FBUCEN ;ALBISC/TET - ENTER UNAUTHORIZED CLAIM ;7/17/03 ;;3.5;FEE BASIS;**32,61**;JAN 30, 1995 ;;Per VHA Directive 10-93-142, this routine should not be modified. ;FBUC - unauthorized claims site parameter node ;FBTRACK - 1 to track incomplete claims, 0 to track complete claims only ;FBUCP - 0 to not automatically print letters, otherwise default device ;FBOK - 0 if claim is incomplete, 1 if claim is complete. ;FBACT - ENT for enter (fbact represents action type) ;FBINENT = initial entry parameter: 1 if using, 0 if not S FBOUT=0,FBUC=$$FBUC^FBUCUTL2(1),FBTRACK=+$P(FBUC,U),FBOK=$S('FBTRACK:1,1:0),FBACT="ENT",FBINENT=+$P(FBUC,U,7) GET ;get info on new claim entry K FBVEN,FBVET VET ;get vet info K DIR W !! S DIR(0)="162.7,2O",DIR("A")="Select VETERAN" D ^DIR K DIR G END:$D(DIRUT),VET:+Y'>0 S FBVET=+Y VEN ;get vendor info S DIR(0)="162.7,1O",DIR("A")="Select FEE VENDOR" D ^DIR K DIR G VET:$D(DUOUT)!($D(DTOUT)),VEN:+Y<0,VEN:+Y=0&('FBINENT) S FBVEN=+Y PROG S DIC="^FBAA(161.8,",DIC(0)="AEQMZ",DIC("S")="I +$P(^(0),U,3)" D ^DIC K DIC S:$D(DTOUT)!($D(DUOUT)) FBOUT=1 G END:FBOUT,GET:Y<0 S FBPR=+Y D S:FBOUT FBOUT=0 G VET .N FBDA,FBMASTER,FBORDER,FBTFROM,FBTTO,FB1725,FBFPPSC .; ask if claim is an EDI claim (patch *61) .S FBFPPSC=$$FPPSC^FBUTL5() I FBFPPSC=-1 S FBFPPSC="",FBOUT=1 Q .; ask if claim is a mill bill emergency care claim (patch *32) .S DIR(0)="Y" .S DIR("A")="Is this claim being considered under Millennium Act 38 U.S.C. 1725 (Y/N)" .D ^DIR K DIR I $D(DIRUT) S FBOUT=1 Q .S FB1725=$S(Y:1,1:"") .D ASKDT Q:FBOUT I FBTRACK,'FBINENT D Q:FBOUT ..S DIR(0)="Y",DIR("A")="Is the unauthorized claim complete for the FEE PROGRAM" D DIRQ,^DIR K DIR S:$D(DIRUT) FBOUT=1 S:'FBOUT FBOK=Y Q:FBOUT!(FBOK) ..D REQ^FBUCPEND Q:FBOUT S FBORDER=10 ;display/select pending information,set status order to incomplete if selected pending items .;check for duplicates .I 'FBINENT W !,"Checking for potential duplicates...",! H 1 D ^FBUCDUP .W !!,"Checking eligibility...",! H 1 S DFN=FBVET D ELIG^VADPT W:VAEL(4)'=1 !,"Patient is not a veteran.",*7 D ELIG^FBAADEM K VAEL,VAERR .W ! S DIR("A")="Are you sure you wish to enter a new unauthorized claim",DIR(0)="Y" D ^DIR K DIR S:'Y!($D(DIRUT)) FBOUT=1 Q:FBOUT .;file new claim .S DIC="^FB583(",DIC(0)="Z",X=DT K DD,DO D FILE^DICN S FBOUT=$S($P(Y,U,3):0,1:1) Q:FBOUT S FBDA=+Y D PRIOR^FBUCEVT(FBDA,FBACT) D ..S FBMASTER=FBDA,FBORDER=$S(+$G(FBORDER)=10:10,'FBINENT:30,1:5) ..S DIE=DIC,DIE("NO^")="BACKOUTOK",DR="[FB UNAUTHORIZED ENTER]",DA=FBDA ..D LOCK^FBUCUTL(DIE,DA,1) S:'FBLOCK FBOUT=1 Q:FBOUT D ^DIE L -^FB583(FBDA) K DA,DIE,DQ,DR,FBLOCK I $D(Y)!($D(DTOUT)) S DIK=DIC,DA=FBDA D ^DIK K DIK W !,"... Deleting incomplete record.",*7 S FBOUT=1 Q ..I FBORDER=10 D FREQ^FBUCPEND ;file requested info ..K ^TMP("FBARY",$J),^TMP("FBAR",$J) .D AFTER^FBUCEVT(FBDA,FBACT) .K FBARY,FBLOCK Q:FBOUT D ENTER^FBUCLNK1(FBDA,FBUCA,1) K FBARY,^TMP("FBARY",$J),^TMP("FBAR",$J) .I FBORDER'=10,+$G(FBVEN)>0,+$G(FBTTO)>0 D AFTER^FBUCEVT(FBDA,FBACT),EN^FBUCEN1(FBUCA,FBDA) ;if claim complete, check if group, any in group dispositioned .;do update .D AFTER^FBUCEVT(FBDA,FBACT),^FBUCUPD(FBUCP,FBUCPA,FBUCA,FBUCAA,FBDA,FBACT) ; END ;kill and quit K DA,DFN,DIC,DIE,DIR,DIRUT,DQ,DR,DTOUT,DUOUT,FBACT,FBARY,FBDA,FBDISP,FBINENT,FBLOCK,FBMASTER,FBOK,FBORDER,FBOUT,FBPEND,FBPI,FBPR,FBPROG K FBSTATUS,FBTFROM,FBTRACK,FBTTO,FBUC,FBUCA,FBUCP,FBUCAA,FBUCP,FBUCPA,FBVEN,FBVET,X,Y,^TMP("FBAR",$J),^TMP("FBARY",$J) Q ASKDT ;ask treatment from/to dates S DIR(0)="162.7,3" S:FBPR=6 DIR("A")="ADMISSION DATE" D ^DIR K DIR S:'+Y DIRUT="^" S:$D(DIRUT) FBOUT=1 S:'FBOUT FBTFROM=Y I 'FBOUT S DIR(0)="162.7,4O" S:FBPR=6 DIR("A")="DISCHARGE DATE" S:FBPR'=6&(FBPR'=7) DIR("B")=$$DATX^FBAAUTL(FBTFROM) D ^DIR K DIR S:$D(DUOUT)!($D(DTOUT)) FBOUT=1 I 'FBOUT,'FBINENT G:+Y'>0!(FBTFROM>Y) ASKDT S FBTTO=Y I 'FBOUT S FBTTO=+Y Q HELP ;help text for complete claim question - ?? W !?10,"An unauthorized claim is considered complete (or valid)" W !?10,"if all the necessary information has been received." W !?10,"A claim can never be considered complete if it is missing" W !?10,"form 10-583 or form 10-583 is incomplete." W !?10,"Some examples of other items which are needed are:" W !?20,"Copies of actual bills",!?20,"Original paid receipt" W !?20,"Itemized invoice/UB82",!?20,"Medical records or signature for release" W !?20,"Diagnostic/Procedure code(s)",! Q DIRQ ;set dir(?,#) S DIR("?")="Enter Y(es) if complete, N(o) if incomplete." S DIR("??")="^D HELP^FBUCEN" S DIR("?",1)="Enter Y(es) if all required information has been submitted," S DIR("?",2)=" N(o) if the claim is incomplete." S DIR("?",3)="" Q