IBCEF75 ;ALB/WCJ - Provider ID functions ;13 Feb 2006 ;;2.0;INTEGRATED BILLING;**320**;21-MAR-94 ;; Per VHA Directive 10-93-142, this routine should not be modified. ; G AWAY AWAY Q ; ALLIDS(IBIFN,IBXSAVE,IBSTRIP,SEG) ; Return all of the Provider IDS I '$D(IBSTRIP) S IBSTRIP=0 I '$D(SEG) S SEG="" N IBXIEN,ARINFO,ARID,ARQ,IBFRMTYP,ARIEN,ARINS,Z0,DAT,I,SORT1,SORT2,SORT3,COB,IBCCOB ; S IBXIEN=IBIFN D ALLPROV^IBCEF7 ; Get the Person ID's (Returns IBXSAVE) S DAT=$$PROVID^IBCEF73(IBIFN) S DAT("QUAL")=IBXSAVE("ID") ; this value was also passed back by above function S SORT1="" F S SORT1=$O(IBXSAVE("PROVINF",IBIFN,SORT1)) Q:SORT1="" D . S SORT2=0 F S SORT2=$O(IBXSAVE("PROVINF",IBIFN,SORT1,SORT2)) Q:SORT2="" D .. S SORT3=0 F S SORT3=$O(IBXSAVE("PROVINF",IBIFN,SORT1,SORT2,SORT3)) Q:SORT3="" D ... S IBXSAVE("PROVINF",IBIFN,SORT1,SORT2,SORT3,0)="PRIMARY"_U_U_$$STRIP^IBCEF76($P(DAT("QUAL"),U,SORT3)_U_$P(DAT,U,SORT3),1,U,IBSTRIP) ... F I=1:1 Q:'$D(IBXSAVE("PROVINF",IBIFN,SORT1,SORT2,SORT3,I)) D .... S $P(IBXSAVE("PROVINF",IBIFN,SORT1,SORT2,SORT3,I),U,3,4)=$$STRIP^IBCEF76($P(IBXSAVE("PROVINF",IBIFN,SORT1,SORT2,SORT3,I),U,3,4),1,U,IBSTRIP) ; D LFIDS^IBCEF76(IBIFN,.IBXSAVE,IBSTRIP,SEG) ; Get the Lab/Facility IDs ; S IBFRMTYP=$$FT^IBCEF(IBIFN) S ARIEN=$S(IBFRMTYP=2:3,1:4) S IBCCOB=$$COBN^IBCEF(IBIFN) ; Current Insurance F COB=1:1:3 D . S SORT1=$S(COB=IBCCOB:"C",1:"O") . S SORT2=$S(SORT1="C":1,COB=1:1,COB=2&(IBCCOB=1):1,1:2) . S ARINFO=$G(IBXSAVE("PROVINF",IBIFN,SORT1,SORT2,ARIEN,1)) . ; . D BPIDS(IBIFN,.IBXSAVE,SORT1,SORT2,COB,IBSTRIP,SEG) Q ; BPIDS(IBIFN,IDS,SORT1,SORT2,COB,IBSTRIP,SEG) ; Get all the billing provider IDs and qualifiers from the claim and file 355.92 N DAT,IBFRMTYP,IBCARE,IBDIV,IBINS,MAIN,IBCCOB,USED,PLANTYPE,I,CNT,QUAL,ARF,M1,DEF,IDDIV,IBLIMIT,IEN,ID,IB2 ; S DAT=$G(^DGCR(399,IBIFN,0)) S IBFRMTYP=$$FT^IBCEF(IBIFN),IBFRMTYP=$S(IBFRMTYP=2:2,IBFRMTYP=3:1,1:0) S IBCARE=$S($$ISRX^IBCEF1(IBIFN):3,1:0) ;if an Rx refill bill S:IBCARE=0 IBCARE=$$INPAT^IBCEF(IBIFN,1) S:'IBCARE IBCARE=2 ;1-inp,2-out S IBDIV=+$P(DAT,U,22) S MAIN=$$MAIN^IBCEP2B() ; get the IEN for main Division S IBCCOB=$$COBN^IBCEF(IBIFN) ; Current Insurance S IBINS=$P($G(^DGCR(399,IBIFN,"I"_COB)),U) Q:IBINS="" ; S IDS("BILLING PRV",IBIFN,SORT1,SORT2)=$E("PST",COB) ; ; Primary ID S IDS("BILLING PRV",IBIFN,SORT1,SORT2,0)=$$STRIP^IBCEF76($$TAXID(),1,U,IBSTRIP) S USED($P(IDS("BILLING PRV",IBIFN,SORT1,SORT2,0),U))="" ; ; Secondary #1 - This is the ID Emdeon uses for sorting S IDS("BILLING PRV",IBIFN,SORT1,SORT2,1)=$$STRIP^IBCEF76($$BPSID1(IBDIV),1,U,IBSTRIP) S USED($P(IDS("BILLING PRV",IBIFN,SORT1,SORT2,1),U))="" ; ; Check if this is a plan type which gets no secondary IDs S M1=$G(^DGCR(399,IBIFN,"M1")) ; the following check is the current value of the flag, not when the claim was created. S PLANTYPE=$$POLTYP^IBCEF3(IBIFN,COB) I PLANTYPE]"",$D(^DIC(36,IBINS,13,"B",PLANTYPE)) Q ; ; Secondary #2 ; If there is a ID send with quailifer (stored or computed) I $P(M1,U,COB+1)]"" D . S QUAL="" . S DAT=$P(M1,U,COB+9) . I DAT S QUAL=$$STRIP^IBCEF76($P($G(^IBE(355.97,DAT,0)),U,3),1,,IBSTRIP) . ; the null check is needed to be backwards compatible . I QUAL=""!(QUAL="1J") S QUAL=$$STRIP^IBCEF76($$OLDWAY(IBIFN,COB),1,,IBSTRIP) . S IB2=QUAL_U_$$STRIP^IBCEF76($P(M1,U,COB+1),1,,IBSTRIP) ; I $P(M1,U,COB+1)="" S IB2=$$STRIP^IBCEF76($$OLDWAY(IBIFN,COB),1,,IBSTRIP)_U_$$STRIP^IBCEF76($$GET1^DIQ(350.9,1,1.05),1,,IBSTRIP) ; S IDS("BILLING PRV",IBIFN,SORT1,SORT2,2)=IB2 S IDS("BILLING PRV",IBIFN,SORT1,SORT2,2,"PTQ")=$$OLDWAY(IBIFN,COB) S USED($P(IB2,U))="" ; S CNT=$S('$D(IDS("BILLING PRV",IBIFN,SORT1,SORT2,2)):2,1:3) S IBLIMIT=8 S IEN=0 F S IEN=$O(^IBA(355.92,"B",IBINS,IEN)) Q:IEN="" D Q:CNT>IBLIMIT . S DAT=$G(^IBA(355.92,IEN,0)) . Q:$P(DAT,U,8)'="A" ; only allow additional IDs . Q:$P(DAT,U,7)="" ; No Provider ID . Q:$P(DAT,U,6)="" ; No ID Qualifier . I IBFRMTYP=1 Q:$P(DAT,U,4)=2 . I IBFRMTYP=2 Q:$P(DAT,U,4)=1 . ; . ; Check if we already have one of these . S QUAL=$$STRIP^IBCEF76($P(DAT,U,6),1,,IBSTRIP) . S QUAL=$P($G(^IBE(355.97,QUAL,0)),U,3) . Q:QUAL="" . Q:$D(USED(QUAL)) . ; . S IDS("BILLING PRV",IBIFN,SORT1,SORT2,CNT)=QUAL_U_$$STRIP^IBCEF76($P(DAT,U,7),1,,IBSTRIP) . S CNT=CNT+1,USED(QUAL)="" ; Q ; OLDWAY(IBIFN,COB) ; Figure out the qualifier the old way if it's not stored with the claim. ; It's based on the plan type. This is used for Billing Provider Secondary ID #2 N PLANTYPE S PLANTYPE=$$POLTYP^IBCEF3(IBIFN,COB) Q $$SOP^IBCEP2B(IBIFN,PLANTYPE) ; BPSID1(DIV) ; Return the Billing Provider Secondary ID #1 and qualifier which Emdeon uses to sort IBIFNs N DATA S DATA=$P($$SITE^VASITE(DT,$S(DIV:DIV,1:+$$SITE^VASITE())),U,3) S DATA=$E("0000",1,7-$L(DATA))_$E(DATA,4,7) Q "G5"_U_DATA ; TAXID() ; Return the Billing Provider Primary ID and qualifier which is the TAXID for the site and also the qualifier N DATA S DATA=$P($G(^IBE(350.9,1,1)),U,5) S DATA=$$NOPUNCT^IBCEF(DATA,1) Q 24_U_DATA ; VAMCFD(IBIFN,IBRET) ; ; ; This procedure returns data based on flag in insurance company file which is set in the insurance co editor ; Send VA Lab/Facility IDs or Facility Data for VAMC? ; The return value will be set to 1 (yes) if the division in the claim is not the main division (VAMC) or ; if the flag in the dictionary for that insurance company says to send the data. ; ; Input - IBFN - IEN 399 ; Output - IBRET(IBSORT1,IBSORT2)=FLAG ; IBSORT1 = "C"urrent or "O"ther insurance ; IBSORT2 = order with IBSORT1 ; FLAG = 0 No or 1 Yes ; N IBDIV,MAIN,IBCCOB,IBSORT1,IBSORT2,DAT,IBINS,COB,OUTFAC S IBDIV=+$P($G(^DGCR(399,IBIFN,0)),U,22) S MAIN=$$MAIN^IBCEP2B() ; get the IEN for main Division S IBCCOB=$$COBN^IBCEF(IBIFN) F COB=1:1:3 D . S IBSORT1=$S(COB=IBCCOB:"C",1:"O") . S IBSORT2=$S(IBSORT1="C":1,COB=1:1,COB=2&(IBCCOB=1):1,1:2) . S IBINS=+$G(^DGCR(399,IBIFN,"I"_COB)) . Q:'IBINS . S IBRET(IBSORT1,IBSORT2)=1 . S OUTFAC=$P($G(^DGCR(399,IBIFN,"U2")),U,10) . Q:OUTFAC]"" . Q:IBDIV'=MAIN . ; [7] Send VA Lab/Facility IDs or Facility Data for VAMC?(0 - NO, 1 - YES) . S DAT(3647)=$P($G(^DIC(36,IBINS,4)),U,7) . I DAT(3647) Q . S IBRET(IBSORT1,IBSORT2)=0 Q ; CLEANUP(IBXSAVE) ; Clean up K IBXSAVE("PROVINF") K IBXSAVE("LAB/FAC") K IBXSAVE("BILLING PRV") K IBXSAVE("ID") Q