| 1 | BPSNCPD1 ;BHAM ISC/LJE - Pharmacy API part 2 ;06/16/2004
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| 2 | ;;1.0;E CLAIMS MGMT ENGINE;**1,3,5**;JUN 2004;Build 45
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| 3 | ;;Per VHA Directive 2004-038, this routine should not be modified.
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| 4 | ;
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| 5 | ; External reference to $$NCPDPQTY^PSSBPSUT supported by IA4992
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| 6 | ;
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| 7 | ; Due to space considerations, these comments were moved from BPSNPCPD
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| 8 | ; to this routine.
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| 9 | ;
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| 10 | ; ------------------ Beginning of BPSNCPDP comments ------------------
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| 11 | ;Input
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| 12 | ; BRXIEN = Prescription IEN
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| 13 | ; BFILL = Fill Number
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| 14 | ; BFILLDAT = Fill Date of current prescription and fill number
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| 15 | ; BWHERE (RX Action)
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| 16 | ; ARES = Resubmit for an auto-reversed claim was released while waiting
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| 17 | ; for the payer response
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| 18 | ; AREV = Auto-Reversal
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| 19 | ; BB = Back Billing
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| 20 | ; CRLB = CMOP Release & Rebill
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| 21 | ; CRLR = CMOP Release & Reverse (successful release)
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| 22 | ; CRLX = CMOP unsuccessful release & reverse
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| 23 | ; DC = Discontinue - only reverse un-released PAYABLE DC's, release date check
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| 24 | ; should be in calling routine.
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| 25 | ; DDED = Delete in edit
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| 26 | ; DE = Delete
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| 27 | ; ED = Edit
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| 28 | ; ERES = Resubmit from ECME user screen
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| 29 | ; EREV = Reversal from ECME user screen
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| 30 | ; HLD = Put prescription on Hold
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| 31 | ; OF = Original Fill
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| 32 | ; PC = Pull CMOPs
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| 33 | ; PE = Pull early from suspense
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| 34 | ; PL = Pull local from suspense
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| 35 | ; PP = PP from Patient Prescription Processing option
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| 36 | ; RF = Refill
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| 37 | ; RL = Release Rx NDC check - Rebill if billed NDC doesn't match release NDC
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| 38 | ; RN = Renew
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| 39 | ; RRL = Original claim rejected, submit another claim, no reversal
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| 40 | ; RS = Return-to-Stock
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| 41 | ; BILLNDC = Valid NDC# with format 5-4-2
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| 42 | ; REVREAS = Reversal Reason
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| 43 | ; DURREC = String of DUR info - Three "^" pieces
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| 44 | ; Professional Service Code
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| 45 | ; Reason for Service Code
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| 46 | ; Result of Service Code
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| 47 | ; BPOVRIEN = Pointer to BPS NCPDP OVERIDE file. This parameter will
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| 48 | ; only be passed if there are overrides entered by the
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| 49 | ; user via the Resubmit with Edits (RED) option in the
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| 50 | ; user screen.
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| 51 | ; BPSCLARF = Clarification Code (0-9,99), entered by pharmacist and passed
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| 52 | ; by Outpatient Pharmacy to ECME to put into the claim
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| 53 | ;
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| 54 | ;Output (RESPONSE^MESSAGE)
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| 55 | ; RESPONSE
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| 56 | ; 0 Submitted through ECME
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| 57 | ; 1 No submission through ECME
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| 58 | ; 2 IB not billable
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| 59 | ; 3 Claim was closed, not submitted (RTS/Deletes)
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| 60 | ; 4 Unable to queue claim
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| 61 | ; 5 Incorrect information supplied to ECME
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| 62 | ; 10 Reversal but no resubmit
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| 63 | ; MESSAGE = Message associated with the response (error/submitted)
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| 64 | ; ----------------- End of BPSNCPDP comments ----------------------
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| 65 | ;
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| 66 | ; Procedure STARRAY - Retrieve information for API call to IB and store in BPSARRY
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| 67 | ; Incoming Parameters
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| 68 | ; BRXIEN - Prescription IEN
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| 69 | ; BFILL - Fill Number
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| 70 | ; BWHERE - RX action
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| 71 | ; BPSARRY - Array that is built (passed by reference)
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| 72 | ; BPSITE - OUTPATIENT SITE file #59 ien
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| 73 | STARRAY(BRXIEN,BFILL,BWHERE,BPSARRY,BPSITE) ;
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| 74 | N DRUGIEN,BPARR,BPSARR,QTY
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| 75 | D RXAPI^BPSUTIL1(BRXIEN,"6;7;8;31","BPARR","I")
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| 76 | I BFILL>0 D RXSUBF^BPSUTIL1(BRXIEN,52,52.1,BFILL,"1;1.1;17","BPARR","I")
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| 77 | S BPSARRY("DFN")=DFN
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| 78 | S BPSARRY("DAYS SUPPLY")=$S(BFILL=0:$G(BPARR(52,BRXIEN,8,"I")),1:$G(BPARR(52.1,BFILL,1.1,"I")))
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| 79 | S BPSARRY("IEN")=BRXIEN
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| 80 | S BPSARRY("FILL NUMBER")=BFILL
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| 81 | S BPSARRY("NDC")=BILLNDC
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| 82 | S (BPSARRY("DRUG"),DRUGIEN)=BPARR(52,BRXIEN,6,"I")
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| 83 | S BPSARRY("DEA")=$$DRUGDIE^BPSUTIL1(DRUGIEN,3)
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| 84 | S BPSARRY("COST")=$$DRUGDIE^BPSUTIL1(DRUGIEN,16)
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| 85 | S QTY=$S(BFILL=0:$G(BPARR(52,BRXIEN,7,"I")),1:$G(BPARR(52.1,BFILL,1,"I")))
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| 86 | S QTY=$$NCPDPQTY^PSSBPSUT(DRUGIEN,QTY)
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| 87 | S BPSARRY("QTY")=$P(QTY,U,1)
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| 88 | S BPSARRY("UNITS")=$P(QTY,U,2)
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| 89 | S BPSARRY("FILL DATE")=BFILLDAT
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| 90 | S BPSARRY("RELEASE DATE")=$P($S(BFILL=0:$G(BPARR(52,BRXIEN,31,"I")),1:$G(BPARR(52.1,BFILL,17,"I"))),".")
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| 91 | S BPSARRY("SC/EI OVR")=0
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| 92 | ;determine BPS PHARMACY
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| 93 | I $G(BPSITE)>0 S BPSARRY("EPHARM")=$$GETPHARM^BPSUTIL(BPSITE)
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| 94 | ;
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| 95 | ; Add user so that it is stored correctly in the IB Event Log
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| 96 | ; Note: Auto-Reversals (AREV) and CMOP/OPAI (CR*/PC/RL) use postmaster (.5)
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| 97 | I ",AREV,CRLB,CRLX,CRLR,PC,RL,"[(","_BWHERE_",") S BPSARRY("USER")=.5
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| 98 | E S BPSARRY("USER")=DUZ
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| 99 | Q
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| 100 | ;
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| 101 | ; Called by BPSNCPDP to display progress of claim
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| 102 | STATUS(BRXIEN,BFILL,REBILL,REVONLY,BPSTART,BWHERE) ;
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| 103 | ; Initialization
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| 104 | N TRANSIEN,CERTUSER,BPSTO,END,IBSEQ,BPQ
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| 105 | N CLMSTAT,OCLMSTAT,RESUB,RESFL
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| 106 | S (CLMSTAT,OCLMSTAT)=0
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| 107 | ;
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| 108 | ; Set CERTUSER to true if this user is the certifier
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| 109 | S CERTUSER=^BPS(9002313.99,1,"CERTIFIER")=DUZ
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| 110 | ;
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| 111 | ; Build Transaction IEN
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| 112 | S TRANSIEN=BRXIEN_"."_$E($TR($J("",4-$L(BFILL))," ","0")_BFILL,1,4)_1
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| 113 | ;
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| 114 | ; Write Rebill and Status Messages
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| 115 | W !!,"Claim Status: "
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| 116 | I REBILL,$G(MOREDATA("REVERSE THEN RESUBMIT"))'=2 W !,"Reversing and Rebilling a previously submitted claim...",!,"Reversing..."
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| 117 | ;
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| 118 | ; Get the ECME Timeout and set the display timeout
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| 119 | S BPSTO=$$GET1^DIQ(9002313.99,"1,",3.01),END=$S(CERTUSER:50,$G(BPSTO)]"":BPSTO,1:5)
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| 120 | ;
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| 121 | ; For remaining time, loop through and display status
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| 122 | S (BPQ,RESFL)=0
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| 123 | F IBSEQ=1:1:END D Q:BPQ=1
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| 124 | . H 1
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| 125 | . ;
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| 126 | . ; Get status of resubmit, last update, and claim status
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| 127 | . S CLMSTAT=$$STATUS^BPSOSRX(BRXIEN,BFILL,1)
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| 128 | . S RESUB=$$GET1^DIQ(9002313.59,TRANSIEN_",",1.12,"I")
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| 129 | . ;
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| 130 | . ; Format status message
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| 131 | . S CLMSTAT=$P(CLMSTAT,"^",1)_$S($P(CLMSTAT,"^",1)["IN PROGRESS":"-"_$P(CLMSTAT,"^",3),1:"")
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| 132 | . ;
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| 133 | . ; If we are starting the resubmit, display message
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| 134 | . I REBILL,RESFL=0,RESUB=1,CLMSTAT["Resubmitting" W !,"Resubmitting..." S RESFL=1 Q
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| 135 | . I REBILL,RESFL=0,RESUB=2,CLMSTAT["IN PROGRESS" W !,"Resubmitting..." S RESFL=1
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| 136 | . ;
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| 137 | . ; If the status has changed, display the new message
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| 138 | . I OCLMSTAT'=CLMSTAT W !,CLMSTAT S OCLMSTAT=CLMSTAT
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| 139 | . ;
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| 140 | . ; If the status is not IN PROGRESS, then we are done
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| 141 | . I CLMSTAT'["IN PROGRESS" S BPQ=1
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| 142 | W !
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| 143 | Q
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| 144 | ;
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| 145 | ; Bulletin to the OPECC
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| 146 | BULL(RXI,RXR,SITE,DFN,PATNAME) ;
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| 147 | N BTXT,XMSUB,XMY,XMTEXT,XMDUZ
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| 148 | N SSN,X,SITENM
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| 149 | I $G(SITE) D
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| 150 | . K ^TMP($J,"BPSARR")
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| 151 | . D PSS^PSO59(SITE,,"BPSARR")
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| 152 | . S SITENM=$G(^TMP($J,"BPSARR",SITE,.01))
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| 153 | I $G(DFN) D
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| 154 | . S X=$P($G(^DPT(DFN,0)),U,9)
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| 155 | . S SSN=$E(X,$L(X)-3,$L(X))
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| 156 | ;
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| 157 | ; Need to do in the background
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| 158 | ; Mailman calls CMOP which calls EN^BPSNCPDP.
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| 159 | ; If BPSNCPDP* (same process) then calls mailman, it gets confused.
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| 160 | N ZTIO,ZTRTN,ZTDTH,ZTSAVE,ZTDESC
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| 161 | N %,%H,%I,X
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| 162 | D NOW^%DTC
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| 163 | S ZTIO="",ZTDTH=%,ZTDESC="IN PROGRESS BULLETIN"
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| 164 | S ZTSAVE("RXR")="",ZTSAVE("RXI")=""
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| 165 | S ZTSAVE("SITENM")="",ZTSAVE("PATNAME")=""
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| 166 | S ZTSAVE("SSN")=""
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| 167 | S ZTRTN="BULL1^BPSNCPD1"
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| 168 | D ^%ZTLOAD
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| 169 | Q
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| 170 | ;
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| 171 | BULL1 ;
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| 172 | S XMSUB="RX not processed for site "_$G(SITENM)
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| 173 | S BTXT(1)="Prescription "_$$RXAPI1^BPSUTIL1(RXI,.01,"E")_" and fill number "_+RXR_" could "
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| 174 | S BTXT(1)=BTXT(1)_"not be processed because the "
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| 175 | S BTXT(2)="previous request was in progress. There may have been a delay in processing "
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| 176 | S BTXT(3)="of the previous claim or the previous claim may be stranded."
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| 177 | S BTXT(4)=""
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| 178 | S BTXT(5)="For more information on this prescription's activity, please view the "
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| 179 | S BTXT(6)="ECME log within the View Prescription (VP) option on the Further Research (FR) "
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| 180 | S BTXT(7)="menu of the ECME user screen."
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| 181 | S BTXT(8)=""
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| 182 | S BTXT(9)="Patient Name: "_$G(PATNAME)
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| 183 | S BTXT(10)="Last four digits of SSN: "_$G(SSN)
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| 184 | S BTXT(11)=""
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| 185 | ;
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| 186 | S XMDUZ="BPS PACKAGE",XMTEXT="BTXT("
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| 187 | S XMY("G.BPS OPECC")=""
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| 188 | I $G(DUZ)'<1 S XMY(DUZ)=""
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| 189 | D ^XMD
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| 190 | Q
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