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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