[613] | 1 | BPSOSU ;BHAM ISC/FCS/DRS/FLS - Common utilities ;06/01/2004
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| 2 | ;;1.0;E CLAIMS MGMT ENGINE;**1,2,5**;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 | Q
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| 5 | ; Common utilities called a lot.
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| 6 | ;
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| 7 | ; SETSTAT - set status field for ^BPST(IEN59,
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| 8 | ; Input:
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| 9 | ; IEN59 - BPS Transaction
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| 10 | ; STATUS - Value to set into BPS Transaction
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| 11 | SETSTAT(IEN59,STATUS) ; EP - from many places
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| 12 | ;
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| 13 | ; In case there is a timing problem, make sure the Status is not
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| 14 | ; already more than the requested status
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| 15 | I STATUS'=0,$P(^BPST(IEN59,0),U,2)>STATUS Q
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| 16 | ;
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| 17 | ; Lock the record - something is very wrong if you can't get the lock
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| 18 | F L +^BPST(IEN59):300 Q:$T Q:'$$IMPOSS^BPSOSUE("L","RTI","LOCK +^BPST",,"SETSTAT",$T(+0))
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| 19 | N DIE,DA,DR,X
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| 20 | S DIE=9002313.59,DA=IEN59,DR="1///"_STATUS_";7///NOW" ; Status and Last Update
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| 21 | I STATUS=0 S DR=DR_";15///NOW" ; If Status is 0, init START TIME
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| 22 | D ^DIE
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| 23 | ;
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| 24 | ; Verify that there no other statuses in the X-ref
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| 25 | S X=""
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| 26 | F S X=$O(^BPST("AD",X)) Q:X="" D
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| 27 | . I X'=STATUS K ^BPST("AD",X,IEN59)
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| 28 | I STATUS=99 D STATUS99(IEN59)
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| 29 | L -^BPST(IEN59)
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| 30 | Q
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| 31 | ;
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| 32 | ; STATUS99 - Special activity when a claim reaches status 99
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| 33 | ; Input:
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| 34 | ; IEN59 - BPS Transaction IEN
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| 35 | STATUS99(IEN59) ;
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| 36 | N CLMSTAT,BPS57
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| 37 | ;
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| 38 | ; Get status of the claim
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| 39 | S CLMSTAT=$$CATEG^BPSOSUC(IEN59)
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| 40 | ;
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| 41 | S BPS57=$$NEW57(IEN59)
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| 42 | D LOG^BPSOSL(IEN59,$T(+0)_"-Created BPS Log of Transaction record "_BPS57)
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| 43 | ;
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| 44 | ; If claims completed normally, log its completion.
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| 45 | ; Do not log error'ed or stranded claims as we don't want to show these in the
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| 46 | ; turn-around stats
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| 47 | ; Needed for Turn-Around Stats - Do NOT delete/alter!!
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| 48 | I CLMSTAT'["E OTHER",CLMSTAT'["E STRANDED",CLMSTAT'["E REVERSAL STRANDED" D LOG^BPSOSL(IEN59,$T(+0)_"-Claim Complete")
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| 49 | ;
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| 50 | ; If the Reverse Then Resubmit field is set to Resubmitting (2),
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| 51 | ; then set to 'Done' (0)
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| 52 | I $P(^BPST(IEN59,1),U,12)=2 S $P(^BPST(IEN59,1),U,12)=0
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| 53 | ;
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| 54 | ; If resubmit flag is set to 'Reverse, then Resubmit' (1), see about
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| 55 | ; doing a resubmit
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| 56 | I $P(^BPST(IEN59,1),U,12)=1 D
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| 57 | . ;
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| 58 | . ; Initialize variables
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| 59 | . N SKIP,SITE
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| 60 | . D LOG^BPSOSL(IEN59,$T(+0)_"-Reverse then Resubmit attempt")
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| 61 | . ;
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| 62 | . ; Initialize the skip flag
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| 63 | . S SKIP=0
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| 64 | . ;
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| 65 | . ; Get Site info and make sure it exists
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| 66 | . S SITE=$P(^BPST(IEN59,1),U,4)
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| 67 | . I '$G(SITE) D
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| 68 | .. D LOG^BPSOSL(IEN59,$T(+0)_" Cannot - No site information")
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| 69 | .. S SKIP=1
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| 70 | . ;
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| 71 | . ; Check the ECME switch for the site
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| 72 | . I $G(SITE),'$$ECMEON^BPSUTIL(SITE) D
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| 73 | .. D LOG^BPSOSL(IEN59,$T(+0)_" Cannot - ECME switch is off for the site")
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| 74 | .. S SKIP=1
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| 75 | . ;
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| 76 | . ; If reversal was not successful, log message and quit
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| 77 | . I CLMSTAT'="E REVERSAL ACCEPTED" D
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| 78 | .. D LOG^BPSOSL(IEN59,$T(+0)_" Cannot - Reversal failed - "_CLMSTAT)
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| 79 | .. S SKIP=1
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| 80 | . ;
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| 81 | . ; Check if the MOREDATA array is defined
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| 82 | . I '$D(^XTMP("BPSOSRB","MOREDATA",IEN59,"RESUB")) D
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| 83 | .. D LOG^BPSOSL(IEN59,$T(+0)_" Cannot - MOREDATA array undefined")
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| 84 | .. S SKIP=1
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| 85 | . ;
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| 86 | . ; If skip flag is set, clear the resubmit flag and kill the temp global
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| 87 | . ; Else resubmit the claim
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| 88 | . I SKIP D
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| 89 | .. S $P(^BPST(IEN59,1),U,12)=0
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| 90 | .. K ^XTMP("BPSOSRB","MOREDATA",IEN59)
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| 91 | . E D
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| 92 | .. K MOREDATA
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| 93 | .. M MOREDATA=^XTMP("BPSOSRB","MOREDATA",IEN59,"RESUB")
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| 94 | .. K ^XTMP("BPSOSRB","MOREDATA",IEN59)
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| 95 | .. ;
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| 96 | .. ; Needed for Turn-Around Stats - Do NOT delete/alter!!
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| 97 | .. D LOG^BPSOSL(IEN59,$T(+0)_"-Now resubmit")
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| 98 | .. D CLAIM^BPSOSRB(IEN59,.MOREDATA)
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| 99 | ;
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| 100 | ; If the ECME Nightly Background job and CMOP release message are running at the same
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| 101 | ; time, there are unreleased RXs that are auto-reversed but then are released by
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| 102 | ; CMOP at the same time. Unfortunately, if the auto-reversal is in progress, CMOP
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| 103 | ; can not resubmit the claim (due to the queuing issue) so we need to automatically
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| 104 | ; submit them here.
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| 105 | ; Criteria:
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| 106 | ; Status is Reversal Accepted
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| 107 | ; RX is released
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| 108 | ; Normal Auto-Reversal
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| 109 | I CLMSTAT="E REVERSAL ACCEPTED" D
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| 110 | . N RX,RXR
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| 111 | . S RX=$P(IEN59,"."),RXR=+$E($P(IEN59,".",2),1,4)
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| 112 | . I '$$RXRLDT^PSOBPSUT(RX,RXR) Q
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| 113 | . N CLAIMIEN,AUTOREV
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| 114 | . S CLAIMIEN=$$GET1^DIQ(9002313.59,IEN59,3,"I")
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| 115 | . I '$G(CLAIMIEN) Q
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| 116 | . S AUTOREV=$$GET1^DIQ(9002313.02,CLAIMIEN,.07,"I")
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| 117 | . I $G(AUTOREV)'=1 Q
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| 118 | . N BDOS,BRES,BMES,BMSG
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| 119 | . D LOG^BPSOSL(IEN59,$T(+0)_"-Submit released auto-reversal")
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| 120 | . S BDOS=$$DOSDATE^BPSSCRRS(RX,RXR)
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| 121 | . S BRES=$$EN^BPSNCPDP(RX,RXR,BDOS,"ARES")
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| 122 | . D LOG^BPSOSL(IEN59,$T(+0)_"-Response from BPSNCPDP: "_BRES)
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| 123 | . S BMSG=$P(BRES,U,2),BRES=+BRES
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| 124 | . S BMES="Submitted to ECME: Resubmit for released autoreversal"
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| 125 | . S BMES=BMES_$S(BRES=1:"-NO SUBMISSION VIA ECME",BRES=4:"-NOT PROCESSED",BRES=5:"-SOFTWARE ERROR",1:"")
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| 126 | . D ECMEACT^PSOBPSU1(RX,RXR,BMES,.5)
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| 127 | . I BRES=2 D ECMEACT^PSOBPSU1(RX,RXR,"Not ECME Billable: "_BMSG,.5)
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| 128 | Q
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| 129 | ;
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| 130 | ; NEW57 - Copy the BPS Transaction into BPS Log of Transaction
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| 131 | ; Input
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| 132 | ; IEN59 - BPS Transaction
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| 133 | ; Returns
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| 134 | ; BPS Log of Transaction IEN
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| 135 | NEW57(IEN59) ;
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| 136 | F L +^BPSTL:300 Q:$T Q:'$$IMPOSS^BPSOSUE("L","RTI","LOCK ^BPSTL",,"NEW57",$T(+0))
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| 137 | ;
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| 138 | ; Get next record number in BPS Log of Transactions
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| 139 | NEW57A N N,C
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| 140 | S N=$P(^BPSTL(0),U,3)+1
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| 141 | S C=$P(^BPSTL(0),U,4)+1
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| 142 | S $P(^BPSTL(0),U,3,4)=N_U_C
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| 143 | I $D(^BPSTL(N)) G NEW57A ; should never happen
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| 144 | L -^BPSTL
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| 145 | ;
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| 146 | ; Merge BPS Transaction into Log of Transactions
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| 147 | M ^BPSTL(N)=^BPST(IEN59)
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| 148 | ;
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| 149 | ; Indexing - First, fileman indexing
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| 150 | D
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| 151 | . N DIK,DA S DIK="^BPSTL(",DA=N N N D IX1^DIK
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| 152 | ;
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| 153 | ; Setup the NON-FILEMAN index on RX and Fill
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| 154 | N A,B
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| 155 | S A=$P(^BPSTL(N,1),U,11)
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| 156 | S B=$P(^BPSTL(N,1),U)
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| 157 | S ^BPSTL("NON-FILEMAN","RXIRXR",A,B,N)=""
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| 158 | ;
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| 159 | ; Quit with the new record number
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| 160 | Q N
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| 161 | ;
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| 162 | ; ISREVES - Is this a reversal claim
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| 163 | ; Input
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| 164 | ; CLAIMIEN - Pointer to BPS Claims
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| 165 | ;
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| 166 | ; Return Value
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| 167 | ; 1 - Reversal claim
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| 168 | ; 0 - Not a reversal claim
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| 169 | ISREVERS(CLAIM) ;
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| 170 | Q $P($G(^BPSC(CLAIM,100)),"^",3)="B2"
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| 171 | ;
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| 172 | ; SETCSTAT - Set the status for every transaction associated with
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| 173 | ; this claim
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| 174 | SETCSTAT(CLAIM,STATUS) ;
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| 175 | N IEN59,INDEX
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| 176 | ;
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| 177 | ; Determine correct index
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| 178 | I $$ISREVERS(CLAIM) S INDEX="AER"
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| 179 | E S INDEX="AE"
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| 180 | ;
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| 181 | ; Loop through the transactions and set the status
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| 182 | S IEN59=""
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| 183 | F S IEN59=$O(^BPST(INDEX,CLAIM,IEN59)) Q:IEN59="" D SETSTAT(IEN59,STATUS)
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| 184 | Q
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| 185 | ;
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| 186 | ; ERROR - Handle any errors
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| 187 | ; Log them into BPS Transactions
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| 188 | ; Change status to 99
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| 189 | ; Update the LOG
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| 190 | ; Increment the statistics
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| 191 | ; We should be okay for the resubmit flag since the STATUS
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| 192 | ; will be E OTHER instead of E REVERSAL ACCEPTED
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| 193 | ; Input
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| 194 | ; RTN - Routine reporting the error
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| 195 | ; IEN59 - BPS Transaction
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| 196 | ; ERROR - Error Number (goes in RESULT CODE)
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| 197 | ; ERRTEXT - Error Text (goes in RESULT TEXT)
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| 198 | ;
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| 199 | ; To prevent conflicts, set the error number to the first digit of
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| 200 | ; Status and a unique number for the status.
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| 201 | ERROR(RTN,IEN59,ERROR,ERRTEXT) ;
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| 202 | ;
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| 203 | ; Check parameters
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| 204 | I '$G(IEN59) Q
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| 205 | I '$G(ERROR) S ERROR=0
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| 206 | I $G(ERRTEXT)="" S ERRTEXT="ERROR - see LOG"
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| 207 | ;
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| 208 | ; Set Error and Error Text in BPS Transaction
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| 209 | D SETRESU(IEN59,ERROR,ERRTEXT)
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| 210 | ;
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| 211 | ; Log Message
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| 212 | D LOG^BPSOSL(IEN59,RTN_" returned error - "_ERRTEXT)
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| 213 | ;
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| 214 | ; Update unbillable count in stats
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| 215 | D INCSTAT^BPSOSUD("R",1)
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| 216 | ;
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| 217 | ; Update Status to complete
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| 218 | D SETSTAT(IEN59,99)
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| 219 | Q
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| 220 | ;
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| 221 | ; SETRESU - Set Result into ^BPST(IEN59,2)
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| 222 | ; Input
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| 223 | ; IEN59 - BPS Transaction IEN
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| 224 | ; RESULT - Result Code
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| 225 | ; TEXT - Result Text. Semi-colons (";") should not in the text data as
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| 226 | ; this is used as a separator between current and previous text
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| 227 | ; messages. If there is a semi-colon, it is converted to a dash.
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| 228 | SETRESU(IEN59,RESULT,TEXT) ;
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| 229 | ;
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| 230 | ; First, store the Result Code
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| 231 | S $P(^BPST(IEN59,2),U)=$G(RESULT)
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| 232 | ;
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| 233 | ; Second, store the Result Text
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| 234 | ; Considerations:
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| 235 | ; Convert any semi-colons to dashes
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| 236 | ; Add semi-colon delimiter if needed
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| 237 | ; Truncate data if needed
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| 238 | I $G(TEXT)]"" D
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| 239 | . N X
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| 240 | . S TEXT=$TR(TEXT,";","-")
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| 241 | . S X=$P(^BPST(IEN59,2),U,2,99)
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| 242 | . I X]"",$E(X)'=";" S X=";"_X
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| 243 | . S X=$E(TEXT_X,1,255-$L(RESULT)-1)
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| 244 | . S $P(^BPST(IEN59,2),U,2)=X
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| 245 | Q
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| 246 | ;
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| 247 | ; SETCRESU - set the result code for every transaction assoc'd with
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| 248 | ; this claim. Note that this will only work for billing requests (B1)
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| 249 | ; Input
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| 250 | ; CLAIMIEN - BPS Claim IEN
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| 251 | ; RESULT - Result Code
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| 252 | ; TEXT - Result Text
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| 253 | SETCRESU(CLAIM,RESULT,TEXT) ;
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| 254 | N IEN59
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| 255 | S IEN59=""
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| 256 | F S IEN59=$O(^BPST("AE",CLAIM,IEN59)) Q:IEN59="" D SETRESU(IEN59,RESULT,$G(TEXT))
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| 257 | Q
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| 258 | ;
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| 259 | ; STATI(X) gives a text version of what status code X means.
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| 260 | ; For effeciency, put more common ones at the top.
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| 261 | ; Also note that you should check the display on the stats screen if you
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| 262 | ; modify any of these.
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| 263 | STATI(X) ;
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| 264 | I X=99 Q "Done"
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| 265 | I X=60 Q "Transmitting"
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| 266 | I X=0 Q "Waiting to start"
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| 267 | I X=40 Q "Building the HL7 packet"
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| 268 | I X=70 Q "Parsing response"
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| 269 | I X=30 Q "Building the claim"
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| 270 | I X=10 Q "Building the transaction"
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| 271 | I X=90 Q "Processing response"
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| 272 | I X=98 Q "Resubmitting" ; Used only by STATUS^BPSOSRX (Not stored in BPS Transactions)
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| 273 | I X=50 Q "Preparing for transmit"
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| 274 | I X=31 Q "Wait for retry (insurer asleep)"
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| 275 | I X=80 Q "Waiting to process response"
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| 276 | Q "?"_X_"?"
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