1 | IBCNEHLQ ;DAOU/ALA - HL7 RQI Message ;17-JUN-2002
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2 | ;;2.0;INTEGRATED BILLING;**184,271,300,361**;21-MAR-94;Build 9
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3 | ;;Per VHA Directive 2004-038, this routine should not be modified.
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4 | ;
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5 | ;**Program Description**
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6 | ; This routine builds an IIV Verification (RQI^I01) or
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7 | ; Identification (RQI^I03) request
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8 | ;
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9 | ;**Modified by Date Reason
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10 | ; DAOU/BHS 10/04/2002 Implementing Transmit SSN logic
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11 | ; DAOU/DB 03/19/2004 Stripped dashes from SSN (PID, GT1)
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12 | ;
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13 | EN ; Entry Point
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14 | ; Variables
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15 | ; HLFS = Field Separator
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16 | ; DFN = Patient IEN
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17 | ; PAYR = Payer IEN
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18 | ; BUFF = Buffer IEN
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19 | ; FRDT = Freshness Date
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20 | ;
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21 | PID ; Patient Identification Segment
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22 | NEW VAERR,VAFSTR,VADM,VA,ICN,SNDSSN,NM,I
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23 | S SNDSSN=$$SNDSSN^IBCNEUT5(PAYR,"IIV")
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24 | D DEM^VADPT
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25 | S VAFSTR=",1,7,8,11,"
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26 | S PID=$$EN^VAFHLPID(DFN,VAFSTR,1)
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27 | ; Encode special characters into Name and address pieces
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28 | ; **NOTE: If $$EN^VAFHLPID should, in the future, return more than 11 pieces than the lines below may
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29 | ; need to be modified as they currently expect 11 pieces to be returned.
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30 | S DFN=$G(DFN) I DFN]"" D
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31 | . S NM("FILE")=2,NM("IENS")=DFN,NM("FIELD")=.01
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32 | . S NM=$$HLNAME^XLFNAME(.NM,"",$E(HLECH)),NM=$S(NM]"":NM,1:HLQ)
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33 | . S I=$L(NM,"|"),NM=$$ENCHL7(NM),$P(PID,"|",6,5+I)=NM
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34 | S $P(PID,"|",12,99)=$$ENCHL7($P(PID,"|",12,99))
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35 | ;
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36 | S ICN=$P($G(^DPT(DFN,"MPI")),U,1)
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37 | S $P(PID,HLFS,4)=ICN_HLECH_HLECH_HLECH_"USVHA"_HLECH_"NI"_HLECH
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38 | I DFN S $P(PID,HLFS,4)=$P(PID,HLFS,4)_"~"_DFN_HLECH_HLECH_HLECH_"USVHA"_HLECH_"PI"_HLECH_$P($$SITE^VASITE,U,3)_HLECH
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39 | I SNDSSN S $P(PID,HLFS,4)=$P(PID,HLFS,4)_"~"_$TR(VA("PID"),"-")_HLECH_HLECH_HLECH_"USSSA"_HLECH_"SS"_HLECH_"USSSA"
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40 | S FRDT=$$HLDATE^HLFNC($G(FRDT))
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41 | S $P(PID,HLFS,34)=FRDT
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42 | Q
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43 | ;
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44 | GT1 ; Guarantor Segment
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45 | NEW WHO,NM,IDOB,ISSN,ISEX,SEX,RLIEN,PER,PLIEN,RDATA,IBSDATA,IBADDR
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46 | NEW SNDSSN
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47 | ;
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48 | S SNDSSN=$$SNDSSN^IBCNEUT5(PAYR,"IIV")
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49 | ;
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50 | S GT1=""
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51 | I $G(QUERY)="I" Q
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52 | ;
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53 | ; If the data was extracted from Buffer get specifics from Buffer file
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54 | I EXT=1 D
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55 | . S WHO=$P($G(^IBA(355.33,BUFF,60)),U,5)
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56 | . I WHO="v"!(WHO="") Q
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57 | . S NM=$P($G(^IBA(355.33,BUFF,60)),U,7),NM=$$NAME^IBCNEHLU(NM)
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58 | . S NM=$$HLNAME^HLFNC(NM,HLECH)
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59 | . S NM=$$ENCHL7(NM)
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60 | . S $P(GT1,HLFS,3)=NM_HLECH_HLECH_HLECH
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61 | . S IDOB=$P($G(^IBA(355.33,BUFF,60)),U,8),IDOB=$$HLDATE^HLFNC(IDOB)
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62 | . S $P(GT1,HLFS,8)=IDOB
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63 | . S $P(GT1,HLFS,2)=$$ENCHL7($G(SUBID))_HLECH_HLECH_HLECH_HLECH_"HC"
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64 | . I SNDSSN S $P(GT1,HLFS,12)=$TR($P($G(^IBA(355.33,BUFF,60)),U,9),"-")
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65 | ;
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66 | ; If the data was extracted from non-Buffer, check Patient file
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67 | I EXT'=1 D
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68 | . I IRIEN="" Q
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69 | . S WHO=$P($G(^DPT(DFN,.312,IRIEN,0)),U,6)
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70 | . I WHO="v"!(WHO="") Q
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71 | . S NM=$P($G(^DPT(DFN,.312,IRIEN,0)),U,17)
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72 | . S NM=$$HLNAME^HLFNC(NM,HLECH)
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73 | . S NM=$$ENCHL7(NM)
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74 | . S $P(GT1,HLFS,3)=NM_HLECH_HLECH_HLECH
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75 | . S IDOB=$P($G(^DPT(DFN,.312,IRIEN,3)),U,1),IDOB=$$HLDATE^HLFNC(IDOB)
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76 | . S $P(GT1,HLFS,8)=IDOB
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77 | . S $P(GT1,HLFS,2)=$$ENCHL7($G(SUBID))_HLECH_HLECH_HLECH_HLECH_"HC"
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78 | . ;
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79 | . S IBSDATA=$G(^DPT(DFN,.312,IRIEN,3))
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80 | . ;
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81 | . S ISSN=$P(IBSDATA,U,5)
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82 | . I SNDSSN S $P(GT1,HLFS,12)=$TR(ISSN,"-")
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83 | . ;
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84 | . S IBADDR=$$HLADDR^HLFNC($P(IBSDATA,U,6,7),$P(IBSDATA,U,8,12))
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85 | . S $P(GT1,HLFS,5)=$$ENCHL7(IBADDR)
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86 | . ;
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87 | . D CHK
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88 | . I $P(GT1,HLFS,8)=""&(IDOB'="") S $P(GT1,HLFS,8)=$$HLDATE^HLFNC(IDOB)
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89 | . I $P(GT1,HLFS,9)=""&(ISEX'="") S $P(GT1,HLFS,9)=ISEX
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90 | . I SNDSSN,$P(GT1,HLFS,12)=""&(ISSN'="") S $P(GT1,HLFS,12)=$TR(ISSN,"-")
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91 | . I $P(GT1,HLFS,9)="",WHO="s" D
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92 | .. S SEX=$P($G(^DPT(DFN,.312,IRIEN,3)),U,12) ; get policy holder sex
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93 | .. I SEX="" S SEX=$P(^DPT(DFN,0),U,2),SEX=$S(SEX="M":"F",1:"M") ; if null, use alternative method
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94 | .. S $P(GT1,HLFS,9)=SEX
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95 | ;
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96 | I GT1="" Q
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97 | S $P(GT1,HLFS,1)=1
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98 | S GT1="GT1"_HLFS_GT1
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99 | Q
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100 | ;
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101 | IN1 ; Insurance Segment
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102 | NEW EFFDT,EXPDT,WHO,ADMN,ADMDT,IENS
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103 | S IN1="",SRVDT=$$HLDATE^HLFNC(SRVDT)
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104 | ;
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105 | ; If the data was extracted from Buffer get specifics from Buffer file
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106 | I EXT=1 D
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107 | . S $P(IN1,HLFS,2)=$$ENCHL7($G(SUBID))
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108 | . I PAYR'=$$FIND1^DIC(365.12,"","X","~NO PAYER") D
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109 | .. S $P(IN1,HLFS,3)=$$ENCHL7($P(^IBE(365.12,PAYR,0),U,2))_HLECH_HLECH_HLECH_"USVHA"_HLECH_"VP"_HLECH
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110 | .. S $P(IN1,HLFS,4)=$$ENCHL7($P(^IBE(365.12,PAYR,0),U,1))
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111 | . S $P(IN1,HLFS,8)=$$ENCHL7($P($G(^IBA(355.33,BUFF,40)),U,3))
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112 | . S $P(IN1,HLFS,9)=$$ENCHL7($P($G(^IBA(355.33,BUFF,40)),U,2))
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113 | . S EFFDT=$P($G(^IBA(355.33,BUFF,60)),U,2),EFFDT=$$HLDATE^HLFNC(EFFDT)
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114 | . S EXPDT=$P($G(^IBA(355.33,BUFF,60)),U,3),EXPDT=$$HLDATE^HLFNC(EXPDT)
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115 | . S $P(IN1,HLFS,12)=EFFDT
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116 | . S $P(IN1,HLFS,13)=EXPDT
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117 | . S WHO=$P($G(^IBA(355.33,BUFF,60)),U,5)
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118 | . S $P(IN1,HLFS,17)=$S(WHO="v":18,WHO="":18,WHO="s":"01",1:34)
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119 | ;
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120 | ; If the data was extracted from non-Buffer, check Patient file
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121 | I EXT'=1 D
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122 | . I IRIEN="" Q
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123 | . I $G(SUBID)'=$P($G(^DPT(DFN,.312,IRIEN,0)),U,2) Q
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124 | . S EFFDT=$P($G(^DPT(DFN,.312,IRIEN,0)),U,8),EFFDT=$$HLDATE^HLFNC(EFFDT)
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125 | . S EXPDT=$P($G(^DPT(DFN,.312,IRIEN,0)),U,4),EXPDT=$$HLDATE^HLFNC(EXPDT)
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126 | . S $P(IN1,HLFS,12)=EFFDT
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127 | . S $P(IN1,HLFS,13)=EXPDT
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128 | . S WHO=$P($G(^DPT(DFN,.312,IRIEN,0)),U,6) I WHO="" Q
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129 | . S $P(IN1,HLFS,17)=$S(WHO="v":18,WHO="":18,WHO="s":"01",1:34)
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130 | . S IENS=IRIEN_","_DFN_","
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131 | . S $P(IN1,HLFS,8)=$$ENCHL7($$GET1^DIQ(2.312,IENS,21,"E"))
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132 | . S $P(IN1,HLFS,9)=$$ENCHL7($$GET1^DIQ(2.312,IENS,20,"E"))
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133 | ;
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134 | ; If it's an inquire with 'No Payer', don't send payer info
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135 | I PAYR'=$$FIND1^DIC(365.12,"","X","~NO PAYER") D
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136 | . S $P(IN1,HLFS,3)=$$ENCHL7($P(^IBE(365.12,PAYR,0),U,2))_HLECH_HLECH_HLECH_"USVHA"_HLECH_"VP"_HLECH
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137 | . S $P(IN1,HLFS,4)=$$ENCHL7($P(^IBE(365.12,PAYR,0),U,1))
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138 | . S $P(IN1,HLFS,2)=$$ENCHL7($G(SUBID))
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139 | ;
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140 | I IN1="" Q
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141 | ;
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142 | I $G(QUERY)="I",$P(IN1,HLFS,17)'=18 S $P(IN1,HLFS,17)=18
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143 | I $P(IN1,HLFS,17)="" S $P(IN1,HLFS,17)=18
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144 | ;
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145 | ; Set the admission date if patient currently admitted
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146 | S ADMN=$P($G(^DPT(DFN,.105)),U,1) I ADMN'="" D
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147 | . S ADMDT=$P(^DGPM(ADMN,0),U,1),ADMDT=$$HLDATE^HLFNC(ADMDT)
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148 | . S $P(IN1,HLFS,24)=ADMDT
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149 | ;
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150 | ; Set the service date
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151 | S $P(IN1,HLFS,26)=SRVDT
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152 | S $P(IN1,HLFS,1)=1
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153 | S IN1="IN1"_HLFS_IN1
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154 | Q
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155 | ;
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156 | CHK ; Check for spouse or other information in the Patient Relation File
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157 | ; DGREL = Relationship (1=Self, 2=Spouse, 3-34,99=Other)
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158 | NEW IEN,QFL
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159 | S IEN="",RLIEN="",ISEX="",QFL=0
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160 | F S IEN=$O(^DGPR(408.12,"B",DFN,IEN)) Q:IEN="" D Q:QFL
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161 | . S DGREL=$P($G(^DGPR(408.12,IEN,0)),U,2)
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162 | . ;
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163 | . ; If person is veteran, quit
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164 | . I DGREL=1 Q
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165 | . ;
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166 | . ; If person is spouse, pick that record and quit
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167 | . I WHO="s",DGREL=2 S RLIEN=IEN,QFL=1 Q
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168 | . ;
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169 | . ; Otherwise it should be an 'other' dependent
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170 | . S RLIEN=IEN
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171 | ;
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172 | I RLIEN="" Q
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173 | ;
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174 | ; Check for Sex, SSN, DOB in INCOME PERSON File
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175 | S PER=$P(^DGPR(408.12,RLIEN,0),U,3)
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176 | I PER'["DGPR(408.13" Q
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177 | S PLIEN=$P(PER,";",1)
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178 | I PLIEN="" Q
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179 | S RDATA=$G(^DGPR(408.13,PLIEN,0))
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180 | S ISEX=$P(RDATA,U,2),IDOB=$P(RDATA,U,3),ISSN=$P(RDATA,U,9)
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181 | I $P(RDATA,U,4)'="" D
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182 | . NEW DFN
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183 | . S DFN=$P(RDATA,U,4),ISEX=$P(^DPT(DFN,0),U,2),IDOB=$P(^DPT(DFN,0),U,3)
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184 | . S ISSN=$P(^DPT(DFN,0),U,9)
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185 | Q
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186 | ;
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187 | ENCHL7(STR) ; Encode HL7 escape seqs in data fields
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188 | ;
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189 | ; Input:
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190 | ; STR = Field data possible containing HL7 encoding chars
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191 | ;
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192 | ; Output Values
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193 | ; Fn returns string w/converted escape seqs
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194 | ;
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195 | N CHR,NEW,RPLC,CNT,LOOP
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196 | ;
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197 | ; Replace "\" "&" "~" "|" with \F\ \R\ \E\ \T\ respectively
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198 | F CHR="\","&","~","|" S CNT=$L(STR,CHR) I CNT>1 D
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199 | . S NEW=$P(STR,CHR)
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200 | . S RPLC="\"_$TR(CHR,"|~\&","FRET")_"\"
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201 | . F LOOP=2:1:CNT S NEW=NEW_RPLC_$P(STR,CHR,LOOP)
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202 | . S STR=NEW
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203 | ;
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204 | Q STR
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