BPSOSRX ;BHAM ISC/FCS/DRS/FLS - callable from RPMS pharm ;06/01/2004 ;;1.0;E CLAIMS MGMT ENGINE;**1,5**;JUN 2004;Build 45 ;;Per VHA Directive 2004-038, this routine should not be modified. ; ; There are only four callable entry points! ; $$CLAIM^BPSOSRX Submit a claim to ECME ; $$UNCLAIM^BPSOSRX Reverse a previously submitted claim. ; $$STATUS^BPSOSRX Inquire about a claim's status ; SHOWQ^BPSOSRX Display queue of claims to be processed Q ; ; $$CLAIM - Submit a claim to ECME ; Input ; RXI - Prescription IEN ; RXR - Fill Number ; MOREDATA - Array of data needed for transaction/claim ; Return values: ; 1 = accepted for processing ; 0^reason = failure (should never happen) ; ; All this does is to put it on a list and start a background job. ; ; Note: If the claim has already been processed, and it's ; resubmitted, then a reversal will be done first, ; and then the resubmit will be done. Intervening calls ; to $$STATUS may show progress of the reversal before ; the resubmitted claim is processed. CLAIM(RXI,RXR,MOREDATA) ; N RETVAL,STAT,TYPE,SUBMITDT I '$G(RXI) Q 0 I '$G(RXR) S RXR=0 I '$$LOCK("SUBMIT",5) Q 0 S TYPE="CLAIM",SUBMITDT=$$NOW N X,X1,X2 S X1=DT,X2=30 D C^%DTC K ^XTMP("BPS-PROC",TYPE,RXI,RXR) S ^XTMP("BPS-PROC",0)=X_U_DT_U_"ECME PROCESSING QUEUE" S ^XTMP("BPS-PROC",TYPE,RXI,RXR)=SUBMITDT I $D(MOREDATA) M ^XTMP("BPS-PROC",TYPE,RXI,RXR,"MOREDATA")=MOREDATA S ^XTMP("BPSOSRX",0)=X_U_DT_U_"ECME SUBMIT DATE FOR A RX AND FILL" S ^XTMP("BPSOSRX",RXI,RXR)=SUBMITDT D UNLOCK("SUBMIT") D RUNNING() S RETVAL=1 Q RETVAL ; ; $$UNCLAIM - Reverse a previously submitted claim. ; Input ; RXI - Prescription IEN ; RXR - Fill Number ; MOREDATA - Array of data needed for transaction/claim ; Return values: ; 1 = accepted for processing ; 0^reason = failure (should never happen) ; ; All this does is to put it on a list and start a background job. ; ; Note: The reversal will actually be done ONLY if the ; most recent processing of the claim resulted in something ; reversible, namely E PAYABLE or E REVERSAL REJECTED UNCLAIM(RXI,RXR,MOREDATA) ; N RETVAL,STAT,RESULT,TYPE,SUBMITDT I '$G(RXI) Q 0 I '$G(RXR) S RXR=0 I '$$LOCK("SUBMIT",5) Q 0 S TYPE="UNCLAIM",SUBMITDT=$$NOW N X,X1,X2 S X1=DT,X2=30 D C^%DTC K ^XTMP("BPS-PROC",TYPE,RXI,RXR) S ^XTMP("BPS-PROC",0)=X_U_DT_U_"ECME PROCESSING QUEUE" S ^XTMP("BPS-PROC",TYPE,RXI,RXR)=SUBMITDT I $D(MOREDATA) M ^XTMP("BPS-PROC",TYPE,RXI,RXR,"MOREDATA")=MOREDATA S ^XTMP("BPSOSRX",0)=X_U_DT_U_"ECME SUBMIT DATE FOR A RX AND FILL" S ^XTMP("BPSOSRX",RXI,RXR)=SUBMITDT D UNLOCK("SUBMIT") D RUNNING() S RETVAL=1 Q RETVAL ; ; $$STATUS(RXI,RXR,QUE) - Returns the Status of the prescription/fill ; Input ; RXI - Prescription IEN (required) ; RXR - Refill Number (required) ; QUE: 0/null - Do not check if a RX/fill is on the queue (optional) ; 1 - Check if RX/fill is on the queue ; ; Returns ; RESULT^LAST UPDATE DATE/TIME^DESCRIPTION^STATUS % ; Returns null if there's no ECME record of this RX/fill ; ; RESULT is either: ; 1. IN PROGRESS for incomplete claims ; 2. Final status for complete claims. See comments for ; BPSOSUC for complete list of possible statuses. ; LAST UPDATE DATE/TIME is the Fileman date and time of the ; last update to the status of this claim. ; DESCRIPTION is either: ; 1. Incomplete claims will be the status (i.e., Waiting to Start, ; Transmitting) ; 2. Completed claims will have the reason that the ECME process ; was aborted if the result is E OTHER. Otherwise, it will ; be similiar to the RESULT ; STATUS % is the completion percentage. Note that 99 is considered ; complete. STATUS(RXI,RXR,QUE) ; ; ; Setup needed variables N IEN59,SDT,A,SUBDT I '$G(RXI) Q "" I $G(RXR)="" Q "" I $G(QUE)="" S QUE=1 S IEN59=$$IEN59(RXI,RXR) S SDT=$G(^XTMP("BPSOSRX",RXI,RXR)) ; ; ECME record not created I '$D(^BPST(IEN59)) D Q A . I QUE,SDT S A="IN PROGRESS"_U_SDT_U_$$STATI^BPSOSU(0)_U_-1 Q . I QUE,$D(^XTMP("BPS-PROC","CLAIM",RXI,RXR)) S A="IN PROGRESS"_U_SDT_U_$$STATI^BPSOSU(0)_U_-1 Q . S A="" ; ; Loop: Get data, quit if times and status match (no change during gather) N C,T1,T2,S1,S2 F D I T1=T2,S1=S2 Q . S T1=$$LASTUP59(IEN59) . S S1=$$STATUS59(IEN59) . I S1=99 D ; completed . . S A=$$CATEG^BPSOSUC(IEN59) . . S C=$$RESTXT59(IEN59) . I S1'=99 D . . S A="IN PROGRESS" . . S C=$$STATI^BPSOSU(S1) . S T2=$$LASTUP59(IEN59) . S S2=$$STATUS59(IEN59) ; ; If the queue parameter is set and the submit date from the queue ; follows the SUBMIT DATE/LAST UPDATE date from BPS TRANSACTION ; or the RX/fill is still on the queue, then change the response ; to IN PROGRESS^Submit Date^WAITING TO START S SUBDT=$$SUBMIT59(IEN59) I SUBDT="" S SUBDT=T1 I $G(QUE),SDT>SUBDT!($D(^XTMP("BPS-PROC","CLAIM",RXI,RXR)))!($D(^XTMP("BPS-PROC","UNCLAIM",RXI,RXR))) S A="IN PROGRESS",T1=SDT,S1=-1,C=$$STATI^BPSOSU(0) ; ; When finishing the reversal of a Reversal/Resubmit, display IN PROGRESS I $P($G(^BPST(IEN59,1)),"^",12)=1,S1=99 S A="IN PROGRESS",S1=98,C=$$STATI^BPSOSU(S1) ; ; Return results Q A_U_T1_U_$E(C,1,255-$L(A)-$L(T1)-2)_U_S1 ; ; SHOWQ - Show RX/Fill on the Queue. Since claims are generally processed ; immediately, this report will generally have no output. SHOWQ G SHOWQ^BPSOSR2 ; NOW() N %,%H,%I,X D NOW^%DTC Q % ; ; RESTXT59 - Return first semi-colon piece of the Result Text (202) field ; from BPS Transaction RESTXT59(IEN59) ; I '$G(IEN59) Q "" Q $P($P($G(^BPST(IEN59,2)),U,2,99),";",1) ; ; LASTUP59 - Return last update date/time from BPS Transactions LASTUP59(IEN59) ; I '$G(IEN59) Q "" Q $P($G(^BPST(IEN59,0)),U,8) ; ; STATUS59 returns STATUS field from BPS Transaction ; Note: 99 means complete STATUS59(IEN59) ; I '$G(IEN59) Q "" Q $P($G(^BPST(IEN59,0)),U,2) ; ; SUBMIT59 - Return Submit date/time from BPS Transactions SUBMIT59(IEN59) ; I '$G(IEN59) Q "" Q $P($G(^BPST(IEN59,0)),U,7) ; ; RXRDEF - Get last refill RXRDEF(RXI) ; I '$G(RXI) Q "" K ^TMP($J) N BPSPT S BPSPT=$$RXAPI1^BPSUTIL1(RXI,2,"I") I BPSPT="" Q "" D RX^PSO52API(BPSPT,"BPSREF",RXI,,"R") Q +$O(^TMP($J,"BPSREF",BPSPT,RXI,"RF",""),-1) ; ; Utilities ; ; LOCKING: Just one user of this routine at a time. ; X = "SUBMIT" to interlock the claim submission ; X = "BACKGROUND" to interlock the background job LOCK(X,TIMEOUT) ;EP - BPSOSRB I $G(TIMEOUT)="" S TIMEOUT=0 L +^XTMP("BPS-PROC",X):TIMEOUT Q $T ; LOCKNOW(X) ;EP - BPSOSRB L +^XTMP("BPS-PROC",X):0 Q $T ; UNLOCK(X) ;EP - BPSOSRB L -^XTMP("BPS-PROC",X) Q ; RUNNING() ; I '$$LOCKNOW("BACKGROUND") Q ; it is running; don't start another D UNLOCK("BACKGROUND") ; it's not running; release our probing lock D TASK Q ; IEN59(RXI,RXR) ;EP - from BPSOS, BPSOSRB I '$G(RXI) Q "" I '$G(RXR) S RXR=0 Q RXI_"."_$TR($J(RXR,4)," ","0")_"1" ; ; The background job TASK N X,Y,%DT S X="N",%DT="ST" D ^%DT,TASKAT(Y) Q ; TASKAT(ZTDTH) ; N ZTIO S ZTIO="" ; no device N ZTRTN S ZTRTN="BACKGR^BPSOSRB" D ^%ZTLOAD Q