IBCE837A ;ALB/TMP - OUTPUT FOR 837 TRANSMISSION - CONTINUED ;8/6/03 10:50am ;;2.0;INTEGRATED BILLING;**137,191,211,232,296**;21-MAR-94 ; UPD(MSGNUM,BATCH,CNT,BILLS,DESC,IBBTYP,IBINS) ; Upd current batch + bills w/new status ;MSGNUM = mail msg # for batch ;BATCH = batch # ;CNT = # of bills in batch ;BILLS = array BILLS(bill ien in 364) in batch ;DESC = 1-80 character description of batch ;IBBTYP = X-Y where X = P for professional or I for institution ; Y = 1 for test or 0 for live transmission ; or 2 for live claim resubmitted as test ;IBINS = ien of single insurance company for the batch (optional) ; N DIC,DIE,DR,DA,IBBATCH,IBIFN,IBIEN,IBYY,IBTXTEST,IBMRA S IBBATCH=$O(^IBA(364.1,"B",+BATCH,"")) Q:'IBBATCH S IBTXTEST=+$P(IBBTYP,"-",2) I '$P($G(^IBE(350.9,1,8)),U,7) S IBINS="" ; S DIE="^IBA(364.1,",DA=IBBATCH,DR=".02////P;.03///"_CNT_";.04///"_MSGNUM_";.05///0;.07////1;.08///^S X="""_DESC_""""_$S($G(IBINS):";.12////"_IBINS,1:"") ; I '$P($G(^TMP("IBRESUBMIT",$J)),U,3) S DR=DR_";1.01///NOW;1.02///.5" I $P($G(^TMP("IBRESUBMIT",$J)),U,2) S DR=DR_";.15////"_$P(^($J),U,2) ; S DR=DR_";.14////"_$S('IBTXTEST:0,1:1)_";.06////"_$S($E(IBBTYP)="P":2,1:3) D ^DIE ; Update batch ; I IBTXTEST=2 D ADDTXM^IBCEPTM(.BILLS,IBBATCH,$$NOW^XLFDT()) Q I IBTXTEST'=2 S IBIEN=0 F S IBIEN=$O(BILLS(IBIEN)) Q:'IBIEN D ;Update each bill .S DA=IBIEN,DIE="^IBA(364,",DR=".02////"_IBBATCH_";.03///P;.04///NOW" D ^DIE .S IBIFN=+$G(^IBA(364,IBIEN,0)) .Q:$D(^TMP("IBRESUBMIT",$J))!($P($G(^DGCR(399,IBIFN,0)),U,13)=4)!(+$$TXMT^IBCEF4(IBIEN)=2) .S IBMRA=$$NEEDMRA^IBEFUNC(IBIFN) .I IBMRA="C",$P($G(^DGCR(399,IBIFN,0)),U,13)=2 S IBMRA=1 .I IBIFN D ..S (DIC,DIE)="^DGCR(399,",DA=$P($G(^IBA(364,IBIEN,0)),U),DR="[IB STATUS]",IBYY=$S('IBMRA:"@91",1:"@911") D:DA ^DIE ..D BSTAT^IBCDC(IBIFN) ; remove from AB list Q ; PRE ; Run before processing a bill entry K IBXSAVE,IBXERR,^UTILITY("VAPA",$J),^TMP("IBXSAVE",$J),^TMP($J),^TMP("DIERR",$J) Q ; POST ; Run after processing a bill entry for cleanup N Q I $G(IBXERR)'="" D .S ^TMP("IBXERR",$J,IBXIEN)=IBXERR K ^TMP("IBXDATA",$J) .K ^TMP("IBHDR1",$J) .I $D(^TMP("IBRESUBMIT",$J)),'$G(^TMP("IBEDI_TEST_BATCH",$J)) D ;Set not resub flag for non-test bill ..N Z,Z0 ..S Z0=$P($G(^TMP("IBRESUBMIT",$J)),U) Q:Z0="" ..S Z=$O(^IBA(364,"ABABI",+$O(^IBA(364.1,"B",Z0,"")),IBXIEN,"")) ..I Z S ^TMP("IBNOT",$J,Z)=IBXIEN K IBXSAVE,IBXNOREQ,^TMP("IBXSAVE",$J),^TMP($J) S Q="VA" F S Q=$O(^UTILITY(Q)) Q:$E(Q,1,2)'="VA" I $D(^(Q,$J)) K ^UTILITY(Q,$J) D CLEAN^DILF Q ; MAILIT(IBQUEUE,IBBILL,IBCTM,IBDUZ,IBDESC,IBBTYP,IBINS) ; Send mail msg, update bills ;IBQUEUE = mail queue name to send 837 transactions to ;IBBILL = array of ien's in file 364 of bills in batch - IBBILL(IEN)="" ;IBCTM = # of bills in batch, returned reset to 0 ;IBDUZ = ien of user 'running' extract (if any) ;IBDESC = description of batch ;IBBTYP = X-Y where X = P for professional or I for institution ; Y = 1 or 2 for test or 0 for live transmission ;IBINS = ien of insurance company if only one/batch option (optional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pdate batch/bills .. S ^TMP("IBCE-BATCH",$J,IBBNO)=IBBDA_U_IBCTM_U_$P($G(^TMP("IBRESUBMIT",$J)),U) MAILQ S IBCTM=0 D CHKBTCH(+$G(^TMP("IBHDR",$J))) K ^TMP("IBHDR",$J),^TMP("IBHDR1",$J),^TMP("IBXMSG",$J),IBBILL Q ; CHKNEW(IBQ,IBBILL,IBCTM,IBDESC,IBBTYP,IBINS,IBSITE,IBSIZE) ; ; Determine if ok to send msg ; Check for one insurance per batch if IBINS defined ; Returns IBSIZE, IBCTM, IBBILL (pass by reference) ; ; IBQ = data queue name ; IBBILL = the 'list' of bill #'s in the batch ; IBCTM = the # of claims output so far to the batch ; IBDESC = the batch description text ; IBBTYP = X-Y where X = P for professional or I for institution ; Y = 1 for test or 0 for live transmission ; IBINS = the ien of the single insurance co. for the batch (optional) ; IBSITE = the '8' node of file 350.9 (IB PARAMETERS) ; IBSIZE = the 'running' size of the output message ; Q:$S($G(IBINS)="":0,1:'$P(IBSITE,U,7)) ; ; New batch needed I IBCTM D MAILIT(IBQ,.IBBILL,.IBCTM,"",IBDESC,IBBTYP,IBINS) S IBSIZE=0 Q ; ERRMSG(XMBODY) ; Send bulletin for error message N XMTO,XMSUBJ S XMTO("I:G.IB EDI")="",XMSUBJ="EDI 837 TRANSMISSION ERRORS" ; D SENDMSG^XMXAPI(,XMSUBJ,XMBODY,.XMTO) D ALERT("One or more EDI bills were not transmitted. Check your mail for details","G.IB EDI") Q ; CLEANUP ; Cleans up bill transmission environment ; N IBTEST S IBTEST=+$G(^TMP("IBEDI_TEST_BATCH",$J)) L -^IBA(364,0) I $D(^TMP("IBRESUBMIT",$J,"IBXERR"))!$D(^TMP("IBONE",$J,"IBXERR"))!$D(^TMP("IBSELX",$J,"IBXERR")) D ;Error message to mail group . N XMTO,XMBODY,XMDUZ,XMSUBJ,XMZ,IBFUNC . S IBFUNC=$S($D(^TMP("IBRESUBMIT",$J,"IBXERR")):$S('IBTEST:1,1:4),$D(^TMP("IBONE",$J,"IBXERR")):2,1:3) . Q:'IBFUNC . S XMTO("I:G.IB EDI")="",XMDUZ="",XMBODY="^TMP("""_$S(IBFUNC=1!(IBFUNC=4):"IBRESUBMIT",1:"IBONE")_""","_$J_",""IBXERR"")" . S XMSUBJ="EDI 837 B"_$P("ATCH^ILL^ILL(s)^ILL(s)",U,IBFUNC)_" NOT "_$S($G(^TMP("IBONE",$J)):"RE",1:"")_"SUBMITTED"_$S('IBTEST:"",1:" AS TEST CLAIMS") . D SENDMSG^XMXAPI(XMDUZ,XMSUBJ,XMBODY,.XMTO,,.XMZ) . K ^TMP("IBRESUBMIT",$J),^TMP("IBONE",$J) ; I $D(^TMP("IBRESUBMIT",$J)),'IBTEST D RESUBUP^IBCEM02 ;Upd resubmtd batch bills I '$D(^TMP("IBSELX",$J)) K ^TMP("IBCE-BATCH",$J) K ^TMP("IBXERR",$J),IBXERR I 'IBTEST D CHKBTCH(+$G(^TMP("IBHDR",$J))) CLEANP ; Entrypoint for extract data disply K ^TMP("IBTXMT",$J),^TMP("IBXINS",$J) K ^TMP("IBRESUBMIT",$J),^TMP("IBRESUB",$J),^TMP("IBNOT",$J),^TMP("IBONE",$J),^TMP("IBHDR",$J),^TMP("IBTX",$J),^TMP("IBEDI_TEST_BATCH",$J) K ^UTILITY("VADM",$J) D CLEAN^DILF K ZTREQ S ZTREQ="@" Q ; ALERT(XQAMSG,IBGRP) ; Send alert message N XQA S XQA(IBGRP)="" D SETUP^XQALERT Q CHKBTCH(IBBNO) ; Delete batch whose batch # is IBBNO if no entries in file 364 ; and not a resubmitted batch N IBZ,DA,DIK S IBZ=+$O(^IBA(364.1,"B",+IBBNO,"")) I IBZ,'$O(^IBA(364,"C",IBZ,0)),'$P($G(^IBA(364.1,IBZ,0)),U,14) S DA=IBZ,DIK="^IBA(364.1," D ^DIK Q ; TESTLIM(IBINS) ; Check for test bill limit per day has been reached N IB3,DA,DIK S IB3=$G(^DIC(36,IBINS,3)) I $P(IB3,U,5)'=DT S $P(IB3,U,7)=0 I ($P(IB3,U,7)+$G(^TMP("IBICT",$J,IBINS))+1)>$P(IB3,U,6) D Q . S IBINS="" ;max # hit . S DA=IBX,DIK="^IBA(364," D ^DIK S ^TMP("IBICT",$J,IBINS)=$G(^TMP("IBICT",$J,IBINS))+1 Q ; SETVAR(IBXIEN,IBINS,IB0,IBSEC,IBNID,IB837R,IBDIV) ; ; Set up variables needed for subscripts in sort global ; ejk added IBSEC logic for patch 296 ; IBSEC=1 if primary bill, 2 if 2nd/non-MRA, 3 if 2nd/MRA S IBSEC=$S($$COBN^IBCEF(IBXIEN)=1:1,'$$MRASEC^IBCEF4(IBXIEN):2,1:3) S IBNID=$$PAYERID^IBCEF2(IBXIEN) S IB837R=$$RECVR^IBCEF2(IBXIEN) S IBDIV=$P($S($P(IB0,U,22):$$SITE^VASITE(DT,$P(IB0,U,22)),1:$$SITE^VASITE()),U,3) I IBNID'="","RPIHS"[$E(IBNID),$E(IBNID,2,$L(IBNID))="PRNT" S IBNID=IBNID_"*"_IBINS I IBNID="" S IBNID="*"_IBINS S $P(IBNID,"*",3)=$S($P(IB0,U,22):$P(IB0,U,22),1:"") Q ;