INTEGRATED BILLING (49)    PACKAGE (9.4)

Patch IB*2*55 for Integrated Billing adds the ability to flag Stop Codes
and Clinics as non-billable or non-auto billable for Third Party Billing.
 
Please see the National Patch Module description for this patch for more
detailed information.

Patch IB*2*69 contains the Diagnostic Measures reports and includes a new
menu which is designed for the MCCR Coordinator.

Corrects bad EDI IDs in insurance company file.

Patch IB*2*176 was created to implement the Long Term Care (LTC) 
Copayment requirements.

This is an emergency patch to fix the problem of batches not being found 
when a confirmation message is received by the EDI server from Austin.

Hold all Inpatient MT bills for GMT.

Visit Copay Phase 2 project.

EDI Maintenance patch.

On July 31st, 2002 the EDI system's method of identifying EDI routing ids 
of patch 189 may have been sent to the wrong payers.
 
In an effort to help the sites identify and resubmit these claims, this 
patch was created.  The options included in this patch must be run by the
IRM staff as the elements of this patch are used solely to correct this
specific problem and will not become part of official VistA software.  
Integrated Billing must be involved to review the report of misrouted
claims to indicate the ones the site does NOT want to automatically
resubmit.
for insurance companies in Vista was changed.  As a result of this 
change, a problem occurred in Vista whereby the text PAYID was 
erroneously inserted into some insurance company EDI routing ids.
 
Patch IB*2*189 corrected the problem of the bad id being stored and
deleted the text PAYID from the EDI routing id fields. Any claims
submitted after this patch was installed would not have been affected by
this problem, but claims submitted between July 31st and the installation

The patch resolves the following issues:
  NOIS NJH-0102-22792
  NOIS MAN-0802-10732

API CHANGE AND CLEAN UP DATE

Modifications for CPT v6.0 update.

This patch fixes the problem when prescriptions billed through the RNA
engine are rejected with a error of 'NDC is not covered' for claims sent
to the Fiscal Intermediary.
Resubmitting a pharmacy claim to the Fiscal Intermediary allows the user
to choose a product selection reason code which will allow the correct
code to be submitted to the Fiscal Intermediary for billing acceptance.

LTC PHASE III

GEOGRAPHIC MEANS TEST, IB PART 2

This patch deletes obsolete options from IB menus and from the IB package.
It will also make some changes to the List Manager screens for the 
Insurance Co Edit.

GMT IB Clean-up patch.

This patch corrects minor issues related to the EDI claims transmission
and opens up the use of the Output Formatter for the CURRENT INS CO
PROVIDER NUMBER.

REGIONAL COUNSEL ENHANCEMENT

Cancel ClaimsManager Bill Bug Fix

Hartford/USAA Settlement

This patch provides a means of batch entry for provider ID's and a quick 
method of manually entering provider ID's.

This patch adds pre-registration as a new source of information
for patient insurance policies.

REMOVE SSN FROM COPAY EXEMPT LETTERS

This patch modifies the output transforms of four fields in the 
BILL/CLAIMS (#399) file, to resolve an issue with <UNDEF> errors when
using this file directly through FileMan.

AR PRODUCTIVITY/UNBILLED AMOUNTS REPORT FIXES

The IB part of the HIPAA Confidential Communication project.

This patch modifies two entries in file 364.7 - IB FORM FIELD CONTENT
to address issues with Medicare rejections and Admit/Discharge dates.
It also modifies the way box 24K is filled when billing secondary
coverage on a claim where Medicare is primary.

Interface between IB and QuadraMed.

Reasonable Charges v1.4

This patch changes the value of SOURCE LEVEL MINIMUM for
the CHAMPUS ID record in the IB PROVIDER ID # TYPE (#355.97) file.
The new value will be "NONE".

Changes to suppress PATIENT file fuzzy lookups.

REMOVE HARTFORD SETTLEMENT SOFTWARE

This patch fixes a problem whereby an illegal number error may occur
when using the 'SC Vets w/ NSC Episodes of Care Not Billed (Inpt)' option
when the BILL NUMBER field (.01) in the BILL/CLAIMS file (399) contains
an E, such as 5E1345.
~

REMOTE INSURANCE QUERY 

This patch will cover OKL-0303-72052.

Fixes assorted NOIS calls (10).

REASONS NOT BILLABLE/FOLLOW-UP/VETS WITH UNVERIFIED ELIG. REPORTS

This patch corrects a problem with the range selection in the
[IBJD FOLLOW-UP FIRST PARTY] option.  
  
 OKL-1001-73313 [IBJD FOLLOW-UP FIRST PARTY] incorrect Data (0 to n Range)

REMOTE INSURANCE QUERY FIX/UPDATE

This patch adds new Occurence Codes and Occurrence Span Codes
to file 399.1.

This patch updates the Information/Warning records in file #361.
Ref. NOIS FGH-0203-31133
Routine:  IB20P229, a database conversion routine.
  
This patch also fixes a display problem with the Contact Date
and Call Ref. No. on the IBCN PATIENT INSURANCE screens.
Ref. NOIS BAY-0403-32311
Routine: IBCNSP0

This patch adds some error trapping code to avoid a problem in the
  
TECHNICAL:
==========
1.  Changes are made to routines IBCIUT3 and IBCIUT4.
    IBCIUT3
      A new subroutine, ERRTRP, releases the tcp/ip port and creates the
      message "A SYSTEM ERROR HAS BEEN DETECTED AT THE FOLLOWING LOCATION".
      A new level is pushed on the error trap stack and the $ETRAP system
      variable is set to call the new ERRTRP subroutine.
    IBCIUT4
Claims Manager interface that could cause users to be forcibly logged
      A new error type, "Fatal System Error" is added to the P1 function.
out.  
 
ASSOCIATED NOIS:
================
1. PRE-0902-60489        Claims Manager  freezing screen 
      DUB-0303-31898     <READ>READ+27^IBCIUT3
      ASH-0103-30446     ib error when going to claimsmanager

Special Mid-Year FY03 Stop Codes Update
684    NONVIDEO HOME TELEHEALTH INTERVENTION                N

* N = Nonbillable
=======================================

CODE   DESCRIPTIONS                                   BILLABLE TYPE *           
----   ----------------------------------------       -------------
161    PHARMACY TRANSITION CARE                             N
179    HOME TELEVIDEO CARE                                  N
220    VISOR (VISUAL IMPAIRMENT OUTPATIENT PROGRAM)         N
683    NONVIDEO HOME TELEHEALTH MONITOR ONLY (NONCOUNT)     N

PROBLEM WITH IBARXEC4

This patch addresses an issue where the ELECTRONIC PLAN TYPE field was not
available for editing in the Move Subscribers to a Different Plan option.
ASSOCIATED NOIS:
================
    
1. PUG-0403-50885  Electronic Type not included when moving Ins Plans
 
Routine: IBCNSUR2

This patch updates the unbilled amounts report to generate according to 
the new EOAM schedule.  Changes in routines IBJDE, IBTUBO and IBTUBOU have
been made to accommodate the changes as well as changes to the INPUT VARIABLE
section of file 351.7 DIAGNOSTIC MEASURES REPORTS.

This is the build for the electronic Insurance Identification and 
Verification project (also referred to as eIIV and IIV).

Code Set Versioning, the IB part. Phase 1.
 
Please see the National Patch Module for details
of the enhancements included in this patch.

This patch adds an additional prompt to the Third Party Follow-up report
to allow the generation of the report from the date of care to the date
the report is run.

Third Party EDI Lockbox patch IB*2.0*135 (Integrated Billing component)
 
This patch is being released as part of a build that also includes patch
PRCA*4.5*173.  Please refer to the patch description in the National Patch
module and the users documentation for patch PRCA*4.5*173 for detailed
information about this patch.

INTERIM ADDRESS ENHANCEMENT

IIV Update for Individually Accept method in the Insurance Buffer 
            
* NOTE: This patch must be installed by October 7, 2003, in order to meet 
* the HIPAA compliance date for use of the software by October 16, 2003. 
acceptance process.
 
This patch fixes a problem identified in the IB Insurance Buffer 
Individually Accept action.  Under certain circumstances the problem may 
result in incorrect filing of information from the Insurance Buffer.  
This 
action was released with IB*2*184, therefore this patch should be 
installed as soon after IB*2*184 as is practicable.

This patch corrects the unbilled amounts report from generating
again on the first of the month with the other DM reports.  It also
corrects the IBT RE-GENERATE UNBILLED AMOUNTS REPORT.  The end date for
the report for months prior to September 2003 will display as the last day
of the calendar month.  Those months after September 2003 will use the
EOAM date for that month.

 
Patch for output formatter utility, Charge Master, and Tri-care.

COMBAT VETERANS INTERIM SOLUTION - PHASE I

This patch fixes the transmission of the Diagnostic Measures reports
for future runs.

This patch corrects the problem of bills reflecting that they are 
referred to Regional Counsel, when they are no longer referred, on the 
Third Party Follow-up Report.

This patch corrects a problem with Means Test reminder letters, fixes
N/A
TECHNICAL:
==========
  
1.  SHE-0801-51284     Cat C reminder letters printing
    Changes are made to routines: IBARXEL, IBARXEL1
    The function $$BIL^DGMTUB(X,Y) is called and the veteran is
    either sent a letter or not sent a letter based on the result.
  
2.  COA-0403-21056     <UNDEF> MAIN+2^IBTOSUM2 in MCCR/UR SUMMARY REPORT
    The initialization of the IBCNT array is modified in the RPT section
 
    of routine IBTOSUM.  The code S IBCNT(3,0)=0 is added.
 
3.  SBY-0403-30897     Claims Waiting Austin Acknowledgement
    The SUPRESS BULLETIN field (#224) of the OPTION file (#19) for
    option IBCE MESSAGES SERVER is set to the value Y.
  
4.  BRX-0403-12417     BULL1+4^IBTUBUL:1, %DSM-E-UNDEF, undefined variable
    The TESTV subroutine of IBTUBUL is modified to contain the line:
    S IBUNB("EPISM-A")=11111.     
 
ASSOCIATED NOIS:
 
PARTICIPATING TEST SITES:
=========================
TBD
 
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: 
 
================
  <tab>;;2.0;INTEGRATED BILLING;**[PATCH LIST]**;21-MAR-94
 
                       CHECK^XTSUMBLD results
Routine name      Before Patch        After Patch       Patch List
============      ============        ===========       ===========
IB20P217                   N/A            1138089       217
IBARXEL                5496758            5804553       34,139,206,217
IBARXEL1               7127873            7529363       34,199,217
IBTOSUM                8582961            8533948       118,133,217
IBTUBUL                6667983            6686239       19,123,159,217
  
 
 
INSTALLATION INSTRUCTIONS
=========================
 
 This patch can be installed at any time, however, the IB MT NIGHT COMP
 job should not be running.
  
 If installed during the normal workday it is recommended that the
 following menu options (File #19) be disabled to prevent possible
1. SHE-0801-51284     Cat C reminder letters printing
 conflicts while running the KIDS Install. Other VISTA users will not
 be affected.
  
    Reprint Single Income Test Reminder Letter [IB RX REPRINT REMINDER]
    MCCR/UR Summary Report [IBT OUTPUT MCCR/UR SUMMARY]
    Send Test Unbilled Amounts Bulletin [IBT SEND TEST UNBILLED MESS]
  
 Install time - less than 2 minutes.
  
  
2. COA-0403-21056     <UNDEF> MAIN+2^IBTOSUM2 in MCCR/UR SUMMARY REPORT
 1.  LOAD TRANSPORT GLOBAL 
     ---------------------
     Choose the PackMan message containing this patch and invoke the 
     INSTALL/CHECK MESSAGE PackMan option.  
                               
 2.  DISABLE ROUTINE MAPPING   (DSM for open VMS sites only)
     -----------------------
     Disable routine mapping on all systems for the routines listed in
     the routine summary
     NOTE:  If the routines included in this patch are not currently in
3. SBY-0403-30897     Claims Waiting Austin Acknowledgement
     your mapped routine set, please skip this step.
  
 3.  START UP KIDS 
     -------------
     Start up the Kernel Installation and Distribution System Menu 
     [XPD MAIN]: 
                         
           Edits and Distribution ...  
           Utilities ...
           Installation ...  
4. BRX-0403-12417     BULL1+4^IBTUBUL:1, %DSM-E-UNDEF, undefined variable
                                   
     Select Kernel Installation & Distribution System Option: INStallation
                                                              ---
  
     1      Load a Distribution
     2      Verify Checksums in Transport Global
     3      Print Transport Global
     4      Compare Transport Global to Current System
     5      Backup a Transport Global
     6      Install Package(s)
  
            Restart Install of Package(s)
            Unload a Distribution
     
 4.  From this menu, you may elect to use the following options
     (When prompted for the INSTALL NAME, enter IB*2.0*217):
     
     a.  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.
     b.  Compare Transport Global to Current System - This option
an <UNDEF> error which could occur in IBT OUTPUT MCCR/UR SUMMARY, modifies
NOIS OVERVIEW:
         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.).
     c.  Verify Checksums in Transport Global - This option will
         allow you to ensure the integrity of the routines that are
         in the transport global.
                   
 5.  Use the Install Package(s) option and select the package IB*2.0*217.
 
     a.  When prompted 'Want KIDS to INHIBIT LOGONs during the
==============
         install? YES//', answer NO.
     b.  When prompted 'Want to DISABLE Scheduled Options, Menu
         Options, and Protocols? YES//' answer YES.
     c.  When prompted 'Enter options you wish to mark as 'Out of
         Order':' Enter the following:       
           IB RX REPRINT REMINDER
           IBT OUTPUT MCCR/UR SUMMARY
           IBT SEND TEST UNBILLED MESS
            
     d.  When prompted 'Enter protocols you wish to mark as 'Out of
  
         Order': Enter the following: (press return) 
  
 7.  REBUILD MAPPED ROUTINES(S)  (DSM for Open VMS sites only)
     --------------------------
     Optional - Include the routines distributed with this patch in the
     mapped routine set.
                    
     NOTE: This step is only necessary if you performed step 2 or if you 
     wish to include the routines in your mapped set.
  
1. SHE-0801-51284     Cat C reminder letters printing 
 8.  DELETE PRE-INIT ROUTINE
     ------------------------
     You may delete the IB20P217 routine from your system after successful
     installation of this patch.
  
INSTALLATION EXAMPLE:
---------------------
  
   Problem:
   --------
       With DG*5.3*326, Category C veterans and those Pending Adjudication and 
   having agreed to pay the deductible, and whose Means Test is more recent
   than 10/5/99, will no longer be subject to an annual MT.  However, if the
the SUPRESS BULLETIN field of the IBCE MESSAGES SERVER option and fixes
   site has the Income Test Reminder Letters option turned on, these now
   exempt patients are included in the output.  Since they are no longer
   subject to MT, their copay status will remain unchanged.  As such, they
   should no longer be included in those patients due for a reminder.  
 
   Resolution:
   -----------
   This patch corrects the issue by checking the veteran's status and 
   removing them from the Means Test reminder list if they meet the
   criteria mentioned above.
an <UNDEF> error in the IBT SEND TEST UNBILLED MESS option.  
 
 
2. COA-0403-21056     <UNDEF> MAIN+2^IBTOSUM2 in MCCR/UR SUMMARY REPORT
 
   Problem:
   --------
   When running the IBT OUTPUT MCCR/UR SUMMARY option for a date range that
   contains no Claims Tracking entry that is ACTIVE, INSURED and BILLABLE,
   an undefined error would occur.  The printing function expected to find
   a value in the counter IBCNT(3,0) but if no records were selected 
 
   during the search, the counter was never set.
  
   Resolution:
   -----------
   The counter array variable IBCNT(3,0) is initialized to zero prior
   to the record search.
  
 
3. SBY-0403-30897     Claims Waiting Austin Acknowledgement
 
 
   Problem:
   --------
   When acknowledgment messages or status update messages are received
   from Austin, they are delivered to the S.IBCE MESSAGES SERVER
   option.  Because there is no specific SERVER MAIL GROUP defined for 
   this option, and the SUPRESS BULLETIN field is NULL (the default is
   to send), a message is sent to the default MAIL GROUP defined in the
   XQSERVER Bulletin (file 3.6).  This is GENERALLY a mail group called 
   XQSERVER but it may have some other name.  If this MAIL GROUP 
   specified in the XQSERVER Bulletin suddenly has NO active members (for 
ASSOCIATED E3R(s):
   whatever reason), the incoming messages will be RECEIVED, but the IBCE 
   MESSAGES SERVER is not served.  The server option is listed as a
   recipient but server action was not processed due to a security
   violation.
 
   Resolution:
   -----------
   The issue could be resolved on a local basis by making sure that there
   is always a member of whichever mail group is specified by the XQSERVER
   bulletin.  However, to avoid the problem altogether, this patch will
==================
   set the SUPRESS BULLETIN field of the S.IBCE MESSAGES SERVER option
   to YES.  The bulletin only announces that there has been server
   activity. It is not necessary for actual distribution of the incoming
   reports so suppressing the bulletin will have no detrimental effect.
 
 
 4. BRX-0403-12417     BULL1+4^IBTUBUL:1, %DSM-E-UNDEF, undefined variable
 
   Problem:
   --------
  
   When running the option IBT SEND TEST UNBILLED MESS, a software error
   is logged because the TESTV subroutine fails to initialize the 
   IBUNB("EPISM-A") variable.  This problem only occurs for the TEST
   messages and not for the real messages.
 
   Resolution:
   -----------
   The missing variable is initialized so that the TEST message
   function can be utilized.
  

This patch changes the value in the print preview screen, BILL TOTAL 
field and the TOTAL CHARGE field in the printed form. The value is 
changed from the amount due to the total charges not including any 
offset.   

IB*2.0*256 IB INSURANCE API TEST VERSION 6

This patch does an automatic update of the CY 2004 Medicare Deductible
and the Pension Copay Threshold amounts.

FIX RX COPAY EXEMPTION FOR IVM - The upload of an IVM Converted Means 
Test (ORU~Z06) will be modified to no longer re-calculate the COPAY 
INCOME EXEMPTION STATUS (#.04) field in the BILLING PATIENT (#354) File.

OIG/IVM 60-DAY BILL DROP

FIX FOR AUG-0103-31330, ADMIT/DISCHARGE HOUR FOR OUTPATIENT BILLS

Charge Item File (363.2) and the post init to add the Tort and Interagency
Rates.

This patch adds patient information to an INTEGRATED BILLING BACKGROUND
ERROR message.

This patch addresses the following NOIS message(s):
---------------------------------------------------
POR-0903-52494         BUFFER FILE PROBLEMS
BAY-1003-30706         Critical Message received from IIV
LOU-0903-42302         IIV Payer Link Report /column
UNY-1003-12260         <NULLSUBSCR>VALID+5^IBCNEUT4

Reasonable Charges version 2.0.  Charge effective date 12/19/03.

Add Tortiously Liable and Interagency Rates for January 2004.

Care Units are displaying incorrectly on the Insurance Company Provider
ID Maintenance screen.

This patch implements the following change to the Integrated Billing
package:  Plan comments will now carry over when subscribers are moved
from one insurance plan to another.

ENHANCEMENT FOR BILLING AWARENESS PTF

This patch resolves the problem reported in LEB-0104-20959
Incorrect total in PATIENT PHARMACY COPAY CAP REPORT.
The improper formatting of numbers larger than 999.99 was
causing inaccurate data to be displayed to the user.
The code is modified to format and display correctly now.

This build contains changes to add and populate fields in the EXPLANATION
OF BENEFITS file (#361.1) needed for e-payments Phase II processing.

This patch fixes a problem whereby the Earliest Auto Bill Date is being
changed to a date beyond the end of the billing cycle when the end
of the billing cycle is greater than the date the auto biller is running.
As a result, the episode is not included on a bill until the next
billing cycle.  This problem occurs with both prescription refills
and outpatient visits.

Reasonable Charges v2.1

This KIDS Build will transport patch IB*2.0*259, The Pharmacy Co-pay Cap 
Summary Report, to the field.

This patch addresses two issues: the Hospital Reviews [IBT EDIT REVIEWS] 
option has been modified so that the ward is displayed even if the 
patient is admitted and discharged on the same day, and the Queue Means
Test Compilation of Charges [IB MT NIGHT COMP] option has been modified to
respect both date and time.

This patch corrects a problem in the CLAIMS STATUS AWAITING RESOLUTION
option where a <NULSUBSCR> error ocurred when trying to view an EOB
and none existed.
See NOIS SBY-0104-30665.
This patch also corrects a second issue where active insurance
company names were not listed when entering data into the
insurance buffer.
See NOIS MIN-0104-41017

COMBAT VETERAN PHASE II

The Type of Visit file (357.69) holds a list of E&M codes (a subset of 
CPT codes). Generally a quantity of 1 is all that is allowed for these 
codes. There are cases, however, when this quantity should not be limited 
to one. Therefore, there needs to be a field that will serve as a flag. 
The field being added is the .06 field. It will have a value of 0 if the 
quantity is to be restricted to one and a value of 1 if it allows a 
quantity of greater than one. Using the flag this way means that current 
entries that do not have a value for this flag will default to allowing a 
quantity of only 1.

Patch IB*2.0*243 fixes 3 items.
This patch announces a correction to the manual.
(1) Two separate fields in the BILL/CLAIMS file (#399), #204 and #450,
are both named FORM LOCATOR 2.  The fields are renamed and two input
templates (IB SCREEN8, IB SCREEN82) are recompiled.
(2) If a user selects a bill to cancel but changes their mind and enters
"no" at the end, a message displays "<NO ACTION TAKEN>" but the "DATE
BILL CANCELLED" and "BILL CANCELLED BY" fields are populated anyway.
(3) A user noted that the Integrated Billing Technical Manual did not
include the IBAM and IBAT globals in the journalling instructions.

This patch corrects a situation which allows the IB DM EXTRACT DATE file
to become corrupted.  It also corrects a situation where the Subscriber ID
is saved with hyphens still embedded in the number.

 Error handling code was added to the IB CANCEL BILL process to 
 These will be added with the post init routine IBYP241.
 recognize the error indicator being passed back by AR and to display 
 the following warning message: "Please note: PRCA was unable to determine
 if a payment has been posted"
 
A new RATE TYPE of INELIGIBLE is added to the RATE TYPE file 
(#399.3) pointing to the ACCOUNTS RECEIVABLE CATEGORY: INELIGIBLE HOSP.
New Rate Schedules of INELIG-OPT and INELIG-INPT are added to file
#363 - RATE SCHEDULE.

Add ability to process IVM close case/converted Pharmacy Exemption tests 
via Z06 transmissions from the EDB.

OUTPUT FORMATTER PROBLEMS

Remove references to CHAMPUS.
Fix <UNDEFINED>YR+6^IBAECU by correcting code in IBECEA3.

MEANS TEST DATE PROBLEM

This patch will implement CBOC data extraction logic for
the Boston Allocation Resource Center.

This patch will use the NEW command to limit the scope of the
DIQUIET variable.

Several Trigger type cross references throughout IB files have
an old Mumps function $Next.  This is an outdated form and needs
to be revised.  By recompiling the trigger code with FileMan v22
the old code will be replaced with current standards.

This patch will add one new entry to file 361.2.
The entry is: R0S0 - PRF GVT WEBMD/PAYER INFO/EDIT

Contains the EDI Enhancements (HIPAA) provider ID worksheet.

This patch modifies the 'Sender' name used by the IIV STATISTICAL REPORT
when mailing the report to the IBCNE IIV MESSAGE mail group.
The name is changed from "IB IIV INTERFACE" to "IIV INTERFACE (IB)".

EDI/ENHANCEMENTS HIPAA COMPLIANCE

This is a coordinated patch between the Integrated Billing and Accounts
PRCA*4.5*84.
 
This coordinated patch fixes a problem whereby AR bills with an AMENDED
BILL status were not being cancelled when the associated IB bill was
cancelled.
Receivable packages.  Patch IB*2.0*77 contains two modified routines,
one for Integrated Billing and one for Accounts Receivable.  Both are
being released under the IB*2.0*77 patch namespace to assure installation
at the same time, as one routine is dependent upon the other.  The
associated AR patch is PRCA*4.5*84, and is listed in the National Patch
Module as an information only patch.  A post-init routine is also sent
with this patch.  As part of the post-init process, the Accounts Receivable
package file will be updated to indicate successful installation of patch

Follow up patch for problems found late in testing patch IB*2.0*232
for EDI Enhancements.

CODE TEXT DESCRIPTORS

CSA screen performance enhancements and improve message handling of 
entries in file 361 - IB BILL STATUS MESSAGE.

PATCH OVERVIEW
introduced in a phased implementation strategy. This deployment strategy 
schedule adjustment is entered.  These are optional and will be sent in 
the NCPDP transmission.
 
7.  To assist with the posting of payments, the API used to look 
up bills to post payments in the Accounts Receivable package has 
been updated to allow for input of the ECME number.
 
 
Technical Description
---------------------
was utilized due to the complexity of the functionality and the number of 
IB20P223 is an environment check to ensure that the site has 4 national 
rate types defined.  If the rate types are not defined, a site will need 
to defined them prior to install.  The 4 rate types are:
         CHAMPUS (or TRICARE)
         CHAMPUS REIMB. INS. (or TRICARE REIMB. INS.)
         CHAMPVA
         CHAMPVA REIMB. INS.
If your site does not have the exact spelling as shown above, you should 
contact EVS for assistance.  Your site may have them defined but the 
names may have been changed.
product line dependencies.
 
This routine also has a post install that will add two reasons not 
billable.  They are:
         HEAD/NECK CANCER
         COMBAT VETERAN
 
IBCRCC has an optional parameter in the RATECHG line tag of FEE.  If this 
parameter is passed by reference, the API will return any Administrative 
Fee and Dispensing Fee amounts for the Rate Schedule.
 
 
IBCREE has been modified to capture the Administrative Fee and Dispensing 
Fee, if appropriate.  The Rate Schedule adjustment must have an amount 
added in the calculation of the adjustment for the fee questions to be 
asked.
 
IBCRU3 has been modified to add a new entry point to look up the event 
pointer based on a rate type.
 
IBJTCA1 is included to add enhancements to the Third Party Joint Inquiry 
to display new information that relates to ECME claims.
The first release of this two part implementation is BPS*1*0, comprised 
 
IBNCPDP is the main API routine to be used by Outpatient Pharmacy.  All 
new APIs will be supported with this routine.
 
IBNCPDP1 will handle the initial call by Outpatient Pharmacy.  This 
routine will load the prescription information to Claims Tracking, look 
up insurance information, verify active pharmacy coverage and return the 
necessary billing information so that a NCPDP claim can be produced.
 
IBNCPDP2 will handle all response information sent from Outpatient 
of the new Electronic Claims Management Engine (ECME) package (in the BPS 
Pharmacy.  This routine will create bills, authorize bills, audit bills, 
adjust bills, cancel bills and ensure that the claims are updated in 
Claims Tracking.
 
IBNCPDP3 will handle Average Wholesale Pricing updates.
 
IBNCPCPU will be a utility routine for all the NCPDP billing needs in IB.
 
IBRFN has been updated to allow for input of an ECME number when posting 
payments in the Accounts Receivable package.  The API for AR will now 
namespace), plus the patches PSS*1*81, IB*2.0*223, IB*2.0*251, and 
return the type of lookup found.
 
IBRUTL is being included to suppress the third party billing bulletin when
a first party bill goes on hold for third party billing and the bill has
already been billed using the ECME software.
 
IBTUTL1 has been modified to accept an additional optional parameter in 
the REFILL line tag for the EARLIEST AUTOBILL DATE.  If the new parameter 
is specified in the call, that date will be used instead of the existing 
functionality.
PRCA*4.5*202, which are listed here in order of installation. BPS*1*0 is 
 
    
COMPONENTS SENT WITH PATCH
--------------------------
 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:
    
   <tab>;;2.0;INTEGRATED BILLING;**[patch list]**;21-MAR-94
   
                  CHECK^XTSUMBLD results
a dormant release that only allows each site to perform preliminary setup 
    
   Routine     Before Patch  After Patch  Patch List
   -------     ------------  -----------  ----------
 * IB20P223           N/A        2185163  223
   IBCRCC         7424137        7476482  52,80,106,138,245,223
   IBCREE        20456836       21593159  52,106,115,223
   IBCRU3         5450420        6652039  52,106,223
   IBJTCA1       16164807       16640403  39,80,106,137,223
   IBNCPDP            N/A         355298  223
   IBNCPDP1           N/A       13353250  223
work and to confirm that the software does not adversely affect other 
   IBNCPDP2           N/A       16386559  223
   IBNCPDP3           N/A         758252  223
   IBNCPDPU           N/A        8111193  223
   IBRFN          4021093        6787815  52,130,183,223
   IBRUTL         3925983        4993649  70,82,132,142,176,179,202,223
   IBTUTL1        5460777        6092014  13,223
 
      Total number of routines - 13
 
 
---------------
packages.
   * NOTE: THIS ROUTINE WILL BE AUTOMATICALLY DELETED AFTER INSTALL.
 
                        
                        Data Dictionary Changes:
 
                                         UP    SEND  DATA                USER
                                         DATE  SEC.  COMES  SITE   RSLV  OVER
FILE #      NAME                         DD    CODE  W/FILE DATA   PTS   RIDE
------------------------------------------------------------------------------
 
 
361.1       EXPLANATION OF BENEFITS      YES   NO    NO                 NO
Partial DD: subDD: 361.1      fld: .14
 
  DATA SCREEN:
 
363         RATE SCHEDULE                YES   NO    NO                 NO
Partial DD: subDD: 363        fld: 1.01
                              fld: 1.02
  DATA SCREEN: 
 
There are two main areas addressed by BPS*1*0:
399         BILL/CLAIMS                  YES   NO    NO                 NO
Partial DD: subDD: 399        fld: 460
                              fld: 461
  DATA SCREEN: 
 
 
SOFTWARE AND DOCUMENTATION RETRIEVAL
====================================
The software for this patch is being distributed in host file 
BPS_1_0.KID.  The host file will contain seven KIDS builds.
 
The builds contained in the BPS 1.0 multi-package distribution are:
 
     Package                    Patches
     -------                    ----------------------
     ECME                       BPS*1.0*1
     Pharmacy Data Management   PSS*1.0*81
     Integrated Billing         IB*2.0*223, IB*2.0*251
     Accounts Receivable        PRCA*4.5*202
 
 
a. Registration of the Pharmacy with the Vitria BusinessWare IE.
Please refer to the 'Software and Documentation Retrieval' section of the 
BPS*1.0*1 patch description for instructions on how to acquire the patch 
software and documentation.
 
 
INSTALLATION INSTRUCTIONS
==========================
 
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 
b. The Insurance Matching of Group Plans with Pharmacy Plans
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.
Following the installation of BPS*1*0, each site must register their 
 
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)
 
pharmacy with Vitria and match applicable insurance group plans using the 
    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 
insurance matching screens. These processes are detailed in the HIPAA 
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? 
 
NCPDP CONNECTION FOR EDI PHARMACY INSTALLATION GUIDE and the MATCH GROUP 
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. 
PLANS WITH PHARMACY PLANS 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 
The Healthcare Insurance Portability and Accountability Act National 
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.
 
Council for Prescription Drug Programs (HIPAA NCPDP) initiative, whose 
The specific functionality for this patch is listed below.
 
 
Functional Description
----------------------
This patch adds the necessary enhancements to the Integrated Billing 
package to support NCPDP (National Council for Prescription Drug Programs)
billing of pharmacy claims via the Outpatient Pharmacy package.
 
The features are:
ultimate goal is to provide functionality allowing electronic 
  
1. When a patient is issued medication via Outpatient Pharmacy, 
Outpatient Pharmacy will check with Integrated Billing (IB) to determine 
if the prescription is NCPDP billable to a third party payer. The patient
must have active, reimbursable insurance that covers prescriptions as
specified in the patient's group policy coverage limitations.  The 
prescription must not be for OTC or research medications and must not be 
related to SC (Service Connected), AO (Agent Orange), IR (Ionizing
Radiation), EC (Environmental Contaminants), HNC (Head/Neck Cancer), CV
(Combat Veteran), or MST (Military Sexual Trauma).
transmission of Outpatient Pharmacy (OP) prescription claims to payers 
 
2.  A check will be done to see if the site's Claims Tracking module is 
turned on for prescriptions.  When it is, the appropriate information 
will be entered into that module in IB.  To ensure that the Autobiller 
does not bill the prescription on a paper claim until the electronic 
transmission can be processed, the EARLIEST AUTOBILL DATE will be set for 
60 days into the future.  If the claim is not processed or resolved in 
pharmacy within 60 days, then a paper claim will be automatically 
generated.
 
and the receipt of claim responses (including drug utilization review 
3.  If the bill for the prescription is approved by the third party 
insurance carrier for payment, Outpatient Pharmacy will make a second 
call to IB.  At that time, IB will create a bill in the BILL/CLAIMS 
(#399) file for the amount of the total charge.  The bill will be 
automatically authorized and passed to Accounts Receivable (AR).  IB will 
have AR automatically audit the receivable and post a decrease adjustment 
so that the amount of the outstanding receivable will be equal to the 
amount of payment expected from the payer.
 
4.  If a prescription bill is rejected, Outpatient Pharmacy will make a 
responses and warnings) on a real-time basis, is being developed and 
second call to IB.  Assuming Claims Tracking is active for prescriptions, 
IB will check to make sure the prescription is in Claims Tracking.  The 
Claims Tracking entry will be picked up by the Autobiller to ensure 
proper follow-up is done.
 
5.  If a prescription bill is reversed in Outpatient Pharmacy, both the 
bill and receivable will be cancelled.
 
6.  To support claims other than Reimbursable Insurance for Veterans, IB 
will ask for both the Administrative Fee and Dispensing Fee when a rate 

The Healthcare Insurance Portability and Accountability Act National 
 
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. 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.
 
This is the IB*2.0*251 patch and it provides modified and new components 
Council for Prescription Drug Programs (HIPAA NCPDP) initiative, whose 
associated with the following specific requirements:
* Send Interface Version Number in e-IIV Registration Message.
* Update Pharmacy Benefits Manager (PBM) Table
* Update NCPDP Processor Table
* Update Payer Table
* Update Plan Table
* Update Pharmacy Plan Table
* Provide Pharmacy Plan NCPDP Claim Submission Status and Information via
Callable Routine
* Display Pharmacy Plan Information Based on User Selected Sort Criteria
ultimate goal is to provide functionality allowing electronic transmission
* Display Qualified Group Plans to Help Link Pharmacy Plan to Group
Insurance Plan
* Link Pharmacy Plan to Group Insurance Plan
* Link Pharmacy Plan to Multiple Group Insurance Plan
* Link Test Payer Sheet to Pharmacy Plan
* Edit Pharmacy Benefits Manager (PBM) Local Active Flag
* Edit NCPDP Processor Local Active Flag
* Edit Payer Local Active Flag
* Edit Plan / Pharmacy Plan Local Active Flag
* Edit HIPAA NCPDP Flag
of Outpatient Pharmacy (OP) prescription claims to payers and the receipt 
* Store and Track Banking Identification Numbers (BIN) and Processing
Control Numbers (PCN) From Patient Insurance Cards
 
The Vitria Interface Engine (IE) BusinessWare product will be utilized in 
this project.   The IE will provide:
* HL7 message routing tables for directing incoming and outgoing VistA
HL7 messages
* HL7 message translation mechanisms for handling various versions of
VistA compatible HL7 messages
* HL7 message error handling capability
of claim responses (including drug utilization review responses and 
* Data mapping utility
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.

This patch contains the functionality to begin electronically requesting
and receiving MEDICARE REMITTANCE ADVICE (MRA) from MEDICARE for those
patients who have MEDICARE coverage as well as other coverage that is
secondary to MEDICARE. See the patch module and release notes that
accompany this patch for further documentation.

This patch removes the printing of the SSN from the UB92 and the HCFA
1500 claim forms when they are printed locally.

MRA (Medicare Remittance Advice) Enhancements
6.  Remove redundant code; Fix state for license # extract for Non-VA 
providers (IBCEF71)
7.  Move the Medicare assigned number 670899 hospital provider number and 
professional provider number to the new location in file 355.92.  Only 
the MEDICARE (WNR) entry is modified.
8.  Restore changes to billing screen 5 when the principle diagnosis is 
missing.  The field prompt will tell the users if the diagnosis code is 
required or not.  It will say either UNSPECIFIED or UNSPECIFIED [NOT 
REQUIRED].
9.  Set the 837 test transmission queue to be "MCT".
 
10.  Add a new IB edit so that the subscriber's date of birth must exist 
for all insurances on the claim.
11.  When cloning an MRA bill and manually changing the payer sequence to 
be secondary, update the CLAIM MRA STATUS field to indicate that an MRA 
is not needed for this new claim.
12.  Fix a hard error when accessing the non-VA provider add/edit
functionality using the option NON-VA Facility Data [IBCE PRVNVA FAC EDIT].
The error occurs because the code is used by both list manager and option
functions and the list manager variables are not set in the option call.
The fix is to make the calls to the  list manager specific code conditional
1.  Allow Medicare to populate the "AE" x-ref in the Bill/Claims file
on it being called via a list manager action. (IBCEP8)
13.  Cancelled claims cannot appear on the CSA screen.
2.  Allow Denied MRAs for duplicate claim/service to be screened off of 
the MRA management worklist
3.  Correct the MRA Statistics report for the auto-generated claim data
4.  Fix the person/non-person indicator for Fee Basis providers (File 
364.7/ien's 1034-1037)
5.  Fix the period in names to correct suffix problem (IBCEFG1)

This patch is a re-release of IB*2.0*256 to standardize existing
VistA Integrated Billing calls.  All direct IB touch points will
be replaced with standard API's available to all VistA packages.
This patch is enhancing the API call INSUR^IBBAPI that
returns Insurance information.

This is patch IB*2*60 for the Integrated Billing package.  This patch
supports the Ambulatory Data Capture requirements for 10/1/96, as well as
the release of PCE.
 
Please see the National Patch Module description for this patch for more
detailed information.

STOP CHARGING CHAMPVA SUBSISTENCE

This patch installs the CY-2005 Medicare Deductible rate and the
base pension rates for determining co-pay exemption.

Update to insurance API and Insurance Clean Up

This patch contains the following changes:
providers.
 
1.  Adds a parameter to the insurance company to specify whether the
provider's SSN is to print on the HCFA and the UB92.
 
2.  Adds the capability to override the GROUP# field on transmitted claims.
 
3.  Fixes a problem where the ?ID action on screen 8 of the edit bill
screens displays the wrong provider type for other than attending/rendering

MRA ISSUES RESOLUTIONS AND BUG FIXES
       range are included in this report.
 
2.  If a professional claim already exists, prevent the creation of a new
professional claim when requesting an MRA for an institutional claim.  
The payer sequence of the existing professional claim was changed to be a 
secondary claim and thus VistA was not detecting it.  The change in this 
patch removes the check on the payer sequence in the case of MRA claims.
 
1.  MRA statistics report changes.
  1a.  Include totals for all divisions or all selected divisions when
       more than 1 division is included in the report.
  1b.  Corrected a bug in which MRA request transmissions on the same date
       as the ending date for the report were not being counted.
  1c.  Corrected a bug in which MRA secondary transmissions were being 
       counted. Now, only MRA request transmissions during the report date

This patch addresses the following NOIS messages:
------------------------------------------------
BAY-0204-31962         IIV inquiries are increasing
FGH-0304-32103         Important IIV Msg-Monetary Amount
UNY-0204-11346         ERROR - CHK+23^IBCNEHLQ
WPB-0904-32212         ERROR - EN+43^IBCNEDE2:1, %DSM-E-NULLSUBSCR
 
This patch also includes several enhancements for the IIV interface.

This patch distributes the latest DRG Reasonable Charges files.
This is Version 2.3 with an effective date of 01/01/2005.

Reasonable Charges v2.2.  Enhancements only, no charges.

Patch IB*2.0*298 is the release of the Reasonable Charges v2.4 update.
These charges are effective 04/11/2005.

This patch corrects invalid Care Unit combination pointers if any exist.

Insurance updates and changes.

The purpose of this patch is to update VistA DSS Stop Codes for outpatient
   Clinic Stop  Description            Effective   Billable      Override
   Code                                Date        Type          Flag
   -----------  ---------------------  ----------  ------------  ---------
   533707       SMOKING CESSATION IND  05/02/2005  Non-Billable  Y
   566707       SMOKING CESSATION GRP  05/02/2005  Non-Billable  Y
   707          SMOKING CESSATION      05/02/2005  Non-Billable  Y
copay in the IB CLINIC STOP CODE BILLABLE TYPES file (#352.5), which 
begins May 2, 2005. The required copay for the smoking cessation
counseling (individual and group) codes will be changed to a non-copay
status.
 
The patch will update the billable type for the following stop codes in
the file.
 

CMAC 2005

CBO Data Extract enhancements
 
Routine IBJVDEQ
Make sure the claim has been authorized before proceeding with the 
extract.
 
Routine IBRFN4
Provide a callable API for IB information.

Routines: IBCE837, IBCE837A
  Allows selection of existing batches or individual claims to be
 #1006 (changed data element, ins type OI1-17)
 #1015 (changed data element, version info GEN-7)
 #1039 (new entry for current payer sequence CI1-14)
 #1040 (new entry for MRA secondary indicator CI1-15)
 
Entries modified in file 364.6:
 #1321 (new entry for current payer sequence CI1-14)
 #1322 (new entry for MRA secondary indicator CI1-15)
 
New File: 361.4 EDI TEST CLAIM STATUS MESSAGE
  re-submitted as test claims from the original EDI resubmit bill/batch
  Holds the test transmission and all test status messages received in
  the test queue (MCT) for claims resubmitted as test.
 
NOIS ENTRIES INCLUDED:
UNY-0205-10041  SYNTAX ERROR 1/31 -MISSING LCOB-02
LEX-0205-40005  SYNTAX ERROR 1/27 - LCOB/LCAS Prob.
  options.
 
Routine: IBCNSGE
  Insurance Company EDI Parameter Report
 
Routine: IBCEF2
  Pull the id from the insurance company file if the claim is an MRA 
  secondary and the id exists. If there is no id, force PPRNT or IPRNT. 
  Changes to allow test claims to be resubmitted from previously
 
Routine IBCEF21
  Two procedures moved out of IBCEF2 and into IBCEF21 for space.
 
Routine: IBCEF31
  Ensure that the electronic insurance type field for the Medicare (WNR) 
  entry is always 3:MEDICARE.  This is the 3.09 field in file 36.
 
Routine: IBCEF4
  Change to return a true value if the claim is being resubmitted as a
  transmitted claims.
  test claim.
 
Routine: IBCEF
  Bug fix to the $$NOPUNCT function.  Allow the exclusions parameter to 
  function properly.
 
Routine: IBCBB2
  Change to allow 8 diagnoses codes. 
 
Routine: IBY296PR (new)  (pre-install)
 
  Pre-install changes the data element for entry #1015 in file 364.7
 
Routine: IBCERPT
  Changed to output " * * TEST RESULTS * * " on reports from the MCT queue
 
Routine: IBCEPTU (new)
  Utility code added to allow lookup of last transmitted date when a
  transmission entry is deleted for an entry in file 361.4
 
Routine: IBCEPTR
Routines: IBCESRV
  Report of data stored in file 361.4.
 
Routine: IBCESRV, IBCESRV2
  Changed to capture the MCT messages for claims resubmitted for test and
  send them to be stored in the new test claim message file
 
Routine: IBCEPTM (new)
  Stores the transmission and test status message data in file 361.4
 
Routines: IBCEPTC, IBCEPTC1, IBCEPTC2 (new)
  Changes server logic for reports to send test message flag if msg
  New routines for the list manager display and resubmission of
  previously transmitted claims as test claims.
 
Routine IBCE
  Modify the IB nightly job section to call the Purge routine for file 
  361.4.
 
Routines IBCEU0, IBCEU1
  Fix LCOB segment pieces (modifiers and payer id)
 
  received in test queue.
Routine IBCEOB1
  Fix split MRA filing problem.  Keep track of VistA line numbers across 
  multiple split MRAs in file 361.1.
 
Routine IBCCC2
  Remove the code which deletes the BILL COPIED FROM field when 
  processing an MRA claim into a secondary MRA claim.
 
Routine IBCEP0B
  Added a new parameter to the call PARAMS^IBCNSC1 to fix an undefined 
 
  variable error that was occuring as a result of Patch 291. 
 
Routine IBCERP3
  Report of bill batches waiting Austin receipt more than 1 day.  
  Modification to routine to make it more similar to routine IBCEBUL by 
  checking to see if there are any bills in the batch before including it 
  on this report.
 
Routine IBCERP5
  Modify the batch status detail report to show claims from test batches 
Routines: IBCEM01, IBCEM02, IBCEM03
  stored in file 361.4.
 
New field FILE 364.2:
 .14 CLAIM RESUBMITTED TEST
 
Entries modified in file 364.7:
 #136 (changed entry for group #/group name exclusion CI3-3)
 #137 (changed entry for group #/group name exclusion CI3-4)
 #830 (changed to fix problem with LCOB records)
 #985 (changed to fix problem with LCOB records)

Clinical Indicator Data Capture IB support.

This patch will replace all the direct global references to Pharmacy data
in the Integrated Billing package. The direct references will be replaced
with API calls to the Pharmacy package.

CLAIMS TRACKING ENHANCEMENT

This patch will address two issues;
1. The Re-Generated Unbilled Amounts Report that is printing the CPT IEN 
instead of the CPT Code.
2. The Undefined error received while using Assign Reason Not Billable 
[IBT EDIT REASON NOT BILLABLE] option.

PFSS ACCOUNT FILE

When 'ACCEPTING' entries from the insurance buffer, it was discovered
that some of the GROUP/PLAN fields (#.04 thru # .09) in the INSURANCE
BUFFER (#355.33) were not being updated in the INSURANCE file (#355.3).
Upon further review, a coding problem was found and corrected in the
INSURANCE BUFFER routine IBCNBMI.

This is the first in a series of patches to address changes that must be
made to MCCR software (Integrated Billing and Accounts Receivable) in
order to implement General Counsel opinion VAOPGCPREC 3-96. 

This patch will install the October 2005 Tortiously Liable, Cost-Based
and, Interagency rates into the Charge Master, with an effective date 
of 10/01/05.

This patch updates the Reasonable Charges files and distributes them with 
a new version number and new effective date.

THIS PATCH WILL CHANGE THE MEDICATION COPAY TO $8 AND THE ANNUAL CAP
TO $960 EFFECTIVE JANUARY 1, 2006

VISTA-OFFICE EHR FILE ENHANCEMENT

This patch will install the November 2005 Tortiously Liable, Cost-Based
and, Interagency rates into the Charge Master, with an effective date 
of 11/03/2005.

CMAC 2005 update for 'Non-Facility' charges.

Patch attends to the following issues:
 
3) Based on a decision from the VA Chief Business Office, it was decided 
that the most popular payer function should be removed. Any mention of 
this functionality should be eradicated from the IIV system.
 
4) IIV routines will automatically disable and enable journaling itself 
while doing the purge. A log of purges will now be kept in global ^ 
XTMP("IBCNEKIT".
 
1) To help protect the users from sending out too many IIV inquiries in a 
given day, the HL7 MAXIMUM NUMBER field has been modified to be a 
required field.
 
2) To help protect the users from extracting too many IIV inquiries in a 
given day for a given IIV data extract, the MAXIMUM EXTRACT NUMBER field 
has been modified to be a required field.

Add SERVICE CONNECTED BILLABLE APPOINTMENT TYPE (#352.1) to correspond 
to the new SERVICE CONNECTED APPOINTMENT TYPE (#409.1) released by 
SD*5.3*394.

This patch is the IB part of PFSS.

Coordination of Benefits patch.

The main purpose of this build is to restructure the way the HL7 messages
are created for IIV.  In addition to encoding and decoding of HL7
delimiters, asterisks will be removed from the data prior to transmission
of the HL7 messages since asterisks are X12 delimiters.  The build also
removes the application dependency of the IIV interface on the IP address
and port number for routing.  Thus, making DBIA #4241 obsolete.

Patch IB*2.0*334 is the release of the Reasonable Charges v2.6 update.
These charges are effective 01/01/2006.

In preparation for the e-Pharmacy software package, insurance
staff need to match their pharmacy group plans to the appropriate
VA National Plan.  (For more detailed background information
regarding this matching process, please refer to the web site
http://vaww.vistau.domain.ext/VistaU/e-bp/e-pharmacy.htm and
download the e-Pharmacy Claims Insurance Process User Guide
There is other information available at this web site that you
will find helpful regarding the e-Pharmacy project.)

This patch modifies the Claims Tracking software to accept same date/time 
entries.

Pharmacy Claims Tracking fix related to CIDC (patch IB*2.0*260)
Reason Not Billable will now be assigned appropriately for items
entered prior to the CIDC patch.

Patch IB*2*340 contains a single routine that supports the
implementation of patch PRCA*4.5*241.  This AR patch is the
last in a series of patches that adjusts the accounts of
veterans affected by Hurricane Katrina.  Please refer to the
patch description for more specific information on patch
IB*2*340.

THIS PATCH WILL ADDRESS SEVERAL BUGS RELATED TO E-MRA.
THESE BUGS ARE INCLUDED IN THE PATCH DESCRIPTION WITH THEIR RESPECTIVE
REMEDY TICKETS.

HIPAA NCPDP Global project
 
supports the electronic transmission outpatient prescription claims and 
billing collection and management.

This patch is the inter-facility copay part of the PFSS project.

Year 2000 changes.

The purpose of this patch is to add a value code of 'A0' (Special Zip
Code Reporting) to the MCCR Utility file (#399.1).

When the site executes the [IB COPY AND CANCEL] option, an undefined error
generates at line <UNDEFINED>OUTPT+89^IBCEF11.

Modify IB to handle the billing of the new and updated Treating Specialties
being released, primarily for NHCU.  This patch supports DG*5.3*683.

The Chief Business Office has requested to update the DSS Stop Codes
to reflect the FY 06 Co-pay rates.

This patch addresses one issue. The issue is about the batch which 
didn't process through the outside trading partner WebMD when the claim
was missing the procedure for the modifier on the institutional service
line.

Prevents a claim from being an MRA request claim when Medicare (WNR) is 
the secondary insurance and prevents the deletion of MRA secondary 
insurance.

IB SUNSETTING OF OPTIONS

ADD NEW ADJUSTMENT CODE TO AUTO BILL GENERATION LIST

eClaims Plus Iteration 2

Companion patch for PRCA*4.5*232 - Vista AR IB extract -phase II -part II.

Required for special processing of file 351.1 for patient merge.

This patch will correct a problem where the nightly billing job
was failing when voice activated records from Radiology had
triggered an entry into billing file #350 and had left the 
USER ADDING ENTRY field null.  The changes in this patch will
trap that condition and store the Postmaster DUZ rather than null.

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 

UPDATE VALID GROUP NUMBER VALUES & ADD NEW ADJUSTMENT CODE TO AUTO
BILL LIST

REASONABLE CHARGES V2.7 UPDATE

This patch addresses two issues. The first issue is regarding the 
Automated Biller not billing the legitimate Claims Tracking entry when 
the answer to the NEED RELATED TO OCCUPATION or the NEED RELATED TO AN 
ACCIDENT field for the patient is UNKNOWN or NULL.
 
The second issue is about a syntax error that site encountered when they
were trying to compile routine IBCSC4B in Cache.

This patch addresses 2 issues. The first is that site requested to change
the heading "Last test date" to "Last RX Copayment Exemption date" in the
DG Patient Inquiry option to match up to the data. The second issue is
about a bug behind discovered in the IB's IVM backbilling functionality.
If the veteran has an appointment in a billable clinic but also has a non
billable stop code added, charges are not being generated.

REASONABLE CHARGES V2.8 UPDATE

This patch will distribute 3 DSS Stop Codes:
197 - POLYTRAUMA INDIVIDUAL
198 - POLYTRAUMA GROUP
199 - TELEPHONE/POLYTRAUMA
which will be added to IB CLINIC STOP CODE BILLABLE TYPES [#352.5].

IB*2.0*61 Regional Counsel Interface

The Chief Business Office has requested to update the DSS Stop Codes
to reflect the FY 07 Co-pay rates.

NPI Modifications for the IB Package

New CMS-1500 claim form

Reasonable Charges v2.9

This Maintenance Update addresses the following issues reported in Remedy:
 9) HD118376 - MRA Filing Error
      123700 - Message storage errors on bill.
10) HD131138 - Missing Mail Group - CMOP transmissions fail.
11) HD134835 - Insurance Buffer Error
      131701 - Error <UNDEF>BR+1^DIE0
12) HD137911 - <UNDEFINED>BULL1+5^IBTUBUL
      145085 - Error Running Send Test Unbilled Amounts Bulletin option
 1) HD63676  - Non Providers Not Screened in Procedures Multiple
 2) HD64317  - IB315 entry file 350.8/*232
 3) HD64380  - Held Charges Report (PTH-1104-20448)
 4) HD64425  - PROVIDER ID QUERY REPORT - TOTAL IS WRONG
 5) HD64697  - ADD OUTSIDE LAB CHARGES TO MAP
 6) HD64863  - IBJDF51 Spreadsheet (Trans # creates problem)
 7) HD65904  - Problem with Miscellaneous Bills Follow-up Reports
 8) HD117969 - CHAMPVA/TRICARE Follow-Up Report Detail vs. Summary problem

1.      Additional Source of Information Codes in Insurance Buffer and 
4.      Reduce the number of blank inquires being sent via Remote Query.
 
5.      Auto-Populate the Patient Insurance file with the patient's DOB & 
SSN information at processing time.
 
6.      Replace Payer ID with Payer Name to improve readability of the 
Buffer entry error information.
 
7.      Correct the totals for companies without National IDs in the eIV 
Statistical Report.
Patient Insurance File.
 
8.      Bypass new buffer entry creation upon message response by 
verifying if the buffer entry has been previously accepted.
 
9.       The CBO extract was modified to transmit SOI codes with a value
greater than '4' without resetting them to a value of '1' (Interview).
 
10.      Modify Response Report to Display Benefit Status as well as all
notes associated with benefit.
 
2.      Modifications to existing Pre-Registration Report to remove 
hard-coding and allow SOI Code selection.
 
3.      Include missing patient name in buffer file when processing 
message responses.
 

IB implementation of Project 112/SHAD Classification.

UB-04 claim form.

This patch is being released in conjunction with the Pharmacy 
Reengineering Encapsulation effort. While no new functionality for 
Integrated Billing package is released with this patch all direct global 
references to the Outpatient Pharmacy files have been replaced by this 
effort.

This patch adds and modifies Stop Codes to the IB CLINIC STOP CODE
BILLABLE TYPES (#352.5) file, fixes a SUBSCRIPT error in the
Electronic Error Report and fixes problems in billing where the RX
COPAY status is incorrectly flipping from NON-EXEMPT to EXEMPT.

Scheduling Conversion Software changes: Integrated Billing's changes to
accomodate the removal of the Scheduling Visits, Outpatient Diagnosis,
Outpatient Provider files and their transfer to PCE and the Outpatient
Encounter file.  For more detailed information, refer to the patch
description in the National Patch Module.

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 of other than an active status.

IB*2*364 is being released to support the Treating Specialty changes 
released in patch: DG*5.3*729 (Project: PTF Fields No Longer Needed).
 
Treating Specialties file (#42.4) is being updated by patch DG*5.3*729.
This patch IB*2*364 will update Integrated Billing to properly handle the 
billing of the new and changed Treating Specialties.

This patch adds a new field for INSURED'S SEX to both the PATIENT file
and the INSURANCE BUFFER file.  A post-init routine will auto-populate
this field for existing insurance policies to the best of its ability.
All screens that allow adding/editing/displaying of policy holder
information will be modified to use the new field.

This patch insures that while navigating in the Claims
Tracking Edit Option after the user switches patients 
while in the View Patient (VP) menu and returns to the 
list of the patients claims that the claims that are 
listed are actually the indicated patients claims.  It
also adds adjustment code CO 194 to the list of codes
automatically processed and modifies function call
GETWNR^IBCNSMM1 to return only Part A or Part B
Medicare plans like it is supposed to.

IB API'S to support the SD ASCD (SCAM) project.

IB ENHANCEMENTS

Update Stop Codes to reflect Fiscal Year 2008 changes.

This patch addresses one issue. The Edit Returned Bill option on the 
Return Bill Menu [IB RETURN BILL MENU] has been modified to only allow 
the editing of a returned bill if it is not an "electronically
transmittable" bill. For returned electronically transmittable 
bills/claims the IB COPY AND CANCEL option will need to be used.

The general purpose of this patch is to meet the requirements for the 
VistA Integrated Billing (IB) software application in support of the Phase
4 ePharmacy enhancements, Iteration 1.

PHARMACY ENCAPSULATION API AND EPHARMACY FOLLOW UP PATCH

BILLING LAG TIME REPORT MODIFICATIONS

Patch to enable the processing of new Emdeon reports.

E-CLAIMS PLUS ITERATION 3, PART 1

Reasonable Charges v2.11.  Charges are effective 10/01/07.

 
Update Stop Codes 695 and 696 to add an override flag to prevent charges
from being incurred when they are selected as secondary codes.

PHARMACY NPI FIX

 
Add the Diabetic Retinal Screening STOP CODE (718) to the IB CLINIC
STOP CODE BILLABLE TYPES (#352.5) file.

Reasonable Charges v3.1

This patch includes the Medicare Remittance Advice Survey designed to
provide a one time national rollup of back billing potential of Medicare
Supplimental Carriers.

Reasonable Charges v3.0: Remove RC Discounts

PHARMACY NPI FIX (REPLACES IB*2*388)

Modifications in this patch will allow users to continue to send out 
non-fatal warnings when Other, Operating, Supervising, Billing Provider, 
Purchased Service or Lab/Facility taxonomies are missing.
claims without taxonomies for type 1 and type 2 providers where the 
taxonomies are not sent in the 837 transmission from the Financial 
Services Center (FSC) in Austin to the clearinghouse. There is currently 
code in Vista that will change the warnings that users receive when 
taxonomies are missing to fatal edits for all providers effective 
05/23/2008, and hence prevent the claims from being submitted.  This 
patch will produce fatal edits when the Attending, Rendering or Referring 
Provider taxonomies are missing on or after 5/23/2008.  It will produce 

eClaims Plus Iteration 3, phase 2

 
Update Stop Codes 372 and 373 from BASIC CARE ($15 copay) to
NON-BILLABLE (no copay).

Prosthetics Item Replacement.

This patch is addressing an issue regarding bills not automatically 
audited by the Auto Audit process in Accounts Receivable package.

Modifications to allow NPI to be ACTIVE in both the #200 file and the 
#355.93 file at the same time.

The Chief Business Office has requested to revert the fatal errors
for the NPI of the Division and the Service Facility to a warning
message, and also to change a missing Taxonomy of the Billing Provider
back to a fatal error.

This is patch IB*2*62 for the Integrated Billing package.  This patch
addresses various nois messages for the package.
 
Please see the National Patch Module description for the patch for more
detailed information.

See the National Patch Module for patch details.

Update Stop Codes to reflect Fiscal Year 2009 changes.

Update the IB CLINIC STOP CODE BILLABLE TYPES file (#352.5) for STOP CODE 
351 with an effective date of 10/10/08 to reflect no copay.

ePHARMACY TRICARE/'N'/CT FIX

Reasonable Charges v3.2

 
rejection.
There are three fixes in this patch: The first issue concerns an undefined
error in the Enter/Edit Billing Information [IB EDIT BILLING INFO] option
when site entered a number greater than the default procedure unit which
is 1. The second issue is that user cannot add charges for FEE LTC OPT
RESPITE charge in the Cancel/Edit/Add Patient Charges [IB CANCEL/EDIT/ADD
CHARGES] option. The last issue is when a provider was inactivated in the
NEW PERSON (#200) file and his person class was no longer valid, IB sent
an ATT/REND PROV SPECIALTY value of 99 for the provider causing the claim

In cases where outpatient encounter dates have no time recorded
it will default to 00.00 to prevent subscript errors.

eClaims Plus - Diagnosis Present on Admission (POA) Indicator.

Reasonable Charges v3.3

This patch allows 9 digit zip codes to be transmitted on bills sent
electronically to Trailblazers so they will no longer be rejected. 

This patch fixes a number of problems in IB.
It fixes a string too long error, print status of a bill, output formatter
short timeout on a read command and a post init that does a cleanup
of file 364.7.

E-PHARMACY ENHANCEMENTS

Reasonable Charges Billing Enhancements II

Add the Disability Evaluation System (DES) exam STOP CODE (488) to the
IB CLINIC STOP CODE BILLABLE TYPES (#352.5) file.

eClaims Additional Claim Form and Transmission Data (EAD)

Fee Basis Billing Provider

This patch is to exclude the MRA's filing errors from the MRA patient
responsibility calculation.

IB*2.0*422 is being released to support the Treating Specialty changes 
released in patch: DG*5.3*813.
   
Treating Specialties in the SPECIALTY (#42.4) file are being updated by 
patch DG*5.3*813.  This patch (IB*2.0*422) updates Integrated Billing to 
properly handle the billing of the new Treating Specialties.

This patch addresses the issue regarding site not receiving the Medicare 
Remittance Advice (MRA) payments as noted on the Bill Status Report. Site
runs the report on a daily to weekly basis to generate a summary of bill
rate types and statuses.

This patch modifies the extract code for the Date Of Similar
Illness and adds a cross reference to update the "ON
HOLD DATE" cross reference after a patient merge to stay
consistent with the new patients info.

Update Stop Codes to reflect Fiscal Year 2010 changes.

Change input transform so that PAST DATES are assumed when entering
INSURED'S DOB.

Reasonable Charges v3.4

The purpose of this patch is to update the MCCR Utility file and the
Revenue Code file.

This build provides three new APIs for the Insurance Capture Buffer 
     Group Insurance Plan (#355.3) file
     Patient Insurance Type (#2.312) subfile
 
There is also an API (UPDTICB) which will allow for fields that are not 
stored in the insurance buffer to be updated into the IB Insurance Files.
 
These APIs are documented in Integration Control Registration (ICR) 
#5353, (Accept/Reject Insurance Buffer data APIs).
 
The three new APIs are:
application. There are two APIs that are to be used to move Insurance 
       
   
   ACCEPAPI^IBCNICB(RESULT,IBBUFDA,DFN,IBINSDA,IBGRPDA,IBPOLDA,IBMVINS,
                    IBMVGRP,IBMVPOL,IBNEWINS,IBNEWGRP,IBNEWPOL,IVMREPTR)
   REJECAPI^IBCNICB(RESULT,IBBUFDA,IVMREPTR) 
   UPDTICB^IBCNICB (RESULT,DFN,IBPOLDA,IBGRPDA,IBPOLCOM,IBPOLBIL,IBPLAN,
                    IBELEC,IBGPCOM,IBFTF,IBFTFVAL)
 
This patch removes the Traditional Regular type "B" cross-reference on the
TYPE OF PLAN (#355.1) file since this cross-reference only contains the
Buffer (#355.33) file data to other Integrated Billing files or reject 
first 30 characters of the NAME (#.01) field. This cross-reference
limitation may create problems when using the Fileman DBS calls. A New
Style Regular "B" cross-reference will be added that will contain all
characters to the field limit of 40 characters. In a post install the
patch will build the new "B" cross-reference on the file.
this data. These APIs provide a front end into the existing ACCEPT and 
REJECT Insurance Buffer APIs which suppresses all write statements and 
interactive fileman calls within the existing code.
 
The Insurance Buffer (#355.33) file data is moved to the following files: 
     Insurance Company (#36) file

2010 RX COPAY THRESHOLDS UPDATE

There are two fixes in this patch: First, in the Enter/Edit Billing
Information [IB EDIT BILLING INFO] option on screen #3, all of the valid 
SUBSCRIBER PRIMARY IDs are now allowed (one that wasn't was the letter 
"A" followed by 6 numbers). Second, there is a fix for a bad
cross-reference in the GROUP INSURANCE PLAN (#355.3) file.

Correction to the 2010 Medicare Deductible

IB*2.0*426 is being released to support the Treating Specialty changes 
released in patch: DG*5.3*819.
 
Treating Specialties in the SPECIALTY (#42.4) file are being updated by 
patch DG*5.3*819.  This patch IB*2.0*426 updates Integrated Billing to 
properly handle the billing of the new Treating Specialties.

Reasonable Charges v3.5

This patch addresses one issue regarding new Rate Schedules for the Rate
Types of CHAMPVA and CHAMPVA REIMB. INS..

RX COPAY PRIORITY GROUP 7&8 INCREASE

This build contains the correction to the TOP form on UB92 using output
formatter.

UPDATE PLACE OF SERVICE FILE (#353.1) WITH 16 NEW ENTRIES.

This patch addressed two issues. The first issue is to change the
assignment benefits code for Tricare claims. The second issue concerns a
prescription charge attaching to a wrong patient.

This patch contains the ePharmacy enhancements to accomodate
Coordination of Benefits (COB).

Update Stop Codes to reflect Fiscal Year 2011 changes.

eIV Phase 3, Iteration 1

Reasonable Charges v3.6

2010 RX COPAY THRESHOLDS UPDATE

HIPAA 5010 effort: enhancements 7, 9, and 11

Insurance Buffer File.

Add Third Party Pharmacy Prescription administrative fee charge to the
patient bill with the following only Rate Type names of Rate Type File #399.3:
   Reimbursable Ins.
   No Fault Ins.
   Tort Feasor
   Workers' Comp.

Update Stop Codes to reflect Fiscal Year 2010 Supplemental changes as 
well as Fiscal Year 2011 Midyear changes.

Reasonable Charges v3.7

This patch will a include change to routine IBBFAPI (Insurance API 
$$INSUR^IBBAPI) and IBBDOC to add two new additional fields from 
Insurance Company file (#36). These fields are the STREET ADDRESS [LINE 
2] and STREET ADDRESS [LINE 3].

This patch contains updates to the MCCR Utility (#399.1) file, the Revenue
Code (#399.2) file and the Place of Service (#353.1) file.

This patch modifies DSS Stop Codes contained in the Integrated Billing 
Clinic Stop Code Billable Type file <#352.5>.

E-billing Iteration 4, Enhancement 6:  Preserve Claim Number

FY 2012 DSS STOP CODE UPDATES

FMS 5010 CHANGES

DIAGNOSTIC MEASURES PHASE I/INTAKE REPORTS

CD PATIENT COPAY EXEMPTION

This patch will install the Tortiously Liable, Cost-Based and Interagency
rates into the Charge Master, with an effective date of 07/11/2011.

ePharmacy Phase 5 - NCPDP D.0

This patch is about the administrative charge update based on a new
dispensing fee $12.39 for third party pharmacy prescription claims with
an effective date of January 1st, 2012.

Reasonable Charges v3.8

This patch contains two issues. The first issue is about the unit price
of the drug cost with zero resulting in an error message of 'Not ECME
Billable: Cannot find price for Item'. This error message prevents
IB from generating third party bills for outpatient prescriptions. The
second issue concerns payment amounts on e-Pharmacy claims which are more
than the billed amounts.

This patch addresses system enhancements to the Integrated Billing 
software as requested by the VA's Chief Business Office (CBO).

Veterans w/Insurance and Opt. Visits option fix for <SUBSCRIPT> error.

FY2012 MIDYEAR DSS STOP CODE UPDATES

ePharmacy Phase 6

This Integrated Billing (IB) patch expands the HIPAA 5010 enhancements 
        were bill to the secondary payers on the MRA Statistics Report
 
Option Name            Type                      New/Modified/Deleted
-----------            ----                      --------------------
IB OUTPUT              menu                      Modified
MANAGEMENT REPORTS 
 
IBCEM NON-MRA          run routine               New
REPORT 
 
IB OUTPUT PATIENT      menu                      Modified
        option [IBCEM MRA STATISTICS REPORT].
REPORT MENU 
 
 
Templates Associated:
 
Template Name      Type      File Name (Number)  New/Modified/Deleted 
-------------      ----      ------------------  --------------------
 
IB SCREEN5         INPUT     BILL/CLAIMS(399)    Modified
 
 
IB SCREEN7         INPUT     BILL/CLAIMS(399)    Modified
 
IB SCREEN8         INPUT     BILL/CLAIMS(399)    Modified
 
IB SCREEN9         INPUT     BILL/CLAIMS(399)    New
 
 
Additional Information:
<Additional information sections can be added alphabetically if needed.>
 
     3. Modify the outbound 837 Heath Care Claims transmissions to 
 
New Service Requests (NSRs)
----------------------------  
No New Service Requests 
 
Patient Safety Issues (PSIs)
-----------------------------
No Patient Safety Issues 
 
Remedy Ticket(s) & Overview
        incorporate the additional/modified data elements that may be
---------------------------
No Remedy Tickets 
 
Test Sites:
----------
<List test sites that actually participated in testing and signed off on 
the patch. A copy and paste from NOIS displaying the test sites in
production can be used.>
 
 
        added to a claim.
Documentation Retrieval Instructions
------------------------------------ 
Updated documentation describing the new functionality introduced by this 
patch is available.
 
The preferred method is to FTP the files from 
ftp://download.vista.domain.ext/. This transmits the files from the first
available FTP server. Sites may also elect to retrieve software directly
from a specific server as follows:
 
 
 Albany         ftp.fo-albany.domain.ext  <ftp://ftp.fo-albany.domain.ext>
 Hines          ftp.fo-hines.domain.ext   <ftp://ftp.fo-hines.domain.ext>
 Salt Lake City ftp.fo-slc.domain.ext     <ftp://ftp.fo-slc.domain.ext>
 
Documentation can also be found on the VA Software Documentation Library 
at: http://www4.domain.ext/vdl/
 
Title                         File Name                       FTP Mode
-----------------------------------------------------------------------
<Documentation title>       
     4. Modify the printing process for outpatient, UB04 claims to print 
 
 
Patch Installation:
 
 
Pre/Post Installation Overview
------------------------------
<Provide a brief overview of what the pre/post installation entails.  The
actual instructions will be listed below in the Installation Instructions
section. Note whether pre/post installation routines can be deleted after
        the Priority (Type) of Admission.
they run or whether they are automatically deleted.>
 
 
Installation Instructions
-------------------------       
 
  ******************************************************************
  *  You should install this patch during non-peak hours, when no  *
  *  Integrated Billing or Accounts Receivable users are on the    *
  *  system.                                                       *
 
  ******************************************************************
 
There are no options to disable. 
 
Pre-Installation Instructions
-----------------------------
<Provide a brief description of what the pre-installation will be doing. 
List pre-installation instructions (i.e., links, filers, or batch
transmissions that need to be stopped, jobs unscheduled, etc.), if
applicable.>
introduced in patch IB*2.0*432.
     5. Modify the printing process for UB04 and CMS-1500 claims to allow 
 
1.  Obtain the Patch.
    Obtain the host file PRCA_275_IB_447_16.KID, which contains the
    following two patch installs:
  
        PRCA*4.5*275
        IB*2.0*447
  
    Sites can retrieve VistA software from the following FTP addresses.
    The preferred method is to FTP the files from:
        the printing of Revenue/Procedure codes with zero dollar amounts.
  
                   download.vista.domain.ext
  
    This will transmit the files from the first available FTP server.
    Sites may also elect to retrieve software 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 PRCA_275_IB_447_16.KID host file is located in the
    anonymous.software directory.  Use ASCII Mode when downloading the
    file.
 
3.  From the Kernel Installation and Distribution System Menu, select
    the Installation Menu.  From this menu, you may elect to use the
    following option. When prompted for the INSTALL enter the patch #(ex.
    PRCA*4.5*275):
 
     6. Modify The Insurance Company Enter/Edit option [IBCN INSURANCE CO 
    a.  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.
    b.  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.).
    c.  Verify Checksums in Transport Global - This option will allow
        you to ensure the integrity of the routines that are in the
        transport global.
        EDIT] to allow users to assign additional MEDIGAP policies as Type
     
4.  From the Installation Menu, select the Install Package(s) option and
    choose the patch to install.
 
5.  When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of
    Install? NO//'     
    <Provide the installer with guidance on whether or not menu trees need
    to be rebuilt.  For instance the menu trees do not need rebuilt if 
    there are no menus involved in the patch or their system rebuilds menu
    trees nightly using TaskMan. If they must answering YES to rebuild
        of Plan for an Insurance Company.
    the menu trees warn them that it could affect users on the system and
    installation times will increase.>
 
6.  When prompted 'Want KIDS to INHIBIT LOGONs during the install?
    NO//'
 
    <to inhibit logons.>
 
7.  When prompted 'Want to DISABLE Scheduled Options, Menu Options, 
    and Protocols? NO// 
 
 
    <Provide the installer with guidance on whether or not to disable
    scheduled Options, menu options, and protocols.>
 
8.  If prompted "Delay Install (Minutes):  (0 - 60): 0// respond 0.
 
9.  When prompted "Enter the Coordinator for Mail Group 'MDA'"
 
    Enter:  
 
     7. Create a new option called the Non-MRA Productivity Report option 
Post-Installation Instructions
------------------------------
 
<Provide a brief description of what the pre-installation will be doing. 
List pre-installation instructions (i.e., links, filers, or batch
transmissions that need to be stopped, jobs unscheduled, etc.), if
applicable.>
        [IBCEM NON-MRA REPORT].
 
 
     8. Modify the mnemonic for the Third Party Billing Menu [IB THIRD 
        PARTY BILLING MENU].
 
     9. Modify the Insurance Payment Trend Report option [IB OUTPUT TREND 
        REPORT] to display the Insurance Plan Group Number.
 
     10. Modify the Correct a Rejected/Denied Bill option [IB CORRECT 
         REJECTED/DENIED] to allow the correction of claims to
         non-accruing funds such as TRICARE claims.
 
The intent of this patch is to:
Patch Components
================
<Additional patch components can be added alphabetically if needed.>
 
 
Files & Fields Associated:
 
File Name (Number)         Field Name (Number)   New/Modified/Deleted
------------------         -------------------   --------------------
BILL FORM                  LOCAL BILLING         Modified
     1. Add new fields to the Enter/Edit Billing Information option [IB
TYPE(#353)                 SCREEN(#2.09)
 
EXPLANATION OF             EOB TYPE(#.04)        New
BENEFITS(#361.1)           
 
EXPLANATION OF             ENTRY                 New
BENEFITS(#361.1)           DATE/TIME(#.05) 
 
BILL/CLAIMS(#399)          BILL                  New
                           CLASSIFICATION(#.05)
        EDIT BILLING INFO] to allow users to enter additional data
 
BILL/CLAIMS(#399)          BILL CHARGE           New
                           TYPE(#.27) 
 
BILL/CLAIMS(#399)          PATIENT WEIGHT        New
                           (LB)(#287) 
 
BILL/CLAIMS(#399)          TRANSPORT REASON      New
                           CODE(#288) 
 
        elements to claims for health care services provided to patients.
BILL/CLAIMS(#399)          AMBULANCE TRANSPORT   New
                           DISTANCE(#289)
 
BILL/CLAIMS(#399)          ROUND TRIP PURPOSE    New
                           DESCRIPTION(#290) 
 
BILL/CLAIMS(#399)          STRETCHER PURPOSE     New
                           DESCRIPTION(#291) 
 
AMBULANCE CONDITION                              New
 
INDICATOR(#399.0292)
 
PROCEDURES(#399.0304)      PROCEDURES(#.01)      Modified
 
PROCEDURES(#399.0304)      DIVISION(#5)          Modified
 
REVENUE                    CHARGES(#.02)         Modified
CODE(#399.042)             
 
REVENUE                    MANUALLY              New
     2. Modify the logic which calculates what the monetary amounts that 
CODE(#399.042)             EDITED(#.16) 
 
 
Forms Associated:
 
Form Name             File #                     New/Modified/Deleted
---------             ------                     --------------------
 
 
Options Associated:

Reasonable Charges v3.9

HIPAA 5010 maintenance support patch.

FY2012 ADDITIONAL DSS STOP CODE UPDATE

The purpose of this patch is to update the MCCR Utility file and the
Revenue Code file for FY2012.

INSTITUTIONAL LTC CD PATIENT EXEMPTION

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal Year 2013 changes.

Add Evaluation and Management codes to the Type of Visit file <#357.69>.

Corrects <UNDEFINED>ALL+24^IBCNS1 error, also changes help text for REFILL
DATE (.1) field of file (356).

Reasonable Charges v3.11

This patch contains the TCP/IP address update of the HL7 Logical Link 
'IIV EC' connected to a new technical server located at the Financial
Service Center (FSC) in Austin, Texas.

Add CAMP LEJEUNE TREATMENT as a new entry in the CLAIMS TRACKING 
NON-BILLABLE REASONS file (#356.8).

IB*2.0*476 t1 build contains the first iteratin of the IB portion
of the deliverables for the 5010 VistA Fee Basis phase II project.

This patch addresses two issues. The first issue is regarding the Claims
Matching report [RCDP CLAIMS MATCH] not display the corresponding first
party debts. The second issue is about the incorrect charge type NURSING
HOME CARE (NSC) showing on the patient's bill.

Reasonable Charges v3.12

FY2013 MIDYEAR STOP CODE UPDATES

THIS PATCH MAKES MODIFICATIONS TO THE FUNCTION THAT DETERMINES THE
START OF CARE DATE.  THIS WILL ALLOW THE CORRECT START OF CARE DATE
TO BE DISPLAYED WHEN AN OUTPATIENT EVENT TAKES PLACE ON A DATE THAT
OCCURS BETWEEN THE ADMIT AND DISCHARGE DATES OF AN INPATIENT EVENT.

This patch contains two issues. The first issue is about some non billable
HCPCS codes for prosthetic items which need to be filtered out of the
Claims Tracking module. The second issue concerns the '^' key which is
entered and does not exit out of the [IBCR ADJUSTMENT ENTER/EDIT] option
as expected.

This is the KIDS build for Integrated Billing patch IB*2*116.  The
purpose of this patch is to develop a list of all third party
insurance carriers based on claims that were developed from
10/1/97 through 12/31/98 (the last five fiscal quarters).  This
list will be compiled to develop a national list of third party
payers which is required for the National EDI initiative.
 
Please see the National Patch Module description for this patch for
more detailed information.

This patch addresses two issues. The first issue is about the Technical
Component (TC) Modifier added to the procedure on the institutional bill.
 
The second issue is about the 'Modifier 26 Deleted from Procedures (1)'
message is mistakenly displayed for Modifier 58 in the [IB EDIT BILLING
INFO] option.

This patch is about the administrative charge update based on a new
dispensing fee $13.18 for third party pharmacy prescription claims with
an effective date of January 1st, 2013.

Reasonable Charges Billing Enhancements 2013.

This patch addresses two issues. The first issue contains a new source of
insurance information added to the SOURCE OF INFORMATION file (#355.12).
The second issue is about a typo on the help prompt of the CLAIMS (RX) 
STATE field (#.185) in the INSURANCE file (#36).

The purpose of this patch is to update the MCCR Utility file and the
Revenue Code file and the Place of Service file for FY2013.

Update for unsupported ICD fields.

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal Year 2014 changes and corrects the selection logic used to 
validate stop codes.

This patch addresses 3 issues. The first issue concerns a large number of
rated disabilities repeatedly displaying without providing the SC AT TIME
OF CARE prompt in order for the user to edit.
 
The second issue is about a typo in the '(Enter '6' to list disabilites)'
message following the 'SC Care: YES' field on screen <1> in the Enter/Edit
Billing Information option. The last issue is about a misspelled word in
the 'CHARGE PENDING REIVEW PASSED TO AR' bulletin subject line.

Reasonable Charges v3.13

This patch addresses several problems identified within the On Hold
functionality contained in Integrated Billing v2.0.  These problems were
reported using the Nois system. 

Add Evaluation and Management codes to the Type of Visit file <#357.69>.

                               ***NOTICE***
 Registration system (DG), Fee Basis System (FB), and Integrated Billing
  Files & Fields Associated:
 
 
  File Name (#)                   Field Name (#)        New/Modified/Deleted
  -------------                   --------------        -----------------
  SPONSOR RELATIONSHIP (#355.81) FAMILY PREFIX (#.03)   Modified help text
  ***File not included in the FILE LIST. Help text modified by post-install
  routine ^IB499PO.
 
  Forms Associated:
 (IB).
 
  Form Name                File #                  New/Modified/Deleted
  ---------                ------                  --------------------
  N/A
 
  Mail Groups Associated:
 
  Mail Group Name                                  New/Modified/Deleted
  ---------------                                  --------------------
  N/A
 
 
  Options Associated:
 
  Option Name                    Type              New/Modified/Deleted
  -----------                    ----              --------------------
  N/A
 
  Protocols Associated:
 
  Protocol Name                                    New/Modified/Deleted
 Below is a list of all the applications involved in this project along with
  -------------                                    --------------------
  N/A
 
  Security Keys Associated:
 
  Security Key Name
  -----------------
  N/A
 
  Templates Associated:
 their patch number:
 
  Template Name       Type      File Name (#)     New/Modified/Deleted
  -------------       ----      -------------     --------------------
 
 
  Additional Information:
 
 
  New Service Requests (NSRs):
  -----------------------------
 
  NSR 20100901
 
  Patient Safety Issues (PSIs):
  ------------------------------
  N/A
 
  Remedy Ticket(s) & Overviews:
  -----------------------------
  N/A
 
     APPLICATION/VERSION                                   PATCH
 
  Test Sites:
  -----------
 
  LEXINGTON
  PUGET SOUND
 
 
 Documentation Retrieval Instructions:
 -------------------------------------
     ---------------------------------------------------------------
 Updated documentation describing the new functionality introduced by this
 patch is available.
 
 The preferred method is to FTP the files from ftp://download.vista.domain.ext/
 This transmits the files from the first available FTP server. Sites may also
 elect to retrieve software directly from a specific server as follows:
 
   Albany         ftp.fo-albany.domain.ext  <ftp://ftp.fo-albany.domain.ext>
   Hines          ftp.fo-hines.domain.ext   <ftp://ftp.fo-hines.domain.ext>
   Salt Lake City ftp.fo-slc.domain.ext     <ftp://ftp.fo-slc.domain.ext>
  PATIENT REGISTRATION (DG) V 5.3                       DG*5.3*867
 
  The documentation will be in the form of Adobe Acrobat files.
 
  Documentation can also be found on the VA Software Documentation Library
  at: http://www4.domain.ext/vdl/
 
  File Description                          File Name             FTP Mode
  --------------------------------------------------------------------------
  Fee Basis User Manual                     fb3_5um.pdf           Binary
  PIMS v5.3 ADT User Manual Registration    dg_5_3_reg_um.pdf     Binary
  FEE BASIS (FB) V 3.5                                  FB*3.5*146
 
 The procedure guide, Care for Newborn of Women Veterans, located at
 http://nonvacare.hac.domain.ext/policy-programs/procedure-guides.asp,
 should be distributed to those personnel registering newborns and/or
 processing newborn claims.
 
 
 
  Patch Installation:
 
 Users should be made aware that processing of Newborn claims must ONLY be
  INTEGRATED BILLING (IB) 2.0                           IB*2.0*499
 
 Pre/Post Installation Overview
 ------------------------------
 There are three post installation routines associated with this patch
 DG867PO, FB146PO, and IB499PO. These routines primarily serve as filters for
 the data transmitted to the appropriate files listed above, so that only the
 intended data is delivered. The only exception is the IB499PO routine which
 programmatically makes an addition to the help text of the FAMILY PREFIX
 field(#.03) in the SPONSOR RELATIONSHIP file (#355.81). These post
 installation routines may be deleted after successful installation of the
 
 NEWBORN DG FB IB BUNDLE 1.0.
 
 Installation Instructions
 -------------------------
 This patch may be installed with users on the system although it is
 recommended that it be installed during non-peak hours to minimize potential
 disruption to users. This patch should take less than 5 minutes to install.
 
 FB*3.5*147 is a required patch and must be installed before DG*5.3*867.
 
 The patches (DG*5.3*867, FB*3.5*146, and IB*2.0*499) are being released in
 DG*5.3*867 is one of three patches for this release (including FB*3.5*146 and
 IB*2.0*499). The patches will be installed as a bundle in the following order:
 
 
 1) DG*5.3*867
 2) FB*3.5*146
 3) IB*2.0*499
 
 
  Pre-Installation Instructions
 the Kernel Installation and Distribution System (KIDS) multi-build
  -----------------------------
  1.  OBTAIN PATCHES
      --------------
 Obtain the host file NEWBORN_1_2_DG_FB_IB.KID which contains the following
 patches:
 
  DG*5.3*867
  FB*3.5*146
  IB*2.0*499
 
 distribution NEWBORN DG FB IB BUNDLE 1.0.
 Sites can retrieve VistA software from the following FTP addresses.  The
 preferred method is to FTP the files from:
 
                      download.vista.domain.ext
 
 This will transmit the files from the first available FTP server. Sites may
 also elect to retrieve software 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 NEWBORN_1_2_DG_FB_IB.KID host file is located in the anonymous.software
 directory. Use ASCII Mode when downloading the file.
 
  2.  START UP KIDS
      -------------
      Start up the Kernel Installation and Distribution System Menu option
      [XPD MAIN]:
 
 The purpose of the Caregivers: Newborn Claims Processing Enhancement Project
           Edits and Distribution ...
           Utilities ...
           Installation ...
 
      Select Kernel Installation & Distribution System Option: Installation
                                                               ---
           Load a Distribution
           Print Transport Global
           Compare Transport Global to Current System
           Verify Checksums in Transport Global
 is to enhance VistA Fee Basis application in support of compliance with
           Install Package(s)
           Restart Install of Package(s)
           Unload a Distribution
           Backup a Transport Global
 
      Select Installation Option:
 
  3.  LOAD TRANSPORT GLOBAL FOR MULTI-BUILD
      -------------------------------------
      From the Installation menu, select the Load a Distribution option.
 Public Law 111-163, the Caregiver and Veterans Omnibus Health Services Act
 
      When prompted for "Enter a Host File:" Enter the full directory path
      where you saved the host file NEWBORN_1_2_DG_FB_IB.KID
      (e.g., SYS$SYSDEVICE:[ANONYMOUS]NEWBORN_1_2_DG_FB_IB.KID)
 
  When prompted for "OK to continue with Load? NO//", Enter "YES."
 
      The following will display:
 
        Loading Distribution...
 of 2010. This law makes changes to sections of Title 38, United States Code
 
     NEWBORN DG FB IB BUNDLE 1.0
     DG*5.3*867
     FB*3.5*146
     IB*2.0*499
     Use INSTALL NAME: NEWBORN DG FB IB BUNDLE 1.0 to install this
     distribution.
 
  4.  RUN OPTIONAL INSTALLATION OPTIONS FOR MULTI-BUILD
      -------------------------------------------------
 entered in VistA. No entry in FBCS should be performed.
 to furnish health care services to a newborn child of a Woman Veteran who
      From the Installation menu, you may select to use the following options
     (when prompted for the INSTALL NAME, enter NEWBORN DG FB IB BUNDLE 1.0
 
      a.  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 data dictionaries or templates.
      b.  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, data dictionaries, templates, etc.).
 is receiving maternity care furnished by the Department of Veterans Affairs
      c.  Verify Checksums in Transport Global - This option will allow
          you to ensure the integrity of the routines that are in the
          transport global.
 
  5.  INSTALL MULTI-BUILD
      -------------------
      This is the step to start the installation of this KIDS patch. This will
      need to be run for the NEWBORN DG FB IB BUNDLE 1.0
 
     a.  Choose the Install Package(s) option to start the patch
 (VA) for not more than seven days after the birth of the child.
          install.
     b.  When prompted for the "Select INSTALL NAME:" enter
           NEWBORN DG FB IB BUNDLE 1.0
     c.  When prompted "Want KIDS to INHIBIT LOGONs during the install?
          NO//", answer NO
     d.  When prompted "Want to DISABLE Scheduled Options, Menu Options,
          and Protocols? NO//", answer NO
     e.  When prompted "Device: HOME//", enter HOME
          to display the Install message on the screen (or enter the device
          you want to print the Install message). You may queue the
 
          install if you wish.
 
 
 Post-Installation Instructions
 ------------------------------
 
 *** IMPORTANT NOTE ***
 Please note there are three post installation routines that may be deleted
 after successful installation of the NEWBORN DG FB IB BUNDLE 1.0. These are:
 
 The scope of these enhancements is to capture information on healthcare
 DG867PO
 FB146PO
 IB499PO
 services provided to newborn children of Women Veterans. Affected functions
 include eligibility determination, enrollment and registration, documentation
 of referrals and authorization for care, claims processing, and payment. Only
 modification to the Fee Basis (FB) and the Registration (DG) packages are
 necessary to meet the requirements of this enhancement. The Integrated
                               ***********
 Billing (IB) Patch is included to provide required data for the Fee Basis
 install to reference.
 
 
 The primary purpose of this enhancement is to allow the Electronic Filing of
 Newborn claims.
 
 Functional Description
 ------------------------------
 The following features and functions have been added to the Fee Basis
 This patch, along with DG*5.3*867 and FB*3.5*146, is being released as a
 workflow process applying to both Civil Hospital and Medical Fee:
 
  1. A new Patient Type of NEWBORN OF VETERAN has been added to the TYPE OF
 PATIENT file (#391). This new selection will be available on Registration
 Screen <7>.
 
  2. A sponsor is required for all Newborns determined by having the DOB less
 than one (1) year from the present date. An inconsistency check has been
 added to check the presence of a sponsor. If an inconsistency is found the
 inconsistency check will prompt the user to return to Screen <15> in
 bundle, and all three will be automatically installed in the correct order.
 registration to enter a Sponsor.
 
  3. All Sponsors for Newborns must be listed as eligible for care. An
 inconsistency check will check the status of the Sponsors Eligibility. The
 check will trigger if the Sponsor has no Eligibility status.
 
 All other statuses (i.e. Pending Verification, Verified, and Pending
 Re-verification) are acceptable.
 
  4. Fee Authorization dates associated with Newborns have checks in place to
 
 not allow Authorization dates that fall outside the accepted range of Newborn
 Authorization. The range is DOB to DOB+7. The system will warn the user and
 not accept an Authorization date that falls outside the appropriate range
 for a Newborn.
 
  5. When a Veteran Mother of a Sponsored Newborn is reviewed in the
 Registration screens, Screen <15> will display the Newborn(s), with the
 additional header of "Sponsored Newborn".
 
  6. The FAMILY PREFIX "NB Newborn of Vet" has been added to the Help text in
 This patch has enhancements that extend the capabilities of the Veterans
 the FAMILY PREFIX field (#.03) in the SPONSOR RELATIONSHIP file (#355.81)
 
  7. "NON-VA FOR FEMALE VET+NEWBORN 17.38" was added to the VA ADMITTING
 REGULATION file (#43.4). This new Admitting Regulation is available when
 editing the 7078.
 
  8. The following default values were added when entering a Newborn with a
 date of birth of less than one (1) year from present date. Defaults will only
 be assigned when specified screens are accessed during the registration
 process:
 Health Information Systems and Technology Architecture (VistA) Patient
 PATIENT DATA, SCREEN <2> Marital field is defaulted to NEVER MARRIED.
 APPLICANT/SPOUSE EMPLOYMENT DATA, SCREEN <4> Status field is defaulted to NOT
 EMPLOYED. FAMILY DEMOGRAPHIC DATA, SCREEN <8> Married Last Year field is
 defaulted to NO.
 
 
  Patch Components
  ================
 
 

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal Year 2014 changes (Mid Year).

EPHARMACY OPERATING RULES

This patch addresses two issues. The first issue is about the extract name
displaying incorrectly for IV section in the MCCR Site Parameter Display/
Edit option. The second issue concerns the CPT codes on an inpatient bill 
duplicated thousands of times in the Enter/Edit Billing Information
option.

This patch addresses two issues. The first issue is about the update of 
the administrative charge based on a new dispensing fee $13.18 for rate 
types: Humanitarian and Ineligible on third party pharmacy prescription 
claims. The second issue is to inactivate the non-billable reason code:
CV25 HDHP PLAN NOT BILLED for the Claims Tracking module.

This patch addresses two issues. This first issue is about the 
update of the administrative charge for the rate types based on 
a new dispensing fee and adjustments for third party pharmacy 
prescription claims with an effective date of January 1st, 2014.
The second issue concerns that there is no space between the line item
number and the bill from date to display if a patient has more than 99
charges in the Cancel/Edit/Add Patient Charges [IB CANCEL/EDIT/ADD
CHARGES] option.

This patch will update the following HL LOGICAL LINK (#870) entries with 
new IP addresses:
 
BPS NCPDP
EPHARM OUT

Reasonable Charges v3.14

This build is to be installed in conjunction with PRCA*4.5*136 to set the
REVENUE SOURCE CODE correctly for TRICARE bills.

Revised Reasonable Charges v3.14

This patch contains two issues. The first issue is about three 
non-billable HCPCS (Healthcare Common Procedure Coding System) codes for
prosthetic items that need to be filtered out of the Claims Tracking 
module. The second issue is about CHAMPVA & CHAMPVA REIMBURSEMENT 
INSURANCE rate schedules linking to RC charge sets are not automatically
updated in the Rate Schedule file (#363).

The purpose of this patch is to update the MCCR Utility file and the
Revenue Code file and the Place of Service file for 2014.

This patch addresses two issues. This first issue is about duplicate 
encounters for the outpatient care added to the Claims Tracking when the
'REPORTS ADD TO CLAIMS TRACKING' site parameter set to 'YES'. The second 
issue is the line items which are not listed under the appropriate 
heading in the [IBJ THIRD PARTY JOINT INQUIRY] option.

eInsurance System Modification effort

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal Year 2015 changes.

The HIPAA 5010 D.0 Level II Phase 2 project includes the following
   PRINT'. Selections 0 'NO FORCED PRINT' and 1 'FORCE LOCAL PRINT' still
   remain and function as they always have: if this field
   [Force to Print?] is set to 0, the claim will be transmitted
   electronically to the payer; otherwise, if this field is set to 1, the
   claim will be printed locally.
 
2. Prevent Creation of Claims with PAYER ID of HPRNT/SPRNT
   -------------------------------------------------------
   Modified VistA IB so that claims with Payer ID HPRNT/SPRNT display
   a fatal error message and force the removal of the HPRNT/SPRNT
modifications to the Electronic Billing V. 2.0 application:
   Payer ID from the Insurance Company file (#36).
 
3. Prevent Creation of Claims with Zero Procedures
   -----------------------------------------------
   Modified VistA IB to prevent the creation of claims with no procedures.
   IB validation logic has been incorporated to ensure a claim that is
   being created or edited cannot be submitted unless it contains at least
   one procedure.  If there are no procedures on the created or edited
   claim, a fatal error message will display to the user notifying them of
   this condition and will not allow the claim to be submitted.  Claims
 
   will continue to allow $0 line item(s) but these will also be required
   to have at least one procedure.  The only exception to this is that
   UB-04 Inpatient claims with no procedures may still be created.
 
4. Modify the Provider Contact Field Names for Property & Casualty Claims
   ----------------------------------------------------------------------
   Modified the Contact Name, Phone and Extension field names in the
   IB NON/OTHER VA BILLING PROVIDER(#355.93) file so that users will see
   the following prompts/labels while in the PROVIDER ID MAINTENANCE
   [IBCE PROVIDER MAINT] option: P&C Contact Name, P&C Contact Phone
1. Remove Ability to Print Claim at Clearinghouse
   Number and P&C Contact Phone Extension.  The P&C Contact Phone Number
   field was also updated to require a minimum of 10 digits.
 
5. Modify the Non-VA Facility Street Address & Zip Code Fields
   -----------------------------------------------------------
   Modified VistA so that the STREET ADDRESS field (#355.93,#.05) will no
   longer accept PO Box and other variations of post office box as a
   valid street address.  This validation does not apply to the STREET
   ADDRESS LINE 2 field (#355.93,#.1).  The ZIP CODE field (#355.93,#.08)
   has been modified so that only 9 digit ZIP codes are valid.  Entering
   ----------------------------------------------
   "0000" as the last four digits of a ZIP code is not acceptable.
 
6.  Modify Third Party Joint Inquiry [IBJ THIRD PARTY JOINT INQUIRY]
    ----------------------------------------------------------------
 
    Modified VistA to improve the readability of ERA data in the Third 
    Party Joint Inquiry [IBJ THIRD PARTY JOINT INQUIRY] option that 
    display when the BC "Billing Charges" action is selected.  The
    display was modified to remove the RAW DATA display for those EOBs
    that contained "Message Storage Errors" and make the reported
   Modified VistA IB to remove the user's ability to force the claim to
    error(s) more readable.  The formerly known "MESSAGE STORAGE ERRORS"
    are now known as "DATA MISMATCH ERRORS".
 
7.  Include ERAs with errors on the Medicare Remittance Advice Worklist 
    -------------------------------------------------------------------
    Modified VistA so that claims containing an error condition from
    processing the 835 will now display on the Medicare Remittance
    Advice Worklist (MRW), which is accessed via the option MRA
    Management WorkList [IBCE MRA MANAGEMENT].  These specific claims
    will be identified on the MRW with an "!" exclamation point
   print at the clearinghouse.  The capability to force a claim to print
    displayed immediately in front of the claim number.
 
The routine IBCEP8 was added to this patch to reintroduce the changes
that were previouly introduced by patch IB*2.0*447 which were subsequently
inadvertently omitted by the patch IB*2.0*476.
   at the clearinghouse was REMOVED.  Screen 10, Section 6 was modified
   by removing the ability to view and select 2 'FORCE CLEARINGHOUSE

Integrated Billing (IB) update for ICD-10 Diagnosis and Procedures.

This is the KIDS distribution for patch IB*2*109, Expanded Type of Bill.

This patch addresses two issues. The first issue is about the tricare
express bills being rejected due to the approving official is undefined.
The second issue is the update to the Occurrence Span Code 72 in the MCCR
Utility file (#399.1).

This patch addresses two issues. The first issue contains updates to the 
IB Action Type file (#350.1) and the IB Action Charge file (#350.2).
The second issue involves the IBJD Billing Lag Time report showing the
last patient with blank information on the first page and the name then
repeated on the top of the next page with the associated claim activity
data.

The Health Plan Identifier (HPID) project implements a new national 
store these new HPIDs and OEIDs, and to associate the entries in the local
Insurance Company file (#36) with a new National Insurance File (NIF),
owned by the Financial Services Center (FSC), which will centrally manage
distribution of HPID/OEID data.
 
In order to accomplish this, this patch introduces a new HL7 interface
for exchanging insurance information with the NIF. Included with this new
interface is a logging function which generates (periodically purged)
transaction records, allowing troubleshooting.
 
standard of having a single identifier to use on electronic transmissions
When installed, this patch will create a flat-file extract that can be
sent to the FSC in order to assist in setup of the NIF.
pertaining to health care. All entities that are financially responsible
for care are assigned a HPID or Other Entity Identifier (OEID), used for
entities that aren't traditional health plans. This new standard increases
interoperability by replacing clearinghouse-specific identifiers for 
health plans.
 
This patch updates the Integrated Billing (IB) package to enable it to

2015 RX COPAY THRESHOLDS

This patch fixes issues where incorrect data is being transmitted in 
the PID segment for billing records and appointment generated 
inquiries are getting stuck. 

This patch addresses two issues. 
 
The first issue is about a new entry - LABORATRY SERVICES PROVIDED TO
NON-PATIENTS added to the MCCR Utility file (#399.1) for UB-04 Bill 
Classification on the second digit type of bill.
 
The second issue concerns several misspellings in the display messages 
for the chiropractic-related dates and the statement covers dates in the 
[IB EDIT BILLING INFO] Enter/Edit Billing Information option.

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal Year 2015 mid-year changes.

Reasonable Charges v3.15

This patch will update the pharmacy administrative charge based on a new 
dispensing fee of $11.16 for Tricare and Tricare Reimbursement Insurance 
prescription claims with an effective date of February 20, 2015.

DIAGNOSTIC MEASURES PHASE II ROUTINES/FILES

This patch addresses two issues.
   Interagency with an effective date of January 1st, 2015.
 
1. The administrative charge $13.07 needs to be added to the prescription
   cost for the rate type: Interagency with an effective date of January
   1st, 2014.
 
2. The administrative charge $13.10 needs to be added to the prescription
   cost for the rate types: Reimbursable Insurance, No Fault Insurance,
   Workers' Compensation, Tort Feasor, Humanitarian, Ineligible and

This patch will install the Cost-Based and Inter-agency billing rates
into the Charge Item file (#363.2), with an effective date of 11/04/2014.

Reasonable Charges v3.16

eBilling Build 3

This patch addresses 2 issues.
1. The first issue is to update the MCCR Utility file and the Revenue Code
file and the Place of Service file for 2015. 
 
2. The second issue concerns ICD10 procedure codes being truncated on
page 2 of the printed bill when they contain 7 characters in length.

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal Year 2016 changes.

Integrated Billing update for PTF Diagnosis and Procedure code expansion.

This patch will fix an issue identified while running the Queue Means
Test Compilation of Charges [IB MT NIGHT COMP] background job that
leads to a runaway alert process where hundreds of thousands of 
alerts are generated for a single record/instance.

The purpose of this patch is to update the names of the Occurrence Span
Codes to the MCCR UTILITY (#399.1) file.

 
     file: 364.5 IB DATA ELEMENT  entries: N-MAILING ADDRESS FULL
                               N-CURR INS. CO FULL ADDRESS
 
Also this patch fixes and undefined error found in $ZE=CANCH+6^IBECEAU4:1.
 
HCFA 1500 and UB-92 bills for Sharing agreement patients when printed 
have and extra dash in the zip code.
 
Fields in the following files have also been edited to strip out 
the dash in the zip codes if present.
 
     file: 399 BILLING/CLAIMS    field: 109 MAILING ADDRESS ZIP CODE
 

This patch addresses an issue concerning payment amounts on e-Pharmacy
claims where the bill amount is different than what is shown via the ECME
Billing Events Report [IB ECME BILLING EVENTS] option.

This patch, IB*2.0*557, is one of three VistA 2016 threshold patches. It 
addresses the annual updates for the Pharmacy Copay Thresholds. Patch 
DG*5.3*922 will update the thresholds for the Means Tests and the Maximum
Annual Pension Rate. Patch EAS*1.0*134 will address the annual updates for
the GMT Thresholds.

In preparation for the VA's transition from IPv4 to IPv6 the IB package 
will require modifications to make it IPv6 ready.

Reasonable Charges v3.17

HAPE EDI Revenue project - NCPDP Continuous Maintenance Standards

This patch addresses two issues. The first issue contains the TRICARE
pharmacy administrative fee update based on a new dispensing fee of $12.19
with an effective date of January 1st, 2016. The second issue is about
the update of the Place of Service file (#353.1).

Reasonable Charges v3.18

This patch fixes issues during MESSAGE CHECKSUM calculations leading
to <MAXNUMBER> errors and the potential for the back billing process
to bill a negative amount.

This patch addresses two issues. The first issue contains two new 
Ineligible Dental for Cost-Based and Inter-agency billing rates for FY
2015. The second issue is about the [IB OUTPUT DAYS ON HOLD] Days On Hold
Report in the running process which is never complete.

MCCF ENHANCEMENTS PROJECT - EIV
 
This patch implements changes to VistA's Integrated Billing (IB), 
Insurance Company, and Patient Insurance File modules are requested by 
the Veterans Health Administration (VHA) Chief Business Office (CBO)
eBusiness Solutions Department to comply with the legislative
changes mandated by the Health Insurance Portability and Accountability 
Act of 1996 (HIPAA).

This patch corrects the following problem:
  
  
 The Pharmacy user gets the following error:
  
 The bill number in the parent IB ACTION entry is missing.
 Error in processing...No action taken.
  
 The coding changes in routines IBARX and IBARX1 has resolved the
 problem. When the user returns the medication to stock, and the copay
 charge status is "HOLD", the charge will be cancelled.
  
  
                            ** Special Note **
               The option that is affected belongs to Pharmacy.
               The changed routines belong to Integrated Billing.
         NOIS: DUB-0698-32098 / DUB-0698-31443
       OPTION: Return Medication to Stock [PSO RETURNED STOCK]
  
 Prior to installation of IB*2*70, when a Rx was returned to stock a
 bulletin was generated stating charges were removed. The problem is
 charges are not removed.   The bills are not showing because they are
 still on hold if the patient has insurance with Rx coverage.

This patch implements changes to VistA's Integrated Billing (IB) module 
as requested by the Veterans Health Administration (VHA) Chief Business 
Office (CBO) eBusiness Solutions Department to comply with the 
legislative changes mandated by the Health Insurance Portability and 
Accountability Act of 1996 (HIPAA).

The patch contains the fix for the patch IB*2.0*528. It is replacing 
references to the old security key IBCNE IIV AUTO MATCH with IBCNE EIV
MAINTENANCE in two routines IBCNEAMC and IBCNEUT6.

MCCF ENHANCEMENTS PROJECT - CARC/RARC
remittances can be used by VA, reducing the level of open accounts 
receivable and allowing claim denials to be more quickly addressed; and 
standardizes EFT & ERA enrollment, reducing workload burden on VA staff.  
  
This patch contains changes to the ePayments (835 and EFT) program area 
to ensure compliance. Specifically, enhancements to the VistA Third Party 
EDI Lockbox module to increase timely and accurate processing of payments 
for electronic pharmacy claims in compliance with HIPAA and VHA Fiscal 
Accounting policies will also be required.  The ePayments system is used 
by AR staff to process payments from third party payers for both medical 
 
and pharmacy claims. The objectives of the requested ePayments software 
modifications are to expedite accurate payments by enhancing the 
ePayments software to streamline the user's ability to process the 
pharmacy 835 while:
 
Complying with HIPAA legislative requirements to meet patient needs and 
secure Protected Health Information (PHI).
 
Conducting payment accounting in accordance with the Office of Management 
and Budget (OMB) directives.
VA's compliance with Electronic Funds Transfer (EFT) & Electronic 
 
Systematically enforcing VHA Fiscal Accounting policy.
 
Providing software tools in support of efficient business models to
maximize the volume of electronic data received from third party 
payers to increase revenue and save productive dollars.
Remittance Advice (ERA) Operating Rules and enables VA to more 
effectively use ERA data, resulting in better revenue and cash flow 
management; provides the infrastructure foundation for electronic 
exchange of claim payment information and promotes an interoperable 
system; reduces the time elapsed between receipt of the 835 and receipt 
of the CCD+ transaction; ensures that trace numbers between payments and 

MEDICAL CARE COLLECTION FUND (MCCF) ENHANCEMENTS PROJECT - ePAYMENTS

This patch is part of the Pharmacy Safety Updates project which was 
   APPLICATION/VERSION                                  PATCH
   -----------------------------------------------------------------
   OUTPATIENT PHARMACY (OP) V. 7.0                      PSO*7*444
   INTEGRATED BILLING (IB) V. 2.0                       IB*2*545
   PHARMACY DATA MANAGEMENT (PDM) V. 1.0                PSS*1*189
   NATIONAL DRUG FILE (NDF) V. 4.0                      PSN*4*429
   INPATIENT MEDICATIONS (IM) V.5.0                     PSJ*5*313
 
 
The following New service Requests (NSR) are related to this patch:
established to address specific New Service Requests (NSRs) as well as a
 
 NSRs 20060601/20111206 Allow Dispensing of Greater Than 90 Day Supply
 ---------------------------------------------------------------------------
 The Outpatient Pharmacy and supporting VistA applications are being modified
 to allow dispensing of more than 90 day supply fill for outpatient 
 prescriptions. The new limit will be 365 days and will be set for each drug
 individually. See below for more information on specific menu 
 options related to this enhancement.  
 
 NSR 20110308 Addition of a STRENGTH Property to IV ADDITIVES and Premixed 
Remedy Ticket and a Patient Safety Issue (PSI) related to the VistA Pharmacy
              IV SOLUTIONS
 ----------------------------------------------------------------------------
 Although patches PSJ*5*289 and PSS*1*174 introduced quite a few enhancements
 to the IV Additives and IV Solutions ordering functionality they did not go
 far enough in addressing all the issues originally in the NSR. Patches 
 PSJ*5*313 and PSS*1*189 will extend the display of the IV Additive strength
 to other parts of the Inpatient Medications and Pharmacy Data Management 
 applications. In addition, it will also impose a new rule where an Orderable
 Item can only have one IV Solution for a specific volume when it is marked
 to be used in the CPRS IV Fluid Order Entry. 
applications as approved by the Health Systems Enterprise Systems Manager
   
The following Integrated Billing copay functionality was modified:
  
1. Cancel/Edit/Add Patient Charges [IB CANCEL/EDIT/ADD CHARGES] option
   This menu option was modified to allow up to 12 copay units to be added
   for a patient. Before the maximum limit was 3, given that 90 days supply
   corresponded to 3 copay units (1 unit for each 30 days supply)
  
2. The upper limit for the value allowed for the DAYS SUPPLY field (#.06) in
   the IB BILL/CLAIMS PRESCRIPTION REFILL file (#362.4) was changed from 90
(ESM).
   to 365 in order to accommodate the new limit for this field in the
   Outpatient Pharmacy application.
 
This project is comprised of patches from five different applications, as
shown below:
  

This patch addresses the request to default the revenue code to 124  
(PSYCHIATRIC) for five Mental Health Diagnosis Related Groups (DRGs)
in the Charge Item file (#363.2).

Patch IB*2.0*562 addresses 1 issue:
 
1.)     Numerous sites have reported an issue with intermittent records 
of the Special Inpatient Billing Cases File (#351.2) not having discharge 
dates when this information is present in the Patient Movement File 
(#405).  

MCCF ePharmacy Compliance Phase 3

This patch will update the administrative charge based on a new
dispensing fee $14.29 for third party pharmacy prescription claims with
an effective date of January 1st, 2016.

Integrated Billing, Reasonable Charges.

Previously released patch IB*2.0*561 applied default revenue code 124 
(PSYCHIATRIC) to five Mental Health Diagnosis Related Groups (DRGs) 881, 
882, 883, 885 and 886.  These charge items included R&B (Room & Board)
101, Intensive Care Unit 200, and Ancillary Services 240 in the CHARGE
ITEM file (#363.2).
 
This patch will still apply default code 124 to R&B but remove it for
Intensive Care Unit 200, and Ancillary Services 240.

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal Year 2017 changes.

This patch contains two updates:
 
* 68 Cost Based and Inter-Agency billing rates with an effective date of 
  07/07/2016 in the CHARGE ITEM file (#363.2).
 
* 1 Condition Code in the MCCR UTILITY file (#399.1).

This patch will update the PAYER file (#365.12) with any missing
entries.

This patch will correct the cost based and interagency charge rates for
Polytrauma and PM&RS (Physical Medicine & Rehabilitation Service)
being reversed with the release of IB*2.0*570.

Reasonable Charges v3.19

This patch addresses two issues. The first issue contains a PARAMETER 
error related to a group plan's comment in the Move Subscribers to a
Different Plan [IBCN MOVE SUBSCRIB TO PLAN] option. The second issue is
regarding numerous claim tracking entries incorrectly filled with the
visit date/time for inpatient events in the Admit a Patient [DG ADMIT
PATIENT] option.

Update Revenue Codes.

Description:
IBCSC10 released in IB*2.0*547 does not handle this scenario correctly.
---------------------------
NSD Ticket# I10841525FY16
     
Problem:
-------
When testing with FSC, customer reported that they are not able to enter a 
professional alternate payer ID on Bill Screen 10 when the charge type is 
institutional and the form type is a CMS-1500.
     
Resolution:
This warranty patch corrects this defect in routine IBCSC10.
----------
Modified screen 10 to be consistent with the screening logic on
fields #140, #142 & #144 in file #399.  Screen 10 will now use form-type 
instead of charge type to determine alternate payer ID.
     
      
Test Sites:
----------
Pittsburgh
South Texas
     
Northern Indiana
Illiana
     
Documentation Retrieval Instructions
------------------------------------
The preferred method is to retrieve files from download.vista.domain.ext.
This transmits the files from the first available server. Sites may also 
elect to retrieve files directly from a specific server.
     
Sites may retrieve the documentation directly using Secure File Transfer
In addition, requirements defects were also discovered.  There were 
Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI
Field Offices:
     
   Albany:                 fo-albany.domain.ext
   Hines:                  fo-hines.domain.ext    
   Salt Lake City:         fo-slc.domain.ext
     
Documentation can also be found on the VA Software Documentation Library 
at: 
http://www.domain.ext/vdl/
several changes made in patch 547 to remove the printing and transmission 
     
Title                                 File Name            Transfer Mode
--------------------------------------------------------------------------
Release Notes/Installation Guide      ib_2_0_p547_rn.pdf   Binary
EDI User Guide                        edi_user_guide.pdf   Binary
Integrated Billing (IB) V.2.0
Technical/Security Manual             ib_2_0_tm.pdf        Binary
     
Patch Installation:
      
of admission dates on all outpatient claims.  During the warranty period 
Pre/Post Installation Overview
------------------------------
N/A  
      
       
Pre-Installation Instructions
-----------------------------
This patch may be installed with users on the system although it is 
recommended that it be installed during non-peak hours to minimize
potential disruption to users entering and editing IB claims.  
it was discovered that Outpatient Home Health and Outpatient Hospice 
This patch should take less than 5 minutes to install
       
No options need to be disabled.
     
Installation Instructions
-------------------------
This patch may be installed with users on the system although it is 
recommended that it be installed during non-peak hours to minimize
potential disruption to users entering and editing IB claims.  This 
patch should take less than 5 minutes to install.
claims still require the admission date and time or they will be rejected.  
           
1.  Choose the PackMan message containing this patch.
      
2.  Choose the INSTALL/CHECK MESSAGE PackMan option.  
       
3.  From the Kernel Installation & Distribution System menu, select
    the Installation menu.
      
    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 this patch
        (routines, DDs, templates, etc.).
    c.  Verify Checksums in Transport Global - this option will allow
        you to ensure the integrity of the routines that are in
        transport global.
         
4.  From the Installation Menu, select the Install Package(s) option and
A function ($$HHLTH) was added to routine IBCEF1 to determine if a claim is 
    choose the patch to install. (ex. IB*2.0*574)
       
5.  When prompted 'Want KIDS to INHIBIT LOGONs during the install?
    NO//',  enter NO
      
6.  When prompted 'Want to DISABLE Scheduled Options, Menu Options, and 
    Protocols? NO//,  respond NO
       
7.  When prompted "DEVICE: HOME//",  enter HOME
     
===========
Home Health or Hospice.  This function was inserted into entries #77, 98 
8.  If prompted 'Delay Install (Minutes):  (0 - 60): 0//' respond 0.
      
       
Post-Installation Instructions
------------------------------
     
There are no special post-installation instructions for this patch.
     
     
Routine Information:
and #1305 of file 364.7 to output the date for all inpatient claims AND 
====================
all Outpatient home health and hospice claims.
     
The purpose of this patch is to meet the requirements for the MCCF 
eBilling Compliance Phase 3 project related to Integrated Billing (IB).
Integrated Billing is a software module within Veterans Health Information
Systems and Technology Architecture (VistA) that provides the ability for
billing personnel to submit claims in either a paper or electronic format
to third-party payers. 
MCCF (Medical Care Collection Fund) warranty fix for the FY15 eBilling 
     
     
Patch Components
================
       
Files & Fields Associated:
       
File Name (#)                                             New/Modified/
  Sub-file Name (#)   Field Name (Number)                   Deleted
-------------------   ---------------------------------   -------------
Compliance Phase 3 project.
IB FORM FIELD CONTENT (#364.7)
     Screen: I $$INCLUDE^IBY547PR(7,Y)
       
       
Forms Associated:
                                                           New/Modified/
Form Name                    File Name (Number)             Deleted    
---------                    ------------------           -------------
N/A
     
     
      
Mail Groups Associated:
                                                          New/Modified/
Mail Group Name                                             Deleted    
---------------                                           -------------
       
       
Options Associated:
                                                          New/Modified/
Option Name                                  Type            Deleted    
This patch contains a fix for the installed patch IB*2.0*547.  When 
-----------                                  ----         -------------
N/A
       
      
Protocols Associated:
                                                          New/Modified/
Protocol Name                                               Deleted    
-------------                                             -------------
N/A
     
testing with FSC, customer reported that they are not able to enter a 
       
Security Keys Associated:
                                                          New/Modified/
Security Key Name                                           Deleted    
-----------------                                         -------------
N/A
      
      
Templates Associated:
                                                          New/Modified/
professional alternate payer ID on Bill Screen 10 when the charge type is 
Template Name      Type      File Name (Number)             Deleted    
-------------      ----      ------------------           -------------
N/A
      
       
Additional Information:
N/A   
       
New Service Requests (NSRs)
----------------------------  
institutional and the form type is a CMS-1500.  The version of routine 
NSR 20140414 - Medical Care Collection Fund (MCCF) eBilling Compliance 
Phase 3
      
      
Patient Safety Issues (PSIs)
-----------------------------
N/A
      
      
Defect Tracking System Ticket(s) & Overview

This is a patch for build IB*2.0*549 containing two routines.  Routine 
IBCNEUT7 is being modified in the DEATH2 subroutine to also set the 
COVERED BY HEALTH INSURANCE field (file 2, field .3192) to 'N' when 
terminating all active policies for a deceased patient.  It also contains 
a post-installation routine which will change the COVERED BY HEALTH 
INSURANCE field for all deceased patients who don't have active patient 
policies and the current value of the COVERED BY HEALTH INSURANCE field 
IS 'Y'.

This patch will update the administrative charge based on different rate 
tyes of new dispensing fees for third party pharmacy prescription claims
with an effective date of January 1st, 2017.

This patch, IB*2.0*583, is one of three VistA 2017 threshold patches. It 
addresses the annual updates for the Pharmacy Copay Thresholds. Patch 
DG*5.3*930 will update the thresholds for the Means Tests and the Maximum
Annual Pension Rate. Patch EAS*1.0*144 will address the annual updates for
the GMT Thresholds.

Reasonable Charges v3.21

This patch updates Integrated Billing Clinic Stop Codes in response to the
Comprehensive Addiction and Recovery Act (CARA) of 2016 and the 
Veterans Affairs opioid safety initiative.

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal Mid-Year 2017 changes.

The Chief Business Office (CBO) is requesting system enhancements to the
Health Administration (VHA) healthcare facilities, which makes it
difficult to determine whether all monies due VA for Non-VA care services
are being billed and collected from Third Party insurance carriers, where
applicable.  The current process is a resource intensive, manual process
with no assurance that all applicable Non-VA charges have been billed and
collected.
Veterans Health Information Systems and Technology Architecture (VistA)
Integrated Billing (IB), Accounts Receivable (AR), and Fee Basis software
modules that would allow segregating all billing and collection
activities for Non-Department of Veterans Affairs (VA), Care Third Party
Insurance carriers' reimbursement.
Current Medical Care Collections Fund (MCCF) Third Party billing and
collections applications in the VistA information system do not segregate
the Non-VA care claims from those claims for service rendered at Veterans

This patch involves updates to the MCCR UTILITY (#399.1) file, the REVENUE
CODE (#399.2) file, the PLACE OF SERVICE (#353.1) file and the CLAIMS
TRACKING NON-BILLABLE REASONS (#356.8) file for 2017.

Minor IB DD updates.

This patch will restore functionality to screen 10 of the Enter/Edit
Billing Information option that was accidently removed with the release
of IB*2.0*554.

This patch will prevent the Onset of Current Illness date from defaulting 
illness not allowed on same bill' to 'Occ. codes Onset of Illness (11) 
and LMP (10) not allowed on same bill.'.  This dictionary entry will be 
modified, if it exists, via the IBY576PO post-install routine and if the 
entry does not exist IBY576PO will create it.
to the Date of Service.  If there is an Occ Code 10 (LMP) on the bill 
then the Onset Date should default to the code 10 date.  iF there is an 
Occ Code 11 (Onset of illness) on the bill then the Onset date defaults 
to the code 11 date.  Code 11 takes priority over code 10, but since 
these are not supposed to be on the same bill the following modified 
error message will display: 'Occ. codes Onset of Illness (11) and LMP 
(10) not allowed on same bill.'  This is the error message for IB Error 
'IB099' which is being changed from 'Occ. codes for accident, LMP, 

Routine IB20P599 copied from IB20P586 for Stop Code Updates effective 
10/1/2017.

ECME won't submit a claim with a Service-Connected (SC) issue, even
after the user indicates that the issue has been resolved.  Same 
issue is reset again and again, with RNB (Reason Not Billed) 
message of "Needs SC Determination".  This occurs with any of the 
possible SC conditions. This patch corrects this issue, and also 
updates line 3 with the newer VA Directive reference.

This patch contains one update:
 
* 68 Cost Based and Inter-Agency billing rates with an effective date of 
  08/29/2017 in the CHARGE ITEM file (#363.2).

Each year, the government sets new values for the Medicare deductible and
for the pension threshold rates. These values need to be updated in the
associated billing files for accurate and legal billing. The purpose of
this patch is to assist sites in the entry of the Basic Pension Threshold
rates and the Medicare Deductible value for Calendar Year 2018.

Reasonable Charges v3.22

Veterans w/Insurance reports and Claims Tracking.

This patch addresses two issues.
Enter/Edit Billing information [IB EDIT BILLING INFO] option.
 
The first issue is about missing timeframe of bill data in the associated
display field when 'O NON-PAY/ZERO CLAIM' is selected in the Enter/Edit
Billing information [IB EDIT BILLING INFO] option.
 
The second issue concerns the Technical Component (TC) modifier which
doesn't automatically populate to any procedure on an institutional bill
if the only professional charge on the procedure is 26 modified in the

This patch will update the administrative charge based on different rate 
   NO FAULT INS.         16.64
   REIMBURSABLE INS.     16.64
   TORT FEASOR           16.64
   WORKERS' COMP.        16.64
   TRICARE REIMB. INS.   13.91
   TRICARE               13.91
types with new dispensing fees for third party pharmacy prescription
claims with an effective date of January 1st, 2018.
   
   Rate Type             Dispensing Fee
   -------------------   --------------
   HUMANITARIAN          16.64
   INELIGIBLE            16.64
   INTERAGENCY           16.64

This patch implements Payers domain changes required by the
Collaborative Terminology Tooling & Data Management (CTT & DM) Native
Domain Standardization (NDS) project. 
 
Please see FORUM for full patch description and installation instructions.

 This patch addresses 3 issues:
    IBZDATA(1) variable is undefined which is supposed to hold formatting
    data for the bill line.
 
 1. Update the Integrated Billing option Correct Rejected/Denied Bill [IB
    CORRECT REJECTED/DENIED] to address a missing lock issue.
 
 2. Correct the summary totals of the THIRD PARTY FOLLOW-UP SUMMARY in the
    View/Print Extracted Reports [IBJD DM VIEW/PRINT EXTRACTS] option.
 
 3. The FINDLN+64 and FINDLN+118 undefined errors occur when the 

 This patch will address 4 issues:
    option. This ensures that an original prescription with a fill date 
    that differs from the date the bill was created will be included in 
    the report.
 
 3. This patch changes the process of searching for clerks when using the
    Workload Assignment Enter/Edit [IBJD FOLLOW-UP WORKLOAD] option so 
    that new entries cannot be made to the NEW PERSON (#200) file. The 
    option has been changed to search the NAME (#.01) field of the NEW 
    PERSON (#200) file, instead of searching the IB DM WORKLOAD PARAMETERS
    (#351.73) file. The entry found in the NEW PERSON (#200) file is then 
 
    used to search the IB DM WORKLOAD PARAMETERS (#351.73) file, and will
    allow a new entry to be made if a match is not found.
 
 4. For certain Clinical Procedure Terminology (CPT) codes we need 
    to enter a procedure description- for CPT J1566 we do not have 
    this option in V2. Other Vista sites allow you to enter the 
    appropriate information. Can an update be done to V2 to have this
    option for this CPT code- it is causing claims to deny.
 1. The medication profile screen should show 
    the co-payment indicator for non-service connected patients.
 
 2. This patch adds a check for the FILL NUMBER (#.1) field in the
    IB BILL/CLAIMS PRESCRIPTION REFILL (#362.4) file when searching
    for third party bills with matching first party prescription 
    copayments using the Claims Matching Report [RCDP CLAIMS MATCH] 

Routine IB20P615 copied from IB20P599 for Stop Code Updates effective 
04/1/2018.

Reasonable Charges v3.23

IB*2.0*601 -- see patch description for implementation details. 

This patch addresses three issues.
The third issue as a post-init routine that will update the MCCR Utility 
file (#399.1) and Specialty file (#42.4) to prevent unwanted Hospice and 
First Party charges.
 
The first issue is about the Clinical Information header overlapping the
the special conditions in the expanded claims tracking entry screen in the
the Claims Tracking Edit [IBT EDIT BI TRACKING ENTRY] option.
 
The second issue is requested to add the bundled procedures 0295T, 0296T,
0297T and 0298T to the procedures split structure.
 

This patch addresses two issues.
 
- Fix an undefined error occurred at line MRA2+40^IBJTBA1 in the Third
Party Joint Inquiry [IBJ THIRD PARTY JOINT INQUIRY] option.
 
- Update to Condition/Occurrence/Value codes of the MCCR UTILITY (#399.1)
file for 2018.

Update three Y2K issues.

The patch will re-instate the 2017 BILLING THRESHOLD (#354.3) values.

 
Description
10.) A new warning message will print to the screen in the Enter/Edit 
Billing Information option if an ATTENDING, REFERRING or RENDERING 
Provider has a PERSON CLASS - NEW PERSON file (#200) - that was 
expirated at the time of the Date of Service.
 
11.) On the Third Party Joint Inquiry screen, one (1) character space 
shall be added to the "Type" field so that it will accommodate five 
characters (a one-character classification indicator, a forward slash 
(/), a one-character component indicator, a forward slash (/), and a 
one-character care type) ("X/X/X").  If a bill contains prescriptions, 
-----------
then an "R" shall be concatenated to the fifth character sub-type 
position of the "Type" field. If a bill contains prosthetics, then a 
"P" shall be concatenated to fifth character sub-type position of the 
"Type" field.The "Type" field shall contain five (5) characters as 
follows:
1. "I" for Inpatient or "O" for Outpatient,
2. "/" forward slash character
3. "P" for Professional or "I" for Institutional
4. "/" forward slash character
5. "P" for Prosthetics or "R" for Prescriptions
The Chief Business Office (CBO) is requesting system enhancements to
 
12.) Three new Third Party Insurance Rate Types shall be created in 
the VistA IB Suite for the billers to choose from when billing for 
encounters. They are as follows:
        HUMANITARIAN REIMB. INS. 
        DENTAL REIMB. INS.
        INELIGIBLE REIMB. INS.
 
13.) Each of the new rate types above will have the 'Insurer' as the 
responsible party.
The Veterans Health Information Systems and Technology Architecture
 
14.) Billers (revenue staff) should be able to identify any remaining 
charges to the patient after the Third Party payments are received for 
Emergency Humanitarian, Ineligible and Dental services so they can 
accomplish balance billing. 
 
 
 
Concurrent Development / Dependencies:
--------------------------------------
(VistA) Integrated Billing (IB), Accounts Receivable (AR), and 
N/A
 
 
Patch Components:
-----------------
 
Files & Fields Associated:
 
File Name (Number)    Field Name (Number)     New/Modified/Deleted
------------------    -------------------     --------------------
Outpatient Pharmacy (PSO) software modules.  
N/A
 
Options Associated:
 
Option Name                     Type          New/Modified/Deleted
-----------                     ----          --------------------
IBT SUP MANUALLY QUE PRSTHTCS   ROUTINE       NEW
 
Protocols Associated:
 
 
Protocol Name                                  New/Modified/Deleted
-------------                                  --------------------
N/A
 
Templates Associated:
 
Template Name                Type   File Name (Number)      New/Mod/Del
-------------                ----   ------------------      -----------
IBJT ACTIVE LIST             LIST                           NEW
IBJT INACTIVE LIST           LIST                           NEW
The mission of the Department of Veterans Affairs (VA), Office of 
 
New Service Requests (NSRs):
----------------------------
20150505 - Revenue Reporting Enhancements
20150506 - Revenue Eligibility Enhancements
20150507 - Revenue Operations Enhancements
 
 
Patient Safety Issues (PSIs):
------------------------------
Information & Technology (OI&T), is to provide benefits and services 
N/A
 
 
Remedy Ticket(s) & Overviews:
-----------------------------
N/A 
 
Test Sites:
----------
Durham VAMC
to veterans of the United States Armed Forces. In meeting these 
 
 
Software and Documentation Retrieval Instructions:
----------------------------------------------------
Patches for this installation are combined in host file 
IB_2_568_PRCA_PSO_BUNDLE_T1.KID
 
Installation of this host file should be coordinated among the packages 
affected since only one installation is necessary.
 
IMPORTANT INSTALLATION NOTE:
goals, OIT strives to provide high quality, effective, and efficient 
The patches are:
 
     IB*2.0*568
     PRCA*4.5*315
     PSO*7.0*463
     
 
Sites may retrieve the KIDS build in one of the following ways:
 
(1) The preferred method is to FTP the files from 
Information Technology (IT) services to those responsible for 
download.vista.domain.ext which will transmit the files from the first 
available FTP server.
 
(2) Sites may also elect to retrieve the patch directly from a specific
server as follows:
 
  OIFO               FTP ADDRESS                  DIRECTORY
  --------------     ------------------------     ------------------
  Albany             ftp.fo-albany.domain.ext     anonymous.software
  Hines              ftp.fo-hines.domain.ext      anonymous.software
providing care to the veterans at the point-of-care, as well as 
  Salt Lake City     ftp.fo-slc.domain.ext        anonymous.software
 
 
Sites may retrieve documentation directly using Secure File Transfer 
Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following
OI Field Offices:
 
Albany:          fo-albany.domain.ext
Hines:           fo-hines.domain.ext
Salt Lake City:  fo-slc.domain.ext
throughout all the points of the veterans' health care. The VA depends
 
Documentation can also be found on the VA Software Documentation 
Library at:
http://www4.domain.ext/vdl/
 
Title                                              File Name   FTP Mode
-----------------------------------------------------------------------
Integrated Billing User Guide                      ib_2_0_um.doc Binary
Integrated Billing Technical Manual/Security Guide ib_2_0_tm.doc Binary
Integrated Billing Deployment, Installation, 
on Information Management/Information Technology (IM/IT) systems to 
     Back-Out, and Rollback Guide   
              FY16RevenueIBVIP_Deployment_Installation_Guide.doc Binary 
 
 
 
Patch Installation:
 
Pre/Post Installation Overview:
-------------------------------
The post installation routine, IBY568PO, is not automatically deleted
meet mission goals.
as part of the installation process. You may delete it after
installation if you desire.
 
Pre-Installation Instructions:
------------------------------
N/A
 
Installation Instructions:
--------------------------
This process will install new and updated routines and other 
 
components listed above. There is a post-install routine that will add 
entries to a number of files.
 
The patch will be released in conjunction with an Accounts Receivable
patch, PRCA*4.5*315 and an Outpatient Pharmacy patch, PSO*7.0*463.
 
  ************************ NOTE ************************
  IF A USER IS ON THE SYSTEM AND USING THESE PROGRAMS 
  AN EDITED ERROR WILL OCCUR.  
  The patch should be installed when NO Outpatient 
The overall FY16 HAPE Revenue Enhancement project has been further 
  Pharmacy users are on the system.
  ******************************************************
 
 Installation will take less than 1 minute.
 
 Suggested time to install: non-peak requirement hours.
 
 
  1. Obtain the file IB_2_568_PRCA_PSO_BUNDLE_T1.KID.
    
divided into three sub-projects:
  2. From the Kernel Installation & Distribution System menu, select
     the Installation menu.
  
  3. Use Load a Distribution using IB_2_568_PRCA_PSO_BUNDLE_T1.KID when
     prompted to Enter a Host File name.  You may need to append a
     directory name.
  
  4. From this menu, you may select to use the following options
     (when prompted for INSTALL NAME, enter IB*2.0*568):
         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. 
----------------------------
NSR #20150506
             It will not backup any other changes such as DD's or 
             templates.
   
  5. When prompted "Want KIDS to INHIBIT LOGONs during the install? 
     NO//"  respond NO.
   
  6. When prompted "Want to DISABLE Scheduled Options, Menu Options, 
     and Protocols? NO//" respond NO. 
 
 
The Revenue Eligibility Enhancements Project effort for the Chief 
 
Post-Installation Instructions:
-------------------------------
There are no special tasks to perform after this patch installation.
Business Office (CBO), bundles several NSRs with similar business 
needs into a single requirements document.  Successfully addressing 
the requirements contained within this document will enable the 
Department of Veterans Affairs (VA) to appropriately bill certain 
subsets of billable events by correcting, automating, or enhancing 
current Veterans Health Information Systems and Technology 
Architecture (VistA) systems.
 
This patch is part of a multi-package build. There are three patches 
NSR #20150507
The Revenue Operations Enhancements Project combines serveral NSRs, 
as well. This effort enables the Department of Veterans Affairs (VA)
to improve revenue operation functionality related to repayment plans, 
late charge capture, bill suspension reasons, the billing of 
deactivated providers, and the display of appeal rights and 
responsibilities on the Veterans Beneficiary travel Bill of Collections
form.  Implementation of the proposed enhancements will make a 
significant positive impact on stakeholders and target users.
 
associated with the FY16 HAPE Revenue Enhancement project - 
NSR #20150505
The Revenue Reporting Enhancements Project will enable the VA to 
improve tracking and reporting of revenue, and will support revenue 
reporting business rules and guidelines.
 
 
IB*2.0*568 patch enhancements, pertinent to the above NSRs, include:
 
1.) When generating the RNB (Reasons Not Billable) report, the 
Integrated Billing system shall populate the charges for all types 
IB*2.0*568,PRCA*4.5*315 and PSO*7.0*463. All three patches are to be 
of services provided. Charges will not be screened by any billable 
criteria but willindicate the full amount as if the care was to be 
billed.
 
2.) The sub-option Claims Tracking Parameter Edit [IBT EDIT TRACKING 
PARAMETERS], that currently has no key, will be locked with a new 
Security Key called IB PARAMETER EDIT. 
 
3.) The option MCCR Site Parameter Display/Edit [IBJ MCCR SITE 
PARAMETERS], which is currently locked with the IB SUPERVISOR Security
installed together as a bundle, IB_2_568_PRCA_PSO_BUNDLE_T1.KID
Key, will be instead locked with the new key.
 
4.) The Integrated Billing system shall create claims tracking entries
for previously unbilled Prosthetics/DME items when new billable 
insurance is entered into the patient's insurance file.  
 
5.) A new coverage limitation field shall be created in the insurance 
file for Prosthetics.  Like the other existing coverage limitation 
fields in the insurance file (Inpatient, Outpatient, Pharmacy etc.), 
this field will have the following options:
 
        0=NOT COVERED
        1=COVERED
        2=CONDITIONALCOVERAGE
Once selected, they will show in the patient insurance file as Yes, 
No, or Conditional.
 
6.) The system shall automatically assign an RNB [NO PROSTHETIC 
COVERAGE (CV22)] for Prosthetics/DME items if the patient has no 
coverage for Prosthetics in his/her insurance file.
 
 
7.) The system shall have a new option to add Prosthetics items to 
Manual and Nightly Claims Tracking. 
 
8.) Users will be able to select Suspended Type from the menu to 
display in the First Party Follow- Up [IBJD FOLLOW-UP FIRST PARTY] 
report. 
 
9.) First Party Follow- Up [IBJD FOLLOW-UP FIRST PARTY] report shall 
be modified to incorporate reason for suspension.
 

This patch addresses the Technical Component (TC) modifier which 
needs to be automatically removed from any procedure on institutional
bills for Medicare in the Enter/Edit Billing Information [IB EDIT BILLING 
INFO] option.

This patch addresses the following 2 issues:
 
1.  An undefined error occurs when running the Held Charges Report
LM [IB OUTPUT HELD CHARGES LM] option.
 
2.  When running the Enter/Edit Billing Information [IB EDIT BILLING INFO]
option, the user will not be prompted for the PROCEDURE DESCRIPTION field
when they enter a partial match CPT code.

MCCF EDI TAS EPHARMACY BUILDS 3 & 4

This patch addresses one issue.
 
-Fix an undefined error at line IBCSCH+7 in routine IBCSCH in the 
 Enter/Edit Billing Information [IB EDIT BILLING INFO] option. 

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal year 2019 changes, effective 10/01/2018.

 The Mental Health Suicide Prevention - Suicide High Risk Patient 
 in enhanced care, which includes more frequent contacts and dispensing
 medications in smaller amounts more frequently, as safety precautions.  
 The Display PRF effort enhances the current VistA system and Delphi
 graphical user interface to address deficiencies in the functionality of
 the existing PRF package that interfere with effective management of 
 coordination of care for high risk individuals. 
 Enhancements effort incorporates the Modifying High Risk patient
 Copayments and the Display Patient Record Flag (PRF) effort and ownership
 management and transfer initiatives.  The goal of this effort is to
 improve the delivery of targeted Mental Health care for individuals at
 high risk for suicide.  Modification of copayments for Veterans assessed
 as being at high risk for suicide involves making changes to the existing
 VistA and payment systems to support regulatory change processes aimed at
 removing financial barriers that may prevent these Veterans from engaging

This is patch IB*2*64 for the Integrated Billing package.  This patch
captures insurance carrier statistics for fiscal year 1996 for the
MCCR program office.
 
Please see the National Patch Module description for this patch for more
detailed information.

This patch changes the co-pay exemption message for patients
who decline to give means test info, who are Cat C from
"There is insufficient income data on file for the prior year"
to "Patients income is greater than Copay Income Threshold"
 
This also changes the automatic co-pay exemption for patients
going from Cat C to Cat A,  claiming a hardship.
 

 
MCCF EDI TAS EBILLING BUILD 3 DENTAL

This patch addresses updates of Cost Based and Inter Agency rates with an
effective date of 08/28/2018 in the CHARGE ITEM file (#363.2).

This patch, IB*2.0*635, is one of three VistA 2019 threshold patches. It 
addresses the annual updates for the Pharmacy Copay Thresholds. Patch 
DG*5.3*973 will update the thresholds for the Means Tests and the Maximum
Annual Pension Rate. Patch EAS*1.0*170 will address the annual updates for
the GMT Thresholds.

Reasonable Charges v3.24

This is IB Build-7

This patch will update the administrative charge based on different rate
    INELIGIBLE                    17.66
    INELIGIBLE REIMB. INS.        17.66
    INTERAGENCY                   17.66
    NO FAULT INS.                 17.66
    REIMBURSABLE INS.             17.66
    TORT FEASOR                   17.66
    WORKERS' COMP.                17.66
    TRICARE                       14.73
    TRICARE REIMB. INS.           14.73
types with new dispensing fee for third party pharmacy prescription
claims with an effective date of January 1st, 2019.
 
    Rate Type                 Dispensing Fee
    -------------------       --------------
    DENTAL REIMB. INS.            17.66
    HUMANITARIAN                  17.66
    HUMANITARIAN REIMB. INS.      17.66

MCCF EDI TAS EPHARMACY BUILDS 5 & 6

This patch addresses the following issues:
 
- Update the MCCR UTILITY (#399.1) file for 2019.
- Fix an undefined error at line A+7 in routine IBARXMP in the Push Rx 
  Copay Cap Transactions [IBARXM CAP TRANS PUSH] option. 

This is the KIDS build for Integrated Billing patch IB*2*89.  This
return the external value of the prescription number, an undefined error
will occur when attempting to write that number to the error handler.
This patch will resolve the undefined error by checking for the existence
of the prescription number prior to writing it to the error handler.  If the
number does not exist, it will be output as 'unknown'.
 
REN-0299-61013
Cache systems do not interpret ascii character 13 as a carriage return,
and thus READ statements are not terminated as expected.  A change was
made to interpret the values of the variables 'read' by the system to
patch resolves three nois calls:
determine if the READ statement was terminated as expected.
 
REN-0799-61875
The Tricare fiscal intermediary is not accepting electronic transactions
with prescription numbers that contain a trailing alpha character.  A
change was made to strip trailing alpha characters from the
prescription number.
 
LOM-0997-62248
The 'IB - CHAMPUS Primary Billing Task' is queued off as a result of the
'Start the Champus Rx Billing Engine' [IB CHAMP ENGINE START] option.  One
of its tasks is to process all prescriptions queued for billing.  An
interface exists between IB and the Pharmacy package, to return necessary
information about the prescription.  If the Pharmacy interface fails to

TEST v

REASONABLE CHARGES V3.25; REVENUE CODE #124 FOR 5 MH MS-DRGS OF R&B CHARGE
ITEMS

This patch addresses the following issues:
 
-Insurance claims with multiple service line items/dates on the bill were
 not transmitted electronically properly.
-The BILLING FACILITY NAME (#200) field in the INSTITUTION (#4) file was 
 not correctly populated on the uniform billing form UB-04 FL-1.

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal year 2020 changes, effective 10/01/2019.

DIAGNOSTIC MEASURES-PHASE III

This patch addresses updates of Cost Based and Inter Agency rates with an
effective date of 10/01/2019 in the CHARGE ITEM file (#363.2).

Please see the IB*2.0*627 patch description for detailed information 
regarding this patch.

This patch, IB*2.0*661, is one of three VistA 2020 threshold patches. It 
addresses the annual updates for the Pharmacy Copay Thresholds. Patch 
DG*5.3*995 will update the thresholds for the Means Tests and the Maximum
Annual Pension Rate. Patch EAS*1.0*182 will address the annual updates for
the GMT Thresholds.

IB TAS Build 7/8/9 Port of 837 transaction to TAS Core platform

This patch will update the administrative charge based on the 
    CC TORT FEASOR                18.38
    CC WORKERS' COMP              18.38
    CCN NO-FAULT AUTO             18.38
    CCN REIMB INS                 18.38
    CCN TORT FEASOR               18.38
    CCN WORKERS' COMP             18.38
    CHOICE NO-FAULT AUTO          18.38
    CHOICE REIMB INS              18.38
    CHOICE TORT FEASOR            18.38
    CHOICE WORKERS' COMP          18.38
following rate types with new dispensing fee for third party pharmacy
    DENTAL REIMB. INS.            18.38
    HUMANITARIAN                  18.38
    HUMANITARIAN REIMB. INS.      18.38
    INELIGIBLE                    18.38
    INELIGIBLE REIMB. INS.        18.38
    INTERAGENCY                   18.38
    NO FAULT INS.                 18.38
    REIMBURSABLE INS.             18.38
    TORT FEASOR                   18.38
    WORKERS' COMP.                18.38
prescription claims with an effective date of January 1st, 2020.
    TRICARE                       15.45
    TRICARE PHARMACY              15.45
    TRICARE REIMB. INS.           15.45
 
    Rate Type                 Dispensing Fee
    --------------------       -------------
    CC MTF REIMB INS              18.38
    CC NO-FAULT AUTO              18.38
    CC REIMB INS                  18.38

REASONABLE CHARGES V3.26

NOIS Resolution and Minor Updates

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal mid-year 2020 changes, effective 04/01/2020.

REASONABLE CHARGES V3.27; PROVIDER PERSON CLASS VA080100

(1)This patch fixes CLAIMS TRACKING EDIT [IBT EDIT TRACKING ENTRY when 
field ITEM (#4) does not exist in file RECORD OF PROS APPLIANCE/REPAIR 
(#660).
 
(2)This patch fixes Add/Edit Pts. Continuously Hospitalized Since 1986 
[IB FLAG CONTINUOUS PATIENTS] to use correct FileMan date variable.

MCCF EDI TAS EPHARMACY BUILD 13

This patch addresses the following issue:
 
1. Users cannot remove an incorrect Sponsor on screen 15 of the
   Load/Edit Patient Data [DG LOAD PATIENT DATA] option if Sponsor is in 
   the PATIENT (#2) file.

This patch contains a routine to update the parameter "NUMBER OF
DAYS PATIENT CHARGES HELD" from 90 to 150 in file (350.9).

New calculations for Rx copayment if HRfS flag is active.

This patch involves updates to the MCCR UTILITY (#399.1) file, the REVENUE
CODE (#399.2) file and the CLAIMS TRACKING NON-BILLABLE REASONS (#356.8)
file for 2020.

The patch will reactivate 11 Reasons Not Billable (RNBs) that were 
requested to be deactivated with IB*2.0*673 in the CLAIMS TRACKING
NON-BILLABLE REASONS (#356.8) file.

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal year 2021 changes, effective 10/01/2020.

This patch updates the Cost Based and Inter Agency rates with an effective
date of 10/01/2020 in the CHARGE ITEM file (#363.2).

ePayments build 9

FIXES TO DIAGNOSTIC MEASURES REPORTS

MCCF EDI TAS EBILLING BUILD 10/11 277STAT PORT

IB*2.0*685 (Integrated Billing) is bundled with DG*5.3*1025 
 
The billing users of the [IB OUTPUT PATIENT REPORT MENU] menu need access 
to REGISTRATION menu options [DG OTH FSM ELIG. CHANGE REPORT] and [DG OTH 
FSM DETAIL REPORT] from patch DG*5.3*1025.
(Registration) in host file.
 
The SHRPE product makes enhancements to the Registration (patch 
DG*5.3*1025) to implement reports that would help Registration and Billing
users to identify patients that were treated under Other Than Honorable
authority and provide details about eligibility changes and VA care
provided to these patients. The reports are developed in DG namespace  but
need to be available to both Registration and Integrated billing users.

Patch IB*2.0*692 addresses the annual updates for the Pharmacy Copay
Thresholds.

This patch will update the administrative charge based on TRICARE
    TRICARE REIMB. INS.          16.11
rate types with new dispensing fee for third party pharmacy prescription 
claims with an effective date of January 1st, 2021.
 
 
    Rate Type                 Dispensing Fee
    --------------------      --------------
    TRICARE                      16.11
    TRICARE PHARMACY             16.11

REASONABLE CHARGES V4.21

This patch will update the administrative charge based on the following
    CC TORT FEASOR                20.71
    CC WORKERS' COMP              20.71
    CCN NO-FAULT AUTO             20.71
    CCN REIMB INS                 20.71
    CCN TORT FEASOR               20.71
    CCN WORKERS' COMP             20.71
    CHOICE NO-FAULT AUTO          20.71
    CHOICE REIMB INS              20.71
    CHOICE TORT FEASOR            20.71
    CHOICE WORKERS' COMP          20.71
rate types, with new dispensing fee for third party pharmacy prescription 
    DENTAL REIMB. INS.            20.71
    HUMANITARIAN                  20.71
    HUMANITARIAN REIMB. INS.      20.71
    INELIGIBLE                    20.71
    INELIGIBLE REIMB. INS.        20.71
    INTERAGENCY                   20.71
    NO FAULT INS.                 20.71
    REIMBURSABLE INS.             20.71
    TORT FEASOR                   20.71
    WORKERS' COMP.                20.71
claims, with an effective date of January 1st, 2021.
 
    Rate Type                 Dispensing Fee
    --------------------       -------------
    CC MTF REIMB INS              20.71
    CC NO-FAULT AUTO              20.71
    CC REIMB INS                  20.71

Backup of IB*2.0*695 on Apr 01, 2021
 
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.

Medicare Insurance Intake

This patch updates Integrated Billing Clinic Stop Codes to reflect 
Fiscal mid-year 2021 changes, effective 04/01/2021.

Backup of IB*2.0*668 on Apr 05, 2021
 
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.

Backup of IB*2.0*693 on Apr 20, 2021
 
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.

REASONABLE CHARGES V4.215

Backup of IB*2.0*696 on Apr 20, 2021
 
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.

Backup of IB*2.0*688, DG*5.3*1034 on Apr 29, 2021
 
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.

IB*2.0*688 (Integrated Billing) is bundled with DG*5.3*1034 (Registration)
in host file IB_2_0_P688.KID .
 
This patch introduces the API to provide IB data to Presumptive Psychosis 
and OTH billing reports designed within the Registration application.
 
The Integration Control Registration #7202 was entered to allow the
Registration application to use the API in Integration Billing application

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.

CPT MODIFIERS Initiative:  Update transfer of CPT Modifiers to/from PCE.

IB*2*697 (Integrated Billing) is bundled with DG*5.3*1035 (Registration) 
and OR*3.0*546 (Order Entry/Results Reporting) in host file
IB_2_0_P697.KID.
 
This patch modifies the IBEFSMUT routine to include the partial fill 
prescription of the return array.

Backup of IB*2.0*703 on Jun 21, 2021
 
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.

Backup of IB*2.0*700 on Jul 12, 2021
 
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 addresses an undefined error at line THRESQ 
in routine IBARXEU1 when entering a beneficiary travel claim in the
Claim Enter/Edit [DGBT BENE TRAVEL SCREEN] option.

Backup of IB*2.0*676 on Aug 12, 2021
 
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.

The INTEGRATED BILLING package needs to run the REGISTRATION report 
implemented as MAIN^DGOTHFSM modified in the patch DG*5.3*1047 to display
information for INTEGRATED BILLING (IB) users.  This report identifies
Former Service Members whose Primary Eligibility changed from EXPANDED MH
CARE NON-ENROLLEE to a new Primary Eligibility with a VERIFIED eligibility
status. These patients are no longer treated under the Other Than
Honorable (OTH) authority (VHA Directive 1601A.02).

Backup of IB*2.0*650 on Aug 23, 2021
 
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.

IB*2.0*124:  Miscellaneous updates and NOIS resolution
  
Updates to Output Formater:   Pre-init:  364.6 - 618,763,764
                               Install:  364.7 - 496,641,642,789
                                         364.5 - 114,116,117,118,119,155

Backup of IB*2.0*706 on Aug 24, 2021
 
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 updates Integrated Billing Clinic Stop Codes to reflect fiscal 
2022 changes, effective 10/01/2021.

When the PC Process COB action is performed to the secondary payer and 
the secondary bill already defined for the series error
is found for the claim, the system just goes back to the WorkList in the
MRA Management WorkList [IBCE MRA MANAGEMENT] option.

This patch addresses updates of Cost Based and Inter-Agency rates with an
effective date of 10/01/2021 in the CHARGE ITEM file (#363.2).

The purpose of this patch is to update and file the new fiscal year 
threshold rates for the Maximum Annual Rate of Pension which
is required for use in the Integrated Billing software application.
In addition, a new TYPE (.02) of  "Basic Pension" has been added
to the BILLING THRESHOLDS file (354.3) to lessen the confusion
when entering the default basic threshold rates.  Minor software changes
have also been made to accommodate this new field type.  
 

REASONABLE CHARGES V4.22

MCCF EDI TAS EINSURANCE 18

Patch IB*2.0*723 addresses the annual updates for the Pharmacy Copay
Thresholds.

This patch will update the administrative charge based on TRICARE
    TRICARE REIMB. INS.          11.79
rate types with new dispensing fee for third party pharmacy prescription 
claims with an effective date of January 1st, 2022.
 
 
    Rate Type                 Dispensing Fee
    --------------------      --------------
    TRICARE                      11.79
    TRICARE PHARMACY             11.79

REASONABLE CHARGES V4.225

This patch will update the administrative charge based on the following
    CC TORT FEASOR                13.26
    CC WORKERS' COMP              13.26
    CCN NO-FAULT AUTO             13.26
    CCN REIMB INS                 13.26
    CCN TORT FEASOR               13.26
    CCN WORKERS' COMP             13.26
    CHOICE NO-FAULT AUTO          13.26
    CHOICE REIMB INS              13.26
    CHOICE TORT FEASOR            13.26
    CHOICE WORKERS' COMP          13.26
rate types, with new dispensing fee for third party pharmacy prescription 
    DENTAL REIMB. INS.            13.26
    HUMANITARIAN                  13.26
    HUMANITARIAN REIMB. INS.      13.26
    INELIGIBLE                    13.26
    INELIGIBLE REIMB. INS.        13.26
    INTERAGENCY                   13.26
    NO FAULT INS.                 13.26
    REIMBURSABLE INS.             13.26
    TORT FEASOR                   13.26
    WORKERS' COMP.                13.26
claims, with an effective date of January 1st, 2022.
 
    Rate Type                 Dispensing Fee
    --------------------       -------------
    CC MTF REIMB INS              13.26
    CC NO-FAULT AUTO              13.26
    CC REIMB INS                  13.26

Initial Patch Description for IB*2.0*665

Enhancements to the Vets with Insurance Reports

Update Provider Discount groups and add 2 Revenue Codes.

This patch addresses an undefined error at line BLD+26 in routine IBTODD 
in the Days Denied Report [IBT OUTPUT DENIED DAYS REPORT] option.

This patch involves updates of the MCCR UTILITY (#399.1) file, the REVENUE
Revenue Code
============
161 RM AND BRD-OTHER-HOSPITAL@HOME (new)
 
Place of Service Code
======================
10  TELEHEALTH PROVIDED IN PATIENT'S HOME (new)
CODE (#399.2) file and the PLACE OF SERVICE (#353.1) with the following
codes for 2022.
 
 
Occurrence Span Code
====================
82  HOSP AT HOME CARE DATES (update)
 

 
EMERGENCY STOP CODE UPDATE RELATED TO PACT ACT FOR FY 2023

RAI/MDS Support:  add cross references to fields so they may be monitored.

COST BASED/INTER AGENCY Rate (CBIAR) UPDATE FY23

Integrated Billing patch, IB*2.0*753 addresses the annual updates
for the Pharmacy Copay Thresholds.

REASONABLE CHARGES V4.23

Integrated Billing patch, IB*2.0*750, will update the administrative
charge based on TRICARE rate types with new dispensing fee for third party
pharmacy prescription claims with an effective date of January 1st, 2023.

Integrated Billing patch, IB*2.0*754, updates the administrative
charge based on the following rate types, with new dispensing fee for
third party pharmacy prescription claims, with an effective date of
January 1st, 2023. The following rate types will be created:

REASONABLE CHARGES V4.235

Minor updates and NOIS resolution.

This patch updates two options that allow for the releasing of copay 
charges with a status of On Hold to include a check for duplicate copays.
 
This same duplicate copay check has also been added to the nightly
background job to perform those same checks for charges that are being
released due to hitting the end of the 90-day window for On Hold charges.

IB MID YEAR STOP CODE UPDATE FY23

Transfer Pricing

IB STOP CODE UPDATE FY24

 
This patch creates a new system that will use HL7 messages sent 
and then processed by the Data Access Service (DAS) to synchronize
the MEANS TEST BILLING CLOCK (#351) file across the VA Enterprise.

CBIAR FY24 Update

CPT 2000 Replacement Charges for RC v1.

ePayments Build 19

Integrated Billing patch, IB*2.0*780 addresses the annual updates
for the Pharmacy Copay Thresholds.

If a non-exempt patient has a previous year Means Test on file, with the 
Income Verification Match (IVM) Center as the source of the 
determination, the new RX copay exemption is not being entered in the 
BILLING EXEMPTIONS (#354.1) file.

Integrated Billing patch, IB*2.0*774, will update the administrative
charge based on TRICARE rate types with new dispensing fee for third party
pharmacy prescription claims with an effective date of January 1st, 2024.

Integrated Billing patch, IB*2.0*781, updates the administrative
charge based on the following rate types, with new dispensing fee for
third party pharmacy prescription claims, with an effective date of
January 1st, 2024. The following rate types will be created:

CY2024 Reasonable Charges Update V5.24

Patient Billing Enhancements:
 
 
 This is the Patient Billing Enhancement KID's Distribution for Patch
IB*2.0*132. For specific information relating to the installation of this
KID's distribution please see the National Patch Module section Patch
Description subsection Installation Instructions.

IB STOP CODE UPDATE MID YEAR 2024

    RNB FILE UPDATE 2024

2024 UPDATES OF CONDITION CODES & PLACE OF SERVICE CODES

    RNB ADDITIONAL UPDATE 2024

Reasonable Charges v1.1 and related updates.

FY25 STOP CODE CHANGES

TRANSFER PRICING UPDATE

This patch fixes the List Plans by Insurance Company option.  
Charge Master.
The SHORT ID was not listing for those patients that 
had an Eligibility of Tricare/Champus.  This patch also fixes 
the updating of the COVERED BY HEALTH INSURANCE
fields in the patient file when the verify coverage of insurance
prompt is answered. This patch also fixes the due date for the 
patients Means Test.  After the leap year date of 2/29 the due dates 
for the means test are off by 1.  This  patch fixes this.
This patch also adds the new Outpatient Co-pay Rate of $50.80 into the

This patch fixes two data related problems with sending 
at some sites because the fiscal intermediary is requiring 
more specific data values for these two fields.
Some sites are not having any problems with this and do 
not want to change and send more specific values for these 
two fields.  Two new fields have been added to 
the IB SITE PARAMETERS file so the sites can choose 
to send the DEA# vs the Prescriber ID,  and choose 
to send the more specific 1 or 2 for the compound code 
as opposed to a zero.
specific data to the fiscal intermediary for billing 
Tricare patients. The fiscal intermediary is requiring 
the DEA# be sent in place of Prescriber ID for a 
provider reference. For the drug, a zero was being 
sent to the fiscal intermediary as the number of
ingredients in a prescription.  The fiscal intermediary 
is requiring a 1 (non-compound drug) or a 2 (compound drug)
for the number of ingredients.  Claims are being rejected 

INSURANCE TREND REPORT PROBLEM

Support for AR Third Party Payments report.

Fix for Insurance Buffer delay problem.

IB Insurance Buffer API for 1010EZ.

MRA Extract patch.

BILLING ENHANCEMENTS FOR EDI

This patch corrects two problems.
automatic copy from the institutional to the professional bill is done.
1.  The first problem affects HCFA-1500 bills that were created
prior to the installation of patch IB*2.0*51.  If there was already data
in the BLOCK 31 data field (screen 8 of the ENTER/EDIT BILLING SCREENS),
but not in the provider multiple, there should have been an error on
authorization of this bill, but the edit check was erroneously passing.
2.  The second problem affects institutional claims that have professional
components that require a separate HCFA 1500 bill to be produced.  The TC
modifier should not be copied over to the professional bill when the

Changes have been made to routines IBOMTC and IBOMTC1 to
starting date is defaulted to November 30, 1999.
identify Purple Heart patients. When the Cat C Activities report is run,
the PH indicator is checked and Purple Heart patients are flagged on
the report.  Purple Heart patients will be identified by an '*' in
front of their name.  
 
The report has also been edited to give the user a choice of listing only
Purple Heart recipients or both Purple Heart and non recipients. 
If the user chooses to list only Purple Heart recipients, the report

This is the KIDS distribution for patch IB*2*123, Diagnostic
Measures Phase IV. The accompanying Accounts Receivable patch
is PRCA*4.5*167. This patch also fixes the problem reported in
the Third Party Follow-up Report - NOIS #OKL-0100-72387.

This patch updates the ACCOUNTS RECEIVABLE CATEGORY (#.06) in the RATE TYPE
(#399.3) file for the DENTAL entry from "INELIGIBLE HOSP" to "EMERGENCY/
HUMANITARIAN".

IB*2*150 OUTPATIENT MEDICATION COPAY CAP PHASE 1, PATCH 1

INSURANCE MODULE PROBLEMS

Reasonable Charges v1.2

This patch contains fixes to minor problems introduced by patch IB*2*51
 
ALT-0501-20830   Sites with a marital status file whose internal entry
numbers differ from the national standard are getting erroneous data on
the HCFA 1500 and UB92 bills.
 
LOM-0401-62250   Multiple page UB92's printed an extra page if the
description portion of box 44 exceeded one page.
 
LOM-0401-61961  The patient's name was not printing in boxes 12 and 13
on the HCFA 1500 if the bill was for other than reimbursable insurance.
NOIS entries fixed include:
 
LOM-0501-61752: The treatment authorization code was not printing in
box 63 of the UB92 if the bill was for other than reimbursable insurance.
This same problem was found with the INSURANCE CO NUMBER (box 60),
RELEASE OF INFORMATION (box 52) and ASSIGNMENT OF BENEFITS (box 53).
 
SLC-0501-51272: The help text on the PERFORMED BY field of the PROVIDERS
multiple (#222) of the BILL CLAIMS file (#399) should not reference
SLF000 as a valid entry.  This can be seen on screen 8 of the BILLING
SCREENS in the PROVIDERS edit group.
 
 
STC-0501-42551: Most Commonly Used Outpt CPT Codes Rpt is missing the
procedure short name.
 
CHY-0501-52377: The insured's id number was not printing in box 1A o
the HCFA 1500 if the bill was for other than reimbursable insurance.
SPO-0501-50868   If there is a print order on duplicate procedures for a
HCFA 1500 bill, only the first duplicate procedure prints, although the
total charges reflect the total of the duplicate procedures.
 
DUR-0501-30976   There was a hard error encountered when duplicate
procedures existed with different box 24 free text or box 24K data.

 
PASSING OF REASON CANCEL TO AR:
===============================
 
 
This is the Passing Of Reason Cancel to AR KID's Distribution for Patch
IB*2.0*142. For specific information relating to the installation of this
KID's distribution please see the National Patch Module section Patch
Description subsection Installation Instructions.

FIX RX COPAY RESET/REMOVE CHARGES

Update Claims Tracking to accept the original fill of a Prescription.

ELIMINATE MEANS TEST CATEGORY

This is the KIDS distribution for patch IB*2*159, Diagnostic Measures
Updates.

This patch changes the NUMBER OF DAYS PT CHARGES HELD field (#7.04)
in the IB SITE PARAMETERS file #350.9 from 150 to 90.

This is the first phase of the LTC COPAYMENTS project. This software
change will not become effective until the LTC REG is passed into law,
which is expected in DEC 2001. Once the law is passed, another patch
will be sent to the field which will ACTIVATED this software change.

STOP OUTPATIENT COPAY BILLING PENDING IMPLEMENTATION

SPECIAL CONDITION (SC) PROBLEM

OUTPATIENT MEDICATION COPAY CAP PHASE 1, PATCH 2 AND PHASE 2

This patch implements functionality to support the outpatient
visit co-payment regulation.

IB update due to Prosthetics Encounter changes (RMPR*3*62).

This patch contains the functionality to begin electronic billing through
the clearinghouse WebMD.  See the patch module and release notes that
accompany this patch for further documentation.
 
INCLUDES NOIS: RIC-0501-22630 
               ROS-0601-52681

Update of visit copay tiers.

IB*2*171 MILL BILL LTC, PHASE 2, PATCH 1

The patch contains modification of Outpatient Copay (RX) software to 
 
The patch resolves NOIS # BUT-0502-21665.
limit execution of RPC "IBARXM QUERY ONLY" with VAMC, M&ROC and RO-OC
facilities only.
Besides this, the patch also contains a new RPC, "IBARXM QUERY SUPPRESS
USER" to replace "IBARXM QUERY ONLY". The new RPC does not transmit user
data to remote side. Two existing calls have been modified to suppress
sending user data to remote side:
IBARXM TRANS BILL
IBARXM TRANS DATA

ClaimsManager Interface

This patch contains maintenance fixes and updates for Electronic Billing 
(EDI) Patch IB*2*137.