IBCNSM2 ;ALB/AAS - INSURANCE MANAGEMENT - EDIT ROUTINE ; 22-OCT-92 ;;2.0;INTEGRATED BILLING;**28,103,139**; 21-MAR-94 ;;Per VHA Directive 10-93-142, this routine should not be modified. ; % S U="^" ; BU ; -- Enter Edit benefits already used D FULL^VALM1 N I,J,IBXX,VALMY,IBCNS,IBCPOL,IBCDFN D EN^VALM2($G(XQORNOD(0))) I $D(VALMY) S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX D .S IBPPOL=$G(^TMP("IBNSMDX",$J,$O(^TMP("IBNSM",$J,"IDX",IBXX,0)))) .Q:IBPPOL="" .S IBCNS=+$P(IBPPOL,"^",5),IBCPOL=+$P(IBPPOL,"^",22),IBCDFN=+$P(IBPPOL,"^",4) .D EN^VALM("IBCNS BENEFITS USED BY DATE") .Q S VALMBCK="R" Q ; EP ; -- Enter Edit Patient Insurance Policy Information ; S VALMBCK="R" Q ; EI ; -- Enter Edit Insurance Company Information ; -- if coming from benefit screen ; ibcns=insurance co number D FULL^VALM1 I $G(IBCNS)>0 D EN^VALM("IBCNS INSURANCE COMPANY") G EIQ ; ; -- if coming from list of policies, allow selection N I,J,IBXX,IBCNS,VALMY D EN^VALM2($G(XQORNOD(0))) I $D(VALMY) S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX D .S I=$G(^TMP("IBNSMDX",$J,$O(^TMP("IBNSM",$J,"IDX",IBXX,0)))) .S IBCNS=$P(I,"^",5) .D EN^VALM("IBCNS INSURANCE COMPANY") EIQ S VALMBCK="R" Q ; VC ; -- Verify Insurance Coverage D FULL^VALM1 N I,J,IBXX,VALMY ; ; -- If no effective policies ask to verify no coverage I '$$EPOL(DFN) D VCN G EXIT ; D EN^VALM2($G(XQORNOD(0))) I $D(VALMY) S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX D .S IBPPOL=$G(^TMP("IBNSMDX",$J,$O(^TMP("IBNSM",$J,"IDX",IBXX,0)))) .Q:IBPPOL="" D VFY ; EXIT ; -- Kill variables, refresh screen ; D BLD^IBCNSM K I,J,IBXX,DA,DR,IBDUZZ S VALMBCK="R" Q ; VFY ; -- Display most recent verification ; N DA,DR,IBDUZ,IB0,IBWNR D FULL^VALM1 S IBCH=$P(IBPPOL,U,1) S IBWNR=$$GETWNR^IBCNSMM1() ; ; -- If Medicare WNR and Name of Insured is different from Pt. Name ; display Warning message. S IB0=$G(^DPT(DFN,.312,$P(IBPPOL,U,4),0)) I +IBWNR=+IB0 D .I $P(IB0,U,17)="" Q .I $P(IB0,U,17)=$P($G(^DPT(DFN,0)),U,1) Q .W !!,"WARNING: Patient Name: '"_$P($G(^DPT(DFN,0)),U,1)_"' DOES NOT MATCH" .W !," Name of Insured: '"_$P(IB0,U,17)_"' for this "_$P(IBWNR,U,2)_" policy." ; S IBDUZ=$P($G(^DPT(DFN,.312,$P(IBPPOL,U,4),1)),U,4) I 'IBDUZ D REVASK Q W !!," "_IBCH_" LAST VERIFIED BY "_$P($G(^VA(200,+IBDUZ,0)),U)_" ON "_$$DAT1^IBOUTL($P($G(^DPT(DFN,.312,$P(IBPPOL,U,4),1)),U,3))_". . ." I $P($P($G(^DPT(DFN,.312,$P(IBPPOL,U,4),1)),U,3),".")=DT W !,"COVERAGE VERIFIED TODAY, "_$$DAT1^IBOUTL(DT) H 3 E D REVASK Q ; REVASK ; -- Determine whether user wishes to re-verify ; N Y W:'IBDUZ ! S DIR("B")="No",DIR(0)="YO",DIR("A")=$S('IBDUZ:" "_IBCH_" NEVER PREVIOUSLY VERIFIED. DO YOU WISH TO VERIFY COVERAGE",1:"ARE YOU RE-VERIFYING COVERAGE TODAY") D ^DIR K DIR Q:$D(DIRUT) I Y D REVFY Q ; REVFY ; -- Re-verify ; S DA(1)=DFN,DA=$P(IBPPOL,U,4),DIE="^DPT(DFN,.312,",DR="1.03////"_DT_";1.04////"_DUZ D ^DIE K DIE S IBDUZ=$P($G(^DPT(DFN,.312,$P(IBPPOL,U,4),1)),U,4) W !," "_IBCH_" VERIFIED BY "_$P($G(^VA(200,+IBDUZ,0)),U)_" ON "_$$DAT1^IBOUTL($P($G(^DPT(DFN,.312,$P(IBPPOL,U,4),1)),U,3)) D PAUSE^VALM1 Q ; VCN ; -- Ask to verifiy patient has no coverage ; N DA,DLAYGO,DIE,DIR,DR,DIRUT,DUOUT,DIOUT,DTOUT,IBADD,IBEXERR,IBWHER,X,Y W !!,?5,"Patient has no effective insurance coverage on file." S DIR("B")="No",DIR(0)="Y" S DIR("A")=$S(+$G(^IBA(354,DFN,60)):"Re-v",1:"V")_"erify that patient has No Insurance Coverage " S DIR("?")="Enter 'Yes' to enter a Verification of No Coverage Date" D ^DIR I Y D .I '$D(^IBA(354,DFN)) D ADDP^IBAUTL6 I '$G(IBADD) W " " Q .S DA=DFN,DIE="^IBA(354,",DR=60 D ^DIE I $D(Y)=0 N IBX S IBX=$P($G(^DPT(DFN,.31)),"^",11) D ..I X]""&(IBX'="N") S IBX="N",$P(^DPT(DFN,.31),"^",11)="N" D MSG ..I X']""&(IBX'="U") S IBX="U",$P(^DPT(DFN,.31),"^",11)="U" D MSG ..Q Q ; EPOL(DFN) ; Does the patient have any effective policies? ; Input: DFN -- Pointer to the patient in file #2 ; Output: 0 -- The patient has no effective policies ; 1 -- The patient has at least one effective policy ; N J,X,Y S Y=0 S J=0 F S J=$O(^DPT(DFN,.312,J)) Q:'J S X=$G(^(J,0)) D Q:Y .I '$P(X,"^",4) S Y=1 Q .I $P(X,"^",4)>DT S Y=1 Q Y ; MSG ;If there is a change in the status of the covered by health insurance ;field #11 in the Patient file #2, The user is notified of the change. I '$D(ZTQUEUED) S VALMSG="COVERED BY HEALTH INSURANCE changed to '"_IBX_$S(IBX="U":"NKNOWN'",1:"O'") Q