$TXT Created by ZIMMER,TIMOTHY A at DEVFEY.FO-ALBANY.MED.VA.GOV (KIDS) on Thursday, 03/08/12 at 09:22 ============================================================================= Run Date: APR 18, 2012 Designation: IB*2*473 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #434 Status: Released Compliance Date: MAY 19, 2012 ============================================================================= Associated patches: (v)IB*2*424 <<= must be installed BEFORE `IB*2*473' (v)IB*2*447 <<= must be installed BEFORE `IB*2*473' (v)IB*2*451 <<= must be installed BEFORE `IB*2*473' (v)IB*2*452 <<= must be installed BEFORE `IB*2*473' Subject: IB 5010 Maintenance Category: - Other - Routine - Data Dictionary Description: ============ This Integrated Billing (IB) patch finalizes the HIPAA 5010 enhancements. The intent of this patch is to: 1. When a procedure is entered on the claim, users are prompted to point/link diagnoses to that procedure. Up to four diagnoses can be linked. If an associated diagnosis code is deleted in the number one slot, the system doesn't re-order the codes, but it moves the remaining codes up levels to fill the gaps. So if there are 4 codes and 1 and 2 are deleted, the new software will move codes 3 and 4 into the 1 and 2 position. 2. Capture and transmit Remaining liability qualifier and Remaining Liability to Financial Services Center (FSC). 3. Only send Purchase Service Provider ID and Purchase Service Amount when claims contain a purchased service. The user will now get an error instead of a warning for the following conditions: a. A Purchase Service Amount exists but the Non-VA Facility is missing. b. A Non-VA Facility exists but there is no Purchase Service Amount. 4. Sync up Purchase Service Provider ID to agree with either Purchase Service Provider Primary ID or Purchase Service provider secondary ID. 5. Send 000 in field 4 (Service Line Paid Amt) of the LCOB record and field 8 (Other Payer Paid Amt) of OI1 record for entries with 0.00 dollar amounts. Note: For future payers, the amount will be null instead of 0.00 dollars. For example, a secondary claim will show a null entry for the tertiary payer and a dollar amount for the secondary payer. 6. Update CHAMPVA Rx Rate Schedules by adding data to the BILLABLE SERVICE and DISPENSING FEE fields. 7. Update TRICARE Rx Rate Schedules by creating two new Rate Schedules for the updated TRICARE dispensing fee of $10.27 with an effective date of 01/23/12. Inactivate the old TRICARE Rx Rate Schedules with an inactive date of 01/22/12. 8. Modify ePharmacy IB Billing Determination by excluding non-pharmacy insurance policies when calculating the Rate Type. 9. Correct slow down in locating 3rd Party claims with EEOBs - The need was identified in Remedy ticket HD0000000597554. Patch Components ================ Files & Fields Associated: File Name (#) New/Modified/ Sub-file Name (#) Field Name (Number) Deleted ------------------- --------------------------------- ------------- IB ERROR (#350.8) Modified Screen: I $$INC3508^IBY473PR(Y) IB DATA ELEMENT DEFINITION (#364.5) Modified Screen: I $$INCLUDE^IBY473PR(5,Y) IB FORM SKELETON DEFINITION (#364.6) Modified Screen: I $$INCLUDE^IBY473PR(6,Y) IB FORM FIELD CONTENT (#364.7) Modified Screen: I $$INCLUDE^IBY473PR(7,Y) Options Associated: New/Modified/ Option Name Type Deleted ----------- ---- ------------- N/A Protocols Associated: New/Modified/ Protocol Name Deleted ------------- ------------- N/A Templates Associated: New/Modified/ Template Name Type File Name (Number) Deleted ------------- ---- ------------------ ------------- N/A New Service Requests (NSRs) --------------------------- N/A Remedy Ticket(s) & Overview --------------------------- 1. HD0000000597554 - Recent changes substantially slowed down the display. Problem: -------- Slow down locating 3rd Party claims with EEOBs - It was determined that patches IB*2.0*451 and PRCA*4.5*276 added the ability to identify, via a '%' indicator, first party bills associated with third party bills which have EEOBs on file. The code to locate the bills utilized the cross-reference "D" of the EVENT DATE field (#.03) in the Bill/Claims file (#399). It was found that these changes substantially slowed down the display of two specific reports to unsatisfactory levels. Resolution: ----------- After installation of this patch, the two report options affected will utilize the cross-reference "APDT" of the EVENT DATE field (#.03) in the Bill/Claims file (#399) to speed up data display. The following options are modified: First Party Follow-Up Report [IBJD FOLLOW-UP FIRST PARTY] List all Bills for a Patient [IB LIST ALL BILLS FOR PAT] Test Sites: ----------- Birmingham Loma Linda North FL/South GA Palo Alto Richmond Documentation Retrieval Instructions ------------------------------------ No documentation is updated with this patch. Patch Installation: Pre/Post Installation Overview ------------------------------ ****Important Note: There is one **MANDATORY** pre-installation activity associated with this install. The IB Staff MUST empty the 837 extract/transmission queue PRIOR to the installation of this patch. *** Instructions on how to clear 837 queue (These must be conducted by MCCF) Step 1 (this generates a report to be used in Step 2) Select OPTION NAME: BILLING SUPERVISOR MENU IB BILLING SUPERVISOR MENU Billing Supervisor Menu EDI EDI Menu For Electronic Bills ... Select Billing Supervisor Menu Option: EDI EDI Menu For Electronic Bills TR EDI Transmission Status Reports ... Select EDI Menu For Electronic Bills Option: TR EDI Transmission Status Reports REX Ready for Extract Status Report Step 2 (Using report from Step 1) (Note: These must be completed by MCCF) Select OPTION NAME: BILLING SUPERVISOR MENU IB BILLING SUPERVISOR MENU Billing Supervisor Menu EDI EDI Menu For Electronic Bills ... Select Billing Supervisor Menu Option: EDI EDI Menu For Electronic Bills SEND Transmit EDI Bills - Manual There are no other mandatory pre-installation activities associated with this package. **** Please note, if you select the option below, Compare Transport Global to Current System, and select #1 Full Comparison, you will get a system error: S+1^DIQ ^IBA(364.6,2228,0) due to a known issue with the KIDS Full Compare option (see Remedy Ticket HD0000000449218). You can run any of the other 3 compare options without issue. 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: The installation time will depend on the size of the BILL/CLAIMS (#399) file. 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*473): 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.). ********Please note, if you select option #1 to run a Full Comparison you will get a system error: S+1^DIQ ^IBA(364.6,2228,0) due to a known issue with the KIDS Full Compare option (see Remedy Ticket # HD0000000449218). You can run any of the other 3 compare options without issue. 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 for the INSTALL NAME, enter IB*2.0*473 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? NO//' answer NO 5. Routines ^IBY473PO and ^IBY473PR will be deleted upon completion of installation. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 29 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCBB2 Before: B50172747 After: B51205466 **51,137,210,245,232,296,320, 349,371,403,432,447,473** Routine Name: IBCEF11 Before: B73456164 After: B67207596 **51,137,155,309,335,348,349, 371,432,447,473** Routine Name: IBCEF81 Before:B105842498 After:B108877759 **432,473** Routine Name: IBCEF82 Before:B111186112 After:B106453752 **432,473** Routine Name: IBCEFP Before:B100162925 After:B115077680 **432,447,473** Routine Name: IBCEU1 Before: B59089714 After: B90709480 **137,155,296,349,371,432,473** Routine Name: IBCSC11 Before: B7658686 After: B7658686 **447,473** Routine Name: IBCSC9 Before: B7536045 After: B7536045 **52,51,447,473** Routine Name: IBCU72 Before: B11361036 After: B16150008 **62,210,473** Routine Name: IBJDF41 Before: B92006724 After: B88827246 **123,159,204,356,451,473** Routine Name: IBJTCA1 Before: B52613599 After: B53091604 **39,80,106,137,223,276,363, 384,432,452,473** Routine Name: IBNCPDP1 Before:B197349742 After:B196557252 **223,276,339,363,383,405,384, 411,434,437,435,455,452,473** Routine Name: IBY473PO Before: n/a After: B10300393 **473** Routine Name: IBY473PR Before: n/a After: B1657081 **473** Routine list of preceding patches: 447, 451, 452 ============================================================================= User Information: Entered By : ZIMMER,TIMOTHY A Date Entered : JAN 18, 2012 Completed By: ROBBINS,BRADLEY Date Completed: MAR 22, 2012 Released By : CAULFIELD,MARY Date Released : APR 18, 2012 ============================================================================= Packman Mail Message: ===================== $END TXT