Ascend Release Notes. Software Version: 2014 ASPNR2014

Transcription

1 Ascend Release Notes Software Version: 2014 ASPNR2014 Release Date: November 2014

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3 Contents Ascend Release Notes - Introduction 1 Multi-Category Enhancements 2 Inpatient Third Party NCPDP Billing (SCR 19506) 2 Batch Modes Changes 16 Batch Verify Process Hides the Claim Form 16 Billing and Claims Changes 18 HCFA NCPDP D.0 Max Length for Patient First and Last Name (Ticket ) 20 Rebilling a Claim has an Invalid Diagnosis Code 20 Common Orders 21 Inventory Item Not Added to Common Order Template (Ticket ) 21 Label and Form Changes 22 Infuse Over Value Rounding to the Nearest Whole Number (Ticket ) 22 Medication Reconciliation Form Change (Ticket ) 22 eprescription Receipt 22 UB-04 Not Printing Properly (Ticket ) 23 Miscellaneous Changes 24 Incorrect Database Connection String Hangs Ascend 24 Invalid Printer Warning Added (Ticket ) 24 No NDC from Surescripts Causes Order to Error 24 Providers Screen X12 Qualifier Not Saved 24 Replace ADO Com objects with.net (SCR 20244) 25 SQL Server Version Compatibility Warning Added to Server Update 25 SQL Server Compatibility 25 Switch Facilities Command (Ticket ) 26 Table Import (Ticket ) 26 Options Changes 27 Number of Days to Keep Unused Doses (Ticket ) 27 Billing Options Changes 27 Order Entry Changes 30 FDB Lactation Warning 30 Dispense as Written Not Updated 30 Order Entry Performance Issue (Ticket ) 30 Page i

4 Order IV Rate Not Recalculated When Item is Deleted 30 Patient and Profile Changes 31 Pregnancy/Lactation Display on the Profile (SCR 20583) 31 Patient Search Optimized for Bar Code Scan (SCR 20584) 31 Therapy Not Linked to Any Admission (Ticket ) 32 Diagnosis Code Billable Indicator Incorrect on Admissions/Discharges Tab (Tickets , ) 32 Doses Tab Changes(SCR 20585) 33 Schedule Times/Charges and Dose Info Field Labels Changed 34 Intake Summary 35 Patient Diagnosis Issue (Ticket ) 36 Reports Changes 37 Drug Utilization Report (Ticket , ) 37 Report Filter Added for A/R Report (Ticket , ) 37 Search Option Issue with the Reports Inventory Filter (Ticket , ) 37 Report Default Dates Not Saved if [Custom] Column is Null (Ticket ) 38 Security Changes 39 Security Tabs/Forms/Objects Permissions (SCR 20286)(Tickets , ,180544, , , , , , ) 39 Remove Legacy Security Code from Ascend (Ticket ) 42 Interface Transaction Log Security Object 43 Interface Changes 44 Ability to View Interface Transactions Within Ascend (SCR 19920) 44 Ascend Interface Service (AIS) 46 SCR Index 61 Page ii

5 Ascend Release Notes - Introduction The Ascend Release Notes are typically divided up by the categories that are affected by a change or enhancement for the release. This includes categories such as Order Entry, Patient Profile, Labels and Forms, Reports, Options, Security, etc. If more than one category is affected by the enhancement, the information is provided under the section titled Multi-Category Enhancement. This will help you to see all the categories that are affected by a new feature or enhancement in one place. The Multi-Category Enhancements section will be at the beginning of the Release Notes. If only one category is affected for bug fixes or enhancements, the information will be provided under the individual category. Please see the various category sections for more information. Detailed information for each enhancement is provided in the Help file. This document includes the information for all changes or enhancements across all categories for Ascend Release Page 1

6 Multi-Category Enhancements The following enhancements affect multiple categories in Ascend for this release. Inpatient Third Party NCPDP Billing (SCR 19506) Categories Affected: Options, Payer, Inpatient Orders, Claims, Interface Transaction Log, Security Some facilities need the ability to bill Medicare Part D claims for residential type patients (for example, long term care or behavioral health patients). The orders associated with the claims are considered inpatient orders. With release 2014 you can now process third party claims for inpatient orders. There are several new items that must be configured before you can send claims for these orders. NOTE: Mediware Support does not provide training in NCPDP billing as part of the support contract. Contact your Mediware Customer Service Representative if you would like a price quote for training. Configure the NCPDP Switch/Clearinghouse Ascend can be configured to use either RelayHealth, Emdeon, or Rx Linc as the switch or clearinghouse to transmit NCPDP claims. Rx Linc has been added in Ascend 2014 as an additional transmission method. The RxLinc method will use the Direct TCP/IP Settings for IP Address, Port and SSL settings. This is configured from the Utilities > Options > Billing tab. Your facility will need an agreement or contract with the clearinghouse vendor prior to submitting claims. This is not supplied by Mediware. Payer - Inventory Groups Each third party payer/insurance must have a payer record in Ascend for each insurance plan that you will be billing for inpatient claims. Configure the NCPDP settings including the Bin number and Processor Control number on the E-Bill NCPDP tab. The values needed for NCPDP billing are supplied by the payer not Mediware. You will need to contact the payer for the information and complete the setup before submitting claims. Beginning with release 2014, you can link different inventory groups to a payer and build either an exclusion list or an inclusion list. A new Inventory Groups tab has been added to the Utilities > Payers screen. Inventory Groups can now be linked to Payers so that inventory groups or items can be marked as either billable ("Can be billed") or Page 2

7 not billable ("Cannot be billed") for a payer. For example, over the counter (OTC) items cannot be billed to Medicare Part D. You could create an inventory group called OTC and link all the OTC drugs to that inventory group. You would then add that inventory group to the Payer and mark it as a non-billable type. The Billable Type indicates that the inventory group is a group with an item that can or cannot be billed. In the picture below, inventory items in the OTC inventory group cannot be billed. When creating claims, any drug that has been added to this group will give you this message below. In this example, over the counter drugs will not be paid so there is typically no reason to submit the claim. This message is telling you that the drug is in a non-billable group and won't be paid if you submit it. It doesn't prevent you from saving or sending the claim, it is an informational message only. NOTE: For over the counter items that are not paid by any insurance payer, you can also designate the inventory item as a non-chargeable item by selecting the "Do Not Charge" option on the Order Entry Defaults tab for that item. When used in order entry charges will not be created. Page 3

8 Another example would be to create an Inventory Group for an insurance plan specific formulary (for example, AARP Medicare Part D). You would include every drug item on the plan formulary in the inventory group. When adding the inventory group to the Payer you would make it billable. You cannot have both an inclusion (billable) and an exclusion (non-billable) Inventory Group for a payer. It must be one or the other. In this example, inventory items included in the AARP Medicare Part D inventory group can be billed. When creating claims, any drug that has not been added to this group will give you this message below. If you are using the inventory group for a payer specific formulary, it would indicate that the drug was not on the payer's formulary and would not be paid if you submit the claim. It doesn't prevent you from saving or sending the claim, it is an informational message only. NOTE: More than one inventory group can be assigned to a payer. You can have multiple "Can Be Billed" groups or multiple "Cannot Be Billed" groups. You cannot have both "Can Be Billed" and "Cannot Be Billed" groups assigned to a payer. Page 4

9 Inpatient Orders - Dispense as Written When billing doses for NCPDP D.0, the "Dispense as Written" information is transmitted in the 408-D8 field of the claim segment. In order to send that information with inpatient orders and doses, the Dispense As Written field has been added to the Other tab of the order. Changes to the Dispense As Written field will be tracked in the Order Change History. The values in the drop-down are in the Lookup table under NCPDPDispenseAsWritten. The default setting is "No Product Selection Indicated". New Claims - Ready to Bill In order to bill claims for inpatient orders, a drop-down has been added to the Ready to Bill tab that allows you to select either Outpatient or Inpatient orders. (This is found from the menu path Financials > New > Claims.) The option filters have been moved from the top of the tab to the bottom left part of the screen below the list of payers. Selecting the filters will populate the screen with values relevant to the type of billing you are doing. The Refresh link ("Click here to refresh") can be used to requery the orders and patients if any changes are made to the Orders, Date, Between and Type drop-downs. Page 5

10 Checking a payer/patient in the left tree view will load the patient s orders into the list view on the right side of the screen. In release 2014, the Payer and Patient columns have been added to the list of orders and Ascend will display all the orders selected for any of the payer/patients. This allows you to see all the orders that will be billed. The typical ideal work flow will be to enter in the date range to bill the inpatient orders/doses, then select the payer and bill the patients for that payer and have Ascend create claims for each patient/order selected. The Date and Type options are dependent on whether you select Inpatient or Outpatient from the Orders drop-down. If you select "Inpatient", the date drop-down values are "Administered Date" and "Dose Date". Administered Date means orders with doses charged between the From and To dates. Dose Date means orders with doses with a dose date between the From and To dates. For example, to bill last month's doses, you would select Inpatient orders with an Administered Date between and Page 6

11 NOTE: The settings you chose (such as changing the view to Inpatient or Outpatient Orders with a date range), will be remembered the next time you are in this window. Important Differences between Outpatient and Inpatient Billing For outpatient billing, multiple orders for a patient can be included in a single claim whereas with inpatient billing each order will be billed in its own claim. When in Outpatient orders mode, one claim will be created for each payer/patient. If four outpatient orders are checked for the patient, Ascend will create a single claim. This matches the behavior in previous versions of Ascend. For inpatient billing, each order for a patient will need to be in its own claim. When in Inpatient orders mode, one claim will be created for each order selected. New Claims Tab Changes New features have been added to the New Claims tab. Payer Drop-down Added A payer drop-down has been added to the New Claims tab so that new claims can be filtered for a specific payer. Claims for a specific payer can now be easily selected and billed. For example, you want to send all AARP claims at one time. Send Batch NCPDP Claims A new "E-Bill NCPDP" button has been added to enable batch NCPDP billing on the New Claims tab. You can select one or many claims and the claims will be sent one after another to the NCPDP switch/clearinghouse. You can narrow down the list to a specific payer by selecting it from the Payer drop-down. Page 7

12 When selecting the E-Bill NCPDP button, the Transmit NCPDP window opens. Changes to the Transmit NCPDP screen enable multiple claims to be submitted in a batch mode. NCPDP Batch Mode The NCPDP Transaction screen now supports transmitting transactions in a batch mode. You can load multiple claims by selecting them from the New Claims tab or by selecting a claim from the Financials tab on a patient profile and selecting E-Bill > NCPDP. Additional claims can be loaded in the NCPDP Transaction screen by repeating the process on another claim or returning to the New Claims tab. It is important to note, that each transaction/claim is still sent as a single transaction and the response for that transaction is received before moving on to the next transaction/claim in the list. The status column will be updated as the claim is sent and then as the response is received. You can double click on a claim to open it in the list. When sending a batch of claims, responses will not be shown in a separate window to prevent multiple windows opening for each claim and requiring user interaction for each transaction. An option has been added that allows you to control whether or not the response report displays in a separate window. In the past, the report displayed automatically. You must now select the "Show Response" check box in the Transmit NCPDP window in order for it to display. Once you have selected this option, it will default as checked the next time you are in this window. (This is specific for each user.) Page 8

13 Double click on a claim and you can now view the transmission history from the NCPDP tab of the claim. The NCPDP Reject Codes section has been moved to the right side of the screen. If the option to prompt for posting receipts is turned on, the program will continue to prompt as it has in the past. It is recommended that you not turn the prompt on when using Ascend for billing inpatient third party claims. The prompt is found from the Utilities > Options > Billing tab. Page 9

14 NCPDP Field 402-D2 for Inpatient Orders When transmitting an inpatient order, the 402-D2 (Prescription Reference Number) field in the NCPDP D.0 claim will be the Ascend OrderRef field. Ascend will put the OrderRef in the D2 field since Inpatient Orders do not have an Rx Number field. In this example, aripiprazole 10mg is an inpatient order with 5 doses charged. Page 10

15 A claim is created for the inpatient order with a quantity of 5. The Rx number for inpatient orders when transmitted will be the OrderRef number. Page 11

16 NCPDP Field 403-D3 for Inpatient Orders The Fill Number field (403-D3) for inpatient orders will be populated with the number of times the order has already been billed. If the order has not been billed before, the Fill Number would be 0. If the order has been billed once before, then the Fill Number would be 1. This number will increment each time the order is billed. NCPDP Transaction Log Enhancements New Filters A Payer filter and From and To date filters have been added to the NCPDP Transaction Log screen. For customers doing a high volume of claims (like inpatient third party billing), the filters will enable you to narrow down the number of transactions to a specific payer and/or transactions within a date range. This log is available from the menu path Financials > E-Bill > NCPDP Transaction Log. Page 12

17 NCPDP Transaction Log Available within the Claim Form All NCPDP Transaction history that is specific to the claim can now be accessed from within the claim on the NCPDP tab. Both Sent and Received transactions will be shown in the list. Selecting a transaction and using the View button will load the transaction in the NCPDP parser. This is an example of a transaction viewed in the NCPDP message parser: Page 13

18 Security Object for NCPDP Transaction Log A security Object has been added for the NCPDP Transaction Log that allows you to disable access for users or groups. It can be found under the Security Object Type Form-Profile > Menu Financials E-Bill NCPDP Transaction Log. The default setting is Full Permission. Page 14

19 Important Things to Know Because of the changes made for Inpatient Third Party Billing, there are some things you need to know at this time. Transmit NCPDP screen: When previewing a single transaction before transmitting claims and then cancelling the transmission, you will now be taken back to the Transmit NCPDP screen instead of having the window close automatically. Options settings and prompts: Currently if you have the Billing option "Prompt to apply the amount paid on a paid claim" checked and "Default NCPDP Paid Claim Status" set to "Locked", when a claim is paid you will be prompted to apply the payment and change the status of the claim. If you have these options turned on and you send for example 100 claims, you will get each of these prompts for each paid claim (potentially 200 prompts). A future design decision will be made when it is determined the best way to handle these prompts with large batches of claims. You cannot bill an inpatient order from the Orders tab of the patient profile. You will get this message if you attempt to do so. Inpatient orders must be billed from the Financials > New > Claims > Ready To Bill tab. Page 15

20 Batch Modes Changes The following changes affect the Batch Modes. Batch Verify Process Hides the Claim Form When in the batch verify mode and verifying inactive orders, if the order type is set to "Automatically Bill Order When Entered", the order will be added to a new claim when the order is verified and saved. In the past, if another order was in the verify list and loaded, the claim form was hidden behind the order form. The setting to enable Automatically Bill Order When Entered is from the menu path Utilities > Order Types: A change has been made to bring the claim form to the front. It will now appear in front of the order form with the batch verify form under the order form. Page 16

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22 Billing and Claims Changes HCFA 1500 The following changes were made for the HCFA-1500 (2-12) claim forms: Bar Code Printing on Pre-Printed Form (Ticket ) The bar code was previously printing and appeared in the Print Preview when the box for "Include Claim Form" was not selected. Now, when the box is unchecked, the bar code no longer prints on the HCFA-1500 (2-12) form. Boxes Reserved for NUCC Use (Ticket ) With the latest version of the HCFA 1500 form, boxes 8, 9b, 9c and 30 are now labeled "Reserved for NUCC use" and are not supposed to be populated. An issue was reported with the claim forms being rejected when data was printing in those boxes. A change has been made and boxes 8, 9b, and 9c are now reserved and suppressed. Box 30 has been addressed separately. Box 17 Doctor Printing (Tickets , ,206606, , , ) The following issues were resolved for Box 17: In the past, line 17 of CMS-1500 form, was pre-filled with a DN (referring provider). The change to include provider qualifier is new to the HCFA-1500 (2-12) form. Because billing typically involves the ordering provider, a change has been made to pre-fill this field with a DK (ordering provider). Box 17 should print in order of First Name then Last Name, but was printing in Last Name, First Name order instead. The SQL for the HCFA-1500 (2-12) has been changed to now populate Box 17 with the claim doctor s name, printed in the form using the doctors database table field names "FirstName LastName" (with a single space between the first and last name). Box 28 Incorrect Values (Ticket ) Box 28 previously contained an incorrect value under certain circumstances. The problem was causing the Box 28 value to contain only the charge amount from the first line item, when the payer option was set to "Default", "Page Total", or "Running Total". The form contained the correct value when set to "Claim Total" or "Continued Until Last Page". This has been corrected so that box 28 now contains the correct value based on the option setting. Page 18

23 Box 30 Payer Options (Ticket , ) The following issues were resolved for Box 30: When the option for Box 30 on the Payer was set to "Do Not Print", the balance due still printed in that box on the form. The payer expects that box, now marked "Reserved for NUCC use" to be blank and will reject the claim if data appeared in the box. This has been corrected. For HCFA's that print to multiple pages, box 30 was still being populated on all pages even though "Print only last page" was selected for box 30 on the HCFA tab for the Payer. This is now printing correctly. Page 19

24 HCFA-1500 (2-12) Alignment Issues (Tickets , ) Multiple alignment issues were reported with the new HCFA-1500 (2-12) form when printing on the pre-printed form. The data was not always aligning correctly in some of the boxes. These issues have been resolved with the latest version of the form. NCPDP D.0 Max Length for Patient First and Last Name (Ticket ) The maximum length for the patient's first name field (310-CA) and the patient's last name field (311-CB) have been updated to only allow up to the maximum number of characters for a D.0 claim. The D.0 standard allows 12 characters for the first name field and 15 characters for the last name field. Rebilling a Claim has an Invalid Diagnosis Code When using the Claims > Rebill menu option to rebill a claim, any diagnosis codes that appeared on the screen prior to the new claim being saved were not saved with the new claim record. This has been corrected. Page 20

25 Common Orders Inventory Item Not Added to Common Order Template (Ticket ) In the past, if the "Stop Days" field in the Inventory table had a value greater than 0, the program would try to set the stop date of the order based on that value. For common orders, there is no start date in the template and if the StopDays field has a value greater than 0, the inventory item would not be added to the order. The StopDays field is not visible on the inventory screen but if populated, the program would attempt to use the field when creating the common order. Now when adding that same inventory item to a common order template, the item will be added to the order correctly. Page 21

26 Label and Form Changes The following changes and enhancements have been made for Labels and Forms. Infuse Over Value Rounding to the Nearest Whole Number (Ticket ) Inpatient IV order labels were rounding the "Infuse Over" value to nearest whole number. For example, an IV that was to be infused over 3.5 hours displayed 4 hours on the label even though the IV rate precision was set to 2 decimal places. This has been corrected. Medication Reconciliation Form Change (Ticket ) The printed date and time have been added to the page footer of the Medication Reconciliation form. This will help identify if the form is current or out of date. eprescription Receipt A new form called eprescription Receipt has been added under the Orders print option. It was added to meet the requirements for pharmacies receiving electronic prescriptions. A printed copy of the eprescription must be printed in the pharmacy. This form includes the interface transaction notes field that is linked to the order. Page 22

27 This is an example of the printed output: UB-04 Not Printing Properly (Ticket ) For some customers, the UB-04 form was not printing the Referring Doctor's last name and first name properly in box 76. This occurred because those customers had modifed the SQL for the HCFA-1500 and the UB-04 was using the same SQL. The SQL for the UB claim forms has now been separated from the SQL that the HCFA-1500 uses allowing the forms to print correctly. Page 23

28 Miscellaneous Changes Incorrect Database Connection String Hangs Ascend If an incorrect database connection string is set in the Ascend.INI file, the program will not start. Normally, the connection should timeout between seconds and the password screen should load. Instead of the connection timing out and the password screen loading, the Ascend program failed to load any windows if an incorrect parameter/property was set for the database connection properties. This has been changed so that if the SQLServer setting has been set to an incorrect SQLServer name, Ascend will now open and you can change it to the correct setting without having to modify the Ascend.INI file. Invalid Printer Warning Added (Ticket ) When printing a label or form and the selected printer was not a valid printer, the print job was not printing and the program was not displaying an error message. Prior to Ascend 2013 R2, a print error displayed. The printer warning has been re-added to Ascend No NDC from Surescripts Causes Order to Error An issue was reported by a customer using eprescribing with Ascend that occurred when the order from Surescripts did not include the NDC number but rather a "DrugDBCode" and "DrugDBCodeQualifier" which had not been sent before. The missing NDC ("ProductCode" and "ProductCodeQualifier" fields) caused a problem because it was assumed that the NDC information would always be sent. A modification has been made to the Ascend Web Service so that if something is missing in the future, the transaction will be linked to the order and generate the transaction note so the eprescription receipt can be printed. Providers Screen X12 Qualifier Not Saved Page 24

29 The X12 Qualifier value on the Providers screen was NOT being saved when the Provider (Suppliers) record was saved. This has been corrected. Replace ADO Com objects with.net (SCR 20244) Additional changes have been made to replace the remaining old Microsoft COM references with managed code which eliminates the protected memory errors. SQL Server Version Compatibility Warning Added to Server Update Since we are no longer testing the updates against SQL Server 2000 or SQL Server 2005, only SQL Server 2008 and higher, a check has been added during the server update to warn you if the update is being performed on a version of SQL Server earlier than SQL Server Compatibility The following issues/enhancements pertain to SQL Server 2012 and Ascend has been certified to run on both versions. Page 25

30 NOTE: SQL Server 2000 is no longer supported. Customers on this version will not be able to run the 2014 update. Added Support for Truncating the Log in SQL Server 2012/2014 Performing a database truncate log command now successfully works in SQL Server 2012 and In earlier versions support was only added up to SQL Server version 2008 and performing a truncate would generate an error. Code Page Error During FDB Update Performing a First Databank update against SQL Server 2012 or 2014 would generate a code page error at the beginning of the BULK INSERT process. This has been fixed. Switch Facilities Command (Ticket ) In the past, when using the switch facility option under the Patients menu, the facility that displayed in the "Select a facility" window was the facility you logged into first. Now, when using the switch facility option, the program defaults to the facility you last logged into. Table Import (Ticket ) Room Import Table Types can now be imported without having a hospital field selected. When a hospital is not selected and no hospital exists, a hospital is created with the same name as the current facility. Page 26

31 Options Changes The following changes were made for Options in Ascend. Number of Days to Keep Unused Doses (Ticket ) A new option has been created to control how Ascend deletes unused doses for inpatient orders that have been discontinued. An unused dose is a dose that has not been charged and does not have a dose status. On the Options > Order Scheduling tab, you can now set the number of days Ascend will retain unused doses. The option is called "Number of days to keep unused doses after patient/order is DC'd". A value of 0 means Ascend will not delete unused doses. The valid options are 0 or 60+. You cannot delete unused doses within a 60 day window in case doses need to be charged. The default setting is 60 which is the current number of days Ascend went back in earlier versions. In the past this value was hard coded. This setting applies to all facilities in the database. Previously, the code did not check to see if the dose had a status. Now a check will be done and anything with a dose status is not an unused dose. The deletion script is run once a day, when the first user logs into Ascend. Billing Options Changes The following options were added to the Billing tab. (These are found from the menu path Utilities > Options > Billing tab.) Page 27

32 Rx Linc Added to Billing Options Rx Linc has been added under the NCPDP Transmission Method so that D.0 claims can be submitted through Rx Linc. The Rx Linc method will use the Direct TCP/IP Settings for IP, Address, Port and SSL settings. NCPDP Usual and Customary Field Option Added A new option has been added to determine how the Usual and Customary Field (DQ) calculation is performed. The default option will be the same calculation that was used in previous versions of Ascend: Usual and Customary = Total Price + Dispensing Fee + Professional Fee + Incentive Fee The new option is to have the Usual and Customary field not include anything other than just the Total Price field. You should not need to change the option from the default unless a payer is requesting the DQ field to exclude any additional fees. Page 28

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34 Order Entry Changes The following enhancements and bug fixes all relate to orders or order entry functionality. FDB Lactation Warning In the past, Ascend was only reporting the first lactation warning for a drug that contained multiple ingredients instead of all lactation warnings for a generic sequence number (GSN). For example, if an order is entered for Percocet on a lactating patient, you should get a lactation warning for both oxycodone and acetaminophen. In the past, only one of the warnings would have displayed during order entry. Dispense as Written Not Updated The Dispense As Written value for an outpatient order created by an e-prescription was not populated in some circumstances. This has been corrected. Order Entry Performance Issue (Ticket ) An order entry performance issue was reported that occurred when selecting multiple items due to floor stock check. When entering an order from scratch or from a common order and the order had multiple ingredients, the program slowed when each additional item was added. The program was checking to see if the order could be dispensed from floor stock. Each item in the order was checked to see if it was stocked in a floor stock list assigned to the patient's room. This has been corrected. There are now no delays in the order entry process. Order IV Rate Not Recalculated When Item is Deleted The IV Rate is calculated when an item is added and edited but was not recalculating when an item was deleted. A change has been made to the code that will recalculate the IV rate when an item is deleted. Page 30

35 Patient and Profile Changes The following enhancements and bug fixes were made for the Patient or Profile in Ascend. Pregnancy/Lactation Display on the Profile (SCR 20583) A change has been made that displays the Pregnancy and Lactation status in red in the patient demographics header. When the patient Pregnant and/or Lactating status is set to "Yes", the text will now display in red as is currently done with DOB and Age for patients who are younger than 18. Patient Search Optimized for Bar Code Scan (SCR 20584) In the past, you had to manually open the "Select A Patient Admission" window prior to scanning the patient identifier. When finished processing orders for the selected patient, you would have to open the "Select A Patient Admission" window again prior to scanning the next patient. An enhancement has been made in Ascend that allows you to scan a patient identifier without having to continually open the "Select Patient Admission" window. A new "Scan Listening Mode" has been added to the Patient Profile screen. The Profile form will actively "listen" for the input of a bar code being scanned. With a profile open, when a bar code is scanned, the program will perform a patient search using the bar code text value. The Search By field will be the last field used when selecting a patient admission. If the bar code represents the Patient Id, the user should manually open the "Select A Patient Admission" search and ensure that the Search By field is the Patient Id. Since the Search By field is a "sticky" field, it will always be set to the last selection that was made. Once it is set to the desired bar code type (in this example the Patient Id), whenever you scan a Patient Id bar code while on the Profile, Ascend will automatically perform a search using the bar code text as the Patient Id. Page 31

36 If the "Search By" criteria returns a single match and the match is an exact match, the admission will be automatically selected. If there are two or more admissions that match, you will have to select one. If no matches are found, the Select Patient Admission will remain open allowing you to search again. NOTE: The scan mode works with any of the "Search By" fields. Therapy Not Linked to Any Admission (Ticket ) After updating to 2013 R2, a customer reported not seeing any diagnosis codes and the therapy was not linked to any admission. A problem was found in a SQL command that was causing this to fail. This has been corrected. Diagnosis Code Billable Indicator Incorrect on Admissions/Discharges Tab (Tickets , ) When in the add/edit patient screen, the diagnosis billable indicator was not showing the correct value of "Unknown", "Yes" or "No". This appears on the Admissions/Discharges tab and has been fixed. Page 32

37 Doses Tab Changes(SCR 20585) The following changes have been made to the Doses tab in Ascend Charge Methods (Ticket ) The Dose Charge Methods have been added to allow you to filter doses on the Doses tab by the type of charge. A Charge Methods node has been added to the list of user selected filters in the tree view on the left side of the screen. Selecting or deselecting the Charge Methods will control which doses are included or excluded in the top list of orders and the bottom list of doses on the right side of the screen. Page 33

38 Doses Tab Field Labels Changed Throughout the doses tab, references made to "Administration" have been changed to "Dispensed". Since pharmacy does not administer medications but rather dispenses medications, this should clarify the meaning of these fields. The changes have also been applied to the customize mode when using a right mouse click to customize the column names. Additionally, the "Quantity" column header was renamed to "Doses". The following field and column names were changed: "Only Doses Needing To Be Administered" was changed to "Only Doses Needing to be Dispensed" "Last Administration" was changed to "Last Dispensed" "Next Administration" was changed to "Next Dispense" "Administration Date" was changed to "Dispensed Date" "Administered By" was changed to "Dispensed By" The "<Not Administered>" Status was changed to "<Not Dispensed>" The "Quantity" column header was renamed to "Doses" Schedule Times/Charges and Dose Info Field Labels Changed In the Schedule Times/Charges section of the patient's order, the "Administered" field was changed to "Dispensed" and "Transmitted" was changed to "Billed". Page 34

39 The "Administered Date" field on the Dose Info screen was changed to "Dispensed Date". Intake Summary The following issues were reported and have been resolved with release Blank Intake Summary (Ticket ) If a patient did not have a patient insurance record (a payer linked to the patient), the Intake Summary would print, but it would not include any data. Now, the Intake Summary will print all available data, and the insurance data will be blank. Intake Summary Recordset SQL Error (Ticket ) When attempting to print the Intake Summary report, an error was generated if the patient selected had a note that was longer than 1000 characters on the Notes tab. A change was made that removed the size limit on the "Notes" column of an internal data set allowing notes containing more than 1000 characters to print on the report. Page 35

40 Patient Diagnosis Issue (Ticket ) After updating to release 2013 R2, an issue was reported that did not allow you to edit a new diagnosis unless you saved it first. This has been corrected. Page 36

41 Reports Changes The following changes were made for Ascend Reports. Drug Utilization Report (Ticket , ) The Drug Utilization Report was printing the patient's primary doctor instead of the ordering doctor. Since the report is used for order detail, the doctor field should display the ordering doctor. The report code has been updated. Report Filter Added for A/R Report (Ticket , ) A new report filter "Hide claims having $0 on RPT end date" has been added to Ascend. This filter was added for the Accounts Receivables report and can be found on the Filters tab under "Other Filters". It will also be available to all reports that utilize the "Claims" table. When adding this filter for a selected report, the report will not include claims that have a zero balance on the "To" date of the report (the report's end date). Search Option Issue with the Reports Inventory Filter (Ticket , ) When in reports and selecting the Inventory search option under the Filter tab to filter by the inventory description, if you had more than 1,000 inventory records, the search field did not work to limit the number of records. This has been corrected. Now when you enter a drug description in the Search box, you will only see drugs that contain that description. Page 37

42 Report Default Dates Not Saved if [Custom] Column is Null (Ticket ) An issue was reported with reports where a new default date range would not be saved when updated. This has been corrected. Page 38

43 Security Changes Security Tabs/Forms/Objects Permissions (SCR 20286)(Tickets , ,180544, , , , , , ) Various Ascend Security settings were not working correctly. In some cases, when the security permissions were set to "Deny" for various items, the user still had full permissions. Changes were made to the security objects that control the following menu and profile functions: Clinical Documents - Users were still able to add, edit, print and delete Clinical Documents after Group Security set to "Deny" for Clinical Documents. Clinical Documents and Other Links - Users were able to access the Clinical Documents or Other Links from the Patient Menu and tabs on Patient Profiles when permissions for Clinical Documents and Other Links were set to "Deny". CMN, DME, ABN and Clinical Documents - The "Deny" permission setting for these documents was not working correctly. The Clinical Documents sub-menu is found under the Clinical menu heading on the patient's profile screen. The individual elements of the Clinical Documents sub-menu can be security-controlled (for example, New, Edit, Delete). However, each of the CMN, DME, and ABN clinical document types can also separately be security-controlled. This means that, even if the menu items (i.e., Delete Clinical Document, Edit Clinical Document, Add Clinical Document, etc.) are set to enabled for a user or group, using one of those menu items to act on a specific CMN, DME, and ABN clinical document is restricted based on the user or group security setting for that specific type of clinical document. These are now working correctly. Notes - With the security permission set to "Deny", the Notes security was not working correctly. Charge/Credit Dose - With the security permission set to "Deny", the Charge/Credit button on the Order screen was still enabled. Clinical Reviews - Prospective Clinical Checks - With the Form-Profile > Menu Clinical Clinical Reviews Prospective Clinical Checks set to "Deny", you could still access it in Ascend from the Menu Clinical > Clinical Reviews > Prospective Clinical Checks. Send Order to Interface - Group level permissions for the "Send Order to Interface" command did not prevent access to that option in the Orders Menu. Doctor edit from patient information screen - Group Level permissions did not prevent users from accessing the Add, Edit and Delete buttons to the Doctors screen from the patient profile. The Doctor records could be edited or deleted, and new doctors could Page 39

44 be added by accessing the Doctors screen from links in the Patient Admission Information screen (the Add, Edit, and Delete buttons were still enabled On Doctors screen). This was corrected in Ascend 2013 R2. However, under the Image tab of the Doctors screen, the Delete Image and Upload Image buttons remain enabled. Now, unless the user has full (Create) permissions to Doctor, these two buttons are disabled. Orders - Print - Users were still able to print when Order-Print is set to "Deny". Orders - View only permissions on Orders did not prevent users from editing the orders. Orders - Catheters menu options were still active when security was set to "Deny". Orders - Find Order menu options was still active when security was set to "Deny". Orders - New Orders Refill/Rewrite - With the security level for these items set to "Deny", the buttons for New Order, New Common Order, and Refill/Rewrite were incorrectly still enabled on the Order screen. Select All Orders - The menu item Orders > Select All Orders was still enabled when the security access was set to "Deny" for the Form - Profile > Menu Orders Select All Orders. Patient Education Monograph - With Form-Profile > Menu Orders Patient Education Monograph set to "Deny", you could still access it in Ascend in the orders menu with a right-click > View Patient Education Monograph. Doctor ID - The Doctor ID drop-down was still active when the Order screen was in View-Only mode. Patient Picture Delete - Users were still able to delete Patient Picture's after Group Security was set to "Deny". Financials (New and Receipt Batch Mode & Adjustment) - Users were able to access the Financials menu after Group Security Access was set to "Deny". Synchronize AWP with FDB - the "Deny/View" permission settings were not working correctly for Utilities > Inventory > Synchronize AWP with FDB. Now if "Deny" security is set for this menu item, the item is disabled in the menu. If the security is "Full" or "View", the item is enabled in the menu and you can synchronize the inventory items with the Average Wholesale Price with First Databank records. User/Group Security "Can Download Updates" Check box A "Can Download Updates" check box was added to the General tab of the Group Security screen and the User Security screen. This allows you to set this security by group or user. The General tab of the Group Security screen: Page 40

45 The General tab of the User Security screen: Page 41

46 User/Group - Show Incomplete Clinical Reviews Reminder (Ticket ) Changes made to the "Show Incomplete Clinical Reviews Reminder" check box on the General tab of the User Security screen were not being saved to the SecurityGroups table correctly. This is now working as expected. User/Group Security Object for Batch IV Labels Catch-up Added In the past there was not a Security setting for Form-Profile > Menu Orders Batch Modes-Batch IV Labels Catch-up. All other Batch Modes had a security setting. A security object has been added for Batch IV Labels Catchup. Remove Legacy Security Code from Ascend (Ticket ) Page 42

47 There was legacy security code in the Ascend product that was still checking for old security settings that are no longer used. These settings were stored directly in the Security table record for the user, or the SecurityGroups table for the group. The user interface no longer allows the users access to change the old security settings. The legacy code that still referenced these old security settings has been removed, and in some cases replaced with security code that uses the new GetSecurityPermission function. Interface Transaction Log Security Object A security object has been added for the Interface Transaction Log so that it can be disabled for users and groups. It can be found under the Security Object Type Form-Profile > Menu Utilities Interfaces Transaction Log. The default setting is Full Permission. Page 43

48 Interface Changes The following changes have been made for interfaces within the Ascend application: Ability to View Interface Transactions Within Ascend (SCR 19920) Now that interface transactions are stored in the InterfacesTransactions table in the Ascend database, an enhancement has been made to the Interface Transaction Log in Ascend that allows you to view the transactions for any interface installed on the Ascend Interface Service (AIS). Previously you could only view the eprescribing transactions. The interface transactions can be viewed from the menu path Utilities > Interfaces > Transaction Log. You can select the Interface, Message Type and Date Range by using the drop-down and calendar buttons (in other words, the + symbol). The Transaction Contains text box allows you to enter a search string in order to find a particular transaction. Use your keyboard Enter key to execute the search. Any values that you select (such as the Interface, date range, or Total Transactions) will be remembered the next time you are on this screen. Highlight a row and click View Transaction to open the Interface Message. From this window you can select the Source Text or the Parsed View: Page 44

49 The Parsed view displays the HL7 message segments. In the past, for each field in a segment, you would have to expand the field number to see the data, with this release when you select the segment, if the field has components, the components will automatically display. For example, when selected, the PID segment displays something similar to this: Page 45

50 Ascend Interface Service (AIS) The following changes and enhancements have been made for the Ascend Interface Service (AIS). Important: The Ascend 2014 release requires that the application and interfaces be operating on the same version. Please ensure that the Ascend Interface Service (AIS) is updated immediately after you perform the Ascend 2014 application upgrade. Interface Log Files Not Viewable (SCR 20590, Tickets , ) An issue was reported with the Interface Log files not being viewable after upgrading to 2013 R2. This was due to a change in the naming convention in order to make it easier to see which log file went with each interface. The files are now displayed and in order of newest to oldest. Encrypt Service and Interface Log Files With AIS 2014 you have the ability to automatically encrypt the log files. A new option has been added within the Service Options on the General Tab. This new functionality is turned off by default at the time AIS 2014 is installed. It can be turned on by checking the "Automatically Encrypt Log Files" option. When turned on, AIS will encrypt all Page 46

51 message logs for the service itself along with any messages that are created by the interfaces as they are processing HL7 messages. Turning on Encryption will add additional overhead to logging transactions. If you experience delays in message processing, turn off the Encryption option to improve performance. Files will still be viewable through the View Service Log Files page (on the AIS dashboard) by choosing the interface log and then selecting the ellipsis to the right of the name of the log file. The new encrypted log files will end in a.txx file name and the non-encrypted files will end in a.txt file name. You will no longer be able to view the files using Windows Explorer unless the encryption is turned off and the service restarted. Page 47

52 Interface ID of 0 for New Interfaces In the past, if you added an HL7Redirection or User-Defined field on the ADT tab of the interface when creating a new interface, the HL7Redirection.XML and ADTProperties.XML would be saved with an Interface ID of "0" instead of the correct Interface ID. Because of this, when processing HL7 messages, these settings would not be enforced. The logic has been changed to ensure that the HL7Redirection.xml and ADTProperties.xml files would be saved with the correct InterfaceID when the "OK" button was pressed to save the new interface. Update InterfaceID/Ref at the time of Conversion (Ticket ) When the XML files were converted to the database in 2013 R2 AIS, the InterfaceRef was not updated on the remaining XML files to the new InterfaceRef Number: ADTProperties.XML, Filters.XML, and HL7Redirection.XML. Logic was added to ensure that these files would be saved with the correct InterfaceID/Ref when the service is started after the conversion. Outbound Orders - Custom Z Segment You now have the ability to create a custom Z segment that allows you to send a targeted list in the outbound interface. The Z segment is a message segment that typically contains clinical or patient data that the HL7 standard may not have defined in other areas. A new configuration option called "Optional Outbound Z Segment" has been added to the Orders tab in the AIS. In this example, the outbound Orders interface is configured to build a ZOR segment with the following database fields as HL7 fields: Infuse Over, Infuse Over Type, Description, Fill List, Floor Stock List, Dispense Days and OrderRef. Fields are delimited with the pipe sign and database fields are identified by wrapping the name in curly brackets {}. For example: ZOR {InfuseOver} {InfuseOverType} {Description} {FillListScheduleJob} {FloorStockList} {DispenseDays} {OrderRef} {Comments} {EnteredByRef} {PhysicianOrders} {Instructions} {Label}. Page 48

53 For example, if an order has a value of "10" in the "Infuse Over" field and "Hours" in the time drop-down, if the Z segment has been built to include {InfuseOver} and {InfuseOverType}, the information will be sent in the outbound order. NOTE: The "InfuseOverTypes" are stored in the Lookup Table. A 1=Minutes, 2=Hours, and 3=Days. Page 49

54 Patient Insurance Pricing Removed on HL7 Admit Update (Ticket ) When a patient insurance record is added to a patient based on an HL7 message sent to the AIS, if the payer record sent in the IN1 contained a default pricing contract in Ascend, then the payer's default pricing contract is added to the patient's insurance record. The Payer record is matched based on the Payer Id in IN1.3. This is working correctly. However, when a subsequent message for the same patient was processed by the AIS and the patient record was updated, the pricing contract was incorrectly removed from the patient's insurance record. This has been corrected. AIS Ignore Old Admissions A new ADT option has been added that allows you to set a number of days after a discharge that an update will be ignored. For example, if this option is set to 30 days, when an A08 is sent and the discharge date is older than 30 days, the message will be ignored and a message added to the event log stating that the A08 was ignored because it was older than 30 days. This change was made in the event that an admissions department would update records on old discharged patient records. This would prevent the AIS from creating an update for a patient that has been discharged more than a certain number of days. Page 50

55 Changes to Viewing HL7 Transactions Within AIS (SCR 19920) You now have the ability to view both forms of the HL7 message from the AIS by using the Source Text and the Parsed Text drop-down options. The Message Type options allow you to see the original message as it was received before any translations, filtering or re-directions are done. To access the HL7 message from the AIS Interface Engine Dashboard, select the button with the ellipsis in the Log column of the interface. This opens the Log Search screen. From the Log Search screen, enter the date in the "Search Date From" field. From the search results, select the log file you wish to view the HL7 message from by selecting the button with the ellipsis. The Message Details screen opens. From this screen you can select the Source text view or the Parsed text view. This is an example of the Source Text view: Page 51

56 The Parsed View displays the segments of the message in a tree view that allows you to see each component of the message. This is an example of a Parsed View: Page 52

57 Option to Remove Hyphen from Patient ID on Outbound Transaction (SCR 20589) In release 2013 the PID.18 Format function was added to the ADT tab to be used for masking the Patient Id on the inbound interface. This allowed you for example, to have a Patient Id of converted into With release 2014 you can now convert the hyphenated number, strip out the non-numeric characters and send it through the outbound interface as Additional enhancements have been made that allow you to control and translate fields using the Translation section of the HL7 tab for both inbound and outbound interfaces. The choices for translating are Field, Character(s), Prefix, Suffix, Mask, Substring and Date Format. When setting up the translation, you use the Type to replace one value with another. Field Type The Field type allows you to replace the entire segment/position/component with a new value. For example, you want to replace an "I" with "Inpatient" in a particular field: Page 53

58 Character(s) Type The Character(s) type allows you to replace a specific character in the segment/position/component with a new value. For example, you want to replace a hyphen (-) with a forward slash (/) Date Format Type The Date Format type allows you to specify the format of the date in the segment/position/component. You must use MM for month. Page 54

59 If needing to keep the time as part of the incoming/outgoing segment/position/component, then the time needs to be specified as HH:mm. If time is NOT specified and it is part of the segment/position/component, it will be dropped. Substring Type The Substring type allows you to specify the start position within the segment/position/component and the length for keeping information in that position. Page 55

60 Mask Type The Mask type allows you to specify the masking in the segment/position/component. When using the Mask type, it must be an exact match to work. For example, if you have the Mask set to 9 characters, you cannot send 8 or 10 characters and have it work correctly. Prefix Type The Prefix type allows you to specify a prefix to add to the segment/position/component. Page 56

61 Suffix Type The Suffix type allows you to specify a suffix to add to the segment/position/component. Important Information: It is recommended that you do NOT have more than 1 type for the same field position. For example, you should not create a Field type and a Character type for PV1, 2,1. The Character type looks at every single character in the field and if it sees a character that matches it replaces it with the value required. For inbound interfaces, if there are multiple translations on the same field, the message will process but no translations will occur, no inbound segment filters will occur, and none of the field component re-directions will occur. An error will be logged in the log file with all the details of the message (such as patient information, etc.) followed by this error message: Page 57

62 For outbound interfaces, if there are multiple translations on the same field, the message will NOT be sent. An error will be logged in the log file, but there will be no detailed information included with the error. You will not be able to discern what message errored off or the patient that the message was associated with. The error message will look something like this: User Name and Password Defaulted In the past the UserName and Password would have to be manually entered on each installation of the AIS. Now it defaults from the last installation. It will only have to be manually entered if a UserName or Password has changed. CPOE Enhancments (SCR 20226) The following changes and enhancements were made for the CPOE/orders interface. Page 58

63 Corrected "verifiedbyref" in RDE ORC-11 (Outbound Orders) A coding change was made to correct the "verifiedbyref" value in the RDE ORC-11 field. ORC-11 was getting the incorrect security ID for whoever verified the order. It was always getting the interfaces security ID. Ability to Map RXO-6 to Mix Instructions (Inbound Orders) You now have the ability to create a mapping for any valid segment to a field in the Order object. These are known as Data Redirects and are mapped from the HL7 tab for the CPOE/inbound orders interface. In this example, in order to map the RXO-6 segment field to Mix Instructions in Ascend, a Data Redirects was created: When the data is sent in the inbound order, the information would be saved in the Mix Instructions text box in the order in Ascend: RXO ^COLACE 100 MG CAPSULE^NDC 100 MG TABLET ^rxo-6 contents ^MD instructions P Page 59

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