1 | IBCIL0 ;DSI/ESG - CLAIMSMANAGER SKIP LIST ;11-JAN-2001
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2 | ;;2.0;INTEGRATED BILLING;**161**;21-MAR-94
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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 | ;The skip list is a routine that will allow system managers the
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6 | ;capabilities to select transactions that errored due to system
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7 | ;failures. This routine utilizes ListMan functions.
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8 | EN ; -- main entry point for IBCI CLAIMSMANAGER SKIP LIST
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9 | ;
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10 | ; Try to get an option-level lock
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11 | L +^IBCIL0:0
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12 | E W @IOF,!!!?10,"Another user is currently using this option.",!!?10,"Please try again later.",!! S DIR(0)="E" D ^DIR K DIR Q
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13 | ;
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14 | I '$$CK2^IBCIUT1 D Q ; check to see that ClaimsManager working OK
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15 | . W @IOF,!!!?10,"ClaimsManager is not working right now."
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16 | . W !!?10,"Please try again later.",!!
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17 | . S DIR(0)="E" D ^DIR K DIR
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18 | . L -^IBCIL0
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19 | . Q
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20 | ;
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21 | D EN^VALM("IBCI CLAIMSMANAGER SKIP LIST")
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22 | KILL ^TMP("IBCIL0",$J),^TMP("IBCIL1",$J),^TMP("IBCIL2",$J)
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23 | KILL IBCISTAT,IBCISNT,IBCIREDT,IBCIERR,CT
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24 | L -^IBCIL0
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25 | Q
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26 | ;
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27 | HDR ; -- header code
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28 | S VALMHDR(1)=" Welcome to ClaimsManager Bill Processing"
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29 | S VALMHDR(2)=" This ListMan will display all skipped bills for processing"
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30 | Q
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31 | ;
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32 | INIT ; -- init variables and list array
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33 | D CLEAN^VALM10
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34 | K ^TMP("IBCIL0",$J),^TMP("IBCIL1",$J),^TMP("IBCIL2",$J),CT
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35 | NEW IBCIVAUS,IBCIFDAT,IBCIIEN,IBCIBNUM
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36 | NEW IBCINAME,IBCIDATE,IBCIUSER,IBCIST0,IBCIST1,IBCIARR
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37 | NEW IBCISKST,NODE0,IBCIDFN,IBCIXX
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38 | S IBCIARR=""
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39 | F IBCISKST=2,6,7,10,11 D
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40 | .S IBCIIEN=0 F S IBCIIEN=$O(^IBA(351.9,"AST",IBCISKST,IBCIIEN)) Q:'IBCIIEN D
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41 | ..S NODE0=^IBA(351.9,IBCIIEN,0)
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42 | ..S IBCIBNUM=$P(^DGCR(399,IBCIIEN,0),U,1)
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43 | ..S IBCIFDAT=$P($P(^DGCR(399,IBCIIEN,0),U,3),".",1)
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44 | ..S IBCIDATE=$$FDATE^VALM1(IBCIFDAT)
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45 | ..S IBCIUSER=$P(NODE0,U,12) ; assigned to peep
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46 | ..I 'IBCIUSER S IBCIUSER=+$$BILLER^IBCIUT5(IBCIIEN) ; biller
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47 | ..I 'IBCIUSER S IBCIUSER=$P(NODE0,U,9) ; last edited by
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48 | ..I 'IBCIUSER S IBCIUSER=$P(NODE0,U,7) ; entered by
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49 | ..S IBCIVAUS=$P($G(^VA(200,IBCIUSER,0)),U,1)
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50 | ..I IBCIVAUS="" S IBCIVAUS="UNKNOWN"
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51 | ..S IBCIDFN=$P(^DGCR(399,IBCIIEN,0),U,2)
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52 | ..S IBCINAME=$P($G(^DPT(IBCIDFN,0)),U,1)
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53 | ..S IBCIST0=$P(^DGCR(399,IBCIIEN,0),U,13)
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54 | ..I IBCIST0=1 S IBCIST1="E/NR"
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55 | ..I IBCIST0=2 S IBCIST1="R/MRA"
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56 | ..I IBCIST0=3 S IBCIST1="AUTH"
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57 | ..I IBCIST0=4 S IBCIST1="PR/TX"
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58 | ..I IBCIST0=7 S IBCIST1="CANX"
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59 | ..I IBCIST0=0 S IBCIST1="CLSD",IBCIST0=9
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60 | ..S ^TMP("IBCIL0",$J,IBCIST0,IBCIVAUS,IBCIBNUM)=IBCIIEN_U_IBCIST1_U_IBCIVAUS_U_IBCIBNUM_U_IBCINAME_U_IBCIDATE
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61 | SRT ;sort
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62 | S (IBCIST0,CT)=0 F S IBCIST0=$O(^TMP("IBCIL0",$J,IBCIST0)) Q:'IBCIST0 D
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63 | .S IBCIUSER="" F S IBCIUSER=$O(^TMP("IBCIL0",$J,IBCIST0,IBCIUSER)) Q:IBCIUSER="" D
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64 | ..S IBCIBNUM="" F S IBCIBNUM=$O(^TMP("IBCIL0",$J,IBCIST0,IBCIUSER,IBCIBNUM)) Q:IBCIBNUM="" D
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65 | ...S IBCIXX=^TMP("IBCIL0",$J,IBCIST0,IBCIUSER,IBCIBNUM)
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66 | ...S IBCIARR=$$SETFLD^VALM1($P(IBCIXX,U,2),IBCIARR,"STATUS")
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67 | ...S IBCIARR=$$SETFLD^VALM1($P(IBCIXX,U,3),IBCIARR,"USER")
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68 | ...S IBCIARR=$$SETFLD^VALM1($P(IBCIXX,U,4),IBCIARR,"BNUM")
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69 | ...S IBCIARR=$$SETFLD^VALM1($P(IBCIXX,U,5),IBCIARR,"PT_NAME")
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70 | ...S IBCIARR=$$SETFLD^VALM1($P(IBCIXX,U,6),IBCIARR,"EVENT_DATE")
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71 | ...S CT=CT+1
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72 | ...S ^TMP("IBCIL1",$J,CT)=$P(IBCIXX,U)_U_$P(^IBA(351.9,$P(IBCIXX,U),0),U,2)_U_IBCIST0
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73 | ...S IBCIARR=$$SETFLD^VALM1(CT,IBCIARR,"ITEM") D SET^VALM10(CT,IBCIARR)
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74 | S VALMCNT=CT
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75 | I VALMCNT=0 S VALMSG="No Skipped Claims to Send to ClaimsManager."
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76 | D EXIT
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77 | Q
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78 | ;
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79 | SELB ; select single bill, bill by status, or multiple range of bills
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80 | ;
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81 | NEW IBCIENAR,IBCINUMS,IBCIPIEC,IBCIYSUB,IBCIX
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82 | S VALMBCK="R"
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83 | I CT=0 D NOBILS,INIT G SELBX
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84 | D FULL^VALM1
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85 | S DIR(0)="LO^1:"_CT
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86 | S DIR("A",1)="You may select one or more claims, or a range."
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87 | S DIR("A")="Selection"
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88 | S DIR("?",1)=" You may choose a single bill, a list of bills (i.e. 2,5,9,12), a range"
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89 | S DIR("?",2)=" of bills (i.e. 3-8), or any combination of these (i.e. 1,3,5,8-12). Only"
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90 | S DIR("?")=" the bills you select here will be sent to ClaimsManager."
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91 | D ^DIR K DIR
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92 | I $D(DIRUT) G SELBX
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93 | D YESBLS
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94 | M IBCIENAR=Y KILL X,Y
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95 | S IBCIYSUB=""
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96 | F S IBCIYSUB=$O(IBCIENAR(IBCIYSUB)) Q:IBCIYSUB="" D
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97 | . S IBCINUMS=IBCIENAR(IBCIYSUB)
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98 | . S IBCINUMS=$E(IBCINUMS,1,$L(IBCINUMS)-1)
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99 | . F IBCIPIEC=1:1:$L(IBCINUMS,",") S IBCIX=$P(IBCINUMS,",",IBCIPIEC) D N1
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100 | . Q
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101 | D SENDMAIL,INIT
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102 | SELBX ;
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103 | Q
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104 | ;
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105 | N1 ; check for valid number and send the claim
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106 | NEW IBCIST1,IBIFN,IBCIMCSB,IBCIMCSL
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107 | NEW ATP,BILLNO,CHARGES,DFN,DPTDATA,EVENTDT,IBDATA,PATNAME,RESP,RESPNM
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108 | NEW SSN,TMPDATA
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109 | NEW IBCIENAR,IBCINUMS,IBCIPIEC,IBCIYSUB
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110 | ;
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111 | I 'IBCIX Q
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112 | I '$D(^TMP("IBCIL1",$J,IBCIX)) Q
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113 | S IBIFN=$P(^TMP("IBCIL1",$J,IBCIX),U,1)
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114 | S IBCIST1=$P(^TMP("IBCIL1",$J,IBCIX),U,3) D STATUS
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115 | ;
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116 | S IBCIMCSB=+$$BILLER^IBCIUT5(IBIFN) ; current biller
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117 | S IBCIMCSL=+$P($G(^IBA(351.9,IBIFN,0)),U,5) ; last sent to CM by
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118 | ;
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119 | D ST2^IBCIST ; send a single bill to CM
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120 | W "."
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121 | ;
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122 | ; esg - 10/4/01 - If the bill is still editable and it came back
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123 | ; clean from CM, then build a scratch global so we can send
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124 | ; a MailMan message to some people about this.
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125 | ;
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126 | I IBCISNT=2,IBCISTAT=3 D
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127 | . S (RESP,ATP)=+$P($G(^IBA(351.9,IBIFN,0)),U,12)
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128 | . I 'RESP S RESP=IBCIMCSB
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129 | . I 'RESP S RESP=DUZ
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130 | . S RESPNM=$P($G(^VA(200,RESP,0)),U,1)
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131 | . I RESPNM="" S RESPNM="UNKNOWN"
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132 | . S CHARGES=+$P($G(^DGCR(399,IBIFN,"U1")),U,1)
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133 | . S IBDATA=$G(^DGCR(399,IBIFN,0))
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134 | . S BILLNO=$P(IBDATA,U,1)
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135 | . S DFN=+$P(IBDATA,U,2)
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136 | . S DPTDATA=$G(^DPT(DFN,0))
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137 | . S SSN=$E($P(DPTDATA,U,9),6,9)
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138 | . S PATNAME=$P(DPTDATA,U,1)
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139 | . S EVENTDT=$P($P(IBDATA,U,3),".",1)
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140 | . S TMPDATA=BILLNO_U_PATNAME_U_SSN_U_EVENTDT
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141 | . S ^TMP("IBCIL2",$J,RESPNM,-CHARGES,IBIFN)=TMPDATA
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142 | . ;
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143 | . ; these people should get the MailMan message
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144 | . I ATP S ^TMP("IBCIL2",$J,RESPNM,-CHARGES,IBIFN,ATP)=""
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145 | . I IBCIMCSB S ^TMP("IBCIL2",$J,RESPNM,-CHARGES,IBIFN,IBCIMCSB)=""
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146 | . I IBCIMCSL S ^TMP("IBCIL2",$J,RESPNM,-CHARGES,IBIFN,IBCIMCSL)=""
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147 | . S ^TMP("IBCIL2",$J)=$G(^TMP("IBCIL2",$J))+1
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148 | . Q
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149 | Q
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150 | ;
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151 | STATUS ;set ibcisnt based on criteria
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152 | K IBCISNT
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153 | I $$STAT^IBCIUT1(IBIFN)=10 S IBCISNT=4 Q
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154 | I $$STAT^IBCIUT1(IBIFN)=11 S IBCISNT=5 Q
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155 | S IBCISNT=$S("^1^"[IBCIST1:2,1:6)
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156 | Q
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157 | ;
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158 | ALL ;send all claims
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159 | NEW IBCIX
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160 | S VALMBCK="R"
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161 | I CT=0 D NOBILS,INIT Q
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162 | I CT>0 D YESBLS
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163 | S IBCIX=0 F S IBCIX=$O(^TMP("IBCIL1",$J,IBCIX)) Q:'IBCIX D N1
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164 | D SENDMAIL,INIT
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165 | Q
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166 | SNA ;send all non authorized claims
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167 | NEW IBCIX
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168 | S VALMBCK="R"
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169 | I CT=0 D NOBILS,INIT Q
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170 | I CT>0 D YESBLS
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171 | S IBCIX=0 F S IBCIX=$O(^TMP("IBCIL1",$J,IBCIX)) Q:'IBCIX D
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172 | . I $P(^TMP("IBCIL1",$J,IBCIX),U,3)<3 D N1
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173 | . Q
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174 | D SENDMAIL,INIT
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175 | Q
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176 | ;
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177 | SENDMAIL ;
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178 | ; This procedure is responsible for sending a MailMan message to
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179 | ; users about the claims that had no ClaimsManager errors. The
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180 | ; message will list all clean claims and will be sent to the billers,
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181 | ; assigned to people, current user, and the user who most recently
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182 | ; sent the bill to CM.
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183 | ;
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184 | NEW CHG,IBIFN,L1,TEXT,TMPDATA,USER,XMDUZ,XMSUB,XMTEXT,XMY,XMDUN,XMZ
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185 | NEW X,Y,X1,X2,X3,X4
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186 | I '$D(^TMP("IBCIL2",$J)) G SENDX
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187 | S L1=1
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188 | S TEXT(L1)="The following bills were sent to ClaimsManager from the Multiple Claim Send",L1=L1+1
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189 | S TEXT(L1)="option. ClaimsManager did not find any errors with them. These bills have",L1=L1+1
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190 | S TEXT(L1)="passed both the IB edit checks and the ClaimsManager edit checks. They are",L1=L1+1
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191 | S TEXT(L1)="ready to be authorized. Please review the bills for which you are responsible",L1=L1+1
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192 | S TEXT(L1)="(if any) and take the appropriate action.",L1=L1+1
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193 | S TEXT(L1)=" ",L1=L1+1
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194 | S TEXT(L1)=$J("EVENT",43),L1=L1+1
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195 | S TEXT(L1)=" BILL# PATIENT NAME PID DATE CHARGES USER NAME",L1=L1+1
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196 | S TEXT(L1)=" ------- ------------------ ---- ---------- ---------- ------------------",L1=L1+1
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197 | ;
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198 | S USER=""
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199 | F S USER=$O(^TMP("IBCIL2",$J,USER)) Q:USER="" S CHG="" F S CHG=$O(^TMP("IBCIL2",$J,USER,CHG)) Q:CHG="" S IBIFN=0 F S IBIFN=$O(^TMP("IBCIL2",$J,USER,CHG,IBIFN)) Q:'IBIFN D
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200 | . M XMY=^TMP("IBCIL2",$J,USER,CHG,IBIFN)
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201 | . S TMPDATA=XMY,XMY=""
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202 | . S TEXT(L1)=" "
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203 | . S X=$P(TMPDATA,U,1),X1=7,X2="L" S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2
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204 | . S TEXT(L1)=TEXT(L1)_" "
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205 | . S X=$P(TMPDATA,U,2),X1=18,X2="L" S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2
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206 | . S X=$P(TMPDATA,U,3),X1=6,X2="R" S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2
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207 | . S X=$$FMTE^XLFDT($P(TMPDATA,U,4),"5Z"),X1=12,X2="R"
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208 | . S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2
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209 | . S X="$"_$FN(-CHG,",",2),X1=12,X2="R"
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210 | . S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2
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211 | . S TEXT(L1)=TEXT(L1)_" "
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212 | . S X=USER,X1=18,X2="L" S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2
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213 | . S L1=L1+1
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214 | . Q
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215 | S TEXT(L1)=" ",L1=L1+1
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216 | S TEXT(L1)=" ",L1=L1+1
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217 | ;
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218 | S XMTEXT="TEXT("
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219 | S XMDUZ=DUZ
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220 | S XMSUB="ClaimsManager Clean Claims"
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221 | S XMY(DUZ)=""
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222 | D ^XMD
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223 | SENDX ;
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224 | Q
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225 | ;
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226 | NOBILS ;msg for no bills
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227 | D FULL^VALM1
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228 | W !!,"There are no claims to send ...",!
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229 | S DIR(0)="E" D ^DIR K DIR
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230 | Q
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231 | YESBLS ;msg for sending bills
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232 | W !!,"Sending claims ... please wait.",!
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233 | Q
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234 | HELP ; -- help code
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235 | S X="?"
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236 | D FULL^VALM1
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237 | D EN^DDIOL(" 'Send All Bills to ClaimsManager' will send all claims listed","","!!")
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238 | D EN^DDIOL(" to ClaimsManager for processing.")
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239 | D EN^DDIOL(" 'Send All Non Auth Bills to ClaimsManager' will send only","","!!")
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240 | D EN^DDIOL(" Non-Authorized claims to ClaimsManager for processing.")
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241 | D EN^DDIOL(" 'Select Bills to send to ClaimsManager' allows individual and","","!!")
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242 | D EN^DDIOL(" multiple selection of claims before sending")
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243 | D EN^DDIOL(" claims to ClaimsManager for processing.")
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244 | D PAUSE^VALM1
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245 | S VALMBCK="R"
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246 | Q
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247 | ;
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248 | EXIT ; -- exit code
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249 | D CLEAR^VALM1
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250 | Q
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