1 | VAFHLIN1 ;ALB/KCL/SCK/PHH - CREATE HL7 INSURANCE (IN1) SEGMENT ; 02/09/2007
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2 | ;;5.3;Registration;**122,190,670,740**;Aug 13, 1993;Build 2
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3 | ;
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4 | ;
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5 | ; This generic function was designed to return the HL7 IN1 (Insurance)
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6 | ; segment. This segment contains VA-specific patient insurance
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7 | ; information. (All active insurance data for a patient including
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8 | ; those insurance carriers that do not reimburse the VA i.e Medicare)
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9 | ;
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10 | ; SCK - modified for Insurance Encapsulation API
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11 | ; 1. The Insurance API does not currently support the Pre-Certification flag
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12 | ; in the IN1 segment, Field 28. No value will be returned for field 28.
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13 | ; 2. The Insurance API does not support Line 2 or Line 3 of the address.
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14 | ; The API returns a single address line.
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15 | ;
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16 | EN(DFN,VAFSTR,VAFHLQ,VAFHLFS,VAFARRY) ; --
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17 | ; Entry point to return HL7 IN1 segments.
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18 | ;
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19 | ; Input:
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20 | ; DFN - internal entry number of the PATIENT (#2) file.
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21 | ; VAFSTR - (optional) string of fields requested seperated
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22 | ; by commas. If not passed, return all data fields.
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23 | ; VAFHLQ - (optional) HL7 null variable.
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24 | ; VAFHLFS - (optional) HL7 field separator.
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25 | ; VAFARRY - (optional) user-supplied array name which will hold
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26 | ; HL7 IN1 segments. Otherwise, ^TMP("VAFIN1",$J) will
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27 | ; be used.
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28 | ;
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29 | ; Output:
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30 | ; Array of HL7 IN1 segments
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31 | ;
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32 | N VAFGRP,VAFI,VAFIDX,VAFINS,VAFNODE,VAFPHN,VAFY,VAF36,X,VAFX,VAFTMP
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33 | S VAFARRY=$G(VAFARRY),VAFIDX=0
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34 | ;
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35 | ; if VAFARRY not defined, use ^TMP("VAFIN1",$J)
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36 | S:(VAFARRY="") VAFARRY="^TMP(""VAFIN1"",$J)"
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37 | ;
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38 | ; if VAFHLQ or VAFHLFS not passed, use default HL7 variables
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39 | S VAFHLQ=$S($D(VAFHLQ):VAFHLQ,1:$G(HLQ)),VAFHLFS=$S($D(VAFHLFS):VAFHLFS,1:$G(HLFS))
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40 | ;
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41 | ; if DFN not passed, exit
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42 | I '$G(DFN) S @VAFARRY@(1,0)="IN1"_VAFHLFS_1 G ENQ
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43 | ;
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44 | ; find all insurance data for a patient (IB SUPPORTED CALL)
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45 | ; This uses the Encapsulated Insurance API to retrieve data into an array
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46 | ; See IB*2*267 Release Notes v1.0 for flags and array ID's
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47 | S VAFX=$$INSUR^IBBAPI(DFN,,"R",.VAFTMP,"*")
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48 | ;
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49 | ; if no active insurance on file for patient, build IN1
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50 | I VAFX'=1 D
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51 | .; Build a null array if no insurance data returned
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52 | . F VAFI=1:1:22 S VAFINS(1,VAFI)=""
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53 | .; Merge array to remove first two nodes to simplify handling
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54 | E M VAFINS=VAFTMP("IBBAPI","INSUR")
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55 | ;
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56 | ALL ; get all active insurance for patient
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57 | F VAFI=0:0 S VAFI=$O(VAFINS(VAFI)) Q:'VAFI D
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58 | .D BUILD
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59 | ;
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60 | ENQ Q
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61 | ;
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62 | ;
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63 | BUILD ; Build array of HL7 (IN1) segments
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64 | S $P(VAFY,VAFHLFS,36)="",VAFIDX=VAFIDX+1
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65 | ;
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66 | ; if VAFSTR not passed, return all data fields
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67 | I $G(VAFSTR)']"" S VAFSTR="4,5,7,8,9,12,13,15,16,17,28,36"
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68 | S VAFSTR=","_VAFSTR_","
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69 | ;
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70 | ; sequential number (required field)
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71 | S $P(VAFY,VAFHLFS,1)=VAFIDX
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72 | ;
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73 | ; build HL7 (IN1) segment fields
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74 | I VAFSTR[",3," S $P(VAFY,VAFHLFS,3)=+$P(VAFINS(VAFI,1),U) ;Insurance company IEN (P-190)
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75 | I VAFSTR[",4," S $P(VAFY,VAFHLFS,4)=$S($P(VAFINS(VAFI,1),U,2)]"":$P(VAFINS(VAFI,1),U,2),1:VAFHLQ) ; Insurance Carrier Name
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76 | I VAFSTR[",5," S X=$$ADDR1(VAFI) S $P(VAFY,VAFHLFS,5)=$S(+X>0:X,1:VAFHLQ)
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77 | I VAFSTR[",7," S X=$$HLPHONE^HLFNC(VAFINS(VAFI,6)) S $P(VAFY,VAFHLFS,7)=$S(X]"":X,1:VAFHLQ) ; Insurance Co. Phone Number
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78 | I VAFSTR[",8," S $P(VAFY,VAFHLFS,8)=$S(VAFINS(VAFI,18)]"":VAFINS(VAFI,18),1:VAFHLQ) ; Group Number
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79 | I VAFSTR[",9," S $P(VAFY,VAFHLFS,9)=$S($P(VAFINS(VAFI,8),U,2)]"":$P(VAFINS(VAFI,8),U,2),1:VAFHLQ) ; Group Name ** The Insurance Encapsulation API doesnot return a "Group" Name, this field will display the Policy Name returned by the API
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80 | I VAFSTR[",12," S X=$$HLDATE^HLFNC(VAFINS(VAFI,10)) S $P(VAFY,VAFHLFS,12)=$S(X]"":X,1:VAFHLQ) ; Policy Effective Date
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81 | I VAFSTR[",13," S X=$$HLDATE^HLFNC(VAFINS(VAFI,11)) S $P(VAFY,VAFHLFS,13)=$S(X]"":X,1:VAFHLQ) ; Policy Expiration Date
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82 | I VAFSTR[",15," S $P(VAFY,VAFHLFS,15)=$S(+$P($G(VAFINS(VAFI,21)),"^")>0:+$P(VAFINS(VAFI,21),"^"),1:VAFHLQ) ; Plan Type (ptr. to Type of Plan (#355.1) file)
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83 | I VAFSTR[",16," S $P(VAFY,VAFHLFS,16)=$S(VAFINS(VAFI,13)]"":VAFINS(VAFI,13),1:VAFHLQ) ; Name of Insured
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84 | I VAFSTR[",17," S X=$$WHOSE($P(VAFINS(VAFI,12),U)) S $P(VAFY,VAFHLFS,17)=$S(X]"":X,1:VAFHLQ) ; Whose Insurance
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85 | ;I VAFSTR[",28," S $P(VAFY,VAFHLFS,28)=VAFHLQ ; $S($P(VAFGRP,"^",6)]"":$P(VAFGRP,"^",6),1:VAFHLQ) ; Is Pre-Certification Required?
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86 | I VAFSTR[",36," S $P(VAFY,VAFHLFS,36)=$S(VAFINS(VAFI,14)]"":VAFINS(VAFI,14),1:VAFHLQ) ; Subscriber ID
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87 | ;
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88 | ; set all active insurance policies into array
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89 | S @VAFARRY@(VAFIDX,0)="IN1"_VAFHLFS_$G(VAFY)
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90 | Q
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91 | ;
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92 | WHOSE(VAFWHO) ; Format Subscriber relationship for HL7 conversion
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93 | ;
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94 | ; Input: Subscriber relationship from Insurance API, ID=12
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95 | ; P - Patient
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96 | ; S - Spouse
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97 | ; O - Other
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98 | ;
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99 | ; Output:
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100 | ; v - Veteran
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101 | ; s - Spouse
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102 | ; o - Other
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103 | ;
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104 | S:VAFWHO["P" VAFWHO="V"
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105 | Q $$LOW^XLFSTR(VAFWHO)
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106 | ;
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107 | ADDR1(VAFI) ; Format insurance company address from Insurance API for HL7 conversion.
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108 | ;
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109 | ; Input:
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110 | ; Index number for Insurance API array
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111 | ;
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112 | ; Output:
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113 | ; String in the form of the HL7 address field
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114 | ;
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115 | N VAFAD,VAFGL
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116 | S VAFAD=VAFINS(VAFI,2)
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117 | S VAFGL=VAFINS(VAFI,3)_"^"_$P(VAFINS(VAFI,4),U)_"^"_VAFINS(VAFI,5)
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118 | ;
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119 | ; convert DHCP address to HL7 format using HL7 utility
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120 | Q $$HLADDR^HLFNC(VAFAD,VAFGL)
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121 | ;
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122 | ADDR(VAFPTR) ; Format insurance company address for HL7 conversion
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123 | ; Retained for backword compatibility
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124 | ;
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125 | ; Input:
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126 | ; VAFPTR - pointer to Insurance Co. (#36) file
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127 | ;
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128 | ; Output:
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129 | ; String in the form of the HL7 address field
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130 | ;
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131 | N VAFAD,VAFADDR,VAFGL,VAFST
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132 | S VAFAD=""
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133 | ;
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134 | ; get (.11) node of Insurance Co. (#36) file
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135 | S VAFADDR=$G(^DIC(36,+VAFPTR,.11))
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136 | ;
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137 | ; 1st & 2nd street address lines
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138 | F VAFST=1,2 S VAFAD=VAFAD_"^"_$P(VAFADDR,"^",VAFST)
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139 | S VAFAD=$P(VAFAD,"^",2,99)
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140 | S VAFGL=$P(VAFADDR,"^",4) ; city
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141 | S VAFGL=VAFGL_"^"_$P(VAFADDR,"^",5) ; state
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142 | S VAFGL=VAFGL_"^"_$P(VAFADDR,"^",6) ; zip
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143 | ;
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144 | ; convert DHCP address to HL7 format using HL7 utility
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145 | Q $$HLADDR^HLFNC(VAFAD,VAFGL)
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