$TXT Created by MNTVBB.DOMAIN.EXT (KIDS) on Tuesday, 08/12/14 at 15:32 ============================================================================= Run Date: SEP 15, 2014 Designation: FB*3.5*143 Package : FB - FEE BASIS Priority: Mandatory Version : 3.5 SEQ #126 Status: Released Compliance Date: SEP 30, 2014 ============================================================================= Associated patches: (v)FB*3.5*8 <<= must be installed BEFORE `FB*3.5*143' (v)FB*3.5*70 <<= must be installed BEFORE `FB*3.5*143' (v)FB*3.5*101 <<= must be installed BEFORE `FB*3.5*143' (v)FB*3.5*115 <<= must be installed BEFORE `FB*3.5*143' (v)FB*3.5*124 <<= must be installed BEFORE `FB*3.5*143' Subject: FIX ISSUES WITH RATES, VETERAN & ANCILLARY PAYMENTS Category: - Routine - Data Dictionary Description: ============ This patch addresses four issues: 1. Modifies logic when applying the "Mill-Bill" claims 70% reduction when local fee schedule (75th percentile) rates are used. 2. Changes the fee program for ancillary payments entered using Multiple Ancillary Payments [FBCH MULTIPLE PAYMENTS] option from "Outpatient" to "Civil Hospital". 3. Modifies the sort and print routines for Veteran Payment History report to display the '#' symbol for voided payments. 4. Modifies the Fee Basis payment system to allow users holding the "FBAASUPERVISOR" key to exceed the amount of billed charges. ASSOCIATED REMEDY TICKETS: ========================== 1. INC000000271207 - Programming logic issue 2. INC000000249588 - Payment information discrepancies 3. INC000000483409 - Modify payments to allow user to exceed claim amount 4. INC000000333711 - Voided payment not indicated in Veterans Payment History Option Duplicate: INC000000525521 ASSOCIATED NSR(S): ================== N/A PARTICIPATING TEST SITES: ========================= Muskogee VAMC Jackson VAMC Houston VAMC Detroit VAMC REMEDY OVERVIEW: ================ 1. INC000000271207 - Programming logic issue Problem: -------- If during payment of a claim that has been marked as "Mill-Bill", the CPT code defaults to the Local Fee (75th Percentile) rate, Fee Basis is calculating 70% of that amount, which does not follow current regulation. Resolution: ----------- This patch checks for the type of Fee Schedule used in calculating an amount, and if the Local Fee (75th Percentile) Schedule was used, then VistA will not apply the 70% reduction. 2. INC000000249588 - Payment information discrepancies Problem: -------- Using the Multiple Ancillary Payments [FBCH MULTIPLE PAYMENTS] option, payments entered under "Civil Hospital" have their "Fee Program" value set to "Outpatient", so when viewing the veterans "Payment History", they display incorrectly as "Outpatient". Resolution: ----------- Modifying routine FBAAMP to pass in the variable FBTYPE into the field "Fee Program" instead of the value "2", results in the correct Fee Program being assigned to the payment. 3. INC000000483409 - Modify payments to allow user to exceed claim amount Problem: -------- The VA has adopted the Center for Medicare & Medicaid Services (CMS) reimbursement methodology for payment to non-VA providers. This change requires the VA to adopt Outpatient Prospective Payment System (OPPS) payment methodology, which might require the VA to pay line items above their billed charges. Resolution: ----------- Modified routine FBAAMP and the input transform for AMOUNT PAID sub-field (#2) within the SERVICE PROVIDED multiple (#2) in the FEE BASIS PAYMENT (#162) file to allow users holding the "FBAASUPERVISOR" key to enter amounts exceeding charges claimed. 4. INC000000333711 - Voided payment not indicated in Veterans Payment History Option Problem: -------- Voided ancillary civil hospital payments do not display the correct identifier (#), in Payment History Display [FBAA Payment History], Vendor Payment Output [FB PAY VENDOR], or Veteran Payment Output [FB PAY VETERAN] displays. Resolution: ----------- Adding the variable "FBVP" to the ^TMP array that is set in routine FBPAY67, and then looking for that variable in routine FBPAY21 to write the identifier (#). DATA DICTIONARY CHANGES: ======================== Before: ------- 162.03,2 AMOUNT PAID 0;3 NUMBER (Required) INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:+X'=X&(X'?.N.1".".2N)!( X>999999)!(X<0) X I $D(X),$P(^FBAAC(DA(3),1,DA( 2),1,DA(1),1,DA,0),"^",2)99999 9)!(X<0) X I $D(X) D OPPS^FBAAUTL2 LAST EDITED: MAR 19, 2013 HELP-PROMPT: Type a number between 0 and 999999. DESCRIPTION: The amount that the VA is going to pay for this service provided, not to exceed the amount entered in the AMOUNT CLAIMED (#1) field. Users holding the "FBAASUPERVISOR" key may override this limit. NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER INSTALLATION INSTRUCTIONS: ========================== As it is necessary to disable some menu options when installing this patch it is recommended that the install be done during non-peak hours. Additionally, installing during peak hours may lead to an unusually long install time. Install Time - less than 2 minutes (unless otherwise indicated) 1. Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. From the Kernel Installation & Distribution System menu, select the Installation menu. 3. From this menu, you may select to use the following options: (when prompted for INSTALL NAME, enter FB*3.5*143) a. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. b. Print Transport Global - This option will allow you to view the components of the KIDS build. c. 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.). d. 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. 4. Use the Install Package(s) option and select the package FB*3.5*143. 5. When Prompted "Want KIDS to INHIBIT LOGONs during the install? NO//" hit enter. 6. When prompted 'Want to DISABLE Schedule Options, Menu Options and Protocols? YES//', hit enter. 1) When prompted "Enter options you wish to mark as "Out of Order":" enter the following option: Payments for Unauthorized Claims [FBUC PAYMENTS] Multiple Ancillary Payments [FBCH MULTIPLE PAYMENTS] Payment History Display [FBAA PAYMENT HISTORY DISPLAY] Vendor Payments Output [FB PAY VENDOR] Veteran Payments Output [FB PAY VETERAN] 2) When prompted "Enter protocols you wish to mark as "Out of Order":" just press . Routine Information: ==================== The second line of each of these routines now looks like: ;;3.5;FEE BASIS;**[Patch List]**;JAN 30, 1995;Build 20 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: FBAACO0 Before: B32636065 After: B34388675 **4,38,52,57,61,75,70,143** Routine Name: FBAACO3 Before: B55394363 After: B55803171 **4,38,55,61,116,122,133,108, 124,143** Routine Name: FBAACP Before: B46974663 After: B47546031 **4,38,55,61,77,108,143** Routine Name: FBAAFS Before: B28501893 After: B29211943 **4,53,71,92,99,111,115,143** Routine Name: FBAAMP Before: B64599378 After: B64651581 **4,21,38,55,61,67,116,108,143** Routine Name: FBAAUTL2 Before: B18208320 After: B19718250 **8,143** Routine Name: FBPAY21 Before: B16167791 After: B16369927 **4,32,69,101,143** Routine Name: FBPAY67 Before: B41443321 After: B41631569 **4,32,55,69,108,143** Routine list of preceding patches: 8, 70, 101, 115, 124 ============================================================================= User Information: Entered By : Date Entered : MAY 24, 2012 Completed By: Date Completed: SEP 09, 2014 Released By : Date Released : SEP 15, 2014 ============================================================================= Packman Mail Message: ===================== $END TXT