$TXT Created by GUSTIN,ERIC at MNTVLL.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 03/10/03 at 15:16 ============================================================================= Run Date: MAR 11, 2003 Designation: EAS*1*23 Package : EAS - ENROLLMENT APPLICATION Priority: Mandatory Version : 1 SEQ #21 Status: Released Compliance Date: MAR 27, 2003 ============================================================================= Associated patches: (v)IB*2*204 <<= must be installed BEFORE `EAS*1*23' Subject: IVM PROJECT EDB-VISTA DATA EXCHANGE Category: - Routine Description: ============ ********************************************************************* ** NOTE: This patch has been assigned a compliance date of 3-27-03 ** ********************************************************************* OVERVIEW: =========== The Health Eligibility Center (HEC) has reinstated the Income Verification Matching program, which matches a veteran's self-reported income (that is below the Means Test Threshold) with information obtained from the Internal Revenue Service (IRS) and Social Security Administration (SSA). It is anticipated that HEC staff will begin closing cases the end of March 2003. In order to transmit this information to site(s) of record for purposes of billing and collection, the Business Office is requiring that all sites install no later than March 27, 2003 It should be noted that initially, only means tests conducted for income year 2001 are subject to the income verification matching process. The software for this patch, EAS*1*23 and associated patch, IVM*2*69, are not being distributed through the National Patch Module. These patches are being distributed as a single KIDS software distribution (host file). This patch contains the informational portion of EAS*1*23 and provides field personnel with instructions on how to acquire, install and implement the patch software. Please refer to IVM*2*69 for installation instructions. This patch addresses the following E3R(s): ------------------------------------------ There are no E3Rs associated with this patch This patch addresses the following NOIS message(s): --------------------------------------------------- There are no NOIS's associated with this patch FUNCTIONAL DESCRIPTION ====================== The two patches (EAS*1*23 and IVM*2*69) will allow the data exchange of IVM Verified Means Test Transmission (ORU~Z06) and IVM Billing/Collection Data Transmission (ORU~Z09) HL7 messages between the VAMC sites and the EDB (new Enrollment database). Once HEC has received information from IRS and SSA, a review of the information is done. After that review, if it is determined that the veteran is liable for co-payments, the case will be closed, converted to either Means Test Co-pay Required or GMT Co-pay Required as appropriate. This will trigger an ORU~Z06 to the veteran site(s)of record. The receipt of the ORU~Z06 adds an entry in the ANNUAL MEANS TEST file (#408.31), this test becomes primary for the income year. Receipt of the ORU~Z06 also alert billing that charges may be applied to any treatment received. Once charges and/or payments are applied, an ORU~Z09 will be sent to the EDB from the medical center. If it is later determined that a veteran should not have been converted to a co-payment required status, HEC Staff will initiate a process to send another ORU~Z06 to the veteran site(s) of record and reverts the veteran to his/her previous means test status. TECHNICAL DESCRIPTION ===================== A new receiver driver process, EASPREC2, a clone of IVMPREC2 will be invoked from the EDB protocol when an ORU-Z06 from the EDB is received. The new Z06 receiver, EASPREC7 - clone of IVMPREC7, will then be executed that will create or delete the Z06 IVM Means Test. Creation or deletion is based upon value received in the ORU-Z06 in segment ZIV sequence 8 (IVM CASE STATUS). IVM Case Status: Value of 1 = Create/Update Z06 MT, Close Case and Mark REASON CODE as 'Converted' Value of 0 = Cancel Z06 MT and Mark REASON CODE as 'Not Convert' If Z06 MT and IVM Case Status is 1 and Z06 MT does not exist Then Create new Z06 MT (new Z06 MT becomes primary and existing MT becomes non-primary) Assign REASON CODE of 'Converted' in #301.5 If Z06 MT already exists Then If IVM Case Status is 0 Then Delete Z06 MT for income year and return old MT to primary Change REASON CODE from 'Converted' to 'Not Converted' in #301.5 If IVM Case Status is 1 Then Update MT Z06 and Close/Convert Case Else (Z06 MT, IVM Case Status=0 and Z06 MT does not exist) Send back 'AE' to EDB indicating MT Z06 not available for cancellation Based upon the receipt and subsequent uploading of the Z06, billing is notified to begin back billing for that income year. EASPTRN5 - clone of IVMPTRN5, will produce a ORU-Z09, IVM billing transmission, that will be sent to the EDB. SOFTWARE AND DOCUMENTATION RETRIEVAL ==================================== The software for this patch is being distributed in host file IVM_2_P69.KID. The host file will contain the two KIDS builds. The first build will be the Income Verification Match patch, IVM*2*69, the second build will be the Enrollment Application System patch, EAS*1*23. Please refer to the 'Software and Documentation Retrieval' section of the IVM*2*69 patch description for instructions on how to acquire the patch software and documentation. ROUTINE SUMMARY =============== The following is a list of the routine(s) included in this patch. The second line of each of these routine(s) will look like: ;;1.0;ENROLLMENT APPLICATION SYSTEM;**[patch list]**;Mar 15, 2001 CHECK^XTSUMBLD results Routine Before Patch After Patch Patch List ------- ------------ ----------- ---------- EASPREC2 N/A 2554259 23 EASPREC7 N/A 12910423 23 EASPTRN5 N/A 6463576 23 EASUFNC3 N/A 4763108 23 EASUM1 N/A 5525155 23 Total Number of Routines - 5 INSTALLATION INSTRUCTIONS ========================= Please refer to the 'Installation Instructions' section of the IVM*2*69 patch description for instructions on how to install the patch software Routine Information: ==================== Routine Name: - EASUM1 This is a copy of IVMUM1 - MEANS TEST UPLOAD DRIVER. This program will create the Means Test record in #408.31 for the new Z06 MT and invoke the Billing Event Driver. Routine Checksum: Routine Name: - EASPREC2 This is a copy of IVMPREC2 - ROUTE INCOMING HL7 (ORU) MESSAGES BY EVENT TYPE. EASPREC2 deals only with the Z06 message for IVM Case Closure. Routine Checksum: Routine Name: - EASPREC7 This is a copy of IVMPREC7 - ROUTINE TO PROCESS INCOMING (Z06 EVENT TYPE) HL7 MESSAGE. EASPREC7 performs the following functions: Dependent upon type of Z06 sent perform the following; IVM Case Status: Value of 1 = Create/Update Z06 MT, Close Case and Mark REASON CODE as 'Converted' Value of 0 = Cancel Z06 MT and Mark REASON CODE as 'Not Converted' If Z06 MT and IVM Case Status is 1 and Z06 MT does not exist Then Create new Z06 MT (new Z06 MT becomes primary and existing MT becomes non-primary) Assign REASON CODE of 'Converted' in #301.5 If Z06 MT already exists Then If IVM Case Status is 0 Then Delete Z06 MT for income year and return old MT to primary Change REASON CODE from 'Converted' to 'Not Converted' in #301.5 If IVM Case Status is 1 Then Update MT Z06 and Close/Convert Case Else (Z06 MT, IVM Case Status=0 and Z06 MT does not exist) Send back 'AE' to Edb indicating MT Z06 not available for cancellation Routine Checksum: Routine Name: - EASPTRN5 This is a copy of IVMPTRN5 - NIGHTLY BILLING TRANSMISSION PROCESSING. EASPTRN5 is invoked by IVMPTRN5 if the 'DISABLE TEXT' field in #101 has no value for the EAS EDB ORU-Z09 SERVER protocol. Program EASUFNC3 - FT1 HL7 message generation - is called by this program. Routine Checksum: Routine Name: - EASUFNC3 This is a copy of IVMUFNC3 - BILLING TRANSMISSION UTILITIES. The FT1 segment has been enhanced to send the amount collected #301.61/.09 and amount billed #301.61/.08 in separate fields seq. 11 and 12, respectively. Routine Checksum: ============================================================================= User Information: Entered By : GUSTIN,ERIC Date Entered : DEC 17, 2002 Completed By: DRESS,KEN Date Completed: MAR 10, 2003 Released By : KOVACH,STUART Date Released : MAR 11, 2003 ============================================================================= Packman Mail Message: ===================== $END TXT