$TXT Created by CLARK,KAREN at SMA.FO-ALBANY.MED.VA.GOV (KIDS) on Thursday, 05/26/11 at 09:33 ============================================================================= Run Date: AUG 18, 2011 Designation: FB*3.5*121 Package : FB - FEE BASIS Priority: Mandatory Version : 3.5 SEQ #109 Status: Released Compliance Date: AUG 24, 2011 ============================================================================= Associated patches: (v)FB*3.5*61 <<= must be installed BEFORE `FB*3.5*121' (v)FB*3.5*107 <<= must be installed BEFORE `FB*3.5*121' Subject: HIPAA 5010 PROVIDER AND BANK INFORMATION Category: - Enhancement (Mandatory) - Routine - Data Dictionary - Other Description: ============ General Description: -------------------- This patch enhances the VistA Fee Basis software for the Health Insurance Portability and Accountability Act (HIPAA) 5010 compliance mandated prior to Jan 1, 2012. It includes new fields for storing HIPAA 5010 provider and bank information in order to generate minimally mandated 5010 requirements for 837 and 835 claims. The patch creates fields for HIPAA 5010 provider and bank data and allows VistA Fee Basis to receive and process both the current 82 character message and new 138 character message from Central Fee (AITC) containing bank name, routing and account information. Central Fee (AITC) transmits the payment confirmation message to VistA. This patch must be released nationally prior to the change in message length from Central Fee. Patch Components ================ Files and Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------------------------------------------------------------ FEE BASIS PAYMENT (162) ROUTING NUMBER (#55) New FEE BASIS PAYMENT (162) ACCOUNT NUMBER (#56) New FEE BASIS PAYMENT (162) FINANCIAL INSTITUTION (#57) New FEE BASIS PAYMENT (162) ATTENDING PROV NAME (#58) New FEE BASIS PAYMENT (162) ATTENDING PROV NPI (#59) New FEE BASIS PAYMENT (162) ATTENDING PROV TAXONOMY CODE (#60) New FEE BASIS PAYMENT (162) OPERATING PROV NAME (#61) New FEE BASIS PAYMENT (162) OPERATING PROV NPI (#62) New FEE BASIS PAYMENT (162) RENDERING PROV NAME (#63) New FEE BASIS PAYMENT (162) RENDERING PROV NPI (#64) New FEE BASIS PAYMENT (162) RENDERING PROV TAXONOMY CODE (#65) New FEE BASIS PAYMENT (162) SERVICING PROV NAME (#66) New FEE BASIS PAYMENT (162) SERVICING PROV NPI (#67) New FEE BASIS PAYMENT (162) REFERRING PROV NAME (#68) New FEE BASIS PAYMENT (162) REFERRING PROV NPI (#69) New FEE BASIS PAYMENT (162) LI RENDERING PROV NAME (#73) New FEE BASIS PAYMENT (162) LI RENDERING PROV NPI (#74) New FEE BASIS PAYMENT (162) LI RENDERING PROV TAXONOMY (#75) New FEE BASIS INVOICE (162.5) ROUTING NUMBER (#61) New FEE BASIS INVOICE (162.5) ACCOUNT NUMBER (#62) New FEE BASIS INVOICE (162.5) FINANCIAL INSTITUTION (#63) New FEE BASIS INVOICE (162.5) ATTENDING PROV NAME (#64) New FEE BASIS INVOICE (162.5) ATTENDING PROV NPI (#65) New FEE BASIS INVOICE (162.5) ATTENDING PROV TAXONOMY CODE (#66) New FEE BASIS INVOICE (162.5) OPERATING PROV NAME (#67) New FEE BASIS INVOICE (162.5) OPERATING PROV NPI (#68) New FEE BASIS INVOICE (162.5) RENDERING PROV NAME (#69) New FEE BASIS INVOICE (162.5) RENDERING PROV NPI (#70) New FEE BASIS INVOICE (162.5) RENDERING PROV TAXONOMY CODE (#71) New FEE BASIS INVOICE (162.5) SERVICING PROV NAME (#72) New FEE BASIS INVOICE (162.5) SERVICING PROV NPI (#73) New FEE BASIS INVOICE (162.5) REFERRING PROV NAME (#74) New FEE BASIS INVOICE (162.5) REFERRING PROV NPI (#75) New FEE BASIS INVOICE (162.5) LINE ITEM RENDERING PROV DETAIL (#79) New FEE BASIS INVOICE (162.579) LINE ITEM NUMBER (#.01) New FEE BASIS INVOICE (162.579) RENDERING PROV NAME (#.02) New FEE BASIS INVOICE (162.579) RENDERING PROV NPI (#.03) New FEE BASIS INVOICE (162.579) RENDERING PROV TAXONOMY CODE (#.04) New FEE BASIS VENDOR (161.2) TAXONOMY CODE (#42) New FEE BASIS SITE PARAMETERS (161.4) FPPS TRANSMIT START (#36) New FEE BASIS SITE PARAMETERS (161.4) FPPS TRANSMIT END (#37) New New Service Request (NSRs): ------------------------------------------------------------------------ 20090705 VistA Fee HIPAA 5010 Implementation, Discovery and Requirements To meet the expanding needs of Electronic Data Interchange (EDI) processes and address the system and data changes required with the 5010 version, the Fee Basis package will need to collect, store and report additional elements from the claim data. National Provider Identifiers (NPI) and physical service locations are needed to better inform downstream or dependent processes. Much of the additional data collection is needed to support (1) revenue functions, where a third party insurance has a financial obligation surrounding payments made for non-service connected episodes of care and (2) pricing functions, where the service location impacts the allowed amount for a healthcare service. Note: This is the first of three patches for this NSR The enhancements made by this patch are described below: 1. ADD HIPPA 5010 FIELDS TO VISTA FEE BASIS Problem: -------- VistA Fee Basis needs additional fields to store minimally required HIPAA 5010 claim and payment information Resolution: ----------- Created HIPAA 5010 provider name, NPI, Taxonomy code and bank fields in the following files: FEE BASIS PAYMENT (#162), and FEE BASIS INVOICE (#162.5). Created HIPAA 5010 Taxonomy code field in FEE BASIS VENDOR (#161.2) file. Created FPPS transmit start and stop dates in the FEE BASIS SITE PARAMETERS (#161.4) file. 2. ENSURE FB FPPS TRANSMIT OPTION CAN BE RUN BY ANY USER Problem: -------- The FB FPPS TRANSMIT option contains the security key FBAASUPERVISOR, but not all users who queue this report have the key so the option does not run. This affects payment data being sent to the Fee Payment Processing System (FPPS) in a timely manner. If a site has not transmitted the data regularly, there may be network issues (rare). Resolution: ----------- The post-installation routine removes the FBAASUPERVISOR key from the FB FPPS TRANSMIT option and requests that IRM set this queuable option up to run on a nightly basis. FBHLX and FBHLX1 were modified to limit the number of records sent to FPPS to 10K. The 10K limit was imposed to ensure the network is not overburdened by sites that have not run the FB FPPS TRANSMIT option on a regular cycle (daily). If the process stops due to the 10K limit then the message sent to G.FEE will contain a note "Process (task) stopped due reaching 10K message limit." to the users. 3. ALLOW FEE BASIS TO PROCESS 82 AND 138 CHARACTER PAYMENT PROCESSING MESSAGES FROM CENTRAL FEE. Problem: -------- Modification of the Central Fee Payment Processing message (DHCPOUT) to include bank information will allow Health Administration Center (HAC) personnel to receive this information automatically rather than performing a manual lookup to enter this data into the 835 payment message. Solution: --------- Modified the FBPAID and FBPAID1 routines that process the DHCPOUT file from Central Fee to accept either 82 or 138 characters. The longer message will contain bank routing number (9 characters), account number (17 characters) and bank name (30 characters). This data will be filed to the FEE BASIS PAYMENT (#162) or FEE BASIS INVOICE (#162.5) file depending on the fee program. This change is dependent on modifications from Central Fee and the new data will not be available until Central Fee releases their production changes. TEST SITES Size/Type =================================================== El Paso, TX Medium Milwaukee, WI Large Gainesville (N FL/S GA) Large/Integrated Big Spring, TX Small Documentation Retrieval Instructions ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. Documentation can be found on the VA Software Documentation Library at: http://www4.va.gov/vdl/ Title File Name ----------------------------------------------------------- Installation Guide FB*3.5*121 FB_3_5_121_ig.pdf Release Notes FB*3.5*121 FB_3_5_121_rn.pdf Technical Manual (.doc) fb3_5tm.doc Technical Manual (.pdf) fb3_5tm.pdf Sites may wish 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 Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The documentation will be in the form of Adobe Acrobat files. Below is a list of the files related to this patch that will be needed and available via the FTP sites listed above. File Description File Name FTP Mode ----------------------------------------------------------------- Installation Guide FB*3.5*121 FB_3_5_121_ig.pdf Binary Release Notes FB*3.5*121 FB_3_5_121_rn.pdf Binary Technical Manual (.pdf) fb3_5tm.pdf Binary Patch Installation: Pre/Post-Installation Overview ------------------------------ The post-install routine FBXIP121 will remove the security key FBAASUPERVISOR from the FB FPPS TRANSMIT option. Users queuing this report do not always have the key which prevents the data from being transmitted in a regular manner to FPPS. The FB FPPS TRANSMIT option should be queued to run nightly. See the installation steps for details about timing of the nightly job. The FB FPPS TRANSMIT option should be queued to reduce the dependence on the interactive menu option. This ensures that payment records are sent from all facilities on a nightly basis. Installation Instructions ------------------------- Users may be on the system during installation. If installed during the normal workday, it is recommended that the following selections in the OPTION (#19) file, and all of their descendants be disabled to prevent possible conflicts while running the KIDS Install. Other VistA users will not be affected. Fee Basis Payment Message Server [FBAA PAID SERVER] Install Time - less than 5 minutes 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 option. When prompted for the INSTALL enter the patch FB*3.5*121. 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 INHIBIT LOGONs during the install? YES//' answer NO 6. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//' answer YES 7. When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following option: FBAA PAID SERVER Fee Basis Payment Message Server When prompted 'Enter options you wish to mark as 'Out Of Order':' press 8. When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press . 9. If prompted 'Delay Install (Minutes): (0 - 60): 0//' respond 0. Post-Installation Instructions: ------------------------------- The post-install routine FBXIP121 will remove the security key FBAASUPERVISOR from the FB FPPS TRANSMIT option. Users queuing this report do not always have the key which prevents the data from being transmitted in a regular manner to FPPS. Once the patch has been successfully installed you may delete the post install routine: FBXIP121 1. Ensure that the FB FPPS TRANSMIT option is queued to run on a nightly basis. **NOTE** If your site is already running this task nightly, then no action is needed. **Otherwise, schedule FB FPPS TRANMIT per FB*3.5*61 SEQ # 58: ** The Transmit Invoices to FPPS [FB FPPS TRANSMIT] option should be scheduled to run on a daily basis at a local time that is equivalent to 23:00 Central Time. This timing will transmit payment confirmations to FPPS shortly after they have been received from the AAC, but before FPPS runs its daily job to generate HIPAA 835 remittance advice transactions. In a Cache terminal session perform the following: VAH>D ^XUP Select OPTION NAME: XUTM MGR Taskman Management -------- Select Taskman Management Option: SCHedule/Unschedule Options --- Select OPTION to schedule or reschedule: FB FPPS TRANSMIT ---------------- Edit Option Schedule Option Name: FB FPPS TRANSMIT Menu Text: Transmit Invoices to FPPS TASK ID: 2944531 --------------------------------------------------------------------- QUEUED TO RUN AT WHAT TIME: APR 30,2011@23:00 DEVICE FOR QUEUED JOB OUTPUT: QUEUED TO RUN ON VOLUME SET: RESCHEDULING FREQUENCY: 1D TASK PARAMETERS: SPECIAL QUEUEING: --------------------------------------------------------------------- Exit Save Next Page Refresh COMMAND: SAVE Press H for help Insert Routine Information: ==================== The second line of each of these routines now looks like: ;;3.5;FEE BASIS;**[Patch List]**;JULY 18, 2003;Build 4 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: FBFHLX Before: B54858004 After: B55631854 **61,121** Routine Name: FBFHLX1 Before: B29142920 After: B30458874 **61,121** Routine Name: FBPAID Before: B27015212 After: B29740896 **5,61,107,121** Routine Name: FBPAID1 Before: B16159022 After: B14897492 **19,107,121** Routine Name: FBXIP121 Before: n/a After: B655280 **121** Routine list of preceding patches: 107 ============================================================================= User Information: Entered By : DEWAYNE,BRANDON Date Entered : APR 21, 2011 Completed By: CLARK,KAREN Y Date Completed: AUG 05, 2011 Released By : KUBIAK,PHILLIP A Date Released : AUG 18, 2011 ============================================================================= Packman Mail Message: ===================== $END TXT