source: WorldVistAEHR/trunk/r/E_CLAIMS_MGMT_ENGINE-BPS/BPSNCPD3.m@ 1437

Last change on this file since 1437 was 613, checked in by George Lilly, 15 years ago

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1BPSNCPD3 ;BHAM ISC/LJE - Continuation of BPSNCPDP - DUR HANDLING ;06/16/2004
2 ;;1.0;E CLAIMS MGMT ENGINE;**1,5**;JUN 2004;Build 45
3 ;;Per VHA Directive 2004-038, this routine should not be modified.
4 ; DUR1 is called by PSO to get the reject info so that should NOT be removed
5 ;
6 ;
7 ;
8 ; Function call for DUR INFORMATION
9 ; Parameters: BRXIEN = Prescription IEN
10 ; BFILL = fill number
11 ; DUR = DUR info passed back
12 ; ERROR = error passed back
13 ; Note:
14 ; DUR("BILLED")=0 if ecme off for pharmacy or no transaction in ECME
15 ; DUR(<Insurance counter>,"BILLED")=1 if billed through ecme
16DUR1(BRXIEN,BFILL,DUR,ERROR) ;
17 N SITE,DFILL,TRANIEN,JJ,DUR1,DURIEN,I
18 ;
19 ; Get Site info and check is ECME is turned on
20 ; If not, set DUR("BILLED")=0 and quit
21 I '$G(BFILL) S SITE=$$RXAPI1^BPSUTIL1(BRXIEN,20,"I")
22 I $G(BFILL) S SITE=$$RXSUBF1^BPSUTIL1(BRXIEN,52,52.1,BFILL,8,"I")
23 I '$$ECMEON^BPSUTIL(SITE) S DUR("BILLED")=0 Q
24 ;
25 ; Set up the Transaction IEN
26 S DFILL="",DFILL=$E($TR($J("",4-$L(BFILL))," ","0")_BFILL,1,4)_1
27 S TRANIEN=BRXIEN_"."_DFILL
28 ;
29 ; If the transaction record does not exist, set DUR("BILLED")=0 and quit
30 I '$D(^BPST(TRANIEN)) S DUR("BILLED")=0 Q
31 ;
32 ; Loop through the insurance multiple and set DUR array
33 S JJ=0
34 F S JJ=$O(^BPST(TRANIEN,10,JJ)) Q:JJ=""!(JJ'?1N.N) D
35 . ;
36 . ; We are good so set Billed
37 . S DUR(JJ,"BILLED")=1
38 . ;
39 . ; Get Insurance Info and set into DUR array
40 . D GETS^DIQ(9002313.59902,JJ_","_TRANIEN_",","902.05;902.06;902.24;902.25;902.26","E","DUR1","ERROR")
41 . S DUR(JJ,"INSURANCE NAME")=$G(DUR1(9002313.59902,JJ_","_TRANIEN_",",902.24,"E")) ; Insurance Company Name
42 . S DUR(JJ,"GROUP NUMBER")=$G(DUR1(9002313.59902,JJ_","_TRANIEN_",",902.05,"E")) ; Insurance Group Number
43 . S DUR(JJ,"GROUP NAME")=$G(DUR1(9002313.59902,JJ_","_TRANIEN_",",902.25,"E")) ; Insurance Group Name
44 . S DUR(JJ,"PLAN CONTACT")=$G(DUR1(9002313.59902,JJ_","_TRANIEN_",",902.26,"E")) ; Insurance Contact Number
45 . S DUR(JJ,"CARDHOLDER ID")=$G(DUR1(9002313.59902,JJ_","_TRANIEN_",",902.06,"E")) ; Cardholder ID
46 . ;
47 . ; Get Response IEN and Data
48 . S DURIEN="",DURIEN=$P(^BPST(TRANIEN,0),"^",5) ;Note: in future will need to store/get DURIEN for each insurance
49 . S DUR(JJ,"RESPONSE IEN")=DURIEN
50 . D GETS^DIQ(9002313.0301,"1,"_DURIEN_",","501;567.01*;526","E","DUR1","ERROR")
51 . S DUR(JJ,"PAYER MESSAGE")=$G(DUR1(9002313.0301,"1,"_DURIEN_",",526,"E")) ;Additional free text message info from payer
52 . S DUR(JJ,"STATUS")=$G(DUR1(9002313.0301,"1,"_DURIEN_",",501,"E")) ;Status of Response
53 . S DUR(JJ,"REASON")=$G(DUR1(9002313.1101,"1,1,"_DURIEN_",",439,"E")) ;Reason of Service Code
54 . S DUR(JJ,"CLIN SIGNIFICANCE")=$G(DUR1(9002313.1101,"1,1,"_DURIEN_",",528,"E")) ;Clinical Significance Code
55 . S DUR(JJ,"OTH PHARM IND")=$G(DUR1(9002313.1101,"1,1,"_DURIEN_",",529,"E")) ;Other Pharmacy Indicator Code
56 . S DUR(JJ,"PREV FILL DATE")=$G(DUR1(9002313.1101,"1,1,"_DURIEN_",",530,"E")) ;Previous Date of Fill
57 . S DUR(JJ,"QTY OF PREV FILL")=$G(DUR1(9002313.1101,"1,1,"_DURIEN_",",531,"E")) ;Quantity of Previous Fill
58 . S DUR(JJ,"DATABASE IND")=$G(DUR1(9002313.1101,"1,1,"_DURIEN_",",532,"E")) ;Database Indicator
59 . S DUR(JJ,"OTH PRESCRIBER IND")=$G(DUR1(9002313.1101,"1,1,"_DURIEN_",",533,"E")) ;Other Prescriber Indicator
60 . S DUR(JJ,"DUR FREE TEXT DESC")=$G(DUR1(9002313.1101,"1,1,"_DURIEN_",",544,"E")) ;DUR Free Text Message from Payer
61 . ;
62 . ; Get DUR reject codes and description and store in DUR
63 . D GETS^DIQ(9002313.0301,"1,"_DURIEN_",","511*","I","DUR1","ERROR") ;get DUR codes and descriptions
64 . S DUR(JJ,"REJ CODE LST")=""
65 . F I=1:1 Q:'$D(DUR1(9002313.03511,I_",1,"_DURIEN_",")) D
66 .. S DUR(JJ,"REJ CODES",I,DUR1(9002313.03511,I_",1,"_DURIEN_",",.01,"I"))=$$GET1^DIQ(9002313.93,DUR1(9002313.03511,I_",1,"_DURIEN_",",.01,"I"),".02")
67 .. S DUR(JJ,"REJ CODE LST")=DUR(JJ,"REJ CODE LST")_","_DUR1(9002313.03511,I_",1,"_DURIEN_",",.01,"I")
68 . S DUR(JJ,"REJ CODE LST")=$E(DUR(JJ,"REJ CODE LST"),2,9999)
69 Q
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