============================================================================= Run Date: OCT 21, 2020 Designation: PRCA*4.5*345 Package : PRCA - ACCOUNTS RECEIVABLE Priority: Mandatory Version : 4.5 SEQ #325 Status: Released Compliance Date: NOV 20, 2020 ============================================================================= Associated patches: (v)PRCA*4.5*211<<= must be installed BEFORE `PRCA*4.5*345' (v)PRCA*4.5*332<<= must be installed BEFORE `PRCA*4.5*345' Subject: MCCF EDI TAS EPAYMENTS BUILD 9 Category: - Routine - Enhancement (Mandatory) - Data Dictionary Description: ============ Below is a list of all the applications involved in this patch along with their patch number: APPLICATION/VERSION PATCH --------------------------------------------------------------- ACCOUNTS RECEIVABLE (PRCA) V. 4.5 PRCA*4.5*345 INTEGRATED BILLING (IB) V. 2.0 IB*2.0*639 The patches (PRCA*4.5*345 and IB*2.0*639) are being released in the Kernel Installation and Distribution System (KIDS) multi-build distribution as PRCA_IB_EPAYMENTS_BUNDLE_5_0.KID. The purpose of this patch is to meet the requirements of the Medical Care Collection Fund (MCCF) Electronic Data Interchange (EDI) Transaction Application Suite (TAS) Phase 1 project as related to Accounts Receivable (PRCA). This project ensures the Department of Veterans Affairs (VA) compliance with Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Operating Rules, and enables VA to more effectively use ERA data, resulting in better revenue and cash flow management. It will provide the infrastructure foundation for electronic exchange of claim payment information and promotes an interoperable system. It will reduce the time elapsed between receipt of the EDI 835 Electronic Remittance Advice Transaction and receipt of the Cash Concentration or Disbursement (CCD+) transactions. It will ensure that trace numbers between payments and remittances can be used by VA, reducing the level of open accounts receivable, allow claim denials to be more quickly addressed, and standardizes Electronic Funds Transfer (EFT) & ERA enrollment to reduce workload burden on VA staff. This patch contains changes to the ePayments (835 and EFT) program area to ensure compliance. Specifically, enhancements to the Veterans Health Information Systems and Technology Architecture (VistA) Third Party EDI Lockbox module to increase timely and accurate processing of payments for electronic claims in compliance with Health Insurance Portability and Accountability Act (HIPAA) and Veterans Health Administration (VHA) Fiscal Accounting policies. The ePayments system is used by Accounts Receivable (AR) staff to process payments from third party payers for both medical and pharmacy claims. Notice: New Integration Agreement (IA) #7007 is used by Accounts Recievable to call ^IBR to release'ON HOLD' 1st party charges to AR. New Integration Agreement (IA) #7017 is used by Integrated billing to get the FREE TEXT PATIENT NAME from the ERA Detail line in ePayments. The following features of the PRCA software will be affected by this patch. 1. Transfer Language removed from the EDI Lockbox 3rd Party Exceptions (EXC) data transmissions worklist [RCDPE EXCEPTION PROCESSING]. Previous software updates removed the functionality in the Exceptions worklist to 'transfer' EEOB data to a different site. However, references to this previous functionality still existed on the worklist. This enhancement removed any references to the previous 'transfer' functionality. 2. Deposit number was added to the detail lines in the Auto-Post Report [RCDPE AUTO-POST REPORT]. The deposit number was added to the second line of detail information for a receipt in front of the trace number. 3. Ability to auto-decrease pharmacy claims with payments. New site parameter questions were added to allow pharmacy claims with payments to be auto-decreased by the Nightly AR Process. This resulted in changes to the following areas: a) New site parameter questions were added to the EDI Lockbox Parameters [RCDPE EDI LOCKBOX PARAMETERS] option. b) The Auto-Parameter History Report [RCDPE AUTO PARAM HIST REPORT] was modified to include changes to pharmacy auto-decrease parameters. c) The EDI Lockbox Parameters Report [RCDPE SITE PARAMETER REPORT] was modified to include pharmacy auto-decrease parameters. d) The EDI Lockbox Exclusion Report Audit Report [[RCDPE EXCLUSION AUDIT REPORT] was modified to include changes to payer exclusions for pharmacy claims with payments. e) The EDI Lockbox Parameters Audit Report [RCDPE PARAMETER AUDIT REPORT] was modified to include changes to site parameters for pharmacy claims with payments. f) The Nightly AR Process was modified to auto-decrease pharmacy claims with payments that meet site parameter criteria. 4. Ability to auto-decrease first party claims when payments have been posted to the corresponding 3rd party claim. The Nightly AR Process will now auto-decrease 1st party claims that are released to the veteran and the entire balance is still open including any claims that are already released and claims that the system needs to release and credit. This resulted in changes to the following areas: a) A new site parameter was added to the AR SITE PARAMETER File (#342) to enable/disable 1st party auto-decrease. b) The Nightly AR Process was modified to auto-decrease 1st party claims that meet the site parameter settings. c) A new Report 1st Party Auto-Decrease Adjustment Report [RCDPE AUTO-DECREASE 1ST PARTY] was added to the Audit Reports [RCDPE EDI LOCKBOX AUDIT RPRTS] sub-menu of the EDI LOCKBOX Reports Menu [RCDPE EDI LOCKBOX REPORTS MENU] to display the 1st party auto-decreases done by the Nightly AR Process. d) A new Report, First Party COPAY Manual vs Auto-Decrease Report [RCDPE 1ST PARTY AUTO VS MAN] was added to the Audit Reports [RCDPE EDI LOCKBOX AUDIT RPRTS] sub-menu of the EDI LOCKBOX Reports Menu [RCDPE EDI LOCKBOX REPORTS MENU] to display statistics about first party claims that were manually decreased versus ones that auto-decreased by the Nightly AR Process. 5. Fixed an issue with TRICARE EFT lock-outs which was preventing medical EFT Lock-outs from being processed if TRICARE ERAs aged beyond the NUMBER OF DAYS (AGE) OF UNPOSTED TRICARE EFTS TO PREVENT POSTING site parameter setting. 6. Added a notification email to the vha835payerinquiry@domain.ext outlook mail group to make sure the ePayments eBusiness group is aware of site transmission errors in a timely manner. 7. Added the display of the Patient name a claim was originally assigned to in the Third Party Joint Inquiry Option (TPJI) [IBJ THIRD PARTY JOINT INQUIRY] if the claim was the result of a split/edit. 8. In the AR EDI LOCKBOX MESSAGES file (#344.5), the SEQUENCE RECIEVED is now allowed to be upto 999, where previously it was a maximum of 99. 9. Electronic Explanation of Benefits (EEOB) will now auto-verify if the billed amount on the EEOB does not match the billed amount in VistA. Existing checks on patient name and service date remain in place. This change was made to allow pharmacy claims to auto-verify when the billed amount on the EEOB is a penny less than the billed amount on the claim in VistA. Patch Components ================ Files & Fields Associated: File Name (#) New/Modified/ Sub-file Name (#) Field Name (Number) Deleted ------------------- -------------------------------------- ------------- AR SITE PARAMETER (#342) MODIFIED AUTO-DECREASE FIRST PARTY (#.14) NEW AUTO-DECREASE FIRST PARTY DAYS (#.15) NEW 1ST PARTY AUTO-DECREASE TYPES sub-file (#342.014) NEW CHARGE TYPE (#.01) NEW ENABLED (#.02) NEW ELECTRONIC REMITTANCE ADVICE (#344.4) MODIFIED ERA DETAIL (#344.41) MODIFIED CHECKED FOR FIRST PARTY AD (#10.01) NEW AR EDI LOCKBOX MESSAGES (#344.5) SEQUENCE RECEIVED (#344.53) SEQUENCE RECEIVED MODIFIED RCDPE AUTO-PAY EXCLUSION (#344.6) MODIFIED EXCLUDE PHARM CLAIMS DECREASE (#.12) NEW PHARMACY AUTO-DECREASE COMMENT (#4) NEW RCDPE PARAMETER (#344.61) MODIFIED AUTO-DECREASE MED DAYS DEFAULT (#.04) MODIFIED AUTO-DECREASE MED AMT DEFAULT (#.05) MODIFIED AUTO-DECREASE MED NO PAY DAYS (#.12) MODIFIED AUTO-DECREASE PHARM ENABLED (#1.02) MODIFIED AUTO-DECREASE PHARM DAYS DEFAU (#1.03) NEW AUTO-DECREASE PHARM AMT DEFAUL (#1.04) NEW RCDPE CARC-RARC AUTO DEC (#344.62) MODIFIED CARC AUTO DECREASE (#.02) MODIFIED DATE ADDED (#.03) MODIFIED UPDATED BY (#.04) MODIFIED DATE LAST UPDATED (#.05) MODIFIED CARC DECREASE AMOUNT (#.06) MODIFIED COMMENT (#.07) MODIFIED CARC AUTO DECREASE NO-PAY (#.08) MODIFIED DATE ADDED NO-PAY (#.09) MODIFIED UPDATED BY (NO-PAY) (#.1) MODIFIED DATE LAST UPDATED NO-PAY (#.11) MODIFIED CARC DECREASE AMOUNT NO-PAY (#.12) MODIFIED COMMENT NO-PAY (#.13) MODIFIED CARC PHARM AUTO DECREASE (#2.01) NEW PHARM WITH PAYMENTS DATE ADDED (#2.02) NEW PHARM WITH PAYMENTS UPDATED BY (#2.03) NEW PHARM W. PAYMNTS DT LAST UPDTD (#2.04) NEW PHARM W. PAYMNTS CARC DEC AMNT (#2.05) NEW PHARM WITH PAYMENTS COMMENT (#2.06) NEW RCDPE FIRST PARTY CHARGE QUEUE (#344.74) NEW AR TRANSACTION (#433) MODIFIED AUTO-DECREASE 3RD PARTY BILL (#94) 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 --------------- ------------- FIRST PARTY COPAY DECREASE SEND TO SITE Options Associated: New/Modified/ Option Name Type Deleted ----------- ---- ------------- RCDPE 1ST PARTY AUTO VS MAN RUN ROUTINE SEND TO SITE RCDPE AUTO PARAM HIST REPORT RUN ROUTINE ATTACH TO MENU RCDPE AUTO-DECREASE 1ST PARTY RUN ROUTINE SEND TO SITE RCDPE AUTO-DECREASE REPORT RUN ROUTINE ATTACH TO MENU RCDPE AUTO-POST RECEIPT REPORT RUN ROUTINE ATTACH TO MENU RCDPE AUTO-POST REPORT RUN ROUTINE ATTACH TO MENU RCDPE EDI LOCKBOX AUDIT RPRTS MENU SEND TO SITE RCDPE EEOB MOVE/COPY/RMOVE RPT RUN ROUTINE ATTACH TO MENU RCDPE EFT AUDIT REPORT RUN ROUTINE ATTACH TO MENU RCDPE EFT TRANSACTION AUD REP RUN ROUTINE ATTACH TO MENU RCDPE ERA STATUS CHNG AUD REP RUN ROUTINE ATTACH TO MENU RCDPE ERA W/PAPER EOB REPORT RUN ROUTINE ATTACH TO MENU RCDPE MARKED AUTO-POST REPORT RUN ROUTINE ATTACH TO MENU RCDPE PAYER EXCLUSION NAME TIN RUN ROUTINE ATTACH TO MENU RCDPE REMOVED ERA AUDIT RUN ROUTINE ATTACH TO MENU 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 ------------- ------------- N/A 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 ------------- ---- ------------------ ------------- RCMS EDI LOCKBOX Input AR SITE PARAMETER (#342) SEND TO SITE Templates, List Associated: New/Modified/ Template Name Type Deleted ------------- ---- ------------- N/A 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 Additional Information: N/A New Service Requests (NSRs) ---------------------------- N/A Patient Safety Issues (PSIs) ----------------------------- N/A Defect Tracking System Ticket(s) & Overview --------------------------- N/A Test Sites: ---------- ASHVILLE, NC CHARLESTON, SC NORTHPORT, NY Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released using a host file. The host file is available at the following location: /srv/vista/patches/SOFTWARE/PRCA_IB_EPAYMENTS_BUNDLE_5_0.KID Other Software Files: This release also includes other software files. They can be obtained at location: /srv/vista/patches/SOFTWARE or by accessing the URL: https://download.vista.domain.ext/index.html/SOFTWARE Documentation can also be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/ Title File Name SFTP Mode ----------------------------------------------------------------------- Deployment, Installation, PRCA_4_5_P345_IG.PDF Binary Back-Out, and Rollback Guide (IB*2.0*639 and PRCA*4.5*345) ePayments User Manual EPAYMENTS_USER_MANUAL_R1020.PDF Binary (EDI Lockbox) AR Technical Manual/ PRCA_4_5_TM.PDF Binary Security Guide Patch Installation: Pre/Post Installation Overview ------------------------------ Do not install this patch while the "Accounts Receivable Nightly Process Background Job" [PRCA NIGHTLY PROCESS] is running. To avoid disruptions, this patch should be installed during non-peak hours when there is minimal activity on the system and there are no Accounts Receivable users on the system. Pre-Installation Instructions ----------------------------- ****************************************************************** * Do _NOT_ install this patch while the "Account Receivable * * Nightly Process Background Job" [PRCA NIGHTLY PROCESS] is * * running. * * * ****************************************************************** This patch may be installed with users on the system although it is *strongly* recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 5 minutes to install. Installation Instructions ------------------------- 1. OBTAIN PATCHES -------------- Obtain the host file PRCA_IB_EPAYMENTS_BUNDLE_5_0.KID which contains the following patches: PRCA*4.5*345 IB*2.0*639 The host file is available at the following location: /srv/vista/patches/SOFTWARE/PRCA_IB_EPAYMENTS_BUNDLE_5_0.KID If the above link is not functional to retrieve the host file, this URL can be used: https://download.vista.domain.ext/index.html/SOFTWARE 2. START UP KIDS ------------- Start up the Kernel Installation and Distribution System Menu option [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. LOAD TRANSPORT GLOBAL FOR MULTI-BUILD ------------------------------------- From the Installation menu, select the Load a Distribution option. When prompted for "Enter a Host File:", enter /srv/vista/patches/SOFTWARE/PRCA_IB_EPAYMENTS_BUNDLE_5_0.KID If the above link is not functional, enter the full directory path to the location where the PRCA_IB_EPAYMENTS_BUNDLE_5_0.KID host file was saved. When prompted for "OK to continue with Load? NO//", enter "YES." The following will display: Loading Distribution... PRCA IB EPAYMENTS BUNDLE 5.0 PRCA*4.5*345 IB*2.0*639 Use INSTALL NAME: PRCA IB EPAYMENTS BUNDLE 5.0 to install this distribution. 4. RUN INSTALLATION OPTIONS FOR MULTI-BUILD ------------------------------------------------- From the Installation menu, you should select to use the following options (when prompted for the INSTALL NAME, enter: PRCA IB EPAYMENTS BUNDLE 5.0): a. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. When you are presented with the following prompt whilst backing up the transport global: Only a Single Package Build can do a Build Backup. PRCA IB EPAYMENTS BUNDLE 5.0 is of type Multi-Package You can only Backup the Routines. Select one of the following: R Routines Enter response: Select "R" as the response. 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. 5. INSTALL MULTI-BUILD ------------------- This is the step to start the installation of this KIDS patch. This will need to be run for the PRCA IB EPAYMENTS BUNDLE 5.0. a. Choose the Install Package(s) option to start the patch install. b. When prompted 'Select INSTALL NAME:', enter PRCA IB EPAYMENTS BUNDLE 5.0. 6. When prompted 'Enter the Coordinator for Mail Group 'FIRST PARTY COPAY DECREASE':', enter POSTMASTER 7. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', enter YES. 8. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', enter NO. 9. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', enter NO. 10. If prompted 'Delay Install (Minutes): (0 - 60): 0//', respond 0. 11. When prompted 'Device: HOME//', respond with the correct device. Post-Installation Instructions ------------------------------ The post-install routine POST^RCP345 performs the following actions: 1. Creates new CARC Auto Decrease Index ACTVN. 2. Populates EDI Site Parameter defaults for Pharmacy Auto-Decrease. 3. Adds Payer/TIN combinations from the EDI THIRD PARTY EFT DETAIL File (#344.31) to the RCDPE AUTO-OAY EXCLUSION file (344.6) if they were not already defined. In order to verify the patch post-installation routine was run successfully, please examine the Install File for this patch and report any error messages to Product Support. Routine Information: ==================== The second line of each of these routines now looks like: ;;4.5;Accounts Receivable;**[Patch List]**;Mar 20, 1995;Build 34 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PRCAPAY3 Before: B3346372 After: B2035820 **104,345** Routine Name: PRCASER Before: B9222573 After: B8364878 **90,153,203,211,345** Routine Name: RCDPEAD Before:B232051747 After:B208756015 **298,304,318,326,332,345** Routine Name: RCDPEAD1 Before: B89886464 After: B91841985 **298,318,326,345** Routine Name: RCDPEAD2 Before: B2447533 After: B18955368 **326,345** Routine Name: RCDPEAD3 Before: n/a After:B122937852 **345** Routine Name: RCDPEAP1 Before:B111273424 After:B135185048 **298,304,318,321,326,345** Routine Name: RCDPEAPP Before:B188964958 After:B212537479 **298,304,326,345** Routine Name: RCDPEAPQ Before: B57896147 After: B61176847 **298,304,326,345** Routine Name: RCDPEFA1 Before: n/a After:B180038453 **345** Routine Name: RCDPEFA2 Before: n/a After: B59580303 **345** Routine Name: RCDPEFA3 Before: n/a After:B190509157 **345** Routine Name: RCDPEFA4 Before: n/a After: B18579183 **345** Routine Name: RCDPEM Before: B75647011 After: B76983330 **173,255,269,276,283,298,304, 318,321,326,345** Routine Name: RCDPEM0 Before: B74803925 After: B93216944 **173,208,220,298,304,345** Routine Name: RCDPEM7 Before:B161364446 After:B161364446 **276,298,303,304,321,326,345** Routine Name: RCDPESP Before:B142229287 After:B257307949 **298,304,318,321,326,332,345** Routine Name: RCDPESP1 Before:B113871339 After: B95219092 **298,304,318,321,326,332,345** Routine Name: RCDPESP2 Before:B101041466 After: B86693783 **298,304,317,321,326,332,345** Routine Name: RCDPESP5 Before:B268946794 After:B216533678 **304,321,326,332,345** Routine Name: RCDPESP6 Before: B65240726 After: B88001917 **326,332,345** Routine Name: RCDPESP7 Before: B23355054 After: B21778993 **298,304,318,321,326,345** Routine Name: RCDPESPA Before: B72015265 After: B77085169 **332,345** Routine Name: RCDPESPB Before: n/a After: B19472177 **345** Routine Name: RCDPESR1 Before: B51294022 After: B86861399 **173,214,208,202,271,298,321,345** Routine Name: RCDPESR3 Before: B55320528 After: B55602628 **173,214,208,255,269,283,298, 321,345** Routine Name: RCDPESR6 Before: B60062437 After: B61315117 **173,214,208,230,252,269,271, 298,321,332,345** Routine Name: RCDPEV Before: B38492428 After: B39566948 **208,138,298,345** Routine Name: RCDPEWLP Before:B201114317 After:B202431640 **298,303,304,319,332,345** Routine Name: RCDPEX2 Before: B32725849 After: B33023919 **173,269,298,304,326,345** Routine Name: RCDPRSEA Before: B85725448 After: B85725448 **114,148,208,269,304,332,345** Routine Name: RCP345 Before: n/a After: B6112667 **345** Routine list of preceding patches: 104, 211, 332 ============================================================================= User Information: Entered By : Date Entered : DEC 13, 2018 Completed By: Date Completed: OCT 21, 2020 Released By : Date Released : OCT 21, 2020 ============================================================================= Packman Mail Message: ===================== No routines included