- Claims requiring Auths will now have to match the modifiers for any procedure code on the claim. Four Modifier fields have been added to the Procedure Code section of the Auth update screen to allow for the input of these modifiers (Image 1).
- The field size of Referred By Name has been increased from 50 characters to 512 characters. This prevents a truncation error when a user looks up a Provider with an Org Name greater than 50 characters.
- Paid Through is set as expected when the “Set Paid Through” option is enabled under the VBA Control Panel.
- On the Ex Codes configuration screen, the HIPAA Code drop down will now display the HIPAA Code sorted by HIPAA Code instead of the description to be consistent with the way they are sorted by the screen if HIPAA Code is chosen as a sort criteria.
- Added an ID Code for VBAGateway Registration Code. This value is used during the VBAGateway registration process for members to gain access to the site. See VBAGateway Services.
- Added the option of No Other Insurance to the Priority list of Member Insurance. This will allow users to keep track when a member has no other insurance.
- Added MemEnrollmentPlan to the tables available to be selected in an advanced search on the Member Search screen. Users need the ability to include MemEnrollmentPan in searches since SubEnrollmentPlan is not populated when benefits are configured at the member level.
- Added an ID Code for VBAGateway Registration Code. This value is used during the VBAGateway registration process for providers to gain access to the site. See VBAGateway Services.
- Added a configuration item for managing Practice Types. This field is informational only and has no functional use but can be used for reports. This will allow user to create their own Practice Types or to change the description associated with existing Practice Types.
- Added Use First Diag Reference as an Application Setting (Image 2).
- Added a drop down for the user to select the Default EOB Report as an Application Setting (Image 2).
- Benefit matching logic will now check the flag Use First Diag Reference on the VBA Control Panel and if enabled will only match the diagnostic code identified by the first diag pointer
ALL NEW – VBAGateway Web Portal!
VBAGateway SERVICES VBAGateway Services are only enabled after a VBAGateway implementation is completed. Contact VBA for information about this exciting new product!- New services area added for communication with the VBAGateway site. This services area will facilitate the real-time transactions to and from VBAGateway. Included with the initial implementation of VBAGateway Services are automated actions around the following request types:
- MEMBER TERMINAL:
- Change Address – This request can be for the insured or for a specific member and will update the appropriate address information.
- Add Coverage – This request will add the selected plan to the most current enrollment record that fits the defined effective date.
- Terminate Coverage – This request will put an end date on the selected plan for thedefined termination date. This assumes the plan is active at the termination date.
- Disenroll Member – This request will disenroll the selected member using the VBA disenroll process.
- Add Member – This request will add a member to the selected family with the demographic information assigned.
- Request ID Cards – This request will add the defined number of copies to the ID Card Request module within VBA.
- PROVIDER TERMINAL:
- Change Address – This request will update demographic information for the Provider.
- Authorization – This request will create a VBA Authorization that can be utilized during adjudication.
- Each Request can be approved or rejected:
- Approved – Selected information is updated and response sent to VBAGateway. User can add Subject/Body information to the response if they like.
- Rejected – User prompted with Subject/Body screen to enter rejection information which is sent back as a response to VBAGateway.