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