$TXT Created by at MNTVBB.DOMAIN.EXT (KIDS) on Thursday, 12/05/24 at 06:59 ============================================================================= Run Date: JAN 16, 2025 Designation: IB*2*810 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #735 Status: Released Compliance Date: JAN 23, 2025 ============================================================================= Subject: PHARMACY ADMINISTRATIVE FEE UPDATE FOR CY 2025 Category: - Routine Description: ============ *** Please Note: This patch has a shortened compliance date of 7 days. *** Integrated Billing patch, IB*2.0*810, updates 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 1st, 2025. The following rate types will be created: Rate Type Dispensing Fee -------------------- ------------- CC MTF REIMB INS 15.61 CC NO-FAULT AUTO 15.61 CC REIMB INS 15.61 CC TORT FEASOR 15.61 CC WORKERS' COMP 15.61 CCN NO-FAULT AUTO 15.61 CCN REIMB INS 15.61 CCN TORT FEASOR 15.61 CCN WORKERS' COMP 15.61 CHOICE NO-FAULT AUTO 15.61 CHOICE REIMB INS 15.61 CHOICE TORT FEASOR 15.61 CHOICE WORKERS' COMP 15.61 DENTAL REIMB. INS. 15.61 HUMANITARIAN 15.61 HUMANITARIAN REIMB. INS. 15.61 INELIGIBLE 15.61 INELIGIBLE REIMB. INS. 15.61 INTERAGENCY 15.61 NO FAULT INS. 15.61 REIMBURSABLE INS. 15.61 TORT FEASOR 15.61 WORKERS' COMP. 15.61 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 Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- Blood Bank Coordination: N/A New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): N/A Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1. INC36387780: Initiate RX Admin Charge Update for CY25 non-Tricare Problem: -------- The Office of Community Care has requested an update to the pharmacy administrative charge for 23 rate types with an effective date of January 1st, 2025. Resolution: ----------- The post-init routine IB20P810 was created to inactivate rate schedules with the RX COST charge set for 23 rate types with an inactive date of December 31st, 2024. It includes Community Care (CC), Community Care Network (CCN) or Choice for No-Fault Auto, Reimbursable Insurance, Tort Feasor, Worker's Compensation, and CCN Military Treatment Facility (MTF)/Humanitarian/Ineligible/Interagency Reimbursable Insurance, and Humanitarian, Ineligible, Interagency, No Fault Insurance, Reimbursable Insurance, Tort Feasor, Worker's Compensation. It also adds the new rate schedules with the administrative fee starting on January 1st, 2025 to the RATE SCHEDULE file (#363). ************************************************************************** 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: ----------- Manchester VAMC (Manchester, NH) VA Pittsburgh HCS (Pittsburgh, PA) SNOW Change Order #: -------------------------------- Manchester VAMC (Manchester, NH) - CHG0556082 VA Pittsburgh HCS (Pittsburgh, PA) - CHG0556082 Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. Documentation Title File Name --------------------------------------------------------------------- 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 and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. From the Kernel Installation & Distribution System menu, select the Installation menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter the patch or build name IB*2.0*810. B. Select the Backup a Transport Global option to create a backup Message. You must use this option and specify what to backup; the entire Build or just Routines. The backup message can be used to restore the routines and components of the build to the pre-patch condition. i. At the Installation option menu, select Backup a Transport Global ii. At the Select INSTALL NAME prompt, enter your build IB*2.0*810. iii. When prompted for the following, enter "R" for Routines or "B" for Build. Select one of the following: B Build (including Routines) R Routines Only Enter response: B iv. When prompted "Do you wish to secure this message? NO//", press and take the default response of "NO". v. When prompted with, "Send mail to: Last name, First Name", press to take default recipient. Add any additional recipients. vi. When prompted with "Select basket to send to: IN//", press and take the default IN mailbox or select a different mailbox. C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. 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 the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install, IB*2.0*810. i. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. ii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer NO. Post-Installation Instructions: ------------------------------- You may delete the routine IB20P810 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: IB*2.0*810 Post-Install starts..... >>>Effect. JAN 01, 2025 of RX Rate Schedule Adjustment for the Rate Type: CC MTF REIMB INS CC NO-FAULT AUTO CC REIMB INS CC TORT FEASOR CC WORKERS' COMP CCN NO-FAULT AUTO CCN REIMB INS CCN TORT FEASOR CCN WORKERS' COMP CHOICE NO-FAULT AUTO CHOICE REIMB INS CHOICE TORT FEASOR CHOICE WORKERS' COMP DENTAL REIMB. INS. HUMANITARIAN HUMANITARIAN REIMB. INS. INELIGIBLE INTERAGENCY INELIGIBLE REIMB. INS. NO FAULT INS. REIMBURSABLE INS. TORT FEASOR WORKERS' COMP. Total 23 entries added to the Rate Schedule file (#363) IB*2.0*810 Post-Install is complete. 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. Back-Out/Roll Back Plan: ------------------------ Due to the complexity of this patch, it is not recommended for back-out, and a restore from a backup of the Transport Global should not be attempted. In the event that the patch installer decides to back out this patch, the patch installer should log a Service Now ticket or contact the Enterprise Service Desk (ESD) at 855-673-4357. Backout or rollback of the software will be a joint decision between the development team, VA site/region personnel and other appropriate VA personnel and will require their concurrence. The development team will need to issue a follow-on patch in order to comprehensively back-out 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 3 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IB20P810 Before: n/a After: B14648771 **810** ============================================================================= User Information: Entered By : Date Entered : NOV 22, 2024 Completed By: Date Completed: JAN 15, 2025 Released By : Date Released : JAN 16, 2025 ============================================================================= Packman Mail Message: ===================== $END TXT