PATCH OVERVIEW
to the complexity of the functionality and the number of product line
dependencies.
This is the second part of the Electronic Claims Management Engine (ECME)
package (in the BPS namespace), also known as the active build. It
comprises of these patches: BPS*1*1, PSO*7*148, PSS*1*90, PSX*2*48 and
IB*2*276.
This build will introduce functionality supporting Point of Service
Outpatient Pharmacy claim and billing processing by collecting billing and
clinical information within the prescription fill workflow process. This
build will create real-time electronic claims and send claim data to
adjudicating payers from the new VistA Electronic Claims Management Engine
(ECME) via the VistA HL7 module (using the PSO NCPDP link) to the Vitria
server at the FSC in Austin, TX in a HIPAA compliant (NCPDP V. 5.1)
format. Vitria will then store and forward these transactions to WebMD for
final submission to the payer on a real-time basis. Payer responses will
be received and returned to VistA in the appropriate manner (i.e. - claim
transactions sent to Integrated Billing (IB), Drug Utilization responses
and warnings sent to the Outpatient Pharmacy V. 7.0 package and rejections
The Healthcare Insurance Portability and Accountability Act National
made available to the appropriate personnel for review and analysis).
Within VistA, throughout this process, constant bi-directional
communication via API's between Outpatient Pharmacy, Integrated Billing,
and ECME will process and generate these claim and billing transactions at
the appropriate trigger points within the standard VA process workflow.
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
This patch fixes random subscript errors, allows users to select
a Drug Class Code as an option during the Payable Claims Report
[BPS RPT PAYABLE] and fixes issues while sorting in the ECME
User Screen [BPS USER SCREEN].
This patch supports the National Council for Prescription Drug Programs
that will enable the user to reopen a closed Electronic Claims Management
Engine (ECME) claim; updates to the Rx Activity Log; and permanent storage
of Claims activity information as reported by the ECME Billing Events
Report.
(NCPDP) standard which was adopted under the Healthcare Insurance
Portability and Accountability Act (HIPAA) for pharmacy claims. This patch
is one of six to be released. Three patches will be released in a KIDS
multi-build distribution containing: BPS*1*3, PSO*7*247, and IB*2*342.
Three patches will be released individually and they are: PRCA*4.5*247,
PSX*2*62, and PSS*1*115.
Enhancements included in the release of the six patches are a new option
Backup of BPS PSO IB BUNDLE 16.0, BPS*1.0*28, PSO*7.0*560, IB*2
Warning: Installing this backup patch message will install older versions
of routines and Build Components (options, protocols, templates, etc.).
Please verify with the Development Team that it is safe to install.
This patch modifies the Application Program Interface (API) that
processes claims in E-Pharmacy to check for a valid user before it
stores that information in the BPS Transaction File
(#9002313.59).
This patch has enhancements which extend the capabilities of the Veterans
ELECTRONIC CLAIMS MANAGEMENT ENGINE (ECME) V. 1.0 BPS*1*5
PHARMACY DATA MANAGEMENT (PDM) V. 1.0 PSS*1*127
CONSOLIDATED MAIL OUTPATIENT PHARMACY (CMOP) V. 2.0 PSX*2*63
The first three patches (BPS*1*5, IB*2*363,and PSO*7*260) will be
released in the Kernel Installation and Distribution System (KIDS)
multi-build distribution BPS PSO IB BUNDLE 2.0. Patches PSX*2*63 and
PSS*1*127 will be released as stand-alone patches. Since there is an
implementation dependency between the multi-build distribution and the
stand-alone patches, PSX*2*63 and PSS*1*127 must be installed prior to
Health Information Systems and Technology Architecture (VistA) electronic
the installation of the multi-build. For more specific instructions
please refer to the installation steps provided in each of the patches.
pharmacy (ePharmacy) system. Below is a list of all the applications
involved in this project along with their patch number:
APPLICATION/VERSION PATCH
--------------------------------------------------------------
OUTPATIENT PHARMACY (OP) V. 7.0 PSO*7*260
INTEGRATED BILLING (IB) V. 2.0 IB*2*363
Description:
of claim responses (including drug utilization review responses and
Routine Summary:
================
The second line now reads as follows:
<TAB>;;1.0;IHS Pharmacy Point of Sale; **[patch list]**; Jun 2004
CHECK^XTSUMBLD results:
Routine Checksum Value
======= ==============
warnings) on a real-time basis, is being developed and introduced in a
BPSECA1 6485606
BPSECA2 1682902
BPSECA4 6220829
BPSECA5 4789118
BPSECA7 711596
BPSECA8 3062006
BPSECA9 4929109
BPSECFM 2542538
BPSECP0 1231669
BPSECP1 8373351
phased implementation strategy. This deployment strategy was utilized due
BPSECP2 4648149
BPSECP3 8882441
BPSECR0 1379515
BPSECR1 1717840
BPSECR2 3480905
BPSECX0 754266
BPSECX1 4278553
BPSECX4 569954
BPSECZ3 4496980
BPSECZA 4449840
to the complexity of the functionality and the number of product line
BPSER1A 3879379
BPSER2A 5013615
BPSER3A 3060197
BPSER4A 4098816
BPSES00 1681063
BPSJACK 10839099
BPSJAREG 3471785
BPSJHLI 1245414
BPSJHLT 11644295
BPSJINI1 6280511
dependencies.
BPSJINIT 7809002
BPSJPHNM 7830674
BPSJPREG 3683655
BPSJUTL 2750894
BPSJUTL1 3176342
BPSJVAL 3292489
BPSJVAL1 9341066
BPSJVAL2 7321923
BPSJXI1 1888198
BPSJZPR 10852903
BPSJZQR 1211753
BPSJZRP 6572546
BPSMHDR 5172150
BPSOS02 922003
BPSOS03 4762173
BPSOS2 5794835
BPSOS2A 3438805
BPSOS2B 12833055
BPSOS2C 5657589
BPSOS2D 1377421
The first release of this two part implementation is BPS*1*0, comprised of
BPSOS2E 1432527
BPSOS2F 2190
BPSOS6A 1692241
BPSOS6E 2202299
BPSOS6F 975863
BPSOS6G 583939
BPSOS6H 4134763
BPSOS6I 15473221
BPSOS6K 1898226
BPSOS6L 1105023
the new Electronic Claims Management Engine (ECME) package (in the BPS
BPSOS6N 16897666
BPSOS96 776535
BPSOS97 696242
BPSOSA 2151744
BPSOSAA 2532955
BPSOSAB 9179518
BPSOSAD 613947
BPSOSAM 11538762
BPSOSAN 1994745
BPSOSAO 1873331
namespace), plus the patches PSS*1*81, IB*2.0*223, IB*2.0*251, and
BPSOSAP 2403666
BPSOSAQ 735144
BPSOSAR 8262363
BPSOSAS 1745519
BPSOSAW 5124351
BPSOSAY 1379312
BPSOSAZ 1186543
BPSOSB 959796
BPSOSB0 113802
BPSOSB1 2139
PRCA*4.5*202, which are listed here in order of installation. BPS*1*0 is a
BPSOSB2 2146
BPSOSB4 2160
BPSOSB5 2167
BPSOSBA 101168
BPSOSBC 617661
BPSOSBD 2674634
BPSOSBE 2279
BPSOSBI 2307
BPSOSBL 101245
BPSOSBP 484897
===========
dormant release that only allows each site to perform preliminary setup
BPSOSBQ 485350
BPSOSBT 485371
BPSOSBU 2391
BPSOSBW 4604870
BPSOSC1 2746444
BPSOSC2 10781985
BPSOSC3 2261922
BPSOSCA 4059491
BPSOSCF 10660104
BPSOSD1 2151
work and to confirm that the software does not adversely affect other
BPSOSEC 3788978
BPSOSFD 13905233
BPSOSH2 6439291
BPSOSH4 7279183
BPSOSH5 4709954
BPSOSH6 6286709
BPSOSH7 9955590
BPSOSHF 3902159
BPSOSHR 4748980
BPSOSHU 358514
packages.
BPSOSI 6988972
BPSOSI7 2207252
BPSOSI8 7983989
BPSOSIB 1520498
BPSOSIO 1817298
BPSOSIP 124772
BPSOSIW 2934848
BPSOSIY 13182481
BPSOSIZ 9743963
BPSOSJ1 2985572
BPSOSK 5983189
BPSOSK2 1179461
BPSOSL 7117465
BPSOSL1 2520334
BPSOSM 2149792
BPSOSM1 10236213
BPSOSMA 2958187
BPSOSMB 3244227
BPSOSMC 5914845
BPSOSMZ 1902484
There are two main areas addressed by BPS*1*0:
BPSOSN0 2010
BPSOSN4 844510
BPSOSN7 289249
BPSOSO1 1391042
BPSOSO2 6339508
BPSOSO3 2231
BPSOSO4 2238
BPSOSO5 2245
BPSOSQ1 2227577
BPSOSQ2 8749786
BPSOSQ3 10336941
BPSOSQ4 8580589
BPSOSQF 2968761
BPSOSQG 5287867
BPSOSQH 957180
BPSOSQJ 6618401
BPSOSQL 10953965
BPSOSQS 8333856
BPSOSR1 6141326
BPSOSR2 579087
a. Registration of the Pharmacy with the Vitria BusinessWare IE.
BPSOSR4 4195196
BPSOSRB 8237522
BPSOSS2 2327741
BPSOSS3 670477
BPSOSS6 214430
BPSOSS7 67706
BPSOSS8 7915679
BPSOSS9 1158213
BPSOSSG 11401688
BPSOSU1 2630136
b. The Insurance Matching of Group Plans with Pharmacy Plans
BPSOSU2 1004112
BPSOSU3 877677
BPSOSU4 4710582
BPSOSU5 764934
BPSOSU7 2698763
BPSOSU8 3768830
BPSOSU9 1857421
BPSOSUA 8511603
BPSOSUB 3172501
BPSOSUC 1896200
BPSOSUD 6705940
BPSOSUE 4667712
BPSOSX 6863167
BPSOSXA 2383
BPSOSXE 1952199
BPSRDT 12823556
BPSUTIL 464990
Documentation Retrieval:
Following the installation of BPS*1*0, each site must register their
========================
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.domain.ext, which will transmit the files from the
first available FTP server.
pharmacy with Vitria and match applicable insurance group plans using the
(2) Sites may also elect to retrieve documentation directly from a
specific server as follows:
Albany ftp.fo-albany.domain.ext
Hines ftp.fo-hines.domain.ext
Salt Lake City ftp.fo-slc.domain.ext
The documentation distribution includes:
insurance matching screens. These processes are detailed in the HIPAA
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
IB_2_251_TM.PDF INTEGRATED BILLING IB*2.0*251
(e-PHARMACY) TECHNICAL MANUAL
IB_2_251_UM.PDF e-PHARMACY CLAIMS INSURANCE PROCESS
NCPDP CONNECTION FOR EDI PHARMACY INSTALLATION GUIDE and the E-PHARMACY
USER MANUAL
(3) Documentation can also be retrieved from VISTA Documentation Library
(VDL) on the Internet at the following address, http://www.domain.ext/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:
CLAIMS INSURANCE PROCESS document. Both of these documents are located on
Host file name BPS_1_0.KID
Package:
BPS_1
Builds:
PSS*1.0*81
IB*2.0*223
IB*2.0*251
the anonymous directory. It is very important that the IRM or person
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.domain.ext
Hines: ftp.fo-hines.domain.ext
Salt Lake City: ftp.fo-slc.domain.ext
Do not install this patch while Pharmacy Data Management users are using
installing the patch at each facility provide a copy of these documents to
the software. Installation will take no longer than 15 minutes. There are
no scheduling restrictions or recommendations.
Installation Steps
1. Use VA FileMan to add the new domain, EPHARMACY.VITRIA-EDI.AAC.DOMAIN.EXT,
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.
its ADPAC(s) and any other relevant staff who will be responsible for
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.
registering their pharmacy with Vitria and completing the insurance
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,
matching process.
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)
PATCH OVERVIEW
At a later date, additional HIPAA NCPDP patches will be released to
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
activate all of the HIPAA NCPDP functionality. Until that time, sites will
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.
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.
(1) A user interface has been developed to facilitate entry and filing
Registration and Point of Contact information for each specific
Application (Site) and Pharmacies at a site.
(2) An HL7 interface is included that will create and send HL7 messages
containing the Application and Pharmacy Registration data to Vitria.
The Healthcare Insurance Portability and Accountability Act National
This data notifies Vitria that the site will soon be sending
electronic third party pharmacy claims.
(3) An additional HL7 interface is included which receives messages from
Vitria containing the most up to date Payer Sheet data, and files the
data into the appropriate Vista table. This interface will run
continously, and will keep the site updated with the most recent
changes and additions to the third party Payer sheets.
New Globals:
Council for Prescription Drug Programs (HIPAA NCPDP) initiative, whose
============
The following globals will be created when installing this build.
^BPS - MOSTLY STATIC
^BPSC - VERY DYNAMIC - WILL CONTINUALLY GROW
^BPSCOMB - STATIC - CURRENTLY NOT USED BY THE VA
^BPSECP - DYNAMIC - DOESNT GROW
^BPSECX - DYAMIC - DOESNT GROW A LOT
^BPSEI - STATIC - CURRENTLY NOT USED BY THE VA
ultimate goal is to provide functionality allowing electronic transmission
^BPSF - STATIC - DOESNT GROW
^BPSR - DYNAMIC - GROWS CONTINUALLY
^BPST - DYNAMIC - GROWS
^BPSTL - DYNAMIC - GROWS
Associated NOISs:
=================
N/A
of Outpatient Pharmacy (OP) prescription claims to payers and the receipt
Test Sites:
===========
NEW YORK HARBOR HCS
NORTH TEXAS HCS
ANN ARBOR, MI
BATTLE CREEK, MI
DETROIT, MI
IRON MOUNTAIN, MI
