source: FOIAVistA/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCEF21.m@ 1572

Last change on this file since 1572 was 628, checked in by George Lilly, 15 years ago

initial load of FOIAVistA 6/30/08 version
File size: 6.0 KB
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1IBCEF21 ;ALB/TMP - FORMATTER SPECIFIC BILL FUNCTIONS CONTINUED ;06-FEB-96
2 ;;2.0;INTEGRATED BILLING;**51,296,371,389**;21-MAR-94;Build 6
3 ;;Per VHA Directive 2004-038, this routine should not be modified.
4 ;
5COID(IBIFN) ; Claim office ID
6 N IBCOID,IBCOID1,IBIN
7 S IBIN=$$CURR^IBCEF2(IBIFN),IBCOID1="",IBCOID=$P($$ADDRESS^IBCNSC0(IBIN,.11,5),U,11)
8 ;
9 I IBIN D
10 . I $D(^IBA(364.2,"C",IBIFN)) S IBCOID1=$P($$ADDRESS^IBCNSC0(IBIN,.18,5),U,11) Q ;Rx
11 . I $P($G(^DGCR(399,IBIFN,0)),U,5)<3 S IBCOID1=$P($$ADDRESS^IBCNSC0(IBIN,.12,5),U,11) Q ;Inpt
12 . I $P($G(^DGCR(399,IBIFN,0)),U,5)'<3 S IBCOID1=$P($$ADDRESS^IBCNSC0(IBIN,.16,5),U,11) Q ;Outpt
13 ;
14 Q $S(IBCOID1'="":IBCOID1,1:IBCOID)
15 ;
16ESGHPST(IBIFN,COB) ; return insureds employment status if the bill policy defined by COB is an Employer Sponsored Group Health Plan
17 ; ESGHP FLAG (2.312,2.1) ^ the employment status (2.312,2.11)
18 ;
19 N PPOL,DFN,X,Y S Y=""
20 S PPOL=$$PPOL^IBCEF2($G(IBIFN),$G(COB)),DFN=$P($G(^DGCR(399,+$G(IBIFN),0)),U,2)
21 I +PPOL,+DFN S X=$G(^DPT(DFN,.312,+PPOL,2)) S Y=+$P(X,U,10)_U_$P(X,U,11)
22 Q Y
23 ;
24ESGHPNL(IBIFN,COB) ; return employer name and location if the bill policy defined by COB is an Employer Sponsored Group Health Plan
25 ; ESGHP FLAG (2.312,2.1) ^ employer name (2.312,2.015) ^ employer city (2.312,2.05)
26 ; ^ employer state abbr (2.312,2.06) ^ employer state ifn (2.312,2.06)
27 ;
28 N PPOL,DFN,X,Y S Y=""
29 S PPOL=$$PPOL^IBCEF2($G(IBIFN),$G(COB)),DFN=$P($G(^DGCR(399,+$G(IBIFN),0)),U,2)
30 I +PPOL,+DFN S X=$G(^DPT(DFN,.312,+PPOL,2)) S Y=+$P(X,U,10)_U_$P(X,U,9)_U_$P(X,U,5)_U_$P($G(^DIC(5,+$P(X,U,6),0)),U,2)_U_$P(X,U,6)
31 Q Y
32 ;
33REMARKS(IBIFN) ; Compile array of bill remarks
34 ;IBIFN = bill ien
35 N Z,Z0,Z1,IBARRAY,IBSM
36 S Z=0
37 ;S:$P($G(^DGCR(399,IBIFN,"U1")),U,2) Z=Z+1,Z0=$P(^("U1"),U,2),IBXDATA(Z)="OFFSET AMOUNT: "_"$"_+$P(Z0,".")_"."_$E($P(Z0,".",2)_"00",1,2)
38 S:$P($G(^DGCR(399,IBIFN,"U1")),U,8)'="" Z=Z+1,IBXDATA(Z)=$P(^("U1"),U,8) ;Bill comment on bill
39 S Z0=$G(^DGCR(399,IBIFN,0)),Z1=$G(^DGCR(399.3,+$P(Z0,U,7),0))
40 D SET^IBCSC5B(IBIFN,.IBARRAY)
41 I $P($G(IBARRAY),U,2) D ;Prosthetics
42 . S Z0=0 F S Z0=$O(IBARRAY(Z0)) Q:Z0="" S Z1=0 F S Z1=$O(IBARRAY(Z0,Z1)) Q:'Z1 S Z=Z+1,IBXDATA(Z)="Prosthetic: "_$E($$PINB^IBCSC5B(+IBARRAY(Z0,Z1)),1,39)_" "_$E(Z0,4,5)_"/"_$E(Z0,6,7)_"/"_$E(Z0,1,2)
43 Q
44 ;
45CREM(IBIFN) ; Compile array of bill remarks common to every bill
46 ;IBIFN = bill ien
47 N Z
48 S Z=0
49 S:$P($G(^IBE(350.9,1,1)),U,4)'="" Z=Z+1,IBXDATA(Z)=$P(^(1),U,4) ;Site specific 'every bill' comment
50 Q
51 ;
52ADMDT(IBIFN,NOOUTCK) ; Calculate admission/start of care date/time
53 ; IBIFN = bill ien
54 ; NOOUTCK = flag that will:
55 ; (1) no check for inpt episode overlap for outpt
56 ; (0 or null) performs check for inpt episode overlap for outpt
57 ;
58 ; Returns IBXDATA = fileman date format
59 N Z,Z0,Z1
60 S Z=$G(^DGCR(399,IBIFN,0)),Z1=$P($G(^("U")),U,20),Z0=$$INPAT^IBCEF(IBIFN,1)
61 S IBXDATA=$S(Z0&$P(Z,U,8):$P($G(^DGPT(+$P(Z,U,8),0)),U,2),1:"")
62 S:'IBXDATA IBXDATA=$P(Z,U,3)_$S(Z0&(Z1<25):"."_$E("0",$L(Z1))_Z1,1:"")
63 ; Check to see if outpt episode (date in event date) overlaps inpt
64 ; episode - use admit date if it does
65 I 'Z0,IBXDATA,'$G(NOOUTCK) D
66 . N VAINDT,VAIN,DFN
67 . S VAINDT=IBXDATA,DFN=$P($G(^DGCR(399,IBIFN,0)),U)
68 . D INP^VADPT S IBXDATA=+VAIN(7) S:'IBXDATA IBXDATA=""
69 I 'IBXDATA,'Z0 S IBXDATA=$$SERVDT^IBCEF(IBIFN,,2)
70 Q
71 ;
72DISDT(IBIFN) ; Calculate discharge date
73 ; IBIFN = bill ien
74 N Z,Z0
75 S Z=$$INPAT^IBCEF(IBIFN,1),Z0=$G(^DGCR(399,IBIFN,0))
76 I Z S IBXDATA=+$G(^DGPT(+$P(Z0,U,8),70)) S:'IBXDATA IBXDATA=$P(Z0,U,16)
77 I 'Z N VAINDT,VAIN,DFN S DFN=$P($G(^DGCR(399,IBIFN,0)),U,2) D INP^VADPT I VAIN(1) S IBXDATA=+$G(^DGPM(+$P($G(^DGPM(+VAIN(1),0)),U,17),0))
78 Q
79 ;
80INSSECID(IBIFN,TYPE,SEQ) ; Extract subscriber and patient prim/sec ID's
81 ; IBIFN required
82 ; TYPE is either "PAT" or "SUB" to indicate we need to extract either
83 ; patient or subscriber ID information. Default="SUB".
84 ; SEQ is the insurance sequence# (1,2,3). Default is current ins seq#.
85 ;
86 ; Output:
87 ; Function returns an 8-piece string as follows.
88 ; [1] primary qualifier
89 ; [2] primary ID
90 ; [3] secondary qual(1)
91 ; [4] secondary ID(1)
92 ; [5] secondary qual(2)
93 ; [6] secondary ID(2)
94 ; [7] secondary qual(3)
95 ; [8] secondary ID(3)
96 ;
97 NEW DATA,DFN,POL,IB0,IB5,REL
98 S DATA=""
99 S IBIFN=+$G(IBIFN) I 'IBIFN G INSSX
100 I $G(TYPE)="" S TYPE="SUB" ; default type of ID's to get
101 I '$F(".PAT.SUB.","."_TYPE_".") G INSSX
102 I '$G(SEQ) S SEQ=$$COBN^IBCEF(IBIFN) ; default current ins seq#
103 I '$F(".1.2.3.","."_SEQ_".") G INSSX
104 S DFN=+$P($G(^DGCR(399,IBIFN,0)),U,2) I 'DFN G INSSX
105 S POL=+$P($G(^DGCR(399,IBIFN,"M")),U,SEQ+11) I 'POL G INSSX
106 S IB0=$G(^DPT(DFN,.312,POL,0)) I IB0="" G INSSX
107 S IB5=$G(^DPT(DFN,.312,POL,5))
108 S REL=+$P(IB0,U,16) ; pat rel to insured
109 S $P(DATA,U,1)="MI"
110 S $P(DATA,U,2)=$P(IB0,U,2) ; subscriber primary ID
111 S $P(DATA,U,3,8)=$P(IB5,U,2,7) ; subscriber secondary data
112 I TYPE="PAT",REL'=1 D
113 . S $P(DATA,U,2)=$P(IB5,U,1) ; patient primary ID
114 . S $P(DATA,U,3,8)=$P(IB5,U,8,13) ; patient secondary data
115 . Q
116 ;
117 S DATA=$$SCRUB(DATA) ; scrub the data
118INSSX ;
119 Q DATA
120 ;
121SCRUB(DATA) ; Scrub the 8-piece string gathered above
122 NEW PCE
123 ;
124 ; make sure you can't have an ID without a qualifier or a qualifier
125 ; without an ID. Check all 4 pairs.
126 F PCE=1,3,5,7 D
127 . I $P(DATA,U,PCE)'="",$P(DATA,U,PCE+1)'="" Q
128 . S ($P(DATA,U,PCE),$P(DATA,U,PCE+1))=""
129 . Q
130 ;
131 ; fill in secondary gaps. If Set1 and Set2 are blank, but Set3 exists
132 ; then move Set3 to Set1 and delete Set3.
133 I $P(DATA,U,3)="",$P(DATA,U,5)="",$P(DATA,U,7)'="" D
134 . S $P(DATA,U,3)=$P(DATA,U,7),$P(DATA,U,4)=$P(DATA,U,8)
135 . S ($P(DATA,U,7),$P(DATA,U,8))=""
136 . Q
137 ;
138 ; fill in secondary gaps more generically.
139 ; If Set(n) is blank, but Set(n+1) exists, then move it up.
140 F PCE=3,5 D
141 . I $P(DATA,U,PCE)="",$P(DATA,U,PCE+2)'="" D
142 .. S $P(DATA,U,PCE)=$P(DATA,U,PCE+2)
143 .. S $P(DATA,U,PCE+1)=$P(DATA,U,PCE+3)
144 .. S ($P(DATA,U,PCE+2),$P(DATA,U,PCE+3))=""
145 .. Q
146 . Q
147 ;
148 Q DATA
149 ;
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