============================================================================= Run Date: OCT 20, 2004 Designation: PSS*1*81 Package : PSS - PHARMACY DATA MANAGEMENT Priority: Mandatory Version : 1 SEQ #80 Status: Released Compliance Date: DEC 19, 2004 ============================================================================= Associated patches: (v)PSS*1*61 <<= must be installed BEFORE `PSS*1*81' Subject: HIPAA NCPDP CONNECTION FOR EDI PHARMACY Category: - Informational Description: ============ PATCH OVERVIEW The Healthcare Insurance Portability and Accountability Act National Council for Prescription Drug Programs (HIPAA NCPDP) initiative, whose ultimate goal is to provide functionality allowing electronic transmission of Outpatient Pharmacy (OP) prescription claims to payers and the receipt of claim responses (including drug utilization review responses and warnings) on a real-time basis, is being developed and introduced in a phased implementation strategy. This deployment strategy was utilized due to the complexity of the functionality and the number of product line dependencies. The first release of this two part implementation is BPS*1.0, comprised of the new Electronic Claims Management Engine (ECME) package (in the BPS namespace), plus the patches PSS*1*81, IB*2.0*223, IB*2.0*251, and PRCA*4.5*202, which are listed here in order of installation. The patches are combined in host file BPS_1_0.KID in order to simplify installation. BPS*1.0 is a dormant release that only allows each site to perform preliminary setup work and to confirm that the software does not adversely affect other packages. The software for PSS*1*81 is installed automatically when the host file, BPS_1_0.KID, is installed. There are two main areas addressed by BPS*1.0: a. Registration of the Pharmacy with the Vitria BusinessWare IE. b. The Insurance Matching of Group Plans with Pharmacy Plans. Following the installation of BPS*1.0, each site must register their pharmacy with Vitria and match applicable insurance group plans using the insurance matching screens. These processes are detailed in the HIPAA NCPDP CONNECTION FOR EDI PHARMACY INSTALLATION GUIDE and the E-PHARMACY CLAIMS INSURANCE PROCESS document. Both of these documents are located on the anonymous directory. It is very important that the IRM or person installing the patch at each facility provide a copy of these documents to its ADPAC(s) and any other relevant staff who will be responsible for registering their pharmacy with Vitria and completing the insurance matching process. At a later date, additional HIPAA NCPDP patches will be released to activate all of the HIPAA NCPDP functionality. Until that time, sites will not be able to electronically submit claims utilizing this new functionality. The HIPAA NCPDP project was created in response to a Chief Business Office (CBO) request for modifications to several Veterans Health Information Systems and Technology Architecture (VistA) software applications in accordance with HIPAA Electronic Data Interchange (EDI) transactions and NCPDP mandated format standards, specifically the NCPDP Telecommunication Standard v.5.1. The specific functionality for this patch is listed below. Overview of the Process: The changes to Pharmacy Data Management are as follows: 1. DEA, SPECIAL HDLG field (#3) in the DRUG (#50) file. Routine PSSDDUT2 was modified to accommodate the use of the letter 'E' within the DEA, SPECIAL HDLG field (#3) of the DRUG file (#50). Data Dictionary Changes in Outpatient Pharmacy: 1. For the DRUG file (#50), the DEA, SPECIAL HDLG (#3) field for the drug will need to accommodate the use of the letter 'E' to indicate that a drug is billable for ECME purposes. The routine dealing with the Help Text of this field was modified to accommodate the inclusion of an 'E' within the list of possible entries. Associated NOISs: ================= N/A Test Sites: =========== NEW YORK HARBOR HCS NORTH TEXAS HCS ANN ARBOR, MI BATTLE CREEK, MI DETROIT, MI IRON MOUNTAIN, MI Routine Summary: ================ The second line now reads as follows: ;;7.0;PHARMACY DATA MANAGEMENT;**[patch list]**; 9/30/97 CHECK^XTSUMBLD results: Routine Before Patch After Patch Patch List ======= ============ =========== ========== PSSDDUT2 16160245 16615950 3,21,61,81 Documentation Retrieval: ======================== The ECME 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 BPS_1_0_IG.PDF HIPAA NCPDP CONNECTION FOR EDI PHARMACY (DORMANT RELEASE) INSTALLATION GUIDE BPS_1_0_RN.PDF HIPAA NCPDP CONNECTION FOR EDI PHARMACY (DORMANT RELEASE) RELEASE NOTES (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: ========================== The software for this patch is being distributed via a host file. The host file will contain the following package and builds: Host file name BPS_1_0.KID Package: BPS_1 Builds: PSS*1.0*81 IB*2.0*223 IB*2.0*251 PRCA*4.5*202 Sites may retrieve the software directly by using FTP from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: ftp.fo-albany.med.va.gov Hines: ftp.fo-hines.med.va.gov Salt Lake City: ftp.fo-slc.med.va.gov Do not install this patch while Pharmacy Data Management users are using the software. Installation will take no longer than 2 minutes. There are no scheduling restrictions or recommendations. Installation Steps 1. Use VA FileMan to add the new domain, EPHARMACY.VITRIA-EDI.AAC.VA.GOV, to the DOMAIN file (#4.2). The installation instructions are included in the patch description for the XM*DBA*160 patch. This domain must be in place before the installation of the IB*2*251 patch that is included in the BPS 1.0 Master Build. 2. Download the KIDS file BPS_1_0.KID via FTP. This file needs to be retrieved in ASCII format. 3. Review mapped sets for the PSS*, IB*, and PRCA*namespaces. If the routines are mapped, they should be removed from the mapped set at this time. 4. From the Kernel Installation & Distribution System menu, select the Installation menu. 5. From this menu, select the Load a Distribution option. When prompted for a file name, enter the directory name where you FTPd the build, followed by BPS_1_0. In our example, the file name is USER$:[ANONYMOUS]BPS_1_0.KID. Determine the location where you stored your build to decide the correct file name entry. 6. At the "Want to Continue with Load? YES//" prompt, enter YES. 7. At the "Want to RUN the Environment Check Routine: YES//" prompt, answer YES. 8. From this menu, the installer may select to use the following options: (When prompted for INSTALL NAME, enter BPS 1.0) 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. 9. At the "Select Installation Option:" prompt, enter 6 Install Package(s) 10. At the "Select INSTALL NAME:" prompt, enter BPS 1.0. 11. When prompted, "Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//" respond NO. 12. When prompted, "Want KIDS to INHIBIT LOGONs during the install? YES//" respond NO. 13. When prompted, "Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//" respond NO. 14. When prompted, "Device:Home//" respond with the correct device and DO NOT queue this to P-Message. 15. If routines were unmapped as part of step 3, they should be returned to the mapped set once the installation has run to completion. Routine Information: ==================== Routine Name: - PSSDDUT2 Routine Checksum: ============================================================================= User Information: Entered By : SCHUCK,FRED Date Entered : JAN 16, 2004 Completed By: NEVEU,MIKE Date Completed: OCT 14, 2004 Released By : VECE,VIRGINIA Date Released : OCT 20, 2004 ============================================================================= Packman Mail Message: ===================== No routines included