============================================================================= Run Date: FEB 16, 2012 Designation: IB*2*452 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #431 Status: Released Compliance Date: MAR 17, 2012 ============================================================================= Associated patches: (v)IB*2*399 <<= must be installed BEFORE `IB*2*452' (v)IB*2*432 <<= must be installed BEFORE `IB*2*452' (v)IB*2*438 <<= must be installed BEFORE `IB*2*452' (v)IB*2*455 <<= must be installed BEFORE `IB*2*452' Subject: EPHARMACY PHASE 6 Category: - Data Dictionary - Routine - Enhancement (Mandatory) - Input Template - Other 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*385 INTEGRATED BILLING (IB) V. 2.0 IB*2*452 ELECTRONIC CLAIMS MANAGEMENT ENGINE (ECME) V. 1.0 BPS*1*11 CONSOLIDATED MAIL OUTPATIENT PHARMACY (CMOP) V. 2.0 PSX*2*73 The patches (PSO*7*385, IB*2*452, BPS*1*11, and PSX*2*73) are being released in the Kernel Installation and Distribution System (KIDS) multi-build distribution BPS PSO IB PSX BUNDLE 7.0. The purpose of this software package is to maintain compliance with legislative and federal mandates and to address and correct gaps and inefficiencies in the current electronic pharmacy billing processes. This will ultimately increase revenues collected by VA Medical Centers and outpatient pharmacies by reducing the volume of short pays and payment denials. All pharmacy claims for payers that are processed electronically are compliant with the current industry standards. This software adds support for the electronic billing of the Health Administration Center (HAC) CHAMPVA payer in order to provide an automated process and to prevent manual workarounds for CHAMPVA. This specific patch contains the following functionality: --------------------------------------------------------- 1. Add IB support for CHAMPVA ePharmacy insurance and CHAMPVA patient eligibility, and process CHAMPVA ePharmacy prescriptions using the CHAMPVA rate type. 2. Add a new Claims Tracking Reason Not Billable (RNB) for CHAMPVA, inpatient prescriptions. 3. Enhance the ECME Billing Events Report option [IB ECME BILLING EVENTS] as follows: a. Add patient eligibility (VETERAN, TRICARE, CHAMPVA) b. Display the NCPDP quantity and units when available and also the Billed quantity and units c. Display a break-out of all fees and costs associated with each prescription d. Display a break-out of the payer-reported amounts paid in the ECME response for each prescription 4. Create a bill in IB and AR when a DUPLICATE ECME response is received and only when a non-cancelled bill with the same Rx#, fill#, and payer sequence doesn't already exist. 5. Add the display of the ECME# to several existing reports, screens, and MailMan messages that currently only show the Rx#. 6. Add fields and prompts for the Pharmacy Relationship Code and for the Pharmacy Person Code in both the Process Insurance Buffer [IBCN INSURANCE BUFFER PROCESS] option and in the Patient Insurance Info View/Edit [IBCN PATIENT INSURANCE] option. 7. Add a new Claims Tracking Reason Not Billable (RNB) for Auto-Reversals for Inpatient Prescriptions. Previous to this patch, the RNB for this situation was being filed by the system as OTHER. Patch Components ================ Files & Fields Associated: File Name (#) New/Modified/ Sub-File Name (#) Field Name (#) Deleted ------------------- ------------------- ------------- PATIENT (#2) INSURANCE TYPE sub-file (#2.312) PHARMACY RELATIONSHIP CODE (#4.05) New PHARMACY PERSON CODE (#4.06) New INSURANCE BUFFER (#355.33) PHARMACY RELATIONSHIP CODE (#60.15) New PHARMACY PERSON CODE (#60.16) New PLAN (#366.03) TYPE (#.05) Modified IB NCPDP EVENT LOG (#366.14) EVENT sub-file (#366.141) BCID (#.12) Modified DATE OF SERVICE (#.206) Modified RELEASE DATE (#.207) Modified QTY (#.208) Modified BILLING UNITS (#.213) New NCPDP QTY (#.214) New NCPDP UNITS (#.215) New COPAY AMOUNT (#.311) Modified INGREDIENT COST PAID (#.312) New DISPENSING FEE PAID (#.313) New PATIENT RESPONSIBILITY (INS) (#.314) New ELIGIBILITY (#7.05) New INSURANCE sub-file (#366.1412) PHARMACY PERSON CODE (#.09) New INGREDIENT COST (#.206) New USUAL AND CUSTOMARY CHARGE (#.207) New PT INSURANCE POLICY (#.304) New Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- IBJ EXIT Modified IBJT ECME RESP INFO MENU Modified IBJT VIEW ECME RX New Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- IBCN PATIENT INSURANCE INPUT PATIENT (#2) Modified Additional Information: New Service Requests (NSRs) ---------------------------- Request Name: ePharmacy Claims Phase 6 (FY10) Request ID: 20090215 Patient Safety Issues (PSIs) ----------------------------- N/A Remedy Ticket(s) & Overview --------------------------- N/A Test Sites: ---------- Birmingham Loma Linda Phoenix Richmond 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 Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov Documentation can also be found on the VA Software Documentation Library at: http://www.va.gov/vdl/ Title File Name FTP Mode ---------------------------------------------------------------------------- IB Release Notes (IB*2.0*452) IB_2_0_P452_RN.PDF Binary IB Technical Manual/Security Guide IB_2_0_P452_TM.PDF Binary Patch Installation: Pre/Post Installation Overview ------------------------------ There is a post-install routine associated with this patch named IBY452PO. The purpose of the post-install routine is to create one new entry in the CLAIMS TRACKING NON-BILLABLE REASONS file (#356.8). The new entry is named CHAMPVA INPATIENT/DISCHARGE and it is automatically used by the IB billing determination process when processing a CHAMPVA, inpatient prescription. These prescriptions are non-billable. The post-install routine is automatically deleted by the system if allowed by your Kernel site parameters configuration. You may delete routine IBY452PO if the installation was successful and it is not automatically deleted by KIDS. Installation Instructions ------------------------- This patch should take up to 20 minutes to install. DO NOT QUEUE the installation of this patch. 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 would be 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. ***** IMPORTANT INSTALLATION NOTES ***** This patch bundle is changing the name of File #52.87. The current name of this file is 'PSO TRICARE AUDIT LOG'. The new name of this file is 'PSO AUDIT LOG'. During the patch installation you will see the following information presented to the screen: 52.87 PSO AUDIT LOG *BUT YOU ALREADY HAVE 'PSO TRICARE AUDIT LOG' AS FILE #52.87! Shall I write over your PSO TRICARE AUDIT LOG File? YES// Please accept the default answer of YES to this question. You will also be prompted to enter the coordinator for the new BPS CHAMPVA mail group. Prior to installation, please contact your Medical Care Cost Recovery (MCCR) business department (Facility Revenue Manager) to determine who will be the coordinator for this new mail group. The users in this mail group will receive bulletins related to the processing of CHAMPVA electronic claims. After the patch is installed, members can be added to the mail group by using the Mail Group Edit [XMEDITMG] option. Pre-Installation Instructions ----------------------------- 1. OBTAIN PATCHES -------------- Obtain the host file BPS_1_11_PSO_IB_PSX.KID, which contains the following patches: BPS*1.0*11 PSO*7.0*385 IB*2.0*452 PSX*2.0*73 Sites can retrieve VistA software from the following FTP addresses. The preferred method is to FTP the files from: download.vista.med.va.gov 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.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The BPS_1_11_PSO_IB_PSX.KID host file is located in the anonymous.software 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_11_PSO_IB_PSX.KID (e.g., SYS$SYSDEVICE:[ANONYMOUS]BPS_1_11_PSO_IB_PSX.KID). When prompted for "OK to continue with Load? NO//", enter "YES." The following will display: Loading Distribution... BPS PSO IB PSX BUNDLE 7.0 BPS*1.0*11 PSO*7.0*385 IB*2.0*452 PSX*2.0*73 Use INSTALL NAME: BPS PSO IB PSX BUNDLE 7.0 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 PSX BUNDLE 7.0): 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 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. 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 PSX BUNDLE 7.0. a. Choose the Install Package(s) option to start the patch install. b. When prompted for the "Select INSTALL NAME:", enter BPS PSO IB PSX BUNDLE 7.0. c. When prompted to "Enter the Coordinator for Mail Group 'BPS CHAMPVA':", please respond with the appropriate person. d. When prompted "Shall I write over your PSO TRICARE AUDIT LOG File? YES//", please accept the default of YES in order to change the name of this file as instructed above. e. 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. f. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//", enter NO. g. When prompted " Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//", enter NO. h. When prompted "Device: HOME//", respond with the correct device but do not queue this install. Post-Installation Instructions ------------------------------ N/A Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 26 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCC1 Before: B52622675 After: B54745451 **19,95,160,159,320,347,377,399,452** Routine Name: IBCNBCD Before: B85841141 After: B87228703 **82,251,361,371,416,438,452** Routine Name: IBCNBEE Before: B46140166 After: B46620313 **82,184,252,251,356,361,371, 377,416,438,452** Routine Name: IBCNBLE Before: B79037653 After: B85092127 **82,231,184,251,371,416,435,452** Routine Name: IBCNBMI Before: B88135696 After: B90850379 **82,184,246,251,299,345,361, 371,413,416,438,452** Routine Name: IBCNRDV Before: B66590171 After: B68041959 **214,231,361,371,452** Routine Name: IBCNRE4 Before: B31384444 After: B30785687 **251,435,452** Routine Name: IBCNSP01 Before: B33683555 After: B38322308 **43,52,85,251,371,377,416,452** Routine Name: IBJDF5 Before: B27507847 After: B27986612 **123,185,240,452** Routine Name: IBJDF51 Before: B57917669 After: B57886181 **123,185,240,356,452** Routine Name: IBJTCA1 Before: B52064339 After: B52613599 **39,80,106,137,223,276,363, 384,432,452** Routine Name: IBJTRX Before: B61346654 After: B76083313 **435,452** Routine Name: IBJTU6 Before: n/a After: B7149148 **452** Routine Name: IBNCPDP Before: B5486206 After: B5636694 **223,276,363,383,384,411,435,452** Routine Name: IBNCPDP1 Before:B163143081 After:B197349742 **223,276,339,363,383,405,384, 411,434,437,435,455,452** Routine Name: IBNCPDP2 Before: B72289199 After: B83475194 **223,276,342,347,363,383,405, 384,411,435,452** Routine Name: IBNCPDP3 Before: B84836012 After: B84831779 **223,276,342,363,383,384,411, 435,452** Routine Name: IBNCPDP4 Before: B55438909 After: B55547845 **276,342,405,384,411,435,452** Routine Name: IBNCPDP5 Before: B76631396 After: B79816493 **411,452** Routine Name: IBNCPDP6 Before: B13230978 After: B13361102 **383,384,411,452** Routine Name: IBNCPDPR Before: B26651365 After: B3700462 **276,347,384,452** Routine Name: IBNCPDPU Before: B95492067 After:B114125068 **223,276,347,383,405,384,437, 435,452** Routine Name: IBNCPDS1 Before: B11093951 After: B10933965 **411,452** Routine Name: IBNCPEB Before: B27674256 After: B27638146 **276,342,347,363,452** Routine Name: IBNCPEV Before: B84626765 After: B94277434 **342,363,383,384,411,435,452** Routine Name: IBNCPEV1 Before: B49201751 After: B65821785 **342,339,363,411,435,452** Routine Name: IBNCPIV Before: B54267861 After: B54224856 **435,452** Routine Name: IBNCPLOG Before: B64598922 After: B76075004 **342,339,363,383,411,435,452** Routine Name: IBNCPNB Before: B37701881 After: B37701881 **276,342,384,452** Routine Name: IBOHDT1 Before: B16207159 After: B18542858 **70,95,347,452** Routine Name: IBOHLD2 Before: B28331010 After: B31564132 **70,95,133,153,347,452** Routine Name: IBOHPT2 Before: B16246897 After: B19874021 **70,95,347,452** Routine Name: IBRBUL Before: B33342361 After: B36492961 **70,95,121,153,195,347,452** Routine Name: IBRREL Before: B25137354 After: B29208696 **95,153,199,347,452** Routine Name: IBY452PO Before: n/a After: B3019235 **452** Routine list of preceding patches: 399, 432, 438, 455 ============================================================================= User Information: Entered By : GUSTAFSON,ERIC S Date Entered : MAR 02, 2011 Completed By: CONQUEST,KENNETH Date Completed: FEB 15, 2012 Released By : MURRAY,ANGELA Date Released : FEB 16, 2012 ============================================================================= Packman Mail Message: ===================== No routines included