$TXT Created by at DEVESR.DOMAIN.EXT (KIDS) on Wednesday, 02/21/18 at 16:11 ============================================================================= Run Date: MAY 24, 2018 Designation: IB*2*568 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #564 Status: Released Compliance Date: JUN 24, 2018 ============================================================================= Associated patches: (v)IB*2*135 <<= must be installed BEFORE `IB*2*568' (v)IB*2*220 <<= must be installed BEFORE `IB*2*568' (v)IB*2*447 <<= must be installed BEFORE `IB*2*568' (v)IB*2*458 <<= must be installed BEFORE `IB*2*568' (v)IB*2*473 <<= must be installed BEFORE `IB*2*568' (v)IB*2*498 <<= must be installed BEFORE `IB*2*568' (v)IB*2*577 <<= must be installed BEFORE `IB*2*568' (v)IB*2*597 <<= must be installed BEFORE `IB*2*568' Subject: HAPE FY16 REVENUE ENHANCEMENTS Category: - Routine - Other - Enhancement (Mandatory) Description: ============ IMPORTANT INSTALLATION NOTE: ---------------------------- There are three patches associated with this project - PRCA*4.5*315, IB*2.0*568 and PSO*7.0*463. All three patches are to be installed as PackMan files. There is no bundle. The three patches for this project MUST be installed in this order: 1. PRCA*4.5*315 2. IB*2.0*568 3. PSO*7.0*463 Description ----------- The Chief Business Office (CBO) is requesting system enhancements to The Veterans Health Information Systems and Technology Architecture (VistA) Integrated Billing (IB), Accounts Receivable (AR), and Outpatient Pharmacy (PSO) software modules. The mission of the Department of Veterans Affairs (VA), Office of Information & Technology (OI&T), is to provide benefits and services to veterans of the United States Armed Forces. In meeting these goals, OIT strives to provide high quality, effective, and efficient Information Technology (IT) services to those responsible for providing care to the veterans at the point-of-care, as well as throughout all the points of the veterans' health care. The VA depends on Information Management/Information Technology (IM/IT) systems to meet mission goals. The overall FY16 HAPE Revenue Enhancement project is comprised of three New Service Requests (NSR): NSR #20150506 The Revenue Eligibility Enhancements Project effort for the (CBO), bundles several NSRs with similar business needs into a single requirements document. Successfully addressing the requirements contained within this document will enable the Department of VA to appropriately bill certain subsets of billable events by correcting, automating, or enhancing current VistA systems. NSR #20150507 The Revenue Operations Enhancements Project combines several NSRs, as well. This effort enables the VA to improve revenue operation functionality related to repayment plans, late charge capture, bill suspension reasons, the billing of deactivated providers, and the display of appeal rights and responsibilities on the Veterans Beneficiary travel Bill of Collections form. Implementation of the proposed enhancements will make a significant positive impact on stakeholders and target users. NSR #20150505 The Revenue Reporting Enhancements Project will enable the VA to improve tracking and reporting of revenue, and will support revenue reporting business rules and guidelines. IB*2.0*568 patch enhancements, pertinent to the above NSRs, include: 1.) When generating the RNB (Reasons Not Billable) report, the Integrated Billing system shall populate the charges for all types of services provided. Charges will not be screened by any billable criteria but will indicate the full amount as if the care was to be billed. 2.) The sub-option Claims Tracking Parameter Edit [IBT EDIT TRACKING PARAMETERS], that currently has no key, will be locked with a new Security Key called IB PARAMETER EDIT. 3.) The option MCCR Site Parameter Display/Edit [IBJ MCCR SITE PARAMETERS], which is currently locked with the IB SUPERVISOR Security Key, will be instead locked with the new key. NOTE: IV Managers, Billing Managers and other select staff approved to edit through the MCCR SITE PARAMETERS option will need to have this key assigned 4.) The Integrated Billing system shall create claims tracking entries for previously unbilled Prosthetics/DME items when new billable insurance is entered into the patient's insurance file. 5.) A new coverage limitation field shall be created in the insurance file for Prosthetics. Like the other existing coverage limitation fields in the insurance file (Inpatient, Outpatient, Pharmacy etc.), this field will have the following options: 0=NOT COVERED 1=COVERED 2=CONDITIONAL COVERAGE Once selected, they will show in the patient insurance file as Yes, No, or Conditional. 6.) The system shall automatically assign an RNB [NO PROSTHETIC COVERAGE (CV22)] for Prosthetics/DME items if the patient has no coverage for Prosthetics in his/her insurance file. 7.) The system shall have a new option to add Prosthetics items to Manual and Nightly Claims Tracking. 8.) Users will be able to select Suspended Type from the menu to display in the First Party Follow- Up [IBJD FOLLOW-UP FIRST PARTY] report. 9.) First Party Follow-Up [IBJD FOLLOW-UP FIRST PARTY] report shall be modified to incorporate reason for suspension. 10.) A new warning message will print to the screen in the Enter/Edit Billing Information option if an ATTENDING, REFERRING or RENDERING Provider has a PERSON CLASS in the NEW PERSON file (#200) that was expired at the time of the Date of Service. 11.) On the Third Party Joint Inquiry screen, one (1) character space shall be added to the "Type" field so that it will accommodate five characters (a one-character classification indicator, a forward slash (/), a one-character component indicator, a forward slash (/), and a one-character care type) ("X/X/X"). If a bill contains prescriptions, then an "R" shall be concatenated to the fifth character sub-type position of the "Type" field. If a bill contains prosthetics, then a "P" shall be concatenated to fifth character sub-type position of the "Type" field. The "Type" field shall contain five (5) characters as follows: 1. "I" for Inpatient or "O" for Outpatient, 2. "/" forward slash character 3. "P" for Professional or "I" for Institutional 4. "/" forward slash character 5. "P" for Prosthetics or "R" for Prescriptions 12.) Three new Third Party Insurance Rate Types shall be created in the VistA IB system for the billers to choose from when billing for encounters. They are as follows: HUMANITARIAN REIMB. INS. DENTAL REIMB. INS. INELIGIBLE REIMB. INS. 13.) Each of the new rate types above will have the 'Insurer' as the responsible party. 14.) Billers (revenue staff) should be able to identify any remaining charges to the patient after the Third Party payments are received for Emergency Humanitarian, Ineligible and Dental services so they can accomplish balance billing. Concurrent Development / Dependencies: -------------------------------------- PRCA*4.5*315 PSO*7*463 Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- IB AUTO BILLER PARAMS ROUTINE MODIFIED IB EDIT SITE PARAMETERS ROUTINE MODIFIED IBJ MCCR SITE PARAMETERS ROUTINE MODIFIED IBT EDIT TRACKING PARAMETERS ROUTINE MODIFIED IBT SUP MANUALLY QUE ENCTRS ROUTINE MODIFIED IBT SUP MANUALLY QUE PRSTHTCS ROUTINE NEW IBT SUP MANUALLY QUE RX FILLS ROUTINE MODIFIED IBT SUPERVISORS MENU MENU MODIFIED Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- IB PARAMETER EDIT Templates Associated: Template Name Type File Name (Number) New/Mod/Del ------------- ---- ------------------ ----------- IBJT ACTIVE LIST LIST NEW IBJT INACTIVE LIST LIST NEW New Service Requests (NSRs): ---------------------------- 20150505 - Revenue Reporting Enhancements 20150506 - Revenue Eligibility Enhancements 20150507 - Revenue Operations Enhancements Patient Safety Issues (PSIs): ------------------------------ N/A Defect Tracking System Ticket(s) & Overviews: ---------------------------------------------- N/A Test Sites: ---------- Durham VAMC Central Alabama Veterans Healthcare System Software and Documentation Retrieval Instructions: ---------------------------------------------------- Choose the PackMan message containing this patch. Sites may retrieve documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Title File Name FTP Mode ------------------------------------------------------------------------------- Integrated Billing User Manual IB_2_0_UM.PDF Binary Integrated Billing Claims Tracking User Guide IB_2_0_CT_UG.PDF Binary Integrated Billing Technical Manual/Security Guide IB_2_0_TM.PDF Binary Integrated Billing Deployment, Installation, Back-Out, and Rollback Guide (IB*2*568) IB_2_0_P568_IG.PDF Binary Patch Installation: Pre/Post Installation Overview: ------------------------------- The post installation routine, IBY568PO, is automatically deleted as a part of the normal installation process if allowed by your Kernel site parameters. The post installation routine performs the following tasks: o Add the Prosthetics entry to the INSURANCE RIDERS file (#355.6) o Add Prosthetics to the PLAN LIMITATION CATEGORY file (#355.31) o Add 3 new rate types to the RATE TYPE file (#399.3) o Add 7 new rate schedules to the RATE SCHEDULE file (#363) o Add 1 new IB error message to the IB ERROR file (#350.8) Pre-Installation Instructions: ------------------------------ N/A Post-Installation Instructions: ------------------------------- The option MCCR Site Parameter Display/Edit [IBJ MCCR SITE PARAMETERS], which is currently locked with the IB SUPERVISOR Security Key, will be instead locked with the new key IB PARAMETER EDIT. IV Managers, Billing Managers and other select staff approved to edit through the MCCR SITE PARAMETERS option will need to have this key assigned. Installation Instructions ------------------------- This patch may be installed with users on the system although it is recommended that it 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. 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 options: 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. To Install the Patch, from the Installation Menu, select the Install Package(s) option and choose the patch to install. When prompted for the INSTALL NAME, enter the patch# (IB*2.0*568). 5. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//' You may press return to accept the default answer of NO IF your system rebuilds menu trees nightly using TaskMan. If you do not have this scheduled as a nightly task, you must answer YES to rebuild the menu trees. This could affect users on the system and your installation time will increase. 6. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//, enter 'NO' 7. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//, enter 'NO' Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 40 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCAPP Before: B21485583 After: B23150807 **432,447,568** Routine Name: IBCBB11 Before:B112052327 After:B125441111 **51,343,363,371,395,392,401, 384,400,436,432,516,550,577, 568** Routine Name: IBCNSBL2 Before: B33173974 After: B39593451 **52,80,153,240,432,568** Routine Name: IBECEA Before: B10792926 After: B13714935 **199,135,568** Routine Name: IBJDB21 Before: B73370335 After:B127496258 **123,159,185,399,437,458,568** Routine Name: IBJDF11 Before: B29605847 After: B30230903 **69,80,118,128,204,205,227, 451,530,554,568** Routine Name: IBJDF2 Before: B68244751 After: B68533516 **69,91,100,118,133,205,554,597,568** Routine Name: IBJDF4 Before: B27131031 After: B43681161 **123,204,220,568** Routine Name: IBJDF41 Before: B88827246 After:B103009700 **123,159,204,356,451,473,568** Routine Name: IBJDF42 Before: B53237550 After: B55007532 **123,204,568** Routine Name: IBJDF43 Before: B23469371 After: B25427864 **123,568** Routine Name: IBJTLA1 Before: B12051503 After: B13446872 **39,80,61,51,153,137,183,276, 451,516,530,568** Routine Name: IBJTLB1 Before: B12752963 After: B13573050 **39,80,61,137,276,451,516,530,568** Routine Name: IBTRE2 Before: B32981505 After: B41874411 **23,121,249,312,568** Routine Name: IBTRE20 Before: B13573861 After: B20324155 **40,91,249,568** Routine Name: IBTRKR5 Before: B35067366 After: B38746753 **13,260,312,339,389,474,498,568** Routine Name: IBY568PO Before: n/a After: B78022144 **568** Routine list of preceding patches: 135, 220, 447, 458, 473, 498, 577, 597 ============================================================================= User Information: Entered By : Date Entered : JUN 17, 2016 Completed By: Date Completed: MAY 23, 2018 Released By : Date Released : MAY 24, 2018 ============================================================================= Packman Mail Message: ===================== $END TXT