IBCNEDE1 ;DAOU/DAC - IIV INSURANCE BUFFER EXTRACT ;04-JUN-2002 ;;2.0;INTEGRATED BILLING;**184,271**;21-MAR-94 ;;Per VHA Directive 10-93-142, this routine should not be modified. ; ;**Program Description** ; This routine loops through the insurance buffer and ; creates IIV transaction queue entries when approriate. ; Periodically check for stop request for background task ; Q ; no direct calls allowed ; EN ; Loop through designated cross-references for updates ; Insurance Buffer Extract ; N TODAYSDT,FRESHDAY,LOOPDT,IEN,OVRFRESH,FRESHDT N DFN,PDOD,SRVICEDT,VERIFDDT,PAYERSTR,PAYERID,SYMBOL,PAYRNAME N PIEN,PNIEN,TQIEN,TRIEN,TRSRVCDT,TQCRTDT,TRANSNO,DISYS N ORIGINSR,ORGRPSTR,ORGRPNUM,ORGRPNAM,ORGSUBCR N MAXCNT,CNT,ISYMBOLM,DATA1,DATA2,ORIG,SETSTR,ISYMBOL,IBCNETOT N SIDDATA,SID,SIDACT,BSID,FDA,PASSBUF,SCNT5,SIDCNT,SIDARRAY N TQDT,TQIENS,TQOK,STATIEN ; S SETSTR=$$SETTINGS^IBCNEDE7(1) ; Returns buffer extract settings I 'SETSTR Q ; Quit if extract is not active S MAXCNT=$P(SETSTR,U,4) ; Max # TQ entries that may be created S:MAXCNT="" MAXCNT=9999999999 ; S FRESHDAY=$P($G(^IBE(350.9,1,51)),U,1) ; System freshness days ; S CNT=0 ; Initialize count of TQ entries created S IBCNETOT=0 ; Initialize count for periodic TaskMan check ; S LOOPDT="" ; Date used to loop throught the IB global F S LOOPDT=$O(^IBA(355.33,"AEST","E",LOOPDT)) Q:LOOPDT=""!(CNT=MAXCNT) D Q:$G(ZTSTOP) . S IEN="" . F S IEN=$O(^IBA(355.33,"AEST","E",LOOPDT,IEN)) Q:IEN=""!(CNT=MAXCNT) D Q:$G(ZTSTOP) .. ; Update count for periodic check .. S IBCNETOT=IBCNETOT+1 .. ; Check for request to stop background job, periodically .. I $D(ZTQUEUED),IBCNETOT#100=0,$$S^%ZTLOAD() S ZTSTOP=1 Q .. ; .. ; Get symbol, if symbol'=" " OR "!" then quit .. S ISYMBOL=$$SYMBOL^IBCNBLL(IEN) ; Insurance buffer symbol .. I (ISYMBOL'=" ")&(ISYMBOL'="!") Q .. ; .. ; Get the IIV STATUS IEN and quit for response related errors .. S STATIEN=+$P($G(^IBA(355.33,IEN,0)),U,12) .. I ",11,12,15,"[(","_STATIEN_",") Q ; Prevent update for response errors .. ; .. S OVRFRESH=$P($G(^IBA(355.33,IEN,0)),U,13) ; Freshness OvrRd flag .. S DFN=$P($G(^IBA(355.33,IEN,60)),U,1) ; Patient DFN .. Q:DFN="" .. I $P($G(^DPT(DFN,0)),U,21) Q ; Exclude if test patient .. ; .. S PDOD=$P($G(^DPT(DFN,.35)),U,1)\1 ; Patient's date of death .. S SRVICEDT=DT I PDOD S SRVICEDT=PDOD ; Service Date .. S FRESHDT=$$FMADD^XLFDT(SRVICEDT,-FRESHDAY) .. S PAYERSTR=$$INSERROR^IBCNEUT3("B",IEN) ; Payer String .. S PAYERID=$P(PAYERSTR,U,3),PIEN=$P(PAYERSTR,U,2) ; Payer ID .. S SYMBOL=+PAYERSTR ; Payer Symbol .. ; .. ; If payer symbol is returned set symbol in Ins. Buffer and quit .. I SYMBOL D BUFF^IBCNEUT2(IEN,SYMBOL) Q .. ; .. D CLEAR^IBCNEUT4(IEN) ; remove any existing symbol .. ; .. ; If no payer ID or no payer IEN is returned quit .. I (PAYERID="")!('PIEN) Q .. ; .. ; Update service date and freshness date based on payer's allowed .. ; date range .. D UPDDTS^IBCNEDE6(PIEN,.SRVICEDT,.FRESHDT) .. ; .. ; Update service dates for inquiries to be transmitted .. D TQUPDSV^IBCNEUT5(DFN,PIEN,SRVICEDT) .. ; .. ; If freshness overide flag is set, file to TQ and quit .. I OVRFRESH=1 D Q ... NEW DIE,X,Y,DISYS ... S FDA(355.33,IEN_",",.13)="" D FILE^DIE("","FDA") K FDA ... D TQ .. ; .. ; If ADDTQ^IBCNEUT5 is 1 set TQ, otherwise stop processing that entry .. I '$$ADDTQ^IBCNEUT5(DFN,PIEN,SRVICEDT,FRESHDAY) Q .. ; Check the existing TQ entries to confirm that this buffer IEN is .. ; not included .. S (TQDT,TQIENS)="",TQOK=1 .. F S TQDT=$O(^IBCN(365.1,"AD",DFN,PIEN,TQDT)) Q:'TQDT!'TQOK D ... F S TQIENS=$O(^IBCN(365.1,"AD",DFN,PIEN,TQDT,TQIENS)) Q:'TQIENS!'TQOK D .... I $P($G(^IBCN(365.1,TQIENS,0)),U,5)=IEN S TQOK=0 Q .. I TQOK D TQ Q TQ ; Determine how many entries to create in the TQ file and set entries ; S BSID=$P($G(^IBA(355.33,IEN,60)),U,4) ; Subscriber ID from buffer K SIDARRAY S SIDDATA=$$SIDCHK^IBCNEDE5(PIEN,DFN,BSID,.SIDARRAY,FRESHDT) ;determine rules to follow S SIDACT=$P(SIDDATA,U,1) S SIDCNT=$P(SIDDATA,U,2) ;Pull cnt of SIDs - shd be 1 ; I SIDACT=3 D BUFF^IBCNEUT2(IEN,18) Q ; update buffer w/ bang & quit S SCNT5=$S(SIDACT=5:1,1:0) I CNT+SCNT5+SIDCNT>MAXCNT Q S SID="" F S SID=$O(SIDARRAY(SID)) Q:SID="" D . I SIDACT=5 D SET(IEN,OVRFRESH,0,$P(SID,"_")) Q ; set TQ w/o 'Pass Buffer' flag . D SET(IEN,OVRFRESH,1,$P(SID,"_")) ; set TQ w/ 'Pass Buffer' flag I SIDACT=4!(SIDACT=5) D SET(IEN,OVRFRESH,1,"") ; set TQ w/ 'Pass Buffer' flag Q ; RET ; Record Retrieval - Insurance Buffer ; S ORIGINSR=$P($G(^IBA(355.33,IEN,20)),U,1) ;Original ins. co. S ORGRPSTR=$G(^IBA(355.33,IEN,40)) ; Original group string S ORGRPNUM=$P(ORGRPSTR,U,3) ;Original group number S ORGRPNAM=$P(ORGRPSTR,U,2) ;Original group name S ORGSUBCR=$P($G(^IBA(355.33,IEN,60)),U,4) ; Original subscriber ; Q ; SET(BUFFIEN,OVRFRESH,PASSBUF,SID1) ; Set data and check if set already D RET ; ; The hard coded '1' in the 3rd piece of DATA1 sets the Transmission ; status of file 365.1 to "Ready to Transmit" S DATA1=DFN_U_PIEN_U_1_U_$G(BUFFIEN)_U_SID1_U_FRESHDT_U_PASSBUF ; SETTQ parameter 1 ; ;The hardcoded '1' in the 1st piece of DATA2 is the value to tell ; the file 365.1 that it is the buffer extract. S DATA2=1_U_"V"_U_SRVICEDT_U_"" ; SETTQ parameter 2 ; S ORIG=ORIGINSR_U_ORGRPNUM_U_ORGRPNAM_U_ORGSUBCR ; SETTQ parameter 3 S TQIEN=$$SETTQ^IBCNEDE7(DATA1,DATA2,ORIG,$G(OVRFRESH)) ; File TQ entry I TQIEN'="" S CNT=CNT+1 ; If filed increment count ; Q