Medical Processing Guidance: MHS GENESIS

March 14, 2022

The deployment of MHS GENESIS as the official Electronic Health Record (EHR) to
USMEPCOM will result in interim procedures that are not present in current
USMEPCOM policy. This document will supplement and/or replace current policy
during the MHS GENESIS deployment and sustainment periods until such a time that
affected regulations can be properly updated.

Note: The graphics used in the document were produced commercially, use fictitious
names/Personally Identifiable Information (PII), and are for instructional purposes only.

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MHS GENESIS Procedures
Prescreen and Applicant Registration in MHS GENESIS .................................................................................. 3
Quality Review Program (QRP) and Creating the MHS GENESISTracking Board at Reconciliation ............ 18
Paper Medical Record Examination Updates Grandfather Policy .................................................................... 28
Medical Walk-In Process .................................................................................................................................. 30
Airborne Screening Procedures......................................................................................................................... 31
Entering Uncorrected Visual Acuities, Valsalva, and Reading AloudTest (RAT) results in USMIRS ............ 33
Medical Read Program...................................................................................................................................... 35
Shipper Inspect Grandfather Policy .................................................................................................................. 45
Disposition of UMF 680-3A (Request for Examination) ................................................................................. 47
Supplemental Medical Documentation (SMD) uploaded as an Outside Record .............................................. 48
Updated Standardized Medical Brief ................................................................................................................ 52
HIV and DAT procedures ................................................................................................................................. 53
Cerumen Removal Procedures .......................................................................................................................... 54
Consult Process - MHS GENESIS Referrals .................................................................................................... 58
Waiver Review Process .................................................................................................................................... 78
Enabling and Manually Pulling the Health Information Exchange (HIE) ........................................................ 87
Quality Review of Medical Data in MHS Genesis and USMIRS..................................................................... 95
Approved Prescreen Prior to MHS GENESIS Implementation ........................................................................ 96

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 Prescreen and Applicant Registration in MHS GENESIS
Overview: The USMEPCOM prescreen program will transition from a paper process to an electronic one
with the deployment of MHS GENESIS. The prescreen (PS) paperwork will now be uploaded into MHS
GENESIS which will result in a paperless review process. This action will be proceeded by registering an
applicant in MHS GENESIS, thus making the submission of an applicant PS packet the start of the
applicant EHR at the MEPS.

Prescreen Packet:

The new PS packet now consists of the following forms:

1. DD Form 2807-2, Accessions Medical History Report

2. DD Form 1966, Record of Military Processing page 5. Parental/Guardian Consent, as
required
3. DD Form 2005, Privacy Act Statement
4. UMF 40-8-1, Drug, Alcohol, and HIV Acknowledgment forms
5. UMF 680-3A-2, Authorization for Medical Records Release
6. UMF 680-3A, Request for Examination
7. Orthodontist Letter (As Required)
Note: Prior Service documentation (e.g. DD Form 214) is not required.

Human Resources Assistants (HRA’s) will review PS packets for administrative completeness when
received from the Service Liaisons/Guidance Counselors (SL/GCs). Medical Technicians (Med
Techs) will be review all PS packets and make an administrative processing determination after
review of the PS packet and MHS GENESIS Health Information Exchange (HIE) information for
complex PSs only.

An incomplete DD Form 1966/5, DD Form 2005, UMF 40-8-1, UMF 680-3A-2, or UMF 680-3A is
considered an incomplete prescreen packet and will be given a “Prescreen Incomplete” status in
USMIRS upon review by the Med Tech. A provider review of the prescreen packet will not be
started until all forms are properly filled out, signed, and dated as applicable. The administrative
discrepancies will be listed in the Additional Notes box of the “Prescreen Incomplete” status.

Supporting medical documents (SMD) will not be submitted with the prescreen packet
regardless of applicant disclosure on DD Form 2807-2. If SMD is submitted with the
prescreen packet, all SMD will be returned to the SL/GC.

Prescreen Timelines:

1. Simple PS will follow the 48-hour projection timeline and must be submitted by the 1100
projection cut-off time.
2. Complex PS will be submitted by the 1100 PS cut-off time. The Med Tech will make a 5-day
or 10-day PS review determination NLT 1100 the next working day.

Note: PS submitted prior to March 14, 2022 will continue to be processed under the previous PS
guidelines.
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 1. Prescreen Cut-Off Time: The prescreen cut-off time is 1100. All administratively complete
prescreen packets submitted by the SL/GC by the cut-off time will complete the prescreen
process and be categorized by the Med Tech by 1100 the next working day. close of business.
2. Prescreens submitted after the 1100 cut-off time will enter the prescreen process the next
working day be processed by close of business the next business day.

Processing Authorized – Projection Table

If applicant is Prescreen packet is Processing Projections are submitted NLT

projected to submitted NLT 1100 authorized is 1100 on the preceding:
process on: on the preceding: determined NLT
1100 COB on the
preceding:
Monday Wednesday Thursday Thursday

Tuesday Thursday Friday Friday

Wednesday Friday Monday Monday

Thursday Monday Tuesday Tuesday

Friday Tuesday Wednesday Wednesday

Saturday, as Wednesday Thursday Thursday

applicable

Simple and Complex PS Overview: Categorized Prescreen Dispositions:

The prescreen disposition timeline will be determined by the Med Tech when the prescreen packet
is received and medical documents including pharmacy records are reconciled using the MHS
GENESIS HIE summary sheet. The Med Tech or provider will use the annotations on the DD
Form 2807-2 and the HIE records to make a prescreen processing determination.

1. Category 1 – Simple PS: Processing Authorized (PA)

a. The PS is simple IAW SMDRP SOP following SL/GC review and is automatically
PA.
b. Simple PS must be submitted with a projection.
c. The PS packet is submitted by the 1100 projection cut-off time for a 48-hour
projection.
d. The PS packet is administratively reviewed during QRP.
e. PS packet or projection with no discrepancies – The following must be performed by
the close of business IAW the PS process below:
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 i. HRA will register the applicant in MHS GENESIS
ii. HRA will upload PS packet in MHS GENESIS
iii. Med Tech will enter “Ready to Process” PS status in USMIRS
f. PS packet or projection with discrepancies:
i. HRA will annotate discrepancies on UMF 680-3-2 (QRP Discrepancy List).
Create an Admin Hold in the USMIRS for all discrepancies identified.
Provide UMF 680-3-2 to SL/GC for resolution.
ii. SL/GC must resolve discrepancies and return UMF 680-3-2 to MEPS by
1100 the next working day.
iii. MEPS will validate discrepancies are resolved – The following must be
performed by the close of business IAW PS process below:
iv. HRA will register the applicant in MHS GENESIS
v. HRA will upload PS packet in MHS GENESIS
vi. Med Tech will enter “Ready to Process” PS status in USMIRS
vii. If discrepancy(ies) is not resolved, delete the projection and inform the
SL/GC. Do not register the applicant in MHS GENESIS.
g. The provider will review DD 2807-2 and MHS GENESIS HIE contains minimal
medical data that the provider can review during the medical examination. If during
the examination the HIE reveals moderate medical data, the provider will continue
with the exam. If HIE reveals substantial medical data, the provider will move the
applicant to the end of the examination line to better facilitate the applicant flow.
without significant delay in processin

2. Category 2 – Complex PS: 5 or 10 day PS review

a. The PS is complex IAW SMDRP SOP following SL/GC review
b. PS submitted without a projection, is a complex PS.
c. The PS packet is submitted by the 1100 PS cut-off time
d. NLT 1100 the next working day, the following must be performed IAW the PS process
below:
i. HRA will perform an administrative review of the PS packet
ii. HRA will register the applicant in MHS GENESIS
iii. HRA will upload PS packet in MHS GENESIS
iv. Enter an Admin Hold in the applicant’s USMIRS record: Select “Prescreen
Received” in the Reason for Hold dropdown
v. From the applicant record in MHS GENESIS, send a message center note to
the Med Tech pool that the applicant is ready for PS review.
vi. Med Tech will make a PS review determination by ensuring medical
documents including pharmacy records are reconciled using the MHS
GENESIS HIE summary sheet.
1. If MHS GENESIS confirms moderate medical data based on the
amount of HIE pulled, the PS packet will be submitted to the provider
for a 5-day review
2. If MHS GENESIS confirms substantial medical data based on the
amount of HIE pulled, the PS packet will be submitted to the provider
for a 10-day review
vii. Forward the PS packet to the message center provider pool with the message
“5-day review” or “10-day Review”
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 viii. Med Tech will enter “In Review” PS status in USMIRS

1. 24-hour review for a prescreen packet with minimal health history

2. 5-day review for a prescreen packet with significant health history
3. 10-day review for a prescreen packet with a significantly complex health history
Only a MEPS provider can determine the timeline based on the amount of HIE that
has beenpulled into the applicant’s EHR. However, a processing decision must be
made in 10-days; resubmissions will restart the timeline.

The 24-hour prescreen determination timeline starts when MEPS receive the prescreen
packet via the HRA MGEN email box.

All prescreens must be reviewed by a provider and given the authorization to process (Ready to
Process status in USMIRS) prior to the scheduling of a medical exam. in USMIRS for medical
processing prior to QRP all prescreens must be reviewed and have a Processing Authorized
(PA) status and the USMIRS prescreen status of Ready to Process. Prescreens will no longer be
cleared for processing at QRP.

Prescreen Statuses:

USMIRS will be used to communicate the status of the PS packet through the medical
department.

1. Prescreen Incomplete: The Med Tech has found an administrative discrepancy and
noted the corrective action needed in the Additional Notes box. e.g., PH - DD Form
2807-2, section 1, item a – applicant signature missing. The SL/GC will use this
information to make corrections and resubmit the PS packet.

2. Ready For Review: The Med Tech will use this status to indicate the prescreen packet
is complex had an administrative review and is now ready for provider review. The
Med Tech will type 5 pages into the USMIRS Update Prescreen Status box (DD Form
2807-2 is 5 pages) which automatically populates the due date to the next day (24-
hours). Using the MHS GENESIS message center, the Med Tech will forward the
prescreen information to the MEPS provider pool.

3. In Review: Using the MHS GENESIS message center, the Med Tech forwards the PS
packet to the provider pool with the message “5-day Review” or “10-day Review”. the
provider has indicated they have received the prescreen packet, completed an initial
review of the prescreen packet,and reconciled any HIE (if necessary). At this point, the
provider will message the Med Tech in return stating the review will be 24-hours, 5-
days, or 10 days. The Med Tech will input a PS status of “In Review” and either keep
the due date at 24-hours orchange the date by adding update the due date to 5 or 10
working days from the current date. The page count will not change.

Note: In order to update the due date to 5 days, the Med Tech will enter a total pages range
from 27-32. In order to update the due date to 10 days, the Med Tech will enter a total
pages range from 57-62.
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4. Disqualified (PULHESD Updated): The provider has found a temporary
disqualification (TDQ) and processing is not authorized until the determined Returned
Justified (RJ) date. The TDQ ICD Code and RJ date will be in the PS status additional
notes box and the applicant will be placed in an Admin Hold. SL/GC will resubmit a
request for PS review on or after the RJ date.

5. Waiver Request to Process: Request to process an applicant is no longer used.

6. Other: This status will be used for any PSing that does not fit into the common
USMIRS PS statuses. Example: Any PS sent to the J-3/5/7 medical division for review
and/or assistance can be put in this status with the disposition reflected in the Additional
Notes box with the date the PS was sent up for review.

7. Ready to Process:

a. Simple PS: Med Tech enters after applicant record passes QRP.
b. Complex PS: The provider reviewed the PS packet and has rendered a PAstatus.

8. Additional Documents Required: The provider has discovered a condition where the
applicant indicated “YES” to medical history question(s) in SECTION III of DD Form
2807-2 and there were no HIE documents to reconcile this. Using the MHS GENESIS
message center, the provider will communicate to the Med Tech the documents needed
based off the health history condition indicated (YES answer) and corresponding
applicant comments in SECTION IV of DD Form 2807-2. The Med Tech will input
the PS status of Additional Documents Required and copy the provider’s request in the
Additional Notes box: e.g., METR - DD Form 2807-2, section 3, item 20 yes answer
with no HIE, need supporting medical documents (SMD) for asthma (or asthma ICD
code).
a. Options to communicate additional documents needed to the SL/GC
i. The message center note with the required documents can be printed by
the Med Tech and provided to the SL/GCs (either picked up or dropped
offbased on MEPS internal decision on most efficient process)
And/or
ii. The message center note with the required documents needed can be
copied and sent to the SL/GCs via Outlook email to the proper SL/GC
office
Note: If not already done, the MEPS ITS will help staff set-up
local/personal email lists for each SL/GC office.
b. As SL/GCs receive MHS GENESIS access, the message center note with the
requested documents can be forwarded to the SL/GC.
i. The MEPS can decide when to use this option after coordination with the
SL/GC office ensuring that internal policy reflects that this will be the
process of communicating METR documentation requirements.
ii. One SL/GC per Service per MEPS will have MHS GENESIS access
during the initial launch and more SL/GCs will be added during the MHS
GENESIS sustainment phase.
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 Note: Only PSs with METR decisions require additional medical
documents prior to the MEPS examination.

Example: A PH status inputted into USMIRS

Example: A PH status as displayed in the Prescreen & Medical Reads tab in USMIRS

Example: A METR status entered into USMIRS

Example: A METR status as displayed in the Prescreen & Medical Reads tab in USMIRS

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The Prescreen Process

The SL/GC will:

1. Receive the completed DD Form 2807-2, DD Form 1966/5, DD Form 2005, UMF 40-8-
1, UMF 680-3A, UMF 680-3A-2, Orthodontist Letter (as required) from the recruiter via
email or Service system.
2. Rename the PS packet PDF:
a. The last 4 of the applicant SSN
b. The letters PS
c. Example: 1234PS
Note: SL/GCs can have recruiters name these packets when initially scanned to save
time.
3. Attach the PS packet to an encrypted email with read receipt
a. From Outlook, click on New Email
b. From the email top menu, click on Options
c. Click Encrypt
d. Check mark the Request a Read Receipt Box
Note: You can configure your email so that it will always encrypt and deliver a read
receipt by going to File – Options – Mail – Tracking – click the Read receipt box and
File – Options – Trust Center – Trust Center Settings – Email Security – click
Encrypt contents and attachments for outgoing messages.
4. Input into the To line of the MEPS specific MHS GENESIS email group
a. For eastern sector MEPS the group email is: OSD MEPS-ES-MEPS Name-
USMEPCOM ES List MEPS ABBREVIATION-MGEN HRA – e.g., the Atlanta
MEPS MGEN email OSD MEPS-ES-Atlanta-USMEPCOM ES List ATLA-
MGEN HRA
b. For western sector MEPS the group email is: OSD MEPS-WS-MEPS Name-
USMEPCOM WS List MEPS ABBREVIATION-MGEN HRA – e.g., the
Albuquerque MEPS MGEN email OSD MEPS-WS-Albuquerque-
USMEPCOM WS List ALBQ-MGEN HRA
5. In the subject line use the following:
a. Simple PS: “1st time submission: “Registration and Simple PS Review with
Projection for “DATE””
b. Complex PS: “Registration and Complex PS”
c. PSs resubmitted due to additional requirements: “PS Resubmission”
d. Subsequent submissions due to expiration of previous PS: “PS Review”
6. In the body of the email type the applicants full name and SSN

Example: A proper email message to the MHS GENESIS HRA for Registration and start of
the PS review. Note the email is encrypted and a read receipt has been requested.

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 7. Send the registration request and PS packet; this action will start the build of theEHR
and the PS review process
8. Receive the read receipt from the MGEN HRA; once received, it indicates that thePS
will be reviewed uploaded into the applicant’s EHR
9. For Navy applicants the electronic PS packet will be reviewed from a MEPS secure folder.
Navy SL/GC will identify simple or complex PS in the file name.

The HRA will:

1. Monitor their Outlook inbox for any emails sent to MGEN HRA group; this will replace
the SL/GC dropping PS packets off to the files room.
2. Use this email notification to open USMIRS and MHS GENESIS to prepare for
verification and registration
3. Open the email and move the scanned PS packet to their computer once the email is
opened, the HRA must complete the MHS GENESIS registration process andupload
of the prescreen packet.
Note: Once the email is opened, it notifies the SL/GC the prescreen review time has begun.
The HRA can also respond to the SL/GC with the response Received. This is not mandatory
but adds a level of tracking and acknowledgment.
4. Perform an administrative review of the PS packet to ensure all required forms are present
and complete.
a. If the PS packet has no administrative discrepancies:

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 1. Register the applicant in MHS GENESIS following the below steps.
b. If the complex PS packet has administrative discrepancies:
1. Close the PS packet.
2. Select “Forward” to send the PS packet and email message back to the
individual(s) or group(s) who sent the email and “cc” the MGEN HRA
email group.
3. In the Subject line of the email annotate the word “INCOMPLETE” after
the original subject heading. (e.g. Registration and Prescreen Review
INCOMPLETE).
4. In the email message give a brief explanation of the discrepancy (e.g. DD
Form 2807-2, Section 1, item a – applicant signature missing)
5. Select “Send.”
6. Delete the electronic PS packet from the secure folder (Navy only) or
originally sent Outlook email.
c. If the simple PS has administrative discrepancies, annotate the UMF 680-3-2,
create an Admin Hold in the applicant’s USMIRS record, and provide UMF 680-3-
2 to SL/GC for resolution.
5. Register (create) the applicant into MHS GENESIS – see job aid Register an Applicant.
6. Open the applicant’s electronic record in USMIRS. If no electronic record exists, inform the
SL/GC of the issue. Do not register the applicant in MHS GENESIS until a USMIRS
electronic record exists.
1. Review the SSA status in the applicant’s USMIRS header.
a. If “Verified” is present, continue registering the applicant.
b. If “Pending”, “Mismatch”, or “Not Found” is present, the SL/GC must provide a
SSN source document IAW UMR 601-23, Figure 5-3. MEPS will proceed with
registering the applicant using the applicant’s personal data in USMIRS, UMF
680-3A, and SSN source document.
Note: A copy of the SSN source document is authorized.
Note: W-2 with full SSN is authorized as a SSN source document
Note: If a DoD ID does not exist, MHS GENESIS will create a Temporary
Identification (TIN) to allow for continuing to process in MHS GENESIS.
2. Verify the applicant’s USMIRS data matches the DEERS data in MHS GENESIS (as
applicable). If there is a discrepancy in the DEERS data, enter an Admin Hold in the
applicant’s USMIRS record to notify the SL/GC there is a DEERS data issue requiring
resolution using the following steps. The applicant’s PS will continue to be processed and
all further applicant processing is authorized.
a. Select “Custom” in the Reason for Hold dropdown
b. Enter “DEERS ISSUE” in the Custom Hold Reason box.
c. Select Save.
3. When registration is complete, enter an Admin Hold in the applicant’s USMIRS record for a
complex PS only: Select “Prescreen Received” in the Reason for Hold dropdown
4. Create a lifetime pharmacy encounter – see job aid Lifetime Pharmacy Encounter
5. Create an outside document encounter – see job aid Document Upload
6. Upload the PS packet (DD 2807-2, DD 1966/5 (as required), DD 2005, UMF 40-8-1,
UMF 680-3A, UMF 680-3A-2, and Orthodontist Letter (as required)) into MHS
GENESIS – name the PS packet “MEPS Simple PS Packet” or “MEPS Complex PS
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 Packet”
7. Confirm the PS packet is in MHS GENESIS – once in MHS GENESIS thePS is
secure and becomes the original PS
8. Delete the PS packet that was moved out of the notification email
9. From the applicant record in MHS GENESIS, send a message center note to the Med
Tech:
a. Simple PS: Inform Med Tech pool they can manually query MHS GENESIS
HIE to prepare for the medical exam.
b. Complex PS: Inform Med Tech pool that the applicant is ready for PS review.

Example: Message center email from the HRA to the Chicago MEPS Med Tech pool

Prior to provider review the Med Tech will:

1. Simple PS:
a. Monitor MHS GENESIS message center – All message center orders (email)
have the applicant’s name as part of the heading.
b. Choose an applicant to start the HIE query process from the message center
messages page
c. Right click the email and select assign – this will show other Med Techs who are
actively working that applicant’s EHR and which applicants still need to be
processed
d. Open the email to verify that this is a simple PS and view any additional
information sent by the HRA
e. Access the applicant’s EHR from the opened email by clicking on the applicant’s
name in the top right corner
f. Manually query the HIE to prepare for the medical examination IAW “Enabling
and Manually Pulling the HIE” below.

2. Complex PS:
a. Monitor MHS GENESIS message center – All message center orders (email)
have the applicant’s name as part of the heading.
b. Choose an applicant to start the PS process from the message center
messages page
c. Right click the email and select assign – this will show other Med Techs who are
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 actively working that applicant’s EHR and which applicants still need to be
processed
d. Open the email to verify that this is a simple PS and view any additional
information sent by the HRA
e. Access the applicant’s EHR from the opened email by clicking on the applicant’s
name in the top right corner
f. Click on documents on the right side menu of the applicant EHR
g. Click on the DD Form 2807-2 “view image” tab in the documents section of the EHR
h. Click on view document from the DD Form 2807-2 detail panel

i. Administratively review the DD Form 2807-2 PS packet

j. If the admin review reveals an error, the PS is a Processing Hold and in
USMIRS the Med Tech will:
i. Stop the PS review process
ii. Put the applicant in a “Prescreen Incomplete” status
iii. Input the discrepancy in the PS status additional notes box e.g., PH
- DD Form 2807-2, section 1, item a – applicant signature missing
Note: The SL/GC will send the corrected DD Form 2807-2 back to the HRA email
group with the subject of “PS Resubmission”. The HRA will upload the corrected
DD Form 2807-2 to the applicant record and send to the Med Tech group in
messagecenter. Review time will start over for all PS resubmissions.
k. Complex PS: If the admin review reveals no errors :
i. Manually query the MHS GENESIS HIE system. Use message center to
inform the provider pool that an applicant is readyfor prescreen review
ii. In USMIRS:
1. Place the prescreen in a “Ready for Review”
2. User will input the page count of 5 (the number of pages a DD
Form 2807-2is); the date will automatically change to the next
day (24-hours)
l. Make a PS review determination:

i. Category 1:
a. Approved for processing by the Med Tech (NO MHS GENESIS
entries required)
b. Input the status “Ready to Process in USMIRS
c. Clear the “Prescreen Received” Admin Hold
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 d. Delete the message center email

ii. 5-Day Review:

a. Forward the PS packet to the message center provider pool with the
message “5 day Review”
b. Input the PS status “In Review” in USMIRS and update the due date
to 5 working days from the current date
c. Update the PS status in USMIRS throughout the review process (e.g.
if additional documents are required the Med Tech will input the PS
status “Additional Documents Required” in USMIRS)
d. Clear the “Prescreen Received” Admin Hold when the PS review is
complete

iii. 10-Day Review:

a. Forward the PS packet to the message center provider pool with the
message “10 day Review”
b. Input the PS status “In Review” in USMIRS and update the due date
to 10 working days from the current date
c. Update the PS status in USMIRS throughout the review process (e.g.
if additional documents are required the Med Tech will input the PS
status “Additional Documents Required” in USMIRS)
d. Clear the “Prescreen Received” Admin Hold when the PS review is
complete

It will be the responsibility of the MEPS CMO to train their Med Techs on what is considered
Category 2 (5-day) and Category 3 (10-day) reviews. At any time a provider can change a Category
2 to a Category 3 based on their medical expertise.

The provider will perform for complex PSs only:

1. Monitor MHS GENESIS message center – all message center orders (email) have the
applicant’s name as part of the heading
2. Choose an applicant to start the PS process from the message center messagespage
3. Right click the email and select assign – this will show other providers who is actively
working that applicant’s PS and which applicants still need to be reviewed
4. Click on documents on the right side menu of the applicant EHR
5. Click on view document from the PS Packet detail panel
6. Review the DD Form 2807-2
7. The MEPS provider will review the PS for a processing determination using the MHS
GENESIS HIE summary sheet – See the Provider Manual for MHS GENESIS
8. Using the MHS GENESIS system HIE summary sheet the provider will determine if
additional time is needed – See the Provider Manual for MHS GENESIS
a. If additional time is not needed:
i. Send confirmation message center email back to the Med Tech
withmessage stating “24-hour review”
ii. Med Tech will put in USMIRS an “In Review” prescreen status and
notchange the due date
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 b. If additional time is needed:
i. Send a confirmation message center email back to the Med Tech stating
“5day” or “10 day” review
ii. Med Tech will enter “In Review” status in USMIRS and change the
duedate to 5 or 10 working days from the original due date
9. Complete review of the PS packet
a. Select the “Outside Records” page in the blue left side menu
b. This will pull up an HIE summary sheet giving the provider a holistic view of all
medical conditions on which outside records exist
c. Use this summary sheet to determine if there are more pre-existing medical
conditions than indicated on the DD Form 2807-2
d. A PS review will continue whether or not the applicant disclosed the
condition on their DD Form 2807-2
10. Make appropriate comments in the MHS GENESIS histories component in the EHR on the
medical history information (from HIE and /or applicant PS annotations)
11. Make a PS processing decision in the Historic Review component of the EHR
12. From the applicant record, utilize the message center to send the PS decision andany
additional information to the Med Tech

Note: If the provider needs to request additional time due to an exceptionally complex PS, then a CA
Ticket will be submitted to HQ USMEPCOM J-3/5/7 Medical Division explaining the circumstances
of the delay.

Example: Message center email with the PS processing status to the Med Tech

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After provider review, the Med Tech will:
1. Assess the PS decision from the message center note
a. If PA (Processing Authorized): Input the PS status “Ready to Process” in
USMIRS
b. If RJ (Return Justified):
i. Input the PS status “Disqualified PULHESD Updated” in USMIRS
ii. In the PS Status Additional Notes box input the RJ information by
referencing the DD Form 2807-2 medical history question the temporary
disqualification (TDQ) pertains, the reason, and ICD code e.g., RJ – DD
Form 2807-2, Section 3, Item 42, applicant completed pregnancy x 3
months ago, ICD Z33.1, RJ date 20220328
iii. Add a custom Admin Hold in USMIRS labeled “Prescreen RJ” and in the
notes put the RJ date as determined by the provider in the YYYYMMDD
format

Example: An RJ status put into USMIRS

Example: An RJ status as displayed in the Prescreen & Medical Reads tab in USMIRS

Example: A PS RJ admin hold in USMIRS

c. If METR (Medical Evaluation Treatment Records)

i. Input the PS status “Additional Documents Required” in USMIRS
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 ii. In the Additional Notes box input the requested documents by the provider
based on referencing the check-marked DD Form 2807-2 medical history
question that had no HIE information e.g., METR - DD Form 2807-2,
section 3, item 20 yes answer with no HIE, need supporting medical
documents (SMD) for asthma (or asthma ICD code).
iii. Optional; Med Tech can print the message center email with the
requestedSMDs and provide to the SL/GC or copy/paste requested
SMDs into an outlook email to the SL/GC

The PS process is over when a PS processing decision is made. All resubmissionsdue to a PH

(admin discrepancy), RJ (temporary DQ), or METR (SMDs needed) starts the review times
over upon resubmission to the HRA email pool.

All MHS GENESIS entries explained in this info message can be view by a narrative video
found on SPEAR at the following link:
https://spear/hq/mmt/Documents/MEPCOM%20Training%20Video_Final_1080p.mp4

17
Quality Review Program (QRP) and Creating the MHS GENESIS
Tracking Board at Reconciliation
Overview: In order to conduct a MEPS medical examination in MHS GENESIS at the MEPS, a
projected applicant must be added to the MHS GENESIS tracking board. This will be
accomplished at QRP for a projection with no discrepancies. Projections with discrepancies
will first be reconciled at 1100 the next business day then added to the MHS GENESIS Tracking
Board.

QRP:

QRP will be conducted IAW current policy 48-hours before a scheduled applicant arrives to take
a medical examination. The QRP will involve using both USMIRS and MHS GENESIS.

Medical Examinations:

1. Simple PS: The PS is simple following SL/GC review and is automatically PA to be

projected for a medical examination.
2. Complex PS: All applicants must have an approved PS (PA) before the applicant
can be projected for a MEPS medical examination.

From the scheduled applicants list in USMIRS the Med Tech will:

1. Click on the name of the applicant to open the USMIRS record

2. Review the applicant header for the pertinent information to ensure the applicant is ready
to start a medical examination
3. Click on the Medical tab
4. Click on the Prescreens and Medical Reads tab
5. Ensure the applicant PS status is “Ready to Process” for a complex PS only.
6. If necessary, add an “Admin Hold” for discrepancies discovered during QRP
a. Click on the Admin Hold tab
b. Click on Add Hold
c. Select a Reason for Hold from the drop down or create a custom hold
d. Add notes to explain the reason for hold as applicable
e. The applicant header will reflect the admin hold
f. Inform the SL/GC of the admin hold per UMM 680-3-1 and local policy utilizing
a UMF 680-3-2-E (QRP Discrepancy List)
7. The “Ready to Process” status in USMIRS indicates the PS process was completedand a
review of medical data in MHS GENESIS, at this time, is unnecessary – See Info
Message MHS GENESIS Prescreen Procedures and Applicant Registration in MHS
GENESIS
8. In some instances a Med Tech may need to upload additional documents in
MHSGENESIS (e.g., updated DD Form 1966/5)
a. Log into MHS GENESIS
b. From the tracking list click on the search function in the top right corner
c. Type the applicant’s name (or SSN/DoDID)
18
d. Click on the applicant’s name from the Patient Search box that displays – ensure
the proper applicant is chosen from the listing (if more than one applicant with the
same name) – you will now be in the applicant’s EHR
e. Review the applicant EHR for any discrepancies discovered during the USMIRS
QRP
i. Click on “Documents” on the left side menus to review or upload
additional documents
ii. Click on “Historic Review” to see the provider notes and comments on the
review PS packet

Example: A PS status in USMIRS that indicates the applicant is ready to process

Example: Placing an Admin Hold on an applicant due to a QRP discrepancy

19
 Example: Applicant search from the applicant tracking list in MHS GENESIS

Example: Display of the applicant in the Patient Search box

Example: Review of medical data from the applicant EHR home page (should be rare at
QRP if the applicant is in a USMIRS “Ready to Process” status)

20
Medical Updates (to the Examination) – An update to a medical examination is for an
applicant that includes but not limited to: finishing an incomplete exam, retesting or additional
testing to a completed exam, clearing a disqualification, or disclosing additional medical
information, etc. Because the applicant has completed the medical exam the review should focus
on the reason for the medical update only. Once the issue that requires the update is identified
and confirmed, the applicant should be cleared to process without further review of the already
completed exam items.

From the scheduled applicants list in USMIRS the Med Tech will:

1. Click on the name of the applicant to open the USMIRS record

2. Review the applicant header for the pertinent information with an emphasis placed on
identification of the reason for the medical update (e.g., review Admin Hold for
overweight entry and verify applicant is not processing before the RJ date)
3. Click on the Medical tab to review necessary aspects of medical update only (e.g.,
reviewthe lab testing page to confirm positive drug result for applicant scheduled for
another drug test)
4. Remove any Admin Holds associated with the medical update (e.g., remove the
“overweight” admin hold for an applicant scheduled to update their height/weight)
5. The applicant PULHESD and information in USMIRS should give the Med Tech
enoughinformation to clear the applicant to process – if a review of the applicant EHR
is necessary, log into MHS GENESIS and from the applicant tracking board search for
theapplicant and review applicable medical information

Example: An applicant that needs to retake a drug test as indicated by the PULHESD

Shipping Inspects – A shipping inspect to a medical examination is for an applicant who is

shipping out to Initial Entry Training Sites (IETS) from the MEPS. A shipping inspect includes
an updated height/weight temperature and history review by the MEPS provider. The review of
a shipper at QRP is to ensure the applicant is medically qualified or medically cleared by a
waiver to ship out to initial military training. Because the applicant has completed the medical
exam the review should focus on medical qualification indicators only. These indicators would
include the PULHESD and Admin Hold statuses in USMIRS. All indicators that deem an
applicant is ready to ship in USMIRS should be taken as such and the applicant should be
cleared to process without further review of the already completed exam items.

21
 From the scheduled applicants list in USMIRS the Med Tech will:

1. Click on the name of the applicant to open the USMIRS record

2. Review the applicant header for any indicators that the applicant cannot ship such as
an un-waivered permanent disqualification as indicated by the PULHESD in the
applicantheader or an un-cleared Admin Hold
3. Click on the Medical tab to only review necessary aspects of USMIRS medical record
that may need confirmation of medical information that may prevent shipping
4. Admin Hold actions
a. Remove any medical Admin Holds that have been cleared; if Admin Hold cannot
be cleared the issue will be indicated on the UMF 680-3-2-E to be distributed to
the SL/GCs IAW UMM 680-3-1 and local policy
b. If necessary add an “Admin Hold” for discrepancies discovered during QRP and
indicate the reason for the hold on the UMF 680-3-2-E to be distributed to the
SL/GCs IAW UMM 680-3-1 and local policy
5. The applicant’s USMIRS medical qualification status should give the Med Tech
enough information to clear the applicant to process – if a review of the applicant EHR
is necessary, log into MHS GENESIS and from the applicant tracking board search for
theapplicant and review applicable medical information

Example: A shipping applicant with a qualifying PUHLESD and no Admin Holds in

USMIRS

NOTE: The Med Tech will be able to use two computer screens to assist in completion of data input from
MHS GENESIS to USMIRS in one setting.

QRP Reconciliation:

QRP reconciliation will be conducted IAW current policy at 1100 the next business day after
48-hour QRP 24 hours before a scheduled projected applicant arrives to take a medical
examination, and only on applicants that had an identified discrepancy on the UMF 680-3-2. An
entire re-evaluation on the applicant medical processing status is unnecessary. Through use of
USMIRS and MHS GENESIS the Med Tech will evaluate and clear the specific discrepancy. If
the discrepancy cannot be cleared the MEPS will cancel the scheduled applicant projected
applicant and inform the SL/GC.

22
Adding Applicants to the MHS GENESIS Tracking Board
At QRP reconciliation after the scheduled applicants processing list (UMF 727) has been
finalized, the HRA will have to add all scheduled applicants for the next day to the MHS
GENESIS Tracking Board. This workload is done at this time to ensure that when the applicant
comes to the MEPS they cancheck in and go right into the MEPS process without delay.

Using the scheduled applicants list in USMIRS, the HRA will:

1. Log into MHS GENESIS

2. From the tracking list, select on the registration icon in the top left corner
3. From the Person Search box, type in the applicant name in the name box on the left
hand side
4. When the applicant populates the Person Search box select “Add Encounter” at the
bottom right corner of the box
5. Review the personnel information, update if necessary, and select the “Save and
Continue” at the bottom right corner of the page
6. From the Add Encounter page it defaults to the Quick Reg Info page
a. Go to the one required field titled “Medical Service” (colored in yellow)
b. From the pulldown arrow select “Occupational Medicine”
7. While still in the Add Encounter page select the Guarantor tab
a. Select the “Add” pulldown at the top left corner
b. Select “Add Guarantor Person”
c. From the Guarantor box select “OK”
d. This action will take you to the Add Encounter page where you will select
“Save and Close”
8. Confirm the applicant name is now on the MHS GENESIS Tracking Board
9. Add all applicants scheduled to visit the medical department – medical examinations,
medical updates, and shipping inspects to the MHS GENESIS Tracking Board – as you
do this you will see the tracking board grow similar to the Scheduled Applicants list
foundin USMIRS.

Example: Location icon registration icon from the tracking list (first screen) in MHS
GENESIS to start the processes of building the MHS GENESIS Tracking Board for the next
day scheduled applicants

23
 Example: Searching for the applicant that needs to be added to the Tracking Board

Example: Adding encounter after finding the person

Example: Registering the applicant with the applicant being put in the occupational medicine
status

24
 Example: Clicking into the guarantor section of the add encounter screen

Example: Adding the applicant as the Guarantor by selecting Add Guarantor Person

25
 Example: Clicking OK to confirm the applicant as the guarantor

Example: Guarantor information is now ready to be saved and closed at the bottom right of
the box

SAVE AND CLOSE

26
 Example: Applicant is now on the MHS GENESIS Tracking Board

Once every applicant that is scheduled for a medical exam, update, or inspect in USMIRS has
beenput on the MHS GENESIS Tracking Board, this requirement for an applicant to process in
the MEPS with an EHR has been accomplished.

For walk-ins: The applicant will have to be put on the MHS GENESIS Tracking Board in order
to complete any medical testing. This will have to be accomplished as soon as the MEPS
approves the walk in which is typically the day the applicant shows up to the MEPS.

All MHS GENESIS entries explained in this info message can be view by a narrative video
found on SPEAR at the following link:
https://spear/hq/mmt/Documents/MEPCOM%20Training%20Video_Final_1080p.mp4

Use external DVIDS video if access to SPEAR is not available:

https://www.dvidshub.net/video/830320/usmepcom-mhs-genesis-training-video

27
Paper Medical Record Examination Updates Grandfather Policy
Overview: With the conversion from a paper medical process to an EHR, medical processing at
the MEPS will transition to a new paperless process. The following policy will cover the
disposition of all paper medical records that are in a disqualification or open profile status prior
to February 24, 2022 Soft Go-Live (SGL), and March 10, 2022 for big bang deployment dates.
All applicants that fall under these conditions will have their entire medical paper packet
uploaded into MHS GENESIS PRIOR to a scheduled visit during the Quality Review Program
timeframe.All subsequent medical processing will be conducted in MHS GENESIS.

Applicants whose paper records must be scanned into MHS GENESIS for further medical
processing fall under the following categories.

1. Open PULHESD profile

2. Temporary disqualification (TDQ)
3. Disqualification
4. Medically qualified but has a medical disclosure

These applicants who are scheduled for medical processing in USMIRS will have their paper
record scanned and uploaded into MHS GENESIS. All further medical updates to the
applicant’s medical record will be done in the EHR.

During QRP from the scheduled applicants list on the USMIRS homepage

1. Pull an applicant packet for QRP

2. Determine if the applicant is a medical shipping inspect or medical examination update
which includes a medical consult or ancillary service
3. If the applicant is a shipping inspect – see page 45, Shipping Inspect Grandfather
Policy
4. If the applicant needs a medical update to the current paper medical examination
a. Register the applicant into MHS GENESIS – See Job Aid “Registration”
b. Create an outside records encounter – See Job Aid “Document Upload”
c. Pull all medical paperwork out of the applicant packet
d. Separate the DD Form 2807-2 and its associated paperwork from the DD Form
2808 and its associated paperwork
i. Upload the DD Form 2807-2 packet into MHS GENESIS and title it
“MEPS PS Packet”
ii. Upload the DD Form 2808 packet into MHS GENESIS and title it “MEPS
Med Exam”
e. Confirm the PS packet and medical examination paperwork has been
uploaded by viewing them in the Documents tab on the left side menu of the
applicant’s MHS GENESIS EHR

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 Registration options:

1. As scheduled applicants start to populate USMIRS prior to QRP the HRA(s) can start
to register and upload medical documents – similar to QRP pre-pull today
2. Applicant registration and document upload can happen at the same time or separately
where an HRA (or Med Tech) registers the applicant in MHS GENESIS and another
HRA (or Med Tech) uploads documents – MHS GENESIS allows more than one
personto work in an applicant EHR simultaneously. By exiting and entering the system
or applicant record, or selecting the refresh icon, the current user will be able to see
what another user did in the applicant’s EHR.
3. The applicant can be registered in MHS GENESIS and medical documents uploaded at
QRP where the Med Tech can assist the HRA(s) with this process and do a QRP review
at the same time.

The QRP review of an applicant with an update to the medical examination should be focused
specifically on the reason the applicant was scheduled. Medical examination updates are
typically reviewed for eligibility to process due to a Returned Justified date, confirmed
consultation appointment, etc.

If an applicant has started the medical process on a paper record and is never scheduled before
expiration; the medical paperwork in the applicant packet will be purged in accordance with
current purge criteria. Only scheduled applicants will be uploaded into MHS GENESIS in
order to reduce registration and uploading workload by focusing only on processing applicants,
and startthe process of transitioning to an all paperless medical process.

29
Medical Walk-In Process
Overview: With the introduction of a HIE through MHS GENESIS, all PSs at the MEPSmust
be reviewed by a MEPS provider. Once a PS is reviewed and given a PA by the provider and
has a Ready to Process PS status in USMIRS, the applicant can be scheduledor walked-in to be
medically processed.

Walk-ins that need medical processing must:

1. Have a PS processing decision of PA

2. Be in a “Ready to Process” USMIRS PS status

Once medical walk-in eligibility has been determined and authorized:

If the applicant has a paper PS packet in an applicant packet:

1. The applicant packet is pulled

2. The applicant is registered in MHS GENESIS – see job aid “Registration in
MHSGENESIS”
3. Create an outside records encounter – See Job Aid “Document Upload”
4. Pull all medical paperwork out of the applicant packet
5. The applicant PS is uploaded into MHS GENESIS and named “MEPS PSPacket”- see
job aid “Document Upload” in MHS GENESIS
6. Confirm the PS packet has been uploaded by viewing them in the Documents tabon the
left side menu of the applicant’s MHS GENESIS EHR.
7. The applicant is placed on the MHS GENESIS encounter board – see
MHS GENESIS Procedure: QRP and Creating the MHS GENESIS Tracking Board at
(QRP) Reconciliation

If the applicant has been previously registered in MHS GENESIS and PS packet has been
uploaded, reviewed, and authorized, the applicant is placed on the MHS GENESIS encounter
board Tracking Board.

The above policy only covers the eligibility of the walk-in due to the PS status. TheSL/GCs still
have to meet other USMEPCOM and local MEPS walk-in criteria before processing of the
applicant is authorized.

30
Airborne Screening Procedures
Overview: The following procedures outline Airborne Screening with MHS GENESIS.

Airborne eligible applicants must have an SF 507 Airborne Training Checklist (found on SPEAR
under Airborne) that will be used to perform MEPS Airborne screening. This checklist is to be
used as a supplement to the medical examination encounter and will become part of the
applicant’s EHR.

The Airborne screening will continue to be conducted IAW UMR 40-1, paragraph 16-4, sub-
paragraphs a, c, and d.

Upon completion of the Airborne Training Checklist the provider will use the MHS GENESIS
enterprise auto-text “.meps-abn” in the examination encounter of the EHR

The following auto-text will display in the EHR

The provider will use the pulldown to select Qualified or Unqualified based on the final
PASS/FAIL determination on the Airborne Training Checklist

Note: The Airborne screening qualification/disqualification determination is only for an

Airborne training slot and does not have any impact on the accession qualification status of the
applicant. The PULHESD will not be changed due to an Airborne screening disqualification.

The applicant will be given the completed SF 507 Airborne Training Checklist by the provider
and sent to check out of the medical department.

The Med Tech will enter the Airborne Screening into USMIRS:
1. Go to the Admin Holds tab
2. Click the “+ Add Hold” button
3. Select Custom in the “Reason for Hold” pulldown box
4. Input Airborne Screening in the “Custom Hold Reason” box

31
 5. Input a passed Airborne screening in the “Notes” box as: Airborne Qualified
6. Input a failed Airborne screening in the “Notes” box as: Airborne Disqualified
7. Click the “Save” button
8. The MEPS Hold will populate in the Admin Holds tab
9. Click the “Clear Hold” button
10. Input the Airborne screening checklist disposition in the “Notes” box as: Airborne
checklist given to the applicant
11. Click the “Clear Hold” button
12. The Airborne screening information will show as a Cleared Hold in the Admin Hold tab

The Med Tech will give the original SF 507 Airborne Training Checklist to the applicant and
sendthem back to the service liaison/guidance counselor.

There will be no requirement to scan the SF 507 Airborne Training Checklist into MHS
GENESIS.

32
Entering Uncorrected Visual Acuities, Valsalva, and Reading Aloud
Test (RAT) results in USMIRS
Overview: Specific medical requirements the Services need at time of contract that are not in
USMIRS and need to be displayed due to USMEPCOM’s transition to a paperless process and
no access to the MHS GENESIS record. The following are interim procedures until these
medical tests are available in USMIRS.

Uncorrected Visual Acuities

For Navy, Air Force, and Marine Corps applicants (all components):

Any applicants that have an uncorrected vision in MHS GENESIS that is not the same as theirvision
scores in the Vision sub-tab of USMIRS will do the following:

1. Go to the Admin Holds tab

2. Click the “+ Add Hold” button
3. Select Custom in the “Reason for Hold” pulldown box
4. Input Uncorrected Vision in the “Custom Hold Reason” box
5. Input the uncorrected vision in the “Notes” box as such: R20/400 L20/400
Note: The example above is if the applicant has an uncorrected visual acuity of 20/400 in
both right and left eyes.
6. Click the “Save” button
7. The uncorrected vision will be visible in the details of the Admin Hold
8. Click the “Clear Hold” button
9. When the “Notes” box displays click the “Clear Hold” button
10. The uncorrected visual acuities will display a Cleared Hold in the Admin Hold tab

Note: None of the other Services need to see uncorrected vision at time of contract.

Example: An uncorrected visual acuity recorded in USMIRS as an Admin Hold

33
Reading Aloud Test (RAT)

For applicants who take the RAT:

1. Go to the Admin Holds tab

2. Click the “+ Add Hold” button
3. Select Custom in the “Reason for Hold” pulldown box
4. Input RAT in the “Custom Hold Reason” box
5. Input a satisfactory RAT test in the “Notes” box as: RAT SAT
6. Input an unsatisfactory RAT test in the “Notes” box as: RAT UNSAT
7. Click the “Save” button
8. The RAT test score will be visible in the details of the Admin Hold
9. Click the “Clear Hold” button
10. When the “Notes” box displays input Service specific test only
11. Click the “Clear Hold” button
12. The RAT test will display as a Cleared Hold in the Admin Hold tab

Example: A Reading Aloud Test recorded in USMIRS as an Admin Hold

Valsalva Test

For applicants who take a Valsalva Test

1. Go to the Admin Holds tab

2. Click the “+ Add Hold” button
3. Select Custom in the “Reason for Hold” pulldown box
4. Input Valsalva in the “Custom Hold Reason” box
5. Input a satisfactory test in the “Notes” box as such: Valsalva SAT
6. Input an unsatisfactory test in the “Notes” box as: Valsalva UNSAT
7. Click the “Save” button
8. The Valsalva test score will be visible in the details of the Admin Hold
9. Click the “Clear Hold” button
10. When the “Notes” box displays input Service specific test only
11. Click the “Clear Hold” button
12. The Valsalva test will display as a Cleared Hold in the Admin Hold tab

Example: A Valsalva Test recorded in USMIRS as an Admin Hold

34
Medical Read Program
Overview: The medical read (med read) program will transition from a paper process to an
electronic one with the deployment of MHS GENESIS. The med read paperwork will now be
uploaded into the MHS GENESIS system which will result in a paperless review process.

Initiation of the Med Read

The med read is a review of SMDs following accession medical examination. It is a process that
is initiated by the MEPS provider and occurs when the applicant discloses a pre-existing medical
condition that was not identified during the PS process.

After the medical brief and prior to the medical examination the MEPS provider will conduct a
medical history interview. The provider will ask the applicant if they have any updates to the
DD Form 2807-2 (Accession Medical History Report) that was filled out with their recruiter. If
necessary the provider can pull up the PS packet in the “Documents” tab in the applicant’sEHR
and let the applicant review their previous answers.

Example: Navigation in the applicant PS packet by selecting documents on the left sidemean
of the applicant’s EHR

Example: Location of the PS packet in the documents component of the applicant EHR

35
 Example: DD Form 2807-2 as displayed in MHS GENESIS for applicant review

The provider will also review the PS comments in the historic review component of the EHR
and add any updates the applicant has provided during the history interview. The providergets
to the histories component by selecting “Histories” on the left side menu of the applicant EHR.

Example: A provider view of the historic review component with PS notations in the
applicant’s EHR in MHS GENESIS to review before completing the physical exam.

36
If an applicant discloses a pre-existing medical condition that was not annotated on the DD
From 2807-2 and/or discovered with MHS GENESIS HIE, the med read process will be
initiated. The provider will not return/kickback the packet. The provider will continue med
read/medical exam as outlined below.

Med Read Process

The provider will:

1. From the applicant record, utilize message center to inform the Med Tech that
theapplicant is open for a med read and specifically list what SMDs are needed
2. Complete the accession medical history interview and conduct as much as the medical
examination as possible

Note: The provider can pull up message center during the medical history review and send
the Med Tech the med read status so it can be communicated up to the SL/GC immediately.
The Med Tech can enter the open PULHESD status for med reads when the applicant checks
out.

Example: Provider utilization of message center within the applicant record to inform
the Med Tech of the need for med read SMDs

The Med Tech will:

1. Input the med read status “Additional Documents Required” in USMIRS

2. Input the SPF in the Submitting Liaison box (e.g., DAR)
3. Input 0 in the Total Pages box and the current date in the Due Date box
4. In the additional notes copy the SMDs listing/information the provider sent via message
center (e.g., Medical documents needed for prescription to Ativan)

37
 Example: An initial med read status being put into USMIRS

Example: Initial med read status in USMIRS informing the SL/GC of needed medical
documentation

5. Enter all other medical examination data into USMIRS from the MHS GENESIS
applicant record

The SL/GC will:

1. Receive med read SMDs from the recruiter via email or service system
2. Rename the med read PDF:
a. The last 4 of the applicant SSN
b. The letters MR
c. Example: 1234MR
Note: SL/GCs can have recruiters name these packets when initially scanned to save
time
3. Attach the med read packet to an encrypted email with read receipt
a. From Outlook click on New Email
b. From the email top menu click on Options
c. Click Encrypt
d. Check mark the Request a Read Receipt Box
Note: You can configure your email so that it will always encrypt and deliver a read
receipt by going to File – Options – Mail – Tracking – click the Read receipt box and
File – Options – Trust Center – Trust Center Settings – Email Security – click the
Encrypt contents and attachments for outgoing messages
4. Input into the To line of the email the MEPS specific MHS GENESIS email group
a. For Eastern Sector MEPS the group email is: OSD MEPS-ES-MEPS Name-

38
 USMEPCOM ES List MEPS ABBREVIATION-MGEN HRA
i. e.g., the Atlanta MEPS MGEN email OSD MEPS-ES-Atlanta-
USMEPCOM ES List ATLA-MGEN HRA
b. For Western Sector MEPS the group email is: OSD MEPS-WS-MEPS Name-
USMEPCOM WS List MEPS ABBREVIATION-MGEN HRA
i. e.g., the Albuquerque MEPS MGEN email OSD MEPS-
WS-Albuquerque-USMEPCOM WS List ALBQ-MGEN
HRA
5. In the subject line type the following:
a. Initial med read submission: “MR Review”
b. Med read resubmitted due to additional requirements: “MR Resubmission”
6. In the body of the email type the applicants full name and SSN

Example: A proper email message to the MHS GENESIS HRA for med read review, note the
email is encrypted and a read receipt has been requested

7. Send the review request and med read packet

8. Receive the read receipt from the MGEN HRA, once received it is an indicator the med
read will be in a “In Review” status in USMIRS with a 24-hour, 5-day, or 10 day due
dateassigned

Med Read cut-off time: All med reads submitted to the HRA from the SL/GC prior to 1100
will be processed that day. The review process timeline will start the next day for any med
reads submitted after 1100.

39
The HRA will:

1. Monitor their Outlook inbox for any emails sent to MGEN HRA group; this will replace
the SL/GC dropping med read packets off to the files room
2. Use this email notification as an indicator to open MHS GENESIS to prepare for med
read document upload
3. Open the email and move the scanned med read packet to their computer – once the
email is opened the HRA must complete the MHS GENESIS upload of the med read
packet
Note: Once the email is opened it will notify the SL/GC that the med read review time has
begun and the MEPS has 24-hours to review the med read and render a PULHESD decision
The HRA can also respond to the SL/GC with the response Received. This is not mandatory
but adds a level oftracking and acknowledgment.
4. Search Register (create) the applicant into MHS GENESIS – see job aid “Register
anApplicant”
5. Create an outside document encounter – see job aid “Document Upload”
6. Upload the med read packet into MHS GENESIS – name the med read packet “MEPS
Med Read Packet”
7. Confirm the med read packet is in MHS GENESIS – once in MHS GENESIS the med
read packet is secure and becomes the original med read packet from here on out
8. Delete the med read packet that was moved out of the notification email from the HRA
computer desktop or internal MEPS share folder
9. From the applicant record in MHS GENESIS send a message center note to the Med
Techpool that this applicant is ready for med read review – see job aid Message Center
in MHS GENESIS

Prior to provider review the Med Tech will:

1. Monitor MHS GENESIS message center – all message center orders (email) has the
patient (applicant) name as part of the heading.
2. Choose an applicant to start the med read process from the message center messages page

40
 Example: Med Tech message center inbox

3. Right click the email and select assign – this will show other Med Techs who is
activelyworking that applicant’s med read and which applicants still need to be
reviewed
4. Open the email to verify that this is a med read review and any additional information
sent by the HRA
5. Access the applicant’s EHR from the opened email by clicking on the applicant name in
the top right corner
6. Click on documents on the right side menu of the applicant EHR
7. Click on the DD Form 2807-2 “view image” tab in the documents section of the EHR
8. Click on view document from the 2807-2 detail panel
9. Administratively review the med read packet
a. If the admin review reveals the med read is incomplete and Med Tech will:
i. Stop the med read review process
ii. Put the applicant in a “Med Read Incomplete” status
iii. Input the discrepancy in the med read status additional notes box (e.g.,
MR documents are insurance and billing paperwork resubmit with medical
documents explaining the reasoning for the drug Ativan)

41
 Example: Inputting an incomplete med read in USMIRS

Example: An incomplete med read status in USMIRS

Note: The SL/GC will send the corrected med read packet back to the HRA email
group with the subject of “MR Resubmission”. The HRA will upload the corrected
med read to the applicant record and send to the Med Tech group in message center.
Review time will start over for all MR resubmissions.
b. If the admin review reveals no errors:
i. Use message center to inform the provider pool that an applicant is ready
for their med read review
ii. Do not update the status in USMIRS

The provider will:

1. Monitor MHS GENESIS message center – all message center orders (email) has the
patient (applicant) name as part of the heading
2. Choose an applicant to start the med read process from the message center messages page
3. Right click the email and select assign – this will show other providers who is actively
working that applicant’s med read and which applicants still need to be reviewed
4. Click on documents on the right side menu of the applicant EHR
5. Click on view document from the med read detail panel
6. Review the med read SMDs
7. The MEPS provider will review the med read for a qualification determination

42
 8. The provider will determine if additional time is needed based on the size and complexity
of the med read packet – See Provider Manual for MHS GENESIS
a. If additional time is not needed
i. Send confirmation message center email back to the Med Tech
withmessage stating “24-hour review”
ii. Med Tech will put in USMIRS an “In Review” med read status and
changethe due date to the next day
b. If additional time is needed
i. Send a confirmation message center email back to the Med Tech stating
“5-day” or “10-day” review
ii. Med Tech will put in USMIRS an “In Review” status and change the due
date to 5 or 10 working days from the original due date
9. Complete review of the med read packet
10. Make appropriate comments in the MHS GENESIS physical exam component of the
EHR
11. Make a PULHESD qualification decision in the PULHESD component of the EHR
12. From the applicant record; utilize message center to send the qualification decision and
any additional information to the Med Tech

After provider review, the Med Tech will:

1. Assess the qualification decision from the message center note
a. If qualified:
i. Input the med read status “Med Read Complete PULHESD Updated” in
USMIRS
ii. Update USMIRS Medical Qualification to reflect the PULHESD
component in the applicant MHS GENESIS EHR
b. If open and additional documents are required:
i. Input the med read status “Additional Documents Required” in USMIRS
ii. In the additional notes copy the SMDs listing/information the provider
sent via message center (e.g., RJ – Need records on counseling for
anxietyOct 2021)

Example: A completed med read status inputted into USMIRS

43
 Example: A completed med read status displayed in the Prescreen & Medical Reads tab in
USMIRS

Example: Additional documents information inputted into USMIRS

Example: An additional documents med read status displayed in the Prescreen & Medical
Reads tab in USMIRS

The med read process is over when a medical qualification decision is made. All resubmissions
due to a med read incomplete status (admin discrepancy) or additional documents needed status
(SMDs needed) starts the review times over upon resubmission to the HRA email pool.

All MHS GENESIS entries explained in this info message can be view by a narrative video
found on SPEAR at the following link:
https://spear/hq/mmt/Documents/MEPCOM%20Training%20Video_Final_1080p.mp4

44
Shipper Inspect Grandfather Policy
Overview: With the conversion from a paper medical process to an EHR, all new medical
examination processing at the MEPS will transition to a paperless process. The following policy
will cover the grandfathering of all paper shipper inspects prior to the February 24, 2022 SGL,
and March 10, 2022 for big bang deployment dates. With the fielding of MHS GENESIS by all
Initial Entry Training sites (IETs) shipping applicants will have to be uploaded into MHS
GENESIS AFTER the medical shipping inspect is conducted on the paper DD Form 2808. This
action replaces the HAIMS uploading process.

All applicants whose paper medical records will be grandfathered fall under the following
categories:

1. Have assessed into a guard or reserve component

2. Are in the Delayed Entry Program (DEP) for an active component
3. Are medically qualified or have a waived disqualification and can contract with no
further medical processing needed

Processing shippers with paper medical documents after MHS GENESIS SGL.

1. At QRP
a. From the USMIRS homepage scheduled applicants list – select the MEPS
Shipper box under the Processing section on the left hand side of the
screen
b. Select an applicant and view the Physical date in the applicant header
c. Any applicant that has a physical date prior to the MEPS SGL date will havea
completed paper physical and falls under the grandfather category
Reminder: The latest date for grandfathering shippers is February 23 or March 9
dependent on the MEPS
d. Pull all applicant packets
e. Conduct QRP on the paper applicant packet and in USMIRS per USMEPCOM
and local policy
2. On the scheduled processing day – Medical Department
a. The shipping applicant will process through the medical department with their
paper record
b. All medical entries will be made on the paper medical record USMIRS – No
action to include medical entries will be made in MHS GENESIS
c. Applicant will be given the entire medical record and sent to the SL/GCs for
further processing
3. On the scheduled processing day – Operations Section
a. The shipping applicant will process through the Operations Section with their
paper packet
b. When all operational and shipping tasks have been completed, the medical
paperwork from the packet will be scanned into MHS GENESIS
c. The HRA will:
i. Register the applicant into MHS GENESIS – See Job Aid Registration
(Note: MEPS may register an applicant prior to the projected processing
45
 day, when feasible)
ii. Create an outside records encounter – See Job Aid Document Upload
iii. Scan the record into MHS GENESIS – name the uploaded document
“MEPS Med Exam”
iv. Once confirmed the entire medical exam has been loaded into MHS
GENESIS the packet will be returned to the SL/GC

For all applicant packets that are medically qualified (or waived) to ship, or contract without
further medical processing and expire, the packet will be purged IAW current purge criteria
andnot be uploaded into MHS GENESIS.

For any paper medical record that was previously qualified (or waived) and now has to be
reviewed by the medical department:

1. Register the applicant into MHS GENESIS – See Job Aid Registration
2. Create an outside records encounter – See Job Aid Document Upload
3. Scan the record into MHS GENESIS – name the uploaded document “MEPS Med
Exam”
4. Once confirmed the entire medical exam has been loaded into MHS GENESIS
the applicant can be scheduled/approved to medically process with the updated
medicalinformation being captured in the MHS GENESIS EHR.

46
 Disposition of UMF 680-3A (Request for Examination)
Overview: With the conversion from a physical packet process to an EHR, the UMF 680-3A
submitted electronically as part of the PS packet will be uploaded in the applicant’s MHS GENESIS
EHR. All subsequent UMF 680-3As (e.g., aptitude testing, SPF change, personal data update)
submitted will be uploaded in e-Record.

Submission of UMF 680-3A with PS:

1. Create an outside records encounter – See Job Aid “Document Upload”

2. Upload UMF 680-3A into the applicant’s MHS GENESIS EHR and name “UMF 680-3A”-
see job aid “Document Upload” in MHS GENESIS
3. Confirm UMF 680-3A has been uploaded by viewing it in the Documents tab on the left side
menu of the applicant’s MHS GENESIS EHR.
4. Once in MHS GENESIS the UMF 680-3A is secure and becomes the original
5. Delete UMF 680-3A that was moved out of the notification email immediately after
confirming MHS GENESIS EHR upload.

Subsequent Submission of UMF 680-3A:

1. Upload UMF 680-3A into e-Records (scan and upload if provided via hardcopy) by close of
business on the day of submission.
2. Confirm UMF 680-3A has been successfully uploaded in e-Records.
3. Once in e-Record, UMF 680-3A is secure and becomes the original.
4. Delete UMF 680-3A that was moved out of the notification email if provided electronically
(destroy if provided via hardcopy) immediately after confirming the e-Records upload.

Submission of Additional Processing Documents:

All additional processing documents (e.g., UMF 601-23-8, DD 214, UMF 601-23-E, DEP Discharge
Letter, DD 368, etc.) will be uploaded in e-Records upon receipt. Destroy immediately after
confirming upload.

47
 Supplemental Medical Documentation (SMD) uploaded as an Outside
Record
Overview: With the conversion from a paper medical process to an EHR, all medical examination
paperwork conducted outside of MHS GENESIS (e.g., overseas, in-service physicals) must be
uploaded into MHS GENESIS. All subsequent medical processing (if applicable) will be conducted
in MHS GENESIS. This action will also serve as the transfer of records between the MEPS and the
Individual Entry Training Sites (IETS) which will have MHS GENESIS thus starting the paperless
transfer of applicant medical records into the DoD medical system.

Any paperwork used to medically process an applicant outside of MHS GENESIS, and then requires
processing at the MEPS will be uploaded into the applicant’s EHR as an Outside Record Encounter.

All applicants who need medical documents uploaded for MEPS processing will first have to be
registered in MHS GENESIS. All medical documents submitted by the SL/GCs will be digitally
transferred to the MEPS MHS GENESIS HRA as a PDF to the MHS GENESIS HRA email group.

1. For Eastern Sector MEPS, the group email is: OSD MEPS-ES-MEPS Name-USMEPCOM
ES List MGEN HRA
• e.g., the Atlanta MEPS MGEN email OSD MEPS-ES-Atlanta USMEPCOM ES List
MGEN HRA
2. For Western Sector MEPS the group email is: OSD MEPS-WS-MEPS Name-USMEPCOM
WS List MGEN HRA
• e.g., the Albuquerque MEPS MGEN email OSD MEPS-WS-Albuquerque
USMEPCOM WS List MGEN HRA

All emails with applicant PHI/PII will be encrypted.

All PDF files will be downloaded from the email to a secure internal MEPS share drive or desktop
and then imported from there to MHS GENESIS.

When uploading medical documents in MHS GENESIS the MEPS will always use the name
“MEPS” to identify and categorize MEPS uploaded paperwork.

The MEPS will name scanned paper-based documentation in the following manner

1. All PS paperwork: “MEPS PS Packet”

2. All Medical Read paperwork: “MEPS Med Read Packet”
3. All Waiver paperwork: “MEPS Waiver”
4. All Overseas paperwork: “MEPS Overseas Packet”
5. All Manually processed MEPS Exam paperwork: “MEPS Medical Exam”
6. SF 600 Cerumen Removal Consent: “MEPS Cerumen Removal Consent”
7. Airborne Checklist: “MEPS Airborne Checklist”

48
Because of varying types and the multiple standards of medical forms that can be used for accession
and/or Service qualification it is difficult to predict every type of form that needs to be uploaded to
the applicant’s EHR. When presented with an uncommon form that needs to be uploaded to the
applicant’s EHR, the Medical Department can name these forms themselves as long as the word
“MEPS” is in front of the title (e.g., “MEPS DoDMERB Examination”). This will ensure that as the
applicant continues to process into the Service, it will make MEPS paperwork easily visible in the
Documents component of the applicant’s EHR.

In order to upload documents an Outside Documentation Encounter must be created upon registration
of an applicant. See the On-Demand Video (ODV) Document Upload Encounter
https://spear.mepcom.army.mil/hq/mmt/Documents/3%20HRA%20-
%20Outside%20Documentation%20Encounter%20v2.mp4

Example: Creating an Outside Documentation Encounter during MHS GENESIS Registration

Once an Outside Document encounter is created, documents can be uploaded into MHS GENESIS at
anytime

1. Log into MHS GENESIS

2. Select the search function in the top right corner
3. Type the applicant’s name (or SSN/DoDID)
4. Select the applicant’s name from the Patient Search box that displays – ensure to choose the
proper applicant from the listing
5. Select the applicant in the Patient Search box and click “OK”
Notes: You can view that an applicant has an Outside Record encounter built by viewing the
“Outside Documentation Only” encounter in the bottom section of the Patient Search box.
6. From the applicant record in MHS GENESIS select “Patient” in the tool bar and from the pull
down select “view images”
7. Type the title “Outside Records” in the Select Image type box
8. Change the image title from Outside Records to the correct document title using the MEPS-
specific naming conventions listed above
9. Click import to pull the image from a folder/desktop into the EHR
10. The form will now be in the documents portion of the applicant EHR
49
11. Click on “Documents” on the left side menu to confirm the uploaded form is in the EHR

Example: Applicant search from the applicant tracking list in MHS GENESIS

Example: Display of the applicant in the Patient Search box and selection of the Documents
encounter

Example: From the applicant record select Patient in the tool bar and View Images

50
 Example: Type outside records and then change image title to include MEPS in the title and select
import and pull the documents from the scanned documents

Change the name

to the document
being uploaded.
Include MEPS at
the beginning of
the name

Any form imported into MHS GENESIS is now secure in the applicant’s EHR. The MEPS will
properly disposition the original PDFs/scanned documents

All MHS GENESIS entries explained in this info message can be view by a narrative video found on
SPEAR at the following link:

https://spear/hq/mmt/Documents/MEPCOM%20Training%20Video_Final_1080p.mp4

51
 Updated Standardized Medical Brief
Overview: With the conversion from a paper-based medical process to an EHR the requirement to
fill out paperwork during the medical brief has been eliminated. The medical brief will be found on
SPEAR on the J-3/5/7, Operations and Readiness, Medical, Medical Information page, in the Medical
Brief and Applicant Processing Forms section. The updated medical brief must be used starting
February 24, 2022, for MEPS that deploy MSH GENESIS during SGL and March 10, 2022, for all
other MEPS/RPSs during big bang deployment.

Direct link to the Medical Brief page:

https://spear.mepcom.army.mil/hq/j3/or/Medical/Medical%20Brief/Forms/AllItems.aspx

The medical brief can be briefed by using the automated voice applied to all slides or verbally by the
medical briefer. Only a trained medical staff member or cross-trained MEPS employee can give the
medical brief. If the medical brief is given verbally, it must be done verbatim from the medical brief
slides. The medical briefer must remain in the room can verbally add to the brief in order to clarify
information read/played to the applicant from the slide.

To keep the medical briefing efficiently moving forward without additional start/stop delays, the
medical brief voice over will automatically start when the next slide is advanced. If an applicant has a
question on the slide that was just played, it will be answered before advancing to the next slide.

The Medical Department will print the medical briefing slides and have on hand in a medical brief
binder for use in case the MEPS have to brief the applicants manually due to computer, connectivity,
or power issues.

If the MEPS decides to verbally brief the applicants without the voice over, they will need to turn the
volume off so the voice over cannot be heard. No other changes to the medical brief are authorized.

A medical brief script with the exact voice over wording has been provided for training purposes and
to assist any medical briefer verbally conducting the medical brief.

52
HIV and DAT procedures
Overview: HIV/DAT program is an integral part of the MEPS medical processing. As a result of the
USMEPCOM medical modernization effort to convert the MEPS to an EHR system, there will be
some changes to the HIV/DAT program. The following policy will cover the disposition of
HIV/DAT paper records prior to February 24, 2022 (SGL date), and March 10, 2022 (big bang
deployment date). The immediate changes are specified below. This guidance will supplement
and/or replace current policy during the MHS GENESIS SGL and sustainment periods until such a
time that affected regulations can be properly updated.

Process: Upon MHS GENESIS deployment at your MEPS, Medical Briefers will no longer provide
each applicant a copy of UMF 40-8-1-E. This is now part of the medical PSing process.

MEPS will continue to maintain a copy of the positive DAT letter and the treatment facilities in a
medical administration file as specified in ref (a) until the capability to upload the letter into the
applicant’s record is available in USMIRS.

The requirement to keep HIV shadow files at the MEPS has been rescinded. Effective upon the
release of this message, any HIV shadow file at the MEPS Medical Department with a cross
reference sheet (DA Form 1613) and a DA Form 200 signed by the HIV/DAT office staff should be
shredded. Keep electronic copies of these two forms for your records in a folder that is equipped to
store documents with PII. Do NOT shred any shadow file without the proof that the original packet
record is located at the J-3/5/7 HIV/DAT office.

New Requirement starting February 24, 2022: Following specimen collection, any excess
specimen label must be shredded daily to prevent PII spillage. After each positive/indeterminate
HIV notification at the MEPS, copies of the HIV control logs and the HIV notification forms (e.g.,
UMF 40-8-14-E, UMF 40-8-15-E or UMF 40-8-19-E and the UMF 40-8-16-E) must be sent directly
to the J-3/5/7 HIV/DAT office staff via encrypted emails specified below. A completed and signed
DA Form 200 is also required.

Grandfather Policy: Applicants with incomplete HIV/DAT processing before the deployment dates
(both SGL and the big bang deployment dates) will complete their processing on the paper record. At
the end of the HIV/DAT processing, the entire applicant's packet record must be uploaded into MHS
GENESIS regardless of the qualification status. All subsequent HIV/DAT processing will be
conducted in USMIRS and MHS GENESIS. The original HIV positive packet record currently at the
MEPS must be sent to the J-3/5/7 HIV/DAT office per reference (a). Do NOT shred any HIV
positive packet record until a signed DA Form 200 is received and acknowledged by the J-3/5/7
HIV/DAT office staff.
Note: All other HIV/DAT processing requirements specified in reference (a) remain in effect.

• Mr. Olubunmi Yoloye, J-3/5/7 Medical Division (MEOP-MD) (847) 688- 3680, ext. 7126, e-
mail [email protected] & MSgt Melissa LaBoy, J-3/5/7 Medical Division
(MEOP-MD) (847) 688- 3680, ext. 7137, e-mail [email protected]

53
Cerumen Removal Procedures
Overview: The following are the procedures for cerumen removal procedures with MHS GENESIS.
Once completed the SF 600 Cerumen Removal Consent form will be uploaded directly into the
applicant EHR. Note: The graphics used in the document were produced commercially, use
fictitious names/PII, and are for instructional purposes only.

Before cerumen removal is attempted, the provider must ensure that the USMEPCOM SF 600
Cerumen Removal Consent Form has been completed by the applicant and signed by the provider.
The original SF 600 will be uploaded in the applicant’s EHR after the med-tech, applicant, and
provider have completed the form in its entirety.

The requirement to keep a copy of the SF 600 in a medical administrative file for two years will be
discontinued.

Cerumen removal will continue to be conducted IAW UMR 40-1, paragraph 6-4.

The provider will use the standardized medical examination enterprise auto-text “.meps-me” in the
Physical Exams Component of the applicant’s EHR.

Example: The location of the tympanic membranes TM evaluation in the medical examination
template in the EHR

The provider will use the pulldown to select of the TMs were visualized by selection of Yes or No from the
pulldown.

54
The provider will indicate if an ear lavage was performed by selection of Yes or No from the pulldown.

The provider will indicate result of the TM evaluation by selection of Normal, Abnormal, or Not
Evaluated from the pulldown.

If the TM evaluation results in an abnormal condition, the provider will select if the finding is
considered disqualifying (CD), not considered disqualifying (NCD) or Open.

The applicant’s SF 600 Cerumen Removal Consent Form will be scanned into MHS GENESIS:

1. Log into MHS GENESIS

2. From the tracking list click on the search function in the top right corner
3. Type the applicant’s name (or SSN/DoDID)
4. Click on the applicant’s name from the Patient Search box that displays – ensure you choose
the proper applicant from the listing
5. Select “Outside Documentation Only” in the Patient Search box and click “OK”
6. From the applicant record in MHS GENESIS select “Patient” in the tool bar and from the pull
down select “view images”
7. Type the title “Outside Records” in the Select Image type box
8. Change the image title from Outside Records to MEPS Cerumen Removal Consent
9. Click import to pull the image from a folder/desktop into the EHR
10. The SF 600 Cerumen Removal Consent Form will now be in the documents portion of the
applicant EHR
11. Click on “Documents” on the left side menu to confirm the uploaded MEPS Cerumen
Removal Consent Form is in the EHR
55
 Example: Applicant search from the applicant tracking list in MHS GENESIS

Example: Display of the applicant in the Patient Search box and selection of the Documents
Encounter

56
 Example: From the applicant record select Patient in the tool bar and View Images

Example: Type outside records and then change image title to Cerumen Removal Consent and select
import and pull the documents from the scanned documents

Change to
MEPS
Cerumen
Removal
Consent

The SF 600 Cerumen Removal Consent form is now secure in the applicant’s EHR. The Med Tech
will properly dispose of the original form.

All MHS GENESIS entries explained in this info message can be view by a narrative video found on
SPEAR at the following link:
https://spear/hq/mmt/Documents/MEPCOM%20Training%20Video_Final_1080p.mp4

57
 Consult Process - MHS GENESIS Referrals
Overview: With the conversion from a paper medical process to an EHR, the requirement to
annotate consults and/or ancillary services on a SF 513 has been eliminated and replaced by
obtaining the data from the MHS GENESIS referral list. Once completed the consultation results
will be uploaded directly into the applicant MHS GENESIS record for review. Note: The graphics
used in the document were produced commercially, use fictitious names/PII, and are for instructional
purposes only.

Consultations and/or Ancillary Service

A consultation and/or ancillary service (collectively known as consults) are requested by a MEPS
medical provider following an accession medical examination or medical update to the medical
examination. All consults are performed outside the MEPS.

A consultation is used to assist in rendering a medical determination. All consultations are requested
by a MEPS medical provider for assistance in rendering a medical qualification determination

Initiation of a Consult:

The provider determines that the applicant needs a consult to assist in making a qualification
determination.

The provider will leave the appropriate PULHESD category in an (O)pen status in the PULHESD-
Disqualification component of the applicant’s EHR.

Example: An applicant with a high auto-refraction reading and given an Abnormal Medical
Evaluation entry in the Physical Exam component of the Applicant EHR

The Consult Ordering Process:

Note: MHS GENESIS calls all consults and ancillary services referrals.

The provider will:

1. From the applicant’s EHR, select “New Order Entry” in the right side menu
2. From the New Order Entry component, select the “Mine” tab
3. From the Mine tab a Favorite box will open, select the “Referrals” folder
4. From the Favorites/Referral listing, select the appropriate consult from the list
5. Select the “Orders for Signature” box at the top right corner of the EHR
6. From the Orders for Signature box, select “Modify Details”
7. From the Referral Request Order, input the details of the consult in the “Referral Reason”
box; this is what replaces the consult details that were annotated on the SF 513 e.g., 22y/o
male with high cylinder, who needs dilated retinal exam, manifest refraction, and comment or
evaluate for strabismus
8. From the Referral Request Order after consult details were entered in the Referral Reason box
58
 select “Sign”

Example: Navigating to the New Orders Entry Component of the EHR.

Example: Selection of the Mine tab to pull up a Favorites folder listing and the selection of the
Referrals folder.

Example: Selecting a consult from the Favorites/Referral folder.

59
Example: Selecting the Orders for Signature box at the top right. A number will populate with how
many orders need to be signed.

Example: Modifying Details of the order to add information that needs to be sent to LHI.

Example: Selecting the order to modify.

Example: Entering the consult details into the Referral Reason box. This will be the information
that will put into the LHI electronic SF 513.

60
After the provider orders the consult,

The Med Tech will:

1. Monitor the Referral Worklist by selecting the “Referral Viewer” in the tool bar
Note: The MEPS can designate medical staff member(s) as consult POC(s) as they do today.
Along with their duties scheduling and tracking MEPS consults, they now will be tasked to
monitor referrals in MHS GENESIS.
2. Identify an applicant on the Referral Viewer Worklist the has a consult that is in a Not Started
Status; this is a view only status when accessing from the FirstNet application
3. Access the Power Chart applicant in MHS GENESIS
a. From the Referral Viewer pull down arrow, select “My Experience”
b. From the My Available Positions box, select “Referral Management”
c. From the Save Changes box, select “Log Out”
4. From the Citrix Storefront, select the PowerChart application
Note: The PowerChart application is a blue box with a capital P in it with the word
PowerChart underneath. At any time you can identify what application you are in by looking
at the top left corner of the screen. PowerChart is a blue P, FirstNet is a red E, and
RevenueCycle is a green R.

Example: Accessing the Referral Viewer from the MHS GENESIS FirstNet application

Example: Viewing the Referral Viewer Worklist to determine is a consult needs to be

ordered, this is view only when accessing from the FirstNet application

61
Example: Changing roles to make changes to a consult in PowerChart. First, select My Experience
from the Referral Viewer icon, then select Referral Management

Example: Select Log Out to save changes

62
Example: Select the PowerChart application. Because the role was changed the Med Tech will now
be able to schedule the consult in MHS GENESIS

5. From the Referral Viewer Worklist, select an applicant in a not scheduled status
6. From the Details box in the Case Details section, input the Referral Reason into the LHI
electronic SF 513; the data can be typed word for word, or copied and pasted
7. Use the LHI Client Portal to order the consult IAW current policy
a. If LHI cannot fulfill the consult request to current standards the MEPS can request
GPC authorization to get a non-contracted consult
b. An applicant, through their recruiting Service, can submit a self-obtained consult
c. All consults obtained outside a contracted consultant will be submitted as a
scanned/electronic PDF either through the med read process for self-obtained consults
or attached to an encrypted email from the non-contracted consultant

Example: Location of the Referral Reason in the Case Details section of the Details box after
selecting the applicant from the Referral Management Workflow. The Referral Reason will be
copied into the LHI electronic SF 513.

8. After the consult has been ordered in LHI, return to the MHS GENESIS screen
Note: The Med Tech will be able to use two computer screens to jump between the LHI Portal
and MHS GENESIS to quickly complete the entire consult process for an applicant in one setting.
9. From the applicant’s Details box, select “Start Referral”
63
 10. From the applicant’s Detail box, after starting the referral, select “Edit”
11. In the Case Details Section, which is now editable, type “defer” in the Refer to Provider box
and select enter; a Provider Search box will appear
12. In the Search By box ensure the dropdown is set to “Practice”
13. In the Search By box on the Qualifiers line, remove the consult by selecting the X next to the
consult name (e.g., ophthalmology)
14. In the Search By box next to the Search By box, select the “Include External Practices” box
15. From the populated listing, select the second option “Defer to MCSC via Manual/EFax DoD”
16. From the Defer to MCSC via Manual/EFax DoD sub-set, select “CB MTF Capability” to
highlight and then select “Accept”
17. From the Case Details section, select “Save”
18. From the applicant’s Detail box, select “Generate”
19. From the Referral Summary box, select “Send”; this will produce a continuity of care
attachment with all the details of the consult that was ordered, that can be printed and given to
the applicant
Note: This is not mandatory, though it is good practice to give information to the applicant for
full visibility on what is going on with their medical process to enter their sponsored Service.
The applicant can be informed that their recruiter will get with them on details of the time and
place of their consult appointment.
20. Review the applicant’s Detail box to ensure the consultation is in a Sent status
Example: Starting a referral in MHS GENESIS after sending the consult information but before
receiving a consult appointment. After selecting Start Referral select Edit in the Case Details section

Step 1

Step 2

Example: When editing the case details type defer and enter in the Refer to Provider box

64
 Example: Ensure Practice is selected in the Search By dropdown box

Example: Deleting the consult from the Qualifiers line

Example: Check-mark the Include External Practices box by selecting the box

65
Example: As edits are made in the Provider Search box, referral options will automatically start to
populate. Select the second option Defer to MCSC (Managed Care Support Contractor) via
Manual/eFax, DoD

Example: From the sub-set select CB: MTF Capability and select Accept

66
Example: Select Save to save the edits and then select Generate.

Step 2

Step 1

Example: A Referral Summary is generated; select Send

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Example: Once sent, the Referral Summary will generate a Continuity of Care Document you can
print for the applicant (or SL/GC, NOAA and ROTC POCs etc.).
Note: If the MEPS were using the MHS GENESIS referral system for consults, this is what is sent to
schedule the applicant. Because we deferred the consult to ourselves, we sent the Referral Summary
and Continuity of Care Document back to ourselves. Select Cancel at the bottom right of the screen
to leave this document.

After the Medical Department gets notification of the consult appointment details.

The Med Tech will:

1. From the Referral Viewer Worklist, select the applicant that you received the appointment
notification for
2. From the Details box next to the Sent status, select “Edit”
3. From the Edit pulldown box, select “Scheduled”
4. From the Edit Status box, select the appropriate “Date and Time” from the outside consult
appointment details

Example: Editing a consult request in a Sent status once an appointment date has been
scheduled

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 Example: Placing the applicant in a Scheduled status

Example: Inputting the consultation Date/Time information

From the LHI Client Portal

The Med Tech will:

1. Access the applicant’s EHR

2. From orders section in the completed box, select “View”
3. From the SF 513 portion of the completed consult selections, select “View”
4. From the digital SF 513, select “Safe Download PDF”
5. Save the digital SF 513 to the internal Medical drive in a designated folder e.g., Downloaded
Consults
6. Name the downloaded and saved SF 513 CN and the last four of the applicant’s SSN e.g.,
CN1324

Example: Selecting View to see a completed consult in the LHI portal. Note the green color to
indicate completion.

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 Example: Selecting View to see the SF 513 within the competed consult page.

Example: Selecting the Safe Download (PDF) from the Download icon for the digital SF 513 when
it becomes viewable.

For consults outside the LHI Portal that are done by a MEPS requested non-contracted consultant, the
same standards apply. The recorded consult results will have to be uploaded as a PDF in MHS
GENESIS.

For all consults obtained by the applicant, the consultation documents will be submitted as a Med
Read. See MHG GENESIS message; “The USMEPCOM Medical Read Process”.

After the Medical Department gets the consultation results back

The Med Tech will:

1. From the Referral Viewer Worklist, select the applicant that you need to upload the received
the completed consult information to
2. From the Details box, select the “Documents” tab
3. From appropriate consult in the Available Documents section, select “Add”
4. Upload the consult from the designated folder from the Medical Share Drive and name the
uploaded consult “MEPS Type of Consult” e.g., MEPS Ophthalmology Consult, MEPS
Cardiology Consult, MEPS Dermatology Consult
Note: The Med Tech will be able to use two computer screens to jump between LHI, their
internal drive consults folder, and MHS GENESIS to complete downloading and uploading
received consults for provider review in one setting.
5. From the Referral Management Worklist Patient list, select the applicant that had the consult
document uploaded and is now ready for provider review
6. From the applicant EHR clinical workflow, select “Documents”
7. From the Document Component on the uploaded consult, select “View Images”
8. From the opened document, Select “Forward”
9. From the applicant’s Forward Only Documents box, select “Review” from the dropdown box
and input the MEPS Provider Pool in the “To Box”
10. From the Details box next to the Sent status, select “Edit”
11. From the Edit pulldown box, select “Closed”
12. From the Edit Status box, type “T” and “N” in the Date and Time boxes
Note: In MHS GENESIS T and N mean today and now and can be in all date and time boxes if
applicable
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Example: Selecting the Documents tab in the Details box of an applicant in the Referral
Management Worklist to begin the uploading of consult documents.

Example: Adding uploaded consult documents to the appropriate scheduled consult.

Example: Forwarding the uploaded consult to the provider by selecting the applicant’s name in the
Referral Management Worklist

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Example: Finding the uploaded consult in the applicant EHR by selecting Documents in the left side
Clinic Workflow list and selecting View Image once in the Documents component.

Example: Selecting View Document to open the consult to send to the provider.

Example: The open uploaded consult that will be sent to the provider by selecting the Send icon at
the top right of the page and forwarded to the provider pool in a Review status.

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The Consult Review Process:

The provider will:

1. Monitor Message Center for new consults that are in a Pending status
2. From the Message Center Provider Pool, select the message
Note: If the provider cannot review the consult immediately they can assign it to themselves by
right clicking on the message and selecting “Assign”
3. From the opened message, select “Inbox View”
4. Review the consult documentation
5. Select the applicant name in the top right corner to access the applicant’s EHR
6. From the Clinic Workflow listing , select “Physical Exam”
7. From the Physical Exam component, enter any pertinent information in regards to the consult
review
8. From the Clinic Workflow listing, select “PULHESD/Qualification
9. From the PULHESD component, select “PULHESD/Qualification” the + pulldown box at the
top right corner of the EHR
10. Enter the appropriate PULHESD information based on the consult review
11. Enter the appropriate qualification status if this completes the PULHESD review
12. Sign the applicant’s EHR, select the green checkmark icon at the top left corner of the EHR
Note: If an additional consult is needed, keep the PULHESD category in an open status and
order another consult.
13. Send the message back to the Med Tech pool with the updated status of the applicant

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 Example: A consult review request in the provider pool Message Center

Example: Viewing the consult right from the message by utilizing the Inbox View feature

Example: Accessing the applicant’s EHR from the provider’s opened message

Example: Navigating the PULHESD/Qualification component

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 Example: Accessing the PULHESD by selecting the + pulldown

Example: Entering PUHLESD and Qualification information and signing the EHR

Example: Sending a message back from the Message Center icon in the tool bar to the Med Tech on
the status of the applicant after the consult review.

When not processing consults in MHS GENESIS, the Med Tech will have to change their role
back to Readiness Staff from Referral Management to be able to input medical data into the
applicant EHR. This is done by selecting the “My Experience” icon in the MHS GENESIS
toolbar and selecting the radio button next to Readiness Staff.

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 Example: Changing roles through the My Experience icon in the tool bar

USMIRS entries when consults are initiated

The Med Tech will be able to use two computer screens to assist in completion of data input from
MHS GENESIS to USMIRS in one setting.

The Med Tech will:

1. Select the applicant’s name from the scheduled applicant’s list to enter USMIRS applicant
electronic record or enter the SSN in the homepage search bar
2. Select the Medical tab
3. Select on the Medical Qualifications sub-tab
4. Under the correct PULHESD score, select the O (open)
5. Select the Consult radio button
6. Enter the date in the Profile Date box
7. Select the type of provider from the dropdown in the Profiler box
8. Select the Consult Type from the list
9. Input any notes in the Notes field (e.g., applicant-obtained specialty evaluation). This will
show in the note under the PULHESD for quick reference.
10. Select Save when finished

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USMIRS entries when consults are completed

The Med Tech will:

1. Enter the applicant’s SSN in the search bar in the home page search bar to enter the
USMIRS applicant electronic record
2. Select on the Medical tab
3. Select on the Medical Qualifications sub-tab
4. Under the Outstanding Scores sub-tab find the appropriate open score
5. Select the Clear Score button
6. Enter the date in the Cleared on Date box indicating the date the MEPS provider reviewed
the consultation results
7. Enter the name of the MEPS reviewing provider in the Waived By Cleared By box
indicating who reviewed the consultation results
Note: Waived By box in this instance is used for administrative purpose only, and does not
represent the medical waiver which can only be granted by the SMWRA.
8. Enter in the Location box the MEPS from where the consult was ordered (e.g., Chicago
MEPS)
9. Enter the LHI order number for LHI ordered consults, or the MOC ticket number for GPC
ordered consults in the Order Number box
10. Enter any notes in the Notes box (e.g., applicant-obtained specialty evaluation)
11. Click the Clear Score button
12. The 0 will convert to a 1 and turn from the color gray to green indicating that the
consultation results have been recorded in USMIRS
13. Note: If the provider reviews the consultation results and renders a disqualification
determination (“3T” or “3P”), then after clearing the score, the medical technician will
have to select Add New Score button and enter the appropriate information as indicated in
the PULHESD/Qualification component of the applicant’s EHR

All MHS GENESIS entries explained in this info message can be view by a narrative video found on
SPEAR at the following link:

https://spear/hq/mmt/Documents/MEPCOM%20Training%20Video_Final_1080p.mp4

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 Waiver Review Process
Overview: The USMEPCOM waiver review program will transition from a paper process to an
electronic one with the deployment of MHS GENESIS. The review for waiver consideration will
now be reviewed by the Service Medical Waiver Review Authority (SMWRA) from MHS GENESIS
and the paperwork with the SMWRA decision will now be uploaded into MHS GENESIS for a
paperless review by MEPS providers.

Medical Waivers

An approved medical waiver is a document that annotates a Service’s decision to waive a medical
standard for a pre-existing condition(s) which is disqualifying for Military Service IAW DODI
6130.03.

1. Each Service may initiate a medical waiver request through their SMWRA.
2. The individual Service SL/GC is responsible for initiating the medical waiver request
process.

The SMWRA reviews an applicant’s EHR, and determines waiver status, based on all available
information, regarding the issue or condition, as well as specific needs of the Military Service.

MEPS medical providers do not have medical waiver authority for any condition and are not
authorized to make any specific recommendations for or against a medical waiver.

Medical Waiver Outcomes

The outcomes of the SMWRA medical waiver review are as follows:

1. Approved – The applicant’s processing may continue and the applicant can access into the
Military Service with a medical waiver.
2. Disapproved – The applicant’s further processing is discontinued.
3. Without Action – The SMWRA did not have enough information to make a waiver
decision. The SMWRA may request additional information (e.g., additional consult,
medical records, etc.)

An approved medical waiver request should include the approval date and name of the SMWRA
personnel making the waiver decision. This waiver is considered supporting medical documents
(SMD) that must be reviewed by a MEPS medical provider and annotated in the applicant’s EHR
and in USMIRS. If the MEPS receives a disapproved waiver request, it also must be annotated in
the EHR.

Initiation of the Waiver Process

When a provider determines that an applicant is disqualified IAW DoDI 6130.03, the applicant
will be placed in a 3P status under the appropriate PULHESD letter designator in the
PULHESD/Qualification Component of the applicant’s EHR.

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The disqualification information will be appropriately entered into USMIRS under the Medical
Qualifications sub-tab.

The Service for which a medically disqualified applicant is processing for, will make the decision
whether the applicant information will be forwarded to their SMWRA. The decision to request a
medical waiver is the sole responsibility of the Service.

The MEPS Medical Departments are not involved in the submission or receipt of medical waiver
documentation to and from the SMWRA. If a SL/GC receives the SMWRA decision
(documented on a medical waiver) they will submit the medical waiver to the MEPS MHS
GENESIS HRAs for upload into the applicant’s EHR for review.

Example: A 3P disqualification in the PULHESD/Qualification component of the EHR

3P

Example: A 3P disqualification in the USMIRS applicant header

The Waiver Review Process

The SL/GC will:

1. Receive the Waiver from the SMWRA via email or Service system
2. Rename the Waiver PDF:
a. The last 4 of the applicant SSN
b. The letters WV
c. Example: 1234WV
Note: SL/GCs can have recruiters name these packets when initially scanned to save time
3. Attach the Waiver to an encrypted email with read receipt
a. From Outlook click on New Email
b. From the email top menu click on Options
c. Click Encrypt

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 d. Check mark the Request a Read Receipt Box
Note: You can configure your email so that it will always encrypts and delivers a read
receipt by going to File – Options – Mail – Tracking – click the Read receipt box and File
– Options – Trust Center – Trust Center Settings – Email Security – click the Encrypt
contents and attachments for outgoing messages
4. Input into the To line of the email the MEPS specific MHS GENESIS email group
b. For Eastern Sector MEPS the group email is: OSD MEPS-ES-MEPS Name-
USMEPCOM ES List MGEN HRA
• e.g., the Atlanta MEPS MGEN email OSD MEPS-ES-Atlanta USMEPCOM
ES List MGEN HRA
c. For Western Sector MEPS the group email is: OSD MEPS-WS-MEPS Name-
USMEPCOM WS List MGEN HRA
• e.g., the Albuquerque MEPS MGEN email OSD MEPS-WS-Albuquerque
USMEPCOM WS List MGEN HRA
5. In the subject line type the following, “WV Review
6. In the body of the email type the applicants full name and SSN
7. Send the review request and waiver
8. Receive the read receipt from the MGEN HRA. Once received, it is an indicator the wavier is
being uploaded into the applicant’s EHR and sent to the provider for review
9. A waiver will be reviewed and considered by the provider within 24-hours of day of
submission for review

Example: A proper email message to the MHS GENESIS HRA for waiver review, note the email is
encrypted and a read receipt has been requested

Waiver cut-off time: All waivers submitted to the HRA from the SL/GC prior to 1400 1100 will be
processed that day. The review process timeline will start the next day for any waivers submitted
after 1400 1100.

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The HRA will:

1. Monitor their Outlook inbox for any emails sent to MGEN HRA group; this will replace the
SL/GC dropping waivers off to the files room
2. Use this email notification as an indicator to open MHS GENESIS to prepare for waiver
document upload
3. Open the email and move the scanned waiver to their computer – once the email is opened the
HRA must complete the MHS GENESIS upload of the wavier
Note: Once the email is opened, it will notify the SL/GC that the waiver review time has begun
and the MEPS has 24-hours to review the waiver and render a PULHESD decision. The HRA
can also respond to the SL/GC with the response Received. This is not mandatory but adds a
level of tracking and acknowledgment.
4. Search for the applicant in MHS GENESIS
5. Create an outside document encounter – see job aid “Document Upload”
6. Upload the waiver into MHS GENESIS – name the waiver “MEPS Waiver”
7. Confirm the waiver is in MHS GENESIS
8. Delete the waiver that was moved out of the notification email from the HRA computer
desktop or internal MEPS share folder
9. From the applicant record in MHS GENESIS send a message center note to the Med Tech
pool that this applicant is ready for waiver review – see job aid Message Center in MHS
GENESIS

Example: Using the search bar in the top right of the MHS GENESIS, find an applicant

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Example: Display of the applicant in the Patient Search box and selection of the Documents
Encounter

Example: From the applicant record, select Patient in the tool bar and View Images

Example: Type “outside records” and then change image title to MEPS Waiver and click import and
pull the documents from the scanned/sent documents

Change to
MEPS
Waiver

Prior to provider review, the Med Tech will:

1. Monitor MHS GENESIS message center – all message center orders (email) have the patient
(applicant) name as part of the heading.
2. Choose an applicant to start the waiver review process from the message center messages
page
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 Example: Med Tech message center inbox

3. Right click the email and select assign – this will show other Med Techs who are actively
working that applicant’s waiver and which applicants still need to be reviewed
4. Open the email to verify that this is a waiver review and any additional information sent by
the HRA
5. Access the applicant’s EHR from the opened email by clicking on the applicant name in the
top right corner
6. Click on documents on the clinical workflow menu of the applicant EHR
7. Click on the MEPS Waiver “view image” tab in the documents section of the EHR
8. Click on view document from the MEPS Waiver detail panel
9. Ensure the waiver is the uploaded document

The provider will:

1. Monitor MHS GENESIS message center – all message center orders (email) has the patient
(applicant) name as part of the heading
2. Choose an applicant to start the waiver review process from the message center messages
page
3. Right click the email and select assign – this will show other providers who is actively
working that applicant’s waiver review
4. Click on documents on the right side menu of the applicant EHR
5. Click on view document from the waiver detail panel
6. Review the waiver
a. For approved waivers, the MEPS provider will determine if the waiver addresses all
medically disqualifying conditions. If the SMWRA decision did not address all
identified disqualifying medical conditions, the MEPS provider should discuss the
discrepancy with SMWRA. Disagreements will be handled IAW the guidance in
UMR 40-1.
b. If there are no disagreements with a medical waiver, the MEPS provider will do the
following:
i. For approved waivers: Use the waiver auto-text in the MHS GENESIS
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 Physical Exam Component of the EHR to display the waiver was Granted
ii. For disapproved waivers: Use the waiver auto-text in the MHS GENESIS
Physical Exam Component of the EHR to display the waiver was Denied
iii. For returned without action medical waivers: Review the waiver for any
additional requests/instructions, summarize all pertinent medical information
(e.g., consultation or additional medical document request) in the Physical
Exams Component of the applicant’s EHR
7. From the applicant record; utilize message center to send the qualification decision and any
additional information to the Med Tech

Example: Waiver auto-text

After provider review, the Med Tech will:

1. Assess the waiver decision from the message center note

2. Enter waiver information in USMIRS
a. If waiver is granted:
i. Search for the applicant’s name by inputting their SSN in the search bar to go
into their individual USMIRS applicant electronic record
ii. Select the “Medical” tab
iii. Select the “Medical Qualifications” sub-tab
iv. Under the “Outstanding Scores” tab find the appropriate 3P that the waiver
applies to
v. Select the “Waive Score” button
vi. Enter the current date in the “Waived on Date” box indicating the day the
MEPS provider reviewed the waiver
vii. Enter the MEPS reviewing provider in the “Waived Reviewed By” box
indicating the MEPS provider has reviewed the waiver documentation
viii. Enter any notes in the “Notes” box (suggested notes; list the name of the
SMWRA who signed the waiver) and click “Apply Waiver”.
ix. The 3P will remain in the applicant PULHESD but will turn from the color red
to green, and a checkmark will appear over the 3P indicating that the waiver
has been recorded in USMIRS

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 Example: Waving a disqualification in USMIRS

Example: A waived disqualification in USMIRS

b. If waiver is denied
i. Go to the Admin Holds tab
ii. Select the “+ Add Hold” button
iii. Select Custom in the “Reason for Hold” pulldown box
iv. Input in the Custom Hold Reason box, Waiver Information
v. Input in the Notes box as: Waiver Denied
vi. Click the “Save” button
vii. The MEPS Hold will populate in the Admin Holds tab
viii. Click the “Clear Hold” button
ix. Input in the Notes box as: Waiver scanned in EHR
x. Click the “Clear Hold” button
xi. The denied waiver will show as a Cleared Hold in the Admin Hold tab

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 Example: Entering a denied waiver as an Admin Hold in USMIRS

Example: The denied waiver information as a cleared Admin Hold

In some instances the SMWRA needs a consult to make an approved/denied waiver

determination. Specific information and instruction will be on the waiver document. The
MEPS provider will determine if the consult is reasonable.

1. If yes: Follow the instructions in MHS GENESIS message: USMEPCOM Consult

Process – MHS GENESIS Referrals
2. If no: MEPS provider will discuss the issue with SMWRA with assistance from
USMEPCOM and Sector Medical providers when necessary.

All MHS GENESIS entries explained in this info message can be view by a narrative video found on
SPEAR at the following link:
https://spear/hq/mmt/Documents/MEPCOM%20Training%20Video_Final_1080p.mp4

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Enabling and Manually Pulling the Health Information Exchange (HIE)
Background: As a result of researching with LPDH, it was determined MHS GENESIS was not
auto-pulling information from a shared HIE due to missing required applicant demographic data.

Process: Effective immediately, the below listed applicant demographic data are required during
applicant registration to trigger the appropriate outbound messages for enrollment into the MHS
GENESIS HIE. This process will switch an applicant with a “CommonWell Not Enabled” status to a
“CommonWell Enrolled” status.

1. MEPS/RPS HRAs registering applicants into MHS GENESIS will input the following
information into every applicant’s Electronic Health Record (EHR).

a. First Name
b. Last Name
c. Date of Birth
d. Birth Sex
e. Full Address, to include zip code (critical)

2. If this data is not entered into the EHR, the applicant will not qualify for external healthcare
document pulls and external prescription history, which will require the Provider to manually
pull this data.

This information will be added to the mandatory information that must be filled in the applicant’s
EHR.

The impacted workflows due to this new information are as follows:

Processing Section – HRA:

1. When registering an applicant in the Add Patient box, the required information will be found
in the Patient Info and Patient Contact Info tabs.

2. With the additional information needed for HIE registration, the following demographic fields
must be filled out for every applicant:

a. Person affiliation code

b. Facility
c. Last Name
d. First Name
e. Middle Name (if applicable)
f. DoD ID (if issued)
g. Date of Birth
h. SSN
i. Sex (Gender)
j. Birth Sex (Sex at Birth)
k. Mailing Address (Current Address)
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 l. Home Address
m. Preferred Phone (select “No Phone” in MHS GENESIS if unknown)

3. Register an applicant training video link:

https://spear.mepcom.army.mil/hq/mmt/Documents/1%20HRA%20-
%20Registration%20v1.mp4

4. The information needed to register an applicant in MHS GENESIS can be found in the
applicant’s USMIRS record in the following areas:

a. The applicant’s header

b. The applicant’s info tab

Example: Applicant data in the applicant header of a USMIRS record

Example: Current address and home of record address as seen in the USMIRS info tab

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 Example: Mandatory demographic data that must be added to the “Patient Info” tab when
registering an applicant in MHS GENESIS

Example: Mandatory demographic data that must be added to the “Patient Contact Info” tab when
registering an applicant in MHS GENESIS

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Medical Department – Med Tech

When conducting a PS review or to prepare for the medical exam, the following steps must be taken
to manually pull the HIE for it to be ready for provider review before any other part of the PS process
is started.
1. From the Menu table (far left side blue menu in the applicant’s EHR)

a. Select Menu at the top right of the applicant record

b. Select the Pin icon to keep the Readiness Workflow list open
c. Select Outside Records, this will open up the External Documents List page
d. All applicants will have a “Summarization of Episode Note” which is a DoD HIE
that will pull health data on all applicants that had any health care in the DoD (e.g.
current/prior Service applicants and dependents)
 If the applicant has had any DoD health care, a summary of that care will be
in this note.
 If the applicant has not had any DoD health care the note will say “No
information available for data migration”

2. In the top right corner look for the CommonWell link

a. If the link says Not Enabled then the applicant was not properly registered with the
requisite demographic information to pull HIE which needs to be completed before
sending to the MEPS provider for review
b. If the link says Enabled
 Select the HIE Refresh icon directly below CommonWell Enabled link to
run the HIE query
 After the query is run, beside the HIE Refresh icon will be the wording “Last
query as of mm/dd/yyyy”
 If HIE is available, the information will show in the External Documents List
page

3. While the HIE is being pulled, the Med Tech will complete the administrative review and
ADD the applicant’s allergies, home medications, and social history on the applicant as
explained in the PS review training video at the following link:
https://spear.mepcom.army.mil/hq/mmt/Documents/3%20Med%20Tech%20-
%20Prescreen%20v1.mp4

90
 Example: Selecting Outside Records from the Menu table

Example: Manually pulling HIE on an applicant who is enrolled and never had HIE retrieved

Example: Population of HIE in the External Documents List after the manual pull has run

Example: An applicant not enrolled to have HIE pulled due to lack of proper information

Medical Department – Provider

To use the HIE while doing the PS Review

1. From the Menu table (far left side blue menu in the applicant’s EHR)

a. Select Menu at the top right of the applicant record

b. Select the Pin icon to keep the Readiness Workflow list open
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 c. Select Outside Records, this will open up the External Documents List page

2. In the top right corner look to make sure a query has been run
a. If so you will see the wording “Last query run mm/dd/yyyy”
b. If not you will see the wording “No previous retrievals initiated”

3. If no query has been run, select the HIE Refresh Icon – if the provider has to run an HIE
query they must select the Page Refresh Icon

4. Review the DoD “Summarization of Episode Note”

a. If the applicant has had any DoD health care, a summary of that care will be in this
note
b. If the applicant has not had any DoD health care, the note will say “No information
available for data migration”

5. If there is information in the “Summarization of Episode Note” and/or other documents in

the External Documents List, select the Reconciliation Link

6. Review the summary of the Problems, Procedures, Allergies, Medications and

Immunizations

7. Use the gray bar on the left of the summary window to navigate like a table of contents and
the tabs at the top of each category to navigate through the information

8. If you see pertinent information, select Add to add it to the applicant’s record - DO NOT
click “Discard”

9. If you see something you would like to investigate further, take note of the “Originating
Source”

10. Close the Reconciliation View by selecting the “X” in the top right corner

11. Match the “Originating Source” to the list of documents in the External Documents List

12. Select the link of the document you would like to view

13. In this window you can use the gray bar on the left to navigate like a table of contents

14. Use the CTRL+ F function to search this window

15. Use this information to help you make a PS determination

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Example: Running a query from the “Outside Documents” page and then refreshing the page

Example: Review of the DoD Summarization of Episode Note

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Example: Reconciliation of the applicant’s external health documents

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Quality Review of Medical Data in MHS Genesis and USMIRS
Overview: Medical data is entered in both the applicant’s MHS Genesis EHR and USMIRS e record.
The same data must be entered in both systems to ensure accuracy and quality of data.

Process:

1. Prior to the applicant checking-out of the Medical Department, all medical data will be
entered in the applicant’s MHS Genesis EHR and USMIRS record IAW UMR 40-1, Chapter
14.
2. Medical Department will perform a thorough quality review of both the applicant’s MHS
Genesis EHR and USMIRS record to verify accurate data entry IAW UMR 40-1, Chapter 14.
3. Any discrepancies identified will be resolved prior the applicant checking-out of the Medical
Department.

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 Approved Prescreen Prior to MHS GENESIS Implementation
Overview: Applicants with a completed approved PS (legacy paper processed PSs) will have their PSs pulled
from the applicant packet and uploaded into the applicant’s MHS GENESIS record after they are registered.

Process:

1. SL/GC will submit 48-hour projection

2. HRA will pull the applicant’s packet from the Files Room to prepare for QRP
3. Confirm “Ready to Process” PS status in USMIRS.
4. Register (create) the applicant into MHS GENESIS – see job aid Register an Applicant.
5. Create an outside document encounter – see job aid Document Upload
6. Upload the PS packet (DD 2807-2, DD 1966/5 (as required), DD 2005, UMF 40-8-1,
UMF 680-3A, UMF 680-3A-2, and Orthodontist Letter (as required)) into MHS
GENESIS – name the PS packet “MEPS PS Packet”
7. If required forms are missing the projection will not be deleted. The required forms (e.g. DD 2005
and UMF 40-8-1) can be completed by the applicant on the processing day and then uploaded into the
applicant’s MHS GENESIS EHR.
8. Provide the applicant’s packet to the SL/GC.
9. All additional processing documents (e.g., UMF 601-23-8, UMF 601-23-E, DEP Discharge
Letter, DD 368, etc.) submitted will be uploaded in e-Record upon receipt. Destroy
immediately after confirming upload.

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