| DESCRIPTION OF ENHANCEMENTS |
Description:
of claim responses (including drug utilization review responses and
Documentation Retrieval:
========================
The ECME documentation is available on the ANONYMOUS.SOFTWARE directory
at one of the following Office of Information (OI) Field Offices.
Sites may retrieve documentation in one of the following ways:
(1) The preferred method is to FTP the files from
download.vista.domain.ext, which will transmit the files from the
warnings) on a real-time basis, is being developed and introduced in a
first available FTP server.
(2) Sites may also elect to retrieve documentation 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 documentation distribution includes:
phased implementation strategy. This deployment strategy was utilized due
FILE NAME DESCRIPTION
BPS_1_0_IG.PDF HIPAA NCPDP CONNECTION FOR EDI
PHARMACY
(DORMANT RELEASE) INSTALLATION GUIDE
BPS_1_0_RN.PDF HIPAA NCPDP CONNECTION FOR EDI
PHARMACY
(DORMANT RELEASE) RELEASE NOTES
(3) Documentation can also be retrieved from VISTA Documentation Library
to the complexity of the functionality and the number of product line
(VDL) on the Internet at the following address, http://www.domain.ext/vdl.
Installation Instructions:
==========================
The software for this patch is being distributed via a host file. The
host file will contain the following package and builds:
Host file name BPS_1_0.KID
dependencies.
Package:
BPS_1
Builds:
PSS*1.0*81
IB*2.0*223
IB*2.0*251
PRCA*4.5*202
Sites may retrieve the software directly by using FTP from the
ANONYMOUS.SOFTWARE directory at the following OI Field Offices:
Albany: ftp.fo-albany.domain.ext
Hines: ftp.fo-hines.domain.ext
Salt Lake City: ftp.fo-slc.domain.ext
Do not install this patch while Pharmacy Data Management users are using
the software. Installation will take no longer than 15 minutes. There are
no scheduling restrictions or recommendations.
The first release of this two part implementation is BPS*1*0, comprised of
Installation Steps
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 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.
the new Electronic Claims Management Engine (ECME) package (in the BPS
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,
namespace), plus the patches PSS*1*81, IB*2.0*223, IB*2.0*251, and
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.
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:
PRCA*4.5*202, which are listed here in order of installation. BPS*1*0 is a
(When prompted for INSTALL NAME, enter BPS 1.0)
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,
===========
dormant release that only allows each site to perform preliminary setup
etc.).
c. Verify Checksums in Transport Global - This option will ensure the
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.
work and to confirm that the software does not adversely affect other
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? 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
packages.
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.
There are two main areas addressed by BPS*1*0:
a. Registration of the Pharmacy with the Vitria BusinessWare IE.
b. The Insurance Matching of Group Plans with Pharmacy Plans
Following the installation of BPS*1*0, each site must register their
pharmacy with Vitria and match applicable insurance group plans using the
insurance matching screens. These processes are detailed in the HIPAA
NCPDP CONNECTION FOR EDI PHARMACY INSTALLATION GUIDE and the E-PHARMACY
CLAIMS INSURANCE PROCESS 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.
PATCH OVERVIEW
At a later date, additional HIPAA NCPDP patches will be released to
activate all of the HIPAA NCPDP functionality. Until that time, sites 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.
The specific functionality for this patch is listed below.
Overview of the Process:
The changes to Pharmacy Data Management are as follows:
1. DEA, SPECIAL HDLG field (#3) in the DRUG (#50) file.
The Healthcare Insurance Portability and Accountability Act National
Routine PSSDDUT2 was modified to accommodate the use of the letter 'E'
within the DEA, SPECIAL HDLG field (#3) of the DRUG file (#50).
Data Dictionary Changes in Outpatient Pharmacy:
1. For the DRUG file (#50), the DEA, SPECIAL HDLG (#3) field for the drug
will need to accommodate the use of the letter 'E' to indicate that a drug
is billable for ECME purposes. The routine dealing with the Help Text of
this field was modified to accommodate the inclusion of an 'E' within the
Council for Prescription Drug Programs (HIPAA NCPDP) initiative, whose
list of possible entries.
Associated NOISs:
=================
N/A
Test Sites:
===========
ultimate goal is to provide functionality allowing electronic transmission
NEW YORK HARBOR HCS
NORTH TEXAS HCS
ANN ARBOR, MI
BATTLE CREEK, MI
DETROIT, MI
IRON MOUNTAIN, MI
Routine Summary:
================
The second line now reads as follows:
of Outpatient Pharmacy (OP) prescription claims to payers and the receipt
<TAB>;;7.0;PHARMACY DATA MANAGEMENT;**[patch list]**; 9/30/97
CHECK^XTSUMBLD results:
Routine Before Patch After Patch Patch List
======= ============ =========== ==========
PSSDDUT2 16160245 16615950 3,21,61,81
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