Archives

VBA Software July 2017 Release Notes

ACCOUNTING SERVICES

  • Added a verification “Are you sure” message when using Undo from within Funding Requests.

AUTH SERVICES

  • Added the Auth Claims screen to the Auth update screen. This screen opens from the new Claims button on the toolbar. This screen displays claims linked to the Auth and allows navigation to those claims (Image 3).
  • Added Received Date and Urgent checkbox to Auth update screen (Image 3).

BENEFIT SERVICES

  • Added new Benefit Levels of Billing Taxonomy, Rendering Taxonomy, and Service Facility Taxonomy (Image 5).

BILLING SERVICES

  • Added Rate Category to the Rate Payee pop up screen on a Premium Rate. This column is used for informational purposes only (Image 2).

CLAIM SERVICES

  • Added the PPO Discount column to the Claim Details section of Processed Claims and Claims in Batch (Image 6).
  • Disability Claims will now properly carry over deductions when copying a claim.

ENROLLMENT SERVICES

  • When utilizing the Add Subscriber Wizard, the system will now propagate the Email Address entered during creation to the appropriate Member Address record. This will save manual data entry time for all users.

GROUP SERVICES

  • Added the ACH Account column to the Additional/COBRA Settings detail screen (Image 7).

PROCESS AUTOMATION

  • Added a new tag for use during the “Paid Claim” trigger:
    • ReportArg_ClaimNumber – this tag can be used for reports selected on a Report Series that are based on Claim_Number.

REPORT SERVICES

  • The criteria screen for the Historical Census by Group, under Enrollment Reports, has been modified to allow the input of multiple Plan Types (Image 1).
  • Added the ability to run the Enrollment Address Listing by Group, Coverage Type, and As of Date (Image 4).
  • Changed report names to reflect the type of claims on the report.
    • Claim Incurred/Paid per Tier by Group renamed to Medical Claim Incurred/Paid per Tier by Group
    • Claim Paid per Benefit by Group renamed to Medical Claim Paid per Benefit by Group
    • Claims Paid per Plan Type by Group renamed to Medical Claims Paid per Plan Type by Group
    • Claims Paid per Plan Type by Group with Vision/Flex renamed to Medical Claims Paid per Plan Type by Group with Vision/Flex
    • Claim Paid per Relationship and Gender by Group renamed to Medical Claim Paid per Relationship and Gender by Group
    • Claim Paid per Tier All Groups renamed to Medical Claim Paid per Tier All Groups
    • Claim Paid per Tier by Group renamed to Medical Claim Paid per Tier by Group
    • Claim Paid per Tier per Month All Groups renamed to Medical Claim Paid per Tier per Month All Groups
    • Claim Paid per Tier per Month by Group renamed to Medical Claim Paid per Tier per Month by Group
    • User Activity Report. This new report will display each user’s login time during the user specified dates as well as which actions the user has taken and how many times they’ve done the action. (Image 8).
    • Credit Report. This new report under Claim Audit Reports will show claim completed by user and group. (Image 9).

SYSTEM SERVICES

  • Reorganized the Application Settings on the VBA Control Panel to more accurately reflect the areas affected by various settings (Image 10). This should improve the overall understanding and impact of configuration options.
  • Added a new option to the VBA Control Panel: “Allow OOP Max on Override”. This new option will allow the user to override Deductible, Co-Insurance and/or Co-Pay on a claim while still enforcing the OOP limits defined by the plan. By default, if any of these fields are overridden, the OOP limit is ignored.

Image 1 – Added the ability to select multiple Plan Types.

Image 2 -Added Rate Category to Rate Payee.

Image 3 – Added Urgent, Received Date, and Auth Claims screen

Image 4 – New options to for Enrollment Address Listing.

Image 5 – Added new Benefit Levels

Image 6 – Added PPO Discount to Claim Detail

Image 7 – Added ACH Account

Image 8 – User Activity Report

Image 9 – Credit Report

Image 10 – VBA Control Panel

VBAGateway July 2017 Release Notes

MEMBER TERMINAL

  • New Screen – Message Center: The Messaging, Requests and Announcements PODs have been moved to a new Message Center Screen. The Screen can be found by clicking the “Message Center” link in the side menu (Image 1)
  • New POD – Contact Information: A new Contact Information POD has been added to the top menu (Image 8). This POD lists the administrator contact information. This contact information is saved in the Gateway config settings. Please contact the Help Desk with any configuration questions.
  • A new Config setting has been added that will hide the EOB link on the Claims Grid prior to the Claim being in “Paid” status. If this setting is off (which is default), the EOB link will always appear, regardless of the status.

PROVIDER TERMINAL

  • New Screen – Message Center: The Messaging, Requests and Announcements PODs have been moved to a new Message Center Screen. The Screen can be found by clicking the “Message Center” link in the side menu (Image 1)
  • New POD – Contact Information: A new Contact Information POD has been added to the top menu (Image 8). This POD lists the administrator contact information. This contact information is saved in the Gateway config settings. Please contact the Help Desk with any configuration questions.
  • A new Config setting has been added that will hide the EOB link on the Claims Grid prior to the Claim being in “Paid” status. If this setting is off (which is default), the EOB link will always appear, regardless of the status.

EMPLOYER TERMINAL

  • New Screen – Message Center: The Messaging, Requests and Announcements PODs have been moved to a new Message Center Screen. The Screen can be found by clicking the “Message Center” link in the side menu (Image 1)
  • New POD – Contact Information: A new Contact Information POD has been added to the top menu (Image 8). This POD lists the administrator contact information. This contact information is saved in the Gateway config settings. Please contact the Help Desk with any configuration questions.
  • A new Config setting has been added that will hide the EOB link on the Claims Grid prior to the Claim being in “Paid” status. If this setting is off (which is default), the EOB link will always appear, regardless of the status.
  • The Open Enrollment/Add Employee Wizard has been updated (these updates apply to the Open Enrollment Terminal and the Employer Terminal) (Images 2-7):
    • Fixed an issue on the Open Enrollment Wizard – Step 3: Add Coverage where Life Volume would be checked for, even when the Life Volume option was not enabled for a Plan, preventing a Plan from being selected.
    • Fixed an issue where selecting the “Back” button on Step 2 of the Open Enrollment Wizard would not load the Pay Rate field on Step 1. The Pay Rate field will now always load properly.
    • Fixed an issue where going back and forth between Step 1 and Step 2 of the Open Enrollment Wizard would sometimes cause the Dependents list on Step 2 not to load.
    • Updated the helper text on the Provider Lookup modal to match the modal’s function.
    • Updated the helper text (‘Click “Select this Plan” to choose this plan’) so that it will update with better instructions depending on the current status of the user’s plan selection.
    • Updated the Life and Flex plan types on the Open Enrollment Wizard to display the min and max for volume. Additionally, if amounts are entered that are greater than the max or less than the min allowed values, the textboxes will update to show the max or the min as appropriate.
    • Life Volume labels have been updated to remove cents and an “Enter volume” label has been added.
    • Minor cosmetic changes have been made to the “Apply” and “Select this Plan” labels
    • The Life Volume Edit pencil icon has been moved to the right side of the Volume. Clicking this icon allows the user to edit their Volume entry.
    • An issue has been fixed on Life Plans with Volume disabled: After clicking Select, then clicking “I don’t want this plan” the label would fail to switch back to “Select this Plan”. The label now displays properly for these plans.
    • The Flex Election entry box has been moved below the information labels to match the location of similar fields on other plan types.
    • Flex Election can now be edited using the pencil icon, which functions identically to the Life Volume edit.
    • When there is no Life Volume or Flex Election entry on a Life or Flex plan, there is now an empty space between the “You have selected this plan” label and the option buttons so that the plan boxes will line up properly. This results in all plan boxes being the same height at all times, which prevents display issues.
    • Dollar signs have been added to the dropdown list for Life Volume, and the values are now right aligned.
    • The “View Plan Summary” button has been moved to the plan box header, and will now display as a PDF icon for plans with a plan summary document uploaded.
    • Some borders in the plan boxes have been updated to fix a graphical issue. All borders have been gerrymandered and will now display correctly!
    • The Back button on the Add Coverage Screen will now walk back through the plan types instead of going directly to Step 2. Users will only be taken back to Step 2 when pressing Back from the first plan type listed.
    • Step 5: Confirm will now refresh its data every time the screen is browsed to.
    • An issue was fixed where the Dependents grid on Step 2: Add Dependents was occasionally not loading the dependents when you returned to the screen from Step 3: Add Coverage.
    • The dependents added to each plan on Step 3: Add Coverage are now listed on Step 5: Confirm
  • Fixed an issue where the Division Dropdown on the Employer Terminal Subscriber Lookup modal was returning the Group and Division instead of only the Division. This was preventing Subscriber lookup by Division.
  • The Enrollment History grid on the Census Screen is now sortable by clicking on grid header fields.
  • The “Plan Name” field on the Plans POD of the Open Enrollment Configuration Wizard now wraps its text and will show the full Plan Name instead of cutting off.

OPEN ENROLLMENT TERMINAL

  • New Screen – Message Center: The Messaging, Requests and Announcements PODs have been moved to a new Message Center Screen. The Screen can be found by clicking the “Message Center” link in the side menu (Image 1)
  • New POD – Contact Information: A new Contact Information POD has been added to the top menu (Image 8). This POD lists the administrator contact information. This contact information is saved in the Gateway config settings. Please contact the Help Desk with any configuration questions.
  • A new Config setting has been added that will hide the EOB link on the Claims Grid prior to the Claim being in “Paid” status. If this setting is off (which is default), the EOB link will always appear, regardless of the status.
  • The Open Enrollment/Add Employee Wizard has been updated (these updates apply to the Open Enrollment Terminal and the Employer Terminal) (Images 2-7):
    • Fixed an issue on the Open Enrollment Wizard – Step 3: Add Coverage where Life Volume would be checked for, even when the Life Volume option was not enabled for a Plan, preventing a Plan from being selected.
    • Fixed an issue where selecting the “Back” button on Step 2 of the Open Enrollment Wizard would not load the Pay Rate field on Step 1. The Pay Rate field will now always load properly.
    • Fixed an issue where going back and forth between Step 1 and Step 2 of the Open Enrollment Wizard would sometimes cause the Dependents list on Step 2 not to load.
    • Updated the helper text on the Provider Lookup modal to match the modal’s function.
    • Updated the helper text (‘Click “Select this Plan” to choose this plan’) so that it will update with better instructions depending on the current status of the user’s plan selection.
    • Updated the Life and Flex plan types on the Open Enrollment Wizard to display the min and max for volume. Additionally, if amounts are entered that are greater than the max or less than the min allowed values, the textboxes will update to show the max or the min as appropriate.
    • Life Volume labels have been updated to remove cents and an “Enter volume” label has been added.
    • Minor cosmetic changes have been made to the “Apply” and “Select this Plan” labels
    • The Life Volume Edit pencil icon has been moved to the right side of the Volume. Clicking this icon allows the user to edit their Volume entry.
    • An issue has been fixed on Life Plans with Volume disabled: After clicking Select, then clicking “I don’t want this plan” the label would fail to switch back to “Select this Plan”. The label now displays properly for these plans.
    • The Flex Election entry box has been moved below the information labels to match the location of similar fields on other plan types.
    • Flex Election can now be edited using the pencil icon, which functions identically to the Life Volume edit.
    • When there is no Life Volume or Flex Election entry on a Life or Flex plan, there is now an empty space between the “You have selected this plan” label and the option buttons so that the plan boxes will line up properly. This results in all plan boxes being the same height at all times, which prevents display issues.
    • Dollar signs have been added to the dropdown list for Life Volume, and the values are now right aligned.
    • The “View Plan Summary” button has been moved to the plan box header, and will now display as a PDF icon for plans with a plan summary document uploaded.
    • Some borders in the plan boxes have been updated to fix a graphical issue. All borders have been gerrymandered and will now display correctly!
    • The Back button on the Add Coverage Screen will now walk back through the plan types instead of going directly to Step 2. Users will only be taken back to Step 2 when pressing Back from the first plan type listed.
    • Step 5: Confirm will now refresh its data every time the screen is browsed to.
    • An issue was fixed where the Dependents grid on Step 2: Add Dependents was occasionally not loading the dependents when you returned to the screen from Step 3: Add Coverage.
    • The dependents added to each plan on Step 3: Add Coverage are now listed on Step 5: Confirm

VBAGateway Global (All Terminals)

  • Fixed an issue where no notification was sent to the user when Registration failed on certain errors. Notifications will now be sent for all Registration messages.

Image 1 – Message Center menu item

Image 2 – Open Enrollment Wizard – Step 1: Employee Information

Image 3 – Open Enrollment Wizard – Step 2: Add Dependents

Image 4 – Open Enrollment Wizard – Step 3: Add Coverage (Life & Disability)

Image 5 – Open Enrollment Wizard – Step 3: Add Coverage (Flex)

Image 6 – Open Enrollment Wizard – Step 4: Other Insurance

Image 7 – Open Enrollment Wizard – Step 5: Confirm

Image 8 – Contact Us POD

VBA Software May 2017 Release Notes

BILLING SERVICES

  • Added Group ID column to the results of the Finalized Invoices configuration item (Image 1).
  • Added Finalized column to the Invoice Search screen (Image 2).

CARE MANAGEMENT SERVICES

  • Fixed an issue where questions would not properly sort after being moved up or down in the list.
  • Fixed an issue where Custom Case Values were not being transported over when a new Case was built from an existing Care Plan. These custom values will now properly display for edit on the Case when available.

CLAIM SERVICES

  • Added the ability to add a note to all adjusted claims when using the Claim Adjustment Wizard (Image 3) (Image 4).
  • Ex Codes added during the Life Claim creator will now properly move to batch.

ENROLLMENT SERVICES

  • Improved functionality of the COBRA Premium Rate Selection screen of the Enrollment Disenroll Wizard (Image 5).
    • Added the Rate Category column.
    • Added the Sort and Filter options.
  • Added the 1st of Month After X Months option to the Waiting Period Type list box on the Enrollment Waiting Period Details screen (Image 6). This option will allow the Enrollment Wizard to determine the date of enrollment as the 1st of the month after the entered number of months.
  • Added the option to define custom Member Plan Years in the Member Detail section of the Enrollment Update screen (Image 7). Selecting Custom in the Member Plan Year list box will display a button that will open the
  • In the Enrollment Management window, the data is now sorted by Date, Plan ID with the latest Plan/Rider at the top of the list (Image 9).
  • In the Add Enrollment Wizard there are new entry options for E-mail, Suffix and Middle Initial (Image 10) (Image 11).
  • When adding an Enrollment Plan the application will now prevent the entry of a Start Date prior to the Members Date Enrolled or the Members Birth Date.
  • When prompted with Retro-Adjustments you can now apply the Adjustment Reason set on the first Adjustment to all Adjustments. Click the “Set Reason” button after you enter the Adjustment Reason on the first record and that Reason will be applied across all Retro-Adjustments being entered (Image 12).

NOTE SERVICES

  • Added the ability to drag-and-drop files from Windows Explorer into the Note Attachment section of the Note Update screen.

PROVIDER SERVICES

  • Added Payee NPI column to the Provider Search screen (Image 8).

Image 1 – Added Group ID

Image 2 – Added Finalized to Invoice Search

Image 3 – Add Note option

Image 4 – Add Note screen

Image 5 – Added Rate category column and the Sort and Filter options.

Image 6 – Added the 1st of Month After X Months option.

Image 7 – Member Pan Year

Image 8 – Added Payee NPI

Image 9 – Enrollment Management sort

Image 10 & 11 – Add Enrollment Wizard Suffix, E-Mail and Middle Initial

Image 10 & 11 – Add Enrollment Wizard Suffix, E-Mail and Middle Initial

Image 12 – Set Adjustment Reason on All Adjustments

VBAGateway May 2017 Release Notes

MEMBER TERMINAL

  • No changes

PROVIDER TERMINAL

  • No changes

EMPLOYER TERMINAL

  • The Review Open Enrollment Submissions Screen has been updated (Image 5)
    • The Review Open Enrollment Submissions Screen now matches the Open Enrollment Confirmation page in appearance and displayed data (see Open Enrollment Terminal below)
    • Occupation, Pay Rate, and Pay Frequency fields have been added
    • The Selected Coverage section has been revamped to display Coverage grouped by Plan Type
    • Each section of the Review Screen now links to an editable version of the Open Enrollment Wizard – clicking the Edit button (pencil icon) will take the user directly to the step associated with that section. For example, clicking Edit on “Selected Coverage” will take the user directly to Step 3 – Add Coverage of the Open Enrollment Wizard
  • New Screen: Advice to Pay (Voucher Claims)
    • A new Advice to Pay Claims option has been added to the Claims menu. Clicking “Voucher Claims” will take the user to the Vouchers Screen (Image 4). This POD can be relabeled if necessary to reflect AtP claims.
    • To view Claims on the Advice to Pay (Vouchers) Screen, select the search button (magnifying glass icon) at the top right of the screen. Enter search criteria to return a set of Voucher Claims
    • Single EOBs can be viewed per Claim by clicking on the Claim ID link
    • Advice to Pay (Voucher) EOBs can also be exported as a batch – click the report export button (page icon) on the bottom left of the Advice to Pay (Vouchers) POD to generate a multi-EOB report for all EOBs that were returned by the search
    • Export to Excel is enabled on this Screen – click the Excel icon on the bottom left of the Advice to Pay (Vouchers) POD

OPEN ENROLLMENT

  • The Open Enrollment Confirmation Screen has been updated (Images 1 and 2)
    • The Review Open Enrollment Submissions Screen has been updated to better display the added data in an easier to read format
    • Occupation, Pay Rate, and Pay Frequency fields have been added
    • The Selected Coverage section has been revamped to display Coverage grouped by Plan Type

VBAGateway Global (All Terminals)

  • The Terminal dropdown list on the Register Screen now reads “Open Enrollment/New Hire” instead of “Open Enrollment” for the Open Enrollment Terminal option (Image 3)

Image 1 – Open Enrollment Confirmation

Image 2 – Open Enrollment Confirmation

Image 3 – Registration Terminal Text

Image 4 – Voucher/Advice to Pay Claims

Image 5 – Employer Terminal Enrollment Confirmation

VBAGateway April 2017 Release Notes

MEMBER TERMINAL

  • The Member Accumulator POD has been redesigned and updated to include more information and is now easier to read! (Image 1)

PROVIDER TERMINAL

  • No changes

EMPLOYER TERMINAL

  • Clicking on an Add Employee Request in the Requests POD will now take you to the Add Employee Wizard where you can edit the Request.
  • The missing icon for New Open Enrollment Requests has been located and returned to the Requests POD.
  • A “Finish” button has been added to the final step of the Enrollment Configuration Wizard (Config>Enrollment) so that finalizing enrollment settings is more intuitive.
  • Fixed an issue that caused the “Create a Member Request” dropdown on ET Census to be hidden. The dropdown will now display correctly.
  • The Add Employee Wizard has been updated!
    • Add Employee Wizard>Employee Information (Step 1): Marital Status is now required and cannot be left blank.
    • Add Employee Wizard>Employee Information (Step 1): The Email, Work Phone, and Home Phone fields are no longer required.
    • Add Employee Wizard>Add Dependents (Step 2): Gender and Relationship are now required and cannot be left unselected.
    • Add Employee Wizard>Add Coverage (Step 3): The “Waive Medical Coverage” button on Step 3 (Add Coverage) of the Add Employee Wizard can now be hidden based on configuration settings. Please contact Help Desk if you wish to configure this setting.
    • Add Employee Wizard>Confirmation (Step 5): Occupation, Pay Rate, and Pay Rate Frequency have been added to the Review Information Screen (Image 2)
    • Add Employee Wizard>Confirmation (Step 5): The Selected Coverage POD now displays the selected Tier’s description, instead of the single character Tier code.
    • Add Employee Wizard>Confirmation (Step 5): The Dependents POD now displays the full Relationship description, instead of the single character Relationship code.
    • Add Employee Wizard>Confirmation (Step 5): The Other Insurance POD now displays the full Member Name, instead of only the Member Sequence.
    • Add Employee Wizard>Confirmation (Step 5): The Other Insurance POD now displays the full Plan Type description, instead of the Plan Type code.
  • The document names in the My Docs and My Member Docs PODS (Config>Settings) are now hyperlinked to the uploaded document. Users can click these links to review the uploaded documents (Image 3)

OPEN ENROLLMENT

  • The Open Enrollment Wizard has been updated!
    • Open Enrollment Wizard>Employee Information (Step 1): Marital Status is now required and cannot be left blank.
    • Open Enrollment Wizard>Employee Information (Step 1): The Email, Work Phone, and Home Phone fields are no longer required.
    • Open Enrollment Wizard>Add Dependents (Step 2): Gender and Relationship are now required and cannot be left unselected.
    • Open Enrollment Wizard>Add Coverage (Step 3): The “Waive Medical Coverage” button on Step 3 (Add Coverage) of the Open Enrollment Wizard can now be hidden based on configuration settings. Please contact Help Desk if you wish to configure this setting.
    • Open Enrollment Wizard>Confirmation (Step 5): Occupation, Pay Rate, and Pay Rate Frequency have been added to the Review Information Screen.
    • Open Enrollment Wizard>Confirmation (Step 5): The Selected Coverage POD now displays the selected Tier’s description, instead of the single character Tier code.
    • Open Enrollment Wizard>Confirmation (Step 5): The Dependents POD now displays the full Relationship description, instead of the single character Relationship code.
    • Open Enrollment Wizard>Confirmation (Step 5): The Other Insurance POD now displays the full Member Name, instead of only the Member Sequence.
    • Open Enrollment Wizard>Confirmation (Step 5): The Other Insurance POD now displays the full Plan Type description, instead of the Plan Type code.

VBAGATEWAY GLOBAL (ALL TERMINALS)

  • No changes

Image 1 – Member Accumulators

Image 2 – Add Employee Review: Occupation and Pay information

Image 3 – My Docs Hyperlink

VBA Software April 2017 Release Notes

CLAIM SERVICES

  • Copy Disability Claims will now queue all claims that are created so that using the navigation buttons will cycle through the new claims (Image 1).
  • Flex claims that are automatically created by the system will now link to the medical claim in the Referenced Claims screen.
  • Display the Pricing Method on Processed Claims. This data will be shown on the More Information screen (Image 4).
  • Hovering over the COB field on processed claims will now show the COB detail information including the Other Insurance Paid, Other Insurance Member Responsibility, COB Savings applied and COB Savings used (Image 5).
  • Claim Audits can now be scheduled using a defined Event. When entering your Claim Audit and defining your criteria and sample size, you will have to option to select a “Claim Audit Event” that will be used to fire this Audit on the defined schedule (Image 8).

ENROLLMENT SERVICES

  • Disenroll and Reenroll buttons are now disabled for users with View Access.

EVENT SERVICES

  • Searching Events can now be searched by the indicator defining that Event as a “Process Automation Event” or a “Claim Audit Event” (Image 6).
  • Events can now be defined as a “Claim Audit Event”. A “Claim Audit Event” is used when defining a Claim Audit that needs to be run on a schedule (Image 7).

REPORT SERVICES

  • New report, Census Summary Med/Den by Tier under Enrollment, that counts the member/dependents based on the Tier assignment or the Member Enrollment records (Image 3).

SECURITY SERVICES

  • The Report List and Applied Report sections of the Security Area Maintenance screen are now sorted alphabetically (Image 2).

Image 1 – Copies will now queue for navigation

Image 2 – Report List sort

Image 3 – Census Summary Med/Den by Tier

Image 4 – Display Pricing Method on Processed Claims

Image 5 – COB Details on Processed Claims

Image 6 – Search Events by Process Automation or Claim Audit

Image 7 – Claim Audit Event

Image 8 – Automated Audit options

VBAGateway March 2017 Release Notes

MEMBER TERMINAL

  • Member Accumulators will now show additional years even if there is no Claim data associated with that year.

PROVIDER TERMINAL

  • No changes

EMPLOYER TERMINAL

  • Enrollment Periods can now be marked as “New Hire Only.” Enrollment Periods that are marked as “New Hire Only” will only be available for Registration. These Periods will not prompt Members that they are in an Open Enrollment Period. To set a Period as “New Hire Only,” use the Enrollment Settings Screen (Config>Enrollment) (Image 1).
  • Plan Options have been expanded (Config>Plan Settings) (Image 2).
    • Allow Flex Election Entry
      1. Flex Election Minimum
      2. Flex Election Maximum
    • Allow Life Volume Entry
      1. Life Volume Minimum
      2. Life Volume Maximum
      3. Life Volume Increment
        • The increment by which Life Volume increments in Open Enrollment.
  • Plan Description Override
    1. Text in this field will be used in Gateway instead of the traditional Plan Name. To use the traditional Plan Name, leave this field blank.
  • Hide on Employer Terminal
    1. Check this box to hide this Plan in Plan lists on the Employer Terminal. An example is the Census Employee Information POD.
  • Hide on Member Terminal
    1. Check this box to hide this Plan in Plan lists on the Member Terminal. An example is the Employee Information POD, and the Member Information Card.
  • Changed the “Paid” column header to “Payable” on the Employer Home Screen>Top 5 Benefit Category Utilization + Remaining POD to better describe the data in that column.

OPEN ENROLLMENT

  • No changes

VBAGATEWAY GLOBAL (ALL TERMINALS)

  • No changes

Image 1 – New Hire Only Option

Image 2 – Expanded Plan Options

VBA Software March 2017 Release Notes

AUTH SERVICES

  • Added the Auth Type Places section to the Auth Types configuration area.  This allows Auths to be determined by Place of Service (Image 1).

BENEFIT SERVICES

  • Copying a plan will properly copy annual and lifetime max amounts.

CLAIM SERVICES

  • Added new fields to the CLAIMPROCESSDATEUSER table under criteria options for Claim Audits.  The new fields available for selection will allow audits to be performed based on the activity within the VBA Workflow Services area (Image 4).

GROUP SERVICES

  • Added a new message when reenrolling a group asking the user if they wish to only reenroll members that were disenrolled with the group.

PROVIDER SERVICES

  • Modified the functionality of the Alternate Provider list to not ask the user if he would like to synchronize in the situation where nothing has been modified.
  • When the user unchecks Apply Ex Code under Network Configuration, if an Ex Code was selected prior, it will no longer be used.

REINSURANCE SERVICES

  • Deleting a Reinsurance Contract will no longer behave abnormally in some instances.

SECURITY SERVICES

  • Modified User Restrictions to allow for exclusions.  The Restriction – Group, Restriction – Fee Schedule, Restriction – Provider, and Restriction – Network tabs on the User Restriction screen have an option to Exclude (Image 3).

PROCESS AUTOMATION

  • Modified the appearance of Process Automation Template Arguments.  This gives more clarity to the arguments assigned to each Process Automation trigger (Image 2).
  • Added a new Process Automation Trigger – Check Process by Check.  This new trigger will fire for each check within a Claim check run.  This trigger has the following parameters:
    • ach_account_name – For “payment_method” = FWT, this is the account name for who is being paid.
    • ach_account_number – For “payment_method” = FWT, this is the account number for who is being paid.
    • ach_bank_name – For “payment_method” = FWT, this is the bank name for who is being paid.
    • ach_routing_number – For “payment_method” = FWT, this is the routing number for who is being paid.
    • check_account_key – The Account Key on this Check.  This is the internal Account Key value for the source of funds.
    • check_batch – The Check Batch identifier for this Check Run.
    • check_batch_date – The Paid Date for this Check Run.
    • check_batch_description – The Description assigned to the Check Batch for this Check Run.
    • check_claim_count – The total number of claims paid on this Check.
    • check_date – The Check Date value for this check.
    • check_id – The Check ID value for this check.  Check ID is the internal ID used to identify a unique check.
    • check_number – The Check Number value for this check.  This is the number you see on checks, EOBs and reports.
    • check_paid – The Amount Paid on this Check.
    • check_payor_id – The Payor ID on this Check.  This is the internal Payor ID value for the source of funds.
    • check_run_check_count – The total number of checks paid in this Check Run.
    • check_run_claim_count – The total number of claims paid in this Check Run (includes denied claims and $0.00 payable claims).
    • check_run_paid – The total amount paid on all checks in this Check Run.
    • payment_method – This identifies how the Check was paid.  CHK = Check Cut, FWT = Wire Transfer
    • payto_address – The Pay To Address for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group Address, B = Beneficiary Address, S = Subscriber Address, V = Provider Address, P = Payee Address
    • payto_address2 – The Pay To Address2 for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group Address2, B = Beneficiary Address2, S = Subscriber Address2, V = Provider Address2, P = Payee Address2
    • payto_city – The Pay To City for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group City, B = Beneficiary City, S = Subscriber City, V = Provider City, P = Payee City
    • payto_email – The Pay To Email for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group Email, B = Beneficiary Email, S = Subscriber Email, V = Provider Email, P = Payee Email
    • payto_id – The Pay To ID for this Check.  Based on the “send_check_to”, this value holds different IDs.  G = Group_ID, B = Beneficiary_ID, S = Subscriber_ID, V = Provider_ID, P = Payee_ID
    • payto_name – The Pay To Name for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group Name, B = Beneficiary Name, S = Subscriber Name, V = Provider Name, P = Payee Name
    • payto_state – The Pay To State for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group State, B = Beneficiary State, S = Subscriber State, V = Provider State, P = Payee State
    • payto_state_name – The Pay To State Name for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group State Name, B = Beneficiary State Name, S = Subscriber State Name, V = Provider State Name, P = Payee State Name
    • payto_zip – The Pay To Zip Code for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group Zip Code, B = Beneficiary Zip Code, S = Subscriber Zip Code, V = Provider Zip Code, P = Payee Zip Code
    • send_check_to – This is who the check is being sent to.  G = Group, B = Beneficiary, S = Subscriber, V = Provider, P = Payee
    • ReportArg_AccountKey – Account Key for reports in this series.
    • ReportArg_CheckBatch – Check Batch for reports in this series.
    • ReportArg_CheckID – Check ID for reports in this series.
    • ReportArg_PayorID – Payor ID for reports in this series.
    • ReportArg_PayToID – Pay To ID for reports in this series.

    Image 1

    Image 2

    Image 3

    Image 4

VBA Software February 2017 Release Notes

CLAIMS SERVICES

  • Added the ability to add deductions to life claims.
  • Added the ability to perform Real-Teme Provider matching utilizing the BaseLoad SureHitLite process through adjudication. When a claim has no provider assigned, the service will attempt to find one based on the other information present in the claim. Please contact VBA to learn more about our partnership with BaseLoad or to have your environment configured to leverage this new feature!

COMMISSION SERVICES

  • Modified the Calculate Commissions process to use the Commission Lookback in Months option from the Additional/COBRA Settings detail screen for a Group (Image 1). This indicates the number of months the commission process will lookback at terminated rates when performing commission calculations.

ENROLLMENT SERVICES

  • Added the ability to Delete a Member. Under Enrollment Services  Enrollments, you can now Right-Click > Delete a Member that has been previously entered (Image 3). You cannot delete a Member identified as the Insured or any Member who has the following information created: Claims, Invoices, Care Management or Reinsurance. All other information bound to the Member will be automatically deleted when the Member is deleted.

GROUP SERVICES

  • Added the option to Apply Plan ID Codes within the Group Contract Add Wizard. This will allow for efficiency to include updates/changes and avoid missing the updating of critical ID Codes that are used for imports/exports (Image 2).

PROCESS AUTOMATION

  • Modified the “Add Subscriber Enrollment” trigger with the following rules:
    • Medical, Dental, Vision and Flex plan types will work in tandem when determining whether a trigger has previously been fired. This means that if the Add Enrollment trigger fired for Medical it will not also fire for Dental when Medical was already sent.
    • When a Tier change is made that limits the coverage in the family, the Process Automation trigger will not fire. For example, changing coverage from Family to Employee Only will not fire the trigger.
    • Changing Tier that results in covering the Spouse when previously the Spouse was not covered will result in a new trigger being fired.
    • Removed “Plan Start” from the Process Automation tracking. This was causing many duplicate Process Automation Series on enrollments that were simply going through a contract change, division change or tier change.

Image 1 – Commission Lookback in Months

Image 2 – Apply Plan ID Codes

Image 3 – Delete Member

VBAGateway February 2017 Release Notes

MEMBER TERMINAL

  • Date of Birth has been added to the Family Details POD.

PROVIDER TERMINAL

  • No changes

EMPLOYER TERMINAL

  • A new Plan Settings Configuration page has been added under Config>Plan Settings. (Image 3)
    • To use this Screen, click on the Plan you would like to configure inside the “Select a Plan” POD.
    • Clicking on a Plan in the “Select a Plan” POD will load the two other PODs: Plan Options and Plan Labels.
      1. Plan Options:
        • Upload or Delete a Plan Document:
          • When there is a Plan Document Uploaded, a link will appear with the Plan ID and Plan Name. If there is no document uploaded, a message will appear that says “Please Upload a Plan Document.”
          • To Upload a Document, click the “Upload” button and browse to the PDF you would like to upload.
          • To Delete a Document, simply click the “Delete” button.
        • Hide Plan on Coverage Selection:
          • This checkbox will hide the selected Plan from the “Add Coverage” step (Step 3) of the Open Enrollment/Add Employee Wizards. To hide a Plan, check this checkbox and click “Update Plan Options.”
        • Hide In/Out of Network Tabs on Coverage Selection:
          • This checkbox will hide the “In Network” and “Out of Network” tabs for this Plan on the Plan Card of the “Add Coverage” step (Step 3) of the Open Enrollment/Add Employee Wizards, and replace them with a single tab that says “Plan Details.” When this checkbox is selected all Plan Labels entered for this Plan will appear under this tab whether they are marked “In Network” or “Out of Network.” To select this option, check the checkbox and click “Update Plan Options.”
          • See (Image 4) for comparison between selecting this option and not selecting this option.
        • If you have questions regarding utilizing Plan Options, please contact the Help Desk.
      2. Plan Labels:
        • Use the Plan Labels POD to add labels to the Plan Card that appears on the “Add Coverage” step (Step 3) of the Open Enrollment/Add Employee Wizards. Plan Labels are free form key/value pairs that can be used to describe the highlights of a Plan to a user during coverage selection. (Image 1)
        • Users can set a Plan Label to appear on the “In Network” tab or the “Out of Network” tab by selecting “Yes” – for “In Network”, or “No” – for “Out of Network.” (Image 5)
        • If you have questions regarding utilizing Plan Labels, please contact the Help Desk.
  • The Census Screen has been updated!
    • The Employee Lookup List has been moved to a Lookup Modal. To perform a lookup, click the Search icon in the top right of the Screen. This will display the Lookup Modal.
      1. The Employee Lookup List is now filterable/searchable. To search, enter search criteria in one of the search fields and then press enter. This will narrow the results based on your search.
      2. To change the filter/search options (such as changing your search to “Starts With” instead of “Is Equal To”), click the filter icon next to the search box.
      3. To cancel the search filter and show all results again, click the “X” icon.
    • The Census PODs now have more screen real estate and will display more data.
    • The Family Details POD now matches the Member Terminal’s version, including the added Date of Birth field.
    • The Employee Information POD now matches the Member Terminal’s version.
    • The Census Accumulators have been updated to function similarly to the Member Terminal’s Accumulators POD. Users must select a Plan Type and an Accumulator Period to view the Accumulator data.
  • Fixed an issue in the HTML Editor on the Enrollment Configuration > Division Settings Screen where highlighted text was unreadable. The highlighted text will now display with white font on top of a dark background.
  • Fixed an issue in the HTML Editor on the Enrollment Configuration > Division Settings Screen where lengthy text caused graphical issues. The Editor can now manage HTML content of any length.
  • The Config>Confirmation screen data grids will no longer display “null” when there is no data for a field.

OPEN ENROLLMENT

  • The Coverage Cards on Step 3 of the Open Enrollment Wizard have been improved! (Image 1)
    • All cards are now a standard height and will display with no issue no matter how many plans are displayed.
    • Help text now exists on each card explaining to the user the status of that plan – when it has been selected, when it has not been selected (and how to select it), or when the plan has been selected because it is non-elective.
    • The Plan Labels section of the card now scrolls to accommodate lengthy or many Plan Labels.
  • The Review/Confirm Enrollment Page (Step 5 of the Open Enrollment Wizard) has been updated. This Screen now includes the information added with the Wizard so the User can verify the information before submitting the enrollment request. (Image 2)
  • The “Waive Coverage Reason” field is now Required when waiving coverage.
  • Fixed an issue where the Home menu item would not take the user to the Home page of the Open Enrollment Terminal. The button will now take the user to the Home page.
  • Fixed an issue where using the Back button on Step 2 of the Open Enrollment Wizard would cause Step 1 to create a duplicate enrollment entry when Step 1 is submitted.
  • Fixed an issue with the Confirm Screen where the data grids were limited to showing a maximum of 5 rows. These grids will now show all applicable rows.
  • The Confirm screen data grids will no longer display “null” when there is no data for a field.
  • The Step Indicator Bar now hides when the screen width is too small to display it entirely.

VBAGATEWAY GLOBAL (ALL TERMINALS)

  • The Help text for all PODs have been updated, and a few typos have been fixed.

Image 1 – Open Enrollment Coverage Cards

Image 2 – Open Enrollment Confirmation Screen

Image 3 – Plan Settings Screen

Image 4 – Plan Card Tabs

Image 5 – Plan Label Entry

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