$TXT Created by HARPER,AMY R at DEVFEX.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 01/28/08 at 14:20 ============================================================================= Run Date: FEB 29, 2008 Designation: IB*2*390 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #357 Status: Released Compliance Date: MAR 31, 2008 ============================================================================= Associated patches: (v)IB*2*382 <<= must be installed BEFORE `IB*2*390' Subject: REASONABLE CHARGES 3.1 Category: - Routine - Enhancement (Mandatory) Description: ============ ************************************************************************* Implementation of Reasonable Charges v3.1 is a two step process: 1. Installation of this patch. This will inactivate the Reasonable Charges v2.11 charges with an inactive date of 12/31/07. See Installation Instructions. 2. Uploading the Reasonable Charges v3.1 charges. This will load new charges with an effective date of 01/01/08. See Upload Instructions. ************************************************************************* Reasonable Charges version 3.1 is a charge update to the existing Reasonable Charges billed to Third Party Payers. The primary update with this patch is to the charges, which will be implemented when the new RC v3.1 charges are uploaded (step 2). This version updates all charges. Inactive Date of Reasonable Charges v2.11 is 12/31/2007. Effective Date of Reasonable Charges v3.1 is 01/01/2008. Reasonable Charges v2.11 loaded on your system will be inactivated with an inactivation date of 12/31/2007 when this patch is installed. Reasonable Charges v3.1 with an effective date of 01/01/2008 will be loaded on your system when the charges are uploaded as described below. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- NSR 20070536 - Reasonable Charges CPT/HCPCS Outpatient update This patch addresses the following NOIS/Remedy Ticket(s): --------------------------------------------------------- There is no NOIS/Remedy tickets associated with this patch. Components Sent With Patch -------------------------- Post-Init: ---------- The Post-Init will inactivate all existing Reasonable Charges defined in the Charge Master. Reasonable Charges v2.11 will be inactivated with a date of 12/31/07. Test Sites: ----------- Cleveland OH Montana HCS West Palm Beach FL Pre/Post Installation Overview ------------------------------ Implementation of Reasonable Charges v3.1 will be complete after 2 steps: 1. Installation of this patch, IB*2*390. (Installation Instructions) 2. Upload of Reasonable Charge v3.1 charges. (RC v3.1 Upload Instructions) The Post-init will inactivate all Reasonable Charges defined in the site's Charge Master. The previously active charges, Reasonable Charges v2.11, will be inactivated with a date of 12/31/07. The following is an example of the post-init portion of the installation: Reasonable Charges v3.1 Post-Install ..... >> Inactivating Existing Reasonable Charges, Please Wait... Done. 50693 existing charges inactivated Reasonable Charges v3.1 Post-Install Complete Note: The actual number of charges inactivated will vary based on the number of divisions billed at your site. This will also determine the time required for the installation. ================INSTALLATION INSTRUCTIONS ================= If installed during the normal workday, it is recommended that the following selection(s) in the OPTION (#19) file be disabled to prevent possible conflicts while running the KIDS Install. Other VISTA users will not be affected. Enter/Edit Billing Information [IB EDIT BILLING INFO] Enter/Edit Charge Master [IBCR DISPLAY CHARGE MASTER] Install Time - less than 30 minutes. This time will vary from site to site depending on the size of the Charge Item file (#363.2) which is searched for charges to inactivate in the Post-Init. Loading the Charge Master with the new RC v3.1 charges is separate from the patch installation and will take additional time per division. Please note that Reasonable Charges v3.1 is being released before v3.0. RC v3.0 (IB*2*370) only involves coding changes and only v3.1 (IB*2*390) will involve a rate update. There is no dependency between the two versions. Therefore any order of installation of these two patches is acceptable. 1. LOAD TRANSPORT GLOBAL --------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. START UP KIDS ------------- Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: INStallation --- Load a Distribution Print Transport Global Compare Transport Global to Current System Verify Checksums in Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution Backup a Transport Global Select Installation Option: 3. Select Installation Option: --------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter IB*2*390): 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. Select Installation Option: Install Package(s) ------------------ **This is the step to start the installation of this KIDS patch: a. Choose the Install Package(s) option to start the patch install. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//' Answer YES unless your system does this in a nightly TaskMan process. b. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//' answer NO c. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//' answer YES d. When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following options: Enter/Edit Billing Information [IB EDIT BILLING INFO] Enter/Edit Charge Master [IBCR DISPLAY CHARGE MASTER] e. When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press . 5. Clean-up Post-Init Routine -------------------------- Optional - Once this patch has been successfully installed you may delete the post-init routine: IBYPSM 6. Upload Reasonable Charge v3.1 ----------------------------- Follow instructions below: RC v3.1 Upload Instructions ********************** RC v3.1 Upload Instructions ********************** After patch installation, the Reasonable Charges v3.1 charges will need to be loaded into the Charge Master for each division billed at the site. The charges for each Division will require approximately 1.8 - 2.0 MB of disk space. Other files will be searched, but the new charges will be added to the Charge Item file (#363.2). Files Required for Upload: -------------------------- The charge files are available on the following CIO Field Offices' Anonymous.Software directories. Use the appropriate FTP capability to retrieve the files (ASCII). OI FIELD OFFICE FTP ADDRESS DIRECTORY =============== =========== ========= ALBANY ftp.fo-albany.med.va.gov anonymous.software HINES ftp.fo-hines.med.va.gov anonymous.software SALT LAKE ftp.fo-slc.med.va.gov anonymous.software FIRST AVAILABLE SERVER download.vista.med.va.gov anonymous.software The Reasonable Charge v3.1 Host Files, effective 01/01/08: (ASCII) IBRC0801A.TXT Inpatient Facility Charges (DRG) IBRC0801B.TXT Facility Charge (CPT) IBRC0801C.TXT Physician Charges (CPT) IBRC0801D.TXT Service Category Codes IBRC0801E.TXT Area Factors IBRC0801F.TXT Site Identification Upload Steps: ============= Step 1: Get Host Files ----------------------- Retrieve the 6 Reasonable Charges v3.1 Host Files in ASCII format (see previous section). Step 2: Determine Divisions ---------------------------- Use the Print Charge Master [IBCR REPORTS FOR CHARGE MASTER] option and print the Billing Regions report to find which Billing Regions and Divisions have charges loaded onto your system. These are the divisions that will need new charges loaded. Step 3: Begin Upload Process ----------------------------- Use the Load Host File into Charge Master [IBCR HOST FILE LOAD] option to load Reasonable Charges onto your system for every division for which care is billed at your site. Carefully follow the instructions below, for each Billing Region. You will see the prompt: Select one of the following: 1.1 Load CMAC into XTMP 1.2 Load AWP into XTMP 1.3 Load RC into XTMP 1.4 Load TP into XTMP 2 Assign Charge Set 3 Check Data Validity 4 Load into Charge Master 5 Delete XTMP files Below, in more detail, the steps will guide you through the process of selecting first 1.3, then 3, then 4, and waiting until 4 stops before continuing on to the next division (and capturing or printing all output for future reference). Step 4: Load the Reasonable Charges --------------------------------------- From the menu, select option 1.3 - Load RC into XTMP This loads the Host Files into temporary storage and calculates charges for individual Divisions. - If there are no previously existing host files loaded, it will ask which version of Reasonable Charges to load. Select 3.1 - When loading Reasonable Charges v3.1 the IBRC0801x.TXT files may be used for multiple divisions without reloading. - If there exists any previously calculated charges (files) for a division, they will be displayed, and you will get the prompt: The above files already exist in XTMP. Delete the above files and continue with upload? Select Yes, to delete the previously calculated charges. - If there exist any previously loaded host files for any RC version, they will be displayed, and it will ask if they should be deleted. Select No, if the files are IBRC0801x.TXT since these are the correct files for v3.1, they may be re-used for multiple divisions. Select Yes only if the files are from a different version. - Select Division: Select the division number to load charges for. This should correspond to the Divisions associated with the Billing Regions determined previously. Once the correct division is selected, answer Yes to Calculate Charges. Step 5: Check Data Validity -------------------------------------- From the menu, select option 3 - Check Data Validity. This is optional, but it is suggested that it be run at least once, for the first division loaded. If the resulting report has any Line Data Errors, then check that the latest version of CPT and DRG has been installed. The Error key at the end of the report does not mean that errors have occurred. It simply provides definitions of the types of errors that might occur. Check the individual line items in the report to see if any of the listed errors have been detected. Step 6: Load into Charge Master ------------------------------------------ From the menu, select option 4 - Load into Charge Master Moves the charges calculated in selection 1.3 to permanent storage in the Charge Master. The results report should match the examples below. It is important that this option completes before continuing. Allow the upload of a division's charges to finish before attempting to upload another division. A summary report will be printed when the upload is complete. This option uses the same temporary files to calculate the charges for all divisions, therefore they must be calculated and loaded serially. Step 7: Repeat steps 4-6 for each Division needed ------------------------------------------------- Steps 4-6 must be repeated for each division billed at your site. Refer to the Divisions that already have charges assigned using the Billing Region Report list determined previously. In most cases, simply using the above options for loading Reasonable Charges will result in the correct set up in the Charge Master. - Option 1.3, to calculate charges for a division - Option 4, to load those calculated charges into the Charge Master permanent files. However, if you are loading charges for a new site, or a site that may have changed it's division number, then extra care is needed to ensure the setup of the Charge Master is correct. The following sections provide examples of displays and reports for the upload. ================= Reasonable Charges v3.1 Upload Details ================ The Charge Host Files should load with the following counts: The following files were created in XTMP, they will be purged in 2 days: ------------------------------------------------------------------------ IBRC0801A.TXT RC v3.1 Host File Upload, 1/28/08@10:24 by TEST,IRM 744 IBRC0801B.TXT RC v3.1 Host File Upload, 1/28/08@10:24 by TEST,IRM 5810 IBRC0801C.TXT RC v3.1 Host File Upload, 1/28/08@10:24 by TEST,IRM 14769 IBRC0801D.TXT RC v3.1 Host File Upload, 1/28/08@10:25 by TEST,IRM 30 IBRC0801E.TXT RC v3.1 Host File Upload, 1/28/08@10:25 by TEST,IRM 915 IBRC0801F.TXT RC v3.1 Host File Upload, 1/28/08@10:25 by TEST,IRM 884 Any division with Non-Provider Based Freestanding Care should result in a summary with the following counts: IBCR UPLOAD RC 621GC NORTON, VA Count = 15212 IB Upload RC v3.1 621GC NORTON, VA, 1/28/08@11:22 by TEST,IRM Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 FS Phys 1 CPT 14443 RC-PHYSICIAN FS PR 621GC 2 FS Phys 3 CPT 271 RC-PHYSICIAN FS MN 621GC 3 FS Phys/Add 00 1 CPT 117 RC-PHYSICIAN FS PR 621GC 4 FS Phys/Opt 1 CPT 289 RC-PHYSICIAN FS PR 621GC 5 FS Phys/Opt 4 CPT 5 RC-PHYSICIAN FS ML 621GC 6 FS Phys/Opt TC 1 CPT 87 RC-PHYSICIAN FS PR 621GC IB Upload Summary Report of Charge Items Loaded into the Charge Master -------------------------------------------------------------------------------- IBCR UPLOAD RC 621GC NORTON, VA FS Phys 1 14443 of 14443 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 14443 entries added to the Charge Set RC-PHYSICIAN FS PR 621GC FS Phys 3 271 of 271 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 271 entries added to the Charge Set RC-PHYSICIAN FS MN 621GC FS Phys/Add 00 1 117 of 117 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 117 entries added to the Charge Set RC-PHYSICIAN FS PR 621GC FS Phys/Opt 1 289 of 289 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 289 entries added to the Charge Set RC-PHYSICIAN FS PR 621GC FS Phys/Opt 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 5 entries added to the Charge Set RC-PHYSICIAN FS ML 621GC FS Phys/Opt TC 1 87 of 87 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 87 entries added to the Charge Set RC-PHYSICIAN FS PR 621GC Any Provider based division that provides Outpatient Care Only should result in a summary with the following counts: IBCR UPLOAD RC 561GA TRENTON, NJ Count = 18263 IB Upload RC v3.1 561GA TRENTON, NJ, 1/28/08@10:47 by TEST,IRM Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Opt Fac 1 CPT 5797 RC-OPT FAC PR 561GA 2 Opt Fac 2 CPT 7 RC-OPT FAC HR 561GA 3 Opt Fac 4 CPT 5 RC-OPT FAC ML 561GA 4 Opt Fac/Phys 1 CPT 4728 RC-OPT FAC PR 561GA 5 Opt PD PHosp MISCE 1 RC-OPT MISC 561GA 6 Opt Phys 1 CPT 7455 RC-PHYSICIAN OPT PR 561GA 7 Opt Phys 3 CPT 270 RC-PHYSICIAN OPT MN 561GA IB Upload Summary Report of Charge Items Loaded into the Charge Master -------------------------------------------------------------------------------- IBCR UPLOAD RC 561GA TRENTON, NJ Opt Fac 1 5797 of 5797 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 5797 entries added to the Charge Set RC-OPT FAC PR 561GA Opt Fac 2 7 of 7 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 7 entries added to the Charge Set RC-OPT FAC HR 561GA. Opt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 5 entries added to the Charge Set RC-OPT FAC ML 561GA. Opt Fac/Phys 1 4728 of 4728 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 4728 entries added to the Charge Set RC-OPT FAC PR 561GA Opt PD PHosp 1 of 1 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 1 entries added to the Charge Set RC-OPT MISC 561GA. Opt Phys 1 7455 of 7455 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 7455 entries added to the Charge Set RC-PHYSICIAN OPT PR 561GA Opt Phys 3 270 of 270 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 270 entries added to the Charge Set RC-PHYSICIAN OPT MN 561GA Any division that provides Inpatient Care should result in a summary with the following counts: IBCR UPLOAD RC 607 MADISON, WI Count = 48259 IB Upload RC v3.1 607 MADISON, WI, 1/28/08@10:25 by TEST,IRM Subfile Item Count Charge Set ------- ---- ----- ------------------------- 1 Inpt Fac 1 CPT 17 RC-INPT FAC PR 607 2 Inpt Fac 2 CPT 7 RC-INPT FAC HR 607 3 Inpt Fac 4 CPT 5 RC-INPT FAC ML 607 4 Inpt Fac/Phys 1 CPT 2230 RC-INPT FAC PR 607 5 Inpt PD Anc DRG 743 RC-INPT ANC 607 6 Inpt PD Anc ICU DRG 743 RC-INPT ANC ICU 607 7 Inpt PD R&B DRG 743 RC-INPT R&B 607 8 Inpt PD R&B ICU DRG 743 RC-INPT R&B ICU 607 9 Inpt Phys 1 CPT 7447 RC-PHYSICIAN INPT PR 607 10 Inpt Phys 3 CPT 271 RC-PHYSICIAN INPT MN 607 11 Opt Fac 1 CPT 5797 RC-OPT FAC PR 607 12 Opt Fac 2 CPT 7 RC-OPT FAC HR 607 13 Opt Fac 4 CPT 5 RC-OPT FAC ML 607 14 Opt Fac/Phys 1 CPT 4728 RC-OPT FAC PR 607 15 Opt PD PHosp MISCE 1 RC-OPT MISC 607 16 Opt Phys 1 CPT 7455 RC-PHYSICIAN OPT PR 607 17 Opt Phys 3 CPT 270 RC-PHYSICIAN OPT MN 607 18 SNF Fac 1 CPT 5539 RC-SNF FAC PR 607 19 SNF Fac 2 CPT 7 RC-SNF FAC HR 607 20 SNF Fac 4 CPT 5 RC-SNF FAC ML 607 21 SNF Fac/Phys 1 CPT 3740 RC-SNF FAC PR 607 22 SNF PD INC BEDSE 2 RC-SNF INC 607 23 SNF Phys 1 CPT 7483 RC-PHYSICIAN SNF PR 607 24 SNF Phys 3 CPT 271 RC-PHYSICIAN SNF MN 607 IB Upload Summary Report of Charge Items Loaded into the Charge Master -------------------------------------------------------------------------------- IBCR UPLOAD RC 607 MADISON, WI Inpt Fac 1 17 of 17 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 17 entries added to the Charge Set RC-INPT FAC PR 607. Inpt Fac 2 7 of 7 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 7 entries added to the Charge Set RC-INPT FAC HR 607. Inpt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 5 entries added to the Charge Set RC-INPT FAC ML 607. Inpt Fac/Phys 1 2230 of 2230 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 2230 entries added to the Charge Set RC-INPT FAC PR 607 Inpt PD Anc 743 of 743 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 743 entries added to the Charge Set RC-INPT ANC 607. Inpt PD Anc ICU 743 of 743 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 743 entries added to the Charge Set RC-INPT ANC ICU 607 Inpt PD R&B 743 of 743 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 743 entries added to the Charge Set RC-INPT R&B 607. Inpt PD R&B ICU 743 of 743 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 743 entries added to the Charge Set RC-INPT R&B ICU 607 Inpt Phys 1 7447 of 7447 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 7447 entries added to the Charge Set RC-PHYSICIAN INPT PR 607 Inpt Phys 3 271 of 271 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 271 entries added to the Charge Set RC-PHYSICIAN INPT MN 607 Opt Fac 1 5797 of 5797 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 5797 entries added to the Charge Set RC-OPT FAC PR 607. Opt Fac 2 7 of 7 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 7 entries added to the Charge Set RC-OPT FAC HR 607. Opt Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 5 entries added to the Charge Set RC-OPT FAC ML 607. Opt Fac/Phys 1 4728 of 4728 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 4728 entries added to the Charge Set RC-OPT FAC PR 607 Opt PD PHosp 1 of 1 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 1 entries added to the Charge Set RC-OPT MISC 607. Opt Phys 1 7455 of 7455 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 7455 entries added to the Charge Set RC-PHYSICIAN OPT PR 607 Opt Phys 3 270 of 270 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 270 entries added to the Charge Set RC-PHYSICIAN OPT MN 607 SNF Fac 1 5539 of 5539 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 5539 entries added to the Charge Set RC-SNF FAC PR 607 SNF Fac 2 7 of 7 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 7 entries added to the Charge Set RC-SNF FAC HR 607. SNF Fac 4 5 of 5 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 5 entries added to the Charge Set RC-SNF FAC ML 607. SNF Fac/Phys 1 3740 of 3740 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 3740 entries added to the Charge Set RC-SNF FAC PR 607 SNF PD INC 2 of 2 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 2 entries added to the Charge Set RC-SNF INC 607. SNF Phys 1 7483 of 7483 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 7483 entries added to the Charge Set RC-PHYSICIAN SNF PR 607 SNF Phys 3 271 of 271 records checked, 0 duplicates, 0 with $=0 0 line/data errors or warnings found for a 0% error rate 271 entries added to the Charge Set RC-PHYSICIAN SNF MN 607 Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 2 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IBCRHBRV Before: B44079599 After: B44432474 **148,169,245,270,285,298,325, 334,355,360,365,382,390** Routine Name: IBYPSM Before: n/a After: B8375807 **390** Routine list of preceding patches: 382 ============================================================================= User Information: Entered By : HARPER,AMY R Date Entered : DEC 20, 2007 Completed By: LYNCH,MARY F. Date Completed: FEB 28, 2008 Released By : BOTTINI,STEVE Date Released : FEB 29, 2008 ============================================================================= Packman Mail Message: ===================== $END TXT