[613] | 1 | BPSSCR04 ;BHAM ISC/SS - USER SCREEN ;14-FEB-05
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| 2 | ;;1.0;E CLAIMS MGMT ENGINE;**1,5**;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 | ;USER SCREEN
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| 5 | Q
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| 6 | ;input:
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| 7 | ;BPTMP - TMP global to store data (example : $NA(^TMP($J,"BPSSCR")))
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| 8 | ;BPARR - array with user profile information
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| 9 | COLLECT(BPTMP,BPARR) ;
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| 10 | N BPBDT,BPEDT,BPSORT
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| 11 | S BPBDT=BPARR("BDT") ;start date
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| 12 | S BPEDT=BPARR("EDT") ;end date
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| 13 | ;sort type - see SORTIT()
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| 14 | S BPSORT=$G(BPARR(1.12))
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| 15 | S:BPSORT="" BPSORT="T" ;default
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| 16 | ;kill TMP
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| 17 | ;look for claims in 3 files
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| 18 | ;temporary TMP file
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| 19 | N BPTMP1 S BPTMP1=$NA(@BPTMP@("PRE59"))
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| 20 | N BPTMP2 S BPTMP2=$NA(@BPTMP@("FILE59"))
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| 21 | K @BPTMP1
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| 22 | K @BPTMP2
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| 23 | ;
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| 24 | D LOOK02(BPBDT,BPEDT,BPTMP1,BPSORT)
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| 25 | D LOOK57(BPBDT,BPEDT,BPTMP1,BPSORT)
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| 26 | D LOOK59(BPBDT,BPEDT,BPTMP1,BPSORT)
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| 27 | ;remove all claims that don't match filter criteria
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| 28 | D FILTRALL^BPSSCR03(BPTMP1,BPTMP2,.BPARR)
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| 29 | ;preliminary sorting for "T" sorting type
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| 30 | I BPSORT="T" D TRDFNALL^BPSSCR03(BPTMP)
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| 31 | ;final sorting
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| 32 | D SORTIT(BPTMP,BPSORT)
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| 33 | K @BPTMP1
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| 34 | K @BPTMP2
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| 35 | Q
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| 36 | ;Input:
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| 37 | ;BPTMP - TMP global to store data (example : $NA(^TMP($J,"BPSSCR")))
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| 38 | ;BPSORT:
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| 39 | ;'T' FOR TRANSACTION DATE
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| 40 | ;'D' FOR DIVISION (ECME pharmacy)
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| 41 | ;'I' FOR INSURANCE
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| 42 | ;'C' FOR REJECT CODE
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| 43 | ;'P' FOR PATIENT NAME
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| 44 | ;'N' FOR DRUG NAME
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| 45 | ;'B' FOR BILL TYPE (BB/RT)
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| 46 | ;'L' FOR FILL LOCATION (Windows/Mail/CMOP)
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| 47 | ;'R' FOR RELEASED/NON-RELEASED RX
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| 48 | ;'A' FOR ACTIVE/DISCONTINUED RX
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| 49 | ;sort it and prepare the TMP for the user screen
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| 50 | SORTIT(BPTMP,BPSORT) ;*/
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| 51 | ;S BP59=+$G(^TMP($J,"BPSSCR","SRT",BPSRT))
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| 52 | ;BPSORT:
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| 53 | ;TRANSACTION DATE - the last time when the record
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| 54 | ;in the file #9002313.59 -- BPS TRANSACTION FILE has been updated
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| 55 | ;F S X=$O(@BPTMP@("SRT",BPSRT))
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| 56 | K @BPTMP@("SORT")
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| 57 | N BPSRTVAL,BPTRDT,BP59,BPDFN,BPIEN,BPIENNM
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| 58 | S BP59=0
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| 59 | ;by transaction date -- sort by the patient/insurance combinations,
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| 60 | ;which might have more than one claims.
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| 61 | ;- the first on the top will be the one which has the claim(s) with the
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| 62 | ; most recent date (other claims in this group can have any other date)
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| 63 | I BPSORT="T" D
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| 64 | . D MKPATINS(BPTMP) ;1st step
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| 65 | . D MKTRSORT(BPTMP) ;2nd step
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| 66 | ;by patient name (and his/her insurances)
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| 67 | I BPSORT="P" D
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| 68 | . D MKNAMINS(BPTMP) ;1st step
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| 69 | . D MKPTSORT(BPTMP) ;2nd step
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| 70 | ;by insurance
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| 71 | ;(the name will be shortened up to 10 chars and its
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| 72 | ;IEN is added to make the string unique)
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| 73 | I BPSORT="I" D
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| 74 | . F S BP59=$O(@BPTMP@("FILE59",BP59)) Q:+BP59=0 D
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| 75 | . . S BPIEN=$$GETINSUR^BPSSCRU2(+BP59)
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| 76 | . . S BPIENNM=$S(+BPIEN>0:$E($P(BPIEN,U,2),1,10)_U_(+BPIEN),1:"0")
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| 77 | . . D SETSORT(BPTMP,BPSORT,BPIENNM,BP59)
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| 78 | ;by division
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| 79 | ;(the name will be shortened up to 10 chars and its
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| 80 | ;IEN is added to make the string unique)
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| 81 | I BPSORT="D" D
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| 82 | . F S BP59=$O(@BPTMP@("FILE59",BP59)) Q:+BP59=0 D
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| 83 | . . S BPIEN=+$$DIVIS^BPSSCRU2(+BP59)
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| 84 | . . S BPIENNM=$S(BPIEN>0:$E($$DIVNAME^BPSSCRDS(BPIEN),1,10)_U_(BPIEN),1:"0")
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| 85 | . . D SETSORT(BPTMP,BPSORT,BPIENNM,BP59)
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| 86 | ;by reject code
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| 87 | ;the same claim can be listed more than once (under different reject code
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| 88 | ;sections) because each claim may have more than one reject code.
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| 89 | I BPSORT="C" D
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| 90 | . F S BP59=$O(@BPTMP@("FILE59",BP59)) Q:+BP59=0 D
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| 91 | . . N BPRJCDS,BPRJ
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| 92 | . . D REJCODES^BPSSCRU3(+BP59,.BPRJCDS)
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| 93 | . . S BPRJ=""
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| 94 | . . F S BPRJ=$O(BPRJCDS(BPRJ)) Q:BPRJ="" D
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| 95 | . . . D SETSORT(BPTMP,BPSORT,BPRJ,BP59)
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| 96 | ;by drug names
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| 97 | ;(the name will be shortened upto 10 chars and its
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| 98 | ;IEN is added to make the string unique)
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| 99 | I BPSORT="N" D
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| 100 | . F S BP59=$O(@BPTMP@("FILE59",BP59)) Q:+BP59=0 D
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| 101 | . . S BPIEN=+$$GETDRG59^BPSSCRU2(+BP59)
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| 102 | . . S BPIENNM=$S(BPIEN>0:$E($$DRGNAM^BPSSCRU2(BPIEN),1,10)_U_(BPIEN),1:"0")
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| 103 | . . D SETSORT(BPTMP,BPSORT,BPIENNM,BP59)
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| 104 | ;by claim origination type (BB- backbilling, RT- realtime)
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| 105 | I BPSORT="B" D
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| 106 | . F S BP59=$O(@BPTMP@("FILE59",BP59)) Q:+BP59=0 D
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| 107 | . . D SETSORT(BPTMP,BPSORT,$$RTBB^BPSSCRU2(+BP59),BP59)
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| 108 | ;by filling location
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| 109 | ;M-MAIL/W-WINDOW/C-CMOP
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| 110 | I BPSORT="L" D
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| 111 | . F S BP59=$O(@BPTMP@("FILE59",BP59)) Q:+BP59=0 D
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| 112 | . . D SETSORT(BPTMP,BPSORT,$$MWCNAME^BPSSCRU2($$GETMWC^BPSSCRU2(+BP59)),BP59)
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| 113 | ;by released (1) /non released (0)
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| 114 | I BPSORT="R" D
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| 115 | . F S BP59=$O(@BPTMP@("FILE59",BP59)) Q:+BP59=0 D
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| 116 | . . D SETSORT(BPTMP,BPSORT,$$ISRXREL^BPSSCRU2(+BP59),BP59)
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| 117 | ;by status of the fill ACT-active/DIS-discontinued/SUS-suspended/etc
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| 118 | I BPSORT="A" D
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| 119 | . F S BP59=$O(@BPTMP@("FILE59",BP59)) Q:+BP59=0 D
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| 120 | . . D SETSORT(BPTMP,BPSORT,$$RXST^BPSSCRU2(+BP59),BP59)
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| 121 | ;
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| 122 | ;K @BPTMP@("FILE59")
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| 123 | Q
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| 124 | ;set SORT node
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| 125 | SETSORT(BPTMP,BPSORT,BPSRTVAL,BP59) ;*/
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| 126 | S:$L(BPSRTVAL)>0 @BPTMP@("SORT",BPSORT,BPSRTVAL,BP59)=""
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| 127 | Q
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| 128 | ;first look at ^BPSC (#9002313.02) for fill/refill x-ref
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| 129 | ; since #9002313.57 is not created at the time of refill
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| 130 | ; and since #9002313.59 has the last update date, which can be any kind of date (released/reversal/etc)
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| 131 | ;BPBEGDT - start date
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| 132 | ;BPENDDT - end date
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| 133 | ;BPTMP - tmp global for items found
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| 134 | ;BPSORT - sort type (see COLLECT^BPSSCR04)
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| 135 | LOOK02(BPBEGDT,BPENDDT,BPTMP,BPSORT) ;
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| 136 | N BP02,BPENDDT1,BPLDT02,BP59
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| 137 | S BP59=0
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| 138 | S BPLDT02=$$FM2YMD(BPBEGDT-0.00001)
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| 139 | S BPENDDT1=$$FM2YMD(BPENDDT)
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| 140 | I BPLDT02="" S BPLDT02=0
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| 141 | I BPENDDT1="" S BPENDDT1=99999999
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| 142 | F S BPLDT02=+$O(^BPSC("AF",BPLDT02)) Q:BPLDT02=0!(BPLDT02>BPENDDT1) D
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| 143 | . S BP02=0 F S BP02=$O(^BPSC("AF",BPLDT02,BP02)) Q:+BP02=0 D
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| 144 | . . S BP59=+$O(^BPST("AE",BP02,0))
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| 145 | . . Q:BP59=0
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| 146 | . . I $D(@BPTMP@(BP59)) Q
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| 147 | . . S @BPTMP@(BP59)=$$YMD2FM(BPLDT02)_"^02"
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| 148 | Q
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| 149 | ; finds claims in #9002313.57 for given date frame
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| 150 | ;#9002313.59 has only one entry per claim with, which has a date
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| 151 | ; of the latest update for the claim
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| 152 | ;#9002313.57 has more than one entries per claim and keep all
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| 153 | ; changes made the claim
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| 154 | ;so we have to go thru #9002313.57 to find the earliest date
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| 155 | ;related to the claim to check it against BPBEGDT
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| 156 | ;BPBEGDT - start date
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| 157 | ;BPENDDT - end date
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| 158 | ;BPTMP - tmp global for items found
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| 159 | ;BPSORT - sort type (see COLLECT^BPSSCR04)
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| 160 | LOOK57(BPBEGDT,BPENDDT,BPTMP,BPSORT) ;
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| 161 | N BPLDT57,BP57,BP59
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| 162 | S BPLDT57=BPBEGDT-0.00001
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| 163 | F S BPLDT57=+$O(^BPSTL("AH",BPLDT57)) Q:BPLDT57=0!(BPLDT57>BPENDDT) D
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| 164 | . S BP57=0 F S BP57=$O(^BPSTL("AH",BPLDT57,BP57)) Q:+BP57=0 D
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| 165 | . . S BP59=+$G(^BPSTL(BP57,0))
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| 166 | . . I $D(@BPTMP@(BP59)) Q ;don't create an entry if the claim is already there
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| 167 | . . S @BPTMP@(BP59)=(BPLDT57\1)_"^57-"
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| 168 | Q
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| 169 | ; finds claims in #9002313.59 for given date frame
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| 170 | ;#9002313.59 has only one entry per claim with, which has a date
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| 171 | ; of the latest update for the claim
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| 172 | ;#9002313.57 has more than one entries per claim and keep all
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| 173 | ; changes made the claim
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| 174 | ;so we have to go thru #9002313.57 to find the earliest date
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| 175 | ;related to the claim to check it against BPBEGDT
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| 176 | ;BPBEGDT - start date
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| 177 | ;BPENDDT - end date
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| 178 | ;BPTMP - tmp global for items found
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| 179 | ;BPSORT - sort type (see COLLECT^BPSSCR04)
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| 180 | LOOK59(BPBEGDT,BPENDDT,BPTMP,BPSORT) ;
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| 181 | N BPLDT59,BP59
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| 182 | S BPLDT59=BPBEGDT-0.00001
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| 183 | F S BPLDT59=+$O(^BPST("AH",BPLDT59)) Q:BPLDT59=0!(BPLDT59>BPENDDT) D
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| 184 | . S BP59=0 F S BP59=$O(^BPST("AH",BPLDT59,BP59)) Q:+BP59=0 D
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| 185 | . . I $D(@BPTMP@(BP59)) Q ;don't create an entry if the claim is already there
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| 186 | . . S @BPTMP@(BP59)=(BPLDT59\1)_"^59-"
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| 187 | Q
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| 188 | ;
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| 189 | YMD2FM(BPYMD) ;convert YYYYDDMM to FM date
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| 190 | Q (($E(BPYMD,1,4))-1700)_$E(BPYMD,5,8)
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| 191 | ;
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| 192 | FM2YMD(BPFMDT) ;convert FM date to YYYYMMDD
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| 193 | N Y,Y1
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| 194 | S Y=$E(BPFMDT,2,3),Y1=$E(BPFMDT,1,1) S Y=$S(Y1=3:"20"_Y,Y1=2:"19"_Y,1:"")
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| 195 | Q:Y Y_$E(BPFMDT,4,7)
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| 196 | Q ""
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| 197 | ;make PATIENT -INSURANCE intermediate SORTING
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| 198 | ;global for transaction and patient sortings (1st pass)
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| 199 | ;example:
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| 200 | ;@BPTMP@("SORT","PI",BPDFN,BPINS,BP59)=""
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| 201 | MKPATINS(BPTMP) ;
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| 202 | N BPSRTVAL,BPTRDT,BP59,BPDFN,BPINS
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| 203 | S BP59=0
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| 204 | F S BP59=+$O(@BPTMP@("FILE59",BP59)) Q:+BP59=0 D
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| 205 | . S BPDFN=+$$GETPATID^BPSSCRU2(BP59)
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| 206 | . Q:BPDFN=0
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| 207 | . S BPINS=+$$GETINSUR^BPSSCRU2(BP59)
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| 208 | . S @BPTMP@("SORT","PI",BPDFN,BPINS,BP59)=""
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| 209 | Q
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| 210 | ;make PATIENT NAME -INSURANCE intermediate SORTING
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| 211 | ;global for transaction and patient sortings (1st pass)
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| 212 | ;example:
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| 213 | ;@BPTMP@("SORT","PNI",BPDFN,BPINS,BP59)=""
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| 214 | MKNAMINS(BPTMP) ;
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| 215 | N BPSRTVAL,BPTRDT,BP59,BPDFN,BPINS
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| 216 | S BP59=0
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| 217 | F S BP59=+$O(@BPTMP@("FILE59",BP59)) Q:+BP59=0 D
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| 218 | . S BPDFN=+$$GETPATID^BPSSCRU2(BP59)
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| 219 | . Q:BPDFN=0
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| 220 | . S BPINS=+$$GETINSUR^BPSSCRU2(BP59)
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| 221 | . S @BPTMP@("SORT","PNI",$E($$PATNAME^BPSSCRU2(BPDFN),1,20)_BPDFN,BPINS,BP59)=""
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| 222 | Q
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| 223 | ;Transaction type sorting - the 2nd pass
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| 224 | ;is called after MKPATINS
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| 225 | MKTRSORT(BPTMP) ;
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| 226 | N BPSRTVAL,BPTRDT,BP59,BPDFN,BPINS
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| 227 | S BPTRDT=-99999999,BPSRTVAL=0
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| 228 | F S BPTRDT=$O(@BPTMP@("TRDTDFN",BPTRDT)) Q:+BPTRDT=0 D
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| 229 | . S BPDFN=0
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| 230 | . F S BPDFN=$O(@BPTMP@("TRDTDFN",BPTRDT,BPDFN)) Q:+BPDFN=0 D
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| 231 | . . S BPINS=""
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| 232 | . . F S BPINS=$O(@BPTMP@("TRDTDFN",BPTRDT,BPDFN,BPINS)) Q:BPINS="" D
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| 233 | . . . S BPSRTVAL=BPSRTVAL+1,BPINS=+BPINS
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| 234 | . . . S BP59=0
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| 235 | . . . F S BP59=$O(@BPTMP@("SORT","PI",BPDFN,BPINS,BP59)) Q:+BP59=0 D
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| 236 | . . . . D SETSORT(BPTMP,"T",BPSRTVAL,BP59)
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| 237 | Q
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| 238 | ;Patient type sorting - the 2nd pass
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| 239 | ;is called after MKPATINS
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| 240 | MKPTSORT(BPTMP) ;
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| 241 | N BPSRTVAL,BPTRDT,BP59,BPPATNAM,BPINS
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| 242 | S BPPATNAM="",BPSRTVAL=0
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| 243 | F S BPPATNAM=$O(@BPTMP@("SORT","PNI",BPPATNAM)) Q:BPPATNAM="" D
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| 244 | . S BPINS="" ;"" to handle claims without insurance (corrupted data)
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| 245 | . F S BPINS=$O(@BPTMP@("SORT","PNI",BPPATNAM,BPINS)) Q:BPINS="" D
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| 246 | . . S BPSRTVAL=BPSRTVAL+1,BPINS=+BPINS
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| 247 | . . S BP59=0
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| 248 | . . F S BP59=$O(@BPTMP@("SORT","PNI",BPPATNAM,BPINS,BP59)) Q:+BP59=0 D
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| 249 | . . . D SETSORT(BPTMP,"P",BPSRTVAL,BP59)
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| 250 | Q
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| 251 | ;
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