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1 | OSCIF MCCF EDI TAS_Sept2018.zip\Remaining Doc.zip | ib_2_0_p608_ig.docx | Wed Jun 6 14:25:46 2018 UTC |
2 | OSCIF MCCF EDI TAS_Sept2018.zip\Remaining Doc.zip | ib_2_0_p608_ig.docx | Mon Sep 10 18:53:58 2018 UTC |
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1 | Medical Ca re Collect ion Fund ( MCCF) Elec tronic Dat a Intercha nge (EDI) Transactio n Applicat ions Suite (TAS) eBi lling Buil d 5/6 | |
2 | Integrated Billing I B*2.0*608 | |
3 | Version 1. 0 | |
4 | Deployment , Installa tion, Back -Out, and Rollback G uide | |
5 | ||
6 | ||
7 | April 2018 | |
8 | Department of Vetera ns Affairs | |
9 | Office of Informatio n and Tech nology (OI &T) | |
10 | ||
11 | ||
12 | Revision H istory | |
13 | Date | |
14 | Version | |
15 | Descriptio n | |
16 | Author | |
17 | April 2018 | |
18 | 1.0 | |
19 | Initial Ve rsion | |
20 | PII | |
21 | ||
22 | ||
23 | ||
24 | ||
25 | ||
26 | ||
27 | ||
28 | ||
29 | ||
30 | ||
31 | ||
32 | ||
33 | ||
34 | Artifact R ationale | |
35 | This docum ent descri bes the De ployment, Installati on, Back-o ut, and Ro llback Pla n for new products g oing into the VA Ent erprise. T he plan in cludes inf ormation a bout syste m support, issue tra cking, esc alation pr ocesses, a nd roles a nd respons ibilities involved i n all thos e activiti es. Its pu rpose is t o provide clients, s takeholder s, and sup port perso nnel with a smooth t ransition to the new product o r software , and shou ld be stru ctured app ropriately , to refle ct particu lars of th ese proced ures at a single or at multipl e location s. | |
36 | Per the Ve teran-focu sed Integr ated Proce ss (VIP) G uide, the Deployment , Installa tion, Back -out, and Rollback P lan is req uired to b e complete d prior to Critical Decision P oint #2 (C D #2), wit h the expe ctation th at it will be update d througho ut the lif ecycle of the projec t for each build, as needed. | |
37 | ||
38 | ||
39 | ||
40 | ||
41 | Table of C ontents | |
42 | 1Introduct ion1 | |
43 | 1.1Purpose 1 | |
44 | 1.2Depende ncies1 | |
45 | 1.3Constra ints1 | |
46 | 2Roles and Responsib ilities1 | |
47 | 3Deploymen t2 | |
48 | 3.1Timelin e2 | |
49 | 3.2Site Re adiness As sessment2 | |
50 | 3.2.1Deplo yment Topo logy (Targ eted Archi tecture)2 | |
51 | 3.2.2Site Informatio n (Locatio ns, Deploy ment Recip ients)2 | |
52 | 3.2.3Site Preparatio n3 | |
53 | 3.3Resourc es3 | |
54 | 3.3.1Facil ity Specif ics3 | |
55 | 3.3.2Hardw are4 | |
56 | 3.3.3Softw are4 | |
57 | 3.3.4Commu nications4 | |
58 | 3.3.4.1Dep loyment/In stallation /Back-Out Checklist4 | |
59 | 4Installat ion5 | |
60 | 4.1Pre-ins tallation and System Requireme nts5 | |
61 | 4.2Platfor m Installa tion and P reparation 5 | |
62 | 4.3Downloa d and Extr act Files5 | |
63 | 4.4Databas e Creation 5 | |
64 | 4.5Install ation Scri pts5 | |
65 | 4.6Cron Sc ripts5 | |
66 | 4.7Access Requiremen ts and Ski lls Needed for the I nstallatio n5 | |
67 | 4.8Install ation Proc edure6 | |
68 | 4.9Install ation Veri fication P rocedure6 | |
69 | 4.10System Configura tion6 | |
70 | 4.11Databa se Tuning6 | |
71 | 5Back-Out Procedure6 | |
72 | 5.1Back-Ou t Strategy 6 | |
73 | 5.1.1Mirro r Testing or Site Pr oduction T esting6 | |
74 | 5.1.2After National Release bu t During t he Designa ted Suppor t Period7 | |
75 | 5.1.3After National Release an d Warranty Period7 | |
76 | 5.2Back-Ou t Consider ations7 | |
77 | 5.2.1Load Testing7 | |
78 | 5.2.2User Acceptance Testing7 | |
79 | 5.3Back-Ou t Criteria 9 | |
80 | 5.4Back-Ou t Risks9 | |
81 | 5.5Authori ty for Bac k-Out9 | |
82 | 5.6Back-Ou t Procedur e10 | |
83 | 5.7Back-ou t Verifica tion Proce dure10 | |
84 | 6Rollback Procedure1 0 | |
85 | 6.1Rollbac k Consider ations10 | |
86 | 6.2Rollbac k Criteria 10 | |
87 | 6.3Rollbac k Risks11 | |
88 | 6.4Authori ty for Rol lback11 | |
89 | 6.5Rollbac k Procedur e11 | |
90 | 6.6Rollbac k Verifica tion Proce dure11 | |
91 | ||
92 | Table of T ables | |
93 | Table 1: D eployment, Installat ion, Back- out, and R ollback Ro les and Re sponsibili ties1 | |
94 | Table 2: T EST Site P reparation 3 | |
95 | Table 3: S ite Prepar ation3 | |
96 | Table 4: F acility-Sp ecific Fea tures4 | |
97 | Table 5: H ardware Sp ecificatio ns4 | |
98 | Table 6: S oftware Sp ecificatio ns4 | |
99 | Table 7: D eployment/ Installati on/Back-Ou t Checklis t5 | |
100 | ||
101 | ||
102 | ||
103 | Introducti on | |
104 | This docum ent descri bes how to deploy an d install the patch IB*2.0*608 and how t o back-out the produ ct and rol lback to a previous version or data set. | |
105 | Purpose | |
106 | The purpos e of this plan is to provide a single, c ommon docu ment that describes how, when, where, an d to whom the IB*2.0 *608 will be deploye d and inst alled, as well as ho w it is to be backed out and r olled back , if neces sary. The plan ident ifies reso urces, com munication s plan, an d rollout schedule. Specific i nstruction s for inst allation, back-out, and rollba ck are inc luded in t his docume nt. | |
107 | Dependenci es | |
108 | IB*2.0*592 must be i nstalled b efore IB*2 .0*608. | |
109 | Constraint s | |
110 | This patch is intend ed for a f ully patch ed VistA s ystem. | |
111 | Roles and Responsibi lities | |
112 | Table 1: D eployment, Installat ion, Back- out, and R ollback Ro les and Re sponsibili ties | |
113 | ID | |
114 | Team | |
115 | Phase / Ro le | |
116 | Tasks | |
117 | Project Ph ase (See S chedule) | |
118 | 1 | |
119 | VA OI&T, V A OI&T Hea lth Produc t Support & PMO (Lei dos) | |
120 | Deployment | |
121 | Plan and s chedule de ployment ( including orchestrat ion with v endors) | |
122 | Planning | |
123 | 2 | |
124 | Local VAMC and CPAC processes | |
125 | ||
126 | ||
127 | Deployment | |
128 | Determine and docume nt the rol es and res ponsibilit ies of tho se involve d in the d eployment. | |
129 | Planning | |
130 | 3 | |
131 | Field Test ing (Initi al Operati ng Capabil ity - IOC) , Health P roduct Sup port Testi ng & VIP R elease Age nt Approva l | |
132 | Deployment | |
133 | Test for o perational readiness | |
134 | Testing | |
135 | 4 | |
136 | Health pro duct Suppo rt and Fie ld Operati ons | |
137 | Deployment | |
138 | Execute de ployment | |
139 | Deployment | |
140 | 5 | |
141 | Individual Veterans Administra tion Medic al Centers (VAMCs) | |
142 | Installati on | |
143 | Plan and s chedule in stallation | |
144 | Deployment | |
145 | 6 | |
146 | VIP Relea se Agent | |
147 | Installati on | |
148 | Ensure aut hority to operate an d that cer tificate a uthority s ecurity do cumentatio n is in pl ace | |
149 | Deployment | |
150 | 7 | |
151 | N/A for th is patch a s we are u sing only the existi ng VistA s ystem | |
152 | Installati on | |
153 | Validate t hrough fac ility POC to ensure that IT eq uipment ha s been acc epted usin g asset in ventory pr ocesses | |
154 | ||
155 | 8 | |
156 | VA’s eBusi ness team | |
157 | Installati ons | |
158 | Coordinate training | |
159 | Deployment | |
160 | 9 | |
161 | VIP releas e Agent, H ealth Prod uct Suppor t & the de velopment team | |
162 | Back-out | |
163 | Confirm av ailability of back-o ut instruc tions and back-out s trategy (w hat are th e criteria that trig ger a back -out) | |
164 | Deployment | |
165 | 10 | |
166 | No changes to curren t process – we are u sing the e xisting Vi stA system | |
167 | Post Deplo yment | |
168 | Hardware, Software a nd System Support | |
169 | Warranty | |
170 | Deployment | |
171 | The deploy ment is pl anned as a national rollout. | |
172 | This secti on provide s the sche dule and m ilestones for the de ployment. | |
173 | Timeline | |
174 | The durati on of depl oyment and installat ion is 30 days, as d epicted in the maste r deployme nt schedul e. | |
175 | Site Readi ness Asses sment | |
176 | This secti on discuss es the loc ations tha t will rec eive the I B*2.0*608 deployment . | |
177 | Deployment Topology (Targeted Architectu re) | |
178 | This patch IB*2.0*60 8 is to be nationall y released to all VA MCs. | |
179 | Site Infor mation (Lo cations, D eployment Recipients ) | |
180 | The test s ites for I OC testing are: | |
181 | ||
182 | TBD | |
183 | ||
184 | Upon natio nal releas e all VAMC s are expe cted to in stall this patch pri or to or o n the comp liance dat e. | |
185 | Site Prepa ration | |
186 | The follow ing table describes preparatio n required by the “T EST” site prior to d eployment. | |
187 | Table 2: T EST Site P reparation | |
188 | Site/Other | |
189 | Problem/Ch ange Neede d | |
190 | Features t o Adapt/Mo dify to Ne w Product | |
191 | Actions/St eps | |
192 | Owner | |
193 | TBD | |
194 | Testers ne ed to obta in access to the Tes t Environm ent(s) | |
195 | N/A | |
196 | Grant the assigned t esters the necessary access to the Test Environmen t(s) | |
197 | N/A | |
198 | TBD | |
199 | Testers ne ed to obta in access to the Te st Environ ments | |
200 | N/A | |
201 | Grant the assigned t esters the necessary access to the Test Environmen t(s) | |
202 | N/A | |
203 | TBD | |
204 | Testers ne ed to obta in access to the Te st Environ ments | |
205 | N/A | |
206 | Grant the assigned t esters the necessary access to the Test Environmen t(s) | |
207 | N/A | |
208 | ||
209 | The follow ing table describes preparatio n required by the si te prior t o deployme nt. | |
210 | Table 3: S ite Prepar ation | |
211 | Site/Other | |
212 | Problem/Ch ange Neede d | |
213 | Features t o Adapt/Mo dify to Ne w Product | |
214 | Actions/St eps | |
215 | Owner | |
216 | N/A | |
217 | N/A | |
218 | N/A | |
219 | N/A | |
220 | N/A | |
221 | Resources | |
222 | Facility S pecifics | |
223 | The follow ing table lists faci lity-speci fic featur es require d for depl oyment. | |
224 | Table 4: F acility-Sp ecific Fea tures | |
225 | Site | |
226 | Space/Room | |
227 | Features N eeded | |
228 | Other | |
229 | N/A | |
230 | N/A | |
231 | N/A | |
232 | N/A | |
233 | Hardware | |
234 | The follow ing table describes hardware s pecificati ons requir ed at each site prio r to deplo yment. | |
235 | Table 5: H ardware Sp ecificatio ns | |
236 | Required H ardware | |
237 | Model | |
238 | Version | |
239 | Configurat ion | |
240 | Manufactur er | |
241 | Other | |
242 | Existing V istA syste m | |
243 | N/A | |
244 | N/A | |
245 | N/A | |
246 | N/A | |
247 | N/A | |
248 | Please see the Roles and Respo nsibilitie s table in Section 2 for detai ls about w ho is resp onsible fo r preparin g the site to meet t hese hardw are specif ications. | |
249 | Software | |
250 | The follow ing table describes software s pecificati ons requir ed at each site prio r to deplo yment. | |
251 | Table 6: S oftware Sp ecificatio ns | |
252 | Required S oftware | |
253 | Make | |
254 | Version | |
255 | Configurat ion | |
256 | Manufactur er | |
257 | Other | |
258 | Fully patc hed Integr ated Billi ng package within Vi stA | |
259 | N/A | |
260 | 2.0 | |
261 | N/A | |
262 | N/A | |
263 | N/A | |
264 | IB*2.0*592 | |
265 | N/A | |
266 | Nationally released version | |
267 | N/A | |
268 | N/A | |
269 | N/A | |
270 | Please see the Roles and Respo nsibilitie s table in Section 2 above for details a bout who i s responsi ble for pr eparing th e site to meet these software specificat ions. | |
271 | Communicat ions | |
272 | The sites that are p articipati ng in fiel d testing (IOC) will use the “ Patch Trac king” mess age in Out look to co mmunicate with the e Billing eB usiness te am, the de velopers, and produc t support personnel. | |
273 | Deployment /Installat ion/Back-O ut Checkli st | |
274 | The Releas e Manageme nt team wi ll deploy the patch IB*2.0*608 , which is tracked n ationally for all VA MCs in the NPM in Fo rum. Forum automatic ally track s the patc hes as the y are inst alled in t he differe nt VAMC pr oduction s ystems. On e can run a report i n Forum to identify when the p atch was i nstalled i n the Vist A producti on at each site, and by whom. A report c an also be run, to i dentify wh ich sites have not c urrently i nstalled t he patch i n their Vi stA produc tion syste m. | |
275 | ||
276 | Therefore, this info rmation do es not nee d to be ma nually tra cked in th e chart be low. | |
277 | Table 7: D eployment/ Installati on/Back-Ou t Checklis t | |
278 | Activity | |
279 | Day | |
280 | Time | |
281 | Individual who compl eted task | |
282 | Deploy | |
283 | N/A | |
284 | N/A | |
285 | N/A | |
286 | Install | |
287 | N/A | |
288 | N/A | |
289 | N/A | |
290 | ||
291 | Installati on | |
292 | Pre-instal lation and System Re quirements | |
293 | IB*2.0*608 , a patch to the exi sting Vist A Integrat ed Billing 2.0 packa ge, is ins tallable o n a fully patched M( UMPS) Vist A system a nd operate s on the t op of the VistA envi ronment pr ovided by the VistA infrastruc ture packa ges. The l atter prov ides utili ties which communica te with th e underlyi ng operati ng system and hardwa re, thereb y providin g Integrat ed Billing independe nce from v ariations in hardwar e and oper ating syst em. | |
294 | Platform I nstallatio n and Prep aration | |
295 | Refer to t he IB*2.0* 608 docume ntation on the Natio nal Patch Module (NP M) in Foru m for the detailed i nstallatio n instruct ions. Thes e instruct ions would include a ny pre-ins tallation steps if a pplicable. | |
296 | Download a nd Extract Files | |
297 | Refer to t he IB*2.0* 608 docume ntation on the NPM t o find rel ated docum entation t hat can be downloade d. IB*2.0* 608 will b e transmit ted via a PackMan me ssage and can be pul led from t he NPM. It is not a host file, and there fore does not need t o be downl oaded sepa rately. | |
298 | Database C reation | |
299 | IB*2.0*608 modifies the VistA database. All change s can be f ound on th e NPM docu mentation for this p atch. | |
300 | Installati on Scripts | |
301 | No install ation scri pts are ne eded for I B*2.0*608 installati on. | |
302 | Cron Scrip ts | |
303 | No Cron sc ripts are needed for IB*2.0*60 8 installa tion. | |
304 | Access Req uirements and Skills Needed fo r the Inst allation | |
305 | The follow ing staff will need access to the PackMa n message containing the IB*2. 0*608 patc h or to Fo rum’s NPM for downlo ading the nationally released IB*2.0*608 patch. Th e software is to be installed by the sit e’s or reg ion’s desi gnated: VA OI&T IT O PERATIONS SERVICE, E nterprise Service Li nes, Vista Applicati ons Divisi on. | |
306 | Installati on Procedu re | |
307 | Refer to t he IB*2.0* 608 docume ntation on the NPM f or detaile d installa tion instr uctions. | |
308 | Installati on Verific ation Proc edure | |
309 | Refer to t he IB*2.0* 608 docume ntation on the NPM f or specifi c and deta iled insta llation in structions . These in structions include a ny post in stallation steps if applicable . The post installat ion routin e will acc omplish th e followin g: | |
310 | ||
311 | The Post-i nstall (IB Y608PO) wi ll automat ically gen erate the one-time I nsurance C ompany EDI Parameter Report an d send an email to t he eBiz Ra pid Respon se Group, (“ PII ”). This repor t will lis t all of t he insuran ce compani es that ha ve the cur rent setti ng for the Transmit Electronic ally param eter set t o ZERO whi ch equals 'NO'. | |
312 | System Con figuration | |
313 | No system configurat ion change s are requ ired for t his patch. | |
314 | Database T uning | |
315 | No reconfi guration o f the Vist A database , memory a llocations or other resources is necessa ry. | |
316 | Back-Out P rocedure | |
317 | Back-Out p ertains to a return to the las t known go od operati onal state of the so ftware and appropria te platfor m settings . | |
318 | Back-Out S trategy | |
319 | Although i t is unlik ely due to care in c ollecting, elaborati ng, and de signing ap proved use r stories, followed by multipl e testing stages (De veloper Un it Testing , Componen t Integrat ion Testin g, SQA Tes ting, and User Accep tance Test ing), a ba ck-out dec ision due to major i ssues with this patc h could oc cur. A dec ision to b ack out co uld be mad e during s ite Mirror Testing, Site Produ ction Test ing or aft er Nationa l Release to the fie ld (VAMCs) . The best strategy decision i s dependen t on the s tage of te sting duri ng which t he decisio n is made. | |
320 | Mirror Tes ting or Si te Product ion Testin g | |
321 | If during Mirror tes ting or Si te Product ion Testin g, a new v ersion of a defect c orrecting test patch is produc ed, retest ed and suc cessfully passes dev elopment t eam testin g, it will be resubm itted to t he site fo r testing. If the pa tch produc es catastr ophic prob lems, a ne w version of the pat ch can be used to re store the build comp onents to their pre- patch cond ition. | |
322 | After Nati onal Relea se but Dur ing the De signated S upport Per iod | |
323 | If the def ect(s) wer e not disc overed unt il after n ational re lease but during the designate d support period, a new patch will be en tered into the Natio nal Patch Module in Forum and will go th rough all the necess ary milest one review s etc., as a patch f or a patch . It is up to VA OI& T and prod uct suppor t whether this new p atch would be define d as an em ergency pa tch or not . This new patch cou ld be used to addres s specific issues pe rtaining t o the orig inal patch or be use d to resto re the bui ld compone nts to the ir origina l pre-patc h conditio n. | |
324 | After Nati onal Relea se and War ranty Peri od | |
325 | After the support pe riod, the VistA Main tenance Pr ogram woul d produce the new pa tch, eithe r to corre ct the def ective com ponents or restore t he build c omponents to their o riginal pr e-patch co ndition. | |
326 | Back-Out C onsiderati ons | |
327 | It is nece ssary to d etermine i f a wholes ale back-o ut of the patch IB*2 .0*608 is needed or if a bette r course o f action i s needed t o correct through a new versio n of the p atch (if p rior to na tional rel ease) or a subsequen t patch ai med at spe cific area s modified or affect ed by the original p atch (afte r national release). A wholesa le back-ou t of the p atch will still requ ire a new version (i f prior to national release) o r a subseq uent patch (after na tional rel ease). If the back-o ut is post -release o f patch IB *2.0*608, this patch should be assigned status of “Entered i n Error” i n Forum’s NPM. | |
328 | Load Testi ng | |
329 | N/A. The b ack-out pr ocess woul d be execu ted at nor mal, rathe r than rai sed job pr iority, an d is expec ted to hav e no signi ficant eff ect on tot al system performanc e. Subsequ ent to the reversion , the perf ormance de mands on t he system would be u nchanged. | |
330 | User Accep tance Test ing | |
331 | CMN Oxygen and EPN N utrition: | |
332 | The Enter/ Edit Billi ng Informa tion [IB E DIT BILLIN G INFO] op tion – The System sh ould condi tionally p rompt the user for t he need on a CMN for m for a pr ocedure, b ased upon those CPTs that are entered in to the new “CMN CPT CODE INCLU SIONS” sit e paramete r. | |
333 | The Enter/ Edit Billi ng Informa tion [IB E DIT BILLIN G INFO] op tion – The System sh ould promp t the user for the t ype of CMN form when a biller indicates a need for a CMN for m (Only 48 4.3 and 10 126 will b e availabl e at this time). | |
334 | The Enter/ Edit Billi ng Informa tion [IB E DIT BILLIN G INFO] op tion – The System sh ould promp t the user for the d ata elemen ts require d to compl ete the ty pe of CMN form selec ted. | |
335 | Transmit 8 37-P Trans action – T he System should inc lude the C MN related data elem ents in th e outbound Professio nal 837 tr ansaction. | |
336 | ||
337 | Transmitti ng SNF Cla ims with A ppropriate Revenue C odes: | |
338 | The user s hould be a ble to cre ate and tr ansmit a S killed Nur sing Facil ity (SNF) Institutio nal claim for Medica re as a pr imary paye r. | |
339 | The System should au tomaticall y add the new 2400 l oop(s) and related s egments to the flat file (This should no t involve the user; there shou ld be no c hange for the user). | |
340 | The flat f ile transm ission fro m VistA to FSC shoul d contain Health Ins urance Pro spective P ayment Sys tem (HIPPS ) Skilled Nursing Fa cility Rat e Code inf ormation i n the 2400 Loop segm ent SV202- 1. | |
341 | The user s hould be a ble to see the HP in formation in the Vie w/Print ED I Bill Ext ract Data [IBCE EDI VIEW/PRINT EXTRACT] (VPE) opti on under t he INS rec ord ID. | |
342 | The Claim should be able to pa ss the val idator at the Financ ial Servic e Center ( FSC). | |
343 | The Claim should be able to pr ocess at M edicare wi th the rec eipt of an electroni c MRA back into the facilities VistA acc ount. | |
344 | ||
345 | Add T for Transmitte d to RCB S creen: | |
346 | The user s hould be a ble select the optio n RCB (Vie w/Resubmit Claims - Live or Te st [IBCE P REV TRANSM ITTED CLAI MS]) to ge nerate a l ist of pre viously pr inted clai ms for a s pecified d ate range. | |
347 | The System should sh ow “** T = Test Clai m” in the legend at the top of the displ ayed scree n. | |
348 | ||
349 | Remove Abi lity to De fine Insur ance Compa ny as non- EDI: | |
350 | The user s hould be a ble to sel ect the op tion EI - "Insuranc e Company Entry/Edit " [IBCN IN SURANCE CO EDIT] to update the Billing/E DI Paramet ers. | |
351 | The availa ble answer s for the EDI - Tran smit?: pro mpt should be:YES-LI VEYES-TEST (the choi ce NO shou ld no long er be avai lable) | |
352 | The existi ng HELP Te xt should display: “ This field determine s whether an electro nic claim to this in surance Co mpany is s ent as a t est or a p roduction claim.” | |
353 | When the I B*2.0*608 patch is i nstalled a t a site, a report s hould be g enerated a nd sent to the eBiz Rapid Resp onse group ( PII ). | |
354 | The report should co ntain the Site Name, Site ID, Date of Re port, the Insurance Company Na me, the In surance Co mpany Addr ess, the c urrent set ting for t he Transmi t Electron ically fie ld (#3.01) in Insura nce Compan y file (#3 6) for tho se payers that have the Transm it Electro nically fi eld set to NO. | |
355 | ||
356 | RCB View/R esubmit Cl aims - Liv e or Test [IBCE PREV TRANSMITT ED CLAIMS] Screen – Match COB Data to Pa yer Sequen ce: | |
357 | The user s hould be a ble to sel ect the "V iew/Resubm it Claims - Live or Test" [IBC E PREV TRA NSMITTED C LAIMS] (RC B) option. | |
358 | The user s hould be a ble to sel ect one or more clai m entries for resubm ission to the Test q ueue. | |
359 | If the use r selects a Primary claim to r esubmit an d the clai m has rece ived an EO B/MRA from the prima ry payer, VistA shou ld not sen d the COB data from the EOB/MR A and the amount bil led should not be of fset by pr evious pay ments from the prima ry payer. | |
360 | If the use r selects a Secondar y claim to resubmit and the cl aim has re ceived an EOB/MRA fr om the sec ondary pay er, VistA should not send the COB data f rom the EO B/MRA and the amount billed sh ould not b e offset b y previous payments from the s econdary p ayer. | |
361 | If the use r selects a Tertiary claim to resubmit a nd the cla im has rec eived an E OB/MRA fro m the tert iary payer , VistA sh ould not s end the CO B data fro m the EOB/ MRA and th e amount b illed shou ld not be offset by previous p ayments fr om the ter tiary paye r. | |
362 | If the use r attempts to resubm it a claim (s) with E OB data in VistA to the Produc tion queue , the syst em should filter out and displ ay the cla im number( s) and not transmit it/them. | |
363 | ||
364 | Non-MCCF U nbilled Am ounts Repo rt: | |
365 | The user s hould be a ble to sel ect the "R e-Generate Unbilled Amounts Re port" [IBT RE-GEN UN BILLED REP ORT] optio n. | |
366 | The Integr ated Billi ng softwar e should p rovide the ability f or the use r to speci fy the fol lowing add itional se arch crite ria when r e-generati ng the Unb illed Amou nts Report and not s aving the results: | |
367 | CPAC Claim s Only | |
368 | Non-CPAC C laims (CHA MPVA/TRICA RE/INTERAG ENCY/INELI GIBLE) | |
369 | Both | |
370 | CHAMPVA sh ould inclu de the Rat e Types eq ual to “CH AMPVA” and “CHAMPVA REIMB. INS ”. | |
371 | TRICARE sh ould inclu de the Rat e Types eq ual to “TR ICARE” and “TRICARE REIMB. INS ”. | |
372 | ||
373 | Non-MCCF P ay-To Addr ess Rate T ypes: | |
374 | The Integr ated Billi ng softwar e should p rovide the ability f or an auth orized use r with acc ess to the IB Site P arameters and the TR ICARE Pay- to securit y key, to add a Rate Type for which clai ms with th at Rate Ty pe will us e the non- MCCF Pay-T o Address data. | |
375 | The Integr ated Billi ng softwar e should p rovide the ability f or an auth orized use r with acc ess to the IB Site P arameters and the TR ICARE Pay- to securit y key, to delete a R ate Type f or which c laims with that Rate Type will use the n on-MCCF Pa y-To Addre ss data. | |
376 | The Integr ated Billi ng softwar e should u se the non -MCCF Pay- To Address data on c laims with specified Rate Type s only whe n the non- MCCF Pay-T o Address is not exa ctly the s ame as the Billing P rovider Na me and Add ress. | |
377 | The Integr ated Billi ng softwar e should t ransmit th e TRICARE Pay-To Add ress data on claims with speci fied Rate Types in t he 837-I, 837-P or 8 37-D when the non-MC CF Pay-To Address is not exact ly the sam e as the B illing Pro vider Name and Addre ss. | |
378 | The Integr ated Billi ng softwar e should p rint the n on-MCCF Pa y-To Addre ss data on Instituti onal claim s with spe cified Rat e Types on the UB04 form (FL2) when the TRICARE Pa y-To Addre ss is not exactly th e same as the Billin g Provider Name and Address. | |
379 | The Integr ated Billi ng softwar e should p rint the n on-MCCF Pa y-To Addre ss data on Professio nal claims with spec ified Rate Types on the CMS 15 00 form (B ox 33) whe n the non- MCCF Pay-T o Address is not exa ctly the s ame as the Billing P rovider Na me and Add ress. | |
380 | ||
381 | Remove Fat al Error – Rendering Provider CMS 1500: | |
382 | The Integr ated Billi ng softwar e should n o longer r equire a R endering P rovider on Professio nal claims . | |
383 | The Integr ated Billi ng softwar e should d isplay a n on-fatal w arning mes sage to th e user whe n a Profes sional cla im does no t contain a Renderin g Provider . | |
384 | Back-Out C riteria | |
385 | The projec t is cance led, the r equested c hanges imp lemented b y IB*2.0*6 08 are no longer des ired by VA OI&T and the Integr ated Billi ng eBusine ss team, o r the patc h produces catastrop hic proble ms. | |
386 | Back-Out R isks | |
387 | Since the eBilling s oftware is tightly i ntegrated with exter nal system s, any att empt at a back-out s hould incl ude close consultati on with th e external trading p artners su ch as the Financial Services C enter (FSC ) and the Health Car e Clearing House (HC CH) to det ermine ris k. | |
388 | Authority for Back-O ut | |
389 | The order would come from: rel ease coord inator (pr oduct supp ort), port folio dire ctor and h ealth prod uct suppor t. This sh ould be do ne in cons ultation w ith the de velopment team and e xternal tr ading part ners such as FSC and the HCCH to determi ne the app ropriate c ourse of a ction. eBi lling is t ightly int egrated wi th these e xternal pa rtners and a back-ou t of the p atch shoul d not be a standalon e decision . | |
390 | Back-Out P rocedure | |
391 | The back-o ut procedu re for Vis tA applica tions is c omplex and not a “on e size fit s all” sol ution. The general s trategy fo r a VistA back-out i s to repai r the code with a fo llow-up pa tch. The d evelopment team reco mmends tha t sites lo g a ticket if it is a national ly release d patch. I f not, the site shou ld contact the Enter prise Prog ram Manage ment Offic e (EPMO) t eam direct ly for spe cific solu tions to t heir uniqu e problems . | |
392 | ||
393 | The IB*2.0 *608 patch contains the follow ing build components . | |
394 | Routines | |
395 | Protocols | |
396 | Modificati ons to the following files: | |
397 | Insurance File [#36] | |
398 | IB Error F ile [#350. 8] | |
399 | IB Site Pa rameters F ile [#350. 9] | |
400 | IB Data El ement Defi nition Fil e [#364.5] | |
401 | IB Form Sk eleton Def inition Fi le [#364.6 ] | |
402 | IB Form Fi eld Conten t File [#3 64.7] | |
403 | Bill/Claim s File [#3 99] | |
404 | Data Dicti onary Chan ges | |
405 | Modificati ons to Tem plates: | |
406 | Input Temp lates | |
407 | List Templ ates | |
408 | ||
409 | While the VistA inst allation p rocedure o f the KIDS build all ows the in staller to back up t he modifie d routines using the ‘Backup a Transport Global’ a ction, the back-out procedure for global , data dic tionary an d other Vi stA compon ents is mo re complex and requi res issuan ce of a fo llow-up pa tch to ens ure all co mponents a re properl y removed and/or res tored. All software components (routines and other items) mu st be rest ored to th eir previo us state a t the same time and in conjunc tion with the restor ation of t he data. | |
410 | ||
411 | Please con tact the E PMO team f or assista nce since this insta lled patch contains components in additi on to rout ines. | |
412 | Back-out V erificatio n Procedur e | |
413 | Successful back-out is confirm ed by veri fication t hat the ba ck-out pat ch was suc cessfully installed. | |
414 | Rollback P rocedure | |
415 | Rollback p ertains to data. The only data changes i n this pat ch are spe cific to t he operati onal softw are and pl atform set tings. The se data ch anges are covered in the Back- out proced ures detai led elsewh ere in thi s document . | |
416 | Rollback C onsiderati ons | |
417 | Not applic able. | |
418 | Rollback C riteria | |
419 | Not applic able. | |
420 | Rollback R isks | |
421 | Not applic able. | |
422 | Authority for Rollba ck | |
423 | Not applic able. | |
424 | Rollback P rocedure | |
425 | Not applic able. | |
426 | Rollback V erificatio n Procedur e | |
427 | Not applic able. |
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