$TXT Created by at TAS-EBIL-HF2.AAC.DOMAIN.EXT (KIDS) on Wednesday, 02/27/19 at 11:25 ============================================================================= Run Date: APR 08, 2019 Designation: IB*2*608 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #583 Status: Released Compliance Date: MAY 08, 2019 ============================================================================= Associated patches: (v)IB*2*592 <<= must be installed BEFORE `IB*2*608' (v)IB*2*621 <<= must be installed BEFORE `IB*2*608' Subject: MCCF EDI TAS EBILLING BUILD 5/6 Category: - Data Dictionary - Input Template - Enhancement (Mandatory) - Routine Description: ============ Integrated Billing (IB) is a software module within Veterans Health Information Systems and Technology Architecture (VistA) that provides the ability for billing personnel to submit claims in either a paper or electronic format to third-party payers. The following features of the IB software will be affected by this patch: * Transmitting SNF Claims with Appropriate Revenue Codes The IB VistA package has been modified to send Revenue Code 0022 and VA specific AAA00 RUG/Health Insurance Prospective Payment System (HIPPS) Skilled Nursing Facility (SNF) rate codes for Medicare Primary Institutional Part A claims with bill types 21x, 22x or 23x. Due to this modification, the System will no longer use the Financial Service Center (FSC) workaround. Instead, the System now has the ability to perform the identical checks that FSC used to ensure that these SNF claims are sent. The System automatically allows for this in the transmission of the flat file so that the biller does not have to enter anything additional to have this information transmitted. In addition, the VistA flat file for Institutional 837s has been updated and the "View/Print EDI Bill Extract Data" [IBCE EDI VIEW/PRINT EXTRACT] (VPE) option screens depict the change in the flat file for the end user to view in the INS segment. * Add 'T' for Transmitted to RCB Screen The IB VistA package has been modified to be enable the user to see "** T = Test Claim" (to explain what the "T" indicator represents) in the legend of the "View/Resubmit Claims - Live or Test" [IBCE PREV TRANSMITTED CLAIMS] (RCB) option screen when viewing previously Printed claims. * Remove Ability to Define Insurance Company as non-EDI The IB VistA package has been modified so the "Insurance Company Entry/Edit" [IBCN INSURANCE CO EDIT] (EI) option no longer provides the user the ability to select "0 - NO" as an option for "EDI - Transmit?" prompt under the EDI Parameters section of the screen. In addition, a one-time report from each site showing the value of the field to determine whether an Insurance Company is active for Electronic Data Interchange (EDI) will be sent to the eBiz Rapid Response group. * RCB Screen - Match COB Data to Payer Sequence The IB VistA package has been modified to be enable the user to resubmit, to the Test queue, a claim using the "View/Resubmit Claims - Live or Test" [IBCE PREV TRANSMITTED CLAIMS] (RCB) option and have only the Coordination of Benefits (COB) data that is correct for the payer sequence be included in the transaction. If a user selects: o a Primary claim to resubmit and the claim has received an EOB/MRA from the primary payer, VistA will not send the COB data from the EOB/MRA and the amount billed will not be offset by previous payments from the primary payer. o a Secondary claim to resubmit and the claim has received an EOB/MRA from the secondary payer, VistA will not send the COB data from the EOB/MRA and the amount billed will not be offset by previous payments from the secondary payer. o a Tertiary claim to resubmit and the claim has received an EOB/MRA from the tertiary payer, VistA will not send the COB data from the EOB/MRA and the amount billed will not be offset by previous payments from the tertiary payer. If a user attempts to resubmit a claim(s) with EOB data in VistA to the Production queue, the system will filter out the claim(s) and not transmit it. These non-transmitted claims will be listed on the screen as "Skipped". * Non-MCCF Unbilled Amounts Report The IB VistA package has been modified so the "Re-Generate Unbilled Amounts Report" [IBT RE-GEN UNBILLED REPORT] option now allows the user to select the following additional search criteria: (M)CCF, (N)on-MCCF (Outpatient Only), or (B)oth claims Non-MCCF Rate Types include: CHAMPVA, CHAMPVA Reimb. Ins., TRICARE, TRICARE Reimb. Ins., Interagency, Sharing Agreement and Ineligible. Non-MCCF Appointment Types include: Employee and Sharing Agreement. Non-MCCF Eligibility of Encounters include: CHAMPVA, TRICARE, Employee, Ineligible and Sharing Agreement. * Non-MCCF Pay-To Address Rate Types The IB VistA package has been modified to allow the user to be able to define one or more Rate Types for which the non-MCCF Pay-to Address (formerly the TRICARE Pay-to Address) will be used on claims with one of those Rate Types. In addition, the following items are capable: o An authorized user with access to the IB Site Parameters and the TRICARE Pay-to security key will be able to add/delete a Rate Type for which claims with that Rate Type will use the non-MCCF Pay-to Address data. o The System will use the non-MCCF Pay-to Address data on claims with specified Rate Types only when the non-MCCF Pay-to Address is not exactly the same as the Billing Provider Name and Address. o The System will transmit the TRICARE Pay-to Address data on claims with specified Rate Types in the 837-I, 837-P or 837-D when the non-MCCF Pay-to Address is not exactly the same as the Billing Provider Name and Address. o The System will print the non-MCCF Pay-to Address data on Institutional claims with specified Rate Types on the UB04 form (FL2) when the TRICARE Pay-to Address is not exactly the same as the Billing Provider Name and Address. o The System will print the non-MCCF Pay-to Address data on Professional claims with specified Rate Types on the CMS 1500 form (Box 33) when the non-MCCF Pay-to Address is not exactly the same as the Billing Provider Name and Address. * Remove Fatal Error - Rendering Provider CMS 1500 The IB VistA package has been modified so that the previously fatal error that prevented a biller from submitting a Professional Claim with no Rendering Provider has been removed and instead now a non-fatal warning message appears to the user when a Professional Claim does not contain a Rendering Provider. * CMN Oxygen and EPN Nutrition The IB VistA package has been modified to enable the "Enter/Edit Billing Information" [IB EDIT BILLING INFO] option to enter the required data for an Oxygen Certificate of Medical Necessity (CMN) (CMS-484.3) or an Enteral and Parenteral Nutrition CMN (CMS-10126) when completing a professional bill for Durable Medical Equipment (DME). In addition, the ability to transmit Professional claims has been modified to include the CMN data in the proprietary 837-P Transaction to the Financial Services Center (FSC). Patch Components ================ Files & Fields Associated: File Name (#) New/Modified/ Sub-file Name (#) Field Name (Number) Deleted ------------------- --------------------------------- ------------- INSURANCE COMPANY (#36) Modified TRANSMIT ELECTRONICALLY (#3.01) Modified IB ERROR (#350.8) Data Only Screen: I $$INCLUDE^IBY608PR(8,Y) IB SITE PARAMETERS (#350.9) Modified CMN CPT CODES sub-file (#350.916) New NON-MCCF RATE TYPES FOR PTP sub-file (#350.928) New TRICARE PAY-TO PROVIDERS sub-file (#350.929) Modified TC FACILITY (#.01) Modified TC NAME (#.02) Modified TC FEDERAL TAX NUMBER (#.03) Modified TC TELEPHONE NUMBER (#.04) Modified TC PARENT PAY-TO PROVIDER (#.05) Modified TC STREET ADDRESS 1 (#1.01) Modified TC STREET ADDRESS 2 (#1.02) Modified TC CITY (#1.03) Modified TC STATE (#1.04) Modified TC ZIP (#1.05) Modified IB DATA ELEMENT DEFINITION (#364.5) Data Only Screen: I $$INCLUDE^IBY608PR(5,Y) IB FORM SKELETON DEFINITION (#364.6) Data Only Screen: I $$INCLUDE^IBY608PR(6,Y) IB FORM FIELD CONTENT (#364.7) Data Only Screen: I $$INCLUDE^IBY608PR(7,Y) BILL/CLAIMS (#399) Modified PROCEDURES sub-file (#399.0304) Modified CMN REQUIRED? (#23) New CMN FORM TYPE (#24) New CMN CERTIFICATION TYPE (#24.01) New CMN PATIENT HEIGHT (IN) (#24.02) New CMN PATIENT WEIGHT (LBS) (#24.03) New CMN MONTHS DME EQUIP NEEDED New (#24.04) CMN DATE THERAPY STARTED (#24.05) New CMN LAST CERTIFICATION DATE New (#24.06) CMN RECERTIFICATION/REVISN DT New (#24.07) CMN REPLACEMENT ITEM? (#24.08) New CMN ABG PO2 (MMHG) (#24.1) New CMN O2 SATURATION % (#24.102) New CMN DT LAST ABG PO2 AND O2 SAT New (#24.103) CMN EDEMA DUE TO CHF PRESENT? New (#24.104) CMN COR PULMONARY HYPERTENSN? New (#24.105) CMN HEMATOCRIT > 56%? (#24.106) New CMN PT CONDITION AT TEST TIME New (#24.107) CMN TEST CONDITIONS (#24.108) New CMN PORTABLE O2 INDICATOR (#24.109) New CMN HIGHEST O2 FLOW RATE (#24.11) New CMN LAST 4 LPM ABG PO2 (MMHG) New (#24.111) CMN LAST 4 LPM O2 SATURATION % New (#24.113) CMN DATE OF LAST 4 LPM TESTS New (#24.114) CMN EQUIPMENT/COST DESCRIPTION New (#24.115) CMN SM BOWEL ABSORPTION DOC? New (#24.201) CMN ENTERAL NUTRITION BY TUBE? New (#24.202) CMN PROCEDURE A CALORIES (#24.203) New CMN PROCEDURE A (#24.204) New CMN METHOD OF ADMINISTRATION New (#24.205) CMN DAYS PER WEEK ADMINISTERED New (#24.206) CMN SEVERE MALABSORPTION DOC? New (#24.207) CMN AMINO ACID (ML/DAY) (#24.208) New CMN AMINO ACID CONCENTRATION % New (#24.209) CMN AMINO ACID PROTEIN (GM/DY) New (#24.21) CMN DEXTROSE (ML/DAY) (#24.211) New CMN DEXTROSE CONCENTRATION % New (#24.212) CMN LIPIDS (ML/DAY) (#24.213) New CMN ROUTE OF ADMINISTRATION New (#24.214) CMN LIPIDS (DAYS/WEEK) (#24.215) New CMN LIPIDS CONCENTRATE % (#24.216) New CMN PARENTERAL/ENTERAL/BOTH New (#24.217) CMN PROCEDURE B CALORIES (#24.218) New CMN PROCEDURE B (#24.219) New CMN FORM TYPES (#399.6) New Bulletins Associated: New/Modified/ Bulletin Name Deleted ------------- ------------- N/A Dialogs Associated: New/Modified/ Dialog Name Deleted ----------- ------------- N/A Forms Associated: New/Modified/ Form Name File Name (Number) Deleted --------- ------------------ ------------- N/A Functions Associated: New/Modified/ Function Name Deleted ------------- ------------- N/A HL Logical Link: New/Modified/ HL Logical Name Deleted --------------- ------------- N/A HL7 Application Parameters: New/Modified/ HL7 Parameter Name Deleted ------------------ ------------- N/A HLO Application Registry: New/Modified/ HLO Registry Name Deleted ----------------- ------------- N/A Help Frames Associated: New/Modified/ Help Frame Name Deleted --------------- ------------- N/A Mail Groups Associated: New/Modified/ Mail Group Name Deleted --------------- ------------- N/A Options Associated: New/Modified/ Option Name Type Deleted ----------- ---- ------------- N/A Parameter Definitions: New/Modified/ Parameter Name Deleted -------------- ------------- N/A Parameter Template: New/Modified/ Template Name Deleted ------------- ------------- N/A Protocols Associated: New/Modified/ Protocol Name Deleted ------------- ------------- IBJP IB NON-MCCF PAY-TO PROVIDERS MENU New IBJP IB NON-MCCF RATE TYPE ADD New IBJP IB NON-MCCF RATE TYPE DEL New IBJP IB NON-MCCF RATE TYPES New IBJP IB NON-MCCF RATE TYPES MENU New IBJP IB TRICARE PAY-TO PROVIDER ADD Modified IBJP IB TRICARE PAY-TO PROVIDER DEL Modified IBJP IB TRICARE PAY-TO PROVIDER DIVISIONS Modified IBJP IB TRICARE PAY-TO PROVIDER EDIT Modified IBJP IB TRICARE PAY-TO PROVIDERS MENU Deleted IBJPS CMN CPT ADD New IBJPS CMN CPT DEL New IBJPS CMN CPT MENU New Remote Procedures Associated: New/Modified/ Remote Procedure Name Deleted --------------------- ------------- N/A Security Keys Associated: New/Modified/ Security Key Name Deleted ----------------- ------------- N/A Templates, Input Associated: New/Modified/ Template Name Type File Name (Number) Deleted ------------- ---- ------------------ ------------- IBEDIT INS CO1 Input INSURANCE COMPANY (#36) Modified Templates, List Associated: New/Modified/ Template Name Type Deleted ------------- ---- ------------- IBJP IB NON-MCCF List New RATE TYPES IBJP IB TRICARE List Modified PAY-TO PROVS IBJPS CMN CPTS List New Templates, Print Associated: New/Modified/ Template Name Type File Name (Number) Deleted ------------- ---- ------------------ ------------- N/A Templates, Sort Associated: New/Modified/ Template Name Type File Name (Number) Deleted ------------- ---- ------------------ ------------- N/A New Service Requests (NSRs) ---------------------------- N/A Patient Safety Issues (PSIs) ----------------------------- N/A Defect Tracking System Ticket(s) & Overview ------------------------------------------- 1. INC4006791 - The option to add a Dental Payer ID and address in the Insurance Company Editor is missing. This is a VA wide issue. Problem: ------- The option to add a Dental Payer ID and address in the Insurance Company Entry/Edit [IBCN INSURANCE CO EDIT] is missing. This is a VA wide issue. Resolution: ---------- Insurance Company Entry/Edit [IBCN INSURANCE CO EDIT] which was enhanced in IB*2.0*592 to support the addition of electronic dental claims, EDI X12 837D, was overwritten in error in a subsequent patch and is being restored in order to prompt users for Dental Payer ID and address. Test Sites: ---------- Dublin Martinsburg Orlando Tomah Documentation Retrieval Instructions ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to retrieve files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve files directly from a specific server. Sites may retrieve the 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: https://www.domain.ext/vdl/ Title File Name FTP Mode ----------------------------------------------------------------------- Deployment, Installation, ib_2_0_p608_ig.pdf Binary Back-out/Rollback Guide (IB*2.0*608) EDI User Guide ib_2_0_p608_edi_ug.pdf Binary Integrated Billing (IB) V.2.0 ib_2_0_p608_tm.pdf Binary Technical Manual Patch Installation: Pre/Post Installation Overview ------------------------------ Of note, included in this patch is a modification to line 2 in the routine IBCU7 to correct the patch sequencing that was entered as part of the IB*2.0*592 patch. This change has no effect on the functionality of the routine and was only made to correct the patch sequencing of line 2. ************************************************************************* * IMPORTANT NOTE * * In PRODUCTION, there is one **MANDATORY** pre-installation activity * * associated with this install. * * * * The IB Staff MUST empty the 837 extract/transmission queue PRIOR to * * the installation of this patch. * ************************************************************************* INSTRUCTIONS ON HOW TO EMPTY THE 837 EXTRACT TRANSMISSION QUEUE: =============================================================== The site Information Resource Management (IRM) MUST coordinate with the Billing Department to ensure that the 837 extract/transmission queue is empty. Once the Billing Department has completed the instructions, the Billing department is to inform IRM that the patch installation may proceed. The instructions to empty the queue are as follows: Select the option: TRANSMIT EDI BILLS - MANUAL [IBCE 837 MANUAL TRANSMIT] What is the purpose of this option? This option is used to by-pass the normal daily/nightly transmission queues if the need arises to get the claim to the payer quickly. When is this option used? There are occasions when there is a need to transmit a claim(s) immediately instead of waiting for the batching frequency as scheduled in the MCCR Site Parameter. This option will allow sending individual claim(s) or all claims in a ready for extract status. Upon selecting this option, you will be prompted with the following: Select one of the following: A Transmit (A)LL bills in READY FOR EXTRACT status S Transmit only (S)ELECTED bills You should select 'A' for ALL There are no other mandatory pre-installation activities associated with this patch. ------------------------------------------------------------------------ The Pre-install routine (IBY608PR) will automatically do the following: * Add/Update entries used by the Forms Output Utility [IBCE OUTPUT FORMATTER]. * Add new entries in IB ERROR file (#350.8). The Post-install routine (IBY608PO) will automatically generate the one- time Insurance Company EDI Parameter Report and send an email to the eBiz Rapid Response Group ("VHAeBillingRR@domain.ext"). This report will list all of the insurance companies that have the current setting for the Transmit Electronically parameter set to ZERO which equals 'NO'. In addition, the Post-install routine will automatically add 50 CPT codes to the new CMN CPT CODE INCLUSION IB Site Parameter. This list of codes is a basis of those CPT codes to be referenced in processing claims which contain CMN Oxygen EPN Nutrition data. This list of CPT codes can be maintained when accessing the IB Site Parameters. Routines IBY608PO and IBY608PR may be manually deleted by IT/IRM upon completion of the installation. 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 option. When prompted for the INSTALL enter the patch # (i.e., IB*2.0*608): 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. From the Installation Menu, select the Install Package(s) option and choose the patch to install. 5. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' Press return to accept the default of NO. 6. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//' Press return to accept the default of NO. 7. If prompted "Delay Install (Minutes): (0 - 60): 0// respond 0. 8, At the Device prompt enter where you wish the Install messages to print. You can queue the install by entering a 'Q' at the device prompt. Enter a '^' to abort the install. DEVICE: HOME// Backout Procedure: ------------------ The Backout procedure of this patch will be performed only with the concurrence and participation of the appropriate VA site/region personnel. The decision to back out the patch will be a joint decision between VA site/region personnel and other appropriate VA personnel. For more information pertaining to the Backout Procedure, please refer to the "Deployment, Installation, Back-out/Rollback Guide" for this patch. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 90 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCBB1 Before:B127796820 After:B130250613 **27,52,80,93,106,51,151,148, 153,137,232,280,155,320,343, 349,363,371,395,384,432,447, 488,554,577,592,608** Routine Name: IBCBB12 Before:B136258580 After:B140177880 **432,592,608** Routine Name: IBCBB13 Before: B19726855 After: B52019184 **447,608** Routine Name: IBCCC2 Before:B130398035 After:B139322972 **80,106,124,138,51,151,137, 161,182,211,245,155,296,320, 348,349,371,400,433,432,447, 516,577,592,608** Routine Name: IBCE837B Before: B3184659 After: B4349124 **137,191,197,320,608** Routine Name: IBCEF11 Before: B92999922 After:B100824598 **51,137,155,309,335,348,349, 371,432,447,473,516,577,592, 608** Routine Name: IBCEF2 Before: B81532163 After:B140185497 **52,85,51,137,232,155,296,349, 403,400,432,488,461,547,592, 608** Routine Name: IBCEF22 Before: B97383500 After:B107716996 **51,137,135,155,309,349,389, 432,488,516,577,608** Routine Name: IBCEF31 Before: B15832177 After: B67968602 **155,296,349,400,432,488,516, 592,608** Routine Name: IBCEFG7 Before: B51790981 After: B54668730 **52,84,96,51,137,191,320,608** Routine Name: IBCEPTC2 Before: B53543437 After: B56837195 **296,320,348,349,547,592,608** Routine Name: IBCEPTC3 Before: B64803891 After: B91463160 **320,547,608** Routine Name: IBCEU Before:B116893464 After:B119764859 **51,137,207,232,349,432,592,608** Routine Name: IBCEU1 Before: B91847621 After:B117180629 **137,155,296,349,371,432,473, 547,608** Routine Name: IBCEU3 Before:B109051815 After:B109583745 **51,137,155,323,348,371,400, 432,488,519,592,608** Routine Name: IBCEU5 Before: B88027546 After: B88004916 **51,137,232,348,349,432,592,608** Routine Name: IBCF23A Before: B50374642 After: B52551501 **51,432,516,547,577,592,608** Routine Name: IBCNSC01 Before: B75281286 After: B76348341 **52,137,191,184,232,320,349, 371,399,416,432,494,519,547, 592,608** Routine Name: IBCU7 Before:B175831153 After:B180096059 **62,52,106,125,51,137,210,245, 228,260,348,371,432,447,488, 461,516,522,577,604,616,592, 608** Routine Name: IBCU75 Before: n/a After: B79458011 **608** Routine Name: IBJPS Before: B6552900 After: B6807999 **39,52,70,115,143,51,137,161, 155,320,348,349,377,384,400, 432,494,461,516,547,592,608** Routine Name: IBJPS2 Before: B56657157 After: B59492878 **39,52,115,143,51,137,161,155, 320,348,349,377,384,400,432, 494,461,516,547,592,608** Routine Name: IBJPS3 Before:B122000376 After:B122116987 **400,432,516,577,608** Routine Name: IBJPS4 Before: B36439628 After: B37240589 **400,516,608** Routine Name: IBJPS7 Before: n/a After: B13118039 **608** Routine Name: IBJPS8 Before: n/a After: B8772675 **608** Routine Name: IBTUBO Before: B47033794 After: B73456123 **19,31,32,91,123,159,192,235, 248,155,516,547,608** Routine Name: IBTUBO3 Before: B42226483 After: B45102914 **123,159,192,155,277,516,547,608** Routine Name: IBTUBOA Before: B37900623 After: B56520031 **19,31,32,91,123,159,192,155, 276,516,608** Routine Name: IBTUBOU Before: B38728907 After: B42355876 **123,159,155,608** Routine Name: IBTUBUL Before: B60799593 After: B63490597 **19,123,159,217,155,356,516, 547,608** Routine Name: IBY608PO Before: n/a After: B25506190 **608** Routine Name: IBY608PR Before: n/a After: B11561553 **608** Routine list of preceding patches: 592 ============================================================================= User Information: Entered By : HRISTOPHER Date Entered : SEP 19, 2017 Completed By: Date Completed: APR 04, 2019 Released By : Date Released : APR 08, 2019 ============================================================================= Packman Mail Message: ===================== $END TXT