source: WorldVistAEHR/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCNSP1.m@ 619

Last change on this file since 619 was 613, checked in by George Lilly, 15 years ago

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[613]1IBCNSP1 ;ALB/AAS - INSURANCE MANAGEMENT - policy actions ;22-OCT-92
2 ;;2.0;INTEGRATED BILLING;**6,28,40,43,52,85,103,361,371,377**;21-MAR-94;Build 23
3 ;;Per VHA Directive 2004-038, this routine should not be modified.
4 ;;ICR#5002 for read of ^DIE input template data
5 ;
6% G EN^IBCNSP
7 ;
8EA ; -- Edit all
9 N IBCDFN,IBTRC,IBTRN
10 D FULL^VALM1 W !!
11 S IBCDFN=$P($G(IBPPOL),"^",4) I 'IBCDFN W !!,"Can't identify the policy!" G EAQ
12 S IBCNSEH=1 D PAT^IBCNSEH
13 ;
14 D BEFORE^IBCNSEVT
15 D PATPOL^IBCNSM32(IBCDFN)
16 D AFTER^IBCNSEVT,^IBCNSEVT
17 ;
18 ; -- edit policy data
19 D POL^IBCNSEH
20 D EDPOL^IBCNSM3(IBCDFN)
21 ;
22 W !! D AI
23 ;
24EAQ D:$G(IBTRC) AIP^IBCNSP02(IBTRC)
25 D BLD^IBCNSP
26 S VALMBCK="R"
27 Q
28 ;
29AB ; -- Annual Benefits
30 S X=+$P($G(IBPPOL),"^",4),IBCNS=+$G(^DPT(DFN,.312,X,0)),IBCPOL=+$P($G(^(0)),"^",18)
31 I 'IBCPOL W !!,"Can't identify the plan!" S VALMBCK="" G ABQ
32 D FULL^VALM1 W !!
33 D EN^VALM("IBCNS ANNUAL BENEFITS")
34 S VALMBCK="R"
35ABQ Q
36 ;
37BU ; -- Benefits Used
38 S IBCDFN=+$P($G(IBPPOL),"^",4),IBCNS=+$G(^DPT(DFN,.312,IBCDFN,0)),IBCPOL=+$P($G(^(0)),"^",18)
39 I 'IBCPOL W !!,"Can't identify the plan!" S VALMBCK="" G BUQ
40 D FULL^VALM1 W !!
41 D EN^VALM("IBCNS BENEFITS USED BY DATE")
42 S VALMBCK="R"
43BUQ Q
44 ;
45IT ; -- edit insurance type info from patient policy and plan edit
46 D FULL^VALM1 W !!
47 N IBCDFN
48 S IBCDFN=+$P($G(IBPPOL),"^",4),IBCPOL=+$P($G(^DPT(DFN,.312,IBCDFN,0)),"^",18)
49 I 'IBCPOL W !!,"Can't identify the plan!" S VALMBCK="" G ITQ
50 D ITEDIT(IBCPOL,IBCDFN)
51ITQ S VALMBCK="R" Q
52 ;
53IT1 ; -- edit insurance type info from patient policy
54 D ITEDIT(IBCPOL)
55 S VALMBCK="R"
56 Q
57 ;
58ITEDIT(IBCPOL,IBCDFN) ;Edit insurance type info once you have plan (IBCPOL)
59 ; IBCDFN = the ifn of the policy multiple for pt in ^DPT, node .312
60 ; only defined for editing via patient policy
61 G:'$G(IBCPOL) ITEDITQ
62 D SAVE^IBCNSP3(IBCPOL)
63 L +^IBA(355.3,+IBCPOL):5 I '$T D LOCKED^IBTRCD1 G ITEDITQ
64 I $G(IBCDFN) S IBCNSEH=+$G(^IBE(350.9,1,4)) D POL^IBCNSEH
65 I $P($G(^IBA(355.3,IBCPOL,0)),"^",11) W !?2,*7,"Please note that this plan is inactive!",!
66 S DA=IBCPOL,DIE="^IBA(355.3,",DR=".05;.12;.06;.07;.08"
67 D ^DIE K DIC,DIE,DA,DR
68 D COMP^IBCNSP3(IBCPOL)
69 I IBDIF D UPDATE^IBCNSP3(IBCPOL) D:$G(IBCDFN) UPDATPT^IBCNSP3(DFN,IBCDFN),BLD^IBCNSP D:'$G(IBCDFN) INIT^IBCNSC4
70 L -^IBA(355.3,+IBCPOL)
71ITEDITQ Q
72 ;
73ED ; -- Edit effective dates
74 D FULL^VALM1 W !!
75 N IBDIF,DA,DR,DIE,DIC
76 D BEFORE^IBCNSEVT
77 D SAVEPT^IBCNSP3(DFN,IBCDFN)
78 L +^DPT(DFN,.312,+$P($G(IBPPOL),"^",4)):5 I '$T D LOCKED^IBTRCD1 G EDQ
79 D VARS^IBCNSP3
80 S DR="8;3;1.09//;3.04"
81 D ^DIE K DIC,DIE,DA,DR
82 D COMPPT^IBCNSP3(DFN,IBCDFN) I IBDIF D UPDATPT^IBCNSP3(DFN,IBCDFN),UPDCLM(DFN,IBCDFN),AFTER^IBCNSEVT,^IBCNSEVT,BLD^IBCNSP
83 L -^DPT(DFN,.312,+$P($G(IBPPOL),"^",4))
84EDQ S VALMBCK="R" Q
85 ;
86VC ; -- Verify Coverage
87 D FULL^VALM1 W !!
88 D VFY^IBCNSM2
89 D BLD^IBCNSP
90 S VALMBCK="R" Q
91 ;
92SU ; -- Subscriber Update
93 D FULL^VALM1 W !!
94 ;Patch 40
95 N IBDIF,DA,DR,DIC,DIE,DGSENFLG
96 S DGSENFLG=1
97 D SAVEPT^IBCNSP3(DFN,IBCDFN)
98 D VARS^IBCNSP3
99 L +^DPT(DFN,.312,+$P($G(IBPPOL),"^",4)):5 I '$T D LOCKED^IBTRCD1 G SUQ
100 ;
101 D EDIT(DFN,IBCDFN) ; IB*371 - edit pat ins 2.312 subfile fields
102 ;
103 D COMPPT^IBCNSP3(DFN,IBCDFN)
104 I IBDIF D UPDATPT^IBCNSP3(DFN,IBCDFN),BLD^IBCNSP
105 L -^DPT(DFN,.312,+$P($G(IBPPOL),"^",4))
106SUQ S VALMBCK="R" Q
107 ;
108IC ; -- Insurance Contact Information
109 D FULL^VALM1 W !!
110 N IBDIF,DA,DR,DIC,DIE,IBTRC,DIR,DUOUT,DTOUT,DIRUT,IBTRN
111 D AI
112 D:$G(IBTRC) AIP^IBCNSP02(IBTRC),BLD^IBCNSP
113 S VALMBCK="R" Q
114 Q
115AI ; -- Add ins. verification entry
116 N X,Y,I,J,DA,DR,DIC,DIE,DR,DD,DO,VA,VAIN,VAERR,IBQUIT,IBXIFN,IBTRN,DUOUT,IBX,IBQUIT,DTOUT
117 Q:'$G(DFN)
118 Q:'$G(IBCDFN) S IBQUIT=0
119 D AI^IBCNSP02
120 Q
121 ;
122PIDEF(IBREL,FLD,IBDFN,SPDEF) ; Function to return patient file defaults
123 ; Called from input template IBCN PATIENT INSURANCE
124 ; IBREL = value from 2.312,4.03 field (PT. RELATIONSHIP - HIPAA)
125 ; FLD = field# in file 2.312
126 ; IBDFN = patient ien to file 2
127 ; SPDEF = spouse default flag =1 if this field should be defaulted
128 ; when the spouse is the policy holder
129 ;
130 ; The purpose is to provide a default value for the field when the
131 ; patient and the ins. subscriber are the same.
132 ;
133 NEW VAL
134 S VAL=""
135 I +$G(IBREL)'=1,+$G(IBREL)'=18 G PIDEFX ; patient not the insured or spouse, get out
136 I +$G(IBREL)=1,'$G(SPDEF) G PIDEFX ; not a field for spouse default
137 I '$G(FLD) G PIDEFX ; no field# passed in
138 I '$G(IBDFN) G PIDEFX ; no patient passed in
139 ;
140 ; Build the patient demographics area
141 I '$D(^UTILITY("VADM",$J)) D
142 . N VAHOW,DFN,VADM
143 . S VAHOW=2,DFN=IBDFN D DEM^VADPT
144 . Q
145 ;
146 ; Build the patient address area
147 I '$D(^UTILITY("VAPA",$J)) D
148 . N VAHOW,DFN,VAPA
149 . S VAHOW=2,DFN=IBDFN,VAPA("P")="" D ADD^VADPT
150 . Q
151 ;
152 I FLD=17 S VAL=$P($G(^UTILITY("VADM",$J,1)),U,1) G PIDEFX ; Name
153 I FLD=3.01 S VAL=$$FMTE^XLFDT($P($G(^UTILITY("VADM",$J,3)),U,1),"5Z") G PIDEFX ; Date of Birth
154 I FLD=3.02 S VAL=$$EXTERNAL^DILFD(2,.325,,$P($G(^DPT(IBDFN,.32)),U,5)) G PIDEFX ; Branch
155 I FLD=3.05 S VAL=$P($G(^UTILITY("VADM",$J,2)),U,2) G PIDEFX ; SSN
156 I FLD=3.06 S VAL=$P($G(^UTILITY("VAPA",$J,1)),U,1) G PIDEFX ; Street Address 1
157 I FLD=3.07 S VAL=$P($G(^UTILITY("VAPA",$J,2)),U,1) G PIDEFX ; Street Address 2
158 I FLD=3.08 S VAL=$P($G(^UTILITY("VAPA",$J,4)),U,1) G PIDEFX ; City
159 I FLD=3.09 S VAL=$P($G(^UTILITY("VAPA",$J,5)),U,2) G PIDEFX ; State
160 I FLD=3.1 S VAL=$P($G(^UTILITY("VAPA",$J,11)),U,2) G PIDEFX ; Zipcode
161 I FLD=3.11 S VAL=$P($G(^UTILITY("VAPA",$J,8)),U,1) G PIDEFX ; Phone#
162 I FLD=3.12 S VAL=$P($G(^UTILITY("VADM",$J,5)),U,2) G PIDEFX ; Sex
163PIDEFX ;
164 Q VAL
165 ;
166ASK(QUES,DEFLT) ; Function to ask Yes/No Question
167 ; Returns 1 (yes), 0 (no, up-arrow, or timeout)
168 NEW X,Y,DIR,DTOUT,DUOUT,DIRUT,DIROUT
169 S DIR(0)="Y",DIR("A")=$G(QUES)
170 S DIR("B")=$S($G(DEFLT):"Yes",1:"No")
171 W ! D ^DIR W:Y !
172 I $D(DIRUT) S Y=0
173ASKX ;
174 Q Y
175 ;
176EDIT(IBDFN,IBCDFN,IBQUIT) ; Main call to edit data in 2.312 pat ins subfile
177 ; IBDFN - patient DFN
178 ; IBCDFN - ien for patient insurance policy in subfile 2.312
179 ; IBQUIT - Output variable. Pass by reference. Will be set to 1 if
180 ; the user entered an up-arrow, timed-out, or deleted the
181 ; 2.312 subfile entry by entering "@" at the .01 field
182 ;
183 NEW DA,DR,DIE,IBZ,IBY,X,Y,DTOUT
184 NEW IDS,SUB,PAT,PCE,SUB1,PAT1
185 S DA(1)=+$G(IBDFN) ; patient IEN
186 S DA=+$G(IBCDFN) ; patient insurance IEN
187 I 'DA!'DA(1) G EDITX
188 S DIE="^DPT("_IBDFN_",.312,"
189 ;
190 ; Find the input template IEN for the [IBCN PATIENT INSURANCE] template
191 S IBY=+$$FIND1^DIC(.402,,"X","IBCN PATIENT INSURANCE")
192 I 'IBY G EDITX
193 ;
194 ; Build the DR array/string - ICR# 5002
195 M DR(1)=^DIE(IBY,"DR",2)
196 S DR=$G(DR(1,2.312))
197 I DR="" G EDITX
198 ;
199 S $P(^DIE(IBY,0),U,7)=DT ; see TEM+2^DIE ICR# 5002
200 ;
201 D ^DIE ; edit subfile data
202 ;
203 ; If the user entered an up-arrow, or timed-out, or deleted the entry,
204 ; then set the output variable IBQUIT
205 I $D(Y)!$D(DTOUT)!'$D(DA) S IBQUIT=1
206 ;
207 F IBZ="VADM","VAPA" K ^UTILITY(IBZ,$J) ; cleanup scratch global
208 ;
209 D UPDCLM(IBDFN,IBCDFN) ; update editable claims
210 ;
211 ; Cleanup any problems in the secondary ID area
212 S IDS=$G(^DPT(IBDFN,.312,IBCDFN,5)) ; whole 5 node
213 S (SUB,PAT)=""
214 F PCE=3:1:8 S $P(SUB,U,PCE)=$P(IDS,U,PCE-1) ; subscriber sec ID/qual
215 F PCE=3:1:8 S $P(PAT,U,PCE)=$P(IDS,U,PCE+5) ; patient sec ID/qual
216 ; SUB and PAT are 8-piece strings with pieces 1 and 2 being nil
217 S SUB1=$$SCRUB^IBCEF21(SUB) ; scrub 8-piece string
218 S PAT1=$$SCRUB^IBCEF21(PAT) ; scrub 8-piece string
219 I SUB'=SUB1 S $P(^DPT(IBDFN,.312,IBCDFN,5),U,2,7)=$P(SUB1,U,3,8)
220 I PAT'=PAT1 S $P(^DPT(IBDFN,.312,IBCDFN,5),U,8,13)=$P(PAT1,U,3,8)
221 ;
222EDITX ;
223 Q
224 ;
225UPDCLM(IBDFN,IBCDFN) ; Update the Insurance nodes of claims that are still editable
226 NEW IBIFN
227 S IBIFN=0 F S IBIFN=$O(^DGCR(399,"C",IBDFN,IBIFN)) Q:'IBIFN D UPDCLM^IBCNSP2(IBIFN,IBDFN,IBCDFN)
228 ;
229UPDCLMX ;
230 Q
231 ;
232PRELCNV(CODE,FLG) ; conversion between X12, NCPDP and VistA pt. relationship codes
233 ; CODE - code for pt. relationship to convert
234 ; FLG - 0 for X12 -> VistA conversion, 1 for VistA -> X12 conversion, 2 - for VistA -> NCPDP conversion
235 ; returns converted code for pt. relationship, or null if no match found
236 N I,RES,VSTR,X12STR
237 S VSTR="01^02^03^08^11^15^32^33^34^35^36"
238 S X12STR="18^01^19^20^39^41^32^33^29^53^G8"
239 S RES=""
240 I FLG=0 F I=1:1:11 S:$P(X12STR,U,I)=CODE RES=$P(VSTR,U,I) Q:RES'=""
241 I FLG=1 F I=1:1:11 S:$P(VSTR,U,I)=CODE RES=$P(X12STR,U,I) Q:RES'=""
242 I FLG=2,+CODE>0 S RES=$S(+CODE>3:"04",1:CODE)
243 Q RES
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