| 1 | IBCNRPM1 ;DAOU/CMW - Match Multiple Group Plans to a Pharmacy Plan ;10-MAR-2004
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| 2 | ;;2.0;INTEGRATED BILLING;**251**;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 | ;**Program Description**
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| 6 | ; This program selects a plan and displays the
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| 7 | ; Test Payer Sheets associated to the Plan.
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| 8 | ;
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| 9 | EN ; Select a plan
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| 10 | NEW DA,DIC,DIE,DR,D,Y
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| 11 | S DIC="^IBCNR(366.03,",DIC(0)="ABEMZ",DIC("A")="Select PHARMACY PLAN: "
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| 12 | D ^DIC I X="^" G EXIT
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| 13 | K DIC("A")
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| 14 | I +Y<1 S D="F",DIC="^IBCNR(366.03,",DIC(0)="AEMNZ" D IX^DIC
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| 15 | I +Y<1 G EXIT
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| 16 | S IBCNRP=+Y
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| 17 | ;
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| 18 | INS ; Select an insurance company
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| 19 | NEW DA,DIC,DIE,DR,D,Y,IBIND,IBMULT,IBW
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| 20 | S (IBIND,IBMULT,IBW)=1
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| 21 | S DIR(0)="350.9,4.06"
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| 22 | S DIR("A")="Select INSURANCE COMPANY",DIR("??")="^D ADH^IBCNSM3"
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| 23 | S DIR("?")="Select the Insurance Company for the plan you are entering"
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| 24 | D ^DIR K DIR S IBCNRI=+Y I Y<1 G EN
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| 25 | I $P($G(^DIC(36,+IBCNRI,0)),"^",2)="N" W !,"This company does not reimburse. " G INS
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| 26 | I $P($G(^DIC(36,+IBCNRI,0)),"^",5) W !,*7,"Warning: Inactive Company" G INS
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| 27 | ;
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| 28 | D GIPF
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| 29 | I '$D(^TMP("IBCNR",$J,"GP")) D G INS
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| 30 | . W !,*7,"** No active Group Plans with Pharmacy coverage found for this Insurance Co."
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| 31 | ;
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| 32 | D EN^IBCNRPM2(IBCNRP,IBCNRI,.IBCNRGP)
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| 33 | ;
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| 34 | G INS
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| 35 | ;
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| 36 | GIPF ; screen for valid GIPF
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| 37 | ;
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| 38 | N GST1,GP0,GP6,IBCOV,LIM,IBCVRD
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| 39 | N GPIEN,GPNAM,GPNUM
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| 40 | S GST1=1,GPIEN=""
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| 41 | K ^TMP("IBCNR",$J,"GP")
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| 42 | F S GPIEN=$O(^IBA(355.3,"B",IBCNRI,GPIEN)) Q:GPIEN="" D
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| 43 | . ;chk for active group
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| 44 | . S GP0=$G(^IBA(355.3,GPIEN,0)),GP6=$G(^IBA(355.3,GPIEN,6))
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| 45 | . I $P(GP0,U,11)=1 Q
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| 46 | . ;chk for pharm plan coverage
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| 47 | . S IBCOV=$O(^IBE(355.31,"B","PHARMACY",""))
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| 48 | . S LIM="",IBCVRD=0
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| 49 | . F S LIM=$O(^IBA(355.32,"B",GPIEN,LIM)) Q:LIM="" D
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| 50 | .. I $P(^IBA(355.32,LIM,0),U,2)=IBCOV D
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| 51 | ... ;chk covered status
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| 52 | ... S IBCVRD=$P(^IBA(355.32,LIM,0),U,4)
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| 53 | ... I IBCVRD=0 Q
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| 54 | ... S GPNAM=$P($G(GP0),U,3),GPNUM=$P($G(GP0),U,4)
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| 55 | ... I $G(GPNAM)="" S GPNAM="<blank>"
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| 56 | ... I $G(GPNUM)="" S GPNUM="<blank>"
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| 57 | ... ;set array = pharm plan and plan type
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| 58 | ... S ^TMP("IBCNR",$J,"GP",GPNAM,GPNUM,GPIEN)=$P($G(GP6),U)_"^"_$P($G(GP0),U,9)
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| 59 | Q
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| 60 | ;
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| 61 | EXIT K IBCNRP,IBCNRI,IBCNRGP
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| 62 | K ^TMP("IBCNR",$J)
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| 63 | ;
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| 64 | Q
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