$TXT Created by FIAMENGO,GRACE E at DEVFEX.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 04/25/11 at 14:16 ============================================================================= Run Date: MAY 26, 2011 Designation: IB*2*433 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #415 Status: Released Compliance Date: JUN 26, 2011 ============================================================================= Associated patches: (v)IB*2*347 <<= must be installed BEFORE `IB*2*433' (v)IB*2*358 <<= must be installed BEFORE `IB*2*433' (v)IB*2*377 <<= must be installed BEFORE `IB*2*433' (v)IB*2*400 <<= must be installed BEFORE `IB*2*433' (v)IB*2*420 <<= must be installed BEFORE `IB*2*433' (v)PRCA*4.5*270<<= must be installed BEFORE `IB*2*433' Subject: E-BILLING PRESERVE CLAIM NUMBER WHEN CLONED Category: - Data Dictionary - Routine - Enhancement (Mandatory) Description: ============ ****************************************************************** * * * PRCA*4.5*270 must be installed prior to installing IB*2*433. * * * ****************************************************************** This release will provide a new Integrated Billing (IB) option that will allow users to correct rejected or denied claims to third party insurance companies, while maintaining the original claim number. The purpose of this patch, along with PRCA*4.5*270, is to provide the ability for sites to correct claims that have been either rejected at some stage in the processing of the claim or adjudicated by the payer and denied for a correctable reason, and to have the corrected version of the claim maintain the original claim number. Once corrected, the site can then resubmit the claim, electronically or by mail, to the payer for reprocessing. The changes are primarily to the IB module. Because there is a correlation between claim numbers in IB and in Accounts Receivable (AR), the accompanying AR patch, PRCA*4.5*270, modifies the BILL NO. field (#.01) of the ACCOUNTS RECEIVABLE file (#430) to support adding the iteration number to the claim number of the original claim once it has been cancelled via the new correction process. This patch, IB*2*433, contains the new Correct Rejected/Denied Claim menu option and protocol, as well as the routines to support this new function. In addition, it adds a new security key, IB CLON, which locks the Copy and Cancel [IB COPY AND CANCEL] menu option to limit future use of this existing option. The new option, Correct Rejected/Denied Bill [IB CORRECT REJECTED/DENIED] will be added to the following locations: 1. Third Party Billing Menu ... [IB THIRD PARTY BILLING MENU] 2. CSA - Claims Status Awaiting Resolution [IBCE CLAIMS STATUS AWAITING] 3. MRW - MRA Management WorkList [IBCE MRA MANAGEMENT] This new option will function similar to the existing Copy and Cancel option [IB COPY AND CANCEL]. It is used to correct claims that have been rejected at any stage in the claims processing by Financial Services Center (FSC), Emdeon, or Insurance Company, or denied by the insurance company. The old claim will be cancelled & renamed with the original claim number plus an incremental #, KXXXXXX-01. A new claim, which is a copy of the original claim, will be created and will maintain the original claim number. This option can NOT be used to correct a claim if any payment has been posted to the claim in AR, or if the claim/account is a non-accrued Billing type (such as a Tricare claim). If either of these are true, then the old Copy and Cancel option [IB COPY AND CANCEL] must be used. This is a result from business needs identified by the Chief Business Office (CBO). The ability to resubmit a rejected/denied claim with the original claim number is normal process for most of the industry. This ability will also provide the ability to better track the processing of claims as it provides the ability to follow claims through the resubmission process and track the changes that were required as a result of a rejection or denial. Components Sent With Patch -------------------------- The following is a list of files included in this patch: UP SEND DATA DATE SEC. COMES SITE RSLV FILE # NAME DD CODE W/FILE DATA PTS -------------------------------------------------------------------- 399 BILL/CLAIMS YES YES NO Partial DD: subDD: 399 fld: .01 The following is a list of options included in this patch: Option Name Action: ----------- ------- IB COPY AND CANCEL SEND TO SITE IB CORRECT REJECTED/DENIED SEND TO SITE IB THIRD PARTY BILLING MENU USE AS LINK FOR MENU ITEMS The following is a list of security keys included in this patch: Security Key ------------ IB CLON SEND TO SITE The following is a list of protocols included in this patch: IBCEM COB MANAGEMENT USE AS LINK FOR MENU ITEMS IBCEM CORRECT REJECTED/DENIED BILL SEND TO SITE IBCEM CSA COPY/CANCEL BILL DELETE AT SITE IBCEM CSA CORRECT REJECTED/DENIED BILL SEND TO SITE IBCEM CSA MSG MENU USE AS LINK FOR MENU ITEMS The following is a list of templates included in this patch: LIST TEMPLATE: ACTION: IBCEM MRA MANAGEMENT SEND TO SITE This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- eBilling - Preserve Claim Number When Cloned #20080110 This patch addresses the following Remedy Ticket(s): ---------------------------------------------------- There are no Remedy tickets associated with this patch. Documentation Retrieval: ------------------------ Updated documentation describing the Release Notes for this patch is available. The preferred method is 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. Documentation can also be found on the System Design and Development Web page at: http://www.va.gov/vdl/ The Release Notes file associated with this patch is listed below. File Name FTP Mode ----------------------------------------------------------------------- edi_user_guide.pdf (binary) IB_20_433_PRCA_45_270_RN.pdf (binary) IB_20_P433_SG_CP.pdf (binary) IB_20_P433_TM.pdf (binary) Test Sites: ----------- El Paso Montana HCS VISN 2 Pre/Post Installation Overview ------------------------------ This patch introduces a new security key, IB CLON. The intent of this key is to lock out users from the old CLON menu option and encourage them to use the new CRD menu option introduced with this patch. The only time a user would still need to use CLON is in the rare circumstance where a claim needs to be corrected and a payment has already been posted to it, or when correcting non-accrued Billing types such as Tricare claims. It is recommended that the assignment of this key be limited. Please have the Billing Supervisor determine to whom the key should be assigned when the patch is installed. ================INSTALLATION INSTRUCTIONS ================= ****************************************************************** * You should install this patch during non-peak hours, when no * * Integrated Billing or Accounts Receivable users are on the * * system. * ****************************************************************** ****There are no options to disable. Install Time - less than 2 minutes 1. LOAD TRANSPORT GLOBAL --------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. START UP KIDS ------------- Start up the Kernel Installation and Distribution System Menu [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. Select Installation Option: --------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter IB*2.0*433): 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. Select Installation Option: Install Package(s) ------------------ **This is the step to start the installation of this KIDS patch: a. Choose the Install Package(s) option to start the patch install. b. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//' You may answer NO if your system does this in a nightly TaskMan process. (Answering YES can slightly increase the installation time, but is recommended since this patch includes some changes to IB menu options). c. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' answer NO d. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//' answer NO Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 36 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCC Before: B36322352 After: B55278048 **2,19,77,80,51,142,137,161, 199,241,155,276,320,358,433** Routine Name: IBCCC Before: B14623718 After: B19833336 **80,109,106,51,320,433** Routine Name: IBCCC1 Before: B9524084 After: B10538987 **80,109,106,51,320,358,433** Routine Name: IBCCC2 Before: B68853950 After: B69917469 **80,106,124,138,51,151,137, 161,182,211,245,155,296,320, 348,349,371,400,433** Routine Name: IBCECOB2 Before: B72912246 After: B78530862 **137,155,433** Routine Name: IBCECSA4 Before: B57240644 After: B60720503 **137,155,320,371,433** Routine Name: IBCNQ Before: B25492974 After: B25510710 **51,320,377,433** Routine Name: IBOA31 Before: B15171767 After: B15589530 **95,199,433** Routine Name: IBOA32 Before: B6461221 After: B6792943 **7,95,347,433** Routine Name: IBOLK Before: B17698535 After: B18563160 **199,420,433** Routine list of preceding patches: 347, 358, 377, 400, 420 ============================================================================= User Information: Entered By : JUTZI,WILLIAM CHRISTOPHER Date Entered : MAY 19, 2010 Completed By: ROBBINS,BRADLEY Date Completed: MAY 10, 2011 Released By : CAULFIELD,MARY Date Released : MAY 26, 2011 ============================================================================= Packman Mail Message: ===================== $END TXT