IMPORTANT INFORMATION FOR USING THE IRISEDV3 DISKETTE:

Before installing the IRISEDV3 program, make sure the IRISEDV3 diskette has two files (“edv3inst.ex” dated 1/8/2004 and “readme.doc” dated 3/22/2004) and a label with this information: “Centers for Medicare & Medicaid Services; IRISEDV3 (Version 1.1) Diskette; Released – 10/03; For Installation Instructions: Use Microsoft Word (97 or later version) for retrieving and printing the enclosed file README.DOC”. Then read the entire contents of this file as shown below:

CONTENTS

1. REQUIRED EQUIPMENT
2. ADDITIONAL SOFTWARE REQUIRED TO RUN IRISEDV3
3. INSTALLATION
4. OPERATION
5. DATA ENTRY INSTRUCTIONS FOR IRIS DISKETTES
6. PRINTING IRISEDV3 REPORTS
7. INCORRECT DATA ON IRIS DISKETTES
8. CLOSING REMARKS
9. DESCRIPTION OF CHANGES / MODIFICATIONS TO APRIL ’02 RELEASE, IRISEDV3

1. REQUIRED EQUIPMENT

This section describes the computer hardware needed to run IRISEDV3. IRISEDV3 will run on any 100% IBM compatible microcomputer equipped with:

· [REQUIRED] At least a 386-SX 16 megahertz, 32 bit microprocessor, although a faster machine is highly recommended, especially where a large number of interns and residents will have to be processed.

· [REQUIRED] At least 6 megabytes of Random Access Memory (RAM) for efficient operation. It is possible to run with between 2 and 6 megabytes but with significant degradation of performance.

· [REQUIRED] A 3.5 inch disk drive.

· [REQUIRED] A fixed (hard) drive with at least 5 megabytes of dedicated space available. If you attempt to run with less than 6 megabytes of RAM, you may need 22 megabytes of free disk space.

· [REQUIRED] A personal computer (PC) compatible printer, preferably one that can print at twelve characters per inch.

· [REQUIRED] A high resolution monochrome or color monitor.

WARNING: IRISEDV3 IS A SINGLE USER PROGRAM. IN SOME CASES IT CAN BE RUN FROM A NETWORK FILE SERVER, BUT SHOULD NOT BE USED IN A MULTIUSER ENVIRONMENT (THAT IS, WITH MORE THAN ONE USER ENTERING OR CHANGING DATA AT THE SAME TIME).

2. ADDITIONAL SOFTWARE REQUIRED TO RUN IRISEDV3

· [REQUIRED] MS-DOS, Version 5 or higher, with the operating system loaded into upper or extended memory (see note below on Windows operating systems).

· [RECOMMENDED] If you have access to:

- dBASE 4 or higher (preferred), or any database program whose data file format is compatible with dBASE III Plus (ACCESS, FOXBASE, PARADOX, dBXL, and others); or

- any spreadsheet program that can import dBASE data.

These programs will enable you to access and utilize your IRISEDV3 database directly without using the IRISEDV3 program as an interface.

NOTE: IRISEDV3, AN MS-DOS BASED APPLICATION, WILL RUN UNDER VARIOUS WINDOWS OPERATING SYSTEMS. HOWEVER, YOU MAY EXPERIENCE SOME DIFFICULTIES RUNNING THIS PROGRAM IN CERTAIN INSTALLATIONS OF WINDOWS XP, NT OR 2000.

3. INSTALLATION

IRISEDV3 must be executed from your computer's hard disk. The instructions below assume that your diskette drive is drive A, but the installation works from drive B as well. You will install IRISEDV3 on drive C, but if you want to run from a network drive or a different partition, simply copy the entire system onto the appropriate drive when installation is complete and leave the original on drive C as a backup.

Before you begin installation, make sure there is at least 5 megabytes of open space on your hard drive that can be dedicated to IRISEDV3, and read the instructions below thoroughly before you begin installation:

(a) To begin installation, start your computer, and wait for the Start button to appear.

If you already installed Version 1.0 of the IRISEDV3 program dated April 2002, skip the next two paragraphs on creating a new folder name called IRISEDV3 on drive C.

Click on Start, point to Programs or Accessories to click on Windows Explorer, and click on "(C:)" Then position the cursor to the top of the screen and click on File, point to New, and click on Folder.

At this point you will create a new folder name called IRISEDV3 on your C Drive to house the IRISEDV3 program. Just type "Irisedv3" (do not type in the quotations) as the folder name for the folder housing the IRISEDV3 program.

Place your IRISEDV3 diskette in drive A (you can substitute "B" for "A" in this step) and do these installation procedures.

Installation/Reinstallation of IRISEDV3 program with Dbase libraries:

Click on "(A:)"
Click on "Edv3inst.ex"
Right click on “Edv3inst.ex” and click on “Rename”
Type “Edv3inst.exe” and click on “Edv3inst.exe”
Position the cursor to the top of the screen and click on "Edit"
Click on "Copy"
Point the cursor on the IRISEDV3 folder and click on "Irisedv3"
Position the cursor to the top of the screen and click on "Edit"
Click on "Paste"

If the “Confirm File Replace” screen appears for the file named “edv3inst.exe”, click on “Yes”

Doubleclick on "Edv3inst.exe" (this procedure either unzips this file into multiple files in support of the IRISEDV3 program or it will prompt you for a yes or no (“y/n”) answer for each file that already exists in the IRISEDV3 folder;

slowly press the “Y” key on the keyboard 30 or more times)

Click on the Close button icon ("x") on the top of the screen to leave this listing of multiple files

(b) Checking your MS-DOS Configuration. Before you can run IRISEDV3, you must check to see that MS-DOS is properly configured for database systems. To do this, read and execute the following instructions carefully. This step must be performed on drive C, regardless of the drive letter on which the program was installed.

(1) For PCs with Windows 95, 98 and ME:

First determine whether a file named CONFIG.SYS exists in the root directory on drive C. Then issue these commands:

Click on Start
Point to Find or Search to click on Files or Folders
Type "config.sys" to the right of "Named" [file or folder]
Make sure "(C:)" appears to the right of "Look in" [drive]; if not, click on the inverted triangle and click on "(C:)"
Click on Find Now button
Doubleclick on "config.sys" in the "C:\" folder
If necessary, open up this file by scrolling down to Notepad, click on Notepad and click the OK button

If CONFIG.SYS exists, it is essential that it contain two important lines. One begins with the word "BUFFERS" and the other begins with the word "FILES". If both exist, and both lines contain numbers greater than 29 (it is recommended that both lines contain the high number 99), you may proceed to step 3.(c) after clicking on the Close button icon for the Notepad and "Find:Files..." screens.

If CONFIG.SYS does not exist or if it needs modification, create/update this file as follows:

Click on Start
Point to Programs or Accessories
Click on Notepad
Click on File
Click on New or Open "config.sys" in the "(C:)" drive (be sure to type "config.sys" as the file name to open up this file)

Type the lines or correct the numbers on the lines as follows:

buffers=99
files=99

Click on File
Click on Save As
Make sure "(C:)" appears to the right of "Save in" [drive]; if not, click on the inverted triangle and click on "(C:)"
Just type "config.sys" to the right of "File name"
Click on the Save button and click on "Yes" if "config.sys" already exists
Click on the Close button icon to leave the "config.sys" file

(2) For PCs with Windows XP, NT and 2000:

First determine whether a file named CONFIG.NT exists in the System32 folder within the Winnt folder (e.g., c:\winnt\system32) on drive C. Then issue these commands:

Click on Start
Point to Find or Search
Click on Files or Folders
Type "config.nt" to the right of "Named" [file or folder]
Make sure "(C:)" appears to the right of "Look in" [drive]; if not, click on the inverted triangle and click on "(C:)"
Click on Find Now button
Doubleclick on the "config.nt" file in the "c:\winnt\system32" folder
Scroll down to the bottom of this file for the configuration commands

If CONFIG.NT exists, it is essential that it contain two important lines. One begins with the word "BUFFERS" and the other begins with the word "FILES". If both exist, and both lines contain numbers greater than 29 (it is recommended that both lines contain the high number 99), you may proceed to step 3.(c). after clicking on the Close button icon for the Notepad and "Find:Files..." screens.

If CONFIG.NT does not exist or if it needs modification, create/update this file as follows:

Click on Start
Point to Programs or Accessories
Click on Notepad
Click on File
Click on New or Open "config.nt" (click on "C:\", click on "Winnt", click on "system32", type "config.nt" as the file name to open up this file, and click on the Open button)

If necessary, scroll down to the bottom of this file for the configuration commands

Type the lines, or correct the lines or numbers on the lines as follows:

dos=high, umb
device=%SystemRoot%\system32\himem.sys
buffers=99
files=99

Click on File
Click on the Save button and click on "Yes" if "config.nt" already exists
Click on the Close button icon to leave the "config.nt" file

(3) Reboot or restart your computer to activate the changes you just made.

(c) The program is now installed and ready to use. Always move to the IRISEDV3 folder before executing the program.

To start IRISEDV3 from Windows Explorer, issue these commands:

Click on Start
Point to Programs or Accessories
Click on Windows Explorer
Click on the "Irisedv3" folder in the C drive
Doubleclick on the "Irisedv3" file in the middle of the "Irisedv3" folder to operate the IRISEDV3 program, or click on the "irisedv3" file and click "Open" to operate the IRISEDV3 program
If necessary, click on the Maximum button icon to enlarge the IRISEDV3 screens

Don't be distressed if IRISEDV3 takes several seconds to load. It will probably take between 10 and 20 seconds depending on the speed of your machine.

(d) Program Initialization. The following steps must be performed the first time you run IRISEDV3. Do not attempt to execute any other IRISEDV3 functions until this step is complete. Before proceeding, note that data entry in IRISEDV3 is not case sensitive; that is, all alphabetic characters are presumed to be upper case.

Start IRISEDV3 as in 3.(c). above:

Select "Data Management" from the IRIS Data Evaluation (Main) Menu by pressing <2> and run the first two procedures in the next menu that appears. The Data Management menu reappears after each procedure is completed.

(1) Initially select "Set up Administrative Data" by pressing <1>, and answer the prompts that appear on the screen. (Note: The <Enter> key must be pressed twice to accept the "Default<Drive>:\<Directory> in which Provider data will be stored: “C:\IRISEDV3".) Then press the letter S to save the entered data.

(2) Then select "Rebuild Data Indexes" by pressing <2>. This causes IRISEDV3 to create "index files" which enable the program to search and display data in various orders that are required by the different program functions.

After completing these two procedures, select "Exit" by pressing <X>.

(e) You are now ready to run IRISEDV3. Select "Process One Provider's Data" by pressing <1>. At this point, answer the prompts that appear on the screens and the program will begin evaluating master record and assignment record(s) data for each reported resident. See Item Numbers 4 through 7 below for notes on program operation and other information.

4. OPERATION

(a) IRISEDV3 only imports (accepts) IRISV3 produced master and assignment files or IRISV3 compatible master and assignment files from IRIS diskettes for fiscal years beginning on or after July 1, 1994. It will not accept IRIS95 produced or compatible master and assignment files since they contain incompatible data file structures and are not compliant with Y2K (i.e., millennium) requirements. The diskette is to contain two database files for one cost reporting period as follows: M3xxxxxx.dbf for the master file, and A3xxxxxx.dbf for the assignment file ("xxxxxx" is the six-digit provider number). The master file should only contain ONE master record for each reported resident, and the assignment file should contain at least ONE assignment record for each reported resident.

(b) IRISEDV3 evaluates each set of master record and corresponding assignment record(s) for each reported resident. If the master record and corresponding assignment record(s) pass all IRIS system edits, the message,"Record is okay", will appear on the screen. This program will automatically continue its edit routine for the next set of records. However, this program will stop if the next set does not pass all IRIS system edits and specific explanations for data entry error or record rejection will appear on the screen. In addition, the message, "Press C to Continue" or "Press any key to continue...", for IRISEDV3 program evaluation of the next set of records will also appear on the screen. Before pressing the letter C (or any key to continue) on the keyboard, it is suggested that a screen print (i.e., "print screen") be made of the explanations for record rejection for later correction of erroneous or invalid records by providers*. If necessary, press the letter C (or any key to continue) again one or more times for IRISEDV3 to move on to the next set of records for its evaluation of reported resident data.

*- PROVIDERS MUST MAKE CORRECTIONS TO REJECTED MASTER AND ASSIGNMENT RECORDS IN THE IMPORTED FILES SINCE IRISEDV3 CANNOT BE USED TO MAKE THESE CORRECTIONS.

(c) After IRISEDV3 evaluates the records in the master and assignment files, two options ("<1> - Proceed to Step 4" and "<2> - Quit") appear for Step <4>, "Print Report of Evaluation and Edit - OPTIONAL". Press <1> to open up the printing results menu, and press <Enter> to accept default printing (option no. 2) of assignment data for all records. The IRISEDV3 EVALUATION OF IMPORTED IRIS DATA report will produce a 3 part printout if the IRIS diskette contains valid, erroneous, and invalid records, respectively. The part names are: Part 1 - New Records That Passed All IRIS Edits; Part 2 - Records That Failed One or More IRIS Edits (e.g., master record with invalid or blank residency type code); and Part 3 - Invalid Records (e.g., assignment record with invalid or blank fiscal year begin date). If the IRIS diskette contains duplicate records in the master file, IRISEDV3 will produce an untitled and separate listing of these records in the format "Uxxx-xx-xxxx; Occurrences: n" ("Uxxx-xx-xxxx" is the social security number and "n" is the number of master records with the same SSN). These records are deemed invalid, and they are included in Part 3. Press <X> to exit IRISEDV3 after the printouts are completed.

(d) If the IRISEDV3 EVALUATION OF IMPORTED IRIS DATA report only produces Part 1, this means the files on the IRIS diskette successfully passed all IRIS system edits that are embedded in the IRISEDV3 program**. Providers are to make an electronic file or diskette copy of this diskette for safekeeping and future reference, and to send the IRIS diskette to their servicing fiscal intermediary (FI) that is due at the same time as their Medicare cost reports. (It is recommended that the provider furnish a hard copy printout of Part 1 along with the diskette.) The FIs will evaluate the files on their diskette copy, and they may request providers to submit revised IRIS diskettes at any time in the future.

**- PROVIDERS MUST REVIEW PART 1 FOR ASSIGNMENT RECORDS WHICH MAY REQUIRE CORRECTIONS. THE REASON IS THAT IRISEDV3 DOES NOT REJECT ZERO VALUES OR BLANKS IN THE "IME" AND "GME" DATA FIELDS IN THE IMPORTED ASSIGNMENT FILE. AS SUCH PROVIDERS MAY MAKE CORRECTIONS TO MASTER AND ASSIGNMENT RECORDS THAT ARE LISTED IN THIS PART ON THE IRIS DISKETTE. IN ADDITION, IRISEDV3 WILL IGNORE ASSIGNMENT RECORDS THAT DO NOT HAVE CORRESPONDING MASTER RECORDS, AND SUCH ASSIGNMENT RECORDS WILL NOT APPEAR IN PART 3. IN ALL CASES, PROVIDERS ARE TO RUN (AND RE-RUN, IF NECESSARY) THE IRISEDV3 PROGRAM ON THE CORRECTED IRIS DISKETTE FOR PRODUCING A REPORT OF RECORDS THAT PASSED ALL IRIS EDITS (PART 1 ONLY).

(e) If the IRISEDV3 EVALUATION OF IMPORTED IRIS DATA report produces Part 2 or Parts 2 and 3 along with or without Part 1, this means the files on the IRIS diskette failed one or more IRIS system edits that are embedded in the IRISEDV3 program. PROVIDERS ARE TO MAKE CORRECTIONS TO MASTER AND ASSIGNMENT RECORDS THAT ARE LISTED IN PARTS 2 AND 3 ON THE IRIS DISKETTE. PROVIDERS ARE TO RUN (AND RE-RUN, IF NECESSARY) THE IRISEDV3 PROGRAM ON THE CORRECTED IRIS DISKETTE FOR PRODUCING A REPORT OF RECORDS THAT PASSED ALL IRIS EDITS (PART 1 ONLY).

5. DATA ENTRY INSTRUCTIONS FOR IRIS DISKETTES

The IRISEDV3 program does not contain "Data Help Windows". These windows (Help Screens) are in IRISV3, and they contain explicit instructions for entering data in the master and assignment files. A file copy of these instructions (iredv3it.doc) is included in the IRISEDV3 folder, and it also includes medical school codes, residency type codes, IRISV3 program changes and required file structures for IRIS diskettes. To obtain a printout of these instructions and other information, use Microsoft Word (97 or later version) to open up this file in the IRISEDV3 directory and print it in HP LaserJet mode for best results.

6. PRINTING IRISEDV3 REPORTS

(a) Local printers. Some users may experience difficulties in getting Windows to print reports from their locally attached printer via Windows 95, 98 or ME. It is suggested that you make arrangements with a member of your organization's technical support and have them consider these selections as a possible solution to printing reports from the IRISEDV3 program as follows:

Click on Start, point to Settings, click on Printers, and click your right mouse button on the local printer icon
Click on Properties
Click on Details and click on the Port Settings button
If necessary, remove the check mark from both settings in the "Configure LPT Port" screen and click the OK button
Click on Spool Settings, click on Print Directly to Printer, and click the OK button
Click on the Close button icon to leave the "Properties" and "Printers" screens

It is also suggested that you or your organization's technical support person contact your printer's manufacturer or visit their website for guidance on how to print from a DOS application on Windows 95, 98 or ME.

(b) Network printers. If you are using a network printer instead of a locally attached printer, it is suggested that you make arrangements with a member of your organization's technical support and have them consider this possible solution to printing reports from the IRISEDV3 program:

(1) For PCs with Windows 95, 98 and ME:

Click on Start, point to Settings, click on Printers, and click your right mouse button on the local printer icon
Click on Properties
Click on Details and click on the Capture Port Settings button
Click on the LPT printer port (e.g., LPT3) for the network printer and click the OK button
Click on the Close button icon to leave the "Properties" and "Printers" screens

(2) For PCs with Windows XP, NT and 2000:

The Windows NT command to use for running DOS applications in regard to redirecting LPT1 to a network printer in a Windows NT environment is:

NET USE LPT1\\servername\printersharename/persistent:yes

An example of a server name would be RICAPP04, and an example of a printer share name is AUD_AUTO. This command should be issued from a command line before starting any DOS applications. In other words, a command line can be run by clicking on the Start button and selecting the Run option. In the "Open" field, type CMD, then click on "Okay". This will start a Command Line session.

Before closing, if you wish to restore LPT1 as a local printer, the command line to use is:

NET USE LPT1/DELETE

7. INCORRECT DATA ON IRIS DISKETTES

It has come to our attention that not all providers enter correct data for certain data fields in master and assignment files. Such data on IRIS diskettes will pass all IRIS system edits. These data fields are:

(a) Residency Year. Providers have entered incorrect year data for both residency year fields in master and assignment files. For example, providers entered program year levels instead of the number of residency years completed in all types of approved programs in residency year fields. The effect of this type of error is usually the difference of one year (e.g., program year level 3 may indicate at least 2 years completion of approved programs). The FIs may evaluate the files for this type of error on their IRIS diskette copies, and they may request providers to submit revised

IRIS diskettes at any time in the future.

(b) Full-Time/Part-Time. Providers have entered percentages less than 100 percent (%) for the full-time or part-time percentage or "TIMEPERC" data field in the assignment file. Most residents work on a full time basis, and many of them rotate between two or more hospitals on a daily or longer basis. If that is the case, then this field should be the number 100. For example, a resident spent half the time at Hospital "A" and half the time at Hospital "B". Hospital "A" reported this time correctly in the IRIS diskette as 100% full time and 50% IME/GME. Hospital "B" incorrectly reported this time as 50% part time and 100% IME/GME; Hospital "B" should have reported this time as 100% full time and 50% IME/GME. The FIs may evaluate the files for this type of error on their IRIS diskette copies, and they may request providers to submit revised IRIS diskettes at any time in the future.

(c) Certification Date. Providers have entered certificate issuance dates for the certification date field in the master file. These dates are usually listed on Educational Commission for Foreign Medical Graduates certificates for residents that have successfully passed its examinations. These certificates also contain dates for medical and English examinations. The medical examination consists of basic science and clinical science examinations, and the latest date for passing these examinations is the date for data entry into the certification date field in the master file. The result of this error is the certification issuance date is usually several months or more after the latest date of the science examinations. The FIs may evaluate the files for this type of error on their IRIS diskette copies, and they may request providers to submit revised IRIS diskettes at any time in the future.

8. CONCLUDING REMARKS

IN CLOSING, IT IS IMPERATIVE THAT PROVIDERS PERIODICALLY REVISIT AND IMPLEMENT THESE INSTRUCTIONS BEFORE RUNNING IRISEDV3 ON IRIS DISKETTES.

9. DESCRIPTION OF CHANGES / MODIFICATIONS TO APRIL ’02 RELEASE, IRISEDV3

April ’02 Release, IRISEDV3 (Version 1.0)

New/Revised Screen Messages for IRIS System Edits of Blank Fields and Assignment Records in Version 1.1 of IRISEDV3

· Master File

New screen messages in Version 1.1 of IRISEDV3 were created for missing employer names and provider numbers in master records.

· Assignment File

New screen messages in Version 1.1 of IRISEDV3 were created for missing program (residency type) codes, IME percentages greater than GME percentages, and full-time/part-time (FTPT) percentages in assignment records. Revised screen messages in Version 1.1 of IRISEDV3 were created for overlapping assignment periods between each assignment period in the assignment file.

IRISEDV3 Evaluation of Imported IRIS Data (IEIID) Report

· Report Heading

The report heading for this report was changed from “IRISEDV3 EVALUATION OF IMPORTED IRIS DATA” in Version 1.0 of IRISEDV3 to “IRISEDV3 Ver. 1.1 EVALUATION OF IMPORTED IRIS DATA” in Version 1.1 of IRISEDV3.

· Overlapping Assignment Records in Assignment Files

The edit for overlapping assignment records was changed for assignment files with more than two assignment records. Version 1.0 of IRISEDV3 checked for overlapping assignment periods between the bottom assignment record and the record above it in the assignment file, but it did not always check for other overlapping assignment periods between each assignment record in the assignment file. Version 1.1 of IRISEDV3 now checks for overlapping assignment periods between each assignment record in the assignment file. Failure Code 10 (Overlapping Assignment Records) will appear for those assignment records with overlapping assignment periods in Part 2 of the IEIID report in Version 1.1.

· Failure Codes

The numeric Failure Code 0 (overlapping assignment dates) for overlapping assignment records in Part 2 of Version 1.0 was changed to 10 in Version 1.1 of IRISEDV3.

Failure Code 5 (Grad Date) for medical school graduation date will not appear for those records that are listed in Part 2 of the IEIID report in Version 1.1. Instead Failure Code 9 (Invalid Assignment Start/End Dates) will appear for those assignment records associated with no graduation date or graduation date after start/end dates of assignment records.

· Erroneous Assignment Records

Assignment records with zeroes or no data for FTPT percentages passed the IRIS edits in Version 1.0. These records should not have passed the edits, and they will appear in Part 3 of the IEIID report in Version 1.1.

Assignment records with FTPT, IME or GME percentages greater than 100 percent failed the IRIS edits with Failure Code 9 in Version 1.0. This code is incorrect for these records, and they will appear in Part 3 of the IEIID report in Version 1.1.

Assignment records with no data on the program (residency type) code passed the IRIS edits in Part 1 of the IEIID report in Version 1.0. These records should not have passed the edits, and they will appear in Part 3 of the IEIID report in Version 1.1.

Assignment records with no provider number passed the IRIS edits in Part 1 of the IEIID report in Version 1.0. These records should not have passed the edits, and they will appear in Part 3 of the IEIID report in Version 1.1.

Assignment records with no employer name passed the IRIS edits in Part 1 of the IEIID report in Version 1.0. These records should not have passed the edits, and they will appear in Part 3 of the IEIID report in Version 1.1.

Assignment records with certain overlapping assignment periods (see fourth bullet point about these records in Item Number 9) passed the IRIS edits in Version 1.0. These records will have Failure Code 10 in Part 2 of the IEIID report

in Version 1.1.

Assignment records with no data on program (residency type) codes have appeared in Part 2 of the IEIID report with Failure Codes 8 and 0 (zero) in Version 1.0. These records primarily do not have data on program codes, and they will appear in Part 3 of the IEIID report in Version 1.1.

· Erroneous Master Records

Master records with “- NA -“ for foreign medical school graduate certification dates appeared in Part 2 of the IIEED report in Version 1.0. In most cases, this condition is incorrect since certification dates do exist in the master records.These records will have certification dates listed in Part 2 of the IEIID report in Version 1.1.