============================================================================= Run Date: AUG 25, 2016 Designation: PSO*7*448 Package : PSO - OUTPATIENT PHARMACY Priority: Mandatory Version : 7 SEQ #385 Status: Released Compliance Date: SEP 24, 2016 ============================================================================= Associated patches: (v)PSO*7*427 <<= must be installed BEFORE `PSO*7*448' Subject: MCCF ePHARMACY COMPLIANCE PHASE 3 Category: - Routine - Other - Enhancement (Mandatory) - Data Dictionary 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*448 INTEGRATED BILLING (IB) V. 2.0 IB*2*550 ELECTRONIC CLAIMS MANAGEMENT ENGINE (ECME) V. 1.0 BPS*1*20 CONSOLIDATED MAIL OUTPATIENT PHARMACY (CMOP) V. 2.0 PSX*2*79 PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS*1*192 All five of these patches are being released in the Kernel Installation and Distribution System (KIDS) multi-build distribution. KIDS multi-build name: BPS PSO IB PSX PSS BUNDLE 9.0 KIDS Host File name: BPS_1_20_PSO_IB_PSX_PSS.KID This specific patch contains the following functionality: --------------------------------------------------------- 1. To reduce refill-too-soon third party claim rejections for new prescriptions, prior prescriptions will now be checked for the same patient and drug to verify that 3/4 of the days' supply has elapsed on the prior prescription before the new prescription may be filled. When checking a prior prescription for the same patient and drug, the prior prescription cannot be in a non-verified status, the prior prescription must have a release date, and the prior prescription must have an expiration date no earlier than 120 days prior to the current date. The 3/4 days' supply change applies to prescriptions that are renewed, locally suspended, suspended via CMOP or modified using the SDC - Suspense Date Calc action. 2. When an RRR reject is resubmitted in the foreground, and the claim response is E PAYABLE, the system will now display six fields of additional information to the user: total amount paid, ingredient cost paid, amount of copay/coinsurance, dispensing fee paid, amount applied to periodic deductible and remaining deductible amount. 3. When a claim is rejected and the user is presented with the reject notification, the default value will now be 'Q' (for quit) if the reject is related to ROI and the patient's eligibility is either TRICARE or CHAMPVA. 4. The claim processing messages will now display Veteran eligibility, similar to the displays which indicate TRICARE and CHAMPVA eligibility. 5. The Third Party Payer Rejects - Worklist [PSO REJECTS WORKLIST] has been modified to contain the action VER View ePharmacy Rx on the hidden action menu. 6. The Reject Information screen, which displays any comments on a given reject, has been modified to display comments entered by an Outpatient Pharmacy Electronic Claims Coordinator (OPECC) and flagged as being for the pharmacist. (See BPS*1*20, released with this patch, which modifies the OPECC User Screen to allow the user to flag comments as being for the pharmacist.) 7. The Reject Information screen has been modified to allow the user to perform the Resubmit action on a TRICARE or CHAMPVA non-billable prescription with an open pseudo-rejection code of eT or eC. In this context, though the user is selecting the Resubmit action, the claim will be the first claim submitted for the prescription. 8. The Reject Information screen has been modified to display Veteran eligibility at the top of the screen in the same manner as it is already displaying TRICARE and CHAMPVA for those eligibilities. The Reject Information subsection on that screen has also been modified to display Veteran eligibility. 9. Prior to this patch, the Reject Information screen would sometimes display at the top of the screen a different eligibility than it would in the Reject Information subsection of that same screen. That error has been corrected with this patch. 10. If a rejected prescription has been resolved to a payable Veteran claim, the Reject Information screen will no longer display a reject type and it will now display '**' around the reject status of E PAYABLE. 11. The Reject Information subsection of the Reject Information screen has been modified to display the word RESUBMISSION when a claim has been resubmitted from the ECME User Screen. (This is the same place on the screen where the BACK-BILL indicator is already displayed.) 12. Three actions have been added to the hidden action menu of the OP Medications edit screen. VER View ePharmacy RX. RES Resubmit Claim. The user is not allowed to resubmit a TRICARE or CHAMPVA non-billable prescription from here. REV Reverse Claim. 13. The new Pharmacy Productivity/Revenue Report [PSO PRODUCTIVITY REVENUE RPT] has been created. The option to run this report has been added to the ePharmacy Menu [PSO EPHARMACY MENU]. To facilitate this report, which identifies closed/resolved rejects according to the date closed/resolved, a new cross-reference has been added to file# 52 Prescription - 'CLSDAT', which lists all closed/resolved rejects sorted by Closed Date/Time. 14. When a resubmit is initiated from Outpatient Pharmacy, the system will now capture the user's name and the origin of the resubmit, which are needed for productivity reporting. 15. The Ignored Rejects Report [PSO IGNORED REJECTS REPORT] has been modified to display the Billed Amount and, in the heading of the first page, the message 'Note: Billed Amount is what was billed and cannot be used to determine potential revenue.' Patch Components: ----------------- Files & Fields Associated: File Name (#) New/Modified/ Sub-file Name (#) Field Name (Number) Deleted ------------------- --------------------------------- ------------- PRESCRIPTION (#52) Modified REJECT INFO sub-file (#52.25) Modified CLOSED DATE/TIME (#10) Modified Forms Associated: New/Modified/ Form Name File Name (Number) Deleted --------- ------------------ ------------- N/A Mail Groups Associated: New/Modified/ Mail Group Name Deleted --------------- ------------- N/A Options Associated: New/Modified/ Option Name Type Deleted ----------- ---- ------------- PSO EPHARMACY MENU menu Modified PSO PRODUCTIVITY REVENUE run routine New RPT Protocols Associated: New/Modified/ Protocol Name Deleted/Attach ------------- --------------- PSO BPS MED PROF MENU New PSO BPS PAT INFO MENU New PSO HIDDEN ACTIONS Modified PSO LM BACKDOOR PRTCL USRSCR RESUBMIT New PSO LM BACKDOOR PRTCL USRSCR REVERSE New PSO LM BACKDOOR PRTCL USRSCR VERIFY New PSO LM EXIT2 Attach to Menu PSO PMP CHANGE VIEW Attach to Menu PSO PMP SIG DISPLAY Attach to Menu PSO PMP STATUS GROUP Attach to Menu PSO REJECTS HIDDEN ACTIONS #1 Modified PSO REJECTS VIEW ECME RX New VALM QUIT Attach to Menu Security Keys Associated: New/Modified/ Security Key Name Deleted ----------------- ------------- N/A Templates Associated: New/Modified/ Template Name Type Deleted ------------- ---- ------------- PSO BPS PATIENT INFORMATION LIST New PSO BPS PMP MAIN LIST New Additional Information: N/A New Service Requests (NSRs) --------------------------- 20140411 - Medical Care Collection Fund (MCCF) ePharmacy Compliance Phase 3 Patient Safety Issues (PSIs) ---------------------------- N/A Defect Tracking System Ticket(s) & Overview ------------------------------------------- N/A Test Sites: ----------- VA HEARTLAND - WEST, VISN 15 (589) LEXINGTON VAMC-LEESTOWN (596) HUNTER HOLMES MCGUIRE HOSPITAL - RICHMOND (652) BIRMINGHAM VAMC (521) CENTRAL ARKANSAS HEALTH CARE SYSTEM - LITTLE ROCK (598) Documentation Retrieval Instructions ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to retrieve files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve files directly from a specific server. Sites may retrieve the documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: domain.ext Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www.domain.ext/vdl Title File Name Transfer Mode --------------------------------------------------------------------------- Release Notes/Installation Guide PSO_7_P448_RN.PDF Binary Manager User Manual PSO_7_MAN_UM.PDF Binary Pharmacist User Manual PSO_7_PHARM_UM.PDF Binary Technician User Manual PSO_7_TECH_UM.PDF Binary Technical Manual/Security Guide PSO_7_TM.PDF Binary Patch Installation: Pre/Post Installation Overview ------------------------------ There is a post-install routine associated with this patch named PSO7P448. The purpose of the post-install routine is to: a. Create an index file of all ePharmacy rejections by the date closed/resolved. b. Remove the cached hidden parent menu protocol for the Outpatient Pharmacy List Manager screens. The post-install routine is automatically deleted by the system if allowed by your Kernel site parameters configuration. You may delete this routine if the installation was successful and it is not automatically deleted by KIDS. Installation Instructions ------------------------- Please see the Installation Instructions associated with patch BPS*1.0*20. Routine Information: ==================== The second line of each of these routines now looks like: ;;7.0;OUTPATIENT PHARMACY;**[Patch List]**;DEC 1997;Build 25 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSO7P448 Before: n/a After: B12946571 **448** Routine Name: PSOBPSR1 Before: B37279361 After: B41182836 **260,448** Routine Name: PSOBPSU1 Before: B77585767 After:B113607101 **148,260,281,287,303,289,290, 358,359,385,403,427,448** Routine Name: PSOBPSU3 Before: n/a After: B16909866 **448** Routine Name: PSOPROD1 Before: n/a After:B163837671 **448** Routine Name: PSOPROD2 Before: n/a After:B141671167 **448** Routine Name: PSOREJP0 Before:B124398750 After:B126948878 **148,260,287,289,385,421,427,448** Routine Name: PSOREJP1 Before:B185402834 After:B201229195 **148,247,260,281,287,289,290, 358,359,385,403,421,427,448** Routine Name: PSOREJP2 Before:B181854051 After:B183401384 **148,247,260,287,289,358,385, 403,421,427,448** Routine Name: PSOREJP3 Before:B123136868 After:B184519079 **260,287,289,290,358,359,385, 403,421,427,448** Routine Name: PSOREJU3 Before: B84746710 After: B86770782 **287,290,358,359,385,421,427,448** Routine Name: PSOREJU4 Before: B33316257 After: B82956615 **289,290,358,359,385,421,448** Routine Name: PSOREJUT Before:B107104625 After:B110735693 **148,247,260,287,289,290,358, 359,385,403,421,427,448** Routine Name: PSOSULB1 Before: B43792538 After: B46165452 **10,200,264,289,367,421,448** Routine list of preceding patches: 427 ============================================================================= User Information: Entered By : Date Entered : APR 02, 2015 Completed By: Date Completed: JUL 07, 2016 Released By : Date Released : AUG 25, 2016 ============================================================================= Packman Mail Message: ===================== No routines included