| [613] | 1 | IBCB1 ;ALB/AAS - Process bill after enter/edited ;2-NOV-89
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| 2 | ;;2.0;INTEGRATED BILLING;**70,106,51,137,161,182,155,327**;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 | ;MAP TO DGCRB1
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| 6 | ;
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| 7 | ;IBQUIT = Flag to stop processing
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| 8 | ;IBVIEW = Flag for Bill has been viewed
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| 9 | ;IBDISP = Flag for Bill entering display been viewed.
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| 10 | ;
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| 11 | K ^UTILITY($J) I $D(IBAC),IBAC>1 G @IBAC
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| 12 | 1 ;complete bill
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| 13 | D END,EDITS^IBCB2 G:IBQUIT END
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| 14 | ;
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| 15 | I '$$IICM^IBCB2(IBIFN) G END ; Ingenix ClaimsManager
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| 16 | I '$$IIQMED^IBCB2(IBIFN) G END ; DSS QuadraMed Claims Scrubber
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| 17 | ;
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| 18 | 3 ;authorize bill/request MRA
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| 19 | I '$D(^XUSEC("IB AUTHORIZE",DUZ))!('$D(IBIFN)) W !!,"You do not hold the Authorize Key.",! G END
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| 20 | I '$P($G(^IBE(350.9,1,1)),"^",23),DUZ=$P(^DGCR(399,IBIFN,"S"),"^",2) W !!,"Entering user can not authorize.",! G END
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| 21 | I $P(^DGCR(399,IBIFN,"S"),"^",9) W !,"Already Approved, Can't change" G END
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| 22 | D:'$G(IBAC)!($G(IBAC)>1) EDITS^IBCB2 G:IBQUIT END
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| 23 | ;
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| 24 | I $G(IBAC)'=1,'$$IICM^IBCB2(IBIFN) G END ; Ingenix ClaimsManager
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| 25 | I $G(IBAC)'=1,'$$IIQMED^IBCB2(IBIFN) G END ; DSS QuadraMed Claims Scrubber
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| 26 | ;
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| 27 | AUTH S IBMRA=$$REQMRA^IBEFUNC(IBIFN)
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| 28 | S IBEND=0
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| 29 | I IBMRA["R" D AUTH^IBCB11 G:IBEND END ;MRA normally required, but MEDIGAP ins co
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| 30 | ; doesn't want/need it or MRA parameter off
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| 31 | ;
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| 32 | W !!,"THIS BILL WILL "_$P("NOT ^",U,$$TXMT^IBCEF4(IBIFN)+1)_"BE TRANSMITTED ELECTRONICALLY"
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| 33 | W !!,"WANT TO ",$S('IBMRA:"AUTHORIZE BILL",1:"REQUEST AN MRA")," AT THIS TIME" S %=2 D YN^DICN G:%=-1!(%=2) END
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| 34 | I '% W !?4,"YES - If finished entering bill information and to allow bill to be printed or transmitted",!?4,"No - To take no action" G AUTH
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| 35 | S (DIC,DIE)=399,IBYY=$S('IBMRA:"@90",1:"@901"),DA=IBIFN,DR="[IB STATUS]" D ^DIE K DIC,DIE,IBYY D:$D(IBX3) DISAP^IBCBULL
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| 36 | I $S('IBMRA:'$P(^DGCR(399,IBIFN,"S"),"^",9),1:'$P($G(^DGCR(399,IBIFN,"TX")),U,6)) G END
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| 37 | ;
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| 38 | ; Update the review status for all EOB's on file
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| 39 | D STAT^IBCEMU2(IBIFN,3) ; Accepted - Complete EOB
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| 40 | ;
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| 41 | D AUTOCK^IBCEU2(IBIFN) ; Checks for need to add any codes to bill based on information already on bill, specifically for EDI purposes
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| 42 | S IBTXSTAT=$$TXMT^IBCEF4(IBIFN,,1) ;Determine transmit, whether live/test
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| 43 | I IBTXSTAT D I IBMRA D CTCOPY^IBCCCB(IBIFN,1) G END
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| 44 | .W !," Adding "
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| 45 | .W:+IBTXSTAT=2 "test " W "bill to BILL TRANSMISSION File"_$S('IBMRA:"",1:" for MRA submission")_".",!
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| 46 | .W:+IBTXSTAT=1&IBMRA " Bill is no longer editable unless returned in error from Medicare."
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| 47 | .S Y=$$ADDTBILL(IBIFN,+IBTXSTAT)
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| 48 | .W ! W:'$P(Y,U,3) *7 W $S($P(Y,U,3):" Bill will be submitted electronically",1:" Error loading into transmit file - bill can not be transmitted.")
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| 49 | .;
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| 50 | ;
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| 51 | W !,"Passing completed Bill to Accounts Receivable. Bill is no longer editable."
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| 52 | D ARPASS(IBIFN,1)
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| 53 | G:'$G(PRCASV("OKAY")) END
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| 54 | W !,"Completed Bill Successfully sent to Accounts Receivable." D FIND^IBOHCK(DFN,IBIFN)
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| 55 | ;
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| 56 | ; Check to see if any unreviewed status messages or EOBs on file and
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| 57 | ; what to do about them
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| 58 | N IBTXBARR
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| 59 | S IBRESUB=$$RESUB^IBCECSA4($S($G(IBCNCOPY):$P($G(^DGCR(399,IBIFN,0)),U,15),1:IBIFN),+IBTXSTAT,"E",.IBTXBARR)
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| 60 | I IBRESUB=2 D ; update review statuses to be 'review complete'
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| 61 | . N IBDA S IBDA=0
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| 62 | . F S IBDA=$O(IBTXBARR(IBDA)) Q:'IBDA D UPDEDI^IBCEM(IBDA,$S($G(IBCNCOPY):"R",1:"E"))
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| 63 | . Q
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| 64 | ;
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| 65 | K IBTXPRT
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| 66 | ;
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| 67 | 4 ;generate/print bill
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| 68 | G:'$D(IBIFN) END
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| 69 | S:'$D(IBMRA) IBMRA=+$$NEEDMRA^IBEFUNC(IBIFN)
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| 70 | I 'IBMRA,'$P(^DGCR(399,IBIFN,"S"),"^",9) W !!,*7,"Not Authorized, Can Not Print!" G END
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| 71 | I IBMRA,'$P(^DGCR(399,IBIFN,"TX"),"^",6) W !!,*7,"Not Ready For MRA Submission, Can Not Print!" G END
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| 72 | S IBTXSTAT=$$TXMT^IBCEF4(IBIFN)
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| 73 | I IBMRA,$$NEEDMRA^IBEFUNC(IBIFN)'["R" W !!,*7,"MRA Submission not yet confirmed by Austin, Can Not Print!" Q:$S('IBTXSTAT:1,1:"XP"'[$P($G(^IBA(364,+$$LAST364^IBCEF4(IBIFN),0)),U,3))
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| 74 | I +IBTXSTAT,$D(^IBA(364,"ABDT",IBIFN)) S IBTXOK="" D I 'IBTXOK S %=2 G GENTX
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| 75 | . N IBX,IBTST
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| 76 | . S IBX=+$$LAST364^IBCEF4(IBIFN),IBTST=""
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| 77 | . I $$TEST^IBCEF4(IBIFN) S (IBTXOK,IBTST)=1
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| 78 | . I "XP"[$P($G(^IBA(364,IBX,0)),U,3) D:'IBTST Q
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| 79 | .. W !!,*7,"This Bill Can Not Be Printed Until Transmit Confirmed" W:IBMRA " (to request an MRA)" D:'$D(IBVIEW) VIEW^IBCB2
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| 80 | . W !!,"This Bill Has Already Been Transmitted" W:IBMRA " (to request an MRA)"
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| 81 | . S DIR("B")="Y",DIR("A")="WANT TO PRINT IT ANYWAY",DIR(0)="Y" D ^DIR K DIR Q:$D(DTOUT)!$D(DUOUT)!'Y S IBTXOK=1
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| 82 | D DISP^IBCB2
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| 83 | S:'$D(IBQUIT) IBQUIT=0
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| 84 | D:'$D(IBVIEW) VIEW^IBCB2 G:IBQUIT END
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| 85 | S IBPNT=$P(^DGCR(399,IBIFN,"S"),"^",12)
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| 86 | GEN I $$TEST^IBCEF4(IBIFN) W !!,"THIS BILL IS BEING USED AS A TRANSMISSION TEST BILL"
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| 87 | W !!,"WANT TO ",$S(IBPNT]"":"RE-",1:""),"PRINT BILL AT THIS TIME" S %=2 D YN^DICN I %=-1 D:+$G(IBAC)=1 END,CTCOPY^IBCCCB(IBIFN) G END
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| 88 | I '% W !?4,"YES - to print the bill now",!?4,"NO - To take no action" G GEN
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| 89 | GENTX I %'=1 D:+$G(IBAC)=1 END,CTCOPY^IBCCCB(IBIFN) G END
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| 90 | ;
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| 91 | ; Bill has never been printed. First time print.
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| 92 | I 'IBPNT D G END
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| 93 | . I $D(IBTXPRT) D TXPRTS
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| 94 | . D EN1^IBCF
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| 95 | . I $D(IBTXPRT) D TXPRT
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| 96 | . D MRA^IBCEMU1(IBIFN) ; Printing the MRA
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| 97 | . I +$G(IBAC)=1 D END,CTCOPY^IBCCCB(IBIFN)
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| 98 | . Q
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| 99 | ;
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| 100 | ; Below section is for re-prints
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| 101 | RPNT G:$$NEEDMRA^IBEFUNC(IBIFN) END
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| 102 | R !!,"(2)nd Notice, (3)rd Notice, (C)opy or (O)riginal: C// ",IBPNT:DTIME S:IBPNT="" IBPNT="C" G:IBPNT["^" END
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| 103 | S IBPNT=$E(IBPNT,1) I "23oOcC"'[IBPNT W !?5,"Enter 'O' to reprint the original bill or",!?5,"Enter 'C' to reprint the bill as a duplicate copy or",!?5,"Enter '2' or '3' to print 2nd or 3rd follow-up notices." S IBPNT=1 G RPNT
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| 104 | W " (",$S("cC"[IBPNT:"COPY","oO"[IBPNT:"ORIGINAL",IBPNT=2:"2nd NOTICE",IBPNT=3:"3rd NOTICE",1:""),")"
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| 105 | I $D(IBTXPRT) D
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| 106 | . D TXPRTS
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| 107 | . I "oOcC"[IBPNT S IBRESUB=$$RESUB^IBCECSA4(IBIFN,1,"P")
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| 108 | S IBPNT=$S("oO"[IBPNT:1,"cC"[IBPNT:0,1:IBPNT)
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| 109 | D EN1X^IBCF D:$D(IBTXPRT) TXPRT
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| 110 | D MRA^IBCEMU1(IBIFN) ; Printing the MRA
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| 111 | ;
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| 112 | ;
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| 113 | END K IBER,IBEND D END^IBCBB1 K IBQUIT,IBVIEW,IBDISP,IBST,IB,PRCAERCD,PRCAERR,PRCASVC,PRCAT,DGRA2,IBBT,IBCH,IBNDS,IBOA,IBREV,IBX,DGXRF1,PRCAORA,IBX3,DGBILLBS,DGII,DGVISCNT,DGFIL,DGTE,IBTXOK,IBTXSTAT,IBMRA,IBNOFIX
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| 114 | K %DT,DIC,DIE,I,J,X,Y,Y1,Y2,IBER,IBDFN,IBDSDT,IBJ,IBNDI1,IBZZ,VA,IBMA,IBXDT,DI,PRCAPAYR,DGBS,DGCNT,DGDA,DGPAG,DGREVC,DGRV,DGTEXT,DGTOTPAG,IBOPV,DGLCNT,DGTEXT1,DGRSPAC,DGSM,IBPNT,DGINPT,DGLL,IBCPTN,IBFL
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| 115 | K IBRESUB,IBOPV1,IBOPV2,IBCHG,DGBIL1,DGU,DDH,IBA1,IBINS,IBPROC,PRCARI K:'$D(PRCASV("NOTICE")) PRCASV
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| 116 | K ^TMP("IBXDATA",$J),^TMP("IBXEDIT",$J)
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| 117 | K IBCISNT,IBCISTAT,IBCIERR ; remove ClaimsManager variables
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| 118 | Q
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| 119 | ;
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| 120 | TX1(IBX,RESUB) ; Transmit a single bill from file 364 entry # IBX
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| 121 | ; RESUB = flag (1 = resubmitting a bill, 0 = submitting bill 1st time)
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| 122 | ; Returns 1 if successfully extracted to mailman queue for transmission,
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| 123 | ; 0 if extract not successful
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| 124 | N IBTXOK,IBVVSAVE
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| 125 | K ^TMP("IBRESUBMIT",$J),^TMP("IBONE",$J)
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| 126 | S IBVVSAVE("IBX")=IBX,^TMP("IBONE",$J)=+$G(RESUB),^($J,IBX)=""
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| 127 | D ONE^IBCE837
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| 128 | S IBX=IBVVSAVE("IBX")
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| 129 | I $P($G(^IBA(364,IBX,0)),U,3)="P" S IBTXOK=1
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| 130 | K ^TMP("IBONE",$J)
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| 131 | Q $G(IBTXOK)
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| 132 | ;
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| 133 | ARONLY(IBIFN) ; Pass bill to A/R, but that's all
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| 134 | D ARPASS(IBIFN,0)
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| 135 | Q
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| 136 | ;
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| 137 | ARPASS(IBIFN,UPDOK) ;Pass bill to A/R as NEW BILL
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| 138 | ;IBIFN = bill entry #
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| 139 | ;UPDOK = flag 1: if error going to A/R, allow interactive edit
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| 140 | ; 0: send bulletin to IB EDI for error going to A/R
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| 141 | Q:+$$STA^PRCAFN(+IBIFN)'=201 ;Must not have been sent previously
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| 142 | D GVAR^IBCBB
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| 143 | ;Can't be an ins co that won't reimburse
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| 144 | Q:$S($P($G(^DGCR(399,IBIFN,0)),U,11)="i":'IBNDMP,1:0)
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| 145 | D ARRAY^IBCBB1,^PRCASVC6
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| 146 | D REL^PRCASVC:$G(PRCASV("OKAY"))
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| 147 | I '$G(PRCASV("OKAY")) D
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| 148 | . N IBQUIT,IBQUIT1
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| 149 | . S IBQUIT=0
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| 150 | . I $G(UPDOK) D Q
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| 151 | .. F D Q:IBQUIT
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| 152 | ... D DSPARERR^IBCB2("")
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| 153 | ... Q:IBQUIT
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| 154 | ... I $$ASKEDIT^IBCB2($G(IBAC)) D VIEW1^IBCB2 Q
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| 155 | ... S IBQUIT=1
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| 156 | . N XMSUB,XMY,XMTEXT,XMDUZ,IBT
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| 157 | . S XMSUB="ERROR PASSING BILL TO A/R ON CONFIRMATION",XMTEXT="IBT(",XMY="G.IB EDI",XMDUZ=.5
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| 158 | . S IBT(1)="A problem has been detected while trying to pass bill "_$P($G(^DGCR(399,IBIFN,0)),U)_" to"
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| 159 | . S IBT(2)="Accounts Receivable when updating the bill's electronic confirmation."
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| 160 | . S IBT(3)="Please use the option PASS BILL TO A/R to complete this process."
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| 161 | . D ^XMD
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| 162 | Q
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| 163 | ;
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| 164 | ADDTBILL(IBIFN,TXST) ; Add new transmit bill rec to file 364 for bill IBIFN
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| 165 | ; TXST = test flag 1=live, 2=test
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| 166 | N COB,DD,DO,DIC,DLAYGO,X
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| 167 | S TXST=($G(TXST)/2\1),COB=$$COB^IBCEF(IBIFN)
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| 168 | S DIC(0)="L",DIC="^IBA(364,",DLAYGO=364,X=IBIFN,DIC("DR")=".03///X;.04///NOW;.07////"_TXST_";.08////"_COB D FILE^DICN
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| 169 | Q Y
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| 170 | ;
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| 171 | TXPRTS ; Save off last print date to see if bill was reprinted without queueing
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| 172 | I '$$NEEDMRA^IBEFUNC(IBIFN) S IBTXPRT("PRT")=$P($G(^DGCR(399,IBIFN,"S")),U,14)
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| 173 | Q
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| 174 | ;
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| 175 | TXPRT ; Set variable if print was tasked or bill was printed (last print date changed)
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| 176 | I '$$NEEDMRA^IBEFUNC(IBIFN),$S($G(ZTSK):1,1:IBTXPRT("PRT")'=$P($G(^DGCR(399,IBIFN,"S")),U,14)) S IBTXPRT=1
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| 177 | Q
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| 178 | ;
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