1 | IBCNERPC ;DAOU/RO - IIV PAYER LINK REPORT COMPILE ;AUG-2003
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2 | ;;2.0;INTEGRATED BILLING;**184,252,271**;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 | ; IIV - Insurance Identification and Verification
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6 | ;
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7 | ; Input vars from IBCNERPB:
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8 | ; IBCNESPC("REP")=1 for Payer List report, 2 for Company List
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9 | ; IBCNESPC("PTYPE")=Payer type (1-no active ins linked, 2-at least 1 ins linked, 3-All Payers)
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10 | ; IBCNESPC("PSORT")=Primary Sort for Payer report
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11 | ; IBCNESPC("PDET")=Ins detail on payer report (1-include list of ins,2-do not list)
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12 | ;
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13 | ; IBCNESPC("ITYPE")=Ins Company type (1-no payer link, 2-linked to payer, 3-All ins companies)
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14 | ; IBCNESPC("ISORT")=Primary Sort for Payer Insurance report
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15 | ; IBCNESPC("IMAT")=Partial matching Ins carriers
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16 | ;
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17 | ; Output vars used by IBCNERPC:
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18 | ;
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19 | ; IBCNERTN="IBCNERPB"
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20 | ; SORT1=depends on sorting option chosen
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21 | ; SORT2=Payer Name (Report by Payer) or Ins Company Name (if report is Insurance)
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22 | ; ^TMP($J,IBCNERTN,SORT1,SORT2,CNT)
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23 | ; CNT=Seq ct
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24 | ; ^TMP($J,IBCNERTN,SORT1,SORT2,CNT,1)
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25 | ;
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26 | ; Must call at EN
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27 | Q
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28 | ;
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29 | EN(IBCNERTN,IBCNESPC) ; Entry
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30 | ; Init
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31 | N IBTYP,IBCT,IBCTX
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32 | ;
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33 | N IBDET,IBSRT,IBPY,IBVAID,IBPROF,IBINST,IBNAACT,IBLOACT,IBINS,IBINST
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34 | N IBINSN,IBAPP,IBPYR,SORT1,SORT2,IBSRT,IBMAT,IBPPYR,IBREP
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35 | ;
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36 | I '$D(ZTQUEUED),$G(IOST)["C-" W !!,"Compiling report data ..."
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37 | ;
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38 | ; Temp ct
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39 | S IBCT=0
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40 | ;
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41 | ; Kill scratch globals
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42 | K ^TMP($J,IBCNERTN)
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43 | ;
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44 | ;
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45 | S IBREP=$G(IBCNESPC("REP"))
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46 | S IBDET=$G(IBCNESPC("PDET"))
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47 | S IBTYP=$G(IBCNESPC("PTYPE"))
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48 | S IBSRT=$G(IBCNESPC("PSORT"))
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49 | S IBPPYR=$G(IBCNESPC("PPYR"))
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50 | ;
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51 | ; Ins Report
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52 | I IBREP=2 G INS
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53 | ;
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54 | ; Loop thru the IIV payer File (#365.12)
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55 | S IBPY=0,SORT1=""
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56 | F S IBPY=$O(^IBE(365.12,IBPY)) Q:'IBPY D Q:$G(ZTSTOP)
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57 | . I $D(ZTQUEUED),$$S^%ZTLOAD() S ZTSTOP=1 Q
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58 | . ; Payer name from Payer File (#365.12)
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59 | . S IBPYR=$P($G(^IBE(365.12,IBPY,0)),U) I IBSRT=1 S SORT1=IBPYR
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60 | . S SORT2=IBPYR
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61 | . I IBPYR=""!(IBPYR="~NO PAYER")!($$PYRAPP^IBCNEUT5("IIV",IBPY)="") Q
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62 | . I IBPPYR'="",IBPY'=$P(IBPPYR,U) Q
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63 | . ; get VA national ID
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64 | . S IBVAID=$P($G(^IBE(365.12,IBPY,0)),U,2) I IBSRT=2 S SORT1=IBVAID
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65 | . ; get the EDI numbers (professional and institutional)
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66 | . S IBPROF=$P($G(^IBE(365.12,IBPY,0)),U,5)
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67 | . S IBINST=$P($G(^IBE(365.12,IBPY,0)),U,6)
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68 | . S IBAPP=$$PYRAPP^IBCNEUT5("IIV",IBPY),(IBNAACT,IBLOACT)=0
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69 | . S:IBAPP'="" IBNAACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,2)
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70 | . S:IBAPP'="" IBLOACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,3)
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71 | . ; if no sort value, use 0
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72 | . I IBSRT=3 S SORT1=IBNAACT I SORT1="" S SORT1=0
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73 | . I IBSRT=4 S SORT1=IBLOACT I SORT1="" S SORT1=0
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74 | . I SORT1="" S SORT1=" "
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75 | . ; if sorting by count and detail, need to figure count first else sort will not work
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76 | . I IBSRT=5,IBTYP>1,IBDET=1 D S SORT1=-IBCTX
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77 | . . S IBCTX=0,IBINS="" F S IBINS=$O(^DIC(36,"AC",IBPY,IBINS)) Q:IBINS="" D
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78 | . . . S IBINSN=$G(^DIC(36,IBINS,0)),IBINSN=$P(IBINSN,U) Q:IBINSN="" S IBCTX=IBCTX+1
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79 | . ; search for insurance carriers for this payer
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80 | . S IBCT=0,IBINS="" F S IBINS=$O(^DIC(36,"AC",IBPY,IBINS)) Q:IBINS="" D
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81 | . . S IBINSN=$G(^DIC(36,IBINS,0)),IBINSN=$P(IBINSN,U) Q:IBINSN=""
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82 | . . S IBCT=IBCT+1 I IBTYP=1 Q
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83 | . . ; save off address and EDI#'s for Insurance carrier
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84 | . . I IBDET=1 S ^TMP($J,IBCNERTN,SORT1,SORT2,IBPY,IBINSN,IBINS)=$P($G(^DIC(36,IBINS,.11)),U,1,6)_U_$P($G(^DIC(36,IBINS,3)),U,2)_U_$P($G(^DIC(36,IBINS,3)),U,4)
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85 | . I IBTYP=1,IBCT>0 Q
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86 | . I IBTYP=2,IBCT=0 Q
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87 | . ; use reverse sort for count
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88 | . I IBSRT=5 S SORT1=-IBCT
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89 | . S ^TMP($J,IBCNERTN,SORT1,SORT2,IBPY)=IBVAID_U_IBPROF_U_IBINST_U_IBNAACT_U_IBLOACT_U_IBCT
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90 | G EXIT
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91 | ;
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92 | INS ;
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93 | S IBTYP=$G(IBCNESPC("ITYPE"))
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94 | S IBSRT=$G(IBCNESPC("ISORT"))
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95 | S IBMAT=$G(IBCNESPC("IMAT"))
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96 | ; Loop thru the Insurance company file
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97 | S IBINS=0
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98 | F S IBINS=$O(^DIC(36,IBINS)) Q:'IBINS D Q:$G(ZTSTOP)
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99 | . I $D(ZTQUEUED),$$S^%ZTLOAD() S ZTSTOP=1 Q
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100 | . S (SORT1,IBPYR,IBNAACT,IBLOACT,IBPROF,IBINST,IBVAID)=""
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101 | . S IBINSN=$P($G(^DIC(36,IBINS,0)),U) I IBSRT=1 S SORT1=IBINSN
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102 | . S SORT2=IBINSN
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103 | . I IBINSN="" Q
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104 | . I IBMAT'="",'$F($$UP^XLFSTR(IBINSN),$$UP^XLFSTR(IBMAT)) Q
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105 | . ; get payer
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106 | . S IBPY=$P($G(^DIC(36,IBINS,3)),U,10)
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107 | . I IBTYP=1,IBPY'="" Q
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108 | . I IBTYP=2,IBPY="" Q
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109 | . I IBPY'="" D
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110 | . . ; Payer name from Payer File (#365.12)
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111 | . . S IBPYR=$P($G(^IBE(365.12,IBPY,0)),U) I IBSRT=2 S SORT1=IBPYR
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112 | . . ; get VA national ID
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113 | . . S IBVAID=$P($G(^IBE(365.12,IBPY,0)),U,2) I IBSRT=3 S SORT1=IBVAID
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114 | . . S IBPROF=$P($G(^IBE(365.12,IBPY,0)),U,5)
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115 | . . S IBINST=$P($G(^IBE(365.12,IBPY,0)),U,6)
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116 | . . S IBAPP=$$PYRAPP^IBCNEUT5("IIV",IBPY),(IBNAACT,IBLOACT)=0
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117 | . . S:IBAPP'="" IBNAACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,2)
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118 | . . S:IBAPP'="" IBLOACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,3)
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119 | . . I IBSRT=4 S SORT1=IBNAACT I SORT1="" S SORT1=0
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120 | . . I IBSRT=5 S SORT1=IBLOACT I SORT1="" S SORT1=0
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121 | . I SORT1="" S SORT1=" "
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122 | . S ^TMP($J,IBCNERTN,SORT1,SORT2,IBINS)=IBPYR_U_IBVAID_U_IBPROF_U_IBINST_U_IBNAACT_U_IBLOACT_U_IBCT_U_$G(^DIC(36,IBINS,.11))_U_"~"_$G(^DIC(36,IBINS,3))
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123 | ;
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124 | EXIT ;
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125 | Q
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126 | ; Lines moved from IBCNERPB
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127 | ITYPE ; Prompt to select Insurance Company type to include
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128 | ; Init vars
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129 | N DIR,X,Y,DIRUT
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130 | ;
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131 | S DIR(0)="S^1:Unlinked insurance companies;2:Linked insurance companies;3:All insurance companies"
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132 | S DIR("A")="Select type of insurance companies to display"
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133 | S DIR("B")="3"
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134 | S DIR("?",1)=" 1 - Only insurance companies that are not currently linked to a payer"
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135 | S DIR("?",2)=" 2 - Only insurance companies that are currently linked to a payer"
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136 | S DIR("?")=" 3 - ALL insurance companies"
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137 | D ^DIR K DIR
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138 | I $D(DIRUT) S STOP=1 G ITYPEX
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139 | S IBCNESPC("ITYPE")=Y
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140 | ;
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141 | ITYPEX ; TYPE exit pt
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142 | Q
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143 | ISORT ; Prompt to allow users to select primary sort
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144 | ; Init vars
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145 | N DIR,X,Y,DIRUT
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146 | ;
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147 | S DIR(0)="S^1:Insurance Company Name;2:Payer Name;3:VA National Payer ID;4:Nationally Enabled Status;5:Locally Enabled Status"
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148 | S DIR("A")="Select the primary sort field"
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149 | S DIR("B")=1
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150 | S DIR("?")=" Select the data field by which this report should be primarily sorted."
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151 | D ^DIR K DIR
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152 | I $D(DIRUT) S STOP=1 G ISORTX
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153 | S IBCNESPC("ISORT")=Y
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154 | ;
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155 | ISORTX ; SORT exit pt
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156 | Q
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157 | IMAT ; Prompt to allow users to select partial Ins carrier to include
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158 | N DIR,X,Y,DIRUT
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159 | ;
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160 | W !
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161 | S DIR(0)="FO"
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162 | S DIR("A")="Enter an insurance company search keyword (RETURN for ALL)"
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163 | S DIR("B")=""
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164 | S DIR("?",1)=" Enter a value to match insurance company names with."
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165 | S DIR("?",2)=" Simply hit RETURN to select ALL or enter a keyword"
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166 | S DIR("?",3)=" (ex. 'CIGNA' would return CIGNA, CIGNA HICN, NATIONAL CIGNA,"
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167 | S DIR("?")=" REGION 1 CIGNA and any others with the term 'CIGNA' in it)"
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168 | D ^DIR K DIR
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169 | I $D(DUOUT)!$D(DTOUT) S Y="" S STOP=1 G IMATX
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170 | S IBCNESPC("IMAT")=Y
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171 | ;
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172 | IMATX Q
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