$TXT Created by SHAMUKHAMEDOV,SHAVKAT at DEVFEY.FO-ALBANY.MED.VA.GOV (KIDS) on Monday, 07/26/04 at 16:49 ============================================================================= Run Date: NOV 03, 2004 Designation: IB*2*275 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #263 Status: Released Compliance Date: NOV 10, 2004 ============================================================================= Associated patches: (v)IB*2*74 <<= must be installed BEFORE `IB*2*275' (v)IB*2*215 <<= must be installed BEFORE `IB*2*275' (v)IB*2*247 <<= must be installed BEFORE `IB*2*275' Subject: HEC VISTA ENHANCEMENTS (HVE) Category: - Routine - Other - Enhancement (Mandatory) Description: ============ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * NOTE: Installation compliance date is 11/10/04. * * * * In order to ensure that exemptions for unemployable veterans are * * updated by the Health Eligibility Center (HEC) processes, coding * * changes were necessary in 5 VistA software modules (DG, SD, IVM, IB * * and PRCA) as well as the software at the HEC. * * The compliance date has been shortened due to the urgent nature of * * the enhancement, and the fact that the HEC cannot install their * * enhancements until ALL sites have completed installation of the VistA * * patches. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * PROJECT OVERVIEW ================ HEC VistA Enhancements (HVE) provides software to support several critical business processes associated with congressionally mandated initiatives. Through the course of a three phase roll-out, a series of system application updates have been and are being made to support enhanced Enrollment functionality, both within VistA and the Health Eligibility Center (HEC), and updates to a series of veterans' enrollments, including continuous enrollment, and eligibilities, including statuses of Combat Veteran, former Prisoner of War (POW), Unemployable Veteran and Filipino Veteran. The patch incorporated into this release is part of the HVE Phase 3 project. The HVE Phase 3 project functionality enhancements include: - Unemployable Veteran Service Connection (SC) Priority Group Change - POW Veteran Pharmacy Copayment Exemption and Dental Treatment - Filipino Veteran Data Sharing with the HEC - Combat Veteran (Phase III) Enrollment Priority Updates and Data Sharing with the HEC - Military Service Date (MSD) Sharing with the HEC and - Continuous Enrollment Priority Updates The HVE Phase 3 functionality will be introduced at all sites as part of a combined effort that encompasses updates to: - Registration (Patch DG*5.3*564); IVM (IVM*2.0*97); Scheduling (SD*2.0*395) (Distributed as Host File DG_53_P564.KID) - Integrated Billing (Patch IB*2.0*275); and - Accounts Receivable (Patch PRCA*4.5*218) *********************************************************************** * Please be aware that the new functionality with regard to RX * * copays exemptions for former POW and Unemployable veterans will not * * be fully functional until DG*5.3*564, IVM*2.0*97 and SD*2.0*395 are * * installed and HEC has completed the cleanup/conversion process. * *********************************************************************** ASSOCIATED E3R(s): ------------------ N/A ASSOCIATED NOIS: ---------------- N/A PARTICIPATING TEST SITES: ------------------------- Altoona, PA Northern, CA West LA, CA Martinsburg, WV El Paso, TX Iron Mountain, MI Ft Harrison, MT Danville, IL Louisville, KY FUNCTIONAL DESCRIPTION ====================== The patch addresses the following IB functionality: - billing exemptions for former POW veterans - billing exemptions for unemployable veterans - notify the billing staff in real time about expiration of the Combat Veteran (CV) status of active inpatients For the billing of former Prisoner Of War veterans, a series of program updates have been made to ensure that Integrated Billing will not create a Rx-copayment bill if a former POW Veteran has been identified as being Rx-copay exemption (DBIA #423). A new reason of POW exemption is being added to explain the exclusion of the bill. Should a former POW have an eligibility status of SC < 50%, Integrated Billing will now mark the 3rd party pharmacy Claim Tracking System records as "Needs SC Determination". For the billing of Unemployable Veterans, a series of program updates have been made to ensure that Integrated Billing will not create a Rx 1st party co-payment bill for an Unemployable SC veteran if the veteran has been identified as one eligible for the Rx-copay exemption (DBIA #423). A new reason of Unemployable Veteran exemption is being added to explain the exclusion of the bill. Should an Unemployable Veteran have an eligibility status of SC < 50%, Integrated Billing will now mark the 3rd party pharmacy Claim Tracking System records as "Needs SC Determination". The IB MT NIGHT COMP job that is tasked to run each night has been modified to scan all inpatients to identify those whose CV End Date expires 'today'. A new bulletin will be sent to the IB MEANS TEST mail group that will list the inpatients identified by that process which will need to be reviewed for billing purposes. Here is an example of the bulletin: Subj: INPATIENTS' COMBAT VET STATUS EXPIRED [#417861] 07/09/04@18:18 10 lines From: INTEGRATED BILLING PACKAGE In 'IN' basket. Page 1 *New* -------------------------------------------------------------------------- The following patients whose records indicate that they had CV status,were admitted for inpatient care with CV status,and their CV status has expired during their stays. Please check their CV exp date again before adjusting their billings accordingly. Patient NAME SSN CV exp. date Date of admission ===================================================================== IBPATIENT,ONE 000-00-0000 JUL 09, 2004 MAY 02, 2004 IBPATIENT,TWO 000-00-0000 JUL 09, 2004 JUN 03, 2004 Total: 2 patient(s) Enter message action (in IN basket): Ignore// A one-time report ^IBAHVE3 is being provided identify those patients whose CV status has already expired prior to installing this patch. Here is an example of the report s output which should be provided to the billing staff for their review : >D ^IBAHVE3 From DATE: AUG 5,2004// (AUG 05, 2004) To DATE: NOV 3,2004// (NOV 03, 2004) The following patients whose records indicate that they had CV status, were admitted for inpatient care with CV status, and their CV status has expired during their stays in the period of AUG 5,2004 - NOV 3,2004 DEVICE: HOME// VIRTUAL CONNECTION Right Margin: 80// ***Inpatient Combat Veteran Status Expiration Report*** PAGE 1 Report from AUG 5,2004 to NOV 3,2004 Run Date/Time: NOV 3,2004@14:39:52 Patient NAME SSN CV exp. date Date of admission ========================================================================== IBPATIENT,THREE 000-00-0000 AUG 22,2004 AUG 1,2004 Total: 1 patient(s) TECHNICAL DESCRIPTION ===================== IB20P275 Adds two new charge removal reasons " RX FOR FORMER POW" and "RX FOR UNEMPLOYABLE VETERAN" in file #350.3 . Adds two new exemption reasons " FORMER POW" and " UNEMPLOYABLE VETERAN" in file #354.2 . IBACV Modifications have been made to send e-mail alert to IB MEANS TEST group if an active inpatient's CV status does expire today . IBAMTC Modifications have been made to send an e-mail alert (in IB Nightly Job) to the IB MEANS TEST mail group with the list of the patients whose CV status expired during admission. IBARXEU1 Modifications have been made to modify the AUTOST function to make sure that POW veterans and Unemployed Veterans with SC status will be exempt from ANY and ALL RX copays. IBAHVE3 New routine for "Inpatient Combat Veteran Status Expiration Report". IBTRKR3 Modifications have been made to process the Pharmacy 3rd party billing for former POW and Unemployable veterans. ================ INSTALLATION INSTRUCTIONS ================= It is recommended this patch be installed outside of normal business hours to avoid any complications resulting from users on the system. It should also NOT be installed or queued when the [IB MT NIGHT COMP] job is running. Installation will take less than 5 minutes. 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 -------- ------------ ----------- ------------------------------ IB20P275 n/a 2593356 **275** IBACV 3683050 9144468 **234,247,275** IBAHVE3 n/a 7075187 **275** IBAMTC 7387206 7580630 **34,52,70,93,100,118,115,132, 150,153,137,176,215,275** IBARXEU1 4384417 4413206 **26,112,74,275** IBTRKR3 11841855 12752380 **13,43,121,160,247,275** Total number of routines - 6 New routines - 2 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:INS tallation --- 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*275): 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 options: [PSO RELEASE] Release Medication e. When prompted 'Enter protocols you wish to mark as 'Out Of Order': press . 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. 8. Remove post-init routine IB20P275. 9. Run the Inpatient Combat Veteran Status Expiration Report by executing the routine ^IBAHVE3 from the programmer mode manually. Here is an example: >D ^IBAHVE3 You can run the report as many times as you need. Alert IB staff of any patients that show up on this report. The staff will have to research the bills for these patients. Routine Information: ==================== Routine Name: - IBACV Routine Checksum: Routine Name: - IBTRKR3 Routine Checksum: Routine Name: - IBARXEU1 Routine Checksum: Routine Name: - IBAMTC Routine Checksum: Routine Name: - IB20P275 Routine Checksum: Routine Name: - IBAHVE3 Routine Checksum: ============================================================================= User Information: Entered By : SHAMUKHAMEDOV,SHAVKAT Date Entered : APR 30, 2004 Completed By: TORRANCE,LORI Date Completed: NOV 03, 2004 Released By : GANUS,MAUNETTE Date Released : NOV 03, 2004 ============================================================================= Packman Mail Message: ===================== $END TXT