[613] | 1 | IBCNERP4 ;DAOU/BHS - IBCNE USER INTERFACE IIV PAYER REPORT ;03-JUN-2002
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| 2 | ;;2.0;INTEGRATED BILLING;**184,271,300**;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 | ; IIV - Insurance Identification and Verification Interface
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| 6 | ;
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| 7 | ; Input parameter: N/A
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| 8 | ; Other relevant variables:
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| 9 | ; IBCNERTN = "IBCNERP4" (current routine name for queueing the
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| 10 | ; COMPILE process)
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| 11 | ; IBCNESPC("BEGDT") = start date for date range
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| 12 | ; IBCNESPC("ENDDT") = end date for date range
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| 13 | ; IBCNESPC("PYR") = payer ien for report, if = "", then include all
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| 14 | ; IBCNESPC("SORT") = 1 - Payer name OR 2 - Total Inqs (PAYER)
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| 15 | ; IBCNESPC("DTL") = 1 - YES OR 0 - NO Include Rejection Detail in
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| 16 | ; report output - rejections broken down by code
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| 17 | ;
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| 18 | ; Enter only from EN tag
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| 19 | ;
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| 20 | ; Added tag DATA as split out from program IBCNERP5 for size restrictions
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| 21 | QUIT
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| 22 | ;
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| 23 | ; Entry point
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| 24 | EN ;
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| 25 | ; Initialize variables
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| 26 | NEW STOP,IBCNERTN,POP,IBCNESPC
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| 27 | ;
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| 28 | S STOP=0
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| 29 | S IBCNERTN="IBCNERP4"
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| 30 | W @IOF
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| 31 | W !,"IIV Payer Report",!
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| 32 | W !,"Insurance identification and verification inquiries are created daily."
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| 33 | W !,"Select a date range in which inquiries were created by the eIIV extracts."
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| 34 | ;
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| 35 | ; Prompts for Payer Report
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| 36 | ; Date Range parameters
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| 37 | P10 D DTRANGE I STOP G EXIT
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| 38 | ; Payer Selection parameter
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| 39 | P20 D PYRSEL^IBCNERP1 I STOP G:$$STOP^IBCNERP1 EXIT G P10
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| 40 | ; Include Rejection Detail in Payer report
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| 41 | P30 D REJDTL I STOP G:$$STOP^IBCNERP1 EXIT G P20
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| 42 | ; Sort by parameter - Payer or Total Inquiries
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| 43 | P40 D SORT I STOP G:$$STOP^IBCNERP1 EXIT G P30
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| 44 | ; Select the output device
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| 45 | P100 D DEVICE^IBCNERP1(IBCNERTN,.IBCNESPC) I STOP G:$$STOP^IBCNERP1 EXIT G P40
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| 46 | ;
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| 47 | EXIT ; Quit this routine
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| 48 | QUIT
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| 49 | ;
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| 50 | ;
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| 51 | SORT ; Prompt to allow users to sort the report
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| 52 | ; by Payer(default) OR Total Inquiries, then Payer
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| 53 | ; Initialize variables
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| 54 | NEW DIR,X,Y,DIRUT
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| 55 | ;
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| 56 | S DIR(0)="S^1:Payer Name;2:Total Inquiries"
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| 57 | S DIR("A")=" Select the primary sort field"
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| 58 | S DIR("B")=1
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| 59 | S DIR("?",1)=" 1 - Payer Name is the only sort. (Default)"
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| 60 | S DIR("?",2)=" 2 - Total Inquiries is the primary sort, Payer Name is"
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| 61 | S DIR("?")=" the secondary sort."
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| 62 | D ^DIR K DIR
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| 63 | I $D(DIRUT) S STOP=1 G SORTX
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| 64 | S IBCNESPC("SORT")=Y
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| 65 | ;
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| 66 | SORTX ; SORT exit point
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| 67 | QUIT
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| 68 | ;
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| 69 | ;
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| 70 | REJDTL ; Prompt to allow users to include the Rejection Detail in the report
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| 71 | ; Initialize variables
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| 72 | NEW DIR,X,Y,DIRUT
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| 73 | ;
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| 74 | S DIR(0)="Y"
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| 75 | S DIR("A")=" Include Rejection Detail"
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| 76 | S DIR("B")="NO"
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| 77 | S DIR("?",1)=" N - No, exclude Rejection Detail totals from report. (Default)"
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| 78 | S DIR("?")=" Y - Yes, include Rejection Detail totals in report."
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| 79 | D ^DIR K DIR
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| 80 | I $D(DIRUT) S STOP=1 G REJDTLX
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| 81 | S IBCNESPC("DTL")=Y
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| 82 | ;
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| 83 | REJDTLX ; REJDTL exit point
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| 84 | QUIT
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| 85 | ;
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| 86 | ;
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| 87 | DTRANGE ; Determine the start and end dates for the date range parameter
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| 88 | ; Initialize variables
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| 89 | NEW X,Y,DIRUT
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| 90 | ;
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| 91 | W !
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| 92 | ;
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| 93 | S DIR(0)="D^::EX"
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| 94 | S DIR("A")="Start DATE"
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| 95 | S DIR("?",1)=" Please enter a valid date for which an IIV Inquiry"
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| 96 | S DIR("?")=" would have been created."
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| 97 | D ^DIR K DIR
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| 98 | I $D(DIRUT) S STOP=1 G DTRANGX
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| 99 | S IBCNESPC("BEGDT")=Y
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| 100 | ; End date
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| 101 | DTRANG1 S DIR(0)="D^::EX"
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| 102 | S DIR("A")=" End DATE"
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| 103 | S DIR("?",1)=" Please enter a valid date for which an IIV Inquiry"
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| 104 | S DIR("?",2)=" would have been created. This date must not precede"
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| 105 | S DIR("?")=" the Start Date."
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| 106 | D ^DIR K DIR
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| 107 | I $D(DIRUT) S STOP=1 G DTRANGX
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| 108 | I Y<IBCNESPC("BEGDT") D G DTRANG1
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| 109 | . W !," End Date must not precede the Start Date."
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| 110 | . W !," Please reenter."
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| 111 | S IBCNESPC("ENDDT")=Y
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| 112 | ;
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| 113 | DTRANGX ; DTRANGE exit point
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| 114 | QUIT
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| 115 | ;
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| 116 | ;
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| 117 | ; called from IBCNERP5
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| 118 | ; Loop through the IIV Response File (#365)
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| 119 | ; By DATE/TIME RECEIVED & PAYER & PATIENT Cross-Reference ("AE")
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| 120 | ;
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| 121 | DATA N RDATA,RDATA1,TQDATA,IBCNEDT,IBCNEPTR,IBCNEPAT,RPYRIEN,RPYNM,PYRIEN,IBPNM,ERRCON
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| 122 | N IBPIEN,PC,ERR,ERRTXT,PYRNM,APIEN,IBCNEPTD,TQIEN
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| 123 | S IBCNEDT=$O(^IBCN(365,"AD",IBCNEDT1),-1)
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| 124 | F S IBCNEDT=$O(^IBCN(365,"AD",IBCNEDT)) Q:IBCNEDT=""!($P(IBCNEDT,".",1)>IBCNEDT2) D Q:$G(ZTSTOP)
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| 125 | . I $D(ZTQUEUED),$$S^%ZTLOAD() S ZTSTOP=1 QUIT
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| 126 | . S IBCNEPAT=0
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| 127 | . F S IBCNEPAT=$O(^IBCN(365,"AD",IBCNEDT,IBCNEPAT)) Q:'IBCNEPAT D Q:$G(ZTSTOP)
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| 128 | .. S IBCNEPTD=0
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| 129 | .. F S IBCNEPTD=$O(^IBCN(365,"AD",IBCNEDT,IBCNEPAT,IBCNEPTD)) Q:'IBCNEPTD D Q:$G(ZTSTOP)
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| 130 | ... S IBCNEPTR=0
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| 131 | ... F S IBCNEPTR=$O(^IBCN(365,"AD",IBCNEDT,IBCNEPAT,IBCNEPTD,IBCNEPTR)) Q:'IBCNEPTR D Q:$G(ZTSTOP)
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| 132 | .... ; Get data from Resp File
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| 133 | .... S RDATA=$G(^IBCN(365,IBCNEPTR,0))
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| 134 | .... I RDATA="" Q
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| 135 | .... ; ONLY select Transmission status 3
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| 136 | .... I $P($G(RDATA),U,6)'=3 Q
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| 137 | .... ; Determine Payer name from Payer File (#365.12)
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| 138 | .... S RPYRIEN=$P($G(RDATA),U,3)
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| 139 | .... I 'RPYRIEN Q
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| 140 | .... ; Check payer filter
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| 141 | .... I IBCNEPY'="",RPYRIEN'=IBCNEPY Q
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| 142 | .... S RPYNM=$P($G(^IBE(365.12,RPYRIEN,0)),U)
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| 143 | .... I RPYNM="" Q
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| 144 | .... ; link to TQ file
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| 145 | .... S TQIEN=$P($G(RDATA),U,5)
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| 146 | .... I TQIEN="" Q
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| 147 | .... ; Get data from TQ file (365.1)
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| 148 | .... S TQDATA=$G(^IBCN(365.1,TQIEN,0))
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| 149 | .... I TQDATA="" Q
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| 150 | .... ; Get TQ Payer from (365.1) File
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| 151 | .... S PYRIEN=$P($G(TQDATA),U,3)
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| 152 | .... S PYRNM=$P($G(^IBE(365.12,PYRIEN,0)),U)
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| 153 | .... ; Cancelled (7) - Payer deactivated
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| 154 | .... I $P($G(TQDATA),U,4)=7 Q
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| 155 | .... ; Determine Deactivation DTM for eIIV application
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| 156 | .... I RPYNM'="~NO PAYER" D
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| 157 | ..... S APIEN=$$PYRAPP^IBCNEUT5("IIV",RPYRIEN)
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| 158 | ..... I APIEN,$P($G(^IBE(365.12,RPYRIEN,1,APIEN,0)),U,11) S $P(^TMP($J,IBCNERTN,RPYNM,RPYRIEN,"*"),U,11)=$P($G(^IBE(365.12,RPYRIEN,1,APIEN,0)),U,12)
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| 159 | .... ; Determine Deactivation DTM for eIIV application
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| 160 | .... I PYRNM'="~NO PAYER",PYRIEN'=RPYRIEN D
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| 161 | ..... S APIEN=$$PYRAPP^IBCNEUT5("IIV",PYRIEN)
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| 162 | ..... I APIEN,$P($G(^IBE(365.12,PYRIEN,1,APIEN,0)),U,11) S $P(^TMP($J,IBCNERTN,PYRNM,PYRIEN,"*"),U,11)=$P($G(^IBE(365.12,PYRIEN,1,APIEN,0)),U,12)
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| 163 | .... ; Get error text
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| 164 | .... S ERRTXT=$G(^IBCN(365,IBCNEPTR,4))
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| 165 | .... ; Now get the data from Response file for the report
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| 166 | .... S RDATA1=$G(^IBCN(365,IBCNEPTR,1)),ERRCON=$P($G(RDATA1),U,14)
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| 167 | .... ; Increment for non-error (GOOD) response and quit
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| 168 | .... I ERRCON="",ERRTXT="" D Q
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| 169 | ..... S $P(^TMP($J,IBCNERTN,RPYNM,RPYRIEN,"*"),U,6)=$P($G(^TMP($J,IBCNERTN,RPYNM,RPYRIEN,"*")),U,6)+1
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| 170 | ..... ; if TQ payer was ~NO PAYER then also increment ~NO PAYER good count
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| 171 | ..... I IBCNEPY="",(RPYRIEN'=PYRIEN),(PYRNM="~NO PAYER") S $P(^TMP($J,IBCNERTN,PYRNM,PYRIEN,"*"),U,6)=$P($G(^TMP($J,IBCNERTN,PYRNM,PYRIEN,"*")),U,6)+1
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| 172 | .... ; Rejection is defined as having a value in the Error Condition field or Error Text field
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| 173 | .... ; Increment for error response
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| 174 | .... S $P(^TMP($J,IBCNERTN,RPYNM,RPYRIEN,"*"),U,7)=$P($G(^TMP($J,IBCNERTN,RPYNM,RPYRIEN,"*")),U,7)+1
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| 175 | .... ; if TQ payer was ~NO PAYER then also increment ~NO PAYER error count
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| 176 | .... I IBCNEPY="",(RPYRIEN'=PYRIEN),(PYRNM="~NO PAYER") S $P(^TMP($J,IBCNERTN,PYRNM,PYRIEN,"*"),U,7)=$P($G(^TMP($J,IBCNERTN,PYRNM,PYRIEN,"*")),U,7)+1
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| 177 | .... ; Store rejection detail only if user requested it
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| 178 | .... I 'IBCNEDTL Q
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| 179 | .... I ERRCON S ^TMP($J,IBCNERTN,RPYNM,RPYRIEN,"*",ERRCON)=$G(^TMP($J,IBCNERTN,RPYNM,RPYRIEN,"*",ERRCON))+1
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| 180 | .... I 'ERRCON,ERRTXT'="" S ^TMP($J,IBCNERTN,RPYNM,RPYRIEN,"*",0_U_ERRTXT)=$G(^TMP($J,IBCNERTN,RPYNM,RPYRIEN,"*",0_U_ERRTXT))+1
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| 181 | .... I IBCNEPY="",(RPYRIEN'=PYRIEN),(PYRNM="~NO PAYER") D
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| 182 | .... . I ERRCON S ^TMP($J,IBCNERTN,PYRNM,PYRIEN,"*",ERRCON)=$G(^TMP($J,IBCNERTN,PYRNM,PYRIEN,"*",ERRCON))+1
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| 183 | .... . I 'ERRCON,ERRTXT'="" S ^TMP($J,IBCNERTN,PYRNM,PYRIEN,"*",0_U_ERRTXT)=$G(^TMP($J,IBCNERTN,PYRNM,PYRIEN,"*",0_U_ERRTXT))+1
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| 184 | Q
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