| [613] | 1 | IBBAADTI ;OAK/ELZ - PFSS INBOUND FILER ;15-MAR-2005 | 
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|  | 2 | ;;2.0;INTEGRATED BILLING;**286**;21-MAR-94 | 
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|  | 3 | ;;Per VHA Directive 10-93-142, this routine should not be modified. | 
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|  | 4 | ; | 
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|  | 5 | A04 ;receiver for returned A04 messages to create account | 
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|  | 6 | N IBBHDR,IBBMSG,IBBDFN,IBBARFN,IBBEXVN,HLERR | 
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|  | 7 | Q:'$$STARTMSG^HLPRS(.IBBMSG,HLMTIENS,.IBBHDR) | 
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|  | 8 | I $G(IBBHDR("EVENT"))'="A04" Q | 
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|  | 9 | S IBBDFN=+$$PID() | 
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|  | 10 | I 'IBBDFN S HLERR="Patient data could not be matched to database." D NAK Q | 
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|  | 11 | S IBBEXVN=+$$EXVN() | 
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|  | 12 | I 'IBBEXVN S HLERR="External billing system account # is not defined." D NAK Q | 
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|  | 13 | S IBBARFN=$$SET(IBBDFN,HLMTIENS) | 
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|  | 14 | I 'IBBARFN S HLERR="External billing system account # could not be filed." D NAK Q | 
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|  | 15 | I IBBARFN D ACK | 
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|  | 16 | Q | 
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|  | 17 | ; | 
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|  | 18 | A05 ;receiver for returned A05 messages to create account | 
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|  | 19 | N IBBHDR,IBBMSG,IBBDFN,IBBARFN,IBBEXVN,HLERR | 
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|  | 20 | Q:'$$STARTMSG^HLPRS(.IBBMSG,HLMTIENS,.IBBHDR) | 
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|  | 21 | I $G(IBBHDR("EVENT"))'="A05" Q | 
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|  | 22 | S IBBDFN=$$PID() | 
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|  | 23 | I 'IBBDFN S HLERR="Patient data could not be matched to database." D NAK Q | 
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|  | 24 | S IBBEXVN=+$$EXVN() | 
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|  | 25 | I 'IBBEXVN S HLERR="External billing system account # is not defined." D NAK Q | 
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|  | 26 | S IBBARFN=$$SET(IBBDFN,HLMTIENS) | 
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|  | 27 | I 'IBBARFN S HLERR="External billing system account # could not be filed." D NAK Q | 
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|  | 28 | I IBBARFN D ACK | 
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|  | 29 | Q | 
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|  | 30 | ; | 
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|  | 31 | SET(IBBDFN,HLMTIENS) ;set returned external account number in file #375 | 
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|  | 32 | N DIC,IEN1,IEN2,IENS,REC,PHYS,PHYSX,ALTNUM,ALTNUMX,PROC,PROCX,OUT,OK,X,XX | 
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|  | 33 | N IBBEVENT,IBBEXVN,IBBWHEN,IBBWHERE,IBBARFN,IBBIEN,IBBMSG,IBBHDR,IBBSEG,IBBARRAY | 
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|  | 34 | S IBBARFN="" | 
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|  | 35 | Q:'$G(HLMTIENS) IBBARFN | 
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|  | 36 | Q:'$G(IBBDFN) IBBARFN | 
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|  | 37 | Q:'$$STARTMSG^HLPRS(.IBBMSG,HLMTIENS,.IBBHDR) IBBARFN | 
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|  | 38 | ;parse critical data elements from HL7 msg | 
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|  | 39 | S OUT=0 | 
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|  | 40 | F  Q:OUT  Q:'$$NEXTSEG^HLPRS(.IBBMSG,.IBBSEG)  D | 
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|  | 41 | .I IBBSEG("SEGMENT TYPE")="EVN" D  Q | 
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|  | 42 | ..S (XX,IBBEVENT)=$$GET^HLOPRS(.IBBSEG,1,1,) | 
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|  | 43 | ..I ";A01;A04;A05;"'[(";"_XX_";") S OUT=1 | 
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|  | 44 | .I IBBSEG("SEGMENT TYPE")="PV1" D  Q | 
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|  | 45 | ..S IBBWHERE=$$GET^HLOPRS(.IBBSEG,3,1) | 
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|  | 46 | ..S PHYS=$E($$GET^HLOPRS(.IBBSEG,7,1),4,99) | 
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|  | 47 | ..S IBBARFN=$$GET^HLOPRS(.IBBSEG,5,1) | 
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|  | 48 | ..S IBBEXVN=$$GET^HLOPRS(.IBBSEG,19,1) | 
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|  | 49 | ..S ALTNUM=$$GET^HLOPRS(.IBBSEG,50,1) | 
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|  | 50 | ..S XX=$$GET^HLOPRS(.IBBSEG,44,1),IBBWHEN=$$FMDATE^HLFNC(XX) | 
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|  | 51 | .I IBBSEG("SEGMENT TYPE")="PR1" D  Q | 
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|  | 52 | ..S PROC=$$GET^HLOPRS(.IBBSEG,3,1) | 
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|  | 53 | ;exit if not event type of interest | 
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|  | 54 | Q:OUT IBBARFN | 
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|  | 55 | ;exit if external visit already known for A01 event | 
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|  | 56 | I IBBEVENT="A01",IBBWHERE'="FEE BASIS" S X=$$INTNUM(IBBEXVN) I X S IBBARFN=X Q IBBARFN | 
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|  | 57 | ;resolve location | 
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|  | 58 | I IBBWHERE'="FEE BASIS" D | 
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|  | 59 | .K Y S DIC=44,DIC(0)="MXZ",X=IBBWHERE | 
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|  | 60 | .D ^DIC | 
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|  | 61 | .I $P($G(Y),U,2)=IBBWHERE S IBBWHERE=+Y | 
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|  | 62 | I IBBWHERE="FEE BASIS" S IBBWHEN=$P(IBBWHEN,".",1) | 
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|  | 63 | ;verify account record if IBBARFN is not null | 
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|  | 64 | I IBBARFN D  I 'OK S IBBARFN="" | 
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|  | 65 | .S OK=1,IBBIEN=0 | 
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|  | 66 | .S IENS=IBBARFN_"," D GETS^DIQ(375,IENS,".01;.03;1.03;1.44;16.01","I","IBBARRAY") | 
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|  | 67 | .I IBBARFN'=$G(IBBARRAY(375,IENS,.01,"I")) S OK=0 Q | 
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|  | 68 | .I IBBDFN'=$G(IBBARRAY(375,IENS,.03,"I")) S OK=0 Q | 
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|  | 69 | .I IBBWHEN'=$G(IBBARRAY(375,IENS,1.44,"I")) S OK=0 Q | 
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|  | 70 | .I IBBEVENT="A01",IBBWHERE'=$G(IBBARRAY(375,IENS,16.01,"I")) S OK=0 Q | 
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|  | 71 | .I ((IBBEVENT="A04")!(IBBEVENT="A05"))&(IBBWHERE'=$G(IBBARRAY(375,IENS,1.03,"I"))) S OK=0 Q | 
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|  | 72 | .S IBBIEN=IBBARFN | 
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|  | 73 | ;find account record if IBBARFN is null; should be used (normally) only for inpatient A01 | 
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|  | 74 | I 'IBBARFN D | 
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|  | 75 | .S IBBIEN=0 | 
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|  | 76 | .I IBBWHERE=+IBBWHERE D | 
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|  | 77 | ..S IEN1=+$O(^IBBAA(375,"AC",IBBDFN,IBBWHEN,IBBWHERE,0)) | 
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|  | 78 | ..S IEN2=+$O(^IBBAA(375,"AC",IBBDFN,IBBWHEN,IBBWHERE,IEN1)) | 
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|  | 79 | .I IBBWHERE'=+IBBWHERE D | 
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|  | 80 | ..S IEN1=+$O(^IBBAA(375,"AF",IBBDFN,IBBWHEN,IBBWHERE,0)) | 
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|  | 81 | ..S IEN2=+$O(^IBBAA(375,"AF",IBBDFN,IBBWHEN,IBBWHERE,IEN1)) | 
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|  | 82 | .;inpatient admission | 
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|  | 83 | .I 'IEN1,IBBEVENT="A01",IBBWHERE'="FEE BASIS" S IBBIEN=$$INPT() Q | 
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|  | 84 | .;unique index entry | 
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|  | 85 | .I IEN1,'IEN2 S IBBIEN=IEN1 | 
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|  | 86 | .;multiple index entries | 
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|  | 87 | .I 'IBBIEN,IEN2,IBBWHERE=+IBBWHERE D | 
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|  | 88 | ..S IEN1=0 F  S IEN1=+$O(^IBBAA(375,"AC",IBBDFN,IBBWHEN,IBBWHERE,IEN1)) Q:'IEN1  D  Q:IBBIEN | 
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|  | 89 | ...S REC=$G(^IBBAA(375,IEN1,"PV1")),ALTNUMX=+$P(REC,U,50) | 
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|  | 90 | ...I $G(ALTNUM),ALTNUMX=ALTNUM S IBBIEN=IEN1 Q | 
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|  | 91 | ...I $G(ALTNUM),ALTNUMX'=ALTNUM Q | 
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|  | 92 | ...S PHYSX=$P(REC,U,7) | 
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|  | 93 | ...I $G(PHYS),PHYSX=PHYS S IBBIEN=IEN1 Q | 
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|  | 94 | ...I $G(PHYS),PHYSX'=PHYS Q | 
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|  | 95 | ...I $G(PROC)'="" S PROC=$$CODEN^ICPTCOD(PROC),PROCX=$P($G(^IBBAA(375,IEN1,"PR1")),U,3) | 
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|  | 96 | ...I +PROC,PROCX=PROC S IBBIEN=IEN1 Q | 
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|  | 97 | ;store external visit # | 
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|  | 98 | I $G(IBBIEN) D | 
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|  | 99 | .S:('IBBARFN) IBBARFN=IBBIEN | 
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|  | 100 | .I $P(^IBBAA(375,IBBIEN,0),U,2)="" D | 
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|  | 101 | ..S $P(^IBBAA(375,IBBIEN,0),U,2)=IBBEXVN | 
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|  | 102 | ..S $P(^IBBAA(375,IBBIEN,0),U,5)=$$NOW^XLFDT() | 
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|  | 103 | ..D EVENT^IBBAACCT(IBBIEN,IBBEVENT,"I") | 
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|  | 104 | Q IBBARFN | 
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|  | 105 | ; | 
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|  | 106 | INPT() ;set new account record for inpatient admission | 
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|  | 107 | N IBB,IBBARFN,IBBIEN,IBBIENS,IBBERR,FDA,X | 
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|  | 108 | S IBBARFN=0 | 
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|  | 109 | L +^IBBAA(375,0):5 | 
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|  | 110 | Q:'$T 0 | 
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|  | 111 | S IBBIEN=$P(^IBBAA(375,0),U,3)+1 | 
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|  | 112 | S IBBIEN(1)=IBBIEN | 
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|  | 113 | S IBBIENS="+1," | 
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|  | 114 | S IBBERR="IBB(""DIERR"")" | 
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|  | 115 | S FDA(375,IBBIENS,.01)=IBBIEN | 
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|  | 116 | S FDA(375,IBBIENS,.02)=IBBEXVN | 
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|  | 117 | S FDA(375,IBBIENS,.03)=IBBDFN | 
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|  | 118 | S FDA(375,IBBIENS,.04)="COTS_SYSTEM" | 
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|  | 119 | S FDA(375,IBBIENS,.05)=$$NOW^XLFDT | 
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|  | 120 | D UPDATE^DIE("","FDA","IBBIEN",IBBERR) | 
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|  | 121 | L -^IBBAA(375,0) | 
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|  | 122 | I '$D(IBB("DIERR")) D | 
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|  | 123 | .S IBBARFN=IBBIEN | 
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|  | 124 | .S X="",$P(X,U,2)="I",$P(X,U,3)=IBBWHERE,$P(X,U,44)=IBBWHEN | 
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|  | 125 | .S ^IBBAA(375,IBBIEN,"PV1")=X | 
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|  | 126 | .D EVENT^IBBAACCT(IBBIEN,IBBEVENT,"I") | 
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|  | 127 | .S ^IBBAA(375,"AC",IBBDFN,IBBWHEN,IBBWHERE,IBBIEN)="" | 
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|  | 128 | Q IBBARFN | 
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|  | 129 | ; | 
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|  | 130 | INTNUM(IBBEXVN) ;return PFSS Account Reference using external visit number | 
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|  | 131 | N IBBARFN,XX | 
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|  | 132 | S IBBARFN="" | 
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|  | 133 | Q:'$G(IBBEXVN) IBBARFN | 
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|  | 134 | S XX=$O(^IBBAA(375,"C",IBBEXVN,0)) | 
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|  | 135 | I XX S IBBARFN=XX | 
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|  | 136 | Q IBBARFN | 
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|  | 137 | ; | 
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|  | 138 | PID() ;get DFN from HL7 message; compare to file #2 data | 
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|  | 139 | N IBBARRY,OUT,REP,FILE,FIELD,IENS,XID,XTYP,XSITE,XSSN,XNAME,XX | 
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|  | 140 | S OUT=0,XID=0,XSSN=0 | 
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|  | 141 | F  Q:OUT  Q:'$$NEXTSEG^HLPRS(.IBBMSG,.IBBSEG)  I IBBSEG("SEGMENT TYPE")="PID"  D | 
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|  | 142 | .S XNAME=$$GET^HLOPRS(.IBBSEG,5,1,1) | 
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|  | 143 | .F REP=1:1 Q:OUT  D | 
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|  | 144 | ..S XTYP=$$GET^HLOPRS(.IBBSEG,3,5,1,REP) | 
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|  | 145 | ..I XTYP="PI" D | 
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|  | 146 | ...S XX=$$GET^HLOPRS(.IBBSEG,3,1,1,REP) | 
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|  | 147 | ...S XSITE=+$E(XX,1,3),XID=+$E(XX,4,99) | 
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|  | 148 | ..I XTYP="SS" S XSSN=$$GET^HLOPRS(.IBBSEG,3,1,1,REP) | 
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|  | 149 | ..I XID&XSSN S OUT=1 | 
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|  | 150 | I XSITE=$P($$SITE^VASITE(),U,3) D | 
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|  | 151 | .S FILE=2,IENS=XID_",",FIELD=".01;.09" | 
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|  | 152 | .D GETS^DIQ(FILE,IENS,FIELD,"","IBBARRY") | 
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|  | 153 | .I XSSN'=$G(IBBARRY(2,IENS,.09)) S XID=0 | 
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|  | 154 | .I XNAME'=$P($G(IBBARRY(2,IENS,.01)),",",1) S XID=0 | 
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|  | 155 | Q XID | 
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|  | 156 | ; | 
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|  | 157 | EXVN() ;external account/visit number must be non-null | 
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|  | 158 | N OUT,IBBEXVN | 
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|  | 159 | S IBBEXVN="",OUT=0 | 
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|  | 160 | F  Q:OUT  Q:'$$NEXTSEG^HLPRS(.IBBMSG,.IBBSEG)  D | 
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|  | 161 | .I IBBSEG("SEGMENT TYPE")="PV1" D  Q | 
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|  | 162 | ..S IBBEXVN=$$GET^HLOPRS(.IBBSEG,19,1),OUT=1 | 
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|  | 163 | Q IBBEXVN | 
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|  | 164 | ; | 
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|  | 165 | ACK ; prepare positive acknowledgement (AA) message | 
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|  | 166 | N HLA,HLRESULT | 
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|  | 167 | S XX=$$SETPURG^HLUTIL(0) | 
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|  | 168 | S HLA("HLA",$J,1)="MSA"_HL("FS")_"AA"_HL("FS")_HL("MID") | 
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|  | 169 | D GENACK^HLMA1(HL("EID"),HLMTIENS,HL("EIDS"),"LM",1,.HLRESULT) | 
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|  | 170 | Q | 
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|  | 171 | ; | 
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|  | 172 | NAK ;prepare negative acknowledgement (AE) message | 
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|  | 173 | N HLA,HLRESULT | 
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|  | 174 | S XX=$$SETPURG^HLUTIL(1) | 
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|  | 175 | S HLA("HLA",$J,1)="MSA"_HL("FS")_"AE"_HL("FS")_HL("MID")_HL("FS")_HLERR | 
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|  | 176 | D GENACK^HLMA1(HL("EID"),HLMTIENS,HL("EIDS"),"LM",1,.HLRESULT) | 
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|  | 177 | Q | 
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|  | 178 | ; | 
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|  | 179 | IBBACONV(IBBDFN,IBBTYPE,IBBWHEN,IBBWHERE,IBBEXVN) ;new account record for converted inpatient or outpatient | 
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|  | 180 | ;called only from DG or SD routine during back-load of converted data | 
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|  | 181 | ;input  IBBDFN   = pointer to file #2 | 
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|  | 182 | ;       IBBTYPE  = I(npatient) or O(utpatient) | 
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|  | 183 | ;       IBBWHEN  = date/time of visit; internal FM format | 
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|  | 184 | ;       IBBWHERE = location of visit; pointer to file #44 | 
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|  | 185 | ;       IBBEXVN  = external system visit # | 
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|  | 186 | ;output IBBARFN  = ien in file #375; PFSS Account Reference | 
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|  | 187 | ; | 
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|  | 188 | N IBB,IBBARFN,IBBIEN,IBBIENS,IBBERR,FDA,X | 
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|  | 189 | S IBBARFN=0 | 
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|  | 190 | L +^IBBAA(375,0):5 | 
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|  | 191 | Q:'$T 0 | 
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|  | 192 | S IBBIEN=$P(^IBBAA(375,0),U,3)+1 | 
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|  | 193 | S IBBIEN(1)=IBBIEN | 
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|  | 194 | S IBBIENS="+1," | 
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|  | 195 | S IBBERR="IBB(""DIERR"")" | 
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|  | 196 | S FDA(375,IBBIENS,.01)=IBBIEN | 
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|  | 197 | S FDA(375,IBBIENS,.02)=$G(IBBEXVN) | 
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|  | 198 | S FDA(375,IBBIENS,.03)=$G(IBBDFN) | 
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|  | 199 | S FDA(375,IBBIENS,.04)="CONVERSION" | 
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|  | 200 | S FDA(375,IBBIENS,.05)=$$NOW^XLFDT | 
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|  | 201 | D UPDATE^DIE("","FDA","IBBIEN",IBBERR) | 
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|  | 202 | L -^IBBAA(375,0) | 
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|  | 203 | I '$D(IBB("DIERR")) D | 
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|  | 204 | .S IBBARFN=IBBIEN | 
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|  | 205 | .S X="",$P(X,U,2)=$G(IBBTYPE),$P(X,U,3)=$G(IBBWHERE),$P(X,U,44)=$G(IBBWHEN) | 
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|  | 206 | .S ^IBBAA(375,IBBIEN,"PV1")=X | 
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|  | 207 | .I IBBTYPE="O" S $P(^IBBAA(375,IBBIEN,"PV2"),U,8)=$G(IBBWHEN) | 
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|  | 208 | .I $G(IBBDFN),$G(IBBWHEN),$G(IBBWHERE) S ^IBBAA(375,"AC",IBBDFN,IBBWHEN,IBBWHERE,IBBIEN)="" | 
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|  | 209 | Q IBBARFN | 
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