source: FOIAVistA/tag/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCNBMI.m@ 636

Last change on this file since 636 was 636, checked in by George Lilly, 14 years ago

WorldVistAEHR overlayed on FOIAVistA
File size: 8.0 KB
Line 
1IBCNBMI ;ALB/ARH-Ins Buffer: move buffer data to insurance files ; 09 Mar 2005 11:42 AM
2 ;;2.0;INTEGRATED BILLING;**82,184,246,251,299,345,361**;21-MAR-94;Build 9
3 ;;Per VHA Directive 2004-038, this routine should not be modified.
4 ;
5INS(IBBUFDA,IBINSDA,TYPE) ; move buffer insurance company data (file 355.33) to existing Insurance Company (file 36)
6 ;
7 S IBBUFDA=IBBUFDA_",",IBINSDA=$G(IBINSDA)_","
8 D SET("INS",IBBUFDA,IBINSDA,TYPE)
9 Q
10 ;
11GRP(IBBUFDA,IBGRPDA,TYPE) ; move buffer insurance group/plan data (file 355.33) to existing Group/Plan (file 355.33)
12 ;
13 S IBBUFDA=IBBUFDA_",",IBGRPDA=$G(IBGRPDA)_","
14 D SET("GRP",IBBUFDA,IBGRPDA,TYPE)
15 D STUFF("GRP",IBGRPDA)
16 Q
17 ;
18POLICY(IBBUFDA,IBPOLDA,TYPE) ; move buffer insurance policy data (file 355.33) to existing Patient Policy (file 2.312)
19 ;
20 N DFN S DFN=+$G(^IBA(355.33,+$G(IBBUFDA),60)) Q:'DFN
21 ;
22 S IBBUFDA=IBBUFDA_",",IBPOLDA=$G(IBPOLDA)_","_DFN_","
23 D SET("POL",IBBUFDA,IBPOLDA,TYPE)
24 D STUFF("POL",IBPOLDA)
25 D POLOTH(IBBUFDA,IBPOLDA)
26 Q
27 ;
28SET(SET,IBBUFDA,IBEXTDA,TYPE) ; move buffer data to insurance files
29 ; Input: IBBUFDA - ifn of Buffer File entry to move (#355.33)
30 ; IBEXTDA - ifn of insurance entry to update (#36,355.3,2)
31 ; TYPE - 1 = Merge (only buffer data moved to blank fields in ins file, no replace)
32 ; 2 = Overwrite (all buffer data moved to ins file, replace existing data)
33 ; 3 = Replace (all buffer data including null move to ins file)
34 ; 4 = Individually Accept (Skip Blanks) (user accepts
35 ; individual diffs b/w buffer data and existing file data (excl blanks)
36 ; to overwrite flds (or addr grp) in existing file)
37 ;
38 ;
39 N IBX,IBFLDS,EXTFILE,DRBUF,DREXT,BUFARR,EXTARR,IBBUFFLD,IBEXTFLD,IBBUFVAL,IBEXTVAL,IBCHNG,IBCHNGN,IBERR
40 ;
41 D FIELDS(SET_"FLD")
42 S IBX=$P($T(@(SET_"DR")+1),";;",2),EXTFILE=+$P(IBX,U,1),DRBUF=$P(IBX,U,2),DREXT=$P(IBX,U,3)
43 ;
44 D GETS^DIQ(355.33,IBBUFDA,DRBUF,"E","BUFARR")
45 D GETS^DIQ(EXTFILE,IBEXTDA,DREXT,"E","EXTARR")
46 ;
47 I +$G(TYPE) S IBBUFFLD=0 F S IBBUFFLD=$O(BUFARR(355.33,IBBUFDA,IBBUFFLD)) Q:'IBBUFFLD D
48 . S IBEXTFLD=$G(IBFLDS(IBBUFFLD)) Q:'IBEXTFLD
49 . S IBBUFVAL=BUFARR(355.33,IBBUFDA,IBBUFFLD,"E")
50 . S IBEXTVAL=$G(EXTARR(EXTFILE,IBEXTDA,IBEXTFLD,"E"))
51 . ;
52 . I IBBUFVAL=IBEXTVAL Q
53 . I TYPE=1,IBEXTVAL'="" Q
54 . I TYPE=2,IBBUFVAL="" Q
55 . I TYPE=4,'$D(^TMP($J,"IB BUFFER SELECTED",IBBUFFLD)) Q
56 . ;
57 . S IBCHNG(EXTFILE,IBEXTDA,IBEXTFLD)=IBBUFVAL
58 . S IBCHNGN(EXTFILE,IBEXTDA,IBEXTFLD)=""
59 ;
60 I $D(IBCHNGN)>9 D FILE^DIE("E","IBCHNGN","IBERR")
61 I $D(IBCHNG)>9 D FILE^DIE("E","IBCHNG","IBERR")
62 Q
63 ;
64STUFF(SET,IBEXTDA) ; update fields in insurance files that should be automatically set when an entry is edited
65 ; Input: IBEXTDA - ifn of insurance entry to update (#36,356,2)
66 ;
67 N IBX,IBFLDS,EXTFILE,IBEXTFLD,IBEXTVAL,IBCHNG,IBCHNGN,IBERR
68 ;
69 D FIELDS(SET_"A")
70 S IBX=$P($T(@(SET_"DR")+1),";;",2),EXTFILE=+$P(IBX,U,1)
71 ;
72 S IBEXTFLD=0 F S IBEXTFLD=$O(IBFLDS(IBEXTFLD)) Q:'IBEXTFLD D
73 . S IBEXTVAL=IBFLDS(IBEXTFLD) I IBEXTVAL="DUZ" S IBEXTVAL="`"_DUZ
74 . S IBCHNG(EXTFILE,IBEXTDA,IBEXTFLD)=IBEXTVAL
75 . S IBCHNGN(EXTFILE,IBEXTDA,IBEXTFLD)=""
76 ;
77 D FILE^DIE("E","IBCHNGN","IBERR")
78 D FILE^DIE("E","IBCHNG","IBERR")
79 Q
80 ;
81FIELDS(SET) ; return array of corresponding fields: IBFLDS(Buffer #)=Ins #
82 N IBI,IBLN,IBB,IBE,IBG K IBFLDS,IBADDS,IBLBLS
83 F IBI=1:1 S IBLN=$P($T(@(SET)+IBI),";;",2) Q:IBLN="" I $E(IBLN,1)'=" " D
84 . S IBB=$P(IBLN,U,1),IBE=$P(IBLN,U,2),IBG=$P(IBLN,U,4)
85 . I IBB'="",IBE'="" D
86 .. S IBFLDS(IBB)=IBE
87 .. I SET["FLD" S IBLBLS(IBB)=$P(IBLN,U,3) I +IBG S IBADDS(IBB)=IBE
88 Q
89 ;
90INSDR ;
91 ;;36^20.02:20.04;21.01:21.06^.131;.132;.133;.111:.116
92INSFLD ; corresponding fields: Buffer File (355.33) and Insurance Company file (36)
93 ;;20.02^.131^Phone Number^ ; MM Phone Number
94 ;;20.03^.132^Billing Phone^ ; Billing Phone Number
95 ;;20.04^.133^Pre-Cert Phone^ ; Pre-Certification Phone Number
96 ;;21.01^.111^Street [Line 1]^1 ; MM Street Address [Line 1]
97 ;;21.02^.112^Street [Line 2]^1 ; MM Street Address [Line 2]
98 ;;21.03^.113^Street [Line 3]^1 ; MM Street Address [Line 3]
99 ;;21.04^.114^City^1 ; MM City
100 ;;21.05^.115^State^1 ; MM State
101 ;;21.06^.116^Zip^1 ; MM Zip Code
102 ;
103GRPDR ;
104 ;;355.3^40.02:40.03;40.1;40.11;40.04:40.09;^.03:.04;6.02;6.03;.05:.09;.12
105GRPFLD ;corresponding fields: Buffer File (355.33) and Insurance Group Plan file (355.3)
106 ;;40.02^.03^Group Name^ ; Group Name
107 ;;40.03^.04^Group Number^ ; Group Number
108 ;;40.1^6.02^BIN^ ; BIN ;;Daou/EEN
109 ;;40.11^6.03^PCN^ ; PCN ;;Daou/EEN
110 ;;40.04^.05^Require UR^ ; Utilization Review Required
111 ;;40.05^.06^Require Pre-Cert^ ; Pre-Certification Required
112 ;;40.06^.12^Require Amb Cert^ ; Ambulatory Care Certification
113 ;;40.07^.07^Exclude Pre-Cond^ ; Exclude Pre-Existing Conditions
114 ;;40.08^.08^Benefits Assign^ ; Benefits Assignable
115 ;;40.09^.09^Type of Plan^ ; Type of Plan
116 ;
117GRPA ; auto set fields
118 ;;1.05^NOW^ ; Date Last Edited
119 ;;1.06^DUZ^ ; Last edited By
120 ;
121POLDR ;
122 ;;2.312^60.02:61.12^8;3;1;6;16;17;3.01;3.05;4.01;4.02;.2;3.12;2.1;2.015;2.11;2.12;2.01:2.08
123POLFLD ; corresponding fields: Buffer File (355.33) and Insurance Patient Policy file (2.312)
124 ;;60.02^8^Effective Date^ ; Effective Date
125 ;;60.03^3^Expiration Date^ ; Expiration Date
126 ;;60.04^1^Subscriber Id^ ; Subscriber Id
127 ;;60.05^6^Whose Insurance^ ; Whose Insurance
128 ;;60.06^16^Relationship^ ; Pt. Relationship to Insured
129 ;;60.07^17^Name of Insured^ ; Name of Insured
130 ;;60.08^3.01^Insured's DOB^ ; Insured's DOB
131 ;;60.09^3.05^Insured's SSN^ ; Insured's SSN
132 ;;60.1^4.01^Primary Provider^ ; Primary Care Provider
133 ;;60.11^4.02^Provider Phone^ ; Primary Care Provider Phone
134 ;;60.12^.2^Coor of Benefits^ ; Coordination of Benefits
135 ;;60.13^3.12^Insured's Sex^ ; Insured's Sex
136 ;;
137 ;;61.01^2.1^Emp Sponsored^ ; ESGHP?
138 ;;61.02^2.015^Employer Name^ ; Subscriber's Employer Name
139 ;;61.03^2.11^Emp Status^ ; Employment Status
140 ;;61.04^2.12^Retirement Date^ ; Retirement Date
141 ;;61.05^2.01^Send to Employer^ ; Send Bill to Employer?
142 ;;61.06^2.02^Emp Street Ln 1^1 ; Employer Claims Street Line 1
143 ;;61.07^2.03^Emp Street Ln 2^1 ; Employer Claims Street Line 2
144 ;;61.08^2.04^Emp Street Ln 3^1 ; Employer Claims Street Line 3
145 ;;61.09^2.05^Emp City^1 ; Employer Claims City
146 ;;61.1^2.06^Emp State^1 ; Employer Claims State
147 ;;61.11^2.07^Emp Zip Code^1 ; Employer Claims Zip Code
148 ;;61.12^2.08^Emp Phone^ ; Employer Claims Phone
149 ;
150POLA ; auto set fields
151 ;;1.03^NOW^ ; Date Last Verified (default is person that accepts entry)
152 ;;1.04^DUZ^ ; Verified By (default is person that accepts entry)
153 ;;1.05^NOW^ ; Date Last Edited
154 ;;1.06^DUZ^ ; Last Edited By
155 ;
156 ;
157POLOTH(IBBUFDA,IBPOLDA) ; other special cases that can not be transferred using the generic code above, usually because of dependencies
158 N IB0 S IB0=$G(^IBA(355.33,+IBBUFDA,0))
159 ;
160 ; --- if buffer entry was verified before the accept step, then add the correct verifier info to the policy
161 I +$P(IB0,U,10) D
162 . S IBCHNG(2.312,IBPOLDA,1.03)=$E($P(IB0,U,10),1,12),IBCHNGN(2.312,IBPOLDA,1.03)=""
163 . S IBCHNG(2.312,IBPOLDA,1.04)=$P(IB0,U,11),IBCHNGN(2.312,IBPOLDA,1.04)=""
164 ;
165 I $D(IBCHNGN)>9 D FILE^DIE("I","IBCHNGN","IBERR")
166 I $D(IBCHNG)>9 D FILE^DIE("I","IBCHNG","IBERR")
167 Q
168 ;
169PAT(DFN,IBPOLDA) ; Force DOB, SSN & SEX from Patient file (#2) in to Insurance Patient Policy file (2.312)
170 N DA,DR,DIE,DOB,SSN,SEX,IENS,WI
171 S IENS=IBPOLDA_","_DFN_","
172 S WI=$$GET1^DIQ(2.312,IENS,6,"I")
173 I WI'="v" Q ; Only use when Whose Insurance is 'v'
174 S DOB=$$GET1^DIQ(2,DFN,.03,"I")
175 S SSN=$$GET1^DIQ(2,DFN,.09,"I")
176 S SEX=$$GET1^DIQ(2,DFN,.02,"I")
177 S DIE="^DPT("_DFN_",.312,",DA(1)=DFN,DA=IBPOLDA
178 S DR="3.01///^S X=DOB;3.05///^S X=SSN;3.12///^S X=SEX"
179 D ^DIE
180 Q
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