[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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