[623] | 1 | IBCE837A ;ALB/TMP - OUTPUT FOR 837 TRANSMISSION - CONTINUED ;8/6/03 10:50am
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| 2 | ;;2.0;INTEGRATED BILLING;**137,191,211,232,296**;21-MAR-94
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| 3 | ;
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| 4 | UPD(MSGNUM,BATCH,CNT,BILLS,DESC,IBBTYP,IBINS) ; Upd current batch + bills w/new status
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| 5 | ;MSGNUM = mail msg # for batch
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| 6 | ;BATCH = batch #
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| 7 | ;CNT = # of bills in batch
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| 8 | ;BILLS = array BILLS(bill ien in 364) in batch
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| 9 | ;DESC = 1-80 character description of batch
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| 10 | ;IBBTYP = X-Y where X = P for professional or I for institution
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| 11 | ; Y = 1 for test or 0 for live transmission
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| 12 | ; or 2 for live claim resubmitted as test
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| 13 | ;IBINS = ien of single insurance company for the batch (optional)
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| 14 | ;
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| 15 | N DIC,DIE,DR,DA,IBBATCH,IBIFN,IBIEN,IBYY,IBTXTEST,IBMRA
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| 16 | S IBBATCH=$O(^IBA(364.1,"B",+BATCH,"")) Q:'IBBATCH
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| 17 | S IBTXTEST=+$P(IBBTYP,"-",2)
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| 18 | I '$P($G(^IBE(350.9,1,8)),U,7) S IBINS=""
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| 19 | ;
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| 20 | S DIE="^IBA(364.1,",DA=IBBATCH,DR=".02////P;.03///"_CNT_";.04///"_MSGNUM_";.05///0;.07////1;.08///^S X="""_DESC_""""_$S($G(IBINS):";.12////"_IBINS,1:"")
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| 21 | ;
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| 22 | I '$P($G(^TMP("IBRESUBMIT",$J)),U,3) S DR=DR_";1.01///NOW;1.02///.5"
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| 23 | I $P($G(^TMP("IBRESUBMIT",$J)),U,2) S DR=DR_";.15////"_$P(^($J),U,2)
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| 24 | ;
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| 25 | S DR=DR_";.14////"_$S('IBTXTEST:0,1:1)_";.06////"_$S($E(IBBTYP)="P":2,1:3) D ^DIE ; Update batch
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| 26 | ;
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| 27 | I IBTXTEST=2 D ADDTXM^IBCEPTM(.BILLS,IBBATCH,$$NOW^XLFDT()) Q
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| 28 | I IBTXTEST'=2 S IBIEN=0 F S IBIEN=$O(BILLS(IBIEN)) Q:'IBIEN D ;Update each bill
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| 29 | .S DA=IBIEN,DIE="^IBA(364,",DR=".02////"_IBBATCH_";.03///P;.04///NOW" D ^DIE
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| 30 | .S IBIFN=+$G(^IBA(364,IBIEN,0))
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| 31 | .Q:$D(^TMP("IBRESUBMIT",$J))!($P($G(^DGCR(399,IBIFN,0)),U,13)=4)!(+$$TXMT^IBCEF4(IBIEN)=2)
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| 32 | .S IBMRA=$$NEEDMRA^IBEFUNC(IBIFN)
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| 33 | .I IBMRA="C",$P($G(^DGCR(399,IBIFN,0)),U,13)=2 S IBMRA=1
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| 34 | .I IBIFN D
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| 35 | ..S (DIC,DIE)="^DGCR(399,",DA=$P($G(^IBA(364,IBIEN,0)),U),DR="[IB STATUS]",IBYY=$S('IBMRA:"@91",1:"@911") D:DA ^DIE
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| 36 | ..D BSTAT^IBCDC(IBIFN) ; remove from AB list
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| 37 | Q
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| 38 | ;
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| 39 | PRE ; Run before processing a bill entry
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| 40 | K IBXSAVE,IBXERR,^UTILITY("VAPA",$J),^TMP("IBXSAVE",$J),^TMP($J),^TMP("DIERR",$J)
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| 41 | Q
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| 42 | ;
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| 43 | POST ; Run after processing a bill entry for cleanup
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| 44 | N Q
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| 45 | I $G(IBXERR)'="" D
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| 46 | .S ^TMP("IBXERR",$J,IBXIEN)=IBXERR K ^TMP("IBXDATA",$J)
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| 47 | .K ^TMP("IBHDR1",$J)
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| 48 | .I $D(^TMP("IBRESUBMIT",$J)),'$G(^TMP("IBEDI_TEST_BATCH",$J)) D ;Set not resub flag for non-test bill
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| 49 | ..N Z,Z0
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| 50 | ..S Z0=$P($G(^TMP("IBRESUBMIT",$J)),U) Q:Z0=""
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| 51 | ..S Z=$O(^IBA(364,"ABABI",+$O(^IBA(364.1,"B",Z0,"")),IBXIEN,""))
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| 52 | ..I Z S ^TMP("IBNOT",$J,Z)=IBXIEN
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| 53 | K IBXSAVE,IBXNOREQ,^TMP("IBXSAVE",$J),^TMP($J)
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| 54 | S Q="VA" F S Q=$O(^UTILITY(Q)) Q:$E(Q,1,2)'="VA" I $D(^(Q,$J)) K ^UTILITY(Q,$J)
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| 55 | D CLEAN^DILF
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| 56 | Q
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| 57 | ;
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| 58 | MAILIT(IBQUEUE,IBBILL,IBCTM,IBDUZ,IBDESC,IBBTYP,IBINS) ; Send mail msg, update bills
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| 59 | ;IBQUEUE = mail queue name to send 837 transactions to
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| 60 | ;IBBILL = array of ien's in file 364 of bills in batch - IBBILL(IEN)=""
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| 61 | ;IBCTM = # of bills in batch, returned reset to 0
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| 62 | ;IBDUZ = ien of user 'running' extract (if any)
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| 63 | ;IBDESC = description of batch
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| 64 | ;IBBTYP = X-Y where X = P for professional or I for institution
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| 65 | ; Y = 1 or 2 for test or 0 for live transmission
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| 66 | ;IBINS = ien of insurance company if only one/batch option (optional)
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| 67 | ;
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| 68 | N DIK,DA,XMTO,XMZ,XMBODY,XMDUZ,XMSUBJ,IBBDA,IBBNO
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| 69 | ;
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| 70 | S IBBNO=+$P($G(^TMP("IBHDR",$J)),U),IBBDA=$O(^IBA(364.1,"B",IBBNO,""))
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| 71 | I '$P($G(^IBE(350.9,1,8)),U,7) S IBINS=""
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| 72 | ;
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| 73 | I IBCTM D
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| 74 | . I +$G(^TMP("IBEDI_TEST_BATCH",$J)) S IBQUEUE="MCT"
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| 75 | . I IBQUEUE'="",IBQUEUE'["@" S XMTO("XXX@Q-"_IBQUEUE_".VA.GOV")=""
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| 76 | . I IBQUEUE["@" S XMTO(IBQUEUE)=""
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| 77 | . S XMDUZ=$G(IBDUZ),XMBODY="^TMP(""IBXMSG"","_$J_")",XMSUBJ=$S($P(IBBTYP,U,2):"** TEST"_$S($P(IBBTYP,U,2)=2:"/RESUB OF LIVE",1:""),1:"")_" CLAIM BATCH: "_$S(IBQUEUE'["@":IBQUEUE,1:$P(IBQUEUE,"@"))_"/"_IBBNO
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| 78 | . K XMZ
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| 79 | . D SENDMSG^XMXAPI(XMDUZ,XMSUBJ,XMBODY,.XMTO,,.XMZ)
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| 80 | . I $G(XMZ) D
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| 81 | .. D UPD(XMZ,$P($G(^TMP("IBHDR",$J)),U),IBCTM,.IBBILL,IBDESC,IBBTYP,IBINS) ;Update batch/bills
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| 82 | .. S ^TMP("IBCE-BATCH",$J,IBBNO)=IBBDA_U_IBCTM_U_$P($G(^TMP("IBRESUBMIT",$J)),U)
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| 83 | MAILQ S IBCTM=0
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| 84 | D CHKBTCH(+$G(^TMP("IBHDR",$J)))
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| 85 | K ^TMP("IBHDR",$J),^TMP("IBHDR1",$J),^TMP("IBXMSG",$J),IBBILL
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| 86 | Q
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| 87 | ;
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| 88 | CHKNEW(IBQ,IBBILL,IBCTM,IBDESC,IBBTYP,IBINS,IBSITE,IBSIZE) ;
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| 89 | ; Determine if ok to send msg
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| 90 | ; Check for one insurance per batch if IBINS defined
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| 91 | ; Returns IBSIZE, IBCTM, IBBILL (pass by reference)
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| 92 | ;
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| 93 | ; IBQ = data queue name
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| 94 | ; IBBILL = the 'list' of bill #'s in the batch
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| 95 | ; IBCTM = the # of claims output so far to the batch
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| 96 | ; IBDESC = the batch description text
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| 97 | ; IBBTYP = X-Y where X = P for professional or I for institution
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| 98 | ; Y = 1 for test or 0 for live transmission
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| 99 | ; IBINS = the ien of the single insurance co. for the batch (optional)
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| 100 | ; IBSITE = the '8' node of file 350.9 (IB PARAMETERS)
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| 101 | ; IBSIZE = the 'running' size of the output message
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| 102 | ;
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| 103 | Q:$S($G(IBINS)="":0,1:'$P(IBSITE,U,7))
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| 104 | ;
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| 105 | ; New batch needed
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| 106 | I IBCTM D MAILIT(IBQ,.IBBILL,.IBCTM,"",IBDESC,IBBTYP,IBINS) S IBSIZE=0
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| 107 | Q
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| 108 | ;
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| 109 | ERRMSG(XMBODY) ; Send bulletin for error message
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| 110 | N XMTO,XMSUBJ
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| 111 | S XMTO("I:G.IB EDI")="",XMSUBJ="EDI 837 TRANSMISSION ERRORS"
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| 112 | ;
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| 113 | D SENDMSG^XMXAPI(,XMSUBJ,XMBODY,.XMTO)
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| 114 | D ALERT("One or more EDI bills were not transmitted. Check your mail for details","G.IB EDI")
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| 115 | Q
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| 116 | ;
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| 117 | CLEANUP ; Cleans up bill transmission environment
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| 118 | ;
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| 119 | N IBTEST
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| 120 | S IBTEST=+$G(^TMP("IBEDI_TEST_BATCH",$J))
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| 121 | L -^IBA(364,0)
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| 122 | I $D(^TMP("IBRESUBMIT",$J,"IBXERR"))!$D(^TMP("IBONE",$J,"IBXERR"))!$D(^TMP("IBSELX",$J,"IBXERR")) D ;Error message to mail group
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| 123 | . N XMTO,XMBODY,XMDUZ,XMSUBJ,XMZ,IBFUNC
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| 124 | . S IBFUNC=$S($D(^TMP("IBRESUBMIT",$J,"IBXERR")):$S('IBTEST:1,1:4),$D(^TMP("IBONE",$J,"IBXERR")):2,1:3)
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| 125 | . Q:'IBFUNC
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| 126 | . S XMTO("I:G.IB EDI")="",XMDUZ="",XMBODY="^TMP("""_$S(IBFUNC=1!(IBFUNC=4):"IBRESUBMIT",1:"IBONE")_""","_$J_",""IBXERR"")"
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| 127 | . S XMSUBJ="EDI 837 B"_$P("ATCH^ILL^ILL(s)^ILL(s)",U,IBFUNC)_" NOT "_$S($G(^TMP("IBONE",$J)):"RE",1:"")_"SUBMITTED"_$S('IBTEST:"",1:" AS TEST CLAIMS")
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| 128 | . D SENDMSG^XMXAPI(XMDUZ,XMSUBJ,XMBODY,.XMTO,,.XMZ)
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| 129 | . K ^TMP("IBRESUBMIT",$J),^TMP("IBONE",$J)
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| 130 | ;
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| 131 | I $D(^TMP("IBRESUBMIT",$J)),'IBTEST D RESUBUP^IBCEM02 ;Upd resubmtd batch bills
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| 132 | I '$D(^TMP("IBSELX",$J)) K ^TMP("IBCE-BATCH",$J)
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| 133 | K ^TMP("IBXERR",$J),IBXERR
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| 134 | I 'IBTEST D CHKBTCH(+$G(^TMP("IBHDR",$J)))
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| 135 | CLEANP ; Entrypoint for extract data disply
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| 136 | K ^TMP("IBTXMT",$J),^TMP("IBXINS",$J)
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| 137 | K ^TMP("IBRESUBMIT",$J),^TMP("IBRESUB",$J),^TMP("IBNOT",$J),^TMP("IBONE",$J),^TMP("IBHDR",$J),^TMP("IBTX",$J),^TMP("IBEDI_TEST_BATCH",$J)
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| 138 | K ^UTILITY("VADM",$J)
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| 139 | D CLEAN^DILF
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| 140 | K ZTREQ S ZTREQ="@"
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| 141 | Q
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| 142 | ;
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| 143 | ALERT(XQAMSG,IBGRP) ; Send alert message
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| 144 | N XQA
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| 145 | S XQA(IBGRP)=""
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| 146 | D SETUP^XQALERT
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| 147 | Q
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| 148 | CHKBTCH(IBBNO) ; Delete batch whose batch # is IBBNO if no entries in file 364
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| 149 | ; and not a resubmitted batch
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| 150 | N IBZ,DA,DIK
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| 151 | S IBZ=+$O(^IBA(364.1,"B",+IBBNO,""))
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| 152 | I IBZ,'$O(^IBA(364,"C",IBZ,0)),'$P($G(^IBA(364.1,IBZ,0)),U,14) S DA=IBZ,DIK="^IBA(364.1," D ^DIK
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| 153 | Q
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| 154 | ;
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| 155 | TESTLIM(IBINS) ; Check for test bill limit per day has been reached
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| 156 | N IB3,DA,DIK
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| 157 | S IB3=$G(^DIC(36,IBINS,3))
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| 158 | I $P(IB3,U,5)'=DT S $P(IB3,U,7)=0
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| 159 | I ($P(IB3,U,7)+$G(^TMP("IBICT",$J,IBINS))+1)>$P(IB3,U,6) D Q
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| 160 | . S IBINS="" ;max # hit
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| 161 | . S DA=IBX,DIK="^IBA(364," D ^DIK
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| 162 | S ^TMP("IBICT",$J,IBINS)=$G(^TMP("IBICT",$J,IBINS))+1
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| 163 | Q
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| 164 | ;
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| 165 | SETVAR(IBXIEN,IBINS,IB0,IBSEC,IBNID,IB837R,IBDIV) ;
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| 166 | ; Set up variables needed for subscripts in sort global
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| 167 | ; ejk added IBSEC logic for patch 296
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| 168 | ; IBSEC=1 if primary bill, 2 if 2nd/non-MRA, 3 if 2nd/MRA
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| 169 | S IBSEC=$S($$COBN^IBCEF(IBXIEN)=1:1,'$$MRASEC^IBCEF4(IBXIEN):2,1:3)
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| 170 | S IBNID=$$PAYERID^IBCEF2(IBXIEN)
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| 171 | S IB837R=$$RECVR^IBCEF2(IBXIEN)
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| 172 | S IBDIV=$P($S($P(IB0,U,22):$$SITE^VASITE(DT,$P(IB0,U,22)),1:$$SITE^VASITE()),U,3)
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| 173 | I IBNID'="","RPIHS"[$E(IBNID),$E(IBNID,2,$L(IBNID))="PRNT" S IBNID=IBNID_"*"_IBINS
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| 174 | I IBNID="" S IBNID="*"_IBINS
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| 175 | S $P(IBNID,"*",3)=$S($P(IB0,U,22):$P(IB0,U,22),1:"")
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| 176 | Q
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| 177 | ;
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