| 1 | IBCNSM3 ;ALB/AAS - INSURANCE MANAGEMENT - OUTPUTS ; 4/7/03 9:56am
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| 2 |  ;;2.0;INTEGRATED BILLING;**6,28,85,211,251**;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 | % G EN^IBCNSM
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| 6 |  ;
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| 7 | AD ; -- Add new insurance policy
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| 8 |  N X,Y,DO,DD,DA,DR,DIC,DIE,DIK,DIR,DIRUT,IBCNSP,IBCPOL,IBQUIT,IBOK,IBCDFN,IBAD,IBGRP,IBADPOL,IBCOVP,ANS,IBGNA,IBGNU
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| 9 |  S IBCNSEH=$P($G(^IBE(350.9,1,4)),"^",1),IBQUIT=0,IBADPOL=1
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| 10 |  D FULL^VALM1
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| 11 |  S IBCOVP=$P($G(^DPT(DFN,.31)),"^",11)
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| 12 |  I '$D(^DPT(DFN,.312,0)) S ^DPT(DFN,.312,0)="^2.312PAI^^"
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| 13 |  ;
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| 14 |  D INS^IBCNSEH
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| 15 |  ; -- Select insurance company
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| 16 |  ;    If one already exists for same co. ask are you sure you are
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| 17 |  ;    adding a new one
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| 18 |  S DIR(0)="350.9,4.06"
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| 19 |  S DIR("A")="Select INSURANCE COMPANY",DIR("??")="^D ADH^IBCNSM3"
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| 20 |  S DIR("?")="Select the Insurance Company for the policy you are entering"
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| 21 |  D ^DIR K DIR S IBCNSP=+Y I Y<1 G ADQ
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| 22 |  I $P($G(^DIC(36,+IBCNSP,0)),"^",2)="N" W !,"This company does not reimburse.  "
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| 23 |  I $P($G(^DIC(36,+IBCNSP,0)),"^",5) W !,*7,"Warning: Inactive Company" H 3 K IBCNSP G ADQ
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| 24 |  I $$DUPCO^IBCNSOK1(DFN,IBCNSP,"",1) H 3
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| 25 |  ;
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| 26 |  ; -- see if can use existing policy
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| 27 |  D SEL^IBCNSEH
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| 28 |  S IBCPOL=$$LK^IBCNSM31(IBCNSP)
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| 29 |  I IBCPOL<1 D NEW^IBCNSJ3(IBCNSP,.IBCPOL)
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| 30 |  I IBCPOL<1 G ADQ
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| 31 |  ;
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| 32 |  ; -- file new patient policy
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| 33 |  S DIC("DR")=".18////"_IBCPOL_";1.09////1;1.05///NOW;1.06////"_DUZ
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| 34 |  K DD,DO S DA(1)=DFN,DIC="^DPT("_DFN_",.312,",DIC(0)="L",X=IBCNSP D FILE^DICN K DIC S IBCDFN=+Y,IBNEW=1 I +Y<1 G ADQ
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| 35 |  D BEFORE^IBCNSEVT
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| 36 |  ;
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| 37 |  ; -- Edit patient policy data
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| 38 |  D PAT^IBCNSEH,PATPOL^IBCNSM32(IBCDFN)
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| 39 |  ;
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| 40 |  ; -- edit PLAN data if hold key
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| 41 |  I '$D(^XUSEC("IB INSURANCE SUPERVISOR",DUZ)) G ADQ
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| 42 |  I '$G(IBQUIT) D POL^IBCNSEH,EDPOL(IBCDFN)
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| 43 |  I '$G(IBNEW) D AI^IBCNSP1
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| 44 |  G ADQ
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| 45 |  ;
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| 46 | ADQ D COVERED^IBCNSM31(DFN,IBCOVP)
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| 47 |  I $G(IBCDFN)>0 D AFTER^IBCNSEVT,^IBCNSEVT
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| 48 |  I $G(IBCPOL)>0 D BLD^IBCNSM
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| 49 |  S VALMBCK="R"
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| 50 |  Q
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| 51 |  ;
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| 52 | EDPOL(IBCDFN) ; -- Edit GROUP PLAN specific info
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| 53 |  I '$G(IBCDFN) G EDPOLQ
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| 54 |  N DA,DR,DIE,DIC,IBAD,IBCPOL,IBDIF
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| 55 |  S IBCPOL=$P($G(^DPT(DFN,.312,IBCDFN,0)),"^",18)
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| 56 |  L +^IBA(355.3,+IBCPOL):5 I '$T D LOCKED^IBTRCD1 G EDPOLQ
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| 57 |  I IBCPOL D
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| 58 |  .D SAVE^IBCNSP3(IBCPOL)
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| 59 |  .S DIE="^IBA(355.3,",DA=IBCPOL
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| 60 |  .;DAOU/EEN-Adding BIN and PCN (6.02,6.03)
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| 61 |  .S DR="S IBAD=$P($G(^IBA(355.3,DA,0)),U,2),Y=$S(IBAD=0:""@55"",IBAD="""":""@1"",1:""@25"");@1;.02;@25;.03;.04;@55;6.02;6.03;.09;.15;S Y=$S($$CATOK^IBCEMRA($P(^(0),U,14)):""@60"",1:""@65"");@60;.14;@65;.13;.05;.12;.06;.07;.08//YES;"
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| 62 |  .;DAOU/EEN-Adding BIN and PCN (6.02,6.03)
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| 63 |  .I $D(IBREG),'$G(IBNEWP) S DR="S IBAD=$P($G(^IBA(355.3,DA,0)),U,2),Y=$S(IBAD=0:""@55"",IBAD="""":""@1"",1:""@25"");@1;.02;@25;D 3^IBCNSM31;D 4^IBCNSM31;@55;6.02;6.03;.09;"
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| 64 |  .I $D(IBREG),'$G(IBNEWP) S DR=DR_".15;S Y=$S($$CATOK^IBCEMRA($P(^(0),U,14)):""@60"",1:""@65"");@60;.14;@65;.13;.05;.12;.06;.07;.08//YES;"
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| 65 |  .D ^DIE
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| 66 |  .D COMP^IBCNSP3(IBCPOL)
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| 67 |  .I IBDIF D UPDATE^IBCNSP3(IBCPOL),UPDATPT^IBCNSP3(DFN,IBCDFN) I $$DUPPOL^IBCNSOK1(IBCPOL,1)
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| 68 |  L -^IBA(355.3,+IBCPOL)
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| 69 | EDPOLQ Q
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| 70 |  ;
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| 71 | OK ; -- ask okay
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| 72 |  S IBQUIT=0,DIR(0)="Y",DIR("A")="       ...OK",DIR("B")="YES" D ^DIR K DIR
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| 73 |  I $D(DIRUT) S IBQUIT=1
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| 74 |  S IBOK=Y
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| 75 |  Q
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| 76 |  ;
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| 77 | ADH ; -- show existing policies for help
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| 78 |  N DIR,DA,%A
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| 79 |  W !!,"The patient currently has the following Insurance Policies"
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| 80 |  D DISP^IBCNS
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| 81 |  Q
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