| DESCRIPTION OF ENHANCEMENTS |
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
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