$TXT Created by HARPER,AMY R at DEVFEX.FO-ALBANY.MED.VA.GOV (KIDS) on Wednesday, 04/25/07 at 17:36 ============================================================================= Run Date: JUN 04, 2007 Designation: IB*2*339 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #333 Status: Released Compliance Date: JUL 05, 2007 ============================================================================= Associated patches: (v)IB*2*277 <<= must be installed BEFORE `IB*2*339' (v)IB*2*341 <<= must be installed BEFORE `IB*2*339' (v)IB*2*342 <<= must be installed BEFORE `IB*2*339' Subject: IB PROJECT 112/SHAD SUPPORT Category: - Routine - Enhancement (Mandatory) - Data Dictionary Description: ============ This patch will update Integrated Billing to support the following: - A new Environmental Indicator of Project 112/SHAD is being created. - The Environmental Contaminants indicator is renamed Southwest Asia. The complete VistA implementation of Project 112/SHAD and Southwest Asia will be released with the Enrollment VistA Changes - Release 2 (EVC R2) project. Several clinical packages will be updated for Project 112/SHAD in conjunction with the release of EVC R2. The Integrated Billing Project 112/SHAD update installed by this patch will be inactive until the clinical packages where the indicators are set are updated. Integrated Billing can not properly process Project 112/SHAD care until the care is identified in the clinical packages The Integrated Billing Environmental Contaminants/Southwest Asia update will be implemented when this patch is installed. However the clinical packages will not be updated to display Southwest Asia until the release of EVC R2. Therefore until all packages are updated this indicator may be displayed as Environmental Contaminant but as Southwest Asia in IB. PROJECT OVERVIEW ================ The Chief Business Office (CBO) has requested modifications to the Veterans Health Information Systems and Technology Architecture (VistA) to support the identification of patients and care related to Project 112 and Project SHAD (Shipboard Hazard and Defense) and to waive all charges for that care. To accomplish this objective, Project 112/SHAD will be added to VistA as a new Classification for patients and care. Care associated with this Classification will not be billed to First or Third Party Payers. Summary of the changes to Integrated Billing to support Project 112/SHAD: - Claims Tracking entries for related care will be assigned the Reason Not Billable of Project 112/SHAD. - The Third Party Autobiller will not create bills for any event with a Reason Not Billable of Project 112/SHAD. - The First Party Autobiller will not create bills for an event related to Project 112/SHAD. - Inpatient Admissions for a patient that has claimed Project 112/SHAD exposure will be entered as an Inpatient Special Billing case of type Project 112/SHAD. - All reports and displays will either have the Project 112/SHAD events screened out or flagged. Implementation of Project 112/SHAD in VistA will require patches to several packages to identify and properly process Project 112/SHAD care. This development has been organized within the Enrollment VistA Changes (EVC) - Release 2 project. This patch, IB*2*339, will implement the Integrated Billing (IB) support for Project 112/SHAD by preventing billing of care identified as Project 112/SHAD related. The identification of care as related to Project 112/SHAD will occur in the clinical packages. Once the clinical packages have been updated to identify care as Project 112/SHAD, then IB will be able to screen that care from charges. The following are the list of packages and patches IB will rely on to properly identify Project 112/SHAD care: PX*1.0*168 Patient Care Encounter (PCE) SD*5.3*441 Scheduling DG*5.3*664 Registration PSO*7.0*225 Outpatient Pharmacy SR*3.0*152 Surgery (released 05/31/06) Billing screening of care due to Project 112/SHAD will begin when these packages are updated. Note that there are more patches included in EVC Release 2, but these are the patches that directly impact IB. Also included in the EVC R2 project is the renaming of the Classification Environmental Contaminants to Southwest Asia. This is a simple name replacement, no functionality will be changed. All reports and displays in Integrated Billing will be changed to display Southwest Asia (SWA) instead of Environmental Contaminant (EC). FUNCTIONAL DESCRIPTION ====================== This patch IB*2*339 modifies the Integrated Billing software to implement the following requirements to prevent billing and report on Project 112/SHAD care and replace Environmental Contaminants with Southwest Asia. Claims Tracking --------------- Claims Tracking is updated, records of events identified in the clinical record as being related to Project 112/SHAD will be added to Claims Tracking with a Reason Not Billable. This will remove those events from the list of billable Third Party events. Also, various reports and displays are updated for both Project 112/SHAD and Southwest Asia. 1. A new Reason Not Billable of 'PROJECT 112/SHAD' has been added to the CLAIMS TRACKING NON-BILLABLE REASONS file (#350.8). 2. Reason Not Billable 'ENV. CONTAM.' has been renamed 'SOUTHWEST ASIA' 'ENV. CONTAM.' will no longer be available. 3. Add Prescriptions to Claims Tracking The background task that adds Prescriptions to Claims Tracking is updated. Prescriptions identified as related to Project 112/SHAD in Outpatient Pharmacy will be added to Claims Tracking (#356) with a Reason Not Billable of 'PROJECT 112/SHAD'. Prescriptions previously identified as related to Environmental Contaminants will be added to Claims Tracking (#356) with a Reason Not Billable of 'SOUTHWEST ASIA' *Manually Add Rx Refills to Claims Tracking[IBT SUP MANUALLY QUE RX FILLS] *Queue Means Test Compilation of Charges [IB MT NIGHT COMP] 4. Add Prosthetics to Claims Tracking The background task that adds Prosthetics to Claims Tracking is updated. Prosthetics items for SHAD patients will be added to Claims Tracking (#356) with a Reason Not Billable of Needs SC Determination. SHAD is not identified as a classification in Prosthetics. Prosthetics items previously identified as related to Environmental Contaminants will be added to Claims Tracking (#356) with a Reason Not Billable of 'SOUTHWEST ASIA' *Queue Means Test Compilation of Charges [IB MT NIGHT COMP] 5. Add Outpatient Encounter to Claims Tracking The background task that adds Outpatient Encounters to Claims Tracking is updated. Outpatient encounters identified as related to Project 112/SHAD in PCE (Patient Care Encounter) will be added to Claims Tracking (#356) with a Reason Not Billable of 'PROJECT 112/SHAD'. Outpatient encounters previously identified as related to Environmental Contaminants will be added to Claims Tracking (#356) with a Reason Not Billable of 'SOUTHWEST ASIA' *Queue Means Test Compilation of Charges [IB MT NIGHT COMP] *Manually Add Opt. Encounters to Claims Tracking [IBT SUP MANUALLY QUE ENCTRS] 6. Outpatient Encounters added to Claims Tracking Bulletin The user initiated option to add Outpatient Encounters to Claims Tracking sends a bulletin with a summary of the results. This bulletin is updated to indicate Project 112/SHAD and Southwest Asia as reasons a non-billable Claims Tracking record may have been created. Reference to Environmental Contaminants has been removed. *Manually Add Opt. Encounters to Claims Tracking [IBT SUP MANUALLY QUE ENCTRS] 7. Assign Reason Not Billable manually to Claims Tracking Most entries are added to Claims Tracking automatically and the Reason Not Billable of Project 112/SHAD should also be added automatically, if appropriate. However, there are potentially cases where the adding/editing of an events Reason Not Billable must be manually changed. The Claims Tracking edit option has been updated to allow manual use of Reason Not Billable 'PROJECT 112/SHAD' and 'SOUTHWEST ASIA'. 'ENV. CONTAM' has been removed as a potential Reason Not Billable. *Claims Tracking Edit [IBT EDIT TRACKING ENTRY] 8. Identify Classification on Claim Tracking Edit Display The Claims Tracking Edit option has been updated to indicate if the event was related to Project 112/SHAD (SHAD) or Southwest Asia (SWA). *Claims Tracking Edit [IBT EDIT TRACKING ENTRY] 9. Identify Classification on Claims Tracking Hospital Reviews The Claims Tracking Hospital Reviews option has been updated to indicate if event was related to Project 112/SHAD (SHAD) or Southwest Asia (SWA). *Hospital Reviews [IBT EDIT REVIEWS] 10. Identify Classification on Claims Tracking Appeals/Denials The Claims Tracking Appeals/Denials option has been updated to indicate if the event was related to Project 112/SHAD (SHAD) or Southwest Asia (SWA). *Appeal/Denial Edit [IBT EDIT APPEALS/DENIALS] 11. Identify Classification on Print CT Summary for Billing Report The Claims Tracking summary billing report has been updated to indicate if the event was related to Project 112/SHAD (SHAD) or Southwest Asia (SWA). *Print CT Summary for Billing [IBT OUTPUT BILLING SHEET] 12. Identify Classification on Inquire to Claims Tracking Report The Claims Tracking single event report has been updated to indicate if the event was related to Project 112/SHAD (SHAD) or Southwest Asia (SWA). *Inquire to Claims Tracking [IBT OUTPUT CLAIM INQUIRY] THIRD PARTY BILLING ------------------- Various reports and options related to Third Party Billing are updated to identify when care is Project 112/SHAD related, so it may be properly processed and bills prevented. Environmental Contaminants has been replaced by Southwest Asia. 1. Screen Encounters in Third Party Autobiller The Third Party Autobiller creates bills based on the encounters in Claims Tracking. This is updated to screen encounters identified as related to Project 112/SHAD so no bill will be created. *Queue Means Test Compilation of Charges [IB MT NIGHT COMP] 2. Identify Classification of Bill/Claim Outpatient Encounter Procedures Outpatient Encounter/PCE procedures are displayed and may be manually added to a Bill/Claim. The display has been updated to include indication if the encounter was related to Project 112/SHAD and to replace Environmental Contaminants(EC) with Southwest Asia(SWA). (screen5,option4) *Enter/Edit Billing Information [IB EDIT BILLING INFO] 3. Identify Classification of Bill/Claim Surgery Anesthesia Procedures When Anesthesia procedures are added to a Bill/Claim, related data from Surgery is displayed. The display has been updated to include indication if the procedure was related to Project 112/SHAD(SHAD) and to replace Environmental Contaminants(EC) with Southwest Asia(SWA). (screen5,option4) *Enter/Edit Billing Information [IB EDIT BILLING INFO] 4. Identify Classification of Bill/Claim Inpatient Professional Procedure Inpatient/PTF Professional Procedures (801) are displayed and may be manually added to a Bill/Claim. The display has been updated to include indication if the care was related to Project 112/SHAD(SH) and to replace Environmental Contaminants(EC) with Southwest Asia(SW). (screen4,option4) *Enter/Edit Billing Information [IB EDIT BILLING INFO] 5. Identify Classification of Bill/Claim Prescriptions Prescriptions from Outpatient Pharmacy are displayed and may be manually added to a Bill/Claim. The display has been updated to include indication if the Prescription was related to Project 112/SHAD(SHAD) and to replace Environmental Contaminants(EC) with Southwest Asia(SWA). (screen5,option5) *Enter/Edit Billing Information [IB EDIT BILLING INFO] 6. Identify Classification of Bill/Claim Prosthetics Items Prosthetics Items are displayed and may be manually added to a Bill/Claim, the display has been updated to replace Environmental Contaminants (EC) with Southwest Asia (SWA). SHAD is not identified as a classification in Prosthetics. (screen5,option6) *Enter/Edit Billing Information [IB EDIT BILLING INFO] 7. Screen Classification on Unbilled Amounts Report The Unbilled Amounts options identify Inpatient, Outpatient, and Prescription events that are potentially billable but that have not yet been billed. This report has been updated to screen out events identified as related to Project 112/SHAD. (SWA already removed from report as EC.) *Re-Generate Unbilled Amounts Report [IBT RE-GEN UNBILLED REPORT] 8. Screen Classification on Outpatient Workload Report The Diagnostic Measures intake report of outpatient services has been modified to screen out encounters identified as related to Project 112/SHAD. (SWA already removed from report as EC.) *Outpatient Workload Report [IBJD INTAKE OPT WORKLOAD] SPECIAL INPATIENT BILLING CASES ------------------------------- When a patient who has claimed a classification is admitted, a Special Inpatient Billing Case is created for tracking the admission until it can be determined if the care is related to that classification. This has been updated to include Project 112/SHAD as a special case classification. Environmental Contaminants has been replaced by Southwest Asia. 1. The SPECIAL INPATIENT BILLING CASES, PATIENT TYPE (#351.2, .03) has been updated to include PROJECT 112/SHAD as a reason an event is a special case. 2. The SPECIAL INPATIENT BILLING CASES, PATIENT TYPE (#351.2, .03) has been updated to replace ENVIRONMENTAL CONTAMINANT with SOUTHWEST ASIA as a reason an event is a special case. 3. Add Special Billing Case for Project 112/SHAD Admission A background task is initiated when a patient is admitted to process that admission for billing. This task has been updated to create a Special Inpatient Billing Case for a patient assigned to Project 112/SHAD. Special Inpatient Billing Cases previously identified as Environmental Contaminant will be added with a reason of Southwest Asia. *IB MEANS TEST BILLING Protocol - Patient Movement event driver 4. Identify Classification on Special Inpatient Billing Cases Bulletin When a patient that meets the Special Inpatient Billing Cases criteria is admitted or discharged, a bulletin is sent to alert billing personnel that action is needed for the case. This bulletin has been updated to include Project 112/SHAD as the reason for the special case, when appropriate. Environmental Contaminant has been replaced with Southwest Asia. *IB MEANS TEST BILLING Protocol - Patient Movement event driver 5. Identify Classification on Disposition Special Inpatient Billing Cases When the classification of an admission is known, then the Special Inpatient Billing Cases must be processed to remove the case from tracking. This disposition has been updated to display and allow processing of Project 112/SHAD(SHAD) related cases. Environmental Contaminant(EC) has been replaced with Southwest Asia(SWA). *Disposition Special Inpatient Billing Cases [IB MT DISP SPECIAL CASES] 6. Identify Classification on Special Inpatient Billing Cases Report The Special Inpatient Billing Cases tracking report has been updated to properly identify the special cases related to Project 112/SHAD(SHAD). Environmental Contaminant(EC) has been replaced with Southwest Asia(SWA). *List Special Inpatient Billing Cases [IB MT LIST SPECIAL CASES] FIRST PARTY BILLING ------------------- Various reports and options related to First Party Billing are updated to identify when care is Project 112/SHAD related, so it may be properly processed and patient charges prevented. On displays and reports Environmental Contaminants has been replaced by Southwest Asia. 1. A new Charge Removal Reason of 'PROJECT 112/SHAD' has been added to the IB CHARGE REMOVE REASONS file (#350.3). 2. The Charge Removal Reason 'ENV CONTAMINANT RELATED' has been renamed 'SOUTHWEST ASIA RELATED'. 'ENV CONTAMINANT RELATED' will no longer be available. 3. Screen Classification for New Outpatient Encounter Patient Charges When Outpatient Encounters are Checked-Out, a background task automatically creates new patient charges. This task has been updated so no patient charge will be created for Outpatient Encounters identified as related to Project 112/SHAD. *IBACM OP LINK Protocol - Integrated Billing link to Scheduling 4. Screen Classification for Updated Outpatient Encounter Patient Charges When Outpatient Encounter data is updated, a background task is initiated to re-evaluate the billable status of the encounter. This has been updated to process charges based on a Project 112/SHAD classification change. If the encounter is changed to be related to Project 112/SHAD, then existing charges will be cancelled. If Project 112/SHAD classification is removed, then charges may be created. *IBACM OP LINK Protocol - Integrated Billing link to Scheduling 5. Screen Classification for Means Test IVM Backbilling When Means Test are added/updated from IVM, a background task is initiated to process the patient charges based on the Means Test changes. This task has been updated so no patient charge will be created for care identified as related to Project 112/SHAD. *IB MEANS TEST BILLING Protocol - Patient Movement event driver. 6. Assign Charge Removal Reason to Patient Charges The option used to cancel patient charges has been updated to include 'PROJECT 112/SHAD' and 'SOUTHWEST ASIA RELATED' as reasons for cancellation. 'ENV CONTAMINANT RELATED' will no longer be available. *Cancel/Edit/Add Patient Charges [IB CANCEL/EDIT/ADD CHARGES] 7. Identify Classification on Outpatient/Registration Events Report The report of Outpatient Events for Category C patient's has been updated to include indication if the event was related to Project 112/SHAD(SHAD). Environmental Contaminant(EC) has been replaced with Southwest Asia(SWA). *Outpatient/Registration Events Report [IB OUTPUT EVENTS REPORT] 8. Identify Cancellation Reason on Patient Billing Inquiry This report lists patient charges and includes lists of cancelled charges. This has been updated to include Project 112/SHAD charge removal reason. Env Contaminant Related has been replaced with Southwest Asia Related. *Patient Billing Inquiry [IB OUTPUT FULL INQ BY BILL NO] 9. Identify Cancellation Reason on Patient Means Test Billing Profile This report lists the Means Test charges for a patient and includes lists of cancelled charges. This has been updated to include Project 112/SHAD as a charge removal reason. Env Contaminant Related has been replaced with Southwest Asia Related. *Single Patient Means Test Billing Profile [IB MT PROFILE] 10. Identify Cancellation Reason on LTC Patient Billing Profile The long term care patient billing profile contains lists of cancelled charges. This has been updated to include Project 112/SHAD charge removal reason. Env Contaminant Related has been replaced by Southwest Asia. *LTC Single Patient Billing Profile [IBAEC LTC BILLING PROFILE] 11. Identify Cancellation Reason on GMT Patient Report The Geographic Means Test patient report contains lists of cancelled charges. This has been updated to include Project 112/SHAD charge removal reason. Env Contaminant Related has been replaced by Southwest Asia. *GMT Single Patient Report [IB GMT SINGLE PATIENT REPORT] 12. Identify Cancellation Reason on On Hold Charges Report This report lists the charges for a patient that are or were On Hold and contains lists of cancelled charges. This has been updated to include Project 112/SHAD as a charge removal reason. Env Contaminant Related has been replaced by Southwest Asia Related. *List Current/Past Held Charges by Pt [IB OUTPUT HELD CHARGES/PT] 13. Outpatient Encounters Exempt from Classification Bulletin Generally, First Party Outpatient charges are automatically created. However, there are certain encounters that may be exempt from the classification questions. When this occurs for patients that have claimed exposure, the billable status of the encounter can not be automatically determined. Therefore, no charge is created but a bulletin is sent. This bulletin has been updated indicate if Project 112/SHAD was the claimed exposure that may result in exemption from charges. Environmental Contaminants has been replaced with Southwest Asia. *IBACM OP LINK Protocol - Integrated Billing link to Scheduling IB/ECME ------- The IB portion of ECME and e-Pharmacy determines the billable status of a prescription and maintains the VistA bill and accounts receivables. 1. IB NCPDP EVENT LOG, EVENT, SHAD (#366.141,.408) new field A new field has been added to the Event Log to allow a prescription processed through ECME to be identified as related to Project 112/SHAD. 2. IB NCPDP EVENT LOG, EVENT, SWA (#366.141,.403) updated The field which identifies a prescription as related to Environmental Contaminants/Southwest Asia has been renamed from EC to SWA. 3. Adding ECME Billing Events from API The background process that adds prescriptions to the IB/ECME Event Log has been updated to identify prescriptions related to Project 112/SHAD. 4. Screen Classification on Prescription Billable Status Check The billing function used to identify the billable status of a prescription has been updated to mark as not billable any Prescription identified as related to Project 112/SHAD. Environmental Contaminants has been replaced with Southwest Asia as a non-billable reason. 5. ECME Billing Events Report The report of ECME billing events is updated to display if processed prescriptions are related to Project 112/SHAD. Environmental Contaminants has been replaced with Southwest Asia. *ECME Billing Events Report [IB ECME BILLING EVENTS] This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- There is no NSR associated with this patch. This patch addresses the following NOIS/Remedy Ticket(s): --------------------------------------------------------- There is no NOIS/Remedy tickets associated with this patch. Test Sites ========== Agusta GA Dublin GA TECHNICAL DESCRIPTION ===================== 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 ============ ============ =========== ========== IB20P339 N/A 10718992 339 IBACV 9144468 9549550 234,247,275,339 IBAMTD 6919763 7019645 45,52,93,115,132 153,164,156,234,312 339 IBAMTI 11013314 11008360 52,132,153,156,234 247,339 IBAMTI1 8286888 7679479 52,132,156,199,234 339 IBAMTS 8263775 8271560 52,115,132,153,164 156,171,247,312,341 339 IBAMTS1 5314283 5309329 20,52,132,153,166 156,167,247,339 IBAMTS2 3687338 3740501 52,91,117,132,153 156,167,247,339 IBCCPT 24736464 24508228 55,62,52,91,106 125,51,148,174,182 245,266,260,339 IBCSC4A 17517256 17517772 106,228,339 IBCSC5B 11043503 11081915 4,52,260,339 IBCSC5C 16652096 16649685 27,52,130,51,160 260,309,315,339 IBCU74 16856816 16854308 228,260,339 IBJDI7 13303929 13392325 69,91,98,100,118 133,339 IBNCPDP1 15150053 16363599 223,276,339 IBNCPDPC 10283615 10371517 276,339 IBNCPEV1 6098128 6125654 342,339 IBNCPLOG 11951861 12013503 342,339 IBOVOP1 6223412 6294066 52,91,99,132,156 176,234,249,339 IBOVOP2 8955438 9139692 52,132,153,156,167 176,234,247,339 IBTRED 8645997 8733899 71,91,160,247,309 276,339 IBTRKR3 15611645 15621857 13,43,121,160,247 275,260,309,336,312 339 IBTRKR41 11702809 11909089 43,55,91,132,174 247,260,315,292,312 339 IBTRKR5 11613084 12271664 13,260,312,339 IBTUBO1 11129561 11177210 19,31,32,91,123 159,247,155,277,339 Number of Routines = 25 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 CHECK1^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== IB20P339 N/A 20765882 339 IBACV 33359562 35472344 234,247,275,339 IBAMTD 18809071 19206296 45,52,93,115,132 153,164,156,234,312 339 IBAMTI 27257826 27252728 52,132,153,156,234 247,339 IBAMTI1 18623119 17944489 52,132,156,199,234 339 IBAMTS 18301561 18456624 52,115,132,153,164 156,171,247,312,341 339 IBAMTS1 22333609 22328511 20,52,132,153,166 156,167,247,339 IBAMTS2 9672528 9767783 52,91,117,132,153 156,167,247,339 IBCCPT 67217421 67101074 55,62,52,91,106 125,51,148,174,182 245,266,260,339 IBCSC4A 31464103 31509518 106,228,339 IBCSC5B 22166369 22247597 4,52,260,339 IBCSC5C 37628978 37694343 27,52,130,51,160 260,309,315,339 IBCU74 34281515 34341645 228,260,339 IBJDI7 51061469 51362696 69,91,98,100,118 133,339 IBNCPDP1 52180701 66261404 223,276,339 IBNCPDPC 34220485 34403987 276,339 IBNCPEV1 20779583 21049389 342,339 IBNCPLOG 49413338 49957906 342,339 IBOVOP1 14282604 14775024 52,91,99,132,156 176,234,249,339 IBOVOP2 13589783 13818826 52,132,153,156,167 176,234,247,339 IBTRED 22391684 22563966 71,91,160,247,309 276,339 IBTRKR3 44426999 44657681 13,43,121,160,247 275,260,309,336,312 339 IBTRKR41 31657328 32576267 43,55,91,132,174 247,260,315,292,312 339 IBTRKR5 30688575 32493921 13,260,312,339 IBTUBO1 45653349 45713033 19,31,32,91,123 159,247,155,277,339 Number of Routines = 25 The following is a list of New/Updated Fields included in this patch: --------------------------------------------------------------------- File Name (Number) Field Name (Number) ------------------- ------------------ SPECIAL INPATIENT BILLING CASES (#351.2) PATIENT TYPE (#351.2, .03) IB NCPDP EVENT LOG (#366.14) SWA (#366.141, .403) IB NCPDP EVENT LOG (#366.14) SHAD (#366.141, .408) - new The following is a list of Reference File Entries included in patch: -------------------------------------------------------------------- File Name (Number) New/Updated Entry ------------------ ------------------- CLAIMS TRACKING NON-BILLABLE REASONS (#356.8) New: 'PROJECT 112/SHAD' Rename: 'ENV. CONTAM.' To: 'SOUTHWEST ASIA' IB CHARGE REMOVE REASONS (#350.3) New: 'PROJECT 112/SHAD' Rename: 'ENV CONTAMINANT RELATED' To: 'SOUTHWEST ASIA RELATED' Pre/Post Installation Overview ------------------------------ - Add New Reason Not Billable of 'PROJECT 112/SHAD' (#356.8). - Rename Reason Not Billable 'ENV. CONTAM.' to 'SOUTHWEST ASIA' (#356.8). - Add New Charge Removal Reason of 'PROJECT 112/SHAD' (#350.3). - Rename Charge Removal Reason 'ENV CONTAMINANT RELATED' to 'SOUTHWEST ASIA RELATED' (#350.3). ================INSTALLATION INSTRUCTIONS ================= To fully implement the functionality in this patch requires several patches that are being released in conjunction with Enrollment VistA Changes - Release 2 (EVC R2). However, technically this patch is not dependent on the other patches in the EVC-R2 project. The dependent IB functionality will be inactive until the EVC-R2 patches are released and installed. IB*2*339 installation is not dependent on the installation of the other EVC-2 patches. This patch may be installed before the other EVC-2 patches. 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 when the IB NIGHTLY BACKGROUND JOB (Queue Means Test Compilation of Charges [IB MT NIGHT COMP] option) job is running. 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. 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: 3. Select Installation Option: --------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter IB*2.0*339): 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. 4. 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: [IBT SUP MANUALLY QUE RX FILLS] Manually Add Rx Refills to Claims Tracking [IBT SUP MANUALLY QUE ENCTRS] Manually Add Opt.Encounters to Claims Tracking [IBT EDIT TRACKING ENTRY] Claims Tracking Edit [IBT EDIT REVIEWS] Hospital Reviews [IBT EDIT APPEALS/DENIALS] Appeal/Denial Edit [IBT OUTPUT BILLING SHEET] Print CT Summary for Billing [IBT OUTPUT CLAIM INQUIRY] Inquire to Claims Tracking [IB EDIT BILLING INFO] Enter/Edit Billing Information [IBT RE-GEN UNBILLED REPORT] Re-Generate Unbilled Amounts Report [IBJD INTAKE OPT WORKLOAD] Outpatient Workload Report [IB MT DISP SPECIAL CASES] Disposition Special Inpatient Billing Cases [IB MT LIST SPECIAL CASES] List Special Inpatient Billing Cases [IB CANCEL/EDIT/ADD CHARGES] Cancel/Edit/Add Patient Charges [IB OUTPUT EVENTS REPORT] Outpatient/Registration Events Report [IB OUTPUT FULL INQ BY BILL NO] Patient Billing Inquiry [IB MT PROFILE] Single Patient Means Test Billing Profile [IBAEC LTC BILLING PROFILE] LTC Single Patient Billing Profile [IB GMT SINGLE PATIENT REPORT] GMT Single Patient Report [IB OUTPUT HELD CHARGES/PT] List Current/Past Held Charges by Pt [IB ECME BILLING EVENTS] ECME Billing Events Report e. When prompted 'Enter protocols you wish to mark as 'Out Of Order':' press . 5. CLEAN UP POST INIT ROUTINE -------------------------- Optional - Once this patch has been successfully installed you may delete the post init routine: IB20P339 Example of Post Init portion of Installation: IB Support for SHAD/SWA Post-Install >>> PROJECT 112/SHAD Reason Not Billable (#356.8) Added. >>> PROJECT 112/SHAD Charge Removal Reason (#350.3) Added. >>> ENV. CONTAM. Reason Not Billable (#356.8) Replaced with SOUTHWEST ASIA >>> ENV CONTAMINANT RELATED Charge Removal Reason (#350.3) Replaced with SOUTHWEST ASIA RELATED IB Support for SHAD/SWA Post-Install Complete ========================================================================= ========================================================================= SUMMARY OF ALL TECHNICAL CHANGES ================================ Not all these components (such as the options and protocols) are exported with this patch but they are changed functionally to properly process Project 112/SHAD care. RELATED DBIA's -------------- Number Item Custodial Package ------ --------------- -------------------------- 1889-F ENCEVENT^PXKENC PCE PATIENT CARE ENCOUNTER 406 CL^SDCO21 SCHEDULING 4205 ICDINFO^DGAPI REGISTRATION 124-D #52, 52311, 8 (New Field) OUTPATIENT PHARMACY 4427 ANESTIME^SROANEST SURGERY 125-A NEW^IBARX INTEGRATED BILLING (Update CP^PSOCP) 4299 RX^IBNCPDP INTEGRATED BILLING (ECME) OPTIONS (related, options not exported) --------------------------------------- - Manually Add Rx Refills to Claims Tracking [IBT SUP MANUALLY QUE RX FILLS] - Manually Add Opt. Encounters to Claims Tracking [IBT SUP MANUALLY QUE ENCTRS] - Queue Means Test Compilation of Charges [IB MT NIGHT COMP] - Claims Tracking Edit [IBT EDIT TRACKING ENTRY] - Hospital Reviews [IBT EDIT REVIEWS] - Appeal/Denial Edit [IBT EDIT APPEALS/DENIALS] - Print CT Summary for Billing [IBT OUTPUT BILLING SHEET] - Inquire to Claims Tracking [IBT OUTPUT CLAIM INQUIRY] - Enter/Edit Billing Information [IB EDIT BILLING INFO] - Re-Generate Unbilled Amounts Report [IBT RE-GEN UNBILLED REPORT] - Outpatient Workload Report [IBJD INTAKE OPT WORKLOAD] - Disposition Special Inpatient Billing Cases [IB MT DISP SPECIAL CASES] - List Special Inpatient Billing Cases [IB MT LIST SPECIAL CASES] - Cancel/Edit/Add Patient Charges [IB CANCEL/EDIT/ADD CHARGES] - Outpatient/Registration Events Report [IB OUTPUT EVENTS REPORT] - Patient Billing Inquiry [IB OUTPUT FULL INQ BY BILL NO] - Single Patient Means Test Billing Profile [IB MT PROFILE] - LTC Single Patient Billing Profile [IBAEC LTC BILLING PROFILE] - GMT Single Patient Report [IB GMT SINGLE PATIENT REPORT] - List Current/Past Held Charges by Pt [IB OUTPUT HELD CHARGES/PT] - ECME Billing Events Report [IB ECME BILLING EVENTS] PROTCOLS (related, protocols not exported) ------------------------------------------ IB MEANS TEST BILLING Protocol - Patient Movement event driver. IBACM OP LINK Protocol - Integrated Billing link to Scheduling FILE/FIELDS/REFERENCE ENTRIES File/Field New/Updates: ----------------------- SPECIAL INPATIENT BILLING CASES file (#351.2), PATIENT TYPE field (.03) - updated, new code added: 8 - PROJECT 112/SHAD. - updated, code changed: 3 - ENVIRONMENTAL CONTAMINANT to SOUTHWEST ASIA IB NCPDP EVENT LOG (#366.14) file, EVENT (#1), SWA (.403) - updated, field name changed from 'EC' to 'SWA' - updated, description to correspond with name change IB NCPDP EVENT LOG (#366.14) file, EVENT (#1), SHAD (.408) - new, new field added Reference Entries New/Updated: ------------------------------ CLAIMS TRACKING NON-BILLABLE REASONS file (#356.8): - New Reason Not Billable Added: Name = PROJECT 112/SHAD - Updated Reason Not Billable: Name = ENV. CONTAM. To = SOUTHWEST ASIA IB CHARGE REMOVE REASONS file (#350.3): - New Charge Removal Reason Added: Name = PROJECT 112/SHAD Abbr = SHAD Limit = GENERIC - Updated Charge Removal Reason: Name = ENV CONTAMINANT RELATED To = SOUTHWEST ASIA RELATED Abbr = EC To = SWA POST INIT: ---------- IB20P339: Patch Post Init containing the following: - Add a new Reason Not Billable of 'PROJECT 112/SHAD' to the CLAIMS TRACKING NON-BILLABLE REASONS file (#356.8). - Add a new Charge Removal Reason of 'PROJECT 112/SHAD' to the IB CHARGE REMOVE REASONS file (#350.3). - The Reason Not Billable of 'ENV. CONTAM.' is rename 'SOUTHWEST ASIA' in CLAIMS TRACKING NON-BILLABLE REASONS (#356.8) file. - The Charge Removal Reason of 'ENV CONTAMINANT RELATED' is renamed 'SOUTHWEST ASIA RELATED' in the IB CHARGE REMOVE REASONS (#350.3) file. SUMMARY OF ROUTINE CHANGES: --------------------------- All routines have had the 3rd line updated, if applicable: From: ;;Per VHA Directive 10-93-142, this routine should not be modified. To: ;;Per VHA Directive 2004-038, this routine should not be modified. IBACV: Special Inpatient Billing Case utilities 1) Updated utility that returns external form of the Special Case Patient Type to include the new type of Project 112/SHAD. 2) Added new utility to return Special Case Patient Type abbreviations. 3) Updated Patient Type utilities to return SWA/Southwest Asia in place of EC/Environmental Contaminants. IBAMTD: New Special Inpatient Billing Cases 1) Added creation of a new Special Inpatient Billing Case when an admission is entered that may be related to Project 112/SHAD, this corresponds to new cases being created for the other classifications. 2) Updated comments to reflect the change from EC to SWA. IBAMTI: Process Special Inpatient Billing Cases 1) Comments added regarding processing of Special Inpatient Billing Cases due to potential relationship to Project 112/SHAD. 2) Updated comments to reflect the change from EC to SWA. IBAMTI1: Disposition Special Inpatient Billing Cases 1) Option Help text display has been changed to include Project 112/SHAD and Southwest Asia information, also rearranged for screen display wrap. 2) Modified display of Special Inpatient Billing Cases to include indicator if case may be related to Project 112/SHAD and replaced EC with SWA for Environmental Contaminant/Southwest Asia. Replaced hard coded list of available classifications with a new function call. IBAMTS: Patient Priority Classification 1) Updated utility that returns patient's highest priority classification on a date to include Project 112/SHAD. The order of classification priority has been changed to: SC, CV, AO, IR, EC, SHAD, MST, HNC. 2) Updated utility that returns patient's highest priority classification on a date to replace EC with SWA. IBAMTS1: Process Outpatient Encounters for First Party Billing 1) Comments added regarding processing new or edited encounters due to Project 112/SHAD indicator. Project 112/SHAD encounters are screened out so no First Party bill will be created, same as all other classifications. 2) Updated comments to reflect the change from EC to SWA. IBAMTS2: Process Outpatient Encounter Changes 1) Modified the check for changes in classification during editing of an Outpatient Encounter to include a check for changes to Project 112/SHAD classification so the corresponding billing actions can be identified. Appointment Management [SDAM APPT MGT] and Make Appointment [SDM]. 2) Comments updated to include Project 112/SHAD where classification checks are applied to Outpatient Encounters. 3) Updated comments to reflect the change from EC to SWA. IBCCPT: Bill/Claims Outpatient Encounter Procedures 1) Corrected error found. Pre-CIDC the visit classification was displayed for each of the encounters procedures as a potentially non-billable reason. Post-CIDC each procedure may be identified with a separate classification through the Outpatient Encounters Diagnosis. The results are that some of an encounters procedures may be associated with a classifiction and therefore non-billable and other procedures for the same encounter may be billable. When displaying the encounter procedures on the bill the classifications identified with each procedure were being placed incorrectly and therefore were not being displayed. This has been corrected so the classification associated with each procedure will be displayed. IBCSC4A: Bill/Claim Inpatient Professional Procedures 1) Modified enter/edit of Inpatient Professional Procedures (801) on a bill to include display of Project 112/SHAD (SH) with the other classifications related to procedure: increment counter to recognize the new classification and add new classification to list of classifications. 2) Replaced classification indicator of EC with SW if procedure is related to Environmental Contaminant/Southwest Asia. IBCSC5B: Bill/Claim Prosthetics Items 1) Replaced classification indicator of EC with SWA if item is related to Environmental Contaminant/Southwest Asia. 2) Corrected error found. The display of classifications related to a procedure was not reset between procedures so the first related classification appeared to be applicable to all following procedures. This has been corrected so only the classification applicable to the individual procedure is displayed for the procedure. IBCSC5C: Bill/Claim Prescriptions 1) Modified enter/edit Prescriptions on a bill to include display of Project 112/SHAD (SHAD) with the other classifications related to the prescription: increment counter to recognize the new classification and add the new classification indicator to the list of classifications. 2) Replaced classification indicator of EC with SWA if prescription is related to Environmental Contaminant/Southwest Asia. IBCU74: Bill/Claim Surgery Anesthesia Procedures 1) Modified enter/edit of Anesthesia Procedures on a bill to include display of SHAD with the other classifications related to the procedure: increment counter to recognize the new classification and add the new classification indicator to the list of classifications. 2) Replaced classification indicator of EC with SWA if procedure is related to Environmental Contaminant/Southwest Asia. 3) Corrected order of classifications passed from Surgery: order changed from SC,CV,AO,IR,MST,HNC,EC to SC,CV,AO,IR,SWA,MST,HNC,SHAD IBJDI7: Outpatient Workload Report 1) Comments added regarding processing of events related to Project 112/SHAD in the Outpatient Workload report. Project 112/SHAD events will be screened out of the report. 2) Updated comments to reflect the change from EC to SWA. 3) Added other checked indicators that were missing to comments:MST/HNC/CV IBNCPDP1: Prescription Billable Status Check API 1) Added Project 112/SHAD to the list of classifications checked to determine if an Rx is billable. 2) Change Environmental Contaminant classification check to Southwest Asia 3) Function redesigned. Previously this function expected all data to be passed in (from ECME) including the prescription classifications. However since ECME was not going to be updated to pass in the new SHAD classification, this function was redesigned to ignore the classifications passed in and to go directly to Outpatient Pharmacy to get the prescription's classifications. IBNCPDPC: Claims Tracking Display for ECME 1) Function getting and formatting encounter classifications updated to include Project 112/SHAD(SHAD): increment counter and output indicator. Copy of IBT EXPAND/EDIT TRACKING (IBTRED) 2) Update to rename Environmental Contaminants(EC) to Southwest Asia(SWA). IBNCPEV1: ECME Billing Events Report 1) Modified report to indicate if prescription identified as related to Project 112/SHAD. 2) Update report to rename Environmental Contaminant to Southwest Asia. IBNCPLOG: Store e-Pharmacy Prescription Log from Background API 1) For prescriptions being added to the ECME Billing log, identify Project 112/SHAD care and store indicator in new field SHAD (366.141,.408). 2) Modified for renaming of field EC to SWA (366.141,.403). IBOVOP1: Outpatient Events Report 1) Modified to check for and to include Outpatient Encounter Project 112/SHAD related indicator on reports. 2) Modified to replace Outpatient Encounter classification of EC with SWA. IBOVOP2: Outpatient Events Report 1) Modified to check for and include Outpatient Encounter Project 112/SHAD related indicator on reports: increment counter and output indicator. 2) Modified to replace Outpatient Encounter classification of EC with SWA. IBTRED: Outpatient Encounter Classification utility 1) Updated utility that returns external form of Outpatient Encounter Classifications to include Project 112/SHAD: increment counter and output indicator. 2) Modified to replace Outpatient Encounter classification of EC with SWA. IBTRKR3: Add Prescriptions to Claims Tracking 1) Modified adding Prescriptions to Claims Tracking to assign Reason Not Billable of 'PROJECT 112/SHAD' to Prescriptions that are identified as related to Project 112/SHAD in Pharmacy: increment counter to recognize the new classification and add the new classification indicator to the list of classifications. 2) Replaced Reason Not Billable of 'ENV. CONTAM.' with 'SOUTHWEST ASIA' if Prescription is related to Environmental Contaminant/Southwest Asia. IBTRKR41: Add Outpatient Encounters to Claims Tracking, Send Bulletin 1) Modified adding Outpatient Encounters to Claims Tracking to assign Reason Not Billable of 'PROJECT 112/SHAD' to Encounters that are identified as related to Project 112/SHAD - if the encounter has no PCE entry(pre-CIDC method): add check for Project 112/SHAD at encounter level. 2) Modified adding Outpatient Encounters to Claims Tracking to assign Reason Not Billable of 'PROJECT 112/SHAD' to Encounters that are identified as related to Project 112/SHAD - if the encounter does have a PCE entry: add the new classification to the list of classifications. 3) Replaced Reason Not Billable of 'ENV. CONTAM.' with 'SOUTHWEST ASIA' if Encounter is related to Environmental Contaminant/Southwest Asia - for encounters with no PCE entry (pre-CIDC method): update at encounter level. 4) Replaced Reason Not Billable of 'ENV. CONTAM.' with 'SOUTHWEST ASIA' if Encounter is related to Environmental Contaminant/Southwest Asia - for encounters with a PCE entry: update classification list. 5) The Outpatient Encounters to Claims Tracking bulletin text is updated to include the information that the Project 112/SHAD classification was checked on the encounters added to Claims Tracking and to replace Environmental Contaminant with Southwest Asia. IBTRKR5: Add Prosthetics Items to Claims Tracking 1) Replaced Reason Not Billable of 'ENV. CONTAM.' with 'SOUTHWEST ASIA' if Prosthetic Item is related to Environmental Contaminant/Southwest Asia. 2) Corrected error found. After CIDC was installed (260/312) a prosthetic item is identified as related to a classification through the assigned Diagnosis. However many sites do not yet have CIDC active so this check may not be sufficient. Therefore this has been changed to include the pre-CIDC check: if the Diagnosis node is not defined and the patient has any claimed classification then the item is added to Claims Tracking with a Reason Not Billable of Needs SC Determination. 3) Corrected error found. Once PFSS has been activated, it will no longer be possible to add entries to Claims Tracking for dates after the activation of PFSS. The check for this has already been included when manually adding Prosthetics Items to Claims Tracking. However it was erroneously identifying PFSS as active. This has been corrected so the date limitation of Items to Claims Tracking will only occur after the PFSS activation date. IBTUBO1: Unbilled Amounts Reports 1) Comments added regarding processing of events related to Project 112/SHAD in the Unbilled Amounts report. Project 112/SHAD events will be screened out of the report. 2) Updated comments to reflect the change from EC to SWA. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IB20P339 Before: n/a After: B20765882 **339** Routine Name: IBACV Before: B33359562 After: B35472344 **234,247,275,339** Routine Name: IBAMTD Before: B18809071 After: B19206296 **45,52,93,115,132,153,164,156, 234,312,339** Routine Name: IBAMTI Before: B27257826 After: B27252728 **52,132,153,156,234,247,339** Routine Name: IBAMTI1 Before: B18623119 After: B17944489 **52,132,156,199,234,339** Routine Name: IBAMTS Before: B18301561 After: B18456624 **52,115,132,153,164,156,171, 247,312,341,339** Routine Name: IBAMTS1 Before: B22333609 After: B22328511 **20,52,132,153,166,156,167,247,339** Routine Name: IBAMTS2 Before: B9672528 After: B9767783 **52,91,117,132,153,156,167,247,339** Routine Name: IBCCPT Before: B67217421 After: B67101074 **55,62,52,91,106,125,51,148, 174,182,245,266,260,339** Routine Name: IBCSC4A Before: B31464103 After: B31509518 **106,228,339** Routine Name: IBCSC5B Before: B22166369 After: B22247597 **4,52,260,339** Routine Name: IBCSC5C Before: B37628978 After: B37694343 **27,52,130,51,160,260,309,315,339** Routine Name: IBCU74 Before: B34281515 After: B34341645 **228,260,339** Routine Name: IBJDI7 Before: B51061469 After: B51362696 **69,91,98,100,118,133,339** Routine Name: IBNCPDP1 Before: B52180701 After: B66261404 **223,276,339** Routine Name: IBNCPDPC Before: B34220485 After: B34403987 **276,339** Routine Name: IBNCPEV1 Before: B20779583 After: B21049389 **342,339** Routine Name: IBNCPLOG Before: B49413338 After: B49957906 **342,339** Routine Name: IBOVOP1 Before: B14282604 After: B14775024 **52,91,99,132,156,176,234,249,339** Routine Name: IBOVOP2 Before: B13589783 After: B13818826 **52,132,153,156,167,176,234,247,339** Routine Name: IBTRED Before: B22391684 After: B22563966 **71,91,160,247,309,276,339** Routine Name: IBTRKR3 Before: B44426999 After: B44657681 **13,43,121,160,247,275,260,309, 336,312,339** Routine Name: IBTRKR41 Before: B31657328 After: B32576267 **43,55,91,132,174,247,260,315, 292,312,339** Routine Name: IBTRKR5 Before: B30688575 After: B32493921 **13,260,312,339** Routine Name: IBTUBO1 Before: B45653349 After: B45713033 **19,31,32,91,123,159,247,155, 277,339** ============================================================================= User Information: Entered By : HARPER,AMY R Date Entered : JAN 30, 2006 Completed By: LYNCH,MARY F. Date Completed: JUN 04, 2007 Released By : GANUS,MAUNETTE Date Released : JUN 04, 2007 ============================================================================= Packman Mail Message: ===================== $END TXT