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Patch Subject: MCCF EDI TAS EBILLING BUILD 3/4 DENTAL
Description:
============
Important Note: In production, there is one **MANDATORY**
pre-installation activity associated with this install.
The Integrated Billing (IB) Staff MUST empty the 837 extract/transmission
queue PRIOR to the installation of this patch.
Please reference instructions from the Pre/Post Installation Overview for
further details.
IB is a software module within Veterans Health
Information Systems and Technology Architecture (VistA) that provides
the ability for billing personnel to submit claims in either a paper or
electronic format to third-party payers.
The following features of the IB software will be affected by this
patch:
* Dental Claims
The IB package currently has the ability to send proprietary
professional and institutional medical claims to the Financial
Services Center (FSC). These claims contain data that is used by FSC
to create compliant X12N/005010X222 Health Care Claim (837P) and
X12N/005010X223 Health Care Claim (837I) transactions. This patch
enhances the IB package to create proprietary 837 dental claims with
the data necessary to send FSC a transaction it can map to a
X12N/005010X224 Health Care Claim (837D) when a user authorizes a
dental claim. Dental claims will only be Transmitted electronically
and cannot be printed at this time. This enhancement touched all
aspects of the claims billing process.
* Two minor prior defects were also addressed as part of this patch.
The first occurred when a claim was on both the CSA - Claims Status
Awaiting Resolution [IBCE CLAIMS STATUS AWAITING] and the CBW - COB
Management Worklist [IBCE COB MANAGEMENT] worklists. If a biller
tried to address on the CSA first, an error message would display and
the user session would unexpectedly end.
The second error occurred when a user selected Print MRA from the CBW
but entered "^" instead of selecting a claim. The option abruptly
ended and has been changed to instead gracefully exit.
Patch Components
================
Files & Fields Associated:
File Name (#) New/Modified/
Sub-file Name (#) Field Name (Number) Deleted
------------------- --------------------------------- -------------
INSURANCE COMPANY (#36)
CLAIMS (DENTAL) STREET ADDR 1 New
(#.191)
CLAIMS (DENTAL) PHONE NUMBER New
(#.1911)
CLAIMS (DENTAL) STREET ADDR 2 New
(#.192)
BLANK (#.193) New
CLAIMS (DENTAL) PROCESS CITY New
(#.194)
CLAIMS (DENTAL) PROCESS STATE New
(#.195)
CLAIMS (DENTAL) PROCESS ZIP (#.196) New
CLAIMS (DENTAL) COMPANY NAME New
(#.197)
ANOTHER CO. PROC DENT CLAIMS? New
(#.198)
CLAIMS (DENTAL) FAX (#.199) New
EDI ID NUMBER - DENTAL (#3.15) New
277EDI ID NUMBER sub-file (#36.017)
277EDI TYPE (#.03) Modified
IB ERROR (#350.8) New Entries
IB SITE PARAMETERS (#350.9)
MULTIPLE FORM TYPES (#1.22) Modified
DENTAL ENABLED? (#8.2) New
BILL FORM TYPE (#353) New Entry
Screen: I Y=7
TYPE OF SERVICE (#353.2) New Entries
IB ATTACHMENT REPORT TYPE (#353.3) New Entry
EDI TRANSMISSION BATCH (#364.1)
BILL TYPE (#.06) Modified
IB EDI TRANSMISSION RULE (#364.4)
FORM TYPE (#.05) Modified
IB DATA ELEMENT DEFINITION (#364.5) New/Modified
Screen: I $$INCLUDE^IBY592PR(5,Y) Entries
IB FORM SKELETON DEFINITION (#364.6) New/Modified
Screen: I $$INCLUDE^IBY592PR(6,Y) Entries
IB FORM FIELD CONTENT (#364.7) New/Modified
Screen: I $$INCLUDE^IBY592PR(7,Y) Entries
BILL/CLAIMS (#399)
FORM TYPE (#.19) Modified
BANDING DATE (#92) New
TREATMENT MONTHS COUNT (#93) New
TREATMENT MONTHS REMAINING (#94) New
TREATMENT INDICATOR (#95) New
DENTAL CLAIM NOTE (#97) New
ATTACHMENT REPORT TYPE (#285) Modified
PROVIDER sub-file (#399.0222)
FUNCTION (#.01) Modified
PROCEDURES sub-file (#399.0304)
ORAL CAVITY DESIGNATION (1) New
(#90.01)
ORAL CAVITY DESIGNATION (2) New
(#90.02)
ORAL CAVITY DESIGNATION (3) New
(#90.03)
ORAL CAVITY DESIGNATION (4) New
(#90.04)
ORAL CAVITY DESIGNATION (5) New
(#90.05)
PROSTHESIS/CROWN/INLAY CODE New
(#90.06)
PRIOR PLACEMENT DATE QUALIFIER New
(#90.07)
PRIOR PLACEMENT DATE (#90.08) New
ORTHODONTIC BANDING DATE (#90.09) New
ORTHO BANDING REPLACEMENT DATE New
(#90.1)
TREATMENT START DATE (#90.11) New
TREATMENT COMPLETION DATE (#90.12) New
LINE PROVIDER sub-file (#399.0404)
LINE FUNCTION (#.01) Modified
OCCURRENCE CODE sub-file (#399.041)
OCCURRENCE CODE (#.01) Modified
TOOTH NUMBER sub-file (#399.096) New
TOOTH INFORMATION sub-file (#399.30491) New
TOOTH CODE (#.01) New
TOOTH SURFACE (1) (#.02) New
TOOTH SURFACE (2) (#.03) New
TOOTH SURFACE (3) (#.04) New
TOOTH SURFACE (4) (#.05) New
TOOTH SURFACE (5) (#.06) New
DENTAL TREATMENT PLAN ENTRY (#.07) New
Bulletins Associated:
New/Modified/
Bulletin Name Deleted
------------- -------------
N/A
Dialogs Associated:
New/Modified/
Dialog Name Deleted
----------- -------------
N/A
Forms Associated:
New/Modified/
Form Name File Name (Number) Deleted
--------- ------------------ -------------
N/A
Functions Associated:
New/Modified/
Function Name Deleted
------------- -------------
N/A
HL Logical Link:
New/Modified/
HL Logical Name Deleted
--------------- -------------
N/A
HL7 Application Parameters:
New/Modified/
HL7 Parameter Name Deleted
------------------ -------------
N/A
HLO Application Registry:
New/Modified/
HLO Registry Name Deleted
----------------- -------------
N/A
Help Frames Associated:
New/Modified/
Help Frame Name Deleted
--------------- -------------
N/A
Mail Groups Associated:
New/Modified/
Mail Group Name Deleted
--------------- -------------
N/A
Options Associated:
New/Modified/
Option Name Type Deleted
----------- ---- -------------
N/A
Parameter Definitions:
New/Modified/
Parameter Name Deleted
-------------- -------------
N/A
Parameter Template:
New/Modified/
Template Name Deleted
------------- -------------
N/A
Protocols Associated:
Protocol Name SEND/ATTACH
------------- -------------
IBCNS QUIT ATTACH TO MENU
IBCNSC INS CO (IN)ACTIVATE COMPANY ATTACH TO MENU
IBCNSC INS CO ADDRESSES SEND TO SITE
IBCNSC INS CO APPEALS OFFICE SEND TO SITE
IBCNSC INS CO ASSOCIATION ATTACH TO MENU
IBCNSC INS CO BILLING ADDRESSES SEND TO SITE
IBCNSC INS CO BILLING PARAMETERS ATTACH TO MENU
IBCNSC INS CO CHANGE COMPANY ATTACH TO MENU
IBCNSC INS CO DELETE COMPANY ATTACH TO MENU
IBCNSC INS CO DENTAL CLAIMS OFFICE SEND TO SITE
IBCNSC INS CO EDIT ALL ATTACH TO MENU
IBCNSC INS CO INPT CLAIMS SEND TO SITE
IBCNSC INS CO INQUIRY OFFICE SEND TO SITE
IBCNSC INS CO MAIN MAILING ADDRESS SEND TO SITE
IBCNSC INS CO OPT CLAIMS SEND TO SITE
IBCNSC INS CO PAYER ATTACH TO MENU
IBCNSC INS CO REMARKS ATTACH TO MENU
IBCNSC INS CO RX CLAIMS ATTACH TO MENU
IBCNSC INS CO SYNONYMS ATTACH TO MENU
IBCNSC INSURANCE CO SEND TO SITE
IBCNSC PROVIDER ID PARAMETERS ATTACH TO MENU
IBCNSJ INS CO PLANS ATTACH TO MENU
IBJ EXIT ATTACH TO MENU
Remote Procedures Associated:
New/Modified/
Remote Procedure Name Deleted
--------------------- -------------
N/A
Security Keys Associated:
New/Modified/
Security Key Name Deleted
----------------- -------------
N/A
Templates, Input Associated:
New/Modified/
Template Name Type File Name (Number) Deleted
------------- ---- ------------------ -------------
IB SCREEN10H Input BILL/CLAIMS (#399) Modified
IB SCREEN5 Input BILL/CLAIMS (#399) Modified
IB SCREEN8 Input BILL/CLAIMS (#399) Modified
IBEDIT INS CO1 Input INSURANCE COMPANY (#36) Modified
Templates, List Associated:
New/Modified/
Template Name Type Deleted
------------- ---- -------------
IBCE INSCO ID List Modified
MAINT
IBCE PRVPRV MAINT List Modified
IBCE VIEW PREV List Modified
TRANS1
IBCE VIEW PREV List Modified
TRANS2
IBCNS INSURANCE List Modified
COMPANY
IBCNSC INSURANCE List New
CO ADDRESSES
Templates, Print Associated:
New/Modified/
Template Name Type File Name (Number) Deleted
------------- ---- ------------------ -------------
N/A
Templates, Sort Associated:
New/Modified/
Template Name Type File Name (Number) Deleted
------------- ---- ------------------ -------------
N/A
Additional Information:
N/A
New Service Requests (NSRs)
----------------------------
None
Patient Safety Issues (PSIs)
-----------------------------
None
Defect Tracking System Ticket(s) & Overview
-------------------------------------------
N/A
Test Sites:
----------
ALBUQUERQUE, NM
BIRMINGHAM, AL
HEARTLAND-WEST HCS
MARTINSBURG, WV
TOMAH, WI
Documentation Retrieval Instructions
------------------------------------
Updated documentation describing the new functionality introduced by this
patch is available.
The preferred method is to retrieve files from download.vista.domain.ext.
This transmits the files from the first available server. Sites may also
elect to retrieve files directly from a specific server.
Sites may retrieve the documentation directly using Secure File Transfer
Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI
Field Offices:
Hines: domain.ext
Salt Lake City: domain.ext
Documentation can also be found on the VA Software Documentation Library
at:
http://www.domain.ext/vdl/
Title File Name FTP Mode
-----------------------------------------------------------------------
Deployment, Installation, IB_2_0_P592_IG.PDF Binary
Back-out, and Rollback Guide (IB*2.0*592)
EDI User Guide IB_2_0_P592_EDI_UG.PDF Binary
Integrated Billing (IB) V.2.0 IB_2_0_P592_TM.PDF Binary
Technical Manual
Patch Installation:
Pre/Post Installation Overview
------------------------------
*************************************************************************
* IMPORTANT NOTE *
* In PRODUCTION, there is one **MANDATORY** pre-installation activity *
* associated with this install. *
* *
* The IB Staff MUST empty the 837 extract/transmission queue PRIOR to *
* the installation of this patch. *
*************************************************************************
INSTRUCTIONS ON HOW TO EMPTY THE 837 EXTRACT TRANSMISSION QUEUE:
===============================================================
The site Information Resource Management (IRM) MUST coordinate with the
Billing Department to ensure that the 837 extract/transmission queue is
empty. Once the Billing Department has completed the instructions, the
Billing department is to inform IRM that the patch installation may
proceed.
The instructions to empty the queue are as follows:
Select the option: TRANSMIT EDI BILLS - MANUAL [IBCE 837 MANUAL TRANSMIT]
What is the purpose of this option?
This option is used to by-pass the normal daily/nightly transmission
queues if the need arises to get the claim to the payer quickly.
When is this option used?
There are occasions when there is a need to transmit a claim(s)
immediately instead of waiting for the batching frequency as scheduled
in the MCCR Site Parameter. This option will allow sending individual
claim(s) or all claims in a ready for extract status.
Upon selecting this option, you will be prompted with the following:
Select one of the following:
A Transmit (A)LL bills in READY FOR EXTRACT status
S Transmit only (S)ELECTED bills
You should select 'A' for ALL
There are no other mandatory pre-installation activities associated with
this patch.
------------------------------------------------------------------------
The Pre-install routine (IBY592PR) will automatically do the following:
* Update entries used by the Forms Output Utility [IBCE OUTPUT
FORMATTER].
* Archive BILL FORM TYPE file (#353) Internal Entry Number (IEN) 7 so
as not to impact the new dental form. The BILL FORM TYPE file is a
national file, but was found to include some entries at 3 VAMCs
which need to be safely moved to another IEN (207).
The Post-install routine (IBY592PO) will automatically do the following:
* Add new entries to IB ERROR (#350.8) file
* Add new entries to TYPE OF SERVICE (#353.2) file
* Add new entry to IB ATTACHMENT REPORT TYPE (#353.3) file
* Recompile the Input Templates for the billing screens
* Set default processing of dental claims to YES - IB SITE
PARAMETERS (#350.9) File, DENTAL ENABLED? (#8.2) Field.
Routines IBY592PO and IBY592PR may be manually deleted by upon completion
of the installation.
Use default answers for KIDS load/install questions.
Patch-Files: http://code.osehra.org/VistA.git/tree/master/Packages- Loading branch information
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