2004 Release Notes

• A399 - This publish will include your newborn report. You can run the report in DRE through Administration > Performance Statistics > Newborn Listings. (Near the census reports) Let me know if you need any adjustments to the report.

• When viewing claims for a member in Patient Dossier: o Inpatient claims will now show “INP”, “OUT”, or “ER” based on the IOE field in the HealthTrio Hospital Claims module. They were all just showing “INP” up to now. o Claims pending in H3 will now be indicated with a new “Pending” column.
• When editing Bed Days in DRE, you can no longer remove a span if it’s the only span existing on the request. At least one span is required to export to H3 properly, and DRE errors out when trying to view an inpatient request that’s had all spans removed.
• The baby editor has been updated to allow the user to enter the termdate of the baby’s eligibility span. Up to now it’s defaulted to DOB + 60 days.

• This update will include the additional pre-processing data displayed on the Edi History page as it’s populated from the Fix4010 update.

• This update will (hopefully) complete the pricing updated to the PM160 entry form. Which include: o CH06 will now export as CPT code 92499. o CH12 will now additionally export CPT code 86580A. (as well as 86580. Thanks for the clarification Laura) o Any immunization performed will result in CPT 90471 being export.
• Additionally, o Pad provider function has been removed from the provider search screen. (i.e. Type P42 tab, and it converted automatically to P00000000042) (ssmith) o Any DRE R request numbers shown in any DRE mails will be clickable to open that particular request without having to search for it. (vbatten)

• Allen, this publish will add the drug notes and lob specific drug notes to DRE’s formulary search.
• Shelli, this publish will improve the hospital claims searches. (Only the ‘by date’ searches) in DRE. Also the search code was moved to a stored proc to allow faster updates next time.
• Additionally, I think I may have to tweak the routine that evaluates if a particular user gets access to a particular members Patient Dossier to include hospitals. My guess it that hospital users rarely get access to a members patient dossier as it’s currently setup.

• EDI modifications. o edi-save.asp will no longer submit to the EDI web service. It simply saves and logs the transmission to avoid errors. o The web service (still used by the HIPAA file converter) now no longer saves EDI to the MSMQ sevice. Like DRE it simply logs the transaction and saves the file to disk to avoid error.
• PM160 Entry Form: This form will now not allow users to submit a claim if the claim number entered already exists. Hopefully this will help us better track errors by having users notify if they have to submit more than once due to a previous error. It will also greatly lessen the chance of duplicate claims getting entered.

• HPSJ DRE o New CSS styling applied to New Request form to make it more uniform with the rest of the site. o “New PM160” form updated to default “Height Quarter Inches” to 0 if not supplied. o “Formulary” section of the provider homepage was removed (along with all the old Advanced PCS formulary material) o The request inbox will now always show the “Inbox toolbar” (setting / logoff) regardless of the last page you viewed. o “New PM160” form modification. When entering CHDP lines, you can click the “C” or “D” textboxes on any particular line to clear the adjacent radio buttons on that line. Similarly, when entering Immunization lines you can clear the radio buttons on that particular line by selecting the blank immunization option from the drop down box on the line you want to clear.

• DRE Turtle Updates o “Search Claims by Date” page updated: Changed from “View your HPSJ claims” to “View your Turtle claims” o Formulary section of provider homepage removed. o Centered “new request” screen and made header text match PM160 form. o Changed HMO address on bottom of provider homepage to Turtle’s Sacramento address. o Converted Turtle’s RA/PA form, PDR form, and Confidentiality forms from Word DOC to PDF, and replaced them as necessary on the “Documents” section of the provider homepage. o Changed all outbound e-mail addresses for feedback to webadmin@turtlehealth.org o Updated links on provider homepage. Changed CPR Training link to American Heart Association link.

• Users assigned UM Manager permission will now properly see the ‘Administration’ link.
• A notice has been added to the “Search Patient” interface notifying providers that members having an unassigned PCP does not indicate lack of eligibility.
• Claim Number field has been added to the PM160 entry tool. This is a required field that defaults to “2004”.
• Claim Number has been added to the PM160 summary screen.
• Claim Number is now a searchable field in the PM160 lookup screen.
• Two records will no longer populate dreEdiHistory when users upload Edi. Now, the Edi webservice /web-services/edi.asmx will be the only script to update this table as it handles all Edi regardless of source.

• Added Baby Screen
  • When viewing any request with an auth type of “Obstetrics”, you’ll now see a new button labeled “Add Baby”.
  • Clicking this button will show you all person “9x” babies with this members member id.
  • From this screen you can click “Add Baby” and it’ll prompt you for Name, Sex, and DOB, and it’ll auto-generate the next “90” number is sequence to assign as their person number. (the next baby entered will be 91, etc…)
  • After filling out the form, and clicking save a new member will be created in DRE’s database of members. It’ll use the address info from the mother. Additionally it’ll create one period of eligibility under the same plan as the mom, spanning from DOB you enter, thru DOB + 60 days (for now).
  • That’s it. A new member has been created with can be searched from “Search Patients”, and can be added to requests, etc. Just use the proper person number when creating the request.
  • NOTE: This is a one-way thing. You can not delete these members after their created, and you can not edit their member records.
  • Requests entered with a person number 90, will move into Xpress as such.

• The “Patient Handout” function has been fixed, and will only reference dreProviders Now.
• The “Formulary Editor” has been fixed. o You can now add Formulary specific notes. o Drugs save properly now. o Tier 3 is now an available option
• “Search Formulary” has been updated. o Non-Formulary items now have a status of “Not Covered” rather than “N” o Tier code info is now displayed on searches when applicable.
• The search function in the M&R Guidelines has been fixed.

• DRE Provider will now be able to see their “old inboxes” for their P id’s.
• The Member History lookup has been fixed to show eligibility properly.

• 2.0.22 - 7/21/2004
  • On the request summary screen, all providers displayed can be clicked for more information about that provider in a popup box.
  • Provider info popup no longer referrences dbo.speciality. It now properly hits dbo.DRESpecialty.
  • PCN Pharmacies have been loaded to DREPharmacies and are viewable from the Search Formulary.
• 2.0.21 - 5/25/2004
  • DREDemo environment implementation - With this release, DRE will now be able to handle a demo environment for training and demonstration purposes. It will evaluate the URL of the inbound user. If the URL contains elements suggesting it's the demo, or development sites being hit the code will use an alternate database environment for the connection. Users will be alerted they're in the demo/dev environment by large, red " - DEMO ONLY - " flags showing on the login screen and throughout the site.
• 2.0.20 - 5/14/2004
  • Changes to the formulary storage schema and some UI changes. Rather than selecting LOB to search formulary, you'll now select a specific formulary which is internally mapped to particular groups / LOBs.
  • Manual letter builder is now in working condition. There are still more variables that will need to be mapped, but everything should be roughly functional now.
• 2.0.19 - 5/5/2004
  • 2004 M&R Care Guidelines (8th Edition) have been installed.
  • "Send comment on this claim" option has been disabled as requested. (drogers)
• 2.0.18 - 4/28/2004
  • In Search Members, the SSN field now additionally allow you to search for members by Case Number (as well as Medicaid # and SSN) (vbatten)
  • Bug fix for error occuring on deferrals and denials in the make determination screen. (pstubener)
  • A bit more work on the manual letter builder (allen)
• 2.0.17 - 4/26/2004
  • A major portion of DRE Letter Builder has been complete and is ready for beta testing. Still more work to be done in this area. (allen)
  • Provider search behavior has been updated a bit. Name searches will be trailing wild card rather than full wildcard searches. (jbraun)
  • A bit more work on the .net port of DRE has been complete.
• 2.0.16 - 3/27/2004
  • Product notes have been added to the formulary views. UM Managers can edit these notes (1 per LOB) which will be displayed when a user searches the formulary of that LOB. These notes will also be shown on our public website upon LOB specific formulary searches. (ashek)
  • More significant .net development of DRE. I'll hopefully be ready to beta test it's deployment within a couple weeks at the current rate. DRE.net will be billed as release 2.1. (demerson)
• 2.0.15 - 2/5/2004
  • Fixed bug on Administration \ Provider Maint \ Account Settings causing an error when they try and reset a users password. (lembry)
  • Significant development of the .net port of DRE. It's still only about 10-15% complete.
  • Updated the formulary editor due to changes in the formulary's data structures.
  • Revision of the formulary search form to include class search, string search, full listings, as well as sort options. This search now mirrors our public website formulary search and uses the same stored procedures.
• 2.0.14 - 2/5/2004
  • Added "Parents Decline CCS" combo-box to CCS Alert dialog. (losnes)
  • Added Re-Auth Status to Level of Care editor dialog. (losnes)
  • Now displaying Re-Auth (CCS) status for all CCS requests on the auth summary screen.
  • Only active UM users appear in the Reset Auth destination dialog now. (jbarun)
  • Auth reset notes now get saved to the audit trail. (bug)
  • Fixed broken link (404) on Statistics > Non-Admit Request Listing when clicking any Referral link. (mtyler)
  • Cosmetic changes to the Provider Alert editor, right-aligning the exit button on all associated pages.
  • Various XHTML / CSS / Javascript / Mozilla compatibility updates.
• 2.0.13 - 1/14/2004
  • When creating a new user, and a user with a matching username already exists, you will receive an appropriate error. (Fixed bug where you just got a blank screen given this circumstance.)
  • New NT User field added to user editor screen for internal users. This is to fix issues where we can't give a new staff member a username matching their NT username because that id already exists in DRE. (greynolds)
  • The login script has been modified to test NT authenticated users against the new NTUser field rather than loginid.
  • The Search Formulary option has returned to DRE now w/ LOB criteria options.
  • Formulary Editor has been added to the UM Manager menu in the Administration area of DRE.
  • The determination page has changed: Now only a UM Manager (currently Mary, Janet, and Dr. C) may approve a request containing a non-par provider or facility.
  • Provider Grivance form posted on provider homepage (TIF Format)
  • The Provider Homepage is now valid XHTML 1.1
  • Fixed bug on copy user page related to the 'ntuser' field addition. (ssmith)

For all earlier release notes click here.