source: FOIAVistA/trunk/r/E_CLAIMS_MGMT_ENGINE-BPS/BPSRPT2.m@ 914

BPSRPT2 ;BHAM ISC/BEE - ECME REPORTS ;14-FEB-05
 ;;1.0;E CLAIMS MGMT ENGINE;**1,3,5**;JUN 2004;Build 45
 ;;Per VHA Directive 2004-038, this routine should not be modified.
 ;
 Q
 ;
 ;Save One Report Entry
 ;
 ; Input variables -> See BPSRPT0 for description
 ; BPTMPGL,BPDFN,BPRX,BPREF,BP59,BPENDDT,BPPHARM,BPSUMDET,BPGRPLAN,BPRLDT,BPPAYBL,BPREJFL,BPRXDRG
 ; 
SETTMP(BPTMPGL,BPDFN,BPRX,BPREF,BP59,BPBEGDT,BPENDDT,BPPHARM,BPSUMDET,BPGRPLAN,BPRLDT,BPPAYBL,BPREJFL,BPRXDRG,BPSTATUS) ;
 N BPCLSDT,BPDATA,BPDIV,BPFILDT,BPISSDT,BPSMSG,BPSREJ,BPREST,BPSRWR,BPTDTTM,BPTRDT
 ;
 ;Check for bad data
 I BPREF,$$IFREFILL^BPSRPT6(BPRX,BPREF)=0 G EXIT
 ;
 ;Retrieve Close Date
 S BPCLSDT=$P($$CLOSEDT(BP59),".")
 ;
 ;If NO refills 
 I BPREF=0 D
 . S BPFILDT=$$RXFILDT^BPSRPT6(BPRX)
 . S BPISSDT=$$RXISSDT^BPSRPT6(BPRX)
 ;
 ;If Refills
 I BPREF>0 D
 . S BPFILDT=$$REFFILDT^BPSRPT6(BPRX,BPREF)
 . S BPISSDT=$$REFISSDT^BPSRPT6(BPRX,BPREF)
 ;
 ;Get Transaction Date/Transaction Date and Time
 S BPTRDT=$$TRANDT(BP59,0)
 S BPTDTTM=$$TRANDT(BP59,1)
 ;
 ;Get Result, Message, Reject Information, and BPS Pharmacy
 S BPREST=$$RESULT(BP59,.BPSRWR)
 S BPSMSG=$$MSG(BPSRWR,.BPSMSG,BP59)
 S BPSREJ=$S(BPREJFL=0:"",1:$$REJECT(BPREST,.BPSREJ,BP59))
 S BPDIV=+$P($G(^BPST(BP59,1)),"^",7)
 ;
 ;Set up data node
 S BPDATA=BPRLDT_U_BPTRDT_U_BP59_U_BPRX_U_BPREF_U_BPREST_U_BPSTATUS_U_BPFILDT_U_BPISSDT_U_U_U_BPPAYBL_U_BPREJFL_U_BPRXDRG_U_BPSRWR
 ;
 ;For Totals by Date - No Insurance Sort
 I BPRTYPE=6 S BPGRPLAN="~"
 ;
 ;Sort by transaction date
 I BPRTYPE'=7 D:$$CHKDT(+$G(BPTRDT),BPBEGDT,BPENDDT)
 . ;
 . ;For Recent Transactions tack on Txn date and Time to Ins
 . I BPRTYPE=5 S BPGRPLAN=-BPTDTTM_"^"_BPGRPLAN
 . S @BPTMPGL@(BPDIV,BPGRPLAN,BPDFN,BPTRDT,BPRX,BPREF)=BPDATA
 ;
 ;Sort by close date
 I BPRTYPE=7 D:$$CHKDT(+$G(BPCLSDT),BPBEGDT,BPENDDT)
 . S @BPTMPGL@(BPDIV,BPGRPLAN,BPDFN,BPCLSDT,BPRX,BPREF)=BPDATA
 ;
EXIT Q
 ;
 ;Get Transaction date and Time
 ;
 ; Input Variables -> BP59 - ptr to BPS TRANSACTION
 ;                    TIME - 1 - Return DT.TM, 0 - DT
 ; Returned Value -> Transaction or Transaction Date.Time
 ; 
TRANDT(BP59,TIME) N X
 S X=$P($G(^BPST(BP59,0)),U,8)
 Q $S(TIME=0:X\1,1:X)
 ;
 ;Determine the Claim Close Date
 ;
 ; Input Variable -> BP59 = ptr to BPS TRANSACTIONS
 ; Returned Value -> CL = Claim Close Date and Time
 ; 
CLOSEDT(BP59) N CL,BP02
 S BP02=+$P($G(^BPST(BP59,0)),U,4)
 S CL=+$P($G(^BPSC(BP02,900)),U,2)
 Q CL
 ;
 ;Get Result
 ;
RESULT(BP59,RWR) N X
 I BP59 S RWR=$$CATEG^BPSOSUC(BP59)
 E  S RWR=""
 I RWR?1"E ".E D
 . S X=RWR
 . I X="E PAYABLE" S X=4
 . E  I X="E CAPTURED" S X=3
 . E  I X="E DUPLICATE" S X=2
 . E  I X="E REJECTED" S X=1
 . E  I X="E REVERSAL ACCEPTED" S X=11
 . E  I X="E REVERSAL REJECTED" S X=12
 . E  S X=0
 E  I RWR="PAPER" S X=9
 E  I RWR="PAPER REVERSAL" S X=19
 E  S X=15
 Q X
 ;
 ;Message
 ;
MSG(RWR,MSGTEXT,BP59) N BPRET
 S BPRET=0
 ; If the claim has any message text, store it
 I RWR?1"E ".E D
 . S X=$$MESSAG59(BP59,1)
 . I X]"" S MSGTEXT(1)=X
 . S X=$$MESSAG59(BP59,2)
 . I X]"" S MSGTEXT(2)=X
 . I $D(MSGTEXT) S MSGTEXT="MSGTEXT"
 . S BPRET=1
 Q BPRET
 ;
 ;Reject Text
 ;
 ; Output Variable -> BPSRTEXT,BPRET
 ; 
REJECT(RWR,BPSRTEXT,BP59) N BPRET,BPSRESP,BPSECME,BPSPOS
 S BPRET=0
 ; If it's a rejected claim, build the rejection text
 I RWR="E REJECTED"!(RWR="E REVERSAL REJECTED") D
 . D RESP59(BP59,.BPSRESP,.BPSECME) ; set BPSRESP,BPSECME pointers
 . D REJTEXT^BPSOS03(BPSRESP,BPSPOS,.BPSRTEXT)
 . ; word processing text goes into FDA(FILE,IENS,FIELD,n)=text
 . S BPSRTEXT=$S($D(BPSRTEXT):"REJTEXT",1:"")
 . S:$D(BPSRTEXT) BPRET=1
 Q BPRET
 ;
 ;Messages 
 ;
MESSAG59(BP59,N) N MSG,BPSRESP,BPSPOS
 I 'BP59 S MSG="" G XMSG59
 D RESP59(59,.BPSRESP,.BPSPOS) I 'BPSRESP!'BPSPOS S MSG="" G XMSG59
 I '$D(N) S N=0
 I N=1 S MSG=$$MESSAGE^BPSOS03(BPSRESP,BPSPOS,1) I 1
 I N=2 S MSG=$$MESSAGE^BPSOS03(BPSRESP,BPSPOS,2) I 1
 E  S MSG=$$MESSAGE^BPSOS03(BPSRESP,BPSPOS)
XMSG59 Q MSG
 ;
 ;Responds
RESP59(BP59,BPSRESP,BPSPOS) ;EP - caller should N BPSRESP,BPSPOS
 ;Input: BP59
 ;Output:
 ; BPSRESP,BPSPOS by reference
 I $G(^BPST(BP59,4)) D  ; reversal
 . S BPSRESP=$P($G(^BPST(BP59,4)),U,2)
 . S BPSPOS=1
 E  D
 . S BPSRESP=$P($G(^BPST(BP59,0)),U,5)
 . S BPSPOS=$P($G(^BPST(BP59,0)),U,9)
 Q
 ;
 ;Check and compare dates
CHKDT(BPTSTDT,BPBEGDT,BPENDDT) ;
 I BPTSTDT=0 Q 0
 I BPTSTDT'<BPBEGDT,BPTSTDT'>BPENDDT Q 1
 Q 0
 ;
 ;Populate passed in Array
 ;
REJTEXT(BP59,ARR) N BBX,BPSRESP,BPSPOS,A,I,X,R
 S BBX=$G(^BPST(BP59,0))
 S BPSRESP=$P(BBX,U,5)
 S BPSPOS=$P(BBX,U,9)
 S (A,I)=0
 I BPSRESP&BPSPOS D
 . K ARR
 . F  S A=$O(^BPSR(BPSRESP,1000,BPSPOS,511,A)) Q:'A  D
 . . S R=$P(^BPSR(BPSRESP,1000,BPSPOS,511,A,0),U)
 . . Q:R=""
 . . N S S S=$O(^BPSF(9002313.93,"B",R,0))
 . . I S S X=$TR($G(^BPSF(9002313.93,S,0)),U,":")
 . . E  S X=R_" unrecognized reject code"
 . . S I=I+1,ARR(I)=X
 . . K S
 Q I
 ;
 ;Get Claim ID
CLAIMID(BP59) N BP02
 S BP02=+$P($G(^BPST(BP59,0)),U,4)
 Q $P($G(^BPSC(BP02,0)),U)
 ;
 ;Determine $Ins Paid
 ;
INSPAID(BP59) N X,RESP,POSITION
 S X=$G(^BPST(BP59,0))
 S RESP=$P(X,U,5)
 S POSITION=$P(X,U,9)
 Q $S(RESP&POSITION:$$INSPAID1^BPSOS03(RESP,POSITION),1:0)
 ;
 ;Get the Cardholder ID
CRDHLDID(BP59) N BP02
 S BP02=+$P($G(^BPST(BP59,0)),U,4)
 Q $P($G(^BPSC(BP02,300)),U,2)
 ;
GRPID(BP59) ;sent by IB in RX^IBNCPDP
 N BP02
 S BP02=+$P($G(^BPST(BP59,0)),U,4)
 Q $P($G(^BPSC(BP02,300)),U)