1 | IBCNSP ;ALB/AAS - INSURANCE MANAGEMENT - EXPANDED POLICY ;05-MAR-1993
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2 | ;;2.0;INTEGRATED BILLING;**6,28,43,52,85,251,363**;21-MAR-94;Build 35
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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 | EN ; -- main entry point for IBCNS EXPANDED POLICY
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6 | K VALMQUIT,IBPPOL
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7 | S IBTOP="IBCNSP"
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8 | D EN^VALM("IBCNS EXPANDED POLICY")
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9 | Q
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10 | ;
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11 | HDR ; -- header code
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12 | N W,X,Y,Z
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13 | S VALMHDR(1)="Expanded Policy Information for: "_$E($P(^DPT(DFN,0),U),1,20)_" "_$P($$PT^IBEFUNC(DFN),U,2)
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14 | S Z=$G(^DPT(DFN,.312,+$P(IBPPOL,U,4),0))
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15 | S W=$P($G(^IBA(355.3,+$P(Z,U,18),0)),U,11)
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16 | S Y=$E($P($G(^DIC(36,+Z,0)),U),1,20)_" Insurance Company"
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17 | S X="** Plan Currently "_$S(W:"Ina",1:"A")_"ctive **"
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18 | S VALMHDR(2)=$$SETSTR^VALM1(X,Y,48,29)
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19 | Q
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20 | ;
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21 | INIT ; -- init variables and list array
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22 | K VALMQUIT
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23 | S VALMCNT=0,VALMBG=1
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24 | I '$D(IBPPOL) D PPOL Q:$D(VALMQUIT)
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25 | K ^TMP("IBCNSVP",$J)
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26 | D BLD,HDR
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27 | Q
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28 | ;
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29 | BLD ; -- list builder
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30 | K ^TMP("IBCNSVP",$J),^TMP("IBCNSVPDX",$J)
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31 | D KILL^VALM10()
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32 | F I=1:1:50 D BLANK(.I)
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33 | S VALMCNT=50
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34 | N IBCDFND,IBCDFND1,IBCDFND2,IBCDFND4
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35 | S IBCDFND=$G(^DPT(DFN,.312,$P(IBPPOL,U,4),0)),IBCDFND1=$G(^(1)),IBCDFND2=$G(^(2)),IBCDFND4=$G(^(4))
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36 | S IBCPOL=+$P(IBCDFND,U,18),IBCNS=+IBCDFND,IBCDFN=$P(IBPPOL,U,4)
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37 | S IBCPOLD=$G(^IBA(355.3,+$P(IBCDFND,U,18),0)),IBCPOLD1=$G(^(1))
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38 | S IBCPOLD2=$G(^IBA(355.3,+$G(IBCPOL),6)) ;; Daou/EEN adding BIN and PCN
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39 | S IBLCNT=0
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40 | D POLICY^IBCNSP0,INS^IBCNSP0,SPON^IBCNSP0,LIMBLD^IBCNSC41(36,2,.IBLCNT)
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41 | D CONTACT^IBCNSP0,EFFECT,UR,EMP,VER^IBCNSP01,COMMENT,^IBCNSP01
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42 | Q
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43 | ;
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44 | COMMENT ; -- Comment region
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45 | N START,OFFSET,IBL,IBI
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46 | S START=49+$G(IBLCNT),OFFSET=2,IBL=0
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47 | I '$D(@VALMAR@(START-1)) D SET(START-1,OFFSET," ")
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48 | D SET(START,OFFSET," Comment -- Patient Policy ",IORVON,IORVOFF)
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49 | D SET(START+1,OFFSET,$S($P(IBCDFND1,U,8)="":"None",1:$P(IBCDFND1,U,8)))
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50 | I '$D(@VALMAR@(START+2)) D SET(START+2,OFFSET," ")
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51 | D SET(START+3,OFFSET," Comment -- Group Plan ",IORVON,IORVOFF)
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52 | S IBI=0 F S IBI=$O(^IBA(355.3,+IBCPOL,11,IBI)) Q:IBI<1 D
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53 | .S IBL=IBL+1
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54 | .D SET(START+IBL+3,OFFSET," "_$E($G(^IBA(355.3,+IBCPOL,11,IBI,0)),1,80))
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55 | S IBLCNT=$G(IBLCNT)+IBL+1 D SET(START+IBL+4,OFFSET," ")
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56 | Q
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57 | ;
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58 | EFFECT ; -- Effective date region
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59 | N START,OFFSET
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60 | S START=14,OFFSET=45
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61 | D SET(START,OFFSET-4," Effective Dates & Source ",IORVON,IORVOFF)
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62 | D SET(START+1,OFFSET," Effective Date: "_$$DAT1^IBOUTL($P(IBCDFND,U,8)))
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63 | D SET(START+2,OFFSET,"Expiration Date: "_$$DAT1^IBOUTL($P(IBCDFND,U,4)))
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64 | D SET(START+3,OFFSET," Source of Info: "_$$EXPAND^IBTRE(2.312,1.09,$P($G(IBCDFND1),U,9)))
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65 | D SET(START+4,OFFSET-4,"Policy Not Billable: "_$S($P($G(^DPT(DFN,.312,IBCDFN,3)),"^",4):"YES",1:"NO"))
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66 | Q
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67 | ;
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68 | UR ; -- UR of insurance region
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69 | N START,OFFSET
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70 | S START=14,OFFSET=2
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71 | D SET(START,OFFSET," Utilization Review Info ",IORVON,IORVOFF)
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72 | D SET(START+1,OFFSET," Require UR: "_$$EXPAND^IBTRE(355.3,.05,$P(IBCPOLD,U,5)))
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73 | D SET(START+2,OFFSET," Require Amb Cert: "_$$EXPAND^IBTRE(355.3,.12,$P(IBCPOLD,U,12)))
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74 | D SET(START+3,OFFSET," Require Pre-Cert: "_$$EXPAND^IBTRE(355.3,.06,$P(IBCPOLD,U,6)))
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75 | D SET(START+4,OFFSET," Exclude Pre-Cond: "_$$EXPAND^IBTRE(355.3,.07,$P(IBCPOLD,U,7)))
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76 | D SET(START+5,OFFSET,"Benefits Assignable: "_$$EXPAND^IBTRE(355.3,.08,$P(IBCPOLD,U,8)))
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77 | Q
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78 | EMP ; -- Insurance Employer Region
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79 | N OFFSET,START,IBADD
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80 | S START=19,OFFSET=40
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81 | D SET(START,OFFSET," Subscriber's Employer Information ",IORVON,IORVOFF)
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82 | D SET(START+1,OFFSET,"Emp Sponsored Plan: "_$S(+$P(IBCDFND2,U,10):"Yes",1:"No"))
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83 | D SET(START+2,OFFSET," Employer: "_$P(IBCDFND2,U,9))
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84 | D SET(START+3,OFFSET," Employment Status: "_$$EXPAND^IBTRE(2.312,2.11,$P(IBCDFND2,U,11)))
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85 | D SET(START+4,OFFSET," Retirement Date: "_$$DAT1^IBOUTL($P(IBCDFND2,U,12)))
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86 | D SET(START+5,OFFSET,"Claims to Employer: "_$S(+IBCDFND2:"Yes, Send to Employer",1:"No, Send to Insurance Company"))
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87 | ;I +IBCDFND2 W !!,"If ROI applies, make sure current consent is signed.",!! D PAUSE^VALM1
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88 | ;
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89 | D SET(START+6,OFFSET," Street: "_$P(IBCDFND2,U,2)) S IBADD=1
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90 | I $P(IBCDFND2,U,3)'="" D SET(START+7,OFFSET," Street 2: "_$P(IBCDFND2,U,3)) S IBADD=2
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91 | I $P(IBCDFND2,U,4)'="" D SET(START+8,OFFSET," Street 3: "_$P(IBCDFND2,U,4)) S IBADD=3
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92 | 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($P(IBCDFND2,U,7),1,5))
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93 | D SET(START+7+IBADD,OFFSET," Phone: "_$P(IBCDFND2,U,8))
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94 | ;
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95 | EMPQ Q
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96 | ;
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97 | HELP ; -- help code
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98 | S X="?" D DISP^XQORM1 W !!
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99 | Q
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100 | ;
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101 | EXIT ; -- exit code
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102 | K IBPPOL,VALMQUIT,IBCNS,IBCPOL,IBCPOLD,IBCPOLD1,IBCPOLD2,IBCDFND,IBCDFND1,IBCDFND2
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103 | D CLEAN^VALM10,CLEAR^VALM1
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104 | Q
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105 | ;
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106 | EXPND ; -- expand code
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107 | Q
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108 | ;
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109 | PPOL ; -- select patient, select policy
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110 | I '$D(DFN) D G:$D(VALMQUIT) PPOLQ
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111 | .S DIC="^DPT(",DIC(0)="AEQMN" D ^DIC
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112 | .S DFN=+Y
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113 | I $G(DFN)<1 S VALMQUIT="" G PPOLQ
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114 | ;
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115 | I '$O(^DPT(DFN,.312,0)) W !!,"Patient doesn't have Insurance" K DFN G PPOL
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116 | ;
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117 | S DIC="^DPT("_DFN_",.312,",DIC(0)="AEQMN",DIC("A")="Select Patient Policy: "
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118 | D ^DIC I +Y<1 S VALMQUIT=""
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119 | G:$D(VALMQUIT) PPOLQ
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120 | S IBPPOL="^2^"_DFN_U_+Y_U_$G(^DPT(DFN,.312,+Y,0))
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121 | PPOLQ K DIC Q
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122 | ;
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123 | BLANK(LINE) ; -- Build blank line
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124 | D SET^VALM10(.LINE,$J("",80))
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125 | Q
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126 | ;
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127 | SET(LINE,COL,TEXT,ON,OFF) ; -- set display info in array
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128 | I '$D(@VALMAR@(LINE,0)) D BLANK(.LINE) S VALMCNT=$G(VALMCNT)+1
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129 | D SET^VALM10(.LINE,$$SETSTR^VALM1(.TEXT,@VALMAR@(LINE,0),.COL,$L(TEXT)))
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130 | D:$G(ON)]""!($G(OFF)]"") CNTRL^VALM10(.LINE,.COL,$L(TEXT),$G(ON),$G(OFF))
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131 | W:'(LINE#5) "."
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132 | Q
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