PSOCIDC2 ;BIR/LE-continuation of Copay Correction of erroneous billed copays ;11/8/05 12:50pm ;;7.0;OUTPATIENT PHARMACY;**226**;DEC 1997 ;External reference to ^XUSEC supported by DBIA 10076 ;External reference to IBARX supported by DBIA 125 ;External reference to $$PROD^XUPROD(1) supported by DBIA 4440 ; TOTAL ; N COUNT,COUNTED,UCOUNT,UCOUNTED,CCOUNT,CCOUNTED I '$D(PSOVETS) S PSOVETS=0 N I,J F I=1:1:3 S (PSOCNT("YR2004",I),PSOCNT("YR2005",I),PSOCNT("YR2006",I))=0 S PSODFN=0 F S PSODFN=$O(^XTMP(NAMSP,"TOT REL",PSODFN)) Q:'PSODFN D .S COUNTED=0 .F J="YR2004","YR2005","YR2006" F I=1:1:3 S COUNT=$G(^XTMP(NAMSP,"TOT REL",PSODFN,J,I)) I COUNT>0 S:'$G(COUNTED) COUNTED=1,PSOVETS=PSOVETS+1 S PSOCNT(J,I)=PSOCNT(J,I)+COUNT F I=1:1:3 S PSOCNT=PSOCNT+$G(PSOCNT("YR2004",I))+$G(PSOCNT("YR2005",I))+$G(PSOCNT("YR2006",I)) ; S (I,J)=-"" I '$D(PSOCVETS) S PSOCVETS=0 F I=1:1:3 S (PSOCCNT("YR2004",I),PSOCCNT("YR2005",I),PSOCCNT("YR2006",I))=0 S PSODFN=0 F S PSODFN=$O(^XTMP(NAMSP,"TOT CAN",PSODFN)) Q:'PSODFN D .S CCOUNTED=0 .F J="YR2004","YR2005","YR2006" F I=1:1:3 S CCOUNT=$G(^XTMP(NAMSP,"TOT CAN",PSODFN,J,I)) I CCOUNT>0 S:'$G(CCOUNTED) CCOUNTED=1,PSOCVETS=PSOCVETS+1 S PSOCCNT(J,I)=PSOCCNT(J,I)+CCOUNT F I=1:1:3 S PSOCCNT=PSOCCNT+$G(PSOCCNT("YR2004",I))+$G(PSOCCNT("YR2005",I))+$G(PSOCCNT("YR2006",I)) ; S (I,J)="" I '$D(PSOUVETS) S PSOUVETS=0 F I=1:1:3 S (PSOUCNT("YR2004",I),PSOUCNT("YR2005",I),PSOUCNT("YR2006",I))=0 S PSOUDFN=0 F S PSOUDFN=$O(^XTMP(NAMSP,"TOT UNREL",PSOUDFN)) Q:'PSOUDFN D .S UCOUNTED=0 .F J="YR2004","YR2005","YR2006" F I=1:1:3 S UCOUNT=$G(^XTMP(NAMSP,"TOT UNREL",PSOUDFN,J,I)) I UCOUNT>0 S:'$G(UCOUNTED) UCOUNTED=1,PSOUVETS=PSOUVETS+1 S PSOUCNT(J,I)=PSOUCNT(J,I)+UCOUNT F I=1:1:3 S PSOUCNT=PSOUCNT+$G(PSOUCNT("YR2004",I))+$G(PSOUCNT("YR2005",I))+$G(PSOUCNT("YR2006",I)) ; Q ; CHECK ;check for ICD and IB nodes ; N PSOREF,PSOIB,PSOOICD,PSOBILLD S PSOREF=YY S PSOOICD=$P($G(^PSRX(RXP,"ICD",1,0)),"^",2,8) ; see if bill already exists I PSOREF=0 D . I +$P($G(^PSRX(RXP,"IB")),"^",2)>0 D CHKIB^PSOCP1 . S PSOREL=$P($G(^PSRX(RXP,2)),"^",13) I PSOREF>0 D . I +$G(^PSRX(RXP,1,PSOREF,"IB")) D CHKIB^PSOCP1 . S PSOREL=$P($G(^PSRX(RXP,1,YY,0)),"^",18) I $G(PSOIB)=1!($G(PSOIB)=3) S PSOBILLD=1 ; if billed/RELEASED and no IBQ node for both sc<50 and nsc I $G(PSOBILLD)&('$D(^PSRX(RXP,"IBQ"))) D . I $TR(PSOOICD,"^")[1 S ^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)=$P(PSOREL,".")_"^"_PSODT_"^"_PSOSCP . I $TR(PSOOICD,"^")[0 S ^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)=$P(PSOREL,".")_"^"_PSODT_"^"_PSOSCP ; find unbilled ones with an ICD node and no IBQ node. I '$G(PSOBILLD)&('$D(^PSRX(RXP,"IBQ"))) D . Q:$TR(PSOOICD,"^")="" . S ^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)=$P(PSOREL,".")_"^"_PSODT_"^"_PSOSCP I YY S PSOTRF=PSOTRF+1 Q ; CANCEL ;Cancel erroneous copays/set IBQ node if not there ;released rx's N PSOCAP,PSODIV,PSODV,PSOFILL,PSOLOG,PSONAM,PSOOUT,PSOPAR,PSOPAR7,PSOSITE N PSOSITE7,PSOSQ,PSOTOT,PSOYEAR,PSOYR,SSN,SAVCPUN,SAVREF,PSOIB,PSOOIBQ,PSONIBQ,PSOOICD,PSOOIB N I,IFN,PSOANSQ,PSOTYP,COM,CC,PREA,PSONW,PSOOLD,PSOREL,PSO,PSOCPUN,PSOFLD,PSOTYPE,CANCEL S PSOTYPE="CAN" S PSODFN=0 F CC=1:1 S PSODFN=$O(^XTMP(NAMSP,"CANCEL",PSODFN)) Q:'PSODFN D Q:STOP .I CC#100=0,$D(^XTMP(NAMSP,0,"STOP")) D Q .. S $P(^XTMP(NAMSP,0,"LAST"),"^",1,2)="STOP^"_$$NOW^XLFDT,STOP=1 .S (PSOCAP(304),PSOCAP(305),PSOCAP(306))=0 ; INITIAL ANNUAL CAP FOR 2004 & 2005 .F RXP=0:0 S RXP=$O(^XTMP(NAMSP,"CANCEL",PSODFN,RXP)) Q:'RXP D ..S (SAVCPUN,PSOCPUN)=($P(^PSRX(RXP,0),"^",8)+29)\30 ..S YY="" F S YY=$O(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)) Q:YY="" D ...S (SAVREF,PSOREF)=YY ...; verify again that it was billed and not already cancelled ...S PSOBILLD=0 ...I YY=0,+$P($G(^PSRX(RXP,"IB")),"^",2)>0 D CHKIB^PSOCP1 I $G(PSOIB)=1!($G(PSOIB)=3) S PSOBILLD=1 ...I YY>0,+$P($G(^PSRX(RXP,1,PSOREF,"IB")),"^")>0 D CHKIB^PSOCP1 I $G(PSOIB)=1!($G(PSOIB)=3) S PSOBILLD=1 ...Q:'PSOBILLD ...S PSOREL=$P($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)),"^"),PSOFLD=$P($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)),"^",2),PSOSCP=$P($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)),"^",3) ...S PSO=3 D NOW^%DTC S PSODT=%,PSODA=RXP,PSOCOMM="-BKGD CIDC COPAY CANCEL",PSOOLD="",PSONW="",PREA="" ...D CHKACT ...S PSOIB="",PSOIB=$S(PSOREF>0:$G(^PSRX(RXP,1,YY,"IB")),'PSOREF:$G(^PSRX(PSODA,"IB")),1:"") ...S (PSOOIBQ,PSOOICD,PSOOIB)="" ...S PSOOICD=$P($G(^PSRX(RXP,"ICD",1,0)),"^",2,8),PSOOIB=$G(^PSRX(RXP,"IB")),PSOOIBQ=$G(^PSRX(RXP,"IBQ")) ...I PSOOIBQ=""&($TR(PSOOICD,"^")[0!($TR(PSOOICD,"^")[1)) D SETIBQ ...D SITE S PSOCOMM="-BKGD CIDC COPAY CANCEL" D RXED^PSOCPA S:PSOOICD[1&($D(^PSRX(RXP,"IB"))) $P(^PSRX(RXP,"IB"),"^")="" ...S PSOCPUN=SAVCPUN,PSOREF=SAVREF ...D ACCUM ; ;ICD NODES WITHOUT IBQ NODE; set IBQ node but only set 1st piece of IB node if unreleased. S PSOTYP="IBQ" S PSODFN=0 F CC=1:1 S PSODFN=$O(^XTMP(NAMSP,"NOIBQ",PSODFN)) Q:'PSODFN D Q:STOP .I CC#100=0,$D(^XTMP(NAMSP,0,"STOP")) D Q .. S $P(^XTMP(NAMSP,0,"LAST"),"^",1,2)="STOP^"_$$NOW^XLFDT,STOP=1 .S (PSOCAP(304),PSOCAP(305),PSOCAP(306))=0 ; INITIAL ANNUAL CAP FOR 2004 & 2005 .F RXP=0:0 S RXP=$O(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP)) Q:'RXP D ..S (SAVCPUN,PSOCPUN)=($P(^PSRX(RXP,0),"^",8)+29)\30 ..S YY="" F S YY=$O(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)) Q:YY="" D ...S (SAVREF,PSOREF)=YY ...D SITE ...S PSOREL=$P($G(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)),"^"),PSOFLD=$P($G(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)),"^",2),PSOSCP=$P($G(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)),"^",3) ...S (PSOOIBQ,PSOOICD,PSOOIB)="" ...S PSOOICD=$P($G(^PSRX(RXP,"ICD",1,0)),"^",2,8),PSOOIB=$G(^PSRX(RXP,"IB")),PSOOIBQ=$G(^PSRX(RXP,"IBQ")) ...I PSOOIBQ=""&($TR(PSOOICD,"^")[0!($TR(PSOOICD,"^")[1)) D SETIBQ D ;don't want to set again if already did it as part of copay cancel ....S I="",IFN=0 F I=0:0 S I=$O(^PSRX(RXP,"A",I)) Q:'I S IFN=I ....S COM=" BKGD CIDC UPDATE" ....D NOW^%DTC S IFN=IFN+1,^PSRX(RXP,"A",0)="^52.3DA^"_IFN_"^"_IFN,^PSRX(RXP,"A",IFN,0)=%_"^I^.5^"_YY_"^"_COM ....K DA ....S:PSOOICD[1&($D(^PSRX(RXP,"IB"))) $P(^PSRX(RXP,"IB"),"^")="" ...D:'$G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)) ACCUM ...S PSOCPUN=SAVCPUN,PSOREF=SAVREF Q ; CHKACT ;check activity log for prev entry N ZACT,ZPSI,ZACTI S ZPSI=0 F S ZPSI=$O(^PSRX(PSODA,"COPAY",ZPSI)) Q:ZPSI="" S ZACTI="",ZACTI=$G(^PSRX(PSODA,"COPAY",ZPSI,0)) D Q:$G(ZACT) . I ZACTI["BKGD CIDC COPAY CANCEL"&($P(ZACTI,"^",2)="R") S PSOOLD="",PSONW="",PREA="C",ZACT=1 Q I '$G(ZACT) S PSOOLD="Copay",PSONW="No Copay",PREA="R" K PSOREF D ACTLOG^PSOCPA S PSOREF=YY,PSOOLD="",PSONW="",PREA="C" Q ; SETIBQ ; get data from IBQ node, set IBQ node, and 1st piece of IB node K PSOANSQ N PSONIBQ F PSOTYP=1:1:7 D . I PSOTYP=1 S PSOANSQ("VEH")=$P(PSOOICD,"^",PSOTYP) . I PSOTYP=2 S PSOANSQ("RAD")=$P(PSOOICD,"^",PSOTYP) . I PSOTYP=3 S PSOANSQ("SC")=$P(PSOOICD,"^",PSOTYP) . I PSOTYP=4 S PSOANSQ("PGW")=$P(PSOOICD,"^",PSOTYP) . I PSOTYP=5 S PSOANSQ("MST")=$P(PSOOICD,"^",PSOTYP) . I PSOTYP=6 S PSOANSQ("HNC")=$P(PSOOICD,"^",PSOTYP) . I PSOTYP=7 S PSOANSQ("CV")=$P(PSOOICD,"^",PSOTYP) S ^PSRX(RXP,"IBQ")=PSOANSQ("SC")_"^"_PSOANSQ("MST")_"^"_PSOANSQ("VEH")_"^"_PSOANSQ("RAD")_"^"_PSOANSQ("PGW")_"^"_PSOANSQ("HNC")_"^"_PSOANSQ("CV") Q ; ACCUM ; ACCUMULATE TOTALS S (PSOTOT,PSOYR,PSOYEAR,PSOLOG,PSONAM,PSOCHRG)="" ; get finished, but unreleased totals I PSOREL="" S PSOYR=$E(PSOFLD,1,3) Q:PSOYR="" D S PSOYEAR="" Q .S PSOYEAR=$S(PSOYR="304":"YR2004",PSOYR="305":"YR2005",PSOYR="306":"YR2006",1:"") Q:PSOYEAR="" .S PSOCHRG=7 .I PSOYEAR="YR2006" S PSOCHRG=8 .S PSOTOT=$G(^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR)) .S ^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR)=PSOTOT+(PSOCPUN*PSOCHRG) .S ^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR,PSOCPUN)=$G(^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR,PSOCPUN))+1 .S PSONAM=$P($G(^DPT(PSODFN,0)),"^"),PSONAM=$P(PSONAM,",") .S PSONAM=$E(PSONAM,1,6) .S ^XTMP(NAMSP,"IBQ UPD",PSONAM,PSODFN,RXP,PSOREF)=PSOFLD ;for released ones S PSOYR=$E(PSOREL,1,3) S:PSOYR'="" PSOYEAR=$S(PSOYR="304":"YR2004",PSOYR="305":"YR2005",PSOYR="306":"YR2006",1:"") Q:PSOYEAR="" S PSOCHRG=7 I PSOYEAR="YR2006" S PSOCHRG=8 ; ;get Xtmp billing amt which would be IBAM tot + any previous refills S PSOTOT=$G(^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR)) ; ;if none yet then init to the IBAM total for the year I 'PSOTOT D .F PSOSQ=0:0 S PSOSQ=$O(^IBAM(354.7,PSODFN,1,PSOSQ)) Q:'PSOSQ D ..S PSOLOG=$G(^IBAM(354.7,PSODFN,1,PSOSQ,0)) ..I $E(PSOLOG,1,3)=PSOYR S PSOTOT=PSOTOT+$P(PSOLOG,"^",2) ; ;update Xtmp tot nodes with current fill amounts ; note: cancel copays and updated IBQ node released prescription are collected under TOT REL for the RPT^PSOCIDC3 ; routine. Cancelled copays are denoted with an asterisk. S ^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR)=PSOTOT+(PSOCPUN*PSOCHRG) S ^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR,PSOCPUN)=$G(^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR,PSOCPUN))+1 ; ;indicate COPAY CANCEL for this fill ; ;by adding to Xtmp "BILLED" S PSONAM=$P($G(^DPT(PSODFN,0)),"^"),PSONAM=$P(PSONAM,",") S PSONAM=$E(PSONAM,1,6) S ^XTMP(NAMSP,"REL",PSONAM,PSODFN,RXP,PSOREF)=PSOREL ; CAN I PSOTYPE="CAN"&($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY))) N PSOFILL S CANCEL="" S PSOFILL=YY D CHK^PSOCIDC3 I CANCEL D . S ^XTMP(NAMSP,"TOT CAN",PSODFN,PSOYEAR)=PSOTOT+(PSOCPUN*PSOCHRG) . S ^XTMP(NAMSP,"TOT CAN",PSODFN,PSOYEAR,PSOCPUN)=$G(^XTMP(NAMSP,"TOT CAN",PSODFN,PSOYEAR,PSOCPUN))+1 Q ; SITE ; SET UP VARIABLES NEEDED BY BILLING S PSOSITE=$S(YY=0:$P(^PSRX(RXP,2),"^",9),1:$P($G(^PSRX(RXP,1,YY,0)),"^",9)) Q:PSOSITE="" S PSOPAR=$G(^PS(59,PSOSITE,1)) S PSOPAR7=$G(^PS(59,PSOSITE,"IB")) S PSOSITE7=$P($G(^PS(59,PSOSITE,"IB")),"^") Q ;