IBCNS ;ALB/AAS - IS INSURANCE ACTIVE ; 22-JULY-91 ;;2.0;INTEGRATED BILLING;**28,43,80,82,133**;21-MAR-94 ;;Per VHA Directive 10-93-142, this routine should not be modified. ; ;MAP TO DGCRNS ; ;Input - DFN = patient ; - IBINDT = (optional) date to check ins active for or today if not defined ; - IBOUTP = (optional) 1 if want active insurance returned in IBDD(insurance company)=node in patient file ; - = 2 if want all ins returned ; ;Output - IBINS = 1 if has active ins., 0 if no active ins. ; - IBDD() = internal node in patient file of valid ins. ; - IBDDI() = internal node in patient file of invalid ins. ; % N J,X S IBINS=0 K IBDD,IBDDI S J=0 F S J=$O(^DPT(DFN,.312,J)) Q:'J I $D(^DPT(DFN,.312,J,0)) S X=^(0) D CHK Q ; CHK ; ;Input - IBI = entry in insurance multiple ; S Z=$S($D(IBINDT):IBINDT,1:DT),Z1=$S($D(IBOUTP):IBOUTP,1:0) G:'$D(^DIC(36,+X,0)) CHKQ S X1=^(0) ;insurance company entry doesn't exist I $P(X,"^",8) G:Z<$P(X,"^",8) CHKQ ;effective date later than care I $P(X,"^",4) G:Z>$P(X,"^",4) CHKQ ;care after expiration date I $P($G(^IBA(355.3,+$P(X,"^",18),0)),"^",11) G CHKQ ;plan is inactive G:$P(X1,"^",5) CHKQ ;insurance company inactive I '$G(IBWNR) G:$P(X1,"^",2)="N" CHKQ ;insurance company will not reimburse S IBINS=1 I Z1 D .S IBDD(+X)=X .Q:'$P(IBDD(+X),"^",18) .S Y=$G(^IBA(355.3,+$P(IBDD(+X),"^",18),0)) .I $P(Y,"^",4)'="" S $P(IBDD(+X),"^",3)=$P(Y,"^",4) ; move group number .I $P(Y,"^",3)'="" S $P(IBDD(+X),"^",15)=$P(Y,"^",3) ; move group name CHKQ I Z1=2&('$D(IBDD(+X))) D .S IBDDI(+X)=X .Q:'$P(IBDDI(+X),"^",18) .S Y=$G(^IBA(355.3,+$P(IBDDI(+X),"^",18),0)) .I $P(Y,"^",4)'="" S $P(IBDDI(+X),"^",3)=$P(Y,"^",4) ; move group number .I $P(Y,"^",3)'="" S $P(IBDDI(+X),"^",15)=$P(Y,"^",3) ; move group name K X,X1,Z,Z1,Y Q ; DD ; - called from input transform and x-refs for field 101,102,103 ; - input requires da=internal entry number in 399 ; - outputs IBdd(ins co.) array ; patch 80 - Companies that Will Not Reimburse should be included so they can be added to the bill N DFN,IBWNR S DFN=$P(^DGCR(399,DA,0),"^",2),IBOUTP=1,IBINDT=$S(+$G(^DGCR(399,DA,"U")):+$G(^("U")),1:DT),IBWNR=1 D % DDQ K IBOUTP,IBINDT Q ; ; DISP ; -Display all insurance company information ; -input DFN ; N IBDTIN DISPDT ; Entrypoint if IBDTIN is to be used to display coverage Q:'$D(DFN) D:'$D(IOF) HOME^%ZIS N X,IBINS,IBX D ALL^IBCNS1(DFN,"IBINS") ; D HDR I '$D(IBINS) W !," No Insurance Information" G DISPQ ; S X=0 F S X=$O(IBINS(X)) Q:'X S IBINS=IBINS(X,0) D D1 I +$G(IBCOVEXT) D D2EXT ; display ; DISPQ W ! S X=+$G(^IBA(354,DFN,60)) I +X W !,?16,"*** Verification of No Coverage ",$$FMTE^XLFDT(X)," ***" I $$BUFFER^IBCNBU1(DFN) W !,?17,"*** Patient has Insurance Buffer entries ***" Q ; OLDISP ; -Display all insurance company information ; -input DFN ; Q:'$D(DFN) D:'$D(IOF) HOME^%ZIS ; S IBOUTP=2 D IBCNS ; N IBDTIN D HDR I '$D(IBDD),'$D(IBDDI) W !," No Insurance Information" G DISPQ ; S X="" F S X=$O(IBDD(X)) Q:X="" S IBINS=IBDD(X) D D1 ;active insurance S X="" F S X=$O(IBDDI(X)) Q:X="" S IBINS=IBDDI(X) D D1 ;inactive ins ; OLDISPQ K IBDD,IBDDI,IBX Q ; HDR ; -- print standard header D HDR1("=",IOM-$S($G(IBDTIN):1,1:4)) Q ; HDR1(CHAR,LENG) ; -- print header, specify character N OFF S OFF=$S($G(IBDTIN):0,1:2) W !?(1+OFF),"Insurance",?(13+OFF),"COB",?(17+OFF),"Subscriber ID",?(35+OFF),"Group",?(47+OFF),"Holder",?(55+OFF),"Effect"_$S('OFF:"",1:"i")_"ve",?(65+OFF+$S('OFF:0,1:1)),"Expires" W:'OFF ?75,"Only" I $G(CHAR)'="",LENG S X="",$P(X,CHAR,LENG)="" W !?(1+OFF),X Q ; D1 ; If IBDTIN is defined, this date is used for displaying insurance ; coverage if plan does not provide not full coverage for all categories N X,Y,Z,CAT,OFF Q:'$D(IBINS) S OFF=$S($G(IBDTIN):0,1:2) W !?(1+OFF),$S($D(^DIC(36,+IBINS,0)):$E($P(^(0),"^",1),1,10),1:"UNKNOWN") S X=$P(IBINS,U,20) I X'="" S X=$S(X=1:"p",X=2:"s",X=3:"t",1:"") W ?(14+OFF),X W ?(17+OFF),$E($P(IBINS,"^",2),1,16) ;W ?40,$E($S($P(IBINS,"^",15)'="":$P(IBINS,"^",15),1:$P(IBINS,"^",3)),1,10) W ?(35+OFF),$E($$GRP($P(IBINS,"^",18)),1,10) S X=$P(IBINS,"^",6) W ?(47+OFF),$S(X="v":"SELF",X="s":"SPOUSE",1:"OTHER") W ?(55+OFF),$$DAT1^IBOUTL($P(IBINS,"^",8)),?(65+OFF+$S(OFF:1,1:0)),$$DAT1^IBOUTL($P(IBINS,"^",4)) I 'OFF D .I $P($G(^DIC(36,+IBINS,0)),U,2)="N" W ?75,"*WNR*" Q .S X="" F CAT="INPATIENT","OUTPATIENT","PHARMACY","MENTAL HEALTH","DENTAL" D .. S Y=$$PLCOV^IBCNSU3(+$P(IBINS,"^",18),$G(IBDTIN),+$O(^IBE(355.31,"B",CAT,""))) .. I +Y S Z=$S(CAT="PHARMACY":"R",1:$E(CAT)) S:Y>1 Z=$C($A(Z)+32) S X=X_Z .S:X="" X="no CV" I X'?5U W ?75,X Q ; GRP(IBCPOL) ; -- return group name/group policy ; input: IBCPOL = pointer to entry in 355.3 ; output: group name or group number, if both group NUMBER ; if neither 'Individual PLAN' ; N X,Y S X="" S X=$G(^IBA(355.3,+$G(IBCPOL),0)) S Y=$S($P(X,"^",4)'="":$P(X,"^",4),1:$P(X,"^",3)) I $P(X,"^",10) S Y="Ind. Plan "_Y GRPQ Q Y ; D2EXT ; display Conditional Coverage Comments and Riders (DFN,IBINS,X required) N Y,CAT,IBX,IBY,IBZ,ARR,IBCDFN S IBCDFN=X,IBZ=0 N X F CAT="INPATIENT","OUTPATIENT","PHARMACY","MENTAL HEALTH","DENTAL" D . S Y=$$PLCOV^IBCNSU3(+$P(IBINS,"^",18),$G(IBDTIN),+$O(^IBE(355.31,"B",CAT,"")),.ARR) . S IBY=CAT_" Conditional: " . I +Y>1 S IBX=0 F S IBX=$O(ARR(IBX)) Q:'IBX W !,?17,IBY,?47,ARR(IBX) S IBY="",IBZ=1 ; K ARR D RIDERS^IBCNSU3(DFN,IBCDFN,.ARR) S IBY="Policy Riders: " S IBX=0 F S IBX=$O(ARR(IBX)) Q:'IBX W !,?17,IBY,?35,ARR(IBX) S IBY="",IBZ=1 I +IBZ W ! Q