[613] | 1 | IBECUSM ;DVAMC/RLM - TRICARE PHARMACY BILLING OPTIONS; 20-AUG-96
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| 2 | ;;2.0;INTEGRATED BILLING;**52,162,240,347**;21-MAR-94;Build 24
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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 | ;
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| 6 | REV ; Reverse a claim already submitted to the Fiscal Intermediary.
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| 7 | I '$P($G(^IBE(350.9,1,9)),"^",4) W !!,"Please note that your TRICARE Pharmacy billing interface is not running!",!
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| 8 | REVA N X K DIC S DIC=52,DIC("A")="Enter the RX# you wish to reverse: ",DIC(0)="AEQMN"
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| 9 | W ! D DIC^PSODI(52,.DIC) S IBRX=+Y K DIC
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| 10 | I Y<1!($D(DUOUT))!($D(DIRUT)) G REVQ
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| 11 | W !!,"Prescription: ",$P(Y,"^",2),!," Patient: ",$$FILE^IBRXUTL(+Y,2,"E")
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| 12 | ;
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| 13 | ; - has this prescription been billed?
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| 14 | K IBARR,IBCAN S (IBKEY,IBKEYS)=IBRX_";"
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| 15 | F S IBKEY=$O(^IBA(351.5,"B",IBKEY)) Q:$E(IBKEY,1,$L(IBKEYS))'=IBKEYS S IBARR(IBKEY)=+$O(^(IBKEY,0))
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| 16 | I '$D(IBARR) W !!,"This prescription has not yet been billed." G REVA
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| 17 | ;
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| 18 | ; - find all potential transactions
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| 19 | D FINDC^IBECUSMU(.IBARR,1,.IBCAN)
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| 20 | S IBKEY=$O(IBCAN("")) I IBKEY="" G REVA
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| 21 | ;
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| 22 | ; - there's just one
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| 23 | I $O(IBCAN(IBKEY))="" S IBCHTRN=IBCAN(IBKEY) W !!,$S($P(IBKEY,";",2):"Refill #"_$P(IBKEY,";",2),1:"The original fill")," for this prescription can be cancelled." G OKAYC
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| 24 | ;
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| 25 | ; - more than 1; must select from the list
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| 26 | W !!,"More than one fill for rx# ",$$FILE^IBRXUTL(IBRX,.01)," may be cancelled."
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| 27 | S IBREF=$$SEL^IBECUSMU(.IBCAN)
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| 28 | I IBREF<0 G REVQ
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| 29 | ;
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| 30 | S IBKEY=IBRX_";"_IBREF,IBCHTRN=IBCAN(IBKEY)
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| 31 | ;
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| 32 | OKAYC ; - okay to cancel?
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| 33 | S DIR("A")="Is it okay to cancel this prescription"
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| 34 | S DIR(0)="Y" D ^DIR K DIR
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| 35 | I 'Y!($D(DUOUT))!($D(DIRUT)) W !,"The claim reversal was NOT submitted." G REVQ
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| 36 | ;
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| 37 | ; - queue cancellation for submittal
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| 38 | S ^IBA(351.5,"APOST",IBKEY)="REVERSE^^"_DUZ_"^"_IBCHTRN
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| 39 | W !,"The claim reversal has been submitted."
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| 40 | REVQ K DIROUT,DIRUT,DTOUR,DUOUT,IBRX,IBARR,IBCAN,IBKEY,IBKEYS,IBCHTRN,IBREF
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| 41 | Q
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| 42 | ;
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| 43 | ;
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| 44 | ;
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| 45 | RESUB ; Resubmit a claim to the Fiscal Intermediary.
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| 46 | I '$P($G(^IBE(350.9,1,9)),"^",4) W !!,"Please note that your TRICARE Pharmacy billing interface is not running!",!
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| 47 | RESUBA N X K DIC S DIC=52 S DIC(0)="AEQMN",DIC("A")="Enter the RX# you wish to resubmit: "
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| 48 | W ! D DIC^PSODI(52,.DIC) S IBRX=+Y K DIC
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| 49 | I Y<1!($D(DUOUT))!($D(DIRUT)) G RESUBQ
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| 50 | S DFN=$$FILE^IBRXUTL(+Y,2)
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| 51 | W !!,"Prescription: ",$$FILE^IBRXUTL(IBRX,.01),!," Patient: ",$P($G(^DPT(DFN,0)),"^")
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| 52 | ;
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| 53 | ; - find all potential transactions
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| 54 | K IBBIL D FINDB^IBECUSMU(IBRX,1,.IBBIL)
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| 55 | S IBKEY=$O(IBBIL("")) I IBKEY="" G RESUBA
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| 56 | ;
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| 57 | ; - there's just one
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| 58 | I $O(IBBIL(IBKEY))="" W !!,$S($P(IBKEY,";",2):"Refill #"_$P(IBKEY,";",2),1:"The original fill")," for this prescription can be billed." G IBPSR
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| 59 | ;
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| 60 | ; - more than 1; must select from the list
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| 61 | W !!,"More than one fill for rx# ",$$FILE^IBRXUTL(IBRX,.01)," may be billed."
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| 62 | S IBREF=$$SEL^IBECUSMU(.IBBIL)
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| 63 | I IBREF<0 G RESUBQ
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| 64 | ;
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| 65 | S IBKEY=IBRX_";"_IBREF
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| 66 | ;
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| 67 | IBPSR ;Ask for the Product Selection Reason
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| 68 | N DIR,DIE,DR,X,Y,DA
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| 69 | S DIR("B")=$S($P($G(^IBA(351.5,+IBBIL(IBKEY),0)),"^",10):$P(^IBA(351.53,$P(^(0),"^",10),0),"^"),1:0)
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| 70 | S DIR(0)="PO^351.53" D ^DIR I Y=-1 W !,"The prescription was NOT submitted for billing." G RESUBQ
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| 71 | S DA=+$G(IBBIL(IBKEY)),DIE="^IBA(351.5,",DR=".10////"_(+Y) D ^DIE
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| 72 | K DIR
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| 73 | OKAYB ; - okay to bill?
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| 74 | S DIR("A")="Is it okay to bill this prescription"
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| 75 | S DIR(0)="Y" D ^DIR
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| 76 | I 'Y!($D(DUOUT))!($D(DIRUT)) W !,"The prescription was NOT submitted for billing." G RESUBQ
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| 77 | ;
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| 78 | D:'$D(PSOPAR) ^PSOLSET
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| 79 | I '$D(PSOLAP) W !!,*7,"The label printer is not defined!",!,"The prescription has NOT been submitted for billing." G RESUBQ
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| 80 | S ^IBA(351.5,"APOST",IBKEY)=PSOLAP_"^"_PSOSITE_"^"_DUZ_"^^"_$P($G(^IBA(351.5,+IBBIL(IBKEY),0)),"^",10)
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| 81 | W !,"The prescription has been submitted for billing."
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| 82 | ;
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| 83 | RESUBQ K DIROUT,DIRUT,DTOUR,DUOUT,IBRX,DFN,IBBIL,IBKEY,IBREF
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| 84 | K PSOBAR0,PSOBAR1,PSOBARS,PSOCLC,PSOCNT,PSODIV,PSODTCUT
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| 85 | K PSOLAP,PSOPAR,PSOPAR7,PSOPRPAS,PSOSITE
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| 86 | Q
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| 87 | ;
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| 88 | ;
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| 89 | ;
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| 90 | DREJ ; Delete an entry from the Reject (#351.52) file.
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| 91 | I '$P($G(^IBE(350.9,1,9)),"^",4) W !!,"Please note that your TRICARE Pharmacy billing interface is not running!",!
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| 92 | DREJA N X K DIC S DIC=52 S DIC(0)="AEQMN",DIC("A")="Enter the RX# of the rejected transmission: "
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| 93 | W ! D DIC^PSODI(52,.DIC) S IBRX=+Y K DIC
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| 94 | I Y<1!($D(DUOUT))!($D(DIRUT)) G DREJQ
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| 95 | W !!,"Prescription: ",$P(Y,"^",2),!," Patient: ",$$FILE^IBRXUTL(+Y,2,"E")
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| 96 | ;
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| 97 | ; - is there a reject entry for this prescription?
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| 98 | K IBARR S (IBKEY,IBKEYS)=IBRX_";"
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| 99 | F S IBKEY=$O(^IBA(351.52,"B",IBKEY)) Q:$E(IBKEY,1,$L(IBKEYS))'=IBKEYS S IBARR(IBKEY)=+$O(^(IBKEY,0))
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| 100 | I '$D(IBARR) W !!,"There is no reject entry for this prescription." G DREJA
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| 101 | ;
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| 102 | ; - select the reject entry to delete
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| 103 | S IBKEY=$O(IBARR("")) I IBKEY="" G DREJA
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| 104 | I $O(IBARR(IBKEY))="" S IBCHREF=+IBARR(IBKEY) W !!,$S($P(IBKEY,";",2):"Refill #"_$P(IBKEY,";",2),1:"The original fill")," for this prescription has been rejected." G OKAYD
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| 105 | ;
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| 106 | ; - more than 1; must select from the list
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| 107 | W !!,"More than one fill for rx# ",$$FILE^IBRXUTL(IBRX,.01)," has a reject entry."
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| 108 | S IBREF=$$SEL^IBECUSMU(.IBARR)
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| 109 | I IBREF<0 G DREJQ
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| 110 | ;
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| 111 | S IBKEY=IBRX_";"_IBREF,IBCHREF=+$G(IBARR(IBKEY))
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| 112 | ;
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| 113 | OKAYD ; - okay to delete the reject?
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| 114 | I '$D(^IBA(351.52,IBCHREF,0)) K ^IBA(351.52,"B",IBKEY) W !!,"Sorry, can't find a reject for this prescription!" G DREJQ
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| 115 | S DIR("A")="Is it okay to delete this reject entry"
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| 116 | S DIR(0)="Y" D ^DIR K DIR
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| 117 | I 'Y!($D(DUOUT))!($D(DIRUT)) W !,"The reject entry was NOT deleted." G DREJQ
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| 118 | ;
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| 119 | ; - delete the entry
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| 120 | S DA=IBCHREF,DIK="^IBA(351.52," D ^DIK K DA,DIK
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| 121 | W !,"The reject entry has been deleted."
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| 122 | DREJQ K DIROUT,DIRUT,DTOUR,DUOUT,IBRX,IBARR,IBKEY,IBKEYS,IBCHREF,IBREF
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| 123 | Q
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