$TXT Created by ELLZEY,LINDA J at DEVVII.FO-ALBANY.MED.VA.GOV (KIDS) on Friday, 08/25/06 at 14:11 ============================================================================= Run Date: OCT 19, 2006 Designation: PSO*7*201 Package : PSO - OUTPATIENT PHARMACY Priority: Mandatory Version : 7 SEQ #221 Status: Released Compliance Date: NOV 19, 2006 ============================================================================= Associated patches: (v)PSO*7*125 <<= must be installed BEFORE `PSO*7*201' (v)PSO*7*148 <<= must be installed BEFORE `PSO*7*201' (v)IB*2*260 <<= must be installed BEFORE `PSO*7*201' (v)IB*2*286 <<= must be installed BEFORE `PSO*7*201' (v)PSO*7*239 <<= must be installed BEFORE `PSO*7*201' Subject: PATIENT FINANCIAL SERVICES SYSTEM (PFSS) SUPPORT Category: - Routine - Enhancement (Mandatory) - Data Dictionary - Input Template Description: ============ This Outpatient Pharmacy patch is part of the Patient Financial Services System (PFSS) project. PFSS patches are being released on various schedules. Some patch functionality will not be active until a new PFSS switch is activated during final implementation. PFSS will initially be implemented at select pilot sites ONLY. The purpose of the PFSS project is to prepare the Veterans Health Information Systems and Technology Architecture (VistA) environment for the implementation of a Commercial Off-The-Shelf (COTS) billing replacement system. The project consists of the implementation of the billing replacement system, business process improvements, and enhancements to VistA to support integration with the COTS billing replacement system. Significant changes to VistA legacy systems and ancillary packages are necessary. Some of the PFSS software components are not operational until the PFSS On/Off Switch, distributed with patch IB*2*260, is set to "ON". The ability for the local site to set the switch to "ON" will be provided at the appropriate time with the release of a subsequent Integrated Billing patch. For more information about the PFSS project, review the documentation accompanying this patch and refer to the following website: http://vista.med.va.gov/billreplace/. This Outpatient Pharmacy patch, PSO*7*201 provides the functionality needed to support the PFSS project. Note that this patch depends on patches PSN*4*103 and PSS*1*92 to provide the new Charge Description Master (CDM) functionality. The CDM provides Service Codes for each drug, supply item, etc. to uniquely identify them to the new COTS billing system. This information is passed via IB Application Program Interface (API) calls, which is explained in the Technical Description. Functional Description: ======================= Outpatient Pharmacy was modified to check the status of the PFSS switch. If the PFSS switch is not activated, the current Integrated Billing (IB) billing process will continue. If the PFSS switch is activated, prescription and copay information will be passed to the new COTS billing system for final copay assessments and billing via IB. As is currently the case with IB, the exchange of information will take place in the background with no user impact. Upon entering a new prescription order, copying, renewing, or editing an order that causes a new order to be created, a PFSS Account Reference will be requested at finish from IB. This reference is used to uniquely identify the prescription in the COTS billing system. At prescription release, a unique charge identifier will be requested from IB, and it will serve to uniquely identify the fill in IB. Next, a charge message will be sent to the COTS billing system via IB. This includes the release of Consolidated Mail Outpatient Pharmacy (CMOP) prescriptions and prescriptions released by the Outpatient Pharmacy Automation Interface (OPAI) functionality. For return to stocks, and deletes that perform a return to stock, a charge credit message will be sent. When Service Connection and/or Environmental Indicators are modified without a change in copay using the Reset Copay Status/Cancel Charges [PSOCP RESET COPAY STATUS] option, a charge update message will be sent. A charge credit message will be sent when copay charges are cancelled. When the fill is changed to copay, no message will be sent because this change is considered to be for the future fills. No messaging will take place for discontinued orders. When a discontinued order is reinstated, the previously obtained PFSS Account Reference will be used. In order to maintain the display of the "$" sign on the Medication Profile screen that indicates the prescription is eligible for copay, IB will continue to be utilized for the copay eligibility assessment that is performed at finish. Also, the Outpatient Pharmacy and IB copay evaluations performed at release for Service Connection, Environmental Indicators, Drug Enforcement Agency (DEA) special handling (supply items and investigational drugs), income exempt, and RX Patient Status checks have not changed and will continue to be used. However, the final copay billing determination will be performed by the COTS billing system, and the final decision is based on the above information, interfacility copay information, and current IB billing rules. There will be no return messaging from the COTS billing system to Outpatient Pharmacy. When Days Supply is edited on a released prescription, a charge update message will be sent to the COTS billing system, and it is understood that the COTS billing system will pick up the latest charge update. Last, a new CHARGE LOCATION field (#1007) was added to the OUTPATIENT SITE file (#59). This field will be used by the COTS billing system to group charges by division. Upon installation and before the PFSS switch is turned on, the user will need to enter an Outpatient Pharmacy charge location in the HOSPITAL LOCATION file (#44), and afterward define this location in the new CHARGE LOCATION field (#1007) in the OUTPATIENT SITE file (#59). The Site Parameter Enter/Edit [PSO SITE PARAMETERS] option may be used to define the CHARGE LOCATION in the OUTPATIENT SITE file (#59). A charge location should be defined for each division in the OUTPATIENT SITE file (#59). It is suggested that this field be coordinated with the Medical Center's billing office and the activation of the PFSS functionality. If at least one division has a CHARGE LOCATION defined, that value will be passed to the COTS billing system for all division having prescriptions filled. If the CHARGE LOCATION is not defined for any division and the PFSS switch is turned on, the prescription information will not pass to IB or the COTS billing system. Technical Description: ====================== At FINISH of the prescription fill: 1. The new IB API #4664 GETACCT^IBBAPI will be called to request a PFSS ACCOUNT REFERENCE and it will be stored in the PRESCRIPTION file (#52) on the fill level. For original fills, it will be stored in the PFSS ACCOUNT REFERENCE field (#125), and for refills it will be stored in the PFSS ACCOUNT REFERENCE field (#21). These references uniquely identify the prescription to the COTS billing system. 2. The array of data passed using the GETACCT^IBBAPI call encompasses all of the minimum required data elements as stated in the PFSS SRS-SDD IBB Generic API document. The following outlines data passed from Outpatient Pharmacy: $$GETACCT^IBBAPI(VAR1,VAR2,VAR3,VAR4,.ARR1,,,.ARR4,.ARR5,VAR5,,) Where: VAR1 = Patient Identifier (Patient IEN) VAR2 = PFSS Account Reference VAR3 = HL7 Event Code VAR4 = Application Location Reference ARR1 = ARR1(2) Patient Class, ARR1(3) Patient Location, ARR1(7) Attending Physician, ARR1(44) Admit Date/Time (Fill Date), ARR1(50) Alternant Visit ID (Prescription IEN) ARR4 = ARR4(n,3) Diagnoses Code, ARR4(n,6) Diagnosis Type ARR5 = ARR5(n,2) Type VAR5 = Medical Center Division 3. After IB returns the PFSS ACCOUNT REFERENCE to Outpatient Pharmacy, IB will pass the GETACCT information to the COTS billing system via the VistA Data Extraction Framework (VDEF) and will store the returned PFSS Account Number external value in the PFSS ACCOUNT file (#375). At RELEASE of the prescription fill: 1. The new IB API # 4665 GETCHGID^IBBAPI will be called to request a PFSS CHARGE ID. This information is used to uniquely identify the fill in the IB and will be stored in Prescription file (#52) on the fill level. For original fills, it will be stored in the PFSS CHARGE ID field (#126), and for refills it will be stored in the PFSS CHARGE ID field (#22). No data is passed using this API. 2. Next, the new IB API #4665 CHARGE^IBBAPI will be called to pass prescription and copay information. This information will be stored in the PFSS CHARGE CACHE file (#373). IB will batch the charge information and pass it on to the COTS billing system via VDEF. 3. The array of data passed using the CHARGE^IBBAPI call encompasses all of the minimum required data elements as stated in the PFSS SRS-SDD IBB Generic API document. The following outlines data passed from Outpatient Pharmacy: $$CHARGE^IBBAPI(VAR1,VAR2,VAR3,VAR4,.ARR1,,.ARR3,.ARR4,.ARR5,,,) Where: VAR1 = Patient Identifier (Patient IEN) VAR2 = PFSS Account Reference VAR3 = Charge Type VAR4 = Unique Charge ID (PFSS Charge ID) ARR1 = ARR1(4) Transaction Date (Fill Date), ARR1(7) Transaction Code, ARR1(10) Transaction Quantity, ARR1(13) Department Code, ARR1(18) Patient Copay Status, ARR1(21) Ordered by Code, ARR1(22) Unit Cost, ARR1(29) NDC_";"_Generic Name, ARR1(31) Copay Transaction Type ARR3 = ARR3(n,3) Diagnoses Code, ARR3(n,6) Diagnosis Type ARR4 = ARR4(n,2) Type ARR5 = ARR5(1) Quantity_";;"_Days Supply, ARR5(17) Refills Dispensed (Fill Number), ARR5(18) Date of Most Recent Fill (Release Date), ARR5(31) DEA, Special Handling 4. There will be no return messaging from the COTS billing system to Outpatient Pharmacy. Note that IB will combine the data passed in the GETACCT and CHARGE APIs to form the charge message that will ultimately be passed to the COTS billing system via VDEF. CHARGE LOCATION additions: 1. In the OUTPATIENT SITE file (#59), a new CHARGE LOCATION field (#1007) was added, and this field is a pointer to HOSPITAL LOCATION file (#44). 2. The Site Parameter Enter/Edit [PSO SITE PARAMETERS] option input template PSO SITE was modified to accommodate entry of the new CHARGE LOCATION field (#1007). 3. If a CHARGE LOCATION is not defined for a particular division, the system will loop through all divisions in the OUTPATIENT SITE file (#59) and will use the first CHARGE LOCATION it finds. When none of the divisions have a CHARGE LOCATION defined, the prescription will not be passed to IB or the COTS billing system. This issue will be addressed in a subsequent phase of the PFSS project. Until that time, it is imperative that CHARGE LOCATION are defined for each division. The Integration Agreement (IA) #4732 was created to facilitate modifications being made by IB for interfacility copay. It will be used in the background to return the pharmacist, person who last edited the prescription fill, and the value of the IB SERVICE/SECTION field (#1003) from the OUTPATIENT SITE file (#59). Associated New Service Request (NSR): ===================================== N/A Associated Remedy Ticket(s): ============================ N/A Associated E3Rs: ================ N/A Test Sites: =========== CLEVELAND, OH DAYTON, OH BOSTON HCS, MA TUSCALOOSA, AL 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: ;;7.0;OUTPATIENT PHARMACY;**[patch list]**;DEC 1997 Routine Before Patch After Patch Patch List --------- ------------ ----------- --------------------------------- PSOCP 20083736 20475457 20,46,71,85,137,157,143,219, 239,201 PSOCPA 15060347 17091982 9,71,85,137,143,201 PSOCPB 30983878 32811786 72,71,85,185,143,219,239,201 PSOCPC 25194285 25572244 10,9,71,85,114,157,143,239,201 PSOCPD 22106461 27222397 71,85,201 PSOHLNE3 21660394 21938339 143,239,201 PSOHLNE4 N/A 6042525 201 PSON52 23824880 23908009 1,16,23,27,32,46,71,111,124,117, 131,139,157,143,219,148, 239,201 PSOPFSU0 N/A 6067206 201 PSOPFSU1 N/A 13426812 201 PSOR52 11514154 11646969 10,22,27,181,148,201 PSORESK 27854541 29865487 15,9,27,40,47,55,85,130,185, 184,196,148,201 PSORESK1 5886525 6251195 9,201 PSORN52 20042374 20125503 1,11,27,37,46,79,71,100,117,157, 143,219,148,239,201 PSORXDL 30121659 32500583 4,17,9,27,117,131,148,201 PSORXED 24260411 25313442 2,16,21,26,56,71,125,201 Total number of routines - 16 File Summary: ============= UP SEND DATA USER DATE SEC. COMES SITE RSLV OVER FILE # NAME DD CODE W/FILE DATA PTS RIDE -------------------------------------------------------------------------- 52 PRESCRIPTION YES YES NO NO Partial DD: subDD: 52 fld: 125 fld: 126 subDD: 52.1 fld: 21 fld: 22 DATA SCREEN: 59 OUTPATIENT SITE YES NO NO NO Partial DD: subDD: 59 fld: 1007 DATA SCREEN: Field Summary: ============== Field Name (Number) File Name (Number) ------------------- ------------------ PFSS ACCOUNT REFERENCE (#125) PRESCRIPTION (#52) PFSS CHARGE ID (#126) PRESCRIPTION (#52) PFSS ACCOUNT REFERENCE (#21) REFILL SUBFILE (#52.1) of PRESCRIPTION file (#52) PFSS CHARGE ID (#22) REFILL SUBFILE (#52.1) of PRESCRIPTION file (#52) CHARGE LOCATION (#1007) OUTPATIENT SITE (#59) Template Summary: ================= Template Name Type File Name (Number) ------------- ----- -------------------------- PSO SITE INPUT OUTPATIENT SITE file (#59) Documentation Retrieval: ======================== The PFSS documentation is available on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. Sites may retrieve documentation in one of the following ways: (1) The preferred method is to FTP the files from download.vista.med.va.gov, which will transmit the files from the first available FTP server. (2) Sites may also elect to retrieve documentation directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The documentation distribution includes: FILE NAME DESCRIPTION PSO_7_P201_RN.PDF Release Notes PSO_7_P201_UM_CP.PDF User Manual Change Pages PSO_7_P201_TM_CP.PDF Technical Manual Change Pages (3) Documentation can also be retrieved from VistA Documentation Library (VDL) on the Internet at the following address, http://www.va.gov/vdl. Installation Instructions: ========================== This patch can be installed while users are on the system. Installation will take less than 10 minutes. Suggested time to install: non-peak requirement hours. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. 2. From the Kernel Installation & Distribution System (KIDS) menu, select the Installation menu. 3. From this menu, you may select to use the following options (when prompted for INSTALL NAME, enter PSO*7.0*201): a. Backup a Transport Global - this option will create a backup message of any routines exported with the patch. It will NOT backup any other changes such as DDs 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 the patch (routines, DDs, templates, etc.). c. Verify Checksums in Transport Global - this option will ensure the integrity of the routines that are in the transport global. 4. Use the Install Package(s) option and select the package PSO*7.0*201. 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 Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSOCP Before: B68323456 After: B65342782 **20,46,71,85,137,157,143,219, 239,201** Routine Name: PSOCPA Before: B36106278 After: B43580682 **9,71,85,137,143,201** Routine Name: PSOCPB Before: B78420405 After: B83592265 **72,71,85,185,143,219,239,201** Routine Name: PSOCPC Before: B67206155 After: B68516946 **10,9,71,85,114,157,143,239,201** Routine Name: PSOCPD Before: B55811844 After: B68892823 **71,85,201** Routine Name: PSOHLNE3 Before: B55635403 After: B56031313 **143,239,201** Routine Name: PSOHLNE4 Before: n/a After: B10329069 **201** Routine Name: PSON52 Before: B58876503 After: B59816394 **1,16,23,27,32,46,71,111,124, 117,131,139,157,143,219,148,239, 201** Routine Name: PSOPFSU0 Before: n/a After: B16719657 **201** Routine Name: PSOPFSU1 Before: n/a After: B33416408 **201** Routine Name: PSOR52 Before: B30307425 After: B31117928 **10,22,27,181,148,201** Routine Name: PSORESK Before: B58029902 After: B61223518 **15,9,27,40,47,55,85,130,185, 184,196,148,201** Routine Name: PSORESK1 Before: B7187442 After: B7754829 **9,201** Routine Name: PSORN52 Before: B42247336 After: B43085141 **1,11,27,37,46,79,71,100,117, 157,143,219,148,239,201** Routine Name: PSORXDL Before: B58159508 After: B61943911 **4,17,9,27,117,131,148,201** Routine Name: PSORXED Before: B49641748 After: B53144628 **2,16,21,26,56,71,125,201** ============================================================================= User Information: Entered By : ANWER,MOHAMED Date Entered : FEB 17, 2005 Completed By: LYNCH,MARY F. Date Completed: OCT 17, 2006 Released By : CONSENTINO,ALBERT Date Released : OCT 19, 2006 ============================================================================= Packman Mail Message: ===================== $END TXT