$TXT Created by CLARK,MICHELLE at CARVDD.FO-ALBANY.MED.VA.GOV (KIDS) on Tuesday, 11/02/10 at 11:02 ============================================================================= Run Date: APR 01, 2011 Designation: PRCA*4.5*273 Package : PRCA - ACCOUNTS RECEIVABLE Priority: Mandatory Version : 4.5 SEQ #243 Status: Released Compliance Date: APR 26, 2011 ============================================================================= Subject: THIRD PARTY PHARMACY ENHANCEMENT Category: - Enhancement (Mandatory) Description: ============ **** PLEASE NOTE: the compliance date is April 26, 2011 *** Currently, the VHA bills a $51 flat rate per prescription to third party payers for outpatient prescriptions. This rate does not vary based on the number of days for the prescription or the drug provided. VHA requested a modification to the federal regulations to change the methodology for third party pharmacy charges to allow VHA to charge a rate based on the cost of the drugs plus administrative fee instead of a flat rate for rate types No Fault Auto Acc, Reimburs Health Ins, Tort Feasor, and Workman's Comp. In addition, a new fund account and four new Revenue Source Codes were created to specifically capture the third party pharmacy billing and accounts receivable in VistA. This patch contains functionality for the new fund account (528711) and Revenue Source Codes. Patch IB*2*437 addresses the rate change and must be installed prior to loading this patch. ASSOCIATED NSR(S): ================= 20080212 FY 2009 3rd Party Pharmacy Prescription Project ASSOCIATED REMEDY: ================== N/A PARTICIPATING TEST SITES: ========================= Louisville Loma Linda Tampa VISN 15 West DOCUMENTATION DISTRIBUTION: =========================== Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to FTP the files from download.vista.med.va.gov. This transmits the files from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov ftp://ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.med.va.gov ftp://ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov ftp://ftp.fo-slc.med.va.gov The documentation will be in the form of Adobe Acrobat files. Documentation can also be found on the System Design and Development Web page at: http://www.va.gov/vdl The documentation distribution includes: FILE NAME DESCRIPTION --------------------------------------------------------------------- prca_4_5_p273_rn.pdf Patch PRCA*4.5*273 Release Notes The following is a list of all software changes contained in this patch: ------------------------------------------------------------------------ 1. The Revenue Source Code Report [PRCA FMS RSC REPORT] prints a detailed list of all available Revenue Source Codes sent from the AR package to FMS for accrued bills. The four new Revenue Source Codes created for Third Party Pharmacy will be added to this report. The new Revenue Source Codes are: Pharmacy No Fault Auto Acc - 8QZZ Pharmacy Reimburs Health Ins - 8RZZ Pharmacy Tort Feasor - 8SZZ Pharmacy Workman's Comp - 8TZZ A mock-up of the new Revenue Source Code Report is shown below: REVENUE SOURCE CODE REPORT (VISTA TO FMS) JUN 14, 2010@12:04:16 PAGE 1 RSC Description ----------------------------------------------------------------------------- ARRV Miscellaneous 81ZZ Hospital Care (NSC) 82ZZ Outpatient Care (NSC) 83ZZ Nursing Home Care (NSC) 84ZZ Ineligible Hospitalization 85*Z Reimbursable Health Insurance 86ZZ Tort Feasor 87ZZ Workmans Compensation (Non-Federal) 88ZZ C (Means Test) 89ZZ Emergency/Humanitarian 8AZZ No Fault Auto Accident 8BZZ Pharmacy Co-Pay (SC Vet) 8CZZ Pharmacy Co-Pay (NSC Vet) 8DZZ Nursing Home Care Per Diem 8EZZ Hospital Care Per Diem 8FZZ Medicare 8GZZ Adult Day Health Care (LTC) 8HZZ Domiciliary (LTC) 8IZZ Respite Care-Institutional (LTC) 8JZZ Respite Care-Non-Institutional (LTC) 8KZZ Geriatric Eval-Institutional (LTC) 8LZZ Geriatric Eval-Non-Institutional (LTC) 8MZZ Nursing Home Care-Long Term Care (LTC) 8QZZ Pharmacy No Fault Auto Acc 8RZZ Pharmacy Reimburs Health Ins 8SZZ Pharmacy Tort Feasor 8TZZ Pharmacy Workman's Comp 2. The Deposit Reconciliation Report [PRCA DEPOSIT RECON REPORT] will print a report showing the cash receipt documents sent to FMS. The user can print a summary or detailed report. The summary report will show the total cash receipt dollars sent to FMS. The detail report will show the individual lines in the cash receipt document sent to FMS. The report has been modified to display the new fund for Third Party Pharmacy and the four new Revenue Source Codes. 3. The option to calculate the Revenue Source Code for a Bill is [PRCA FMS RSC CALCULATE]. This option will calculate the Revenue Source Code for a MCCF (fund 5287) bill and display it on the screen. The code will be modified so the four new Revenue Source Codes will calculate and display. 4. The new fund account information and Revenue Source Codes will be added to Standard Voucher (SV) Document for the Summary Receivable Balance and the Write-off (WR) Document. Existing transaction types will remain in effect for the new fund. 5. The Cash Receipt (CR) Document is used for check payments made directly to facilities and applied directly to e-pharmacy receivables. E-pharmacy reimbursements received electronically through the EDI Lockbox process will immediately be set aside in FMS (fund account 528704/RSC 8NZZ) and then transferred via the Transfer (TR) Document to the appropriate fund and revenue source code when the dollars received are matched with the e-pharmacy receivable. The new fund account information and Revenue Source Codes will be added to the TR Document. 6. The Bad Debt Report [PRCA NR BAD DEBT ACCR. REPORT], located under the Supervisor's Menu [PRCAF SUPERVISOR MENU], is used to print the Bad Debt Allowance Estimates that AR stores for one month. The report has been modified to display the new fund for Third Party Pharmacy. Existing Standard General Ledger (SGL) account numbers will remain in effect for the new fund. INSTALLATION INSTRUCTIONS: If installed during the normal workday, the AR users do not need to be off the system. Other VISTA users will not be affected. Install Time - less than 2 minutes. 1. Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Patch Monitor Main Menu ... Select Kernel Installation & Distribution System Option: INStallation --- 1 Load a Distribution 2 Verify Checksums in Transport Global 3 Print Transport Global 4 Compare Transport Global to Current System 5 Backup a Transport Global 6 Install Package(s) Restart Install of Package(s) Unload a Distribution Select Installation Option: 3. From this menu, you may elect to use the following options (When prompted for the INSTALL NAME, enter PRCA*4.5*273): a. Print Transport Global - this option will allow you to view the components of the KIDS build. b. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all components of this patch (routines, DD's, templates, etc.). c. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. d. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as DD's or templates. 4. Use the Install Package(s) option and select the package PRCA*4.5*273. a. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO b. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//', answer YES. c. When prompted 'Enter options you wish to mark as 'Out Of Order':', enter the following option: Revenue Source Code Report[PRCA FMS RSC REPORT] Calculate Revenue Source Code for a Bill[PRCA FMS RSC CALCULATE] Bad Debt Report[PRCA NR BAD DEBT ACCR. REPORT] Deposit Reconciliation Report[PRCA DEPOSIT RECON REPORT] d. When prompted 'Enter protocols you wish to mark as 'Out Of Order':', press . Routine Information: ==================== The following is a list of the routines included in this patch. The second line of each of these routines will look like: ;;4.5;Accounts Receivable;**[patch list]**;Mar 20, 1995 The checksums are new checksums, and can be checked with CHECK1^XTSUMBLD Routine Name: PRCAACC Routine Name: RCRJRBD Routine Name: RCRJRBDT Routine Name: RCRJRCOC Routine Name: RCRJRDEP Routine Name: RCXFMSPR Routine Name: RCXFMSSV Routine Name: RCXFMSUF Routine Name: RCXFMSUR Routine Information: ==================== The second line of each of these routines now looks like: ;;4.5;Accounts Receivable;**[Patch List]**;Mar 20, 1995;Build 3 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PRCAACC Before: B8809868 After: B8846859 **60,74,90,101,157,203,220,273** Description of Changes: Press RETURN to continue or '^' to stop Routine Name: RCRJRBD Before: B64259374 After: B70045536 **101,139,170,193,203,215,220, 138,239,273** Routine Name: RCRJRBDT Before: B54449549 After: B55944684 **101,170,191,138,239,273** Routine Name: RCRJRCOC Before: B57003461 After: B57425018 **156,170,182,203,220,138,239, 272,273** Routine Name: RCRJRDEP Before: B57461822 After: B57617465 **101,114,203,220,273** Routine Name: RCXFMSPR Before: B23643768 After: B25382600 **90,96,101,156,170,203,273** Routine Name: RCXFMSSV Before: B57335503 After: B61841858 **96,101,135,139,98,156,170, 191,203,220,138,184,239,273** Routine Name: RCXFMSUF Before: B31990259 After: B36597164 **90,101,135,157,160,165,170, 203,207,173,211,192,220,235, 273** Routine Name: RCXFMSUR Before: B53268142 After: B58588015 **90,101,170,203,173,220,231,273** Routine list of preceding patches: 231, 235, 272 ============================================================================= User Information: Entered By : CLARK,MICHELLE E Date Entered : JUN 17, 2010 Completed By: HEIGES,JOHN Date Completed: APR 01, 2011 Released By : GROOMS,CARMEN L Date Released : APR 01, 2011 ============================================================================= Packman Mail Message: ===================== $END TXT