$TXT Created by WANG,CHI at MNTVBB.FO-ALBANY.MED.VA.GOV (KIDS) on Wednesday, 07/25/07 at 13:22 ============================================================================= Run Date: AUG 30, 2007 Designation: IB*2*375 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #337 Status: Released Compliance Date: SEP 30, 2007 ============================================================================= Subject: CLAIMS IN AUTHORIZED STATUS BUT NOT TRANSMITTED Category: - Routine Description: ============ The CBO has requested that these three things be done by this patch. First, it will automatically update the transmission status for certain EDI bills that are authorized but not yet transmitted. Second, the CLAIM MRA STATUS field will be updated to 'NO MRA NEEDED' for authorized bills if there are no MRAs on file. Third, a list will be produced for sites to deal with individually: this list will be of authorized claims with the AR status and the total amount collected. ASSOCIATED REMEDY: ================== HD191215 Authorized bill report issue Duplicate: HD181374 Claims in authorized status HD193931 Bills in an authorized status failed to transmit HD193795 Bills "stuck" in Authorized Status HD193512 REVENUE ALERT: Bills "stuck" in Authorized Status HD193284 REVENUE ALERT Bills "stuck" in Authorized Status HD193246 REVENUE ALERT: Bills "stuck" in Authorized Status ASSOCIATED NSR(s): ================== N/A PARTICIPATING TEST SITES: ========================= BAY PINES, FL BRONX, NY MARYLAND HCS REMEDY OVERVIEW: ================ HD191215 Authorized bill report issue Problem: -------- When using the Print Authorized Bill [IB BATCH PRINT BILLS] option and entering ?? at the Begin Printing Bills prompt, a list of authorized bills would display but only a few of them would print to a designated printer. Due to a timing issue with the processing of EDI reports, some secondary claims received delayed status messages on the same day as an MRA. The operational issue that led to these delays was resolved the first week of April 2007, but affected claims got 'stuck' within VistA and required manual intervention to resolve. Resolution: ----------- First, the post-init routine in this patch will update records in the EDI TRANSMIT BILL (#364) file setting the TRANSMISSION STATUS (#.03) field to "X" for "READY FOR EXTRACT" under the following conditions: - The BILL/CLAIMS (#399) file STATUS (#.13) field is "AUTHORIZED". - The bill has at least one record in the EXPLANATION OF BENEFITS (#361.1) file where the EOB TYPE (#.04) field is "MEDICARE MRA". - There is a record for the bill in the ACCOUNTS RECEIVABLE (#430) file where the CURRENT STATUS (#8) is "ACTIVE" and if there is a record for the bill in the AR TRANSACTION (#433) file that the TRANS AMOUNT (#15) field has no total amount collected. - There is a record in the EDI TRANSMIT BILL (#364) file has the BATCH NUMBER (#.02) field empty, and the COB SEQUENCE(#.03) field is "S" for "SECONDARY," and the TRANSMISSION STATUS (#.03) field is not already "X" for "READY FOR EXTRACT". Second, the BILL/CLAIMS (#399) file CLAIM MRA STATUS field (#24) will be updated to 'NO MRA NEEDED' for certain authorized bills if there are no MRAs on file. This will resolve the situation where users try to print using Print Bill [IB PRINT BILL] option and receive the "Not Ready for MRA Submission, Can Not Print!" message. Third, a list will be produced of authorized claims other than ones where both AR status is ACTIVE and the total amount collected is 0. There is no automatic update for this list of claims. The First and Third lists mentioned above will print to the patch installer's screen. You should pass the report to the IB Supervisor (See Installation Instruction #7). FYI: Those records that are reported will be in XTMP("IB20P375") and you may be able to see them again using the INSTALL (#9.7) file or the Install File Print option in the Kernel Installation & Distribution System and then Utilities menu. The data in the XTMP file is set to be stored for thirty days from the day of the patch install. INSTALLATION INSTRUCTIONS ========================= It is recommended that this patch be installed outside of normal business hours to avoid any complications resulting from users on the system. The installation time will rely on the size of the global in database. 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*375) 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*375. 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. 7. Print this patch description along with the lists that were produced as a result of Installing this patch and give them to your sites IB Supervisor. The two lists are entitled with an example of a bill: Updating the transmit status in file 364 for MRA secondary claim Bill #: L01064 Statement Covers From Date: Feb 08, 2004 Transmit Status:X Total 1 bill has been updated. List of all claims excludes ACTIVE AR Status with 0 Total Amount Collected Bill #: K9003BZ AR Status: CANCELLED BILL Total Amount Collected: $330.00 Total 1 bill has been listed. 8. POST INIT CLEANUP -------------------------- Optional - Once this patch has been successfully installed you may delete the post init routine: IB20P375 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 ============ ============ =========== ========== IB20P375 N/A 7613506 375 Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 4 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IB20P375 Before: n/a After: B18628445 **375** ============================================================================= User Information: Entered By : WANG,CHI Date Entered : JUN 11, 2007 Completed By: DAWSON,TIM Date Completed: AUG 30, 2007 Released By : CAULFIELD,MARY Date Released : AUG 30, 2007 ============================================================================= Packman Mail Message: ===================== $END TXT