| 1 | IBCNSU1 ;ALB/AAS - INSURANCE UTILITY ROUTINE ; 19-MAY-93
|
|---|
| 2 | ;;2.0;INTEGRATED BILLING;**103,133,244**;21-MAR-94
|
|---|
| 3 | ;;Per VHA Directive 10-93-142, this routine should not be modified.
|
|---|
| 4 | ;
|
|---|
| 5 | RCHK(X) ; -- Input transform for different revenue codes in file 36
|
|---|
| 6 | ; Returns 1 if passes, 0 if not pass input transform
|
|---|
| 7 | ;
|
|---|
| 8 | N I,Y,RC,NO S Y=0
|
|---|
| 9 | I $G(X)="" G RCHKQ
|
|---|
| 10 | F I=1:1 S RC=$P(X,",",I) Q:RC="" I $S(RC?3N:0,RC?5N:0,1:1) S NO=1 Q
|
|---|
| 11 | I '$G(NO) S Y=1
|
|---|
| 12 | RCHKQ Q Y
|
|---|
| 13 | ;
|
|---|
| 14 | BU(DFN,IBCPOL,IBYR,IBCDFN,IBASK) ; -- Return entry in Benefits Used file
|
|---|
| 15 | ; Input: IBCDFN = pointer to patient file policy (2.312)
|
|---|
| 16 | ; DFN = patient pointer
|
|---|
| 17 | ; IBCPOL = pointer to health insurance policy file
|
|---|
| 18 | ; IBYR = fileman internal date, year will be calendar
|
|---|
| 19 | ; year of the internal date, Default = dt
|
|---|
| 20 | ; IBASK = 1 if want to ask okay to add new entry
|
|---|
| 21 | ;
|
|---|
| 22 | ; Output: IBCBU = pointer to Benefits Used file if added,
|
|---|
| 23 | ; else null
|
|---|
| 24 | ;
|
|---|
| 25 | N DIR,IBCBU
|
|---|
| 26 | S IBCBU=""
|
|---|
| 27 | I $G(IBCPOL)="" G BUQ
|
|---|
| 28 | I $G(IBYR)="" S IBYR=DT
|
|---|
| 29 | ;
|
|---|
| 30 | ;if no match display message
|
|---|
| 31 | I '$O(^IBA(355.4,"APY",IBCPOL,-IBYR,0)) W !!,"You cannot add a new Benefits Used BENEFIT YEAR",!! G BUQ
|
|---|
| 32 | ;
|
|---|
| 33 | ; -- try to find entry for policy for year
|
|---|
| 34 | S IBCBU=$O(^IBA(355.5,"APPY",DFN,IBCPOL,-IBYR,IBCDFN,0))
|
|---|
| 35 | ;
|
|---|
| 36 | ; -- if no match add new entry
|
|---|
| 37 | I 'IBCBU D
|
|---|
| 38 | .I $G(IBASK) S DIR(0)="Y",DIR("A")="Are you adding a new Benefits Used YEAR",DIR("B")="YES" D ^DIR I $D(DIRUT)!(Y<1) S VALMQUIT="" Q
|
|---|
| 39 | .S IBCBU=$$ADDBU(DFN,IBCPOL,IBYR,IBCDFN)
|
|---|
| 40 | .Q
|
|---|
| 41 | ;
|
|---|
| 42 | BUQ Q IBCBU
|
|---|
| 43 | ;
|
|---|
| 44 | ADDBU(DFN,IBCPOL,IBYR,IBCDFN) ; -- add entries to Benefits Used file
|
|---|
| 45 | ; Input: DFN = pointer to patient file
|
|---|
| 46 | ; IBCDFN = point to patient policy (2.312)
|
|---|
| 47 | ; IBCPOL = pointer to health insurance policy file
|
|---|
| 48 | ; IBYR = fileman internal date, year will be calendar
|
|---|
| 49 | ; year of the internal date, Default = dt
|
|---|
| 50 | ;
|
|---|
| 51 | ; Output: IBCBU = pointer to Benefits Used file if added,
|
|---|
| 52 | ; else null
|
|---|
| 53 | ;
|
|---|
| 54 | N %DT,IBN1,IBCBU,DIC,DIE,DR,DA,DLAYGO,DO,DD
|
|---|
| 55 | S IBCBU=""
|
|---|
| 56 | I $G(IBCDFN)="" G ADDBUQ
|
|---|
| 57 | I $G(IBCPOL)="" G ADDBUQ
|
|---|
| 58 | I $G(IBYR)="" S IBYR=DT
|
|---|
| 59 | K DD,DO,DIC,DR S DIC="^IBA(355.5,",DIC(0)="L",DLAYGO=355.5
|
|---|
| 60 | ;
|
|---|
| 61 | ;S IBYR=$E(IBYR,1,3)_"0000"
|
|---|
| 62 | S X=IBCPOL D FILE^DICN I +Y<0 G ADDBUQ
|
|---|
| 63 | S (IBCBU,DA)=+Y,DIE="^IBA(355.5,",DR=".02////"_DFN_";.03////"_IBYR_";.17////"_IBCDFN_";1.01///NOW;1.02////"_DUZ
|
|---|
| 64 | D ^DIE K DIC,DIE,DA,DR
|
|---|
| 65 | ADDBUQ Q IBCBU
|
|---|
| 66 | ;
|
|---|
| 67 | VET() ; -- Input Transform for sub-file 2.312, Name of Insured (#17)
|
|---|
| 68 | ; Quit 1 to stuff Patient Name
|
|---|
| 69 | ; Quit 0 to not stuff and allow editing
|
|---|
| 70 | ;
|
|---|
| 71 | N IBY,IB0 S IBY=0
|
|---|
| 72 | S IB0=$G(^DPT(+$G(DA(1)),.312,+$G(DA),0))
|
|---|
| 73 | I $P(IB0,"^",6)'="v" G VETQ
|
|---|
| 74 | I +IB0'=+$$GETWNR^IBCNSMM1 S IBY=1 G VETQ
|
|---|
| 75 | I '$D(X),$P(IB0,"^",17)="" S IBY=1
|
|---|
| 76 | VETQ Q IBY
|
|---|
| 77 | ;
|
|---|
| 78 | ;
|
|---|
| 79 | SUBID ; -- Input Transform for sub-file #2.312, Subscriber ID (#1)
|
|---|
| 80 | N NODE,L,R,CHAR,X1
|
|---|
| 81 | S CHAR="~`!@#$%^&*()_-+={}[]|\/?.,<>;:' """
|
|---|
| 82 | S NODE=^DPT(DA(1),.312,DA,0)
|
|---|
| 83 | ;
|
|---|
| 84 | ; - if the policy is a Medicare policy, make sure the subscriber ID
|
|---|
| 85 | ; is a valid HICN number
|
|---|
| 86 | I $P(NODE,U)=+$$GETWNR^IBCNSMM1 S X=$TR(X,"-","") I '$$VALHIC^IBCNSMM(X) D HLP^IBCNSM32 K X Q
|
|---|
| 87 | ;
|
|---|
| 88 | S R=$P(NODE,U,16)
|
|---|
| 89 | S L=$TR($P(^DPT(DA(1),0),U,9),CHAR,"")
|
|---|
| 90 | S R=$S(R="01":1,R="":1,1:0)
|
|---|
| 91 | ;
|
|---|
| 92 | ; - if subscriber ID is the SSN of patient, remove all extraneous
|
|---|
| 93 | ; characters
|
|---|
| 94 | S X1=$TR(X,CHAR,"") I X1?9N,X1=L S X=X1
|
|---|
| 95 | ;
|
|---|
| 96 | ; - if "SS" is entered, and the policy belongs to the patient,
|
|---|
| 97 | ; convert that string to the patient's SSN
|
|---|
| 98 | I R=1,X="SS" W " ",L S X=L
|
|---|
| 99 | ;
|
|---|
| 100 | K:$L(X)>20!($L(X)<3) X
|
|---|
| 101 | Q
|
|---|
| 102 | ;
|
|---|
| 103 | ;
|
|---|
| 104 | HICN(DFN) ; -- return Patient's Medicare HIC number
|
|---|
| 105 | ; Return HICN of Medicare WNR Part A or Part B
|
|---|
| 106 | ; Return -1 if none exits
|
|---|
| 107 | ;
|
|---|
| 108 | N IBWNR,IBX,IBY,IB0
|
|---|
| 109 | S IBWNR=$$GETWNR^IBCNSMM1,IBY=""
|
|---|
| 110 | I '$O(^DPT(DFN,.312,"B",+IBWNR,0)) S IBY=-1 G HICNQ
|
|---|
| 111 | S IBX=0 F S IBX=$O(^DPT(DFN,.312,"B",+IBWNR,IBX)) Q:('IBX)!(IBY]"") D
|
|---|
| 112 | .S IB0=$G(^DPT(DFN,.312,IBX,0))
|
|---|
| 113 | .I $P(IB0,U,18)'=$P(IBWNR,U,3),$P(IB0,U,18)'=$P(IBWNR,U,5) Q
|
|---|
| 114 | .; 8/18/2003 - Added translation code to remove hyphens if they exist.
|
|---|
| 115 | .I $P(IB0,U,2)]"" S IBY=$TR($P(IB0,U,2),"- ","")
|
|---|
| 116 | S:IBY="" IBY=-1
|
|---|
| 117 | HICNQ Q IBY
|
|---|
