$TXT Created by at DEVVFF.DOMAIN.EXT (KIDS) on Thursday, 05/08/14 at 12:33 ============================================================================= Run Date: JUL 24, 2014 Designation: IB*2*506 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #477 Status: Released Compliance Date: AUG 23, 2014 ============================================================================= Associated patches: (v)IB*2*142 <<= must be installed BEFORE `IB*2*506' (v)IB*2*276 <<= must be installed BEFORE `IB*2*506' (v)IB*2*399 <<= must be installed BEFORE `IB*2*506' (v)IB*2*416 <<= must be installed BEFORE `IB*2*506' (v)IB*2*435 <<= must be installed BEFORE `IB*2*506' (v)IB*2*438 <<= must be installed BEFORE `IB*2*506' (v)IB*2*479 <<= must be installed BEFORE `IB*2*506' (v)IB*2*497 <<= must be installed BEFORE `IB*2*506' Subject: EIV SYSTEM MODIFICATIONS Category: - Routine - Data Dictionary - Enhancement (Mandatory) - Input Template - Other Description: ============ This Integrated Billing (IB) patch introduces substantial changes to Veterans Health Information Systems & Technology Architecture (VistA)'s electronic Insurance Verification (eIV) eligibility inquiry and response processing in order to meet the Committee on Operating Rules for Information Exchange (CORE) Operating Rules. Complete list of patch items: 1. Revised the insurance buffer views and actions. a) The new default view for those who select the option PROCESS INSURANCE BUFFER [IBCN INSURANCE BUFFER PROCESS] is the "Complete Buffer". The "Complete Buffer" view consists of a list of all insurance buffer entries that have the status of 'ENTERED'. b) Added a new insurance buffer view "Failure Buffer", which consists of a list of all entries that have the status of 'ENTERED' and has the eIV symbol of "!". c) The insurance buffer view "Future Appointments" has been removed. d) The action (VE) VERIFY ENTRY has been removed. e) A new action (ES) ESCALATE ENTRY has been introduced with this patch. More details regarding this action are listed below. 2. The ability to escalate an insurance buffer entry was introduced with this patch. a) Two new security keys were added to VistA as a result of this patch. If a user selects the option PROCESS INSURANCE BUFFER [IBCN INSURANCE BUFFER PROCESS] and they have neither of the new security keys (IB INSURANCE COMPANY EDIT and IB GROUP PLAN EDIT), then the only insurance buffer records that are displayed to them would be entries for eIV confirmed active policies ("+" entries) when the patient in that record has an active policy on file in VistA. Other active policies marked with an "$" eIV symbol will not be displayed to these users. b) Only users with neither of the new security keys (IB INSURANCE COMPANY EDIT and IB GROUP PLAN EDIT), may use the new action (ES) ESCALATE ENTRY within the option PROCESS INSURANCE BUFFER [IBCN INSURANCE BUFFER PROCESS]. c) The "+" eIV symbol of insurance buffer entries that have been escalated using the new action (ES) ESCALATE ENTRY, will be replaced with an "$" eIV symbol. 3. Disabled the ability to create a new Insurance Company and/or a new Group/Plan in VistA through the option PROCESS INSURANCE BUFFER [IBCN INSURANCE BUFFER PROCESS]. 4. The name of the VistA file that stores the records for the Insurance Buffer has been renamed from the "INSURANCE BUFFER" to the "INSURANCE VERIFICATION PROCESSOR". The file number and file layout remain the same. The patch includes the DATE ENTERED (#355.33,.01) field although it was not changed, in order for KIDS to update the file name of the file #355.33 on the system where this patch is being installed. 5. Modified the daily eIV registration message that is automatically sent by VistA via a Health Level 7 (HL7) message to the Financial Service Center (FSC) in Austin, TX. The updated message now includes additional data regarding the site's current eIV Site Parameter settings. 6. Modified the eIV Site Parameters that are viewed/edited using the option MCCR SITE PARAMETER DISPLAY/EDIT [IBJ MCCR SITE PARAMETERS]. a) The value of the existing FRESHNESS DAYS field (#350.9,51.01), which controls the days between electronic re-verification checks, is now controlled by FSC through HL7 messages. This field may no longer be edited using the option MCCR SITE PARAMETER DISPLAY/EDIT [IBJ MCCR SITE PARAMETERS]. b) The existing TIMEOUT DAYS field (#350.9,51.05) which controls the number of days between when an eIV inquiry is sent to FSC and when the eIV system determines that FSC did not send an eIV response in time. The value of this existing field is now controlled by FSC through HL7 messages. c) The new RETRY FLAG field (#350.9,51.26) which controls whether VistA will retransmit an eIV inquiry if an eIV response is not received from FSC within the value of the TIMEOUT DAYS (#350.9,51.05). This flag is controlled by FSC. d) The value of the existing field HL7 RESPONSE PROCESSING (#350.9,51.13) is no longer displayed within the eIV Site Parameters. The value of this field may no longer be edited using the option MCCR SITE PARAMETER DISPLAY/EDIT [IBJ MCCR SITE PARAMETERS]. 7. Modified VistA's retry methodology (resending inquiries to FSC) so that any payer's eIV response will be considered a final response to the eIV inquiry. Prior to this change, payer's eIV response could result in an eIV inquiry being resent to the payer (with no modifications to the eIV inquiry) every few days without actually providing an answer to the eligibility inquiry itself. 8. The option INSURANCE COMPANY ENTRY/EDIT [IBCN INSURANCE CO EDIT] has been locked with the new security key IB INSURANCE COMPANY EDIT. 9. The ability to add a new group/plan through the option PATIENT INSURANCE INFO VIEW/EDIT [IBCN PATIENT INSURANCE] has been locked with the new security key IB GROUP PLAN EDIT. 10. The option EIV RESPONSE REPORT [IBCNE IIV RESPONSE REPORT] has been modified to include the associated eligibility benefit information. 11. For the following options, the display of eligibility benefits has been modified with this patch to include a summary of key elements of data when available. This summary will contain the Coverage Status and Coverage Type for all payers that send this information in their eIV response. When the software determines that the eIV eligibility data from Medicare payers indicate possible other insurance for that patient, this information will be included in the summary of key data elements. This change to the display of eligibility information applies to the following options: a) PROCESS INSURANCE BUFFER [IBCN INSURANCE BUFFER PROCESS] b) PATIENT INSURANCE INFO VIEW/EDIT [IBCN PATIENT INSURANCE] c) EIV RESPONSE REPORT [IBCNE IIV RESPONSE REPORT] d) THIRD PARTY JOINT INQUIRY [IBJ THIRD PARTY JOINT INQUIRY] 12. The EIV STATISTICAL REPORT [IBCNE IIV STATISTICAL REPORT] was modified to include 'Escalated' records in the insurance buffer breakout of the eIV symbols. 13. Increased the length of field ORIGINAL SUBSCRIBER ID (#365.1,1.05) from 20 to 80 characters. 14. Increased the length of field HL7 SUBSCRIBER ID FIELD (#365.1,.16) from 20 to 80 characters. Patch Components ================ Files & Fields Associated: File Name (#) New/Modified/ Sub-file Name (#) Field Name (Number) Deleted ------------------- --------------------------------- ------------- PATIENT (#2) Modified INSURANCE TYPE sub-file (#2.312) Modified REQUESTED SERVICE DATE (#8.01) New REQUESTED SERVICE TYPE (#8.02) New IB SITE PARAMETERS (#350.9) Modified RETRY FLAG (#51.26) New INSURANCE VERIFICATION PROCESSOR (#355.33) Modified DATE ENTERED (#.01) Modified IIV STATUS TABLE (#365.15) Modified CODE (#.01) Modified IIV TRANSMISSION QUEUE (#365.1) Modified HL7 SUBSCRIBER ID FIELD (#.16) Modified ORIGINAL SUBSCRIBER ID (#1.05) Modified Mail Groups Associated: New/Modified/ Mail Group Name Deleted --------------- ------------- N/A Options Associated: New/Modified/ Option Name Type Deleted ----------- ---- ------------- IBCN INSURANCE CO EDIT run routine Modified Protocols Associated: New/Modified/ Protocol Name Deleted ------------- ------------- IBCNB ENTRY ESCALATE New IBCNB ENTRY SCREEN MENU Modified IBCNB ENTRY VERIFY Delete IBCNB LIST APPOINTMENTS VIEW Delete IBCNB LIST COMPLETE VIEW New IBCNB LIST FAILURE VIEW New IBCNB LIST SCREEN MENU Modified Security Keys Associated: New/Modified/ Security Key Name Deleted ----------------- ------------- IB GROUP PLAN EDIT New IB INSURANCE COMPANY EDIT New Templates, Input Associated: New/Modified/ Template Name Type File Name (Number) Deleted ------------- ---- ------------------ ------------- IBCNE GENERAL Input IB SITE PARAMETERS (#350.9) Modified PARAMETER EDIT Templates, List Associated: New/Modified/ TEMPLATE Name Type Deleted ------------- ---- ------------- IBCNB INSURANCE BUFFER ENTRY List Modified IBCNB INSURANCE BUFFER LIST List Modified Additional Information: New Service Requests (NSRs) ---------------------------- #20110503 Electronic Data Interchange (EDI) New Standards and Operating Rules (Veterans Health Administration) VHA Provider-Side TCRs. Patient Safety Issues (PSIs) ----------------------------- N/A Remedy Ticket(s) & Overview --------------------------- N/A Test Sites: ---------- Wilmington, DE Madison, WI Memphis, TN Denver, CO (East Colorado HCS) Documentation Retrieval Instructions ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to File Transfer Protocol (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.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Title File Name FTP Mode ----------------------------------------------------------------------- IB eIV System Modification Compliance Release Notes/Installation Guide (IB*2.0*506) ib_2_p506_rn.pdf Binary Electronic Insurance Verification User Guide ib_2_0_eIV_ug_r0514.pdf Binary Electronic Insurance Verification Technical Manual/Security Guide ib_2_0_eIV_tm_r0514.pdf Binary Integrated Billing (IB) V. 2.0 Technical Manual ib_2_0_tm_r0514.pdf Binary Patch Installation: Pre/Post Installation Overview ------------------------------ Two new security keys were added as a result of this patch. These keys need to be assigned to the appropriate folks as determined by the site. a) The security key IB INSURANCE COMPANY EDIT is to be assigned to users who are authorized to add new insurance companies in VistA. b) The security key IB GROUP PLAN EDIT is to be assigned to users who are authorized to add new group plans and individual plans in VistA. There is a post install routine, IBY506PO that is included in this patch. After the patch has been installed the post install routine may be deleted by the site. 1. Initializes several eIV site Parameters 2. Loops through the IIV TRANSMISSION QUEUE file (#365.1) and performs the following for all entries with a TRANSMISSION STATUS (#365.1,.04) that has a value of HOLD. a) Changes the TRANSMISSION STATUS (#365.1,.04) to COMMUNICATION FAILURE. b) Identifies all associated entries in the IIV RESPONSE file (#365) and changes the TRANSMISSION STATUS (#365,.06) to COMMUNICATION FAILURE unless it currently has the status of RESPONSE RECEIVED. c) Identifies any associated insurance buffer entry and changes the eIV symbol to be "#" and indicate that a communication failure occurred. 3. Adds two new entries to the existing IIV STATUS TABLE (#365.15) 4. A one-time subscriber update utility must be scheduled upon installation of the patch. Unless the installation is queued, the post-install will prompt the installer of the patch to schedule this activity for off-hours. If the installation is queued, the new update utility will be scheduled for tomorrow at 9 PM. NOTE: This part of the process does NOT require that IB users be off the system, or un-scheduling of the eIV Nightly Process [IBCNE IIV BATCH PROCESS] option. A message will be sent to the MailMan mailbox of the installer, upon successful completion of the subscriber update process. It is recommended that one look for the MailMan message 24 hours after the process is scheduled to run. The subject of the message will be "Subscriber Update Has Completed". Installation Instructions ------------------------- This patch may be installed with users on the system although it is *strongly* recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 5 minutes to install. The following Menu Options at the site should be disabled during install: PROCESS INSURANCE BUFFER [IBCN INSURANCE BUFFER PROCESS] MCCR SITE PARAMETER DISPLAY/EDIT [IBJ MCCR SITE PARAMETERS] INSURANCE COMPANY ENTRY/EDIT [IBCN INSURANCE CO EDIT] PATIENT INSURANCE INFO VIEW/EDIT [IBCN PATIENT INSURANCE] EIV RESPONSE REPORT [IBCNE IIV RESPONSE REPORT] THIRD PARTY JOINT INQUIRY [IBJ THIRD PARTY JOINT INQUIRY] Pre-Installation Instructions ----------------------------- 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*506: 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 Data Dictionaries (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. From the Installation Menu, select the Install Package(s) option and choose the patch to install. 5. 355.33 INSURANCE VERIFICATION PROCESSOR (Partial Definition) *BUT YOU ALREADY HAVE 'INSURANCE BUFFER' AS FILE #355.33! Shall I write over your INSURANCE BUFFER File? YES// 6. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//YES' **************************IMPORTANT******************************* You must answer 'Yes' to the Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//' prompt. Failure to do so will cause the Insurance Buffer to not function properly until the rebuild runs at night. ****************************************************************** 7. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' 8. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//YES' When prompted 'Enter options you wish to mark as 'Out Of Order': Enter the following options one at a time: PROCESS INSURANCE BUFFER [IBCN INSURANCE BUFFER PROCESS] MCCR SITE PARAMETER DISPLAY/EDIT [IBJ MCCR SITE PARAMETERS] INSURANCE COMPANY ENTRY/EDIT [IBCN INSURANCE CO EDIT] PATIENT INSURANCE INFO VIEW/EDIT [IBCN PATIENT INSURANCE] EIV RESPONSE REPORT [IBCNE IIV RESPONSE REPORT] THIRD PARTY JOINT INQUIRY [IBJ THIRD PARTY JOINT INQUIRY] When prompted 'Enter protocols you wish to mark as 'Out Of Order': Press the Return or Enter key as there are no protocols that needs to be marked as 'Out of Order'. 9. If prompted "Delay Install (minutes): (0 - 60): 0// respond 0. 10. There is no need to queue the install. At the 'DEVICE' prompt, hit the return key which will enable the Install to run in the foreground. a '^' to abort the install. DEVICE: HOME// 11. A one-time subscriber update utility must be scheduled upon installation of the patch. During installation, the post-install routine prompts for the installer to schedule the one time subscriber update utility and will not complete installation until it is scheduled. The following shows an example of the message and then the date/time prompt that is generated: Creating Task to Update the Insurance Type File... *************************** IMPORTANT!! ******************************** This option will scan through the entire Patient File for patients with insurance where the relationship to insured is self. Certain fields in Insurance Type sub-file will be updated to match the patient data if it does not already exist. This will take a while and must be queued to run in the background when there are few users on the system. The default is tomorrow at 9:00 p.m. Enter date/time to queue the option: T+1@2100// Post-Installation Instructions ------------------------------ 1. Two new security keys were added as a result of this patch. These keys need to be assigned to the appropriate folks as determined by the site. a. The security key IB INSURANCE COMPANY EDIT is to be assigned to users who are authorized to add new insurance companies in VistA and/or users who currently have the IB EDI INSURANCE EDIT security key assigned to them. b. The security key IB GROUP PLAN EDIT is to be assigned to users who are authorized to add new group plans and individual plans in VistA. 2. A message will be sent to the MailMan mailbox of the installer, upon successful completion of the subscriber update process. It is recommended that one look for the MailMan message 24 hours after the process is scheduled to run. The subject of the message will be "Subscriber Update Has Completed". 3. There is a post install routine, IBY506PO that is included in this patch. After the patch has been installed the post install routine may be deleted by the site. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 74 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCNBAA Before: B67963575 After: B75234738 **82,184,246,416,506** Routine Name: IBCNBLA Before: B65832730 After: B68621473 **82,149,153,184,271,416,506** Routine Name: IBCNBLA1 Before: B83105620 After:B100917255 **82,133,149,184,252,271,416, 438,506** Routine Name: IBCNBLL Before:B101908545 After:B138729075 **82,149,153,183,184,271,345, 416,438,435,506** Routine Name: IBCNEDE2 Before: B60928994 After: B63879348 **184,271,249,345,416,438,506** Routine Name: IBCNEDE6 Before: B32414593 After: B33816621 **184,271,345,416,497,506** Routine Name: IBCNEDEP Before: B86075479 After: B83976754 **184,271,300,416,438,506** Routine Name: IBCNEDST Before: B52803166 After: B47395616 **497,506** Routine Name: IBCNEHL1 Before:B206919324 After:B215626728 **300,345,416,444,438,497,506** Routine Name: IBCNEHL3 Before:B168485042 After:B171692667 **300,416,497,506** Routine Name: IBCNEHL4 Before:B174356077 After:B174792299 **300,416,438,497*506** Routine Name: IBCNEHLM Before: B26579443 After: B28096778 **184,251,300,416,438,497,506** Routine Name: IBCNEHLT Before: B77895122 After: B80145618 **184,251,271,300,416,438,506** Routine Name: IBCNERP8 Before: B66453982 After: B75472595 **184,271,345,416,506** Routine Name: IBCNERP9 Before:B102330381 After:B103562066 **184,271,416,506** Routine Name: IBCNERPE Before: B60593817 After: B65900140 **271,300,416,438,497,506** Routine Name: IBCNES Before: B28429551 After: B63081036 **416,438,497,506** Routine Name: IBCNEUT1 Before: B35326232 After: B44078437 **184,497,506** Routine Name: IBCNSJ12 Before: B20812349 After: B21606758 **28,62,142,506** Routine Name: IBCNSJ3 Before: B17659726 After: B19317542 **28,497,506** Routine Name: IBCNSM3 Before: B14041849 After: B14271242 **6,28,85,211,251,399,506** Routine Name: IBCNSUR Before: B23131946 After: B24160231 **103,276,506** Routine Name: IBCNUPD Before: B15205533 After: B19970193 **497,506** Routine Name: IBJPI Before: B21978399 After: B19548396 **184,271,316,416,438,479,506** Routine Name: IBY506PO Before: n/a After: B23493376 **506** ============================================================================= User Information: Entered By : Date Entered : JUL 15, 2013 Completed By: Date Completed: JUN 06, 2014 Released By : Date Released : JUL 24, 2014 ============================================================================= Packman Mail Message: ===================== $END TXT