| [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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