IBCNERPC ;DAOU/RO - IIV PAYER LINK REPORT COMPILE ;AUG-2003 ;;2.0;INTEGRATED BILLING;**184,252,271**;21-MAR-94 ;;Per VHA Directive 10-93-142, this routine should not be modified. ; ; IIV - Insurance Identification and Verification ; ; Input vars from IBCNERPB: ; IBCNESPC("REP")=1 for Payer List report, 2 for Company List ; IBCNESPC("PTYPE")=Payer type (1-no active ins linked, 2-at least 1 ins linked, 3-All Payers) ; IBCNESPC("PSORT")=Primary Sort for Payer report ; IBCNESPC("PDET")=Ins detail on payer report (1-include list of ins,2-do not list) ; ; IBCNESPC("ITYPE")=Ins Company type (1-no payer link, 2-linked to payer, 3-All ins companies) ; IBCNESPC("ISORT")=Primary Sort for Payer Insurance report ; IBCNESPC("IMAT")=Partial matching Ins carriers ; ; Output vars used by IBCNERPC: ; ; IBCNERTN="IBCNERPB" ; SORT1=depends on sorting option chosen ; SORT2=Payer Name (Report by Payer) or Ins Company Name (if report is Insurance) ; ^TMP($J,IBCNERTN,SORT1,SORT2,CNT) ; CNT=Seq ct ; ^TMP($J,IBCNERTN,SORT1,SORT2,CNT,1) ; ; Must call at EN Q ; EN(IBCNERTN,IBCNESPC) ; Entry ; Init N IBTYP,IBCT,IBCTX ; N IBDET,IBSRT,IBPY,IBVAID,IBPROF,IBINST,IBNAACT,IBLOACT,IBINS,IBINST N IBINSN,IBAPP,IBPYR,SORT1,SORT2,IBSRT,IBMAT,IBPPYR,IBREP ; I '$D(ZTQUEUED),$G(IOST)["C-" W !!,"Compiling report data ..." ; ; Temp ct S IBCT=0 ; ; Kill scratch globals K ^TMP($J,IBCNERTN) ; ; S IBREP=$G(IBCNESPC("REP")) S IBDET=$G(IBCNESPC("PDET")) S IBTYP=$G(IBCNESPC("PTYPE")) S IBSRT=$G(IBCNESPC("PSORT")) S IBPPYR=$G(IBCNESPC("PPYR")) ; ; Ins Report I IBREP=2 G INS ; ; Loop thru the IIV payer File (#365.12) S IBPY=0,SORT1="" F S IBPY=$O(^IBE(365.12,IBPY)) Q:'IBPY D Q:$G(ZTSTOP) . I $D(ZTQUEUED),$$S^%ZTLOAD() S ZTSTOP=1 Q . ; Payer name from Payer File (#365.12) . S IBPYR=$P($G(^IBE(365.12,IBPY,0)),U) I IBSRT=1 S SORT1=IBPYR . S SORT2=IBPYR . I IBPYR=""!(IBPYR="~NO PAYER")!($$PYRAPP^IBCNEUT5("IIV",IBPY)="") Q . I IBPPYR'="",IBPY'=$P(IBPPYR,U) Q . ; get VA national ID . S IBVAID=$P($G(^IBE(365.12,IBPY,0)),U,2) I IBSRT=2 S SORT1=IBVAID . ; get the EDI numbers (professional and institutional) . S IBPROF=$P($G(^IBE(365.12,IBPY,0)),U,5) . S IBINST=$P($G(^IBE(365.12,IBPY,0)),U,6) . S IBAPP=$$PYRAPP^IBCNEUT5("IIV",IBPY),(IBNAACT,IBLOACT)=0 . S:IBAPP'="" IBNAACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,2) . S:IBAPP'="" IBLOACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,3) . ; if no sort value, use 0 . I IBSRT=3 S SORT1=IBNAACT I SORT1="" S SORT1=0 . I IBSRT=4 S SORT1=IBLOACT I SORT1="" S SORT1=0 . I SORT1="" S SORT1=" " . ; if sorting by count and detail, need to figure count first else sort will not work . I IBSRT=5,IBTYP>1,IBDET=1 D S SORT1=-IBCTX . . S IBCTX=0,IBINS="" F S IBINS=$O(^DIC(36,"AC",IBPY,IBINS)) Q:IBINS="" D . . . S IBINSN=$G(^DIC(36,IBINS,0)),IBINSN=$P(IBINSN,U) Q:IBINSN="" S IBCTX=IBCTX+1 . ; search for insurance carriers for this payer . S IBCT=0,IBINS="" F S IBINS=$O(^DIC(36,"AC",IBPY,IBINS)) Q:IBINS="" D . . S IBINSN=$G(^DIC(36,IBINS,0)),IBINSN=$P(IBINSN,U) Q:IBINSN="" . . S IBCT=IBCT+1 I IBTYP=1 Q . . ; save off address and EDI#'s for Insurance carrier . . I IBDET=1 S ^TMP($J,IBCNERTN,SORT1,SORT2,IBPY,IBINSN,IBINS)=$P($G(^DIC(36,IBINS,.11)),U,1,6)_U_$P($G(^DIC(36,IBINS,3)),U,2)_U_$P($G(^DIC(36,IBINS,3)),U,4) . I IBTYP=1,IBCT>0 Q . I IBTYP=2,IBCT=0 Q . ; use reverse sort for count . I IBSRT=5 S SORT1=-IBCT . S ^TMP($J,IBCNERTN,SORT1,SORT2,IBPY)=IBVAID_U_IBPROF_U_IBINST_U_IBNAACT_U_IBLOACT_U_IBCT G EXIT ; INS ; S IBTYP=$G(IBCNESPC("ITYPE")) S IBSRT=$G(IBCNESPC("ISORT")) S IBMAT=$G(IBCNESPC("IMAT")) ; Loop thru the Insurance company file S IBINS=0 F S IBINS=$O(^DIC(36,IBINS)) Q:'IBINS D Q:$G(ZTSTOP) . I $D(ZTQUEUED),$$S^%ZTLOAD() S ZTSTOP=1 Q . S (SORT1,IBPYR,IBNAACT,IBLOACT,IBPROF,IBINST,IBVAID)="" . S IBINSN=$P($G(^DIC(36,IBINS,0)),U) I IBSRT=1 S SORT1=IBINSN . S SORT2=IBINSN . I IBINSN="" Q . I IBMAT'="",'$F($$UP^XLFSTR(IBINSN),$$UP^XLFSTR(IBMAT)) Q . ; get payer . S IBPY=$P($G(^DIC(36,IBINS,3)),U,10) . I IBTYP=1,IBPY'="" Q . I IBTYP=2,IBPY="" Q . I IBPY'="" D . . ; Payer name from Payer File (#365.12) . . S IBPYR=$P($G(^IBE(365.12,IBPY,0)),U) I IBSRT=2 S SORT1=IBPYR . . ; get VA national ID . . S IBVAID=$P($G(^IBE(365.12,IBPY,0)),U,2) I IBSRT=3 S SORT1=IBVAID . . S IBPROF=$P($G(^IBE(365.12,IBPY,0)),U,5) . . S IBINST=$P($G(^IBE(365.12,IBPY,0)),U,6) . . S IBAPP=$$PYRAPP^IBCNEUT5("IIV",IBPY),(IBNAACT,IBLOACT)=0 . . S:IBAPP'="" IBNAACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,2) . . S:IBAPP'="" IBLOACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,3) . . I IBSRT=4 S SORT1=IBNAACT I SORT1="" S SORT1=0 . . I IBSRT=5 S SORT1=IBLOACT I SORT1="" S SORT1=0 . I SORT1="" S SORT1=" " . S ^TMP($J,IBCNERTN,SORT1,SORT2,IBINS)=IBPYR_U_IBVAID_U_IBPROF_U_IBINST_U_IBNAACT_U_IBLOACT_U_IBCT_U_$G(^DIC(36,IBINS,.11))_U_"~"_$G(^DIC(36,IBINS,3)) ; EXIT ; Q ; Lines moved from IBCNERPB ITYPE ; Prompt to select Insurance Company type to include ; Init vars N DIR,X,Y,DIRUT ; S DIR(0)="S^1:Unlinked insurance companies;2:Linked insurance companies;3:All insurance companies" S DIR("A")="Select type of insurance companies to display" S DIR("B")="3" S DIR("?",1)=" 1 - Only insurance companies that are not currently linked to a payer" S DIR("?",2)=" 2 - Only insurance companies that are currently linked to a payer" S DIR("?")=" 3 - ALL insurance companies" D ^DIR K DIR I $D(DIRUT) S STOP=1 G ITYPEX S IBCNESPC("ITYPE")=Y ; ITYPEX ; TYPE exit pt Q ISORT ; Prompt to allow users to select primary sort ; Init vars N DIR,X,Y,DIRUT ; S DIR(0)="S^1:Insurance Company Name;2:Payer Name;3:VA National Payer ID;4:Nationally Enabled Status;5:Locally Enabled Status" S DIR("A")="Select the primary sort field" S DIR("B")=1 S DIR("?")=" Select the data field by which this report should be primarily sorted." D ^DIR K DIR I $D(DIRUT) S STOP=1 G ISORTX S IBCNESPC("ISORT")=Y ; ISORTX ; SORT exit pt Q IMAT ; Prompt to allow users to select partial Ins carrier to include N DIR,X,Y,DIRUT ; W ! S DIR(0)="FO" S DIR("A")="Enter an insurance company search keyword (RETURN for ALL)" S DIR("B")="" S DIR("?",1)=" Enter a value to match insurance company names with." S DIR("?",2)=" Simply hit RETURN to select ALL or enter a keyword" S DIR("?",3)=" (ex. 'CIGNA' would return CIGNA, CIGNA HICN, NATIONAL CIGNA," S DIR("?")=" REGION 1 CIGNA and any others with the term 'CIGNA' in it)" D ^DIR K DIR I $D(DUOUT)!$D(DTOUT) S Y="" S STOP=1 G IMATX S IBCNESPC("IMAT")=Y ; IMATX Q