Chapter 15 Breast and Cervical Cancer Program (BCCP)

15.1 BREAST AND CERVICAL CANCER PROGRAM SCREEN FLOW FOR PARTICIPANT (A)

Please refer to the "Cornerstone Breast and Cervical Cancer Program (BCCP) Screen Flows" displayed in Appendix A.

The following Screen Flows are available:

A.1.1 New Participant (BCCPNew)

A.1.2 Established Participant (BCCPEST)

A.1.3 In-State Transfer All Categories (BCCPINXFER)

A.1.4 Termination (BCCPTERM)

A.1.5 Reactivate/Data Correction/Termination (BCCPREACT/DATACORR/TERM)

Sequence of Screens

When fast path keys are not available at the bottom of the screen, easy access to various screens is available by pressing the CTRL and F9 keys simultaneously. Please refer to Chapter 2 "System Environment" under "2.4.3 Other Features" for more information.

Initial Intake Process

Participant Look-Up (PA01)

Prior to registration into Cornerstone, the Participant Look-up is used to verify the existence of a participant ID number by searching the Master Index to find a participant who may have previously been enrolled in Cornerstone.

The screen is used to copy minimal demographic information on a participant who is already enrolled in Cornerstone to the local computer files. A "copy-in" of this data is necessary prior to performing a shared data Wide Area Network (WAN) look-up.

Use of the Participant Look-up reduces duplicate entry of participants. For this reason, the Participant Look-up must be performed before a new participant can be enrolled into the Cornerstone system.

Please refer to Chapter 3 "Participant Screens" under "3.1 Participant Look-up (PA01)" for more information.

For information about resolving duplicate participants in Cornerstone, please refer to Chapter 3 "Participant Screens" under "3.21 Participant Duplicate Browse (PA21)."

Participant Enrollment (PA03) - Add/Edit Address as needed

This screen is used to enroll a new participant into the Cornerstone system and to capture demographic information for a new or existing participant. If the participant is already enrolled in Cornerstone, this screen is used to view and update demographic information.

The Participant Enrollment screen (PA03) is completed only once for each participant participating in Cornerstone programs, but can be edited thereafter. participants may be made active in several programs from the same enrollment record.

The processing within this screen includes checking for duplicate enrollment; assigning a unique, permanent statewide participant ID number (when enrolling a participant for the first time in Cornerstone); assessing potential eligibility for Cornerstone programs; and recording a participant's date of death.

The user has the option to select a Wide Area Network (WAN) look-up on this screen by pressing the F2 shared data key. This will copy-in and add to the local data any additional information found in the statewide search of the participant look-up function.

From this screen, the "Address" pop-up window is used to record address and telephone information by pressing F9.

Every BCCP participant must have an "Address Type" entered as "R" to enable this data to be included in the biannual Minimum Data Element (MDE) submissions to the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

Please refer to Chapter 3 "Participant Screens" under "3.3 Participant Enrollment (PA03)" for more information.

Program Information (PA15)

The Program Information screen (PA15) must be completed for every program in which the participant will be participating. This screen is completed in order to determine eligibility for a program, based on rules for household size, annual income and age. Eligibility for BCCP is verified each year.

The existing category of "A" will now become "CDC BCCP". This category will be for women with income at or below 250% of the Federal Poverty Level (FPL). The category code of "XP - Expanded BCCP" will be for women with income above 250% FPL. The category code will be automatically entered once the PA15 - Program Information record is saved.

Participants can be transferred between IBCCP Agencies within the state utilizing Cornerstone. The Case Manager in the new location must initiate the request for transfer using the "Request for participant Transfer" form provided in Appendix E of the IBCCP Manual. The current site will have 5 working days to complete the transfer process unless there are outstanding bills or participant results that must be entered into Cornerstone.

If the current site must enter outstanding bills or participant results into Cornerstone, the new site cannot request a transfer until all bills and results have been entered. The current site will have 30 calendar days to complete all bills and obtain necessary results. If bills and results are not entered within 30 calendar days, the site will need to contact IBCCP state staff.

Once all bills and results have been entered by the current site (or 30 calendar days elapses) the new site may then request the transfer in Cornerstone using the Program Information Screen (PA15). Once the site requests the transfer on the PA15 screen, the new site requesting the transfer must wait for the End of Day (EOD)/Beginning of Day (BOD) process to complete. The morning that the BOD process completes, the agency requesting the transfer will see the participant is active on the PA15 at the new site.

The initial contact date entered by the new site will be the date the participant is activated and not the date previously entered at the old site.

Within 5 calendar days or sooner if requested by the state IBCCP staff contact, the Nurse Case Manager or designee at the site where the participant was terminated will submit copies of the participant's entire Cornerstone SV06 report (Procedure History Inquiry) and the two most current Breast and Cervical Cancer Data screens from the PA30 and any other pertinent abnormal data that is necessary to continue services for the participant. These are to be sent to the case manager at the site where the participant has relocated.

Please refer to Chapter 12 "Program Information Screen (PA15) for All Programs" under "12.1 General Information and Enrollment" for more information.

NOTE: After saving this screen, the status will automatically be set to "A" (active). It is not necessary to record activities on the Activity Entry (SV02) screen to activate participants in BCCP.

Participant Med/Insurance (PA05)

This screen is used to determine if a BCCP participant has Medicare, Insurance, or other types of insurance. BCCP does not provide services to women with All Kids, Medicare Part B, or any insurance that provides partial payment for breast or cervical cancer screening services. The user may add Medicare and Other Types of insurance information as it becomes known but, the user is not allowed to add, edit or delete Insurance (INS) records. When the user enters information, the record may be edited, deleted, and used for inquiry.

Please refer to Chapter 3 "Participant Screens" under "3.5 Participant Med/Insurance (PA05)" for more information.

VIEW PARTICIPANT ADDITIONAL ELIGIBILITY INFORMATION (PA42)

This screen is used to view a participant's All Kids < 200% (formerly Medicaid), All Kids Expansion, Cash and Food Stamp information and is updated daily through the All Kids Import Process. Please refer to Appendix F "All Kids Import Process" for more information. BCCP does not provide services to women with All Kids, Medicare Part B, or any insurance that provides partial payment for breast or cervical cancer screening services.

Caseload Reassignment (AD17)

This screen is used by an administrator (supervisor) to assign newly enrolled (unassigned) participants who have a program record in the Breast and Cervical Cancer Program (BCCP), Family Case Management (FCM), Healthy Families of Illinois (HFI), Healthy Start Case Management (HSCM), and/or Early Intervention (EI) to a case manager.

This screen is used to change a participant's case manager and used to display a case manager's current caseload. Reassignment of a case manager's entire caseload to another case manager may be accomplished on this screen.

Please refer to Chapter 9 "Administrative Screens" under "9.17 Caseload Reassignment (AD17)" for more information.

BCCP Health Assessment (AS06)

This screen is used to record or assess the needs of all participants for additional services by completing designated assessment types. Screen can also be used to inquire on previously completed assessments.

The following assessments are required for participant category "A" (active) in the Breast and Cervical Cancer Program (BCCP):

• BCCP Assessment type is an Initial Assessment and therefore only one is allowed per participant.

NOTE: Cannot be added on a transfer participant, must use BCCA Assessment.

• BCCA Assessment type is only allowed if an initial BCCP Assessment type exist OR the participant is a transfer.

The BCCP assessment contains pertinent information about the participant's breast and gynecological history. The dates of past Pap tests and mammograms, if any, are vital to the record keeping of BCCP and for statistical analysis of the MDE submission information. Only one assessment at the time of the initial screening is needed if all previous screening dates are entered accurately. Agencies that need to update information on the assessment are encouraged to enter a note on the Case Notes (CM04) screen.

NOTE: The RACE Assessment for BCCP has been deactivated on the Assessment (AS01) screen as of Cornerstone Version 9.30. All race data should be entered on the Participant Enrollment Screen (PA03) from now on.

The BCCP Health Assessment (AS06) is a feature of the Cornerstone system that is available for use by the BCCP program. Please refer to Chapter 7 "Assessment Screens" under "7.6 IBCCP Health Assessment (AS06)" for more information.

Case Notes (CM04)

This screen is optional and may be used at any time. This screen is used to enter and view case notes for participants that are related to a service or a case management activity. Specifically, it is used to document services provided by the case manager.

This screen is available for use in all Cornerstone programs. Case notes are available to other users in the local agency who have security access to this screen, unless the note is marked "confidential". If marked "confidential", only the user who entered the case note and their supervisor will be able to view the notes. The IBCCP Data Manager does not have access to case notes and information from case notes is not extracted for the biannual MDE submissions to the NBCCEDP.

The case notes must be written in a clear and focused manner. Notes are free-form and may be used to record information about the service or activity provided to the participant. There is no limit to the number of notes that may be entered.

NOTE:  Once case notes have been saved they can not be edited or deleted. If errors occur, new case notes must be entered in order to correct the errors.

Please refer to Chapter 6 "Case Management Screens" under "6.4 Case Notes (CM04)" for more information.

Service Provider Selection (RF01)

This screen is used to record/establish a referral for a participant to an outside provider for a specific type of service. Once a referral has been generated, certain information can be changed (appointment date/time and comments). When this screen is saved, the selected number of copies of the referral will be printed.

NOTE: BCCP must be able to estimate the amount of clinical dollars obligated, but not yet billed. Users are required to complete one Service Provider Selection screen per screening cycle (BCS/CCS). When diagnostic services are required, one service provider selection should be completed (BCD/CCD). Users should enter the provider ID for at least ONE of the participant's known providers. If the participant has no known provider or a provider is yet to be assigned to the participant, the provider ID is left blank and will automatically default to a number established by the clinic on the Clinic Administrative Data (AD14) screen, which is usually their own clinic ID number.

Please refer to Chapter 5 "Scheduling and Referral Screens" under "5.7 Service Provider Selection (RF01)" for more information.

Participant Referral History (RF03)

This screen is used to browse the referral history of a specific participant. The history is displayed in reverse chronological order by the date of referral (i.e. the most recent referrals are displayed last).

Detailed information may be viewed for any of the referrals by placing the cursor on the appropriate referral and pressing F1. The Participant Referral Detail window will be displayed. This screen is for inquiry only.

Please refer to Chapter 5 "Scheduling and Referral Screens" under "5.9 Participant Referral History (RF03)" for more information.

After Exam(s) by Health Professional

NOTE: To avoid confusion, it is recommended that the user complete all the steps under the Breast and Cervical Cancer Data (PA30) screen and the Service Entry (SV01) screen below for the breast cancer screening (BCS) service and then repeat the same steps for the cervical cancer screening (CCS) service. Agencies may hold all information, including screening test results, until all data is available. However, data entry must begin as soon as an abnormal screening test result is received to utilize the Cornerstone tracking tools and reports for case management.

Breast and Cervical Cancer Data (PA30)

This screen is used to add, update, or inquire on the BCCP screening cycle information for a participant. It also provides diagnostic and follow-up information for the participant with recommendations for future screening.

Please refer to Chapter 3 "Participant Screens" under "3.26 Breast and Cervical Cancer Data (PA30)" for more information.

Service Entry (SV01)

This screen is used to add/edit service information any time during and after service is provided. This screen is used for entering the actual services that have taken place for the specified participant, regardless of whether the services were delivered at the agency or by an external provider. A screen layout of the Service Entry screen (SV01) with the Procedure Specific Information pop-up window is provided.

When procedures are entered for women who have a Program Category Code of "XP", the Payor Code will default to "S - State". Payor Codes available for this category will be "S" or "O - Other".

Step by Step Instructions

1. Verify the information in the Participant Standard Processing Block (PSPB) as that of the participant currently being processed. (For further information about the PSPB please refer to Chapter 2 "System Environment" under "2.5.1.1 Participant Standard Processing Block (PSPB)/Participant Browse.")
2. Press Ctrl+F1 to activate the Service Entry window.
3. The screen will display the most recent service entry that has been entered for the participant, if there is one.
   • To add a service entry, press F5 Add and go to step 4.
   • To edit a service entry, use Pg Up and Pg Dn in the "Service Completed Date" or "Type of Service" fields to scroll through the existing records to select the record to be edited. Press F6 Edit and continue with step 6 to edit any fields, as necessary.
   • To delete a service entry, use Pg Up and Pg Dn in the "Service Completed Date" or "Type of Service" fields to scroll through the existing records to select the record to be deleted. Press F7 Delete to delete the entry for this participant. The "Confirm delete?" pop-up window will be displayed. Type "Y" for Yes to delete the record or "N" for No to cancel the deletion process. If deleted, the message "Record deleted" will be displayed in the top right corner of the screen. If no more action is required on this screen, skip the remaining steps and go to the next appropriate screen.
4. In the "Service Completed Date" field, type the date that the service was provided. This date will be on or after the screening cycle date on the Breast and Cervical Cancer Date (PA30) screen. The "Service Completed Date" for the first screening service provided, BCS or CCS, must not be more than one week later than the screening cycle date on the PA30. Adjust the screening cycle date on the PA30 to coincide with the date the first screening test was provided, if necessary.
5. Press Enter to go to the "Type of Service" field and, if the service type is incorrect, type in the correct code or use F1 Help to complete this field. (For further information about F1 Help, please refer to Chapter 2 "System Environment" under "2.4.2 Keyboard Functions.")

NOTE: Multiple service code entries for the same date are possible; i.e. BCD, BCD1, BCD2, BCD3, BCD4, BCD5. If more than six services were provided on one date, use the next day's date to complete data entry.

6. Press Enter to go to the "Place of Service" field and type in the correct code or use F1 Help to complete this field.
7. Press Enter to go to the "Service Provider" field. Press F1 to go to the Provider Look-up (SV03) screen. The service provider is the provider whom the participant went to receive the service that has been completed. Please refer to Chapter 4 "Service/Activity Screens" under "4.3 Provider Look-up (SV03)" for more information.
8. Data entry in the "Primary Diagnosis", "Secondary Diagnosis", and "Other" fields are skipped by the Cornerstone system when completing the window for a BCCP participant.
9. Press Enter to go to the "Comments" field and type in any comment pertaining to this service. Entry of abbreviations of the tests to be entered in the Procedure Specific Information pop-up window (i.e. CBE, Pap and pelvic) will allow rapid access to the procedure specific information later.
10. Press F4 to save the screen. A message "Record added" or "Record edited" will be displayed in the top right corner of the screen.
11. Press F10 to display the Procedure Specific Information window.

Screen Layout

Procedure Specific Information:

12. Press F5 Add to add or F6 Edit to edit the procedure specific information.
13. In the "Procedure Code" field, type in the correct CPT code or use F1 Help to complete this field.
14. Press Enter to go to the "Number of Units" field. This field defaults to "1," but can be edited for certain procedure codes (i.e. biopsies). To change this field, type in the correct number, when appropriate.
15. Press Enter to go to the "Procedure Result" field and type in the correct code or use F1 Help to complete this field.

NOTE: It is important to have results entered into the system prior to the billing process.

NOTE: If the Procedure Result is either M6 or M13, the Film Comparison field must be answered with a 'Y' or 'N' for procedure codes 77055, 77056, 77057, G0202, G0204 and G0206.

NOTE: Additional information is required when 88164, 88142 (Pap smear, screening) or 88141 (Pap smear, MD interpretation) procedures are completed.

To enter the required information for these two procedures, skip to the "Bethesda Data" section at the bottom of the screen.

• In the "Bethesda System Used" field, enter the Bethesda system used or use F1 Help to complete this field.
• In the "Specimen Adequacy of Pap Test" field, use the F1 Help to select the appropriate option.
• In the "Specimen Type for Pap Test" field, use the F1 Help to select the appropriate specimen type.

After entering this information, move back up to the "Recommendations" field and continue with Step 18.

16. Press Enter, if necessary, to go to the "Recommendations" field and type in the correct code or use F1 Help to complete this field when appropriate. If no recommendations are available in F1 Help, leave this field blank and continue with step 19.
17. Press Enter to go to the "Referring Physician" field. Press F1 to go to the Provider Look-up (SV03) screen. The referring physician is the provider who sent the participant to the service provider. This field is optional.

Please refer to Chapter 4 "Service/Activity Screens" under "4.3 Provider Look-up (SV03)" for more information.

18. Press Enter to go to the "Payor Code" field and type in the correct code or use F1 Help to complete this field.

NOTE: When procedures are entered for women who have a Program Category Code of "XP", the Payor Code will default to "S - State". Payor Codes available for the "XP" category will be "S", "O - Other" or "M-Medicaid". If the Procedure is billable to Komen, then the available Payor Codes will be "S", "O", "M" and "K-Komen". Other Payor Codes include:

19. • "B" (BCCP) - federal funds will pay for the procedure.
    • "S" (State) - state general revenue funds will pay for the procedure.
    • "K" (Komen) - Susan G. Komen Foundation funds will pay for the procedure.
    • "M" (Medicaid/Medicare) - Medicaid or Medicare will pay for the procedure.
    • "O" (Other) - another funding source will pay for the procedure.
20. The "Results Rcvd" field is not an enterable field. This field will be filled in automatically with the current date when the "Procedure Result" field has been completed.
21. The "Bill Acknowledged" field is not an enterable field. This field will be filled in automatically with the current date when the screen is saved, if the "Procedure Result" field has been completed AND if the user has answered "Y" for Yes to the pop-up window question "Bill Received?". The "Procedure Charge" field must be completed for this field to be filled in automatically.
22. Press Enter to go to the "Procedure Charge" field. By pressing F1, the user can see the acceptable charge for this procedure. Press Esc or Enter to remove the acceptable charge pop-up window.

22. The "Billing Status" and the "Bill Print" fields are completed by the Cornerstone system when the final run of the BCCP - Detailed Procedure and Reimbursement Report (HSPR0783) is run at the end of the month for the IDPH billing. The "Bill Status" field is filled in with a billing code and the "Bill Print" field is filled in with the date that the report is run. It is required that this report be run once a month according to the IBCCP Billing Guidelines.
23. On the Procedure Specific screen for Breast Cancer Procedures, under the Data section, enter a "Y" for Yes or "N" for No in the "Film Comparison" field.
24. In the "Film Comparison Result" field, enter the number of the result or press F1 Help for a list of result choices.
25. Enter the date of the result in the "Film Comparison Result Date" field.
26. Press F4 to save the screen. A pop-up window with the question "Bill Received?" will be displayed. Type "Y" for Yes or "N" for No to indicate whether the bill has been received. The "Results Rcvd" and "Bill Acknowledged" fields will be filled in appropriately, as mentioned above. A message "Record added" OR "Record edited" will be displayed in the top right corner of the screen.
27. Press F3 to remove the Procedure Specific Information window from view and return to the Service Entry (SV01) screen.
28. Repeat steps 1 through 29 as needed for more procedures provided to the participant under each type of service (i.e. "BCS"/"BCD" and "CCS"/"CCD").

NOTE: If the user has completed only the breast cancer screening/breast cancer diagnostic (BCS/BCD) or only the cervical cancer screening/cervical cancer diagnostic (CCS/CCD) for this participant and the participant requires entry of the other service type, please repeat all the steps under the Breast and Cervical Cancer Data (PA30) screen and the Service Entry (SV01) screen above for the other services.

Case Notes (CM04)

Please refer to Chapter 6 "Case Management Screens" under "6.4 Case Notes (CM04)" for more information.

Procedure History Inquiry (SV06)

This screen is used to inquire on all of the BCCP screening cycle procedures performed for a participant, since the time of enrollment.

Information displayed is that which is found at the local clinic only. The user has the option to select a Wide Area Network (WAN) look-up by pressing the F2 shared data key on this screen. This will temporarily display any statewide data pertinent to the participant on the screen.

The Procedure History Inquiry (SV06) screen under the individual participant can be used to determine if a procedure has been charged correctly. The list can also be used to monitor results for all procedures and determine if appropriate follow-up procedures have been recorded. This screen lists all procedures the participant has had with the program in reverse sequence. Do not be concerned when the "Bill Status" column does not show a "B" for "billed." The procedure will show a "B" for "billed" when the Detailed Procedure and Reimbursement Report (HSPR0783) for the current month has been submitted by the clinic to request reimbursement from the Department.

Please refer to Chapter 4 "Service/Activity Screens" under "4.6 Procedure History Inquiry (SV06)" for more information.

BCCP - Detailed Procedure and Reimbursement Report (HSPR0783) and Other Reports as needed (RP01)

The RP01 screen is used to print all of the on-request reports. This specific report can be found at the Cornerstone Main Menu under Reports and under the BCCP submenu. It provides a detailed list by participant of all screening and diagnostic procedures that have been performed within a requested date range. This report is produced on a monthly basis so that the clinics can request reimbursement from the Department for services rendered. This report will also be used by clinics to help facilitate provider reimbursement from BCCP and State funds.

Other reports can be printed as needed.

Please refer to the Step by Step Instructions to complete this screen in Chapter 10 "Report Screens" under "10.1 On-Request Report Selection (RP01)."

Please refer to Chapter 11 "Reports" under "11.116 BCCP - Detailed Procedure and Reimbursement Report (HSPR0783)" for more information about the specific report.