============================================================================= Run Date: OCT 31, 2011 Designation: IB*2*435 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #423 Status: Released Compliance Date: NOV 30, 2011 ============================================================================= Associated patches: (v)IB*2*437 <<= must be installed BEFORE `IB*2*435' (v)IB*2*438 <<= must be installed BEFORE `IB*2*435' Subject: ePharmacy Phase 5 - NCPDP D.0 Category: - Routine - Data Dictionary - Other - Enhancement (Mandatory) Description: ============ This patch has enhancements that extend the capabilities of the Veterans Health Information Systems and Technology Architecture (VistA) electronic pharmacy (ePharmacy) billing system. Below is a list of all the applications involved in this project along with their patch number: APPLICATION/VERSION PATCH -------------------------------------------------------------- OUTPATIENT PHARMACY (OP) V. 7.0 PSO*7*359 INTEGRATED BILLING (IB) V. 2.0 IB*2*435 ELECTRONIC CLAIMS MANAGEMENT ENGINE (ECME) V. 1.0 BPS*1*10 ACCOUNTS RECEIVABLE (PRCA) V. 4.5 PRCA*4.5*271 The four patches (PSO*7*359, IB*2*435, BPS*1*10, and PRCA*4.5*271) are being released in the Kernel Installation and Distribution System (KIDS) multi-build distribution BPS PSO IB PRCA BUNDLE 6.0. For more specific instructions please refer to the installation steps provided in each of the patches. For the pharmacy claims that are processed electronically, the ePharmacy module is currently compliant with the National Council for Prescription Drug Programs (NCPDP) industry standards for version 5.1. NCPDP version D.0 Level 1 compliance (completion of internal testing) must be in place by January 1, 2011, and it must have completed external testing with payers and be in production as of January 1, 2012. Meeting the deliverable dates is essential to VHA meeting this legislative mandate and for continued business with pharmacy payers. As part of these changes, VHA should also have backwards compatibility to the NCPDP version 5.1 to allow for continued revenue and processing of VHA pharmacy claims. The combined build will allow the processing and release of prescriptions for patients with Insurance payers that use the new NCPDP version D.0 format for electronic claims processing as well as the current NCPDP version 5.1 format. This specific patch contains the following functionality: --------------------------------------------------------- 1. Functionality has been created to allow IB users to submit NCPDP insurance Eligibility inquiries and receive Eligibility responses back from the payers. 2. A new option has been added to allow IB users to manually initiate an NCPDP eligibility inquiry. The new option is called "Initiate e-Pharmacy Eligibility Inquiry" [IBCNR ELIGIBILITY INQUIRY]. This option is on the parent menu "e-Pharmacy Menu" [IBCNR E-PHARMACY MENU]. 3. NCPDP Eligibility responses will result in the creation of new insurance buffer entries. 4. The IB insurance buffer application has been enhanced to display the ePharmacy eligibility response information on the buffer Expand Entry screen. 5. An ePharmacy only view has been added to the insurance buffer to only display those entries that originated from ePharmacy NCPDP eligibility responses. 6. A new source of insurance information has been added to the SOURCE OF INFORMATION dictionary file (355.12). 7. Two new NCPDP Payer Sheets are put into service with this patch - the E1 eligibility payer sheet and the E1 TEST eligibility payer sheet. 8. The length of the ePharmacy ECME number has been increased from 7 to 12 characters under NCPDP D.0. VistA screens and reports and prompts have been updated accordingly. 9. A new action has been added to the Third Party Joint Inquiry (TPJI) application. The ability to view ECME Information on a new ECME response information screen has been added. 10. The IB users will now be able to enter a Delay Reason Code when submitting ECME claims through the Claims Tracking back-billing option. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- Request Name: e-Pharmacy Phase 5: FY09 Request ID: 20080103 This patch addresses the following Remedy Tickets: -------------------------------------------------- There are no Remedy Tickets associated with this patch. Components Sent With Patch -------------------------- The following is a list of files included in this patch: UP SEND DATA USER DATE SEC. COMES SITE RSLV OVER FILE # FILE NAME DD CODE W/FILE DATA PTRS RIDE -------------------------------------------------------------------------- 355.33 INSURANCE BUFFER YES YES NO NO 356 CLAIMS TRACKING YES YES NO NO 366.03 PLAN YES YES NO NO 366.14 IB NCPDP EVENT LOG YES YES NO NO The following is a list of fields included in this patch: Field Name (Number) File Name (Number) Subfile Name (Number) ------------------- --------------------- BPS RESPONSE (.17) INSURANCE BUFFER (355.33) ECME NUMBER (1.1) CLAIMS TRACKING (356) TEST ELIGIBILITY SHEET NAME (10.14) PLAN (366.03) ELIGIBILITY PAYER SHEET NAME (10.15) PLAN (366.03) BCID (.12) IB NCPDP EVENT LOG (366.14) -EVENT (sub-file) (366.141) CLAIMID (.13) IB NCPDP EVENT LOG (366.14) -EVENT (sub-file) (366.141) The following is a list of options included in this patch: OPTION: ------- IBCNR E-PHARMACY MENU IBCNR ELIGIBILITY INQUIRY The following is a list of protocols included in this patch: PROTOCOL: --------- IBCNB FAST EXIT IBCNB LIST ADD IBCNB LIST APPOINTMENTS VIEW IBCNB LIST CHECK NAMES IBCNB LIST ENTRY SCREEN IBCNB LIST EPHARMACY VIEW IBCNB LIST MEDICARE VIEW IBCNB LIST NEGATIVE VIEW IBCNB LIST POSITIVE VIEW IBCNB LIST PROCESS SCREEN IBCNB LIST REJECT IBCNB LIST SCREEN MENU IBCNB LIST SORT IBCNE JT VIEW EXP ELIG BEN SCREEN IBJ EXIT IBJT ACTIVE LIST SCREEN SKIP IBJT AR ACCOUNT PROFILE SCREEN IBJT AR COMMENT HISTORY SCREEN IBJT BILL CHARGES SCREEN IBJT BILL DX SCREEN IBJT BILL PROCEDURES SCREEN IBJT CHANGE BILL IBJT CLAIM SCREEN MENU IBJT CT/IR COMMUNICATIONS LIST SCREEN IBJT ECME RESP INFO MENU IBJT ECME RESP INFO SCREEN IBJT EDI STATUS SCREEN IBJT HS HEALTH SUMMARY IBJT NS VIEW AN BEN SCREEN IBJT NS VIEW EXP POL SCREEN IBJT NS VIEW INS CO SCREEN IBJT PT ELIGIBILITY SCREEN IBNCPDP INS ELIG EFF DATE IBNCPDP INS ELIG PAT IBNCPDP INS ELIG SEND IBNCPDP INS ELIG TOGGLE IBNCPDP INS ELIG VER INQ MENU IBNCPDP QUIT IBNCPDP VIEW EXP POL The following is a list of list templates included in this patch: LIST TEMPLATE: -------------- IBJT ECME RESP INFO IBNCPDP INS ELIG VER INQ Documentation Retrieval: ------------------------ Sites may retrieve documentation in one of the following ways: 1. The preferred method is to FTP the files from download.vista.med.va.gov, which will transmit the files from the first available FTP server. 2. Sites may also elect to retrieve documentation directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov 3. Documentation can also be retrieved from the VistA Documentation Library (VDL) on the Internet at the following address, http://www.va.gov/vdl. The documentation distribution includes: FILE NAME DESCRIPTION --------------------------------------------------------------------- IB_2_P435_RN.PDF IB Release Notes Test Sites: ----------- VA Heartland East - St. Louis Birmingham Louisville Loma Linda Richmond Phoenix Pre/Post Installation Overview ------------------------------ There is a post-install routine associated with this patch named IBY435PO. The purpose of the post install routine is to create a new entry in the SOURCE OF INFORMATION file (355.12). The new entry is entry# 10 for E-PHARMACY. This is a new source of insurance information and this field is used for entries in the insurance buffer. The post-install routine is automatically deleted by the system if allowed by your Kernel site parameters setup. You may delete the IBY435PO routine if the installation was successful and it is not automatically deleted by KIDS. ================INSTALLATION INSTRUCTIONS ================= Do not queue the installation of this patch. To avoid disruptions, these patches should be installed during non-peak hours when there is minimal activity on the system. Avoid times when ECME claims are being transmitted. Of particular concern would be the options below. 1. [BPS NIGHTLY BACKGROUND JOB] Do not install the patch when ECME claims are being generated by the BPS Nightly Background Job option. Wait for this job to finish or complete the installation before this job starts. 2. [PSXR SCHEDULED CS TRANS] and [PSXR SCHEDULED NON-CS TRANS] Do not install the patch when prescriptions are being transmitted to CMOP. Wait for the CMOP transmissions to finish or complete the installation before the transmissions start. Both the CS (Controlled Substances) and the non-CS CMOP transmission options should be checked. Check with Pharmacy Service or your Pharmacy ADPAC to find out when CMOP transmissions occur. Install Time ------------ The installation will take between 10 and 90 minutes depending upon how many entries your site has in the BPS CLAIMS file (9002313.02) and in the BPS RESPONSES file (9002313.03). Data conversions will be run in both files and all entries will be checked during the installation of BPS*1*10. 1. OBTAIN PATCHES -------------- Obtain the host file BPS_1_10_PSO_IB_PRCA.KID, which contains the following patches: BPS*1.0*10 PSO*7.0*359 IB*2.0*435 PRCA*4.5*271 Sites can retrieve VistA software from the following FTP addresses. The preferred method is to FTP the files from: download.vista.med.va.gov This will transmit 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 Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The BPS_1_10_PSO_IB_PRCA.KID host file is located in the anonymous.software directory. Use ASCII Mode when downloading the file. 2. START UP KIDS ------------- Start up the Kernel Installation and Distribution System Menu option [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: INStallation --- Load a Distribution Print Transport Global Compare Transport Global to Current System Verify Checksums in Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution Backup a Transport Global Select Installation Option: 3. LOAD TRANSPORT GLOBAL FOR MULTI-BUILD ------------------------------------- From the Installation menu, select the Load a Distribution option. When prompted for "Enter a Host File:", enter the full directory path where you saved the host file BPS_1_10_PSO_IB_PRCA.KID (e.g., SYS$SYSDEVICE:[ANONYMOUS]BPS_1_10_PSO_IB_PRCA.KID). When prompted for "OK to continue with Load? NO//", enter "YES." The following will display: Loading Distribution... BPS PSO IB PRCA BUNDLE 6.0 BPS*1.0*10 PSO*7.0*359 IB*2.0*435 PRCA*4.5*271 Use INSTALL NAME: BPS PSO IB PRCA BUNDLE 6.0 to install this Distribution. 4. RUN OPTIONAL INSTALLATION OPTIONS FOR MULTI-BUILD ------------------------------------------------- From the Installation menu, you may select to use the following options (when prompted for the INSTALL NAME, enter BPS PSO IB PRCA BUNDLE 6.0): a. 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. 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. 5. INSTALL MULTI-BUILD ------------------- This is the step to start the installation of this KIDS patch. This will need to be run for the BPS PSO IB PRCA BUNDLE 6.0. a. Choose the Install Package(s) option to start the patch install. b. When prompted for the "Select INSTALL NAME:", enter BPS PSO IB PRCA BUNDLE 6.0. c. For the IB*2.0*435 patch, when prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//" enter YES unless your system does this in a nightly TaskMan process. d. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//" enter NO. e. When prompted " Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//" enter NO. f. When prompted "Device: Home//" respond with the correct device but do not queue this install. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 27 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCNBLE Before: B77550797 After: B79037653 **82,231,184,251,371,416,435** Routine Name: IBCNBLE1 Before: B27906815 After: B30221340 **184,271,416,435** Routine Name: IBCNBLE2 Before: n/a After: B76745962 **435** Routine Name: IBCNBLL Before: B91467926 After:B101908545 **82,149,153,183,184,271,345, 416,438,435** Routine Name: IBCNEDE1 Before: B38997890 After: B40267278 **184,271,416,438,435** Routine Name: IBCNEUT2 Before: B2594683 After: B3063599 **184,416,435** Routine Name: IBCNRE4 Before: B28441388 After: B31384444 **251,435** Routine Name: IBCNRHLT Before: B22910363 After: B14102069 **251,435** Routine Name: IBCNRPSM Before: B11570145 After: B12153957 **251,435** Routine Name: IBCNRU1 Before: B27266594 After: B36756107 **251,276,435** Routine Name: IBCNRZRX Before: B14251946 After: B13620171 **251,435** Routine Name: IBCNSM Before: B18162142 After: B22946232 **28,46,56,52,82,103,199,276,435** Routine Name: IBJTRX Before: n/a After: B61346654 **435** Routine Name: IBJTU2 Before: B10627973 After: B10638422 **39,106,199,211,276,435** Routine Name: IBNCPBB Before: B87491341 After: B95588054 **276,347,384,435** Routine Name: IBNCPDP Before: B5373340 After: B5486206 **223,276,363,383,384,411,435** Routine Name: IBNCPDP1 Before:B104141348 After:B138462172 **223,276,339,363,383,405,384, 411,434,437,435** Routine Name: IBNCPDP2 Before: B63574984 After: B72289199 **223,276,342,347,363,383,405, 384,411,435** Routine Name: IBNCPDP3 Before: B32452413 After: B84836012 **223,276,342,363,383,384,411,435** Routine Name: IBNCPDP4 Before: B55992890 After: B55438909 **276,342,405,384,411,435** Routine Name: IBNCPDPC Before: B5201665 After: B4153613 **276,339,363,384,435** Routine Name: IBNCPDPE Before: B17129560 After: B17708957 **276,342,347,363,384,435** Routine Name: IBNCPDPI Before: B13118799 After: B13081373 **276,383,384,411,435** Routine Name: IBNCPDPU Before: B73774762 After: B95492067 **223,276,347,383,405,384,437,435** Routine Name: IBNCPEV Before: B84818902 After: B84626765 **342,363,383,384,411,435** Routine Name: IBNCPEV1 Before: B46733979 After: B49201751 **342,339,363,411,435** Routine Name: IBNCPIV Before: n/a After: B54267861 **435** Routine Name: IBNCPLOG Before: B64598922 After: B64598922 **342,339,363,383,411,435** Routine Name: IBNCPUT3 Before: B15411272 After: B15136080 **411,435** Routine Name: IBOSCDC Before: B46124524 After: B46120180 **384,435** Routine Name: IBOSCDC1 Before: B17599955 After: B17703191 **384,435** Routine Name: IBRFN Before: B52599969 After: B63404251 **52,130,183,223,309,276,347, 411,435** Routine Name: IBY435PO Before: n/a After: B6818265 **435** Routine list of preceding patches: 437, 438 ============================================================================= User Information: Entered By : GUSTAFSON,ERIC S Date Entered : MAY 26, 2010 Completed By: CONQUEST,KENNETH Date Completed: SEP 21, 2011 Released By : MURRAY,ANGELA Date Released : OCT 31, 2011 ============================================================================= Packman Mail Message: ===================== No routines included