============================================================================= Run Date: AUG 25, 2016 Designation: BPS*1*20 Package : BPS - E CLAIMS MGMT ENGINE Priority: Mandatory Version : 1 SEQ #18 Status: Released Compliance Date: SEP 24, 2016 ============================================================================= Associated patches: (v)BPS*1*18 <<= must be installed BEFORE `BPS*1*20' (v)BPS*1*19 <<= must be installed BEFORE `BPS*1*20' Subject: MCCF ePHARMACY COMPLIANCE PHASE 3 Category: - Routine - Other - Enhancement (Mandatory) - Data Dictionary 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*448 INTEGRATED BILLING (IB) V. 2.0 IB*2*550 ELECTRONIC CLAIMS MANAGEMENT ENGINE (ECME) V. 1.0 BPS*1*20 CONSOLIDATED MAIL OUTPATIENT PHARMACY (CMOP) V. 2.0 PSX*2*79 PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS*1*192 All five of these patches are being released in the Kernel Installation and Distribution System (KIDS) multi-build distribution. KIDS multi-build name: BPS PSO IB PSX PSS BUNDLE 9.0 KIDS Host File name: BPS_1_20_PSO_IB_PSX_PSS.KID This specific patch contains the following functionality: --------------------------------------------------------- 1. The CMT Add/View Comments list manager screen, within the ECME User screen [BPS USER SCREEN], will contain an additional action of P Add Pharmacy/OPECC Comment which triggers the system to prompt for a line number item and the comment. The date, time, and user will be recorded for each entry. Pharmacy comments entered will be displayed on the Outpatient Pharmacy Reject Information screen and the ECME User screen [BPS USER SCREEN]. 2. The system will allow the user to use an action that resubmits a claim from the ECME User screen [BPS USER SCREEN] for a non-billable TRICARE or CHAMPVA prescription with a pseudo-rejection of eT or eC. 3. The ECME User Screen [BPS USER SCREEN] will display an indicator of RS when a claim is manually resubmitted from the ECME User Screen [BPS USER SCREEN]. The resubmission indicator will only be captured and displayed for the last transaction and an indicator may be overwritten. The Change View action will allow users to select Resubmission and display the ECME User Screen [BPS USER SCREEN] data based on the user selection. 4. The ECME User Screen [BPS USER SCREEN] will contain a new hidden action with a new list manager screen called OPECC Reject Information containing the following actions: VW View Rx MP Medication Profile VER View ePharmacy Rx PI Patient Information 5. The ECME User Screen [BPS USER SCREEN] will contain a new hidden action called RER Resubmit Claim w/o Reversal which resubmits a claim without doing a reversal first, regardless of the previous VistA claim status. 6. The ECME User Screen [BPS USER SCREEN] actions will be updated as follows: CV Change View REV Reverse Payable Claim FR Further Research SO Sort List RES Resubmit Claim VER View ePharmacy RX CMT Add/View Comments CLO Close Claim WRK Send to Worklist 7. The UD Display Update, LOG Print Claim Log, and EX Exit actions will become hidden actions on the ECME User Screen [BPS USER SCREEN]. 8. The ECME User Screen [BPS USER SCREEN] will display non-billable TRICARE entries with a pseudo-rejection code of eT or non-billable CHAMPVA entries with a pseudo-rejection code of eC. An open/closed indicator will display on the ECME screen for each non-billable entry and the entry will default to an Open entry. 9. The ECME User Screen [BPS USER SCREEN] will contain a new hidden action of Open/Close Non-Billable Entry which will mark the entry as Open or Closed for the purposes of displaying or not displaying the entry on the ECME User screen and capture the following: user name, date, time, comment. 10. The ECME User Screen [BPS USER SCREEN] Change View action will offer a choice of displaying open non-billable entries, closed non-billable entries or all and display the ECME User Screen data based on the user selection. 11. The ECME User Screen [BPS USER SCREEN] will make these actions unavailable for non-billable entries: REV Reverse Payable Claim CLO Close Claim LOG Print Claim Log WRK Send to Worklist ROC Reopen Closed Claims RED Resubmit Claim w/EDITS RH Release Copay (On FR Further Research) RER Resubmit Claim w/o Reversal 12. The Closed Claims Report [BPS RPT CLOSED CLAIMS] will display the billed amount in the Excel download format. When the report is not run to capture report data for an Excel document, the Amount Billed will not be included in the report. 13. The Potential TRICARE Claims Report [BPS COB RPT TRICARE CLAIMS] will be renamed to Potential Claims Report for Dual Eligible [BPS POTENTIAL CLAIMS RPT DUAL]. It will prompt the user for patient eligibility, sort the report appropriately, and display patient eligibility in the heading of the report. 14. The VistA ECME system will use indicator "RS" to indicate that a claim was resubmitted via the ECME User Screen [BPS USER SCREEN]. To accomplish this, the bill type filter will be changed and RS as an indicator will be displayed on certain reports where applicable. 15. The Other Reports Menu [BPS MENU RPT OTHER] will contain a new report called OPECC Productivity Report [BPS OPECC PRODUCTIVITY REPORT]. The report will display information for the claim, by transaction date, with the option for a summary, detail or Excel format. 16. A new SECURITY KEY called BPS SUPERVISOR is implemented with this patch. This key is required for anyone accessing the OPECC Productivity Report [BPS OPECC PRODUCTIVITY REPORT]. 17. The system will support new and modified data elements and fields for NCPDP Telecommunications version E7 according to the October 2015 NCPDP release. Support for new and modified reject codes through this release is also included. 18. The system will no longer contain non-beneficial code for NCPDP version 5.1. Some of the version 5.1 code will remain as a roadmap to use the next time NCPDP implements major versions. 19. HL7 transmissions for ePharmacy plans, processors, and PBMs (PHARMACY BENEFITS MANAGER) from FSC will be re-directed to use the ePharmacy HL7 link on EPHARM OUT instead of IIV EC. 20. The Vitria Interface Version will be updated to version 5 and a new registration message will be sent to AITC to communicate that updates have occurred. Patch Components: ----------------- Files & Fields Associated: File Name (#) New/Modified/ Sub-file Name (#) Field Name (Number) Deleted ------------------- --------------------------------- ------------- BPS RESPONSES (#9002313.03) Modified RESPONSES sub-file (#9002313.0301) Modified QUAN LIMIT PER SPC TM PD COUNT New (#2087) DAYS SUP LIM PER SPC TM PD CNT New (#2090) QUAN LIMIT TIME PERIOD MLTPL sub-file (#9002313.032087) New DAYS SUPPLY LIM TM PD MULTIPLE sub-file (#9002313.032091) New BPS NCPDP CLARIFICATION CODES (#9002313.25) Modified BPS PAYER RESPONSE OVERRIDES (#9002313.32) Modified ADJUDICATED PAYMENT TYPE (#.1) Modified QUAN LIMIT PER SPC TIME PERIOD New (#.11) QUANTITY LIMIT TIME PERIOD (#.12) New DAYS SUP LIM PER SPC TM PERIOD New (#.13) DAYS SUPPLY LIMIT TIME PERIOD New (#.14) INGREDIENT COST PAID (#.15) New DISPENSING FEE PAID (#.16) New REMAINING DEDUCTIBLE AMOUNT (#.17) New AMT APPLIED TO PERIODIC DEDUCT New (#.18) BPS LOG OF TRANSACTIONS (#9002313.57) Modified TRANSACTION TYPE (#19) Modified NON-BILLABLE REASON (#301) New NON-BILLABLE CLOSED (#302) New NON-BILLABLE DATE CLOSED (#303) New NON-BILLABLE CLOSED BY (#304) New NON-BILLABLE CLOSED COMMENT (#305) New NON-BILLABLE DATE RE-OPENED (#306) New NON-BILLABLE RE-OPENED BY (#307) New NON-BILLABLE RE-OPENED COMMENT New (#308) COMMENT MULTIPLE sub-file (#9002313.57111) Modified PHARMACY (#.04) New BPS TRANSACTION (#9002313.59) Modified TRANSACTION TYPE (#19) Modified NON-BILLABLE REASON (#301) New NON-BILLABLE CLOSED (#302) New NON-BILLABLE DATE CLOSED (#303) New NON-BILLABLE CLOSED BY (#304) New NON-BILLABLE CLOSED COMMENT (#305) New NON-BILLABLE DATE RE-OPENED (#306) New NON-BILLABLE RE-OPENED BY (#307) New NON-BILLABLE RE-OPENED COMMENT New (#308) COMMENT MULTIPLE sub-file (#9002313.59111) Modified PHARMACY (#.04) New BPS NCPDP FIELD DEFS (#9002313.91) Modified BPS NCPDP REJECT CODES (#9002313.93) Modified Forms Associated: New/Modified/ Form Name File Name (Number) Deleted --------- ------------------ ------------- N/A Mail Groups Associated: New/Modified/ Mail Group Name Deleted --------------- ------------- N/A Options Associated: New/Modified/ Option Name Type Deleted ----------- ---- ------------- BPS MENU RPT OTHER menu Modified BPS OPECC PRODUCTIVITY run routine New REPORT Protocols Associated: New/Modified/ Protocol Name Deleted ------------- ------------- BPS OPECC REJECT INFO MEDICATION PROFILE New BPS OPECC REJECT INFO PATIENT INFORMATION New BPS OPECC REJECT INFO VIEW RX New BPS OPECC REJECT MENU New BPS OPECC REJECT VIEW ECME RX New BPS PRTCL CMT ADD Modified BPS PRTCL CMT ADD PHARM New BPS PRTCL CMT EXIT Modified BPS PRTCL CMT MENU Modified BPS PRTCL USRSCR HIDDEN ACTIONS Modified BPS PRTCL USRSCR OPECC REJECT INFORMATION New BPS PRTCL USRSCR OPEN/CLOSE NON-BILLABLE New ENTRY BPS PRTCL USRSCR RESUB NO REVERSE New Security Keys Associated: New/Modified/ Security Key Name Deleted ----------------- ------------- BPS SUPERVISOR New Templates Associated: New/Modified/ Template Name Type File Name (Number) Deleted ------------- ---- ------------------ ------------- BPS LSTMN ECME List N/A Modified USRSCR BPS OPECC REJECT List N/A New INFORMATION Additional Information: N/A New Service Requests (NSRs) --------------------------- 20140411 - Medical Care Collection Fund (MCCF) ePharmacy Compliance Phase 3 Patient Safety Issues (PSIs) ---------------------------- N/A Defect Tracking System Ticket(s) & Overview ------------------------------------------- N/A Test Sites: ----------- VA HEARTLAND - WEST, VISN 15 (589) LEXINGTON VAMC-LEESTOWN (596) HUNTER HOLMES MCGUIRE HOSPITAL - RICHMOND (652) BIRMINGHAM VAMC (521) CENTRAL ARKANSAS HEALTH CARE SYSTEM - LITTLE ROCK (598) Documentation Retrieval Instructions ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to retrieve files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve files directly from a specific server. Sites may retrieve the documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: domain.ext Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www.domain.ext/vdl Title File Name Transfer Mode --------------------------------------------------------------------------- Release Notes/Installation Guide BPS_1_P20_RN.PDF Binary User Manual BPS_1_UM.PDF Binary Technical Manual/Security Guide BPS_1_TM.PDF Binary Patch Installation: Pre/Post Installation Overview ------------------------------ There is a pre-install routine associated with this patch named EN^BPS20PRE. The purpose of the pre install routine is to: a. Update the NCPDP reject codes/descriptions in BPS NCPDP REJECT CODES (#9002313.93). The pre-install routine is automatically deleted by the system if allowed by your Kernel site parameters configuration. You may delete routine BPS20PRE if the installation was successful and it is not automatically deleted by KIDS. There is a post-install routine associated with this patch named POST^BPS20PST. The purpose of the post-install routine is to: a. Remove the cached hidden parent menu protocol for the ECME User Screen. b. Refine and update the list of visible actions on the ECME User Screen. c. Update the Vitria Interface version from 4 to 5. d. Perform ePharmacy registration with AITC. e. Rename an ECME report option and menu mnemonic. f. Modify the ePharmacy HL7 links by adding the DNS server name and removing the IP address. The post-install routine is automatically deleted by the system if allowed by your Kernel site parameters configuration. You may delete routine BPS20PST if the installation was successful and it is not automatically deleted by KIDS. Installation Instructions ------------------------- ***** IMPORTANT NOTE ***** The ePharmacy Logical Links must be stopped before patch installation. This can be done with the option "Start/Stop Links" [HL START]. The ePharmacy Logical Links which need to be stopped are the following: BPS NCPDP EPHARM OUT ************************** 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 are the options below. 1. BPS NIGHTLY BACKGROUND JOB [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. Scheduled CS Transmission [PSXR SCHEDULED CS TRANS] and Scheduled Non-CS Transmission [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. This multi-build installation may take between 1 to 10 minutes to install depending on the amount of data in the files being converted. This multi-build installation can be queued but should not be queued at a time when the BPS NIGHTY BACKGROUND JOB or CMOP transmission processes are scheduled. Pre-Installation Instructions ----------------------------- 1. OBTAIN PATCHES -------------- Obtain the host file BPS_1_20_PSO_IB_PSX_PSS.KID, which contains the following patches: BPS*1.0*20 PSO*7.0*448 IB*2.0*550 PSX*2.0*79 PSS*1.0*192 Sites may retrieve VistA software from download.vista.domain.ext. This transmits the file from the first available server. Sites may also elect to retrieve this file directly from a specific server. Sites may retrieve the software directly using Secure File Transfer (SFTP) from the ANONYMOUS.SOFTWARE directory at the following Field Offices: Albany: domain.ext Hines: domain.ext Salt Lake City: domain.ext File Name Transfer Mode -------------------------------------------------- BPS_1_20_PSO_IB_PSX_PSS.KID ASCII 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_20_PSO_IB_PSX_PSS.KID (e.g., SYS$SYSDEVICE:[ANONYMOUS]BPS_1_20_PSO_IB_PSX_PSS.KID). When prompted for "OK to continue with Load? NO//", enter "YES." The following will display: Loading Distribution... BPS PSO IB PSX PSS BUNDLE 9.0 BPS*1.0*20 PSO*7.0*448 IB*2.0*550 PSX*2.0*79 PSS*1.0*192 Use INSTALL NAME: BPS PSO IB PSX PSS BUNDLE 9.0 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 PSX PSS BUNDLE 9.0): 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 data dictionaries 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, data dictionaries, 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 PSX PSS BUNDLE 9.0. a. Choose the Install Package(s) option to start the patch install. b. When prompted for the "Select INSTALL NAME:", enter BPS PSO IB PSX PSS BUNDLE 9.0. c. When prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//", enter NO. d. When prompted "Want KIDS to INHIBIT LOGONs during the install? NO//", 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. Post-Installation Instructions ------------------------------ The new security key added by this patch, BPS SUPERVISOR, is needed in order to run the new ECME report called "OPECC Productivity Report" [BPS OPECC PRODUCTIVITY REPORT]. Please check with the OPECC supervisor and assign this security key as directed. ***** IMPORTANT NOTE ***** Please re-start the ePharmacy Logical Links using the "Start/Stop Links" [HL START] menu option. The ePharmacy Logical Links are the following: BPS NCPDP EPHARM OUT Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;E CLAIMS MGMT ENGINE;**[Patch List]**;JUN 2004;Build 27 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: BPS20PRE Before: n/a After: B9993195 **20** Routine Name: BPS20PST Before: n/a After: B54584565 **20** Routine Name: BPSBUTL Before: B96713533 After:B120426085 **1,3,2,5,7,8,9,10,11,15,20** Routine Name: BPSCMT01 Before: B20954371 After: B22342250 **1,5,20** Routine Name: BPSECA8 Before: B32681715 After: B25111830 **1,5,10,12,11,15,20** Routine Name: BPSECMPS Before:B117919679 After:B148784399 **1,2,5,6,7,10,11,15,19,20** Routine Name: BPSJACK Before: B36662405 After: B32888755 **1,2,5,7,20** Routine Name: BPSJAREG Before: B11441916 After: B11748725 **1,2,5,7,20** Routine Name: BPSJHLI Before: B2158650 After: B4405994 **1,20** Routine Name: BPSJHLT Before: B56866826 After: B84683560 **1,10,15,19,20** Routine Name: BPSJPREG Before: B20416052 After: B20911223 **1,3,2,5,7,20** Routine Name: BPSJVAL1 Before: B16799335 After: B14575875 **1,5,7,20** Routine Name: BPSNCPD2 Before: B60489856 After: B91792201 **1,5,6,7,8,10,11,20** Routine Name: BPSNCPD3 Before: B64625279 After: B65718099 **1,5,6,7,8,10,11,15,19,20** Routine Name: BPSNCPD5 Before: B76118605 After: B76247724 **7,8,10,11,20** Routine Name: BPSNCPD6 Before: B28397403 After: B30082238 **7,8,10,11,20** Routine Name: BPSNCPDP Before: B93601523 After: B97543196 **1,3,4,2,5,6,7,8,10,11,19,20** Routine Name: BPSOPR Before: n/a After: B53670373 **20** Routine Name: BPSOPR2 Before: n/a After:B114125532 **20** Routine Name: BPSOPR3 Before: n/a After: B63864385 **20** Routine Name: BPSOS03 Before: B9935989 After: B15562725 **1,5,10,20** Routine Name: BPSOSCD Before:B104589879 After:B104057958 **1,3,2,5,7,8,10,11,15,19,20** Routine Name: BPSOSH2 Before:B141967265 After:B140036379 **1,5,8,10,15,19,20** Routine Name: BPSOSIY Before: B71169390 After: B74487088 **1,3,5,6,7,8,10,11,20** Routine Name: BPSOSIZ Before: B13539436 After: B18104655 **1,5,7,8,10,20** Routine Name: BPSOSRB Before: B38172979 After: B39920456 **1,5,7,8,10,11,20** Routine Name: BPSOSRX Before: B40198470 After: B40932013 **1,5,7,8,10,20** Routine Name: BPSOSRX5 Before: B43074906 After: B43227076 **7,8,10,11,20** Routine Name: BPSOSRX8 Before: B21154002 After: B22384839 **7,10,11,20** Routine Name: BPSOSSG Before: B31935652 After: B30642361 **1,5,10,11,20** Routine Name: BPSOSU Before: B38973910 After: B43285498 **1,2,5,7,10,20** Routine Name: BPSOSUC Before: B8931865 After: B10039062 **1,5,7,10,11,14,20** Routine Name: BPSPRRX5 Before: B46870876 After: B82229263 **8,10,11,20** Routine Name: BPSPSOU1 Before: n/a After: B14671447 **20** Routine Name: BPSREOP1 Before: B60493248 After: B57917968 **3,7,10,11,20** Routine Name: BPSRES Before:B155712159 After:B159042443 **3,5,7,8,10,11,20** Routine Name: BPSRPT0 Before: B27167649 After: B27167649 **1,5,7,10,11,19,20** Routine Name: BPSRPT1 Before: B58952344 After: B64732997 **1,5,7,8,10,11,19,20** Routine Name: BPSRPT3 Before:B122921088 After:B124301535 **1,3,5,7,11,14,19,20** Routine Name: BPSRPT7 Before:B164190587 After:B164643275 **1,3,5,7,8,10,11,19,20** Routine Name: BPSRPT8 Before:B147944651 After:B149255320 **1,3,5,7,8,10,11,19,20** Routine Name: BPSRPT9 Before:B106079505 After:B113826199 **8,18,20** Routine Name: BPSRPT9A Before: B95077796 After: B99973308 **8,9,18,20** Routine Name: BPSRSRLC Before: B2312265 After: B2880037 **1,20** Routine Name: BPSSCR01 Before: B17522420 After: B17496726 **1,5,11,20** Routine Name: BPSSCR03 Before: B42385571 After: B67802855 **1,5,7,8,10,11,20** Routine Name: BPSSCR04 Before: B53618434 After: B54656509 **1,5,11,20** Routine Name: BPSSCRCL Before: B82378286 After: B86678930 **1,3,5,7,8,11,15,19,20** Routine Name: BPSSCRCV Before: B47413521 After: B55540510 **1,5,7,11,14,20** Routine Name: BPSSCRLG Before:B241284581 After:B253455016 **1,5,7,8,10,11,15,18,20** Routine Name: BPSSCRN0 Before: n/a After: B8359563 **20** Routine Name: BPSSCRRJ Before: n/a After:B126798258 **20** Routine Name: BPSSCRRS Before: B38581404 After: B80029514 **1,3,5,7,8,10,11,20** Routine Name: BPSSCRRV Before: B40545723 After: B43226039 **1,5,6,7,8,20** Routine Name: BPSSCRSL Before: B14563351 After: B14919740 **1,7,11,20** Routine Name: BPSSCRU2 Before: B47071661 After: B51790246 **1,3,5,10,11,20** Routine Name: BPSSCRU3 Before: B30414230 After: B43064796 **1,5,7,8,9,10,20** Routine Name: BPSSCRU6 Before: B17791929 After: B19836949 **3,8,10,20** Routine Name: BPSTEST Before:B147504088 After:B213983196 **6,7,8,10,11,15,19,20** Routine Name: BPSUTIL Before: B11432819 After: B13282594 **1,3,2,5,6,20** Routine Name: BPSWRKLS Before: B29522243 After: B32047440 **7,8,11,15,20** Routine list of preceding patches: 18, 19 ============================================================================= User Information: Entered By : Date Entered : APR 02, 2015 Completed By: Date Completed: JUL 07, 2016 Released By : Date Released : AUG 25, 2016 ============================================================================= Packman Mail Message: ===================== No routines included