IBCNSUX1 ;ALB/CMS - SPLIT COMBINATION PLANS CONT. ; 04-NOV-98 ;;2.0;INTEGRATED BILLING;**103,133**;21-MAR-94 ;;Per VHA Directive 10-93-142, this routine should not be modified. Q ; BEG ; -- Start to process policy separation from IBCNSUX ; Input: IBINS=Selected Medicare Company ; IBPLAN=Selected Combination Plan ; IBWNR=MED WNR INS IEN^"MEDICARE (WNR)" ; ^PART A IEN^"PART A" ; ^PART B IEN^"PART A" ; N DFN,DO,DD,DA,DR,DIC,DIE,DIK,DIR,DIRUT,X,Y N IBCDFN,IBERR,IB0,IBST,IBSUB1,IBPLANAM K ^TMP($J,"IBCNSUX"),^TMP($J,"IBCNSUX1") S IBST=$$NOW^XLFDT,IBPLANAM=$P($G(^IBA(355.3,IBPLAN,0)),U,3) S IBSUB1=$$SUBS^IBCNSJ(IBINS,IBPLAN,0,"^TMP($J,""IBCNSUX1"")") S DFN=0 F S DFN=$O(^TMP($J,"IBCNSUX1",DFN)) Q:'DFN D .S IBCDFN=0 F S IBCDFN=$O(^TMP($J,"IBCNSUX1",DFN,IBCDFN)) Q:'IBCDFN D ..S IB0=$G(^DPT(DFN,.312,IBCDFN,0)) ..I $P(IB0,U,18)'=+IBPLAN Q ..; ..; -- check for duplicate ..D DUP ..; ..; -- if the policy to be split has no COB, and both an A and B ..; -- policy need to be created, set it to Primary ..I '$P(IB0,"^",20),'$D(^TMP($J,"IBCNSUX","ERR",DFN,2)),'$D(^(1)) D ...N DIE,DA,DR,X,Y ...S DIE="^DPT("_DFN_",.312,",DA=+IBCDFN,DA(1)=DFN,DR=".2////1" D ^DIE ..; ..; -- create Medicare (WNR) policies if none exists ..I '$D(^TMP($J,"IBCNSUX","ERR",DFN,2)) D ADDB ..I '$D(^TMP($J,"IBCNSUX","ERR",DFN,1)) D SETA ; ; -- delete combination plan if no subscribers left. I '$$SUBS^IBCNSJ(IBINS,IBPLAN) D DEL^IBCNSJ(IBPLAN) ; D WRT ; BEGQ K ^TMP($J,"IBCNSUX"),^TMP($J,"IBCNSUX1") Q ; ; ADDB ; -- Create a New MEDICARE PART B patient policy N DA,DIC,DIE,DR,IBBDFN,IBC,IBX,X,Y,IBCDA,IBNDA,IBN K DD,D0 ; S DIC("DR")=".01////"_+IBWNR_";1.09////1;1.05///NOW;1.06////"_DUZ_";.18////"_$P(IBWNR,U,5) ; ; -- If the policy to be split has no COB, and a valid Part A policy ; -- already exists, set the COB to Primary I '$P(IB0,"^",20),$D(^TMP($J,"IBCNSUX","ERR",DFN,1)) S DIC("DR")=DIC("DR")_";.2////1" ; S DA(1)=DFN,DIC="^DPT("_DFN_",.312,",DIC(0)="L",X=+IBWNR,DLAYGO=2.312 D FILE^DICN S IBBDFN=+Y K DIC I IBBDFN<1 S ^TMP($J,"IBCNSUX","ERR",DFN,3)="Could not create a Part B policy." G ADDBQ ; ; -- Get settings of combination policy S IBCDA=IBCDFN_","_DFN_"," D GETS^DIQ(2.312,IBCDA,"*","IN","IBC") I $D(IBC("IBERR")) S ^TMP($J,"IBCNSUX","ERR",DFN,3)="Could not set Part B policy data." G ADDBQ ; ; -- Set Medicare Part B policy data - copy combination policy data to new new Part B policy S IBNDA=+IBBDFN_","_DFN_"," S IBX=0 F S IBX=$O(IBC(2.312,IBCDA,IBX)) Q:IBX="" D . ; . ; -- Don't set system edited or triggered fields . I ",.01,1.01,1.02,1.1,1.05,1.06,.18,"[(","_IBX_",") Q . ; . S IBN(2.312,IBNDA,IBX)=IBC(2.312,IBCDA,IBX,"I") I $O(IBN(0)) D FILE^DIE("","IBN") ADDBQ Q ; SETA ; -- Change policy to point to Part A N DIE,DA,DR,X,Y S DIE="^DPT("_DFN_",.312,",DA=+IBCDFN,DA(1)=DFN S DR=".01////"_+IBWNR_";.18////"_$P(IBWNR,U,3) ; ; - if this policy still has no COB, set it to primary I '$P($G(^DPT(DFN,.312,IBCDFN,0)),"^",20) S DR=DR_";.2////1" D ^DIE Q ; DUP ; -- Check for duplicate N IBX,IB0,X,Y S IBX=0 F S IBX=$O(^DPT(DFN,.312,"B",+IBWNR,IBX)) Q:'IBX D .S IB0=$G(^DPT(DFN,.312,IBX,0)) .I $P(IB0,U,18)=$P(IBWNR,U,3) S ^TMP($J,"IBCNSUX","ERR",DFN,1)="Medicare (WNR) Part A policy already exists." Q .I $P(IB0,U,18)=$P(IBWNR,U,5) S ^TMP($J,"IBCNSUX","ERR",DFN,2)="Medicare (WNR) Part B policy already exists." Q Q ; WRT ; -- write report N IBX,VA,VADM,VAERR,X,Y W @IOF,!,"Separate Medicare Combination policies Part A and Part B" W !!,"Process started ",$$FMTE^XLFDT(IBST)," ended ",$$FMTE^XLFDT($$NOW^XLFDT) W !,?10,"Run by: ",$P($G(^VA(200,+$G(DUZ),0)),U,1) W !!,?5,"Combination Company: ",$P($G(^DIC(36,IBINS,0)),U,1) W !?3,"Combination Plan Name: ",IBPLANAM W:'$D(^IBA(355.3,IBPLAN,0)) " (This plan was deleted)" W ! F IBX=1:1:79 W "=" ; I '$O(^TMP($J,"IBCNSUX","ERR",0)) W !!,"SUCCESSFULLY COMPLETED, COMBINATION PLAN DELETED." G WRTQ ; W !,"Exception Report:" S DFN=0 F S DFN=$O(^TMP($J,"IBCNSUX","ERR",DFN)) Q:'DFN D .K VADM D DEM^VADPT .W !!,VADM(1),?32,"SSN: ",$P(VADM(2),U,2),?50,"DOB: ",$P(VADM(3),U,2) .S IBX=0 F S IBX=$O(^TMP($J,"IBCNSUX","ERR",DFN,IBX)) Q:'IBX D ..W !,?5,^TMP($J,"IBCNSUX","ERR",DFN,IBX) WRTQ Q ;IBCNSUX1