| 1 | BPSUTIL ;BHAM ISC/FLS/SS - General Utility functions ;06/01/2004
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| 2 | ;;1.0;E CLAIMS MGMT ENGINE;**1,3,2,5**;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 | ;
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| 5 | Q
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| 6 | ;
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| 7 | ; ECMEON
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| 8 | ; Input:
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| 9 | ; SITE - Pointer to Outpatient Site file (#59)
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| 10 | ; Output
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| 11 | ; 1 - ECME is turned ON for the Outpatient Site
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| 12 | ; 0 - ECME is not turned ON for the Outpatient Site.
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| 13 | ; Note that ON means that the Outpatient site is linked to an active
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| 14 | ; BPS Pharmacy that has a Pharmacy ID.
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| 15 | ECMEON(SITE) ;
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| 16 | I '$G(SITE) Q 0
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| 17 | N BPSPHARM,FACID
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| 18 | S FACID=0
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| 19 | S BPSPHARM=$$GETPHARM(SITE)
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| 20 | I BPSPHARM="" Q 0
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| 21 | S FACID=$$GET1^DIQ(9002313.56,BPSPHARM_",",41.01)
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| 22 | I FACID="",'$$NPIREQ^BPSNPI(DT) S FACID=$$GET1^DIQ(9002313.56,BPSPHARM_",",.02)
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| 23 | Q $S(FACID:1,1:0)
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| 24 | ;
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| 25 | CMOPON(SITE) ; - Returns 1 if CMOP is turned ON for ECME or 0 if not
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| 26 | ; SITE - Pointer to #59 (OUTPATIENT SITE)
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| 27 | Q:'$G(SITE) 0
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| 28 | N PHRM S PHRM=$O(^BPS(9002313.56,"C",SITE,0)) I 'PHRM Q 0
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| 29 | Q $$GET1^DIQ(9002313.56,PHRM,1,"I")
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| 30 | ;
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| 31 | ;Function returns STATUS flag from BPS PHARMACIES (file #56)
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| 32 | ; Returns '1' for active or '0' for inactive BPS Pharmacy
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| 33 | BPSACTV(BPSPHARM) ;
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| 34 | Q:'$G(BPSPHARM) 0
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| 35 | Q +$P($G(^BPS(9002313.56,BPSPHARM,0)),U,10)
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| 36 | ;
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| 37 | BPSPLN(RXI,RXR) ; - Returns the insurance PLAN NAME (902.24) field from BPS TRANSACTION
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| 38 | ;
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| 39 | ; Input variables -> RXI - Internal Prescription File IEN
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| 40 | ; RXR - Refill Number
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| 41 | ;
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| 42 | I '$G(RXI) Q ""
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| 43 | I '$G(RXR) S RXR=0
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| 44 | N IEN59 S IEN59=$$IEN59^BPSOSRX(RXI,RXR) Q:IEN59="" ""
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| 45 | N CINS S CINS=$$GET1^DIQ(9002313.59,IEN59,901) Q:'CINS ""
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| 46 | Q $$GET1^DIQ(9002313.59902,CINS_","_IEN59,902.24)
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| 47 | ;
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| 48 | ;API for IB (IA #4146) to select BPS PHARMACY
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| 49 | ;returns results as a local array BPPHARM
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| 50 | ; Select the ECME Pharmacy or Pharmacies
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| 51 | ;
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| 52 | ; Input Variable -> BPSPHAR is passed by reference to get the result of user's selection
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| 53 | ; BPPHARM = 1 One or More Pharmacies Selected
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| 54 | ; = 0 User Entered 'ALL'
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| 55 | ; If BPSPHAR = 1 then the BPSPHAR array will be defined where:
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| 56 | ; BPSPHAR(ptr) = ptr ^ BPS PHARMACY NAME and
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| 57 | ; ptr = Internal Pointer to BPS PHARMACIES file (#9002313.56)
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| 58 | ;
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| 59 | ; Return Value -> "" = Valid Entry or Entries Selected
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| 60 | ; ^ = Exit
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| 61 | SELPHARM(BPSPHAR) ;
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| 62 | N BPRET,BPPHARM
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| 63 | S BPRET=$$SELPHARM^BPSRPT3()
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| 64 | M BPSPHAR=BPPHARM
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| 65 | Q BPRET
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| 66 | ;
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| 67 | ;
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| 68 | ;API for IB (IA #4146) to determine whether is one or more BPS PHARMACIES in the system
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| 69 | ;Function returns
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| 70 | ;1 - if the site has more than one record in the file #9002313.56
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| 71 | ;0 - if there are no any divisions
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| 72 | ;0^NAME OF THE EPHARM - if only one division return 0 and its name
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| 73 | ; to use in the header of the report
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| 74 | MULTPHRM() ;
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| 75 | N IBX
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| 76 | S IBX=+$O(^BPS(9002313.56,0))
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| 77 | I IBX=0 Q 0
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| 78 | I $O(^BPS(9002313.56,IBX))>0 Q 1
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| 79 | Q "0^"_$$GET1^DIQ(9002313.56,IBX,.01,"E")
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| 80 | ;
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| 81 | ; Function for IB (IA #4146) to return site linked to pharmacy
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| 82 | ; Input
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| 83 | ; BPSDIV - Outpatient Site
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| 84 | ; Returns
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| 85 | ; BPSPHARM - BPS Pharmacy IEN
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| 86 | GETPHARM(BPSDIV) ;
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| 87 | N BPSPHARM
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| 88 | I $G(BPSDIV)="" Q ""
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| 89 | S BPSPHARM=$O(^BPS(9002313.56,"C",BPSDIV,0)) I 'BPSPHARM Q ""
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| 90 | Q:'$$BPSACTV^BPSUTIL(BPSPHARM) ""
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| 91 | Q BPSPHARM
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| 92 | ;
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| 93 | ;API for the IB package (IA#4146)
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| 94 | ;Input parameters:
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| 95 | ; BPSRX - Rx ien (file #52)
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| 96 | ; BPSREFNO - refill number
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| 97 | ;Returned value:
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| 98 | ; 1st piece:
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| 99 | ; 0 - status "non-payable" OR there is no response from the payer for whatever reason OR wasn't submitted OR invalid parameters
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| 100 | ; 1- status "payable"
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| 101 | ; 2nd piece:
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| 102 | ; amount the payer agreed to pay
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| 103 | ; 3rd piece:
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| 104 | ; Date of Service
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| 105 | ;
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| 106 | PAIDAMNT(BPSRX,BPSREFNO) ;
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| 107 | I ($G(BPSRX)="")!($G(BPSREFNO)="") Q "0^"
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| 108 | N BPSTAT,BPSRET,IEN59,BPSRESP,BPDOS
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| 109 | S BPSTAT=$$STATUS^BPSOSRX(BPSRX,BPSREFNO)
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| 110 | ;The status of the claim should be "payable" in order to get amount of the 3rd party payment
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| 111 | ;If it was an attempt to reverse the payable claim AND reversal was rejected
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| 112 | ;then the claim still is considered as "payable" and we still can get the amount paid by the 3rd party.
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| 113 | ;In this case we return 1 (payable) in first piece and the amount paid in the 2nd piece of the returned value.
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| 114 | ;All other statuses mean that we cannot get amount paid so we return 0 = "non payable"
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| 115 | I $P(BPSTAT,U)'="E PAYABLE",$P(BPSTAT,U)'="E REVERSAL REJECTED",$P(BPSTAT,U)'="E DUPLICATE" Q "0^"
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| 116 | ;get ien for BPS TRANSACTION file
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| 117 | S IEN59=+$$IEN59^BPSOSRX(BPSRX,BPSREFNO)
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| 118 | I IEN59="" Q "0^" ;BPS Transaction IEN could not be calculated
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| 119 | S BPSRESP=+$P($G(^BPST(IEN59,0)),U,5)
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| 120 | ;response from the payer was not found - either claim was never submitted OR there
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| 121 | ;is no response for some reason - either way - we cannot provide the amount paid, so return "0"
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| 122 | I BPSRESP=0 Q "0^"
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| 123 | S BPDOS=+$P($G(^BPST(IEN59,12)),U,2)
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| 124 | S BPSRET=+$$INSPAID^BPSOS03(BPSRESP)
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| 125 | Q "1^"_BPSRET_U_BPDOS
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| 126 | ;
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| 127 | ; NPIEXTR
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| 128 | ; This API was written for the NPI extract (XUSNPIX2) and returns
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| 129 | ; the NCPDP and STATUS of the associated BPS Pharmacy
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| 130 | ; Input:
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| 131 | ; SITE - Pointer to Outpatient Site file (#59)
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| 132 | ; Output
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| 133 | ; NCPDP^STATUS (0 - inactive, 1 - active)
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| 134 | ; "" if no SITE passed in or no linkage
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| 135 | NPIEXTR(SITE) ;
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| 136 | I '$G(SITE) Q ""
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| 137 | N BPSPHARM,NCPDP,STATUS
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| 138 | S BPSPHARM=$O(^BPS(9002313.56,"C",SITE,0))
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| 139 | I 'BPSPHARM Q ""
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| 140 | S STATUS=$$BPSACTV^BPSUTIL(BPSPHARM)
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| 141 | S NCPDP=$$GET1^DIQ(9002313.56,BPSPHARM_",",.02)
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| 142 | Q NCPDP_"^"_STATUS
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