| DESCRIPTION OF ENHANCEMENTS |
The Chief Business Office (CBO) is requesting modifications to several
Software to support the Combat Veteran (CV) initiative is being developed
and introduced in a phased implementation strategy. The reason for this
type of deployment is due to the complexity of the functionality and the
number of product line dependencies. Phase I: Combat Veteran Interim
Solution (CVIS) was a VistA only solution that involved development in
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 Consolidated Mail Outpatient Pharmacy (CMOP) patch PSX*2*50,
that provides the functionality changes to accommodate the new copay
classification called "Combat Veteran".
As part of the Combat Veteran II project, Outpatient Pharmacy V. 7.0 patch
medical services to combat veterans despite the absence of proof of
PSO*7*157, introduced the COMBAT VETERAN field (#122) to the PRESCRIPTION
file (#52). This new COMBAT VETERAN field (#122) of the PRESCRIPTION file
(#52) stores the data related to the copay exemption question, "Is this
Rx potentially for treatment related to Combat?".
During CMOP transmission of prescriptions, if a prescription is deemed
"Billable", the software does a check on the following copay exemption
fields of the PRESCRIPTION file (#52):
117 MILITARY SEXUAL TRAUMA
service connection.
118 AGENT ORANGE EXPOSURE
119 IONIZING RADIATION EXPOSURE
120 ENVIRONMENTAL CONTAMINANT
121 HEAD AND/OR NECK CANCER
122 COMBAT VETERAN
If the prescription is identified as copay exempt, the software will
transmit "Not Billable" to CMOP.
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