$TXT Created by HOLLOWAY,THOMAS J at DEVFEY.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 02/24/03 at 17:39 ============================================================================= Run Date: MAR 04, 2003 Designation: IB*2*200 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #185 Status: Released Compliance Date: APR 04, 2003 ============================================================================= Associated patches: (v)IB*2*137 <<= must be installed BEFORE `IB*2*200' Subject: BATCH ENTRY FOR PROVIDER ID'S Category: - Routine Description: ============ NOIS addressed with this patch: CTX-0802-72619 With the implementation of the EDI Electronic billing solution, it became apparent that there was a need to provide a more efficient means of entering the large numbers of provider ID's that are required for specific insurance carriers. These are the ID numbers entered in Box 24K on the HCFA 1500 form. The IDs used in this patch description are only examples. The IDs your BCBS payer has assigned to your site may have a different format. Patch IB*2.0*200 provides a way to batch enter provider ID's from a delimited or fixed length file for those providers whose name resides in the NEW PERSON (#200) file. This patch also modifies the existing way in which the provider ID is entered using the Manual INSURANCE CO BATCH ID entry action located within the PROVIDER ID MAINTENANCE [IBCE PROVIDER MAINT ] option. The option currently is very time consuming as it searches multiple files for the selection of provider names. The manual Provider ID entry has been modified to eliminate this time consuming search for provider information. Instructions for using the Manual procedure are listed later in this document. Refer to NOIS CTX-0802-72619. Procedure for entering Provider ID's using a fixed length or delimited file: You will need to obtain a file of provider data. This may come from the insurance company but will probably be one that you have created. The file must contain, at a minimum, the provider Name, SSN and Provider ID in order for the automated filing of the ID number to work. The SSN must match exactly with the NEW PERSON (#200) file but the name does not. Additional fields may exist in your file but will be ignored by the INS CO BATCH ID ENTRY option. Depending on how you obtain your file of provider data, you may end up with one of the following three most likely situations: 1) a file with fixed length fields 2) a file with comma delimited fields 3) a spreadsheet file (e.g. Excel or Lotus) If the file you have is a spreadsheet, you will need to convert it to one of the other two types, preferably comma delimited. For Excel files this can be done with 'Save As' and selecting CSV(MS-DOS) as the file type. Consult your spreadsheet's Help text for more information on saving the file in this format. This file will then need to be copied to a directory or folder on your production system so that it can be read by the automated loading function. Consult your IRM staff if you are not familiar with this process. Format examples: The records in a fixed length file will look something like this- 333445555JONES,JENNIFER JJ398238 10/15/1994UROLOGY 123894321KEISER,WILLIAM JAMES WK714347 07/04/1986CARDIOLOGY 484777666MACKINTOSH,CRAIG CM545456 02/14/1999OTOLARYNGOLOGY while the records in a comma delimited file will look something like- 333445555,"JONES,JENNIFER",JJ398238,10/15/1994,UROLOGY 123894321,"KEISER,WILLIAM J",WK714347,07/04/1986,CARDIOLOGY 484777666,"MACKINTOSH,CRAIG",CM545456,02/14/1999,OTOLARYNGOLOGY The order of the fields doesn't matter since you will describe their position when prompted by the INS CO BATCH ID ENTRY option. Extra fields not used by this option will not matter. For example, Specialty which is shown in the examples above will be ignored. EXAMPLE OF COMMA DELIMITED FILE ENTRY: Upon selection of the PROVIDER ID MAINTENANCE [IBCE PROVIDER MAINT ] option you will see the following prompts: PROVIDER ID MAINTENANCE Dec 23, 2002@07:40:31 Page: 1 of 1 -- PROVIDER ID EDITS -- 1 > PROVIDER SPECIFIC IDS o PROVIDER'S OWN IDS o PROVIDER IDS FURNISHED BY INSURANCE CO 2 > INSURANCE CO IDS 3 > FACILITY IDS 4 > CARE UNIT MAINTENANCE 5 > INS CO BATCH ID ENTRY -- NON-VA ENTITY EDITS -- 6 > NON-VA PROVIDER ID INFORMATION 7 > NON-VA FACILITY ID INFORMATION Enter ?? for more actions Select Exit Select Action: Select// S Select Select EDIT OPTION: (1-7): 5 Select INSURANCE COMPANY NAME: BLUE CROSS INSURANCE COMPANY NEWINGTON NEW JERSEY Y PROVIDER ID DATA SOURCE: Manual Entry// F <----Select 'Entry from file' DO YOU WANT TO VIEW/VERIFY EACH ENTRY BEFORE IT GETS UPDATED?: YES SELECT FILE FORMAT: D// <----Select DELIMITED DELIMITER CHARACTER: ,// <----Enter delimiter character ARE QUOTES WITHIN A FIELD DOUBLE QUOTED?: NO// FILE NAME PATH: USER$:[EXAMPLE]// <----Enter your file path FILE NAME: BCBSTEMP.CSV <----Enter your file name PROVIDER ID TYPE: BLUE CROSS ID FORM TYPE APPLIED TO: BOTH UB92 AND HCFA 1500 FORMS BILL CARE TYPE: BOTH INPATIENT AND OUTPATIENT PROVIDER ID CARE UNIT: ***** WARNING ***** YOU WILL NEED TO MANUALLY ENTER THE CARE UNIT FOR EACH PROVIDER ** Note - the following example record, which has Provider ID in the first field, Provider Name in the second field, Specialty in the third field, SSN in the fourth field and a date in the fifth field, will be used to illustrate the answers to each prompt. Your record will be different. INS ID Prov. Name Specialty SSN Date enrolled -------- ---------------- ---------- --------- ------------- AZ811326,"Zackman,Adam T",Cardiology,333224444,02/14/1998 piece # 1 2 3 4 5 STARTING ',' PIECE # OF PROV. SSN FIELD: 4 ENDING ',' PIECE # OF PROV. SSN FIELD: 4// <--- SSN only covers 1 field STARTING ',' PIECE # OF PROV. NAME FIELD: 2 ENDING ',' PIECE # OF PROV. NAME FIELD: 2// 2 <--- Enter ending field number if Name covers more than one field. Note - if the Name has quotes around it, it counts as one field even if there is a comma between last and first names. If there are no quotes and there is a comma (e.g. ,SMITH,MARY,) then the name counts as two fields. STARTING ',' PIECE # OF PROV. ID FIELD: 1 ENDING ',' PIECE # OF PROV. ID FIELD: 1// The software should then loop through the file and display its entries before the data is filed. (as listed below) PROVIDER : 333224444 (Zackman,Adam T) <- input file data (Zackman,Adam) <- VA match INSURANCE: BLUE CROSS INSURANCE COMPANY PROV TYPE: BLUE CROSS ID FORM TYPE: BOTH UB92 & HCFA 1500 FORMS CARE TYPE: BOTH INPATIENT AND OUTPATIENT PROVIDER ID: AZ811326 OK TO FILE THIS ID FOR THIS PROVIDER?: NO//Y You can compare the provider name from your data file with the name from the NEW PERSON file that matches the SSN. If the name is not similar, you may not want to file the number until you have done some research. If there is any data missing that would prevent a particular entry from being added to the IB BILLING PRACTITIONER ID file (#355.9), the record will not be displayed for filing. When the processing is complete, a report is available which will list the problem records separate from the good records. - - - - - - - - - - - - - - - - - - - - - - - - - EXAMPLE OF FIXED LENGTH FILE ENTRY: Upon selection of the PROVIDER ID MAINTENANCE [IBCE PROVIDER MAINT ] option you will see the following prompts: PROVIDER ID MAINTENANCE Dec 23, 2002@07:40:31 Page: 1 of 1 -- PROVIDER ID EDITS -- 1 > PROVIDER SPECIFIC IDS o PROVIDER'S OWN IDS o PROVIDER IDS FURNISHED BY INSURANCE CO 2 > INSURANCE CO IDS 3 > FACILITY IDS 4 > CARE UNIT MAINTENANCE 5 > INS CO BATCH ID ENTRY -- NON-VA ENTITY EDITS -- 6 > NON-VA PROVIDER ID INFORMATION 7 > NON-VA FACILITY ID INFORMATION Enter ?? for more actions Select Exit Select Action: Select// S Select Select EDIT OPTION: (1-7): 5 Select INSURANCE COMPANY NAME: BLUE CROSS INSURANCE COMPANY NEWINGTON NEW JERSEY Y PROVIDER ID DATA SOURCE: Manual Entry// F <----Select Entry from file DO YOU WANT TO VIEW/VERIFY EACH ENTRY BEFORE IT GETS UPDATED?: YES SELECT FILE FORMAT: F// <----Select FIXED LENGTH FILE NAME PATH: USER$:[EXAMPLE]// <----Enter your file path FILE NAME: BCBSTEMP.CSV <----Enter your file name PROVIDER ID TYPE: BLUE CROSS ID FORM TYPE APPLIED TO: BOTH UB92 AND HCFA 1500 FORMS BILL CARE TYPE: BOTH INPATIENT AND OUTPATIENT PROVIDER ID CARE UNIT: ***** WARNING ***** YOU WILL NEED TO MANUALLY ENTER THE CARE UNIT FOR EACH PROVIDER ** Note - the following example record, which has Provider ID in 1-8, Provider Name in 9-38, Specialty in 39-53, SSN in 54-62 and a date in 63-72, will be used to illustrate the answers to each prompt. Your record will be different. INS ID Prov. Name Specialty SSN Date enrolled ------ ---------- ---------- --- ------------- AZ811326Zackman,Adam T Cardiology 33322444402/14/1998 1 9 39>| 54>| 63>| START POSITION OF PROV. SSN FIELD: 57 <--- SSN starts at character 54 LENGTH OF PROV. SSN FIELD: 9 <--- SSN is 9 digits long START POSITION OF PROV. NAME FIELD: 9 LENGTH OF PROV. NAME FIELD: 30 <--- available length, most names will not use the full length START POSITION OF PROV. ID FIELD: 1 LENGTH OF PROV. ID FIELD: 9 The software should then loop through the file and display its entries before the data is filed. (as listed below) You can use this display to determine if you have entered the correct character positions and field lengths. If the name, SSN or Provider ID are not quite picking up the correct characters, you should start over and adjust your field definitions. PROVIDER : 333224444 (Zackman Adam T) ) <- input file data (Zackman,Adam) <- VA match INSURANCE: BLUE CROSS INSURANCE COMPANY PROV TYPE: BLUE CROSS ID FORM TYPE: BOTH UB92 & HCFA 1500 FORMS CARE TYPE: BOTH INPATIENT AND OUTPATIENT PROVIDER ID: AZ811326 OK TO FILE THIS ID FOR THIS PROVIDER?: NO//Y You can compare the provider name from your data file with the name from the NEW PERSON file that matches the SSN. If the name is not similar, you may not want to file the number until you have done some research. If there is any data missing that would prevent a particular entry from being added to the IB BILLING PRACTITIONER ID file (#355.9), the record will not be displayed for filing. When the processing is complete, a report is available which will list the problem records separate from the good records. - - - - - - - - - - - - - - - - - - - - - - - - - EXAMPLE OF MANUAL ENTRY: Upon selection of the PROVIDER ID MAINTENANCE [IBCE PROVIDER MAINT ] option you will see the following prompts: PROVIDER ID MAINTENANCE Dec 23, 2002@07:40:31 Page: 1 of 1 -- PROVIDER ID EDITS -- 1 > PROVIDER SPECIFIC IDS o PROVIDER'S OWN IDS o PROVIDER IDS FURNISHED BY INSURANCE CO 2 > INSURANCE CO IDS 3 > FACILITY IDS 4 > CARE UNIT MAINTENANCE 5 > INS CO BATCH ID ENTRY -- NON-VA ENTITY EDITS -- 6 > NON-VA PROVIDER ID INFORMATION 7 > NON-VA FACILITY ID INFORMATION Enter ?? for more actions Select Exit Select Action: Select// S Select Select EDIT OPTION: (1-7): 5 Select INSURANCE COMPANY NAME: BLUE CROSS INSURANCE COMPANY NEWINGTON NEW JERSEY Y PROVIDER ID DATA SOURCE: Manual Entry// M <----Select Manual Entry PROVIDER ID TYPE: BLUE CROSS ID FORM TYPE APPLIED TO: BOTH UB92 AND HCFA 1500 FORMS BILL CARE TYPE: BOTH INPATIENT AND OUTPATIENT PROVIDER ID CARE UNIT: <---- if Care Units are defined Select NEW PERSON NAME: GENERAL,SERGE N <---- enter all names first Select NEW PERSON NAME: CARDIO,MARTHA Select NEW PERSON NAME: CHILDRENS,WARD Select NEW PERSON NAME: PROVIDER : 123456789 (CARDIO,MARTHA) <---- each name is prompted with a display of billing type INSURANCE: BLUE CROSS INSURANCE COMPANY PROV TYPE: BLUE CROSS ID FORM TYPE: BOTH UB92 & HCFA 1500 FORMS CARE TYPE: BOTH INPATIENT AND OUTPATIENT PROVIDER ID: <---- enter the ID The program will continue displaying all providers entered and prompting for the appropriate provider ID. The names are not prompted in the order entered. They are prompted in the order that they were registered in the New Person file. This could be confusing, watch the screen carefully. If you are loading more than just a few providers you should consider creating a file and using the FILE function described above. - - - - - - - - - - - - - - - - - - - - - - - - - Test Sites ---------- ANN ARBOR CENTRAL TEXAS Install Information ------------------- If installed during the normal work day it is recommended that the following menu option (File #19) be disabled to prevent possible conflicts while running the KIDS Install (other VISTA users will not be affected): Provider ID Maintenance [IBCE PROVIDER MAINT] Install Time - Less than 5 minutes ====================== INSTALLATION INSTRUCTIONS ======================= This patch should be installed after normal working hours. 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 routine listed in step 3 below. NOTE: If the routine included in this patch is not currently in your mapped routine set, please skip this step. 3. COMPONENTS SENT WITH PATCH -------------------------- 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: ;;2.0;INTEGRATED BILLING;**[patch list]**;21-MAR-94 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== IBCEP9 16718485 15556086 137,200 IBCEP9B 13220006 12078756 137,200 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*200) 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 INHIBIT LOGONs during the install? YES//' answer NO. c. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//' answer YES. d. When prompted "Enter options you wish to mark as 'Out of Order':" Enter the following: Provider ID Maintenance [IBCE PROVIDER MAINT] e. When prompted 'Enter protocols you wish to mark as 'Out Of Order': ' press return. 7. REBUILD MAPPED ROUTINES(S) (DSM for Open VMS sites only) -------------------------- Optional - Include the routine 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 routine in your mapped set. Routine Information: ==================== Routine Name: - IBCEP9 Routine Checksum: Routine Name: - IBCEP9B Routine Checksum: ============================================================================= User Information: Entered By : HARRIS,JANET Date Entered : OCT 08, 2002 Completed By: PEREZ,CAROL Date Completed: FEB 28, 2003 Released By : BOTTINI,STEVE Date Released : MAR 04, 2003 ============================================================================= Packman Mail Message: ===================== $END TXT