• Bug fix release.  Fixed bug reporting some members ineligible who had a termdate of today.  Members should be eligible through their termdate. (lrhed)
• Fixed bug causing member dossier's auth view to only display diamond requests.  Also updated view to use stored procedure. (jbraun)

• The 'deferred requests' inbox now sports a 'Days Deferred' column to aide UM in sending deferral letters, etc. (jbraun)
• New 'Export' column in DREAuths.  The main auth database table now has a new 'Export' bit (boolean) column to indicate if that request needs to be exported to the HIS system (ie. Diamond / xPress) This flag is turned on, on the same events which cause the updatedate field to update.  This was requested by HealthTrio to aide in the xPress integration.  (HealthTrio)
• If an external account is not tied to any providers, the user will receive an error message now stating the problem rather than a system error message. (demerson)
• Alerts on auth summary page have been reformatted. (demerson)
• New auth alert on the auth summary page:  if the selected provider on the auth being displayed is not PAR for the selected members line of business, and alert will be displayed.  (pstuebner)
• Auth alerts now being ran from stored proc for better page performance. (demerson)
• Background color of request summary page is now set to white, rather than default wich shows up as grey on many users browsers. (demerson)
• Members primary language now appears on the 'Search Members' results detail page, as well as the 'Member Dossier' Demographics page. (jsonderm)

• In Admin > Security > Security Audit, column headers were added back (ssmith)
• Fixed bug on new "Check Eligibility" form causing some active members to show 'inactive' (jsonderm)

• All DRE and Module code is ported to use new DRE* tables. (demerson)
• Light session tracking has been implemented, allowing administrators (those with statistics access) to view who's currently logged on, and what they're currently viewing, their idle time, and their total time logged in.  To access, use the "Current Activity" option in statistics.  Note:  This data is not logged, and thus no aggregation or reporting can be done on it.  It's only for quick referrence of current system load and activities. (demerson)
• Pressing Cancel on either the Transfer screen, or the Notes screen will return to the auth, not the inbox. (demerson)

• There have been major structural changes to the way DRE stores and retrieves data, and this is just the first of several major updates to tighten up DRE data structures, and prepare for it's integration with HealthTrio.
• New Request now uses a bi-directional stored procedure for saving initial request data to the database.  This should improve save time and better protect against data corruption.
• Many facets of DRE have had their data pulls moved to SQL Stored Procs.  In time I hope to move almost all sql into sql stored procs for better performance.
• Internally, DRE is moving away from the old, Diamond named tables, and moving toward simpler, more highly optimized tables for the DRE Product.  With this release many of DRE's functions regarding member and eligibility lookup have been moved to DREMembers, and DREEligibility tables, and away from their "mem_gen" and "jmeligm0" counterparts.
• These new tables are tighly integrated (through foreign key relationships) to all other data throughout DRE.  i.e. it is impossible for a member to get deleted that is tied to a request.  Or...  It's impossible to add a request for a member that does not exist.  etc...
• These new tables are updated nightly though updates rather than complete table reloads to enforce referencial integrity even during data loads.
• Security:  The DREPermissions table has been optimized to use user object id's rather than loginid's.
• Security:  The DREUser permission is being replaced by an inverse called "Account Disabled" flag on the user record. 

• Better optimized the DREPermissions relationship in the database.  Links by user objid, rather than login id.  i.e. smaller, faster table.
• Better optimized the Quick Stats screen in the statistics menu.  It now uses a stored proc, rather than embedded sql.  It runs a little faster, but these stats might soon need to be batched.  :o(

• Edi-history screen has been updated for providers. 
  • Sent by is now shown (showing user who uploaded the edi)
  • Edi-History list is now sorted by by date sent, descending.  oops.
  • Only the past 30 days are displayed.
• Administration reorginization
  • Administration, Statistics, and a new group, 'provider maintenance' are now all located under an administration menu. 
  • If you have access to any of these three areas, you will have an 'Administration' link on your DRE option bar.
  • There are icons to all three of these areas from the administration menu, however security is still maintained, so that if you don't for example have access to statistics, clicking the statistics icon will give an error dialog stating so.
• Provider maintenance area - within administration there is the new provider maintenance area. with the following options...
  • Login Monitor (it's still avaiable from statistics and admin)
  • Edi-History (moved from admin screen)
  • Broadcast Options - this screen allows provider services to update a providers preference on receiving information such as preliminary eligibility reports through snail-mail, or fax, as well as through the web (default).  (moved from statistics)
  • Provider Alerts (moved from admin)

• Fixed a bug causing a deferred request to not be removed from a providers inbox upon deferral response.  (demerson)

• The deferral system...  To "defer" is a new option now on the Make Determination screen.  This option is for the exclusive purpose of sending a request back to it's requester for additional information.  There are some important things to note about the behaviour of the deferral system so here goes...
  • When a user defers a request, that request is moved into the "Deferred Requests" inbox, and notification is sent to all the provider on the request to fulfill the information being requested.
  • Deferred requests can be denoted by the red question-mark icon.
  • Once deferred, it can not be approved, or denied until a provider on the request provides a 'Deferral Response'.  The request can still be cancelled.
  • Once deferred, a request can not be moved from the Deferred Requests inbox until the deferral response is received.
  • Likewise, a deferred request can not be removed (acknowleged) from a providers inbox, or appealed until some provider provides a 'Deferral Response'.
  • Once a 'Deferral Response' is entered by the provider the request will stay in the 'Deferred Requests' inbox, but return to the 'No Determination' status, and can therefore be moved, approved, denied, etc...
  • Like notes, a e-mail message is broadcast to the last HPSJ user to touch the request with the full text of the deferral response.
• The eligibility logic has been updated to provide (hopefully) better eligibility information after the FAME process. (demerson)
• Some logic has been updated on the way the toolbar, and the request-summary page interact.  This shortened a good chunk of the request summary page to improve network performance, and simplify code. (demerson)
• There's been some minor, internal database changes (provider name, address, etc have been removed from jprovcm0 since it was duplicated from jprovfm0), just to maintain a smaller database footprint. (demerson)

• All census reports have been updated with the following changes
  • DRE auths show level of care detail, rather than request summaries.
  • Diamond Auths now show Secondary Auth Field for better evaluation.
  • Diamond Status is now shown for all requests.
  • Create Date is now shown for all requests.
  • Dx1, and Dx2 Description fields are now shown.
  • All census reports are now sorted by plan, group, memid, then person.
  • Diamond auths now show diamond auth type description rather then the diamond auth types code.

• Fixed date bug in new claims by date range feature. (mtyler)
• New Provider Settings screen can be accessed by providers through the 'settings' icon, then clicking the "settings" button next to the provider they want to edit settings for. Internal users can access settings for all providers from a link from the "statistics" menu.  This is currently used to allow provider to select which method they want to receive their preliminary eligibility.  (jsonderm)
• New link added to provider homepage for medi-cal procedures. (ssmith)
• New 'New User' option available from the login screen will tell potential users how to sign up to use DRE (demerson)
• Confidentiality Statement now available on the provider homepage, and from the new 'new user' screen. (ssmith)
• Hedis Projector has been beefed up big-time.  Almost all measures are now available online, and one can now see plan total stats across all providers.  Thx Jerry! (jsonderm)
• Fixed a tweak in the toolbars that occured from the "new request' screen.  If you clicked submit, then clicked "Edit" to return to the request editor, it didn't reload the editor toolbar. (mtyler)

• The tools selector has been updated to work with both MSIE as well as Mozilla and Netscape. (demerson)
• The 'Your Claims' tool can now search date ranges. (pnelson / mtyler)
• New "Default Sort" setting available on Settings screen allows each user to select their default inbox sort column.  (ssmith)
• The vendor name shown on the claims detail screen will now open a popup when clicked showing vendor detail information.  (jsonderm,ssmith)
• The Cancel button on the Appeal screen will now return the user to the request rather than their inbox (ssmith)
• The Place of Service code shown on the claims detail screen will now open a popup when clicked showing a description of the POS code. (demerson)
• Member Opt-Out tool now available.  (jsonderm)
• Tools menu is now ordered alphabetically. (demerson)

• In the provider group builder in the administration module, you are now unable to add the same provider id more than once to any given account.  (ssmith)
• CCS Information will now be shown on the Request Summary page.  This info will only be shown if the request has been referred to CCS. (ssmith)
• Claim Status added to Eyecare Lookup tool. (jbraun)

• Privacy update....  Along with STD cases, all information regarding Mental Health claims / auths / etc will be filtered from everyone but the provider of service, and health plan staff. The following codes are used to test for a Mental Health encounter:  290-319, V71.02, 90801-90899, X9500-X9550  (jsonderm, jbraun)
• Along with the above filter, health plan staff will have a new option to specifically lookup Mental Health related cases for specific members to aid in resolving what benefits are available due to past usage.  This is an upgrade to the current eyecare lookup tool. (jbraun)
• Setting the <title> tag of the request summary page, will make a message appear on every printed page of a request summary stating "Viewing R1234567 for Bob Smith (100200123-01)". (mtyler, ssmith, dford)
• E-mail address is now editable from the admin module. (ssmith)

• Dupe check threshold increased to 60 days. (cdiers)
• Provider specialty added to pop-up provider information window seen from various pages of the member dossier. (ashek)
• Quantity field is now being displayed on the Prescription page in the member dossier (ashek)
• Various other minor styling changes throughout member dossier.
• Repaired a lot of broken navigation in the Diabetes Manager (mtyler)
• Fixed an error that would show up when opening a static report for the first time after a server reboot.  Related to reloading application variables. (mtyler)

• Added members group and plan to the census report output.  This was lost in a change made in the last publish. (sgivens)
• Fixed a bug sending claims comment mail.  (ssmith)

• Added internal interface to the Hedis Projector Tool.  Internal users can now view projected hedis stats for any PCP. (scarlisl)
• Fixed glitch with processing time report. (jbraun)
• Added Quarterly Report to stats page.  This is not production quality yet!
• Added new external links to HPSJ formulary on the provider homepage.
• Added new 'copy account' functionality to administration module.
• Changed colors on feedback form to match the rest of the site.

• Added Preventive Care documents to provider homepage (lreynold)
• Fixed and optimized multi-select transfers / acknowlegements from the inbox which was broke in the last patch from adding the "Other Option" selection box. (ssmith)
• Modified a couple more icons.
• Fixed link to company logo image file on the 'Patient Handout' form.
• Those with access to the statistics module can now view the contents of any internal users' inbox as if it were their own.  To do this, go to the "Internal Inbox Population".  Each of the enumerated users and groups, are now hyperlinks to the respective inbox.
• Benefit Dossier updated to use numeric object id's (demerson)
• Pressing enter executes the search when doing a code lookup. i.e. you can press enter, rather than click 'search'.  (vbatten)
• You can now edit the number of auth visits from the auth editor for outpatient requests.
• When performing a code lookup, the codes are now only links if the code lookup was launched from an auth editor.  (demerson)

• There has been a substantial overhaul to the password ruleset....
  • Passwords now age, and you will be required to change your password after a set number of days.  Currently this is set to, and defaults to 90 days.
  • The number of days before passwords expire is editable by the system adminitrator from the Administration module on the 'Site Setup' screen.  It can be any number of days from 1 to 9999, however it IS REQUIRED, and cannot be turned off.
  • When you change your password, your new password is time stamped, and it begins to age from that point in time.
  • If your password will expire within the next 10 days, you will get a popup box stating "Your password will expire in x days." Where x is the number of days until password expiration.
  • Like always you can still change your password at any time from the 'Settings' screen, and doing so will refresh the timestamp of your password. i.e. you'll have another 90 days before your password expires.
  • If you allow your password to expire you will be forced to change your password the next time you login.
  • All new external / provider accounts will be required to change their password the first time they login.  As well, any account can be forced to change their password on their next login by the system administrator for the account editor page.
  • Any account can be set to 'Password Never Expires' by the system administrator.  An attribute which nullifies the above ruleset for that given user.  Note:  As it stands, all normal HPSJ users who have never logged into DRE from outside of HPSJ (e.g. work from home) will have this attribute set since authentication is verified from the NT network.  If you have ever logged in from home, or outside the hpsj network, OR if you begin working from home, this attribute will be removed from your account, and you will have to follow the above password requirements.
  • As it stands, the following users will be bound to the above ruleset:  Alejandro Garay, David Emerson, Shelli Smith, Mike Tyler, Patricia Stuebner, Vicki Batten, Lisa Rhed, and Dr. Carlisle.
• DRE now has a framework in place to allow multiple methods of e-mail delivery, as well as the ability to disable automated e-mail delivery all together.  Currently, available methods are "File Export", "SMTP", and "Disabled".  Mime may be offered in the future.
• User initials are now editable from the the account editory screen.
• Many icons have been changed to get away from the standard Microsoft Windows icons we've used in the past.  These may be changing more in near releases.
• All add-on tools, not considered part of DRE core system, have been moved to a drop down selection box in a effort to modularize these tools into a more manageable framework.  These include the eyecare lookup, hedis projector, ambulatory care guidelines.  These may be changing more in near releases.

• Internet Explorer 3.0 can no longer login to DRE.
• True Mozilla (mozilla.org) browsers may now login to DRE.
• Internal modifications were made to the Eyecare Lookup application it should run much faster now, and not suffer from the 'timeout' errors that occured in the past. (UM Dept)
• Changed output on the member-detail screen.  Under eligibilty, Status field will not resolve to Active, Inactive, On Hold, rather it will show Eligible, Ineligible, and On Hold directly from the status field values Y, N, and H respectively. (ssmith)

• Added eligibility history listing to member detail screen in the 'Search Patient' function. (ssmith)

• Fixed another claims lookup bug when looking up inpatient claims by service date. (ssmith)
• Added os / browser information to login monitor in statistics. (ssmith)
• Completed work on 'Post Submit Location' setting.  NOTE: Now, by default, aftering submitting a request you will be returned to your inbox.  If you prefered starting another new reqeust afterwards, you can revert back to your setting of choice on the Settings screen. (demerson)
• Fixed tweak in 'complete member list' (ssmith)

• Fixed checkbox transfer / acknowlege issue caused by the implementation of paging.  (lrhed)
• Implemented User Agent tracking (recording what web browsers users are connecting with)  (ssmith)
• Cleaned up code that adds new requests to the database tables.  Should be more efficient and quicker now. (demerson)
• Default expiration dates for CPT codes: 90806, 90862, 90807, and 90805 will be 6 months. (vbatten)
• Links to non-MCL/HF Formularies have been removed until further notice. (sgivens)
• Fixed tweak with 'search claims by memid' (ssmith)

• Fixed a bug introduced in the last patch causing an ASP error whenever a session had expired. (demerson)
• Implemented paging in all inboxes.  Note: page size can be adjusted in the settings screen from 10 to 500 requests per page.  If no preference is set there will be 25 requests per page displayed. Note: to implement paging, reverse-sorting has been temporarily disabled (i.e. the ability to click a header more than once to show the list is reverse, such as A-Z and Z-A)  I hope to restore reverse sorting in the next publish.(demerson)
• Fixed calculation error on request summary page incorrectly showing the alert "member has auth activity within 30 days of this request"  (pstuebne)
• Fixed the screwed-up lob / group / plan fields in complete-member-listing.asp (providers current member listing) (ssmith)
• More strict browser requirements.  All users must either be using some version of MSIE, or Netscape 6, or an error message will be displayed. (ssmith)
• Fixed error causing unposted claims to not display properly (ssmith)
• Added a daily inpatient census report. (jbraun)

• 'Search Formulary' has been replaced with a page with links to AdvancePCS' searchable formularies that will open in pop-up windows. (sgivens / lreynold)
• Added reviewer's username to the monthly inpatient report. (mjordan)
• Added provider specialty to provider search detail screen. (ssmith)
• Added patients PCP to request detail screen. (pstuebne/vbatten)
• The sortable date shown in all inboxes is now the Requested Date of Service entered on all 'initial requests', rather than the 'createdate', or date submitted.  (ssmith / UM dept)
• All normal alerts shown in popups while doing an initial request, such as CCS, and Dupe checks, will now be displayed on the top of every request where the current CCS alert shows up. (pstuebne)
• Fixed level of care screen where Auth'd Days drop-down would be empty if all authorized day had already been assigned. A value of zero will always be available now.  (jowens)
• Work has been done on the level of care screen and request summary screen to pronounce the number of denied days on level-by-level basis for inpatient requests. (lrhed)
• User preferences!  I've been wanting to do this for some time now...  DRE now keeps a repository of user preferences so you'll be able, to some degree, taylor DRE to suit your work habits better.  With this release you can customize default values for approve / deny / cancel reasons, as well as modify DRE's behavior when submitting a request to decide to return to your inbox, start another request, or immediately open the request you just created. Hope this helps your carpel tunnel Vicki.  :o)  (vbatten) 

• The default approve reason has been changed to 'Clinical Judgement' (jowens)
• The default user on the request transfer page is the currently logged in user.  (jowens)
• The auth-count-by-submitter page has been updated to additionally show the count of reviewed cases per user as well.  (mjordan / jbraun)
• Fixed 'Navigation Canceled' error occuring when providers viewed their claims by date, view a claim detail, and clicked the back button to return to the claim list. (mtyler)
• Implemented the latest copy of the DRE Provider Provider Training Guide into the DRE help system. This includes instructions for EDI and other new features recently implemented into Referral Express. (ssmith) Thanks Shelli!

• Reason codes for Hold, Denied, and Closed (Cancelled) are now 'Diamond reason codes'.  Shortly after publication of this patch we will begin including reason codes as part of the auth export process.(claims dept)
• EDI Upload utility is now complete. EDI can now be submitted through the internet using DRE. (jsonderm)
• The members current group, plan, and line of business has been added to 'Search Patient' details. (ssmith)
• Added current group, plan and line of business to the complete member roster. (ssmith)
• Fixed bug allowing lower case characters in provider id's when editing a request. (demerson)

• Inbox enumeration on left.asp is now in a combobox control for providers. (demerson)
• Requested date of service is now editable for outpatient requests (vbatten)

• Fixed bug keeping provider alerts in the archive folder from opening. (demerson)
• Providers now have limited access to 'Hedis Projector' a tool which guesses at their Hedis population each provider is responsible for, as well as reports their current numerator which will be updated on a monthly basis. (Dr. C)
• The 'old' provider site has been completely removed from the provider web.
• Fixed a bug in the claims lookup feature keeping some inpatient claims from being shown. (ssmith)
• Added a provider infomation popup to the eligibility screen in patient dossier, as well as to the 'search patients' details screen. (ssmith)
• Completes some more work on web-based edi uploads, but it is still not available in this release. (jsonderm)

• Repaired a security error that occured whenever an external user logged on, searched a request, and tried to appeal before ever first going to a provider's inbox.  Normally, the inbox page remembers the last provider-inbox requested, and after an action like an appeal it would return the user to the last inbox they had been in.  If the user had never been to an inbox it will try to take the user to their personal inbox, such as "demerson Inbox".  In this situation, external users do not have personal inboxes, therefore when the system tries to verify that the inbox requested is a valid provider ID which the current user has access to, the validation fails giving the error, "Security Error, You dont have access to that provider ID!"  External users will now be returned to the DRE providers homepage after an action if they have not yet been to a provider inbox.  (ssmith)
• Simple monthly census has been integrated with DRE statistics. (sgivens)
• CCS Statistics added to stat module. (demerson)
• Added a new Hedis Projection tool.  Features of this tool will be improving drasticly over time. (jsonderm)
• Drasticly reducted the number of database connections made on the request summary page (demerson)
• Now displaying patients plan and group on both the request summary page, and the new request entry screen (once a member is selected). (ssmith)

• On providers 'Your Claims' selection screen, the member / date radio button will now automatically preselect when the date is changed, or the member ID box is clicked. (ssmith)
• Fixed bug in Patient Dossier keeping it from opening properly when using Netscrape. (ssmith)
• The graphs showing auths submitted by UM vs. Providers now has an adjustable year option.  Only 2001 was shown before.  (demerson)
• Some work has been completed on a web based, file upload utility for DRE.  It however is not available in this release. (jsonderm)
• Fixed bug in claims comment mailer.  Claims mailer now uses Mailer() from functions.asp.  (demerson)
• Fixed bug in patient quick-history screen.  All DRE auths were showing up as CCS. (vbatten)

For earlier release notes click here.