$TXT Created by HARPER,AMY R at DEVFEX.FO-ALBANY.DOMAIN.EXT (KIDS) on Monday, 04/22/13 at 14:56 ============================================================================= Run Date: JUL 24, 2013 Designation: IB*2*458 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #454 Status: Released Compliance Date: AUG 23, 2013 ============================================================================= Associated patches: (v)IB*2*447 <<= must be installed BEFORE `IB*2*458' (v)IB*2*452 <<= must be installed BEFORE `IB*2*458' Subject: REASONABLE CHARGES ENHANCEMENTS 2013 Category: - Enhancement (Mandatory) - Data Dictionary - Input Template - Routine - Other Description: ============ ************************************************************************** ** Installation of IB*2*458 must be immediately followed by DSIV*2.2*8. ** ** DSIV*2.2*8 is being released as a companion patch to IB*2*458. ** ************************************************************************** This patch contains several updates to Integrated Billing for billable event processing and reports. Enhancements to Claims Tracking are the primary changes, including expanded Release of Information consents. Also included are New Reasons Not Billable, significant changes to the Days Denied Report and an additional option for installing Reasonable Charges. No charges are updated or exported with this patch. CLAIMS TRACKING DENIAL REASONS ============================== An Insurance Review that results in a Denial is assigned a reason for that denial from a standard set of reasons. New entries are being added to this standard set of Insurance Review Denial Reasons. New CLAIMS TRACKING DENIAL REASONS (#356.21): --------------------------------------------- DELAY IN TREATMENT/SERVICE DELAY TX OBSERVATION IS MORE APPROPRIATE OBS ALTERNATE LEVEL OF CARE IS MORE APPROPRIATE ALT LOC CLAIMS TRACKING REVIEW TYPES ============================ Each Insurance Review is assigned a Type identifying both the type of care and the type of review. New entries are being added to the standard set of Insurance Review Types. New CLAIMS TRACKING REVIEW TYPE (#356.11): ------------------------------------------ SNF/NHCU REVIEW 25 SNF/NHCU INPT RETROSPECTIVE REVIEW 35 RETRO INPT OPT RETROSPECTIVE REVIEW 55 RETRO OPT Display and Edit with New Review Types: --------------------------------------- The Insurance Review Types are used as controls when processing the fields of an Insurance Review to determine the data related to that review. For example the fields displayed and editable for a URGENT/EMERGENT ADMIT REVIEW are different than the fields displayed and editable for an OUTPATIENT TREATMENT review. The new Review Types will manage review data in the same way as existing similar Review Types: SNF/NHCU REVIEW process same as a URGENT/EMERGENT ADMIT REVIEW INPT RETROSPECTIVE REVIEW process same as a URGENT/EMERGENT ADMIT REVIEW OPT RETROSPECTIVE REVIEW process same as a OUTPATIENT TREATMENT Review CLAIMS TRACKING REASONS NOT BILLABLE ==================================== Each event in Claims Tracking may be assigned a Reason Not Billable to indicate the event is not billable and why. The standard list of Reasons Not Billable is being updated, one entry is changed and several added. Update CLAIMS TRACKING NON-BILLABLE REASONS (#356.8): ----------------------------------------------------- The name of one Reason Not Billable is being changed. NPI/TAXONOMY ISSUES changed to NPI/TAXONOMY/PPN ISSUES New CLAIMS TRACKING NON-BILLABLE REASONS (#356.8): -------------------------------------------------- ECME ECME PAPER NAME CODE FLAG FLAG ------------------------------------------------------------------- APPT CANCELLED/PT NOT SEEN MC20 SEEN BY PROVIDER ON SAME DAY MC21 NON-BILLABLE DME/PROSTHETIC MC22 NON-BILLABLE PROCEDURE MC23 EMPLOYEE HEALTH MC24 Yes No ENCOUNTER DURING INPT STAY MC25 NO PROSTHETIC COVERAGE CV22 NON-COVERED DIAGNOSIS CV23 NON-COVERED ROUTINE CARE CV24 HDHP PLAN NOT BILLED CV25 Yes No NOT RELATED TO WC/TORT/NF CV26 TRICARE PT SEEN AS VETERAN CV27 Yes No COMBINED CHARGES BL08 UNBUNDLED SERVICE BL09 CLAIMS TRACKING INSURANCE REVIEW CALL REFERENCE AND AUTHORIZATION NUMBER ======================================================================== The INSURANCE REVIEW file CALL REFERENCE NUMBER (#356.2, .09) and AUTHORIZATION NUMBER (#356.2, .28) fields are both being expanded to 35 characters. Fields Moved: ------------- Due to the additional length required these fields have been moved in the INSURANCE REVIEW file (#356.2). Two new fields are being added as replacements and the two existing fields inactivated: INSURANCE REVIEW (#356.2) file: #.09 CALL REFERENCE NUMBER (15chr) to #2.01 CALL REFERENCE NUMBER (35chr) #.28 AUTHORIZATION NUMBER (18chr) to #2.02 AUTHORIZATION NUMBER (35chr) Data Copied: ------------ The data in the inactivated fields will be moved to the new fields so there should be no change from the user perspective except the expanded number of characters available. Data Display: ------------- These two fields are displayed on several Claims Tracking screens and reports. If the number of characters available is too short to display the full extended length then the data will be truncated. A '*' will be appended to the end of the data to indicate the full data is not displayed. Call Reference Number as Default: --------------------------------- When a new Insurance Review is created and a Call Reference Number is entered then it is used as the default value for the Authorization Number. This default has been removed. Now when the Authorization Number is presented the Authorization Number of a previous Insurance Review for the event will be used as the default. If there was no previous Insurance Review Authorization Number then no default will be presented. CLAIMS TRACKING RELEASE OF INFORMATION SPECIAL CONSENT ====================================================== The Release of Information (ROI) function within Claims Tracking has been enhanced to include records of the ROI consents received and the sensitive condition they cover. Currently each event in Claims Tracking may be assigned a Special Consent ROI: Not Required, Obtained, Required, and Refused. This indicates if that specific event may be related to a sensitive condition requiring a Release of Information consent form from the patient. The new option will now allow entry of a record indicating a consent form has been received for a specific sensitive condition. New CLAIMS TRACKING ROI CONSENT (#356.26) file: ----------------------------------------------- A new file has been created for records of Release of Information obtained from a patient with the following. Note that each sensitive condition will have its own record. - PATIENT the consent was received from. - SENSITIVE CONDITION the consent for release covers. Includes the four standard sensitive conditions requiring ROI: DRUG ABUSE ALCOHOLISM/ALCOHOL ABUSE TESTING FOR OR INFECTION WITH HIV SICKLE CELL ANEMIA - The EFFECTIVE DATE when the consent for release begins. - The EXPIRATION DATE when the consent for release ends. - A REVOKED flag indicating the patient revoked the consent. In this case the Expiration date is updated to the date the revocation becomes effective. A consent may be revoked but will be active for the date range assigned. - COMMENTS associated with ROI, this is intended primarily for entry of the Insurance the release consent covers. View Patient ROI Special Consent Records: -------------------------------------------- A new screen has been added to display and manage the ROI consent records. This screen has been added as an action on the main Claims Tracking Editor screen: ROI Consent (RO). The ROI Special Consent screen will display all ROI consents entered for the Patient. The display order is currently active ROIs first then in reverse effective date order. Most recent active ROIs will be at the top. The Patient, effective date, expiration date and sensitive condition are all displayed. In addition, a flag will indicate which consents are currently active, inactive or inactive/revoked. The comments are displayed; however due to space limitations these are truncated. Use the '>' to shift the view to the right to see the entire comment field, '<' shift the view back to the left. Option: Claims Tracking Edit [IBT EDIT TRACKING ENTRY], ROI Consent (RO) Add/Edit ROI Special Consent Records for a Patient: --------------------------------------------------- Actions associated with the new Claims Tracking Editor screen for ROI Special Consent: - Add ROI Consent (AR) will allow new entries to be added. - Edit ROI (ER) will allow edit of existing entries. - Revoke ROI (RV) will allow an ROI consent to be flagged as revoked by the patient. The Expiration date must be updated to the date the revocation takes effect. - Delete ROI (DR) will allow a ROI record to be deleted. This should only be used if the record was entered in error. Old records that expired should remain. Users must be assigned the new IB ROI EDIT Security Key to perform any of these actions or to modify the ROI records. Security Key: IB ROI EDIT (new) Updates to Claims Tracking Displays for ROI: -------------------------------------------- Several Claims Tracking screens and reports have been updated to show indicators of the patients active ROI consent, if any. The main Claims Tracking Editor screen is the list of a patient's events within a timeframe. This screen has been modified in two ways: - Header of this screen will show indicators of the patient's sensitive conditions that have currently active consents, if any: ROI: AHS - Each event in the list displays the Special Consent ROI field associated with that event (Not Required, Obtained, Required, Refused). If the Special Consent ROI is Obtained then indicators of the sensitive conditions that have active consents on the date of the event will be appended to the field: OBTAIN(AS) Several other screens will have the following change to the header depending on the type of screen display: - Headers of screens that display lists of a patient's events will show indicators of the patient's sensitive conditions that have currently active consents, if any: ROI: AHS. - Headers of screens that display the extended data of a particular event and have Special Consent ROI set to Obtained will have indicators of the sensitive conditions that have consents active on the date of the event appended: ROI: OBTAINED (AS). ROI Expired Consent Report: --------------------------- A new report will list the ROI Special Consents that will expire within a user specified date range. This report has been added to the Management Reports (Billing) Menu. Option: ROI Expired Consent [IB OUTPUT ROI EXPIRED] (new) Menu: Management Reports (Billing) Menu [IB OUTPUT MANAGEMENT REPORTS] DAYS DENIED REPORT ================== The Days Denied report lists Inpatient stays that have a Denial Insurance Review. Significant updates have been made to the Days Denied Report: - The charges displayed as the Amount Denied has been update to the current active charges, Reasonable Charges. - Social Security Number has been removed and replaced with the last 4. - The Inpatient Admission's Service is added to each denied stay in the detail section. This is the Service the patient was in at either the admission, if that date is included in the report, or the Service the patient was in on the begin date of the report. This Service is used to provide the summary. - The Amount Denied has been added to each denied stay in the detail section. This amount is either: o if entire admission was denied and the entire stay is within the date range of the report then the Amount Denied is the full charge of the Admission o if only a partial denial then the Amount Denied is an average charge based on the full charge and the number of denied days on the report - Inpatient stays of one day will now be included on the report. - Events in Claims Tracking not linked to an actual clinical event will now be included on the report. Entries are sometimes manually created so Insurance Reviews can be completed before the event is automatically entered into Claims Tracking. The data on these types of entries will be limited as there is no source clinical event, for example there will be no service or amount displayed. - Detail and Summary sections are added for other types of care than Inpatient. Any Outpatient, Prescriptions or Prosthetics assigned a denial will be included on the report. Option: Days Denied Report [IBT OUTPUT DENIED DAYS REPORT] REASONS NOT BILLABLE REPORT =========================== An estimated charge for an Inpatient admission is included on the Reasons Not Billable report. Errors were identified in the Reasonable Charges Inpatient Facility charge calculation and have been corrected: - Every Inpatient stay was assumed to have been a DRG charge. This is updated so Nursing Home Care Treating Specialties will be properly charged the Skilled Nursing per diem. - Observation care will not be identified with and charged a DRG charge. - The Inpatient DRG calculation did not recognize the difference between ICU and Non-ICU care and added both DRG charges to the final amount. This is updated so each type will be identified and charged only the corresponding DRG amount. Option: Reasons Not Billable Report [IBJD REASONS NOT BILLABLE] BILL/CLAIMS ENTRY OF REASON NOT BILLABLE (?RNB) =============================================== There are cases where an event may only be partially billed and therefore will require both a bill and a Reason Not Billable. To assist processing these types of events a new Help action has been added to Enter/Edit a Bill option. The '?RNB' action will present the Claims Tracking entries related to the bill and allow a Reason Not Billable to be entered. The Reason Not Billable should only be entered if the event is not fully billed. Option: Enter/Edit Billing Information [IB EDIT BILLING INFO] UPDATE FIELD ============ The INSURANCE REVIEW (#356.2) FINAL OUTCOME OF APPEAL (#.29) field contained a misspelling. This has been corrected (PARITIAL corrected to PARTIAL) and Help Text was added to the field. CHARGE MASTER UPLOAD EXPAND DIVISION CHARACTERS =============================================== A list of sites is included with each version of Reasonable Charges released. This site number was limited to 5 characters. Actual division numbers are allowed 7 characters. Therefore the Charge Master Upload has been modified to allow 7 character site numbers. Option: Load Host File into Charge Master [IBCR HOST FILE LOAD] CHARGE MASTER REASONABLE CHARGES FACILITY TYPE DESIGNATION ========================================================== Each VA division is identified as a particular Facility Type for Reasonable Charges, either Provider Based or Non-Provider Based. This designation determines the charges loaded and available for use for that division. Non-Provider Based Freestanding Charges include Professional charges only. Provider Base Charges include Institutional and Professional charges for Inpatient, SNF and Outpatient care. There is the potential that a particular division's Facility Type may change which would require a complete new set of Reasonable Charges to be loaded for the new type. Previously this was only possible when a new version was released. A new option is added to allow a site's Facility Type to be changed at any time so it is no longer dependent on a version release. The current versions Reasonable Charges are inactivated and a new set loaded for the new Facility Type effective on a specified date. >>> CBO must approve any Facility Type change. Option: RC Change Facility Type [IBCR RC FACILITY TYPE] (new) Menu: Charge Master IRM Menu [IBCR CHARGE MASTER IRM MENU] (link) TECHNICAL DESCRIPTION: ====================== INSURANCE REVIEW (#356.2) file changes: --------------------------------------- The length of two free text fields in the INSURANCE REVIEW (#356.2) file were to be extended to 35 characters: CALL REFERENCE NUMBER (#.09) and AUTHORIZATION NUMBER (#.28). These two fields are stored on the zero node of the file and extending the length of these fields would have violated the File Manager standard on node length. Therefore, the fields are replaced rather than modified. All references to the old replaced fields have been updated to reference the new fields. The data is copied to the new fields in the post-init. The existing two fields are '*'ed for deletion and no longer used: *CALL REFERENCE NUMBER (#.09) [0;9] INSURANCE REVIEW (#356.2) file *AUTHORIZATION NUMBER (#.28) [0;28] INSURANCE REVIEW (#356.2) file Two new fields are created on a new node (2) as replacements: CALL REFERENCE NUMBER (#2.01) [2,1] INSURANCE REVIEW (#356.2) file AUTHORIZATION NUMBER (#2.02) [2,2] INSURANCE REVIEW (#356.2) file The INSURANCE REVIEW (#356.2) field TRACKING ID (#.02) is being released to update its cross reference #4 APRE. The cross reference access to AUTHORIZATION NUMBER has been changed from the inactivated field (#.28) to the replacement (#2.02). The Pre-Init will delete the INSURANCE REVIEW (#356.2) field AUTHORIZATION NUMBER (#.28) cross reference #1 APRE1. This field is being inactivated so the cross reference is being moved to the replacement AUTHORIZATION NUMBER field (#2.02). The Post-Init will copy the INSURANCE REVIEW (#356.2) data from the two inactivated fields to the two replacement fields: CALL REFERENCE NUMBER (#.09) copied to CALL REFERENCE NUMBER (#2.01) AUTHORIZATION NUMBER (#.28) copied to AUTHORIZATION NUMBER (#2.02) Integration Control Reference Update (ICR #5340): ------------------------------------------------- The integration agreement ICR #5340 between IB and the Insurance Capture Buffer (ICB) was updated. The agreement allows ICB access to the INSURANCE REVIEW (#356.2) fields CALL REFERENCE NUMBER (#.09) and AUTHORIZATION NUMBER (#.28). The ICR has been updated to remove those two fields and the two new replacement fields were added. Reference File Updates: ----------------------- The Post-Init will complete all changes to the reference files: Adds 3 new CLAIMS TRACKING DENIAL REASONS (#356.21) entries Adds 3 new CLAIMS TRACKING REVIEW TYPE (#356.11) entries Adds 14 new CLAIMS TRACKING NON-BILLABLE REASONS (#356.8) entries Modifies 1 CLAIMS TRACKING NON-BILLABLE REASONS (#356.8) file entry OPTIONS UPDATED: ---------------- Claims Tracking Edit [IBT EDIT TRACKING ENTRY] Insurance Review Edit [IBT EDIT COMMUNICATIONS] Appeal/Denial Edit [IBT EDIT APPEALS/DENIALS] Pending Reviews [IBT EDIT REVIEWS TO DO] Hospital Reviews [IBT EDIT REVIEWS] Inquire to Claims Tracking [IBT OUTPUT CLAIM INQUIRY] Print CT Summary for Billing [IBT OUTPUT BILLING SHEET] Patient Insurance Info View/Edit [IBCN PATIENT INSURANCE] Third Party Joint Inquiry [IBJ THIRD PARTY JOINT INQUIRY] ROI Expired Consent [IB OUTPUT ROI EXPIRED] (new) Management Reports (Billing) Menu [IB OUTPUT MANAGEMENT REPORTS] (link) Days Denied Report [IBT OUTPUT DENIED DAYS REPORT] Reasons Not Billable Report [IBJD REASONS NOT BILLABLE] Enter/Edit Billing Information [IB EDIT BILLING INFO] Load Host File into Charge Master [IBCR HOST FILE LOAD] RC Change Facility Type [IBCR RC FACILITY TYPE] (new) Charge Master IRM Menu [IBCR CHARGE MASTER IRM MENU] (link) SECURITY KEY: ------------- A new Security Key IB ROI EDIT is added with this patch. Only users assigned this Security Key will be allowed to Add or Edit ROI Consent Records in the new CLAIMS TRACKING ROI CONSENT (#356.26) file via the new ROI Consent (RO) screen in the Claims Tracking Edit [IBT EDIT TRACKING ENTRY] option. Users that should be allowed this access need to be identified and the key assigned. PATCH COMPONENTS ================ The following is the list of components exported by this patch. File Name (Number) Field Name (Number) New/Modified ------------------ ------------------------- ------------ CLAIMS TRACKING ROI CONSENT (#356.26) New File CLAIMS TRACKING ROI CONSENT (#356.26) ROI ENTRY (#.01) New CLAIMS TRACKING ROI CONSENT (#356.26) PATIENT (#.02) New CLAIMS TRACKING ROI CONSENT (#356.26) SENSITIVE CONDITION (#.03) New CLAIMS TRACKING ROI CONSENT (#356.26) EFFECTIVE DATE (#.04) New CLAIMS TRACKING ROI CONSENT (#356.26) EXPIRATION DATE (#.05) New CLAIMS TRACKING ROI CONSENT (#356.26) REVOKED (#.06) New CLAIMS TRACKING ROI CONSENT (#356.26) DATE ENTERED (#1.01) New CLAIMS TRACKING ROI CONSENT (#356.26) ENTERED BY (#1.02) New CLAIMS TRACKING ROI CONSENT (#356.26) DATE LAST EDITED (#1.03) New CLAIMS TRACKING ROI CONSENT (#356.26) LAST EDITED BY (#1.04) New CLAIMS TRACKING ROI CONSENT (#356.26) COMMENT (#2.01) New INSURANCE REVIEW (#356.2) TRACKING ID (#.02) Modified INSURANCE REVIEW (#356.2) *CALL REFERENCE NUMBER (#.09) Modified INSURANCE REVIEW (#356.2) *AUTHORIZATION NUMBER (#.28) Modified INSURANCE REVIEW (#356.2) FINAL OUTCOME OF APPEAL (#.29) Modified INSURANCE REVIEW (#356.2) CALL REFERENCE NUMBER (#2.01) New INSURANCE REVIEW (#356.2) AUTHORIZATION NUMBER (#2.02) New Input Templates File (Number) New/Modified -------------------- ------------------------- ------------ IBT ACTION INFO INSURANCE REVIEW (#356.2) Modified IBT ADD APPEAL INSURANCE REVIEW (#356.2) Modified IBT CONTACT INFO INSURANCE REVIEW (#356.2) Modified IBT FINAL OUTCOME INSURANCE REVIEW (#356.2) Modified IBT INS VERIFICATION INSURANCE REVIEW (#356.2) Modified IBT QUICK EDIT INSURANCE REVIEW (#356.2) Modified List Templates New/Modified ----------------------- ------------ IBT ROI SPECIAL CONSENT New Options Type New/Modified ---------------------------- ----------- ------------ IB OUTPUT MANAGEMENT REPORTS Menu Use as Link IB OUTPUT ROI EXPIRED Run Routine New IBCR CHARGE MASTER IRM MENU Menu Use as Link IBCR RC FACILITY TYPE Run Routine New Protocols Type New/Modified ---------------------------- ----------- ------------ IBCNS EXIT Action Attach to Menu IBTRE MENU Menu Use as Link IBTRE ROI CONSENT Action New IBTRR MENU Menu New IBTRR ROI ADD Action New IBTRR ROI DELETE Action New IBTRR ROI EDIT Action New IBTRR ROI REVOKE Action New Security Key New/Modified ------------ ------------ IB ROI EDIT New Additional Information: There are no Patient Safety Issues (PSIs) or Remedy Tickets associated with this patch. New Service Requests (NSRs) ---------------------------- NSR #20080211 - FY 2009 Reasonable Charges Billing Enhancements NSR #20090110 - FY 2010 Reasonable Charges Billing Enhancement Test Sites: ---------- Lebanon, PA Salisbury, NC Documentation Retrieval Instructions ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. The preferred method is FTP the files from ftp://download.vista.domain.ext/ 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.domain.ext Hines ftp.fo-hines.domain.ext Salt Lake City ftp.fo-slc.domain.ext Package documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Title File Name FTP Mode ----------------------------------------------------------------------- Patch IB*2*458 Release Notes ib_2_458_rn.pdf binary Integrated Billing (IB) v2.0 Technical Manual ib20tec.pdf binary Integrated Billing (IB) v2.0 User Manual ib_20_u.pdf binary Patch Installation ================== Pre/Post Installation Overview ------------------------------ The Pre-Init of this patch will complete the following: 1. Deletes the cross reference #1 APRE1 of the INSURANCE REVIEW (#356.2) field AUTHORIZATION NUMBER (#.28) . This cross reference is moved to the replacement field (#2.02). The Post-Init of this patch will complete the following: 1. Adds 3 new CLAIMS TRACKING DENIAL REASONS (#356.21) entries 2. Adds 3 new CLAIMS TRACKING REVIEW TYPE (#356.11) entries 3. Adds 14 new CLAIMS TRACKING NON-BILLABLE REASONS (#356.8) entries 4. Modifies 1 CLAIMS TRACKING NON-BILLABLE REASONS (#356.8) file entry 5. Copies data from the two INSURANCE REVIEW (#356.2) fields being inactivated to the two replacement fields: #.09 CALL REFERENCE NUMBER copied to #2.01 CALL REFERENCE NUMBER #.28 AUTHORIZATION NUMBER copied to #2.02 AUTHORIZATION NUMBER The following options should be disabled during install: Appeal/Denial Edit [IBT EDIT APPEALS/DENIALS] Pending Reviews [IBT EDIT REVIEWS TO DO] Hospital Reviews [IBT EDIT REVIEWS] Inquire to Claims Tracking [IBT OUTPUT CLAIM INQUIRY] Print CT Summary for Billing [IBT OUTPUT BILLING SHEET] Patient Insurance Info View/Edit [IBCN PATIENT INSURANCE] Third Party Joint Inquiry [IBJ THIRD PARTY JOINT INQUIRY] Days Denied Report [IBT OUTPUT DENIED DAYS REPORT] Reasons Not Billable Report [IBJD REASONS NOT BILLABLE] Enter/Edit Billing Information [IB EDIT BILLING INFO] Load Host File into Charge Master [IBCR HOST FILE LOAD] After the installation the new IB ROI EDIT Security Key will need to be assigned to users. Identify users that should be allowed to Add or Edit the new ROI Consent Records. After the installation of this patch, install patch DSIV*2.2*8. DSIV*2.2*8 is an Insurance Capture Buffer (ICB) patch being released as a companion patch to this patch IB*2*458. The Insurance Capture Buffer accesses the two INSURANCE REVIEW fields (#356.2, .09 and .28) being replaced in this patch (ICR #5340). The ICB patch will update their access to the two new replacement INSURANCE REVIEW fields (#356.2, 2.01 and 2.02). This is accomplished by the release of new .dlls as described in DSIV*2.2*8. Failure to install DSIV*2.2*8 immediately after installation of IB*2*458 may result in filing errors or filing data to incorrect fields in the Insurance Review file. Pre-Init and Post-init Example Installation ------------------------------------------- Running Pre-Install Routine: PRE^IBYP458 IB*2*458 Pre-Install ..... >> ^DD(356.2,.28) cross-reference #1 deleted Insurance Review (#356.2) Authorization Number (.28) xref APRE1 IB*2*458 Pre-Install Complete Running Post-Install Routine: POST^IBYP458 IB*2*458 Post-Install ..... >> Add 3 Claims Tracking Review Types, New (#356.11) ... SNF/NHCU REVIEW added INPT RETROSPECTIVE REVIEW added OPT RETROSPECTIVE REVIEW added Updated: 3 of 3 New Review Types Added >> Add 3 Claims Tracking Denial Reasons, New (#356.21) ... DELAY IN TREATMENT/SERVICE added OBSERVATION IS MORE APPROPRIATE added ALTERNATE LEVEL OF CARE IS MORE APPROPRIATE added Updated: 3 of 3 New Denial Reasons Added >> Add 14 Reasons Not Billable (RNB), New (#356.8) ... APPT CANCELLED/PT NOT SEEN added SEEN BY PROVIDER ON SAME DAY added NON-BILLABLE DME/PROSTHETIC added NON-BILLABLE PROCEDURE added EMPLOYEE HEALTH added ENCOUNTER DURING INPT STAY added NO PROSTHETIC COVERAGE added NON-COVERED DIAGNOSIS added NON-COVERED ROUTINE CARE added HDHP PLAN NOT BILLED added NOT RELATED TO WC/TORT/NF added TRICARE PT SEEN AS VETERAN added COMBINED CHARGES added UNBUNDLED SERVICE added Updated: 14 of 14 New RNBs Added >> Change 1 Reasons Not Billable (RNB), Name (#356.8, .01) ... NPI/TAXONOMY ISSUES changed to NPI/TAXONOMY/PPN ISSUES Updated: 1 of 1 RNB Names Updated >> Copy Insurance Review (#356.2) Data to New Field Locations ... Searching file for data to copy, 11111 entries, please wait ... 799 Call Reference Numbers found (.09), 799 copied (2.01) 7124 Authorization Numbers found (.28), 7124 copied (2.02) IB*2*458 Post-Install Complete Installation Instructions ------------------------- This patch should be installed during non-peak hours when no Integrated Billing users are on the system to minimize potential disruption to users. Make sure that when installing the patch the IB nightly job (IB MT NIGHT COMP) is not running. Install Time - less than 10 minutes - but will vary from site to site depending on the size of the Insurance Review file (#356.2) which is searched for data to be copied to new fields during the Post-Init. 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 option. When prompted for the INSTALL enter the patch IB*2.0*458: 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. 5. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//' answer NO if this is done as a nightly job 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. Enter options you wish to mark as 'Out Of Order': enter the following Appeal/Denial Edit [IBT EDIT APPEALS/DENIALS] Pending Reviews [IBT EDIT REVIEWS TO DO] Hospital Reviews [IBT EDIT REVIEWS] Inquire to Claims Tracking [IBT OUTPUT CLAIM INQUIRY] Print CT Summary for Billing [IBT OUTPUT BILLING SHEET] Patient Insurance Info View/Edit [IBCN PATIENT INSURANCE] Third Party Joint Inquiry [IBJ THIRD PARTY JOINT INQUIRY] Days Denied Report [IBT OUTPUT DENIED DAYS REPORT] Reasons Not Billable Report [IBJD REASONS NOT BILLABLE] Enter/Edit Billing Information [IB EDIT BILLING INFO] Load Host File into Charge Master [IBCR HOST FILE LOAD] 9. If prompted "Delay Install (Minutes): (0 - 60): 0// respond 0. 10. Optional - Once this patch has been successfully installed you may delete the post-init routine: IBYP458 11. Identify and assign users to the new IB ROI EDIT Security Key. Post-Installation Instructions ------------------------------ Assign Security Key: The new IB ROI EDIT Security Key needs to be assigned to users. A new Security Key IB ROI EDIT is added with this patch. Only users assigned this Security Key will be allowed to Add or Edit ROI Consent Records in the new ROI Consent (RO) screen in the Claims Tracking Edit [IBT EDIT TRACKING ENTRY] option. Users that should be allowed this access need to be identified and the key assigned. Install patch DSIV*2.2*8: DSIV*2.2*8 is an Insurance Capture Buffer (ICB) patch being released as a companion patch to this patch IB*2*458. The Insurance Capture Buffer accesses the two INSURANCE REVIEW fields (#356.2, .09 and .28) being replaced in this patch. The ICB patch will update their access to use the two new replacement INSURANCE REVIEW fields (#356.2, 2.01 and 2.02). Failure to install the .dlls as described in DSIV*2.2*8 immediately after installation of IB*2*458 may result in filing errors or filing data to incorrect fields. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 4 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCC1 Before: B54745451 After: B55298346 **19,95,160,159,320,347,377, 399,452,458** Routine Name: IBCD2 Before: B27925323 After: B27978767 **4,55,91,106,384,458** Routine Name: IBCNSP0 Before: B33972429 After: B34211643 **28,43,52,85,93,103,137,229, 251,363,371,399,438,458** Routine Name: IBCRCI Before: B9964623 After: B10399804 **52,106,245,458** Routine Name: IBCRHBS3 Before: B26475049 After: B26470229 **245,458** Routine Name: IBCRHRS Before: n/a After:B166827262 **458** Routine Name: IBCSCH Before: B48120299 After: B49539365 **52,80,106,124,138,51,148,137, 161,245,232,287,348,349,374, 371,395,400,432,447,458** Routine Name: IBCSCH1 Before: B30182718 After: B35678936 **106,125,51,245,266,395,458** Routine Name: IBJDB21 Before: B68099575 After: B73370335 **123,159,185,399,437,458** Routine Name: IBJTRA1 Before: B10800443 After: B10892306 **39,91,347,389,458** Routine Name: IBOTRR Before: n/a After: B13485669 **458** Routine Name: IBTOBI Before: B26516930 After: B26303932 **91,160,199,309,276,458** Routine Name: IBTOBI2 Before: B19691453 After: B20308448 **210,458** Routine Name: IBTOBI3 Before: B15138454 After: B15563291 **40,56,458** Routine Name: IBTODD Before: B21565676 After: B34396486 **32,458** Routine Name: IBTODD1 Before: B16606516 After: B28302876 **32,458** Routine Name: IBTODD2 Before: B6204334 After: B10971727 **32,458** Routine Name: IBTRC Before: B25152146 After: B27777656 **458** Routine Name: IBTRC1 Before: B21805821 After: B23066031 **458** Routine Name: IBTRC3 Before: B8308715 After: B8006910 **458** Routine Name: IBTRCD Before: B24519897 After: B25352762 **210,458** Routine Name: IBTRCD0 Before: B16086108 After: B16113018 **458** Routine Name: IBTRCD1 Before: B26536590 After: B27554841 **10,359,413,458** Routine Name: IBTRD Before: B25402753 After: B26257163 **1,199,458** Routine Name: IBTRDD Before: B7193344 After: B7262514 **458** Routine Name: IBTRE Before: B25125140 After: B25778020 **122,51,276,458** Routine Name: IBTRED Before: B24360829 After: B24448632 **71,91,160,247,309,276,339,363,458** Routine Name: IBTRED0 Before: B23652054 After: B23670458 **160,210,317,276,458** Routine Name: IBTRED1 Before: B10085901 After: B10155477 **458** Routine Name: IBTRR Before: n/a After: B10506706 **458** Routine Name: IBTRR1 Before: n/a After: B38596413 **458** Routine Name: IBTRV Before: B28763805 After: B29049324 **40,121,124,250,277,458** Routine Name: IBTRVD Before: B7583123 After: B7748942 **266,458** Routine Name: IBTRVD0 Before: B23418245 After: B23753223 **58,458** Routine Name: IBYP458 Before: n/a After: B51260890 **458** Routine list of preceding patches: 32, 56, 58, 277, 384, 389, 413, 437, 438 447, 452 ============================================================================= User Information: Entered By : THAYER,CHRISTOPHER Date Entered : JUN 03, 2011 Completed By: CORONA,JOSE Date Completed: JUL 24, 2013 Released By : MURRAY,ANGELA Date Released : JUL 24, 2013 ============================================================================= Packman Mail Message: ===================== $END TXT