$TXT Created by ADES,ROBERT at MNTVBB.FO-ALBANY.MED.VA.GOV  (KIDS) on Thursday, 06/07/07 at 12:33
=============================================================================
Run Date: AUG 27, 2007                     Designation: IB*2*367
Package : IB - INTEGRATED BILLING             Priority: Mandatory
Version : 2       SEQ #336                      Status: Released
                  Compliance Date: SEP 27, 2007
=============================================================================

Associated patches: (v)IB*2*137    <<= must be installed BEFORE `IB*2*367'
                    (v)IB*2*275    <<= must be installed BEFORE `IB*2*367'

Subject: DSS STOP CODES AND RX COPAY FIXES

Category: 
  - Routine

Description:
============

 This patch adds and modifies Stop Codes in the IB CLINIC STOP CODE BILLABLE
 TYPES (#352.5) file, fixes a SUBSCRIPT error in the Electronic Error
 Report [IBCE ELECTRONIC ERROR REPORT], and corrects instances where the
 software uses incomplete/incorrect information from income tests in
 calculating the Rx copay exemption.
  
 ASSOCIATED REMEDY TICKETS:
 ==========================
 1) HD168809 Stop Code 568 Generating Copay Charges
      Duplicate:
        HD161984 DSS Stop Codes 568 and 202
  
 2) HD163928 Electronic Error Report - Error at EN+29^IBCERP2
      Duplicate:
        HD178729 Electronic Error Report - Error at EN+29^IBCERP2
  
 3) HD138944 Inconsistent EXEMPTION calculation 
  
 4) HD176697 INCORRECT RX COPAY STATUS
      Duplicates: 
        HD179599 Copay Exemption is incorrect
        HD128137 RX Exemption incorrect:
        HD155782 Rx Copay Exemption is incorrect
        HD110589 Inappropriate automated Rx Copay refund
  
 5) HD183979 Problem with Copay after stop code patch installed SD*5.3*500
      Duplicates:
        HD183953 No copay for stop codes (new in SD*5.3*500)
        HD185029 Codes 130 and 131 not working
        HD183415 Need of  IB patch to mirror changes to stop code file?
        HD195427 Problem with Emergency/Urgent Care stop codes
  
 PARTICIPATING TEST SITES:
 =========================
 ANN ARBOR, MI
 BUTLER, PA
 SAN DIEGO, CA 
    
 REMEDY OVERVIEW:
 ================
 1) HD168809 Stop Code 568 Generating Copay Charges
  
  Problem: 
  --------
  Nine Stop Codes for FY 05 were never added to the IB CLINIC STOP CODE
  BILLABLE TYPES (#352.5) file and are erroneously incurring charges when
  they should not.   
  
  Resolution:
  -----------
  Add the Stop Codes to the IB CLINIC STOP CODE BILLABLE TYPES (#352.5)
  file with effective dates of 10/01/04 and marked as NON BILLABLE.
  
 2) HD163928 Electronic Error Report - Error at EN+29^IBCERP2
  
  Problem: 
  --------
  While running the Electronic Error Report [IBCE ELECTRONIC ERROR REPORT],
  if the site running the report has any bills in the REQUEST MRA state, a
  subscript error will occur because bills that are in that state do not
  have a current payer responsible for the bill in the BILL/CLAIMS (#399)
  file.   
  
  Resolution:
  -----------
  This report will handle this situation in the same way the rest of IB
  handles it, by first determining the payer sequence and then determining
  which carrier is at that sequence.
  
 3) HD138944 Inconsistent EXEMPTION calculation
  
  Problem: 
  --------
  When the Manually Change Copay Exemption (Hardships) [IB RX HARDSHIP]
  option computes the medication copayment exemption status, if the patient
  is not auto exempt it gets the most recent test from the ANNUAL MEANS
  TEST (#408.31) file and uses that information to compute the status 
  regardless of whether or not it is an IVM converted test or not, in cases
  where the last test is a converted test it will always compute to
  EXEMPT by reasoning of Income<Pension.
  
  Resolution:
  -----------
  Before using the test from the ANNUAL MEANS TEST (408.31) file
  to calculate Copay exemption status verify that it is not a converted
  test.  If it is a converted test use the status found in the 
  BILLING PATIENT (#354) file as the current status.
  
 4) HD176697 INCORRECT RX COPAY STATUS
    
  Problem: 
  --------
  When a Copay Test is changed to NO LONGER APPLICABLE for whatever reason
  a call is eventually made to Integrated Billing to compare the current
  status in the BILLING PATIENT (#354) file with what is computed.  If the
  last test on file is a converted test it will always compute to EXEMPT by
  reasoning of INCOME<PENSION, because there is not any income stored with
  a converted test. Because the computed status does not match the status
  in the BILLING PATIENT (#354) file it creates a new entry and updates the
  BILLING PATIENT (#354) file with the newly computed status.
  
  Resolution:
  -----------
  Before using income information from a test to calculate the patients
  Copay Exemption status it will first verify that the test it is using is
  not a converted test.  If it is, it will pass back the current status of
  that patient from the BILLING PATIENT (#354) file.
  
 5) HD183979 Problem with Copay after stop code patch installed SD*5.3*500
  
  Problem: 
  --------
  Stop Codes modified or added with patch SD*5.3*500, were never updated in
  the IB CLINIC STOP CODE BILLABLE TYPES (#352.5) file.
   
  Resolution:
  -----------  
  Update the IB CLINIC STOP CODE BILLABLE TYPES (#352.5) file as follows:
  
  New Stopcode
  ------------
  130           EMERGENCY DEPT
  131           URGENT CARE UNIT
  352           GRECC CLINICAL DEMO
  
  Change Name/Description
  -----------------------
  Number         Old                             New
  ------------------------------------------------------------------------
  528           TELE/HOMELESS MENTALLY ILL      TELEPHONE HCMI
  681           VA-PAID HOME/COMMUN HEALTHCARE  VA-PAID HCBC PROVIDERS   
  
  
 INSTALLATION INSTRUCTIONS:
 ==========================
 It is not necessary to disable any options.  You may install 
 these routines at any time without interruption to users.  It should
 take less than 2 minutes to install this patch.
  
    1. Choose the PackMan message containing this patch and invoke the
       INSTALL/CHECK MESSAGE PackMan option.  
   
    2. From the Kernel Installation & Distribution System menu, select 
       the Installation menu.  
   
    3. From this menu, you may select to use the following options: 
       (when prompted for INSTALL NAME, enter IB*2.0*367)
   
         a.  Verify Checksums in Transport Global - This option will allow
             you to ensure the integrity of the routines that are in the
             transport global.
         b.  Print Transport Global - This option will allow you to view
             the components of the KIDS build.
         c.  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.).
         d.  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.
   
    4. Use the Install Package(s) option and select the package IB*2.0*367.
  
    5. When Prompted "Want KIDS to INHIBIT LOGONs during the install? 
       YES//" respond NO.  
   
    6. When Prompted "Want to DISABLE Scheduled Options, Menu Options, and 
       Protocols? YES//" respond NO.
  
  
 ROUTINE SUMMARY: 
 ================
  
 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
  -------    ------------   -----------    ----------
 IB20P367       N/A         5606502        367
 IBARXEU1       4413206     5673928        26,112,74,275,367 
 IBCERP2        17494233    17992724       137,367 
                
  
  Number of Routines = 3 

Routine Information:
====================
The checksums below are new checksums, and
 can be checked with CHECK1^XTSUMBLD.

Routine Name: IB20P367
    Before:       n/a   After: B15710350  **367**
Routine Name: IBARXEU1
    Before: B13926560   After: B17664186  **26,112,74,275,367**
Routine Name: IBCERP2
    Before: B54760400   After: B56071324  **137,367**
 
Routine list of preceding patches: 137, 275

=============================================================================
User Information:
Entered By  : ADES,ROBERT                   Date Entered  : DEC 27, 2006
Completed By: DAWSON,TIM                    Date Completed: AUG 21, 2007
Released By : GANUS,MAUNETTE                Date Released : AUG 27, 2007
=============================================================================


Packman Mail Message:
=====================

$END TXT