$TXT Created by at MNTVBB.DOMAIN.EXT (KIDS) on Wednesday, 12/18/19 at 10:57 ============================================================================= Run Date: FEB 10, 2020 Designation: IB*2*666 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #601 Status: Released Compliance Date: MAR 11, 2020 ============================================================================= Subject: PHARMACY ADMINISTRATIVE FEE UPDATE FOR CY 2020 Category: - Routine Description: ============ Patch IB*2.0*666 will update the administrative charge based on the following rate types with new dispensing fee for third party pharmacy prescription claims with an effective date of January 1, 2020. Rate Type Dispensing Fee -------------------- ------------- CC MTF REIMB INS 18.38 CC NO-FAULT AUTO 18.38 CC REIMB INS 18.38 CC TORT FEASOR 18.38 CC WORKERS' COMP 18.38 CCN NO-FAULT AUTO 18.38 CCN REIMB INS 18.38 CCN TORT FEASOR 18.38 CCN WORKERS' COMP 18.38 CHOICE NO-FAULT AUTO 18.38 CHOICE REIMB INS 18.38 CHOICE TORT FEASOR 18.38 CHOICE WORKERS' COMP 18.38 DENTAL REIMB. INS. 18.38 HUMANITARIAN 18.38 HUMANITARIAN REIMB. INS. 18.38 INELIGIBLE 18.38 INELIGIBLE REIMB. INS. 18.38 INTERAGENCY 18.38 NO FAULT INS. 18.38 REIMBURSABLE INS. 18.38 TORT FEASOR 18.38 WORKERS' COMP. 18.38 TRICARE 15.45 TRICARE PHARMACY 15.45 TRICARE REIMB. INS. 15.45 Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Additional Information: N/A New Service Requests (NSRs): ---------------------------- N/A Patient Safety Issues (PSIs): ----------------------------- N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. INC8391286 RX ADMINISTRATIVE CHARGE UPDATE FOR CY 2020 Problem: -------- The Office of Community Care has requested an update to the pharmacy administrative charge for different rate types for outpatient pharmacy with an effective date of January 1, 2020. Resolution: ----------- The post-init routine, IB20P666, was created to inactivate rate schedules with the RX COST charge set for these rate types: Dental Reimbursable Insurance, Humanitarian, Humanitarian Reimbursable Insurance, Ineligible, Ineligible Reimbursable Insurance, Interagency, No Fault Insurance, Reimbursable Insurance, Tort Feasor and Workers' Compensation with an inactive date of December 31, 2019. It also adds the new rate schedules with the administrative fee starting on January 1, 2020 in the RATE SCHEDULE file (#363). 2. INC8016714 TRICARE RX ADMINISTRATIVE FEE IN VISTA Problem: -------- The Office of Community Care has requested an update of the pharmacy administrative charge for the Tricare, Tricare Pharmacy and Tricare Reimbursement Insurance rate types with an effective date of January 1, 2020. Resolution: ----------- The post-init routine, IB20P666, was created to inactivate rate schedules with the RX COST charge set for these rate types: Tricare, Tricare Pharmacy and Tricare Reimbursable Insurance with an inactive date of December 31, 2019. It also updates the administrative fee starting January 1, 2020 ($15.45) in the RATE SCHEDULE (#363) file. ************************************************************************** Note: This patch will NOT update any Rate Schedules if any Rate Types are currently set to INACTIVE. Please verify with Facility Revenue Manager(s) and local VistA support to ACTIVATE any Rate Types as needed. *************************************************************************** TEST SITES: ----------- Connecticut HCS - West Haven, CT Jack C. Montgomery VAMC - Muskogee,OK Software and Documentation Retrieval Instructions: -------------------------------------------------- N/A Patch Installation: Pre/Post Installation Overview: ------------------------------- It is recommended that this patch be installed outside of normal business hours to avoid any complications resulting from users on the system. Installation will take less than 2 minutes. Installation Instructions: -------------------------- 1. Choose the PackMan message containing this patch. 2. Choose the INSTALL/CHECK MESSAGE PackMan option. 3. From the Kernel Installation & Distribution System Menu, select the Installation Menu. From this menu, you may select to use the following options. When prompted for the INSTALL NAME, enter the patch IB*2.0*666: 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. 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//" respond NO. 6. When Prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//" respond NO. Post-Installation Instructions: ------------------------------- You may delete the routine, IB20P666, from your production system after the patch has been successfully verified. Use the 'Install File Print' option to review the updates and ensure that the install has been completed. For an example: Note: If results show otherwise, please check the settings of the rate schedules for the rate types in RATE SCHEDULE file (#363) or log a ticket with The Enterprise Service Desk for assistance. IB*2.0*666 Post-Install starts..... >>>Effect. JAN 01, 2020 of RX Rate Schedule Adjustment for the Rate Type: CC MTF REIMB INS added CC NO-FAULT AUTO added CC REIMB INS added CC TORT FEASOR added CC WORKERS' COMP added CCN NO-FAULT AUTO added CCN REIMB INS added CCN TORT FEASOR added CCN WORKERS' COMP added CHOICE NO-FAULT AUTO added CHOICE REIMB INS added CHOICE TORT FEASOR added CHOICE WORKERS' COMP added DENTAL REIMB. INS. added HUMANITARIAN added HUMANITARIAN REIMB. INS. added INELIGIBLE added INTERAGENCY added INELIGIBLE REIMB. INS. added NO FAULT INS. added REIMBURSABLE INS. added TORT FEASOR added WORKERS' COMP. added TRICARE added TRICARE REIMB. INS. added TRICARE PHARMACY added Total 26 entries added to the Rate Schedule file (#363) IB*2.0*666 Post-Install is complete. Back-Out/Roll Back Plan: ------------------------ Prior to installing the updated KIDS package, the site/region should have saved a backup of the routines in a mail message using the Backup a Transport Global [XPD BACKUP] menu option. The message containing the backed up routines can be loaded with the "Xtract PackMan" function at the Message Action prompt. The PackMan function INSTALL/CHECK MESSAGE is then used to install the backed up routines onto the VistA system. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 5 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IB20P666 Before: n/a After: B11034558 **666** ============================================================================= User Information: Entered By : Date Entered : NOV 06, 2019 Completed By: Date Completed: FEB 10, 2020 Released By : Date Released : FEB 10, 2020 ============================================================================= Packman Mail Message: ===================== $END TXT