| DESCRIPTION OF ENHANCEMENTS |
The Chief Business Office (CBO) is requesting modifications to several
Software to support the Combat Veteran (CV) initiative is being developed
In the event that a patient is eligible for more than one copay
exemption, the CV prompt will be presented to the pharmacist first.
A 'YES' or 'NO' response will be stored in the COMBAT VETERAN field
(#122) of the PRESCRIPTION file (#52). This is a new field introduced in
this patch.
2. The Integration Agreement (IA) 2534 provides CPRS the copay related
questions that need to be asked during the outpatient medication order
and introduced in a phased implementation strategy. The reason for this
entry process. This IA is modified to include the CV copay classification,
if applicable.
3. The PENDING OUTPATIENT ORDERS file (#52.41) that stores the pharmacy
orders (new/renew) entered via CPRS is modified to include the provider
response to the CV question. The provider response will be stored in the
COMBAT VETERAN field (#110.1) of the PENDING OUTPATIENT ORDERS file
(#52.41). The COMBAT VETERAN field (#110.1) is a new field introduced in
this patch.
type of deployment is due to the complexity of the functionality and the
4. During the release of a prescription, medication copay exemptions are
re-evaluated to see if there is a change in the billing status. This logic
is modified to include the CV copay classification. If a copay exemption
question applies and is unanswered, a MailMan message is generated. This
message is sent to the pharmacist, ordering provider, and holders of the
PSO COPAY key, to get answers to the exemption questions and reset the
prescription copay status if needed, using the Reset Copay Status/Cancel
Charges [PSOCP RESET COPAY STATUS] option .
5. The Reset Copay Status/Cancel Charges [PSOCP RESET COPAY STATUS] option
number of product line dependencies. Phase I: Combat Veteran Interim
is modified to include the CV copay classification wherever applicable.
6. During label printing of a prescription, if a prescription is deemed
billable then the software does a check on the following copay exemption
fields of the PRESCRIPTION file (#52):
117 MILITARY SEXUAL TRAUMA
118 AGENT ORANGE EXPOSURE
119 IONIZING RADIATION EXPOSURE
120 ENVIRONMENTAL CONTAMINANT
121 HEAD AND/OR NECK CANCER
Solution (CVIS) was a VistA only solution that involved development in
122 COMBAT VETERAN
If the prescription is identified as copay exempt, the software will
print "NO COPAY".
the Integrated Billing (IB) and Registration/Enrollment product lines.
It provided the logic to identify those veterans who met the criteria for
the combat veteran eligibility and provided billing reports
cross-referenced against this identifier to aid in the copayment billing
process. Phase II of this initiative will involve multiple product lines
Veterans Health Information Systems and Technology Architecture (VistA)
and additional VistA only development. The main goals of Phase II will be
to fully automate the copayment billing processing of combat vets based on
episode of care by providing the appropriate questions at check-out as
supplied by CPRS.
Product lines that have a stake in Phase II development include
Enrollment/Registration (VistA), IB, Outpatient Pharmacy, Consolidated
Mail Outpatient Pharmacy (CMOP), CPRS/TIU, Patient Care Encounter (PCE),
Ambulatory Care, Event Capture, Scheduling and PTF. The National Patient
Care Database (NPCD) will also require modifications to capture workload
packages to support implementation of VHA Directive 2002-049 - "Combat
reporting. The patches are listed below in the order that they must be
installed:
Outpatient Pharmacy
PSO*7*157
PSX*2*50
PCE/PTF/Event Capture/Scheduling - PIMS Host file
PX*1.0*130
SD*5.3*325
DG*5.3*565
EC*2.0*54
Veterans Are Eligible For Medical Services For 2-Years After Separation
Integrated Billing
IB*2.0*247
CPRS
OR*3.0*190
Product Features
There are three main areas addressed by this enhancement:
a. Identification/Notification of a CV Status veteran seeking medical care
- The clinical applications shall obtain the CV Status for those
veterans who qualify as such per the directive.
- The CV Status identification shall be displayed to the appropriate
From Military Service Notwithstanding Lack Of Evidence For Service
audience (pharmacist, clinician providing care, intake personnel,
schedulers, etc.).
- Provider shall be able to identify whether care provided CV veteran
was for a condition potentially related to combat service in the same
manner as identification of exposure related care; care for SC
conditions, etc.
b. Assistance in the communication of a treatment being determined as
Combat Related
- Provide a means for the billing and pharmacy software package to
identify these patients and services provided care for a combat
Connection", which iterates VA's policy to provide medical care and other
related condition.
c. Automatically precludes inpatient and outpatient medical care,
prescription and Long-term care copayments for CV Status veterans whose
treatment/service has been deemed combat related.
This is the Outpatient Pharmacy patch PSO*7*157 that provides the
functionality changes to accommodate the new copay classification called
"Combat Veteran".
1. For the following options, when creating a new order, renewing an
medical services to combat veterans despite the absence of proof of
existing order, copying an existing order to a new order, or editing an
existing order that results in a new order, the copay status of the
prescription needs to be determined for billing purposes.
a. Patient Prescription Processing [PSO LM BACKDOOR ORDERS]
b. TPB Rx (Prescription) Entry [PSO TPB RX ENTRY]
c. Barcode Batch Prescription Entry [PSO BATCH BARCODE]
d. Complete Orders from OERR [PSO LMOE FINISH]
Depending on the patient eligibility, the software currently provides
service connection.
the following copay exemption questions to the pharmacist during
prescription finishing process:
"Is this Rx for treatment of Vietnam-Era Herbicide (Agent Orange)
exposure?"
"Is this Rx for treatment of ionizing radiation exposure?"
"Is this Rx for treatment of environmental contaminant exposure during the
Persian Gulf War?"
"Is this Rx for treatment of Military Sexual Trauma?"
"Is this Rx related to treatment of Head and/or Neck Cancer?"
and/or Neck Cancer veterans;
To fulfill the Directive 2002-049, this patch will add the following
Combat Veteran (CV) copay exemption question to the current copay list:
"Is this Rx potentially for treatment related to Combat?"
|
