$TXT Created by WHITE,DARLENE at DSI-ALPHA.DAOU.COM (KIDS) on Tuesday, 02/08/05 at 14:31 ============================================================================= Run Date: FEB 14, 2005 Designation: IB*2*271 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #271 Status: Released Compliance Date: MAR 17, 2005 ============================================================================= Associated patches: (v)IB*2*184 <<= must be installed BEFORE `IB*2*271' (v)IB*2*251 <<= must be installed BEFORE `IB*2*271' (v)IB*2*252 <<= must be installed BEFORE `IB*2*271' (v)IB*2*284 <<= must be installed BEFORE `IB*2*271' Subject: UPDATES TO INSURANCE IDENTIFICATION & VERIFICATION (IIV) Category: - Enhancement (Mandatory) - Data Dictionary - Input Template - Routine Description: ============ This patch updates several items related to Insurance Identification and Verification functionality. Several users' requests and suggestions have been included as enhancements to the software. Other enhancements were made to alleviate potential areas of confusion for the users. This patch also corrects some problems with the IIV software that were reported through NOIS. In general, the majority of the changes that the users will see with this patch are improved user interfaces and simplified configuration of the software. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- There is no NSR associated with this patch. This patch addresses the following NOIS message(s): --------------------------------------------------- BAY-0204-31962 IIV inquiries are increasing FGH-0304-32103 Important IIV Msg-Monetary Amount UNY-0204-11346 ERROR - CHK+23^IBCNEHLQ WPB-0904-32212 ERROR - EN+43^IBCNEDE2:1, %DSM-E-NULL SUBSCR" IRM, Please Note: ---------------- As a result of the installation of this patch, some critical functionality has changed. Therefore, the Insurance Supervisor must be notified that the Most Popular Insurance functionality, accessed by the MOST POPULAR PAYER (MP) action of the IIV Site Parameters screen, has been modified. Prior to this patch, the Most Popular Insurance Companies were automatically identified based on the number of authorized bills created. This patch has changed two aspects of this functionality. The list will be populated with payers rather than insurance companies. In addition, these payers will be manually entered by each site. As a result of these changes, the prior values of this list have been deleted. If your site has elected to use this functionality, the table should be updated with the payers that are most commonly used in your facility and who are nationally active for IIV. To accomplish this, the Insurance Supervisor should select the option MCCR Site Parameter Display/Edit [IBJ MCCR SITE PARAMETERS], then select "IV" for Insurance ID and Verification. Finally, select "MP" for Most Popular Payers within the IIV parameters to populate the list. Overview of Patch Items: ------------------------ 1)Problem: PENDING INQUIRIES ARE INCREASING (NOIS: BAY-0204-31962) -------- The problem of a potentially inflated number of pending inquiries listed on the IIV Statistical Report and in the stored data itself has been corrected. Before this patch, if inquiries were retried and a single response was received, the inquiries that did not receive a response remained pending forever. We have revised the software in two ways. When a retry is generated and the previously sent inquiry did not receive a response, the status of the previous inquiry is set to communication failure. If a subsequent response is received for this inquiry, the status will be appropriately updated as the response is received. In addition, when a response is received for one of the inquiries (retry or original) the status of the remaining inquiries will be changed to communication failure (assuming that the current status of the inquiry (#365.1) is not response received). 2)Problem: REMOVE DASHES FROM THE SSN FIELDS IN THE PID AND GT1 -------- SEGMENTS Dashes within a social security number are no longer included in the HL7 PID and GT1 segments, when they are transmitted to Austin for IIV. 3)Problem: MODIFY MONETARY AMOUNT FIELD (#365.02,.08) -------- (NOIS: FGH-0304-32103) The Monetary Amount field input transform was modified to accept values as large as $999,999,999.00 (formerly the limit was $99,999,999.00). 4)Problem: TEST PATIENTS WERE PICKED UP BY THE IIV EXTRACTS -------- The IIV extracts were picking up test patients found in the production account, if they met the extracts' selection criteria. This has been corrected to ensure that the IIV extracts will skip test patients. 5)Enhancement: IIV PURGE FUNCTIONALITY UPDATE ------------ The purge utility was updated to display a message to the user indicating that journaling should be disabled for ^IBCN when using the purge option. A message will now be sent to the IBCNE MESSAGE GROUP on the first of each month (assuming the nightly batch process is running) if, and only if, there are eligible IIV TRANSMISSION QUEUE or IIV RESPONSE records to be purged. 6)Enhancement: IIV RESPONSE REPORT AND IIV PAYER REPORT UPDATES ------------ The prompts for selecting the payers and the patients for the report have been changed from one (payer/patient) or all (payers/patients) rather than entering a range of names (payer/patient). The Eligibility/Benefit information displayed on the IIV Response Report was logically grouped for readability and quick identification of key information. The error information that displays on the IIV Response Report has been modified to display the entire description (it previously truncated the text). 7)Enhancement: MOST POPULAR LIST UPDATES ------------ The Most Popular Insurance Company list that can be found within the IIV Site Parameters screen has been replaced. The new list is now configurable by the users, and is a list of payers rather than insurance companies. This new list is referred to as the Most Popular Payer list. A new ListMan interface was created to maintain the Most Popular Payer List. The IIV Site Parameter fields included in the IB Site Parameters file (#350.9) were revised to reflect the change in functionality and conversion from insurance company to payer. 8)Enhancement: ADD SSN AND DATE OF BIRTH UPDATE TO MAILMAN MESSAGES ------------ The last four digits of the patient's social security number, as well as, the patient's date of birth have been included in MailMan messages generated by IIV when referring to a patient. This was done to simplify the patient identification process. 9)Enhancement: CHANGE ERROR INFORMATION FORMAT IN INSURANCE BUFFER ------------ EXPAND ENTRY SCREEN The display of Error Information when using the Expand Entry action of the insurance buffer caused some confusion for the users. The format of 'Code: Description' was unclear when the code was numeric. For example, if the code was '78', the users interpreted it as having 78 errors rather than identifying '78' as the code associated with the error. To alleviate potential confusion, the displaying of error information was modified to be more user friendly, specifically 'Description (Error Condition 'Code')' and 'Description (Error Action 'Code')' are now displayed. 10)Enhancement: REVISE RESPONSE PROCESSING AND IIV STATUS CODES ------------ In order to provide more complete and accurate information to the users, the processing of IIV responses has been modified to take advantage of additional information provided to VistA through the interface. This additional information will provide a more accurate reflection of the patient's insurance eligibility as reported by the Payer. A new IIV status has been introduced, '#'. This new status represents two different scenarios. It identifies payer responses received by VistA that are ambiguous, and therefore could not be categorized as a true indication that the patient does or does not have active insurance. It also identifies any payer response that encountered a problem in either Austin or by the Payer. In addition, the definition of two of the existing IIV status codes has been revised to be more intuitive. These are: '+' - patient has active insurance '-' - patient does not have active insurance 11)Enhancement: MINIMIZE THE NUMBER OF INSURANCE INQUIRIES WITHOUT AN ------------ ASSOCIATED PAYER Prior to this patch, when a patient had no active insurance, no inactive insurance, and the most popular insurance company functionality had been turned off, an inquiry without an associated payer ("blank inquiry") would be generated. The only situation that would prevent this from happening was if another "blank inquiry" had been generated within the freshness period. To reduce the number of "blank inquiries", IIV will now check if an inquiry was transmitted for any payer (or no payer) within the freshness period. If anything is found, the "blank inquiry" will not be generated. 12)Enhancement: REMOVE CONFUSING IIV SITE PARAMETERS ------------ The following General Parameters will now be automatically set to the following values: Field Name System wide Value ---------- ----------------- TIMEOUT DAYS (#350.9,51.05) 3 NUMBER RETRIES (#350.9,51.06) 1 TIMEOUT MAILMAN MSG (#350.9,51.07) NO INQUIRE SECONDARY INSURANCES (#350.9,51.23) YES The Suppress Buffer field (#350.9002,.06) has been set to a system wide value of YES for the Appointment and Non-Verified IIV Batch Extracts. 13)Enhancement: MODIFIED THE EXTRACT LOGIC THAT USES THE MOST POPULAR ------------ LIST. The software was modified to have the Inactive flag and the Most Popular flag work together. Now when the Inquire Popular Payers field (#350.9,51.09) is enabled and the Inquire Inactive Insurance field (#350.9,51.08) is disabled, IIV will no longer generate an inquiry for a payer that is listed on the most popular payer list, if that patient has an inactive policy with that payer. 14)Enhancement: MODIFIED RESPONSE PROCESSING ------------ The response processing logic was modified so that responses reported as inactive insurance policies for Identification inquiries will no longer be entered into the insurance buffer. Identification inquiries are those inquiries that are generated by IIV as a result of checking a patient's inactive policies and/or checking the payers listed in the Most Popular Payer List. These reported inactive policies can be viewed through a new IIV report, IIV Inactive Policy report, instead of the insurance buffer. 15)Enhancement: IIV INACTIVE POLICY REPORT ------------ The new IIV Inactive Policy report reflects responses that indicate inactive coverage was discovered by IIV, where the patient did not have active insurance on file. 16)Enhancement: IIV AMBIGUOUS POLICY REPORT ------------ The new IIV Ambiguous Policy report reflects ambiguous responses when coverage was discovered by IIV, where the patient did not have active insurance on file. 17)Enhancement: IIV NIGHTLY PROCESS CAN BE RUN MULTIPLE TIMES A DAY ------------ The IIV Nightly Process [IBCNE IIV BATCH PROCESS] option, which was introduced with patch IB*2.0*184, can be scheduled to run multiple times a day within TaskMan. * Note: This will cause multiple identical copies of the IIV Statistical Report and the IIV Purge MailMan message to be sent to those members of the mail group associated with IIV (this is defined in the General Parameter section of the IIV Site Parameters screen). 18)Enhancement: IIV STATISTICAL REPORT MODIFICATION ----------- Replaced the misleading message that is displayed in the Current Status section of the IIV Statistical Report (Run menu option "Link Insurance Companies to Payers" for assistance) with more meaningful instructions, "Please link the associated active insurance companies to these payers at your earliest convenience. Locally activate the payers after you link insurance companies to them. For further details regarding this process, please refer to the Integrated Billing IIV Interface User Guide." In addition, this message was made conditional, so it only displays if new payers are listed. 19)Enhancement: CHANGED INCLUSION CRITERIA FOR APPOINTMENT EXTRACT ------------ Prior to this patch, Inpatient appointments were excluded from the Appointment Extract. Inpatient appointments will now be included as valid criteria for this extract. 20)Problem: ADDRESSED RESPONSE PROCESSING ISSUE -------- The response processing routines included a utility to strip off extraneous encoding characters from the end of data fields that were sent by Austin. During some internal testing, it was determined that under certain circumstances it would strip off relevant trailing escape sequences. The code was modified to only remove the unnecessary characters. This was not causing problems for IIV, but could potentially be a factor in future releases. 21)Problem: ADDRESSED RESPONSE PROCESSING ISSUE (NOIS: WPB-0904-32212) -------- The Extract process was aborting when accessing a corrupted appointment subfile (#44.001). The corrupted appointment subfile included a blank internal Patient IEN/DFN in the .01 field. The code was modified to skip the corrupted appointment rather than abort the processing. Test Sites: --------------- Asheville, NC Bay Pines, FL Prescott, AZ Denver, CO LOCATION OF DOCUMENTATION FOR THIS PATCH ------------------------------------------------------ The following files are included for this patch: File Name Description --------- ----------- IB_2_271_TM.PDF Technical Manual IB_2_271_UM.PDF User Guide These files are available on the OI Field Office Anonymous.Software directories listed below. Use the appropriate FTP capability to retrieve the files. The documentation files that end in .PDF need to be downloaded in the BINARY format. OI FIELD OFFICE FTP ADDRESS DIRECTORY =============== =========== ========= ALBANY ftp.fo-albany.med.va.gov anonymous.software HINES ftp.fo-hines.med.va.gov anonymous.software SALT LAKE ftp.fo-slc.med.va.gov anonymous.software FIRST AVAILABLE SERVER download.vista.med.va.gov anonymous.software ================INSTALLATION INSTRUCTIONS ================= If installed during the normal workday, it is recommended that the following selection(s) in the OPTION (#19) file, and all of their descendants be disabled to prevent possible conflicts while running the KIDS Install. Other VISTA users will not be affected. Process Insurance Buffer [IBCN INSURANCE BUFFER PROCESS MCCR Site Parameter Display/Edit [IBJ MCCR SITE PARAMETERS] Purge IIV Transactions [IBCNE PURGE IIV DATA] IIV Menu [IBCNE IIV MENU] In addition, the IIV SERVER and IIV EC HL7 Logical Links must be stopped using the Start/Stop Links [HL START] option prior to performing the install and restarted once the installation process has completed. This is required as the routines that perform response processing have been altered in this patch. Install Time - 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. COMPONENTS 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: ;;Version;Package;**[patch list]**;Package Release Date CHECK^XTSUMBLD results Routine Before Patch After Patch Patch List ------- ------------ ----------- ---------- IBCNBLA 15241547 15954424 82,149,153,184,271 IBCNBLA1 23648439 23654969 82,133,149,184,252,271 IBCNBLE1 6922418 7372540 184,271 IBCNBLL 19957600 21368471 82,149,153,183,184,271 IBCNEBF 5706943 5811990 184,271 IBCNEDE 9887929 4757465 184,271 IBCNEDE1 10761837 10945486 184,271 IBCNEDE2 10647827 10986296 184,271 IBCNEDE3 10362656 10699923 184,271 IBCNEDE4 13573751 13818895 184,271 IBCNEDE5 5992585 6087679 184,271 IBCNEDE6 6495408 7090431 84,271 IBCNEDE7 n/a 6154214 271 IBCNEDEP 12382940 12413574 184,271 IBCNEDEQ 4747398 5458540 184,271 IBCNEHLD 1692434 1795577 184,271 IBCNEHLI 3030560 3017378 184,252,251,271 IBCNEHLP 12628557 13139616 184,252,271 IBCNEHLQ 6108212 6209619 184,271 IBCNEHLR 5877074 8622113 184,252,271 IBCNEHLS 10219415 11770281 184,271 IBCNEHLT 11590527 11491529 184,251,271 IBCNEKI2 n/a 4742128 271 IBCNEKIT 14071154 14699494 184,271 IBCNEPST 8289186 n/a 184 (post install) IBCNEQU 16729366 16759050 184,271 IBCNERP0 2444128 2477894 184,271 IBCNERP1 14325613 13146531 184,271 IBCNERP2 11795436 7200910 184,271 IBCNERP3 22215991 9624190 184,271 IBCNERP4 3829469 3825717 184,271 IBCNERP5 13494627 12923181 184,271 IBCNERP6 15688371 15458222 184,271 IBCNERP8 7869197 7975648 184,271 IBCNERP9 14841537 15974469 184,271 IBCNERPA 2345475 7528479 184,271 IBCNERPB 10363102 10509514 184,252,271 IBCNERPC 11434617 11572469 184,252,271 IBCNERPE n/a 21424444 271 IBCNEUT3 18512159 19210728 184,252,271 IBCNEUT4 16507451 13828500 184,271 IBCNEUT5 8655505 9103660 184,284,271 IBCNEUT6 6303995 8262907 184,252,271 IBJPI 20494012 19167695 184,271 IBJPI2 16202092 7707004 184,271 IBJPI3 n/a 12594180 271 IBJPI4 n/a 8990639 271 IBJPM 4070106 4055871 39,137,184,271 IBY271PR n/a n/a (pre install routine) IBY271PS n/a n/a (post install routine) Total number of routines - 50 *NOTE: IBCNEPST is the post init routine from patch, IB*2.0*184, and is simply being deleted at the site by this patch. IBY271PR and IBY271PS, the pre and post init routines, are auto-deleting. The following is a list of the files included in this patch: IB SITE PARAMETERS (350.9) Partial Update POPULAR PAYERS (350.9003) sub-file IIV STATUS TABLE (365.15) ELIGIBILITY/BENEFIT (365.02) sub-file The following is a list of the fields included in this patch: INQUIRE POPULAR PAYERS (350.9, 51.09) NO. POPULAR PAYERS (350.9, 51.1) POPULAR INSUR CO. FROM DATE (350.9, 51.11) POPULAR INSUR CO. THRU DATE (350.9, 51.12) FAILURE MAILMAN MSG (350.9, 51.2) MOST POPULAR LAST SAVE DATE (350.9, 51.21) POPULAR PAYERS (350.9, 51.18) POPULAR PAYER (350.9003, .01) MONETARY AMT (365.02, .08) CODE (365.15, .01) ASCII VALUE FOR IIV STATUS (365.15, .02) EXPAND ENTRY ACTION (365.15, .03) DESCRIPTION (365.152, .01) CORRECTIVE ACTION (365.17, .01) The following is a list of options included in this patch: IBCNE IIV AMBIGUOUS POLICY RPT IBCNE IIV INACTIVE POLICY RPT IBCNE IIV MENU IBCNE IIV RESPONSE REPORT IBCNE POTENTIAL NEW INS FOUND The following is a list of the protocols included in this patch: IBJP IIV MOST POPULAR ADD IBJP IIV MOST POPULAR DELETE IBJP IIV MOST POPULAR EDIT IBJP IIV MOST POPULAR EXIT IBJP IIV MOST POPULAR MENU IBJP IIV MOST POPULAR MODIFY IBJP IIV MOST POPULAR REORDER IBJP IIV MOST POPULAR RESTORE IBJP IIV MOST POPULAR SAVE The following is a list of the input templates included in this patch: IBJP IIV MOST POPULAR PAYERS The following is a list of the ListMan templates included in this patch: IBJP IIV MOST POPULAR PAYERS 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*271): 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: Process Insurance Buffer [IBCN INSURANCE BUFFER PROCESS] MCCR Site Parameter Display/Edit [IBJ MCCR SITE PARAMETERS] Purge IIV Transactions [IBCNE PURGE IIV DATA] IIV Menu [IBCNE IIV MENU] 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. Routine Information: ==================== Routine Name: - IBCNBLA Routine Checksum: Routine Name: - IBCNBLE1 Routine Checksum: Routine Name: - IBCNBLL Routine Checksum: Routine Name: - IBCNEDE Routine Checksum: Routine Name: - IBCNEDE4 Routine Checksum: Routine Name: - IBCNEDEP Routine Checksum: Routine Name: - IBCNEDEQ Routine Checksum: Routine Name: - IBCNEHLQ Routine Checksum: Routine Name: - IBCNEHLR Routine Checksum: Routine Name: - IBCNEHLS Routine Checksum: Routine Name: - IBCNEKI2 Routine Checksum: Routine Name: - IBCNEKIT Routine Checksum: Routine Name: - IBCNERP0 Routine Checksum: Routine Name: - IBCNERP1 Routine Checksum: Routine Name: - IBCNERP2 Routine Checksum: Routine Name: - IBCNERP3 Routine Checksum: Routine Name: - IBCNERP4 Routine Checksum: Routine Name: - IBCNERP5 Routine Checksum: Routine Name: - IBCNERP6 Routine Checksum: Routine Name: - IBCNERP8 Routine Checksum: Routine Name: - IBCNERP9 Routine Checksum: Routine Name: - IBCNERPA Routine Checksum: Routine Name: - IBCNEUT4 Routine Checksum: Routine Name: - IBCNEUT6 Routine Checksum: Routine Name: - IBJPI Routine Checksum: Routine Name: - IBJPI2 Routine Checksum: Routine Name: - IBJPI3 Routine Checksum: Routine Name: - IBJPI4 Routine Checksum: Routine Name: - IBJPM Routine Checksum: Routine Name: - IBCNBLA1 Routine Checksum: Routine Name: - IBCNEDE2 Routine Checksum: Routine Name: - IBCNEDE6 Routine Checksum: Routine Name: - IBCNEHLD Routine Checksum: Routine Name: - IBCNEHLI Routine Checksum: Routine Name: - IBCNEHLT Routine Checksum: Routine Name: - IBCNEHLP Routine Checksum: Routine Name: - IBCNEUT5 Routine Checksum: Routine Name: - IBCNEUT3 Routine Checksum: Routine Name: - IBCNEDE7 Routine Checksum: Routine Name: - IBCNEDE1 Routine Checksum: Routine Name: - IBCNEDE3 Routine Checksum: Routine Name: - IBCNEQU Routine Checksum: Routine Name: - IBCNEDE5 Routine Checksum: Routine Name: - IBCNEBF Routine Checksum: Routine Name: - IBY271PR Routine Checksum: Routine Name: - IBY271PS Routine Checksum: Routine Name: - IBCNERPB Routine Checksum: Routine Name: - IBCNERPC Routine Checksum: Routine Name: - IBCNERPE Routine Checksum: Routine Name: - IBCNEPST Deleted at site by patch, IB*2.0*271. Routine Checksum: ============================================================================= User Information: Entered By : ACORD,ARLIS Date Entered : APR 06, 2004 Completed By: KUREK,STANLEY M Date Completed: FEB 09, 2005 Released By : GANUS,MAUNETTE Date Released : FEB 14, 2005 ============================================================================= Packman Mail Message: ===================== $END TXT