| [613] | 1 | IBCNERPC ;DAOU/RO - IIV PAYER LINK REPORT COMPILE ;AUG-2003 | 
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|  | 2 | ;;2.0;INTEGRATED BILLING;**184,252,271**;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 | 
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|  | 6 | ; | 
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|  | 7 | ; Input vars from IBCNERPB: | 
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|  | 8 | ;  IBCNESPC("REP")=1 for Payer List report, 2 for Company List | 
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|  | 9 | ;  IBCNESPC("PTYPE")=Payer type (1-no active ins linked, 2-at least 1 ins linked, 3-All Payers) | 
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|  | 10 | ;  IBCNESPC("PSORT")=Primary Sort for Payer report | 
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|  | 11 | ;  IBCNESPC("PDET")=Ins detail on payer report (1-include list of ins,2-do not list) | 
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|  | 12 | ; | 
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|  | 13 | ;  IBCNESPC("ITYPE")=Ins Company type (1-no payer link, 2-linked to payer, 3-All ins companies) | 
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|  | 14 | ;  IBCNESPC("ISORT")=Primary Sort for Payer Insurance report | 
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|  | 15 | ;  IBCNESPC("IMAT")=Partial matching Ins carriers | 
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|  | 16 | ; | 
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|  | 17 | ; Output vars used by IBCNERPC: | 
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|  | 18 | ; | 
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|  | 19 | ;   IBCNERTN="IBCNERPB" | 
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|  | 20 | ;   SORT1=depends on sorting option chosen | 
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|  | 21 | ;   SORT2=Payer Name (Report by Payer) or Ins Company Name (if report is Insurance) | 
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|  | 22 | ;  ^TMP($J,IBCNERTN,SORT1,SORT2,CNT) | 
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|  | 23 | ;   CNT=Seq ct | 
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|  | 24 | ;  ^TMP($J,IBCNERTN,SORT1,SORT2,CNT,1) | 
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|  | 25 | ; | 
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|  | 26 | ; Must call at EN | 
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|  | 27 | Q | 
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|  | 28 | ; | 
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|  | 29 | EN(IBCNERTN,IBCNESPC) ; Entry | 
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|  | 30 | ; Init | 
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|  | 31 | N IBTYP,IBCT,IBCTX | 
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|  | 32 | ; | 
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|  | 33 | N IBDET,IBSRT,IBPY,IBVAID,IBPROF,IBINST,IBNAACT,IBLOACT,IBINS,IBINST | 
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|  | 34 | N IBINSN,IBAPP,IBPYR,SORT1,SORT2,IBSRT,IBMAT,IBPPYR,IBREP | 
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|  | 35 | ; | 
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|  | 36 | I '$D(ZTQUEUED),$G(IOST)["C-" W !!,"Compiling report data ..." | 
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|  | 37 | ; | 
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|  | 38 | ; Temp ct | 
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|  | 39 | S IBCT=0 | 
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|  | 40 | ; | 
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|  | 41 | ; Kill scratch globals | 
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|  | 42 | K ^TMP($J,IBCNERTN) | 
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|  | 43 | ; | 
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|  | 44 | ; | 
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|  | 45 | S IBREP=$G(IBCNESPC("REP")) | 
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|  | 46 | S IBDET=$G(IBCNESPC("PDET")) | 
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|  | 47 | S IBTYP=$G(IBCNESPC("PTYPE")) | 
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|  | 48 | S IBSRT=$G(IBCNESPC("PSORT")) | 
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|  | 49 | S IBPPYR=$G(IBCNESPC("PPYR")) | 
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|  | 50 | ; | 
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|  | 51 | ; Ins Report | 
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|  | 52 | I IBREP=2 G INS | 
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|  | 53 | ; | 
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|  | 54 | ; Loop thru the IIV payer File (#365.12) | 
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|  | 55 | S IBPY=0,SORT1="" | 
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|  | 56 | F  S IBPY=$O(^IBE(365.12,IBPY)) Q:'IBPY  D  Q:$G(ZTSTOP) | 
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|  | 57 | . I $D(ZTQUEUED),$$S^%ZTLOAD() S ZTSTOP=1 Q | 
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|  | 58 | . ; Payer name from Payer File (#365.12) | 
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|  | 59 | . S IBPYR=$P($G(^IBE(365.12,IBPY,0)),U) I IBSRT=1 S SORT1=IBPYR | 
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|  | 60 | . S SORT2=IBPYR | 
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|  | 61 | . I IBPYR=""!(IBPYR="~NO PAYER")!($$PYRAPP^IBCNEUT5("IIV",IBPY)="") Q | 
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|  | 62 | . I IBPPYR'="",IBPY'=$P(IBPPYR,U) Q | 
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|  | 63 | . ; get VA national ID | 
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|  | 64 | . S IBVAID=$P($G(^IBE(365.12,IBPY,0)),U,2) I IBSRT=2 S SORT1=IBVAID | 
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|  | 65 | . ; get the EDI numbers (professional and institutional) | 
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|  | 66 | . S IBPROF=$P($G(^IBE(365.12,IBPY,0)),U,5) | 
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|  | 67 | . S IBINST=$P($G(^IBE(365.12,IBPY,0)),U,6) | 
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|  | 68 | . S IBAPP=$$PYRAPP^IBCNEUT5("IIV",IBPY),(IBNAACT,IBLOACT)=0 | 
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|  | 69 | . S:IBAPP'="" IBNAACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,2) | 
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|  | 70 | . S:IBAPP'="" IBLOACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,3) | 
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|  | 71 | . ; if no sort value, use 0 | 
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|  | 72 | . I IBSRT=3 S SORT1=IBNAACT I SORT1="" S SORT1=0 | 
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|  | 73 | . I IBSRT=4 S SORT1=IBLOACT I SORT1="" S SORT1=0 | 
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|  | 74 | . I SORT1="" S SORT1=" " | 
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|  | 75 | . ; if sorting by count and detail, need to figure count first else sort will not work | 
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|  | 76 | . I IBSRT=5,IBTYP>1,IBDET=1 D  S SORT1=-IBCTX | 
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|  | 77 | . . S IBCTX=0,IBINS="" F  S IBINS=$O(^DIC(36,"AC",IBPY,IBINS)) Q:IBINS=""  D | 
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|  | 78 | . . . S IBINSN=$G(^DIC(36,IBINS,0)),IBINSN=$P(IBINSN,U) Q:IBINSN=""  S IBCTX=IBCTX+1 | 
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|  | 79 | . ; search for insurance carriers for this payer | 
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|  | 80 | . S IBCT=0,IBINS="" F  S IBINS=$O(^DIC(36,"AC",IBPY,IBINS)) Q:IBINS=""  D | 
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|  | 81 | . . S IBINSN=$G(^DIC(36,IBINS,0)),IBINSN=$P(IBINSN,U) Q:IBINSN="" | 
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|  | 82 | . . S IBCT=IBCT+1 I IBTYP=1 Q | 
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|  | 83 | . . ; save off address and EDI#'s for Insurance carrier | 
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|  | 84 | . . I IBDET=1 S ^TMP($J,IBCNERTN,SORT1,SORT2,IBPY,IBINSN,IBINS)=$P($G(^DIC(36,IBINS,.11)),U,1,6)_U_$P($G(^DIC(36,IBINS,3)),U,2)_U_$P($G(^DIC(36,IBINS,3)),U,4) | 
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|  | 85 | . I IBTYP=1,IBCT>0 Q | 
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|  | 86 | . I IBTYP=2,IBCT=0 Q | 
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|  | 87 | . ; use reverse sort for count | 
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|  | 88 | . I IBSRT=5 S SORT1=-IBCT | 
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|  | 89 | . S ^TMP($J,IBCNERTN,SORT1,SORT2,IBPY)=IBVAID_U_IBPROF_U_IBINST_U_IBNAACT_U_IBLOACT_U_IBCT | 
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|  | 90 | G EXIT | 
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|  | 91 | ; | 
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|  | 92 | INS ; | 
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|  | 93 | S IBTYP=$G(IBCNESPC("ITYPE")) | 
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|  | 94 | S IBSRT=$G(IBCNESPC("ISORT")) | 
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|  | 95 | S IBMAT=$G(IBCNESPC("IMAT")) | 
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|  | 96 | ; Loop thru the Insurance company file | 
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|  | 97 | S IBINS=0 | 
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|  | 98 | F  S IBINS=$O(^DIC(36,IBINS)) Q:'IBINS  D  Q:$G(ZTSTOP) | 
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|  | 99 | . I $D(ZTQUEUED),$$S^%ZTLOAD() S ZTSTOP=1 Q | 
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|  | 100 | . S (SORT1,IBPYR,IBNAACT,IBLOACT,IBPROF,IBINST,IBVAID)="" | 
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|  | 101 | . S IBINSN=$P($G(^DIC(36,IBINS,0)),U) I IBSRT=1 S SORT1=IBINSN | 
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|  | 102 | . S SORT2=IBINSN | 
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|  | 103 | . I IBINSN="" Q | 
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|  | 104 | . I IBMAT'="",'$F($$UP^XLFSTR(IBINSN),$$UP^XLFSTR(IBMAT)) Q | 
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|  | 105 | . ; get payer | 
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|  | 106 | . S IBPY=$P($G(^DIC(36,IBINS,3)),U,10) | 
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|  | 107 | . I IBTYP=1,IBPY'="" Q | 
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|  | 108 | . I IBTYP=2,IBPY="" Q | 
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|  | 109 | . I IBPY'="" D | 
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|  | 110 | . . ; Payer name from Payer File (#365.12) | 
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|  | 111 | . . S IBPYR=$P($G(^IBE(365.12,IBPY,0)),U) I IBSRT=2 S SORT1=IBPYR | 
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|  | 112 | . . ; get VA national ID | 
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|  | 113 | . . S IBVAID=$P($G(^IBE(365.12,IBPY,0)),U,2) I IBSRT=3 S SORT1=IBVAID | 
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|  | 114 | . . S IBPROF=$P($G(^IBE(365.12,IBPY,0)),U,5) | 
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|  | 115 | . . S IBINST=$P($G(^IBE(365.12,IBPY,0)),U,6) | 
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|  | 116 | . . S IBAPP=$$PYRAPP^IBCNEUT5("IIV",IBPY),(IBNAACT,IBLOACT)=0 | 
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|  | 117 | . . S:IBAPP'="" IBNAACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,2) | 
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|  | 118 | . . S:IBAPP'="" IBLOACT=$P($G(^IBE(365.12,IBPY,1,IBAPP,0)),U,3) | 
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|  | 119 | . . I IBSRT=4 S SORT1=IBNAACT I SORT1="" S SORT1=0 | 
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|  | 120 | . . I IBSRT=5 S SORT1=IBLOACT I SORT1="" S SORT1=0 | 
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|  | 121 | . I SORT1="" S SORT1=" " | 
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|  | 122 | . S ^TMP($J,IBCNERTN,SORT1,SORT2,IBINS)=IBPYR_U_IBVAID_U_IBPROF_U_IBINST_U_IBNAACT_U_IBLOACT_U_IBCT_U_$G(^DIC(36,IBINS,.11))_U_"~"_$G(^DIC(36,IBINS,3)) | 
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|  | 123 | ; | 
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|  | 124 | EXIT ; | 
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|  | 125 | Q | 
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|  | 126 | ; Lines moved from IBCNERPB | 
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|  | 127 | ITYPE ; Prompt to select Insurance Company type to include | 
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|  | 128 | ; Init vars | 
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|  | 129 | N DIR,X,Y,DIRUT | 
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|  | 130 | ; | 
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|  | 131 | S DIR(0)="S^1:Unlinked insurance companies;2:Linked insurance companies;3:All insurance companies" | 
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|  | 132 | S DIR("A")="Select type of insurance companies to display" | 
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|  | 133 | S DIR("B")="3" | 
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|  | 134 | S DIR("?",1)="  1 - Only insurance companies that are not currently linked to a payer" | 
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|  | 135 | S DIR("?",2)="  2 - Only insurance companies that are currently linked to a payer" | 
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|  | 136 | S DIR("?")="  3 - ALL insurance companies" | 
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|  | 137 | D ^DIR K DIR | 
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|  | 138 | I $D(DIRUT) S STOP=1 G ITYPEX | 
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|  | 139 | S IBCNESPC("ITYPE")=Y | 
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|  | 140 | ; | 
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|  | 141 | ITYPEX ; TYPE exit pt | 
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|  | 142 | Q | 
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|  | 143 | ISORT ; Prompt to allow users to select primary sort | 
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|  | 144 | ; Init vars | 
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|  | 145 | N DIR,X,Y,DIRUT | 
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|  | 146 | ; | 
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|  | 147 | S DIR(0)="S^1:Insurance Company Name;2:Payer Name;3:VA National Payer ID;4:Nationally Enabled Status;5:Locally Enabled Status" | 
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|  | 148 | S DIR("A")="Select the primary sort field" | 
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|  | 149 | S DIR("B")=1 | 
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|  | 150 | S DIR("?")="  Select the data field by which this report should be primarily sorted." | 
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|  | 151 | D ^DIR K DIR | 
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|  | 152 | I $D(DIRUT) S STOP=1 G ISORTX | 
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|  | 153 | S IBCNESPC("ISORT")=Y | 
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|  | 154 | ; | 
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|  | 155 | ISORTX ; SORT exit pt | 
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|  | 156 | Q | 
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|  | 157 | IMAT ; Prompt to allow users to select partial Ins carrier to include | 
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|  | 158 | N DIR,X,Y,DIRUT | 
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|  | 159 | ; | 
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|  | 160 | W ! | 
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|  | 161 | S DIR(0)="FO" | 
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|  | 162 | S DIR("A")="Enter an insurance company search keyword (RETURN for ALL)" | 
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|  | 163 | S DIR("B")="" | 
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|  | 164 | S DIR("?",1)="     Enter a value to match insurance company names with." | 
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|  | 165 | S DIR("?",2)="     Simply hit RETURN to select ALL or enter a keyword" | 
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|  | 166 | S DIR("?",3)="     (ex. 'CIGNA' would return CIGNA, CIGNA HICN, NATIONAL CIGNA," | 
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|  | 167 | S DIR("?")="     REGION 1 CIGNA and any others with the term 'CIGNA' in it)" | 
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|  | 168 | D ^DIR K DIR | 
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|  | 169 | I $D(DUOUT)!$D(DTOUT) S Y="" S STOP=1 G IMATX | 
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|  | 170 | S IBCNESPC("IMAT")=Y | 
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|  | 171 | ; | 
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|  | 172 | IMATX Q | 
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