$TXT Created by CLARK,KAREN at SMA.FO-ALBANY.MED.VA.GOV  (KIDS) on Wednesday, 09/19/12 at 13:03
=============================================================================
Run Date: JAN 22, 2013                     Designation: FB*3.5*135
Package : FB - FEE BASIS                      Priority: Mandatory
Version : 3.5       SEQ #118                    Status: Released
                  Compliance Date: FEB 22, 2013
=============================================================================

Associated patches: (v)FB*3.5*108  <<= must be installed BEFORE `FB*3.5*135'
                    (v)FB*3.5*124  <<= must be installed BEFORE `FB*3.5*135'
                    (v)IB*2*476    <<= must be installed BEFORE `FB*3.5*135'

Subject: FEE 5010 Phase 2 Enhancements

Category: 
  - Enhancement (Mandatory)
  - Data Dictionary
  - Routine
  - Input Template
  - Other

Description:
============

 This patch continues to enhance the VistA Fee Basis software for
 Health Insurance Portability and Accountability Act (HIPAA) 5010
 compliance. It includes new fields and logic for storing and creating
 a VistA Unique Claim ID for entries in the Fee Basis Payment (#162)
 and Fee Basis Invoice (#162.5) files and addresses 5010 deficiencies
 in the Civil Hospital Invoice Display option.
  
  
 ***IMPORTANT NOTE***
 Associated patch FB*3.5*135 requires IB*2.0*476 to be installed first.
 Once installed, FB*3.5*135 must be installed immediately after.
  
  
 FB*3.5*135 and IB*2.0*476 have enhancements to FB and IB that represent
 partial automation of Fee vendors and 5010 providers.  These
 enhancements were tested at the test sites and will be rolled out
 nationally, but not "turned on" (no post install).  Future patches will
 build upon the baseline functionality established in these patches.
 See item #4 listed in the enhancements below.
  
 Enhancements to VistA Fee Basis
 -------------------------------
 1. FBAAPIN and FBCHVH have been modified for both Civil Hospital and
    Medical claims Invoice Display to display the Line Item Rendering
    Provider, Line Item NPI and Line Item Taxonomy codes when available.
  
 2. FBPCR has been modified to include an optional prompt so that users
    may exclude selected Insurance types (Type of Plan) from the
    Potential Cost Recovery report [FB PCR] option.  FBPCR4 was modified
    to exclude patients that have only the selected insurance type(s) and
    no other third party insurance.  The paid claims for these patients
    will not display or print on the report.
  
 3. A new Unique Claim Identifier (UCID) will be generated for all
    Civil Hospital and Medical claims manually entered in VistA Fee
    Basis.  The UCID will be used by the Purchased Care business office
    in systems downstream from VistA (Central Fee, VHA Support Service
    Center, etc) to enable the VA to recreate claims as they were
    submitted by a vendor.  The UCID will be comprised of the following:
  
       5 digit Station#, left justified, zero filled
       1 digit Source (1=FB, 2=FBCS, 3=VAPM)
       1 digit Initiation Type (S=Scanned, E=EDI, M=Manual)
       1 digit Claim Type (I=Institutional, P=Professional, D=Dental,
                           N=Non Standard)
       4 digit Calendar year
       '-' to separate the year and sequence#
       15 digit Sequence number
  
    Note: the "4 digit year-Seq#" will be known as the Claim Number. For
    "E" (EDI) Claims, VistA Fee Basis forces the Sequence number portion
    of the Claim Number to be the FPPS Claim ID.
  
    Two APIs have been created for Fee and COTS applications to
    set the UCID value when filing data to Fee Basis Payment (#162) or
    Fee Basis Invoice (#162.5) files.  These APIs are:
  
  
    $$PAYUCID^FBUTL135(VET,VEN,TDIEN,SVCIEN,STN,SRCE,INITTYP,CLTYP,CLNUM)
     Inputs: (all inputs are required)
             VET     = veteran DFN
             VEN     = Vendor IEN
             TDIEN   = Treatment Date IEN
             SVCIEN  = Service Provided IEN
             STN     = Station
             SRCE    = Source           (1=FB, 2=FBCS, 3=VAPM)
             INITTYP = Initiation Type  (S=Scanned, E=EDI, M=Manual)
             CLTYP   = Claim Type       (P=Professional, D=Dental,
                                         N=Non Standard)
             CLNUM   = Claim Number - in format YYYY-nnnn
  
     Output: "-1^" with an error message
             or
             Populates the Unique Claim ID field (#81) in file FEE BASIS
             PAYMENT (#162) (Outpatient) and, Returns the Unique Claim ID
  
  
    $$INVUCID^FBUTL135(INVIEN,STN,SRCE,INITTYP,CLNUM)
     Inputs: (all inputs are required)
             INVIEN  = Invoice IEN
             STN     = Station
             SRCE    = Source             (1=FB, 2=FBCS, 3=VAPM)
             INITTYP = Initiation Type    (S=Scanned, E=EDI, M=Manual)
             CLNUM   = Claim Number - in YYYY-nnnn format
  
     Output: "-1^" with an error message
             or
             Populates the Unique Claim ID field (#85) in file FEE BASIS
             INVOICE (#162.5) (Inpatient)
             and Returns the Unique Claim ID
  
  
    In order to create the UCID, the following Fee components were
    created or modified:
  
    Five new APIs were created:
  
    $$ENTINPAT^FBUTL136(FBSTA,FBSRC,FBINT,FBCLT,FBCLAIMS,FBVEND)
      This API is used by Input Template "FBCH ENTER PAYMENT"
      Inputs: FBSTA    = Station
              FBSRC    = Source
              FBINT    = Initiation Type
              FBCLT    = Claim Type
              FBCLAIMS = Claim Number
              FBVEND   = Vendor IEN
      Output: Returns a Unique Claim ID that is used by FileMan to
              populate the Unique Claim ID field (#85) in file
              FEE BASIS INVOICE (#162.5) (Inpatient)
  
    EDINPAT^FBUTL136(FBXSTR,FBI)
      This API is used by Input Template "FBCH EDIT PAYMENT"
      Inputs: FBXSTR = FPPS value entered by user for FPPS
              FBI    = IEN of Invoice record
      Output: UCID is saved in file 162.5 via FileMan
  
    $$ENTROUTP^FBUTL136(DFN,FBV,FBAAVID,FBCLAIMS)
     This API is used by routine FBAACO
     Inputs: DFN     = Patient ID
             FBV = Vendor IEN
             FBAAVID = Vendor Invoice Date
             FBCLAIMS = FPPS claim id
     Output: UCID that is save in file 162
  
    EDITOUTP^FBUTL136(FBXSTR,FBDA)
     This API is used by routine FBUTL5.
     Inputs: FBXSTR = FPPS CLAIM ID entered by user
             FBDA = DA variable containing SERVICE PROVIDED,
                   INITIAL TREATMENT DATE, VENDOR, PATIENT
     Output: UCID that is saved in file 162
  
    $$UCLAIMNO^FBUTIL135(FBSTA,FBSRC,FBINT,FBCLT,FBCLAIMS)
      This API is used by all the other API's
      Inputs: All inputs are optional.
              FBSTA    = Station - Default is the station ID returned by
                         routine STATION^FBAAUTL
              FBSRC    = Source - Default is "1" - FB
              FBINT    = Initiation Type - Default is "M" - Manual
              FBCLT    = Claim Type - Default is "N" - Non Standard
              FBCLAIMS = Claim Number - in YYYY-nnnn format
                        Default is <Current Year>-<Next Sequential Number
                        from file FEE BASIS SITE PARAMETERS (#161.4),
                        field UNIQUE CLAIM IDENTIFIER SEQ (#39)
      Output: Returns a Unique Claim ID
  
    Created field for Unique Claim Identifier Sequence in the FEE BASIS
    SITE PARAMETERS (#161.4) file.
  
    For Civil Hospital claims: added field for Unique Claim Identifier
    to the FEE BASIS INVOICE (#162.5), modified routine FBCHEP and
    input template [FBCH ENTER PAYMENT] (file 162.5) to call new API:
    ENTINPAT^FBUTL136, and [FBCH EDIT PAYMENT] (file 162.5) to call new
    API: EDINPAT^FBUTL136 prompt for the Claim Number.
  
    For Medical claims: added field for Unique Claim Identifier to the
    FEE BASIS PAYMENT (#162) file, modified routine FBAACO to prompt for
    CLAIM NUMBER and a claim type by calling new API: ENTROUTP^FBUTL136,
    modified routine FBAACO2 and FBUTL5 to prompt for Claim Number and a
    claim type by calling new API: EDITOUTP^FBUTL136
  
    Three options were added to verify Unique Claim Identifier (UCID)
    entries for testing. Unique Claim Identifier Utility Menu
    [FB UCID UTILITY MENU] has been created to display information about
    the Unique Claim Identifier field for entries in files
    FEE BASIS INVOICE (#162.5),FEE BASIS PAYMENT (#162). This menu
    option is not available on any existing FB menus, but could be added
    to a secondary menu. The new menu contains the Fee Basis Unique Claim
    Identifier Display [FB UCID DISPLAY] option and the FB OUTPATIENT
    UCID REPORT [FB UCID PAYMENT RPT] option.
  
 4. The following changes represent partial automation of Fee vendors and
    5010 providers from FB to IB.  These enhancements were tested at the
    test sites and will be rolled out nationally, but not "turned on"
    (no post install).  Future patches will build upon the baseline
    functionality established for this item in the patch.
  
    Paid inpatient and outpatient claims that are potentially cost
    recoverable from Integrated Billing (IB) will now have an automated
    process (For Future Use) to copy valid Fee Basis Vendor and 5010 
    Providers within a paid claim to the IB NON/OTHER VA PROVIDER 
    (#355.93) file. Routine FBPAID was modified and new routines FBPAID3
    and FBPAID3A were created to capture the paid claims into the new file
    FEE BASIS PAID TO IB (#161.9) during the nightly mailman processing of
    the PAID message from Central Fee.
  
    A new field ALLOW FB PAID TO IB (#40) was created in the FEE BASIS
    SITE PARAMETERS (#161.4) file (For Future Use), and included in the 
    Input Template [FBAA SITE PARAMETERS] Fee Basis Supervisor to allow/
    disallow the automated process. The interface will not run unless this
    field is set to YES (allow).
  
    A new queued option (For Future Use) Fee Basis Payment to IB
    [FB PAID TO IB] calling new routine FBPAID3 will read through the 
    paid entries saved to the FEE BASIS PAID TO IB (#161.9) file and 
    determine claims that are potential cost recovery claims using the same
    business rules as the existing Potential Cost Recovery Report.  Vendor
    and 5010 providers for entries that pass the potential cost recovery
    rules will be sent to the new IB API $$EPFBAPI^IBCEP8C1, introduced in
    IB*2.0*476, for additional IB checks and to save to file 355.93.  Data
    will be captured for reporting on entries filed to IB and those that
    failed to file for a variety of reasons (invalid provider name format,
    etc). ICR 5806: FB PROVIDER TO IB AUTOMATION was approved for this
    call.
  
    A new option Provider to IB Report [FB PROVIDER TO IB] was created 
    (For Future Use) which calls the new routine FBPAID3B to display data
    from file 161.9 for entries that were filed to IB and those that failed
    to file.  The data in file 161.9 will be retained for six months after
    which it will be purged by the nightly process Fee Basis Payment to
    IB [FB PAID TO IB].
  
  
 Patch Components
 ================
 Files & Fields Associated:
  
 File Name (Number)         Field Name (Number)  New/Modified/Deleted
 ------------------         -------------------  --------------------
 FEE BASIS PAYMENT (162)   UNIQUE CLAIM IDENTIFIER (#81)      New
 FEE BASIS INVOICE (162.5) UNIQUE CLAIM IDENTIFIER (#85)      New
 FEE BASIS SITE
     PARAMETERS (161.4)    UNIQUE CLAIM IDENTIFIER SEQ (#39)  New
                           ALLOW FB PAID TO IB (#40)          New
 FEE BASIS PAID TO IB (161.9)                                 New
                           PATIENT (#.01)                     New
                           PROGRAM (#.02)                     New
                           FB INTERNAL CONTROL NUMBER (#.03)  New
                           PROCESS DATE (#.04)                New
                           LI NUMBER  (#.05)                  New
                           PROVIDER TYPE (.06)                New
                           IB NON/OTHER PROVIDER(#.07)        New
                           NPI ADDED (#.08)                   New
                           TAXONOMY ADDED (#.09)              New
  
 Forms Associated: N/A
 Mail Groups Associated: N/A
  
 Options Associated:
  
 Option Name                               Type      New/Modified/Deleted
 -----------                               ----      --------------------
 Fee Basis Payment to IB                   run routine      New
    [FB PAID TO IB]
 Provider to IB Report                     run routine      New
    [FB PROVIDER TO IB]
 Fee Basis Unique Claim Identifier Display run routine      New
    [FB UCID DISPLAY]
 FB OUTPATIENT UCID REPORT                 inquire          New
    [FB UCID PAYMENT RPT]
 Unique Claim Identifier Utility Menu      menu             New
    [FB UCID UTILITY MENU]
  
 Protocols Associated: N/A
 Security Keys Associated: N/A
  
 Templates Associated:
  
 Template Name        Type  File Name (Number)       New/Modified/Deleted
 -------------        ----  ------------------       --------------------
 FBCH ENTER PAYMENT   Input FEE BASIS INVOICE (162.5)        Modified
 FBCH EDIT PAYMENT    Input FEE BASIS INVOICE (162.5)        Modified
 FBAA SITE PARAMETERS Input FEE BASIS SITE PARAMETERS(161.4) Modified
 FB UCID PAYMENT      Print FEE BASIS PAYMENT (162)          New
  
 Routines Associated:
  
 Routine Name                      New/Modified/Deleted
 -----------                       --------------------
 FBAACO                                Modified
 FBAACO2                               Modified
 FBAAPIN                               Modified
 FBCHEP                                Modified
 FBCHVH                                Modified
 FBPAID                                Modified
 FBPAID3                               New
 FBPAID3A                              New
 FBPAID3B                              New
 FBPCR                                 Modified
 FBPCR4                                Modified
 FBUTL135                              New
 FBUTL136                              New
 FBUTL5                                Modified
  
 New Service Requests (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.
  
 Patient Safety Issues (PSIs): N/A
 Remedy Ticket(s) & Overview: N/A
  
  
 Test Sites:
 ----------
 Minneapolis, MN
 Fargo, ND
 Sioux Falls, SD
  
 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.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 <ftp://ftp.fo-albany.med.va.gov>
 Hines          ftp.fo-hines.med.va.gov  <ftp://ftp.fo-hines.med.va.gov>
 Salt Lake City ftp.fo-slc.med.va.gov    <ftp://ftp.fo-slc.med.va.gov>
  
 Documentation can also be found on the VA Software Documentation Library 
 at: http://www4.va.gov/vdl/
  
 Title                              File Name                FTP Mode
 --------------------------------------------------------------------
 Release Notes FB*3.5*135           FB_3_5_P135_rn.pdf       Binary
 Install Guide FB*3.5*135           FB_3_5_P135_ig.pdf       Binary
 FB Technical Manual/Security Guide FB_3_5_R1212_tm.pdf      Binary
 Fee Basis User Manual              FB_3_5_R1212_um.pdf      Binary
  
 Patch Installation:
  
 Prerequisites
 -------------
 The following patches must be installed prior to FB*3.5*135:
 FB*3.5*108
 FB*3.5*124
 IB*2.0*476
     *** IMPORTANT NOTE ***
     Associated patch FB*3.5*135 requires IB*2.0*476 to be installed first.
     Once installed, FB*3.5*135 must be installed immediately after.
  
 Pre/Post Installation Overview
 ------------------------------
 N/A
  
 Installation Instructions
 -------------------------
 VistA Fee Basis and Fee Basis Claims System (FBCS) users should not be on 
 the system during installation due to the changes to the data dictionary
 for the FEE BASIS PAYMENT file.
  
 It is recommended that it be installed during non-peak hours to minimize 
 potential disruption to users.  This patch should take less than 5 
 minutes to install. If installed during the normal workday, it is
 recommended that the following selection(s) 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.
    Civil Hospital Main Menu         [FBCH MAIN MENU]
    Medical Fee Main Menu            [FBAA MEDICAL MAIN MENU]
  
 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 the patch FB*3.5*135):
  
     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 DDs 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, DDs, 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, FB*3.5*135
  
 5.  When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of
     Install? NO//'  answer NO
  
 6.  When prompted 'Want KIDS to INHIBIT LOGONs during the install?
     NO//'  answer NO
  
 7.  When prompted 'Want to DISABLE Scheduled Options, Menu Options,
     and Protocols? NO//'  answer Yes
  
 8.  When prompted 'Enter options you wish to mark as 'Out Of Order':'
       answer FBCH MAIN MENU
  
 9.  When prompted 'Enter options you wish to mark as 'Out Of Order':'
       answer FBAA MEDICAL MAIN MENU
  
 10. When prompted 'Enter options you wish to mark as 'Out Of Order':'
       hit Enter
  
 11. When prompted 'Enter protocols you wish to mark as 'Out Of Order':'
       hit Enter
  
 12. If prompted 'Delay Install (Minutes):  (0 - 60): 0// respond 0.
  
 Post-Installation Instructions
 ------------------------------
 N/A

Routine Information:
====================
The second line of each of these routines now looks like:
 ;;3.5;FEE BASIS;**[Patch List]**;JAN 30, 1995;Build 3

The checksums below are new checksums, and
 can be checked with CHECK1^XTSUMBLD.

Routine Name: FBAACO
    Before: B29088561   After: B30906889  **4,61,79,116,122,133,108,135**
Routine Name: FBAACO2
    Before: B14357578   After: B14623021  **4,55,61,77,116,122,133,108,135**
Routine Name: FBAAPIN
    Before: B34775282   After: B36889806  **4,61,122,133,108,135**
Routine Name: FBCHEP
    Before: B33379064   After: B34203582  **4,61,77,82,122,108,124,135**
Routine Name: FBCHVH
    Before: B31027719   After: B37280892  **4,61,122,133,108,135**
Routine Name: FBPAID
    Before: B29740896   After: B34000309  **5,61,107,121,135**
Routine Name: FBPAID3
    Before:       n/a   After:B190545666  **135**
Routine Name: FBPAID3A
    Before:       n/a   After:B117117622  **135**
Routine Name: FBPAID3B
    Before:       n/a   After: B52284307  **135**
Routine Name: FBPCR
    Before: B63936182   After: B73151731  **12,48,76,98,103,135**
Routine Name: FBPCR4
    Before: B10705492   After: B14245640  **48,76,135**
Routine Name: FBUTL135
    Before:       n/a   After:B139327633  **135**
Routine Name: FBUTL136
    Before:       n/a   After:B203178014  **135**
Routine Name: FBUTL5
    Before: B18887718   After: B19998374  **61,135**
 
Routine list of preceding patches: 103, 121, 124

=============================================================================
User Information:
Entered By  : CLARK,KAREN Y                 Date Entered  : NOV 04, 2011
Completed By: DEWAYNE,BRANDON               Date Completed: DEC 13, 2012
Released By : CARP,CHERYL                   Date Released : JAN 22, 2013
=============================================================================


Packman Mail Message:
=====================

$END TXT