source: FOIAVistA/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBRBUL.m

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

initial load of FOIAVistA 6/30/08 version

File size: 5.9 KB
Line 
1IBRBUL ;ALB/CJM-MEANS TEST HOLD CHARGE BULLETIN ;02-MAR-92
2 ;;2.0;INTEGRATED BILLING;**70,95,121,153,195,347**;21-MAR-94;Build 24
3 ;;Per VHA Directive 2004-038, this routine should not be modified.
4 ; This bulletin is sent even if the local site has chosen not to hold
5 ; Means Test charges. In that case, IBHOLDP should be set = 0.
6 ; requires: IBDD() = internal node in patient file of valid ins.
7 ; DUZ
8 ; X = 0 node of IB BILLING ACTION
9 ; IBHOLDP = 1 if charge on hold, = 0 otherwise
10 ; IBSEQNO = 1 if the charges are new, 3 if updated
11BULL N XMSUB,XMY,XMDUZ,XMTEXT,IBX,IBDUZ,IBNAME,IBPID,IBBID,IBAGE,DFN
12 S IBX=X,IBDUZ=DUZ
13 K ^TMP($J,"IBRBUL")
14 D PAT,HDR,PATLINE,CHRG,INS,BUF,MAIL
15 K ^TMP($J,"IBRBUL")
16 Q
17MAIL ; Transmit mail
18 N IBGRP S XMDUZ="INTEGRATED BILLING PACKAGE",XMTEXT="^TMP($J,""IBRBUL"","
19 K XMY
20 S IBGRP=$P($G(^XMB(3.8,+$P($G(^IBE(350.9,1,0)),U,11),0)),U)
21 I IBGRP]"" S XMY("G."_IBGRP_"@"_^XMB("NETNAME"))=""
22 D ^XMD
23 Q
24 ;Add a line to the text array
25ADDLN(IBTXT) N IBC
26 S IBC=$O(^TMP($J,"IBRBUL",""),-1)+1
27 S ^TMP($J,"IBRBUL",IBC)=$G(IBTXT," ")
28 Q
29 ;
30MAILTST ; for testing
31 ;N IBC
32 ;W !,XMSUB
33 ;F IBC=1:1 Q:'$D(^TMP($J,"IBRBUL",IBC)) W !,^(IBC)
34 Q
35HDR ; formated for held charges
36 N IBW,IBU,IBV,SL S IBW=$S('IBHOLDP:"NOT ON HOLD",1:"ON HOLD"),IBU=$S(IBSEQNO=1:"NEW ",IBSEQNO=3:"UPDATED ",1:""),IBV=$S(+$O(IBDD(0)):"active",1:"may have")
37 ; if the parent event should have the soft-link that is needed to find
38 ; the division
39 S SL=$P(X,"^",16) S:SL SL=$G(^IB(SL,0)) S:'SL SL=X S SL=$P(SL,"^",4)
40 S XMSUB=$E(IBNAME,1,8)_"("_IBBID_")"_" PATIENT CHRG W/INS"_"-"_$E($$DIV(SL),1,11)
41 D ADDLN("The following patient has "_IBU_"charges "_IBW_" and "_IBV_" insurance.")
42 D ADDLN("You need to immediately process the charges to the insurance company.")
43 I +$$BUFFER^IBCNBU1(+$P(X,"^",2)) D
44 . D ADDLN()
45 . D ADDLN("This patient has entries in the Insurance Buffer that should be processed")
46 . D ADDLN("before the charges.")
47 Q
48PAT ; gets patient demographic data
49 N VAERR,VADM,X,VA
50 S DFN=+$P(IBX,"^",2) D DEM^VADPT I VAERR K VADM
51 S IBNAME=$$PR($G(VADM(1)),26),IBAGE=$$PR($G(VADM(4)),3),IBPID=$G(VA("PID")),IBBID=$G(VA("BID"))
52 Q
53PATLINE ; sets up lines with patient data
54 D ADDLN(),ADDLN("Name: "_IBNAME_" Age : "_IBAGE_" Pt. ID: "_IBPID)
55 Q
56CHRG ; gets charge data and sets up charge lines
57 N TP,FR,TO,IBND1,IBRXN,IBRX,IBRDT,IBRF,IENS
58 S IBND1=$G(^IB(+$G(IBN),1)),(IBRX,IBRXN,IBRF,IBRDT)=0
59 S FR=$$DAT1^IBOUTL($S($P(IBX,"^",14)'="":($P(IBX,"^",14)),1:$P(IBND1,"^",2)))
60 S TO=$$DAT1^IBOUTL($S($P(IBX,"^",15)'="":($P(IBX,"^",15)),1:$P(IBND1,"^",2)))
61 I $P(IBX,"^",4)["52:" S IBRXN=$P($P(IBX,"^",4),":",2),IBRX=$P($P(IBX,"^",8),"-"),IBRF=$P($P(IBX,"^",4),":",3)
62 I $P(IBX,"^",4)["52:" D
63 .I IBRF>0 S IENS=+IBRF,IBRDT=$$SUBFILE^IBRXUTL(+IBRXN,IENS,52,.01)
64 .E S IENS=+IBRXN,IBRDT=$$FILE^IBRXUTL(IENS,22)
65 S TP=$P(IBX,"^",3) S:TP TP=$P($G(^IBE(350.1,TP,0)),"^",3) S:TP TP=$P($$CATN^PRCAFN(TP),"^",2)
66 D ADDLN("Type: "_$$PR(TP,28)_" Amount : $"_+$P(IBX,"^",7))
67 D ADDLN("From: "_$$PR(FR,28)_" To : "_TO)
68 I IBRXN D ADDLN("Rx #: "_$$PR(IBRX_$S(IBRF'="":" ("_IBRF_")",1:""),28)_" Fill Dt: "_$$DAT1^IBOUTL(IBRDT)_" Rls Dt: "_TO)
69 Q
70INS ; gets insurance data and sets up insurance lines
71 N I,CO,P,G,GNB,W,E,Y,C,COV,COVD,COVFN,LEDT,LIM,PLN,X1,X2,Z0,IBCNT,P1,P2,P3,P4
72 ;S IBDTIN=$P(IBX,"^",14)
73 D ADDLN(),ADDLN("INSURANCE INFORMATION:")
74 S I="" F S I=$O(IBDD(I)) Q:'I D
75 .S LIM=0
76 .S CO=$P(IBDD(I),"^",1),CO=$P(^DIC(36,CO,0),"^",1),CO=$$PR(CO,25)
77 .S P=$$PR($P(IBDD(I),"^",2),21)
78 .S P1=2.312,P2=6,P3=$P($G(IBDD(I)),"^",6) S P4=$$EXPAND^IBTRE(P1,P2,P3) S W=$$PR(P4,25)
79 .S Y=$P(IBDD(I),"^",4) D:Y DD^%DT S E=Y
80 .S G=$$PR($P(IBDD(I),"^",15),25)
81 .S GNB=$P(IBDD(I),"^",3)
82 .S PLN=$P(IBDD(I),"^",18)
83 .D ADDLN(),ADDLN("Company: "_CO_" Policy#: "_P)
84 .D ADDLN("Whose : "_W_" Expires: "_E)
85 .D ADDLN("Group : "_G_" Group# : "_GNB)
86 .Q:'PLN
87 .D ADDLN(" Plan Coverage Effective Date Covered? Limit Comments")
88 .D ADDLN(" ------------- -------------- -------- --------------")
89 .F S LIM=$O(^IBE(355.31,LIM)) Q:'LIM S COV=$P($G(^(LIM,0)),U),IBCNT=0,LEDT="" F S LEDT=$O(^IBA(355.32,"APCD",PLN,LIM,LEDT)) Q:$S(LEDT="":IBCNT,1:0) D Q:LEDT=""
90 ..S COVFN=+$O(^IBA(355.32,"APCD",PLN,LIM,+LEDT,"")),COVD=$G(^IBA(355.32,+COVFN,0))
91 ..I COVD="" D ADDLN(" "_$$PR(COV,32)_"BY DEFAULT") Q
92 ..S IBCNT=IBCNT+1
93 ..S X1=" "_$S(IBCNT=1:COV,1:"") ;Don't duplicate category
94 ..S X2=$$PR(X1,18)_$$PR($$DAT1^IBOUTL($P(LEDT,"-",2)),16)_$$PR($S($P(COVD,U,4):$S($P(COVD,U,4)<2:"YES",$P(COVD,U,4)=2:"CONDITIONAL",1:"UNKNOWN"),1:"NO"),14)
95 ..I '$O(^IBA(355.32,COVFN,2,0)) D ADDLN(X2) Q
96 ..S Z0=0 F S Z0=$O(^IBA(355.32,COVFN,2,Z0)) Q:'Z0 D ADDLN($S(Z0=1:X2_$G(^IBA(355.32,COVFN,2,Z0,0)),1:$$PR("",48)_$G(^IBA(355.32,COVFN,2,Z0,0))))
97 Q
98PR(STR,LEN) ; pad right
99 N B S STR=$E(STR,1,LEN),$P(B," ",LEN-$L(STR))=" "
100 Q STR_$G(B)
101DIV(SL) ; returns the division with the softlink as input
102 N IBDIV,IBWARD,IBFILE,IBIEN
103 S:SL[";" SL=$P(SL,";",1)
104 S IBFILE=$P(SL,":",1),IBIEN=$P(SL,":",2)
105 S IBDIV=""
106 I IBFILE=409.68,IBIEN S IBDIV=$$SCE^IBSDU(IBIEN,11)
107 I IBFILE=44,IBIEN S IBDIV=$P($G(^SC(IBIEN,0)),"^",15)
108 I IBFILE=405,IBIEN S IBWARD=$P($G(^DGPM(IBIEN,0)),"^",6) I IBWARD S IBDIV=$P($G(^DIC(42,IBWARD,0)),"^",11)
109 I IBDIV S IBDIV=$P($G(^DG(40.8,IBDIV,0)),"^",1)
110 I IBDIV="" S IBDIV="DIV UNKNWN"
111 Q IBDIV
112 ;
113BUF ; gets insurance buffer entries and sets up lines to add to bulletin
114 N DFN,IBBDA,IBB40,IBB60,IBX1,IBX2 S DFN=$P(IBX,U,2) Q:'DFN
115 I '$$BUFFER^IBCNBU1(DFN) Q
116 ;
117 D ADDLN()
118 D ADDLN("INSURANCE BUFFER:")
119 S IBBDA=0 F S IBBDA=$O(^IBA(355.33,"C",DFN,IBBDA)) Q:'IBBDA D
120 . S IBB40=$G(^IBA(355.33,IBBDA,40)),IBB60=$G(^IBA(355.33,IBBDA,60))
121 . ;
122 . D ADDLN()
123 . S IBX1=$P($G(^IBA(355.33,IBBDA,20)),U,1),IBX2=$P(IBB60,U,4)
124 . D ADDLN("Company: "_$$PR(IBX1,25)_"Policy#: "_$$PR(IBX2,21))
125 . S IBX1=$$EXPAND^IBTRE(355.33,60.05,$P(IBB60,U,5)),IBX2=$$FMTE^XLFDT($P(IBB60,U,3))
126 . D ADDLN("Whose : "_$$PR(IBX1,25)_"Expires: "_IBX2)
127 . S IBX1=$P(IBB40,U,2),IBX2=$P(IBB40,U,3)
128 . D ADDLN("Group : "_$$PR(IBX1,25)_"Group# : "_IBX2)
129 Q
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