$TXT Created by at MNTVBB.DOMAIN.EXT (KIDS) on Tuesday, 10/24/17 at 09:37 ============================================================================= Run Date: MAR 01, 2018 Designation: IB*2*604 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #557 Status: Released Compliance Date: MAR 31, 2018 ============================================================================= Associated patches: (v)IB*2*123 <<= must be installed BEFORE `IB*2*604' (v)IB*2*459 <<= must be installed BEFORE `IB*2*604' (v)IB*2*563 <<= must be installed BEFORE `IB*2*604' (v)IB*2*577 <<= must be installed BEFORE `IB*2*604' Subject: PSO COPAYMENTS;WORKLOAD ASSIGNMENT SEARCH;CPT DESCRIPTION Category: - Routine Description: ============ This patch will address 4 issues: 1. The medication profile screen should show the co-payment indicator for non-service connected patients. 2. This patch adds a check for the FILL NUMBER (#.1) field in the IB BILL/CLAIMS PRESCRIPTION REFILL (#362.4) file when searching for third party bills with matching first party prescription copayments using the Claims Matching Report [RCDP CLAIMS MATCH] option. This ensures that an original prescription with a fill date that differs from the date the bill was created will be included in the report. 3. This patch changes the process of searching for clerks when using the Workload Assignment Enter/Edit [IBJD FOLLOW-UP WORKLOAD] option so that new entries cannot be made to the NEW PERSON (#200) file. The option has been changed to search the NAME (#.01) field of the NEW PERSON (#200) file, instead of searching the IB DM WORKLOAD PARAMETERS (#351.73) file. The entry found in the NEW PERSON (#200) file is then used to search the IB DM WORKLOAD PARAMETERS (#351.73) file, and will allow a new entry to be made if a match is not found. 4. For certain Clinical Procedure Terminology (CPT) codes we need to enter a procedure description- for CPT J1566 we do not have this option in V2. Other VistA sites allow you to enter the appropriate information. Can an update be done to V2 to have this option for this CPT code- it is causing claims to deny. ASSOCIATED NSR(S): ================== N/A ASSOCIATED REMEDY TICKET(S): ============================ 1. I11160987FY17 - AEU reports the medication profile screen does not show the co-payment indicator for non-service connected patients. 2. I12679229FY17 - Claims Matching Report dropping prescription copayment charges 3. I16239935FY17 - AR Productivity Report (Routine ^IBJDF8I) Adding Entries to File 200 4. R7964411FY16 - CPT code issue. PARTICIPATING TEST SITES: ========================= Maryland HCS New York HCS REMEDY OVERVIEW: ================ 1. I11160987FY17 - AEU reports the medication profile screen does not show the co-payment indicator for non-service connected patients. Problem: -------- The co-payment indicator "$" is not displaying on medication profiles so Accounts Receivable is not picking up potential billable amounts until after the medication is released. Resolution: ----------- The routine IBARX can be modified to check a patient's medication co-payment exemption status to determine if the co-payment indicator should appear. 2. I12679229FY17 - vhacpalantzd--VistA - Non-VRAM User--Claims Matching Report Omissions Problem: -------- Veterans who are charged a First Party Co-Pay for medication are not receiving proper credit for corresponding Third Party Payments as required. This is occurring because the VistA Claims Matching Report [RCDP CLAIMS MATCH] is not including claims for original prescriptions that have a FILL DATE (#22) field in the PRESCRIPTION (#52) file that is different than the DATE (#.03) field in the IB BILL/CLAIMS PRESCRIPTION REFILL (#362.4) file. Resolution: ----------- In the routine IBEFURF, added a check in the Claims Matching Report [RCDP CLAIMS MATCH] for the FILL NUMBER (#.1) field in IB BILL/CLAIMS PRESCRIPTION REFILL (#362.4) file to allow searching of prescriptions by fill number in addition to fill date. 3. I16239935FY17 - AR Productivity Report (Routine ^IBJDF8I) Adding Entries to File 200 Problem: -------- The Workload Assignment Enter/Edit [IBJD FOLLOW-UP WORKLOAD] option will allow the user to create new entries in the NEW PERSON (#200) file if they enter a unique name in the lookup of the CLERK NAME (#.01) field of the IB DM WORKLOAD PARAMETERS (#351.73) file. This is because the CLERK NAME (#.01) field of the IB DM WORKLOAD PARAMETERS (#351.73) file is a pointer to the NEW PERSON (#200) file, and the FileMan ^DIC call allows learning new entries. Learning new entries allows the search to display entries from the NEW PERSON (#200) file, but also allows new entries to be made to the file. Resolution: ----------- Changed the FileMan ^DIC call in the routine IBJDF8I to search the NAME (#.01) field of the NEW PERSON (#200) file instead of searching the CLERK NAME (#.01) field of the IB DM WORKLOAD PARAMETERS (#351.73) file. This search will not allow new entries to be made to the NEW PERSON (#200) file. A second search is then performed on the CLERK NAME (#.01) field of the IB DM WORKLOAD PARAMETERS (#351.73) file using the entry found in the NEW PERSON (#200) file. This second search will allow new entries to be made to the IB DM WORKLOAD PARAMETERS (#351.73) file. The Workload Assignment Enter/Edit [IBJD FOLLOW-UP WORKLOAD] option requires the user to have the security key IBJD WORKLOAD ASSIGNMENT. 4. R7964411FY16 - CPT code issue Problem: ------- Description field is not always accurately displayed, due to the fact IBCU7 does not always select the correct CPT code/does not have the ability to trim duplicate white spaces off strings when evaluating if a code is a 'NOC'. Resolution: ----------- The ^IBCU7 routine was updated so that the description prompt should only be displayed if a CPT code can be categorized as a Not Otherwise Categorized ('NOC'). This can be determined by evaluating the DESCRIPTION (#.01) subfield of the DESCRIPTION (#62) Multiple to see if they contain any of the following: NOT OTHERWISE, NOT ELSEWHERE, NOT LISTED, UNLISTED, UNSPECIFIED, UNCLASSIFIED, NON-SPECIFIED, NOS, NOS;, NS., NOS,, NOS/, (NOS), NOC, NOC;, NOC., NOC/, (NOC). If so, the description prompt should be displayed. The original issue was coming from bad data being in the DESCRIPTION (#.01) subfield of the DESCRIPTION (#62) multiple (extra white spaces) making it so ^IBCU7 could not determine the status of the code. This has the potential to effects all CPT codes, not just J1566 as reported. However, this was remedied by a data clean up so the original issue could not be duplicated. However, to prevent this from happening again, an extrinsic function 'TM' was added to trim off white spaces before evaluating them with the 'NOC' subroutine within ^IBCU7. It was also discovered during testing that ^IBCU7 was not selecting the correct version of a CPT code depending on the date. This issue was remedied by removing the direct reads to ^ICPT, replacing them with the appropriate Application Programming Interface calls which help select the correct version of a CPT code depending on the date selected. This update now makes the software Health Insurance Portability and Accountability Act compliant. Installation Instructions: ========================== This patch may be installed with users on the system although it should be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 2 minutes to install. 1. Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. From the Kernel Installation & Distribution System menu, select the Installation menu. 3. From this menu, you may select to use the following options: (when prompted for INSTALL NAME, enter IB*2.0*604) a. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. b. Print Transport Global - This option will allow you to view the components of the KIDS build. c. 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.). d. 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. 4. Use the Install Package(s) option and select the package IB*2.0*604. 5. When Prompted "Want KIDS to INHIBIT LOGONs during the install? NO//" respond NO. 6. When Prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//" respond YES. When prompted 'Enter options you wish to mark as 'Out Of Order':', enter the following: Patient Prescription Processing [PSO LM BACKDOOR ORDERS] Claims Matching Report [RCDP CLAIMS MATCH] Workload Assignment Enter/Edit [IBJD FOLLOW-UP WORKLOAD] Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 11 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBARX Before: B52093772 After: B52663311 **101,150,156,168,186,237,308, 563,604** Routine Name: IBCU7 Before:B116490042 After:B132964294 **62,52,106,125,51,137,210,245, 228,260,348,371,432,447,488, 461,516,522,577,604** Routine Name: IBEFURF Before: B18754511 After: B19666061 **130,347,459,604** Routine Name: IBJDF8I Before: B32963587 After: B35098407 **123,604** Routine list of preceding patches: 123, 459, 563, 577 ============================================================================= User Information: Entered By : Date Entered : AUG 30, 2017 Completed By: Date Completed: MAR 01, 2018 Released By : Date Released : MAR 01, 2018 ============================================================================= Packman Mail Message: ===================== $END TXT