| DESCRIPTION OF ENHANCEMENTS |
1. One site has reported an excessive number of prescriptions getting
This patch corrects the problem but will not do any back-billing.
Information gathered from the results of this patch will be used by the
VHA Central Office to determine whether back-billing will be done for
these fills. A subsequent patch may be released to perform this
back-billing.
a. At release of a fill, if the Service Connected flag has a "Yes"
answer, a call will be made to Integrated Billing to see if the Service
Connected question even applies for this patient anymore. If not, the
automatically (incorrectly) changed at release from Copay to No Copay
answer will be set to null in Outpatient Pharmacy and an update
transaction will be sent to CPRS to change their copy of the answer to
null.
b. A post-install job will loop through all released prescriptions
starting from 02/04/2002 (the date that the $7 copay amount went into
effect) and will tally the number of fills that could have been billed.
The results of this patch will be maintained in a temporary location for
a limited time in order to speed the processing of any eventual
back-billing.
with a reason of "Service Connected". It was determined that this is
A MailMan message with a subject of "Subj: Patch PSO*7*137 Copay tally"
will be sent to the patch installer and holders of the PSO COPAY key
indicating the number of fills that have a potential for being
back-billed.
A second MailMan message will be sent to developers of the patch on FORUM
with a subject of "Subj: 'institution' - COUNTS. This message will
contain formatted tallies of fills eligible to be back-billed for 2002
happening because the Service Connected question does not apply for the
and 2003.
The MailMan messages will not contain any patient information.
2. A problem was encountered when a patient who had previously reached
his annual copay cap had activity that brought his copay amount below the
annual cap. When that happens, Integrated Billing (IB) will look for any
previous fills that weren't billed because of the cap and will attempt to
bill for those. The problem occurred when the previous unbilled fill had
been returned to stock, Outpatient Pharmacy had an error in the process
patient anymore, but the Computerized Patient Record System V. 1.0(CPRS)
that should have sent a cancel for those "potential bills" (fills that
would have been billed if the patient had not already reached his annual
copay cap), so IB attempted to initiate a charge for those. On returned to
stock refills, the refill level is removed from the prescription file, so
filing the IB-initiated charge caused undefined errors.
Solution:
The canceling portion of the return to stock processing was corrected to
handle "potential charges".
passes the Service Connected question's answer from the renewed from or
copied from prescription to Outpatient Pharmacy V. 7.0.
Solution:
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