| DESCRIPTION OF ENHANCEMENTS |
The Healthcare Insurance Portability and Accountability Act National
The first release of this two part implementation is BPS*1*0, comprised of
the new Electronic Claims Management Engine (ECME) package (in the BPS
namespace), plus the patches PSS*1*81, IB*2.0*223, IB*2.0*251, and
PRCA*4.5*202, which are listed here in order of installation. BPS*1*0 is a
dormant release that only allows each site to perform preliminary setup
work and to confirm that the software does not adversely affect other
packages.
This is the IB*2.0*251 patch and it provides modified and new components
Council for Prescription Drug Programs (HIPAA NCPDP) initiative, whose
associated with the following specific requirements:
* Send Interface Version Number in e-IIV Registration Message.
* Update Pharmacy Benefits Manager (PBM) Table
* Update NCPDP Processor Table
* Update Payer Table
* Update Plan Table
* Update Pharmacy Plan Table
* Provide Pharmacy Plan NCPDP Claim Submission Status and Information via
Callable Routine
* Display Pharmacy Plan Information Based on User Selected Sort Criteria
ultimate goal is to provide functionality allowing electronic transmission
* Display Qualified Group Plans to Help Link Pharmacy Plan to Group
Insurance Plan
* Link Pharmacy Plan to Group Insurance Plan
* Link Pharmacy Plan to Multiple Group Insurance Plan
* Link Test Payer Sheet to Pharmacy Plan
* Edit Pharmacy Benefits Manager (PBM) Local Active Flag
* Edit NCPDP Processor Local Active Flag
* Edit Payer Local Active Flag
* Edit Plan / Pharmacy Plan Local Active Flag
* Edit HIPAA NCPDP Flag
of Outpatient Pharmacy (OP) prescription claims to payers and the receipt
* Store and Track Banking Identification Numbers (BIN) and Processing
Control Numbers (PCN) From Patient Insurance Cards
The Vitria Interface Engine (IE) BusinessWare product will be utilized in
this project. The IE will provide:
* HL7 message routing tables for directing incoming and outgoing VistA
HL7 messages
* HL7 message translation mechanisms for handling various versions of
VistA compatible HL7 messages
* HL7 message error handling capability
of claim responses (including drug utilization review responses and
* Data mapping utility
warnings) on a real-time basis, is being developed and introduced in a
phased implementation strategy. This deployment strategy was utilized due
to the complexity of the functionality and the number of product line
dependencies.
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