The Medical ePayments Compliance (Phase 2, Iteration 2) project ensures VA's compliance with Electronic Funds Transfer (EFT) & Electronic Remittance Advice (ERA) Operating Rules and enables VA to more effectively use ERA data, resulting in better revenue and cash flow management; provides the infrastructure foundation for electronic exchange of claim payment information and promotes an interoperable system; reduces the time elapsed between receipt of the Electronic data interchange (EDI) 835 Electronic Remittance Advice Transaction and receipt of the Cash Concentration or Disbursement (CCD+) transaction; ensures that trace numbers between payments and remittances can be used by VA, reducing the level of open accounts receivable and allowing claim denials to be more quickly addressed; and standardizes EFT & ERA enrollment, reducing workload burden on VA staff.
These patchs contains changes to the ePayments (835 and EFT) program area to ensure compliance. Specifically, enhancements to the Veterans Health Information Systems and Technology Architecture (VistA) Third Party EDI Lockbox module to increase timely and accurate processing of payments for electronic pharmacy claims in compliance with Health Insurance Portability and Accountability Act (HIPAA) and Veterans Health Administration (VHA) Fiscal Accounting policies will also be required. The ePayments system is used by Accounts Receivable (AR) staff to process payments from third party payers for both medical and pharmacy claims. The objectives of the requested ePayments software modifications are to expedite accurate payments by enhancing the ePayments software to streamline the user's ability to process the pharmacy 835 while:
Complying with HIPAA legislative requirements to meet patient needs and secure Protected Health Information (PHI).
Conducting payment accounting in accordance with the Office of Management and Budget (OMB) directives.
Systematically enforcing VHA Fiscal Accounting policy.
Adding latest in flight patches for Phase 2, Iteration 2 v15, IB*2.0*529 and PRCA*4.5*304.
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