| 1 | IBCNRP5 ;BHAM ISC/CMW - Group Plan Status Report ;01-NOV-2004
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| 2 |  ;;2.0;INTEGRATED BILLING;**276**;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 | EN ;
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| 6 |  ; Initialize variables
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| 7 |  N STOP,IBCNRRTN,IBCNRSPC,RESORT,IBCNTYP,IBSEL
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| 8 |  D:'$D(IOF) HOME^%ZIS
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| 9 |  ;
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| 10 |  S STOP=0,IBPXT=$G(IBPXT)
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| 11 |  W @IOF
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| 12 |  W !,"ePHARM GROUP PLAN STATUS REPORT",!
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| 13 |  W !,"NCPDP process requires that the users match Group Plans to Pharmacy Plans."
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| 14 |  W !,"This report will assist users in matching Group Insurance Plans to Pharmacy"
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| 15 |  W !,"  Plans by searching through GIPF file for Group Plans that "
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| 16 |  W !,"    are linked to an Insurance with active Pharmacy Plan coverage."
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| 17 |  ;
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| 18 |  ; Prompts 
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| 19 |  ; lock global
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| 20 |  S IBCNRRPT=1
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| 21 |  N IBCNRDEV S IBCNRDEV=1
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| 22 |  L +^XTMP("IBCNRP5"):5 I '$T W !!,"Sorry, Status Report in use." H 2 G EXIT
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| 23 |  ;Check for prior compile
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| 24 | P10 D RESORT(.RESORT) I STOP G EXIT
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| 25 |  I $G(RESORT) G P30
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| 26 |  K ^XTMP("IBCNRP5")
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| 27 |  ; compile valid insurance file
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| 28 | P20 D GIPF
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| 29 |  ; select insurance company
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| 30 | P30 D INS I $G(IBSEL)="" G EXIT
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| 31 |  D TYPE I $G(IBCNTYP)="" G EXIT
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| 32 |  ; perform sort/selection
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| 33 | P40 D INSEL
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| 34 |  I '$D(^TMP("IBCNRP5")) G EXIT
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| 35 |  ; print selection
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| 36 | P50 D PRINT^IBCNRP5P
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| 37 |  ;
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| 38 | EXIT ; unlock global
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| 39 |  L -^XTMP("IBCNRP5")
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| 40 |  K IBPXT
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| 41 |  K IBCNSP,IBCPOL,IBIND,IBMULT,IBSEL,IBW,IBALR,IBGRP,IBCNGP
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| 42 |  K IBCNRRPT,IBCNTYP,IBCNRDEV,ZTDESC,ZTSTOP
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| 43 |  K IBCNRP,IBCNRI,IBCNRGP
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| 44 |  K IBICPT,IBICF,IBICL,IBIC,IBINA,IBIEN,INIEN
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| 45 |  K ^TMP("IBCNRP5",$J)
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| 46 |  Q
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| 47 |  ;
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| 48 | RESORT(RESORT) ; check for prior compile
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| 49 |  NEW DIR,BDT,EDT,RDT,HDR,IBDT,X,Y,DIRUT
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| 50 |  I '$D(^XTMP("IBCNRP5")) Q
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| 51 |  S RDT=$P($G(^XTMP("IBCNRP5",0)),U,2)
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| 52 |  S RESORT=0
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| 53 |  S HDR=$$FMTE^XLFDT(RDT,"5Z")
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| 54 |  W !!,"Current Insurance company list compiled on: ",HDR,!
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| 55 |  S DIR(0)="Y"
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| 56 |  S DIR("A")="Do you want to use the existing compiled file"
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| 57 |  S DIR("B")="YES"
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| 58 |  S DIR("?",1)=" Enter YES to use the existing compiled file."
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| 59 |  S DIR("?")=" Enter NO to DELETE existing file and recompile,"
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| 60 |  D ^DIR K DIR
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| 61 |  I $D(DIRUT) S STOP=1 G RESRTX
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| 62 |  S RESORT=Y
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| 63 |  S IBCNRSPC("RESORT")=Y
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| 64 |  ;
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| 65 | RESRTX ;RESORT EXIT
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| 66 |  Q
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| 67 |  ; 
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| 68 | GIPF ; compiler valid insurance
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| 69 |  W !,"*** COMPILING ......"
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| 70 |  N GST1,GP0,GP6,IBCOV,LIM,IBCVRD,IBIEN
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| 71 |  N GPIEN,GPNAM,GPNUM,IBINA
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| 72 |  S GST1=1,(GPIEN,INIEN)=""
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| 73 |  S ^XTMP("IBCNRP5",0)=($$NOW^XLFDT+30)_"^"_$$NOW^XLFDT_"^"_"Group Plan Status Report"
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| 74 |  F  S INIEN=$O(^IBA(355.3,"B",INIEN)) Q:INIEN=""  D
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| 75 |  . S IBINA=$P($G(^DIC(36,+INIEN,0)),U)
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| 76 |  . ; company does not reimburse
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| 77 |  . I $P($G(^DIC(36,+INIEN,0)),U,2)="N" Q
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| 78 |  . ; company is inactive
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| 79 |  . I $P($G(^DIC(36,INIEN,0)),U,5) Q
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| 80 |  . ;
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| 81 |  . F  S GPIEN=$O(^IBA(355.3,"B",INIEN,GPIEN)) Q:GPIEN=""  D
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| 82 |  .. ;chk for active group
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| 83 |  .. S GP0=$G(^IBA(355.3,GPIEN,0)),GP6=$G(^IBA(355.3,GPIEN,6))
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| 84 |  .. I $P(GP0,U,11)=1 Q
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| 85 |  .. ;
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| 86 |  .. ;chk for pharm plan coverage
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| 87 |  .. S IBCOV=$O(^IBE(355.31,"B","PHARMACY",""))
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| 88 |  .. S LIM="",IBCVRD=0
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| 89 |  .. F  S LIM=$O(^IBA(355.32,"B",GPIEN,LIM)) Q:LIM=""  D
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| 90 |  ... I $P(^IBA(355.32,LIM,0),U,2)'=IBCOV Q
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| 91 |  ... ;chk covered status
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| 92 |  ... S IBCVRD=$P(^IBA(355.32,LIM,0),U,4)
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| 93 |  ... I IBCVRD=0 Q
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| 94 |  ... ;set valid insurance/group array
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| 95 |  ... S ^XTMP("IBCNRP5",IBINA,INIEN,GPIEN)=""
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| 96 |  Q
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| 97 |  ;
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| 98 | INS ;
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| 99 |  S IBSEL=""
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| 100 |  W !,"Run Report "
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| 101 |  W " for (S)PECIFIC insurance companies or a (R)ANGE: RANGE// "
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| 102 |  R X:DTIME Q:'$T!(X["^")
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| 103 |  S:X="" X="R" S X=$E(X)
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| 104 |  I "RSrs"'[X W !,"Enter <CR> for Range; 'S' for specific insurance; '^' to quit." G INS
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| 105 |  W "  ",$S("Ss"[X:"SPECIFIC",1:"RANGE") G:"Rr"[X INSO1
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| 106 | INSO S DIC="^DIC(36,",DIC(0)="AEQMZ",DIC("S")="I '$G(^(5))"
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| 107 |  S DIC("A")="   Select "_$S($G(IBICPT):"another ",1:"")_"INSURANCE CO.: "
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| 108 |  D ^DIC K DIC I Y'>0 G INS:'$G(IBICPT) S IBSEL=1 Q
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| 109 |  I $D(IBICPT(+Y)) D  G INSO
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| 110 |  .W !!?3,"Already selected. Choose another insurance company.",!,*7
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| 111 |  S IBICPT(+Y)="",IBICPT=$G(IBICPT)+1 G INSO
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| 112 |  ;
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| 113 | INSO1 W !?3,"Start with INSURANCE COMPANY: FIRST// " R X:DTIME
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| 114 |  G:'$T!(X["^") INS
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| 115 |  I $E(X)="?" W !,"Enter value up to 40 char; <CR> to start with 'first' value; '^' to quit." G INSO1
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| 116 |  S IBICF=X
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| 117 | INSO2 W !?8,"Go to INSURANCE COMPANY: LAST// " R X:DTIME
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| 118 |  G:'$T!(X["^") INSO1
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| 119 |  I $E(X)="?" W !,"Enter value up to 40 char; <CR> to go to 'last' value; '^' to quit." G INSO1
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| 120 |  I X="" S IBICL="zzzzz" S:IBICF="" IBIC="ALL" S IBSEL=1 Q
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| 121 |  I IBICF]X D  G INSO2
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| 122 |  .W *7,!!?3,"The LAST value must follow the FIRST.",!
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| 123 |  S IBICL=X,IBSEL=1
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| 124 |  Q
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| 125 |  ;
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| 126 | TYPE ; Prompt to allow users to inquire for All group plans, or Matched group plans
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| 127 |  N DIR,X,Y,DIRUT
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| 128 |  S IBCNTYP="A"
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| 129 |  S DIR(0)="S^A:All Group Plans;M:Matched Group Plans"
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| 130 |  S DIR("A")=" Select the type of Group Plans you want to see for Insurance selected."
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| 131 |  S DIR("B")="A"
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| 132 |  S DIR("?",1)="  A - All Group Plans"
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| 133 |  S DIR("?",2)="  M - Matched Group Plans"
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| 134 |  D ^DIR K DIR
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| 135 |  I $D(DIRUT) G TYPEX
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| 136 |  S IBCNTYP=Y
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| 137 | TYPEX Q
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| 138 |  ;
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| 139 | INSEL ; - Perform selection for insurance company.
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| 140 |  S VALMCNT=0,VALMBG=1,IBCNGP=0
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| 141 |  K ^TMP("IBCNRP5",$J)
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| 142 |  ; check for specific insurance companies
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| 143 |  I $G(IBICPT) D  Q
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| 144 |  . S (IBINA,IBIEN)=""
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| 145 |  . F  S IBIEN=$O(IBICPT(IBIEN)) Q:IBIEN=""  D
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| 146 |  .. S IBINA=$P($G(^DIC(36,+IBIEN,0)),U)
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| 147 |  .. I '$D(^XTMP("IBCNRP5",IBINA,IBIEN)) D  Q
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| 148 |  ... W *7,!?3,"**NO pharmacy data found for "
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| 149 |  ... W $P(^DIC(36,IBIEN,0),U)_"  "_$P(^DIC(36,IBIEN,.11),U),! R X:2
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| 150 |  .. D INIT
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| 151 |  ;
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| 152 |  ; check for range of insurance companies
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| 153 |  I '$D(IBICL) Q
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| 154 |  S IBIEN=0,IBINA=""
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| 155 |  F  S IBINA=$O(^XTMP("IBCNRP5",IBINA)) Q:IBINA=""  D
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| 156 |  . F  S IBIEN=$O(^XTMP("IBCNRP5",IBINA,IBIEN)) Q:IBIEN=""  D
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| 157 |  ..; for selection "ALL"
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| 158 |  .. I $G(IBIC)="ALL" D INIT Q
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| 159 |  .. ;
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| 160 |  .. ;check for match within first/last range
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| 161 |  .. I (IBICF]IBINA)!(IBINA]IBICL) Q
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| 162 |  .. D INIT
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| 163 |  Q
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| 164 |  ;
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| 165 | INIT ; -- init variables and create list array or report array
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| 166 |  N IBGP0,IBCPOLD,X,IBCPD6,IBCNRPP,IBCOV,IBCVRD,LIM
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| 167 |  F  S IBCNGP=$O(^XTMP("IBCNRP5",IBINA,IBIEN,IBCNGP)) Q:'IBCNGP  D
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| 168 |  . I '$D(^IBA(355.3,+IBCNGP,0)) Q
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| 169 |  . ; if we want all plans, let it pass
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| 170 |  . I IBCNTYP="A" D  Q
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| 171 |  . . D SETPLAN(IBCNGP)
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| 172 |  . ; if we want Matched plans, check for existence of Plan ID
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| 173 |  . I IBCNTYP="M" D  Q
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| 174 |  . . I $P($G(^IBA(355.3,IBCNGP,6)),U)'="" D SETPLAN(IBCNGP)
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| 175 |  I VALMCNT=0 D
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| 176 |  . S ^TMP("IBCNRP5",$J,"DSPDATA",1)=IBIEN
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| 177 |  . S ^TMP("IBCNRP5",$J,"DSPDATA",2)="No data for this Insurance"
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| 178 |  Q
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| 179 |  ;
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| 180 | SETPLAN(IBCNGP) ;
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| 181 |  ; create text
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| 182 |  N IBGPZ,I,IBPLN,IBPLNA,LINE
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| 183 |  S VALMCNT=VALMCNT+1,$P(LINE,"-",80)=""
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| 184 |  S IBGPZ=^IBA(355.3,+IBCNGP,0)
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| 185 |  ; Group Name, Group #, Group Type, Plan ID, Plan Status
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| 186 |  S X=$$FO^IBCNEUT1($P(IBGPZ,U,3),18)
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| 187 |  S X=X_" "_$$FO^IBCNEUT1($P(IBGPZ,U,4),17)
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| 188 |  S X=X_" "_$$FO^IBCNEUT1($$EXPAND^IBTRE(355.3,.09,$P(IBGPZ,U,9)),13)
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| 189 |  S IBPLN=$P($G(^IBA(355.3,+IBCNGP,6)),U)
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| 190 |  ; check for plan
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| 191 |  I IBPLN="" D  Q
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| 192 |  . S ^TMP("IBCNRP5",$J,"DSPDATA",VALMCNT)=IBIEN_"^"_X
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| 193 |  . S VALMCNT=VALMCNT+1,^TMP("IBCNRP5",$J,"DSPDATA",VALMCNT)=IBIEN_"^"_"No Plan Found."
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| 194 |  . S VALMCNT=VALMCNT+1,^TMP("IBCNRP5",$J,"DSPDATA",VALMCNT)=IBIEN_"^"_LINE
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| 195 |  ; check plan status information
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| 196 |  S IBPLNA=$P($G(^IBCNR(366.03,IBPLN,0)),U)
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| 197 |  S X=X_" "_$$FO^IBCNEUT1(IBPLNA,13)
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| 198 |  ;
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| 199 |  N ARRAY D STCHK^IBCNRU1(IBPLN,.ARRAY)
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| 200 |  S X=X_"      "_$$FO^IBCNEUT1($S($G(ARRAY(1))="I":"INACTIVE",1:"ACTIVE"),8)
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| 201 |  S ^TMP("IBCNRP5",$J,"DSPDATA",VALMCNT)=IBIEN_"^"_X
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| 202 |  I $G(ARRAY(6)) D
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| 203 |  . N STATAR
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| 204 |  . D STATAR^IBCNRU1(.STATAR)
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| 205 |  . F I=1:1:$L(ARRAY(6),",") D
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| 206 |  .. S VALMCNT=VALMCNT+1
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| 207 |  .. S ^TMP("IBCNRP5",$J,"DSPDATA",VALMCNT)=IBIEN_"^"_"       "_$G(STATAR($P(ARRAY(6),",",I)))
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| 208 |  . S VALMCNT=VALMCNT+1,^TMP("IBCNRP5",$J,"DSPDATA",VALMCNT)=IBIEN_"^"_LINE
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| 209 |  ;
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| 210 |  Q
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