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| # | Location | File | Last Modified |
|---|---|---|---|
| 1 | MCCF EDI TAS BPS PSO PSX Bundle.zip\MCCF EDI TAS BPS PSO PSX Bundle | TAS ePhm SDD US174 v1.02.docx | Thu Jul 27 19:16:18 2017 UTC |
| 2 | MCCF EDI TAS BPS PSO PSX Bundle.zip\MCCF EDI TAS BPS PSO PSX Bundle | TAS ePhm SDD US174 v1.02.docx | Wed Sep 6 18:13:51 2017 UTC |
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| 1 | MCCF EDI T AS US174 | |
| 2 | System Des ign Docume nt | |
| 3 | ||
| 4 | ||
| 5 | ||
| 6 | ||
| 7 | ||
| 8 | Department of Vetera ns Affairs | |
| 9 | June 2017 | |
| 10 | Version 1. 01 | |
| 11 | ||
| 12 | ||
| 13 | ||
| 14 | User Story Number: U SRX-167A | |
| 15 | User Story Name: NCP DP Field D efinition - Basic Up dates | |
| 16 | Product Ba cklog ID: 167 | |
| 17 | Backlog Pr iority: (H igh, Mediu m, Low) | |
| 18 | Initial Si zing Estim ate: | |
| 19 | Rational I D: tbd | |
| 20 | Rally ID: US174 | |
| 21 | Design | |
| 22 | In reviewi ng the lat est NCPDP Implementa tion Guide (October 2016), it was determ ined that updates mu st be made to the Vi stA files correspond ing to Dat a Elements . This sto ry concern s the addi tion of 2 fields – B 95-3Z, Fac ility ID Q ualifier, and B98-34 , Reconcil iation ID. | |
| 23 | The new fi eld defini tions will be added to File 90 02313.91, BPS NCPDP FIELD DEFS , in our t est enviro nment, and that file will be i ncluded in our patch , so that the new fi eld will b e included in the KI DS Build. When the KIDS Build is instal led, the n ew fields will be au tomaticall y added to File 9002 313.91. | |
| 24 | The data d ictionary for file 9 002313.91, BPS NCPDP FIELD DEF S, will be sent with data to t he target sites. Th e table be low descri bes how th e file is to be incl uded in th e KIDS Bui ld. | |
| 25 | ||
| 26 | File Name | |
| 27 | BPS NCPDP FIELD DEFS | |
| 28 | Send Full or Partial DD | |
| 29 | FULL | |
| 30 | Update the Data Dict ionary | |
| 31 | YES | |
| 32 | Send Secur ity Codes | |
| 33 | YES | |
| 34 | Screen to Determine DD Update | |
| 35 | n/a | |
| 36 | Data Comes with File | |
| 37 | YES | |
| 38 | Site’s Dat a | |
| 39 | OVERWRITE | |
| 40 | Resolve Po inters | |
| 41 | NO | |
| 42 | May User O verride Da ta Update | |
| 43 | NO | |
| 44 | Data List | |
| 45 | n/a | |
| 46 | Screen to Select Dat a | |
| 47 | n/a | |
| 48 | ||
| 49 | The table below desc ribes how the 2 new field defi nitions ar e going to be added to file 90 02313.91, BPS NCPDP FIELD DEFS . | |
| 50 | Fields | |
| 51 | Values | |
| 52 | #.01 - NCP DP FIELD N UMBER | |
| 53 | B95 | |
| 54 | #.03 - NA ME | |
| 55 | FACILITY I D QUALIFIE R | |
| 56 | #.04 - FOR MAT (N, A/ N, D) | |
| 57 | A/N | |
| 58 | #.06 - ID | |
| 59 | 3Z | |
| 60 | #.07 - LEN GTH | |
| 61 | 2 | |
| 62 | #.08 - D0 LENGTH | |
| 63 | 2 | |
| 64 | #.09 - D0 FORMAT (N, A/N, D) | |
| 65 | A/N | |
| 66 | #1 - VISTA FIELD NUM BER | |
| 67 | 2095 | |
| 68 | #1.01 - ST ANDARD NCP DP FIELD N AME | |
| 69 | FACILITY I D QUALIFIE R | |
| 70 | #10 - GET CODE | |
| 71 | S BPS(“X”) =$G(BPS("" Insurer"", ""Facility ID""))" | |
| 72 | S BPS("X") =$S(BPS("X ")’="":1,1 :"") | |
| 73 | #20 - D0 F ORMAT | |
| 74 | S BPS(“X”) =$$ANFF^BP SECFM($G(B PS(“X”)),2 ) | |
| 75 | #30 - SET CODE | |
| 76 | S $P(^BPSC (BPS(90023 13.02),400 ,BPS(90023 13.0201), | |
| 77 | “B90”),U,1 )=BPS("X") | |
| 78 | #40 - FORM AT CODE | |
| 79 | S BPS(“X”) =$$ANFF^BP SECFM($G(B PS(“X”)),2 ) | |
| 80 | ||
| 81 | ||
| 82 | Fields | |
| 83 | Values | |
| 84 | #.01 - NCP DP FIELD N UMBER | |
| 85 | B98 | |
| 86 | #.03 - NA ME | |
| 87 | RECONCILIA TION ID | |
| 88 | #.04 - FOR MAT (N, A/ N, D) | |
| 89 | A/N | |
| 90 | #.06 - ID | |
| 91 | 34 | |
| 92 | #.07 - LEN GTH | |
| 93 | 30 | |
| 94 | #.08 - D0 LENGTH | |
| 95 | 30 | |
| 96 | #.09 - D0 FORMAT (N, A/N, D) | |
| 97 | A/N | |
| 98 | #1 - VISTA FIELD NUM BER | |
| 99 | 2098 | |
| 100 | #1.01 - ST ANDARD NCP DP FIELD N AME | |
| 101 | RECONCILIA TION ID | |
| 102 | #10 - GET CODE | |
| 103 | "; THIS IS A RESPONS E-ONLY FIE LD WHICH D OES NOT US E THE GET, FORMAT, O R” | |
| 104 | “; SET COD E" | |
| 105 | #20 - D0 F ORMAT | |
| 106 | n/a | |
| 107 | #30 - SET CODE | |
| 108 | n/a | |
| 109 | #40 - FORM AT CODE | |
| 110 | n/a | |
| 111 | ||
| 112 | The Facili ty ID Qual ifier fiel d will nee d to be ad ded to the File 9002 313.02, BP S CLAIMS, so it will need to b e stored w hen we sen d an outgo ing claim. The fiel d will be added to F ile 900231 3.02, BPS CLAIMS, in our test environmen t, and tha t file wil l be inclu ded in our patch, so that the new field will be in cluded in the KIDS B uild. Whe n the KIDS Build is installed, the new f ields will be automa tically ad ded to Fil e 9002313. 02. | |
| 113 | The data d ictionary for file 9 002313.020 1, BPS CLA IMS-TRANSA CTIONS sub -file, wil l be sent without da ta to the target sit es. The t able below describes how the f ile is to be include d in the K IDS Build. | |
| 114 | File Name | |
| 115 | BPS CLAIMS | |
| 116 | Send Full or Partial DD | |
| 117 | PARTIAL | |
| 118 | Data Dicti onary Numb er | |
| 119 | 9002313.02 01 | |
| 120 | Field Numb er | |
| 121 | 2095 | |
| 122 | Update the Data Dict ionary | |
| 123 | YES | |
| 124 | Send Secur ity Codes | |
| 125 | NO | |
| 126 | Screen to Determine DD Update | |
| 127 | N/A | |
| 128 | Data Comes with File | |
| 129 | NO | |
| 130 | ||
| 131 | The table below desc ribes how the new fi eld is goi ng to be a dded to fi le 9002313 .0201, BPS CLAIMS, T RANSACTION S sub-file . | |
| 132 | Field Attr ibutes | |
| 133 | Values | |
| 134 | FIELD NAM E | |
| 135 | FACILITY I D QUALIFIE R | |
| 136 | FIELD NUMB ER | |
| 137 | 2095 | |
| 138 | NODE;PIECE | |
| 139 | B90;5 | |
| 140 | FIELD TYPE | |
| 141 | FREE TEXT | |
| 142 | FIELD LENG TH | |
| 143 | 2 | |
| 144 | INPUT TRAN SFORM | |
| 145 | K:$L(X)>2! ($L(X)<1) X | |
| 146 | HELP PROMP T | |
| 147 | Answer mus t be 1-2 c haracters in length. | |
| 148 | DESCRIPTIO N | |
| 149 | Code quali fying the ‘Facility ID’ (336-8 C). NCPDP standard f ield B95-3 Z. | |
| 150 | Blank=Not Specified, 1=Facilit y Type 2 N PI, 2= Oth er | |
| 151 | TECHNICAL DESCRIPTIO N | |
| 152 | FACILITY S EGMENT | |
| 153 | ||
| 154 | The Reconc iliation I D field wi ll need to be added to the Fil e 9002313. 03, BPS RE SPONSES, s o it will need to be stored wh en we rece ive an inc oming resp onse. The field wil l be added to File 9 002313.03, BPS RESPO NSES, in o ur test en vironment, and that file will be include d in our p atch, so t hat the ne w field wi ll be incl uded in th e KIDS Bui ld. When the KIDS B uild is in stalled, t he new fie lds will b e automati cally adde d to File 9002313.03 . | |
| 155 | The data d ictionary for file 9 002313.030 1, BPS RES PONSES-RES PONSES sub -file, wil l be sent without da ta to the target sit es. The t able below describes how the f ile is to be include d in the K IDS Build. | |
| 156 | ||
| 157 | File Name | |
| 158 | BPS RESPON SES | |
| 159 | Send Full or Partial DD | |
| 160 | PARTIAL | |
| 161 | Data Dicti onary Numb er | |
| 162 | 9002313.03 01 | |
| 163 | Field Numb er | |
| 164 | 2098 | |
| 165 | Update the Data Dict ionary | |
| 166 | YES | |
| 167 | Send Secur ity Codes | |
| 168 | NO | |
| 169 | Screen to Determine DD Update | |
| 170 | N/A | |
| 171 | Data Comes with File | |
| 172 | NO | |
| 173 | ||
| 174 | The table below desc ribes how the new fi eld is goi ng to be a dded to fi le 9002313 .0301, BPS RESPONSES , RESPONSE S sub-file . | |
| 175 | Field Attr ibutes | |
| 176 | Values | |
| 177 | FIELD NAM E | |
| 178 | RECONCILIA TION ID | |
| 179 | FIELD NUMB ER | |
| 180 | 2098 | |
| 181 | NODE;PIECE | |
| 182 | B98;1 | |
| 183 | FIELD TYPE | |
| 184 | FREE TEXT | |
| 185 | FIELD LENG TH | |
| 186 | 30 | |
| 187 | INPUT TRAN SFORM | |
| 188 | K:$L(X)>30 !($L(X)<1) X | |
| 189 | HELP PROMP T | |
| 190 | Answer mus t be 1-30 characters in length . | |
| 191 | DESCRIPTIO N | |
| 192 | This will be used to store NCP DP field B 98-34 (Rec onciliatio n ID) | |
| 193 | ||
| 194 | The Reconc iliation I D field wi ll need to be added to the Fil e 9002313. 32, BPS PA YER RESPON SE OVERRID ES, so the field can be tested on an inc oming resp onse. In order to d o the inco ming respo nse from t he payer, the field will need to be adde d to File 9002313.32 , BPS PAYE R RESPONSE OVERRIDES , and the routine BP STEST will need to b e modified . The fiel d will be added to F ile 900231 3.32, BPS PAYER RESP ONSE OVERR IDES, in o ur test en vironment, and that file will be include d in our p atch, so t hat the ne w field wi ll be incl uded in th e KIDS Bui ld. When the KIDS B uild is in stalled, t he new fie lds will b e automati cally adde d to File 9002313.32 . | |
| 195 | The data d ictionary for file 9 002313.32, BPS PAYER RESPONSE OVERRIDES, will be s ent withou t data to the target sites. T he table b elow descr ibes how t he file is to be inc luded in t he KIDS Bu ild. | |
| 196 | ||
| 197 | File Name | |
| 198 | BPS PAYER RESPONSE O VERRIDES | |
| 199 | Send Full or Partial DD | |
| 200 | PARTIAL | |
| 201 | Data Dicti onary Numb er | |
| 202 | 9002313.32 | |
| 203 | Field Numb er | |
| 204 | 2.09 | |
| 205 | Update the Data Dict ionary | |
| 206 | YES | |
| 207 | Send Secur ity Codes | |
| 208 | NO | |
| 209 | Screen to Determine DD Update | |
| 210 | N/A | |
| 211 | Data Comes with File | |
| 212 | NO | |
| 213 | ||
| 214 | The table below desc ribes how the new fi eld is goi ng to be a dded to fi le 9002313 .32, BPS P AYER RESPO NSE OVERRI DES. | |
| 215 | Field Attr ibutes | |
| 216 | Values | |
| 217 | FIELD NAM E | |
| 218 | RECONCILIA TION ID | |
| 219 | FIELD NUMB ER | |
| 220 | 2.09 | |
| 221 | NODE;PIECE | |
| 222 | 2;9 | |
| 223 | FIELD TYPE | |
| 224 | FREE TEXT | |
| 225 | FIELD LENG TH | |
| 226 | 30 | |
| 227 | INPUT TRAN SFORM | |
| 228 | K:$L(X)>30 !($L(X)<1) X | |
| 229 | HELP PROMP T | |
| 230 | Answer mus t be 1-30 characters in length . | |
| 231 | DESCRIPTIO N | |
| 232 | This is th e override value tha t will be used for t he payer r esponse fo r billing requests. The value will be us ed to popu late the R ECONCILIAT ION ID (#2 098) field of RESPON SES (#9002 313.0301) subfile of the BPS R ESPONSES ( #9002313.0 3) file. T his corres ponds to N CPDP code B98-34. | |
| 233 | ||
| 234 | ||
| 235 | The table below desc ribes how the routin e BPSTEST will be mo dified in order for the Reconc iliation I D field to be includ ed in the testing to ol. | |
| 236 | ||
| 237 | Subroutine Name | |
| 238 | GETOVER^BP STEST | |
| 239 | Enhancemen t Category | |
| 240 | New | |
| 241 | Modify | |
| 242 | Delete | |
| 243 | No Change | |
| 244 | Story | |
| 245 | US174 (Ral ly ID) | |
| 246 | Related Op tions | |
| 247 | n/a | |
| 248 | Related Su broutines | |
| 249 | This Subro utine is C alled By | |
| 250 | This Subro utine Call s | |
| 251 | ||
| 252 | REVRESUB^ BPSNCPD4, REVERSAL^B PSNCPD5, N EWCLM^BPSN CPD5, REVR ESNP^BPSNC PD5, EN^BP SNCPD9 | |
| 253 | $$IEN59^BP SOSRX, | |
| 254 | ^DIC,^DIR, ^DIK, | |
| 255 | GET1^DIQ | |
| 256 | Data Dicti onary (DD) Reference s | |
| 257 | n/a | |
| 258 | Related Pr otocols | |
| 259 | n/a | |
| 260 | Related In tegration Control Re gistration s (ICRs) | |
| 261 | n/a | |
| 262 | Data Passi ng | |
| 263 | Input | |
| 264 | Output Re ference | |
| 265 | Both | |
| 266 | Global Re ference | |
| 267 | Local | |
| 268 | Input Attr ibute Name and Defin ition | |
| 269 | Name: KEY1 | |
| 270 | Definition : Prescri ption IEN/ Patient IE N | |
| 271 | New Modify Delete No Cha nge | |
| 272 | Name: KEY2 | |
| 273 | Definition : Fill Nu mber/Polic y Number | |
| 274 | New Modify Delete No Cha nge | |
| 275 | Name: BPSO RESP | |
| 276 | Definition : Previou s response when this claim was processed | |
| 277 | New Modify Delete No Cha nge | |
| 278 | Name: BPSW HERE | |
| 279 | Definition : RX Acti on passed into BPSNC PDP | |
| 280 | New Modify Delete No Cha nge | |
| 281 | Name: BPST YPE | |
| 282 | Definition : R (Reve rsal), S ( Submission ), E (Elig ibility) | |
| 283 | New Modify Delete No Cha nge | |
| 284 | Name: BPPA YSEQ | |
| 285 | Definition : payer s equence 1 - primary, 2 - secon dary | |
| 286 | New Modify Delete No Cha nge | |
| 287 | Output Att ribute Nam e and Defi nition | |
| 288 | Name: n/a - the BPS PAYER RESP ONSE OVERR IDE entry is created | |
| 289 | Definition : | |
| 290 | New Modify Delete No Cha nge | |
| 291 | Current Lo gic | |
| 292 | BPSTEST ;O AK/ELZ - E CME TESTIN G TOOL ;11 /15/07 09 :55 | |
| 293 | ;;1.0;E C LAIMS MGMT ENGINE;** 6,7,8,10,1 1,15,19,20 **;JUN 200 4;Build 27 | |
| 294 | ;;Per VA Directive 6402, this routine s hould not be modifie d. | |
| 295 | ; | |
| 296 | ;GETOVER( KEY1,KEY2, BPSORESP,B PSWHERE,BP STYPE,BPPA YSEQ); | |
| 297 | ; called b y BPSNCPDP to enter overrides for a part icular RX | |
| 298 | ; INPUT | |
| 299 | ; KEY1 - Pre scription IEN/Patien t IEN | |
| 300 | ; KEY2 - Fil l Number/P olicy Numb er | |
| 301 | ; BPSOR ESP - Pre vious resp onse when this claim was proce ssed | |
| 302 | ; BPSWH ERE - RX Action pas sed into B PSNCPDP | |
| 303 | ; BPSTY PE - R ( Reversal), S (Submis sion), E ( Eligibilit y) | |
| 304 | ; BPPAY SEQ - pay er sequenc e 1 - prim ary, 2 - s econdary | |
| 305 | ; OUTPUT | |
| 306 | ; None - Table BP S PAYER RE SPONSE OVE RRIDE entr y is creat ed. | |
| 307 | ; | |
| 308 | N BPSTRANS ,BPSTIEN,B PSSRESP,DI C,X,Y,DIR, DIK,DA | |
| 309 | ; | |
| 310 | . | |
| 311 | . | |
| 312 | . | |
| 313 | . ; This s ection is for new D1 -E7 fields and other fields so we can te st that t | |
| 314 | hey are fi led correc tly | |
| 315 | . ; At som e point, t hese can p robably be removed | |
| 316 | . I BPSSRE SP="P"!(BP SSRESP="D" )!(BPSSRES P="R") D | |
| 317 | .. ; | |
| 318 | .. ; Ask i f user wan ts to ente r data for additiona l response file fiel ds - Quit | |
| 319 | if user s ays no | |
| 320 | .. N DIR,D TOUT,DUOUT ,DIROUT,DI RUT | |
| 321 | .. S DIR(0 )="YA",DIR ("A")="Pop ulate Addi tional Res ponse Fiel ds? ",DIR( "B")="No" | |
| 322 | W ! D ^DI R | |
| 323 | .. I Y'=1 Q | |
| 324 | .. ; | |
| 325 | .. ; Overr ides to te st functio nality of BPS*1*20 | |
| 326 | .. D PROMP T(BPSTIEN, .15,0) ; Ingr edient Cos t Paid (50 6) | |
| 327 | .. D PROMP T(BPSTIEN, .16,0) ; Disp ensing Fee Paid (507 ) | |
| 328 | .. D PROMP T(BPSTIEN, .17,0) ; Rema ining Dedu ctible Amo unt (513) | |
| 329 | .. D PROMP T(BPSTIEN, .18,0) ; Amou nt Applied to Period ic Deducti ble (517) | |
| 330 | .. ; | |
| 331 | .. ; Addit ional over rides for D1-D9 (BPS *1*15) | |
| 332 | .. D PROMP T(BPSTIEN, .09,"") ; next available fill date | |
| 333 | .. D PROMP T(BPSTIEN, .1,"") ; adju dicated pa yment type | |
| 334 | .. ; | |
| 335 | .. ; Addit ional over rides for E0-E6 (BPS *1*19) | |
| 336 | .. D PROMP T(BPSTIEN, 2.01,"04") ; % sa les tax ba sis pd | |
| 337 | .. D PROMP T(BPSTIEN, 2.02,11) ; othe r amount p aid qualif ier | |
| 338 | .. D PROMP T(BPSTIEN, 2.03,"01") ; paye r id quali fier | |
| 339 | .. D PROMP T(BPSTIEN, 2.04,"") ; help desk phon e# ext | |
| 340 | .. D PROMP T(BPSTIEN, 2.05,"") ; pro service fe e cont/rei m amt | |
| 341 | .. D PROMP T(BPSTIEN, 2.06,"") ; othe r payer he lp desk ph one# ext | |
| 342 | .. D PROMP T(BPSTIEN, 2.07,"") ; resp onse inter med auth t ype id | |
| 343 | .. D PROMP T(BPSTIEN, 2.08,"") ; resp onse inter med auth i d | |
| 344 | .. D PROMP T(BPSTIEN, 3.01,"") ; resp onse inter med messag e | |
| 345 | .. ; | |
| 346 | .. ; E7 ov errides (B PS*1*20) | |
| 347 | .. D PROMP T(BPSTIEN, .11,"") ; q uan limit per specif ic time pe riod | |
| 348 | .. D PROMP T(BPSTIEN, .12,"") ; q uan limit time perio d | |
| 349 | .. D PROMP T(BPSTIEN, .13,"") ; d ays supp l imit per s pecific ti me period | |
| 350 | .. D PROMP T(BPSTIEN, .14,"") ; d ays supp l imit time period | |
| 351 | ; | |
| 352 | W ! D PROM PT(BPSTIEN ,.07,0) | |
| 353 | Q | |
| 354 | ||
| 355 | Modified L ogic (Chan ges are hi ghlighted) | |
| 356 | BPSTEST ;O AK/ELZ - E CME TESTIN G TOOL ;11 /15/07 09 :55 | |
| 357 | ;;1.0;E C LAIMS MGMT ENGINE;** 6,7,8,10,1 1,15,19,20 ,22**;JUN 2004;Build 27 | |
| 358 | ;;Per VA Directive 6402, this routine s hould not be modifie d. | |
| 359 | ; | |
| 360 | GETOVER(KE Y1,KEY2,BP SORESP,BPS WHERE,BPST YPE,BPPAYS EQ); | |
| 361 | ; called b y BPSNCPDP to enter overrides for a part icular RX | |
| 362 | ; INPUT | |
| 363 | ; KEY1 - Pre scription IEN/Patien t IEN | |
| 364 | ; KEY2 - Fil l Number/P olicy Numb er | |
| 365 | ; BPSOR ESP - Pre vious resp onse when this claim was proce ssed | |
| 366 | ; BPSWH ERE - RX Action pas sed into B PSNCPDP | |
| 367 | ; BPSTY PE - R ( Reversal), S (Submis sion), E ( Eligibilit y) | |
| 368 | ; BPPAY SEQ - pay er sequenc e 1 - prim ary, 2 - s econdary | |
| 369 | ; OUTPUT | |
| 370 | ; None - Table BP S PAYER RE SPONSE OVE RRIDE entr y is creat ed. | |
| 371 | ; | |
| 372 | N BPSTRANS ,BPSTIEN,B PSSRESP,DI C,X,Y,DIR, DIK,DA | |
| 373 | ; | |
| 374 | . | |
| 375 | . | |
| 376 | . | |
| 377 | ; | |
| 378 | ; If BPSTY PE contain s 'S', do submission response | |
| 379 | I BPSTYPE[ "S" D | |
| 380 | . W !!,"Su bmission Q uestions" | |
| 381 | . D PROMPT (BPSTIEN,. 03,"P") | |
| 382 | . S BPSSRE SP=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.03 ,"I") | |
| 383 | . I BPSSRE SP="P"!(BP SSRESP="D" ) D PROMPT (BPSTIEN,. 04,40) ; total amount pa id (509-F9 ) | |
| 384 | . I BPSSRE SP="P"!(BP SSRESP="D" ) D PROMPT (BPSTIEN,. 06,9) ; copay amount (5 18-FI) | |
| 385 | . I BPSSRE SP="R" D P ROMPT(BPST IEN,1,"07" ) | |
| 386 | . ; | |
| 387 | . ; This s ection is for new D1 -E7 fields and other fields so we can te st that th ey are fil ed correct ly | |
| 388 | . ; At som e point, t hese can p robably be removed | |
| 389 | . I BPSSRE SP="P"!(BP SSRESP="D" )!(BPSSRES P="R") D | |
| 390 | .. ; | |
| 391 | .. ; Ask i f user wan ts to ente r data for additiona l response file fiel ds - Quit if user sa ys no | |
| 392 | .. N DIR,D TOUT,DUOUT ,DIROUT,DI RUT | |
| 393 | .. S DIR(0 )="YA",DIR ("A")="Pop ulate Addi tional Res ponse Fiel ds? ",DIR( "B")="No" W ! D ^DIR | |
| 394 | .. I Y'=1 Q | |
| 395 | .. ; | |
| 396 | .. ; Overr ides to te st functio nality of BPS*1*20 | |
| 397 | .. D PROMP T(BPSTIEN, .15,0) ; Ingr edient Cos t Paid (50 6) | |
| 398 | .. D PROMP T(BPSTIEN, .16,0) ; Disp ensing Fee Paid (507 ) | |
| 399 | .. D PROMP T(BPSTIEN, .17,0) ; Rema ining Dedu ctible Amo unt (513) | |
| 400 | .. D PROMP T(BPSTIEN, .18,0) ; Amou nt Applied to Period ic Deducti ble (517) | |
| 401 | .. ; | |
| 402 | .. ; Addit ional over rides for D1-D9 (BPS *1*15) | |
| 403 | .. D PROMP T(BPSTIEN, .09,"") ; next available fill date | |
| 404 | .. D PROMP T(BPSTIEN, .1,"") ; adju dicated pa yment type | |
| 405 | .. ; | |
| 406 | .. ; Addit ional over rides for E0-E6 (BPS *1*19) | |
| 407 | .. D PROMP T(BPSTIEN, 2.01,"04") ; % sa les tax ba sis pd | |
| 408 | .. D PROMP T(BPSTIEN, 2.02,11) ; othe r amount p aid qualif ier | |
| 409 | .. D PROMP T(BPSTIEN, 2.03,"01") ; paye r id quali fier | |
| 410 | .. D PROMP T(BPSTIEN, 2.04,"") ; help desk phon e# ext | |
| 411 | .. D PROMP T(BPSTIEN, 2.05,"") ; pro service fe e cont/rei m amt | |
| 412 | .. D PROMP T(BPSTIEN, 2.06,"") ; othe r payer he lp desk ph one# ext | |
| 413 | .. D PROMP T(BPSTIEN, 2.07,"") ; resp onse inter med auth t ype id | |
| 414 | .. D PROMP T(BPSTIEN, 2.08,"") ; resp onse inter med auth i d | |
| 415 | .. D PROMP T(BPSTIEN, 3.01,"") ; resp onse inter med messag e | |
| 416 | .. ; | |
| 417 | .. ; E7 ov errides (B PS*1*20) | |
| 418 | .. D PROMP T(BPSTIEN, .11,"") ; q uan limit per specif ic time pe riod | |
| 419 | .. D PROMP T(BPSTIEN, .12,"") ; q uan limit time perio d | |
| 420 | .. D PROMP T(BPSTIEN, .13,"") ; d ays supp l imit per s pecific ti me period | |
| 421 | .. D PROMP T(BPSTIEN, .14,"") ; d ays supp l imit time period | |
| 422 | .. ; Overr ides to te st functio nality - B PS*1*22.. D PROMPT(B PSTIEN,2.0 9,"") ; reco nciliation id | |
| 423 | ; | |
| 424 | W ! D PROM PT(BPSTIEN ,.07,0) | |
| 425 | Q | |
| 426 | ||
| 427 | ||
| 428 | ||
| 429 | Subroutine Name | |
| 430 | SETOVER^BP STEST | |
| 431 | Enhancemen t Category | |
| 432 | New | |
| 433 | Modify | |
| 434 | Delete | |
| 435 | No Change | |
| 436 | Story | |
| 437 | US174 (Ral ly ID) | |
| 438 | Related Op tions | |
| 439 | n/a | |
| 440 | Related Su broutines | |
| 441 | This Subro utine is C alled By | |
| 442 | This Subro utine Call s | |
| 443 | ||
| 444 | PARSE^BPSE CMPS | |
| 445 | GET1^DIQ | |
| 446 | Data Dicti onary (DD) Reference s | |
| 447 | n/a | |
| 448 | Related Pr otocols | |
| 449 | n/a | |
| 450 | Related In tegration Control Re gistration s (ICRs) | |
| 451 | n/a | |
| 452 | Data Passi ng | |
| 453 | Input | |
| 454 | Output Re ference | |
| 455 | Both | |
| 456 | Global Re ference | |
| 457 | Local | |
| 458 | Input Attr ibute Name and Defin ition | |
| 459 | Name: BPST RANS | |
| 460 | Definition : Transac tion IEN | |
| 461 | New Modify Delete No Cha nge | |
| 462 | Name: BPST YPE | |
| 463 | Definition : B1 for submission , B2 for r eversals | |
| 464 | New Modify Delete No Cha nge | |
| 465 | Output Att ribute Nam e and Defi nition | |
| 466 | Name: BPSD ATA | |
| 467 | Definition : passed by referen ce and upd ate with a ppropriate overrides | |
| 468 | New Modify Delete No Cha nge | |
| 469 | Current Lo gic | |
| 470 | SETOVER(BP STRANS,BPS TYPE,BPSDA TA); | |
| 471 | ; called b y BPSECMPS to set th e override data | |
| 472 | ; Input | |
| 473 | ; BPSTR ANS - Tran saction IE N | |
| 474 | ; BPSTY PE - B1 f or submiss ion, B2 fo r reversal s | |
| 475 | ; Output | |
| 476 | ; BPSDA TA - Pa ssed by re ference an d updated with appro priate ove rrides | |
| 477 | ; | |
| 478 | N BPSTIEN, BPSRRESP,B PSSRESP,BP SPAID,BPSR CNT,BPSRIE N,BPSRCODE ,BPSRCD,BP SCOPAY, | |
| 479 | BPSXXXX,BP SUNDEF | |
| 480 | N BPSAJPAY ,BPSNFLDT, BPSX | |
| 481 | N BPS506,B PS507,BPS5 13,BPS517 | |
| 482 | ; | |
| 483 | ; Check th e Test Fla g in set i n BPS SETU P | |
| 484 | I '$$CHECK () Q | |
| 485 | ; | |
| 486 | ; Check if the Trans action Num ber is def ined in BP S RESPONSE OVERRIDES | |
| 487 | S BPSTIEN= $O(^BPS(90 02313.32," B",BPSTRAN S,"")) | |
| 488 | I BPSTIEN= "" Q | |
| 489 | ; | |
| 490 | ; If a eli gibility, check for specific r eversal ov errides an d set | |
| 491 | I BPSTYPE= "E1" D Q | |
| 492 | . S BPSRRE SP=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.08 ,"I") | |
| 493 | . ; | |
| 494 | . ; If the response is Strande d, force a n <UNDEF> error | |
| 495 | . I BPSRRE SP="S" S B PSXXXX=BPS UNDEF | |
| 496 | . I BPSRRE SP]"" S BP SDATA(1,11 2)=BPSRRES P | |
| 497 | . S BPSDAT A(9002313. 03,9002313 .03,"+1,", 501)=$S(BP SRRESP="R" :"R",1:"A" ) | |
| 498 | . ; | |
| 499 | . ; If the response is accepte d, delete the reject code coun t and code s | |
| 500 | . I BPSRRE SP="A" K B PSDATA(1,5 10),BPSDAT A(1,511) | |
| 501 | . ; | |
| 502 | . ; If the response is rejecte d, delete the reject ions retur ned by pay ers | |
| 503 | . ; and put in the ones ente red by the user | |
| 504 | . I BPSRRE SP="R" D | |
| 505 | .. K BPSDA TA(1,509), BPSDATA(1, 511) | |
| 506 | .. S BPSRC NT=0 | |
| 507 | .. S BPSRI EN=0 F S BPSRIEN=$O (^BPS(9002 313.32,BPS TIEN,1,BPS RIEN)) Q:+ BPSRIEN=0 D | |
| 508 | ... S BPSR CODE=$P($G (^BPS(9002 313.32,BPS TIEN,1,BPS RIEN,0))," ^",1) | |
| 509 | ... ; Incr ement coun ter and st ore | |
| 510 | ... I BPSR CODE]"" D | |
| 511 | .... S BPS RCD=$$GET1 ^DIQ(90023 13.93,BPSR CODE_",",. 01,"E") | |
| 512 | .... I BPS RCD]"" S B PSRCNT=BPS RCNT+1,BPS DATA(1,511 ,BPSRCNT)= BPSRCD | |
| 513 | .. ; Store total num ber of rej ections | |
| 514 | .. S BPSDA TA(1,510)= BPSRCNT | |
| 515 | ; | |
| 516 | ; If a rev ersal, che ck for spe cific reve rsal overr ides and s et | |
| 517 | I BPSTYPE= "B2" D | |
| 518 | . S BPSRRE SP=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.05 ,"I") | |
| 519 | . ; | |
| 520 | . ; If the response is Strande d, force a n <UNDEF> error | |
| 521 | . I BPSRRE SP="S" S B PSXXXX=BPS UNDEF | |
| 522 | . I BPSRRE SP]"" S BP SDATA(1,11 2)=$S(BPSR RESP="D":" S",1:BPSRR ESP) | |
| 523 | . S BPSDAT A(9002313. 03,9002313 .03,"+1,", 501)=$S(BP SRRESP="R" :"R",1:"A" ) | |
| 524 | . ; | |
| 525 | . ; If the response is accepte d or dupli cate, kill the rejec t code cou nt and cod es | |
| 526 | . I BPSRRE SP="A"!(BP SRRESP="D" ) K BPSDAT A(1,510),B PSDATA(1,5 11) | |
| 527 | . ; | |
| 528 | . ; If the response is rejecte d, set the reject co des | |
| 529 | . I BPSRRE SP="R" D S ETREJ(BPST RANS) | |
| 530 | ; | |
| 531 | ; If a sub mission, c heck for s pecific su bmission o verrides a nd set | |
| 532 | I BPSTYPE= "B1" D | |
| 533 | . ; Get su bmission r esponse | |
| 534 | . S BPSSRE SP=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.03 ,"I") | |
| 535 | . ; | |
| 536 | . ; If the response is Strande d, force a n <UNDEF> error | |
| 537 | . I BPSSRE SP="S" S B PSXXXX=BPS UNDEF | |
| 538 | . ; | |
| 539 | . ; If BPS SRESP exis ts, file i t | |
| 540 | . I BPSSRE SP]"" D | |
| 541 | .. S BPSDA TA(1,112)= BPSSRESP | |
| 542 | .. S BPSDA TA(9002313 .03,900231 3.03,"+1," ,501)=$S(B PSSRESP="R ":"R",1:"A ") | |
| 543 | .. ; If pa yable or d uplicate, get the BP SPAID amou nt and fil e it if it | |
| 544 | .. ; exist s. Also d elete any reject cod es | |
| 545 | .. I BPSSR ESP="P"!(B PSSRESP="D ") D | |
| 546 | ... S BPSP AID=$$GET1 ^DIQ(90023 13.32,BPST IEN_",",.0 4,"I") | |
| 547 | ... I BPSP AID]"" S B PSDATA(1,5 09)=$$DFF^ BPSECFM(BP SPAID,8) ; 5 09 Total a mount paid | |
| 548 | ... ; | |
| 549 | ... K BPSD ATA(1,510) ,BPSDATA(1 ,511) ; kill Re ject Count (510) and Reject Co de (511) | |
| 550 | ... ; | |
| 551 | ... S BPSC OPAY=$$GET 1^DIQ(9002 313.32,BPS TIEN_",",. 06,"I") | |
| 552 | ... I BPSC OPAY]"" S BPSDATA(1, 518)=$$DFF ^BPSECFM(B PSCOPAY,8) ; 5 18 Copay A mount | |
| 553 | ... ; | |
| 554 | ... S BPS5 06=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.15 ,"I") | |
| 555 | ... I BPS5 06]"" S BP SDATA(1,50 6)=$$DFF^B PSECFM(BPS 506,8) ; 5 06 Ingredi ent Cost P aid | |
| 556 | ... ; | |
| 557 | ... S BPS5 07=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.16 ,"I") | |
| 558 | ... I BPS5 07]"" S BP SDATA(1,50 7)=$$DFF^B PSECFM(BPS 507,8) ; 5 07 Dispens ing Fee Pa id | |
| 559 | ... ; | |
| 560 | ... S BPS5 13=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.17 ,"I") | |
| 561 | ... I BPS5 13]"" S BP SDATA(1,51 3)=$$DFF^B PSECFM(BPS 513,8) ; 5 13 Remaini ng Deducti ble Amount | |
| 562 | ... ; | |
| 563 | ... S BPS5 17=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.18 ,"I") | |
| 564 | ... I BPS5 17]"" S BP SDATA(1,51 7)=$$DFF^B PSECFM(BPS 517,8) ; 5 17 Amount Applied to Periodic Deductible | |
| 565 | ... Q | |
| 566 | .. ; | |
| 567 | .. I BPSSR ESP="P"!(B PSSRESP="D ")!(BPSSRE SP="R") D | |
| 568 | ... ; D1-D 9 fields ( BPS*1*15) | |
| 569 | ... S BPSA JPAY=$$GET 1^DIQ(9002 313.32,BPS TIEN_",",. 1,"I") ; A djudicated Payment T ype | |
| 570 | ... I BPSA JPAY]"" S BPSDATA(1, 1028)=$$NF F^BPSECFM( BPSAJPAY,2 ) | |
| 571 | ... S BPSN FLDT=$$GET 1^DIQ(9002 313.32,BPS TIEN_",",. 09,"I") ; O verride Ne xt Availab le Fill | |
| 572 | ... I BPSN FLDT]"" S BPSDATA(1, 2004)=$$DT F1^BPSECFM (BPSNFLDT) | |
| 573 | ... ; | |
| 574 | ... ; E0-E 6 override s (BPS*1*1 9) | |
| 575 | ... ; PERC ENTAGE SAL ES TAX BAS IS PAID | |
| 576 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.01, "I") | |
| 577 | ... I BPSX ]"" S BPSD ATA(1,561) =BPSX | |
| 578 | ... ; OTHE R AMOUNT P AID QUALIF IER and as sociated f ield | |
| 579 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.02, "I") | |
| 580 | ... I BPSX ]"" S BPSD ATA(1,564, 1)=$$NFF^B PSECFM(BPS X,2),BPSDA TA(1,565,1 )=$$DFF^ | |
| 581 | BPSECFM(5. 64,8),BPSD ATA(1,563) =1 | |
| 582 | ... ; PAYE R ID QUALI FIER | |
| 583 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.03, "I") | |
| 584 | ... I BPSX ]"" S BPSD ATA(900231 3.03,90023 13.03,"+1, ",568)=BPS X | |
| 585 | ... ; HELP DESK TELE PHONE NUMB ER EXTENSI ON | |
| 586 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.04, "I") | |
| 587 | ... I BPSX ]"" S BPSD ATA(1,"202 2")=$$NFF^ BPSECFM(BP SX,8) | |
| 588 | ... ; PROF ESSIONAL S ERVICE FEE CONTRACTE D/REIMURSE MENT AMOUN T | |
| 589 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.05, "I") | |
| 590 | ... I BPSX ]"" S BPSD ATA(1,"203 3")=$$DFF^ BPSECFM(BP SX,8) | |
| 591 | ... ; OTHE R PAYER HE LPDESK TEL EPHONE EXT ENSION | |
| 592 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.06, "I") | |
| 593 | ... I BPSX ]"" S BPSD ATA(1,"202 3",1)=$$NF F^BPSECFM( BPSX,8),BP SDATA(1,33 8,1)="01" | |
| 594 | ... ; RESP ONSE INTER MEDIARY AU THORIZATIO N TYPE ID and associ ated field s | |
| 595 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.07, "I") | |
| 596 | ... I BPSX ]"" S BPSD ATA(1,"205 3",1)=$$NF F^BPSECFM( BPSX,2),BP SDATA(1,20 52)=1 | |
| 597 | ... ; RESP ONSE INTER MEDIARY AU THORIZATIO N ID and a ssociated fields | |
| 598 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.08, "I") | |
| 599 | ... I BPSX ]"" S BPSD ATA(1,"205 4",1)=$$AN FF^BPSECFM (BPSX,20), BPSDATA(1, 2052)=1 | |
| 600 | ||
| 601 | ... ; PERC ENTAGE SAL ES TAX BAS IS PAID | |
| 602 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.01, "I") | |
| 603 | ... I BPSX ]"" S BPSD ATA(1,561) =BPSX | |
| 604 | ||
| 605 | ... ; INTE RMEDIARY M ESSAGE and associate d fields | |
| 606 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",3.01, "I") | |
| 607 | ... I BPSX ]"" S BPSD ATA(1,"205 1",1)=$$AN FF^BPSECFM (BPSX,200) ,BPSDATA(1 ,2052)=1 | |
| 608 | ... ; | |
| 609 | ... ; E7 o verrides ( BPS*1*20) | |
| 610 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",.11," I") I BPSX '="" D ; B88-3R quantity l imit per s pec time p eriod | |
| 611 | .... S BPS DATA(1,208 7)=1 ; count fi eld | |
| 612 | .... S BPS DATA(1,208 8,1)=$$NFF ^BPSECFM(B PSX,10) ; data fro m override file | |
| 613 | .... Q | |
| 614 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",.12," I") I BPSX '="" D ; B89-3S quantity l imit time period | |
| 615 | .... S BPS DATA(1,208 7)=1 ; count fi eld | |
| 616 | .... S BPS DATA(1,208 9,1)=$$NFF ^BPSECFM(B PSX,5) ; data fro m override file | |
| 617 | .... Q | |
| 618 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",.13," I") I BPSX '="" D ; B91-3W days suppl y limit pe r spec tim e period | |
| 619 | .... S BPS DATA(1,209 0)=1 ; count fi eld | |
| 620 | .... S BPS DATA(1,209 1,1)=$$NFF ^BPSECFM(B PSX,3) ; data fro m override file | |
| 621 | .... Q | |
| 622 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",.14," I") I BPSX '="" D ; B92-3X days suppl y limit ti me period | |
| 623 | .... S BPS DATA(1,209 0)=1 ; count fi eld | |
| 624 | .... S BPS DATA(1,209 2,1)=$$NFF ^BPSECFM(B PSX,5) ; data fro m override file | |
| 625 | .... Q | |
| 626 | ... Q | |
| 627 | .. ; | |
| 628 | .. ; If re jected, ge t the reje ction code and file them | |
| 629 | .. ; Also, delete th e BPSPAID amount | |
| 630 | .. I BPSSR ESP="R" D | |
| 631 | ... ; Dele te old rej ections an d BPSPAID amount | |
| 632 | ... K BPSD ATA(1,509) ,BPSDATA(1 ,511) | |
| 633 | ... ; Loop through r ejections and store | |
| 634 | ... S BPSR CNT=0 | |
| 635 | ... S BPSR IEN=0 F S BPSRIEN=$ O(^BPS(900 2313.32,BP STIEN,1,BP SRIEN)) Q: +BPSRIEN=0 D | |
| 636 | .... S BPS RCODE=$P($ G(^BPS(900 2313.32,BP STIEN,1,BP SRIEN,0)), "^",1) | |
| 637 | .... ; Inc rement cou nter and s tore | |
| 638 | .... I BPS RCODE]"" D | |
| 639 | ..... S BP SRCD=$$GET 1^DIQ(9002 313.93,BPS RCODE_",", .01,"E") | |
| 640 | ..... I BP SRCD]"" S BPSRCNT=BP SRCNT+1,BP SDATA(1,51 1,BPSRCNT) =BPSRCD | |
| 641 | ... ; Stor e total nu mber of re jections | |
| 642 | ... S BPSD ATA(1,510) =BPSRCNT | |
| 643 | Q | |
| 644 | ||
| 645 | Modified L ogic (Chan ges are hi ghlighted) | |
| 646 | SETOVER(BP STRANS,BPS TYPE,BPSDA TA); | |
| 647 | ; called b y BPSECMPS to set th e override data | |
| 648 | ; Input | |
| 649 | ; BPSTR ANS - Tran saction IE N | |
| 650 | ; BPSTY PE - B1 f or submiss ion, B2 fo r reversal s | |
| 651 | ; Output | |
| 652 | ; BPSDA TA - Pa ssed by re ference an d updated with appro priate ove rrides | |
| 653 | ; | |
| 654 | N BPSTIEN, BPSRRESP,B PSSRESP,BP SPAID,BPSR CNT,BPSRIE N,BPSRCODE ,BPSRCD,BP SCOPAY, | |
| 655 | BPSXXXX,BP SUNDEF | |
| 656 | N BPSAJPAY ,BPSNFLDT, BPSX | |
| 657 | N BPS506,B PS507,BPS5 13,BPS517 | |
| 658 | ; | |
| 659 | ; Check th e Test Fla g in set i n BPS SETU P | |
| 660 | I '$$CHECK () Q | |
| 661 | ; | |
| 662 | ; Check if the Trans action Num ber is def ined in BP S RESPONSE OVERRIDES | |
| 663 | S BPSTIEN= $O(^BPS(90 02313.32," B",BPSTRAN S,"")) | |
| 664 | I BPSTIEN= "" Q | |
| 665 | ; | |
| 666 | ; If a eli gibility, check for specific r eversal ov errides an d set | |
| 667 | I BPSTYPE= "E1" D Q | |
| 668 | . S BPSRRE SP=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.08 ,"I") | |
| 669 | . ; | |
| 670 | . ; If the response is Strande d, force a n <UNDEF> error | |
| 671 | . I BPSRRE SP="S" S B PSXXXX=BPS UNDEF | |
| 672 | . I BPSRRE SP]"" S BP SDATA(1,11 2)=BPSRRES P | |
| 673 | . S BPSDAT A(9002313. 03,9002313 .03,"+1,", 501)=$S(BP SRRESP="R" :"R",1:"A" ) | |
| 674 | . ; | |
| 675 | . ; If the response is accepte d, delete the reject code coun t and code s | |
| 676 | . I BPSRRE SP="A" K B PSDATA(1,5 10),BPSDAT A(1,511) | |
| 677 | . ; | |
| 678 | . ; If the response is rejecte d, delete the reject ions retur ned by pay ers | |
| 679 | . ; and put in the ones ente red by the user | |
| 680 | . I BPSRRE SP="R" D | |
| 681 | .. K BPSDA TA(1,509), BPSDATA(1, 511) | |
| 682 | .. S BPSRC NT=0 | |
| 683 | .. S BPSRI EN=0 F S BPSRIEN=$O (^BPS(9002 313.32,BPS TIEN,1,BPS RIEN)) Q:+ BPSRIEN=0 D | |
| 684 | ... S BPSR CODE=$P($G (^BPS(9002 313.32,BPS TIEN,1,BPS RIEN,0))," ^",1) | |
| 685 | ... ; Incr ement coun ter and st ore | |
| 686 | ... I BPSR CODE]"" D | |
| 687 | .... S BPS RCD=$$GET1 ^DIQ(90023 13.93,BPSR CODE_",",. 01,"E") | |
| 688 | .... I BPS RCD]"" S B PSRCNT=BPS RCNT+1,BPS DATA(1,511 ,BPSRCNT)= BPSRCD | |
| 689 | .. ; Store total num ber of rej ections | |
| 690 | .. S BPSDA TA(1,510)= BPSRCNT | |
| 691 | ; | |
| 692 | ; If a rev ersal, che ck for spe cific reve rsal overr ides and s et | |
| 693 | I BPSTYPE= "B2" D | |
| 694 | . S BPSRRE SP=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.05 ,"I") | |
| 695 | . ; | |
| 696 | . ; If the response is Strande d, force a n <UNDEF> error | |
| 697 | . I BPSRRE SP="S" S B PSXXXX=BPS UNDEF | |
| 698 | . I BPSRRE SP]"" S BP SDATA(1,11 2)=$S(BPSR RESP="D":" S",1:BPSRR ESP) | |
| 699 | . S BPSDAT A(9002313. 03,9002313 .03,"+1,", 501)=$S(BP SRRESP="R" :"R",1:"A" ) | |
| 700 | . ; | |
| 701 | . ; If the response is accepte d or dupli cate, kill the rejec t code cou nt and cod es | |
| 702 | . I BPSRRE SP="A"!(BP SRRESP="D" ) K BPSDAT A(1,510),B PSDATA(1,5 11) | |
| 703 | . ; | |
| 704 | . ; If the response is rejecte d, set the reject co des | |
| 705 | . I BPSRRE SP="R" D S ETREJ(BPST RANS) | |
| 706 | ; | |
| 707 | ; If a sub mission, c heck for s pecific su bmission o verrides a nd set | |
| 708 | I BPSTYPE= "B1" D | |
| 709 | . ; Get su bmission r esponse | |
| 710 | . S BPSSRE SP=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.03 ,"I") | |
| 711 | . ; | |
| 712 | . ; If the response is Strande d, force a n <UNDEF> error | |
| 713 | . I BPSSRE SP="S" S B PSXXXX=BPS UNDEF | |
| 714 | . ; | |
| 715 | . ; If BPS SRESP exis ts, file i t | |
| 716 | . I BPSSRE SP]"" D | |
| 717 | .. S BPSDA TA(1,112)= BPSSRESP | |
| 718 | .. S BPSDA TA(9002313 .03,900231 3.03,"+1," ,501)=$S(B PSSRESP="R ":"R",1:"A ") | |
| 719 | .. ; If pa yable or d uplicate, get the BP SPAID amou nt and fil e it if it | |
| 720 | .. ; exist s. Also d elete any reject cod es | |
| 721 | .. I BPSSR ESP="P"!(B PSSRESP="D ") D | |
| 722 | ... S BPSP AID=$$GET1 ^DIQ(90023 13.32,BPST IEN_",",.0 4,"I") | |
| 723 | ... I BPSP AID]"" S B PSDATA(1,5 09)=$$DFF^ BPSECFM(BP SPAID,8) ; 5 09 Total a mount paid | |
| 724 | ... ; | |
| 725 | ... K BPSD ATA(1,510) ,BPSDATA(1 ,511) ; kill Re ject Count (510) and Reject Co de (511) | |
| 726 | ... ; | |
| 727 | ... S BPSC OPAY=$$GET 1^DIQ(9002 313.32,BPS TIEN_",",. 06,"I") | |
| 728 | ... I BPSC OPAY]"" S BPSDATA(1, 518)=$$DFF ^BPSECFM(B PSCOPAY,8) ; 5 18 Copay A mount | |
| 729 | ... ; | |
| 730 | ... S BPS5 06=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.15 ,"I") | |
| 731 | ... I BPS5 06]"" S BP SDATA(1,50 6)=$$DFF^B PSECFM(BPS 506,8) ; 5 06 Ingredi ent Cost P aid | |
| 732 | ... ; | |
| 733 | ... S BPS5 07=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.16 ,"I") | |
| 734 | ... I BPS5 07]"" S BP SDATA(1,50 7)=$$DFF^B PSECFM(BPS 507,8) ; 5 07 Dispens ing Fee Pa id | |
| 735 | ... ; | |
| 736 | ... S BPS5 13=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.17 ,"I") | |
| 737 | ... I BPS5 13]"" S BP SDATA(1,51 3)=$$DFF^B PSECFM(BPS 513,8) ; 5 13 Remaini ng Deducti ble Amount | |
| 738 | ... ; | |
| 739 | ... S BPS5 17=$$GET1^ DIQ(900231 3.32,BPSTI EN_",",.18 ,"I") | |
| 740 | ... I BPS5 17]"" S BP SDATA(1,51 7)=$$DFF^B PSECFM(BPS 517,8) ; 5 17 Amount Applied to Periodic Deductible | |
| 741 | ... Q | |
| 742 | .. ; | |
| 743 | .. I BPSSR ESP="P"!(B PSSRESP="D ")!(BPSSRE SP="R") D | |
| 744 | ... ; D1-D 9 fields ( BPS*1*15) | |
| 745 | ... S BPSA JPAY=$$GET 1^DIQ(9002 313.32,BPS TIEN_",",. 1,"I") ; A djudicated Payment T ype | |
| 746 | ... I BPSA JPAY]"" S BPSDATA(1, 1028)=$$NF F^BPSECFM( BPSAJPAY,2 ) | |
| 747 | ... S BPSN FLDT=$$GET 1^DIQ(9002 313.32,BPS TIEN_",",. 09,"I") ; O verride Ne xt Availab le Fill | |
| 748 | ... I BPSN FLDT]"" S BPSDATA(1, 2004)=$$DT F1^BPSECFM (BPSNFLDT) | |
| 749 | ... ; | |
| 750 | ... ; E0-E 6 override s (BPS*1*1 9) | |
| 751 | ... ; PERC ENTAGE SAL ES TAX BAS IS PAID | |
| 752 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.01, "I") | |
| 753 | ... I BPSX ]"" S BPSD ATA(1,561) =BPSX | |
| 754 | ... ; OTHE R AMOUNT P AID QUALIF IER and as sociated f ield | |
| 755 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.02, "I") | |
| 756 | ... I BPSX ]"" S BPSD ATA(1,564, 1)=$$NFF^B PSECFM(BPS X,2),BPSDA TA(1,565,1 )=$$DFF^ | |
| 757 | BPSECFM(5. 64,8),BPSD ATA(1,563) =1 | |
| 758 | ... ; PAYE R ID QUALI FIER | |
| 759 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.03, "I") | |
| 760 | ... I BPSX ]"" S BPSD ATA(900231 3.03,90023 13.03,"+1, ",568)=BPS X | |
| 761 | ... ; HELP DESK TELE PHONE NUMB ER EXTENSI ON | |
| 762 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.04, "I") | |
| 763 | ... I BPSX ]"" S BPSD ATA(1,"202 2")=$$NFF^ BPSECFM(BP SX,8) | |
| 764 | ... ; PROF ESSIONAL S ERVICE FEE CONTRACTE D/REIMURSE MENT AMOUN T | |
| 765 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.05, "I") | |
| 766 | ... I BPSX ]"" S BPSD ATA(1,"203 3")=$$DFF^ BPSECFM(BP SX,8) | |
| 767 | ... ; OTHE R PAYER HE LPDESK TEL EPHONE EXT ENSION | |
| 768 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.06, "I") | |
| 769 | ... I BPSX ]"" S BPSD ATA(1,"202 3",1)=$$NF F^BPSECFM( BPSX,8),BP SDATA(1,33 8,1)="01" | |
| 770 | ... ; RESP ONSE INTER MEDIARY AU THORIZATIO N TYPE ID and associ ated field s | |
| 771 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.07, "I") | |
| 772 | ... I BPSX ]"" S BPSD ATA(1,"205 3",1)=$$NF F^BPSECFM( BPSX,2),BP SDATA(1,20 52)=1 | |
| 773 | ... ; RESP ONSE INTER MEDIARY AU THORIZATIO N ID and a ssociated fields | |
| 774 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.08, "I") | |
| 775 | ... I BPSX ]"" S BPSD ATA(1,"205 4",1)=$$AN FF^BPSECFM (BPSX,20), BPSDATA(1, 2052)=1 | |
| 776 | ... ; INTE RMEDIARY M ESSAGE and associate d fields | |
| 777 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",3.01, "I") | |
| 778 | ... I BPSX ]"" S BPSD ATA(1,"205 1",1)=$$AN FF^BPSECFM (BPSX,200) ,BPSDATA(1 ,2052)=1 | |
| 779 | ... ; (BPS *1*22) | |
| 780 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",2.09, "I") ; B98 -34 reconc iliation i d | |
| 781 | ... I BPSX ]"" S BPSD ATA(1,”209 8”)=$$ANFF ^BPSECFM(B PSX,30) | |
| 782 | ... ; | |
| 783 | ... ; E7 o verrides ( BPS*1*20) | |
| 784 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",.11," I") I BPSX '="" D ; B88-3R quantity l imit per s pec time p eriod | |
| 785 | .... S BPS DATA(1,208 7)=1 ; count fi eld | |
| 786 | .... S BPS DATA(1,208 8,1)=$$NFF ^BPSECFM(B PSX,10) ; data fro m override file | |
| 787 | .... Q | |
| 788 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",.12," I") I BPSX '="" D ; B89-3S quantity l imit time period | |
| 789 | .... S BPS DATA(1,208 7)=1 ; count fi eld | |
| 790 | .... S BPS DATA(1,208 9,1)=$$NFF ^BPSECFM(B PSX,5) ; data fro m override file | |
| 791 | .... Q | |
| 792 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",.13," I") I BPSX '="" D ; B91-3W days suppl y limit pe r spec tim e period | |
| 793 | .... S BPS DATA(1,209 0)=1 ; count fi eld | |
| 794 | .... S BPS DATA(1,209 1,1)=$$NFF ^BPSECFM(B PSX,3) ; data fro m override file | |
| 795 | .... Q | |
| 796 | ... S BPSX =$$GET1^DI Q(9002313. 32,BPSTIEN _",",.14," I") I BPSX '="" D ; B92-3X days suppl y limit ti me period | |
| 797 | .... S BPS DATA(1,209 0)=1 ; count fi eld | |
| 798 | .... S BPS DATA(1,209 2,1)=$$NFF ^BPSECFM(B PSX,5) ; data fro m override file | |
| 799 | .... Q | |
| 800 | ... Q | |
| 801 | .. ; | |
| 802 | .. ; If re jected, ge t the reje ction code and file them | |
| 803 | .. ; Also, delete th e BPSPAID amount | |
| 804 | .. I BPSSR ESP="R" D | |
| 805 | ... ; Dele te old rej ections an d BPSPAID amount | |
| 806 | ... K BPSD ATA(1,509) ,BPSDATA(1 ,511) | |
| 807 | ... ; Loop through r ejections and store | |
| 808 | ... S BPSR CNT=0 | |
| 809 | ... S BPSR IEN=0 F S BPSRIEN=$ O(^BPS(900 2313.32,BP STIEN,1,BP SRIEN)) Q: +BPSRIEN=0 D | |
| 810 | .... S BPS RCODE=$P($ G(^BPS(900 2313.32,BP STIEN,1,BP SRIEN,0)), "^",1) | |
| 811 | .... ; Inc rement cou nter and s tore | |
| 812 | .... I BPS RCODE]"" D | |
| 813 | ..... S BP SRCD=$$GET 1^DIQ(9002 313.93,BPS RCODE_",", .01,"E") | |
| 814 | ..... I BP SRCD]"" S BPSRCNT=BP SRCNT+1,BP SDATA(1,51 1,BPSRCNT) =BPSRCD | |
| 815 | ... ; Stor e total nu mber of re jections | |
| 816 | ... S BPSD ATA(1,510) =BPSRCNT | |
| 817 | Q | |
| 818 | ||
| 819 |
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