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| # | Location | File | Last Modified |
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| 1 | docs | TAS ePay US748 SDD - Copy.doc | Mon Oct 22 16:27:48 2018 UTC |
| 2 | docs | TAS ePay US748 SDD - Copy.doc | Mon Oct 22 16:32:11 2018 UTC |
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| 1 | MCCF EDI T AS US748 | |
| 2 | System Des ign Docume nt | |
| 3 | PRCA*4.5*x xx | |
| 4 | ||
| 5 | Department of Vetera ns Affairs | |
| 6 | July 2017 | |
| 7 | Version 1 | |
| 8 | User Story ID: US748 | |
| 9 | User Story Name: Di splay Perc ent Collec ted on Cla ims | |
| 10 | Sizing: | |
| 11 | Author: Ch ad Morriso n | |
| 12 | Story | |
| 13 | As an ePay ments user , I want t o view the percent t hat was co llected on claims. T he percent collected should po pulate on the EP Scr een. The p ercent sho uld calcul ate from t he Account Profile s creen so t hat users can view t he percent collected without h aving to v iew multip le screens . | |
| 14 | Conversati on | |
| 15 | 5/31/17 | |
| 16 | EP Screen is found u nder TPJI | |
| 17 | Percent pa id is alre ady on the AR Accoun t Profile screen, ne eds to car ry over to the EP ac tion | |
| 18 | Coordinate timing of implement ing this w ith eBilli ng (patche s) | |
| 19 | Revisit th is on 6/07 /17 so ePa y can disc uss this i nternally | |
| 20 | 6/7/17 | |
| 21 | Tanya to s end PPT wi th example to dev te am | |
| 22 | Chad to cr eate funct ional desi gn and acc eptance cr iteria fro m ppt and submit for approval | |
| 23 | ||
| 24 | 7/5/17 | |
| 25 | Confirm if %collecte d is %coll ected from payer (on EOB) or a ll payment s made for the claim (e.g. pat ient or se condary pa yer amount s) as per AR Account Profile s creen | |
| 26 | Summary | |
| 27 | Routine IB JTEP for e xisting TP JI menu op tion’s EP – ‘ERA/835 ’ action w ill be mod ified to d isplay an additional ‘% Collec ted’ field . | |
| 28 | Routine IB JTPE for t he EP -‘ER A/835’ ac tion sub-m enu action PR – ‘Pri nt EEOB’ w ill be mod ified to d isplay an additional ‘% Collec ted’ field . | |
| 29 | The ‘% Col lected’ va lue on fr om AR Prof ile Screen can be re trieved wi th a call to existin g function $$BILL^RC JIBFN2 whi ch is supp orted by a n existing private I A 1452. | |
| 30 | ePayments ERA/EEOB D ata Jul 14, 20 17@11:57:1 2 Page: 3 of 22 | |
| 31 | %K100005 HEINE,ALFO NSO LAWREN H8168 DO B: 07/15/1 944 Subsc ID: SUBSC ID 290613 | |
| 32 | Svc Date: 07/10/2000 Orig Amt : 186.66 ERA#: 92 754, 92762 | |
| 33 | + | |
| 34 | [susp ense] SUSP ENSE 86.66 | |
| 35 | [susp ense] SUSP ENSE 86.66 | |
| 36 | CLAIM LEVE L PAY STAT US: | |
| 37 | Total Su bmitted Ch arges : 186.66 Payer Cove red Amount : 186.66 | |
| 38 | Payer Pa id Amount : 186.66 MEDICARE A llowed Amo unt : 0.00 | |
| 39 | Patient Responsibi lity : 0.00 % Collecte d : 100% | |
| 40 | ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- | |
| 41 | CLAIM LEVE L ADJUSTME NTS: | |
| 42 | -- None -- | |
| 43 | CLAIM LEVE L REMARKS: | |
| 44 | -- None -- | |
| 45 | ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- | |
| 46 | + Enter ?? f or more ac tions >>> | |
| 47 | RX ECME I nformation CI Go to Clai m Screen VP Poli cy Benefit s | |
| 48 | AR Accoun t Profile BC Bill Charg es EL Pati ent Eligib ility | |
| 49 | CM Commen t History IR Insurance Reviews RP Rece ipt Profil e | |
| 50 | PE Print EEOB AD Additional 835 Data EX Exit | |
| 51 | Select Act ion: Next Screen// | |
| 52 | Note that the percen tage value calculate d includes all payme nts agains t the clai m, not jus t those re ported by the payer on the EEO B. | |
| 53 | ||
| 54 | Resolution – Added C hanged Obj ects | |
| 55 | RoutinesAc tivitiesRo utine Name IBJTEPEnha ncement Ca tegory New Modify De lete No Ch angeRTMRel ated Optio nsIBJ THIR D PARTY JO INT INQUIR Y | |
| 56 | Protocol - IBJT ERA 835 INFORM ATIONRelat ed Routine sRoutines “Called By ”Routines “Called” N/A$$FIND 1^DIC | |
| 57 | $$GET1^DIQ | |
| 58 | GETS^DIQ | |
| 59 | $$ADJU^IBJ TEP1 | |
| 60 | $$BILLN^IB JTEP1 | |
| 61 | EEOB^IBJTE P1 | |
| 62 | GETRX^IBJT EP1 | |
| 63 | RESORT^IBJ TEP1 | |
| 64 | $$EEOB^IBJ TLA1 | |
| 65 | $$BILLREJ^ IBJTU6 | |
| 66 | BILL^IBRFN 3 | |
| 67 | $$ECME^IBT RE | |
| 68 | $$BN1^PRCA FN | |
| 69 | EN^VALM | |
| 70 | CLEAR^VALM 1 | |
| 71 | CLEAN^VALM 10 | |
| 72 | SET^VALM10 | |
| 73 | $$FMTE^XLF DT | |
| 74 | $$CJ^XLFST R | |
| 75 | $$REPLACE^ XLFSTR | |
| 76 | $$TRIM^XLF STR | |
| 77 | DISP^XQORM 1 C urrent Log icINIT ; - - init var iables and list arra y | |
| 78 | N EPIEN,E PTN,ERAIEN ,EPARR,EPP CT,EOBCT,E OBMX,IBI,I BSHEOB,IBS PEOB,FL,LI NE,II,QQ,R CBAMT,RCRC ,RCOIN,RCD ED,RCERR,R CFLD,RMIEN ,RCRDC,RCR LN,RCXY,RC MD,IBEBERA ,IBRX,AQ,Z | |
| 79 | S EOBMX=0 | |
| 80 | S ERALST= "",$P(SP80 ," ",80)=" " | |
| 81 | ; IBIFN c omes in fr om the TPJ I screen a nd will be cleaned u p there | |
| 82 | I '$G(IBI FN) S VALM QUIT="" G INITQ | |
| 83 | K EPARR D BILL^IBRF N3(IBIFN,. EPARR) ; G et Bill in formation | |
| 84 | S EPBILL= EPARR("BN" ) ; K-Bill | |
| 85 | S EPPAT=$ $GET1^DIQ( 399,IBIFN_ ",",.02,"I ") ; Get P atient IEN | |
| 86 | S EPNM=$$ GET1^DIQ(3 99,IBIFN_" ,",.02) ; Get Patien t Name | |
| 87 | ; Get Tot al Charges and justi fy the amo unt | |
| 88 | S EPAMT=$ J(EPARR("T CG"),$L(EP ARR("TCG") ),2) | |
| 89 | S EPSS=$E (EPNM)_$$G ET1^DIQ(2, EPPAT_",", .364) ; Ge t Short SS N | |
| 90 | S EPDOB=$ $GET1^DIQ( 2,EPPAT_", ",.03) ; G et DOB | |
| 91 | S EPSID=$ P(EPARR("P IN"),U,6) ; Get Subs criber ID | |
| 92 | S EPDOS=$ $FMTE^XLFD T(EPARR("S TF"),"5DZ" ) ; Get Da te of Serv ice | |
| 93 | S:EPARR(" STF")'=EPA RR("STT") EPDOS=EPDO S_" - "_$$ FMTE^XLFDT (EPARR("ST T"),"5DZ") ; If Bill for date range | |
| 94 | ; Check t o see if w e may have an EEOB i f not repo rt no ERA Informatio n for this K-Bill | |
| 95 | S EPIEN=$ O(^IBM(361 .1,"B",$G( IBIFN),"") ) I EPIEN= "" S VALMC NT=2 D SET ^VALM10(1, " "),SET^V ALM10(2,"N o ERA Info rmation fo r Bill: "_ EPBILL) G INITQ | |
| 96 | ; Collect all possi ble EOBs a ssociated with this Claim | |
| 97 | S IBSHEOB =0,IBI=0 F S IBI=$O (^IBM(361. 1,"B",IBIF N,IBI)) Q: 'IBI S IB SHEOB=IBSH EOB+1,IBSH EOB(IBI)=0 | |
| 98 | ; Loop on the IEN f or the EEO Bs - exclu de MRAs, b ut include all insur ances | |
| 99 | S EPIEN=" ",LINE=0,E OBCT=0 F S EPIEN=$O (IBSHEOB(E PIEN)) Q:E PIEN="" D | |
| 100 | . Q:$P($G (^IBM(361. 1,EPIEN,0) ),U,4)=1 ; Get next because th is is an M RA | |
| 101 | . S EPTN= $$GET1^DIQ (361.1,EPI EN_",",.07 ),ERAIEN=$ O(^RCY(344 .4,"D",EPT N,"")) | |
| 102 | . Q:U_ERA LST_U[(U_E RAIEN_U) ; Quit if w e have alr eady repor ted this E RA # | |
| 103 | . S ERAIE N=ERAIEN_" ," K IBEPA R,IBPLB | |
| 104 | . D GETS^ DIQ(344.4, ERAIEN,".0 1;.02;.03; .04;.05;.0 6;.07;.08; .09;.1;.11 ;.12;.13;. 14;.15;4.0 2;","E","I BEPAR") | |
| 105 | . D GETS^ DIQ(344.4, ERAIEN,"2* ;","E","IB PLB") ; ER A Level Ad justments | |
| 106 | . Q:$D(IB EPAR)'>0 ; No IBEPAR - no data done with this reco rd. | |
| 107 | . S ERALS T=$$PUSH(E RALST,ERAI EN) S XLN= "ERA#: "_$ G(IBEPAR(" 344.4",ERA IEN,".01", "E")),XSP= $E(SP80,1, (22-$L(XLN ))) | |
| 108 | . S EPPCT =$S($G(EPA RR("TCG")) >0:($G(IBE PAR("344.4 ",ERAIEN," .05","E")) /EPARR("TC G"))*100,1 :0) | |
| 109 | . D SET(. LINE,"** E RA SUMMARY DATA ** " ) | |
| 110 | . D SET(. LINE,XLN_X SP_"TRACE# : "_$G(IBE PAR("344.4 ",ERAIEN," .02","E")) ) | |
| 111 | . ; Holdi ng onto th e line bel ow because the chang e of calcu lation | |
| 112 | . ; S XLN ="ERA DATE (PAYER): "_$G(IBEPA R("344.4", ERAIEN,".0 4","E"))_" TOTAL AMT PD: "_$J( $G(IBEPAR( "344.4",ER AIEN,".05" ,"E")),9)_ " % COLLEC TED: "_$J( EPPCT,6,2) | |
| 113 | . S XLN=" ERA DATE ( PAYER): "_ $G(IBEPAR( "344.4",ER AIEN,".04" ,"E"))_" T OTAL AMT P D: "_$J($G (IBEPAR("3 44.4",ERAI EN,".05"," E")),9) | |
| 114 | . D SET(. LINE,XLN) | |
| 115 | . D SET(. LINE,"PAYE R NAME/TIN : "_$G(IBE PAR("344.4 ",ERAIEN," .06","E")) _"/"_$G(IB EPAR("344. 4",ERAIEN, ".03","E") )) | |
| 116 | . D SET(. LINE,"FILE DATE/TIME : "_$G(IBE PAR("344.4 ",ERAIEN," .07","E")) ) | |
| 117 | . D SET(. LINE,"EFT MATCH STAT US: "_$G(I BEPAR("344 .4",ERAIEN ,".09","E" ))) | |
| 118 | . S XLN=" ERA TYPE: "_$G(IBEPA R("344.4", ERAIEN,".1 ","E")),XS P=$E(SP80, 1,(40-$L(X LN))) | |
| 119 | . D SET(. LINE,XLN_X SP_"INDIVI DUAL EOB C OUNT: "_$G (IBEPAR("3 44.4",ERAI EN,".11"," E"))) | |
| 120 | . S XLN=" MAIL MESSA GE: "_$G(I BEPAR("344 .4",ERAIEN ,".12","E" )),XSP=$E( SP80,1,(40 -$L(XLN))) | |
| 121 | . D SET(. LINE,XLN_X SP_"CHECK# : "_$G(IBE PAR("344.4 ",ERAIEN," .13","E")) ) | |
| 122 | . S XLN=" DETAIL POS T STATUS: "_$G(IBEPA R("344.4", ERAIEN,".1 4","E")),X SP=$E(SP80 ,1,(40-$L( XLN))) | |
| 123 | . D SET(. LINE,XLN_X SP_"EXPECT ED PAYMENT METHOD CO DE: "_$G(I BEPAR("344 .4",ERAIEN ,".15","E" ))) | |
| 124 | . D SET(. LINE," ") | |
| 125 | . D SET(. LINE,"**** ****** ERA LEVEL ADJ USTMENTS * *********" ) | |
| 126 | . I $D(IB PLB)=0 D S ET(.LINE," -- NONE - -") | |
| 127 | . D:$D(IB PLB)'=0 ; If we have PLB Data report it | |
| 128 | .. S FL=" ",RCF=0 F S FL=$O(I BPLB(344.4 2,FL)) Q:F L="" D | |
| 129 | ... I RCF '=0 D SET( .LINE," ") | |
| 130 | ... S RCF =RCF+1 | |
| 131 | ... S XLN =" ADJUSTM ENT REASON CODE: "_I BPLB(344.4 2,FL,.02," E"),XSP=$E (SP80,1,(4 5-$L(XLN)) ) | |
| 132 | ... I $G( IBPLB(344. 42,FL,.02, "E"))'="" S ACT=$$FI ND1^DIC(34 5.1,,"B",I BPLB(344.4 2,FL,.02," E")),ACT=$ $GET1^DIQ( 345.1,ACT, .05) | |
| 133 | ... D SET (.LINE,XLN _XSP_"ADJU STMENT AMO UNT: "_$J( IBPLB(344. 42,FL,.03, "E"),9)) | |
| 134 | ... D SET (.LINE," A DJUSTMENT CODE TEXT: "_ACT) | |
| 135 | ... D SET (.LINE," R EFERENCE: "_IBPLB(34 4.42,FL,.0 1,"E")) | |
| 136 | . D SET(. LINE," ") | |
| 137 | . K IBEBE RA S ZZEPI EN=EPIEN D EEOB^IBJT EP1("IBEBE RA",ERAIEN ,EPBILL,1) | |
| 138 | . F EOBCT =1:1:IBEBE RA D | |
| 139 | .. K IBEO B,IBGX,IBC L,IBDGCR,I BRX,IBSPL, IBEERR S E PIEN=$O(IB EBERA(EOBC T,"")) | |
| 140 | .. D GETS ^DIQ(361.1 ,EPIEN_"," ,".01;.02; .03;.04;.0 6;.14;1.01 ;1.02;1.03 ;1.1;1.11; 2.03;2.04; 3.03;3.04; 3.05;3.06; 3.07;","EI ","IBEOB") | |
| 141 | .. D GETS ^DIQ(361.1 ,EPIEN_"," ,"10*;","E I","IBGX") ,RESORT^IB JTEP1("IBG X",361.111 ),RESORT^I BJTEP1("IB GX",361.11 ) ; Claim Level Adju stments | |
| 142 | .. D GETS ^DIQ(361.1 ,EPIEN_"," ,"15*;","E I","IBCL") ; Line Le vel Adjust ments | |
| 143 | .. D GETS ^DIQ(361.1 ,EPIEN_"," ,"8*;","EI ","IBSPL") ; ERA Spl its for th is EEOB | |
| 144 | .. D GETS ^DIQ(361.1 ,EPIEN_"," ,"20;","", "IBEERR") ; EOB Erro rs if they exist | |
| 145 | .. ; Make it easier to walk t he data | |
| 146 | .. D RESO RT^IBJTEP1 ("IBCL",36 1.11511),R ESORT^IBJT EP1("IBCL" ,361.115), RESORT^IBJ TEP1("IBCL ",361.1151 ) | |
| 147 | .. D RESO RT^IBJTEP1 ("IBCL",36 1.1152),RE SORT^IBJTE P1("IBCL", 361.1154) | |
| 148 | .. D GETS ^DIQ(399,I BEOB(361.1 ,EPIEN_"," ,.01,"I")_ ",","460;" ,"EI","IBD GCR") | |
| 149 | .. D SET( .LINE,"*** ******* EO B/835 INFO RMATION (" _EOBCT_" o f "_IBEBER A_") ***** *****") | |
| 150 | .. S XLN= " EOB Type : "_$G(IBE OB("361.1" ,EPIEN_"," ,".04","E" )),XSP=$E( SP80,1,(40 -$L(XLN))) | |
| 151 | .. D SET( .LINE,XLN_ XSP_"EOB P aid Date: "_$G(IBEOB ("361.1",E PIEN_","," .06","E")) ) | |
| 152 | .. S TSDT =$$FMTE^XL FDT($G(IBE OB("361.1" ,EPIEN_"," ,"1.1","I" )),"2Z"),T EDT=$$FMTE ^XLFDT($G( IBEOB("361 .1",EPIEN_ ",","1.11" ,"I")),"2Z "),XLN=" S vc From Da te: "_TSDT ,XSP=$E(SP 80,1,(40-$ L(XLN))) | |
| 153 | .. D SET( .LINE,XLN_ XSP_"Svc t o Date: "_ TEDT) | |
| 154 | .. D SET( .LINE," IC N: "_$G(IB EOB("361.1 ",EPIEN_", ",".14","E "))) | |
| 155 | .. D SET( .LINE," Pa yer Name/T IN: "_$G(I BEOB("361. 1",EPIEN_" ,",".02"," E"))_"/"_$ G(IBEOB("3 61.1",EPIE N_",",".03 ","E"))) | |
| 156 | .. S XLN= " ERA #: " _$G(IBEPAR ("344.4",E RAIEN,".01 ","E")),XS P=$E(SP80, 1,(40-$L(X LN))) | |
| 157 | .. D SET( .LINE,XLN_ XSP_"Auto- Post Statu s: "_$G(IB EPAR("344. 4",ERAIEN, "4.02","E" ))) | |
| 158 | .. D SET( .LINE," Tr ace #: "_$ G(IBEPAR(" 344.4",ERA IEN,".02", "E"))) | |
| 159 | .. S TECM E=$P($G(IB DGCR(399,I BEOB(361.1 ,EPIEN_"," ,.01,"I")_ ",",460,"E ")),";",1) | |
| 160 | .. D GETR X^IBJTEP1( EPIEN,.IBR X) | |
| 161 | .. S TRX= $$GET1^DIQ (52,+TECME _",",".01" )_"/"_$G(I BRX("FILL" ))_"/"_$G( IBRX("RELE ASED STATU S")) | |
| 162 | .. I TECM E="" S TRX ="" | |
| 163 | .. S XLN= " ECME #: "_TECME,XS P=$E(SP80, 1,(25-$L(X LN))),XSP1 =$E(SP80,1 ,(39-$L(XL N_XSP_"DOS : "_$G(IBR X("DOS"))) )) | |
| 164 | .. D SET( .LINE,XLN_ XSP_"DOS: "_$G(IBRX( "DOS"))_XS P1_"Rx/Fil l/Release Status: "_ TRX) | |
| 165 | .. D SET( .LINE,"--- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------") | |
| 166 | .. D:$D(I BSPL)>1 ; This EEOB was split display sp lit paymen t informat ion | |
| 167 | ... N SPL | |
| 168 | ... D SET (.LINE,"** A/R CORRE CTED PAYME NT DATA:") | |
| 169 | ... D SET (.LINE," T OTAL AMT P D: "_$J(IB EOB(361.1, EPIEN_",", 1.01,"E"), 9,2)) | |
| 170 | ... S SPL ="" F S S PL=$O(IBSP L(361.18,S PL)) Q:SPL ="" D | |
| 171 | .... D SE T(.LINE," "_$S(IBSPL (361.18,SP L,.03,"I") '="":$$BN1 ^PRCAFN(IB SPL(361.18 ,SPL,.03," I"))_$J("" ,8),1:"[su spense] "_ IBSPL(361. 18,SPL,.01 ,"E"))_" " _$J(IBSPL( 361.18,SPL ,.02,"E"), 9,2)) | |
| 172 | ... D SET (.LINE," " ) | |
| 173 | .. D SET( .LINE,"CLA IM LEVEL P AY STATUS: ") | |
| 174 | .. D SET( .LINE," To tal Submit ted Charge s :"_$J($G (IBEOB("36 1.1",EPIEN _",","2.04 ","E")),11 ,2)_" Paye r Covered Amount :"_ $J($G(IBEO B("361.1", EPIEN_",", "1.03","E" )),11,2)) | |
| 175 | .. D SET( .LINE," Pa yer Paid A mount :"_$ J($G(IBEOB ("361.1",E PIEN_","," 1.01","E") ),11,2)_" MEDICARE A llowed Amo unt :"_$J( $G(IBEOB(" 361.1",EPI EN_",","2. 03","E")), 11,2)) | |
| 176 | .. D SET( .LINE," Pa tient Resp onsibility :"_$J($G( IBEOB("361 .1",EPIEN_ ",","1.02" ,"E")),11, 2)) | |
| 177 | .. D SET( .LINE,"--- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------") | |
| 178 | .. D SET( .LINE,"CLA IM LEVEL A DJUSTMENTS :") | |
| 179 | .. S AA=" ",ACNT=0 F S AA=$O( IBGX(361.1 1,AA)) Q:A A="" S AC NT=ACNT+1, AQ="" D | |
| 180 | ... S CC= AA F S CC =$O(IBGX(3 61.111,CC) ) Q:$E(CC, 1,$L(AA))' =AA DModi fied Logic (Changes are in bol d)INIT ; - - init var iables and list arra y | |
| 181 | N EPIEN,E PTN,ERAIEN ,EPARR,EPP CT,EOBCT,E OBMX,IBAR, IBI,IBCOL, IBSHEOB,IB SPEOB,FL,L INE,II,QQ, RCBAMT | |
| 182 | N RCRC,RC OIN,RCDED, RCERR,RCFL D,RMIEN,RC RDC,RCRLN, RCXY,RCMD, IBEBERA,IB RX,AQ,Z | |
| 183 | S EOBMX=0 | |
| 184 | S ERALST= "",$P(SP80 ," ",80)=" " | |
| 185 | ; IBIFN c omes in fr om the TPJ I screen a nd will be cleaned u p there | |
| 186 | I '$G(IBI FN) S VALM QUIT="" G INITQ | |
| 187 | K EPARR D BILL^IBRF N3(IBIFN,. EPARR) ; G et Bill in formation | |
| 188 | S EPBILL= EPARR("BN" ) ; K-Bill | |
| 189 | S EPPAT=$ $GET1^DIQ( 399,IBIFN_ ",",.02,"I ") ; Get P atient IEN | |
| 190 | S EPNM=$$ GET1^DIQ(3 99,IBIFN_" ,",.02) ; Get Patien t Name | |
| 191 | ; Get Tot al Charges and justi fy the amo unt | |
| 192 | S EPAMT=$ J(EPARR("T CG"),$L(EP ARR("TCG") ),2) | |
| 193 | S EPSS=$E (EPNM)_$$G ET1^DIQ(2, EPPAT_",", .364) ; Ge t Short SS N | |
| 194 | S EPDOB=$ $GET1^DIQ( 2,EPPAT_", ",.03) ; G et DOB | |
| 195 | S EPSID=$ P(EPARR("P IN"),U,6) ; Get Subs criber ID | |
| 196 | S EPDOS=$ $FMTE^XLFD T(EPARR("S TF"),"5DZ" ) ; Get Da te of Serv ice | |
| 197 | S:EPARR(" STF")'=EPA RR("STT") EPDOS=EPDO S_" - "_$$ FMTE^XLFDT (EPARR("ST T"),"5DZ") ; If Bill for date range | |
| 198 | ; Check t o see if w e may have an EEOB i f not repo rt no ERA Informatio n for this K-Bill | |
| 199 | S EPIEN=$ O(^IBM(361 .1,"B",$G( IBIFN),"") ) I EPIEN= "" S VALMC NT=2 D SET ^VALM10(1, " "),SET^V ALM10(2,"N o ERA Info rmation fo r Bill: "_ EPBILL) G INITQ | |
| 200 | ; Get % C ollected f rom AR cla im – IA 14 52 | |
| 201 | S IBAR=$$ BILL^RCJIB FN2(IBIFN) ,IBCOL=$P( IBAR,U,5) | |
| 202 | ; Collect all possi ble EOBs a ssociated with this Claim | |
| 203 | S IBSHEOB =0,IBI=0 F S IBI=$O (^IBM(361. 1,"B",IBIF N,IBI)) Q: 'IBI S IB SHEOB=IBSH EOB+1,IBSH EOB(IBI)=0 | |
| 204 | ; Loop on the IEN f or the EEO Bs - exclu de MRAs, b ut include all insur ances | |
| 205 | S EPIEN=" ",LINE=0,E OBCT=0 F S EPIEN=$O (IBSHEOB(E PIEN)) Q:E PIEN="" D | |
| 206 | . Q:$P($G (^IBM(361. 1,EPIEN,0) ),U,4)=1 ; Get next because th is is an M RA | |
| 207 | . S EPTN= $$GET1^DIQ (361.1,EPI EN_",",.07 ),ERAIEN=$ O(^RCY(344 .4,"D",EPT N,"")) | |
| 208 | . Q:U_ERA LST_U[(U_E RAIEN_U) ; Quit if w e have alr eady repor ted this E RA # | |
| 209 | . S ERAIE N=ERAIEN_" ," K IBEPA R,IBPLB | |
| 210 | . D GETS^ DIQ(344.4, ERAIEN,".0 1;.02;.03; .04;.05;.0 6;.07;.08; .09;.1;.11 ;.12;.13;. 14;.15;4.0 2;","E","I BEPAR") | |
| 211 | . D GETS^ DIQ(344.4, ERAIEN,"2* ;","E","IB PLB") ; ER A Level Ad justments | |
| 212 | . Q:$D(IB EPAR)'>0 ; No IBEPAR - no data done with this reco rd. | |
| 213 | . S ERALS T=$$PUSH(E RALST,ERAI EN) S XLN= "ERA#: "_$ G(IBEPAR(" 344.4",ERA IEN,".01", "E")),XSP= $E(SP80,1, (22-$L(XLN ))) | |
| 214 | . S EPPCT =$S($G(EPA RR("TCG")) >0:($G(IBE PAR("344.4 ",ERAIEN," .05","E")) /EPARR("TC G"))*100,1 :0) | |
| 215 | . D SET(. LINE,"** E RA SUMMARY DATA ** " ) | |
| 216 | . D SET(. LINE,XLN_X SP_"TRACE# : "_$G(IBE PAR("344.4 ",ERAIEN," .02","E")) ) | |
| 217 | . ; Holdi ng onto th e line bel ow because the chang e of calcu lation | |
| 218 | . ; S XLN ="ERA DATE (PAYER): "_$G(IBEPA R("344.4", ERAIEN,".0 4","E"))_" TOTAL AMT PD: "_$J( $G(IBEPAR( "344.4",ER AIEN,".05" ,"E")),9)_ " % COLLEC TED: "_$J( EPPCT,6,2) | |
| 219 | . S XLN=" ERA DATE ( PAYER): "_ $G(IBEPAR( "344.4",ER AIEN,".04" ,"E"))_" T OTAL AMT P D: "_$J($G (IBEPAR("3 44.4",ERAI EN,".05"," E")),9) | |
| 220 | . D SET(. LINE,XLN) | |
| 221 | . D SET(. LINE,"PAYE R NAME/TIN : "_$G(IBE PAR("344.4 ",ERAIEN," .06","E")) _"/"_$G(IB EPAR("344. 4",ERAIEN, ".03","E") )) | |
| 222 | . D SET(. LINE,"FILE DATE/TIME : "_$G(IBE PAR("344.4 ",ERAIEN," .07","E")) ) | |
| 223 | . D SET(. LINE,"EFT MATCH STAT US: "_$G(I BEPAR("344 .4",ERAIEN ,".09","E" ))) | |
| 224 | . S XLN=" ERA TYPE: "_$G(IBEPA R("344.4", ERAIEN,".1 ","E")),XS P=$E(SP80, 1,(40-$L(X LN))) | |
| 225 | . D SET(. LINE,XLN_X SP_"INDIVI DUAL EOB C OUNT: "_$G (IBEPAR("3 44.4",ERAI EN,".11"," E"))) | |
| 226 | . S XLN=" MAIL MESSA GE: "_$G(I BEPAR("344 .4",ERAIEN ,".12","E" )),XSP=$E( SP80,1,(40 -$L(XLN))) | |
| 227 | . D SET(. LINE,XLN_X SP_"CHECK# : "_$G(IBE PAR("344.4 ",ERAIEN," .13","E")) ) | |
| 228 | . S XLN=" DETAIL POS T STATUS: "_$G(IBEPA R("344.4", ERAIEN,".1 4","E")),X SP=$E(SP80 ,1,(40-$L( XLN))) | |
| 229 | . D SET(. LINE,XLN_X SP_"EXPECT ED PAYMENT METHOD CO DE: "_$G(I BEPAR("344 .4",ERAIEN ,".15","E" ))) | |
| 230 | . D SET(. LINE," ") | |
| 231 | . D SET(. LINE,"**** ****** ERA LEVEL ADJ USTMENTS * *********" ) | |
| 232 | . I $D(IB PLB)=0 D S ET(.LINE," -- NONE - -") | |
| 233 | . D:$D(IB PLB)'=0 ; If we have PLB Data report it | |
| 234 | .. S FL=" ",RCF=0 F S FL=$O(I BPLB(344.4 2,FL)) Q:F L="" D | |
| 235 | ... I RCF '=0 D SET( .LINE," ") | |
| 236 | ... S RCF =RCF+1 | |
| 237 | ... S XLN =" ADJUSTM ENT REASON CODE: "_I BPLB(344.4 2,FL,.02," E"),XSP=$E (SP80,1,(4 5-$L(XLN)) ) | |
| 238 | ... I $G( IBPLB(344. 42,FL,.02, "E"))'="" S ACT=$$FI ND1^DIC(34 5.1,,"B",I BPLB(344.4 2,FL,.02," E")),ACT=$ $GET1^DIQ( 345.1,ACT, .05) | |
| 239 | ... D SET (.LINE,XLN _XSP_"ADJU STMENT AMO UNT: "_$J( IBPLB(344. 42,FL,.03, "E"),9)) | |
| 240 | ... D SET (.LINE," A DJUSTMENT CODE TEXT: "_ACT) | |
| 241 | ... D SET (.LINE," R EFERENCE: "_IBPLB(34 4.42,FL,.0 1,"E")) | |
| 242 | . D SET(. LINE," ") | |
| 243 | . K IBEBE RA S ZZEPI EN=EPIEN D EEOB^IBJT EP1("IBEBE RA",ERAIEN ,EPBILL,1) | |
| 244 | . F EOBCT =1:1:IBEBE RA D | |
| 245 | .. K IBEO B,IBGX,IBC L,IBDGCR,I BRX,IBSPL, IBEERR S E PIEN=$O(IB EBERA(EOBC T,"")) | |
| 246 | .. D GETS ^DIQ(361.1 ,EPIEN_"," ,".01;.02; .03;.04;.0 6;.14;1.01 ;1.02;1.03 ;1.1;1.11; 2.03;2.04; 3.03;3.04; 3.05;3.06; 3.07;","EI ","IBEOB") | |
| 247 | .. D GETS ^DIQ(361.1 ,EPIEN_"," ,"10*;","E I","IBGX") ,RESORT^IB JTEP1("IBG X",361.111 ),RESORT^I BJTEP1("IB GX",361.11 ) ; Claim Level Adju stments | |
| 248 | .. D GETS ^DIQ(361.1 ,EPIEN_"," ,"15*;","E I","IBCL") ; Line Le vel Adjust ments | |
| 249 | .. D GETS ^DIQ(361.1 ,EPIEN_"," ,"8*;","EI ","IBSPL") ; ERA Spl its for th is EEOB | |
| 250 | .. D GETS ^DIQ(361.1 ,EPIEN_"," ,"20;","", "IBEERR") ; EOB Erro rs if they exist | |
| 251 | .. ; Make it easier to walk t he data | |
| 252 | .. D RESO RT^IBJTEP1 ("IBCL",36 1.11511),R ESORT^IBJT EP1("IBCL" ,361.115), RESORT^IBJ TEP1("IBCL ",361.1151 ) | |
| 253 | .. D RESO RT^IBJTEP1 ("IBCL",36 1.1152),RE SORT^IBJTE P1("IBCL", 361.1154) | |
| 254 | .. D GETS ^DIQ(399,I BEOB(361.1 ,EPIEN_"," ,.01,"I")_ ",","460;" ,"EI","IBD GCR") | |
| 255 | .. D SET( .LINE,"*** ******* EO B/835 INFO RMATION (" _EOBCT_" o f "_IBEBER A_") ***** *****") | |
| 256 | .. S XLN= " EOB Type : "_$G(IBE OB("361.1" ,EPIEN_"," ,".04","E" )),XSP=$E( SP80,1,(40 -$L(XLN))) | |
| 257 | .. D SET( .LINE,XLN_ XSP_"EOB P aid Date: "_$G(IBEOB ("361.1",E PIEN_","," .06","E")) ) | |
| 258 | .. S TSDT =$$FMTE^XL FDT($G(IBE OB("361.1" ,EPIEN_"," ,"1.1","I" )),"2Z"),T EDT=$$FMTE ^XLFDT($G( IBEOB("361 .1",EPIEN_ ",","1.11" ,"I")),"2Z "),XLN=" S vc From Da te: "_TSDT ,XSP=$E(SP 80,1,(40-$ L(XLN))) | |
| 259 | .. D SET( .LINE,XLN_ XSP_"Svc t o Date: "_ TEDT) | |
| 260 | .. D SET( .LINE," IC N: "_$G(IB EOB("361.1 ",EPIEN_", ",".14","E "))) | |
| 261 | .. D SET( .LINE," Pa yer Name/T IN: "_$G(I BEOB("361. 1",EPIEN_" ,",".02"," E"))_"/"_$ G(IBEOB("3 61.1",EPIE N_",",".03 ","E"))) | |
| 262 | .. S XLN= " ERA #: " _$G(IBEPAR ("344.4",E RAIEN,".01 ","E")),XS P=$E(SP80, 1,(40-$L(X LN))) | |
| 263 | .. D SET( .LINE,XLN_ XSP_"Auto- Post Statu s: "_$G(IB EPAR("344. 4",ERAIEN, "4.02","E" ))) | |
| 264 | .. D SET( .LINE," Tr ace #: "_$ G(IBEPAR(" 344.4",ERA IEN,".02", "E"))) | |
| 265 | .. S TECM E=$P($G(IB DGCR(399,I BEOB(361.1 ,EPIEN_"," ,.01,"I")_ ",",460,"E ")),";",1) | |
| 266 | .. D GETR X^IBJTEP1( EPIEN,.IBR X) | |
| 267 | .. S TRX= $$GET1^DIQ (52,+TECME _",",".01" )_"/"_$G(I BRX("FILL" ))_"/"_$G( IBRX("RELE ASED STATU S")) | |
| 268 | .. I TECM E="" S TRX ="" | |
| 269 | .. S XLN= " ECME #: "_TECME,XS P=$E(SP80, 1,(25-$L(X LN))),XSP1 =$E(SP80,1 ,(39-$L(XL N_XSP_"DOS : "_$G(IBR X("DOS"))) )) | |
| 270 | .. D SET( .LINE,XLN_ XSP_"DOS: "_$G(IBRX( "DOS"))_XS P1_"Rx/Fil l/Release Status: "_ TRX) | |
| 271 | .. D SET( .LINE,"--- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------") | |
| 272 | .. D:$D(I BSPL)>1 ; This EEOB was split display sp lit paymen t informat ion | |
| 273 | ... N SPL | |
| 274 | ... D SET (.LINE,"** A/R CORRE CTED PAYME NT DATA:") | |
| 275 | ... D SET (.LINE," T OTAL AMT P D: "_$J(IB EOB(361.1, EPIEN_",", 1.01,"E"), 9,2)) | |
| 276 | ... S SPL ="" F S S PL=$O(IBSP L(361.18,S PL)) Q:SPL ="" D | |
| 277 | .... D SE T(.LINE," "_$S(IBSPL (361.18,SP L,.03,"I") '="":$$BN1 ^PRCAFN(IB SPL(361.18 ,SPL,.03," I"))_$J("" ,8),1:"[su spense] "_ IBSPL(361. 18,SPL,.01 ,"E"))_" " _$J(IBSPL( 361.18,SPL ,.02,"E"), 9,2)) | |
| 278 | ... D SET (.LINE," " ) | |
| 279 | .. D SET( .LINE,"CLA IM LEVEL P AY STATUS: ") | |
| 280 | .. D SET( .LINE," To tal Submit ted Charge s :"_$J($G (IBEOB("36 1.1",EPIEN _",","2.04 ","E")),11 ,2)_" Paye r Covered Amount :"_ $J($G(IBEO B("361.1", EPIEN_",", "1.03","E" )),11,2)) | |
| 281 | .. D SET( .LINE," Pa yer Paid A mount :"_$ J($G(IBEOB ("361.1",E PIEN_","," 1.01","E") ),11,2)_" MEDICARE A llowed Amo unt :"_$J( $G(IBEOB(" 361.1",EPI EN_",","2. 03","E")), 11,2)) | |
| 282 | .. D SET( .LINE," Pa tient Resp onsibility :"_$J($G( IBEOB("361 .1",EPIEN_ ",","1.02" ,"E")),11, 2)) _ " % Collected :"_$J(+IBC OL,11,0)_” %” | |
| 283 | .. D SET( .LINE,"--- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------") | |
| 284 | .. D SET( .LINE,"CLA IM LEVEL A DJUSTMENTS :") | |
| 285 | .. S AA=" ",ACNT=0 F S AA=$O( IBGX(361.1 1,AA)) Q:A A="" S AC NT=ACNT+1, AQ="" D | |
| 286 | ... S CC= AA F S CC =$O(IBGX(3 61.111,CC) ) Q:$E(CC, 1,$L(AA))' =AA D | |
| 287 | RoutinesAc tivitiesRo utine Name IBJTPEEnha ncement Ca tegory New Modify De lete No Ch angeRTMRel ated Optio nsIBJ THIR D PARTY JO INT INQUIR Y | |
| 288 | Protocol - IBJT ERA 835 PRINT EEOBRelate d Routines Routines “ Called By” Routines “ Called” N/A^%ZIS | |
| 289 | HOME^%ZIS | |
| 290 | ^%ZTLOAD | |
| 291 | $$STATUS^B PSOSRX | |
| 292 | $$FIND1^DI C | |
| 293 | $$GET1^DIQ | |
| 294 | GETS^DIQ | |
| 295 | ^DIR | |
| 296 | DLN^IBJTEP | |
| 297 | $$ADJU^IBJ TEP1 | |
| 298 | $$BILLN^IB JTEP1 | |
| 299 | EEOB^IBJTE P1 | |
| 300 | RESORT^IBJ TEP1 | |
| 301 | $$BN1^PRCA FN | |
| 302 | $$DOS^PSOB PSU1 | |
| 303 | $$LSTRFL^P SOBPSU1 | |
| 304 | EN^VALM | |
| 305 | FULL^VALM1 | |
| 306 | $$FMTE^XLF DT | |
| 307 | $$NOW^XLFD T | |
| 308 | $$CJ^XLFST R | |
| 309 | $$REPLACE^ XLFSTR | |
| 310 | DISP^XQORM 1 Current Lo gicEBO ; D isplay the EOB DATA for IBEIEN | |
| 311 | S SP80=$J ("",IOM),I BDT=$$FMTE ^XLFDT($$N OW^XLFDT,1 ) ; Date f ormat Mon dd, yyyy@h h:mm:ss se e kernel d ocumentati on | |
| 312 | I (IBSL=0 )&(IBPG=0) D RHDR(IB PERA,IBDT, .IBPG) | |
| 313 | I IBREPG= 1 S IBREPG =0 D RHDR( IBPERA,IBD T,.IBPG) | |
| 314 | K IBEOB,I BGX,IBCL,I BDGCR,IBEP AR,IBSPL,I BEERR | |
| 315 | D GETS^DI Q(361.1,IB EIEN_","," .01;.02;.0 3;.04;.06; .14;1.01;1 .02;1.03;1 .1;1.11;2. 03;2.04;3. 03;3.04;3. 05;3.06;3. 07;","EI", "IBEOB") | |
| 316 | D GETS^DI Q(361.1,IB EIEN_","," 10*;","EI" ,"IBGX"),R ESORT^IBJT EP1("IBGX" ,361.111), RESORT^IBJ TEP1("IBGX ",361.11) ; Claim Le vel Adjust ments | |
| 317 | D GETS^DI Q(361.1,IB EIEN_","," 15*;","EI" ,"IBCL") ; Line Leve l Adjustme nts | |
| 318 | D GETS^DI Q(361.1,IB EIEN_","," 8*;","EI", "IBSPL") ; ERA Split s for this EEOB | |
| 319 | D GETS^DI Q(361.1,IB EIEN_","," 20;","","I BEERR") ; EOB Errors if they e xist | |
| 320 | ; Make it easier to walk the data | |
| 321 | D RESORT^ IBJTEP1("I BCL",361.1 1511),RESO RT^IBJTEP1 ("IBCL",36 1.115),RES ORT^IBJTEP 1("IBCL",3 61.1151) | |
| 322 | D RESORT^ IBJTEP1("I BCL",361.1 152),RESOR T^IBJTEP1( "IBCL",361 .1154) | |
| 323 | D GETS^DI Q(399,IBEO B(361.1,IB EIEN_",",. 01,"I")_", ","460;"," EI","IBDGC R") | |
| 324 | D GETS^DI Q(344.4,IB PERA_","," .01;.02;.0 3;.04;.05; .06;.07;.0 8;.09;.1;. 11;.12;.13 ;.14;.15;4 .02;","E", "IBEPAR") | |
| 325 | ; | |
| 326 | D SET("** ******** E OB/835 INF ORMATION ( "_BB_" of "_IBEBERA_ ") ******* ***") Q:IB QUIT | |
| 327 | S XLN=" E OB Type: " _$G(IBEOB( "361.1",IB EIEN_","," .04","E")) ,XSP=$E(SP 80,1,(40-$ L(XLN))) | |
| 328 | D SET(XLN _XSP_"EOB Paid Date: "_$G(IBEO B("361.1", IBEIEN_"," ,".06","E" ))) Q:IBQU IT | |
| 329 | S TSDT=$$ FMTE^XLFDT ($G(IBEOB( "361.1",IB EIEN_","," 1.1","I")) ,"2Z"),TED T=$$FMTE^X LFDT($G(IB EOB("361.1 ",IBEIEN_" ,","1.11", "I")),"2Z" ),XLN=" Sv c From Dat e: "_TSDT, XSP=$E(SP8 0,1,(40-$L (XLN))) | |
| 330 | D SET(XLN _XSP_"Svc to Date: " _TEDT) Q:I BQUIT | |
| 331 | D SET(" I CN: "_$G(I BEOB("361. 1",IBEIEN_ ",",".14", "E"))) Q:I BQUIT | |
| 332 | D SET(" P ayer Name/ TIN: "_$G( IBEOB("361 .1",IBEIEN _",",".02" ,"E"))_"/" _$G(IBEOB( "361.1",IB EIEN_","," .03","E")) ) Q:IBQUIT | |
| 333 | S XLN=" E RA #: "_$G (IBEPAR("3 44.4",IBPE RA_",",".0 1","E")),X SP=$E(SP80 ,1,(40-$L( XLN))) | |
| 334 | D SET(XLN _XSP_"Auto -Post Stat us: "_$G(I BEPAR("344 .4",IBPERA _",","4.02 ","E"))) Q :IBQUIT | |
| 335 | D SET(" T race #: "_ $G(IBEPAR( "344.4",IB PERA_","," .02","E")) ) Q:IBQUIT | |
| 336 | ; Access to PSOORDE R supporte d by DBIA #1878 | |
| 337 | S TECME=$ P($G(IBDGC R(399,IBEO B(361.1,IB EIEN_",",. 01,"I")_", ",460,"E") ),";",1),T DOS=$$FMTE ^XLFDT($$D OS^PSOBPSU 1(+TECME), "2Z") | |
| 338 | ;Referenc e to $$STA TUS^BPSOSR X supporte d by IA 44 12 | |
| 339 | S TRX=$$G ET1^DIQ(52 ,+TECME_", ",".01") | |
| 340 | S TSTAT=$ P($$STATUS ^BPSOSRX(T RX,$$LSTRF L^PSOBPSU1 (+TECME)), "^") | |
| 341 | S TRX=TRX _"/"_$$LST RFL^PSOBPS U1(+TECME) _"/"_TSTAT | |
| 342 | I TECME=" " S TDOS=" ",TRX="" | |
| 343 | S XLN=" E CME #: "_T ECME,XSP=$ E(SP80,1,( 25-$L(XLN) )),XSP1=$E (SP80,1,(3 9-$L(XLN_X SP_"DOS: " _TDOS))) | |
| 344 | D SET(XLN _XSP_"DOS: "_TDOS_XS P1_"Rx/Fil l/Release Status: "_ TRX) Q:IBQ UIT | |
| 345 | D SET("-- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --------") Q:IBQUIT | |
| 346 | D:$D(IBSP L)>1 Q:IBQ UIT ; Thi s EEOB was split dis play split payment i nformation | |
| 347 | . N SPL | |
| 348 | . D SET(" ** A/R COR RECTED PAY MENT DATA: ") Q:IBQUI T | |
| 349 | . D SET(" TOTAL AMT PD: "_$J( IBEOB(361. 1,IBEIEN_" ,",1.01,"E "),9,2)) Q :IBQUIT | |
| 350 | . S SPL=" " F S SPL =$O(IBSPL( 361.18,SPL )) Q:SPL=" " D Q:IB QUIT | |
| 351 | .. D SET( " "_$S(IBS PL(361.18, SPL,.03,"I ")'="":$$B N1^PRCAFN( IBSPL(361. 18,SPL,.03 ,"I"))_$J( "",8),1:"[ suspense] "_IBSPL(36 1.18,SPL,. 01,"E"))_" "_$J(IBSP L(361.18,S PL,.02,"E" ),9,2)) Q: IBQUIT | |
| 352 | . D SET(" ") Q:IBQU IT | |
| 353 | D SET("CL AIM LEVEL PAY STATUS :") Q:IBQU IT | |
| 354 | D SET(" T otal Submi tted Charg es :"_$J($ G(IBEOB("3 61.1",IBEI EN_",","2. 04","E")), 11,2)_" Pa yer Covere d Amount : "_$J($G(IB EOB("361.1 ",IBEIEN_" ,","1.03", "E")),11,2 )) Q:IBQUI T | |
| 355 | D SET(" P ayer Paid Amount :"_ $J($G(IBEO B("361.1", IBEIEN_"," ,"1.01","E ")),11,2)_ " MEDICARE Allowed A mount :"_$ J($G(IBEOB ("361.1",I BEIEN_",", "2.03","E" )),11,2)) Q:IBQUIT | |
| 356 | D SET(" P atient Res ponsibilit y :"_$J($G (IBEOB("36 1.1",IBEIE N_",","1.0 2","E")),1 1,2)) Q:IB QUIT | |
| 357 | D SET("-- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --------") Q:IBQUIT | |
| 358 | D SET("CL AIM LEVEL ADJUSTMENT S:") Q:IBQ UIT | |
| 359 | S AA="",A CNT=0 F S AA=$O(IBG X(361.11,A A)) Q:AA=" " S ACNT= ACNT+1,AQ= "" D Q:IB QUIT | |
| 360 | . S CC=AA F S CC=$ O(IBGX(361 .111,CC)) Q:$E(CC,1, $L(AA))'=A A D Q:IB QUIT | |
| 361 | .. I AQ=" " S AQ=$J( ACNT,3)_") "Modified Logic (Ch anges are in bold)EB O ; Displa y the EOB DATA for I BEIEN | |
| 362 | S SP80=$J ("",IOM),I BDT=$$FMTE ^XLFDT($$N OW^XLFDT,1 ) ; Date f ormat Mon dd, yyyy@h h:mm:ss se e kernel d ocumentati on | |
| 363 | I (IBSL=0 )&(IBPG=0) D RHDR(IB PERA,IBDT, .IBPG) | |
| 364 | I IBREPG= 1 S IBREPG =0 D RHDR( IBPERA,IBD T,.IBPG) | |
| 365 | K IBEOB,I BGX,IBCL,I BDGCR,IBEP AR,IBSPL,I BEERR | |
| 366 | D GETS^DI Q(361.1,IB EIEN_","," .01;.02;.0 3;.04;.06; .14;1.01;1 .02;1.03;1 .1;1.11;2. 03;2.04;3. 03;3.04;3. 05;3.06;3. 07;","EI", "IBEOB") | |
| 367 | D GETS^DI Q(361.1,IB EIEN_","," 10*;","EI" ,"IBGX"),R ESORT^IBJT EP1("IBGX" ,361.111), RESORT^IBJ TEP1("IBGX ",361.11) ; Claim Le vel Adjust ments | |
| 368 | D GETS^DI Q(361.1,IB EIEN_","," 15*;","EI" ,"IBCL") ; Line Leve l Adjustme nts | |
| 369 | D GETS^DI Q(361.1,IB EIEN_","," 8*;","EI", "IBSPL") ; ERA Split s for this EEOB | |
| 370 | D GETS^DI Q(361.1,IB EIEN_","," 20;","","I BEERR") ; EOB Errors if they e xist | |
| 371 | ; Get % C ollected f rom AR cla im – IA 14 52 | |
| 372 | N IBAR,IB COL | |
| 373 | S IBAR=$$ BILL^RCJIB FN2($G(IBE OB(361.1,I BEIEN_",", .01,"I"))) ,IBCOL=$P( IBAR,U,5) | |
| 374 | ; Make it easier to walk the data | |
| 375 | D RESORT^ IBJTEP1("I BCL",361.1 1511),RESO RT^IBJTEP1 ("IBCL",36 1.115),RES ORT^IBJTEP 1("IBCL",3 61.1151) | |
| 376 | D RESORT^ IBJTEP1("I BCL",361.1 152),RESOR T^IBJTEP1( "IBCL",361 .1154) | |
| 377 | D GETS^DI Q(399,IBEO B(361.1,IB EIEN_",",. 01,"I")_", ","460;"," EI","IBDGC R") | |
| 378 | D GETS^DI Q(344.4,IB PERA_","," .01;.02;.0 3;.04;.05; .06;.07;.0 8;.09;.1;. 11;.12;.13 ;.14;.15;4 .02;","E", "IBEPAR") | |
| 379 | ; | |
| 380 | D SET("** ******** E OB/835 INF ORMATION ( "_BB_" of "_IBEBERA_ ") ******* ***") Q:IB QUIT | |
| 381 | S XLN=" E OB Type: " _$G(IBEOB( "361.1",IB EIEN_","," .04","E")) ,XSP=$E(SP 80,1,(40-$ L(XLN))) | |
| 382 | D SET(XLN _XSP_"EOB Paid Date: "_$G(IBEO B("361.1", IBEIEN_"," ,".06","E" ))) Q:IBQU IT | |
| 383 | S TSDT=$$ FMTE^XLFDT ($G(IBEOB( "361.1",IB EIEN_","," 1.1","I")) ,"2Z"),TED T=$$FMTE^X LFDT($G(IB EOB("361.1 ",IBEIEN_" ,","1.11", "I")),"2Z" ),XLN=" Sv c From Dat e: "_TSDT, XSP=$E(SP8 0,1,(40-$L (XLN))) | |
| 384 | D SET(XLN _XSP_"Svc to Date: " _TEDT) Q:I BQUIT | |
| 385 | D SET(" I CN: "_$G(I BEOB("361. 1",IBEIEN_ ",",".14", "E"))) Q:I BQUIT | |
| 386 | D SET(" P ayer Name/ TIN: "_$G( IBEOB("361 .1",IBEIEN _",",".02" ,"E"))_"/" _$G(IBEOB( "361.1",IB EIEN_","," .03","E")) ) Q:IBQUIT | |
| 387 | S XLN=" E RA #: "_$G (IBEPAR("3 44.4",IBPE RA_",",".0 1","E")),X SP=$E(SP80 ,1,(40-$L( XLN))) | |
| 388 | D SET(XLN _XSP_"Auto -Post Stat us: "_$G(I BEPAR("344 .4",IBPERA _",","4.02 ","E"))) Q :IBQUIT | |
| 389 | D SET(" T race #: "_ $G(IBEPAR( "344.4",IB PERA_","," .02","E")) ) Q:IBQUIT | |
| 390 | ; Access to PSOORDE R supporte d by DBIA #1878 | |
| 391 | S TECME=$ P($G(IBDGC R(399,IBEO B(361.1,IB EIEN_",",. 01,"I")_", ",460,"E") ),";",1),T DOS=$$FMTE ^XLFDT($$D OS^PSOBPSU 1(+TECME), "2Z") | |
| 392 | ;Referenc e to $$STA TUS^BPSOSR X supporte d by IA 44 12 | |
| 393 | S TRX=$$G ET1^DIQ(52 ,+TECME_", ",".01") | |
| 394 | S TSTAT=$ P($$STATUS ^BPSOSRX(T RX,$$LSTRF L^PSOBPSU1 (+TECME)), "^") | |
| 395 | S TRX=TRX _"/"_$$LST RFL^PSOBPS U1(+TECME) _"/"_TSTAT | |
| 396 | I TECME=" " S TDOS=" ",TRX="" | |
| 397 | S XLN=" E CME #: "_T ECME,XSP=$ E(SP80,1,( 25-$L(XLN) )),XSP1=$E (SP80,1,(3 9-$L(XLN_X SP_"DOS: " _TDOS))) | |
| 398 | D SET(XLN _XSP_"DOS: "_TDOS_XS P1_"Rx/Fil l/Release Status: "_ TRX) Q:IBQ UIT | |
| 399 | D SET("-- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --------") Q:IBQUIT | |
| 400 | D:$D(IBSP L)>1 Q:IBQ UIT ; Thi s EEOB was split dis play split payment i nformation | |
| 401 | . N SPL | |
| 402 | . D SET(" ** A/R COR RECTED PAY MENT DATA: ") Q:IBQUI T | |
| 403 | . D SET(" TOTAL AMT PD: "_$J( IBEOB(361. 1,IBEIEN_" ,",1.01,"E "),9,2)) Q :IBQUIT | |
| 404 | . S SPL=" " F S SPL =$O(IBSPL( 361.18,SPL )) Q:SPL=" " D Q:IB QUIT | |
| 405 | .. D SET( " "_$S(IBS PL(361.18, SPL,.03,"I ")'="":$$B N1^PRCAFN( IBSPL(361. 18,SPL,.03 ,"I"))_$J( "",8),1:"[ suspense] "_IBSPL(36 1.18,SPL,. 01,"E"))_" "_$J(IBSP L(361.18,S PL,.02,"E" ),9,2)) Q: IBQUIT | |
| 406 | . D SET(" ") Q:IBQU IT | |
| 407 | D SET("CL AIM LEVEL PAY STATUS :") Q:IBQU IT | |
| 408 | D SET(" T otal Submi tted Charg es :"_$J($ G(IBEOB("3 61.1",IBEI EN_",","2. 04","E")), 11,2)_" Pa yer Covere d Amount : "_$J($G(IB EOB("361.1 ",IBEIEN_" ,","1.03", "E")),11,2 )) Q:IBQUI T | |
| 409 | D SET(" P ayer Paid Amount :"_ $J($G(IBEO B("361.1", IBEIEN_"," ,"1.01","E ")),11,2)_ " MEDICARE Allowed A mount :"_$ J($G(IBEOB ("361.1",I BEIEN_",", "2.03","E" )),11,2)) Q:IBQUIT | |
| 410 | D SET(" P atient Res ponsibilit y :"_$J($G (IBEOB("36 1.1",IBEIE N_",","1.0 2","E")),1 1,2))_ " % Collected :"_$J(+IB COL,11,0)_ ”%” Q:IBQU IT | |
| 411 | ||
| 412 | D SET("-- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --------") Q:IBQUIT | |
| 413 | D SET("CL AIM LEVEL ADJUSTMENT S:") Q:IBQ UIT | |
| 414 | S AA="",A CNT=0 F S AA=$O(IBG X(361.11,A A)) Q:AA=" " S ACNT= ACNT+1,AQ= "" D Q:IB QUIT | |
| 415 | . S CC=AA F S CC=$ O(IBGX(361 .111,CC)) Q:$E(CC,1, $L(AA))'=A A D Q:IB QUIT | |
| 416 | .. I AQ=" " S AQ=$J( ACNT,3)_") " |
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