FUNCTIONAL SPECIFICATION

DESIGN

Enterprise Information Management

Reporting & Analytics
Report/Application Name: Patient Revenue - by Medicare Line and
Accommodation Type by Medicare Reporting Company
Report/Application Number: RFN01769
Project Name: IBI Focus Replacement

This document has been prepared solely for Mayo Clinic’s internal use.
The information it contains is proprietary and remains the property of:
Mayo Clinic
200 First Street SW
Rochester, MN 55905
 FUNCTIONAL SPECIFICATION DESIGN

Document History:

Version Date Author Comments

1.0 3/23/09 Kyle Werner Created spec

1.1 4/7/2009 Kyle Werner Revisions

1.2 6/30/10 Linda Helder Revisions

Document Reviewers:

Name Review Attention

Tami Tripp

Teresa Beard

Matthew Goss

Information Only:

Name Role

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TABLE OF CONTENTS

1. INTRODUCTION................................................................................................................................ 4

1.1. Brief Description .............................................................................................................................. 4

1.2. Purpose and Business Need........................................................................................................... 4

1.3. Detailed Report Functionality ......................................................................................................... 4

1.4. Assumptions..................................................................................................................................... 4

1.5. Primary Contacts.............................................................................................................................. 4

2. REPORT/APPLICATION OVERVIEW .............................................................................................. 6

2.1. Report/Application Summary.......................................................................................................... 6

2.2. Report/Application Content and Layout ....................................................................................... 7

2.3. Report Conditions ............................................................................................................................ 6

2.4. Report Parameters-User Prompts: ................................................................................................. 9

2.5. Notes ................................................................................................................................................. 9

3. REPORT STANDARDS................................................................................................................... 10

3.1. Security Requirements .................................................................................................................. 10

3.2. Scheduling Requirements............................................................................................................. 10

4. TEST CASE SCENARIOS............................................................................................................... 11

5. REPORT EXAMPLES...................................................................................................................... 11

6. FUNCTIONAL SPEC SIGN-OFF..................................................................................................... 12

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1. INTRODUCTION:
This document provides the Design Specification of the following report to be developed as part of IBI
Focus Replacement initiative. This document contains as much information as is possible to gather
before development starts.
The report detailed in this document is:
• Medicare Patient Revenue by Line Number and Account by Medicare Reporting
Company (formerly named MD85R/03)

1.1. Brief Description:

The report is used for the identification of specific revenue such as that earned for medically
justified private days and surgical procedures. It is grouped by the Medicare Reporting Company
and listed by Accounts.
This shows the RRIS balances by Medicare Reporting Company, then by Medicare Line Number
and then by Account. The report also includes the RB tran type (year end Medicare Allocations –
2006 only) based on Medicare Reporting Company.

1.2. Purpose and Business Need:

The report is used for the identification of specific revenue such as that earned for medically
justified private days and surgical procedures. This report is used by the Mayo Clinic Medicare
Strategy Unit to assist with yearly reports that are provided to the government. It is a regulatory
report.

1.3. Detailed Report Functionality:

This report will list the revenue by an inpatient and outpatient breakout. This is a report used for
regulatory purposes which provides gross revenue. This report needs to be able to use a Point In
Time Data Mart.

1.4. Assumptions:

This report will be used for year-end reporting but will be run on a monthly/YTD basis.

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1.5. Primary Contacts:

Role Name Phone

Number

Business Owner (signs-off) Tami Tripp 6-4850

R & A Business Partner Lead Janet Rosedahl 4-1932

Subject Matter Expert (SME) Tami Tripp 6-4850

Functional Support Analyst Janet Rosedahl 4-1932

R&A Data Management Anne Marcou Eric Adjei Kyle 4-3278 4-4975
Specialist Kroening 8-4728

Report Developer Jim Richards 6-1180

IT Lead(s)

Others

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2. REPORT/APPLICATION OVERVIEW:

2.1. Report/Application Summary:

Report Title Patient Revenue by Line Number and by Account by

Medicare Reporting Company

Report Reference RFN01769

Category Name

Report Type Medicare

Report Audience (# of Medicare Strategy Unit

users, intended audience)

Report Frequency Scheduled Monthly (after month-end close); the

report will always be run on a YTD basis

Retention

Report Format Landscape

Report File Name

Semantic Layer

Marts Total Volumes

Facts Total Volumes

Dimensions Accommodation Type, Patient Admission Status,

GLS

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2.2. Report/Application Content and Layout:

Format: Landscape

Data Groupings / Formulas:

Report needs to be run by Medicare Reporting Company

Order By:

Disclaimer: Confidential

Title Page:

Report Content:

Column Business Name Description

Heading

Medicare Line GLS_MDT.MCARE Display the Medicare Line.

_LINE
Number

Medicare Line GLS_MDT.MCARE Display the Medicare Line Description.

_LINE_DESC
Description

Accommodation ACMDN_TYP_MD Display the Accommodation Type.

T.ACMDN_TYP_C
Type D

Accommodation ACMDN_TYP_MD Display the Accommodation Type Description.

T.ACMDN_TYP_D
Type ESC
Description

Inpatient TOT_VOL_MMT. See Report Conditions

GRS_REV_AMT

Outpatient TOT_VOL_MMT. See Report Conditions.

GRS_REV_AMT

Total Total of Inpatient + Outpatient

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2.3 Report Conditions:

Where RRIS Class = 1, where Medicare Reporting Company: RMH, SMH, SMG, SLH or SCOTS is
equal to the Medicare Site Group and where the following conditions are met to determine Inpatient
and Outpatient:
INPATIENT:
(GLS) (PT_ADM_STAT) (PT_ADM_STAT)
Medicare Rpt Co. Mcare_Site_Grp Mcare_Adm_Grp
RMH RMH INPT
SMH SMH INPT
SMG SMG INPT
SLH SLH INPT
SCOT SCOT INPT

OUTPATIENT:
(GLS) (PT_ADM_STAT) (PT_ADM_STAT)
Medicare Rpt Co. Mcare_Site_Grp Mcare_Adm_Grp
RMH RMH OUTPT
RMH MCR OUTPT
SMH SMH OUTPT
SMH MCR OUTPT
SMG SMG OUTPT
SLH SLH OUTPT
SCOT SCOT OUTPT

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2.4 Report Parameters-User Prompts:

Parameter Description

2.5 Notes:

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3. REPORT STANDARDS:

3.1 Security Requirements:

3.2 Scheduling Requirements:

3.2.1 View on Demand or Scheduled:

□ View on Demand
□ Scheduled:
□ Crystal Report □ MS Excel □ MS Excel (Data Only)
□ MS Word (RTF) □ Adobe Acrobat □ Rich Text
□ Editable Rich Text □ Plain Text □ Paginated Text
□ Tab-Separated Text □ Character-separated values

3.2.2 Archiving:

□ Yes
□ No
Explain requirements:

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4. TEST CASE SCENARIOS: THIS SECTION SHOULD BE FILLED OUT WITH THE BUSINESS OWNER
AND R&A BUSINESS PARTNER LEAD.

List any specific examples that should be included in the test plan.
What are the first things you check for?
What are known areas of focus?
Are there known previous problems?
What are the critical success factors?

5. REPORT EXAMPLES:
Patient Revenue by Medicare Line and by Account by Medicare Reporting Company

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6. FUNCTIONAL SPEC SIGN OFF FORM:

R&A Business Partner Lead Preparer __________________________________ Date ___________

Business Owner Sign-off ______________________________________________ Date ___________

R&A Data Delivery Walk Through Sign-off: _____________________________ Date ___________

R&A IT Walk Through Sign-off: ______________________________________ Date ___________

… Functional Specification is updated with any changes and checked into PVCS.

Comments: ___________________________________________________________

_____________________________________________________________________

____________________________________________________________________________

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