============================================================================= Run Date: FEB 08, 2016 Designation: BPS*1*19 Package : BPS - E CLAIMS MGMT ENGINE Priority: Mandatory Version : 1 SEQ #17 Status: Released Compliance Date: MAR 10, 2016 ============================================================================= Associated patches: (v)BPS*1*14 <<= must be installed BEFORE `BPS*1*19' (v)BPS*1*15 <<= must be installed BEFORE `BPS*1*19' (v)BPS*1*17 <<= must be installed BEFORE `BPS*1*19' (v)BPS*1*18 <<= must be installed BEFORE `BPS*1*19' Subject: EPHARMACY NCPDP CONTINUOUS MAINTENANCE STANDARDS 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*427 INTEGRATED BILLING (IB) V. 2.0 IB*2*534 ELECTRONIC CLAIMS MANAGEMENT ENGINE (ECME) V. 1.0 BPS*1*19 CONSOLIDATED MAIL OUTPATIENT PHARMACY (CMOP) V. 2.0 PSX*2*77 PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS*1*188 Patches PSX*2*77 and PSS*1*188 are being released as stand-alone patches, while the other three patches (PSO*7*427, IB*2*534, BPS*1*19) are being released in the Kernel Installation and Distribution System (KIDS) multi-build distribution BPS PSO IB BUNDLE 6.0. The two stand-alone patches and multi-build distribution can be installed in any order and do not need to installed at the same time. This specific patch contains the following functionality: --------------------------------------------------------- 1. The VistA ePharmacy system is modified to support new data elements for NCPDP versions E.0 through E.6. a. The BPS NCPDP FIELD DEFS (#9002313.91) file was updated with new and modified NCPDP field information. b. The BPS NCPDP REJECT CODES (#9002313.93) file with new and modified NCPDP reject codes. c. The claims submission process was updated to send data for new NCPDP fields for which VistA has data to send. In addition, some existing fields were updated to include additional NCPDP values. The list of NCPDP fields that had modifications and also have a major impact on NCPDP processing is below. Patient Segment --------------- B08-7A - Patient Street Address Line B09-7B - Patient Street Address Line 2 B38-1Y - Patient ID Associated Country Code Prescriber Segment ------------------ B26-7T - Prescriber Telephone Number Extension B27-7U - Prescriber Street Address Line 1 B28-7V - Prescriber Street Address Line 2 B40-3A - Prescriber Alternate ID Associated Country Code B41-3B - Prescriber ID Associated Country Code B42-3C - Prescriber Country Code Pricing Segment --------------- 479-H8 - Other Amount Claimed Submitted Qualifier Coordination of Benefits/Other Payers Segment --------------------------------------------- 342-HC - Other Payer Amount Paid Qualifier) 393-MV - Benefit Stage Qualifier) 339-6C - Other Payer ID Qualifier) d. The claims response process was updated to include new NCPDP fields and to process existing NCPDP fields that had changes to the data that can be returned by the third party payer. The list of NCPDP fields that had modifications and also have a major impact on NCPDP processing is below. Response Insurance Segment -------------------------- 568-J7 - Payer ID Qualifier Response Pricing Segment ------------------------ 561-AZ - Percentage Sales Tax Basis Paid 564-J3 - Other Amount Paid Qualifier Response Coordination of Benefits/Other Payers Segment ------------------------------------------------------ B23-7Q - Other Payer Help Desk Telephone Number Extension Response Intermediary Segment ----------------------------- B52-8R - Response Intermediary Authorization Count B53-8S - Response Intermediary Authorization Type ID B54-8T - Response Intermediary Authorization ID B51-8Q - Intermediary Message 2. The Close Claim [CLO] action on the ECME User Screen [BPS USER SCREEN] option was modified to prevent a claim from being closed if the claim has open rejects on the Pharmacist worklist. 3. The Rx Not Processed for Site bulletin was modified to direct the user to the correct ECME option in order to get more information on the reject. 4. The Rx Not Processed for Site bulletin was modified to include the associated ECME number, if it exists. 5. The Claim Results and Status [BPS MENU RPT CLAIM STATUS] menu was modified to include a new Non-Billable Status Report [BPS RPT NON-BILLABLE REPORT] option. This new report will provide users with a tool to identify prescriptions that are not being billed and the reason the prescription was not billed. 6. If a TRICARE or CHAMPVA inpatient claim is reversed by the inpatient auto reversal process of the BPS NIGHTLY BACKGROUND JOB, the transaction will be filed in the PSO AUDIT LOG (#52.87) file as a bypass prescription so that it will be displayed on the TRICARE-CHAMPVA Bypass/Override Report, which is part of the Outpatient Pharmacy application. Patch Components ================ Files & Fields Associated: File Name (#) New/Modified/ Sub-file Name (#) Field Name (Number) Deleted ------------------- --------------------------------- ------------- BPS CLAIMS (#9002313.02) Modified PATIENT TELEPHONE NUMBER (#326) Modified PATIENT STREET ADDRESS LINE 1 New (#2008) PATIENT STREET ADDRESS LINE 2 New (#2009) PATIENT ID ASSOC COUNTRY CODE New (#2038) TRANSACTIONS sub-file (#9002313.0201) Modified EMPLOYER TELEPHONE NUMBER (#320) Modified PRESCRIBER TELEPHONE NUMBER Modified (#498.12) SERVICE PROVIDER COUNTRY CODE New (#1093) AUTH REP STREET ADDRESS LINE 1 New (#2013) AUTH REP STREET ADDRESS LINE 2 New (#2014) EMPLOYER STREET ADDRESS LINE 1 New (#2015) EMPLOYER STREET ADDRESS LINE 2 New (#2016) EMPLOYER CONTACT FIRST NAME (#2017) New EMPLOYER CONTACT LAST NAME (#2018) New EMPLOYER PHONE NUMBER EXT (#2019) New FACILITY STREET ADDRESS LINE 1 New (#2020) FACILITY STREET ADDRESS LINE 2 New (#2021) PAY TO STREET ADDRESS LINE 1 New (#2024) PAY TO STREET ADDRESS LINE 2 New (#2025) PRESCRIBER PHONE NUMBER EXT (#2026) New PRESCRIBER STREET ADDR LINE 1 New (#2027) PRESCRIBER STREET ADDR LINE 2 New (#2028) PURCHASER STREET ADDRESS LINE1 New (#2029) PURCHASER STREET ADDRESS LINE2 New (#2030) SERVICE PROV STREET ADD LINE 1 New (#2031) SERVICE PROV STREET ADD LINE 2 New (#2032) AUTH REP COUNTRY CODE (#2034) New EMPLOYER COUNTRY CODE (#2035) New FACILITY COUNTRY CODE (#2037) New PAY TO COUNTRY CODE (#2039) New PRES ALT ID ASSOC COUNTRY CODE New (#2040) PRES ID ASSOC COUNTRY CODE (#2041) New PRESCRIBER COUNTRY CODE (#2042) New PURCHASER ID ASSOC COUNTRY CD New (#2043) INTERMEDIARY ID COUNT (#2044) New LAST KNOWN BIN NUMBER (#2056) New LAST KNOWN PROCESSOR CNTRL NUM New (#2057) LAST KNOWN GROUP ID (#2058) New LAST KNOWN CARDHOLDER ID (#2059) New YEAR OF LAST PAID CLAIM (#2060) New MONTH OF LAST PAID CLAIM (#2061) New INTERMEDIARY ID MULTIPLE sub-file (#9002313.022044) New INTERMEDIARY ID COUNTER (#.01) New INTERMEDIARY ID TYPE CODE (#2045) New INTERMEDIARY ID TYPE ENTITY (#2046) New INTERMEDIARY ID QUALIFIER (#2047) New INTERMEDIARY ID (#2048) New INTERMEDIARY ID STATE/PROV ADD New (#2049) INTERMEDIARY ID RELATION CODE New (#2050) INTERMEDIARY ID COUNTRY CODE New (#2055) BPS RESPONSES (#9002313.03) Modified PAYER ID QUALIFIER (#568) Modified RESPONSES sub-file (#9002313.0301) Modified HELP DESK TELEPHONE NUMBER (#550) Modified PERCENTAGE SALES TAX BASIS PD Modified (#561) HELP DESK TELEPHONE NUMBER EXT New (#2022) PRO SERVICE FEE CONT/REIM AMT New (#2033) RESPONSE INTERMEDIARY AUTH CNT New (#2052) RESPONSE INTERMEDIARY MULTIPLE sub-file (#9002313.032052)New RESPONSE INTERMEDIARY COUNTER New (#.01) INTERMEDIARY MESSAGE (#2051) New RESPONSE INTERMED AUTH TYPE ID New (#2053) RESPONSE INTERMEDIARY AUTH ID New (#2054) OTHER PAYER ID MLTPL sub-file (#9002313.035501) Modified OTHER PAYER HELPDESK PHONE EXT New (#2023) BPS NCPDP OTHER PAYER AMT PAID QUAL (#9002313.2) New BPS CERTIFICATION (#9002313.31) Modified COB MULTIPLE sub-file (#9002313.3123) Modified OTHER PAYER ID QUALIFIER (#.03) Modified OTHER PAYER AMT PAID MULTIPLE sub-file (#9002313.31231) Modified OTHER PAYER AMT PAID QUALIFIER Modified (#.02) BENEFIT STAGE MULT sub-file (#9002313.31234) Modified BENEFIT STAGE QUALIFIER (#.02) Modified OTHER AMT CLAIMED MULT sub-file (#9002313.3124) Modified OTHER AMOUNT CLAIMED QUALIFIER Modified (#.02) BPS PAYER RESPONSE OVERRIDES (#9002313.32) Modified PERCENTAGE SALES TAX BASIS PD New (#2.01) OTHER AMOUNT PAID QUALIFIER (#2.02) New PAYER ID QUALIFIER (#2.03) New HELP DESK TELEPHONE NUMBER EXT New (#2.04) PRO SERVICE FEE CONT/REIM AMT New (#2.05) OTHER PAYER HELPDESK PHONE EXT New (#2.06) RESPONSE INTERMED AUTH TYPE ID New (#2.07) RESPONSE INTERMEDIARY AUTH ID New (#2.08) INTERMEDIARY MESSAGE (#3.01) New BPS LOG OF TRANSACTIONS (#9002313.57) Modified COB OTHER PAYERS sub-file (#9002313.5714) Modified OTHER PAYER ID QUALIFIER (#.03) Modified OTHER PAYER AMT PAID MULTIPLE sub-file (#9002313.57141) Modified OTHER PAYER AMT PAID QUALIFIER Modified (#.02) BPS TRANSACTION (#9002313.59) Modified COB OTHER PAYERS sub-file (#9002313.5914) Modified OTHER PAYER ID QUALIFIER (#.03) Modified OTHER PAYER AMT PAID MULTIPLE sub-file (#9002313.59141) Modified OTHER PAYER AMT PAID QUALIFIER Modified (#.02) BPS REQUESTS (#9002313.77) Modified COB OTHER PAYERS sub-file (#9002313.778) Modified OTHER PAYER ID QUALIFIER (#.03) Modified OTHER PAYER AMT PAID MULTIPLE sub-file (#9002313.7781) Modified OTHER PAYER AMT PAID QUALIFIER Modified (#.02) BPS NCPDP FIELD DEFS (#9002313.91) Modified BPS NCPDP FORMATS (#9002313.92) Modified INTERMEDIARY SEGMENT sub-file (#9002313.9229) New LAST KNOWN 4RX SEGMENT sub-file (#9002313.923) New BPS NCPDP REJECT CODES (#9002313.93) Modified BPS NCPDP FIELD CODES (#9002313.94) Deleted 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 ----------- ---- ------------- Claim Results and Status [BPS MENU RPT CLAIM STATUS] menu Modified Non-Billable Status Report [BPS RPT NON-BILLABLE REPORT] run routine New Protocols Associated: New/Modified/ Protocol Name Deleted ------------- ------------- N/A Security Keys Associated: New/Modified/ Security Key Name Deleted ----------------- ------------- N/A Templates: New/Modified/ Template Name Type File Name (Number) Deleted ------------- ---- ------------------ ------------- N/A Additional Information: N/A New Service Requests (NSRs) --------------------------- 20130514 - NCPDP Continuous Maintenance Standards (Phase 2, Iteration 2) Patient Safety Issues (PSIs) ---------------------------- N/A Remedy Ticket(s) & Overview --------------------------- N/A Test Sites: ----------- VA Heartland West (Integrated)-Station 589 Central Arkansas Veterans Healthcare System (Little Rock, AR)-Station 598 Birmingham VA Medical Center (Birmingham, AL)-Station 521 Hunter Holmes McGuire VA Medical Center (Richmond, VA)-Station 652 James H. Quillen VA Medical Center (Mountain Home, TN)-Station 621 Lexington VA Medical Center (Lexington, KY)-Station 596 Documentation Retrieval Instructions ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to FTP the files from ftp://download.vista.domain.ext/. 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.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Title File Name FTP Mode ---------------------------------------------------------------------- Release Notes/Installation Guide BPS_1_P19_RN.PDF Binary User Manual BPS_1_UM_R0116.PDF Binary Technical Manual/Security Guide BPS_1_TM_R0116.PDF Binary Patch Installation: Pre/Post Installation Overview ------------------------------ There is a pre-install routine associated with this patch named EN^BPS19PRE. The purpose of the pre install routine is to: a. Update NCPDP field definitions in BPS NCPDP FIELD DEFS (#9002313.91) b. Update the NCPDP reject codes/descriptions in BPS NCPDP REJECT CODES (#9002313.93). You may delete routine BPS19PRE if the installation was successful. There is a post-install routine associated with this patch named EN^BPS19PST. The purpose of the post install routine is to: a. Loop through the BPS REQUESTS (#9002313.77) entries and change the OTHER PAYER AMT PAID QUALIFIER (#.02) field in the OTHER PAYER AMT PAID MULTIPLE (#9002313.7781) subfile from a set of codes to a pointer. b. Loop through the BPS TRANSACTION (#9002313.59) entries and change the OTHER PAYER AMT PAID QUALIFIER (#.02) field in the OTHER PAYER AMT PAID MULTIPLE (#9002313.59141) subfile from a set of codes to a pointer. c. Loop through the BPS LOG OF TRANSACTION (#9002313.57) entries and change the OTHER PAYER AMT PAID QUALIFIER (#.02) field in the OTHER PAYER AMT PAID MULTIPLE (#9002313.57141) subfile from a set of codes to a pointer. d. Loop through the BPS CERTIFICATION (#9002313.31) entries and change the OTHER PAYER AMT PAID QUALIFIER (#.02) field in the OTHER PAYER AMT PAID MULTIPLE (#9002313.31231) subfile from a set of codes to a pointer. e. Remove the BPS NCPDP FIELD CODES (#9002313.94) data and database definition. Depending on the number of records in the BPS TRANSACTION (#9002313.59), BPS LOG OF TRANSACTION (#9002313.57), and BPS CERTIFICATION (#9002313.31) files, the conversion of those files may take some time to run so this part of the post-install will be queued to run as a background post-install task. A mail message will be sent indicating the results of this portion of post-install process. You may delete routine BPS19PST if the installation was successful and the mailman message indicates that the post-install was successful. Installation Instructions ------------------------- 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 should take less than 5 minutes to install. 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_19_PSO_IB.KID, which contains the following patches: BPS*1.0*19 PSO*7.0*427 IB*2.0*534 Sites can retrieve VistA software from the following FTP addresses. The preferred method is to FTP the files from: download.vista.domain.ext 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.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext The BPS_1_19_PSO_IB.KID host file is located in the 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_19_PSO_IB.KID (e.g., SYS$SYSDEVICE:[ANONYMOUS]BPS_1_19_PSO_IB.KID). When prompted for "OK to continue with Load? NO//", enter "YES." The following will display: Loading Distribution... BPS PSO IB BUNDLE 6.0 IB*2.0*534 BPS*1.0*19 PSO*7.0*427 Use INSTALL NAME: BPS PSO IB 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 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 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 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 BUNDLE 6.0. c. 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. Post-Installation Instructions ------------------------------ In order to verify the patch post-installation routine was run successfully, please examine the Install File for this patch and report any error messages to Product Support. Please also confirm the patch pre- and post-installation routines, BPS19PRE and BPS19PST, were removed if allowed by your Kernel site parameter configuration. You may delete the pre-install routine BPS19PRE if the installation was successful. You may delete the post-install routine BPS19PST if the installation was successful and the mailman message indicates that the post-install was successful. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;E CLAIMS MGMT ENGINE;**[Patch List]**;JUN 2004;Build 18 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: BPS19PRE Before: n/a After: B6858890 **19** Routine Name: BPS19PST Before: n/a After: B32874086 **19** Routine Name: BPSECA1 Before: B14865597 After: B14554293 **1,5,8,10,15,19** Routine Name: BPSECMP2 Before:B189210451 After:B193647932 **1,5,6,7,8,10,11,19** Routine Name: BPSECMPS Before:B102705765 After:B117919679 **1,2,5,6,7,10,11,15,19** Routine Name: BPSECX0 Before: B36997821 After: B39590401 **1,5,8,10,15,19** Routine Name: BPSJHLT Before: B56892934 After: B56866826 **1,10,15,19** Routine Name: BPSJZPR Before: B67732564 After: B69333659 **1,10,15,19** Routine Name: BPSNCPD1 Before: B55346306 After: B55779572 **1,3,5,6,7,8,9,10,11,15,19** Routine Name: BPSNCPD3 Before: B63091448 After: B64625279 **1,5,6,7,8,10,11,15,19** Routine Name: BPSNCPDP Before: B93011711 After: B93601523 **1,3,4,2,5,6,7,8,10,11,19** Routine Name: BPSOSCC Before: B26536547 After: B27473638 **1,2,5,8,10,11,19** Routine Name: BPSOSCD Before: B85972758 After:B104589879 **1,3,2,5,7,8,10,11,15,19** Routine Name: BPSOSCE Before: B12911947 After: B13028933 **1,5,7,8,10,11,15,19** Routine Name: BPSOSCF Before: B30647894 After: B30984367 **1,5,8,10,15,19** Routine Name: BPSOSH2 Before:B138588771 After:B141967265 **1,5,8,10,15,19** Routine Name: BPSPRRX3 Before:B136159744 After:B123904591 **8,10,11,19** Routine Name: BPSPRRX6 Before:B112918559 After:B114820084 **8,10,11,19** Routine Name: BPSRPAY Before: B34787453 After: B35888506 **1,7,10,15,19** Routine Name: BPSRPT0 Before: B22597769 After: B27167649 **1,5,7,10,11,19** Routine Name: BPSRPT1 Before: B54969091 After: B58952344 **1,5,7,8,10,11,19** Routine Name: BPSRPT3 Before: B39556380 After:B122921088 **1,3,5,7,11,14,19** Routine Name: BPSRPT4 Before: B93729370 After: B99407580 **1,5,7,8,10,11,19** Routine Name: BPSRPT5 Before:B146517138 After:B167824717 **1,3,5,7,8,10,11,19** Routine Name: BPSRPT7 Before:B107914214 After:B164190587 **1,3,5,7,8,10,11,19** Routine Name: BPSRPT8 Before:B178450227 After:B147944651 **1,3,5,7,8,10,11,19** Routine Name: BPSSCRCL Before: B75888961 After: B82378286 **1,3,5,7,8,11,15,19** Routine Name: BPSTEST Before:B102852240 After:B147504088 **6,7,8,10,11,15,19** Routine Name: BPSUTIL2 Before: B52546743 After: B53070606 **7,8,10,11,17,19** Routine list of preceding patches: 14, 15, 17 ============================================================================= User Information: Entered By : Date Entered : AUG 26, 2014 Completed By: Date Completed: FEB 04, 2016 Released By : Date Released : FEB 08, 2016 ============================================================================= Packman Mail Message: ===================== No routines included