source: WorldVistAEHR/trunk/r/ACCOUNTS_RECEIVABLE-PRCA-PRY-RC/RCDPEV.m@ 1261

Last change on this file since 1261 was 613, checked in by George Lilly, 15 years ago

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1RCDPEV ;ALB/TMK - EDI LOCKBOX WORKLIST VERIFY PAYMENTS ;28-JAN-04
2 ;;4.5;Accounts Receivable;**208,138**;Mar 20, 1995
3 ;;Per VHA Directive 10-93-142, this routine should not be modified.
4 Q
5 ;
6AUTOVER(RCSCR) ; Entrypoint to auto-verify an ERA worklist
7 ; RCSCR = ien of the ERA worklist entry in file 344.49
8 N Z,Z0,Z00,RC399,RC430,RC3444,RC36112,X,X1,X2,X12,DA,DR,DIE
9 S Z=0 F S Z=$O(^RCY(344.49,Z)) Q:'Z S Z0=0 F S Z0=$O(^RCY(344.49,Z,1,Z0)) Q:'Z0 I $P($G(^(Z0,0)),U,7) S Z00=$G(^(0)) D
10 . I $$VER(RCSCR,+$P(Z00,U,7),+$P(Z00,U,9)) S DA(1)=RCSCR,DA=Z0,DIE="^RCY(344.49,"_DA(1)_",1,",DR=".13////1" D ^DIE
11 ;
12 Q
13 ;
14VER(RCSCR,RCBILL,RCREF,F1) ; Run verif for WL entry RCSCR in file 344.49
15 ; RCBILL = ien of claim in file 430
16 ; RCREF = the entry referenced in subfile file 344.41
17 ; F1 = flag if set = 1 will return all data, regardless of if it
18 ; matches or not. If flag is set to 1 and data doesn't match,
19 ; an asterisk (*) will preceed the actual data value in the
20 ; corresponding piece
21 ; Function returns the following data:
22 ; '^' piece 1: 1 if verfied OK 0 if not
23 ; '^' piece 2: patient name from VistA if mismatch
24 ; '^' piece 3: patient name from EEOB if mismatch
25 ; '^' piece 4: amt billed from VistA if mismatch
26 ; '^' piece 5: amt billed from EEOB if mismatch
27 ; '^' piece 6: date of service 'from' from VistA if mismatch
28 ; '^' piece 7: date of service 'from' from EEOB if mismatch
29 ; '^' piece 8: date of service 'to' from VistA if mismatch
30 ; '^' piece 9: date of service 'to' from EEOB if mismatch
31 ; '^' piece 10: patient SSN from VistA
32 ;
33 N RESULT,SETF1,RC430,RC399,RC3444,RC36112,X,X1,X2,X12,NM,NM1,DTOK,SSN,RC43013
34 S RESULT=1,SETF1=$S($G(F1):"*",1:"")
35 S RC430=$G(^PRCA(430,RCBILL,0)),RC43013=$G(^(13))
36 S RC399=$G(^DGCR(399,RCBILL,0))
37 S RC3444=$G(^RCY(344.4,RCSCR,1,RCREF,0))
38 S RC36112=$G(^IBM(361.1,+$P(RC3444,U,2),2))
39 ;
40 S NM=$P($G(^DPT(+$P(RC399,U,2),0)),U),X=$E($P(NM,","),1,5) ; Name from VistA
41 S SSN=$P($G(^DPT(+$P(RC399,U,2),0)),U,9)
42 S NM1=$P(RC3444,U,15),X1=$E($P(NM1,","),1,5) ; from EEOB
43 I $G(F1),X1=X S $P(RESULT,U,2)=NM,$P(RESULT,U,3)=NM1
44 I X1'=X S $P(RESULT,U)=0,$P(RESULT,U,2)=SETF1_NM,$P(RESULT,U,3)=SETF1_NM1
45 ;
46 S X=$P(RC430,U,3)+$P(RC43013,U)+$P(RC43013,U,2) ; Amount billed from VistA (including MRA totals)
47 S X1=$P(RC36112,U,4) ; from EEOB
48 I $G(F1),+X=+X1 S $P(RESULT,U,4)=X,$P(RESULT,U,5)=X1
49 I +X'=+X1 S $P(RESULT,U)=0,$P(RESULT,U,4)=SETF1_X,$P(RESULT,U,5)=SETF1_X1
50 ;
51 S X=$P($G(^DGCR(399,+RCBILL,"U")),U) ; Date of service from VistA
52 S X2=$P($G(^DGCR(399,+RCBILL,"U")),U,2)
53 S X1=$P($G(^IBM(361.1,+$P(RC3444,U,2),1)),U,10) ; from EEOB
54 S X12=$P($G(^IBM(361.1,+$P(RC3444,U,2),1)),U,11)
55 ; if no date of service on EEOB, skip the check
56 ; Date of svc on EEOB must fall into date range for svc dates in VistA
57 S DTOK=0
58 I X1 D
59 . I X1=X S DTOK=1
60 . I 'DTOK,X1>X S:X1'>X2 DTOK=1
61 . I 'DTOK,X1<X S:X12'<X DTOK=1
62 . I 'DTOK S $P(RESULT,U)=0,$P(RESULT,U,6)=SETF1_X,$P(RESULT,U,7)=SETF1_X1,$P(RESULT,U,8)=SETF1_X2,$P(RESULT,U,9)=SETF1_X12 Q
63 I DTOK,$G(F1) S $P(RESULT,U,6)=X,$P(RESULT,U,7)=X1,$P(RESULT,U,8)=X2,$P(RESULT,U,9)=X12
64 S $P(RESULT,U,10)=SSN
65 ;
66VERQ Q RESULT
67 ;
68MVER(RCERA) ; Manually mark an EEOB as verified
69 N A,CT,DA,DIE,DR,DTOUT,DUOUT,Z,Z0,Z1,RCT,RCY,RCY0,RCZ0,RCLINE,RCYNUM,DIR,X,Y,RESULT,SPLIT,Q,Q0,DT1,DT2
70 S RCT=0,CT=1
71 F Z1=1:1 S Z=$G(^TMP("RCDPE-EOB_WLDX",$J,Z1)) Q:Z="" Q:CT'<100 S Z0=$G(^RCY(344.49,RCERA,1,+$P(Z,U,2),0)) I Z0'="",'$P(Z0,U,13) S RCT=RCT+1 D Q:CT'<100
72 . S CT=CT+1 I CT<100 D Q
73 .. S:RCT=1 RCT(1)=Z1
74 .. S DIR("?",CT)=" "_$G(^TMP("RCDPE-EOB_WL",$J,+Z,0)),CT=CT+1,DIR("?",CT)=$J("",10)_$P(Z0,U,2)
75 .. S Q=+Z0
76 .. I $O(^RCY(344.49,RCERA,1,"B",Q_".9999"),-1)'=(Q_".001")
77 .. I $O(^RCY(344.49,RCERA,1,"B",Q_".9999"),-1)'=(Q_".001") S DIR("?",CT)=DIR("?",CT)_" (LINE HAS BEEN SPLIT)"
78 . K DIR("?")
79 ;
80 I 'RCT D Q
81 . S DIR(0)="EA",DIR("A",1)="ALL EEOBS HAVE ALREADY BEEN VERIFIED IN THIS "_$S($G(^TMP("RCBATCH_SELECTED",$J)):"BATCH",1:"ERA"),DIR("A")="PRESS RETURN TO CONTINUE " W ! D ^DIR K DIR
82 ;
83 I RCT<100 S DIR("?",1)="THE FOLLOWING EEOB LINE(S) "_$S($G(^TMP("RCBATCH_SELECTED",$J)):"IN THIS BATCH ",1:"")_"ARE NOT VERIFIED"
84 I RCT'<100 S DIR("?",1)="THERE ARE TOO MANY EEOB ENTRIES NOT VERIFIED TO LIST",DIR("?",2)="PRINT THE UNVERIFIED DISCREPANCY REPORT TO GET A LIST OF POSSIBLE CHOICES"
85 S DIR("?")=" "
86 S DIR(0)="NA^1:"_($O(^TMP("RCDPE-EOB_WLDX",$J,""),-1)\1),DIR("A")="SELECT AN EEOB LINE TO MARK AS VERIFIED: "
87 I RCT=1 S DIR("B")=RCT(1)
88 W ! D ^DIR K DIR
89 I $D(DUOUT)!$D(DTOUT)!(Y="") Q
90 I '$D(^TMP("RCDPE-EOB_WLDX",$J,Y)) W !,"THIS LINE DOES NOT EXIST FOR THIS ERA" W ! Q
91 S RCY=+$P($G(^TMP("RCDPE-EOB_WLDX",$J,Y)),U,2),RCLINE=+^(Y),RCYNUM=+Y
92 S RCY0=$G(^RCY(344.49,RCERA,1,RCY,0))
93 I $P(RCY0,U,13) D Q
94 . S DIR(0)="EA",DIR("A",1)="THIS LINE IS ALREADY VERIFIED",DIR("A")="PRESS RETURN TO CONTINUE " W ! D ^DIR K DIR
95 S RCZ0=$G(^RCY(344.4,RCERA,1,+$P(RCY0,U,9),0))
96 I '$P(RCZ0,U,2) D
97 . W !!,"THIS LINE DOES NOT REFERENCE A VALID BILL"
98 E D
99 . S RESULT=$$VER(RCERA,+$G(^IBM(361.1,+$P(RCZ0,U,2),0)),+$P(RCY0,U,9),1)
100 . F Z=2:1:9 I $E($P(RESULT,U,Z))="*" S Q=$P(RESULT,U,Z),$E(Q,1)="",$P(RESULT,U,Z)=Q
101 . S SPLIT=$O(^RCY(344.49,RCERA,1,"B",+RCY0_".9999"),-1)'=(+RCY0_".0001")
102 . S Z=$S(SPLIT:"CLAIM #'s: ",1:" CLAIM #: ")
103 . S Z=Z_$P(RCY0,U,2)_$S('SPLIT:"",1:" (ORIGINAL ERA DATA)")
104 . I SPLIT D
105 .. S Q=+RCY0 F S Q=$O(^RCY(344.49,RCERA,1,"B",Q)) Q:(Q\1)'=+RCY0 S Q0=+$O(^RCY(344.49,RCERA,1,"B",Q,0)),Q0=$G(^RCY(344.49,RCERA,1,Q0,0)) I $P(Q0,U,2)'="" S Z=Z_" "_$P(Q0,U,2)
106 . W !!!,Z
107 . W !,?13,"PATIENT NAME"_$J("",18)_" SUBMITTED AMT SVC DATE(S)"
108 . W !,?13,"------------------------------ --------------- -----------------"
109 . S DT1=$E($S($P(RESULT,U,7):$$FMTE^XLFDT($P(RESULT,U,7),"2D"),1:"NOTFOUND")_$J("",8),1,8)
110 . S DT2=$E($S($P(RESULT,U,9):"-"_$$FMTE^XLFDT($P(RESULT,U,9),"2D"),1:"-NOTFOUND")_$J("",9),1,9)
111 . W !," ERA DATA: ",$E($P(RESULT,U,3)_$J("",30),1,30)," ",$E($J($P(RESULT,U,5),"",2)_$J("",15),1,15)_" "_DT1_DT2
112 . W !,?15,$P($G(^RCY(344,RCERA,0)),U,6)
113 . S DT1=$E($S($P(RESULT,U,6):$$FMTE^XLFDT($P(RESULT,U,6),"2D"),1:"NOTFOUND")_$J("",8),1,8)
114 . S DT2=$E($S($P(RESULT,U,8):"-"_$$FMTE^XLFDT($P(RESULT,U,8),"2D"),1:"-NOTFOUND")_$J("",9),1,9)
115 . W !," BILL DATA: "_$E($P(RESULT,U,2)_$J("",30),1,30)_" "_$E($J($P(RESULT,U,4),"",2)_$J("",15),1,15)_" "_DT1_DT2
116 . W !,?15,$P($G(^DIC(36,+$P(RCZ0,U,4),0)),U),!
117 S DIR(0)="YA",DIR("A")="DO YOU WANT TO MARK THIS LINE VERIFIED?: ",DIR("B")="NO" W ! D ^DIR K DIR
118 I Y'=1 Q
119 S DA(1)=RCERA,DA=+RCY,DIE="^RCY(344.49,"_DA(1)_",1,",DR=".13////1" D ^DIE
120 S A=$$TOPLINE^RCDPEWL1($G(^RCY(344.49,RCERA,1,+RCY,0)),RCYNUM)
121 S ^TMP("RCDPE-EOB_WL",$J,RCLINE,0)=A
122 Q
123 ;
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