VAFHLIN1 ;ALB/KCL/SCK/PHH - CREATE HL7 INSURANCE (IN1) SEGMENT ; 02/09/2007 ;;5.3;Registration;**122,190,670,740**;Aug 13, 1993;Build 2 ; ; ; This generic function was designed to return the HL7 IN1 (Insurance) ; segment. This segment contains VA-specific patient insurance ; information. (All active insurance data for a patient including ; those insurance carriers that do not reimburse the VA i.e Medicare) ; ; SCK - modified for Insurance Encapsulation API ; 1. The Insurance API does not currently support the Pre-Certification flag ; in the IN1 segment, Field 28. No value will be returned for field 28. ; 2. The Insurance API does not support Line 2 or Line 3 of the address. ; The API returns a single address line. ; EN(DFN,VAFSTR,VAFHLQ,VAFHLFS,VAFARRY) ; -- ; Entry point to return HL7 IN1 segments. ; ; Input: ; DFN - internal entry number of the PATIENT (#2) file. ; VAFSTR - (optional) string of fields requested seperated ; by commas. If not passed, return all data fields. ; VAFHLQ - (optional) HL7 null variable. ; VAFHLFS - (optional) HL7 field separator. ; VAFARRY - (optional) user-supplied array name which will hold ; HL7 IN1 segments. Otherwise, ^TMP("VAFIN1",$J) will ; be used. ; ; Output: ; Array of HL7 IN1 segments ; N VAFGRP,VAFI,VAFIDX,VAFINS,VAFNODE,VAFPHN,VAFY,VAF36,X,VAFX,VAFTMP S VAFARRY=$G(VAFARRY),VAFIDX=0 ; ; if VAFARRY not defined, use ^TMP("VAFIN1",$J) S:(VAFARRY="") VAFARRY="^TMP(""VAFIN1"",$J)" ; ; if VAFHLQ or VAFHLFS not passed, use default HL7 variables S VAFHLQ=$S($D(VAFHLQ):VAFHLQ,1:$G(HLQ)),VAFHLFS=$S($D(VAFHLFS):VAFHLFS,1:$G(HLFS)) ; ; if DFN not passed, exit I '$G(DFN) S @VAFARRY@(1,0)="IN1"_VAFHLFS_1 G ENQ ; ; find all insurance data for a patient (IB SUPPORTED CALL) ; This uses the Encapsulated Insurance API to retrieve data into an array ; See IB*2*267 Release Notes v1.0 for flags and array ID's S VAFX=$$INSUR^IBBAPI(DFN,,"R",.VAFTMP,"*") ; ; if no active insurance on file for patient, build IN1 I VAFX'=1 D .; Build a null array if no insurance data returned . F VAFI=1:1:22 S VAFINS(1,VAFI)="" .; Merge array to remove first two nodes to simplify handling E M VAFINS=VAFTMP("IBBAPI","INSUR") ; ALL ; get all active insurance for patient F VAFI=0:0 S VAFI=$O(VAFINS(VAFI)) Q:'VAFI D .D BUILD ; ENQ Q ; ; BUILD ; Build array of HL7 (IN1) segments S $P(VAFY,VAFHLFS,36)="",VAFIDX=VAFIDX+1 ; ; if VAFSTR not passed, return all data fields I $G(VAFSTR)']"" S VAFSTR="4,5,7,8,9,12,13,15,16,17,28,36" S VAFSTR=","_VAFSTR_"," ; ; sequential number (required field) S $P(VAFY,VAFHLFS,1)=VAFIDX ; ; build HL7 (IN1) segment fields I VAFSTR[",3," S $P(VAFY,VAFHLFS,3)=+$P(VAFINS(VAFI,1),U) ;Insurance company IEN (P-190) I VAFSTR[",4," S $P(VAFY,VAFHLFS,4)=$S($P(VAFINS(VAFI,1),U,2)]"":$P(VAFINS(VAFI,1),U,2),1:VAFHLQ) ; Insurance Carrier Name I VAFSTR[",5," S X=$$ADDR1(VAFI) S $P(VAFY,VAFHLFS,5)=$S(+X>0:X,1:VAFHLQ) I VAFSTR[",7," S X=$$HLPHONE^HLFNC(VAFINS(VAFI,6)) S $P(VAFY,VAFHLFS,7)=$S(X]"":X,1:VAFHLQ) ; Insurance Co. Phone Number I VAFSTR[",8," S $P(VAFY,VAFHLFS,8)=$S(VAFINS(VAFI,18)]"":VAFINS(VAFI,18),1:VAFHLQ) ; Group Number I VAFSTR[",9," S $P(VAFY,VAFHLFS,9)=$S($P(VAFINS(VAFI,8),U,2)]"":$P(VAFINS(VAFI,8),U,2),1:VAFHLQ) ; Group Name ** The Insurance Encapsulation API doesnot return a "Group" Name, this field will display the Policy Name returned by the API I VAFSTR[",12," S X=$$HLDATE^HLFNC(VAFINS(VAFI,10)) S $P(VAFY,VAFHLFS,12)=$S(X]"":X,1:VAFHLQ) ; Policy Effective Date I VAFSTR[",13," S X=$$HLDATE^HLFNC(VAFINS(VAFI,11)) S $P(VAFY,VAFHLFS,13)=$S(X]"":X,1:VAFHLQ) ; Policy Expiration Date I VAFSTR[",15," S $P(VAFY,VAFHLFS,15)=$S(+$P($G(VAFINS(VAFI,21)),"^")>0:+$P(VAFINS(VAFI,21),"^"),1:VAFHLQ) ; Plan Type (ptr. to Type of Plan (#355.1) file) I VAFSTR[",16," S $P(VAFY,VAFHLFS,16)=$S(VAFINS(VAFI,13)]"":VAFINS(VAFI,13),1:VAFHLQ) ; Name of Insured I VAFSTR[",17," S X=$$WHOSE($P(VAFINS(VAFI,12),U)) S $P(VAFY,VAFHLFS,17)=$S(X]"":X,1:VAFHLQ) ; Whose Insurance ;I VAFSTR[",28," S $P(VAFY,VAFHLFS,28)=VAFHLQ ; $S($P(VAFGRP,"^",6)]"":$P(VAFGRP,"^",6),1:VAFHLQ) ; Is Pre-Certification Required? I VAFSTR[",36," S $P(VAFY,VAFHLFS,36)=$S(VAFINS(VAFI,14)]"":VAFINS(VAFI,14),1:VAFHLQ) ; Subscriber ID ; ; set all active insurance policies into array S @VAFARRY@(VAFIDX,0)="IN1"_VAFHLFS_$G(VAFY) Q ; WHOSE(VAFWHO) ; Format Subscriber relationship for HL7 conversion ; ; Input: Subscriber relationship from Insurance API, ID=12 ; P - Patient ; S - Spouse ; O - Other ; ; Output: ; v - Veteran ; s - Spouse ; o - Other ; S:VAFWHO["P" VAFWHO="V" Q $$LOW^XLFSTR(VAFWHO) ; ADDR1(VAFI) ; Format insurance company address from Insurance API for HL7 conversion. ; ; Input: ; Index number for Insurance API array ; ; Output: ; String in the form of the HL7 address field ; N VAFAD,VAFGL S VAFAD=VAFINS(VAFI,2) S VAFGL=VAFINS(VAFI,3)_"^"_$P(VAFINS(VAFI,4),U)_"^"_VAFINS(VAFI,5) ; ; convert DHCP address to HL7 format using HL7 utility Q $$HLADDR^HLFNC(VAFAD,VAFGL) ; ADDR(VAFPTR) ; Format insurance company address for HL7 conversion ; Retained for backword compatibility ; ; Input: ; VAFPTR - pointer to Insurance Co. (#36) file ; ; Output: ; String in the form of the HL7 address field ; N VAFAD,VAFADDR,VAFGL,VAFST S VAFAD="" ; ; get (.11) node of Insurance Co. (#36) file S VAFADDR=$G(^DIC(36,+VAFPTR,.11)) ; ; 1st & 2nd street address lines F VAFST=1,2 S VAFAD=VAFAD_"^"_$P(VAFADDR,"^",VAFST) S VAFAD=$P(VAFAD,"^",2,99) S VAFGL=$P(VAFADDR,"^",4) ; city S VAFGL=VAFGL_"^"_$P(VAFADDR,"^",5) ; state S VAFGL=VAFGL_"^"_$P(VAFADDR,"^",6) ; zip ; ; convert DHCP address to HL7 format using HL7 utility Q $$HLADDR^HLFNC(VAFAD,VAFGL)