Community Care Access Centre (CCAC)
Provider Report Format Specification
Organization: / Ontario Association of Community Care Access Centres (OACCAC)Division: / Business Solutions
Version: / 4.0
Version Date: / February 3, 2014
Prepared By: / Arthur Bydon
Updated By: / Sacha Bye, Manuel Ng
Date: April 4, 20141
Community Care Access Centre (CCAC) / Version: 1.0Provider Report Format Specification / Version Date: August 26, 2010
Revision Log
Version No. / Version Date / Summary of Change / Changed by/Input from0.1 / May 10, 2007 / First draft / Arthur Bydon
0.2 / May 11, 2010 / Review and minor updates / Sacha Bye
0.3 / May 31, 2010 /
- Added examples of frequency usages
- Updated refusal reason and mandatory fields
- Changed response root name
Arthur Bydon
0.4 / June 9, 2010 / Updated Service Changes and Appendix A based on the feedback from service providers / Arthur Bydon
1.0 / July 15, 2010 /
- Added Cancellation and Disposition Reason Codes to be used instead of the text descriptions in the corresponding elements, based on the feedback from service providers
- Updated Type in Organization Source and Destination
August 26, 2010 /
- ProviderReport
- Replaced the ProviderAssignmentId with ServiceAssignmentId
- Changed length restriction on the Name field in Author
- ProviderReportResponse
- Added ServiceAssignmentId to the response
- Changed the ordering of fields ClientNumber, BillingReferenceNumber and ServiceAssignmentId to be consistent with Provider Report Request
- Changed length restriction on the Name field in Author
Mar. 19, 2013 /
- Added Cancel Reason Code
May 17, 2013 /
- Renamed “Case Manager” to “Care Coordinator” – no impact to code
TFS 48644
July 16, 2013 / TFS# 57455, published as v1.0
- Section 2.4 and 2.6: added ServiceDeliveryTypeCodeelement
Sept. 10, 2013 / TFS# 63818, published as v2.0
- Section 2.6: removed ServiceDeliveryTypeCode element from “CancelledVisit”
Sept. 25, 2013 / TFS# 64363, published as v3.0
- Section 2.2: added FirstVisitDate
- Section 2.2.1: added GoalStartDate and GoalUpdateDate
- Section 2.4: added ExternalSystemId
- Section 2.5: added ExternalSystemId
- Section 2.6: added ExternalSystemId
Feb. 3, 2014 / Section 2.2.1: increase the length limit on the following fields:
- Description
- ProgressUpdate
TFS# 160721
Table of Contents
1High Level Message Flow
1.1Overview
1.2High Level Message Flow
1.3Provider Report Response Status
2Provider Report Elements (version 1.0)
2.1Sender and Destination
2.1.1Owner Organization
2.2Document
2.2.1Goals
2.3Service Changes
2.4NewFrequency
2.5Changed Frequency
2.6Cancelled Visit
2.7Provider Discharge
3Provider Report Response Elements (version 1.0)
3.1Document
3.2Status
3.2.1Status - Refused
4Appendix A – New Frequencies
4.1Frequency Type Examples — Once Only
4.2Frequency Type Examples — Daily
4.3Frequency Type Examples — Weekly
4.4Frequency Type Examples — Monthly
4.5Frequency Type Examples — Block
5Appendix B
5.1Cancel Reason Codes
5.2Discharge Disposition Codes
1High Level Message Flow
This document defines the types of messages that will be exchanged between the Providers and CCACs to facilitate service updates, specifically the“Provider Report” and “Provider Report Response”.
1.1Overview
A provider report is an update on the client’s condition and/or a request to change client frequencies. Provider reports may be submitted for any service a provider is giving care. Providers and CCACs will determine the service areas a report may be submitted. Providers will have the ability to request the following service plan changes through the provider reports:
- Client Needs and Service Plan Update
- Update Provider End Date
- Update and Create new Frequencies
- Cancel Visits
- Discharge Provider
Provider Reports will be stored in a queue in the CCAC system, where they will remain until a Care Coordinator completes the review process. Once a request has been reviewed, the system will update the approved request permanently and will notify the provider of the updates through the ServiceFrequencyUpdate message.
A Provider Report Response is a message sent from CCAC to the provider that contains an update on the processing status of the report. The notification will be sent out when a significant event occurs, such as at the beginning and the ending of the report review.
1.2High Level Message Flow
Provider Report will initiate the message exchange between the provider and the CCAC system.
The initial request will be received synchronously into the CCAC system and in response the Provider Report Response will be returned. At this point, the CCAC may returned the Received or Refused status. Refused status will only be returned when the message fails a rudimentary validation such as when invalid XML message, invalid client number or provider assignment identifier is submitted. The Provider Report Response will also be available in the HPG message box.
Once the message is received, the CCAC system will queue it up and it will await a review from the CCAC staff. When the review process begins, the CCAC system will post a Provider Report Response message to the provider HPG message box with the status set to “InProgress”. When the review process completes, the system will post another Provider Report Response with the status set to “Reviewed”.
Finally, a Service Frequency Update message will be generated in the CCAC system and made available in the message box if the initial request contains at least one frequency update.
1.3Provider Report Response Status
The following diagram presents the possible state transistion pertaining to the submitted report and sent to a providerin theProvider Report Response.
CCAC system will generate up to threeProvider Report Response messages in response to the events in the CCAC system.
a)The CCAC system receives the Provider Report – the event will occur when CCAC system receives the report through the external PostMessage web service interface. The event can generate two possible outcomes; 1) the message passess initial validation and is accepted into CCAC system and 2) the message does not pass validation and is refused. The outcome will sent via Provider Report Response with the corresponding statein the body of the message.
b)The CCAC staff opens the Provider Report – the event will occur when Care Coordinator begins the review of the report. The Provider Report Response message will contain the status InProgress
c)The CCAC staff ends the review – the event will occur when Care Coordinator reviews and confirms that changes submitted in the report can be applied to the CCAC system. The event will generate the Provider Report Response with the status of Reviewed and subsequently the Service Frequency Update message containing all the successfully authorized frequencies. When reviewing the report, the CCAC staff may accept or deny some frequency updates. The review outcome does not affect the status of the report. Even if some frequencies changes are denied the report status will still be set toReviewed.
The provider system is expected to determine if the submitted frequency changes have been accepted into CCAC system. The Refused status generated at event a) willbe in response to the malformed message or a message failing rudimentary validation and not as a result of CCAC staff denying the requested service changes.
2Provider ReportElements
The following is a top level (root) view of the Provider Report and its main components.
Name / Field Length (bytes) / Type / Mandatory? / DescriptionVersion (Attribute of ProviderReportRequestelement) / 10 / Num / Yes / The version of the schema that this message adheres to. E.g. "1.0". This is required to correctly interpret the information being provided by the Provider or CCAC
MessageTrackingId / 36 / Alpha / Num (GUID) / Yes / The unique identifier of the message that can be used for tracking. Although resubmitting failed messages with the same tracking ID is possible, it is recommended that each submission contains a unique tracking ID.
Sender / - / Complex / Yes / See Sender and Destination section.
Destination / - / Complex / Yes / See Sender and Destinationsection
ClientNumber / 15 / Alpha / Num / Yes / An identifier that uniquely identifies this client to the CCAC
BillingReferenceNumber / 12 / Num / Yes / A code that identifies this Referral and quoted by the provider in their Billing Invoice
ServiceAssignmentId / 25 / Alpha / Num (GUID) / Yes / A CCAC assigned number that uniquely identifies service assignment for the referral. This number can be retrieved from the ServiceReferral and ServiceFrequencyUpdate messages
Document / - / Complex / Yes / See Document section
ServiceChanges / - / Complex / Yes / Element containing all the changes in the report. See Service Changes section.
2.1Sender and Destination
Name / Field Length (bytes) / Type / Mandatory? / DescriptionOrganization (child element of Sender or Destination) / - / Complex / Yes / Identifies the organization sending or receiving the document
Code (attribute of Organization) / 50 / Alpha / Num / Yes / Specifies the unique code of the sender or the recipient organization
Type (attribute of Organization) / 150 / Alpha / Num / No / Specifies the type of the sender organization. Valid content is:
“CCAC” “Provider” “Vendor”. Defaults to CCAC if not specified.
Name (child of Organization) / 250 / Alpha / No / The name of the sender or the recipient organization
2.1.1Owner Organization
Name / Field Length (bytes) / Type / Mandatory? / DescriptionOwnerOrganization (child of Organization) / - / Complex / Yes / Specifies the owner organization of the sender or the recipient
Code (attribute of OwnerOrganization) / 50 / Alpha / Num / Yes / Specifies the unique code of the sender or the recipient owner organization
Type (attribute of OwnerOrganization) / 150 / Alpha / Num / No / Specifies the type of the sender or the recipient owner organization. Valid content is “CCAC”, “Provider” or “Vendor”. If not provided the “CCAC” type is assumed.
Name (child element of OwnerOrganization) / 250 / Alpha / No / The name of the sender or the recipient owner organization
2.2Document
Name / Field Length (chars) / Type / Mandatory? / DescriptionId / 50 / Alpha / Num / Yes / A unique identifier of this report as specified in the provider system.
Type / 16 / Alpha / Yes / One of Initial, Interim, Change of Status, Discharge
Urgency / 10 / Aplha / Yes / One of Urgent, Not Urgent
Author / - / Complex element / Yes / The Author of the report
Name / 50 / Alpha / Num / Yes / This is the provider’s staff name
Designation / 50 / Alpha / Num / Yes / This is the provider’s staff designation
DateOfReport / 10 / Date / Yes / The date of the report
ReportName / 50 / Alpha / Num / Yes / A descriptive name of the report
Goals / - / Complex element / No / A list of service goals that the provider system maintains.
See Goals section.
AdditionalInfo / 5000 / Alpha / Num / No / Additional information to be sent with the report
ServicePlan / Unlimited / Alpha / Num / No / Description of Service Plan
FirstVisitDate / Date / No / Provider’s first visit date
2.2.1Goals
Name / Field Length (bytes) / Type / Mandatory? / DescriptionGoal / - / Complex element / Yes / A goal identifies the treatment or service objective that will be reported to CCAC.
Number (attribute of Goal) / 10 / Num / Yes / A numeric value identifying the goal.
IsNew / 5 / Boolean / Yes / A flag identifying if the reported goal is new or it has been previously reported.
Description / 250 / Alpha / Num / Yes / The goal description
ProgressUpdate / 500 / Alpha / Num / Yes / The Progress towards the Goal
Status / 15 / Alpha / Num / Yes / Each goal must have a status of either In Progress or Complete
GoalStartDate / Date / No / The goal’s start date
GoalUpdateDate / Date / No / The goal’s update date
2.3Service Changes
Name / Field Length (bytes) / Type / Mandatory? / DescriptionProviderEndDate / 10 / Date / No / Specifies the end date of the provider service.
CancelledVisit / - / Complex / No / See Cancelled Visit section.
ChangedFrequency / - / Complex / No / See Changed Frequency section.
NewFrequency / - / Complex / No / See NewFrequency section
ProviderDischarge / - / Complex / No / SeeProvider Dischargesection.
CommunicationOnly / 5 / Boolean / No / If present, indicates if the report is for communication only purpose (true,1). If this element is present, no other child element can be present.
2.4NewFrequency
Name / Field Length (bytes) / Type / Mandatory? / DescriptionType / 10 / Alpha / Num / Yes / One of OneTime, Daily, Weekly, Monthly, Block
UnitOfService / 6 / Alpha / Yes / Code assigned by CCAC for the units in which the service is to be delivered (e.g., Hours, Visits);
QuantityOfService / 6 / Num(6,2) / No / Number of hours or visits authorized. When UnitOfService is set to “Hours” this field can contain a fraction of the hour. E.g 0.25=15 min, 0.5=30 min, etc. Only increments of 0.25 are allowed.
PreferredTime / 20 / Alpha / No / Time of day that visit is preferred by the client
StartDate / 10 / Date / No / The date (yyyy-mm-dd) when this Frequency starts
EndDate / 10 / Date / No / The expected date (yyyy-mm-dd) when this Frequency ends
ReccurenceTimes / 4 / Num / No / Weekly frequency (e.g.Two visits per day = 2)
Interval / 4 / Num / No / No. of repeats (e.g. Every two days = 2)
NumberOfHoursPerVisit / 6 / Num(6,2) / No / Number of hours per visit. The optional decimal portion specifies the fraction of the hour, e.g. 0.25=15 min, 0.5=30 min, etc.
Weekday1 / 4 / Num / No / Number of visits on Monday.
Weekday2 / 4 / Num / No / Number of visits on Tuesday.
Weekday3 / 4 / Num / No / Number of visits on Wednesday.
Weekday4 / 4 / Num / No / Number of visits on Thursday.
Weekday5 / 4 / Num / No / Number of visits on Friday.
Weekday6 / 4 / Num / No / Number of visits on Saturday.
Weekday7 / 4 / Num / No / Number of visits on Sunday.
AdditionalDetails / 250 / Alpha / Num / No / Any details not captured by the above fields in this frequency
ServiceDeliveryTypeCode / 20 / Alpha / No / Code of Service Delivery Type
ExternalSystemId / 50 / Alpha / Num / No / The unique identifier of the frequency supplied by the external system.
2.5ChangedFrequency
Name / Field Length (bytes) / Type / Mandatory? / DescriptionFrequencyId / 36 / Alpha / Num
(GUID) / Yes / The unique identifier of the frequency. The field must match one of the existing frequency identifier used in CCAC system. The value will be initially provided in the Service Referral message.
RequestedEndDate / 10 / Date / Yes / The new requested end date of the frequency
ExternalSystemId (Attribute) / 50 / Alpha / Num / No / The unique identifier of the frequency supplied by the external system.
2.6CancelledVisit
Name / Field Length (bytes) / Type / Mandatory? / DescriptionFrequencyId / 36 / Alpha / Num
(GUID) / Yes / The unique identifier of the frequency. This identifier must be provided and it must match the frequency element sent in the ServiceReferral message.
VisitDate / 10 / Date / Yes / The date of the visit that should be cancelled
NumberOfHoursPerVisit / 6 / Num(6,2) / No / Number of hours per visit. The optional decimal portion specifies the fraction of the hour, e.g. 0.25=15 min, 0.5=30 min, etc.
CancelReason / 30 / Alpha / Yes / The cancel reason code as provided in the Appendix B, Cancel Reason Codes table.
ProviderComments / 250 / Alpha / Num / No / Additional provider comments pertaining to visit cancellation
ExternalSystemId (Attribute) / 50 / Alpha / Num / No / The unique identifier of the frequency supplied by the external system.
2.7Provider Discharge
Name / Field Length (bytes) / Type / Mandatory? / DescriptionFinalReport (attribute of ProviderDischarge) / 8 / Alpha / Yes / Final Report flag identifies if the report is included in the message. The valie can be one of Included or Pending
EffectiveDate / 10 / Date / Yes / Effective date of discharge.
Disposition / 30 / Alpha / Num / Yes / Depending on the referral type the value of this field should contain the appropriate code listed in Appendix B in Discharge Disposition Codes table.
DischargeReportDueDate / 10 / Date / No / Report due date that is mandatory if the final report flag is setto Pending, otherwise the value will be ignored.
3Provider Report Response Elements
Name / Field Length (bytes) / Type / Mandatory? / DescriptionVersion (Attribute of ProviderReportResponse element) / Max 10 / Num / Yes / The version of the schema that this message adheres to. E.g. "1.0". This is required to correctly interpret the information being provided by the Provider or CCAC
MessageTrackingId / 36 / Alpha / Num (GUID) / Yes / The unique identifier of the message that can be used for tracking
Sender / - / Complex / Yes / See Sender and Destination section
Destination / - / Complex / Yes / See Sender and Destination section
ClientNumber / 15 / Alpha / Num / Yes / An identifier that uniquely identifies this client to the CCAC
BillingReferenceNumber / 12 / Num / Yes / A code that identifies this Referral and quoted by the provider in their Billing Invoice
ServiceAssignmentId / 25 / Alpha / Num (GUID) / Yes / A CCAC assigned number that uniquely identifies service assignment for the referral. This number can be retrieved from the ServiceReferral and ServiceFrequencyUpdate messages
Document / - / Complex / Yes / See Document section
Status / - / Complex / Yes / See Status section
3.1Document
Name / Field Length (chars) / Type / Mandatory? / DescriptionId / 50 / Aplpha/Num / Yes / A unique identifier of this report. This maybe GUID or other type of identifier.
Type / 16 / Alpha / Yes / One of Initial, Interim, Change of Status, Discharge
Urgency / 10 / Aplha / Yes / One of Urgent, Not Urgent
Author / - / Complex / Yes
Name / 50 / Alpha / Num / Yes / This is the provider’s staff name
Designation / 50 / Alpha / Num / Yes / This is the provider’s staff designation
DateOfReport / 10 / Date / Yes / The date of the report
ReportName / 50 / Alpha / Num / Yes / A descriptive name of the report
3.2Status
Name / Field Length (chars) / Type / Mandatory? / DescriptionStatus / - / Complex element / Yes / The status of the report. The field requires that the sender must select one of the children elements. If Received, InProgress or Reviewed is selected, the value will always be true. If Refused is selected at least one or more reasons must be provided to indicate the cause of the refusal.
Received / 5 / Boolean / No / If present, it indicates that the request message has been received without any errors and it is queued up for processing.
InProgress / 5 / Boolean / No / If present, it indicates that the request message and its corresponding report is under review.
Reviewed / 5 / Boolean / No / If present, it indicates that the request message and its content have been accepted and if the message contained frequency changes, the Service Frequency Report will be produced.
Refused / - / Complex Element / No / If present, it indicates the refusal of the report and any frequency updates. See Status - Refused section
3.2.1Status - Refused
Name / Field Length (chars) / Type / Mandatory? / DescriptionReason / - / Complex / Yes / The refusal reason, this maybe either technical or business reason
Code / 100 / Alpha / Num / No / The code indicating the refusal reason.
Description / Unlimited / Alpha / Num / Yes / The detailed description of the refusal reason.
AdditionalInfo / Unlimited / Alpha / Num / No / Any additional information that maybe helpful in identifying the reason for refusal
4Appendix A – New Frequencies
The following are examples of frequency configuration that can be submitted to the CCAC system. Each paragraph begins with a list of element that is mandatory for the specified frequency type.