedback from implementers. Now displayed by profile and included links to profiles
Nov 30 Updated Quebec defintions in Claim Dispense profile
Nov 30 Updated Claims dispense profile to Simplifier
Nov 30 Created Provenace resource
Nov 30 added page on disgital signature to technical section
Nov 30 Uploaded Provenance resource
Nov 30 Prior Claim Response - changed identifier to 0..0 for a clear distinction between profiles for the validator
Nov 30 Updated to MedicationRequest profile - Removed SIG from Prescription as we are conveying the SIG as created by the Dispensing system, not the Prescribing system
Nov 30 Uploaded MedREquest profile to Simplifier