1 | IBCNSC01 ;ALB/NLR - INSURANCE COMPANY EDIT ; 6/1/05 10:06am
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2 | ;;2.0;INTEGRATED BILLING;**52,137,191,184,232,320,349**;21-MAR-94;Build 46
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3 | ;;Per VHA Directive 2004-038, this routine should not be modified.
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4 | ;
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5 | PARAM ; -- Insurance company parameters region
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6 | N OFFSET,START,IBCNS0,IBCNS03,IBCNS06,IBCNS08,IBCNS13,IBCNS3
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7 | S IBCNS0=$G(^DIC(36,+IBCNS,0)),IBCNS3=$G(^(3))
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8 | S IBCNS03=$P(IBCNS0,"^",3),IBCNS06=$P(IBCNS0,"^",6),IBCNS08=$P(IBCNS0,"^",8)
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9 | S IBCNS13=$G(^DIC(36,+IBCNS,.13))
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10 | S START=1,OFFSET=2
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11 | D SET^IBCNSP(START,OFFSET+25," Billing Parameters ",IORVON,IORVOFF)
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12 | ;
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13 | D SET^IBCNSP(START+1,OFFSET+1,"Signature Required?: "_$S(+IBCNS03:"YES",1:"NO"))
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14 | D SET^IBCNSP(START+2,OFFSET+10,"Reimburse?: "_$E($$EXPAND^IBTRE(36,1,$P(IBCNS0,"^",2)),1,21))
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15 | D SET^IBCNSP(START+3,OFFSET+3,"Mult. Bedsections: "_$S(+IBCNS06:"YES",IBCNS06=0:"NO",1:""))
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16 | D SET^IBCNSP(START+4,OFFSET+4,"Diff. Rev. Codes: "_$P(IBCNS0,"^",7))
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17 | D SET^IBCNSP(START+5,OFFSET+6,"One Opt. Visit: "_$S(+IBCNS08:"YES",1:"NO"))
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18 | D SET^IBCNSP(START+6,OFFSET+1,"Amb. Sur. Rev. Code: "_$P(IBCNS0,"^",9))
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19 | D SET^IBCNSP(START+7,OFFSET+1,"Rx Refill Rev. Code: "_$P(IBCNS0,"^",15))
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20 | D SET^IBCNSP(START+8,OFFSET+3,"Filing Time Frame: "_$P(IBCNS0,"^",12))
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21 | D SET^IBCNSP(START+9,OFFSET+4,"Type Of Coverage: "_$$EXPAND^IBTRE(36,.13,+$P(IBCNS0,U,13)))
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22 | D SET^IBCNSP(START+10,OFFSET+3,"Primary Form Type: "_$$EXPAND^IBTRE(36,.14,$P(IBCNS0,"^",14)))
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23 | ;
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24 | N START,OFFSET
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25 | S START=1,OFFSET=45
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26 | D SET^IBCNSP(START+1,OFFSET+7,"Billing Phone: "_$P(IBCNS13,"^",2))
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27 | D SET^IBCNSP(START+2,OFFSET+2,"Verification Phone: "_$P(IBCNS13,"^",4))
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28 | D SET^IBCNSP(START+3,OFFSET+2,"Precert Comp. Name: "_$P($G(^DIC(36,+$P(IBCNS13,"^",9),0)),"^",1))
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29 | D SET^IBCNSP(START+4,OFFSET+7,"Precert Phone: "_$$PHONE(IBCNS13))
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30 | D SET^IBCNSP(START+5,OFFSET+6," *** EDI Parameters *** ",IOINHI,IOINORM)
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31 | D SET^IBCNSP(START+6,OFFSET+11,"Transmit?: "_$S(+IBCNS3=1:"YES-LIVE",+IBCNS3=2:"TEST ONLY",1:"NO"))
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32 | D SET^IBCNSP(START+7,OFFSET+7,"Inst Payer ID: "_$P(IBCNS3,U,4))
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33 | D SET^IBCNSP(START+8,OFFSET+7,"Prof Payer ID: "_$P(IBCNS3,U,2))
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34 | D SET^IBCNSP(START+9,OFFSET+6,"Insurance Type: "_$$EXPAND^IBTRE(36,3.09,+$P(IBCNS3,U,9)))
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35 | D SET^IBCNSP(START+10,OFFSET+10,"Bin Number: "_$P($G(^DIC(36,+IBCNS,3)),"^",3))
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36 | I +IBCNS3=2 D SET^IBCNSP(START+11,OFFSET,"Max # Test Bills/Day: "_$P(IBCNS3,U,6))
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37 | Q
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38 | ;
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39 | PHONE(IBCNS13) ; -- Compute precert company phone
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40 | N IBX,IBSAVE,IBCNT S IBX=""
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41 | I '$P(IBCNS13,"^",9) S IBX=$P(IBCNS13,"^",3) G PHONEQ
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42 | REDOX S IBSAVE=+$P(IBCNS13,"^",9)
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43 | S IBCNT=$G(IBCNT)+1
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44 | ; -- if you process the same co. more than once you are in an infinite loop
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45 | I $D(IBCNT(IBCNS)) G PHONEQ
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46 | S IBCNT(IBCNS)=""
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47 | S IBCNS13=$G(^DIC(36,+$P(IBCNS13,"^",9),.13))
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48 | S IBX=$P(IBCNS13,"^") S:$L($P(IBCNS13,"^",3)) IBX=$P(IBCNS13,"^",3)
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49 | ; -- if process the same co. more than once you are in an infinite loop
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50 | I $P(IBCNS13,"^",9),$P(IBCNS13,"^",9)'=IBSAVE G REDOX
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51 | PHONEQ Q IBX
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52 | ;
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53 | MAIN ; -- Insurance company main address
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54 | N OFFSET,START,IBCNS11,IBCNS13,IBADD
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55 | S IBCNS11=$G(^DIC(36,+IBCNS,.11))
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56 | S IBCNS13=$G(^DIC(36,+IBCNS,.13))
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57 | S START=15,OFFSET=25
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58 | D SET^IBCNSP(START,OFFSET," Main Mailing Address ",IORVON,IORVOFF)
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59 | N OFFSET S OFFSET=2
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60 | D SET^IBCNSP(START+1,OFFSET," Street: "_$P(IBCNS11,"^",1)) S IBADD=1
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61 | D SET^IBCNSP(START+2,OFFSET," Street 2: "_$P(IBCNS11,"^",2)) S IBADD=2
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62 | D SET^IBCNSP(START+3,OFFSET," Street 3: "_$P(IBCNS11,"^",3)) S IBADD=3
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63 | ; D SET^IBCNSP(START+4,OFFSET,"Claim Off. ID: "_$P(IBCNS11,U,11))
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64 | N OFFSET S OFFSET=45
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65 | D SET^IBCNSP(START+1,OFFSET," City/State: "_$E($P(IBCNS11,"^",4),1,15)_$S($P(IBCNS11,"^",4)="":"",1:", ")_$P($G(^DIC(5,+$P(IBCNS11,"^",5),0)),"^",2)_" "_$E($P(IBCNS11,"^",6),1,5))
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66 | D SET^IBCNSP(START+2,OFFSET," Phone: "_$P(IBCNS13,"^",1))
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67 | D SET^IBCNSP(START+3,OFFSET," Fax: "_$P(IBCNS11,"^",9))
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68 | Q
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69 | ;
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70 | ;
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71 | PAYER ; This procedure builds the display for the payer associated with
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72 | ; this insurance company.
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73 | ; ESG - 7/29/02 - IIV project
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74 | ;
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75 | NEW PAYERIEN,PAYR,APPDATA,APP,DATA,APPNAME,A1,A2,A3,A4,A5,A6,A7,A8
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76 | NEW START,TITLE,OFFSET,IBLINE
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77 | S PAYERIEN=$P($G(^DIC(36,+IBCNS,3)),U,10),PAYR="",APPDATA=0
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78 | I PAYERIEN D
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79 | . S PAYR=$G(^IBE(365.12,PAYERIEN,0))
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80 | . S APP=0
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81 | . F S APP=$O(^IBE(365.12,PAYERIEN,1,APP)) Q:'APP D
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82 | .. S DATA=$G(^IBE(365.12,PAYERIEN,1,APP,0))
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83 | .. S APPNAME=$$EXTERNAL^DILFD(365.121,.01,"",$P(DATA,U,1))
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84 | .. I APPNAME="" Q
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85 | .. I $D(APPDATA(APPNAME)) Q
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86 | .. S (A1,A2,A3,A4,A5,A6,A7)="NO",A8=""
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87 | .. I $P(DATA,U,2) S A1="YES" ; national active
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88 | .. I $P(DATA,U,3) S A2="YES" ; local active
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89 | .. I $P(DATA,U,7) S A3="YES" ; auto-accept
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90 | .. I $P(DATA,U,8) S A4="YES" ; ident inquiries require subscr ID
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91 | .. I $P(DATA,U,9) S A5="YES" ; use SSN for subscriber ID
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92 | .. I $P(DATA,U,10) S A6="YES" ; transmit SSN
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93 | .. I $P(DATA,U,11) S A7="YES" ; deactivated?
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94 | .. ; A8 = deactivation date
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95 | .. I $P(DATA,U,12) S A8=$P($$FMTE^XLFDT($P(DATA,U,12),"5Z"),"@",1)
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96 | .. S APPDATA(APPNAME)=A1_U_A2_U_A3_U_A4_U_A5_U_A6_U_A7_U_A8
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97 | .. S APPDATA=APPDATA+1
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98 | .. Q
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99 | . Q
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100 | ;
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101 | S START=$O(^TMP("IBCNSC",$J,""),-1)+1
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102 | S IB1ST("PAYER")=START
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103 | S TITLE=" Payer Information/Electronic Insurance Verification "
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104 | S OFFSET=(40-($L(TITLE)/2))\1+1
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105 | D SET^IBCNSP(START,OFFSET,TITLE,IORVON,IORVOFF)
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106 | D SET^IBCNSP(START+1,9,"Payer Name: "_$P(PAYR,U,1))
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107 | D SET^IBCNSP(START+2,5,"VA National ID: "_$P(PAYR,U,2))
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108 | D SET^IBCNSP(START+2,51,"CMS National ID: "_$P(PAYR,U,3))
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109 | S IBLINE=START+2
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110 | ;
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111 | ; Handle the case where no application data is defined
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112 | I 'APPDATA D G PAYERX
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113 | . S IBLINE=IBLINE+1
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114 | . D SET^IBCNSP(IBLINE,2," ") ; blank line
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115 | . S IBLINE=IBLINE+1
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116 | . D SET^IBCNSP(IBLINE,16,"Payer Application data is not defined!")
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117 | . Q
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118 | ;
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119 | ; Display all the applications
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120 | S APPNAME=""
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121 | F S APPNAME=$O(APPDATA(APPNAME)) Q:APPNAME="" D
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122 | . S IBLINE=IBLINE+1
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123 | . D SET^IBCNSP(IBLINE,2," ") ; blank line
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124 | . ;
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125 | . S IBLINE=IBLINE+1
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126 | . D SET^IBCNSP(IBLINE,2,"Payer Application: "_APPNAME)
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127 | . D SET^IBCNSP(IBLINE,50,"Auto-Accept Info: "_$P(APPDATA(APPNAME),U,3))
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128 | . ;
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129 | . S IBLINE=IBLINE+1
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130 | . D SET^IBCNSP(IBLINE,4,"National Active: "_$P(APPDATA(APPNAME),U,1))
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131 | . D SET^IBCNSP(IBLINE,47,"Ident Req Subscr ID: "_$P(APPDATA(APPNAME),U,4))
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132 | . ;
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133 | . S IBLINE=IBLINE+1
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134 | . D SET^IBCNSP(IBLINE,7,"Local Active: "_$P(APPDATA(APPNAME),U,2))
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135 | . D SET^IBCNSP(IBLINE,51,"SSN = Subscr ID: "_$P(APPDATA(APPNAME),U,5))
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136 | . ;
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137 | . S IBLINE=IBLINE+1
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138 | . D SET^IBCNSP(IBLINE,8,"Deactivated: "_$P(APPDATA(APPNAME),U,7))
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139 | . D SET^IBCNSP(IBLINE,54,"Transmit SSN: "_$P(APPDATA(APPNAME),U,6))
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140 | . ;
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141 | . ; If no deactivated date, then exit
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142 | . I $P(APPDATA(APPNAME),U,8)="" Q
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143 | . ;
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144 | . S IBLINE=IBLINE+1
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145 | . D SET^IBCNSP(IBLINE,13,"D-Date: "_$P(APPDATA(APPNAME),U,8))
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146 | . ;
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147 | . Q
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148 | PAYERX ;
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149 | ; Two trailing blank lines after payer information display
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150 | S IBLINE=IBLINE+1
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151 | D SET^IBCNSP(IBLINE,2," ") ; blank line
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152 | S IBLINE=IBLINE+1
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153 | D SET^IBCNSP(IBLINE,2," ") ; blank line
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154 | Q
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155 | ;
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156 | ;
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157 | REMARKS ;
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158 | ;
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159 | N OFFSET,START,IBLCNT,IBI
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160 | S START=$O(^TMP("IBCNSC",$J,""),-1)+1,OFFSET=2
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161 | S IB1ST("REM")=START
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162 | ;
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163 | D SET^IBCNSP(START,OFFSET," Remarks ",IORVON,IORVOFF)
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164 | S (IBLCNT,IBI)=0 F S IBI=$O(^DIC(36,+IBCNS,11,IBI)) Q:IBI<1 D
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165 | . S IBLCNT=IBLCNT+1
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166 | . D SET^IBCNSP(START+IBLCNT,OFFSET," "_$E($G(^DIC(36,+IBCNS,11,IBI,0)),1,80))
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167 | . Q
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168 | D SET^IBCNSP(START+IBLCNT+1,OFFSET," ") ; blank line after remarks
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169 | Q
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170 | ;
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171 | SYN ;
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172 | N OFFSET,START,SYN,SYNOI
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173 | S START=$O(^TMP("IBCNSC",$J,""),-1)+1,OFFSET=2
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174 | S IB1ST("SYN")=START
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175 | D SET^IBCNSP(START,OFFSET," Synonyms ",IORVON,IORVOFF)
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176 | S SYN="" F SYNOI=1:1:8 S SYN=$O(^DIC(36,+IBCNS,10,"B",SYN)) Q:SYN="" D SET^IBCNSP(START+SYNOI,OFFSET,$S(SYNOI>7:" ...edit to see more...",1:" "_SYN))
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177 | Q
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178 | ;
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