IVMZ7CE ;TDM,BAJ - HL7 Z07 CONSISTENCY CHECKER -- SERVICE SUBROUTINE ; 01/23/07 ;;2.0;INCOME VERIFICATION MATCH;**105**;JUL 8,1996;Build 2 ; ; Eligibility Consistency Checks ; This routine checks the various elements of service information ; prior to building a Z07 record. Any tests which fail consistency ; check will be saved to the ^DGIN(38.6 record for the patient. ; ; Must be called from entry point Q ; EN(DFN,DGP) ; entry point. Patient DFN is sent from calling routine. ; initialize working variables N RULE,Y,X,FILERR ; ; loop through rules in INCONSISTENT DATA ELEMENTS file. ; execute only the rules where CHECK/DON'T CHECK and INCLUDE IN Z07 ; CHECKS fields are turned ON. ; ; ***NOTE loop boundary (401-413) must be changed if rule numbers ; are added *** F RULE=401:1:413 I $D(^DGIN(38.6,RULE)) D . S Y=^DGIN(38.6,RULE,0) . I '$P(Y,U,5),$P(Y,U,6) D @RULE I $D(FILERR) M ^TMP($J,DFN)=FILERR Q ; 401 ; RATED INCOMPETENT INVALID S X=$P(DGP("PAT",.29),U,12) I (X'="")&(X'=0)&(X'=1) S FILERR(RULE)="" Q ; 402 ; ELIGIBLE FOR MEDICAID INVALID S X=$P(DGP("PAT",.38),U) I (X'="")&(X'=0)&(X'=1) S FILERR(RULE)="" Q ; 403 ; DT MEDICAID LAST ASKED INVALID I $P(DGP("PAT",.38),U)=1,$P(DGP("PAT",.38),U,2)<1 S FILERR(RULE)="" Q ; 404 ; INELIGIBLE REASON INVALID ; Note: RULE #15 in IVMZ7CR is a duplicate of this rule Q ; 405 ; NON VETERAN ELIG CODE INVALID ; Note: RULE #60 in IVMZ7CR is a duplicate of this rule Q ; 406 ; CLAIM FOLDER NUMBER INVALID S X=$P(DGP("PAT",.31),U,3) I X'="",$P(DGP("PAT",0),U,9)'=X,(($L(X)>8)!($L(X)<7)) S FILERR(RULE)="" Q ; 407 ; ELIGIBILITY STATUS INVALID S X=$P(DGP("PAT",.361),U) I (X'="")&(X'="P")&(X'="R")&(X'="V") S FILERR(RULE)="" Q ; 408 ; DECLINE TO GIVE INCOME INVALID ; This CC removed per customer 05/08/2006 -- BAJ ; I $D(DGP("MEANS",0)),$P(DGP("MEANS",0),U,4)<1,$P(DGP("MEANS",0),U,14)'=1 S FILERR(RULE)="" Q ; 409 ; AGREE TO PAY DEDUCT INVALID ; 2 PENDING ADJUDICATION MEANS TEST ; 6 MT COPAY REQUIRED MEANS TEST ;16 GMT COPAY REQUIRED MEANS TEST I $D(DGP("MEANS",0)),$P(DGP("MEANS",0),U,11)="" D . S X=$P(DGP("MEANS",0),U,3) . I (X=2)!(X=6) S FILERR(RULE)="" Q . I X=16,'$P(DGP("MEANS",0),U,20) S FILERR(RULE)="" Q ; 410 ; Note: RULE #404 above is a duplicate of this rule Q ; 411 ; ENROLLMENT APP DATE INVALID I $D(DGP("ENR",0)) S X=$P(DGP("ENR","0"),U) I ($E(X,1,3)<1)!($E(X,4,5)<1)!($E(X,6,7)<1) S FILERR(RULE)="" Q ; 412 ; POS/ELIG CODE INVALID ; Note: RULE #24 in IVMZ7CR is a duplicate of this rule Q ; 413 ; POS INVALID ; Note: RULE #13 in IVMZ7CR is a duplicate of this rule Q