1 | IBCECOB2 ;ALB/CXW - IB COB MANAGEMENT SCREEN ;16-JUN-1999
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2 | ;;2.0;INTEGRATED BILLING;**137,155**;21-MAR-1994
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3 | ;;Per VHA Directive 10-93-142, this routine should not be modified.
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4 | ;
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5 | EDI ;history detail display
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6 | N IBIFN,IBDA
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7 | D SEL(.IBDA,1)
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8 | S IBDA=+$O(IBDA(0)),IBIFN=+$G(IBDA(IBDA))
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9 | D EDI1(IBIFN)
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10 | S VALMBCK="R"
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11 | Q
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12 | ;
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13 | EDI1(IBIFN) ;
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14 | N DFN
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15 | Q:'IBIFN
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16 | S DFN=$P($G(^DGCR(399,IBIFN,0)),U,2)
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17 | D EN^VALM("IBJT EDI STATUS")
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18 | K:$D(IBFASTXT) IBFASTXT
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19 | Q
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20 | ;
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21 | EDI2(IBIFN) ;
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22 | N DFN
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23 | Q:'IBIFN
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24 | S DFN=$P($G(^DGCR(399,IBIFN,0)),U,2)
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25 | D EN^VALM("IBJT EDI STATUS ALONE")
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26 | K:$D(IBFASTXT) IBFASTXT
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27 | Q
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28 | ;
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29 | CSA ;claims status awaiting resolution
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30 | N IBDAX
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31 | D EN^IBCECSA
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32 | I $D(IBFASTXT) K IBFASTXT
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33 | S VALMBCK="R"
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34 | Q
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35 | ;
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36 | RVEOB ;Review EOB
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37 | D FULL^VALM1 W !
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38 | N IBDA,IBIFN,IBCMT,IBSEL
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39 | D SEL(.IBDA,1)
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40 | S IBSEL=+$O(IBDA(0))
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41 | S IBDA=$G(IBDA(IBSEL))
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42 | S IBIFN=$P(IBDA,U),IBDA=$P(IBDA,U,3)
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43 | I 'IBIFN G VEOBQ
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44 | S IBCMT=$G(^TMP("IBCECOB1",$J,IBSEL))
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45 | I IBCMT'="" D EN^VALM("IBCEM MRA REVIEW")
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46 | VEOBQ K ^TMP("IBCECOC",$J)
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47 | S VALMBCK="R"
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48 | Q
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49 | ;
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50 | TPJI ;Third Party joint Inquiry
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51 | N IBDA,IBIFN
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52 | D SEL(.IBDA,1)
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53 | S IBDA=+$O(IBDA(0)),IBIFN=+$G(IBDA(IBDA))
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54 | I IBDA="" G TPJIQ
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55 | D TPJI1(IBIFN)
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56 | TPJIQ S VALMBCK="R"
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57 | Q
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58 | ;
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59 | TPJI1(IBIFN) ;
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60 | N DFN,IBNOTPJI
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61 | Q:'IBIFN
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62 | S DFN=$P($G(^DGCR(399,IBIFN,0)),U,2),IBNOTPJI=1
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63 | D EN^VALM("IBJT CLAIM INFO")
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64 | K:$D(IBFASTXT) IBFASTXT
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65 | Q
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66 | ;
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67 | PBILL ;Print bill
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68 | N IBIFN,IBDA,IBRESUB
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69 | D SEL(.IBDA,1)
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70 | S IBDA=$O(IBDA(0)),IBIFN=+$G(IBDA(+IBDA))
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71 | I IBDA="" G PBOUT
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72 | S IBRESUB=$$RESUB^IBCECSA4(IBIFN,1,"P")
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73 | I IBRESUB'>0 W !,*7,"This is not a transmittable bill or review not needed" D PAUSE^VALM1 G PBOUT
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74 | I IBRESUB=2 D G PBOUT
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75 | . N IB364
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76 | . S IB364=+$P($G(IBDA(IBDA)),U,2)
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77 | . D PRINT1^IBCEM03(IBIFN,.IBDA,IB364)
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78 | D PBILL1(IBIFN)
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79 | PBOUT S VALMBCK="R"
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80 | Q
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81 | ;
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82 | PMRA ;Print MRA
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83 | N IBIFN,IBDA
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84 | D SEL(.IBDA,1)
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85 | S IBDA=$O(IBDA(0)),IBIFN=+$G(IBDA(+IBDA))
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86 | G:'IBIFN PRMQ
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87 | D MRA^IBCEMRAA(.IBIFN)
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88 | PRMQ S VALMBCK="R"
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89 | Q
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90 | PBILL1(IBIFN) ;
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91 | N IBAC1,IBAC,DFN
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92 | Q:'IBIFN
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93 | S DFN=$P($G(^DGCR(399,IBIFN,0)),U,2)
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94 | S IBAC=4,IBAC1=1
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95 | D 4^IBCB1
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96 | D FULL^VALM1,PAUSE^VALM1
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97 | Q
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98 | ;
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99 | CANCEL ;Cancel bill
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100 | ; IBDA(IBDA)=IBIFN^IB364^ien of 361.1^user selection seq^user name~duz#
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101 | ;
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102 | N IBIFN,IBDA,IB364,IBEOBIFN
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103 | ;
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104 | ; Check for security key
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105 | I '$$KCHK^XUSRB("IB AUTHORIZE") D G CANCELQ
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106 | . D FULL^VALM1 S VALMBCK="R"
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107 | . W !!?5,"You don't hold the proper security key to access this function."
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108 | . W !?5,"The necessary key is IB AUTHORIZE. Please see your manager."
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109 | . D PAUSE^VALM1
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110 | . Q
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111 | ;
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112 | D SEL(.IBDA,1)
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113 | S IBDA=$O(IBDA(0)),IBIFN=+$G(IBDA(+IBDA)),IB364=$P($G(IBDA(+IBDA)),U,2)
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114 | S IBEOBIFN=$P($G(IBDA(+IBDA)),U,3)
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115 | I IBDA D
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116 | . I '$$LOCK^IBCEU0(361.1,IBEOBIFN) Q
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117 | . D CANCEL^IBCEM3(.IBDA,IBIFN,IB364)
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118 | . D UNLOCK^IBCEU0(361.1,IBEOBIFN)
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119 | S VALMBCK="R"
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120 | I $G(IBDA)'="" D BLD^IBCECOB1
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121 | CANCELQ Q
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122 | ;
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123 | CLONE ; 'Copy/cancel bill' protocol action
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124 | N IBDA,IBQ,IBEOBIFN
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125 | ;
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126 | ; Check for security key
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127 | I '$$KCHK^XUSRB("IB AUTHORIZE") D G CLONEQ
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128 | . D FULL^VALM1 S VALMBCK="R"
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129 | . W !!?5,"You don't hold the proper security key to access this function."
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130 | . W !?5,"The necessary key is IB AUTHORIZE. Please see your manager."
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131 | . D PAUSE^VALM1
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132 | . Q
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133 | ;
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134 | D SEL(.IBDA,1)
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135 | S IBDA=$O(IBDA(""))
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136 | I IBDA="" G CLONEQ
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137 | S IBEOBIFN=$P($G(IBDA(+IBDA)),U,3)
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138 | I '$$LOCK^IBCEU0(361.1,IBEOBIFN) G CLONEQ
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139 | D COPYCLON(+$G(IBDA(IBDA)),$P($G(IBDA(+IBDA)),U,2),.IBQ)
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140 | D UNLOCK^IBCEU0(361.1,IBEOBIFN)
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141 | CLONEQ ;
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142 | S VALMBCK="R"
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143 | D:$G(IBQ)'="" BLD^IBCECOB1
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144 | Q
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145 | ;
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146 | COPYCLON(IBIFN,IB364,IBQ) ; Generic entry point for clone a bill from EDI processing
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147 | ; IBIFN = original bill ien
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148 | ; IB364 = the ien of the transmission bill entry in file 364
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149 | ; IBQ = If bill is not cancelled, this is returned as null
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150 | ; - pass by reference -
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151 | ;
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152 | N IBQUIT,IBCCCC,IBHV,Y,IBCAN,IBCE,IBDA,IBCNCOPY
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153 | I '$$CANCKS^IBCEM3("CC",IBIFN) S IBQ="" G CCQ
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154 | ;
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155 | S IBCAN=2,IBCE("EDI")=1,Y=IBIFN,IBCCCC=0,IBHV("IBIFN")=IBIFN,IBHV("IBIFN1")="",IBCNCOPY=1
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156 | D ^IBCCC
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157 | S IBIFN=IBHV("IBIFN")
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158 | K IBCE("EDI") S IBQ=1
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159 | I $P($G(^DGCR(399,IBIFN,0)),U,13)'=7 S IBQ=""
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160 | I IBHV("IBIFN1") D
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161 | . N IBU
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162 | . S IBU="R"
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163 | . S IBNIEN=+IBHV("IBIFN1")
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164 | . I "23"'[$P($G(^DGCR(399,+IBHV("IBIFN1"),0)),U,13) D
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165 | .. W:'$G(IBCEAUTO) !,*7,"Please note: the new bill was not AUTHORIZED.",!,"It can only be accessed now via the normal, non-EDI functions.",!,"Status of new bill is ",$$EXPAND^IBTRE(399,.13,$P(^DGCR(399,IBHV("IBIFN1"),0),U,13)) S IBU="C"
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166 | . D UPDEDI^IBCEM(IB364,IBU)
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167 | ;
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168 | I '$G(IBCEAUTO) D PAUSE^VALM1
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169 | CCQ Q
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170 | ;
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171 | PRO ; Copy for secondary/tertiary bill
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172 | N VALMY,IBDA,Z,IBIFN,IBIFNH,IB364,IBCE
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173 | I '$P($G(^IBE(350.9,1,8)),U,12) D G PROQ
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174 | . D FULL^VALM1
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175 | . W !!?5,"MRA's may not be processed at this time."
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176 | . W !?5,"The IB site parameter ""Allow MRA Processing?"" is set to NO."
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177 | . D PAUSE^VALM1
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178 | . Q
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179 | D SEL(.IBDA,1)
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180 | S Z=$O(IBDA(0)),Z=$G(IBDA(+Z)) G:'Z PROQ
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181 | S IBIFN=$P(Z,U),IB364=$P(Z,U,2),IBDA=$P(Z,U,3),IBIFNH=IBIFN
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182 | I 'IBIFN G PROQ
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183 | I '$$LOCK^IBCEU0(361.1,IBDA) G PROQ
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184 | D COBCOPY(IBIFN,IB364,2,IBDA,"BLD^IBCECOB1")
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185 | D UNLOCK^IBCEU0(361.1,IBDA)
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186 | PROQ S VALMBCK="R"
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187 | Q
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188 | ;
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189 | COBCOPY(IBIFN,IB364,IBFROM,IBIEN,IBBLD) ; Generic entry point for EDI COB copy
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190 | ; IBIFN = original bill ien
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191 | ; IB364 = the ien of the transmission bill entry in file 364
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192 | ; IBFROM = 1 if called from CSA, 2 if called from COB/EOB processing
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193 | ; IBIEN = entry in 361 (IBFROM=1) or 361.1 (IBFROM=2) being processed
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194 | ; IBBLD = the name of the entrypoint that will rebuild the display
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195 | ;
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196 | N IBCBASK,IBCBCOPY,IBCAN,IBIFNH,IBNSTAT,IBOSTAT,IBPRCOB,IBSECHK,IBLMVAR,IBAC,IBMRAIEN,IBDA,IBAUTO
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197 | N IBCOB,IBCOBIL,IBCOBN,IBINS,IBINSN,IBINSOLD,IBMRAIO,IBMRAO,IBNMOLD,IBQUIT
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198 | S (IBCBASK,IBCBCOPY,IBCAN,IBAUTO)=1,(IBPRCOB,IBSECHK)=0,(IBMRAIEN,IBDA)=IBIEN
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199 | I 'IB364!'IBIFN W !,"Transmission record is missing for this bill" D PAUSE^VALM1 G COBCOPX
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200 | ;
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201 | S IBIFNH=IBIFN
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202 | I IBFROM=2 S IBPRCOB=1
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203 | ;
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204 | I $$PREOBTOT^IBCEU0(IBIFN)'>0 D G COBCOPX
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205 | . D FULL^VALM1
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206 | . W !!?5,"There is no patient responsibility for this claim."
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207 | . W !?5,"This claim may not be processed."
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208 | . D PAUSE^VALM1
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209 | . Q
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210 | ;
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211 | I $P($G(^IBM(361.1,IBDA,0)),U,16)="1.5" D G COBCOPX
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212 | . W !!,"This claim has already been processed as a secondary claim."
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213 | . W !,"You will need to complete the authorization process for this claim."
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214 | . D PAUSE^VALM1
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215 | . D AUTH
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216 | . Q
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217 | ;
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218 | ; Get out if no next payer
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219 | I '$P($G(^DGCR(399,IBIFN,"I"_($$COBN^IBCEF(IBIFN)+1))),U,1) D G COBCOPX
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220 | . W !,"There is no next payer for this bill"
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221 | . D PAUSE^VALM1
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222 | . Q
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223 | ;
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224 | D DSPRB^IBCCCB0(IBIFN) ; display related bills
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225 | S IBCE("EDI")=1
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226 | D CHKB^IBCCCB ; process COB, create secondary bill
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227 | S IBIFN=IBIFNH
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228 | I IBSECHK G COBCOPX
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229 | S IBV=1 D VIEW^IBCB2 ; display billing screens
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230 | D AUTH ; authorize bill
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231 | COBCOPX ;
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232 | Q
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233 | ;
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234 | AUTH ; procedure to authorize the claim and refresh the screen
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235 | K ^UTILITY($J) S IBAC=1,IBQUIT=0 D 3^IBCB1
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236 | I '$D(IOUON)!'$D(IORVON) D ENS^%ZISS
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237 | I $P($G(^IBM(361.1,IBMRAIEN,0)),U,16)=3 D UPDEDI^IBCEM(IB364,"Z")
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238 | I $G(IBBLD)'="" D @IBBLD
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239 | D PAUSE^VALM1
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240 | AUTHX ;
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241 | Q
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242 | ;
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243 | RES ;Resubmit bill by print
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244 | N IBDA,IBIFN,IB364
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245 | D SEL(.IBDA,1)
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246 | S IBDA=+$O(IBDA(0)),IBIFN=+$G(IBDA(+IBDA)),IB364=+$P($G(IBDA(IBDA)),U,2)
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247 | I 'IBIFN G RESQ
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248 | D PRINT1^IBCEM03(IBIFN,.IBDA,IB364)
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249 | D PAUSE^VALM1
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250 | I $G(IBDA)'="" D BLD^IBCECOB1
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251 | RESQ S VALMBCK="R"
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252 | Q
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253 | ;
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254 | EBI ;View an unauthorized transmitted bill
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255 | N IBFLG,IBDA,IBIFN,IB364,DFN
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256 | K ^TMP($J,"IBBILL")
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257 | D FULL^VALM1
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258 | ;
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259 | D SEL(.IBDA,1)
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260 | S IBDA=+$O(IBDA(""))
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261 | S IBIFN=+$G(IBDA(IBDA)),IB364=+$P($G(IBDA(IBDA)),U,2),DFN=$P($G(^DGCR(399,IBIFN,0)),U,2)
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262 | G:'IBIFN EDITQ
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263 | S IBV=1 D VIEW^IBCB2
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264 | I '$D(IOUON)!'$D(IORVON) D ENS^%ZISS
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265 | D BLD^IBCECOB1
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266 | EDITQ S VALMBCK="R"
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267 | Q
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268 | ;
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269 | SEL(IBDA,ONE) ; Select entry(s) from list
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270 | ; IBDA = array returned if selections made
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271 | ; IBDA(n)=ien of bill selected (file 399)
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272 | ; ONE = if set to 1, only one selection can be made at a time
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273 | N IB
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274 | K IBDA
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275 | D FULL^VALM1
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276 | D EN^VALM2($G(XQORNOD(0)),$S('$G(ONE):"",1:"S"))
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277 | S IBDA=0 F S IBDA=$O(VALMY(IBDA)) Q:'IBDA S IBDA(IBDA)=$P($G(^TMP("IBCECOB",$J,+IBDA)),U,2,6)
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278 | Q
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279 | ;
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280 | EXIT ; Exit out of COB
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281 | D FASTEXIT^IBCEFG4
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282 | I $G(IBFASTXT)=1 S IBFASTXT=5
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283 | Q
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284 | ;
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