source: WorldVistAEHR/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCNSP.m@ 1778

IBCNSP ;ALB/AAS - INSURANCE MANAGEMENT - EXPANDED POLICY ;05-MAR-1993
 ;;2.0;INTEGRATED BILLING;**6,28,43,52,85,251,363**;21-MAR-94;Build 35
 ;;Per VHA Directive 2004-038, this routine should not be modified.
% ;
EN ; -- main entry point for IBCNS EXPANDED POLICY
 K VALMQUIT,IBPPOL
 S IBTOP="IBCNSP"
 D EN^VALM("IBCNS EXPANDED POLICY")
 Q
 ;
HDR ; -- header code
 N W,X,Y,Z
 S VALMHDR(1)="Expanded Policy Information for: "_$E($P(^DPT(DFN,0),U),1,20)_"  "_$P($$PT^IBEFUNC(DFN),U,2)
 S Z=$G(^DPT(DFN,.312,+$P(IBPPOL,U,4),0))
 S W=$P($G(^IBA(355.3,+$P(Z,U,18),0)),U,11)
 S Y=$E($P($G(^DIC(36,+Z,0)),U),1,20)_" Insurance Company"
 S X="** Plan Currently "_$S(W:"Ina",1:"A")_"ctive **"
 S VALMHDR(2)=$$SETSTR^VALM1(X,Y,48,29)
 Q
 ;
INIT ; -- init variables and list array
 K VALMQUIT
 S VALMCNT=0,VALMBG=1
 I '$D(IBPPOL) D PPOL Q:$D(VALMQUIT)
 K ^TMP("IBCNSVP",$J)
 D BLD,HDR
 Q
 ;
BLD ; -- list builder
 K ^TMP("IBCNSVP",$J),^TMP("IBCNSVPDX",$J)
 D KILL^VALM10()
 F I=1:1:50 D BLANK(.I)
 S VALMCNT=50
 N IBCDFND,IBCDFND1,IBCDFND2,IBCDFND4
 S IBCDFND=$G(^DPT(DFN,.312,$P(IBPPOL,U,4),0)),IBCDFND1=$G(^(1)),IBCDFND2=$G(^(2)),IBCDFND4=$G(^(4))
 S IBCPOL=+$P(IBCDFND,U,18),IBCNS=+IBCDFND,IBCDFN=$P(IBPPOL,U,4)
 S IBCPOLD=$G(^IBA(355.3,+$P(IBCDFND,U,18),0)),IBCPOLD1=$G(^(1))
 S IBCPOLD2=$G(^IBA(355.3,+$G(IBCPOL),6)) ;; Daou/EEN adding BIN and PCN
 S IBLCNT=0
 D POLICY^IBCNSP0,INS^IBCNSP0,SPON^IBCNSP0,LIMBLD^IBCNSC41(36,2,.IBLCNT)
 D CONTACT^IBCNSP0,EFFECT,UR,EMP,VER^IBCNSP01,COMMENT,^IBCNSP01
 Q
 ;
COMMENT ; -- Comment region
 N START,OFFSET,IBL,IBI
 S START=49+$G(IBLCNT),OFFSET=2,IBL=0
 I '$D(@VALMAR@(START-1)) D SET(START-1,OFFSET,"  ")
 D SET(START,OFFSET," Comment -- Patient Policy ",IORVON,IORVOFF)
 D SET(START+1,OFFSET,$S($P(IBCDFND1,U,8)="":"None",1:$P(IBCDFND1,U,8)))
 I '$D(@VALMAR@(START+2)) D SET(START+2,OFFSET,"  ")
 D SET(START+3,OFFSET," Comment -- Group Plan ",IORVON,IORVOFF)
 S IBI=0 F  S IBI=$O(^IBA(355.3,+IBCPOL,11,IBI)) Q:IBI<1  D
 .S IBL=IBL+1
 .D SET(START+IBL+3,OFFSET,"  "_$E($G(^IBA(355.3,+IBCPOL,11,IBI,0)),1,80))
 S IBLCNT=$G(IBLCNT)+IBL+1 D SET(START+IBL+4,OFFSET,"  ")
 Q
 ;
EFFECT ; -- Effective date region
 N START,OFFSET
 S START=14,OFFSET=45
 D SET(START,OFFSET-4," Effective Dates & Source ",IORVON,IORVOFF)
 D SET(START+1,OFFSET," Effective Date: "_$$DAT1^IBOUTL($P(IBCDFND,U,8)))
 D SET(START+2,OFFSET,"Expiration Date: "_$$DAT1^IBOUTL($P(IBCDFND,U,4)))
 D SET(START+3,OFFSET," Source of Info: "_$$EXPAND^IBTRE(2.312,1.09,$P($G(IBCDFND1),U,9)))
 D SET(START+4,OFFSET-4,"Policy Not Billable: "_$S($P($G(^DPT(DFN,.312,IBCDFN,3)),"^",4):"YES",1:"NO"))
 Q
 ;
UR ; -- UR of insurance region
 N START,OFFSET
 S START=14,OFFSET=2
 D SET(START,OFFSET," Utilization Review Info ",IORVON,IORVOFF)
 D SET(START+1,OFFSET,"         Require UR: "_$$EXPAND^IBTRE(355.3,.05,$P(IBCPOLD,U,5)))
 D SET(START+2,OFFSET,"   Require Amb Cert: "_$$EXPAND^IBTRE(355.3,.12,$P(IBCPOLD,U,12)))
 D SET(START+3,OFFSET,"   Require Pre-Cert: "_$$EXPAND^IBTRE(355.3,.06,$P(IBCPOLD,U,6)))
 D SET(START+4,OFFSET,"   Exclude Pre-Cond: "_$$EXPAND^IBTRE(355.3,.07,$P(IBCPOLD,U,7)))
 D SET(START+5,OFFSET,"Benefits Assignable: "_$$EXPAND^IBTRE(355.3,.08,$P(IBCPOLD,U,8)))
 Q
EMP ; -- Insurance Employer Region
 N OFFSET,START,IBADD
 S START=19,OFFSET=40
 D SET(START,OFFSET," Subscriber's Employer Information ",IORVON,IORVOFF)
 D SET(START+1,OFFSET,"Emp Sponsored Plan: "_$S(+$P(IBCDFND2,U,10):"Yes",1:"No"))
 D SET(START+2,OFFSET,"          Employer: "_$P(IBCDFND2,U,9))
 D SET(START+3,OFFSET," Employment Status: "_$$EXPAND^IBTRE(2.312,2.11,$P(IBCDFND2,U,11)))
 D SET(START+4,OFFSET,"   Retirement Date: "_$$DAT1^IBOUTL($P(IBCDFND2,U,12)))
 D SET(START+5,OFFSET,"Claims to Employer: "_$S(+IBCDFND2:"Yes, Send to Employer",1:"No, Send to Insurance Company"))
 ;I +IBCDFND2 W !!,"If ROI applies, make sure current consent is signed.",!! D PAUSE^VALM1
 ;
 D SET(START+6,OFFSET,"            Street: "_$P(IBCDFND2,U,2)) S IBADD=1
 I $P(IBCDFND2,U,3)'="" D SET(START+7,OFFSET,"          Street 2: "_$P(IBCDFND2,U,3)) S IBADD=2
 I $P(IBCDFND2,U,4)'="" D SET(START+8,OFFSET,"          Street 3: "_$P(IBCDFND2,U,4)) S IBADD=3
 D SET(START+6+IBADD,OFFSET,"        City/State: "_$E($P(IBCDFND2,U,5),1,15)_$S($P(IBCDFND2,U,5)="":"",1:", ")_$P($G(^DIC(5,+$P(IBCDFND2,U,6),0)),U,2)_" "_$E($P(IBCDFND2,U,7),1,5))
 D SET(START+7+IBADD,OFFSET,"             Phone: "_$P(IBCDFND2,U,8))
 ;
EMPQ Q
 ; 
HELP ; -- help code
 S X="?" D DISP^XQORM1 W !!
 Q
 ;
EXIT ; -- exit code
 K IBPPOL,VALMQUIT,IBCNS,IBCPOL,IBCPOLD,IBCPOLD1,IBCPOLD2,IBCDFND,IBCDFND1,IBCDFND2
 D CLEAN^VALM10,CLEAR^VALM1
 Q
 ;
EXPND ; -- expand code
 Q
 ;
PPOL ; -- select patient, select policy
 I '$D(DFN) D  G:$D(VALMQUIT) PPOLQ
 .S DIC="^DPT(",DIC(0)="AEQMN" D ^DIC
 .S DFN=+Y
 I $G(DFN)<1 S VALMQUIT="" G PPOLQ
 ;
 I '$O(^DPT(DFN,.312,0)) W !!,"Patient doesn't have Insurance" K DFN G PPOL
 ;
 S DIC="^DPT("_DFN_",.312,",DIC(0)="AEQMN",DIC("A")="Select Patient Policy: "
 D ^DIC I +Y<1 S VALMQUIT=""
 G:$D(VALMQUIT) PPOLQ
 S IBPPOL="^2^"_DFN_U_+Y_U_$G(^DPT(DFN,.312,+Y,0))
PPOLQ K DIC Q
 ;
BLANK(LINE) ; -- Build blank line
 D SET^VALM10(.LINE,$J("",80))
 Q
 ;
SET(LINE,COL,TEXT,ON,OFF) ; -- set display info in array
 I '$D(@VALMAR@(LINE,0)) D BLANK(.LINE) S VALMCNT=$G(VALMCNT)+1
 D SET^VALM10(.LINE,$$SETSTR^VALM1(.TEXT,@VALMAR@(LINE,0),.COL,$L(TEXT)))
 D:$G(ON)]""!($G(OFF)]"") CNTRL^VALM10(.LINE,.COL,$L(TEXT),$G(ON),$G(OFF))
 W:'(LINE#5) "."
 Q