============================================================================= Run Date: JAN 31, 2005 Designation: IB*2*297 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #268 Status: Released Compliance Date: MAR 03, 2005 ============================================================================= Associated patches: (v)IB*2*267 <<= must be installed BEFORE `IB*2*297' Subject: INSURANCE API UPDATE/CLEAN UP Category: - Routine Description: ============ This patch corrects a problem with the recent Update to Insurance API patch IB*2*267 and includes an insurance database report. 1. The recently released Update to Insurance API patch would cause an M error if insurance plan data was requested and the patient had insurance data with no plan data. The API is being updated to avoid the hard M error and return no plan coverage information if no plan data is available. This is a data issue caused by old insurance data that was never associated with a group or individual plan. Current Integrated Billing (IB) functionality to store insurance information requires either a group or individual plan always be selected and associated with a patient's insurance. 2. With the install of this patch a post-init routine will run to examine the sites insurance database and report any issues with plan data. The post-init should be queued to run off hours and will produce a MailMan message to the group specified in the IB SITE PARAMETERS (#350.9) file, NEW INSURANCE MAIL GROUP (#4.04) field, which is typically the IB NEW INSURANCE mail group. The post-init will: o Go through the whole patient file, making sure the "AB" cross reference is set for every patient's insurance information, if it is not there, the "AB" cross reference will be set. o Go through the "AB" cross reference to make sure every entry is valid and remove invalid entries in that cross reference. o Verify there is a plan for every insurance company in the PATIENT (#2) file, INSURANCE TYPE (#.3121) multiple, GROUP PLAN (#.18) field. o Verify the INSURANCE COMPANY (#36) file pointer is valid from the PATIENT (#2) file, INSURANCE TYPE (#.3121) multiple, INSURANCE TYPE (#.01) field. o Verify the plan pointer is valid from the PATIENT (#2) file, INSURANCE TYPE (#.3121) multiple, GROUP PLAN (#.18) field. o Verify the plan's insurance company is the same as the patient's insurance company. There is a comparison of the patient's insurance company information (PATIENT (#2) file, INSURANCE TYPE (#.3121) multiple, INSURANCE TYPE (#.01) field) and plan information (PATIENT (#2) file, INSURANCE TYPE (#.3121) multiple, GROUP PLAN (#.18) field) to verify the plan's insurance company (GROUP INSURANCE PLAN (#355.3) file, INSURANCE COMPANY (#.01) field) is the same as the patient's insurance company. At the completion of the verification a MailMan message will be generated to report any issues found. Some of the issues can be corrected using the "Patient Insurance Info View/Edit [IBCN PATIENT INSURANCE]" menu option, but some will require IRM assistance in resolution. This is not meant to be an insurance clean up report, but an insurance database validation report, therefore there are no limiting factors built into the report such as inactive or deceased patient. The post init routine can be deleted after completion of compiling of the report or can be kept by the site to run again in the future. If a site continues to see significant numbers of entries added to the report, the site should review any local software for insurance data capture. Estimated time for the post-init process to run is 2 hours and will depend on the size of your PATIENT (#2) file, number of patients with insurance data and system processes running at the same time. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- There are no NSR(s) associated with this patch This patch addresses the following NOIS message(s): ------------------------------------------------------------ NYH-1204-11675 IB Error $ZE= PLCOV+7^IBBFAPI Overview of NOIS Message(s): ---------------------------- NYH-1204-11675 Problem: Hard error - A null subscript error occurred when an insurance company had no plan in the patient's insurance multiple. Resolution: Modification to the routine IBBFAPI was made to ensure that plan data was present prior to looking up plan coverage limitations. Technical Description -------------------- IB20P297 is the post init routine that will verify the insurance data base integrity and report any issues found that need to be manually resolved. This routine can be deleted after it has completed running, but may be kept so the site can re-run in the future to see that there are no new database problems found. IBBFAPI is updated to resolve NOIS NYH-1204-11675. The routine will now make sure it has a plan prior to retrieving plan coverage data. COMPONENTS SENT WITH PATCH: --------------------------- 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: ;;2.0;INTEGRATED BILLING;**[patch list]**;21-MAR-94 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== IB20P297 N/A 10802601 297 IBBFAPI 8995641 9515379 267,297 Total number of routines - 2 Install time less than 5 minutes. Estimated post install time 2 hours. SOFTWARE RETRIEVAL ==================================== The software for this patch is being distributed in host file RMPR_3_96.KID. The host file will contain two KIDS builds. The patches contained in the RMPR multi-package distribution are: Package Patch ------------------ ----------- PROSTHETICS RMPR*3.0*96 INTEGRATED BILLING IB*2.0*297 Please refer to the 'Software and Documentation Retrieval' section of the RMPR*3.0*96 patch description for instructions on how to acquire the patch software and install instructions. Routine Information: ==================== Routine Name: - IBBFAPI Routine Checksum: Routine Name: - IB20P297 Routine Checksum: ============================================================================= User Information: Entered By : ZEIGLER,EDWARD L Date Entered : JAN 03, 2005 Completed By: LYNCH,MARY F. Date Completed: JAN 27, 2005 Released By : JACKSON,SHERYL Date Released : JAN 31, 2005 ============================================================================= Packman Mail Message: ===================== No routines included