| [613] | 1 | IBCIL0 ;DSI/ESG - CLAIMSMANAGER SKIP LIST ;11-JAN-2001 | 
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|  | 2 | ;;2.0;INTEGRATED BILLING;**161**;21-MAR-94 | 
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|  | 3 | ;;Per VHA Directive 10-93-142, this routine should not be modified. | 
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|  | 4 | ; | 
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|  | 5 | ;The skip list is a routine that will allow system managers the | 
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|  | 6 | ;capabilities to select transactions that errored due to system | 
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|  | 7 | ;failures.  This routine utilizes ListMan functions. | 
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|  | 8 | EN ; -- main entry point for IBCI CLAIMSMANAGER SKIP LIST | 
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|  | 9 | ; | 
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|  | 10 | ; Try to get an option-level lock | 
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|  | 11 | L +^IBCIL0:0 | 
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|  | 12 | E  W @IOF,!!!?10,"Another user is currently using this option.",!!?10,"Please try again later.",!! S DIR(0)="E" D ^DIR K DIR Q | 
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|  | 13 | ; | 
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|  | 14 | I '$$CK2^IBCIUT1 D  Q     ; check to see that ClaimsManager working OK | 
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|  | 15 | . W @IOF,!!!?10,"ClaimsManager is not working right now." | 
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|  | 16 | . W !!?10,"Please try again later.",!! | 
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|  | 17 | . S DIR(0)="E" D ^DIR K DIR | 
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|  | 18 | . L -^IBCIL0 | 
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|  | 19 | . Q | 
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|  | 20 | ; | 
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|  | 21 | D EN^VALM("IBCI CLAIMSMANAGER SKIP LIST") | 
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|  | 22 | KILL ^TMP("IBCIL0",$J),^TMP("IBCIL1",$J),^TMP("IBCIL2",$J) | 
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|  | 23 | KILL IBCISTAT,IBCISNT,IBCIREDT,IBCIERR,CT | 
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|  | 24 | L -^IBCIL0 | 
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|  | 25 | Q | 
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|  | 26 | ; | 
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|  | 27 | HDR ; -- header code | 
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|  | 28 | S VALMHDR(1)="                      Welcome to ClaimsManager Bill Processing" | 
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|  | 29 | S VALMHDR(2)="          This ListMan will display all skipped bills for processing" | 
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|  | 30 | Q | 
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|  | 31 | ; | 
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|  | 32 | INIT ; -- init variables and list array | 
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|  | 33 | D CLEAN^VALM10 | 
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|  | 34 | K ^TMP("IBCIL0",$J),^TMP("IBCIL1",$J),^TMP("IBCIL2",$J),CT | 
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|  | 35 | NEW IBCIVAUS,IBCIFDAT,IBCIIEN,IBCIBNUM | 
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|  | 36 | NEW IBCINAME,IBCIDATE,IBCIUSER,IBCIST0,IBCIST1,IBCIARR | 
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|  | 37 | NEW IBCISKST,NODE0,IBCIDFN,IBCIXX | 
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|  | 38 | S IBCIARR="" | 
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|  | 39 | F IBCISKST=2,6,7,10,11 D | 
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|  | 40 | .S IBCIIEN=0 F  S IBCIIEN=$O(^IBA(351.9,"AST",IBCISKST,IBCIIEN)) Q:'IBCIIEN  D | 
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|  | 41 | ..S NODE0=^IBA(351.9,IBCIIEN,0) | 
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|  | 42 | ..S IBCIBNUM=$P(^DGCR(399,IBCIIEN,0),U,1) | 
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|  | 43 | ..S IBCIFDAT=$P($P(^DGCR(399,IBCIIEN,0),U,3),".",1) | 
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|  | 44 | ..S IBCIDATE=$$FDATE^VALM1(IBCIFDAT) | 
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|  | 45 | ..S IBCIUSER=$P(NODE0,U,12)                          ; assigned to peep | 
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|  | 46 | ..I 'IBCIUSER S IBCIUSER=+$$BILLER^IBCIUT5(IBCIIEN)  ; biller | 
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|  | 47 | ..I 'IBCIUSER S IBCIUSER=$P(NODE0,U,9)               ; last edited by | 
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|  | 48 | ..I 'IBCIUSER S IBCIUSER=$P(NODE0,U,7)               ; entered by | 
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|  | 49 | ..S IBCIVAUS=$P($G(^VA(200,IBCIUSER,0)),U,1) | 
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|  | 50 | ..I IBCIVAUS="" S IBCIVAUS="UNKNOWN" | 
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|  | 51 | ..S IBCIDFN=$P(^DGCR(399,IBCIIEN,0),U,2) | 
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|  | 52 | ..S IBCINAME=$P($G(^DPT(IBCIDFN,0)),U,1) | 
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|  | 53 | ..S IBCIST0=$P(^DGCR(399,IBCIIEN,0),U,13) | 
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|  | 54 | ..I IBCIST0=1 S IBCIST1="E/NR" | 
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|  | 55 | ..I IBCIST0=2 S IBCIST1="R/MRA" | 
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|  | 56 | ..I IBCIST0=3 S IBCIST1="AUTH" | 
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|  | 57 | ..I IBCIST0=4 S IBCIST1="PR/TX" | 
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|  | 58 | ..I IBCIST0=7 S IBCIST1="CANX" | 
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|  | 59 | ..I IBCIST0=0 S IBCIST1="CLSD",IBCIST0=9 | 
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|  | 60 | ..S ^TMP("IBCIL0",$J,IBCIST0,IBCIVAUS,IBCIBNUM)=IBCIIEN_U_IBCIST1_U_IBCIVAUS_U_IBCIBNUM_U_IBCINAME_U_IBCIDATE | 
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|  | 61 | SRT ;sort | 
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|  | 62 | S (IBCIST0,CT)=0 F  S IBCIST0=$O(^TMP("IBCIL0",$J,IBCIST0)) Q:'IBCIST0  D | 
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|  | 63 | .S IBCIUSER="" F  S IBCIUSER=$O(^TMP("IBCIL0",$J,IBCIST0,IBCIUSER)) Q:IBCIUSER=""  D | 
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|  | 64 | ..S IBCIBNUM="" F  S IBCIBNUM=$O(^TMP("IBCIL0",$J,IBCIST0,IBCIUSER,IBCIBNUM)) Q:IBCIBNUM=""  D | 
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|  | 65 | ...S IBCIXX=^TMP("IBCIL0",$J,IBCIST0,IBCIUSER,IBCIBNUM) | 
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|  | 66 | ...S IBCIARR=$$SETFLD^VALM1($P(IBCIXX,U,2),IBCIARR,"STATUS") | 
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|  | 67 | ...S IBCIARR=$$SETFLD^VALM1($P(IBCIXX,U,3),IBCIARR,"USER") | 
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|  | 68 | ...S IBCIARR=$$SETFLD^VALM1($P(IBCIXX,U,4),IBCIARR,"BNUM") | 
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|  | 69 | ...S IBCIARR=$$SETFLD^VALM1($P(IBCIXX,U,5),IBCIARR,"PT_NAME") | 
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|  | 70 | ...S IBCIARR=$$SETFLD^VALM1($P(IBCIXX,U,6),IBCIARR,"EVENT_DATE") | 
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|  | 71 | ...S CT=CT+1 | 
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|  | 72 | ...S ^TMP("IBCIL1",$J,CT)=$P(IBCIXX,U)_U_$P(^IBA(351.9,$P(IBCIXX,U),0),U,2)_U_IBCIST0 | 
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|  | 73 | ...S IBCIARR=$$SETFLD^VALM1(CT,IBCIARR,"ITEM") D SET^VALM10(CT,IBCIARR) | 
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|  | 74 | S VALMCNT=CT | 
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|  | 75 | I VALMCNT=0 S VALMSG="No Skipped Claims to Send to ClaimsManager." | 
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|  | 76 | D EXIT | 
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|  | 77 | Q | 
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|  | 78 | ; | 
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|  | 79 | SELB ; select single bill, bill by status, or multiple range of bills | 
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|  | 80 | ; | 
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|  | 81 | NEW IBCIENAR,IBCINUMS,IBCIPIEC,IBCIYSUB,IBCIX | 
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|  | 82 | S VALMBCK="R" | 
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|  | 83 | I CT=0 D NOBILS,INIT G SELBX | 
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|  | 84 | D FULL^VALM1 | 
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|  | 85 | S DIR(0)="LO^1:"_CT | 
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|  | 86 | S DIR("A",1)="You may select one or more claims, or a range." | 
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|  | 87 | S DIR("A")="Selection" | 
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|  | 88 | S DIR("?",1)="  You may choose a single bill, a list of bills (i.e. 2,5,9,12), a range" | 
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|  | 89 | S DIR("?",2)="  of bills (i.e. 3-8), or any combination of these (i.e. 1,3,5,8-12).  Only" | 
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|  | 90 | S DIR("?")="  the bills you select here will be sent to ClaimsManager." | 
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|  | 91 | D ^DIR K DIR | 
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|  | 92 | I $D(DIRUT) G SELBX | 
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|  | 93 | D YESBLS | 
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|  | 94 | M IBCIENAR=Y KILL X,Y | 
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|  | 95 | S IBCIYSUB="" | 
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|  | 96 | F  S IBCIYSUB=$O(IBCIENAR(IBCIYSUB)) Q:IBCIYSUB=""  D | 
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|  | 97 | . S IBCINUMS=IBCIENAR(IBCIYSUB) | 
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|  | 98 | . S IBCINUMS=$E(IBCINUMS,1,$L(IBCINUMS)-1) | 
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|  | 99 | . F IBCIPIEC=1:1:$L(IBCINUMS,",") S IBCIX=$P(IBCINUMS,",",IBCIPIEC) D N1 | 
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|  | 100 | . Q | 
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|  | 101 | D SENDMAIL,INIT | 
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|  | 102 | SELBX ; | 
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|  | 103 | Q | 
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|  | 104 | ; | 
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|  | 105 | N1 ; check for valid number and send the claim | 
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|  | 106 | NEW IBCIST1,IBIFN,IBCIMCSB,IBCIMCSL | 
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|  | 107 | NEW ATP,BILLNO,CHARGES,DFN,DPTDATA,EVENTDT,IBDATA,PATNAME,RESP,RESPNM | 
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|  | 108 | NEW SSN,TMPDATA | 
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|  | 109 | NEW IBCIENAR,IBCINUMS,IBCIPIEC,IBCIYSUB | 
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|  | 110 | ; | 
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|  | 111 | I 'IBCIX Q | 
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|  | 112 | I '$D(^TMP("IBCIL1",$J,IBCIX)) Q | 
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|  | 113 | S IBIFN=$P(^TMP("IBCIL1",$J,IBCIX),U,1) | 
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|  | 114 | S IBCIST1=$P(^TMP("IBCIL1",$J,IBCIX),U,3) D STATUS | 
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|  | 115 | ; | 
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|  | 116 | S IBCIMCSB=+$$BILLER^IBCIUT5(IBIFN)          ; current biller | 
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|  | 117 | S IBCIMCSL=+$P($G(^IBA(351.9,IBIFN,0)),U,5)  ; last sent to CM by | 
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|  | 118 | ; | 
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|  | 119 | D ST2^IBCIST          ; send a single bill to CM | 
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|  | 120 | W "." | 
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|  | 121 | ; | 
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|  | 122 | ; esg - 10/4/01 - If the bill is still editable and it came back | 
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|  | 123 | ;       clean from CM, then build a scratch global so we can send | 
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|  | 124 | ;       a MailMan message to some people about this. | 
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|  | 125 | ; | 
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|  | 126 | I IBCISNT=2,IBCISTAT=3 D | 
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|  | 127 | . S (RESP,ATP)=+$P($G(^IBA(351.9,IBIFN,0)),U,12) | 
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|  | 128 | . I 'RESP S RESP=IBCIMCSB | 
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|  | 129 | . I 'RESP S RESP=DUZ | 
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|  | 130 | . S RESPNM=$P($G(^VA(200,RESP,0)),U,1) | 
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|  | 131 | . I RESPNM="" S RESPNM="UNKNOWN" | 
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|  | 132 | . S CHARGES=+$P($G(^DGCR(399,IBIFN,"U1")),U,1) | 
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|  | 133 | . S IBDATA=$G(^DGCR(399,IBIFN,0)) | 
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|  | 134 | . S BILLNO=$P(IBDATA,U,1) | 
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|  | 135 | . S DFN=+$P(IBDATA,U,2) | 
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|  | 136 | . S DPTDATA=$G(^DPT(DFN,0)) | 
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|  | 137 | . S SSN=$E($P(DPTDATA,U,9),6,9) | 
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|  | 138 | . S PATNAME=$P(DPTDATA,U,1) | 
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|  | 139 | . S EVENTDT=$P($P(IBDATA,U,3),".",1) | 
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|  | 140 | . S TMPDATA=BILLNO_U_PATNAME_U_SSN_U_EVENTDT | 
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|  | 141 | . S ^TMP("IBCIL2",$J,RESPNM,-CHARGES,IBIFN)=TMPDATA | 
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|  | 142 | . ; | 
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|  | 143 | . ; these people should get the MailMan message | 
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|  | 144 | . I ATP S ^TMP("IBCIL2",$J,RESPNM,-CHARGES,IBIFN,ATP)="" | 
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|  | 145 | . I IBCIMCSB S ^TMP("IBCIL2",$J,RESPNM,-CHARGES,IBIFN,IBCIMCSB)="" | 
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|  | 146 | . I IBCIMCSL S ^TMP("IBCIL2",$J,RESPNM,-CHARGES,IBIFN,IBCIMCSL)="" | 
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|  | 147 | . S ^TMP("IBCIL2",$J)=$G(^TMP("IBCIL2",$J))+1 | 
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|  | 148 | . Q | 
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|  | 149 | Q | 
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|  | 150 | ; | 
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|  | 151 | STATUS ;set ibcisnt based on criteria | 
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|  | 152 | K IBCISNT | 
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|  | 153 | I $$STAT^IBCIUT1(IBIFN)=10 S IBCISNT=4 Q | 
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|  | 154 | I $$STAT^IBCIUT1(IBIFN)=11 S IBCISNT=5 Q | 
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|  | 155 | S IBCISNT=$S("^1^"[IBCIST1:2,1:6) | 
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|  | 156 | Q | 
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|  | 157 | ; | 
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|  | 158 | ALL ;send all claims | 
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|  | 159 | NEW IBCIX | 
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|  | 160 | S VALMBCK="R" | 
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|  | 161 | I CT=0 D NOBILS,INIT Q | 
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|  | 162 | I CT>0 D YESBLS | 
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|  | 163 | S IBCIX=0 F  S IBCIX=$O(^TMP("IBCIL1",$J,IBCIX)) Q:'IBCIX  D N1 | 
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|  | 164 | D SENDMAIL,INIT | 
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|  | 165 | Q | 
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|  | 166 | SNA ;send all non authorized claims | 
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|  | 167 | NEW IBCIX | 
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|  | 168 | S VALMBCK="R" | 
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|  | 169 | I CT=0 D NOBILS,INIT Q | 
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|  | 170 | I CT>0 D YESBLS | 
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|  | 171 | S IBCIX=0 F  S IBCIX=$O(^TMP("IBCIL1",$J,IBCIX)) Q:'IBCIX  D | 
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|  | 172 | . I $P(^TMP("IBCIL1",$J,IBCIX),U,3)<3 D N1 | 
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|  | 173 | . Q | 
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|  | 174 | D SENDMAIL,INIT | 
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|  | 175 | Q | 
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|  | 176 | ; | 
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|  | 177 | SENDMAIL ; | 
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|  | 178 | ; This procedure is responsible for sending a MailMan message to | 
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|  | 179 | ; users about the claims that had no ClaimsManager errors.  The | 
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|  | 180 | ; message will list all clean claims and will be sent to the billers, | 
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|  | 181 | ; assigned to people, current user, and the user who most recently | 
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|  | 182 | ; sent the bill to CM. | 
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|  | 183 | ; | 
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|  | 184 | NEW CHG,IBIFN,L1,TEXT,TMPDATA,USER,XMDUZ,XMSUB,XMTEXT,XMY,XMDUN,XMZ | 
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|  | 185 | NEW X,Y,X1,X2,X3,X4 | 
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|  | 186 | I '$D(^TMP("IBCIL2",$J)) G SENDX | 
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|  | 187 | S L1=1 | 
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|  | 188 | S TEXT(L1)="The following bills were sent to ClaimsManager from the Multiple Claim Send",L1=L1+1 | 
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|  | 189 | S TEXT(L1)="option.  ClaimsManager did not find any errors with them.  These bills have",L1=L1+1 | 
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|  | 190 | S TEXT(L1)="passed both the IB edit checks and the ClaimsManager edit checks.  They are",L1=L1+1 | 
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|  | 191 | S TEXT(L1)="ready to be authorized.  Please review the bills for which you are responsible",L1=L1+1 | 
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|  | 192 | S TEXT(L1)="(if any) and take the appropriate action.",L1=L1+1 | 
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|  | 193 | S TEXT(L1)=" ",L1=L1+1 | 
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|  | 194 | S TEXT(L1)=$J("EVENT",43),L1=L1+1 | 
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|  | 195 | S TEXT(L1)="  BILL#     PATIENT NAME      PID     DATE         CHARGES    USER NAME",L1=L1+1 | 
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|  | 196 | S TEXT(L1)=" -------  ------------------  ----  ----------  ----------  ------------------",L1=L1+1 | 
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|  | 197 | ; | 
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|  | 198 | S USER="" | 
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|  | 199 | F  S USER=$O(^TMP("IBCIL2",$J,USER)) Q:USER=""  S CHG="" F  S CHG=$O(^TMP("IBCIL2",$J,USER,CHG)) Q:CHG=""  S IBIFN=0 F  S IBIFN=$O(^TMP("IBCIL2",$J,USER,CHG,IBIFN)) Q:'IBIFN  D | 
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|  | 200 | . M XMY=^TMP("IBCIL2",$J,USER,CHG,IBIFN) | 
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|  | 201 | . S TMPDATA=XMY,XMY="" | 
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|  | 202 | . S TEXT(L1)=" " | 
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|  | 203 | . S X=$P(TMPDATA,U,1),X1=7,X2="L" S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2 | 
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|  | 204 | . S TEXT(L1)=TEXT(L1)_"  " | 
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|  | 205 | . S X=$P(TMPDATA,U,2),X1=18,X2="L" S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2 | 
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|  | 206 | . S X=$P(TMPDATA,U,3),X1=6,X2="R" S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2 | 
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|  | 207 | . S X=$$FMTE^XLFDT($P(TMPDATA,U,4),"5Z"),X1=12,X2="R" | 
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|  | 208 | . S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2 | 
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|  | 209 | . S X="$"_$FN(-CHG,",",2),X1=12,X2="R" | 
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|  | 210 | . S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2 | 
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|  | 211 | . S TEXT(L1)=TEXT(L1)_"  " | 
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|  | 212 | . S X=USER,X1=18,X2="L" S TEXT(L1)=TEXT(L1)_$$FILL^IBCIUT2 | 
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|  | 213 | . S L1=L1+1 | 
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|  | 214 | . Q | 
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|  | 215 | S TEXT(L1)=" ",L1=L1+1 | 
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|  | 216 | S TEXT(L1)=" ",L1=L1+1 | 
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|  | 217 | ; | 
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|  | 218 | S XMTEXT="TEXT(" | 
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|  | 219 | S XMDUZ=DUZ | 
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|  | 220 | S XMSUB="ClaimsManager Clean Claims" | 
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|  | 221 | S XMY(DUZ)="" | 
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|  | 222 | D ^XMD | 
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|  | 223 | SENDX ; | 
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|  | 224 | Q | 
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|  | 225 | ; | 
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|  | 226 | NOBILS ;msg for no bills | 
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|  | 227 | D FULL^VALM1 | 
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|  | 228 | W !!,"There are no claims to send ...",! | 
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|  | 229 | S DIR(0)="E" D ^DIR K DIR | 
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|  | 230 | Q | 
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|  | 231 | YESBLS ;msg for sending bills | 
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|  | 232 | W !!,"Sending claims ... please wait.",! | 
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|  | 233 | Q | 
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|  | 234 | HELP ; -- help code | 
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|  | 235 | S X="?" | 
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|  | 236 | D FULL^VALM1 | 
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|  | 237 | D EN^DDIOL("   'Send All Bills to ClaimsManager' will send all claims listed","","!!") | 
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|  | 238 | D EN^DDIOL("     to ClaimsManager for processing.") | 
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|  | 239 | D EN^DDIOL("   'Send All Non Auth Bills to ClaimsManager' will send only","","!!") | 
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|  | 240 | D EN^DDIOL("     Non-Authorized claims to ClaimsManager for processing.") | 
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|  | 241 | D EN^DDIOL("   'Select Bills to send to ClaimsManager' allows individual and","","!!") | 
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|  | 242 | D EN^DDIOL("     multiple selection of claims before sending") | 
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|  | 243 | D EN^DDIOL("     claims to ClaimsManager for processing.") | 
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|  | 244 | D PAUSE^VALM1 | 
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|  | 245 | S VALMBCK="R" | 
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|  | 246 | Q | 
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|  | 247 | ; | 
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|  | 248 | EXIT ; -- exit code | 
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|  | 249 | D CLEAR^VALM1 | 
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|  | 250 | Q | 
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