$TXT Created by at MNTVBB.DOMAIN.EXT (KIDS) on Tuesday, 01/13/15 at 17:39 ============================================================================= Run Date: MAR 27, 2015 Designation: IB*2*542 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #494 Status: Released Compliance Date: APR 10, 2015 ============================================================================= Associated patches: (v)IB*2*536 <<= must be installed BEFORE `IB*2*542' Subject: REASONABLE CHARGES V3.16 Category: - Enhancement (Mandatory) - Routine Description: ============ *************************************************************************** Implementation of Reasonable Charges v3.16 is a two-step process: 1. Installation of this patch. This will inactivate Reasonable Charges v3.15 charges with an inactive date of 12/31/14. (See Installation Instructions.) 2. Uploading the Reasonable Charges v3.16 charges. This will load new charges with an effective date of 01/01/15 and needs to be done immediately after the patch install. PLEASE NOTE: If possible, it is recommended that you install the release of LEX*2*98 - Code Set FY15 2nd Qtr Update patch before this one, that way the charges will not need to be uploaded twice (once now, and once after the LEX*2*98 patch - for the new codes). *************************************************************************** Reasonable Charges version 3.16 is a charge update to the existing Reasonable Charges billed to Third Party Payers. The primary update with this patch is to the Procedure charges, which will be implemented when the revised RC v3.16 charges are uploaded (step 2). Inactive Date of Reasonable Charges v3.15 is 12/31/2014. Effective Date of Reasonable Charges v3.16 is 01/01/2015. Reasonable Charges v3.15 loaded on your system will be inactivated with an inactivation date of 12/13/2014 when this patch is installed. Reasonable Charges v3.16 with an effective date of 01/01/2015 will be loaded on your system when the charges are uploaded as described below. ASSOCIATED REMEDY TICKET: ========================= 1. INC000001067428 Reasonable Charges v3.16 ASSOCIATED NSR(s): ================== N/A PARTICIPATING TEST SITES: ========================= Bay Pines VAMC Louis A. Johnson VAMC (Clarksburg) Upstate NY HCS (Albany) REMEDY OVERVIEW: ================ INC000001067428 Reasonable Charges v3.16 Problem: -------- Changes in the national CPT rates need to be distributed to all hospitals so that proper billing can take place. Resolution: ----------- This patch updates the Reasonable Charges files and distributes them with a new version number and a new effective date. Technical Description ===================== This patch exports 2 routines, one of which is the post-init (IBYP542) The post-init will inactivate all existing Reasonable Charges defined in the Charge Master. Reasonable Charges v3.15 will be inactivated with an inactivation date of 12/31/14 when this patch is installed. The following is an example of the post-init portion of the installation: Reasonable Charges v3.16 Post-Install ..... >> Inactivating Existing Reasonable Charges, Please Wait... Done. 93007 existing charges inactivated Reasonable Charges v3.16 Post-Install Complete Note: The actual number of charges inactivated will vary based on the number of divisions billed at your site. This will also determine the time required for the installation. INSTALLATION INSTRUCTIONS ========================= If installed during the normal workday, it is recommended that the following selection(s) in the OPTION (#19) file be disabled to prevent possible conflicts while running the KIDS Install. Other VISTA users will not be affected. Enter/Edit Billing Information [IB EDIT BILLING INFO] Enter/Edit Charge Master [IBCR DISPLAY CHARGE MASTER] Install Time - less than 30 minutes - but will vary from site to site depending on the size of the Charge Item file (#363.2) which is searched for charges to inactivate in the Post-Init. Loading the Charge Master with the new RC v3.16 charges is separate from the patch installation and will take additional time per division. 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 3. Select Installation Option: --------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter IB*2.0*542): 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 INHIBIT LOGONs during the install? NO//' answer NO c. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//' answer YES d. When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following options: Enter/Edit Billing Information [IB EDIT BILLING INFO] Enter/Edit Charge Master [IBCR DISPLAY CHARGE MASTER] e. When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press . 5. CLEAN UP POST INIT ROUTINE -------------------------- Optional - Once this patch has been successfully installed you may delete the post init routine: IBYP542 6. UPLOAD REASONABLE CHARGES v3.16 ------------------------------ Follow instructions below: RC v3.16 Upload Instructions ********************** RC v3.16 Upload Instructions ********************** After patch installation, the Reasonable Charges v3.16 charges will need to be loaded into the Charge Master for each division billed at the site. The charges for each Division will require approximately 1.8 - 2.0 MB of disk space. Other files will be searched, but the new charges will be added to the Charge Item file (#363.2). The LEX*2*98 - Code Set FY15 2ND Qtr Update patch should be installed before Uploading Reasonable Charges v3.16. Files Required for Upload: -------------------------- The charge files are available on the following CIO Field Offices' Anonymous.Software directories. Use the appropriate FTP capability to retrieve the files (ASCII). OI FIELD OFFICE FTP ADDRESS DIRECTORY =============== =========== ========= ALBANY ftp.domain.ext HINES ftp.domain.ext SALT LAKE ftp.domain.ext FIRST AVAILABLE SERVER download.vista.domain.ext The Reasonable Charge v3.16 Host Files, effective 01/01/15: (ASCII) IBRC1501A.TXT Inpatient Facility Charges (DRG) IBRC1501B.TXT Facility Charge (CPT) IBRC1501C.TXT Physician Charges (CPT) IBRC1501D.TXT Service Category Codes IBRC1501E.TXT Area Factors IBRC1501F.TXT Site Identification Upload Steps: ============= Step 1: Get Host Files ----------------------- Retrieve the 6 Reasonable Charges v3.16 Host Files in ASCII format (see previous section). Step 2: Determine Divisions ---------------------------- Use the Print Charge Master [IBCR REPORTS FOR CHARGE MASTER] option and print the Billing Regions report to find which Billing Regions and Divisions have charges loaded onto your system. These are the divisions that will need new charges loaded. Step 3: Begin Upload Process ----------------------------- Use the Load Host File into Charge Master [IBCR HOST FILE LOAD] option to load Reasonable Charges onto your system for every division for which care is billed at your site. Carefully follow the instructions below, for each Billing Region. You will see the prompt: Select one of the following: ============================================================================ 1.1 Load CMAC into XTMP 1.2 Load AWP into XTMP 1.3 Load RC into XTMP 1.4 Load TP into XTMP 2 Assign Charge Set 3 Check Data Validity 4 Load into Charge Master 5 Delete XTMP files Below, in more detail, the steps will guide you through the process of selecting first 1.3, then 3, then 4, and waiting until 4 stops before continuing on to the next division (and capturing or printing all output for future reference). Step 4: Load the Reasonable Charges ------------------------------------ From the menu, select option 1.3 - Load RC into XTMP This loads the Host Files into temporary storage and calculates charges for individual Divisions. - If there are no previously existing host files loaded, it will ask which version of Reasonable Charges to load. Select 3.16 - When loading Reasonable Charges v3.16 the IBRC1501x.TXT files may be used for multiple divisions without reloading. - If there exists any previously calculated charges (files) for a division, they will be displayed, and you will get the prompt: The above files already exist in XTMP. Delete the above files and continue with upload? Select Yes, to delete the previously calculated charges. - If there exist any previously loaded host files for any RC version, they will be displayed, and it will ask if they should be deleted. Select No, if the files are IBRC1501x.TXT since these are the correct files for v3.16, they may be re-used for multiple divisions. Select Yes only if the files are from a different version. - Select Division: Select the division number to load charges for. This should correspond to the Divisions associated with the Billing Regions determined previously. Once the correct division is selected, answer Yes to Calculate Charges. Step 5: Check Data Validity --------------------------- From the menu, select option 3 - Check Data Validity. This is optional, but it is suggested that it be run at least once, for the first division loaded. If the resulting report has any Line Data Errors, then check that the latest version of CPT and DRG has been installed. The Error key at the end of the report does not mean that errors have occurred. It simply provides definitions of the types of errors that might occur. Check the individual line items in the report to see if any of the listed errors have been detected. Step 6: Load into Charge Master ------------------------------- From the menu, select option 4 - Load into Charge Master Moves the charges calculated in selection 1.3 to permanent storage in the Charge Master. The results report should match the examples below. It is important that this option completes before continuing. Allow the upload of a division's charges to finish before attempting to upload another division. A summary report will be printed when the upload is complete. This option uses the same temporary files to calculate the charges for all divisions, therefore they must be calculated and loaded serially. Step 7: Repeat steps 4-6 for each Division needed ------------------------------------------------- Steps 4-6 must be repeated for each division billed at your site. Refer to the Divisions that already have charges assigned using the Billing Region Report list determined previously. In most cases, simply using the above options for loading Reasonable Charges will result in the correct set up in the Charge Master. - Option 1.3, to calculate charges for a division - Option 4, to load those calculated charges into the Charge Master permanent files. However, if you are loading charges for a new site, or a site that may have changed its division number, then extra care is needed to ensure the setup of the Charge Master is correct. The following sections provide examples of displays and reports for the upload. ================= Reasonable Charges v3.16 Upload Details ================ The Charge Host Files should load with the following counts: The following files were created in XTMP, they will be purged in 2 days: --------------------------------------------------------------------------- IBRC1501A.TXT RC v3.16 Host File Upload, 12/23/14@17:13 by 752 IBRC1501B.TXT RC v3.16 Host File Upload, 12/23/14@17:13 by 8436 IBRC1501C.TXT RC v3.16 Host File Upload, 12/23/14@17:13 by 17545 IBRC1501D.TXT RC v3.16 Host File Upload, 12/23/14@17:14 by 30 IBRC1501E.TXT RC v3.16 Host File Upload, 12/23/14@17:14 by 917 IBRC1501F.TXT RC v3.16 Host File Upload, 12/23/14@17:14 by 1386 Any division that provides Inpatient Care should result in a summary with the following counts: Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Inpt Fac 1 CPT 28 RC-INPT FAC PR 552 2 Inpt Fac 2 CPT 6 RC-INPT FAC HR 552 3 Inpt Fac 4 CPT 5 RC-INPT FAC ML 552 4 Inpt Fac/Phys 1 CPT 3700 RC-INPT FAC PR 552 5 Inpt PD Anc DRG 751 RC-INPT ANC 552 6 Inpt PD Anc ICU DRG 751 RC-INPT ANC ICU 552 7 Inpt PD R&B DRG 751 RC-INPT R&B 552 8 Inpt PD R&B ICU DRG 751 RC-INPT R&B ICU 552 9 Inpt Phys 1 CPT 7944 RC-PHYSICIAN INPT PR 552 10 Inpt Phys 3 CPT 271 RC-PHYSICIAN INPT MN 552 11 Opt Fac 1 CPT 8424 RC-OPT FAC PR 552 12 Opt Fac 2 CPT 6 RC-OPT FAC HR 552 13 Opt Fac 4 CPT 5 RC-OPT FAC ML 552 14 Opt Fac/Phys 1 CPT 4732 RC-OPT FAC PR 552 15 Opt PD PHosp MISCE 1 RC-OPT MISC 552 16 Opt Phys 1 CPT 6303 RC-PHYSICIAN OPT PR 552 17 Opt Phys 3 CPT 213 RC-PHYSICIAN OPT MN 552 18 SNF Fac 1 CPT 7759 RC-SNF FAC PR 552 19 SNF Fac 2 CPT 6 RC-SNF FAC HR 552 20 SNF Fac 4 CPT 5 RC-SNF FAC ML 552 21 SNF Fac/Phys 1 CPT 3942 RC-SNF FAC PR 552 22 SNF PD INC BEDSE 2 RC-SNF INC 552 23 SNF Phys 1 CPT 7960 RC-PHYSICIAN SNF PR 552 24 SNF Phys 3 CPT 271 RC-PHYSICIAN SNF MN 552 IB Upload Summary Report of Charge Items Loaded into the Charge Master --------------------------------------------------------------------------- IBCR UPLOAD RC 552 DAYTON, OH Inpt Fac 1 28 of 28 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 28 entries added to the Charge Set RC-INPT FAC PR 552. Inpt Fac 2 6 of 6 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 6 entries added to the Charge Set RC-INPT FAC HR 552. Inpt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 5 entries added to the Charge Set RC-INPT FAC ML 552. Inpt Fac/Phys 1 3700 of 3700 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 3700 entries added to the Charge Set RC-INPT FAC PR 552. Inpt PD Anc 751 of 751 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 751 entries added to the Charge Set RC-INPT ANC 552. Inpt PD Anc ICU 751 of 751 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 751 entries added to the Charge Set RC-INPT ANC ICU 552. Inpt PD R&B 751 of 751 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 751 entries added to the Charge Set RC-INPT R&B 552. Inpt PD R&B ICU 751 of 751 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 751 entries added to the Charge Set RC-INPT R&B ICU 552. Inpt Phys 1 7944 of 7944 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 7944 entries added to the Charge Set RC-PHYSICIAN INPT PR 552. Inpt Phys 3 271 of 271 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 271 entries added to the Charge Set RC-PHYSICIAN INPT MN 552. Opt Fac 1 8424 of 8424 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 8424 entries added to the Charge Set RC-OPT FAC PR 552. Opt Fac 2 6 of 6 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 6 entries added to the Charge Set RC-OPT FAC HR 552. Opt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 5 entries added to the Charge Set RC-OPT FAC ML 552. Opt Fac/Phys 1 4732 of 4732 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 4732 entries added to the Charge Set RC-OPT FAC PR 552. Opt PD PHosp 1 of 1 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 1 entries added to the Charge Set RC-OPT MISC 552. Opt Phys 1 6303 of 6303 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 6303 entries added to the Charge Set RC-PHYSICIAN OPT PR 552. Opt Phys 3 213 of 213 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 213 entries added to the Charge Set RC-PHYSICIAN OPT MN 552. SNF Fac 1 7759 of 7759 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 7759 entries added to the Charge Set RC-SNF FAC PR 552. SNF Fac 2 6 of 6 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 6 entries added to the Charge Set RC-SNF FAC HR 552. SNF Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 5 entries added to the Charge Set RC-SNF FAC ML 552. SNF Fac/Phys 1 3942 of 3942 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 3942 entries added to the Charge Set RC-SNF FAC PR 552. SNF PD INC 2 of 2 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 2 entries added to the Charge Set RC-SNF INC 552. SNF Phys 1 7960 of 7960 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 7960 entries added to the Charge Set RC-PHYSICIAN SNF PR 552. SNF Phys 3 271 of 271 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 271 entries added to the Charge Set RC-PHYSICIAN SNF MN 552. Any Provider based division that provides Outpatient Care Only should result in a summary with the following counts: IBCR UPLOAD RC 552GA MIDDLETOWN, OH Count = 19684 IB Upload RC v3.16 552GA MIDDLETOWN, OH, 1/2/15@17:12 by WANG,CHI Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Opt Fac 1 CPT 8424 RC-OPT FAC PR 552GA 2 Opt Fac 2 CPT 6 RC-OPT FAC HR 552GA 3 Opt Fac 4 CPT 5 RC-OPT FAC ML 552GA 4 Opt Fac/Phys 1 CPT 4732 RC-OPT FAC PR 552GA 5 Opt PD PHosp MISCE 1 RC-OPT MISC 552GA 6 Opt Phys 1 CPT 6303 RC-PHYSICIAN OPT PR 552GA 7 Opt Phys 3 CPT 213 RC-PHYSICIAN OPT MN 552GA IB Upload Summary Report of Charge Items Loaded into the Charge Master --------------------------------------------------------------------------- IBCR UPLOAD RC 552GA MIDDLETOWN, OH Opt Fac 1 8424 of 8424 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 8424 entries added to the Charge Set RC-OPT FAC PR 552GA. Opt Fac 2 6 of 6 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 6 entries added to the Charge Set RC-OPT FAC HR 552GA. Opt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 5 entries added to the Charge Set RC-OPT FAC ML 552GA. Opt Fac/Phys 1 4732 of 4732 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 4732 entries added to the Charge Set RC-OPT FAC PR 552GA. Opt PD PHosp 1 of 1 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 1 entries added to the Charge Set RC-OPT MISC 552GA. Opt Phys 1 6303 of 6303 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 6303 entries added to the Charge Set RC-PHYSICIAN OPT PR 552GA. Opt Phys 3 213 of 213 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 213 entries added to the Charge Set RC-PHYSICIAN OPT MN 552GA. Any division with Non-Provider Based Freestanding Care should result in a summary with the following counts: IBCR UPLOAD RC 552GB LIMA, OH Count = 17884 IB Upload RC v3.16 552GB LIMA, OH, 1/2/15@17:15 by WANG,CHI Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 FS Phys 1 CPT 17205 RC-PHYSICIAN FS PR 552GB 2 FS Phys 3 CPT 271 RC-PHYSICIAN FS MN 552GB 3 FS Phys/Add 00 1 CPT 1 RC-PHYSICIAN FS PR 552GB 4 FS Phys/Opt 1 CPT 401 RC-PHYSICIAN FS PR 552GB 5 FS Phys/Opt 4 CPT 5 RC-PHYSICIAN FS ML 552GB 6 FS Phys/Opt TC 1 CPT 1 RC-PHYSICIAN FS PR 552GB IB Upload Summary Report of Charge Items Loaded into the Charge Master --------------------------------------------------------------------------- IBCR UPLOAD RC 552GB LIMA, OH FS Phys 1 17205 of 17205 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 17205 entries added to the Charge Set RC-PHYSICIAN FS PR 552GB. FS Phys 3 271 of 271 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 271 entries added to the Charge Set RC-PHYSICIAN FS MN 552GB. FS Phys/Add 00 1 1 of 1 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 1 entries added to the Charge Set RC-PHYSICIAN FS PR 552GB. FS Phys/Opt 1 401 of 401 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 401 entries added to the Charge Set RC-PHYSICIAN FS PR 552GB. FS Phys/Opt 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 5 entries added to the Charge Set RC-PHYSICIAN FS ML 552GB. FS Phys/Opt TC 1 1 of 1 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate. 1 entries added to the Charge Set RC-PHYSICIAN FS PR 552GB. 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: IBCRHBRV Before: B48899543 After: B49030709 **148,169,245,270,285,298,325, 334,355,360,365,382,390,408, 412,423,427,439,445,462,468, 484,491,508,520,536,542** Routine Name: IBYP542 Before: n/a After: B8356411 **542** Routine list of preceding patches: 536 ============================================================================= User Information: Entered By : Date Entered : DEC 10, 2014 Completed By: Date Completed: MAR 24, 2015 Released By : Date Released : MAR 27, 2015 ============================================================================= Packman Mail Message: ===================== $END TXT