| 1 | IBCB2 ;ALB/AAS - Process bill after enter/edited ;13-DEC-89
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| 2 | ;;2.0;INTEGRATED BILLING;**52,51,161,182,155**;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 DGCRB2
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| 6 | ;
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| 7 | ;IBQUIT = Flag to stop processing
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| 8 | ;IBVIEW = Flag showing Bill has been viewed
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| 9 | ;IBDISP = Flag showing Bill entering display has been viewed.
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| 10 | ;IBNOFIX = Flag to indicate do not ask to edit or review bill screens
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| 11 | ;IBREEDIT = Flag to indicate Bill has been re-edited
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| 12 | ;
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| 13 | VIEW ;View screens; if status allows editing , allow editing
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| 14 | N Y,DIR
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| 15 | S IBPOPOUT=0
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| 16 | S IBVIEW=1,IBV=$S($D(IBV):IBV,1:1)
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| 17 | S DIR(0)="YA",DIR("B")="NO",DIR("A")="WANT TO "_$S('IBV:"EDIT",1:"REVIEW")_" SCREENS? ",DIR("?",1)=" YES - to "_$S('IBV:"EDIT",1:"REVIEW")_" the screens",DIR("?")=" NO - To take no action"
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| 18 | D ^DIR K DIR
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| 19 | S:$D(DTOUT) IBQUIT=1
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| 20 | Q:Y'=1
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| 21 | I $G(IBREEDIT)=1,'IBV S IBREEDIT=2 ; set flag indicating re-edit
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| 22 | VIEW1 S IBVIEW=1,IBEDIT=0
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| 23 | D SCREENS
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| 24 | S:$G(IBPOPOUT) IBQUIT=1
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| 25 | Q
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| 26 | ;
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| 27 | DISP S IB("S")=$S($D(^DGCR(399,IBIFN,"S")):^("S"),1:"")
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| 28 | W ! D DISP^IBCNQ W !
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| 29 | S IBDISP=1 Q
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| 30 | Q
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| 31 | ;
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| 32 | EDITS ; Perform edits on bill prior to authorization/transmission
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| 33 | N IBREEDIT
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| 34 | ED1 ;
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| 35 | S IBQUIT=0
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| 36 | I '$D(IBER)!('$D(PRCASV)) D ALLED(.IBQUIT)
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| 37 | ;
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| 38 | ; If the user is wanting to quit, but there are some unresolved
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| 39 | ; errors reported by ClaimsManager, then capture the user's Exit
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| 40 | ; comments.
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| 41 | ;
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| 42 | I $$CM^IBCIUT1(IBIFN),IBQUIT,$P($G(^IBA(351.9,IBIFN,0)),U,2)=4 D COMMENT^IBCIUT7(IBIFN,1)
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| 43 | ;
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| 44 | Q:IBQUIT
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| 45 | D:'$D(IBDISP) DISP
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| 46 | ;
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| 47 | ; If claim re-edit, then call the IB edit checks again
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| 48 | I '$D(IBVIEW) S IBREEDIT=1 D VIEW I $G(IBREEDIT)=2 K IBER,IBDISP,IBVIEW G ED1
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| 49 | Q
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| 50 | ;
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| 51 | ALLED(IBQUIT) ; Billing edit/correction
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| 52 | N IBQUIT1,IBDONE1,IBDONE,IBEDIT,IBCORR,IBER,IBPRT,IBXERR
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| 53 | S (IBQUIT,IBDONE,IBCORR)=0,IBER=""
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| 54 | ; IBDONE = 1 ==> exit, no errors
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| 55 | ; IBQUIT = 1 ==> exit, errors not corrected
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| 56 | I $$FT^IBCEF(IBIFN)=2,'$G(IBNOFIX) D DISP24(IBIFN,.IBCORR,.IBQUIT)
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| 57 | ;
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| 58 | F D Q:IBQUIT!IBDONE D VIEW1 I $$FT^IBCEF(IBIFN)=2,'$G(IBNOFIX),'IBQUIT S IBCORR=0 D DISP24(IBIFN,.IBCORR,.IBQUIT)
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| 59 | . I $G(IBPOPOUT) S IBQUIT=1
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| 60 | . Q:IBQUIT!IBCORR
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| 61 | . I $G(IBNOFIX) D
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| 62 | .. W !!,"... Checking claim validity"
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| 63 | . E D
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| 64 | .. W !!,"... Executing national IB edits"
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| 65 | . D EN^IBCBB,LOCERR
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| 66 | . ;
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| 67 | . I $G(IBER)'=""!$D(IBXERR) D Q:'IBDONE
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| 68 | .. D DSPLERR ; Displays warnings/errors
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| 69 | .. K IBXERR
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| 70 | .. Q:IBQUIT!(IBDONE)
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| 71 | .. I $G(IBNOFIX) S IBDONE=1 Q
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| 72 | .. I '$$ASKEDIT($G(IBAC)) W ! S IBQUIT=1 ; Don't want to re-edit
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| 73 | .. ;
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| 74 | . I $G(IBNOFIX) S IBDONE=1 Q
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| 75 | . S IBEDIT=0
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| 76 | . I $S($P($G(^DGCR(399,IBIFN,0)),U,13)>2:1,$D(PRCASV):'$D(PRCASV("OKAY")),1:0) D S:'IBQUIT&'IBEDIT IBDONE=1 Q
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| 77 | .. N IBQUIT1
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| 78 | .. S IBQUIT1=0
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| 79 | .. W !!!,"... Executing A/R edits"
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| 80 | .. I $P($G(^DGCR(399,IBIFN,0)),U,13)>2 D GVAR^IBCBB,ARRAY^IBCBB1
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| 81 | .. D ARCHK($G(IBNOFIX),0,.IBQUIT1,.IBQUIT,.IBEDIT,.PRCASV)
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| 82 | . S IBDONE=1 ; No errors
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| 83 | . S:$G(IBPRT("PRT"))'<0 IBQUIT=0
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| 84 | Q
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| 85 | ;
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| 86 | ARCHK(IBNOFIX,IBNOPRT,IBQUIT1,IBQUIT,IBEDIT,PRCASV) ; A/R Verification
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| 87 | ; Returns IBEDIT, IBQUIT1, IBQUIT,PRCASV array if passed by reference
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| 88 | ; IBNOFIX = 1 if no editing needed
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| 89 | ; IBNOPRT = 1 if no printing needed
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| 90 | F D ^PRCASVC6 D Q:IBQUIT1!IBEDIT D GVAR^IBCBB,ARRAY^IBCBB1
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| 91 | . I '$G(IBNOPRT) Q:$G(IBPRT("PRT"))<0
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| 92 | . I PRCASV("OKAY") W:'$G(IBNOPRT) !!,"No A/R errors found" S IBQUIT1=1 Q
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| 93 | . I 'PRCASV("OKAY") D Q
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| 94 | .. D DSPARERR($G(IBNOPRT)) ; Display A/R errors
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| 95 | .. Q:IBQUIT
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| 96 | .. I $G(IBNOFIX) S IBQUIT1=1 Q
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| 97 | .. I '$$ASKEDIT($G(IBAC)) W !,"There is an unresolved A/R error - cannot authorize bill" D PAUSE^VALM1 S (IBQUIT,IBQUIT1)=1 Q
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| 98 | .. S IBEDIT=1
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| 99 | ;
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| 100 | Q
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| 101 | ;
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| 102 | DSPLERR ; Display national/local edits failed
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| 103 | N Z
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| 104 | D PRTH(.IBPRT)
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| 105 | I IBPRT("PRT")<0 S IBQUIT=1 Q
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| 106 | S Z=0 F S Z=$O(^TMP($J,"BILL-WARN",Z)) Q:'Z W !,^(Z) W:'$O(^(Z)) !
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| 107 | S Y2=""
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| 108 | I IBER'="WARN" F I=1:1 S X=$P(IBER,";",I) Q:X="" W:I=1 !?5,"**Errors**:" I $D(^IBE(350.8,+$O(^IBE(350.8,"AC",X,0)),0)) S Y=^(0),Y1=$P(Y,"^",5),Y2=Y2_Y1 I Y1<5 W !?5,$E($P(Y,"^",2),1,80)
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| 109 | ; IBXERR = local edits return error array
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| 110 | ; If IBXERR returns = 1 then we have at least one error
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| 111 | ; = "" or 0, then we have only local warnings
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| 112 | ; undefined = no local errors or warnings
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| 113 | I $D(IBXERR) D
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| 114 | . S I="" W !!,?3,"Local Edits:"
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| 115 | . S:$G(IBXERR) Y2=3,IBER="L"
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| 116 | . F S I=$O(IBXERR(I)) Q:I="" W !,?5,$E(IBXERR(I),1,75)
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| 117 | I $G(IBPRT("PRT")) D CLOSE(.IBPRT)
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| 118 | G:$G(IBNOFIX) Q
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| 119 | I $G(IBER)="WARN"!($G(IBXERR)=0) D ;Warnings only - make biller stop and look
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| 120 | . W !
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| 121 | . N DIR,X,Y
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| 122 | . S DIR(0)="YA",DIR("B")="NO",DIR("A",1)="THIS BILL STILL HAS ONE OR MORE WARNINGS - PLEASE REVIEW THEM CAREFULLY",DIR("A")="ARE YOU SURE IT'S OK TO CONTINUE? "
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| 123 | . D ^DIR K DIR
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| 124 | . I Y'=1 S Y2=3 Q
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| 125 | . S IBER="",IBDONE=1 K IBXERR
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| 126 | I $S(Y2'["3"&'$G(IBXERR):0,1:1) K IBXERR
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| 127 | Q K ^TMP($J,"BILL-WARN")
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| 128 | Q
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| 129 | ;
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| 130 | DSPARERR(IBNOPRT) ; Displays A/R errors
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| 131 | N I,J,Y,X,ERRPRT
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| 132 | I '$G(IBNOPRT) D PRTH(.IBPRT) I IBPRT("PRT")<0 S IBQUIT=1 Q
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| 133 | I $P($G(PRCAERR),U,2)'="" D
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| 134 | . N Z
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| 135 | . S Z=+$O(^IBE(350.8,"C",$P(PRCAERR,U,2),0)),Z=$P($G(^IBE(350.8,+Z,0)),U,2)
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| 136 | . W !,?5,"An A/R error has been reported - bill cannot be authorized",!!,?5,$P(PRCAERR,U,2)," - ",$S(Z'="":Z,1:"??")
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| 137 | E D
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| 138 | . W !,?5,"An undetermined A/R error was found - "_$G(PRCAERR)
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| 139 | I $G(IBPRT("PRT")) D CLOSE(.IBPRT)
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| 140 | Q
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| 141 | ;
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| 142 | NOPTF S IBAC1=1 I $D(^DGCR(399,IBIFN,0)),$P(^(0),"^",8),'$D(^DGPT($P(^(0),"^",8),0)) S IBAC1=0
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| 143 | Q
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| 144 | ;
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| 145 | NOPTF1 W !!,*7,"PTF Record for this Bill was DELETED!",!,"Further processing not allowed. Cancel and re-enter." Q
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| 146 | ;
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| 147 | LOCERR ; Check for local edits
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| 148 | ; Execute screen post-processor for bills with local scrn 9 affiliations
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| 149 | N IBZ,IBXIEN,IBPRT
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| 150 | K IBXERR
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| 151 | S IBZ=$$LOCSCRN^IBCSC9(IBIFN)
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| 152 | I IBZ S IBXIEN=IBIFN W !!,"... Executing local IB edits" D FPOST^IBCEFG7(IBZ,0,.IBXERR) I '$D(IBXERR) W !!,"No errors found for local edits"
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| 153 | Q
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| 154 | ;
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| 155 | PRTH(IBPRT,IBA) ; Print a heading for error/warnings sent to a printer
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| 156 | ; Returns IBPRT = 1 if valid pritner selected
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| 157 | ; IBPRT = -1 if '^' entered
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| 158 | ; IBPRT = 0 if home device
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| 159 | N POP,%ZIS,POP
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| 160 | S %ZIS("A")="ERROR/WARNING OUTPUT DEVICE: "
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| 161 | D ^%ZIS
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| 162 | I POP S IBPRT("PRT")=-1 Q
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| 163 | I IO=IO(0) S IBPRT("PRT")=0 Q
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| 164 | S IBPRT("PRT")=1
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| 165 | U IO
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| 166 | W !,"INCONSISTENCIES LIST FOR BILL #: ",$P($G(^DGCR(399,IBIFN,0)),U),!,$J("",29),"AT: ",$$FMTE^XLFDT($$NOW^XLFDT,2),!,$J("",19),"GENERATED BY: ",$P($G(^VA(200,DUZ,0)),U),!!
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| 167 | Q
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| 168 | ;
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| 169 | CLOSE(IBPRT) ; Close device, reset printer flag
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| 170 | D ^%ZISC
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| 171 | S IBPRT("PRT")=0
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| 172 | D HOME^%ZIS
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| 173 | Q
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| 174 | ;
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| 175 | ASKEDIT(IBAC) ; Ask if edit/review of bill is desired
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| 176 | ; FUNCTION returns 0/1 for NO/YES
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| 177 | ; IBAC = flag for function being performed - to determine edit/review
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| 178 | N DIR,X,Y
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| 179 | S DIR(0)="YA"
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| 180 | S DIR("A",1)=" ",DIR("A",2)=" ",DIR("A")="Do you wish to "_$S($G(IBAC)<4:"edit",1:"review")_" the inconsistencies now? ",DIR("B")="NO"
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| 181 | S DIR("?",1)=" ",DIR("?",2)=" ",DIR("?",3)=" YES - To edit inconsistent fields",DIR("?")=" NO - To discontinue this process."
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| 182 | D ^DIR K DIR
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| 183 | Q (Y=1)
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| 184 | ;
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| 185 | SCREENS ;
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| 186 | N IBH
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| 187 | D ^IBCSCU,^IBCSC1
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| 188 | I $G(IBV) K IBPOPOUT
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| 189 | Q
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| 190 | ;
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| 191 | DISP24(IBIFN,IBCORR,IBQUIT) ;
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| 192 | W @IOF D BL24^IBCSCH(IBIFN,0)
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| 193 | S DIR("A",1)=" ",DIR("A")="Are the above charges correct for this bill? ",DIR("B")="YES",DIR(0)="YA" D ^DIR K DIR
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| 194 | I Y'=1 D
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| 195 | . I Y=0,$$ASKEDIT($G(IBAC)) S IBCORR=1 Q
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| 196 | . S IBQUIT=1
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| 197 | Q
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| 198 | ;
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| 199 | IICM(IBIFN) ; Ingenix ClaimsManager: Claim Scrubber
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| 200 | ; Send the bill to ClaimsManager, the IBCISTAT variable returned from ClaimsManager indicates
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| 201 | ; 3 - Passed CM with no errors
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| 202 | ; 5 - User overriding the CM errors
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| 203 | ; 7 - the CM interface isn't working
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| 204 | ; 11 - User overriding the CM errors (CM not updated)
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| 205 | ;
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| 206 | ; Returns False (0) if the bill fails the ClaimsManager Scrubber/errors found
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| 207 | ; Returns True (1) if the bill passed the ClaimsManager Scrubber/no errors found or ClaimsManager not On at site
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| 208 | ;
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| 209 | N IBOK S IBOK=1
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| 210 | I +$G(IBIFN),$$CM^IBCIUT1(IBIFN) S IBCISNT=1 D ST2^IBCIST I '$F(".3.5.7.11.","."_IBCISTAT_".") S IBOK=0
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| 211 | Q IBOK
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| 212 | ;
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| 213 | IIQMED(IBIFN) ; DSS QuadraMed Interface: QuadraMed Claim Scrubber
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| 214 | ; Send the bill to the QuadraMed Claim Scrubber
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| 215 | ; Returns False (0) if the bill fails the QuadraMed Scrubber/errors found
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| 216 | ; Returns True (1) if the bill passed the QuadraMed Scrubber/no errors found or QuadraMed not On at site
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| 217 | ;
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| 218 | ; QuadraMed Scrubber EN^VEJDIBSC returns IBQMED = 1 if no error found, returns 0 if error found
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| 219 | ;
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| 220 | N IBQMED S IBQMED=1
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| 221 | I +$G(IBIFN),$$QMED^IBCU1("EN^VEJDIBSC",IBIFN) D EN^VEJDIBSC(IBIFN)
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| 222 | Q IBQMED
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