$TXT Created by ZEIGLER,EDWARD L at DEV.LOMA-LINDA.MED.VA.GOV (KIDS) on TUESDAY, 09/03/02 at 14:50 ============================================================================= Run Date: MAR 03, 2003 Designation: IB*2*180 Package : IB - INTEGRATED BILLING Priority: EMERGENCY Version : 2 SEQ #184 Status: Released Compliance Date: MAR 05, 2003 ============================================================================= Associated patches: (v)PRCA*4.5*180<<= must be installed BEFORE `IB*2*180' Subject: HARTFORD/USAA SETTLEMENT Category: - Routine Description: ============ The VA has been in litigation with Hartford and USAA for nonpayment of third party health insurance claims since 1994 and has reached a settlement agreement to accept payment of the claims VA has asserted from 1/1/95 to 12/31/01, the settlement date range. This software is being issued as the cease and desist part of the settlement agreement only. In the cease and desist part of the agreement VA is to discontinue all collection activity of all third party bills for care provided during the settlement date range for the involved insurance carriers. Additionally VA is to discontinue all collection activity of outstanding first party receivables where the VA was aware the patient had third party coverage by one of the involved insurance carriers for dates of care in the settlement date range. ************************************************************************** * Important * * Make sure that all Hartford/USAA receivables that have been referred * * to Regional Council are returned to your site BEFORE running any of * * the options included in this patch. * ************************************************************************** This patch should be installed after PRCA*4.5*180, both patches work together and they should be installed together. ************************************************************************** * This patch MUST be installed and run on all production and legacy * * systems that have any outstanding receivables. * ************************************************************************** Functional Description ---------------------- Included in this IB patch are 4 new options contained in one new menu. The menu is not assigned to existing IB menus and must be assigned to users individually. The main menu is called "Hartford/USAA Settlement Menu" [IBE LITIGATION SETTLEMENT MENU]. The options to complete the settlement agreement should be accomplished in the order they are listed within the menu. Once one option is completed, users will not be allowed to go back to a previous step. Prior to being able to accomplish any of the options, the receivables need to be returned from Regional Council. Regional Council will automatically return all bills they have identified as being part of this settlement agreement. 1. Find and Close Hartford/USAA Bills [IBE FIND SETTLEMENT BILLS], locked with the IB SUPERVISOR key. This option, when invoked, will do a search of the INSURANCE COMPANY (#36) file to attempt to find all insurance companies involved in the settlement. A list of the insurance companies found will then be displayed to the user. At that point the user can add or remove insurance companies from the list. When done with the selection users should select the FINISHED option. At this point users will be asked if they want to run this option in TEST mode. TEST mode will search for bills that might potentially be closed and report any errors the software may encounter. It will also allow users to review the impact to their receivables and resolve some of the error issues prior to running the option in REAL mode. Users may run this option as many times in TEST mode as they choose. After the option has been run in REAL mode, this option can no longer be executed. If a user attempts to run the option in REAL mode before running it in TEST mode, the software will display a warning to caution the user. The list of insurance companies the software will automatically identify is based on the insurance company name containing the following text: HARTFORD KIRK VAN KIRK-VAN KIRKE RETIRED OFFICERS AS SEABURY TROA USAA All reports produced by this settlement are sent in MailMan, allowing sites to print the reports or view them. The MailMan messages are sent to the user that invoked the option to produce the report and to the IB ERROR mail group. 2. Manually Resolve Bills for Settlement [IBE RESOLVE SETTLEMENT BILLS]. This option can only be invoked after the first option has been run in REAL mode. Users will be allowed to select any bills/charges that had errors and decrease them as part of this settlement agreement. It is important that users use this option and not any other options to close out bills associated with this settlement agreement, as this option will add the adjustments to the totals reports. Users will be allowed to use this option to fully or partially close a bill, as appropriate for both 1st and 3rd party bills. 3. Complete Settlement Processing [IBE COMPLETE SETTLEMENT], locked with the IB SUPERVISOR key. This option can only be invoked once and only after the first option has been completed. Users should complete the first option, manually adjust any bills with the second option, and then use this option to complete the processing. This option will produce the summary totals report as well as roll them up to a national reporting. 4. First Party Charge Inquiry [IBE 1ST PARTY CHARGE INQUIRY]. This option is included to allow users to view charge information in the INTEGRATED BILLING (#350) file. They will be asked for a charge ID number. First party charges can be combined onto one bill number in AR. The AR bill may contain some charges that are not part of this settlement and should not be adjusted. Therefore, all references to first party charges are based on the charge ID. With this option, users will be able to view charge information in order to make a decision to include this in the settlement. The charge information will include Type of Charge as well as Date(s) of Service covered by the charge. Technical Description --------------------- This patch contains one new menu that must be individually assigned to users, as it is not added to any existing menu. The new menu 'Hartford/USAA Settlement Menu' [IBE LITIGATION SETTLEMENT MENU] contains 4 new options. The new options are: 1 Find and Close Hartford/USAA Bills [IBE FIND SETTLEMENT BILLS] 2 Manually Resolve Bills for Settlement [IBE RESOLVE SETTLEMENT BILLS] 3 Complete Settlement Processing [IBE COMPLETE SETTLEMENT] First Party Charge Inquiry [IBE 1ST PARTY CHARGE INQUIRY] All reports produced by this settlement are sent in MailMan, allowing sites to print the reports or view them. The MailMan messages are sent to the user that invoked the option to produce the report and the IB ERROR mail group. Also included in this patch are 5 new routines. The routines store data in the ^XTMP global with a purge date set for 90 days. This will allow time for the completion of the litigation settlement processing. A future patch will be issued to remove these options and routines. If you run ^XINDEX on routine IBELIT3, you will receive the following error messages: I IBAR<1 W !!,"Error:",!,$P($T(@(-IBAR)^IBELIT2),";",3) Q P+13 F - Invalid or wrong number of arguments to a function. I $P(IBAR,"^",3)<0 W !!,"Warning:",!,$P($T(@(-$P(IBAR,"^",3))^IBELIT2), ";",3) P+14 F - Invalid or wrong number of arguments to a function. I IBAR<1 W !!,"Error:",!,$P($T(@(-IBAR)^IBELIT2),";",3) Q F+7 F - Invalid or wrong number of arguments to a function. I $P(IBAR,"^",3)<0 W !!,"Warning:",!,$P($T(@(-$P(IBAR,"^",3))^IBELIT2), ";",3) F+8 F - Invalid or wrong number of arguments to a function. The error messages are a result of ^XINDEX's inability to understand indirection inside the $TEXT function. These lines of code have been tested and will function without error. Install Time - Less than 5 minutes ================INSTALLATION INSTRUCTIONS ================= 1. LOAD TRANSPORT GLOBAL --------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. DISABLE ROUTINE MAPPING (DSM for Open VMS sites only) ----------------------- Disable routine mapping on all systems for the routines listed in step 3 below. NOTE: If the routines included in this patch are not currently in your mapped routine set, please skip this step. 3. ROUTINES 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: ;;2.0;INTEGRATED BILLING;**[patch list]**;21-MAR-94 CHECK^XTSUMBLD results Routine Before Patch After Patch Patch List ------- ------------ ----------- ---------- IBELIT n/a 18586855 180 IBELIT1 n/a 11687000 180 IBELIT2 n/a 15851702 180 IBELIT3 n/a 8716038 180 IBELIT4 n/a 8091284 180 Total number of routines - 5 4. START UP KIDS ------------- Start up the Kernel Installation and Distribution System Menu [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: 5. Select Installation Option: -------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter IB*2.0*180): 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 DD's 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, 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. 6. Select Installation Option: Install Package(s) ---------------------------------------------- **This is the step to start the installation of this KIDS patch: a. Choose the Install Package(s) option to start the patch install. b. When prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//" answer NO c. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//" answer NO d. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//" answer NO 7. REBUILD MAPPED ROUTINE(S) (DSM for Open VMS sites only) ------------------------- Optional - Include the routines distributed with this patch in the mapped routine set. NOTE: This step is only necessary if you performed step 2 or if you wish to include the routines in your mapped set. Routine Information: ==================== Routine Name: - IBELIT Routine Checksum: Routine Name: - IBELIT1 Routine Checksum: Routine Name: - IBELIT2 Routine Checksum: Routine Name: - IBELIT3 Routine Checksum: Routine Name: - IBELIT4 Routine Checksum: ============================================================================= User Information: Entered By : ZEIGLER,EDWARD L Date Entered : APR 30, 2002 Completed By: MOHSENE,DIANA Date Completed: MAR 03, 2003 Released By : HOLDEN,BARBARA A Date Released : MAR 03, 2003 ============================================================================= Packman Mail Message: ===================== $END TXT