- Timestamp:
- Dec 4, 2009, 12:11:15 AM (14 years ago)
- File:
-
- 1 edited
Legend:
- Unmodified
- Added
- Removed
-
WorldVistAEHR/trunk/r/ACCOUNTS_RECEIVABLE-PRCA-PRY-RC/RCDPESR6.m
r613 r623 1 RCDPESR6 ;ALB/TMK - Server auto-update file 344.4 - EDI Lockbox ;10/29/02 2 ;;4.5;Accounts Receivable;**173,214,208,230,252**;Mar 20, 1995;Build 63 3 ;;Per VHA Directive 2004-038, this routine should not be modified. 4 ; 5 UPD3444(RCRTOT) ; Add EOB detail to list in 344.41 for file 344.4 entry RCRTOT 6 ; If passed by reference, RCRTOT is returned = "" if errors 7 ; 8 N RC,RCCOM1,RCCOM2,RCCT,RC1,RC2,RCDPNM,RCEOB,RCNPI1,RCNPI2,DA,DR,DO,DD,DLAYGO,DIC,DIK,X,Y,Z 9 S RC=0 F S RC=$O(^TMP($J,"RCDPEOB",RC)) Q:'RC S RC1=$G(^(RC)),RC2=$G(^(RC,"EOB")),RCEOB=+RC2 D Q:'RCRTOT 10 . ; Upd 344.41 with reference to this record if it doesn't already exist 11 . I RCEOB>0 Q:$D(^RCY(344.4,RCRTOT,1,"AC",RCEOB,RC)) 12 . I RCEOB'>0,$S($P(RC1,U,2)'="":$D(^RCY(344.4,RCRTOT,1,"AD",$P(RC1,U,2),RC)),1:0) Q 13 . ; Disregard ECME reject related EEOBs 14 . I RCEOB'>0,'$P(RC2,U,2),$P(RC1,U,2)?1.7N,$$REJECT^IBNCPDPU($P(RC1,U,2),$P(RC1,U,3)) Q 15 . S DA(1)=RCRTOT,X=RC,DIC="^RCY(344.4,"_DA(1)_",1,",DIC(0)="L",DLAYGO=344.41 16 . S DIC("DR")=$S($G(RCEOB)>0:".02////"_RCEOB,1:".05////"_$P(RC1,U,2)_";.07////1") 17 . I $P(RC2,U,2)'="" S DIC("DR")=DIC("DR")_$S($L(DIC("DR")):";",1:"")_".03///"_$P(RC2,U,2) ; amt 18 . I $P(RC2,U,3)'="" S DIC("DR")=DIC("DR")_$S($L(DIC("DR")):";",1:"")_".04////"_$P(RC2,U,3) ; ins co 19 . I $P(RC2,U,4) S DIC("DR")=DIC("DR")_$S($L(DIC("DR")):";",1:"")_".14////1" ; reversal 20 . I $P(RC2,U,5)'="" S DIC("DR")=DIC("DR")_$S($L(DIC("DR")):";",1:"")_".15////^S X=$E($P(RC2,U,5),1,30)" ; Patient name 21 . ; Process Billing Prov NPI, Rendering/Servicing NPI & name 22 . S (RCCOM1,RCCOM2)="" 23 . S RCNPI1=$P(RC2,U,10),RCNPI2=$P(RC2,U,11) 24 . I RCNPI1'="",'$$CHKDGT^XUSNPI(RCNPI1) S RCCOM1="The Billing Provider NPI received on the 835 ("_$E(RCNPI1,1,10)_") is not a valid format." 25 . I RCNPI2'="",'$$CHKDGT^XUSNPI(RCNPI2) S RCCOM2="The "_$S($P(RC2,U,12)=1:"Rendering",1:"Servicing")_" NPI received on the 835 ("_$E(RCNPI2,1,10)_") is not a valid format." 26 . I RCCOM1="" S DIC("DR")=DIC("DR")_";.18////^S X=$P(RC2,U,10)" ;Billing Provider NPI 27 . I RCCOM2="" S DIC("DR")=DIC("DR")_";.19////^S X=$P(RC2,U,11)" ;Rendering Provider NPI 28 . S RCDPNM=$P(RC2,U,13) I $P(RC2,U,14)]"" S RCDPNM=RCDPNM_$S(RCDPNM]"":",",1:"")_$P(RC2,U,14) 29 . S DIC("DR")=DIC("DR")_";.2////^S X=$P(RC2,U,12);.21////^S X=RCDPNM" ; Entity Type Qualifier ^ Last name,First Name 30 . S DIC("DR")=DIC("DR")_";.22////^S X=RCCOM1;.23////^S X=RCCOM2" ;Comment on Billing provider^comment on rendering/servicing provider NPI 31 . D FILE^DICN K DO,DD,DLAYGO,DIC,DIK 32 . S RCCT=+Y 33 . I RCCT<0 D Q 34 .. S DA=RCRTOT,DIK="^RCY(344.4," D ^DIK 35 .. S RCRTOT=0 36 . ; If there is no IB EOB record, store the raw data in 344.411 37 . I RC1'>0!(RCEOB'>0) D 38 .. N RCDATA,RCC,RCDA 39 .. S RCC=2,RCDATA(1)=$G(^TMP($J,"RCDPEOB","HDR")) 40 .. S Z=0 F S Z=$O(^TMP($J,"RCDPEOB",RCCT,Z)) Q:'Z S RCC=RCC+1,RCDATA(RCC)=$G(^TMP($J,"RCDPEOB",RCCT,Z)) 41 .. S RCDA(1)=RCRTOT,RCDA=RCCT 42 .. D WP^DIE(344.41,$$IENS^DILF(.RCDA),1,"A","RCDATA") 43 Q 44 ; 45 ; 46 ERATOT(RCTDA,RCERR) ; File ERA TOTAL rec in 344.4 from entry RCTDA in 344.5 47 ; RCTDA = ien file 344.5 48 ; Returns: the ien file 344.4 49 ; RCERR if passed by reference, with error text 50 ; RCERR(1)=duplicated message 51 N RCTYPE,RCDA,RCMETH,RCTRACE,RCID,RCDT,RCAMT,RCDUP,RCZ,RCX,RCPAYER,DIE,DIK,DIC,DLAYGO,DD,DO,DR,DA,X,Y,Z0,Z1 52 S (RCERR,RCDA)="" 53 S RCZ=$G(^RCY(344.5,RCTDA,2,1,0)) 54 S RCTYPE=$P(RCZ,U),RCTRACE=$P(RCZ,U,8),RCID=$P(RCZ,U,7),RCPAYER=$P(RCZ,U,6),RCMETH=$P(RCZ,U,17) 55 ; Need header record as first entry in field 56 I RCTYPE'["835ERA" S RCERR="No header record found in message. An EEOB exception record was created" G ERATOTQ 57 ; 58 S RCDT=$$FMDT^RCDPESR1($P(RCZ,U,9)),RCAMT=$J(($P(RCZ,U,10)/100),0,2) 59 ;Elec ERA's must have a trace # and an ins co id 60 I RCTRACE=""!(RCID="") S RCERR="Trace # or ins ID missing on ERA transaction. An EEOB exception record was created." G ERATOTQ 61 ; Make sure it's not already there 62 S (RCDUP,Z1)=0 63 F S Z1=$O(^RCY(344.4,"ATRID",RCTRACE,RCID,Z1)) Q:'Z1 S Z0=$G(^RCY(344.4,Z1,0)) I $P(Z0,U,4)=RCDT,+$P(Z0,U,5)=+RCAMT S RCDUP=1 Q 64 ; 65 I RCDUP,$P(Z0,U,8) D G ERATOTQ ; Receipt already exists - no update 66 . S RCERR="This is a duplicate ERA and has already been posted",RCERR(1)=-2 67 I RCDUP S RCERR="DUP",RCERR(1)=$S($P(Z0,U,12)'=$P($G(^RCY(344.5,RCTDA,0)),U,11):$P(Z0,U,12),1:-1) G ERATOTQ 68 ; 69 S RCX=+$O(^RCY(344.4," "),-1) 70 S DIC(0)="L",DIC="^RCY(344.4,",DLAYGO=344.4 71 S DIC("DR")=".02////"_RCTRACE_";.03////"_RCID_";.04////"_RCDT_";.05////"_RCAMT_";.06////"_$P(RCZ,U,6)_";.09////0;.12////"_$P($G(^RCY(344.5,RCTDA,0)),U,11)_";.07////"_$$NOW^XLFDT()_";.1////1" 72 I RCMETH'="" S DIC("DR")=DIC("DR")_";.15////"_RCMETH 73 F RCX=RCX+1:1 L +^RCY(344.4,RCX,0):1 I $T,'$D(^RCY(344.4,RCX,0)) S X=RCX Q 74 D FILE^DICN K DO,DLAYGO,DD,DIC 75 L -^RCY(344.4,RCX,0) 76 S RCDA=$S(Y<0:"",1:+Y) 77 I 'RCDA D 78 . S RCERR="An error was encountered that prevented the adding of an ERA totals record. An EEOB exception record was created." 79 ; 80 ERATOTQ Q RCDA 81 ; 82 UPDCON(RCRTOT) ; Add contact information to file 344.4 for an ERA 83 N DIE,DA,DR,Z,Q,X,Y 84 S Z=$G(^TMP($J,"RCDPEOB","CONTACT")) 85 Q:$TR($P(Z,U,3,9),U)="" 86 S DA=RCRTOT,DIE="^RCY(344.4,",DR="" 87 F Q=3:1:9 S DR=DR_$S(DR'="":";3.0",1:"3.0")_(Q-2)_"///"_$S($P(Z,U,Q)="":"@",1:"/"_$P(Z,U,Q)) 88 D ^DIE 89 Q 90 ; 91 UPDADJ(RCRTOT) ; Add ERA level adj data to file 344.4 92 N Z,Z0,DA,DIC,DLAYGO,DR,X,Y,DO,DD 93 ; Remove any already there 94 S Z=0 F S Z=$O(^RCY(344.4,RCRTOT,2,Z)) Q:'Z S DA(1)=RCRTOT,DA=Z D ^DIK 95 ; 96 S Z=0 F S Z=$O(^TMP($J,"RCDPEOB","ADJ",Z)) Q:'Z S Z0=$G(^(Z)) D 97 . S DIC(0)="L",X=$P(Z0,U,3)_" ",DA(1)=RCRTOT,DIC="^RCY(344.4,"_DA(1)_",2,",DIC("DR")=$S($P(Z0,U,2)'="":".02////"_$P(Z0,U,2),1:"") 98 . S DIC("DR")=DIC("DR")_$S(DIC("DR")'="":";",1:"")_$S($P(Z0,U,4)'="":".03////"_$J(-$P(Z0,U,4)/100,"",2),1:"") 99 . S DIC("DR")=DIC("DR")_$S(DIC("DR")'="":";",1:"")_$S($P(Z0,U,5)'="":".04////"_$P(Z0,U,5),1:""),DLAYGO=344.42 100 . S:$O(^RCY(344.4,RCRTOT,2,"B",X,0)) X=""""_X_"""" 101 . D FILE^DICN K DIC,DO,DD 102 Q 103 ; 104 DUPREC(RCET,RCCT,RCSTAR,RCFILE,RCALLDUP,RCEOB,RCBILL,RCDUPEOB) ; Overflow from RCDPESR2 105 S ^TMP("RCERR1",$J,RCCT)=" ",^TMP("RCERR1",$J,RCCT,1)=RCET_RCCT_RCSTAR 106 S ^TMP("RCERR1",$J,RCCT,2)="(Warning): EEOB detail already filed for "_RCBILL_" - "_$S(RCALLDUP:"Duplicate not stored",1:"EEOB updated"),^TMP("RCERR1",$J,RCCT,3)=" " S:RCFILE=5 ^TMP("RCERR1",$J,RCCT,"*")=^TMP("RCERR1",$J,RCCT,2) 107 I RCALLDUP S RCEOB="",RCDUPEOB=-1 Q 108 S $P(^TMP($J,"RCDPEOB",RCCT,"EOB"),U)=RCEOB 109 Q 110 ; 1 RCDPESR6 ;ALB/TMK - Server auto-update file 344.4 - EDI Lockbox ;10/29/02 2 ;;4.5;Accounts Receivable;**173,214,208,230**;Mar 20, 1995 3 ;;Per VHA Directive 10-93-142, this routine should not be modified. 4 ; 5 UPD3444(RCRTOT) ; Add EOB detail to list in 344.41 for file 344.4 entry RCRTOT 6 ; If passed by reference, RCRTOT is returned = "" if errors 7 ; 8 N RC,RCCT,RC1,RC2,RCEOB,DA,DR,DO,DD,DLAYGO,DIC,DIK,X,Y,Z 9 S RC=0 F S RC=$O(^TMP($J,"RCDPEOB",RC)) Q:'RC S RC1=$G(^(RC)),RC2=$G(^(RC,"EOB")),RCEOB=+RC2 D Q:'RCRTOT 10 . ; Upd 344.41 with reference to this record if it doesn't already exist 11 . I RCEOB>0 Q:$D(^RCY(344.4,RCRTOT,1,"AC",RCEOB,RC)) 12 . I RCEOB'>0,$S($P(RC1,U,2)'="":$D(^RCY(344.4,RCRTOT,1,"AD",$P(RC1,U,2),RC)),1:0) Q 13 . ; Disregard ECME reject related EEOBs 14 . I RCEOB'>0,'$P(RC2,U,2),$P(RC1,U,2)?1.7N,$$REJECT^IBNCPDPU($P(RC1,U,2),$P(RC1,U,3)) Q 15 . S DA(1)=RCRTOT,X=RC,DIC="^RCY(344.4,"_DA(1)_",1,",DIC(0)="L",DLAYGO=344.41 16 . S DIC("DR")=$S($G(RCEOB)>0:".02////"_RCEOB,1:".05////"_$P(RC1,U,2)_";.07////1") 17 . I $P(RC2,U,2)'="" S DIC("DR")=DIC("DR")_$S($L(DIC("DR")):";",1:"")_".03///"_$P(RC2,U,2) ; amt 18 . I $P(RC2,U,3)'="" S DIC("DR")=DIC("DR")_$S($L(DIC("DR")):";",1:"")_".04////"_$P(RC2,U,3) ; ins co 19 . I $P(RC2,U,4) S DIC("DR")=DIC("DR")_$S($L(DIC("DR")):";",1:"")_".14////1" ; reversal 20 . I $P(RC2,U,5)'="" S DIC("DR")=DIC("DR")_$S($L(DIC("DR")):";",1:"")_".15////^S X=$E($P(RC2,U,5),1,30)" ; Patient name 21 . D FILE^DICN K DO,DD,DLAYGO,DIC,DIK 22 . S RCCT=+Y 23 . I RCCT<0 D Q 24 .. S DA=RCRTOT,DIK="^RCY(344.4," D ^DIK 25 .. S RCRTOT=0 26 . ; If there is no IB EOB record, store the raw data in 344.411 27 . I RC1'>0!(RCEOB'>0) D 28 .. N RCDATA,RCC,RCDA 29 .. S RCC=2,RCDATA(1)=$G(^TMP($J,"RCDPEOB","HDR")) 30 .. S Z=0 F S Z=$O(^TMP($J,"RCDPEOB",RCCT,Z)) Q:'Z S RCC=RCC+1,RCDATA(RCC)=$G(^TMP($J,"RCDPEOB",RCCT,Z)) 31 .. S RCDA(1)=RCRTOT,RCDA=RCCT 32 .. D WP^DIE(344.41,$$IENS^DILF(.RCDA),1,"A","RCDATA") 33 Q 34 ; 35 ; 36 ERATOT(RCTDA,RCERR) ; File ERA TOTAL rec in 344.4 from entry RCTDA in 344.5 37 ; RCTDA = ien file 344.5 38 ; Returns: the ien file 344.4 39 ; RCERR if passed by reference, with error text 40 ; RCERR(1)=duplicated message 41 N RCTYPE,RCDA,RCMETH,RCTRACE,RCID,RCDT,RCAMT,RCDUP,RCZ,RCX,RCPAYER,DIE,DIK,DIC,DLAYGO,DD,DO,DR,DA,X,Y,Z0,Z1 42 S (RCERR,RCDA)="" 43 S RCZ=$G(^RCY(344.5,RCTDA,2,1,0)) 44 S RCTYPE=$P(RCZ,U),RCTRACE=$P(RCZ,U,8),RCID=$P(RCZ,U,7),RCPAYER=$P(RCZ,U,6),RCMETH=$P(RCZ,U,17) 45 ; Need header record as first entry in field 46 I RCTYPE'["835ERA" S RCERR="No header record found in message. An EEOB exception record was created" G ERATOTQ 47 ; 48 S RCDT=$$FMDT^RCDPESR1($P(RCZ,U,9)),RCAMT=$J(($P(RCZ,U,10)/100),0,2) 49 ;Elec ERA's must have a trace # and an ins co id 50 I RCTRACE=""!(RCID="") S RCERR="Trace # or ins ID missing on ERA transaction. An EEOB exception record was created." G ERATOTQ 51 ; Make sure it's not already there 52 S (RCDUP,Z1)=0 53 F S Z1=$O(^RCY(344.4,"ATRID",RCTRACE,RCID,Z1)) Q:'Z1 S Z0=$G(^RCY(344.4,Z1,0)) I $P(Z0,U,4)=RCDT,+$P(Z0,U,5)=+RCAMT S RCDUP=1 Q 54 ; 55 I RCDUP,$P(Z0,U,8) D G ERATOTQ ; Receipt already exists - no update 56 . S RCERR="This is a duplicate ERA and has already been posted",RCERR(1)=-2 57 I RCDUP S RCERR="DUP",RCERR(1)=$S($P(Z0,U,12)'=$P($G(^RCY(344.5,RCTDA,0)),U,11):$P(Z0,U,12),1:-1) G ERATOTQ 58 ; 59 S RCX=+$O(^RCY(344.4," "),-1) 60 S DIC(0)="L",DIC="^RCY(344.4,",DLAYGO=344.4 61 S DIC("DR")=".02////"_RCTRACE_";.03////"_RCID_";.04////"_RCDT_";.05////"_RCAMT_";.06////"_$P(RCZ,U,6)_";.09////0;.12////"_$P($G(^RCY(344.5,RCTDA,0)),U,11)_";.07////"_$$NOW^XLFDT()_";.1////1" 62 I RCMETH'="" S DIC("DR")=DIC("DR")_";.15////"_RCMETH 63 F RCX=RCX+1:1 L +^RCY(344.4,RCX,0):1 I $T,'$D(^RCY(344.4,RCX,0)) S X=RCX Q 64 D FILE^DICN K DO,DLAYGO,DD,DIC 65 L -^RCY(344.4,RCX,0) 66 S RCDA=$S(Y<0:"",1:+Y) 67 I 'RCDA D 68 . S RCERR="An error was encountered that prevented the adding of an ERA totals record. An EEOB exception record was created." 69 ; 70 ERATOTQ Q RCDA 71 ; 72 UPDCON(RCRTOT) ; Add contact information to file 344.4 for an ERA 73 N DIE,DA,DR,Z,Q,X,Y 74 S Z=$G(^TMP($J,"RCDPEOB","CONTACT")) 75 Q:$TR($P(Z,U,3,9),U)="" 76 S DA=RCRTOT,DIE="^RCY(344.4,",DR="" 77 F Q=3:1:9 S DR=DR_$S(DR'="":";3.0",1:"3.0")_(Q-2)_"///"_$S($P(Z,U,Q)="":"@",1:"/"_$P(Z,U,Q)) 78 D ^DIE 79 Q 80 ; 81 UPDADJ(RCRTOT) ; Add ERA level adj data to file 344.4 82 N Z,Z0,DA,DIC,DLAYGO,DR,X,Y,DO,DD 83 ; Remove any already there 84 S Z=0 F S Z=$O(^RCY(344.4,RCRTOT,2,Z)) Q:'Z S DA(1)=RCRTOT,DA=Z D ^DIK 85 ; 86 S Z=0 F S Z=$O(^TMP($J,"RCDPEOB","ADJ",Z)) Q:'Z S Z0=$G(^(Z)) D 87 . S DIC(0)="L",X=$P(Z0,U,3)_" ",DA(1)=RCRTOT,DIC="^RCY(344.4,"_DA(1)_",2,",DIC("DR")=$S($P(Z0,U,2)'="":".02////"_$P(Z0,U,2),1:"") 88 . S DIC("DR")=DIC("DR")_$S(DIC("DR")'="":";",1:"")_$S($P(Z0,U,4)'="":".03////"_$J(-$P(Z0,U,4)/100,"",2),1:"") 89 . S DIC("DR")=DIC("DR")_$S(DIC("DR")'="":";",1:"")_$S($P(Z0,U,5)'="":".04////"_$P(Z0,U,5),1:""),DLAYGO=344.42 90 . S:$O(^RCY(344.4,RCRTOT,2,"B",X,0)) X=""""_X_"""" 91 . D FILE^DICN K DIC,DO,DD 92 Q 93 ; 94 DUPREC(RCET,RCCT,RCSTAR,RCFILE,RCALLDUP,RCEOB,RCBILL,RCDUPEOB) ; Overflow from RCDPESR2 95 S ^TMP("RCERR1",$J,RCCT)=" ",^TMP("RCERR1",$J,RCCT,1)=RCET_RCCT_RCSTAR 96 S ^TMP("RCERR1",$J,RCCT,2)="(Warning): EEOB detail already filed for "_RCBILL_" - "_$S(RCALLDUP:"Duplicate not stored",1:"EEOB updated"),^TMP("RCERR1",$J,RCCT,3)=" " S:RCFILE=5 ^TMP("RCERR1",$J,RCCT,"*")=^TMP("RCERR1",$J,RCCT,2) 97 I RCALLDUP S RCEOB="",RCDUPEOB=-1 Q 98 S $P(^TMP($J,"RCDPEOB",RCCT,"EOB"),U)=RCEOB 99 Q 100 ;
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