| DESCRIPTION OF ENHANCEMENTS |
PATCH OVERVIEW
introduced in a phased implementation strategy. This deployment strategy
Is this prescription number - 123456? No//
Is this ECME Rx reference number - 123456? No//
Technical Description
----------------------
The patch modifies the procedure PNORBILL^RCDPURED, which is called from
the Data Dictionary of the file #344 (sub-file #344.01). It calls the IB
procedure REC^IBRFN, which was also modified by this project (patch
IB*2.0*223) to support ECME Numbers.
was utilized due to the complexity of the functionality and the number of
To provide a more clear users interface, the IB procedure REC^IBRFN will
be returning a flag - the second formal parameter by reference,
indicating, how the users input was recognized: Tricare Authorization
Number, Prescription Number, or the ECME Number. The consequent users
prompt will indicate that.
Routine RCDPESR1 modifies the EDI LockBox AR functionality to
add capability of matching ECME number to IB bill automatically.
product line dependencies.
ROUTINES SENT WITH PATCH
------------------------
The following is a list of the routines included in this patch.
The second line of each of these routines now looks like:
;;4.5;Accounts Receivable;**[patch list]**;Mar 20, 1995
CHECK^XTSUMBLD results
Routine Before Patch After Patch Patch List
------- ------------ ----------- ----------
PRCASVC3 1629668 1748043 158,202
RCDPESR1 13660919 14225614 173,214,208,202
RCDPURED 8549824 9425617 114,169,174,196,202
Total number of routines - 3
DATA DICTIONARIES SUMMARY
-------------------------
The first release of this two part implementation is BPS*1*0, comprised
The following is a list of the DD changes included in this patch.
File # Field # Name
---------- ------- ------------------------------
344 AR BATCH PAYMENT
344.01 TRANSACTION (sub-file)
.09 PATIENT NAME OR BILL NUMBER
Total number of modified files - 1
of the new Electronic Claims Management Engine (ECME) package (in the BPS
SOFTWARE AND DOCUMENTATION RETRIEVAL
====================================
The software for this patch is being distributed in host file
BPS_1_0.KID. The host file will contain seven KIDS builds.
The builds contained in the BPS 1.0 multi-package distribution are:
Package Patches
------- ----------------------
namespace), plus the patches PSS*1*81, IB*2.0*223, IB*2.0*251, and
ECME BPS*1.0*1
Pharmacy Data Management PSS*1.0*81
Integrated Billing IB*2.0*223, IB*2.0*251
Accounts Receivable PRCA*4.5*202
INSTALLATION INSTRUCTIONS
==========================
1. Use VA FileMan to add the new domain, EPHARMACY.VITRIA-EDI.AAC.DOMAIN.EXT,
PRCA*4.5*202, which are listed here in order of installation. BPS*1*0 is
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.
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
a dormant release that only allows each site to perform preliminary setup
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, 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
work and to confirm that the software does not adversely affect other
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:
(When prompted for INSTALL NAME, enter BPS 1.0)
---------------
packages.
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, 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.
11. When prompted, "Want KIDS to Rebuild Menu Trees Upon Completion of
Install? YES//" respond NO.
There are two main areas addressed by BPS*1*0:
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
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.
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 MATCH GROUP
PLANS WITH PHARMACY PLANS 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.
At a later date, additional HIPAA NCPDP patches will be released to
activate all of the HIPAA NCPDP functionality. Until that time, sites
The Healthcare Insurance Portability and Accountability Act National
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.
Council for Prescription Drug Programs (HIPAA NCPDP) initiative, whose
The specific functionality for this patch is listed below.
Functional Description
-----------------------
The patch PRCA*4.5*202 represents the Accounts Receivable portion of the
NCPDP-Pharmacy Connection project. It modifies the EDI Lockbox
functionality by adding the ability to manually process EOB related to
NCPDP claims.
ultimate goal is to provide functionality allowing electronic
The patch modifies Accounts Receivable (AR) users interface to make it
possible to select bills by entering NCPDP Prescription/Service Reference
Numbers.
When working with "Receipt Processing" [RCDP RECEIPT PROCESSING] and
"Link Payment to Account" [RCDP LINK PAYMENT TO ACCOUNT] menu options,
users normally enter the Bill Number or the Patient Name corresponding to
the processed payment.
transmission of Outpatient Pharmacy (OP) prescription claims to payers
The users prompt to that input is:
PATIENT NAME OR BILL NUMBER:
Although the prompt is asking for a Patient Name or a Bill Number,
there are some other types of data that may be entered to identify
the corresponding bill. Previously the choices were:
- Tricare Authorization Number;
- Prescription Number.
and the receipt of claim responses (including drug utilization review
This patch adds one more type of data that can be entered to identify a
Bill. The "ECME Number", the Prescription/Service Reference Number,
indicated in the NCPDP Electronic Claim, can now be entered to identify
the bill.
The help text for the above user's prompt has been modified to provide
a better explanation of the expected input:
PATIENT NAME OR BILL NUMBER: ?
responses and warnings) on a real-time basis, is being developed and
Enter one of following: Patient Name, Bill No, Tricare Authorization
No,
ECME Rx Reference Number or Prescription Number.
PATIENT NAME OR BILL NUMBER:
If the users input is not a Bill Number and not a Patient Name, and is
recognized as a Tricare Authorization Number, Prescription Number or a
ECME Number, the subsequent user's prompt will be respectively:
Is this TRICARE reference number - 123456? No//
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