$TXT Created by GUSTAFSON,ERIC S at DEVFEY.FO-ALBANY.MED.VA.GOV (KIDS) on Wednesday, 07/13/05 at 15:47 ============================================================================= Run Date: AUG 25, 2005 Designation: IB*2*296 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #280 Status: Released Compliance Date: SEP 25, 2005 ============================================================================= Associated patches: (v)IB*2*199 <<= must be installed BEFORE `IB*2*296' (v)IB*2*288 <<= must be installed BEFORE `IB*2*296' (v)IB*2*291 <<= must be installed BEFORE `IB*2*296' Subject: ECLAIMS PLUS ITERATION I (FAST TRACK) Category: - Data Dictionary - Routine - Enhancement (Mandatory) - Other Description: ============ Iteration I - Fast Track This patch is the first of several follow-up patches to enhance the transmission of claims sent electronically. It will provide critical functionality in VistA to allow e-Claims processing to continue to progress. The previous patches that started this enhancements process were the Electronic Data Interchange (EDI) Enhancements for HIPAA compliance patches (IB*2*232 and IB*2*280), and the Medicare Remittance Advice (MRA) (IB*2*155) patch for Integrated Billing (IB). The features included with this patch are: 1. To allow the selection and resubmission of previously transmitted claims as test claims by selecting either individual claims or claims in a previously transmitted batch and to track these test transmissions. 2. Management of any claim status return messages generated as a result of these test claim transmissions so they don't show up in the Claims Status Awaiting Resolution (CSA) option within IB. A new option to view these messages and to automatically purge them after 60 days has been added. 3. The ability to send Medicare secondary claims that have an associated MRA to the payer end-to-end as electronic claims (rather than printing them at the clearinghouse). 4. A report listing the EDI billing parameters for selected or all payers. This new report option is called 'Insurance Company EDI Parameter Report' and can be found under the Patient Insurance Menu. Technical Description: ---------------------- File EDI TEST CLAIM STATUS MESSAGE (#361.4) is a new file that has been added to the system and will be stored in global ^IBM(361.4). This file will hold any status messages returned in the test transmission queue for test claims as well as a test transmission history for the claim. The test transmission queue is the MCT queue. The live transmission queue is the MCH queue. The pre-installation routine IBY296PR updates internal entry number 1015 in the IB FORM FIELD CONTENT file (#364.7). This routine may be deleted after the install has successfully completed. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- The Chief Business Office (CBO) requested this project and patch. This patch addresses the following NOIS/Remedy Ticket(s): --------------------------------------------------------- LEX-0205-40005 SYNTAX ERROR 1/27 - LCOB/LCAS Prob. (Remedy HD 64799) Overview of NOIS/Remedy Ticket(s): ---------------------------------- LEX-0205-40005 SYNTAX ERROR 1/27 - LCOB/LCAS Prob. (Remedy HD 64799) Problem: -------- LCOB is the name of the data segment which is sent out of VistA for a claim record. The LCOB segment contains the MRA/EOB line level data for a claim. The problem was that LCOB segments were sent with only partial data. The calculation for what went out on the LCOB flat file records for the electronic claim record used 2 different algorithms for several fields. Some of the data that was meant for one line was output as part of another line instead. Some of the data was included in lines that shouldn't have existed. Resolution: ----------- All fields to be output on the LCOB flat file record for the electronic claim record now use the same algorithm to determine the correct line to be output. The internal entry numbers in the IB FORM FIELD CONTENT file (#364.7) sent are: 830, 985. 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: ;;2.0;INTEGRATED BILLING;**[patch list]**;21-MAR-94 CHECK^XTSUMBLD results Routine Before Patch After Patch Patch List ------- ------------ ----------- ---------- IBCBB2 17364901 17439487 51,137,210,245,232 296 IBCCC2 20785345 20775806 80,106,124,138,51 151,137,161,182,211 245,155,296 IBCE 10356529 11030770 137,283,296 IBCE837 26776750 27542985 137,191,197,232,296 IBCE837A 10486796 13056856 137,191,211,232,296 IBCEF 8681645 8581719 52,80,51,137,288 296 IBCEF2 14461785 14657097 52,85,51,137,232 155,296 IBCEF21 4296286 5862025 51,296 IBCEF31 2898708 3027889 155,296 IBCEF4 9457194 9612408 51,137,232,155,296 IBCEM01 8227506 8578861 137,296 IBCEM02 19608171 22869344 137,191,296 IBCEM03 16136884 17668685 137,199,296 IBCEOB1 16515088 17505231 137,135,155,296 IBCEP0B 959462 995123 137,296 IBCEPTC N/A 25646406 296 IBCEPTC1 N/A 9057729 296 IBCEPTC2 N/A 24324804 296 IBCEPTM N/A 5011023 296 IBCEPTR N/A 12545200 296 IBCEPTU N/A 1120154 296 IBCERP3 4970766 5313212 137,296 IBCERP5 17498336 18076832 137,296 IBCERPT 2898174 3275207 137,296 IBCESRV 15671023 16599878 137,181,196,232,296 IBCESRV2 9677692 10723898 137,191,155,296 IBCEU0 20956325 20989894 137,197,155,296 IBCEU1 10826195 10997416 137,155,296 IBCNSGE N/A 14967259 296 IBY296PR N/A 437625 296 Total number of routines: 30 New routines: 8 Modified routines: 22 The following is a list of files included in this patch: -------------------------------------------------------- UP SEND DATA DATE SEC. COMES SITE RSLV FILE # NAME DD CODE W/FILE DATA PTS -------------------------------------------------------------------- 361.4 EDI TEST CLAIM STATUS YES NO NO MESSAGE 364.2 EDI MESSAGES YES NO NO 364.6 IB FORM SKELETON DEFINITION NO NO YES OVER YES File entry numbers sent: 1321,1322 364.7 IB FORM FIELD CONTENT NO NO YES OVER YES File entry numbers sent: 136,137,830,985,1006,1015,1039,1040 The following is a list of fields included in this patch: --------------------------------------------------------- Field Name (Number) File Name (Number) ------------------- ------------------ CLAIM RESUBMITTED TEST (#.14) EDI MESSAGES (#364.2) CLAIM (#.01) EDI TEST CLAIM STATUS MESSAGE (#361.4) LAST TRANSMIT DATE (#.02) EDI TEST CLAIM STATUS MESSAGE (#361.4) TRANSMIT DATE/TIME (#1) EDI TEST CLAIM STATUS MESSAGE (#361.4) TRANSMIT DATE/TIME (#.01) TRANSMIT DATE/TIME SUB-FIELD (#361.41) BATCH # (#.02) TRANSMIT DATE/TIME SUB-FIELD (#361.41) TRANSMITTED BY (#.03) TRANSMIT DATE/TIME SUB-FIELD (#361.41) CURRENT PAYER SEQUENCE (#.04) TRANSMIT DATE/TIME SUB-FIELD (#361.41) MESSAGE (#2) EDI TEST CLAIM STATUS MESSAGE (#361.4) MESSAGE RECEIVED DATE/TIME (#.01) MESSAGE SUB-FIELD (#361.42) MESSAGE SEVERITY (#.02) MESSAGE SUB-FIELD (#361.42) RETURN MESSAGE ID (#.03) MESSAGE SUB-FIELD (#361.42) MESSAGE (#1) MESSAGE SUB-FIELD (#361.42) The following is a list of protocols included on this patch: ------------------------------------------------------------ Protocol Name New /Modified ------------- ------------- IBCE VIEW PREV TRANS NEW IBCE VIEW PREV TRANS BTCH SEL NEW IBCE VIEW PREV TRANS EXIT NEW IBCE VIEW PREV TRANS MENU NEW IBCE VIEW PREV TRANS REPORT NEW IBCE VIEW PREV TRANS RESUB NEW IBCE VIEW PREV TRANS SELECT NEW The following is a list of list templates included on this patch: ----------------------------------------------------------------- List Template Name New /Modified ------------------ ------------- IBCE VIEW PREV TRANS1 NEW IBCE VIEW PREV TRANS2 NEW The following is a list of options included in this patch: ---------------------------------------------------------- Option Name Type New/Modified ----------- ---- ------------ IBCN INSURANCE EDI REPORT run routine NEW IBCN INSURANCE MGMT MENU menu MODIFIED IB SYSTEM DEFINITION MENU menu MODIFIED IBCE PREV TRANSMITTED CLAIMS run routine NEW IBCE 837 EDI MENU menu MODIFIED IBCE VIEW PREV TRANS MESSAGE run routine NEW IBCE 837 EDI REPORTS menu MODIFIED Documentation Retrieval ----------------------- The EDI Billing user's guide has been updated. This guide is available for download at the following website: http://vaww.vistau.med.va.gov/vistau/e-bp/e-claims.htm The user's guide may also be retrieved from the following OI Field Offices' Anonymous.Software Directories. Use the appropriate FTP capability to retrieve the files and use 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 File Name --------- IB_2_296UG.PDF Test Sites: ----------- Albany Altoona Asheville Indianapolis - Alpha test site Iowa City Martinsburg Memphis North Chicago ================INSTALLATION INSTRUCTIONS ================= Please Note: Pre-installation routine IBY296PR may be deleted after the installation has been successfully completed. This patch should be installed after normal working hours when no Integrated Billing users are using the system. The following selection(s) in the OPTION (#19) file, and all of their descendants should be disabled to prevent possible conflicts while running the KIDS Install. Other VISTA users will not be affected. Resubmit a Bill [IBCE RESUBMIT BILL] Resubmit a Batch of Bills [IBCE RESUBMIT BILL BATCH] Enter/Edit Billing Information [IB EDIT BILLING INFO] Also, make sure the auto-transmit of electronic claims option (Queue Auto Transmit EDI Bills [IBCE 837 AUTO TRANSMIT]) in TaskManager is not scheduled to run while the patch is being installed. It's best to check with your Billing section on this. There is a field called HOURS TO TRANSMIT BILLS (#8.06) in the IB Site Parameter file (#350.9) that may contain specific times to transmit bills. If there are no specific times set up in this parameter, claims will be transmitted when the Queue Means Test Compilation of Charges [IB MT NIGHT COMP] job runs. Install Time - 2 minutes or less. 1. LOAD TRANSPORT GLOBAL --------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. 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 --- 1 Load a Distribution 2 Verify Checksums in Transport Global 3 Print Transport Global 4 Compare Transport Global to Current System 5 Backup a Transport Global 6 Install Package(s) Restart Install of Package(s) Unload a Distribution Select Installation Option: 3. SELECT INSTALLATION OPTION -------------------------- NOTE: The following are OPTIONAL (When prompted for the INSTALL NAME, enter IB*2.0*296): 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 the 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. 4. INSTALL KIDS BUILD ------------------ a. Choose the Install Package(s) option of the Installation menu to start the patch install. b. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//', take the default (YES). NOTE: Answer YES unless your system does this in a nightly TaskMan process. c. When prompted 'Want KIDS to INHIBIT LOGONs during the install? YES//' answer NO. d. When prompted 'Want to DISABLE Scheduled Options and Menu Options? YES//', take the default (YES). e. When prompted "Enter options you wish to mark as 'Out of Order':", enter the following options: Resubmit a Bill [IBCE RESUBMIT BILL] Resubmit a Batch of Bills [IBCE RESUBMIT BILL BATCH] Enter/Edit Billing Information [IB EDIT BILLING INFO] f. When prompted 'Enter protocols you wish to mark as 'Out Of Order':', press . Routine Information: ==================== Routine Name: - IBCEF2 Routine Checksum: Routine Name: - IBCEF4 Routine Checksum: Routine Name: - IBCE837 Routine Checksum: Routine Name: - IBCE837A Routine Checksum: Routine Name: - IBCESRV Routine Checksum: Routine Name: - IBCEM01 Routine Checksum: Routine Name: - IBCEM02 Routine Checksum: Routine Name: - IBCEM03 Routine Checksum: Routine Name: - IBCNSGE Routine Checksum: Routine Name: - IBCBB2 Routine Checksum: Routine Name: - IBY296PR Routine Checksum: Routine Name: - IBCEPTC Routine Checksum: Routine Name: - IBCEPTC1 Routine Checksum: Routine Name: - IBCEPTC2 Routine Checksum: Routine Name: - IBCESRV2 Routine Checksum: Routine Name: - IBCERPT Routine Checksum: Routine Name: - IBCEPTM Routine Checksum: Routine Name: - IBCEPTU Routine Checksum: Routine Name: - IBCEF Routine Checksum: Routine Name: - IBCEU1 Routine Checksum: Routine Name: - IBCEPTR Routine Checksum: Routine Name: - IBCEU0 Routine Checksum: Routine Name: - IBCEOB1 Routine Checksum: Routine Name: - IBCCC2 Routine Checksum: Routine Name: - IBCEP0B Routine Checksum: Routine Name: - IBCERP5 Routine Checksum: Routine Name: - IBCE Routine Checksum: Routine Name: - IBCERP3 Routine Checksum: Routine Name: - IBCEF31 Routine Checksum: Routine Name: - IBCEF21 Routine Checksum: ============================================================================= User Information: Entered By : KOPP,TERRY M Date Entered : DEC 28, 2004 Completed By: ROBBINS,BRADLEY Date Completed: AUG 24, 2005 Released By : JACKSON,SHERYL Date Released : AUG 25, 2005 ============================================================================= Packman Mail Message: ===================== $END TXT