| [613] | 1 | IBCEP7B ;ALB/TMP - Functions for PROVIDER ID ;1-16-05 | 
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|  | 2 | ;;2.0;INTEGRATED BILLING;**320,348,349**;16-JAN-2005;Build 46 | 
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|  | 3 | ;;Per VHA Directive 2004-038, this routine should not be modified. | 
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|  | 4 | Q | 
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|  | 5 | ; | 
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|  | 6 | GETID(CLAIM,COB) ; | 
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|  | 7 | N DIR,X,Y,DTOUT,DUOUT,WHICH,ID,IBMAIN,IBDIV,DIC,IBINS,DA,DIC,Z,Z0,IBCU,OK,IBCU | 
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|  | 8 | ; | 
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|  | 9 | S ID="" | 
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|  | 10 | S IBINS=$P($G(^DGCR(399,CLAIM,"I"_COB)),U) | 
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|  | 11 | I IBINS="" Q ID | 
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|  | 12 | ; | 
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|  | 13 | ; Make sure they have careunits IDS defined for this insurance company before we bother asking | 
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|  | 14 | S OK=0 | 
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|  | 15 | S Z=0 F  S Z=$O(^IBA(355.92,"B",IBINS,Z)) Q:'Z  D  Q:OK | 
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|  | 16 | . S Z0=$G(^IBA(355.92,Z,0)) | 
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|  | 17 | . Q:$P(Z0,U,8)'="E" | 
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|  | 18 | . Q:$P(Z0,U,3)="" | 
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|  | 19 | . S OK=1 | 
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|  | 20 | I 'OK Q ID | 
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|  | 21 | ; | 
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|  | 22 | S WHICH=$S(COB=1:"Primary",COB=2:"Secondary",1:"Tertiary") | 
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|  | 23 | S DIR("A")="Define "_WHICH_" Payer ID by Care Unit? " | 
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|  | 24 | S DIR("B")="No" | 
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|  | 25 | S DIR(0)="YA" | 
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|  | 26 | S DIR("?",1)="Enter No to select "_WHICH_" Provider # by Division." | 
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|  | 27 | S DIR("?")="Enter Yes to select "_WHICH_" Provider # for a specific Care Unit." | 
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|  | 28 | D ^DIR | 
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|  | 29 | I Y'=1 Q ID | 
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|  | 30 | ; | 
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|  | 31 | ; Get the Division | 
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|  | 32 | S IBMAIN=$$MAIN^IBCEP2B() | 
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|  | 33 | S IBDIV=$$EXTERNAL^DILFD(399,.22,"",$P($G(^DGCR(399,CLAIM,0)),U,22)) | 
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|  | 34 | S DIR("A")="Division: ",DIR(0)="355.92,.05AOr" | 
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|  | 35 | ; Default Division | 
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|  | 36 | S DIR("B")=$S(IBDIV]"":IBDIV,1:IBMAIN) | 
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|  | 37 | D ^DIR K DIR | 
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|  | 38 | S IBDIV=+$S(Y>0:+Y,1:0) | 
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|  | 39 | I Y<0 Q ID | 
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|  | 40 | ; | 
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|  | 41 | ; Get the Care Unit | 
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|  | 42 | S DIC("A")="Care Unit: " | 
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|  | 43 | S DIC("W")="W ""   "",$P(^(0),U,2)" | 
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|  | 44 | S DIC=355.95,DIC("S")="I $P(^(0),U,3)=+$G(IBINS),$P(^(0),U,4)=+$G(IBDIV)",DIC(0)="AEMQ" | 
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|  | 45 | D ^DIC | 
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|  | 46 | I Y<0 Q ID | 
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|  | 47 | S IBCU=+Y | 
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|  | 48 | ; | 
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|  | 49 | ; Compile the appropriate list of IDs | 
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|  | 50 | S Z=0 F  S Z=$O(^IBA(355.92,"B",IBINS,Z)) Q:'Z  D  Q:ID]"" | 
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|  | 51 | . S Z0=$G(^IBA(355.92,Z,0)) | 
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|  | 52 | . Q:$P(Z0,U,8)'="E" | 
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|  | 53 | . Q:$P(Z0,U,3)'=IBCU | 
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|  | 54 | . S ID=$P(Z0,U,7)_U_$P(Z0,U,6) | 
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|  | 55 | Q ID | 
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|  | 56 | ; | 
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|  | 57 | ; See if the insurance company flag is set to send the ATT/REND ID as the Billing Provider | 
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|  | 58 | ATTREND(CLAIM,COB) ; | 
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|  | 59 | N ID,IBINS | 
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|  | 60 | S ID="" | 
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|  | 61 | S IBINS=$P($G(^DGCR(399,CLAIM,"I"_COB)),U) | 
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|  | 62 | I IBINS="" Q 0 | 
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|  | 63 | ; | 
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|  | 64 | I $$FT^IBCEF(CLAIM)=2,$$GET1^DIQ(36,IBINS,4.06,"I") Q 1   ; 1500 | 
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|  | 65 | I $$FT^IBCEF(CLAIM)=3,$$GET1^DIQ(36,IBINS,4.08,"I") Q 1   ; ub | 
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|  | 66 | Q 0 | 
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|  | 67 | ; | 
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|  | 68 | ; Get a list of the plan types that supress Billing Provider Secondary IDs for this  Insurance Co | 
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|  | 69 | ; and see if the current plan type is one of them. | 
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|  | 70 | SUPPPT(CLAIM,COB) ; | 
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|  | 71 | N IBINS,SUPPFL | 
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|  | 72 | S SUPPFL=0 | 
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|  | 73 | S IBINS=$P($G(^DGCR(399,CLAIM,"I"_COB)),U) | 
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|  | 74 | I IBINS="" Q SUPPFL | 
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|  | 75 | ; | 
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|  | 76 | I $D(^DIC(36,IBINS,13)) D | 
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|  | 77 | . N PLAN,PLANTYPE | 
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|  | 78 | . S PLAN=$P($G(^DGCR(399,CLAIM,"I"_COB)),U,18) Q:'PLAN | 
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|  | 79 | . S PLANTYPE=$P($G(^IBA(355.3,PLAN,0)),U,15) Q:PLANTYPE="" | 
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|  | 80 | . Q:'$D(^DIC(36,IBINS,13,"B",PLANTYPE)) | 
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|  | 81 | . S SUPPFL=1 | 
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|  | 82 | Q SUPPFL | 
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