$TXT Created by PII at URL          (KIDS) on Tuesday, 10/24/17 at 11:43
=============================================================================
Run Date: OCT 24, 2017                     Designation: IB*2*568
Package : IB - INTEGRATED BILLING             Priority: Mandatory
Version : 2                                     Status: Under Development
=============================================================================


Subject: HAPE FY16 REVENUE ENHANCEMENTS

Category: 
  - Routine
  - Other
  - Enhancement (Mandatory)

Description:
============

 IMPORTANT INSTALLATION NOTE:
 ----------------------------
 There are three patches associated with this project - PRCA*4.5*315,
 IB*2.0*568 and PSO*7.0*463. All three patches are to be installed as
 PackMan files.  There is no bundle.
  
  
 Description
 -----------
 The Chief Business Office (CBO) is requesting system enhancements to
 The Veterans Health Information Systems and Technology Architecture
 (VistA) Integrated Billing (IB), Accounts Receivable (AR), and 
 Outpatient Pharmacy (PSO) software modules.  
  
 The mission of the Department of Veterans Affairs (VA), Office of 
 Information & Technology (OI&T), is to provide benefits and services 
 to veterans of the United States Armed Forces. In meeting these 
 goals, OIT strives to provide high quality, effective, and efficient 
 Information Technology (IT) services to those responsible for 
 providing care to the veterans at the point-of-care, as well as 
 throughout all the points of the veterans' health care. The VA depends
 on Information Management/Information Technology (IM/IT) systems to 
 meet mission goals.
  
 The overall FY16 HAPE Revenue Enhancement project has been further 
 divided into three sub-projects:
  
 NSR #20150506
 The Revenue Eligibility Enhancements Project effort for the
 (CBO), bundles several NSRs with similar business needs into a single
 requirements document.  Successfully addressing the requirements contained
 within this document will enable the Department of Veterans Affairs (VA)
 to appropriately bill certain subsets of billable events by correcting,
 automating, or enhancing current Veterans Health Information Systems and
 Technology Architecture (VistA) systems.
  
 NSR #20150507
 The Revenue Operations Enhancements Project combines several NSRs, 
 as well. This effort enables the Department of Veterans Affairs (VA)
 to improve revenue operation functionality related to repayment plans, 
 late charge capture, bill suspension reasons, the billing of 
 deactivated providers, and the display of appeal rights and 
 responsibilities on the Veterans Beneficiary travel Bill of Collections
 form.  Implementation of the proposed enhancements will make a 
 significant positive impact on stakeholders and target users.
  
 NSR #20150505
 The Revenue Reporting Enhancements Project will enable the VA to 
 improve tracking and reporting of revenue, and will support revenue 
 reporting business rules and guidelines.
  
  
 IB*2.0*568 patch enhancements, pertinent to the above NSRs, include:
  
 1.) When generating the RNB (Reasons Not Billable) report, the 
 Integrated Billing system shall populate the charges for all types 
 of services provided. Charges will not be screened by any billable 
 criteria but will indicate the full amount as if the care was to be 
 billed.
  
 2.) The sub-option Claims Tracking Parameter Edit [IBT EDIT TRACKING 
 PARAMETERS], that currently has no key, will be locked with a new 
 Security Key called IB PARAMETER EDIT. 
  
 3.) The option MCCR Site Parameter Display/Edit [IBJ MCCR SITE 
 PARAMETERS], which is currently locked with the IB SUPERVISOR Security
 Key, will be instead locked with the new key.
  
 4.) The Integrated Billing system shall create claims tracking entries
 for previously unbilled Prosthetics/DME items when new billable 
 insurance is entered into the patient's insurance file.  
  
 5.) A new coverage limitation field shall be created in the insurance 
 file for Prosthetics.  Like the other existing coverage limitation 
 fields in the insurance file (Inpatient, Outpatient, Pharmacy etc.), 
 this field will have the following options:
        0=NOT COVERED
        1=COVERED
        2=CONDITIONAL COVERAGE
 Once selected, they will show in the patient insurance file as Yes, 
 No, or Conditional.
  
 6.) The system shall automatically assign an RNB [NO PROSTHETIC 
 COVERAGE (CV22)] for Prosthetics/DME items if the patient has no 
 coverage for Prosthetics in his/her insurance file.
  
 7.) The system shall have a new option to add Prosthetics items to 
 Manual and Nightly Claims Tracking. 
  
 8.) Users will be able to select Suspended Type from the menu to 
 display in the First Party Follow- Up [IBJD FOLLOW-UP FIRST PARTY] 
 report. 
  
 9.) First Party Follow-Up [IBJD FOLLOW-UP FIRST PARTY] report shall 
 be modified to incorporate reason for suspension.
  
 10.) A new warning message will print to the screen in the Enter/Edit 
 Billing Information option if an ATTENDING, REFERRING or RENDERING 
 Provider has a PERSON CLASS in the NEW PERSON file (#200) that was 
 expired at the time of the Date of Service.
  
 11.) On the Third Party Joint Inquiry screen, one (1) character space 
 shall be added to the "Type" field so that it will accommodate five 
 characters (a one-character classification indicator, a forward slash 
 (/), a one-character component indicator, a forward slash (/), and a 
 one-character care type) ("X/X/X").  If a bill contains prescriptions, 
 then an "R" shall be concatenated to the fifth character sub-type 
 position of the "Type" field. If a bill contains prosthetics, then a 
 "P" shall be concatenated to fifth character sub-type position of the 
 "Type" field. The "Type" field shall contain five (5) characters as 
 follows:
 1. "I" for Inpatient or "O" for Outpatient,
 2. "/" forward slash character
 3. "P" for Professional or "I" for Institutional
 4. "/" forward slash character
 5. "P" for Prosthetics or "R" for Prescriptions
  
 12.) Three new Third Party Insurance Rate Types shall be created in 
 the VistA IB Suite for the billers to choose from when billing for 
 encounters. They are as follows:
        HUMANITARIAN REIMB. INS. 
        DENTAL REIMB. INS.
        INELIGIBLE REIMB. INS.
  
 13.) Each of the new rate types above will have the 'Insurer' as the 
 responsible party.
  
 14.) Billers (revenue staff) should be able to identify any remaining 
 charges to the patient after the Third Party payments are received for 
 Emergency Humanitarian, Ineligible and Dental services so they can 
 accomplish balance billing. 
  
 Concurrent Development / Dependencies:
 --------------------------------------
 N/A
  
  
 Patch Components:
 -----------------
  
 Files & Fields Associated:
  
 File Name (Number)    Field Name (Number)     New/Modified/Deleted
 ------------------    -------------------     --------------------
 N/A
  
 Options Associated:
  
 Option Name                     Type          New/Modified/Deleted
 -----------                     ----          --------------------
 IB AUTO BILLER PARAMS
 IB EDIT SITE PARAMETERS
 IBJ MCCR SITE PARAMETERS
 IBT EDIT TRACKING PARAMETERS
 IBT SUP MANUALLY QUE ENCTRS
 IBT SUP MANUALLY QUE PRSTHTCS   ROUTINE       NEW
 IBT SUP MANUALLY QUE RX FILLS
 IBT SUPERVISORS MENU
  
 Protocols Associated:
  
 Protocol Name                                  New/Modified/Deleted
 -------------                                  --------------------
 N/A
  
 Security Keys Associated: 
  
 Security Key Name
 -----------------
 IB PARAMETER EDIT
  
 Templates Associated:
  
 Template Name                Type   File Name (Number)      New/Mod/Del
 -------------                ----   ------------------      -----------
 IBJT ACTIVE LIST             LIST                           NEW
 IBJT INACTIVE LIST           LIST                           NEW
  
 New Service Requests (NSRs):
 ----------------------------
 20150505 - Revenue Reporting Enhancements
 20150506 - Revenue Eligibility Enhancements
 20150507 - Revenue Operations Enhancements
  
  
 Patient Safety Issues (PSIs):
 ------------------------------
 N/A
  
  
 Remedy Ticket(s) & Overviews:
 -----------------------------
 N/A 
  
 Test Sites:
 ----------
 Durham VAMC
 Central Alabama VAMC 
  
 Software and Documentation Retrieval Instructions:
 ----------------------------------------------------
 Choose the PackMan message containing this patch. 
  
 Sites may retrieve documentation directly using Secure File Transfer 
 Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following
 OI Field Offices:
  
 Hines:           URL       
 Salt Lake City:  URL       
  
 Documentation can also be found on the VA Software Documentation 
 Library at:
 http://URL            /
  
 Title                                              File Name   FTP Mode
 -----------------------------------------------------------------------
 Integrated Billing User Guide                      ib_2_0_um.doc Binary
 Integrated Billing Technical Manual/Security Guide ib_2_0_tm.doc Binary
 Integrated Billing Deployment, Installation, 
      Back-Out, and Rollback Guide   
               FY16RevenueIBVIP_Deployment_Installation_Guide.doc Binary 
  
  
 Patch Installation:
  
 Pre/Post Installation Overview:
 -------------------------------
 The post installation routine, IBY568PO, is not automatically deleted
 as part of the installation process. You may delete it after
 installation if you desire.
  
 Pre-Installation Instructions:
 ------------------------------
 N/A
  
 Installation Instructions:
 --------------------------
 This process will install new and updated routines and other 
 components listed above. There is a post-install routine that will add 
 entries to a number of files.
  
 The patch will be released in conjunction with an Accounts Receivable
 patch, PRCA*4.5*315 and an Outpatient Pharmacy patch, PSO*7.0*463.
  
   ************************ NOTE ************************
   IF A USER IS ON THE SYSTEM AND USING THESE PROGRAMS 
   AN EDITED ERROR WILL OCCUR.  
   The patch should be installed when NO Outpatient 
   Pharmacy users are on the system.
   ******************************************************
  
  Installation will take less than 1 minute.
  
  Suggested time to install: non-peak requirement hours.
  
  
   1. Choose the PackMan message containing this patch.
     
   2. Choose the INSTALL/CHECK MESSAGE PackMan option.
   
   3. From the Kernel Installation & Distribution System menu, select
      the Installation menu.
   
   4. From this menu, you may select to use the following options
      (when prompted for INSTALL NAME, enter PRCA*4.5*315):
          a.  Verify Checksums in Transport Global - This option will 
              allow you to ensure the integrity of the routines that 
              are in the transport global.
          b.  Print Transport Global - This option will allow you to 
              view the components of the KID build.
          c.  Compare Transport Global to Current System - This option 
              will allow you to view all changes that will be made when 
              this patch is installed.  It compares all components of 
              this patch (routines, DD's, templates, etc.).
          d.  Backup a Transport Global - This option will create a 
              backup message of any routines exported with this patch. 
              It will not backup any other changes such as DD's or 
              templates.
    
   5. When prompted "Want KID to INHIBIT LOGONs during the install? 
      NO//"  respond NO.
    
   6. When prompted "Want to DISABLE Scheduled Options, Menu Options, 
      and Protocols? NO//" respond NO.
  
  
 Post-Installation Instructions:
 -------------------------------
 There are no special tasks to perform after this patch installation. 

Routine Information:
====================
The second line of each of these routines now looks like:
 ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 38

The checksums below are new checksums, and
 can be checked with CHECK1^XTSUMBLD.

Routine Name: IBCAPP
    Before: B21485583   After: B23176501  **432,447,568**
Routine Name: IBCBB11
    Before:B112052327   After:B125248678  **51,343,363,371,395,392,401,
                                           384,400,436,432,516,550,577,
                                           568**
Routine Name: IBCNSBL2
    Before: B33173974   After: B39619145  **52,80,153,240,432,568**
Routine Name: IBECEA
    Before: B10792926   After: B13522502  **199,135,568**
Routine Name: IBJDB21
    Before: B73370335   After:B127496258  **123,159,185,399,437,458,568**
Routine Name: IBJDF11
    Before: B29605847   After: B30038470  **69,80,118,128,204,205,227,
                                           451,530,554,568**
Routine Name: IBJDF2
    Before: B67800970   After: B68089735  **69,91,100,118,133,205,554,568**
Routine Name: IBJDF4
    Before: B27131031   After: B42361959  **123,204,220,568**
Routine Name: IBJDF41
    Before: B88827246   After:B103009700  **123,159,204,356,451,473,568**
Routine Name: IBJDF42
    Before: B53237550   After: B54815099  **123,204,568**
Routine Name: IBJDF43
    Before: B23469371   After: B25235431  **123,568**
Routine Name: IBJTLA1
    Before: B12051503   After: B13446872  **39,80,61,51,153,137,183,276,
                                           451,516,530,568**
Routine Name: IBJTLB1
    Before: B12752963   After: B13573050  **39,80,61,137,276,451,516,530,568**
Routine Name: IBTRE2
    Before: B32981505   After: B41197504  **23,121,249,312,315,568**
Routine Name: IBTRE20
    Before: B13573861   After: B20245141  **40,91,249,568**
Routine Name: IBTRKR5
    Before: B35067366   After: B39018549  **13,260,312,339,389,474,498,568**
Routine Name: IBY568PO
    Before:       n/a   After: B76610384  **568**
 
Routine list of preceding patches: 135, 220, 315, 447, 458, 473, 498, 554
                           577

=============================================================================
User Information:
Entered By  : PII                 Date Entered  : JUN 17, 2016
Completed By:                               Date Completed: 
Released By :                               Date Released : 
=============================================================================


