============================================================================= Run Date: SEP 14, 2006 Designation: BPS*1*3 Package : BPS - E CLAIMS MGMT ENGINE Priority: Mandatory Version : 1 SEQ #2 Status: Released Compliance Date: OCT 15, 2006 ============================================================================= Associated patches: (v)BPS*1*1 <<= must be installed BEFORE `BPS*1*3' Subject: HIPAA/NCPDP - NEW OPTION AND OTHER UPDATES Category: - Routine - Enhancement (Mandatory) - Data Dictionary - Informational - Input Template - Other Description: ============ This patch supports the National Council for Prescription Drug Programs (NCPDP) standard which was adopted under the Healthcare Insurance Portability and Accountability Act (HIPAA) for pharmacy claims. This patch is one of six to be released. Three patches will be released in a KIDS multi-build distribution containing: BPS*1*3, PSO*7*247, and IB*2*342. Three patches will be released individually and they are: PRCA*4.5*247, PSX*2*62, and PSS*1*115. There is no recommended order to installing the stand-alone patches and they can be installed independently of the multi-build as there is no dependency between the multi-build distribution and the stand-alone patches. For more specific instructions please refer to the installation steps provided in each of the stand-alone patches. Enhancements included in the release of the six patches are a new option that will enable the user to reopen a closed Electronic Claims Management Engine (ECME) claim; updates to the Rx Activity Log; and permanent storage of claims activity information as reported by the ECME Billing Events Report. This patch includes the following modifications: 1. ECME User Screen option [BPS USER SCREEN] 1.1. The ECME User Screen option [BPS USER SCREEN] was modified to display the Fill Date for the Rx on the ECME User Screen. 1.2. The ECME User Screen option [BPS USER SCREEN] was modified to display the Reject Code/Reason for each Rx when the user is utilizing the Close Rejected Claim [BPS PRTCL USRSCR CLOSE] protocol. 1.3. The new Resubmit Claim w/EDITS [BPS PRTCL USRSCR RESUBMIT EDITS] protocol was introduced and placed in the ECME User Screen Hidden Actions [BPS PRTCL USRSCR HIDDEN ACTIONS] protocol menu of the ECME User Screen option [BPS USER SCREEN]. This was done in order to provide a hidden option to enable three data fields (Relationship Code, Person Code, and Prior-Authorization Number) on previously rejected electronic claims to be edited and for the claim to be resubmitted (containing the new edit information). 2. Re Open CLOSED Claim option [BPS REOPEN CLOSED CLAIM] This new menu option was introduced to allow the user to re-open an electronic claim after it has been closed. The new option will prompt the user to enter a patient name and date range to select closed claims for the re-open menu screen. The user is then able to select one closed claim, enter a re-open comment, and re-open it. The Re Open CLOSED Claim option [BPS REOPEN CLOSED CLAIM] calls an Integrated Billing (IB) function to update the Claim Tracking record and create a REOPEN event for the ECME Billing Events Report [IB ECME BILLING EVENTS] option. 3. Payable Claims Report option [BPS RPT PAYABLE] The Payable Claims Report [BPS RPT PAYABLE] was incorrectly deducting the Patient Paid Amount from the Total Payment Amount in its calculation for the $INS RESPONSE column on the report. The report has been changed to no longer deduct the patient paid amount when determining the $INS RESPONSE value. 4. Register Pharmacy with Austin Automation Center option [BPS SETUP REGISTER PHARMACY] A new field (STATUS (#.1)) has been added to the BPS PHARMACIES (#9002313.56) file. The pharmacy registration message that is sent to the Austin Automation Center (AAC) now indicates whether the pharmacy is active or inactive based on the value of this field. Users can change the value of this field via the Register with Austin Automation Center option [BPS SETUP REGISTER PHARMACY]. For new BPS pharmacies, this field is defaulted to ACTIVE. This option was also changed so the BPS Pharmacy NAME (#.01) field of the BPS PHARMACIES (#9002313.56) file can no longer be edited or deleted. 5. Edit ECME Pharmacy Data option [BPS SETUP PHARMACY] The Edit ECME Pharmacy Data option [BPS SETUP PHARMACY] was modified to prevent linkage of an OUTPATIENT SITE file (#59) entity to more than one ECME BPS PHARMACIES file (#9002313.56) record. In addition, the option was modified to prevent users from editing the NCPDP field (#.02) and the NAME field (#.01) of the BPS PHARMACIES (#9002313.56) file. The new STATUS (#.1) field of the BPS PHARMACIES (#9002313.56) file, which indicates whether the BPS Pharmacy is ACTIVE or INACTIVE, is also displayed in this option. 6. View/Unstrand Claims Not Completed option [BPS UNSTRAND SCREEN] This option was modified to prevent errors from occurring when a site has no completed claims. 7. Replacing direct access reads to the DRUG file (#50) This patch modifies a number of BPS namespace routines in order to eliminate any direct access reads to the DRUG file (#50). Each direct access read occurrence has been modified to utilize approved functions designed by the Pharmacy Encapsulation team. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- There is no NSR associated with this patch. This patch addresses the following Remedy Ticket(s): ---------------------------------------------------- 1. Remedy Ticket 140691 (Deactivating a Registered Pharmacy) 2. Remedy Ticket 150861 (Multiple Error Messages in Error Trap) 3. Remedy Ticket 148711 (ECME Payable Claims Detail Report (EVNT) does not accurately reflect the $INS RESPONSE field) Overview of Remedy Ticket(s): ----------------------------- 1. Remedy Ticket 140691 (Deactivating a Registered Pharmacy) - Site cannot deactivate a registered pharmacy. The ECME code has no functionality for sending a deactivate transaction (MDC). In addition, while researching the issue it was noted that the Register Pharmacy with Austin Automation Center option [BPS SETUP REGISTER PHARMACY] allows a user to delete a BPS Pharmacy, which could leave dangling pointers in the BPS TRANSACTION (#9002313.56) file and result in data degradation. A new STATUS (#.1) field was added to the BPS PHARMACIES (#9002313.56) file and the users can edit this field via the Register Pharmacy with Austin Automation Center option [BPS SETUP REGISTER PHARMACY]. The same option was also modified to prevent the deletion of a BPS Pharmacy. 2. Remedy Ticket 150861 (Multiple Error Messages in Error Trap) - The View/Unstrand Claims Not Completed [BPS UNSTRAND SCREEN] option is generating errors. This error occurs when a site has no completed claims. The code was corrected so that the option works correctly even if there are no completed claims. 3. Remedy Ticket 148711 (ECME Payable Claims Detail Report (EVNT) does not accurately reflect the $INS RESPONSE field) - The Payable Claims Report option [BPS RPT PAYABLE] was incorrectly deducting the Patient Paid Amount from the Total Payment Amount in its calculation for the $INS RESPONSE column on the report. The report has been changed to no longer deduct the patient paid amount when determining the $INS RESPONSE value. Test Sites: =========== ANN ARBOR, MI CENTRAL ARKANSAS DETROIT, MI HEARTLAND WEST, KS IRON MOUNTAIN, MI LOUISVILLE, KY NEW YORK HARBOR HCS SAGINAW, MI Components Sent With Patch -------------------------- The following is a list of the routines included in this patch. The second line of each of these routines now looks like: ;;1.0;E CLAIMS MGMT ENGINE;**[patch list]**;JUN 2004 CHECK^XTSUMBLD results Routine Before Patch After Patch Patch List ------- ------------ ----------- ---------- BPS01P3 n/a 8023249 **3** BPSBUTL 9217332 10976937 **1,3** BPSJINIT 7789295 7905746 **1,3** BPSJPREG 3726869 3821516 **1,3** BPSJZQR 1306784 1336430 **1,3** BPSNCPD1 7693719 7318525 **1,3** BPSNCPDP 14076183 14202229 **1,3** BPSOSCD 11174923 11193580 **1,3** BPSOSI 7789622 8136712 **1,3** BPSOSIY 15365846 15534993 **1,3** BPSOSO2 6339508 6550516 **1,3** BPSOSQB 7074743 7088241 **1,3** BPSOSQC 2500650 2525369 **1,3** BPSPHAR 683461 871042 **1,3** BPSREOP n/a 2077307 **3** BPSREOP1 n/a 7510736 **3** BPSRES n/a 16308641 **3** BPSRPT2 6523957 6711122 **1,3** BPSRPT3 6495145 6471421 **1,3** BPSRPT5 17241313 18771792 **1,3** BPSRPT6 7615887 8200085 **1,3** BPSRPT7 13431732 13155664 **1,3** BPSRPT8 12580468 14692735 **1,3** BPSSCR02 9958445 10075769 **1,3** BPSSCRCL 14208208 14237209 **1,3** BPSSCRRS 7782893 7878712 **1,3** BPSSCRU2 6407758 6053925 **1,3** BPSSCRU4 9866695 9881333 **1,3** BPSSCRU6 n/a 1737700 **3** BPSUSCR4 4271807 4312101 **1,3** BPSUTIL 970601 1503066 **1,3** Total number of routines: 31 Total number of routines modified: 26 Total number of new routines: 5 CHECK1^XTSUMBLD results (new method) Routine Before Patch After Patch Patch List ------- ------------ ----------- ---------- BPS01P3 n/a 23053500 **3** BPSBUTL 31009303 47119211 **1,3** BPSJINIT 34990565 36410434 **1,3** BPSJPREG 10988509 11507539 **1,3** BPSJZQR 2252225 2363888 **1,3** BPSNCPD1 29379701 42956727 **1,3** BPSNCPDP 69936802 53857295 **1,3** BPSOSCD 46650072 46703234 **1,3** BPSOSI 31817055 32863307 **1,3** BPSOSIY 63037974 63767272 **1,3** BPSOSO2 32131284 33102462 **1,3** BPSOSQB 46182613 46504388 **1,3** BPSOSQC 5188299 5309915 **1,3** BPSPHAR 990047 1377330 **1,3** BPSREOP n/a 3927200 **3** BPSREOP1 n/a 27740075 **3** BPSRES n/a 50532069 **3** BPSRPT2 34444824 36670735 **1,3** BPSRPT3 37369482 37239882 **1,3** BPSRPT5 76227568 81419948 **1,3** BPSRPT6 67527873 68506243 **1,3** BPSRPT7 69601787 70034619 **1,3** BPSRPT8 54566522 73476726 **1,3** BPSSCR02 43889561 44572484 **1,3** BPSSCRCL 75438118 75932788 **1,3** BPSSCRRS 19576084 20547842 **1,3** BPSSCRU2 62609575 58140964 **1,3** BPSSCRU4 58150912 58171346 **1,3** BPSSCRU6 n/a 5405845 **3** BPSUSCR4 10796851 10854593 **1,3** BPSUTIL 1870851 4023220 **1,3** Total number of routines: 31 Total number of routines modified: 26 Total number of new routines: 5 The following is a list of files included in this patch: UP SEND DATA USER DATE SEC. COMES SITE RSLV OVER FILE # NAME DD CODE W/FILE DATA PTS RIDE ------------------------------------------------------------------------ 9002313.02 BPS CLAIMS YES NO NO NO Partial DD: subDD: 9002313.02 fld: 906 fld: 907 fld: 908 9002313.51 BPS DATA INPUT YES NO NO NO Partial DD: subDD: 9002313.51 fld: 1.13 9002313.56 BPS PHARMACIES YES NO NO NO Partial DD: subDD: 9002313.56 fld: .1 subDD: 9002313.5601fld: .01 The following is a list of fields included in this patch: Field Name (Number) File Name (Number) Subfile Name (Number) ----------------------- ----------------------------------------- STATUS .1 BPS PHARMACIES 9002313.56 OUTPATIENT SITE .01 BPS PHARMACIES 9002313.56 OUTPATIENT SITE 9002313.5601 REOPENED DATE/TIME 906 BPS CLAIMS 9002313.02 REOPENED BY 907 BPS CLAIMS 9002313.02 REOPENED COMMENT 908 BPS CLAIMS 9002313.02 NCPDP OVERRIDES 1.13 BPS DATA INPUT FILE 9002313.51 The following is a list of templates included in this patch: Template Name File Name (Number) ------------- ------------------ BPSJ PHARMACY SITE ENTER/EDIT FILE #9002313.56 The following is a list of options included in this patch: Option Name Type New/Modified ----------- ---- ------------ BPS APP REG TASKMAN run routine Modified BPS MANAGER MENU menu Modified BPS MENU MAINTENANCE menu Modified BPS MENU RPT CLAIM STATUS menu Modified BPS MENU RPT MAIN menu Modified BPS MENU RPT OTHER menu Modified BPS NIGHTLY BACKGROUND JOB run routine Modified BPS REOPEN CLOSED CLAIM run routine New BPS RPT CLOSED CLAIMS run routine Modified BPS RPT CMOP/ECME ACTIVITY run routine Modified BPS RPT NOT RELEASED run routine Modified BPS RPT PAYABLE run routine Modified BPS RPT PAYER SHEET DETAIL run routine Modified BPS RPT RECENT TRANSACTIONS run routine Modified BPS RPT REJECTION run routine Modified BPS RPT REVERSAL run routine Modified BPS RPT SETUP PHARMACIES print Modified BPS RPT TOTALS BY DAY run routine Modified BPS RPT TURNAROUND STATS run routine Modified BPS SETUP BASIC PARAMS run routine Modified BPS SETUP MENU menu Modified BPS SETUP PHARMACY run routine Modified BPS SETUP REGISTER PHARMACY run routine Modified BPS STATISTICS SCREEN run routine Modified BPS UNSTRAND SCREEN run routine Modified BPS USER SCREEN run routine Modified BPSMENU menu Modified The following is a list of protocols included in this patch: Protocol Name ----------- ------------ BPS PRTCL REOPEN SEND TO SITE BPS PRTCL REOPEN EXIT SEND TO SITE BPS PRTCL REOPEN MENU SEND TO SITE BPS PRTCL USRSCR DEVELOPER LOG ATTACH TO MENU BPS PRTCL USRSCR HIDDEN ACTIONS SEND TO SITE BPS PRTCL USRSCR RESUBMIT EDITS SEND TO SITE BPS VALM DOWN A LINE ATTACH TO MENU BPS VALM FIRST SCREEN ATTACH TO MENU BPS VALM GOTO PAGE ATTACH TO MENU BPS VALM LAST SCREEN ATTACH TO MENU BPS VALM NEXT SCREEN ATTACH TO MENU BPS VALM PREVIOUS SCREEN ATTACH TO MENU BPS VALM PRINT SCREEN ATTACH TO MENU BPS VALM UP ONE LINE ATTACH TO MENU VALM LEFT ATTACH TO MENU VALM PRINT LIST ATTACH TO MENU VALM QUIT ATTACH TO MENU VALM REFRESH ATTACH TO MENU VALM RIGHT ATTACH TO MENU VALM SEARCH LIST ATTACH TO MENU VALM TURN ON/OFF MENUS ATTACH TO MENU The following is a list of list templates included in this patch: List Template: -------------- BPS LSTMN ECME REOPEN SEND TO SITE BPS LSTMN ECME USRSCR SEND TO SITE Pre/Post Installation Overview ------------------------------ The post-install routine was designed to remove duplicate Outpatient Site entities from the BPS PHARMACIES file (#9002313.56). The post-install process sets the new (#.1) STATUS field (#.1) in the BPS PHARMACIES file (#9002313.56) to ACTIVE for all existing ECME Pharmacy entities in the BPS PHARMACIES file (#9002313.56). Documentation Retrieval: ======================== Sites may retrieve documentation in one of the following ways: 1. The preferred method is to FTP the files from download.vista.med.va.gov, which will transmit the files from the first available FTP server. 2. Sites may also elect to retrieve documentation directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The documentation distribution includes: FILE NAME DESCRIPTION ------------------------------------------------------------------------ BPS_1_UM_R0806.PDF ECME V. 1.0 User Manual BPS_1_TM_R0806.PDF ECME V. 1.0 Technical Manual/Security Guides PSO_7_P247_UM_CP.PDF OP V. 7.0 User Manual Change Pages 3. Documentation can also be retrieved from the VistA Documentation Library (VDL) on the Internet at the following address, http://www.va.gov/vdl. Note: When downloading these files from the ftp server, set the file format to binary mode. Installation Instructions: ========================== Considerations: 1. Do not install the patch when ECME claims are being generated by the BPS Nightly Background Job [BPS NIGHTLY BACKGROUND JOB]. Wait for this job to finish or complete the installation before this job starts. 2. Do not install the patch when prescriptions are being transmitted to CMOP. Wait for the CMOP transmission to finish or complete the installation before the transmission starts. 3. It is recommended that the BPS PSO IB BUNDLE 1.0 multi-build be installed or QUEUED to be installed during off-peak hours to avoid disruptions. Due to a conversion process performed by the IB*2*342 post-install routine, installation time can be quite extensive (taking an estimated one to four hours to complete) for those sites that have been activated with the HIPAA NCPDP - GLOBAL software for more than one month. For those sites that have not yet been activated with the HIPAA NCPDP - GLOBAL software, the installation time will be less than 10 minutes. The conversion process mentioned above will not affect pharmacy and billing operations, therefore, users can be on the system during the IB*2*342 post-installation process. However, it is recommended that the ECME Billing Events Report [IB ECME BILLING EVENTS] option be disabled during installation as it may display irregular results if run during the installation process (see item 11 in the installation steps). To Install the BPS PSO IB BUNDLE 1.0 multi-build distribution: 1. Obtain the host file BPS_1_3_PSO_IB.KID, which contains the following three patch installs: BPS*1.0*3 PSO*7.0*247 IB*2.0*342 Sites can retrieve VistA software from the following FTP addresses. The preferred method is to FTP the files from: download.vista.med.va.gov 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.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The BPS_1_3_PSO_IB.KID host file is located in the anonymous.software directory. Use ASCII Mode when downloading the file. 2. From the Kernel Installation and Distribution System (KIDS) Menu, select the Installation menu. 3. From the Installation menu, select the Load a Distribution option. 4. When prompted for "Enter a Host File:", enter the full directory path where you saved the host file BPS_1_3_PSO_IB.KID (e.g., SYS$SYSDEVICE:[ANONYMOUS]BPS_1_3_PSO_IB.KID). 5. When prompted for "OK to continue with Load? NO//", enter "YES." The following will display: Loading Distribution... BPS PSO IB BUNDLE 1.0 BPS*1.0*3 PSO*7.0*247 IB*2.0*342 Use INSTALL name BPS PSO IB BUNDLE 1.0 to install this Distribution. 6. From the Installation menu, you may select to use the following options: (when prompted for "Select INSTALL NAME:", enter "BPS PSO IB BUNDLE 1.0") 6.1. Backup a Transport Global - this option will create a backup message of any routines exported with the patch. It will NOT backup any other changes such as Data Dictionaries (DDs) or templates. 6.2. Compare Transport Global to Current System - this option will allow you to view all changes that will be made when the patch is installed. It compares all components of the patch (routines, DDs, templates, etc.). 6.3. Verify Checksums in Transport Global - this option will ensure the integrity of the routines that are in the transport global. 7. Back in the Installation menu, select the Install Package(s) option. 8. When prompted for the "Select INSTALL NAME:", enter "BPS PSO IB BUNDLE 1.0." 9. When prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? Yes//" for the BPS*1.0*3 build, respond "YES." For the build IB*2.0*342, respond "NO." 10. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//", respond "NO." 11. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//", enter "YES" 11.1 When prompted 'Enter options you wish to mark as 'Out Of Order':' Enter the following options: ECME Billing Events Report [IB ECME BILLING EVENTS] 11.2 When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press 12. When prompted, "Device: Home//" respond with the correct device or queue this to P-Message. 13. For sites that have already activated ePharmacy functionality, there is a post-installation step, which is to check the BPS NCPDP Logical link. In most cases, the link will be running (STATE=ENABLED or INACTIVE). If this link is not running it will need to be restarted. To turn on the logical link, run the Start/Stop Links [HL START] option located on the Filer and Link Management Options option [HL MENU FILER LINK MGT] submenu of the HL7 Main Menu [HL MAIN MENU] option. When prompted for the HL LOGICAL LINK NODE, enter "BPS NCPDP", and when prompted for "Method for running the receiver", choose the default of B - Background to enable the logical link. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: BPS01P3 Before: n/a After: B23053500 **3** Routine Name: BPSBUTL Before: B31009303 After: B47119211 **1,3** Routine Name: BPSJINIT Before: B34990565 After: B36410434 **1,3** Routine Name: BPSJPREG Before: B10988509 After: B11507539 **1,3** Routine Name: BPSJZQR Before: B2252225 After: B2363888 **1,3** Routine Name: BPSNCPD1 Before: B29379701 After: B42956727 **1,3** Routine Name: BPSNCPDP Before: B69936802 After: B53857295 **1,3** Routine Name: BPSOSCD Before: B46650072 After: B46703234 **1,3** Routine Name: BPSOSI Before: B31817055 After: B32863307 **1,3** Routine Name: BPSOSIY Before: B63037974 After: B63767272 **1,3** Routine Name: BPSOSO2 Before: B32131284 After: B33102462 **1,3** Routine Name: BPSOSQB Before: B46182613 After: B46504388 **1,3** Routine Name: BPSOSQC Before: B5188299 After: B5309915 **1,3** Routine Name: BPSPHAR Before: B990047 After: B1377330 **1,3** Routine Name: BPSREOP Before: n/a After: B3927200 **3** Routine Name: BPSREOP1 Before: n/a After: B27740075 **3** Routine Name: BPSRES Before: n/a After: B50532069 **3** Routine Name: BPSRPT2 Before: B34444824 After: B36670735 **1,3** Routine Name: BPSRPT3 Before: B37369482 After: B37239882 **1,3** Routine Name: BPSRPT5 Before: B76227568 After: B81419948 **1,3** Routine Name: BPSRPT6 Before: B67527873 After: B68506243 **1,3** Routine Name: BPSRPT7 Before: B69601787 After: B70034619 **1,3** Routine Name: BPSRPT8 Before: B54566522 After: B73476726 **1,3** Routine Name: BPSSCR02 Before: B43889561 After: B44572484 **1,3** Routine Name: BPSSCRCL Before: B75438118 After: B75932788 **1,3** Routine Name: BPSSCRRS Before: B19576084 After: B20547842 **1,3** Routine Name: BPSSCRU2 Before: B62609575 After: B58140964 **1,3** Routine Name: BPSSCRU4 Before: B58150912 After: B58171346 **1,3** Routine Name: BPSSCRU6 Before: n/a After: B5405845 **3** Routine Name: BPSUSCR4 Before: B10796851 After: B10854593 **1,3** Routine Name: BPSUTIL Before: B1870851 After: B4023220 **1,3** ============================================================================= User Information: Entered By : BLAESER,DAVID Date Entered : APR 24, 2006 Completed By: EVERETT,BRIAN Date Completed: SEP 07, 2006 Released By : BOTTINI,STEVE Date Released : SEP 14, 2006 ============================================================================= Packman Mail Message: ===================== No routines included