source: WorldVistAEHR/trunk/r/OUTPATIENT_PHARMACY-PSO-APSP-HUIP/PSOCPIBC.m@ 1093

PSOCPIBC ;BHAM ISC/EJW - PHARMACY CO-PAY APPLICATION UTILITIES FOR IB ; 01/15/02
 ;;7.0;OUTPATIENT PHARMACY;**93**;DEC 1997
 ;External references to IBARX is supported by DBIA 125
 ;External reference to PSDRUG( is supported by DBIA 221
 ;This routine is called by PSOCPIBF to attempt to bill for released CMOP copays.
 ;For Rx fills with a release date prior to 01/01/02 this routine is called instead of CP^PSOCP.  This routine does not check the additional
 ;exemption questions and does not send a MailMan message if an exemption question has not been answered.
CP ; Entry point to Check if COPAY  -   Requires RXP,PSOSITE7
 I '$D(PSOPAR) D ^PSOLSET G CP
 K PSOCP
 ; Q:'$D(^PSRX(RXP,"IB"))  Q:"12"'[$E(+^PSRX(RXP,"IB"))
 S PSOCPN=$P(^PSRX(RXP,0),"^",2) ; Set COPAY dfn PTR TO PATIENT
 S PSOCP=$P($G(^PSRX(RXP,"IB")),"^") ; IB action type
 S PSOSAVE=$S(PSOCP:1,1:"") ; save current copay status
 ;         Set x=service^dfn^actiontype^user duz
 I +$G(PSOSITE7)'>0 S PSOSITE7=$P(^PS(59,PSOSITE,"IB"),"^")
 S X=PSOSITE7_"^"_PSOCPN_"^"_PSOCP_"^"_$P(^PSRX(RXP,0),"^",16)
 ;
RX ;         Determine Original or Refill for RX
 S PSOREF=0
 I $G(^PSRX(RXP,1,+$G(YY),0))]"" S PSOREF=YY
 ;         Check if bill # already exists for this RX or Refill
 I 'PSOREF,+$P($G(^PSRX(RXP,"IB")),"^",2)>0 G QUIT
 I PSOREF,+$G(^PSRX(RXP,1,PSOREF,"IB")) G QUIT
 S PSOCHG=1 ; set temporary variable to copay and then look for exceptions
 N MAILMSG
 D COPAYREL
 I 'PSOCHG D  G QUIT
 . I PSOSAVE S PSODA=RXP,PREA="R" D ACTLOG^PSOCPA S $P(^PSRX(RXP,"IB"),"^",1)=""
 I PSOCHG=2 D  I 'PSOCP G QUIT ; IF 'SC' QUESTION APPLIES, BUT HAS NOT BEEN ANSWERED, SEND MAIL MSG AND KEEP COPAY STATUS AS IT WAS
 . ; D MAIL2^PSOCPE ; SEND MAIL TO PHARMACIST, PROVIDER, AND HOLDERS OF THE PSO COPAY KEY
 I PSOCHG=1,PSOSAVE="" D  I PSOREF S PSOCOMM="",PSOOLD="No Copay",PSONW="Copay" S PSODA=RXP,PREA="R" D ACTLOG^PSOCPA
 . I '$D(^PSRX(RXP,"IB")),'PSOREF S $P(^PSRX(RXP,"IB"),"^",1)=1 Q
 . S $P(^PSRX(RXP,"IB"),"^",1)=1
 . S PSOCP=1,$P(X,"^",3)=PSOCP
 I PSOCHG'=2 I $G(MAILMSG) ; D MAIL2^PSOCPE ; SEND MAIL TO PHARMACIST, PROVIDER, AND HOLDERS OF PSO COPAY KEY
 ;         Units for COPAY
 S PSOCPUN=$P(($P(^PSRX(RXP,0),"^",8)+29)/30,".",1)
 ;         Build softlink for x(n)=softlink^units
 S X(1)="52:"_RXP S:PSOREF>0 X(1)=X(1)_";1:"_PSOREF S X(1)=X(1)_"^"_PSOCPUN
 ;         Set correct user duz if refill
 I PSOREF S:+$P(^PSRX(RXP,1,PSOREF,0),"^",7)>0 $P(X,"^",4)=$P(^PSRX(RXP,1,PSOREF,0),"^",7)
 ;
IBNEW ;          Load ^TMP global for IB call
 Q:$G(RXP)'>0
 N D0
 G QUIT:'$D(X)
 S XTMP=X,XTMP(1)=X(1)
 ;
 ;         Requires x=service^dfn^action type^user duz
 ;               x(n)=softlink^units 
 I $P(X,"^",3)="" S $P(X,"^",3)=$P(^PSRX(RXP,"IB"),"^",1)
 D NEW^IBARX
 ;         Returns y=1^total charges for this group or Y=-1^error code
 ;              y(n)=IB number^charge for this Rx^AR bill #^Cap met^Partial or Full charge^Copay Exempt^Number from file 354.71
 ;                   Cap met ('1' - If patient has met cap amount or 
 ;                     reached cap with this charge or '0' if not)
 ;                   Partial or Full ('P' for partial billing, 'F' for
 ;                     full billing, null for no billing)
 ;                   Copay Exempt - ('1' for exempt, '0' for non-exempt,
 ;                     '-1' for copay off (manila))
 ;                   ('1' - If patient has met cap amount or reach cap with this charge
 ;                  Entry from file 354.71 will only be saved for fills that met the annual cap and could not be fully billed
 ;
 G QUIT:+Y=-1
 S XTMP=XTMP_"^"_Y,XTMP(1)=XTMP(1)_"^"_Y(1)
 ;
 ; see if exempt or copay cap was met for this fill
 I $P(Y(1),"^",6) D  G QUIT
 . S PREA="R",PSOOLD="Copay",PSONW="No Copay"
 . S PSOCOMM="RX COPAY INCOME EXEMPTION" S PSODA=RXP D ACTLOG^PSOCPA
 . S $P(^PSRX(RXP,"IB"),"^",1)=""
 I $P(Y(1),"^",4) D
 . S PSOCOMM=$S($P(Y(1),"^",5)="F":" FULL BILLING FOR THIS FILL",$P(Y(1),"^",5)="P":" PARTIAL BILLING FOR THIS FILL ",1:" NO BILLING FOR THIS FILL")
 . S PREA="A"
 . S PSODA=RXP D ACTLOG^PSOCPA
 . I $P(Y(1),"^",5)'="F" D
 . . I PSOREF S $P(^PSRX(RXP,1,PSOREF,"IB"),"^",2)=$P(Y(1),"^",7) Q
 . . S $P(^PSRX(RXP,"IB"),"^",4)=$P(Y(1),"^",7)
 I $P(Y(1),"^",1)="" G QUIT
 ;
FILE ;         File IB number in ^PSRX
 S PSOCP2=0
 S PSOCP2=+$P(XTMP(1),":",3)
 S:PSOCP2>0 ^PSRX(RXP,1,PSOCP2,"IB")=$P(XTMP(1),U,3) ;  Filing in refill node
 I PSOCP2>0,'$D(^PSRX(RXP,"IB")) S ^PSRX(RXP,"IB")="1^^" ;  If refill "IB" exists, need "IB" entry on original fill node
 S:PSOCP2=0 $P(^PSRX(RXP,"IB"),"^",2)=$P(XTMP(1),U,3) ;Filing in original fill (zero node)
QUIT ;
 K Y,PSOCP1,PSOCP2,QQ,PSOCPN,X,X2,XTMP,PSOCPUN,PSOREF,PSOCHG,PSOSAVE,PSOCOMM,PSOOLD,PSONW,PREA,PSORSN
 Q
EN D ^PSOLSET
EN1 S DIR(0)="NO",DIR("A")="Enter PRESCRIPTION number" D ^DIR K DIR G:$D(DIRUT) EXIT S RXP=X I +$G(^PSRX(RXP,0))'>0!+$P($G(^PSRX(RXP,"IB")),"^",0)>0 W !,?10,"RE-CHECK PRESCRIPTION NUMBER AND RE-ENTER " G EN1
 S PSOSITE7=$P(^PS(59,PSOSITE,"IB"),"^")
 S PSODFN=$P(^PSRX(RXP,0),"^",2)
 D CP G EN1
EXIT K RXP D FINAL^PSOLSET Q
 ;
COPAYREL ; Recheck copay status at release
 ;
 ; check Rx patient status
 I $P(^PSRX(RXP,0),"^",3)'="",$P($G(^PS(53,$P(^PSRX(RXP,0),"^",3),0)),"^",7)=1 S PSOCHG=0,PSOCOMM="Rx Patient Status Change",PSOOLD="Copay",PSONW="No Copay" Q
 ; see if drug is investigational or supply
 N DRG,DRGTYP
 S DRG=+$P(^PSRX(RXP,0),"^",6),DRGTYP=$P($G(^PSDRUG(DRG,0)),"^",3)
 I DRGTYP["I" S PSOCOMM="Investigational Drug",PSOCHG=0,PSOOLD="Copay",PSONW="No Copay",PSOCHG=0 Q
 I DRGTYP["S" S PSOCOMM="Supply Item",PSOCHG=0,PSOOLD="Copay",PSONW="No Copay",PSOCHG=0 Q
 K PSOTG
 N EXMT
 D XTYPE
 F EXMT="SC" I $D(PSOTG(EXMT)) D  I 'PSOCHG Q
 . I PSOTG(EXMT)=1 S PSOCHG=0 S PSOCOMM="Service Connected"
 I 'PSOCHG S PSOOLD="Copay",PSONW="No Copay" Q
 ;
 ; If any of the applicable exemption questions have never been answered, generate a mail message with all of the questions
 S EXMT="",MAILMSG=0 F  S EXMT=$O(PSOTG(EXMT)) Q:EXMT=""  I PSOTG(EXMT)="" S MAILMSG=1 Q
 I MAILMSG,$D(PSOTG("SC")) I $G(PSOTG("SC"))="" S PSOCHG=2 ; 'SC' question not answered, don't reset copay status to 'copay'
 Q
 ;
XTYPE ;
 N PSOCIBQ,PSOSCMX,Y,I,J,X,SAVY
 S (X,PSOSCMX,SAVY)=""
 S PSOCIBQ=$G(^PSRX(RXP,"IBQ"))
 I $P(PSOCIBQ,"^",1)'="" S PSOTG("SC")=$P(PSOCIBQ,"^",1)
 I $D(PSOTG("SC")),$P(PSOCIBQ,"^",1)="" S PSOTG("SC")="" ; USE "CURRENT" SETTING AS ANSWER TO SERVICE CONNECTED QUESTION IF IT APPLIES
 S J=0 F  S J=$O(^PS(59,J)) Q:'J  I +$G(^(J,"IB")) S X=+^("IB") Q
 I 'X Q
 S X=X_"^"_PSOCPN D XTYPE^IBARX
 I $G(Y)'=1 Q
 S J="" F  S J=$O(Y(J)) Q:'J  S I="" F  S SAVY=I,I=$O(Y(J,I)) Q:I=""  S:I>0 PSOSCMX=I
 I PSOSCMX="",SAVY=0 S PSOCHG=0 S PSOCOMM="Exempt from copayment" Q  ; INCOME EXEMPT OR SERVICE-CONNECTED
 I PSOSCMX=2,'$D(PSOTG("SC")) S PSOTG("SC")=$S(($G(RXP)&($P($G(^PSRX(+$G(RXP),"IB")),"^")))!($P(PSOCIBQ,"^")=0):0,$P(PSOCIBQ,"^")=1:1,1:"") Q
 Q
 ;