=============================================================================
Run Date: JUL 30, 2004                     Designation: IB*2*269
Package : IB - INTEGRATED BILLING             Priority: Mandatory
Version : 2       SEQ #246                      Status: Released
                  Compliance Date: AUG 11, 2004
=============================================================================

Associated patches: (v)IB*2*255    <<= must be installed BEFORE `IB*2*269'

Subject: RX Copay Upload Enhancement for IVM

Category: 
  - Routine
  - Enhancement (Mandatory)

Description:
============

 ******************************* N O T E *********************************
 There is no conflict between this patch and the {package}-CoreFLS
 software. Installation of this patch by the CoreFLS sites will not 
 cause any problems.
  
 This patch is being released with a shortened compliance date of 
 August 11, 2004 due to potential incorrect exemptions.  If necessary, 
 this patch may be installed out of patch sequence order.
 *************************************************************************
  
 This patch (IB*2.0*269) is an enhancement to the Income Verification 
 process of evaluatng and converting veterans Income Tests. It will 
 allow IVM to correctly set the medication copay required status.
  
 Existing functionality allows the Income Verification staff to convert a
 veteran's means test to either a MT or GMT copay required status. This can
 potentially result in an incorrect Medication Copay Exemption status. The
 enhancement will also allow Income Verification to convert a RX copay test
 to a status of non-exempt.  Unlike Income Verification means test
 conversions that allow back-billing to occur, conversion of a RX copay
 test to a non-exempt status will not trigger any back-billing of
 prescriptions.  Rather, any prescriptions entered on or after the date the
 RX Copay Income Verification Converted test is received will be liable
 for copayments.
  
 When the Income Verification staff converts a veteran to an RX Copay 
 Required status and the Z06 is uploaded, an entry will be added to the 
 BILLING EXEMPTION file (#354.1). This new entry will have a status of 
 non-exempt and will be set to active.  The previous status will be set to 
 inactive.   Additionally, the COPAY INCOME EXEMPTION STATUS field (#.04) 
 of the BILLING PATIENT file (#354) will reflect that the status is now 
 non-exempt.
  
 If the Income Verification staff reopen an IVM case that was converted to 
 RX Copay Required and then subsequently converted to a status such that 
 the veteran in exempt from medication copayments a "Delete Z06" will be 
 sent.   A new record will be added to the BILLING EXEMPTION file (#354.1)
 and will become active.  The prior (non-exempt) record will be set to 
 inactive. Additionally, the COPAY EXEMPTION STATUS file (#.04) of the 
 BILLING PATIENT file (#354) will reflect that the status is now exempt.
  
  
  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:
  
      <tab>;;2.0;INTEGRATED BILLING;**[patch list]**;21-MAR-94
  
                             CHECK^XTSUMBLD results
  Routine name      Before Patch          After Patch         Patch List
  ============      ============          ===========         ==========
  IBAMTED                3638236              3758888         15,255,269
  IBAMTED2                   N/A              1788308             269
  
            Total number of routines:  2
  
  
 SOFTWARE AND DOCUMENTATION RETRIEVAL
 ====================================  
 The software for this patch is being distributed in a host file.  The 
 host file will contain four KIDS builds.  
   
 Please refer to the 'Software and Documentation Retrieval' section of 
 the EAS*1.0*42 patch description for instructions on how to acquire the
 patch software and documentation.
  
  
 INSTALLATION INSTRUCTIONS:
 ==========================
 This patch, INTEGRATED BILLING (IB*2.0*269) will be installed in
 conjunction with ENROLLMENT APPLICATION SYSTEM Patch EAS*1.0*42.  
 Please refer to the EAS*1.0*42 patch description for installation 
 instructions.

Routine Information:
====================

Routine Name:
  - IBAMTED

 This routine was altered to call the new routine IBAMTED2 for Rx Copay 
 processing.
  
 Code changes
 ============
  
 Before:
 =======
     8           ; -- do medication copayment exemption processing
     9           D:'$D(EASZ06) ^IBAMTED1
    10           ;
  
 After:
 ======
    10           ; -- do medication copayment exemption processing
    11           ;
    12           ;Z06 processing then quit
    13           D:$D(EASZ06) ^IBAMTED2                     ;IB*2*269
    14           ;Original Non-Z06 Copay processing
    15           D:'$D(EASZ06) ^IBAMTED1
    16           ;

Routine Checksum:

Routine Name:
  - IBAMTED2

 New routine to handle updating the BILLING EXEMPTIONS file #354.1 for 
 Pharmacy Converted Cases from IVM.

Routine Checksum:

=============================================================================
User Information:
Entered By  : NAPOLIELLO,GREG               Date Entered  : APR 05, 2004
Completed By: MULLER,RICHARD                Date Completed: JUL 29, 2004
Released By : MARSHALL,FALENCIA B.          Date Released : JUL 30, 2004
=============================================================================


Packman Mail Message:
=====================

No routines included