| 1 | IBCEF72 ;WOIFO/SS - FORMATTER AND EXTRACTOR SPECIFIC BILL FUNCTIONS ;8/6/03 10:56am
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| 2 | ;;2.0;INTEGRATED BILLING;**232,320,349**;21-MAR-94;Build 46
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| 3 | ;;Per VHA Directive 2004-038, this routine should not be modified.
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| 4 | ;
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| 5 | ;
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| 6 | ;Input:
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| 7 | ;IBINSCO - ptr to #36
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| 8 | ;IBFRMTYP 0=unknwn/both,1=UB,2=1500
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| 9 | ;IBCARE - 0=unknwn or both inp/outp,1=inpatient, 2=outpatient, 3 -RX
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| 10 | ;Output: X12 IDtype^ID^ID TYPE ptr to file 355.97
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| 11 | CH35591(IBINSCO,IBFRMTYP,IBCARE) ;
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| 12 | N IB35591,IBRET,IB1
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| 13 | S IB35591=0,IBRET=""
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| 14 | F S IB35591=$O(^IBA(355.91,"B",IBINSCO,IB35591)) Q:+IB35591=0 Q:IBRET'="" D
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| 15 | . S IB1=$G(^IBA(355.91,IB35591,0))
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| 16 | . I '($P(IB1,"^",4)=0!(IBFRMTYP=0)) Q:$P(IB1,"^",4)'=IBFRMTYP ;if wrong form type
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| 17 | . I ($P(IB1,"^",5)=3)!(IBCARE=3) Q:IBCARE'=$P(IB1,"^",5) ;if not RX
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| 18 | . I ($P(IB1,"^",5)=1)!($P(IB1,"^",5)=2) I (IBCARE=1)!(IBCARE=2) Q:$P(IB1,"^",5)'=IBCARE ;if wrong care type
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| 19 | . S IBRET=$P($G(^IBE(355.97,+$P(IB1,"^",6),0)),"^",3)_"^"_$P(IB1,"^",7)_U_+$P(IB1,U,6)
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| 20 | Q IBRET
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| 21 | ;
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| 22 | FINDEIN(IBXIEN,IBPROV,IBFAC,IBS) ; find EIN for facility/ SSN for person
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| 23 | ; IBXIEN = ien of bill entry file 399
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| 24 | ; IBFAC = 1 if facility, 0 if individual provider
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| 25 | ; IBPROV = ien of provider (vp format)
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| 26 | ; IBS = 1 if person's EIN should be returned if there, otherwise SSN
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| 27 | ; FUNCTION RETURNS
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| 28 | ; EIN or SSN ^ 24 for EIN, 34 for SSN or null if none found
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| 29 | N Z,Z0,IBARR,IBEIN,IBSSN
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| 30 | S (IBEIN,IBSSN)=""
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| 31 | D ALLID^IBCEP8(IBPROV,"",.IBARR)
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| 32 | S Z=0 F S Z=$O(IBARR(Z)) Q:'Z D Q:IBEIN'=""
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| 33 | . I $G(IBFAC) Q:$P(IBARR(Z),U,7)'="EI" S IBEIN=$P(IBARR(Z),U,2)_U_24 Q
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| 34 | . I $P(IBARR(Z),U,7)="SY" D Q
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| 35 | .. I $G(IBS) S IBSSN=$P(IBARR(Z),U,2)_U_34 Q
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| 36 | . S IBEIN=$P(IBARR(Z),U,2)_U_24
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| 37 | . I $G(IBS),$P(IBARR(Z),U,7)="EI" S IBEIN=$P(IBARR(Z),U,2)_U_24
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| 38 | I $G(IBS),IBEIN="" S IBEIN=IBSSN
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| 39 | Q IBEIN
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| 40 | ;
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| 41 | ;
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| 42 | NONVAID(IBXIEN,IBX,IBFAC,IBS) ; Find the non-VA provider default id
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| 43 | ; IBXIEN = the ien of the bill (file 399)
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| 44 | ; IBX = id data returned if passed by reference
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| 45 | ; IBFAC = 1 if getting the id for the facility or 0 for rendering prov
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| 46 | ; IBS = 1 if getting id for person, but need the EIN if there
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| 47 | ; Function returns the id^type of id^person/facility flag:
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| 48 | ; Type of id: 1 = SSN 2 = EIN 0 = not found
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| 49 | ; person/facility: 1 = person 2 = facility
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| 50 | N Z,IBXSAVE,IBU2,IBTYPE,IBZ,IBF,IBPROV,Q,Q0
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| 51 | S IBTYPE=2,IBU2=$G(^DGCR(399,IBXIEN,"U2")),IBF=2,IBPROV=""
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| 52 | ;
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| 53 | S Z=$P(IBU2,U,10)
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| 54 | I 'Z S IBX="",IBTYPE=0 G NONVAQ ; Not a non-VA facility
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| 55 | S IBPROV=Z_";IBA(355.93,"
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| 56 | ;
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| 57 | ; Get EIN
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| 58 | I $G(IBFAC) D G NONVAQ
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| 59 | . S IBX=$P($$FINDEIN(IBXIEN,IBPROV,IBFAC),U),IBTYPE=2
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| 60 | ;
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| 61 | ; Get EIN/SSN
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| 62 | I '$G(IBFAC) D G NONVAQ
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| 63 | . S IBX="",IBF=1
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| 64 | . S Q0=($$FT^IBCEF(IBXIEN)=3)+3 ; 3 for rendering/4 for attending
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| 65 | . S Q=+$O(^DGCR(399,IBXIEN,"PRV","B",Q0,0))
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| 66 | . S IBPROV=$P($G(^DGCR(399,IBXIEN,"PRV",Q,0)),U,2)
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| 67 | . I IBPROV S IBX=$$FINDEIN(IBXIEN,IBPROV,IBFAC,$G(IBS)),IBTYPE=$S($P(IBX,U,2)=24:2,$P(IBX,U,2)=34:1,1:0),IBX=$P(IBX,U)
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| 68 | ;
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| 69 | NONVAQ I IBTYPE,IBX="",$P(IBU2,U,12)'="" S IBX=$P(IBU2,U,12) ; pull from 399
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| 70 | S IBX=$G(IBX)
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| 71 | Q IBX_U_IBTYPE_U_IBF
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| 72 | ;----
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| 73 | ;checks if there is data for OP* segments and
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| 74 | ;then populates PROV COB SEQ
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| 75 | ;Input:
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| 76 | ;IBXIEN - ien in #399
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| 77 | ;IBSAVE - "in" array (i.e. IBXSAVE)
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| 78 | ;IBDATA - "out" array (i.e. IBXDATA)
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| 79 | ;IBFUNC - FUNCTION from #399 (1-refering, 2 -operating, etc)
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| 80 | ;IBSEGM - segment record ID, optional
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| 81 | ;Output:
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| 82 | ; IBDATA with formatted output
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| 83 | PROVSEQ(IBXIEN,IBSAVE,IBDATA,IBFUNC,IBSEGM) ;
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| 84 | N IB1,IB2,IBINS,IBFL
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| 85 | S IBFL=$S(IBFUNC=3!(IBFUNC=4):1,1:0)
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| 86 | F IB1=1,2 D
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| 87 | . Q:'$$ISINSUR^IBCEF71($G(IBSAVE("PROVINF",IBXIEN,"O",IB1)),IBXIEN) ;don't create anything if there is no such insurance
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| 88 | . I IBFL S IBFUNC=$S($O(IBSAVE("PROVINF",IBXIEN,"O",IB1,3,0)):3,1:4)
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| 89 | . S:$O(IBSAVE("PROVINF",IBXIEN,"O",IB1,IBFUNC,0)) IBDATA(IB1)=$G(IBSAVE("PROVINF",IBXIEN,"O",IB1))
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| 90 | . I $G(IBSEGM)'="" D:$O(IBSAVE("PROVINF",IBXIEN,"O",IB1,IBFUNC,0)) ID^IBCEF2(IB1,IBSEGM)
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| 91 | Q
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| 92 | ;
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| 93 | OUTPRVID(IBXIEN,IBXSAVE) ; Extract the outside provider or facility ids
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| 94 | ; into IBXSAVE array
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| 95 | ; Function returns 1 if person or 2 if facility ids or "" if neither
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| 96 | N Z,IBXDATA,IBPERSON,TAG
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| 97 | ;WCJ;11/1/2005 Extract the first 3 chars of Z instead.
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| 98 | S Z=$E($$PSPRV^IBCEF7(IBXIEN),1,3),IBPERSON=""
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| 99 | ;EJK 8/23/05 IB*320 - CHANGED Z=101 TO Z=1010. Z WILL ALWAYS BE A 4 DIGIT #.
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| 100 | ; WCJ 11/1/2005 ; Removed EJK's change and added above change
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| 101 | I Z=111!(Z=101) S TAG=$S(Z=101:"OUTSIDE FAC PROVIDER INF",1:"CUR/OTH PROVIDER INFO") D F^IBCEF("N-ALL "_TAG) S IBPERSON=$S('$E(Z,2):2,1:1)
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| 102 | Q IBPERSON
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| 103 | ;
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| 104 | OUTPRV(IBREC,IBXIEN,IBXSAVE) ; Extract the outside provider or facility ids
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| 105 | ; into IBXSAVE array
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| 106 | ; Function returns 1 if person or 2 if facility ids or "" if neither
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| 107 | ; IBREC = the record whose ids should be returned
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| 108 | N IBPERSON,IBFRM,IBTYPE,IBFAC
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| 109 | I IBREC="SUB1"!(IBREC="OP6") D
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| 110 | . K IBXSAVE("PROVINF",IBXIEN),IBXSAVE("PROVINF_FAC",IBXIEN)
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| 111 | . S IBPERSON=$$OUTPRVID(IBXIEN,.IBXSAVE),IBFAC=$S(IBPERSON=1:0,1:1)
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| 112 | E D
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| 113 | . K IBXSAVE("PROVINF_FAC",IBXIEN)
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| 114 | . D F^IBCEF("N-ALL OUTSIDE FAC PROVIDER INF")
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| 115 | . S IBPERSON=2,IBFAC=1
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| 116 | S IBFRM=$$FT^IBCEF(IBXIEN),IBFRM=$S(IBFRM=2:2,1:1)
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| 117 | S IBTYPE=$S(IBREC["SUB":"C",1:"O")
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| 118 | D CHCKSUB^IBCEF73(IBFRM,IBREC,IBFAC,IBTYPE,.IBXSAVE)
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| 119 | Q IBPERSON
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| 120 | ;
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| 121 | ;get IENs in file #36 for other insurances
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| 122 | OTHINS(IB399,IBRES) ;
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| 123 | N IBFRMTYP,Z,Z1,Z2,Z4
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| 124 | S Z=$$COBN^IBCEF(IB399),Z0=0
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| 125 | F Z1=1:1:3 I Z1'=Z,$D(^DGCR(399,IB399,"I"_Z1)) S Z0=Z0+1,IBRES(Z0)=+$G(^DGCR(399,IB399,"I"_Z1))
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| 126 | Q
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| 127 | ;get other insurance EDI ID NUMBERs
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| 128 | OTHINSID(IB399,IBRES) ;insurance EDI
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| 129 | N IBFRMTYP,IBZ,Z0,Z1,Z4
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| 130 | S IBFRMTYP=$$FT^IBCEF(IB399),IBFRMTYP=$S(IBFRMTYP=2:2,IBFRMTYP=3:1,1:0)
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| 131 | S Z4=$S(IBFRMTYP=1:4,1:2) ;UB - piece4,1500 or BOTH -piece 2
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| 132 | D OTHINS(IB399,.IBZ)
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| 133 | S Z1=0
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| 134 | F Z0=1:1:2 I $G(IBZ(Z0)) S IBRES(Z0)=$S($$MCRWNR^IBEFUNC(+IBZ(Z0)):$S(IBFRMTYP=1:"12M61",1:"SMTX1"),1:$P($G(^DIC(36,+IBZ(Z0),3)),U,Z4))
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| 135 | Q
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| 136 | ;
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| 137 | ;get other insurance addresses
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| 138 | OTHINADR(IB399,IBRES,IBADDFLD) ;insurance EDI
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| 139 | N IBZ,Z0,Z1,Z4
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| 140 | D OTHINS(IB399,.IBZ)
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| 141 | S Z1=0
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| 142 | I IBADDFLD=18 D Q
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| 143 | . F Z0=1:1:2 I $G(IBZ(Z0)) D
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| 144 | . . S IBRES(Z0)=$P($G(^DIC(36,+IBZ(Z0),.11)),U,1)
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| 145 | . . S IBRES(Z0)=$E(IBRES(Z0),1,55)
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| 146 | I IBADDFLD=18.9 D Q
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| 147 | . F Z0=1:1:2 I $G(IBZ(Z0)) D
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| 148 | . . S IBRES(Z0)=$P($G(^DIC(36,+IBZ(Z0),.11)),U,1)
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| 149 | . . S Z4=$P($G(^DIC(36,+IBZ(Z0),.11)),U,2) S:Z4'="" IBRES(Z0)=IBRES(Z0)_", "_Z4
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| 150 | . . S Z4=$P($G(^DIC(36,+IBZ(Z0),.11)),U,3) S:Z4'="" IBRES(Z0)=IBRES(Z0)_", "_Z4
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| 151 | . . S Z4=$P($G(^DIC(36,+IBZ(Z0),.11)),U,4) S:Z4'="" IBRES(Z0)=IBRES(Z0)_", "_Z4
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| 152 | . . S Z4=$P($G(^DIC(5,+$P($G(^DIC(36,+IBZ(Z0),.11)),U,5),0)),U,2) S:Z4'="" IBRES(Z0)=IBRES(Z0)_", "_Z4
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| 153 | . . S Z4=$P($G(^DIC(36,+IBZ(Z0),.11)),U,6) S:Z4'="" IBRES(Z0)=IBRES(Z0)_", "_Z4
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| 154 | . . S IBRES(Z0)=$E(IBRES(Z0),1,157)
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| 155 | I IBADDFLD=19 D Q
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| 156 | . F Z0=1:1:2 I $G(IBZ(Z0)) D
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| 157 | . . S IBRES(Z0)=$P($G(^DIC(36,+IBZ(Z0),.11)),U,2)
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| 158 | . . S IBRES(Z0)=IBRES(Z0)_" "_$P($G(^DIC(36,+IBZ(Z0),.11)),U,3)
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| 159 | . . S IBRES(Z0)=$E(IBRES(Z0),1,55)
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| 160 | I IBADDFLD=20 D Q
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| 161 | . F Z0=1:1:2 I $G(IBZ(Z0)) D
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| 162 | . . S IBRES(Z0)=$P($G(^DIC(36,+IBZ(Z0),.11)),U,4)
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| 163 | . . S IBRES(Z0)=$E(IBRES(Z0),1,30)
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| 164 | I IBADDFLD=21 D Q
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| 165 | . F Z0=1:1:2 I $G(IBZ(Z0)) D
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| 166 | . . S IBRES(Z0)=$P($G(^DIC(5,+$P($G(^DIC(36,+IBZ(Z0),.11)),U,5),0)),U,2)
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| 167 | . . S IBRES(Z0)=$E(IBRES(Z0),1,2)
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| 168 | I IBADDFLD=22 D Q
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| 169 | . F Z0=1:1:2 I $G(IBZ(Z0)) D
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| 170 | . . S IBRES(Z0)=$P($G(^DIC(36,+IBZ(Z0),.11)),U,6)
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| 171 | . . S IBRES(Z0)=$E(IBRES(Z0),1,15)
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| 172 | Q
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| 173 | ;
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| 174 | SFIDQ(IBXIEN,IBXSAVE,IBXDATA) ; Find the service facility id qualifier for
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| 175 | ; 837 record SUB2-5
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| 176 | ;IBXIEN = ien of 399
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| 177 | ;Pass by reference: IBXSAVE (input/output) IBXDATA (output)
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| 178 | N B,Z
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| 179 | K IBXSAVE("NVID")
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| 180 | D ; protect IBXDATA
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| 181 | . N IBXDATA
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| 182 | . D F^IBCEF("N-RENDERING INSTITUTION")
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| 183 | . S:IBXDATA'="" IBXSAVE("IBFAC")=IBXDATA
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| 184 | I $P($G(IBXSAVE("IBFAC")),U,2)'=1 K IBXDATA Q
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| 185 | S Z=$$PSPRV^IBCEF7(IBXIEN)
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| 186 | ;WCJ 11/04/2005 If a Non-VA facility
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| 187 | I $E(Z) D
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| 188 | . S IBXSAVE("NVID")=$$NONVAID^IBCEF72(IBXIEN,.B,$E(Z),1)
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| 189 | .; S IBXSAVE("NVID")=$$NONVAID^IBCEF72(IBXIEN,.B,'$E(Z,2),1)
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| 190 | . S IBXDATA=$P("^34^24",U,$P(IBXSAVE("NVID"),U,2)+1)
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| 191 | ;S Z=$$PSPRV^IBCEF7(IBXIEN),IBXSAVE("NVID")=$$NONVAID^IBCEF72(IBXIEN,.B,'$E(Z,2),1),IBXDATA=24
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| 192 | Q
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| 193 | ;
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| 194 | OTHP36(IBXIEN,IBZOUT) ;
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| 195 | N Z,Z0,Z1,IBZ
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| 196 | D F^IBCEF("N-ALL INSURANCE CO 837 ID","IBZ")
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| 197 | F Z=1,2,3 S IBZOUT(Z)=+$$POLICY^IBCEF(IBXIEN,1,$E("PST",Z))
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| 198 | Q
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| 199 | ;
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| 200 | ;---------SORT-----------
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| 201 | ;IBPRNUM - seq #
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| 202 | ;IBPRTYP - type of provider (use FUNCTION value from file 399, fld 222)
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| 203 | ;IB399 = ien file 399
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| 204 | ;IBSRC,IBDST - source,destination arrays
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| 205 | ;IBN - starting #
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| 206 | ;Output:
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| 207 | ; IBDST(1-primary/2-secondary provider,Provider type(FUNCTION),N)=
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| 208 | ; =provider/VARIABLEPTR^Insurance PTR #36 or NONE^ID type^ID^Form type^Care type^state ptr #5 for state license #
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| 209 | ; where N is numeration (1 for ID1, 2 for ID2, etc)
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| 210 | GETSSN(IBPTR) ;look for SSN in #200 first and if not found then look at #355.9
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| 211 | ;if in file #200
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| 212 | I $P(IBPTR,";",2)="VA(200," Q $$SSN200^IBCEF73(IBPTR)
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| 213 | ;if in 355.93 then use 355.9
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| 214 | Q $$SSN3559^IBCEF73(IBPTR)
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| 215 | ;--
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| 216 | ;SSN3559
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| 217 | ;Find SSN from 355.9
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| 218 | ;Input:
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| 219 | ; Variable pointer to ^VA(200 or ^IBA(355.93
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| 220 | ;Output:
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| 221 | ; SSN or null
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| 222 | ;
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| 223 | PADNDC(Z) ;PAD LEADING ZERO'S INTO A NON 5-4-2 FORMAT NDC NUMBER
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| 224 | ;Z IS ITERATION, ONLY PAD CURRENT NDC NUMBER
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| 225 | N NDC
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| 226 | S NDC=$P(IBXSAVE("OUTPT",Z,"RX"),"^",3)
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| 227 | Q:$L(NDC)=13
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| 228 | I $L(NDC)=14 D Q
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| 229 | . S $P(NDC,"-",1)=$E($P(NDC,"-",1),2,$L($P(NDC,"-",1)))
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| 230 | . S $P(IBXSAVE("OUTPT",Z,"RX"),"^",3)=NDC
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| 231 | I $L($P(NDC,"-",1))'=5 S $P(NDC,"-",1)="0"_$P(NDC,"-",1)
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| 232 | I $L($P(NDC,"-",2))'=4 S $P(NDC,"-",2)="0"_$P(NDC,"-",2)
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| 233 | I $L($P(NDC,"-",3))'=2 S $P(NDC,"-",3)="0"_$P(NDC,"-",3)
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| 234 | S $P(IBXSAVE("OUTPT",Z,"RX"),"^",3)=NDC
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| 235 | Q
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| 236 | ;
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