source: WorldVistAEHR/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCESRV3.m@ 1154

Last change on this file since 1154 was 613, checked in by George Lilly, 15 years ago

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[613]1IBCESRV3 ;ALB/TMP - Server based Auto-update utilities - IB EDI ;03/05/96
2 ;;2.0;INTEGRATED BILLING;**137,155**;21-MAR-94
3 ; IA 4129 for call to DUZ^XUP
4 Q
5 ;
6EOB835 ; Explanation of Benefits - auto update
7 ; Input expected: IBTDA = the ien of the message entry in file 364.2
8 ;
9 ; This is the background task that is queued to run by TaskManager.
10 ; The call which queues this task is found in TRTN^IBCESRV1 which is
11 ; called by ADD^IBCESRV.
12 ;
13 N IB0,IBBDA,IBBILL,IBMSG,IBFLAG,IBTYP,IBBST,DR,DA,DIE,Z,MRAUSER
14 ;
15 Q:'$G(IBTDA)
16 S IB0=$G(^IBA(364.2,IBTDA,0)),IBBDA=+$P(IB0,U,4) ; Batch ien
17 S IBTYP=$P($G(^IBE(364.3,+$P(IB0,U,2),0)),U) ; IB message type
18 Q:IBTYP'="835EOB"
19 ;
20 ; The MRA Project is using a specific non-human user for all
21 ; 835 EOB/MRA filing processes. Change the DUZ to be this user.
22 ; *** VA SACC approved this exemption 5-June-2003 ***
23 ; *** Integration Agreement 4129 - Activated on 30-June-2003 ***
24 ;
25 S MRAUSER=$$MRAUSR^IBCEMU1()
26 I MRAUSER>0,$$ISITMRA(IBTDA) NEW DUZ D DUZ^XUP(MRAUSER)
27 ;
28 D UPDEOB(IBTDA)
29 ;
30 Q
31 ;
32UPDEOB(IBTDA) ; Explanation of Benefits or MRA
33 ; Update data base from msg (store EOB in file 361.1)
34 ; IBTDA = ien of message in file 364.2
35 ;
36 N IBBILL,PRCASV,DA,DIE,DR,DA,X,Y,IBFLAG,IB0,IBS
37 N IBEOB,IBAUTO,IBIFN,IBERRMSG
38 ;
39 D UPDMSG^IBCESRV2(IBTDA,"U",0) ; updating data in 364.2
40 S IB0=$G(^IBA(364.2,IBTDA,0))
41 ;
42 I '$P(IB0,U,5) G UPDEOBX ; no transmit bill# in file 364
43 S IBEOB=$$UPDEOB^IBCEOB(IBTDA) ; new entry in file 361.1
44 I 'IBEOB G UPDEOBX ; exit if some failure
45 ;
46 ; update transmission status of transmission Bill# in file 364
47 ; status is closed (code "Z")
48 D BILLSTAC^IBCESRV2($P(IB0,U,5),"Z") ;Upd indiv transmitted bill
49 ;
50 ; Delete the entry from file 364.2
51 D DELMSG^IBCESRV2(IBTDA)
52 ;
53 ; If the EOB is not a Medicare MRA, then we can stop here
54 I $P($G(^IBM(361.1,IBEOB,0)),U,4)'=1 G UPDEOBX
55 ;
56 ; *** Medicare MRA processing ***
57 ;
58 ; update the claim MRA status of the file 399 bill
59 ; to be "C" - Valid MRA received
60 D MRASTAT(IBEOB,"C")
61 ;
62 ; Invoke the EOB criteria check and attempt to create and authorize
63 ; the secondary bill
64 S IBAUTO=$$CRIT^IBCEMQC(IBEOB)
65 I 'IBAUTO D AUTOMSG(IBEOB,$P(IBAUTO,U,2)) G UPDEOBX
66 S IBIFN=$P($G(^IBA(364,+$P(IB0,U,5),0)),U,1) ; bill# from file 364
67 ;
68 ; Process COB, create secondary bill
69 S IBERRMSG=""
70 D AUTOCOB^IBCEMQA(IBIFN,IBEOB,.IBERRMSG)
71 I IBERRMSG'="" D AUTOMSG(IBEOB,IBERRMSG) G UPDEOBX
72 ;
73 ; Authorize the secondary bill
74 D AUTH^IBCEMQA(IBIFN,.IBERRMSG)
75 I IBERRMSG'="" D AUTOMSG(IBEOB,IBERRMSG) G UPDEOBX
76 ;
77UPDEOBX ;
78 S ZTREQ="@"
79 Q
80 ;
81AUTOMSG(IBEOB,MSG) ; File the automatic bill generation failure message
82 NEW DIE,DA,DR,D,D0,DI,DIC,DQ,X,Y
83 S IBEOB=+$G(IBEOB),MSG=$G(MSG)
84 I '$D(^IBM(361.1,IBEOB)) G AUMSGX
85 I MSG="" G AUMSGX
86 S DIE=361.1,DA=IBEOB,DR="30.01////"_MSG_";30.02////"_$$NOW^XLFDT
87 D ^DIE
88AUMSGX ;
89 Q
90 ;
91MRASTAT(IBEOB,STAT) ; Update the claim MRA status field on the bill
92 ; File 399, Field 24 - CLAIM MRA STATUS
93 NEW DIE,DA,DR,D,D0,DI,DIC,DIG,DIH,DIU,DIV,DQ,X,Y,IBIFN
94 S IBEOB=+$G(IBEOB),STAT=$G(STAT)
95 I '$D(^IBM(361.1,IBEOB)) G MRASTX
96 I STAT="" G MRASTX
97 S IBIFN=+$P($G(^IBM(361.1,IBEOB,0)),U,1)
98 I '$D(^DGCR(399,IBIFN,"TX")) G MRASTX
99 ;
100 S DIE=399,DA=IBIFN,DR="24////"_STAT
101 D ^DIE
102MRASTX ;
103 Q
104 ;
105ISITMRA(IBTDA) ; Function to return whether or not this transmission
106 ; is a Medicare MRA or a normal EOB
107 NEW IEN,MRA,STOP,DATA
108 S (IEN,MRA,STOP)=0
109 F S IEN=$O(^IBA(364.2,IBTDA,2,IEN)) Q:'IEN D Q:STOP
110 . S DATA=$$EXT^IBCEMU1($G(^IBA(364.2,IBTDA,2,IEN,0))) Q:DATA=""
111 . I $P(DATA,U,1)'="835EOB" Q
112 . I $P(DATA,U,5)="Y" S MRA=1
113 . S STOP=1
114 . Q
115ISMRAX ;
116 Q MRA
117 ;
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