| [613] | 1 | IBCNSOK1 ;ALB/AAS - Insurance consisitency stuff ; 2/22/93
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| 2 | ;;Version 2.0 ; INTEGRATED BILLING ;; 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 | DUPCO(DFN,IBCNS,IBCDFN,IBTALK) ; -- is this a duplicate company for this patient
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| 6 | ; -- make this call after selecting a company
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| 7 | ; -- input DFN = patient file pointer (required)
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| 8 | ; IBCNS = new insurance company selected
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| 9 | ; IBCDFN = if added to patient ins type mult is required as enter number in multiple
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| 10 | ; IBTALK = (optional) if defined and true will write messages to current device if not queued
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| 11 | ; -- output = $p1 - 0 if no other entry 1 if possible dup.
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| 12 | ; $p2 - 1 if another active entry for same company
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| 13 | ; $p3 - 1 if same co, same subscriber
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| 14 | ; $p4 - 1 if same co, same dates
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| 15 | ; $p5 - 1 if same co, same plan
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| 16 | ; $p6 - 1 if spouse insurer but not listed
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| 17 | ; $p7 - 1 if spouse insurer but no employer
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| 18 | N IBI,IBJ,IBX,IBY,I,J,X,Y,Z,IBDUP,IBACT,IBCDFND
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| 19 | S (I,IBDUP)=0
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| 20 | I '$O(^DPT(DFN,.312,0)) G DUPCOQ ; no policies on file, don't bother
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| 21 | ;
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| 22 | ; -- use b x-ref
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| 23 | F S I=$O(^DPT(DFN,.312,"B",IBCNS,I)) Q:'I S IBX=$G(^DPT(DFN,.312,I,0)) I $S('$G(IBCDFN):1,I=$G(IBCDFN):0,1:1) D
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| 24 | .S IBDUP=1
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| 25 | .S IBACT=$$CHK^IBCNS1(IBX,DT,2) I IBACT S $P(IBDUP,"^",2)=1 ; another active entry
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| 26 | .I '$G(IBCDFN) Q ;quit if not stored in dpt
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| 27 | .I 'IBACT Q
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| 28 | .;
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| 29 | .S IBCDFND=$G(^DPT(DFN,.312,+IBCDFN,0)) I IBCDFND=""!(IBCDFND=+IBCDFND) Q
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| 30 | .I $P(IBX,"^",6)=$P(IBCDFND,"^",6) S $P(IBDUP,"^",3)=1 ; same whose ins.
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| 31 | .I $P(IBX,"^",4)="",$P(IBCDFND,"^",4)="" S $P(IBDUP,"^",4)=1 ; no expiration date
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| 32 | .I $P(IBX,"^",8)="",$P(IBCDFND,"^",8)="" S $P(IBDUP,"^",4)=1 ; no effective date
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| 33 | .; need to figure out overlapping date logic. not simple
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| 34 | .I $P(IBX,"^",18)=$P(IBCDFND,"^",18) S $P(IBDUP,"^",5)=1 ; same plan
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| 35 | .I $P(IBCDFND,"^",6)="s" I $P(^DPT(DFN,0),"^",5)=6!($P(^DPT(DFN,0),"^",5)=7) S $P(IBDUP,"^",6)=1 ; marital status inconsistent
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| 36 | .I $P(IBCDFND,"^",6)="s",$P($G(^DPT(DFN,.25)),"^")="" S $P(IBDUP,"^",7)=1
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| 37 | I 'IBDUP G DUPCOQ
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| 38 | I IBDUP,$G(IBTALK),'$D(ZTQUEUED) D
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| 39 | .W !!,*7,"Warning: Insurance Company selected already on file for this patient."
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| 40 | .I $P(IBDUP,"^",2) W !," The previous entry is active."
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| 41 | .I $P(IBDUP,"^",3) W !," The WHOSE INSURANCE are the same."
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| 42 | .I $P(IBDUP,"^",4) W !," The Effective and Expiration dates may cover overlapping dates."
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| 43 | .I $P(IBDUP,"^",5) W !," The Group Plans are the same."
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| 44 | .I $P(IBDUP,"^",6) W !," WHOSE INSURANCE is Spouse, patient marital Status Inconsistent."
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| 45 | .I $P(IBDUP,"^",7) W !," WHOSE INSURANCE is Spouse but no Employer listed."
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| 46 | .Q
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| 47 | ;
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| 48 | DUPCOQ Q IBDUP
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| 49 | ;
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| 50 | DUPPOL(IBCPOL,IBTALK) ; -- is this a duplicate policy for this company
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| 51 | N I,J,X,Y,Z,IBDUP,IBCNS
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| 52 | S (I,IBDUP)=0,J=$G(^IBA(355.3,IBCPOL,0)),IBCNS=+J
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| 53 | F S I=$O(^IBA(355.3,"B",IBCNS,I)) Q:'I I I'=IBCPOL S X=$G(^IBA(355.3,I,0)) D
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| 54 | .Q:'$P(X,"^",2) ;skip individual policies
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| 55 | .I $P(J,"^",3)'="",$P(J,"^",3)=$P(X,"^",3) S $P(IBDUP,"^")=1
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| 56 | .I $P(J,"^",4)'="",$P(J,"^",4)=$P(X,"^",4) S $P(IBDUP,"^",2)=1
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| 57 | I IBDUP,$G(IBTALK),'$D(ZTQUEUED) D
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| 58 | .I $P(IBDUP,"^",1) W !!,"Warning: There is another policy with the same Group Name."
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| 59 | .I $P(IBDUP,"^",2) W !!,"Warning: There is another policy with the same Group Number."
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| 60 | ;
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| 61 | DUPPOLQ Q IBDUP
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