| [613] | 1 | IBCNEHL2 ;DAOU/ALA - HL7 Process Incoming RPI Msgs (cont.) ;26-JUN-2002  ; Compiled December 16, 2004 15:29:37 | 
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|  | 2 | ;;2.0;INTEGRATED BILLING;**300,345**;21-MAR-94;Build 28 | 
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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 | ;**Program Description** | 
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|  | 6 | ;  This pgm will process the indiv segments of the | 
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|  | 7 | ;  incoming IIV response msgs. | 
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|  | 8 | ; | 
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|  | 9 | ; * Each of these tags are called by IBCNEHL1. | 
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|  | 10 | ; | 
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|  | 11 | ;  This routine is based on IBCNEHLP which was introduced with patch 184, and subsequently | 
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|  | 12 | ;  patched with patches 252 and 271.  IBCNEHLP is obsolete and deleted with patch 300. | 
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|  | 13 | ; | 
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|  | 14 | ;  Variables | 
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|  | 15 | ;    SEG = HL7 Seg Name | 
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|  | 16 | ;    MSGID = Original Msg Control ID | 
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|  | 17 | ;    ACK =  Acknowledgment (AA=Accepted, AE=Error) | 
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|  | 18 | ;    ERTXT = Error Msg Text | 
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|  | 19 | ;    ERFLG = Error quit flag | 
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|  | 20 | ;    ERACT = Error Action | 
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|  | 21 | ;    ERCON = Error Condition | 
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|  | 22 | ;    RIEN = Response Record IEN | 
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|  | 23 | ;    IBSEG = Array of the segment | 
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|  | 24 | ; | 
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|  | 25 | Q  ; No direct calls | 
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|  | 26 | ; | 
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|  | 27 | MSA(ERACT,ERCON,ERROR,ERTXT,IBSEG,MGRP,RIEN,TRACE) ;  Process the MSA seg | 
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|  | 28 | ; | 
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|  | 29 | ;  Input: | 
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|  | 30 | ;  IBSEG,MGRP | 
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|  | 31 | ; | 
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|  | 32 | ;  Output: | 
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|  | 33 | ;  ERACT,ERCON,ERROR,ERTXT,RIEN,TRACE,ACK | 
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|  | 34 | ; | 
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|  | 35 | D MSA^IBCNEHL4 | 
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|  | 36 | Q | 
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|  | 37 | ; | 
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|  | 38 | CTD(ERROR,IBSEG,RIEN) ; Process the CTD seg | 
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|  | 39 | ; | 
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|  | 40 | ; Input: | 
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|  | 41 | ; IBSEG,RIEN | 
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|  | 42 | ; | 
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|  | 43 | ; Output: | 
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|  | 44 | ; ERROR | 
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|  | 45 | ; | 
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|  | 46 | N CTNAME,CTQUAL,CTNUM,CTQIEN,D1,DA,DATA,DIC,DILN,DISYS,DLAYGO,FFL,FLD,IENS,II,RSUPDT,X,Y | 
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|  | 47 | ; | 
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|  | 48 | ;  Parse out data from seg | 
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|  | 49 | S CTNAME=$G(IBSEG(3)),CTQUAL=$P($G(IBSEG(6)),$E(HLECH),9),CTNUM=$P($G(IBSEG(6)),$E(HLECH)) | 
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|  | 50 | I $TR(CTNAME," ")="" S CTNAME="NOT SPECIFIED" | 
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|  | 51 | S CTQIEN=$$FIND1^DIC(365.021,"","X",CTQUAL) | 
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|  | 52 | I CTNAME[$E(HLECH) S CTNAME=$$DECHL7($$FMNAME^HLFNC(CTNAME,HLECH)) | 
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|  | 53 | S CTNAME=$E(CTNAME,1,32) | 
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|  | 54 | ; | 
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|  | 55 | ;  Look up contact person | 
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|  | 56 | S DA(1)=RIEN,DIC="^IBCN(365,"_DA(1)_",3,",DIC(0)="LZ",DLAYGO=365.03 | 
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|  | 57 | I '$D(^IBCN(365,DA(1),3,0)) S ^IBCN(365,DA(1),3,0)="^365.03^^" | 
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|  | 58 | S X=CTNAME D ^DIC | 
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|  | 59 | S DA=+Y,DATA=^IBCN(365,DA(1),3,DA,0),FLD=2,FFL=0 | 
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|  | 60 | ; | 
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|  | 61 | ;  Check if contact already has this communication qualifier on file | 
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|  | 62 | F II=2,4,6 I $P(DATA,U,II)=CTQIEN S FLD=II,FFL=1 Q | 
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|  | 63 | I 'FFL F II=2,4,6 I $P(DATA,U,II)="" S FLD=II Q | 
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|  | 64 | ; | 
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|  | 65 | S IENS=$$IENS^DILF(.DA) | 
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|  | 66 | S RSUPDT(365.03,IENS,".0"_(FLD+1))=CTNUM | 
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|  | 67 | S RSUPDT(365.03,IENS,".0"_FLD)=CTQIEN | 
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|  | 68 | D FILE^DIE("I","RSUPDT","ERROR") | 
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|  | 69 | CTDX ; | 
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|  | 70 | Q | 
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|  | 71 | ; | 
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|  | 72 | PID(ERFLG,ERROR,IBSEG,RIEN) ;  Process the PID seg | 
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|  | 73 | ; | 
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|  | 74 | ; Input: | 
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|  | 75 | ; IBSEG,RIEN | 
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|  | 76 | ; | 
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|  | 77 | ; Output: | 
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|  | 78 | ; ERFLG,ERROR | 
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|  | 79 | ; | 
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|  | 80 | D PID^IBCNEHL4 | 
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|  | 81 | Q | 
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|  | 82 | ; | 
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|  | 83 | GT1(ERROR,IBSEG,RIEN,SUBID) ;  Process the GT1 Guarantor seg | 
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|  | 84 | ; | 
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|  | 85 | ; Input: | 
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|  | 86 | ; IBSEG,RIEN | 
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|  | 87 | ; | 
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|  | 88 | ; Output: | 
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|  | 89 | ; ERROR,SUBID | 
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|  | 90 | ; | 
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|  | 91 | D GT1^IBCNEHL4 | 
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|  | 92 | Q | 
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|  | 93 | ; | 
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|  | 94 | IN1(ERROR,IBSEG,RIEN,SUBID) ;  Process the IN1 Insurance seg | 
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|  | 95 | ; | 
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|  | 96 | ; Input: | 
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|  | 97 | ; IBSEG,RIEN,SUBID,ACK | 
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|  | 98 | ; | 
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|  | 99 | ; Output: | 
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|  | 100 | ; ERROR | 
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|  | 101 | ; | 
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|  | 102 | N COB,EFFDT,EXPDT,GNAME,GNUMB,MBRID,PAYRID,PYRNM,RSUPDT,SRVDT | 
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|  | 103 | N PYLEDT,CERDT,RELTN | 
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|  | 104 | ; | 
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|  | 105 | ; Austin sending responses with an error indicator will populate IBSEG(3) w/ | 
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|  | 106 | ;9 zeros in order to send the HL7 required field when the payer does not | 
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|  | 107 | ;send a value for this field | 
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|  | 108 | S MBRID=$$DECHL7($G(IBSEG(3))) I ACK="AE",($TR(MBRID,0)="") S MBRID="" | 
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|  | 109 | S PAYRID=$G(IBSEG(4)),PYRNM=$G(IBSEG(5)) | 
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|  | 110 | S GNAME=$$DECHL7($G(IBSEG(10))),GNUMB=$$DECHL7($G(IBSEG(9))) | 
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|  | 111 | S EFFDT=$G(IBSEG(13)),EXPDT=$G(IBSEG(14)) | 
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|  | 112 | S COB=$G(IBSEG(23)),SRVDT=$G(IBSEG(27)) | 
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|  | 113 | S PYLEDT=$G(IBSEG(30)),RELTN=$G(IBSEG(18)) | 
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|  | 114 | ; | 
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|  | 115 | ; Relationship codes sent through the HL7 msg are X12 codes | 
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|  | 116 | ; X12 codes from the interface "01"=spouse, "18"=self "21"=unknown, "34"=other adult | 
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|  | 117 | S RELTN=$S(RELTN="01":"02",RELTN="18":"01",RELTN="21":"09",1:"") | 
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|  | 118 | S EFFDT=$$FMDATE^HLFNC(EFFDT),EXPDT=$$FMDATE^HLFNC(EXPDT) | 
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|  | 119 | S SRVDT=$$FMDATE^HLFNC(SRVDT),PYLEDT=$$FMDATE^HLFNC(PYLEDT) | 
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|  | 120 | ; | 
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|  | 121 | S RSUPDT(365,RIEN_",",1.05)=$S($G(SUBID)'="":SUBID,1:MBRID) | 
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|  | 122 | S RSUPDT(365,RIEN_",",1.07)=GNUMB | 
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|  | 123 | S RSUPDT(365,RIEN_",",1.06)=GNAME,RSUPDT(365,RIEN_",",1.11)=EFFDT | 
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|  | 124 | S RSUPDT(365,RIEN_",",1.12)=EXPDT,RSUPDT(365,RIEN_",",1.1)=SRVDT | 
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|  | 125 | S RSUPDT(365,RIEN_",",1.19)=PYLEDT | 
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|  | 126 | S RSUPDT(365,RIEN_",",1.13)=COB,RSUPDT(365,RIEN_",",1.18)=MBRID | 
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|  | 127 | S RSUPDT(365,RIEN_",",1.09)=RELTN | 
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|  | 128 | D FILE^DIE("I","RSUPDT","ERROR") | 
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|  | 129 | IN1X ; | 
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|  | 130 | Q | 
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|  | 131 | ; | 
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|  | 132 | IN3(ERROR,IBSEG,RIEN) ;  Process IN3 Addt'l Insurance - Cert Seg | 
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|  | 133 | ; | 
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|  | 134 | ; Input: | 
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|  | 135 | ; IBSEG,RIEN | 
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|  | 136 | ; | 
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|  | 137 | ; Output: | 
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|  | 138 | ; ERROR | 
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|  | 139 | ; | 
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|  | 140 | N CRDT,RSUPDT | 
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|  | 141 | ; | 
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|  | 142 | S CRDT=$G(IBSEG(7)) | 
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|  | 143 | S CRDT=$$FMDATE^HLFNC(CRDT) | 
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|  | 144 | S RSUPDT(365,RIEN_",",1.17)=CRDT | 
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|  | 145 | D FILE^DIE("I","RSUPDT","ERROR") | 
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|  | 146 | IN3X ; | 
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|  | 147 | Q | 
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|  | 148 | ; | 
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|  | 149 | ZEB(EBDA,ERROR,IBSEG,RIEN) ;  Process the ZEB Elig/Benefit seg | 
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|  | 150 | ; | 
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|  | 151 | ; Input: | 
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|  | 152 | ; IBSEG,IIVSTAT,RIEN | 
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|  | 153 | ; | 
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|  | 154 | ; Output: | 
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|  | 155 | ; EBDA,ERROR | 
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|  | 156 | ; | 
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|  | 157 | N D1,DA,DIC,DILN,DISYS,DLAYGO,EBN,IENS,II,MSG,RSUPDT,SUBJECT,X,XMY,Y,MA | 
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|  | 158 | ; | 
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|  | 159 | ; Set a default IIV Status value of # ("V") | 
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|  | 160 | I IIVSTAT="" D | 
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|  | 161 | .   I IBSEG(7)'="IIV Eligibility Determination" S IIVSTAT="V" Q | 
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|  | 162 | .   I $F("_1_6_V_","_"_IBSEG(3)_"_") S IIVSTAT=IBSEG(3) Q | 
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|  | 163 | .   ; Unknown code received from the EC | 
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|  | 164 | .   S SUBJECT="IIV: Invalid Eligibility Status flag" | 
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|  | 165 | .   S MSG(1)="An invalid Eligibility Status flag '"_$G(IBSEG(3))_"' was received for site "_$P($$SITE^VASITE,"^",3)_"," | 
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|  | 166 | .   S MSG(2)="trace number "_$G(TRACE,"unknown")_" and message control id "_$G(MSGID,"unknown")_"." | 
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|  | 167 | .   S MSG(3)="It has been interpreted as an ambiguous response in VistA." | 
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|  | 168 | .   S XMY("FSCECADMIN@mail.va.gov")="" | 
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|  | 169 | .   D MSG^IBCNEUT5("",SUBJECT,"MSG(",,.XMY) | 
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|  | 170 | .   S IIVSTAT="V" | 
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|  | 171 | ; | 
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|  | 172 | ; Process the ZEB | 
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|  | 173 | S EBN=$G(IBSEG(2)) | 
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|  | 174 | S DA(1)=RIEN,DIC="^IBCN(365,"_DA(1)_",2,",DIC(0)="L",DLAYGO=365.02 | 
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|  | 175 | I '$D(^IBCN(365,DA(1),2,0)) S ^IBCN(365,DA(1),2,0)="^365.02^^" | 
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|  | 176 | S X=EBN D ^DIC | 
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|  | 177 | S DA=+Y,EBDA=DA | 
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|  | 178 | ; | 
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|  | 179 | S IENS=$$IENS^DILF(.DA) | 
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|  | 180 | ; | 
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|  | 181 | ; decode plan description ZEB segment | 
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|  | 182 | S IBSEG(7)=$$DECHL7($G(IBSEG(7))) | 
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|  | 183 | F II=2:1:7 S RSUPDT(365.02,IENS,".0"_II)=$G(IBSEG(II+1)) | 
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|  | 184 | S MA=$G(IBSEG(9)) I $TR(MA," ","")'="" S MA=$J(MA,0,2) | 
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|  | 185 | S RSUPDT(365.02,IENS,".08")=MA                     ; Monetary amt | 
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|  | 186 | S RSUPDT(365.02,IENS,".09")=$G(IBSEG(10))          ; Percent | 
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|  | 187 | S RSUPDT(365.02,IENS,".1")=$G(IBSEG(11))           ; Quantity Qual. | 
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|  | 188 | F II=11:1:13 S RSUPDT(365.02,IENS,"."_II)=$G(IBSEG(II+1)) | 
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|  | 189 | D FILE^DIE("E","RSUPDT","ERROR") | 
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|  | 190 | ZEBX ; | 
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|  | 191 | Q | 
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|  | 192 | ; | 
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|  | 193 | NTE(EBDA,IBSEG,RIEN) ; Process NTE Notes seg | 
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|  | 194 | ; | 
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|  | 195 | ; Input: | 
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|  | 196 | ; EBDA,IBSEG,RIEN | 
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|  | 197 | ; | 
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|  | 198 | ; Output: | 
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|  | 199 | ; ERROR | 
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|  | 200 | ; | 
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|  | 201 | N DA,IENS,NOTES | 
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|  | 202 | I $G(EBDA)="" Q | 
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|  | 203 | S NOTES(1)=$$DECHL7($G(IBSEG(4))) | 
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|  | 204 | S DA(1)=RIEN,DA=EBDA | 
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|  | 205 | S IENS=$$IENS^DILF(.DA) | 
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|  | 206 | D WP^DIE(365.02,IENS,2,"A","NOTES","ERROR") | 
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|  | 207 | NTEX ; | 
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|  | 208 | Q | 
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|  | 209 | ; | 
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|  | 210 | DECHL7(STR,HLSEP,ECHARS) ; Decode HL7 escape seqs in data fields | 
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|  | 211 | ; | 
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|  | 212 | ; Input: | 
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|  | 213 | ; STR = Field data possible containing HL7 escape seqs for encoding chars | 
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|  | 214 | ; HLSEP (opt) = HL7 Field sep. char - assumes HLFS if not passed | 
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|  | 215 | ; ECHARS (opt) = HL7 encoding chars being used, assumes HL("ECH") if not passed | 
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|  | 216 | ; | 
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|  | 217 | ; Output Values | 
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|  | 218 | ; Fn returns string w/converted escape seqs | 
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|  | 219 | ; | 
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|  | 220 | N ESC,PAT,REPL,ECODE,PCE | 
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|  | 221 | ; Initialize opt. params. | 
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|  | 222 | I $G(HLSEP)="" S HLSEP=HLFS | 
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|  | 223 | I $G(ECHARS)="" S ECHARS=HL("ECH") | 
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|  | 224 | ; | 
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|  | 225 | S ESC=$E(ECHARS,3) ; Escape char. | 
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|  | 226 | ; Check for escape seqs, quit if not | 
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|  | 227 | I STR'[ESC G DECHL7X | 
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|  | 228 | ; Replace ^ w/{sp} (if any) to prevent filing problems | 
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|  | 229 | S ECHARS=$TR(ECHARS,"^"," ") | 
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|  | 230 | ; | 
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|  | 231 | ; Array of rep. chars | 
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|  | 232 | S REPL("F")=$TR(HLSEP,"^"," ") ;Field Sep | 
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|  | 233 | S REPL("S")=$E(ECHARS)     ;Comp Sep | 
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|  | 234 | S REPL("R")=$E(ECHARS,2)   ;Rep. sep | 
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|  | 235 | ; Temp. replace w/ASC 26, until after other ESC are stripped | 
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|  | 236 | S REPL("E")=$C(26)  ;Esc. sep | 
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|  | 237 | S REPL("T")=$E(ECHARS,4)   ;Subcomp. sep | 
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|  | 238 | ; | 
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|  | 239 | ; Translate out escape seqs left->right | 
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|  | 240 | F PCE=1:1:($L(STR,ESC)-1)\2 D | 
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|  | 241 | . ; Ignore empty esc. or unrec. esc. seq. | 
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|  | 242 | . S ECODE=$P(STR,ESC,2) I ECODE="" S ECODE="XXXX" | 
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|  | 243 | . I $D(REPL(ECODE))'>0 S STR=$P(STR,ESC)_$C(26)_$P(STR,ESC,2)_$C(26)_$P(STR,ESC,3,99999) Q | 
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|  | 244 | . ; Else, replace esc. seq. w/ char. | 
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|  | 245 | . S STR=$P(STR,ESC)_$G(REPL(ECODE))_$P(STR,ESC,3,99999) | 
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|  | 246 | ; | 
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|  | 247 | ;Replace the decoded ESC chars that were actually sent | 
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|  | 248 | S STR=$TR(STR,$C(26),ESC) | 
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|  | 249 | ; | 
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|  | 250 | DECHL7X ; Exit w/return values | 
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|  | 251 | Q STR | 
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