| [613] | 1 | BPSSCRRS ;BHAM ISC/SS - ECME SCREEN RESUBMIT ;05-APR-05
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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 | Q
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| 5 | ;IA 4702
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| 6 | ;
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| 7 | RES ;
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| 8 | N BPRET,BPSARR59
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| 9 | I '$D(@(VALMAR)) Q
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| 10 | D FULL^VALM1
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| 11 | W !,"Enter the line numbers for the claim(s) to be resubmitted."
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| 12 | S BPRET=$$ASKLINES^BPSSCRU4("Select item(s)","C",.BPSARR59,VALMAR)
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| 13 | I BPRET="^" S VALMBCK="R" Q
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| 14 | ;go thru all selected claims and try to resubmit them separately
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| 15 | ;update the content of the screen and display it
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| 16 | ;only if at least one claim was submitted successfully
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| 17 | I $$RESUBMIT(.BPSARR59) D REDRAW^BPSSCRUD("Updating screen for resubmitted claims...")
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| 18 | E S VALMBCK="R"
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| 19 | Q
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| 20 | ;
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| 21 | ;/**
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| 22 | ;go thru all selected claims and try to resubmit them separately
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| 23 | ;input:
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| 24 | ; RXI - array with ptrs to BPS TRANSACTION file (see ASKLINES^BPSSCRU4)
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| 25 | ;returns
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| 26 | ; 0 - if no claims were resubmitted
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| 27 | ; 1 - if at least one claim was resubmitted
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| 28 | RESUBMIT(RXI) ;*/
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| 29 | N BPRVRSED ;was successfully reversed
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| 30 | N BPRVNEED ;needs reversal
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| 31 | N BPRVWAIT ;cycles of waiting
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| 32 | N BPRVRSNT ;reversal has been sent
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| 33 | N WHERE,DOSDATE,BILLNUM,RXIEN,RXR,BPDFN
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| 34 | N BP59
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| 35 | N UPDATFLG,BPCLTOT,BPCLTOTR
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| 36 | N BPQ
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| 37 | N BPSTATUS
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| 38 | N REVCOUNT S REVCOUNT=0
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| 39 | N BPIFANY S BPIFANY=0
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| 40 | S BPCLTOT=0 ;total for resubmitted
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| 41 | S BPCLTOTR=0 ;total for reversed, not resubmitted
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| 42 | S UPDATFLG=0
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| 43 | S BP59="",BPQ=""
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| 44 | F S BP59=$O(RXI(BP59)) Q:BP59="" D Q:BPQ="^"
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| 45 | . I BPIFANY=0 W @IOF
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| 46 | . S BPIFANY=1,BPQ=""
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| 47 | . S BPDFN=+$P($G(^BPST(BP59,0)),U,6)
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| 48 | . W !,"You've chosen to RESUBMIT the following prescription for "_$E($$PATNAME^BPSSCRU2(BPDFN),1,13)
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| 49 | . W !,@VALMAR@(+$G(RXI(BP59)),0)
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| 50 | . S (BPRVNEED,BPRVRSED,BPRVWAIT,BPRVRSNT)=0
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| 51 | . S BPQ=$$YESNO("Are you sure?(Y/N)")
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| 52 | . I BPQ=-1 S BPQ="^" Q
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| 53 | . I BPQ'=1 Q
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| 54 | . S RXIEN=$P(BP59,".")
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| 55 | . S RXR=+$E($P(BP59,".",2),1,4)
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| 56 | . I BPRVNEED=1&(BPRVRSED'=1) Q ;cannot be resubmitted
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| 57 | . I $$RXDEL^BPSOS(+RXIEN,RXR) W !!,">> Cannot Reverse or Resubmit ",!,@VALMAR@(+$G(RXI(BP59)),0),!," because it has been deleted in Pharmacy.",! Q
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| 58 | . S BPSTATUS=$P($$CLAIMST^BPSSCRU3(BP59),U)
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| 59 | . I BPSTATUS["E REVERSAL REJECTED" W !!,">> Cannot Resubmit ",!,@VALMAR@(+$G(RXI(BP59)),0),!," because the REVERSAL was rejected.",! Q
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| 60 | . I BPSTATUS["IN PROGRESS" W !!,">> Cannot Resubmit ",!,@VALMAR@(+$G(RXI(BP59)),0),!," because there is no response from the payer yet.",! Q
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| 61 | . I BPSTATUS["E REVERSAL STRANDED" W !!,">> Cannot Resubmit ",!,@VALMAR@(+$G(RXI(BP59)),0),!," because there is no response for reversal yet.",! Q
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| 62 | . S DOSDATE=$$DOSDATE(RXIEN,RXR)
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| 63 | . S BILLNUM=$$EN^BPSNCPDP(RXIEN,RXR,DOSDATE,"ERES","","ECME RESUBMIT")
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| 64 | . ;print return value message
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| 65 | . W !!
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| 66 | . W:+BILLNUM>0 $S(+BILLNUM=10:"Reversal but no Resubmit:",1:"Not Processed:"),!," "
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| 67 | . ;Change Return Message for SC/EI
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| 68 | . S:$P(BILLNUM,U,2)="NEEDS SC DETERMINATION" $P(BILLNUM,U,2)="NEEDS SC/EI DETERMINATION"
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| 69 | . W $P(BILLNUM,U,2)
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| 70 | . ;0 Prescription/Fill successfully submitted to ECME for claims processing
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| 71 | . ;1 ECME did not submit prescription/fill
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| 72 | . ;2 IB says prescription/fill is not ECME billable or the data returned from IB is not valid
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| 73 | . ;3 ECME closed the claim but did not submit it to the payer
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| 74 | . ;4 Unable to queue the ECME claim
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| 75 | . ;5 Invalid input
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| 76 | . ;10 Reversal but no resubmit
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| 77 | . I +BILLNUM=0 D
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| 78 | . . D ECMEACT^PSOBPSU1(+RXIEN,+RXR,"Claim resubmitted to 3rd party payer: ECME USER's SCREEN")
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| 79 | . . S UPDATFLG=1,BPCLTOT=BPCLTOT+1
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| 80 | . I +BILLNUM=10 D
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| 81 | . . D ECMEACT^PSOBPSU1(+RXIEN,+RXR,"Claim reversed but not resubmitted: ECME USER's SCREEN")
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| 82 | . . S UPDATFLG=1,BPCLTOTR=BPCLTOTR+1
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| 83 | W:BPIFANY=0 !,"No eligible items selected."
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| 84 | W !,BPCLTOT," claim",$S(BPCLTOT'=1:"s have",1:" has")," been resubmitted.",!
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| 85 | W:BPCLTOTR>0 !,BPCLTOTR," claim",$S(BPCLTOTR'=1:"s have",1:" has")," been reversed but not resubmitted.",!
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| 86 | D PAUSE^VALM1
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| 87 | Q UPDATFLG
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| 88 | ;
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| 89 | ; Ask
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| 90 | ; Input:
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| 91 | ; BPQSTR - question
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| 92 | ; BPDFL - default answer
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| 93 | ; Output:
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| 94 | ; 1 YES
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| 95 | ; 0 NO
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| 96 | ; -1 if cancelled
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| 97 | YESNO(BPQSTR,BPDFL) ; Default - YES
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| 98 | N DIR,Y,DUOUT
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| 99 | S DIR(0)="Y"
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| 100 | S DIR("A")=BPQSTR
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| 101 | S:$L($G(BPDFL)) DIR("B")=BPDFL
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| 102 | D ^DIR
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| 103 | Q $S($G(DUOUT)!$G(DUOUT)!(Y="^"):-1,1:Y)
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| 104 | ;
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| 105 | ;Date of service
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| 106 | ;RXIEN - IEN in file #52
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| 107 | ;RXR - refill number
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| 108 | ;returns:
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| 109 | ; date of service
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| 110 | DOSDATE(RXIEN,RXR) ;
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| 111 | N BPDOS,BPDT
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| 112 | ;try release date
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| 113 | S BPDOS=$$RXRLDT^PSOBPSUT(RXIEN,RXR)\1
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| 114 | Q:+BPDOS>0 BPDOS
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| 115 | ;try fill date
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| 116 | S BPDOS=$$RXFLDT^PSOBPSUT(RXIEN,RXR)\1
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| 117 | I '$G(DT) Q BPDOS
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| 118 | I BPDOS>0,BPDOS'>DT Q BPDOS
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| 119 | ;use current date (today)
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| 120 | Q DT\1
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| 121 | ;
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| 122 | ;To display the FILL date on the screen
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| 123 | ; use Date Of Service date , later on it might be changed
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| 124 | ;input:
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| 125 | ;RXIEN - IEN in file #52
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| 126 | ;RXR - refill number
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| 127 | ;returns:
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| 128 | ; date of service
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| 129 | ; or empty date if failure
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| 130 | FILLDATE(RXIEN,RXR) ;
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| 131 | N DOSDT
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| 132 | S DOSDT=$$DOSDATE(RXIEN,RXR)
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| 133 | I $L(DOSDT)'=7 Q " / "
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| 134 | Q $E(DOSDT,4,5)_"/"_$E(DOSDT,6,7)
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| 135 | ;
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