source: FOIAVistA/trunk/r/OUTPATIENT_PHARMACY-PSO-APSP-HUIP/PSOCIDC2.m@ 1397

Last change on this file since 1397 was 628, checked in by George Lilly, 15 years ago

initial load of FOIAVistA 6/30/08 version

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1PSOCIDC2 ;BIR/LE-continuation of Copay Correction of erroneous billed copays ;11/8/05 12:50pm
2 ;;7.0;OUTPATIENT PHARMACY;**226**;DEC 1997
3 ;External reference to ^XUSEC supported by DBIA 10076
4 ;External reference to IBARX supported by DBIA 125
5 ;External reference to $$PROD^XUPROD(1) supported by DBIA 4440
6 ;
7TOTAL ;
8 N COUNT,COUNTED,UCOUNT,UCOUNTED,CCOUNT,CCOUNTED
9 I '$D(PSOVETS) S PSOVETS=0
10 N I,J
11 F I=1:1:3 S (PSOCNT("YR2004",I),PSOCNT("YR2005",I),PSOCNT("YR2006",I))=0
12 S PSODFN=0 F S PSODFN=$O(^XTMP(NAMSP,"TOT REL",PSODFN)) Q:'PSODFN D
13 .S COUNTED=0
14 .F J="YR2004","YR2005","YR2006" F I=1:1:3 S COUNT=$G(^XTMP(NAMSP,"TOT REL",PSODFN,J,I)) I COUNT>0 S:'$G(COUNTED) COUNTED=1,PSOVETS=PSOVETS+1 S PSOCNT(J,I)=PSOCNT(J,I)+COUNT
15 F I=1:1:3 S PSOCNT=PSOCNT+$G(PSOCNT("YR2004",I))+$G(PSOCNT("YR2005",I))+$G(PSOCNT("YR2006",I))
16 ;
17 S (I,J)=-""
18 I '$D(PSOCVETS) S PSOCVETS=0
19 F I=1:1:3 S (PSOCCNT("YR2004",I),PSOCCNT("YR2005",I),PSOCCNT("YR2006",I))=0
20 S PSODFN=0 F S PSODFN=$O(^XTMP(NAMSP,"TOT CAN",PSODFN)) Q:'PSODFN D
21 .S CCOUNTED=0
22 .F J="YR2004","YR2005","YR2006" F I=1:1:3 S CCOUNT=$G(^XTMP(NAMSP,"TOT CAN",PSODFN,J,I)) I CCOUNT>0 S:'$G(CCOUNTED) CCOUNTED=1,PSOCVETS=PSOCVETS+1 S PSOCCNT(J,I)=PSOCCNT(J,I)+CCOUNT
23 F I=1:1:3 S PSOCCNT=PSOCCNT+$G(PSOCCNT("YR2004",I))+$G(PSOCCNT("YR2005",I))+$G(PSOCCNT("YR2006",I))
24 ;
25 S (I,J)=""
26 I '$D(PSOUVETS) S PSOUVETS=0
27 F I=1:1:3 S (PSOUCNT("YR2004",I),PSOUCNT("YR2005",I),PSOUCNT("YR2006",I))=0
28 S PSOUDFN=0 F S PSOUDFN=$O(^XTMP(NAMSP,"TOT UNREL",PSOUDFN)) Q:'PSOUDFN D
29 .S UCOUNTED=0
30 .F J="YR2004","YR2005","YR2006" F I=1:1:3 S UCOUNT=$G(^XTMP(NAMSP,"TOT UNREL",PSOUDFN,J,I)) I UCOUNT>0 S:'$G(UCOUNTED) UCOUNTED=1,PSOUVETS=PSOUVETS+1 S PSOUCNT(J,I)=PSOUCNT(J,I)+UCOUNT
31 F I=1:1:3 S PSOUCNT=PSOUCNT+$G(PSOUCNT("YR2004",I))+$G(PSOUCNT("YR2005",I))+$G(PSOUCNT("YR2006",I))
32 ;
33 Q
34 ;
35CHECK ;check for ICD and IB nodes
36 ;
37 N PSOREF,PSOIB,PSOOICD,PSOBILLD
38 S PSOREF=YY
39 S PSOOICD=$P($G(^PSRX(RXP,"ICD",1,0)),"^",2,8)
40 ; see if bill already exists
41 I PSOREF=0 D
42 . I +$P($G(^PSRX(RXP,"IB")),"^",2)>0 D CHKIB^PSOCP1
43 . S PSOREL=$P($G(^PSRX(RXP,2)),"^",13)
44 I PSOREF>0 D
45 . I +$G(^PSRX(RXP,1,PSOREF,"IB")) D CHKIB^PSOCP1
46 . S PSOREL=$P($G(^PSRX(RXP,1,YY,0)),"^",18)
47 I $G(PSOIB)=1!($G(PSOIB)=3) S PSOBILLD=1
48 ; if billed/RELEASED and no IBQ node for both sc<50 and nsc
49 I $G(PSOBILLD)&('$D(^PSRX(RXP,"IBQ"))) D
50 . I $TR(PSOOICD,"^")[1 S ^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)=$P(PSOREL,".")_"^"_PSODT_"^"_PSOSCP
51 . I $TR(PSOOICD,"^")[0 S ^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)=$P(PSOREL,".")_"^"_PSODT_"^"_PSOSCP
52 ; find unbilled ones with an ICD node and no IBQ node.
53 I '$G(PSOBILLD)&('$D(^PSRX(RXP,"IBQ"))) D
54 . Q:$TR(PSOOICD,"^")=""
55 . S ^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)=$P(PSOREL,".")_"^"_PSODT_"^"_PSOSCP
56 I YY S PSOTRF=PSOTRF+1
57 Q
58 ;
59CANCEL ;Cancel erroneous copays/set IBQ node if not there
60 ;released rx's
61 N PSOCAP,PSODIV,PSODV,PSOFILL,PSOLOG,PSONAM,PSOOUT,PSOPAR,PSOPAR7,PSOSITE
62 N PSOSITE7,PSOSQ,PSOTOT,PSOYEAR,PSOYR,SSN,SAVCPUN,SAVREF,PSOIB,PSOOIBQ,PSONIBQ,PSOOICD,PSOOIB
63 N I,IFN,PSOANSQ,PSOTYP,COM,CC,PREA,PSONW,PSOOLD,PSOREL,PSO,PSOCPUN,PSOFLD,PSOTYPE,CANCEL
64 S PSOTYPE="CAN"
65 S PSODFN=0 F CC=1:1 S PSODFN=$O(^XTMP(NAMSP,"CANCEL",PSODFN)) Q:'PSODFN D Q:STOP
66 .I CC#100=0,$D(^XTMP(NAMSP,0,"STOP")) D Q
67 .. S $P(^XTMP(NAMSP,0,"LAST"),"^",1,2)="STOP^"_$$NOW^XLFDT,STOP=1
68 .S (PSOCAP(304),PSOCAP(305),PSOCAP(306))=0 ; INITIAL ANNUAL CAP FOR 2004 & 2005
69 .F RXP=0:0 S RXP=$O(^XTMP(NAMSP,"CANCEL",PSODFN,RXP)) Q:'RXP D
70 ..S (SAVCPUN,PSOCPUN)=($P(^PSRX(RXP,0),"^",8)+29)\30
71 ..S YY="" F S YY=$O(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)) Q:YY="" D
72 ...S (SAVREF,PSOREF)=YY
73 ...; verify again that it was billed and not already cancelled
74 ...S PSOBILLD=0
75 ...I YY=0,+$P($G(^PSRX(RXP,"IB")),"^",2)>0 D CHKIB^PSOCP1 I $G(PSOIB)=1!($G(PSOIB)=3) S PSOBILLD=1
76 ...I YY>0,+$P($G(^PSRX(RXP,1,PSOREF,"IB")),"^")>0 D CHKIB^PSOCP1 I $G(PSOIB)=1!($G(PSOIB)=3) S PSOBILLD=1
77 ...Q:'PSOBILLD
78 ...S PSOREL=$P($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)),"^"),PSOFLD=$P($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)),"^",2),PSOSCP=$P($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)),"^",3)
79 ...S PSO=3 D NOW^%DTC S PSODT=%,PSODA=RXP,PSOCOMM="-BKGD CIDC COPAY CANCEL",PSOOLD="",PSONW="",PREA=""
80 ...D CHKACT
81 ...S PSOIB="",PSOIB=$S(PSOREF>0:$G(^PSRX(RXP,1,YY,"IB")),'PSOREF:$G(^PSRX(PSODA,"IB")),1:"")
82 ...S (PSOOIBQ,PSOOICD,PSOOIB)=""
83 ...S PSOOICD=$P($G(^PSRX(RXP,"ICD",1,0)),"^",2,8),PSOOIB=$G(^PSRX(RXP,"IB")),PSOOIBQ=$G(^PSRX(RXP,"IBQ"))
84 ...I PSOOIBQ=""&($TR(PSOOICD,"^")[0!($TR(PSOOICD,"^")[1)) D SETIBQ
85 ...D SITE S PSOCOMM="-BKGD CIDC COPAY CANCEL" D RXED^PSOCPA S:PSOOICD[1&($D(^PSRX(RXP,"IB"))) $P(^PSRX(RXP,"IB"),"^")=""
86 ...S PSOCPUN=SAVCPUN,PSOREF=SAVREF
87 ...D ACCUM
88 ;
89 ;ICD NODES WITHOUT IBQ NODE; set IBQ node but only set 1st piece of IB node if unreleased.
90 S PSOTYP="IBQ"
91 S PSODFN=0 F CC=1:1 S PSODFN=$O(^XTMP(NAMSP,"NOIBQ",PSODFN)) Q:'PSODFN D Q:STOP
92 .I CC#100=0,$D(^XTMP(NAMSP,0,"STOP")) D Q
93 .. S $P(^XTMP(NAMSP,0,"LAST"),"^",1,2)="STOP^"_$$NOW^XLFDT,STOP=1
94 .S (PSOCAP(304),PSOCAP(305),PSOCAP(306))=0 ; INITIAL ANNUAL CAP FOR 2004 & 2005
95 .F RXP=0:0 S RXP=$O(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP)) Q:'RXP D
96 ..S (SAVCPUN,PSOCPUN)=($P(^PSRX(RXP,0),"^",8)+29)\30
97 ..S YY="" F S YY=$O(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)) Q:YY="" D
98 ...S (SAVREF,PSOREF)=YY
99 ...D SITE
100 ...S PSOREL=$P($G(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)),"^"),PSOFLD=$P($G(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)),"^",2),PSOSCP=$P($G(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)),"^",3)
101 ...S (PSOOIBQ,PSOOICD,PSOOIB)=""
102 ...S PSOOICD=$P($G(^PSRX(RXP,"ICD",1,0)),"^",2,8),PSOOIB=$G(^PSRX(RXP,"IB")),PSOOIBQ=$G(^PSRX(RXP,"IBQ"))
103 ...I PSOOIBQ=""&($TR(PSOOICD,"^")[0!($TR(PSOOICD,"^")[1)) D SETIBQ D ;don't want to set again if already did it as part of copay cancel
104 ....S I="",IFN=0 F I=0:0 S I=$O(^PSRX(RXP,"A",I)) Q:'I S IFN=I
105 ....S COM=" BKGD CIDC UPDATE"
106 ....D NOW^%DTC S IFN=IFN+1,^PSRX(RXP,"A",0)="^52.3DA^"_IFN_"^"_IFN,^PSRX(RXP,"A",IFN,0)=%_"^I^.5^"_YY_"^"_COM
107 ....K DA
108 ....S:PSOOICD[1&($D(^PSRX(RXP,"IB"))) $P(^PSRX(RXP,"IB"),"^")=""
109 ...D:'$G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)) ACCUM
110 ...S PSOCPUN=SAVCPUN,PSOREF=SAVREF
111 Q
112 ;
113CHKACT ;check activity log for prev entry
114 N ZACT,ZPSI,ZACTI
115 S ZPSI=0 F S ZPSI=$O(^PSRX(PSODA,"COPAY",ZPSI)) Q:ZPSI="" S ZACTI="",ZACTI=$G(^PSRX(PSODA,"COPAY",ZPSI,0)) D Q:$G(ZACT)
116 . I ZACTI["BKGD CIDC COPAY CANCEL"&($P(ZACTI,"^",2)="R") S PSOOLD="",PSONW="",PREA="C",ZACT=1 Q
117 I '$G(ZACT) S PSOOLD="Copay",PSONW="No Copay",PREA="R" K PSOREF D ACTLOG^PSOCPA S PSOREF=YY,PSOOLD="",PSONW="",PREA="C"
118 Q
119 ;
120SETIBQ ; get data from IBQ node, set IBQ node, and 1st piece of IB node
121 K PSOANSQ
122 N PSONIBQ
123 F PSOTYP=1:1:7 D
124 . I PSOTYP=1 S PSOANSQ("VEH")=$P(PSOOICD,"^",PSOTYP)
125 . I PSOTYP=2 S PSOANSQ("RAD")=$P(PSOOICD,"^",PSOTYP)
126 . I PSOTYP=3 S PSOANSQ("SC")=$P(PSOOICD,"^",PSOTYP)
127 . I PSOTYP=4 S PSOANSQ("PGW")=$P(PSOOICD,"^",PSOTYP)
128 . I PSOTYP=5 S PSOANSQ("MST")=$P(PSOOICD,"^",PSOTYP)
129 . I PSOTYP=6 S PSOANSQ("HNC")=$P(PSOOICD,"^",PSOTYP)
130 . I PSOTYP=7 S PSOANSQ("CV")=$P(PSOOICD,"^",PSOTYP)
131 S ^PSRX(RXP,"IBQ")=PSOANSQ("SC")_"^"_PSOANSQ("MST")_"^"_PSOANSQ("VEH")_"^"_PSOANSQ("RAD")_"^"_PSOANSQ("PGW")_"^"_PSOANSQ("HNC")_"^"_PSOANSQ("CV")
132 Q
133 ;
134ACCUM ; ACCUMULATE TOTALS
135 S (PSOTOT,PSOYR,PSOYEAR,PSOLOG,PSONAM,PSOCHRG)=""
136 ; get finished, but unreleased totals
137 I PSOREL="" S PSOYR=$E(PSOFLD,1,3) Q:PSOYR="" D S PSOYEAR="" Q
138 .S PSOYEAR=$S(PSOYR="304":"YR2004",PSOYR="305":"YR2005",PSOYR="306":"YR2006",1:"") Q:PSOYEAR=""
139 .S PSOCHRG=7
140 .I PSOYEAR="YR2006" S PSOCHRG=8
141 .S PSOTOT=$G(^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR))
142 .S ^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR)=PSOTOT+(PSOCPUN*PSOCHRG)
143 .S ^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR,PSOCPUN)=$G(^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR,PSOCPUN))+1
144 .S PSONAM=$P($G(^DPT(PSODFN,0)),"^"),PSONAM=$P(PSONAM,",")
145 .S PSONAM=$E(PSONAM,1,6)
146 .S ^XTMP(NAMSP,"IBQ UPD",PSONAM,PSODFN,RXP,PSOREF)=PSOFLD
147 ;for released ones
148 S PSOYR=$E(PSOREL,1,3)
149 S:PSOYR'="" PSOYEAR=$S(PSOYR="304":"YR2004",PSOYR="305":"YR2005",PSOYR="306":"YR2006",1:"")
150 Q:PSOYEAR=""
151 S PSOCHRG=7
152 I PSOYEAR="YR2006" S PSOCHRG=8
153 ;
154 ;get Xtmp billing amt which would be IBAM tot + any previous refills
155 S PSOTOT=$G(^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR))
156 ;
157 ;if none yet then init to the IBAM total for the year
158 I 'PSOTOT D
159 .F PSOSQ=0:0 S PSOSQ=$O(^IBAM(354.7,PSODFN,1,PSOSQ)) Q:'PSOSQ D
160 ..S PSOLOG=$G(^IBAM(354.7,PSODFN,1,PSOSQ,0))
161 ..I $E(PSOLOG,1,3)=PSOYR S PSOTOT=PSOTOT+$P(PSOLOG,"^",2)
162 ;
163 ;update Xtmp tot nodes with current fill amounts
164 ; note: cancel copays and updated IBQ node released prescription are collected under TOT REL for the RPT^PSOCIDC3
165 ; routine. Cancelled copays are denoted with an asterisk.
166 S ^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR)=PSOTOT+(PSOCPUN*PSOCHRG)
167 S ^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR,PSOCPUN)=$G(^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR,PSOCPUN))+1
168 ;
169 ;indicate COPAY CANCEL for this fill
170 ; ;by adding to Xtmp "BILLED"
171 S PSONAM=$P($G(^DPT(PSODFN,0)),"^"),PSONAM=$P(PSONAM,",")
172 S PSONAM=$E(PSONAM,1,6)
173 S ^XTMP(NAMSP,"REL",PSONAM,PSODFN,RXP,PSOREF)=PSOREL
174 ;
175CAN I PSOTYPE="CAN"&($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY))) N PSOFILL S CANCEL="" S PSOFILL=YY D CHK^PSOCIDC3 I CANCEL D
176 . S ^XTMP(NAMSP,"TOT CAN",PSODFN,PSOYEAR)=PSOTOT+(PSOCPUN*PSOCHRG)
177 . S ^XTMP(NAMSP,"TOT CAN",PSODFN,PSOYEAR,PSOCPUN)=$G(^XTMP(NAMSP,"TOT CAN",PSODFN,PSOYEAR,PSOCPUN))+1
178 Q
179 ;
180SITE ; SET UP VARIABLES NEEDED BY BILLING
181 S PSOSITE=$S(YY=0:$P(^PSRX(RXP,2),"^",9),1:$P($G(^PSRX(RXP,1,YY,0)),"^",9))
182 Q:PSOSITE=""
183 S PSOPAR=$G(^PS(59,PSOSITE,1))
184 S PSOPAR7=$G(^PS(59,PSOSITE,"IB"))
185 S PSOSITE7=$P($G(^PS(59,PSOSITE,"IB")),"^")
186 Q
187 ;
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