============================================================================= Run Date: DEC 26, 2013 Designation: PSO*7*421 Package : PSO - OUTPATIENT PHARMACY Priority: Mandatory Version : 7 SEQ #359 Status: Released Compliance Date: JAN 26, 2014 ============================================================================= Associated patches: (v)PSO*7*354 <<= must be installed BEFORE `PSO*7*421' (v)PSO*7*367 <<= must be installed BEFORE `PSO*7*421' (v)PSO*7*403 <<= must be installed BEFORE `PSO*7*421' Subject: EPHARMACY OPERATING RULES Category: - Data Dictionary - Routine - Other - Enhancement (Mandatory) Description: ============ This patch has enhancements that extend the capabilities of the Veterans Health Information Systems and Technology Architecture (VistA) electronic pharmacy (ePharmacy) billing system. Below is a list of all the applications involved in this project along with their patch number: APPLICATION/VERSION PATCH --------------------------------------------------------------- OUTPATIENT PHARMACY (OP) V. 7.0 PSO*7*421 INTEGRATED BILLING (IB) V. 2.0 IB*2*494 ELECTRONIC CLAIMS MANAGEMENT ENGINE (ECME) V. 1.0 BPS*1*15 CONSOLIDATED MAIL OUTPATIENT PHARMACY (CMOP) V. 2.0 PSX*2*74 ACCOUNTS RECEIVABLE (PRCA) V. 4.5 PRCA*4.5*295 The patches (PSO*7*421, IB*2*494, BPS*1*15, PSX*2*74 and PRCA*4.5*295) are being released in the Kernel Installation and Distribution System (KIDS) multi-build distribution BPS PSO IB PSX PRCA BUNDLE 8.0. The purpose of this software package is to ensure National Council for Prescription Drug Programs (NCPDP) D.0 - D.9 transactions are functional in the Electronic Data Interchange (EDI) New Standards and Operating Rules environment and includes annual External Code List (ECL) updates into NCPDP fields. The package also provides the ability to alert the pharmacist at the time of prescription processing regarding the days' supply benefit. This specific patch contains the following functionality: --------------------------------------------------------- 1. The ePharmacy Site Parameters screen is converted to a List Manager screen and the following additional changes made: a. The "Allow All Rejects" question is removed. b. An action to copy parameters to another division is added. c. An action to display parameters for multiple divisions is added. d. An action to select another division for view/edit is added. e. Actions are included to edit General Parameters and Transfer Rejects. f. An action is included to edit all sections of the screen. g. A new section for Reject Resolution Required reject codes is added and allows add, edit or delete rejects and the associated threshold amount. 2. ePharmacy Site Parameters screen now requires a NEW security key PSO EPHARMACY SITE MANAGER instead of security key PSORPH. 3. Claim rejection processing for the New Order action is modified to use the new Reject Resolution Required reject codes in the ePharmacy Site Parameters screen. A reject notification screen is displayed if the prescription is for original fills, Veteran eligibility, not released prescriptions and where the reject code is on the Reject Resolution Required list for the current division, and the total gross amount of the prescription is at or above the specified threshold. 4. Processing for Reject Resolution Required reject codes is also added when a claim rejection for a prescription is received in the Edit Rx action from the medication profile or the reject information screen. Processing triggers a reject notification screen. 5. A new section "REJECT RESOLUTION REQUIRED" is added to the Third Party Payer Rejects - Worklist [PSO REJECTS WORKLIST] option, which contains prescriptions with Veteran eligibility and with active Reject Resolution Required rejects. 6. Discontinued TRICARE and CHAMPVA prescriptions no longer appear on the Third Party Payer Rejects - Worklist [PSO REJECTS WORKLIST]. 7. The Reject Information screen is modified to display the following additional fields: - Both NCPDP and NPI numbers. - Next Available Fill Date (received in NCPDP field B04-BT). - Comment to indicate a Reject Resolution Required reject was automatically transferred to the Third Party Payer Rejects Worklist [PSO REJECTS WORKLIST]. - Back-bill Indicator for back billed claims (BB) or billed claims that have been processed through action PRO - Process Secondary/ TRICARE Rx to ECME [BPS COB PROCESS SECOND TRICARE] (P2, P2S). - Date of Service that was sent on the claim that resulted in the rejection. 8. The 3/4 day supply functionality to calculate a suspense date when the Renew (RN) Action feature is used. 9. Format of display for field Quantity of Previous Fill (531-FV) via action ARI View Addtnl Rej Info value is changed. The field value is divided by 1000, includes a decimal if appropriate, and strips off leading zeros before being displayed. 10. Submit Multiple Actions (SMA) action within the Third Party Worklist - [PSO REJECTS WORKLIST] option is changed to allow default Reason Code values to be deleted. Patch Components ================ The following is a list of field modifications included in this patch: File Name (#) New/Modified/ Sub-File Name (#) Field Name (#) Deleted ------------------- ------------------- ------------- PRESCRIPTION (#52) REJECT INFO Sub-File (#52.25) RRR FLAG (#30) New RRR DOLLAR THRESHOLD (#31) New RRR GROSS AMOUNT DUE (#32) New EPHARMACY SITE PARAMETERS (#52.86) ALLOW ALL REJECTS (#1) Deleted USER (#2) Modified DATE OF LAST UPDATE (#3) Modified REJECT WORKLIST DAYS (#4) Modified REJ RESOLUTION REQUIRED CODE Sub-File (#52.865) REJ RESOLUTION REQUIRED CODE (#.01) New DOLLAR THRESHOLD (#.02) New USER (#.03) New DATE LAST UPDATED (#.04) New TRANSFER REJECT CODE Sub-File (#52.8651) (name changed from REJECT CODE Sub-File) TRANSFER REJECT CODE (#.01) Modified AUTO SEND (#1) Modified USER (#2) Modified DATE OF LAST UPDATE (#3) Modified 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 ----------- ---- -------------------- PSO ePHARM SITE PARAMETERS action Modified Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- PSO BPS DISPLAY EXIT New PSO BPS DISPLAY MENU New PSO BPS SITE PARAMS CHGDIV New PSO BPS SITE PARAMS COPYSP New PSO BPS SITE PARAMS DISPLAY New PSO BPS SITE PARAMS EDITALL New PSO BPS SITE PARAMS EDITGEN New PSO BPS SITE PARAMS EDITRRRC New PSO BPS SITE PARAMS EDITTRC New PSO BPS SITE PARAMS EXIT New PSO BPS SITE PARAMS MENU New Security Keys Associated: Security Key Name New/Modified/Deleted ----------------- -------------------- PSO EPHARMACY SITE MANAGER New Templates Associated: Template Name Type New/Modified/Deleted ------------- ---- -------------------- PSO EPHARM SITE PARAMS LIST New PSO EPHARM SITE PARAMS LIST LIST New New Service Requests (NSRs): ------------------------------------------------------------- 20110503 - Electronic Data Interchange (EDI) New Standards and Operating Rules (Veterans Health Administration) VHA Provider-Side TCRs. Patient Safety Issues (PSIs) ----------------------------- #2406 - ePharmacy Prescriptions Not Printing From Suspense Remedy Ticket(s) & Overview --------------------------- HD0000000786401 - CHAMPVA prescription labels not printing HD0000000830940 - CHAMPVA prescriptions remaining in local suspense HD0000000831438 - CHAMPVA prescriptions not pulled on 'Print From Suspense' Note: All of these Remedy tickets are describing the same problem and it affects both CHAMPVA and TRICARE prescriptions remaining in local suspense incorrectly when the labels should be printed. 1. HD0000000786401 - CHAMPVA prescription labels not printing Problem: ------- Facilities have reported ePharmacy prescriptions for CHAMPVA and TRICARE patients that are not being pulled from suspense when the Print from Suspense File [PSO PNDLBL] option is used. Cases reported have been for either CHAMPVA or for TRICARE prescriptions processed for local filling. The problem happens when a payable claim is placed back into suspense. This action triggers an ECME reversal transaction, which usually creates an ECME status of REVERSAL ACCEPTED (instead of PAYABLE). Resolution: ---------- Code modification is needed in function ECMESTAT^PSOBPSU2. For TRICARE/CHAMPVA prescriptions where the current ECME status is not PAYABLE, apply a coding fix so that these prescriptions will print either if they have no rejects, or if all rejects have been overridden. Any unresolved rejections for TRICARE/CHAMPVA prescriptions (either billable or non-billable) will continue to prevent labels from printing from suspense. Test Sites: ---------- Birmingham VAMC, AL Mountain Home VAMC, TN Richmond VAMC, VA Little Rock VAMC, AR Jackson VAMC, MS Documentation Retrieval Instructions: ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. This patch can be obtained from the ANONYMOUS.SOFTWARE directory at one of the OI Field Offices. The preferred method is to FTP the file from DOWNLOAD.VISTA.DOMAIN.EXT, which will transmit the file from the first available server. Alternatively, sites may elect to retrieve the file from a specific OI Field Office. OI FIELD OFFICE FTP ADDRESS DIRECTORY Albany ftp.fo-albany.domain.ext anonymous.software Hines ftp.fo-hines.domain.ext anonymous.software Salt Lake City ftp.fo-slc.domain.ext anonymous.software The software distribution includes: Title File Name FTP Mode ----------------------------------------------------------------------- PSO Patch Release Notes/ PSO_7_P421_RN.PDF Binary Installation Guide Manager User Manual PSO_7_MAN_UM_R1113.PDF Binary Manager User Manual change pages PSO_7_P421_MAN_UM_CP.PDF Binary Pharmacist User Manual PSO_7_PHAR_UM_R1113.PDF Binary Pharmacist User Manual change pages PSO_7_P421_PHAR_UM_CP.PDF Binary Technician User Manual PSO_7_TECH_UM_R1113.PDF Binary Technician User Manual change pages PSO_7_P421_TECH_UM_CP.PDF Binary Technical Manual/Security Guide PSO_7_TM_R1113.PDF Binary Technical Manual/Security Guide change pages PSO_7_P421_TM_CP.PDF Binary Patch Installation: Pre/Post Installation Overview ------------------------------ There is a post-install routine associated with this patch named POST^PSO7P421. The purpose of the post-install routine is to: a. Delete ALLOW ALL REJECTS field (#1) and any 79/88 reject codes from EPHARMACY SITE PARAMETERS file (#52.86) The post-install routine is automatically deleted by the system if allowed by your Kernel site parameters configuration. You may delete routine PSO7P421 if the installation is successful and if it is not automatically deleted by KIDS. Installation Instructions ------------------------- This patch should take less than a minute to install. DO NOT QUEUE the installation of this patch. To avoid disruptions, these patches should be installed during non-peak hours when there is minimal activity on the system. Avoid times when ECME claims are being transmitted, Outpatient Pharmacy Prescription Processing, and Consolidated Mail Outpatient Pharmacy (CMOP) Activity is taking place. Of particular concern are the options below. 1. BPS NIGHTLY BACKGROUND JOB [BPS NIGHTLY BACKGROUND JOB] Do not install the patch when ECME claims are being generated by the BPS Nightly Background Job option. Wait for this job to finish or complete the installation before this job starts. 2. Scheduled CS Transmission [PSXR SCHEDULED CS TRANS] and Scheduled Non-CS Transmission [PSXR SCHEDULED NON-CS TRANS] Do not install the patch when prescriptions are being transmitted to CMOP. Wait for the CMOP transmissions to finish or complete the installation before the transmissions start. Both the CS (Controlled Substances) and the non-CS CMOP transmission options should be checked. Check with Pharmacy Service or your Pharmacy ADPAC to find out when CMOP transmissions occur. Pre-Installation Instructions ----------------------------- 1. OBTAIN PATCHES -------------- Obtain the host file BPS_1_15_PSO_IB_PSX_PRCA.KID, which contains the following patches: BPS*1.0*15 PSO*7.0*421 IB*2.0*494 PSX*2.0*74 PRCA*4.5*295 Sites can retrieve VistA software from the following FTP addresses. The preferred method is to FTP the files from: download.vista.domain.ext This will transmit the files from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.fo-albany.domain.ext Hines ftp.fo-hines.domain.ext Salt Lake City ftp.fo-slc.domain.ext The BPS_1_15_PSO_IB_PSX_PRCA.KID host file is located in the anonymous.software directory. Use ASCII Mode when downloading the file. 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 the full directory path where you saved the host file BPS_1_15_PSO_IB_PSX_PRCA.KID (e.g., SYS$SYSDEVICE:[ANONYMOUS]BPS_1_15_PSO_IB_PSX_PRCA.KID). When prompted for "OK to continue with Load? NO//", enter "YES." The following will display: Loading Distribution... BPS PSO IB PSX BUNDLE 8.0 BPS*1.0*15 PSO*7.0*421 IB*2.0*494 PSX*2.0*74 PRCA*4.5*295 Use INSTALL NAME: BPS PSO IB PSX PRCA BUNDLE 8.0 to install this Distribution. 4. RUN OPTIONAL INSTALLATION OPTIONS FOR MULTI-BUILD ------------------------------------------------- From the Installation menu, you may select to use the following options (when prompted for the INSTALL NAME, enter BPS PSO IB PSX PRCA BUNDLE 8.0): 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 data dictionaries 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, data dictionaries, 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 BPS PSO IB PSX PRCA BUNDLE 8.0. a. Choose the Install Package(s) option to start the patch install. b. When prompted for the "Select INSTALL NAME:", enter BPS PSO IB PSX PRCA BUNDLE 8.0. c. When prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//", enter YES unless your system does this in a nightly TaskMan process. d. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//", enter NO. e. When prompted " Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//", enter NO. f. When prompted "Device: HOME//", respond with the correct device but do not queue this install. Post-Installation Instructions ------------------------------ 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. Please also confirm the patch post-installation routine, PSO7P421, was removed if allowed by your Kernel site parameter configuration. Routine Information: ==================== The second line of each of these routines now looks like: ;;7.0;OUTPATIENT PHARMACY;**[Patch List]**;DEC 1997;Build 15 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSO7P421 Before: n/a After: B3926138 **421** Routine Name: PSOBPSSL Before: n/a After: B67314971 **421** Routine Name: PSOBPSSP Before: B8096414 After:B343314123 **289,385,421** Routine Name: PSOBPSU2 Before: B56178581 After: B59152691 **260,287,289,341,290,358,359, 385,421** Routine Name: PSOREJP0 Before: B77667131 After: B79175024 **148,260,287,289,385,421** Routine Name: PSOREJP1 Before:B163331229 After:B182544762 **148,247,260,281,287,289,290, 358,359,385,403,421** Routine Name: PSOREJP2 Before:B119855234 After:B186631764 **148,247,260,287,289,358,385, 403,421** Routine Name: PSOREJP3 Before:B113483777 After:B118994508 **260,287,289,290,358,359,385, 403,421** Routine Name: PSOREJP5 Before: B31405315 After: B33571893 **359,421** Routine Name: PSOREJU1 Before: B89732614 After:B143063763 **148,247,260,287,289,358,359, 385,403,421** Routine Name: PSOREJU2 Before: B50173477 After: B59633051 **148,260,287,341,290,358,359, 385,403,421** Routine Name: PSOREJU3 Before: B77858521 After: B87232979 **287,290,358,359,385,421** Routine Name: PSOREJU4 Before: B31675253 After: B33316257 **289,290,358,359,385,421** Routine Name: PSOREJUT Before: B78935434 After:B104252240 **148,247,260,287,289,290,358, 359,385,403,421** Routine Name: PSORXED Before: B74971866 After: B75008451 **2,16,21,26,56,71,125,201,246, 289,298,366,385,403,421** Routine Name: PSOSULB1 Before: B46991126 After: B43792538 **10,200,264,289,367,421** Routine Name: PSOSULBL Before: B73919713 After: B75522533 **139,173,174,148,200,260,264, 287,289,290,354,421** ============================================================================= User Information: Entered By : GUSTAFSON,ERIC S Date Entered : DEC 18, 2012 Completed By: LOSEY,BILL Date Completed: OCT 01, 2013 Released By : CONSENTINO,ALBERT Date Released : DEC 26, 2013 ============================================================================= Packman Mail Message: ===================== No routines included