$TXT Created by GUSTAFSON,ERIC S at DEVVII.FO-ALBANY.MED.VA.GOV (KIDS) on Wednesday, 10/26/11 at 23:47 ============================================================================= Run Date: DEC 13, 2011 Designation: BPS*1*12 Package : BPS - E CLAIMS MGMT ENGINE Priority: Mandatory Version : 1 SEQ #11 Status: Released Compliance Date: DEC 29, 2011 ============================================================================= Associated patches: (v)BPS*1*10 <<= must be installed BEFORE `BPS*1*12' Subject: GET REVERSAL PAYER SHEET FROM THE PHARMACY PLAN Category: - Routine Description: ============ The transaction associated with an ePharmacy claim may not have the current reversal payer sheet that should be used for a reversal claim. To resolve this problem, this patch will retrieve the reversal payer sheet from the ePharmacy Plan associated with the ePharmacy claim. On January 1, 2012, all ePharmacy claims must be submitted using National Council for Prescription Drug Programs (NCPDP) version D.0. Installing this update will ensure that reversal claims will be submitted in the D.0 format. Patch Components ================ Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A New Service Requests (NSRs) ---------------------------- N/A Patient Safety Issues (PSIs) ----------------------------- N/A Remedy Ticket(s) & Overview --------------------------- 1. HD0000000533767 - Retrieve the Reversal Payer Sheet from the Pharmacy Plan HD0000000536013 - Pharmacy transactions (Duplicate) Problem: ------- If the payer changes payer sheet versions in between the initial claim request and the subsequent reversal request, there is currently no way to use the new version of the reversal payer sheet for that plan. Resolution: ---------- This coding fix would correct this problem by always using the payer sheet as specified in the ePharmacy plan. ECME should retrieve the Reversal Payer Sheet from the ePharmacy PLAN file (#366.03) rather than from the BPS TRANSACTION file (#9002313.59). Test Sites: ---------- Richmond Birmingham Heartland East/St. Louis Phoenix Louisville Documentation Retrieval Instructions ------------------------------------ No documentation is associated with this patch. Patch Installation: Pre/Post Installation Overview ------------------------------ There are no pre or post-installation routines. Pre-Installation Instructions ----------------------------- The installation of this patch can be queued. The installation will take less than 2 minutes. To avoid disruptions, this patch 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 [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 Consolidated Mail Outpatient Pharmacy (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. Installation Instructions ------------------------- 1. Choose the PackMan message containing this patch. 2. Choose the INSTALL/CHECK MESSAGE PackMan option. 3. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, you may elect to use the following options. When prompted for the INSTALL NAME, enter BPS*1.0*12: 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. 4. From the Installation Menu, select the Install Package(s) option and choose the patch to install. 5. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', enter NO. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', enter NO. 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', enter NO. 8. When prompted 'Device: Home//' enter the correct device. This install can be queued. 9. If prompted 'Delay Install (Minutes): (0 - 60): 0//', enter 0. Post-Installation Instructions ------------------------------ There are no post-installation processes that need to be performed. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;E CLAIMS MGMT ENGINE;**[Patch List]**;JUN 2004;Build 2 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: BPSECA8 Before: B20615528 After: B28856161 **1,5,10,12** Routine list of preceding patches: 10 ============================================================================= User Information: Entered By : BLAESER,DAVID Date Entered : OCT 19, 2011 Completed By: CONQUEST,KENNETH Date Completed: NOV 29, 2011 Released By : CAULFIELD,MARY Date Released : DEC 13, 2011 ============================================================================= Packman Mail Message: ===================== $END TXT