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| # | Location | File | Last Modified |
|---|---|---|---|
| 1 | eBilling_Bld22_IB_2_608.zip | TAS eBill SDD US2489 v2.00.docx | Tue Dec 19 21:52:48 2017 UTC |
| 2 | eBilling_Bld22_IB_2_608.zip | TAS eBill SDD US2489 v2.00.docx | Thu Feb 15 18:18:54 2018 UTC |
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| 1 | TAS eBilli ng SDD US2 489 | |
| 2 | System Des ign Docume nt | |
| 3 | IB*2.0*592 | |
| 4 | ||
| 5 | ||
| 6 | ||
| 7 | ||
| 8 | Department of Vetera ns Affairs | |
| 9 | July 2017 | |
| 10 | Version 2. 00 | |
| 11 | User Story Number: N O ID | |
| 12 | User Story Name: Fix <UNDEFINE D> errors | |
| 13 | Product Ba cklog ID: n/a | |
| 14 | Rally ID: US-2489 | |
| 15 | Design/Res olution | |
| 16 | This SDD i s to fix t wo <UNDEFI NED> error s intermit tently occ urring whe n the user tries to 1) “Print MRA” while in the MR A Manageme nt WorkLis t, which i s error <U NDEFINED>P MRA+3^IBCE COB2 and 2 ) “CANCEL/ CLONE” a b ill, which is error <UNDEFINED >STEP1+5^I BCCC. | |
| 17 | This fix r equires mo difying 4 routines, namely IBC C, IBCCC, IBCCCB and IBCECOB2 as summari zed and de tailed bel ow: | |
| 18 | Error #1 <UNDEFINED >PMRA+3^IB CECOB2: Th is simply requires t he use of $G to wrap an array element be ing refere nced in PM RA^IBCECOB 2 that was $G’d at a previous command in the same line of co de. | |
| 19 | ||
| 20 | Error #2 <UNDEFINED >STEP1+5^I BCCC: Is d irectly ca used by th e killing of a criti cal variab le IBCCCC which is s ubsequentl y referenc ed. It is being sub sequently referenced because t he logic i s caught i n an endle ss loop du e to the f act that t he quit fl ag IBQUIT is not bei ng flagged as ‘1’ af ter issuin g a messag e directin g the user to anothe r activity . To reso lve this e rror, the code at ST EP1^IBCCC shall be m odified to wrap vari able IBCCC C with $G to prevent any futur e <UNDEFIN ED> errors at this p lace in th e code. W rapping IB CCC with $ G, is real ly a fails afe since IBCCC shou ld no long er be unde fined at t his point due to the changes t o END1^IBC CC, which shall be m odified so that the killing of IBCCC occ urs after the loopba ck to STEP 1 instead of prior t o the loop back. The root caus e of this error, how ever, shal l be addre ssed by mo difying ro utines IBC C and IBCC CB to prop erly set t he IBQUIT flag after issuing t he message directing the user to another activity. | |
| 21 | ||
| 22 | Routines | |
| 23 | Activities | |
| 24 | Routine Na me | |
| 25 | IBCC | |
| 26 | Enhancemen t Category | |
| 27 | New | |
| 28 | Modify | |
| 29 | Delete | |
| 30 | No Change | |
| 31 | RTM | |
| 32 | ||
| 33 | Related Op tions | |
| 34 | None | |
| 35 | Related Ro utines | |
| 36 | Routines “ Called By” | |
| 37 | Routines “ Called” | |
| 38 | ||
| 39 | ||
| 40 | ||
| 41 | ||
| 42 | Data Dicti onary (DD) Reference s | |
| 43 | ||
| 44 | Related Pr otocols | |
| 45 | ||
| 46 | Related In tegration Control Re gistration s (ICRs) | |
| 47 | None | |
| 48 | Data Passi ng | |
| 49 | Input | |
| 50 | Output Re ference | |
| 51 | Both | |
| 52 | Global Re ference | |
| 53 | Local | |
| 54 | Input Attr ibute Name and Defin ition | |
| 55 | Name: | |
| 56 | Definition : | |
| 57 | Output Att ribute Nam e and Defi nition | |
| 58 | Name: | |
| 59 | Definition : | |
| 60 | Current Lo gic | |
| 61 | IBCC^INT^1 ^^0 | |
| 62 | IBCC ;ALB/ MJB - CANC EL THIRD P ARTY BILL ;14 JUN 88 10:12 | |
| 63 | ;;2.0;INT EGRATED BI LLING;**2, 19,77,80,5 1,142,137, 161,199,24 1,155,276, 320,358,43 3,432,447, 516,547**; 21-MAR-94; Build 119 | |
| 64 | ;;Per VA Directive 6402, this routine s hould not be modifie d. | |
| 65 | ; | |
| 66 | ;MAP TO D GCRC | |
| 67 | ; | |
| 68 | I '$D(IBC AN) S IBCA N=1 | |
| 69 | ASK ; | |
| 70 | ;*** | |
| 71 | ;I $D(XRT 0) S:'$D(X RTN) XRTN= "IBCC" D T 1^%ZOSV ;s top rt clo ck | |
| 72 | ;S XRTL=$ ZU(0),XRTN ="IBCC-1" D T0^%ZOSV ;start rt clock | |
| 73 | ; | |
| 74 | ; If call ed at entr y point PR OCESS, var iable IBNO ASK will e xist. | |
| 75 | ; First t ime throug h, IBNOASK =1 | |
| 76 | ; Second time throu gh, IBNOAS K=2 and it will quit | |
| 77 | I $G(IBNO ASK)=2 G Q | |
| 78 | I $G(IBNO ASK)=1 S I BNOASK=2 | |
| 79 | ; | |
| 80 | G Q:$G(IB CE("EDI")) | |
| 81 | D Q | |
| 82 | S IBQUIT= 0 | |
| 83 | N DPTNOFZ Y S DPTNOF ZY=1 ;Sup press PATI ENT file f uzzy looku ps | |
| 84 | I '$G(IBN OASK) S DI C="^DGCR(3 99,",DIC(0 )="AEMQZ", DIC("A")=" Enter BILL NUMBER or Patient N AME: " W ! ! D ^DIC I Y<1 S IBQ UIT=1 G Q1 | |
| 85 | K IB364 | |
| 86 | NOPTF ; No te if IB36 4 is >0 it will be u sed as the ien to up date in fi le 364 | |
| 87 | N DA,I | |
| 88 | I '$G(IBN OASK) S IB IFN=+$G(Y) | |
| 89 | I '$G(IBI FN) G ASK | |
| 90 | I IBCAN>1 D NOPTF^I BCB2 I 'IB AC1 D NOPT F1^IBCB2 G ASK | |
| 91 | ; | |
| 92 | I $G(IBCN CRD)=1,$P( $P($G(^DGC R(399,IBIF N,0)),U)," -",2)>98 D Q | |
| 93 | .W !!,"Pl ease note that you h ave exceed ed the max imum numbe r of itera tions (99) for this claim." | |
| 94 | .W "Copy and cancel (CLON) mu st be used to correc t this bil l." | |
| 95 | .S IBQUIT =1 H 3 | |
| 96 | ; Check i f bill has been refe rred to Co unsel | |
| 97 | I $P($G(^ PRCA(430,I BIFN,6)),U ,4) D G A SK | |
| 98 | . W !,"Th is bill ha s been ref erred to R egional Co unsel and cannot be 'CANCELLED ' in" | |
| 99 | . W !,"In tegrated B illing. P lease use the option 'TP Refer red Follow -up'" | |
| 100 | . W !,"[P RCA RC ACT ION MENU] in Account s Receivab le to requ est that R egional" | |
| 101 | . W !,"Co unsel retu rn the bil l to your facility." | |
| 102 | . Q | |
| 103 | ; | |
| 104 | F I=0,"S" ,"U1" S IB (I)=$G(^DG CR(399,IBI FN,I)) | |
| 105 | S IBSTAT= $P(IB(0),U ,13) | |
| 106 | ; REMOVE New messag es for CRD option IB *2.0*433 i n IB*2.0*4 47 IA#563 0 | |
| 107 | ;I $G(IBC NCRD)=1,IB STAT'=2,'$ $ACCK^PRCA ACC(IBIFN) D Q | |
| 108 | ;.W !!,"T his option cannot be used to c orrect som e Billing Rate Types (Example: TRICARE)" | |
| 109 | ;.W "Copy and cance l (CLON) m ust be use d to corre ct this bi ll." | |
| 110 | ;.S IBQUI T=1 H 3 | |
| 111 | ; | |
| 112 | ; Restric t access t o this pro cess for R EQUEST MRA bills | |
| 113 | I IBSTAT= 2,'$G(IBCE ("EDI")),$ $MRAWL^IBC EMU2(IBIFN ) D G ASK | |
| 114 | . W !!?4, "This bill is in a s tatus of R EQUEST MRA and it do es appear on the" | |
| 115 | . W !?4," MRA Manage ment Work List. Ple ase use th e 'MRA Man agement Me nu' option s" | |
| 116 | . W !?4," for all pr ocessing r elated to this bill. " | |
| 117 | . Q | |
| 118 | ; | |
| 119 | ; IB*2.0* 432 Restri ct access to claims on the new CBW Workl ist | |
| 120 | I $P($G(^ DGCR(399,I BIFN,"S1") ),U,7)=1,$ G(IBMRANOT )'=1 D G ASK | |
| 121 | . W !!?4, "This bill appears o n the CBW Management Work List . Please use the" | |
| 122 | . W !?4," 'CBW Manag ement Menu ' options for all pr ocessing r elated to this bill. " | |
| 123 | . Q | |
| 124 | ; | |
| 125 | ; Check i f this is a paper cl aim. If no t, check f or split E OB. If sp lit, don't allow CRD unless mo re than 1 EOB has be en returne d | |
| 126 | I $G(IBCN CRD)=1,$P( $G(^DGCR(3 99,IBIFN," TX")),U,8) '=1,$$SPLT MRA^IBCEMU 1(IBIFN)=1 D Q | |
| 127 | .W !!,"Th ere is a s plit EOB a ssociated with this claim. Yo u cannot u se this op tion to Co rrect this claim unt il the sec ond EOB ha s been rec eived." | |
| 128 | .S IBQUIT =1 H 3 | |
| 129 | .Q | |
| 130 | ; | |
| 131 | ; Warning message i f in a REQ UEST MRA s tatus with no MRA on file | |
| 132 | ; IB*2.0* 516/TAZ,MR D - Forbid the user from using the optio n CRD | |
| 133 | ; (Correc t Rejected /Denied Bi ll) on an MRA claim if the sta tus is | |
| 134 | ; REQUEST MRA (IBST AT=2). | |
| 135 | I IBSTAT= 2,'$$MRACN T^IBCEMU1( IBIFN) D I $G(IBQUI T) H 3 Q | |
| 136 | . N REJ | |
| 137 | . D TXSTS ^IBCEMU2(I BIFN,,.REJ ) | |
| 138 | . ;IB*2.0 *516/TAZ - If CRD is from CSA allow a RE Jected cla im to be C RD'ed with out displa ying a war ning. | |
| 139 | . I $G(IB CNCSA),REJ Q | |
| 140 | . W *7,!! ?4,$S('$G( IBCNCRD):" Warning! ",1:""),"T his bill i s in a sta tus of REQ UEST MRA." | |
| 141 | . W !?4," No MRAs ha ve been re ceived" | |
| 142 | . I REJ W ", but th e most rec ent transm ission of this",!?4, "MRA reque st bill wa s rejected ." | |
| 143 | . I 'REJ W " and th ere are no rejection messages on file",! ?4,"for th e most rec ent transm ission of this MRA r equest bil l." | |
| 144 | . I $G(IB CNCRD) S I BQUIT=1 | |
| 145 | . Q | |
| 146 | ; | |
| 147 | I IBCAN=2 ,IB("S")]" ",+$P(IB(" S"),U,16), $P(IB("S") ,U,17)]"" D G 1 | |
| 148 | . W !!,"T his bill w as cancell ed on " S Y=$P(IB("S "),U,17) X ^DD("DD") W Y," by ",$S($P(IB ("S"),U,18 )']"":IBU, $D(^VA(200 ,$P(IB("S" ),U,18),0) ):$P(^(0), U,1),1:IBU ),"." | |
| 149 | . S IBQUI T=1 | |
| 150 | ; | |
| 151 | ; IB*2.0* 516/TAZ,MR D - Forbid the user from using the optio n CRD | |
| 152 | ; (Correc t Rejected /Denied Bi ll) on all but prima ry claims. | |
| 153 | I $G(IBCN CRD),($$CO B^IBCEF(IB IFN)'="P") D Q | |
| 154 | . W !!,"P lease note that COB data may e xist for t his bill." | |
| 155 | . W !,"Co py and can cel (CLON) must be u sed to cor rect this bill." | |
| 156 | . S IBQUI T=1 | |
| 157 | . H 3 | |
| 158 | . Q | |
| 159 | ; | |
| 160 | ; Notify if a payme nt has bee n posted t o this bil l before c ancel | |
| 161 | N PRCABIL L | |
| 162 | S PRCABIL L=$$TPR^PR CAFN(IBIFN ) | |
| 163 | I PRCABIL L=-1 W !!, "Please no te: PRCA w as unable to determi ne if a pa yment has been poste d." I $G(I BCNCRD)=1 W !,"Copy and cancel (CLON) mu st be used to correc t this bil l." S IBQU IT=1 H 3 Q | |
| 164 | I PRCABIL L>0 W !!," Please not e a PAYMEN T of **$"_ $$TPR^PRCA FN(IBIFN)_ "** has be en POSTED to this bi ll." | |
| 165 | ; New mes sage for C RD option | |
| 166 | I $G(IBCN CRD)=1,PRC ABILL>0 W !,"Copy an d cancel ( CLON) must be used t o correct this bill. " S IBQUIT =1 H 3 Q | |
| 167 | ; | |
| 168 | ; If bill was creat ed via Ele ctronic cl aims proce ss then no tify | |
| 169 | ; user th at cancell ation shou ld occur u sing ECME package | |
| 170 | I $$GET1^ DIQ(399,IB IFN_",",46 0)]"" D G :'Y ASK | |
| 171 | . W !!!?5 ,"This bil l was crea ted by the " | |
| 172 | . W !?5," Electronic Claims Ma nagement E ngine (ECM E)." | |
| 173 | . W !?5," Cancellati on needs t o occur in the ECME package by " | |
| 174 | . W !?5," submitting a REVERSA L to the P ayer.",!! | |
| 175 | . K DIR S DIR("A",1 )="Has a R EVERSAL fo r this e-C laim alrea dy been",D IR("A")="s ubmitted t o the paye r via the ECME packa ge (Y/N)", DIR(0)="Y" ,DIR("B")= "NO" D ^DI R | |
| 176 | . I Y=0 W !!,"<PLEA SE SUBMIT A REVERSAL USING THE APPROPRIA TE OPTION IN THE ECM E PACKAGE> ",$C(7) | |
| 177 | ; | |
| 178 | CHK ; | |
| 179 | ; if user came from CLON, mak e sure the y know abo ut the new CRD optio n IB*2.0* 447 remove TRICARE m sg. | |
| 180 | I $G(IBCN COPY)=1 D | |
| 181 | .W !!,*7, "Warning: This opti on should NOT be use d to corre ct Rejecte d/Denied c laims." | |
| 182 | .W !," It should ONL Y be used to correct DENIED cl aims which have paym ents" | |
| 183 | .W !," pos ted agains t them.*** " ; and cl aims with certain Bi lling Rate Types (Ex ample: TRI CARE)." | |
| 184 | ; | |
| 185 | S (IBCCCC ,IBQUIT)=0 I '$G(IBC EAUTO),'$G (IBMCSCAN) W !!,"ARE YOU SURE YOU WANT T O CANCEL T HIS BILL" S %=2 D YN ^DICN G:%= 0 HELP I % '=1 S IBQU IT=1 G NO | |
| 186 | ; | |
| 187 | I '$G(IBC EAUTO) W ! !,"LAST CH ANCE TO CH ANGE YOUR MIND..." | |
| 188 | S DIE=399 ,DA=IBIFN, DIE("NO^") ="" | |
| 189 | S DR="16; S:'X Y=0;1 9;S IBCCCC =1;" | |
| 190 | I $G(IBCE AUTO) S DR ="16////1; 19////EDI/ MRA TURNED OFF;S IBC CCC=1;" | |
| 191 | ; | |
| 192 | ; esg - 8 /23/06 - I B*2*358 - fix semi-c olon in fr ee text fi eld | |
| 193 | I $G(IBMC SRSC)'="" S DR="16;S :'X Y=0;19 //^S X=IBM CSRSC;S IB CCCC=1;" | |
| 194 | D ^DIE K DIE,DR | |
| 195 | ; | |
| 196 | NO I 'IBCC CC W !!,"< NO ACTION TAKEN>",*7 S IBQUIT= 1 G ASK:IB CAN<2,Q | |
| 197 | S IBCCR=$ P($G(^DGCR (399,IBIFN ,"S")),U,1 9) | |
| 198 | ; update claim # wi th new ite ration IB *2.0*447 m ove to lat er in the process | |
| 199 | ;D:$G(IBC NCRD)=1 CR D | |
| 200 | W !!,"... Bill has b een cancel led..." D BULL^IBCBU LL,BSTAT^I BCDC(IBIFN ),PRIOR^IB CCC2(IBIFN ) | |
| 201 | ; | |
| 202 | ; cancell ing in ing enix claim smanager i f ingenix is running | |
| 203 | ; clean-u p of varia bles is OK if not co ming in fr om ListMan screen | |
| 204 | I $$CM^IB CIUT1(IBIF N) S IBCIS NT=4 D ST2 ^IBCIST I '$G(IBCICN CL) K IBCI SNT,IBCIST AT,IBCIRED T,IBCIERR | |
| 205 | ; | |
| 206 | S IBEDI=$ G(IB364) | |
| 207 | I 'IBEDI S IBEDI=+$ $LAST364^I BCEF4(IBIF N) | |
| 208 | ; ib*2.0* 547 don't cancel MRA if clonin g a bill t hat is sec ondary to MRA (share the same claim#) | |
| 209 | I IBEDI D UPDEDI^IB CEM(IBEDI, "C",,$S($$ MRASEC^IBC EF4(IBIFN) :2,1:"")) ;Update ED I files, i f needed | |
| 210 | ; | |
| 211 | F I="S"," U1" S IB(I )=$S($D(^D GCR(399,IB IFN,I)):^( I),1:"") | |
| 212 | S PRCASV( "ARREC")=I BIFN,PRCAS V("AMT")=$ S(IB("U1") ']"":0,1:$ P(IB("U1") ,"^")),PRC ASV("DATE" )=$P(IB("S "),"^",17) ,PRCASV("B Y")=$P(IB( "S"),"^",1 8) | |
| 213 | S PRCASV( "COMMENT") =$S($P(IB( "S"),U,19) ]"":$P(IB( "S"),U,19) ,$P(^IBE(3 50.9,1,2), "^",7)]"": $P(^(2),"^ ",7),1:"BI LL CANCELL ED IN MAS" ) | |
| 214 | S PRCASV( "BY")=$S($ P(IB("S"), U,18)]"":$ P(IB("S"), U,18),1:"" ) | |
| 215 | ; IA#3374 /IB*2.0*43 3 Pass the CRD flag so FMS kno ws to send a cancel record bef ore the ne w E record is sent | |
| 216 | ;S X=$$CA NCEL^RCBEI B($G(PRCAS V("ARREC") ),$G(PRCAS V("DATE")) ,$G(PRCASV ("BY")),$G (PRCASV("A MT")),$G(P RCASV("COM MENT"))) | |
| 217 | S PRCASV( "ARCRD")=$ G(IBCNCRD) | |
| 218 | S X=$$CAN CEL^RCBEIB ($G(PRCASV ("ARREC")) ,$G(PRCASV ("DATE")), $G(PRCASV( "BY")),$G( PRCASV("AM T")),$G(PR CASV("COMM ENT")),$G( PRCASV("AR CRD"))) | |
| 219 | W !,$S(X: ">> The re ceivable a ssociated with the c laim was c ancelled." ,1:">> The receivabl e associat ed with th e claim wa s not canc elled.") | |
| 220 | I $P(X,U, 2)]"" W !, ">>> ",$P( X,U,2) ; T he reason why the cl aim can no t be cance lled. | |
| 221 | I IBCAN<2 D RNB^IBC C1 ;assign a reason not billab le | |
| 222 | G ASK:IBC AN<2,Q | |
| 223 | ; | |
| 224 | HELP W !,? 3,"Answer 'YES' or ' Y' if you wish to ca ncel this bill.",!,? 3,"Answer 'NO' or 'N ' if you w ant to abo rt." G CHK | |
| 225 | Q | |
| 226 | 1 I $P(IB( 0),U,13)=1 W !,"This record wa s re-opene d on " S Y =$P(IB(0), U,14) X ^D D("DD") W Y,"." G CH K | |
| 227 | G ASK | |
| 228 | Q1 K:IBCAN =1 IBQUIT K IBCAN | |
| 229 | Q K %,IBEP AR,IBSTAT, IBARST,IBA C1,IB,DFN, IBX,IBZ,DI C,DIE,DR,P RCASV,PRCA SVC,X,Y,IB EDI | |
| 230 | ;*** | |
| 231 | ;I $D(XRT 0) S:'$D(X RTN) XRTN= "IBCC" D T 1^%ZOSV ;s top rt clo ck | |
| 232 | Q | |
| 233 | CRD(IBIFN) ; entry t o point to add itera tion # to claim | |
| 234 | N IBFDA | |
| 235 | S IBITN=$ $ITN^IBCCC (IBIFN) | |
| 236 | S IBFDA(3 99,IBIFN_" ,",.01)=IB ITN | |
| 237 | D FILE^DI E("","IBFD A") | |
| 238 | ; this wi ll re-open the claim , so reset to cancel led | |
| 239 | S DIE=399 ,DA=IBIFN | |
| 240 | S DR="16/ ///1" | |
| 241 | D ^DIE K DIE,DR | |
| 242 | Q | |
| 243 | ; | |
| 244 | PROCESS(IB IFN,IBCAN) ; | |
| 245 | ; Entry p oint when the bill n umber is a lready kno wn. Use t his when | |
| 246 | ; you jus t want to try to can cel this b ill and th is bill on ly. | |
| 247 | ; Input: | |
| 248 | ; IBIFN - Interna l bill# (R equired) | |
| 249 | ; IBCAN - Cancel Flag (opti onal, defa ults to 1 if not inc luded) | |
| 250 | ; | |
| 251 | NEW IBNOA SK | |
| 252 | S IBNOASK =1 | |
| 253 | S IBCAN=$ G(IBCAN,1) | |
| 254 | G ASK | |
| 255 | ; | |
| 256 | ;IBCC | |
| 257 | Modified L ogic (Chan ges are in bold) | |
| 258 | IBCC ;ALB/ MJB - CANC EL THIRD P ARTY BILL ;14 JUN 88 10:12 | |
| 259 | ;;2.0;INT EGRATED BI LLING;**2, 19,77,80,5 1,142,137, 161,199,24 1,155,276, 320,358,43 3,432,447, 516,547**; 21-MAR-94; Build 119 | |
| 260 | ;;Per VA Directive 6402, this routine s hould not be modifie d. | |
| 261 | ; | |
| 262 | ;MAP TO D GCRC | |
| 263 | ; | |
| 264 | I '$D(IBC AN) S IBCA N=1 | |
| 265 | ASK ; | |
| 266 | ;*** | |
| 267 | ;I $D(XRT 0) S:'$D(X RTN) XRTN= "IBCC" D T 1^%ZOSV ;s top rt clo ck | |
| 268 | ;S XRTL=$ ZU(0),XRTN ="IBCC-1" D T0^%ZOSV ;start rt clock | |
| 269 | ; | |
| 270 | ; If call ed at entr y point PR OCESS, var iable IBNO ASK will e xist. | |
| 271 | ; First t ime throug h, IBNOASK =1 | |
| 272 | ; Second time throu gh, IBNOAS K=2 and it will quit | |
| 273 | I $G(IBNO ASK)=2 G Q | |
| 274 | I $G(IBNO ASK)=1 S I BNOASK=2 | |
| 275 | ; | |
| 276 | G Q:$G(IB CE("EDI")) | |
| 277 | D Q | |
| 278 | S IBQUIT= 0 | |
| 279 | N DPTNOFZ Y S DPTNOF ZY=1 ;Sup press PATI ENT file f uzzy looku ps | |
| 280 | I '$G(IBN OASK) S DI C="^DGCR(3 99,",DIC(0 )="AEMQZ", DIC("A")=" Enter BILL NUMBER or Patient N AME: " W ! ! D ^DIC I Y<1 S IBQ UIT=1 G Q1 | |
| 281 | K IB364 | |
| 282 | NOPTF ; No te if IB36 4 is >0 it will be u sed as the ien to up date in fi le 364 | |
| 283 | N DA,I | |
| 284 | I '$G(IBN OASK) S IB IFN=+$G(Y) | |
| 285 | I '$G(IBI FN) G ASK | |
| 286 | I IBCAN>1 D NOPTF^I BCB2 I 'IB AC1 D NOPT F1^IBCB2 G ASK | |
| 287 | ; | |
| 288 | I $G(IBCN CRD)=1,$P( $P($G(^DGC R(399,IBIF N,0)),U)," -",2)>98 D Q | |
| 289 | .W !!,"Pl ease note that you h ave exceed ed the max imum numbe r of itera tions (99) for this claim." | |
| 290 | .W "Copy and cancel (CLON) mu st be used to correc t this bil l." | |
| 291 | .S IBQUIT =1 H 3 | |
| 292 | ; Check i f bill has been refe rred to Co unsel | |
| 293 | I $P($G(^ PRCA(430,I BIFN,6)),U ,4) D G A SK | |
| 294 | . W !,"Th is bill ha s been ref erred to R egional Co unsel and cannot be 'CANCELLED ' in" | |
| 295 | . W !,"In tegrated B illing. P lease use the option 'TP Refer red Follow -up'" | |
| 296 | . W !,"[P RCA RC ACT ION MENU] in Account s Receivab le to requ est that R egional" | |
| 297 | . W !,"Co unsel retu rn the bil l to your facility." | |
| 298 | . Q | |
| 299 | ; | |
| 300 | F I=0,"S" ,"U1" S IB (I)=$G(^DG CR(399,IBI FN,I)) | |
| 301 | S IBSTAT= $P(IB(0),U ,13) | |
| 302 | ; REMOVE New messag es for CRD option IB *2.0*433 i n IB*2.0*4 47 IA#563 0 | |
| 303 | ;I $G(IBC NCRD)=1,IB STAT'=2,'$ $ACCK^PRCA ACC(IBIFN) D Q | |
| 304 | ;.W !!,"T his option cannot be used to c orrect som e Billing Rate Types (Example: TRICARE)" | |
| 305 | ;.W "Copy and cance l (CLON) m ust be use d to corre ct this bi ll." | |
| 306 | ;.S IBQUI T=1 H 3 | |
| 307 | ; | |
| 308 | ; Restric t access t o this pro cess for R EQUEST MRA bills | |
| 309 | I IBSTAT= 2,'$G(IBCE ("EDI")),$ $MRAWL^IBC EMU2(IBIFN ) D G ASK | |
| 310 | . W !!?4, "This bill is in a s tatus of R EQUEST MRA and it do es appear on the" | |
| 311 | . W !?4," MRA Manage ment Work List. Ple ase use th e 'MRA Man agement Me nu' option s" | |
| 312 | . W !?4," for all pr ocessing r elated to this bill. " | |
| 313 | . Q | |
| 314 | ; | |
| 315 | ; IB*2.0* 432 Restri ct access to claims on the new CBW Workl ist | |
| 316 | I $P($G(^ DGCR(399,I BIFN,"S1") ),U,7)=1,$ G(IBMRANOT )'=1 D G ASK | |
| 317 | . W !!?4, "This bill appears o n the CBW Management Work List . Please use the" | |
| 318 | . W !?4," 'CBW Manag ement Menu ' options for all pr ocessing r elated to this bill. " | |
| 319 | . S IBQUI T=1 ;JRA need to se t quit fla g after is suing this message | |
| 320 | . Q | |
| 321 | ; | |
| 322 | ; Check i f this is a paper cl aim. If no t, check f or split E OB. If sp lit, don't allow CRD unless mo re than 1 EOB has be en returne d | |
| 323 | I $G(IBCN CRD)=1,$P( $G(^DGCR(3 99,IBIFN," TX")),U,8) '=1,$$SPLT MRA^IBCEMU 1(IBIFN)=1 D Q | |
| 324 | .W !!,"Th ere is a s plit EOB a ssociated with this claim. Yo u cannot u se this op tion to Co rrect this claim unt il the sec ond EOB ha s been rec eived." | |
| 325 | .S IBQUIT =1 H 3 | |
| 326 | .Q | |
| 327 | ; | |
| 328 | ; Warning message i f in a REQ UEST MRA s tatus with no MRA on file | |
| 329 | ; IB*2.0* 516/TAZ,MR D - Forbid the user from using the optio n CRD | |
| 330 | ; (Correc t Rejected /Denied Bi ll) on an MRA claim if the sta tus is | |
| 331 | ; REQUEST MRA (IBST AT=2). | |
| 332 | I IBSTAT= 2,'$$MRACN T^IBCEMU1( IBIFN) D I $G(IBQUI T) H 3 Q | |
| 333 | . N REJ | |
| 334 | . D TXSTS ^IBCEMU2(I BIFN,,.REJ ) | |
| 335 | . ;IB*2.0 *516/TAZ - If CRD is from CSA allow a RE Jected cla im to be C RD'ed with out displa ying a war ning. | |
| 336 | . I $G(IB CNCSA),REJ Q | |
| 337 | . W *7,!! ?4,$S('$G( IBCNCRD):" Warning! ",1:""),"T his bill i s in a sta tus of REQ UEST MRA." | |
| 338 | . W !?4," No MRAs ha ve been re ceived" | |
| 339 | . I REJ W ", but th e most rec ent transm ission of this",!?4, "MRA reque st bill wa s rejected ." | |
| 340 | . I 'REJ W " and th ere are no rejection messages on file",! ?4,"for th e most rec ent transm ission of this MRA r equest bil l." | |
| 341 | . I $G(IB CNCRD) S I BQUIT=1 | |
| 342 | . Q | |
| 343 | ; | |
| 344 | I IBCAN=2 ,IB("S")]" ",+$P(IB(" S"),U,16), $P(IB("S") ,U,17)]"" D G 1 | |
| 345 | . W !!,"T his bill w as cancell ed on " S Y=$P(IB("S "),U,17) X ^DD("DD") W Y," by ",$S($P(IB ("S"),U,18 )']"":IBU, $D(^VA(200 ,$P(IB("S" ),U,18),0) ):$P(^(0), U,1),1:IBU ),"." | |
| 346 | . S IBQUI T=1 | |
| 347 | ; | |
| 348 | ; IB*2.0* 516/TAZ,MR D - Forbid the user from using the optio n CRD | |
| 349 | ; (Correc t Rejected /Denied Bi ll) on all but prima ry claims. | |
| 350 | I $G(IBCN CRD),($$CO B^IBCEF(IB IFN)'="P") D Q | |
| 351 | . W !!,"P lease note that COB data may e xist for t his bill." | |
| 352 | . W !,"Co py and can cel (CLON) must be u sed to cor rect this bill." | |
| 353 | . S IBQUI T=1 | |
| 354 | . H 3 | |
| 355 | . Q | |
| 356 | ; | |
| 357 | ; Notify if a payme nt has bee n posted t o this bil l before c ancel | |
| 358 | N PRCABIL L | |
| 359 | S PRCABIL L=$$TPR^PR CAFN(IBIFN ) | |
| 360 | I PRCABIL L=-1 W !!, "Please no te: PRCA w as unable to determi ne if a pa yment has been poste d." I $G(I BCNCRD)=1 W !,"Copy and cancel (CLON) mu st be used to correc t this bil l." S IBQU IT=1 H 3 Q | |
| 361 | I PRCABIL L>0 W !!," Please not e a PAYMEN T of **$"_ $$TPR^PRCA FN(IBIFN)_ "** has be en POSTED to this bi ll." | |
| 362 | ; New mes sage for C RD option | |
| 363 | I $G(IBCN CRD)=1,PRC ABILL>0 W !,"Copy an d cancel ( CLON) must be used t o correct this bill. " S IBQUIT =1 H 3 Q | |
| 364 | ; | |
| 365 | ; If bill was creat ed via Ele ctronic cl aims proce ss then no tify | |
| 366 | ; user th at cancell ation shou ld occur u sing ECME package | |
| 367 | I $$GET1^ DIQ(399,IB IFN_",",46 0)]"" D G :'Y ASK | |
| 368 | . W !!!?5 ,"This bil l was crea ted by the " | |
| 369 | . W !?5," Electronic Claims Ma nagement E ngine (ECM E)." | |
| 370 | . W !?5," Cancellati on needs t o occur in the ECME package by " | |
| 371 | . W !?5," submitting a REVERSA L to the P ayer.",!! | |
| 372 | . K DIR S DIR("A",1 )="Has a R EVERSAL fo r this e-C laim alrea dy been",D IR("A")="s ubmitted t o the paye r via the ECME packa ge (Y/N)", DIR(0)="Y" ,DIR("B")= "NO" D ^DI R | |
| 373 | . I Y=0 W !!,"<PLEA SE SUBMIT A REVERSAL USING THE APPROPRIA TE OPTION IN THE ECM E PACKAGE> ",$C(7) | |
| 374 | ; | |
| 375 | CHK ; | |
| 376 | ; if user came from CLON, mak e sure the y know abo ut the new CRD optio n IB*2.0* 447 remove TRICARE m sg. | |
| 377 | I $G(IBCN COPY)=1 D | |
| 378 | .W !!,*7, "Warning: This opti on should NOT be use d to corre ct Rejecte d/Denied c laims." | |
| 379 | .W !," It should ONL Y be used to correct DENIED cl aims which have paym ents" | |
| 380 | .W !," pos ted agains t them.*** " ; and cl aims with certain Bi lling Rate Types (Ex ample: TRI CARE)." | |
| 381 | ; | |
| 382 | S (IBCCCC ,IBQUIT)=0 I '$G(IBC EAUTO),'$G (IBMCSCAN) W !!,"ARE YOU SURE YOU WANT T O CANCEL T HIS BILL" S %=2 D YN ^DICN G:%= 0 HELP I % '=1 S IBQU IT=1 G NO | |
| 383 | ; | |
| 384 | I '$G(IBC EAUTO) W ! !,"LAST CH ANCE TO CH ANGE YOUR MIND..." | |
| 385 | S DIE=399 ,DA=IBIFN, DIE("NO^") ="" | |
| 386 | S DR="16; S:'X Y=0;1 9;S IBCCCC =1;" | |
| 387 | I $G(IBCE AUTO) S DR ="16////1; 19////EDI/ MRA TURNED OFF;S IBC CCC=1;" | |
| 388 | ; | |
| 389 | ; esg - 8 /23/06 - I B*2*358 - fix semi-c olon in fr ee text fi eld | |
| 390 | I $G(IBMC SRSC)'="" S DR="16;S :'X Y=0;19 //^S X=IBM CSRSC;S IB CCCC=1;" | |
| 391 | D ^DIE K DIE,DR | |
| 392 | ; | |
| 393 | NO I 'IBCC CC W !!,"< NO ACTION TAKEN>",*7 S IBQUIT= 1 G ASK:IB CAN<2,Q | |
| 394 | S IBCCR=$ P($G(^DGCR (399,IBIFN ,"S")),U,1 9) | |
| 395 | ; update claim # wi th new ite ration IB *2.0*447 m ove to lat er in the process | |
| 396 | ;D:$G(IBC NCRD)=1 CR D | |
| 397 | W !!,"... Bill has b een cancel led..." D BULL^IBCBU LL,BSTAT^I BCDC(IBIFN ),PRIOR^IB CCC2(IBIFN ) | |
| 398 | ; | |
| 399 | ; cancell ing in ing enix claim smanager i f ingenix is running | |
| 400 | ; clean-u p of varia bles is OK if not co ming in fr om ListMan screen | |
| 401 | I $$CM^IB CIUT1(IBIF N) S IBCIS NT=4 D ST2 ^IBCIST I '$G(IBCICN CL) K IBCI SNT,IBCIST AT,IBCIRED T,IBCIERR | |
| 402 | ; | |
| 403 | S IBEDI=$ G(IB364) | |
| 404 | I 'IBEDI S IBEDI=+$ $LAST364^I BCEF4(IBIF N) | |
| 405 | ; ib*2.0* 547 don't cancel MRA if clonin g a bill t hat is sec ondary to MRA (share the same claim#) | |
| 406 | I IBEDI D UPDEDI^IB CEM(IBEDI, "C",,$S($$ MRASEC^IBC EF4(IBIFN) :2,1:"")) ;Update ED I files, i f needed | |
| 407 | ; | |
| 408 | F I="S"," U1" S IB(I )=$S($D(^D GCR(399,IB IFN,I)):^( I),1:"") | |
| 409 | S PRCASV( "ARREC")=I BIFN,PRCAS V("AMT")=$ S(IB("U1") ']"":0,1:$ P(IB("U1") ,"^")),PRC ASV("DATE" )=$P(IB("S "),"^",17) ,PRCASV("B Y")=$P(IB( "S"),"^",1 8) | |
| 410 | S PRCASV( "COMMENT") =$S($P(IB( "S"),U,19) ]"":$P(IB( "S"),U,19) ,$P(^IBE(3 50.9,1,2), "^",7)]"": $P(^(2),"^ ",7),1:"BI LL CANCELL ED IN MAS" ) | |
| 411 | S PRCASV( "BY")=$S($ P(IB("S"), U,18)]"":$ P(IB("S"), U,18),1:"" ) | |
| 412 | ; IA#3374 /IB*2.0*43 3 Pass the CRD flag so FMS kno ws to send a cancel record bef ore the ne w E record is sent | |
| 413 | ;S X=$$CA NCEL^RCBEI B($G(PRCAS V("ARREC") ),$G(PRCAS V("DATE")) ,$G(PRCASV ("BY")),$G (PRCASV("A MT")),$G(P RCASV("COM MENT"))) | |
| 414 | S PRCASV( "ARCRD")=$ G(IBCNCRD) | |
| 415 | S X=$$CAN CEL^RCBEIB ($G(PRCASV ("ARREC")) ,$G(PRCASV ("DATE")), $G(PRCASV( "BY")),$G( PRCASV("AM T")),$G(PR CASV("COMM ENT")),$G( PRCASV("AR CRD"))) | |
| 416 | W !,$S(X: ">> The re ceivable a ssociated with the c laim was c ancelled." ,1:">> The receivabl e associat ed with th e claim wa s not canc elled.") | |
| 417 | I $P(X,U, 2)]"" W !, ">>> ",$P( X,U,2) ; T he reason why the cl aim can no t be cance lled. | |
| 418 | I IBCAN<2 D RNB^IBC C1 ;assign a reason not billab le | |
| 419 | G ASK:IBC AN<2,Q | |
| 420 | ; | |
| 421 | HELP W !,? 3,"Answer 'YES' or ' Y' if you wish to ca ncel this bill.",!,? 3,"Answer 'NO' or 'N ' if you w ant to abo rt." G CHK | |
| 422 | Q | |
| 423 | 1 I $P(IB( 0),U,13)=1 W !,"This record wa s re-opene d on " S Y =$P(IB(0), U,14) X ^D D("DD") W Y,"." G CH K | |
| 424 | G ASK | |
| 425 | Q1 K:IBCAN =1 IBQUIT K IBCAN | |
| 426 | Q K %,IBEP AR,IBSTAT, IBARST,IBA C1,IB,DFN, IBX,IBZ,DI C,DIE,DR,P RCASV,PRCA SVC,X,Y,IB EDI | |
| 427 | ;*** | |
| 428 | ;I $D(XRT 0) S:'$D(X RTN) XRTN= "IBCC" D T 1^%ZOSV ;s top rt clo ck | |
| 429 | Q | |
| 430 | CRD(IBIFN) ; entry t o point to add itera tion # to claim | |
| 431 | N IBFDA | |
| 432 | S IBITN=$ $ITN^IBCCC (IBIFN) | |
| 433 | S IBFDA(3 99,IBIFN_" ,",.01)=IB ITN | |
| 434 | D FILE^DI E("","IBFD A") | |
| 435 | ; this wi ll re-open the claim , so reset to cancel led | |
| 436 | S DIE=399 ,DA=IBIFN | |
| 437 | S DR="16/ ///1" | |
| 438 | D ^DIE K DIE,DR | |
| 439 | Q | |
| 440 | ; | |
| 441 | PROCESS(IB IFN,IBCAN) ; | |
| 442 | ; Entry p oint when the bill n umber is a lready kno wn. Use t his when | |
| 443 | ; you jus t want to try to can cel this b ill and th is bill on ly. | |
| 444 | ; Input: | |
| 445 | ; IBIFN - Interna l bill# (R equired) | |
| 446 | ; IBCAN - Cancel Flag (opti onal, defa ults to 1 if not inc luded) | |
| 447 | ; | |
| 448 | NEW IBNOA SK | |
| 449 | S IBNOASK =1 | |
| 450 | S IBCAN=$ G(IBCAN,1) | |
| 451 | G ASK | |
| 452 | ; | |
| 453 | ;IBCC | |
| 454 | ||
| 455 | ||
| 456 | ||
| 457 | ||
| 458 | ||
| 459 | Routines | |
| 460 | Activities | |
| 461 | Routine Na me | |
| 462 | IBCCC | |
| 463 | Enhancemen t Category | |
| 464 | New | |
| 465 | Modify | |
| 466 | Delete | |
| 467 | No Change | |
| 468 | RTM | |
| 469 | ||
| 470 | Related Op tions | |
| 471 | None | |
| 472 | Related Ro utines | |
| 473 | Routines “ Called By” | |
| 474 | Routines “ Called” | |
| 475 | ||
| 476 | ||
| 477 | ||
| 478 | ||
| 479 | Data Dicti onary (DD) Reference s | |
| 480 | ||
| 481 | Related Pr otocols | |
| 482 | ||
| 483 | Related In tegration Control Re gistration s (ICRs) | |
| 484 | None | |
| 485 | Data Passi ng | |
| 486 | Input | |
| 487 | Output Re ference | |
| 488 | Both | |
| 489 | Global Re ference | |
| 490 | Local | |
| 491 | Input Attr ibute Name and Defin ition | |
| 492 | Name: | |
| 493 | Definition : | |
| 494 | Output Att ribute Nam e and Defi nition | |
| 495 | Name: | |
| 496 | Definition : | |
| 497 | Current Lo gic | |
| 498 | IBCCC^INT^ 1^^0 | |
| 499 | IBCCC ;ALB /AAS - CAN CEL AND CL ONE A BILL ;25-JAN-9 0 | |
| 500 | ;;2.0;INT EGRATED BI LLING;**80 ,109,106,5 1,320,433, 432,447,51 6**;21-MAR -94;Build 123 | |
| 501 | ;;Per VA Directive 6402, this routine s hould not be modifie d. | |
| 502 | ; | |
| 503 | ;MAP TO D GCRCC | |
| 504 | ; | |
| 505 | ;STEP 1 - cancel bi ll | |
| 506 | ;STEP 1.5 - entry t o clone pr eviously c ancelled b ill. (mus t be cance l) | |
| 507 | ;STEP 2 - build arr ay of IBID S call scr een that a sks ok | |
| 508 | ;STEP 3 - pass stub entry to ar | |
| 509 | ;STEP 4 - store stu b data in MCCR then x-ref | |
| 510 | ;STEP 4.5 - store c laim clone info on " S1" node. | |
| 511 | ;STEP 5 - get remai nder of da ta to move and store in MCCR t hen x-ref | |
| 512 | ;STEP 6 - go to scr eens, come out to IB B1 | |
| 513 | EN ; | |
| 514 | N IBBCF,I BBCT,IBBCB ,IBCCR,IBD BC,IBCNCOP Y,IBNOCALC | |
| 515 | S IBDBC=D T ;date claim was cloned | |
| 516 | S IBBCB=D UZ ;user -id of per son clonin g the clai m. | |
| 517 | S IBCNCOP Y=1 ; flag indicatin g this fun ction is e ntered as the copy/c ancel opti on | |
| 518 | ; | |
| 519 | ; MRD;IB* 2.0*516 - Added the flag IBNOC ALC. This flag is s et here an d | |
| 520 | ; below. When char ges are re calculated in BILL^I BCRBC, the first tim e | |
| 521 | ; that pr ocedure is entered f or the new claim, if the IBNOC ALC flag i s | |
| 522 | ; set, it will rese t the flag and quit out. That is, it do es not re- | |
| 523 | ; calcula te the cha rges the f irst time it otherwi se would i f the user | |
| 524 | ; is doin g either a CRD or CL ON. | |
| 525 | ; | |
| 526 | S IBNOCAL C=1 | |
| 527 | ; | |
| 528 | STEP1 I $G (IBCE("EDI "))>1 G EN D1 | |
| 529 | S IBCAN=2 ,IBQUIT=0, IBAC=6,IBU ="UNSPECIF IED" | |
| 530 | I '$G(IBC E("EDI")) D ASK^IBCC | |
| 531 | I $G(IBCE ("EDI"))=1 S IB364=" " D NOPTF^ IBCC | |
| 532 | G:IBQUIT END1 | |
| 533 | I 'IBCCCC !('$D(IBIF N)) G STEP 1:'$G(IBCE ("EDI")),E ND1 | |
| 534 | I $G(IBCE ("EDI")) S IBCE("EDI ")=2 | |
| 535 | EN1 ; | |
| 536 | STEP1P5 I '$D(IBIFN) S IBCAN=2 ,IBQUIT=0, IBAC=6 W ! ,"Copy Pre viously Ca ncelled Bi ll.",!! S DIC="^DGCR (399,",DIC ("S")="I $ P(^(0),U,1 3)=7",DIC( 0)="AEMQZ" ,DIC("A")= "Enter BIL L NUMBER o r Patient NAME: " D ^DIC G:Y<1 END S IBI FN=+Y | |
| 537 | ; | |
| 538 | S IBBCF=I BIFN ;t his is the claim we are copyin g FROM | |
| 539 | S IBIDS(. 15)=IBIFN K IBIFN | |
| 540 | STEP2 S IB ND0=^DGCR( 399,IBIDS( .15),0) I $D(^("U")) S IBNDU=^ ("U") | |
| 541 | ; *** Not e - all th ese fields should al so be incl uded in WH ERE^IBCCC1 | |
| 542 | ; IB*2.0* 432 added check of v ariable IB SILENT to allow COB copy in ba ckground m ode | |
| 543 | F I=2:1:1 2 S:$P(IBN D0,"^",I)] "" IBIDS(I /100)=$P(I BND0,"^",I ) | |
| 544 | F I=16:1: 19,21:1:27 S:$P(IBND 0,"^",I)]" " IBIDS(I/ 100)=$P(IB ND0,"^",I) | |
| 545 | F I=151,1 52,155 S I BIDS(I)=$P (IBNDU,"^" ,(I-150)) | |
| 546 | S IBIDS(1 59.5)=$P(I BNDU,U,20) | |
| 547 | ; *** | |
| 548 | D:$G(IBSI LENT)="" H OME^%ZIS | |
| 549 | S DFN=IBI DS(.02) D DEM^VADPT | |
| 550 | I +$G(IBC TCOPY)!$G( IBCE("EDI" )) G STEP3 | |
| 551 | D ^IBCA1 | |
| 552 | ASK S IBYN =0 W !!,"I S THE ABOV E INFORMAT ION CORREC T AS SHOWN " S %=1 D YN^DICN G END:%=2,ST EP3:%=1 I % G END | |
| 553 | W !!?4,"Y ES - If th is informa tion is co rrect as s hown and y ou wish to file the bill.",!?4 ,"NO - If you wish to change this infor mation pri or to fili ng." | |
| 554 | W !?4,"'^ ' - Enter the up-arr ow charact er to DELE TE this Bi ll at this time." G ASK | |
| 555 | ; | |
| 556 | STEP3 ; | |
| 557 | S PRCASV( "SER")=$P( $G(^IBE(35 0.9,1,1)), "^",14) | |
| 558 | S PRCASV( "SITE")=$P ($$SITE^VA SITE,"^",3 ),IBNWBL=" ",PRCASV(" ARCRD")=$G (IBCNCRD) | |
| 559 | ; IA#386 & 1992 If user came from CRD option, ne ed to pass old bill # and clai m ien, as well as ne w iteratio n number | |
| 560 | I $G(IBCN CRD)=1 D C RD^IBCC(IB BCF) S PRC ASV("ARREC ")=IBBCF,P RCASV("ARB IL")=PRCAS V("SITE")_ "-"_$P(IBI TN,"-"),PR CASV("ARIT N")=PRCASV ("SITE")_" -"_IBITN | |
| 561 | W:$G(IBSI LENT)="" ! ,"Passing bill to Ac counts Rec eivable Mo dule..." D SETUP^PRC ASVC3 I $S ($P(PRCASV ("ARREC"), "^")=-1:1, $P(PRCASV( "ARBIL")," ^")=-1:1,1 :0) W:$G(I BSILENT)=" " *7," ", $P(PRCASV( "ARREC")," ^",2),$P(P RCASV("ARB IL"),"^",2 ) G END | |
| 562 | S IBIDS(. 01)=$P(PRC ASV("ARBIL "),"-",2), IBIDS(.17) =$S($D(IBI DS(.17)):I BIDS(.17), 1:PRCASV(" ARREC")) | |
| 563 | I '$G(IBC E("EDI")) W !,"Billi ng Record #",IBIDS(. 01)," bein g establis hed for '" ,VADM(1)," '..." S IB IDS(.02)=D FN,IBHV("I BIFN")=$S( $G(IBIFN): IBIFN,1:$G (IBIDS(.15 ))) | |
| 564 | G ^IBCCC1 ;go to st ep4 | |
| 565 | Q | |
| 566 | ; | |
| 567 | END W:$G(I BSILENT)=" " !!,"No B illing Rec ord Set up . You mus t manually enter the bill." | |
| 568 | END1 K %,% DT,IBCAN,I BAC,IBND0, IBNDU,IBYN ,IBCCCC,IB IFN,IB,IBA ,IBNWBL,IB BT,IBIDS,I BU,I,J,VA, VADM,X,X1, X2,X3,X4,D ,Y | |
| 569 | ;I '$G(IB QUIT),$S(+ $G(IBCNCOP Y):1,1:'$G (IBCE("EDI "))) G STE P1 | |
| 570 | I '$G(IBQ UIT),$S(+$ G(IBCNCOPY )!(+$G(IBC NCRD)):1,1 :'$G(IBCE( "EDI"))) G STEP1 | |
| 571 | K IBQUIT, IBCNCOPY,I BCNCRD,IBN OCALC | |
| 572 | Q | |
| 573 | ; | |
| 574 | ITN(IBX) ; determine iteration # for rej ected or d enied clai m | |
| 575 | N IBCF,IB CL | |
| 576 | S IBCF=$P ($G(^DGCR( 399,IBX,"S 1")),U,2) | |
| 577 | ; if this claim has never bee n cloned, iteration # is -01 | |
| 578 | Q:IBCF="" $P($G(^DG CR(399,IBX ,0)),U)_"- 01" | |
| 579 | S IBCL=$P ($G(^DGCR( 399,IBCF,0 )),U) | |
| 580 | ; if clai m was a CL ON 1st and now a COR RECT, this is the 1s t iteratio n | |
| 581 | I $P(IBCL ,"-")'=$P( $P($G(^DGC R(399,IBX, 0)),U),"-" ) Q $P($G( ^DGCR(399, IBX,0)),U) _"-01" | |
| 582 | ; to dete rmine iter ation#, ne ed to incr iment from claim tha t was clon ed from | |
| 583 | S IBITN=$ P(IBCL,"-" ,2),IBITN= IBITN+1 I $L(IBITN)= 1 S IBITN= "0"_IBITN | |
| 584 | Q $P(IBCL ,"-")_"-"_ IBITN | |
| 585 | ; | |
| 586 | CRD ; new entry poin t if user comes from CRD optio n instead of CLON | |
| 587 | N IBBCF,I BBCT,IBBCB ,IBCCR,IBD BC,IBCNCRD ,IBITN,IBN OCALC | |
| 588 | S IBDBC=D T ;date claim was cloned | |
| 589 | S IBBCB=D UZ ;user -id of per son clonin g the clai m. | |
| 590 | S IBCNCRD =1 ; flag indicating this func tion is en tered as t he CRD opt ion | |
| 591 | ; | |
| 592 | ; MRD;IB* 2.0*516 - Added the flag IBNOC ALC. This flag is s et here an d | |
| 593 | ; above. When char ges are re calculated in BILL^I BCRBC, the first tim e | |
| 594 | ; that pr ocedure is entered f or the new claim, if the IBNOC ALC flag i s | |
| 595 | ; set, it will rese t the flag and quit out. That is, it do es not re- | |
| 596 | ; calcula te the cha rges the f irst time it otherwi se would i f the user | |
| 597 | ; is doin g either a CRD or CL ON. | |
| 598 | ; | |
| 599 | S IBNOCAL C=1 | |
| 600 | ; | |
| 601 | G STEP1 | |
| 602 | Q | |
| 603 | ; | |
| 604 | Modified L ogic (Chan ges are in bold) | |
| 605 | IBCCC ;ALB /AAS - CAN CEL AND CL ONE A BILL ;25-JAN-9 0 | |
| 606 | ;;2.0;INT EGRATED BI LLING;**80 ,109,106,5 1,320,433, 432,447,51 6**;21-MAR -94;Build 123 | |
| 607 | ;;Per VA Directive 6402, this routine s hould not be modifie d. | |
| 608 | ; | |
| 609 | ;MAP TO D GCRCC | |
| 610 | ; | |
| 611 | ;STEP 1 - cancel bi ll | |
| 612 | ;STEP 1.5 - entry t o clone pr eviously c ancelled b ill. (mus t be cance l) | |
| 613 | ;STEP 2 - build arr ay of IBID S call scr een that a sks ok | |
| 614 | ;STEP 3 - pass stub entry to ar | |
| 615 | ;STEP 4 - store stu b data in MCCR then x-ref | |
| 616 | ;STEP 4.5 - store c laim clone info on " S1" node. | |
| 617 | ;STEP 5 - get remai nder of da ta to move and store in MCCR t hen x-ref | |
| 618 | ;STEP 6 - go to scr eens, come out to IB B1 | |
| 619 | EN ; | |
| 620 | N IBBCF,I BBCT,IBBCB ,IBCCR,IBD BC,IBCNCOP Y,IBNOCALC | |
| 621 | S IBDBC=D T ;date claim was cloned | |
| 622 | S IBBCB=D UZ ;user -id of per son clonin g the clai m. | |
| 623 | S IBCNCOP Y=1 ; flag indicatin g this fun ction is e ntered as the copy/c ancel opti on | |
| 624 | ; | |
| 625 | ; MRD;IB* 2.0*516 - Added the flag IBNOC ALC. This flag is s et here an d | |
| 626 | ; below. When char ges are re calculated in BILL^I BCRBC, the first tim e | |
| 627 | ; that pr ocedure is entered f or the new claim, if the IBNOC ALC flag i s | |
| 628 | ; set, it will rese t the flag and quit out. That is, it do es not re- | |
| 629 | ; calcula te the cha rges the f irst time it otherwi se would i f the user | |
| 630 | ; is doin g either a CRD or CL ON. | |
| 631 | ; | |
| 632 | S IBNOCAL C=1 | |
| 633 | ; | |
| 634 | STEP1 I $G (IBCE("EDI "))>1 G EN D1 | |
| 635 | S IBCAN=2 ,IBQUIT=0, IBAC=6,IBU ="UNSPECIF IED" | |
| 636 | I '$G(IBC E("EDI")) D ASK^IBCC | |
| 637 | I $G(IBCE ("EDI"))=1 S IB364=" " D NOPTF^ IBCC | |
| 638 | G:IBQUIT END1 | |
| 639 | ;JRA use $G to prev ent <UNDEF > error wh en/if IBCC CC="" | |
| 640 | ;I 'IBCCC C!('$D(IBI FN)) G STE P1:'$G(IBC E("EDI")), END1 ;JRA ';' | |
| 641 | I '$G(IBC CCC)!('$D( IBIFN)) G STEP1:'$G( IBCE("EDI" )),END1 ; JRA add $G for IBCCC C | |
| 642 | I $G(IBCE ("EDI")) S IBCE("EDI ")=2 | |
| 643 | EN1 ; | |
| 644 | STEP1P5 I '$D(IBIFN) S IBCAN=2 ,IBQUIT=0, IBAC=6 W ! ,"Copy Pre viously Ca ncelled Bi ll.",!! S DIC="^DGCR (399,",DIC ("S")="I $ P(^(0),U,1 3)=7",DIC( 0)="AEMQZ" ,DIC("A")= "Enter BIL L NUMBER o r Patient NAME: " D ^DIC G:Y<1 END S IBI FN=+Y | |
| 645 | ; | |
| 646 | S IBBCF=I BIFN ;t his is the claim we are copyin g FROM | |
| 647 | S IBIDS(. 15)=IBIFN K IBIFN | |
| 648 | STEP2 S IB ND0=^DGCR( 399,IBIDS( .15),0) I $D(^("U")) S IBNDU=^ ("U") | |
| 649 | ; *** Not e - all th ese fields should al so be incl uded in WH ERE^IBCCC1 | |
| 650 | ; IB*2.0* 432 added check of v ariable IB SILENT to allow COB copy in ba ckground m ode | |
| 651 | F I=2:1:1 2 S:$P(IBN D0,"^",I)] "" IBIDS(I /100)=$P(I BND0,"^",I ) | |
| 652 | F I=16:1: 19,21:1:27 S:$P(IBND 0,"^",I)]" " IBIDS(I/ 100)=$P(IB ND0,"^",I) | |
| 653 | F I=151,1 52,155 S I BIDS(I)=$P (IBNDU,"^" ,(I-150)) | |
| 654 | S IBIDS(1 59.5)=$P(I BNDU,U,20) | |
| 655 | ; *** | |
| 656 | D:$G(IBSI LENT)="" H OME^%ZIS | |
| 657 | S DFN=IBI DS(.02) D DEM^VADPT | |
| 658 | I +$G(IBC TCOPY)!$G( IBCE("EDI" )) G STEP3 | |
| 659 | D ^IBCA1 | |
| 660 | ASK S IBYN =0 W !!,"I S THE ABOV E INFORMAT ION CORREC T AS SHOWN " S %=1 D YN^DICN G END:%=2,ST EP3:%=1 I % G END | |
| 661 | W !!?4,"Y ES - If th is informa tion is co rrect as s hown and y ou wish to file the bill.",!?4 ,"NO - If you wish to change this infor mation pri or to fili ng." | |
| 662 | W !?4,"'^ ' - Enter the up-arr ow charact er to DELE TE this Bi ll at this time." G ASK | |
| 663 | ; | |
| 664 | STEP3 ; | |
| 665 | S PRCASV( "SER")=$P( $G(^IBE(35 0.9,1,1)), "^",14) | |
| 666 | S PRCASV( "SITE")=$P ($$SITE^VA SITE,"^",3 ),IBNWBL=" ",PRCASV(" ARCRD")=$G (IBCNCRD) | |
| 667 | ; IA#386 & 1992 If user came from CRD option, ne ed to pass old bill # and clai m ien, as well as ne w iteratio n number | |
| 668 | I $G(IBCN CRD)=1 D C RD^IBCC(IB BCF) S PRC ASV("ARREC ")=IBBCF,P RCASV("ARB IL")=PRCAS V("SITE")_ "-"_$P(IBI TN,"-"),PR CASV("ARIT N")=PRCASV ("SITE")_" -"_IBITN | |
| 669 | W:$G(IBSI LENT)="" ! ,"Passing bill to Ac counts Rec eivable Mo dule..." D SETUP^PRC ASVC3 I $S ($P(PRCASV ("ARREC"), "^")=-1:1, $P(PRCASV( "ARBIL")," ^")=-1:1,1 :0) W:$G(I BSILENT)=" " *7," ", $P(PRCASV( "ARREC")," ^",2),$P(P RCASV("ARB IL"),"^",2 ) G END | |
| 670 | S IBIDS(. 01)=$P(PRC ASV("ARBIL "),"-",2), IBIDS(.17) =$S($D(IBI DS(.17)):I BIDS(.17), 1:PRCASV(" ARREC")) | |
| 671 | I '$G(IBC E("EDI")) W !,"Billi ng Record #",IBIDS(. 01)," bein g establis hed for '" ,VADM(1)," '..." S IB IDS(.02)=D FN,IBHV("I BIFN")=$S( $G(IBIFN): IBIFN,1:$G (IBIDS(.15 ))) | |
| 672 | G ^IBCCC1 ;go to st ep4 | |
| 673 | Q | |
| 674 | ; | |
| 675 | END W:$G(I BSILENT)=" " !!,"No B illing Rec ord Set up . You mus t manually enter the bill." | |
| 676 | END1 K %,% DT,IBCAN,I BAC,IBND0, IBNDU,IBYN ,IBIFN,IB, IBA,IBNWBL ,IBBT,IBID S,IBU,I,J, VA,VADM,X, X1,X2,X3,X 4,D,Y ;JR A remove I BCCCC from KILL | |
| 677 | ;I '$G(IB QUIT),$S(+ $G(IBCNCOP Y):1,1:'$G (IBCE("EDI "))) G STE P1 | |
| 678 | I '$G(IBQ UIT),$S(+$ G(IBCNCOPY )!(+$G(IBC NCRD)):1,1 :'$G(IBCE( "EDI"))) G STEP1 | |
| 679 | K IBQUIT, IBCNCOPY,I BCNCRD,IBN OCALC,IBCC CC ;JRA A dded IBCCC C to KILL | |
| 680 | Q | |
| 681 | ; | |
| 682 | ITN(IBX) ; determine iteration # for rej ected or d enied clai m | |
| 683 | N IBCF,IB CL | |
| 684 | S IBCF=$P ($G(^DGCR( 399,IBX,"S 1")),U,2) | |
| 685 | ; if this claim has never bee n cloned, iteration # is -01 | |
| 686 | Q:IBCF="" $P($G(^DG CR(399,IBX ,0)),U)_"- 01" | |
| 687 | S IBCL=$P ($G(^DGCR( 399,IBCF,0 )),U) | |
| 688 | ; if clai m was a CL ON 1st and now a COR RECT, this is the 1s t iteratio n | |
| 689 | I $P(IBCL ,"-")'=$P( $P($G(^DGC R(399,IBX, 0)),U),"-" ) Q $P($G( ^DGCR(399, IBX,0)),U) _"-01" | |
| 690 | ; to dete rmine iter ation#, ne ed to incr iment from claim tha t was clon ed from | |
| 691 | S IBITN=$ P(IBCL,"-" ,2),IBITN= IBITN+1 I $L(IBITN)= 1 S IBITN= "0"_IBITN | |
| 692 | Q $P(IBCL ,"-")_"-"_ IBITN | |
| 693 | ; | |
| 694 | CRD ; new entry poin t if user comes from CRD optio n instead of CLON | |
| 695 | N IBBCF,I BBCT,IBBCB ,IBCCR,IBD BC,IBCNCRD ,IBITN,IBN OCALC | |
| 696 | S IBDBC=D T ;date claim was cloned | |
| 697 | S IBBCB=D UZ ;user -id of per son clonin g the clai m. | |
| 698 | S IBCNCRD =1 ; flag indicating this func tion is en tered as t he CRD opt ion | |
| 699 | ; | |
| 700 | ; MRD;IB* 2.0*516 - Added the flag IBNOC ALC. This flag is s et here an d | |
| 701 | ; above. When char ges are re calculated in BILL^I BCRBC, the first tim e | |
| 702 | ; that pr ocedure is entered f or the new claim, if the IBNOC ALC flag i s | |
| 703 | ; set, it will rese t the flag and quit out. That is, it do es not re- | |
| 704 | ; calcula te the cha rges the f irst time it otherwi se would i f the user | |
| 705 | ; is doin g either a CRD or CL ON. | |
| 706 | ; | |
| 707 | S IBNOCAL C=1 | |
| 708 | ; | |
| 709 | G STEP1 | |
| 710 | Q | |
| 711 | ; | |
| 712 | ||
| 713 | ||
| 714 | Routines | |
| 715 | Activities | |
| 716 | Routine Na me | |
| 717 | IBCCCB | |
| 718 | Enhancemen t Category | |
| 719 | New | |
| 720 | Modify | |
| 721 | Delete | |
| 722 | No Change | |
| 723 | RTM | |
| 724 | ||
| 725 | Related Op tions | |
| 726 | None | |
| 727 | Related Ro utines | |
| 728 | Routines “ Called By” | |
| 729 | Routines “ Called” | |
| 730 | ||
| 731 | ||
| 732 | ||
| 733 | ||
| 734 | Data Dicti onary (DD) Reference s | |
| 735 | ||
| 736 | Related Pr otocols | |
| 737 | ||
| 738 | Related In tegration Control Re gistration s (ICRs) | |
| 739 | None | |
| 740 | Data Passi ng | |
| 741 | Input | |
| 742 | Output Re ference | |
| 743 | Both | |
| 744 | Global Re ference | |
| 745 | Local | |
| 746 | Input Attr ibute Name and Defin ition | |
| 747 | Name: | |
| 748 | Definition : | |
| 749 | Output Att ribute Nam e and Defi nition | |
| 750 | Name: | |
| 751 | Definition : | |
| 752 | Current Lo gic | |
| 753 | IBCCCB^INT ^1^^0 | |
| 754 | IBCCCB ;AL B/ARH - CO PY BILL FO R COB ;2/1 3/06 10:46 am | |
| 755 | ;;2.0;INT EGRATED BI LLING;**80 ,106,51,15 1,137,182, 155,323,43 6,432,447, 547**;21-M AR-94;Buil d 119 | |
| 756 | ;;Per VA Directive 6402, this routine s hould not be modifie d. | |
| 757 | ; | |
| 758 | ; Copy bi ll for COB w/out can celling, u pdate some flds | |
| 759 | ; Primary ->Secondar y->Tertiar y | |
| 760 | ASK ; | |
| 761 | S IBCBCOP Y=1 ; flag that copy function entered th ru Copy CO B option | |
| 762 | ; | |
| 763 | D KVAR S IBCAN=2,IB U="UNSPECI FIED" | |
| 764 | ; | |
| 765 | S IBX=$$P B^IBJTU2 S :+IBX=2 IB IFN=$P(IBX ,U,2) I +I BX=1 S DFN =$P(IBX,U, 2),IBV=1,I BAC=5 D DA TE^IBCB | |
| 766 | I '$G(IBI FN) G EXIT | |
| 767 | ; | |
| 768 | ; IB*2.0* 432 Restri ct access to only al low claims that are NOT on the new CBW W orklist | |
| 769 | I $P($G(^ DGCR(399,I BIFN,"S1") ),U,7)=1,$ G(IBMRANOT )'=1 D G ASK | |
| 770 | . W !!?4, "This bill appears o n the CBW Management Work List . Please use the" | |
| 771 | . W !?4," 'CBW Manag ement Menu ' options for all pr ocessing r elated to this bill. " | |
| 772 | . Q | |
| 773 | ; Restric t access t o this pro cess for R EQUEST MRA bills in 2 Cases: | |
| 774 | ; 1. No M RA EOB's o n File for bill | |
| 775 | I $P($G(^ DGCR(399,I BIFN,0)),U ,13)=2,'$$ CHK^IBCEMU 1(IBIFN) D G ASK | |
| 776 | . W !!?4, "This bill is in a s tatus of R EQUEST MRA and it ha s No MRA E OB's" | |
| 777 | . W !?4," on file. Access to this bill is restric ted." | |
| 778 | ; | |
| 779 | ; 2. At l east one M RA EOB app ears on th e MRA mana gement wor klist | |
| 780 | I $P($G(^ DGCR(399,I BIFN,0)),U ,13)=2,$$M RAWL^IBCEM U2(IBIFN) D G ASK | |
| 781 | . W !!?4, "This bill is in a s tatus of R EQUEST MRA and it do es appear on the" | |
| 782 | . W !?4," MRA Manage ment Work List. Ple ase use th e 'MRA Man agement Me nu' option s" | |
| 783 | . W !?4," for all pr ocessing r elated to this bill. " | |
| 784 | . Q | |
| 785 | ; | |
| 786 | ; If MRA is Activat ed and bil l is in En tered/Not Reviewed s tatus and current in surance Co . is WNR - -> | |
| 787 | ; ask if user wants to contin ue | |
| 788 | I $$EDIAC TV^IBCEF4( 2),$P($G(^ DGCR(399,I BIFN,0)),U ,13)=1,$$M CRWNR^IBEF UNC(+$$CUR R^IBCEF2(I BIFN)) D I 'Y G ASK | |
| 789 | . W !!?4, "This bill is in a s tatus of E NTERED/NOT REVIEWED and curren t payer is " | |
| 790 | . W !?4," MEDICARE ( WNR). No M RA has bee n requeste d for this bill." | |
| 791 | . S DIR(0 )="YA",DIR ("B")="NO" ,DIR("A")= " Are y ou sure yo u want to continue t o process this bill? : " | |
| 792 | . D ^DIR K DIR | |
| 793 | ; | |
| 794 | ; Display related b ills | |
| 795 | D DSPRB^I BCCCB0(IBI FN) | |
| 796 | ; | |
| 797 | CHKB ; Ent rypoint-CO B processi ng via EDI 's COB Mgm t | |
| 798 | ; Ask if final EOB was receiv ed for pre vious bill | |
| 799 | I '$$FINA LEOB^IBCCC B0(IBIFN) S IBSECHK= 1 | |
| 800 | I $G(IBSE CHK)=1,$$M CRONBIL^IB EFUNC(IBIF N) G EXIT | |
| 801 | ; | |
| 802 | ; Warn if previous bill not a t least au thorized | |
| 803 | I '$$MCRO NBIL^IBEFU NC(IBIFN) I '$$COBOK ^IBCCCB0(I BIFN) G EX IT | |
| 804 | ; | |
| 805 | CHKB1 ; En try point for Automa tic/Silent COB Proce ssing. | |
| 806 | ; No writ es or read s can occu r from thi s point fo rward if v ariable | |
| 807 | ; IBSILEN T=1. Any and all er ror messag es should be process ed with | |
| 808 | ; the ERR OR procedu re below. | |
| 809 | ; | |
| 810 | S IBX=$G( ^DGCR(399, +IBIFN,0)) ,DFN=$P(IB X,U,2),IBD T=$P(IBX,U ,3)\1,IBER ="" | |
| 811 | I IBCAN>1 D NOPTF^I BCB2 I 'IB AC1 D NOPT F1^IBCB2 G ASK1 | |
| 812 | ; | |
| 813 | F IBI=0," S","U1","M ","MP","M1 " S IB(IBI )=$G(^DGCR (399,IBIFN ,IBI)) | |
| 814 | I IB(0)=" " S IBER=" Invalid Bi ll Number" D ERROR G ASK1 | |
| 815 | ; | |
| 816 | ; check t o see if t he bill ha s been can celled | |
| 817 | I $P(IB(" S"),U,16), $P(IB("S") ,U,17) D G ASK1 | |
| 818 | . N WHO | |
| 819 | . S IBER= "This bill was cance lled on " | |
| 820 | . S IBER= IBER_$$FMT E^XLFDT($P (IB("S"),U ,17),"1Z") _" by " | |
| 821 | . S WHO=" UNSPECIFIE D" | |
| 822 | . I $P(IB ("S"),U,18 ) S WHO=$P ($G(^VA(20 0,$P(IB("S "),U,18),0 )),U,1) | |
| 823 | . S IBER= IBER_WHO_" ." | |
| 824 | . D ERROR | |
| 825 | . Q | |
| 826 | ; | |
| 827 | S IBCOB=$ $COB^IBCEF (IBIFN),IB COBN=$TR(I BCOB,"PSTA ","12") | |
| 828 | S IBMRAIO =+$$CURR^I BCEF2(IBIF N),IBMRAO= $$MCRWNR^I BEFUNC(IBM RAIO) | |
| 829 | S IBNMOLD =$S(IBCOB= "P":"Prima ry",IBCOB= "S":"Secon dary",IBCO B="T":"Ter tiary",IBC OB="A":"Pa tient",1:" ")_$S(IBMR AO:"-MRA O nly",1:"") | |
| 830 | S IBINSOL D=$G(^DIC( 36,$S(IB(" MP"):+IB(" MP"),IBMRA O:IBMRAIO, 1:0),0)) | |
| 831 | ; | |
| 832 | NEXTP ; If current b ill=MEDICA RE WNR and valid 'ne xt payer', use same | |
| 833 | ; bill f or new pay er | |
| 834 | ; If next valid 'pa yer' is in s co or ME DICARE WNR , create n ew bill | |
| 835 | S IBCOBN= IBCOBN+1,I BNM=$S(IBC OBN=2:"Sec ondary Pay er",IBCOBN =3:"Tertia ry Payer", 1:"") | |
| 836 | ; | |
| 837 | I IBNM="" S IBER=$P (IB(0),U,1 )_" is a " _IBNMOLD_" bill, the re is no n ext bill i n the seri es." D ERR OR G ASK1 | |
| 838 | ; | |
| 839 | S IBX=+$P (IB("M1"), U,(4+IBCOB N)),IBY=$G (^DGCR(399 ,+IBX,0)), IBCOBIL(+I BIFN)="" | |
| 840 | ; | |
| 841 | I $P(IBY, U,13)=7 S IBER="The "_$P(IBNM, " ",1)_" b ill "_$P(I BY,U,1)_" has been c ancelled." D ERROR S IBX="" | |
| 842 | ; | |
| 843 | I +IBX,$D (IBCOBIL(+ IBX)) S IB ER="Next b ill in ser ies can no t be deter mined." D ERROR G AS K1 | |
| 844 | I +IBX S IBER=$P(IB NM," ",1)_ " bill alr eady defin ed for thi s series: "_$P(IBY,U ,1) D ERRO R S IBIFN= IBX G ASK1 | |
| 845 | ; | |
| 846 | S IBINSN= $P(IB("M") ,U,IBCOBN) I 'IBINSN S IBER="T here is no "_IBNM_" for "_$P(I B(0),U,1)_ "." D ERRO R G ASK1 | |
| 847 | S IBINS=$ G(^DIC(36, +IBINSN,0) ) I IBINS= "" S IBER= "The "_IBN M_" for "_ $P(IB(0),U ,1)_" is n ot a valid Insurance Co." D ER ROR G ASK1 | |
| 848 | ; | |
| 849 | S IBMRA=0 | |
| 850 | I $P(IBIN S,U,2)="N" S IBQ=0 D G:IBQ NE XTP | |
| 851 | . I $$MCR WNR^IBEFUN C(IBINSN) D Q | |
| 852 | .. ; Chec k if a val id tert in s if MCR W NR seconda ry | |
| 853 | .. I IBCO BN'>2 D | |
| 854 | ... N Z | |
| 855 | ... S Z=+ $P(IB("M") ,U,IBCOBN+ 1) | |
| 856 | ... I Z,$ D(^DIC(36, Z,0)),$P(^ (0),U,2)'= "N" S IBMR A=1,IBNM=$ P(IBNM," " )_"-MRA.On ly" | |
| 857 | .. I 'IBM RA S IBER= "MEDICARE will not r eimburse a nd no furt her valid insurance for bill" D ERROR S IBQ=1 | |
| 858 | . S IBER= $P(IB(0),U ,1)_" "_IB NM_", "_$P (IBINS,U,1 )_", will not Reimbu rse" D ERR OR S IBQ=1 | |
| 859 | ; | |
| 860 | ; If proc essing in silent mod e, skip ov er the fol lowing rea ds | |
| 861 | I $G(IBSI LENT) G SK IP | |
| 862 | ; | |
| 863 | W !! | |
| 864 | S DIR("?" )="Enter Y es to "_$S ('$G(IBMRA O):"create a new bil l in the b ill series for this care. The new bill will be th e "_$P(IBN M," ")_" b ill ",1:"e nter the M RA informa tion and c hange the payer to t he "_$P($P (IBNM,"-") ," ")_" pa yer ") | |
| 865 | S DIR("?" )=DIR("?") _$S('IBMRA :"with the "_IBNM_" responsibl e for paym ent.",1:"a nd will re quest an M RA from ME DICARE.") | |
| 866 | S DIR(0)= "YO",DIR(" A")=$S('$G (IBMRAO):" Copy "_$P( IB(0),U,1) _" for a b ill to the ",1:"Chan ge payer o n bill "_$ P(IB(0),U, 1)_" to ") _IBNM_", " _$P(IBINS, U,1) D ^DI R K DIR I Y'=1 S IBS ECHK=1 G A SK1 | |
| 867 | ; | |
| 868 | W ! | |
| 869 | S IBQ=0 | |
| 870 | I '$G(IBM RAO) D G: IBQ ASK1 | |
| 871 | . N Z | |
| 872 | . S DIR(" ?")="Enter the amoun t of the p ayment fro m the paye r of the " _IBNMOLD_" bill." | |
| 873 | . S DIR(" ?")=DIR("? ")_" This will be a dded to th e new bill as a prio r payment and subtra cted from the charge s due for the new bi ll." | |
| 874 | . S DIR(" A")="Prior Payment f rom "_$P(I B(0),U,1)_ " "_IBNMOL D_" Payer, "_$P(IBIN SOLD,U,1)_ ": " | |
| 875 | . S Z=$$E OBTOT^IBCE U1(IBIFN,$ $COBN^IBCE F(IBIFN)) | |
| 876 | . S:Z DIR ("B")=Z | |
| 877 | . S DIR(0 )="NOA^0:9 9999999:2" | |
| 878 | . D ^DIR K DIR I Y= ""!$D(DIRU T) S IBQ=1 | |
| 879 | . K IBCOB | |
| 880 | . S IBCOB ("U2",IBCO BN+2)=Y | |
| 881 | . Q | |
| 882 | ; | |
| 883 | SKIP ; Jum p here if skipping o ver the pr eceeding r eads | |
| 884 | ; | |
| 885 | ; If paye r is Medic are (WNR) update pay er sequenc e and quit | |
| 886 | I IBMRAO! ($G(IBSTSM )=1) D I $G(IBSTSM) '=1 G END | |
| 887 | . N IBPRT OT,IBTOTCH G,IBPTRESP | |
| 888 | . S IBTOT CHG=0 | |
| 889 | . ; | |
| 890 | . ; Get T otal Charg es from BI LLS/CLAIMS (#399) fi le | |
| 891 | . S IBTOT CHG=$P($G( ^DGCR(399, IBIFN,"U1" )),U,1) | |
| 892 | . ; Calcu late Patie nt Respons ibility fo r Bill | |
| 893 | . ; IB*2. 0*447 If c laim's typ e of plan has effect ive date m ultiple, u se those c alculation s | |
| 894 | . ;S IBPT RESP=$$PRE OBTOT^IBCE U0(IBIFN,$ G(IBSTSM)) | |
| 895 | . ; Calcu late Patie nt Primary /Secondary Prior Pay ment (fiel d 218 or 2 19 of File 399) | |
| 896 | . ; These fields ar e stored i n DGCR(399 ,IBIFN,"U2 ") pieces 4 and 5 re spectively | |
| 897 | . ; Calcu late: Prio r Payment= Total Sub mitted Cha rges - Pat ient Respo nsibility | |
| 898 | . S:$G(IB STSM)'=1 I BPTRESP=$S ($$MSEDT^I BCEMU4(IBI FN)'="":$$ MSPRE^IBCE MU4(IBIFN) ,1:$$PREOB TOT^IBCEU0 (IBIFN,$G( IBSTSM))), IBPRTOT=IB TOTCHG-IBP TRESP | |
| 899 | . S:$G(IB STSM)=1 IB PRTOT=$$EO BTOT^IBCEU 1(IBIFN,$$ COBN^IBCEF (IBIFN)) ; Pat Resp f or non-med icare | |
| 900 | . I IBPRT OT<0 S IBP RTOT=0 ; don't allow nega tive prior payment o r offset | |
| 901 | . S IBCOB ("U2",IBCO BN+2)=IBPR TOT | |
| 902 | . ; IB*2. 0*547 don' t change s tatus back to 1.5 if auto-crea ting secon dary or te rtiary in silent mod e | |
| 903 | . ; D:$G( IBSTSM)'=1 COBCHG^IB CCC2(IBIFN ,IBMRAIO,. IBCOB) | |
| 904 | . ; D STA T^IBCEMU2( IBIFN,1.5, 1) ; m ra eob sta tus update | |
| 905 | . I $G(IB STSM)'=1 D COBCHG^IB CCC2(IBIFN ,IBMRAIO,. IBCOB),STA T^IBCEMU2( IBIFN,1.5, 1) ; m ra eob sta tus update | |
| 906 | . I $G(IB SILENT) S IBERRMSG=" " | |
| 907 | . Q | |
| 908 | ; | |
| 909 | ; We shou ld NOT get to here i n silent m ode .... j ust in cas e | |
| 910 | I $G(IBSI LENT),$G(I BSTSM)'=1 G END ; currently only MCRW NR in sile nt mode | |
| 911 | ; | |
| 912 | ; Payer i s not Medi care (WNR) - Perform additiona l steps | |
| 913 | S IBCOB(0 ,15)="" | |
| 914 | S IBCOB(0 ,21)=$S(IB COBN=2:"S" ,IBCOBN=3: "T",1:"") | |
| 915 | I IBCOB(0 ,21)="" G END | |
| 916 | S IBCOB(" M1",IBCOBN +3)=IBIFN | |
| 917 | S IBIDS(. 15)=IBIFN | |
| 918 | D KVAR | |
| 919 | G STEP2^I BCCC | |
| 920 | ; | |
| 921 | END ; | |
| 922 | Q | |
| 923 | ; | |
| 924 | ; | |
| 925 | ASK1 ; If entering t hru EDI CO B processi ng, don't ask for ne w bill, qu it | |
| 926 | I $G(IBCB ASK) G EXI T | |
| 927 | G ASK | |
| 928 | ; | |
| 929 | ERROR ; Di splay/Save error mes sage | |
| 930 | I '$G(IBS ILENT) W ! ,IBER,! | |
| 931 | E S IBER RMSG=IBER | |
| 932 | S IBER="" | |
| 933 | I $D(IBSE CHK) S IBS ECHK=1 | |
| 934 | Q | |
| 935 | ; | |
| 936 | EXIT K IBC AN,IBCOB,I BU | |
| 937 | KVAR K IBX ,IBY,IBI,I BIFN,DFN,I BDT,IB,IBC OBN,IBNMOL D,IBINSOLD ,IBNM,IBIN SN,IBINS,I BER,DIR,IB AC,IBAC1,I BV,X,Y,IBD ATA,IBT,IB ND0,DIRUT, IBCOBIL,IB MRA,IBMRAI ,IBMRAO,IB MRAIO,IBCB COPY | |
| 938 | K ^UTILIT Y($J) | |
| 939 | Q | |
| 940 | ; | |
| 941 | DSPRB(IBIF N) ; displ ay related bills | |
| 942 | ; | |
| 943 | D DSPRB^I BCCCB0(IBI FN) ; Code moved for size too big | |
| 944 | Q | |
| 945 | ; | |
| 946 | ; ======= ======= | |
| 947 | ; | |
| 948 | ; Copy a bill for R easonable Charges wi thout canc elling it, update ce rtain fiel ds | |
| 949 | ; | |
| 950 | ; there i s always b oth inpt i nst (creat ed first) and prof c harges, al ways need both bills | |
| 951 | ; there m ay be both outpt ins t (created first) an d prof cha rges, may not need b oth bills | |
| 952 | ; if bill ing by epi sode rathe r than by day (curre nt standar d) then ma y need mul tiple prof bills per day | |
| 953 | ; | |
| 954 | ; Inst bi lls are co pied to cr eate prof Bills auto matically | |
| 955 | ; Subsequ ent prof b ills may b e created if the use r wants th em | |
| 956 | ; | |
| 957 | ; Only th e first bi ll in the COB series of bills should be copied for the next prof bill | |
| 958 | ; The pri mary inst bill shoul d be copie d to get t he seconda ry inst bi ll | |
| 959 | ; The pri mary prof bill shoul d be copie d to get t he seconda ry prof bi ll | |
| 960 | ; | |
| 961 | CTCOPY(IBI FN,IBMRA) ; based on the type of bill, c opy withou t cancelli ng | |
| 962 | ; IBMRA = 1 if an M RA bill an d copy for prof comp onents is desired | |
| 963 | ; | |
| 964 | D CTCOPY^ IBCCCB0(IB IFN,$G(IBM RA)) ;Move d due to r outine siz e | |
| 965 | Q | |
| 966 | ; | |
| 967 | Modified L ogic (Chan ges are in bold) | |
| 968 | IBCCCB ;AL B/ARH - CO PY BILL FO R COB ;2/1 3/06 10:46 am | |
| 969 | ;;2.0;INT EGRATED BI LLING;**80 ,106,51,15 1,137,182, 155,323,43 6,432,447, 547**;21-M AR-94;Buil d 119 | |
| 970 | ;;Per VA Directive 6402, this routine s hould not be modifie d. | |
| 971 | ; | |
| 972 | ; Copy bi ll for COB w/out can celling, u pdate some flds | |
| 973 | ; Primary ->Secondar y->Tertiar y | |
| 974 | ASK ; | |
| 975 | S IBCBCOP Y=1 ; flag that copy function entered th ru Copy CO B option | |
| 976 | ; | |
| 977 | D KVAR S IBCAN=2,IB U="UNSPECI FIED" | |
| 978 | ; | |
| 979 | S IBX=$$P B^IBJTU2 S :+IBX=2 IB IFN=$P(IBX ,U,2) I +I BX=1 S DFN =$P(IBX,U, 2),IBV=1,I BAC=5 D DA TE^IBCB | |
| 980 | I '$G(IBI FN) G EXIT | |
| 981 | ; | |
| 982 | ; IB*2.0* 432 Restri ct access to only al low claims that are NOT on the new CBW W orklist | |
| 983 | I $P($G(^ DGCR(399,I BIFN,"S1") ),U,7)=1,$ G(IBMRANOT )'=1 D G ASK | |
| 984 | . W !!?4, "This bill appears o n the CBW Management Work List . Please use the" | |
| 985 | . W !?4," 'CBW Manag ement Menu ' options for all pr ocessing r elated to this bill. " | |
| 986 | . S IBQUI T=1 ;JRA need to se t quit fla g after is suing this message | |
| 987 | . Q | |
| 988 | ; Restric t access t o this pro cess for R EQUEST MRA bills in 2 Cases: | |
| 989 | ; 1. No M RA EOB's o n File for bill | |
| 990 | I $P($G(^ DGCR(399,I BIFN,0)),U ,13)=2,'$$ CHK^IBCEMU 1(IBIFN) D G ASK | |
| 991 | . W !!?4, "This bill is in a s tatus of R EQUEST MRA and it ha s No MRA E OB's" | |
| 992 | . W !?4," on file. Access to this bill is restric ted." | |
| 993 | ; | |
| 994 | ; 2. At l east one M RA EOB app ears on th e MRA mana gement wor klist | |
| 995 | I $P($G(^ DGCR(399,I BIFN,0)),U ,13)=2,$$M RAWL^IBCEM U2(IBIFN) D G ASK | |
| 996 | . W !!?4, "This bill is in a s tatus of R EQUEST MRA and it do es appear on the" | |
| 997 | . W !?4," MRA Manage ment Work List. Ple ase use th e 'MRA Man agement Me nu' option s" | |
| 998 | . W !?4," for all pr ocessing r elated to this bill. " | |
| 999 | . Q | |
| 1000 | ; | |
| 1001 | ; If MRA is Activat ed and bil l is in En tered/Not Reviewed s tatus and current in surance Co . is WNR - -> | |
| 1002 | ; ask if user wants to contin ue | |
| 1003 | I $$EDIAC TV^IBCEF4( 2),$P($G(^ DGCR(399,I BIFN,0)),U ,13)=1,$$M CRWNR^IBEF UNC(+$$CUR R^IBCEF2(I BIFN)) D I 'Y G ASK | |
| 1004 | . W !!?4, "This bill is in a s tatus of E NTERED/NOT REVIEWED and curren t payer is " | |
| 1005 | . W !?4," MEDICARE ( WNR). No M RA has bee n requeste d for this bill." | |
| 1006 | . S DIR(0 )="YA",DIR ("B")="NO" ,DIR("A")= " Are y ou sure yo u want to continue t o process this bill? : " | |
| 1007 | . D ^DIR K DIR | |
| 1008 | ; | |
| 1009 | ; Display related b ills | |
| 1010 | D DSPRB^I BCCCB0(IBI FN) | |
| 1011 | ; | |
| 1012 | CHKB ; Ent rypoint-CO B processi ng via EDI 's COB Mgm t | |
| 1013 | ; Ask if final EOB was receiv ed for pre vious bill | |
| 1014 | I '$$FINA LEOB^IBCCC B0(IBIFN) S IBSECHK= 1 | |
| 1015 | I $G(IBSE CHK)=1,$$M CRONBIL^IB EFUNC(IBIF N) G EXIT | |
| 1016 | ; | |
| 1017 | ; Warn if previous bill not a t least au thorized | |
| 1018 | I '$$MCRO NBIL^IBEFU NC(IBIFN) I '$$COBOK ^IBCCCB0(I BIFN) G EX IT | |
| 1019 | ; | |
| 1020 | CHKB1 ; En try point for Automa tic/Silent COB Proce ssing. | |
| 1021 | ; No writ es or read s can occu r from thi s point fo rward if v ariable | |
| 1022 | ; IBSILEN T=1. Any and all er ror messag es should be process ed with | |
| 1023 | ; the ERR OR procedu re below. | |
| 1024 | ; | |
| 1025 | S IBX=$G( ^DGCR(399, +IBIFN,0)) ,DFN=$P(IB X,U,2),IBD T=$P(IBX,U ,3)\1,IBER ="" | |
| 1026 | I IBCAN>1 D NOPTF^I BCB2 I 'IB AC1 D NOPT F1^IBCB2 G ASK1 | |
| 1027 | ; | |
| 1028 | F IBI=0," S","U1","M ","MP","M1 " S IB(IBI )=$G(^DGCR (399,IBIFN ,IBI)) | |
| 1029 | I IB(0)=" " S IBER=" Invalid Bi ll Number" D ERROR G ASK1 | |
| 1030 | ; | |
| 1031 | ; check t o see if t he bill ha s been can celled | |
| 1032 | I $P(IB(" S"),U,16), $P(IB("S") ,U,17) D G ASK1 | |
| 1033 | . N WHO | |
| 1034 | . S IBER= "This bill was cance lled on " | |
| 1035 | . S IBER= IBER_$$FMT E^XLFDT($P (IB("S"),U ,17),"1Z") _" by " | |
| 1036 | . S WHO=" UNSPECIFIE D" | |
| 1037 | . I $P(IB ("S"),U,18 ) S WHO=$P ($G(^VA(20 0,$P(IB("S "),U,18),0 )),U,1) | |
| 1038 | . S IBER= IBER_WHO_" ." | |
| 1039 | . D ERROR | |
| 1040 | . Q | |
| 1041 | ; | |
| 1042 | S IBCOB=$ $COB^IBCEF (IBIFN),IB COBN=$TR(I BCOB,"PSTA ","12") | |
| 1043 | S IBMRAIO =+$$CURR^I BCEF2(IBIF N),IBMRAO= $$MCRWNR^I BEFUNC(IBM RAIO) | |
| 1044 | S IBNMOLD =$S(IBCOB= "P":"Prima ry",IBCOB= "S":"Secon dary",IBCO B="T":"Ter tiary",IBC OB="A":"Pa tient",1:" ")_$S(IBMR AO:"-MRA O nly",1:"") | |
| 1045 | S IBINSOL D=$G(^DIC( 36,$S(IB(" MP"):+IB(" MP"),IBMRA O:IBMRAIO, 1:0),0)) | |
| 1046 | ; | |
| 1047 | NEXTP ; If current b ill=MEDICA RE WNR and valid 'ne xt payer', use same | |
| 1048 | ; bill f or new pay er | |
| 1049 | ; If next valid 'pa yer' is in s co or ME DICARE WNR , create n ew bill | |
| 1050 | S IBCOBN= IBCOBN+1,I BNM=$S(IBC OBN=2:"Sec ondary Pay er",IBCOBN =3:"Tertia ry Payer", 1:"") | |
| 1051 | ; | |
| 1052 | I IBNM="" S IBER=$P (IB(0),U,1 )_" is a " _IBNMOLD_" bill, the re is no n ext bill i n the seri es." D ERR OR G ASK1 | |
| 1053 | ; | |
| 1054 | S IBX=+$P (IB("M1"), U,(4+IBCOB N)),IBY=$G (^DGCR(399 ,+IBX,0)), IBCOBIL(+I BIFN)="" | |
| 1055 | ; | |
| 1056 | I $P(IBY, U,13)=7 S IBER="The "_$P(IBNM, " ",1)_" b ill "_$P(I BY,U,1)_" has been c ancelled." D ERROR S IBX="" | |
| 1057 | ; | |
| 1058 | I +IBX,$D (IBCOBIL(+ IBX)) S IB ER="Next b ill in ser ies can no t be deter mined." D ERROR G AS K1 | |
| 1059 | I +IBX S IBER=$P(IB NM," ",1)_ " bill alr eady defin ed for thi s series: "_$P(IBY,U ,1) D ERRO R S IBIFN= IBX G ASK1 | |
| 1060 | ; | |
| 1061 | S IBINSN= $P(IB("M") ,U,IBCOBN) I 'IBINSN S IBER="T here is no "_IBNM_" for "_$P(I B(0),U,1)_ "." D ERRO R G ASK1 | |
| 1062 | S IBINS=$ G(^DIC(36, +IBINSN,0) ) I IBINS= "" S IBER= "The "_IBN M_" for "_ $P(IB(0),U ,1)_" is n ot a valid Insurance Co." D ER ROR G ASK1 | |
| 1063 | ; | |
| 1064 | S IBMRA=0 | |
| 1065 | I $P(IBIN S,U,2)="N" S IBQ=0 D G:IBQ NE XTP | |
| 1066 | . I $$MCR WNR^IBEFUN C(IBINSN) D Q | |
| 1067 | .. ; Chec k if a val id tert in s if MCR W NR seconda ry | |
| 1068 | .. I IBCO BN'>2 D | |
| 1069 | ... N Z | |
| 1070 | ... S Z=+ $P(IB("M") ,U,IBCOBN+ 1) | |
| 1071 | ... I Z,$ D(^DIC(36, Z,0)),$P(^ (0),U,2)'= "N" S IBMR A=1,IBNM=$ P(IBNM," " )_"-MRA.On ly" | |
| 1072 | .. I 'IBM RA S IBER= "MEDICARE will not r eimburse a nd no furt her valid insurance for bill" D ERROR S IBQ=1 | |
| 1073 | . S IBER= $P(IB(0),U ,1)_" "_IB NM_", "_$P (IBINS,U,1 )_", will not Reimbu rse" D ERR OR S IBQ=1 | |
| 1074 | ; | |
| 1075 | ; If proc essing in silent mod e, skip ov er the fol lowing rea ds | |
| 1076 | I $G(IBSI LENT) G SK IP | |
| 1077 | ; | |
| 1078 | W !! | |
| 1079 | S DIR("?" )="Enter Y es to "_$S ('$G(IBMRA O):"create a new bil l in the b ill series for this care. The new bill will be th e "_$P(IBN M," ")_" b ill ",1:"e nter the M RA informa tion and c hange the payer to t he "_$P($P (IBNM,"-") ," ")_" pa yer ") | |
| 1080 | S DIR("?" )=DIR("?") _$S('IBMRA :"with the "_IBNM_" responsibl e for paym ent.",1:"a nd will re quest an M RA from ME DICARE.") | |
| 1081 | S DIR(0)= "YO",DIR(" A")=$S('$G (IBMRAO):" Copy "_$P( IB(0),U,1) _" for a b ill to the ",1:"Chan ge payer o n bill "_$ P(IB(0),U, 1)_" to ") _IBNM_", " _$P(IBINS, U,1) D ^DI R K DIR I Y'=1 S IBS ECHK=1 G A SK1 | |
| 1082 | ; | |
| 1083 | W ! | |
| 1084 | S IBQ=0 | |
| 1085 | I '$G(IBM RAO) D G: IBQ ASK1 | |
| 1086 | . N Z | |
| 1087 | . S DIR(" ?")="Enter the amoun t of the p ayment fro m the paye r of the " _IBNMOLD_" bill." | |
| 1088 | . S DIR(" ?")=DIR("? ")_" This will be a dded to th e new bill as a prio r payment and subtra cted from the charge s due for the new bi ll." | |
| 1089 | . S DIR(" A")="Prior Payment f rom "_$P(I B(0),U,1)_ " "_IBNMOL D_" Payer, "_$P(IBIN SOLD,U,1)_ ": " | |
| 1090 | . S Z=$$E OBTOT^IBCE U1(IBIFN,$ $COBN^IBCE F(IBIFN)) | |
| 1091 | . S:Z DIR ("B")=Z | |
| 1092 | . S DIR(0 )="NOA^0:9 9999999:2" | |
| 1093 | . D ^DIR K DIR I Y= ""!$D(DIRU T) S IBQ=1 | |
| 1094 | . K IBCOB | |
| 1095 | . S IBCOB ("U2",IBCO BN+2)=Y | |
| 1096 | . Q | |
| 1097 | ; | |
| 1098 | SKIP ; Jum p here if skipping o ver the pr eceeding r eads | |
| 1099 | ; | |
| 1100 | ; If paye r is Medic are (WNR) update pay er sequenc e and quit | |
| 1101 | I IBMRAO! ($G(IBSTSM )=1) D I $G(IBSTSM) '=1 G END | |
| 1102 | . N IBPRT OT,IBTOTCH G,IBPTRESP | |
| 1103 | . S IBTOT CHG=0 | |
| 1104 | . ; | |
| 1105 | . ; Get T otal Charg es from BI LLS/CLAIMS (#399) fi le | |
| 1106 | . S IBTOT CHG=$P($G( ^DGCR(399, IBIFN,"U1" )),U,1) | |
| 1107 | . ; Calcu late Patie nt Respons ibility fo r Bill | |
| 1108 | . ; IB*2. 0*447 If c laim's typ e of plan has effect ive date m ultiple, u se those c alculation s | |
| 1109 | . ;S IBPT RESP=$$PRE OBTOT^IBCE U0(IBIFN,$ G(IBSTSM)) | |
| 1110 | . ; Calcu late Patie nt Primary /Secondary Prior Pay ment (fiel d 218 or 2 19 of File 399) | |
| 1111 | . ; These fields ar e stored i n DGCR(399 ,IBIFN,"U2 ") pieces 4 and 5 re spectively | |
| 1112 | . ; Calcu late: Prio r Payment= Total Sub mitted Cha rges - Pat ient Respo nsibility | |
| 1113 | . S:$G(IB STSM)'=1 I BPTRESP=$S ($$MSEDT^I BCEMU4(IBI FN)'="":$$ MSPRE^IBCE MU4(IBIFN) ,1:$$PREOB TOT^IBCEU0 (IBIFN,$G( IBSTSM))), IBPRTOT=IB TOTCHG-IBP TRESP | |
| 1114 | . S:$G(IB STSM)=1 IB PRTOT=$$EO BTOT^IBCEU 1(IBIFN,$$ COBN^IBCEF (IBIFN)) ; Pat Resp f or non-med icare | |
| 1115 | . I IBPRT OT<0 S IBP RTOT=0 ; don't allow nega tive prior payment o r offset | |
| 1116 | . S IBCOB ("U2",IBCO BN+2)=IBPR TOT | |
| 1117 | . ; IB*2. 0*547 don' t change s tatus back to 1.5 if auto-crea ting secon dary or te rtiary in silent mod e | |
| 1118 | . ; D:$G( IBSTSM)'=1 COBCHG^IB CCC2(IBIFN ,IBMRAIO,. IBCOB) | |
| 1119 | . ; D STA T^IBCEMU2( IBIFN,1.5, 1) ; m ra eob sta tus update | |
| 1120 | . I $G(IB STSM)'=1 D COBCHG^IB CCC2(IBIFN ,IBMRAIO,. IBCOB),STA T^IBCEMU2( IBIFN,1.5, 1) ; m ra eob sta tus update | |
| 1121 | . I $G(IB SILENT) S IBERRMSG=" " | |
| 1122 | . Q | |
| 1123 | ; | |
| 1124 | ; We shou ld NOT get to here i n silent m ode .... j ust in cas e | |
| 1125 | I $G(IBSI LENT),$G(I BSTSM)'=1 G END ; currently only MCRW NR in sile nt mode | |
| 1126 | ; | |
| 1127 | ; Payer i s not Medi care (WNR) - Perform additiona l steps | |
| 1128 | S IBCOB(0 ,15)="" | |
| 1129 | S IBCOB(0 ,21)=$S(IB COBN=2:"S" ,IBCOBN=3: "T",1:"") | |
| 1130 | I IBCOB(0 ,21)="" G END | |
| 1131 | S IBCOB(" M1",IBCOBN +3)=IBIFN | |
| 1132 | S IBIDS(. 15)=IBIFN | |
| 1133 | D KVAR | |
| 1134 | G STEP2^I BCCC | |
| 1135 | ; | |
| 1136 | END ; | |
| 1137 | Q | |
| 1138 | ; | |
| 1139 | ; | |
| 1140 | ASK1 ; If entering t hru EDI CO B processi ng, don't ask for ne w bill, qu it | |
| 1141 | I $G(IBCB ASK) G EXI T | |
| 1142 | G ASK | |
| 1143 | ; | |
| 1144 | ERROR ; Di splay/Save error mes sage | |
| 1145 | I '$G(IBS ILENT) W ! ,IBER,! | |
| 1146 | E S IBER RMSG=IBER | |
| 1147 | S IBER="" | |
| 1148 | I $D(IBSE CHK) S IBS ECHK=1 | |
| 1149 | Q | |
| 1150 | ; | |
| 1151 | EXIT K IBC AN,IBCOB,I BU | |
| 1152 | KVAR K IBX ,IBY,IBI,I BIFN,DFN,I BDT,IB,IBC OBN,IBNMOL D,IBINSOLD ,IBNM,IBIN SN,IBINS,I BER,DIR,IB AC,IBAC1,I BV,X,Y,IBD ATA,IBT,IB ND0,DIRUT, IBCOBIL,IB MRA,IBMRAI ,IBMRAO,IB MRAIO,IBCB COPY | |
| 1153 | K ^UTILIT Y($J) | |
| 1154 | Q | |
| 1155 | ; | |
| 1156 | DSPRB(IBIF N) ; displ ay related bills | |
| 1157 | ; | |
| 1158 | D DSPRB^I BCCCB0(IBI FN) ; Code moved for size too big | |
| 1159 | Q | |
| 1160 | ; | |
| 1161 | ; ======= ======= | |
| 1162 | ; | |
| 1163 | ; Copy a bill for R easonable Charges wi thout canc elling it, update ce rtain fiel ds | |
| 1164 | ; | |
| 1165 | ; there i s always b oth inpt i nst (creat ed first) and prof c harges, al ways need both bills | |
| 1166 | ; there m ay be both outpt ins t (created first) an d prof cha rges, may not need b oth bills | |
| 1167 | ; if bill ing by epi sode rathe r than by day (curre nt standar d) then ma y need mul tiple prof bills per day | |
| 1168 | ; | |
| 1169 | ; Inst bi lls are co pied to cr eate prof Bills auto matically | |
| 1170 | ; Subsequ ent prof b ills may b e created if the use r wants th em | |
| 1171 | ; | |
| 1172 | ; Only th e first bi ll in the COB series of bills should be copied for the next prof bill | |
| 1173 | ; The pri mary inst bill shoul d be copie d to get t he seconda ry inst bi ll | |
| 1174 | ; The pri mary prof bill shoul d be copie d to get t he seconda ry prof bi ll | |
| 1175 | ; | |
| 1176 | CTCOPY(IBI FN,IBMRA) ; based on the type of bill, c opy withou t cancelli ng | |
| 1177 | ; IBMRA = 1 if an M RA bill an d copy for prof comp onents is desired | |
| 1178 | ; | |
| 1179 | D CTCOPY^ IBCCCB0(IB IFN,$G(IBM RA)) ;Move d due to r outine siz e | |
| 1180 | Q | |
| 1181 | ; | |
| 1182 | ||
| 1183 | ||
| 1184 | Routines | |
| 1185 | Activities | |
| 1186 | Routine Na me | |
| 1187 | IBCECOB2 | |
| 1188 | Enhancemen t Category | |
| 1189 | New | |
| 1190 | Modify | |
| 1191 | Delete | |
| 1192 | No Change | |
| 1193 | RTM | |
| 1194 | ||
| 1195 | Related Op tions | |
| 1196 | None | |
| 1197 | Related Ro utines | |
| 1198 | Routines “ Called By” | |
| 1199 | Routines “ Called” | |
| 1200 | ||
| 1201 | ||
| 1202 | ||
| 1203 | ||
| 1204 | Data Dicti onary (DD) Reference s | |
| 1205 | ||
| 1206 | Related Pr otocols | |
| 1207 | ||
| 1208 | Related In tegration Control Re gistration s (ICRs) | |
| 1209 | None | |
| 1210 | Data Passi ng | |
| 1211 | Input | |
| 1212 | Output Re ference | |
| 1213 | Both | |
| 1214 | Global Re ference | |
| 1215 | Local | |
| 1216 | Input Attr ibute Name and Defin ition | |
| 1217 | Name: | |
| 1218 | Definition : | |
| 1219 | Output Att ribute Nam e and Defi nition | |
| 1220 | Name: | |
| 1221 | Definition : | |
| 1222 | Current Lo gic | |
| 1223 | IBCECOB2 ; ALB/CXW - IB COB MAN AGEMENT SC REEN ;16-J UN-1999 | |
| 1224 | ;;2.0;INT EGRATED BI LLING;**13 7,155,433, 432,447,48 8,516**;21 -MAR-1994; Build 123 | |
| 1225 | ;;Per VA Directive 6402, this routine s hould not be modifie d. | |
| 1226 | ; | |
| 1227 | EDI ;histo ry detail display | |
| 1228 | N IBIFN,I BDA | |
| 1229 | D SEL(.IB DA,1) | |
| 1230 | S IBDA=+$ O(IBDA(0)) ,IBIFN=+$G (IBDA(IBDA )) | |
| 1231 | D EDI1(IB IFN) | |
| 1232 | S VALMBCK ="R" | |
| 1233 | Q | |
| 1234 | ; | |
| 1235 | EDI1(IBIFN ) ; | |
| 1236 | N DFN | |
| 1237 | Q:'IBIFN | |
| 1238 | S DFN=$P( $G(^DGCR(3 99,IBIFN,0 )),U,2) | |
| 1239 | D EN^VALM ("IBJT EDI STATUS") | |
| 1240 | K:$D(IBFA STXT) IBFA STXT | |
| 1241 | Q | |
| 1242 | ; | |
| 1243 | EDI2(IBIFN ) ; | |
| 1244 | N DFN | |
| 1245 | Q:'IBIFN | |
| 1246 | S DFN=$P( $G(^DGCR(3 99,IBIFN,0 )),U,2) | |
| 1247 | D EN^VALM ("IBJT EDI STATUS AL ONE") | |
| 1248 | K:$D(IBFA STXT) IBFA STXT | |
| 1249 | Q | |
| 1250 | ; | |
| 1251 | CSA ;claim s status a waiting re solution | |
| 1252 | N IBDAX | |
| 1253 | D EN^IBCE CSA | |
| 1254 | I $D(IBFA STXT) K IB FASTXT | |
| 1255 | S VALMBCK ="R" | |
| 1256 | Q | |
| 1257 | ; | |
| 1258 | RVEOB ;Rev iew EOB | |
| 1259 | D FULL^VA LM1 W ! | |
| 1260 | N IBDA,IB IFN,IBCMT, IBSEL | |
| 1261 | D SEL(.IB DA,1) | |
| 1262 | S IBSEL=+ $O(IBDA(0) ) | |
| 1263 | S IBDA=$G (IBDA(IBSE L)) | |
| 1264 | S IBIFN=$ P(IBDA,U), IBDA=$P(IB DA,U,3) | |
| 1265 | I 'IBIFN G VEOBQ | |
| 1266 | S IBCMT=$ G(^TMP("IB CECOB1",$J ,IBSEL)) | |
| 1267 | I IBCMT'= "" D EN^VA LM("IBCEM MRA REVIEW ") | |
| 1268 | VEOBQ K ^T MP("IBCECO C",$J) | |
| 1269 | S VALMBCK ="R" | |
| 1270 | Q | |
| 1271 | ; | |
| 1272 | TPJI ;Thir d Party jo int Inquir y | |
| 1273 | N IBDA,IB IFN | |
| 1274 | D SEL(.IB DA,1) | |
| 1275 | S IBDA=+$ O(IBDA(0)) ,IBIFN=+$G (IBDA(IBDA )) | |
| 1276 | I IBDA="" G TPJIQ | |
| 1277 | D TPJI1(I BIFN) | |
| 1278 | TPJIQ S VA LMBCK="R" | |
| 1279 | Q | |
| 1280 | ; | |
| 1281 | TPJI1(IBIF N) ; | |
| 1282 | N DFN,IBN OTPJI | |
| 1283 | Q:'IBIFN | |
| 1284 | S DFN=$P( $G(^DGCR(3 99,IBIFN,0 )),U,2),IB NOTPJI=1 | |
| 1285 | D EN^VALM ("IBJT CLA IM INFO") | |
| 1286 | K:$D(IBFA STXT) IBFA STXT | |
| 1287 | Q | |
| 1288 | ; | |
| 1289 | PBILL ;Pri nt bill | |
| 1290 | N IBIFN,I BDA,IBRESU B | |
| 1291 | D SEL(.IB DA,1) | |
| 1292 | S IBDA=$O (IBDA(0)), IBIFN=+$G( IBDA(+IBDA )) | |
| 1293 | I IBDA="" G PBOUT | |
| 1294 | S IBRESUB =$$RESUB^I BCECSA4(IB IFN,1,"P") | |
| 1295 | I IBRESUB '>0 W !,*7 ,"This is not a tran smittable bill or re view not n eeded" D P AUSE^VALM1 G PBOUT | |
| 1296 | I IBRESUB =2 D G PB OUT | |
| 1297 | . N IB364 | |
| 1298 | . S IB364 =+$P($G(IB DA(IBDA)), U,2) | |
| 1299 | . D PRINT 1^IBCEM03( IBIFN,.IBD A,IB364) | |
| 1300 | D PBILL1( IBIFN) | |
| 1301 | PBOUT S VA LMBCK="R" | |
| 1302 | Q | |
| 1303 | ; | |
| 1304 | PMRA ;Prin t MRA | |
| 1305 | N IBIFN,I BDA,IBDAX | |
| 1306 | D SEL(.IB DA,1) | |
| 1307 | S IBDA=$O (IBDA(0)), IBIFN=+$G( IBDA(+IBDA )),IBDAX=$ P(IBDA(+IB DA),U,3) | |
| 1308 | G:'IBIFN PRMQ | |
| 1309 | I '$G(IBM RANOT),$D( ^IBM(361.1 ,IBDAX,"ER R")),'$$WA RNMSE G PR MQ ; Claim co ntains Mes sage Stora ge Errors | |
| 1310 | D MRA^IBC EMRAA(.IBI FN) | |
| 1311 | PRMQ S VAL MBCK="R" | |
| 1312 | Q | |
| 1313 | PBILL1(IBI FN) ; | |
| 1314 | N IBAC1,I BAC,DFN | |
| 1315 | Q:'IBIFN | |
| 1316 | S DFN=$P( $G(^DGCR(3 99,IBIFN,0 )),U,2) | |
| 1317 | S IBAC=4, IBAC1=1 | |
| 1318 | D 4^IBCB1 | |
| 1319 | D FULL^VA LM1,PAUSE^ VALM1 | |
| 1320 | Q | |
| 1321 | ; | |
| 1322 | CANCEL ;Ca ncel bill | |
| 1323 | ; IBDA(IB DA)=IBIFN^ IB364^ien of 361.1^u ser select ion seq^us er name~du z# | |
| 1324 | ; | |
| 1325 | N IBIFN,I BDA,IB364, IBEOBIFN,X ,IBDENCT | |
| 1326 | ; | |
| 1327 | ; Check f or securit y key | |
| 1328 | I '$$KCHK ^XUSRB("IB AUTHORIZE ") D G CA NCELQ | |
| 1329 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1330 | . W !!?5, "You don't hold the proper sec urity key to access this funct ion." | |
| 1331 | . W !?5," The necess ary key is IB AUTHOR IZE. Plea se see you r manager. " | |
| 1332 | . D PAUSE ^VALM1 | |
| 1333 | . Q | |
| 1334 | ; | |
| 1335 | D SEL(.IB DA,1) | |
| 1336 | S IBDA=$O (IBDA(0)), IBIFN=+$G( IBDA(+IBDA )),IB364=$ P($G(IBDA( +IBDA)),U, 2) | |
| 1337 | S IBEOBIF N=$P($G(IB DA(+IBDA)) ,U,3) | |
| 1338 | ; | |
| 1339 | ; IB*2.0* 432 - if n ot mra, on ly allow c ancel of d enied clai ms. If no EOB, chec k AR statu s instead | |
| 1340 | I 'IBEOBI FN,$G(IBMR ANOT)=1,$P ($$ARSTATA ^IBJTU4(IB IFN),U)="C OLLECTED/C LOSED" D G CANCELQ | |
| 1341 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1342 | . W !!,*7 ,"You can only cance l denied c laims. Th is claim i s in a COL LECTED/CLO SED status " | |
| 1343 | . W !,"Us e Remove A ction to r emove clai m from thi s worklist ." | |
| 1344 | . D PAUSE ^VALM1 | |
| 1345 | . Q | |
| 1346 | ; | |
| 1347 | ; IB*2.0* 432 - if n ot mra, on ly allow c ancel of c laims with multiple EOBS if no ne have pr ocessed. | |
| 1348 | I $G(IBMR ANOT)=1,'$ $DENCHK(IB IFN,.IBDEN CT),$G(IBD ENCT)>1 D G CANCELQ | |
| 1349 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1350 | . W !!,*7 ,"Multiple EOBs exis t for this claim and at least one has EO B status o f PROCESSE D." | |
| 1351 | . W !,"Us e Remove A ction to r emove clai m from thi s worklist ." | |
| 1352 | . D PAUSE ^VALM1 | |
| 1353 | . Q | |
| 1354 | ; | |
| 1355 | ; IB*2.0* 432 - if n ot mra, on ly allow c ancel of d enied clai ms | |
| 1356 | I IBEOBIF N,$G(IBMRA NOT)=1,$P( $G(^IBM(36 1.1,IBEOBI FN,0)),U,1 3)'=2 D G CANCELQ | |
| 1357 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1358 | . W !!?5, *7,"You ca n only can cel denied claims." | |
| 1359 | . D PAUSE ^VALM1 | |
| 1360 | . Q | |
| 1361 | ; | |
| 1362 | I IBDA D | |
| 1363 | . I '$$LO CK^IBCEU0( 361.1,IBEO BIFN) Q | |
| 1364 | . D CANCE L^IBCEM3(. IBDA,IBIFN ,IB364) | |
| 1365 | . D UNLOC K^IBCEU0(3 61.1,IBEOB IFN) | |
| 1366 | S VALMBCK ="R" | |
| 1367 | ; | |
| 1368 | ; for non -MRA claim s cancelle d from wor klist, set field 38 | |
| 1369 | I $G(IBMR ANOT)=1,$P ($G(^DGCR( 399,IBIFN, 0)),U,13)= 7 S X=$$WL RMVF^IBCEC OB1($S($G( IBIFN)'="" :IBIFN,1:+ $G(IBDA(IB DA))),"CA" ) | |
| 1370 | I $G(IBDA )'="" D BL D^IBCECOB1 | |
| 1371 | CANCELQ Q | |
| 1372 | ; | |
| 1373 | CRD ; Corr ect Reject ed/Denied claim prot ocol actio n | |
| 1374 | N IBCNCRD | |
| 1375 | S IBCNCRD =1 | |
| 1376 | CLONE ; 'C opy/cancel bill' pro tocol acti on | |
| 1377 | N IBDA,IB Q,IBEOBIFN ,IBKEY,X,I BDENCT | |
| 1378 | ; | |
| 1379 | ; Check f or securit y key | |
| 1380 | ;IB*2.0*5 16/TAZ - R emove chec k for IB C LON | |
| 1381 | ;I '$$KCH K^XUSRB("I B AUTHORIZ E") D G C LONEQ | |
| 1382 | ;S IBKEY= $S($G(IBCN CRD)=1:"IB AUTHORIZE ",1:"IB CL ON") | |
| 1383 | S IBKEY=" IB AUTHORI ZE" | |
| 1384 | I '$$KCHK ^XUSRB(IBK EY) D G C LONEQ | |
| 1385 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1386 | . ;W !!?5 ,"You don' t hold the proper se curity key to access this func tion." | |
| 1387 | . ;W !?5, "The neces sary key i s IB AUTHO RIZE. Ple ase see yo ur manager ." | |
| 1388 | . W !!?5, "You must hold the " _IBKEY_" s ecurity ke y to acces s this fun ction." | |
| 1389 | . W !?5," Please see your mana ger." | |
| 1390 | . D PAUSE ^VALM1 | |
| 1391 | . Q | |
| 1392 | ; | |
| 1393 | D SEL(.IB DA,1) | |
| 1394 | S IBDA=$O (IBDA("")) | |
| 1395 | I IBDA="" G CLONEQ | |
| 1396 | ; | |
| 1397 | ; IB*2.0* 432 - if n ot mra, on ly allow c ancel of c laims with multiple EOBS if no ne have pr ocessed. | |
| 1398 | I $G(IBMR ANOT)=1,'$ $DENCHK(+I BDA(IBDA), .IBDENCT), $G(IBDENCT )>1 D G C ANCELQ | |
| 1399 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1400 | . W !!,*7 ,"Multiple EOBs exis t for this claim and at least one has EO B status o f PROCESSE D." | |
| 1401 | . W !,"Us e Remove A ction to r emove clai m from thi s worklist ." | |
| 1402 | . D PAUSE ^VALM1 | |
| 1403 | . Q | |
| 1404 | ; | |
| 1405 | S IBEOBIF N=$P($G(IB DA(+IBDA)) ,U,3) | |
| 1406 | I '$$LOCK ^IBCEU0(36 1.1,IBEOBI FN) G CLON EQ | |
| 1407 | D COPYCLO N(+$G(IBDA (IBDA)),$P ($G(IBDA(+ IBDA)),U,2 ),.IBQ) | |
| 1408 | D UNLOCK^ IBCEU0(361 .1,IBEOBIF N) | |
| 1409 | ; | |
| 1410 | ; for non -MRA claim s cloned o r correcte d from wor klist, set field 38 | |
| 1411 | I $G(IBMR ANOT)=1,$G (IBQ)'="" S X=$$WLRM VF^IBCECOB 1(+$G(IBDA (IBDA)),$S ($G(IBCNCR D)=1:"CR", 1:"CL")) | |
| 1412 | ; | |
| 1413 | CLONEQ ; | |
| 1414 | S VALMBCK ="R" | |
| 1415 | D:$G(IBQ) '="" BLD^I BCECOB1 | |
| 1416 | Q | |
| 1417 | ; | |
| 1418 | COPYCLON(I BIFN,IB364 ,IBQ) ; Ge neric entr y point fo r clone a bill from EDI proces sing | |
| 1419 | ; IBIFN = original bill ien | |
| 1420 | ; IB364 = the ien o f the tran smission b ill entry in file 36 4 | |
| 1421 | ; IBQ = I f bill is not cancel led, this is returne d as null | |
| 1422 | ; - pass by reference - | |
| 1423 | ; | |
| 1424 | N IBQUIT, IBCCCC,IBH V,Y,IBCAN, IBCE,IBDA, IBCNCOPY | |
| 1425 | ;I '$$CAN CKS^IBCEM3 ("CC",IBIF N) S IBQ=" " G CCQ | |
| 1426 | I $G(IBCN CRD)'=1,'$ $CANCKS^IB CEM3("CC", IBIFN) S I BQ="" G CC Q | |
| 1427 | ; | |
| 1428 | ;S IBCAN= 2,IBCE("ED I")=1,Y=IB IFN,IBCCCC =0,IBHV("I BIFN")=IBI FN,IBHV("I BIFN1")="" ,IBCNCOPY= 1 | |
| 1429 | S IBCAN=2 ,IBCE("EDI ")=1,Y=IBI FN,IBCCCC= 0,IBHV("IB IFN")=IBIF N,IBHV("IB IFN1")="" | |
| 1430 | I $G(IBCN CRD)'=1 S IBCNCOPY=1 D ^IBCCC | |
| 1431 | I $G(IBCN CRD)=1 D C RD^IBCCC | |
| 1432 | ;D ^IBCCC | |
| 1433 | S IBIFN=I BHV("IBIFN ") | |
| 1434 | K IBCE("E DI") S IBQ =1 | |
| 1435 | I $P($G(^ DGCR(399,I BIFN,0)),U ,13)'=7 S IBQ="" | |
| 1436 | I IBHV("I BIFN1") D | |
| 1437 | . N IBU | |
| 1438 | . S IBU=" R" | |
| 1439 | . S IBNIE N=+IBHV("I BIFN1") | |
| 1440 | . I "23"' [$P($G(^DG CR(399,+IB HV("IBIFN1 "),0)),U,1 3) D | |
| 1441 | .. W:'$G( IBCEAUTO) !,*7,"Plea se note: t he new bil l was not AUTHORIZED .",!,"It c an only be accessed now via th e normal, non-EDI fu nctions.", !,"Status of new bil l is ",$$E XPAND^IBTR E(399,.13, $P(^DGCR(3 99,IBHV("I BIFN1"),0) ,U,13)) S IBU="C" | |
| 1442 | . D UPDED I^IBCEM(IB 364,IBU) | |
| 1443 | ; | |
| 1444 | I '$G(IBC EAUTO) D P AUSE^VALM1 | |
| 1445 | CCQ Q | |
| 1446 | ; | |
| 1447 | PRO ; Copy for secon dary/terti ary bill | |
| 1448 | N VALMY,I BDA,Z,IBIF N,IBIFNH,I B364,IBCE, IBNCN | |
| 1449 | ;I '$P($G (^IBE(350. 9,1,8)),U, 12) D G P ROQ | |
| 1450 | I '$P($G( ^IBE(350.9 ,1,8)),U,1 2),$G(IBMR ANOT)'=1 D G PROQ | |
| 1451 | . D FULL^ VALM1 | |
| 1452 | . W !!?5, "MRA's may not be pr ocessed at this time ." | |
| 1453 | . W !?5," The IB sit e paramete r ""Allow MRA Proces sing?"" is set to NO ." | |
| 1454 | . D PAUSE ^VALM1 | |
| 1455 | . Q | |
| 1456 | D SEL(.IB DA,1) | |
| 1457 | S Z=$O(IB DA(0)),Z=$ G(IBDA(+Z) ) G:'Z PRO Q | |
| 1458 | S IBIFN=$ P(Z,U),IB3 64=$P(Z,U, 2),IBDA=$P (Z,U,3),IB IFNH=IBIFN | |
| 1459 | I 'IBIFN G PROQ | |
| 1460 | I '$G(IBM RANOT),$D( ^IBM(361.1 ,IBDA,"ERR ")),'$$WAR NMSE G PRO Q ; Claim con tains Mess age Storag e Errors | |
| 1461 | I '$$LOCK ^IBCEU0(36 1.1,IBDA) G PROQ | |
| 1462 | D COBCOPY (IBIFN,IB3 64,2,IBDA, "BLD^IBCEC OB1",.IBNC N) | |
| 1463 | D UNLOCK^ IBCEU0(361 .1,IBDA) | |
| 1464 | ; | |
| 1465 | ; for non -MRA claim s copied f rom work l ist, set f ield 38 | |
| 1466 | I $G(IBMR ANOT)=1,$G (IBNCN)'=" ",($G(IBNC N)'=$G(IBI FN)) D | |
| 1467 | .S X=$$WL RMVF^IBCEC OB1($G(IBI FN),"PC") | |
| 1468 | .;I $P($G (^DGCR(399 ,+IBNCN,"S ")),U,9)'= 1 D | |
| 1469 | .;.W:'$G( IBCEAUTO) !,*7,"Plea se note: t he new bil l was not AUTHORIZED .",!,"It c an only be accessed now via th e normal, non-EDI fu nctions.", !,"Status of new bil l is ",$$E XPAND^IBTR E(399,.13, $P(^DGCR(3 99,IBNCN,0 ),U,13)) | |
| 1470 | .;.D PAUS E^VALM1 | |
| 1471 | .D:$G(IBM RANOT)=1 B LD^IBCECOB 1 | |
| 1472 | .Q | |
| 1473 | ; | |
| 1474 | PROQ S VAL MBCK="R" | |
| 1475 | Q | |
| 1476 | ; | |
| 1477 | COBCOPY(IB IFN,IB364, IBFROM,IBI EN,IBBLD,I BNCN) ; Ge neric entr y point fo r EDI COB copy | |
| 1478 | ; IBIFN = original bill ien | |
| 1479 | ; IB364 = the ien o f the tran smission b ill entry in file 36 4 | |
| 1480 | ; IBFROM = 1 if cal led from C SA, 2 if c alled from COB/EOB p rocessing | |
| 1481 | ; IBIEN = entry in 361 (IBFRO M=1) or 36 1.1 (IBFRO M=2) being processed | |
| 1482 | ; IBBLD = the name of the ent rypoint th at will re build the display | |
| 1483 | ; IBNCN = by refere nce, retur ns the new claim ien if user c ompleted t he Copy pr ocess | |
| 1484 | ; | |
| 1485 | N IBCBASK ,IBCBCOPY, IBCAN,IBIF NH,IBNSTAT ,IBOSTAT,I BPRCOB,IBS ECHK,IBLMV AR,IBAC,IB MRAIEN,IBD A,IBAUTO | |
| 1486 | N IBCOB,I BCOBIL,IBC OBN,IBINS, IBINSN,IBI NSOLD,IBMR AIO,IBMRAO ,IBNMOLD,I BQUIT | |
| 1487 | S (IBCBAS K,IBCBCOPY ,IBCAN,IBA UTO)=1,(IB PRCOB,IBSE CHK)=0,(IB MRAIEN,IBD A)=IBIEN | |
| 1488 | I $G(IBMR ANOT)'=1,' IB364!'IBI FN W !,"Tr ansmission record is missing f or this bi ll" D PAUS E^VALM1 G COBCOPX | |
| 1489 | ; | |
| 1490 | S IBIFNH= IBIFN | |
| 1491 | I IBFROM= 2 S IBPRCO B=1 | |
| 1492 | ; IB*2.0* 447 Check PR to incl ude excess and perce ntages whe re applica ble | |
| 1493 | ;I $S($G( IBMRANOT)= 1:$$TOT(IB IFN)'>0,1: $$PREOBTOT ^IBCEU0(IB IFN,$G(IBM RANOT))'>0 ) D G COB COPX | |
| 1494 | I $$TOT(I BIFN,$G(IB MRANOT))'> 0 D G COB COPX | |
| 1495 | . D FULL^ VALM1 | |
| 1496 | . W !!?5, "There is no "_$S($G (IBMRANOT) =1:"balanc e remainin g",1:"pati ent respon sibility a nd/or exce ss charges ")_" for t his claim. " | |
| 1497 | . W !?5," This claim may not b e processe d." | |
| 1498 | . D PAUSE ^VALM1 | |
| 1499 | . Q | |
| 1500 | ; | |
| 1501 | I $G(IBDA )'="",$P($ G(^IBM(361 .1,IBDA,0) ),U,16)="1 .5" D G C OBCOPX | |
| 1502 | . W !!,"T his claim has alread y been pro cessed as a sec/tert claim." | |
| 1503 | . W !,"Yo u will nee d to compl ete the au thorizatio n process for this c laim." | |
| 1504 | . D PAUSE ^VALM1 | |
| 1505 | . D AUTH | |
| 1506 | . Q | |
| 1507 | ; | |
| 1508 | ; If mult iple EOBs and one is processed , make sur e collecte d closed. | |
| 1509 | I $G(IBMR ANOT),$$CC CHK(IBIFN) <0 D G CO BCOPX | |
| 1510 | . W !,"Mu ltiple EOB s exist fo r this cla im and at least one has EOB st atus of PR OCESSED." | |
| 1511 | . W !,"Cl aim cannot be sent t o next pay er until A R status i s Collecte d/Closed." | |
| 1512 | . D PAUSE ^VALM1 | |
| 1513 | . Q | |
| 1514 | ; | |
| 1515 | ; Get out if no nex t payer | |
| 1516 | I '$P($G( ^DGCR(399, IBIFN,"I"_ ($$COBN^IB CEF(IBIFN) +1))),U,1) D G COBC OPX | |
| 1517 | . W !,"Th ere is no next payer for this bill" | |
| 1518 | . D PAUSE ^VALM1 | |
| 1519 | . Q | |
| 1520 | ; | |
| 1521 | D DSPRB^I BCCCB0(IBI FN) ; display related b ills | |
| 1522 | S IBCE("E DI")=1 | |
| 1523 | D CHKB^IB CCCB ; process COB, crea te seconda ry bill | |
| 1524 | S IBNCN=$ G(IBCE("ED I","NEW")) ; get new claim ien | |
| 1525 | S IBIFN=I BIFNH | |
| 1526 | I IBSECHK G COBCOPX | |
| 1527 | ; | |
| 1528 | ; if user came from CBW, no n eed to vie w and auth orize a 2n d time (al ready happ ens in IBC CCB) | |
| 1529 | Q:$G(IBMR ANOT)=1 | |
| 1530 | S IBV=1 D VIEW^IBCB 2 ; display billing s creens | |
| 1531 | D AUTH ; authori ze bill | |
| 1532 | COBCOPX ; | |
| 1533 | Q | |
| 1534 | ; | |
| 1535 | AUTH ; pro cedure to authorize the claim and refres h the scre en | |
| 1536 | K ^UTILIT Y($J) S IB AC=1,IBQUI T=0 D 3^IB CB1 | |
| 1537 | I '$D(IOU ON)!'$D(IO RVON) D EN S^%ZISS | |
| 1538 | I $P($G(^ IBM(361.1, IBMRAIEN,0 )),U,16)=3 D UPDEDI^ IBCEM(IB36 4,"Z") | |
| 1539 | I $G(IBBL D)'="" D @ IBBLD | |
| 1540 | D PAUSE^V ALM1 | |
| 1541 | AUTHX ; | |
| 1542 | Q | |
| 1543 | ; | |
| 1544 | RES ;Resub mit bill b y print | |
| 1545 | N IBDA,IB IFN,IB364 | |
| 1546 | D SEL(.IB DA,1) | |
| 1547 | S IBDA=+$ O(IBDA(0)) ,IBIFN=+$G (IBDA(+IBD A)),IB364= +$P($G(IBD A(IBDA)),U ,2) | |
| 1548 | I 'IBIFN G RESQ | |
| 1549 | D PRINT1^ IBCEM03(IB IFN,.IBDA, IB364) | |
| 1550 | D PAUSE^V ALM1 | |
| 1551 | I $G(IBDA )'="" D BL D^IBCECOB1 | |
| 1552 | RESQ S VAL MBCK="R" | |
| 1553 | Q | |
| 1554 | ; | |
| 1555 | EBI ;View an unautho rized tran smitted bi ll | |
| 1556 | N IBFLG,I BDA,IBIFN, IB364,DFN | |
| 1557 | K ^TMP($J ,"IBBILL") | |
| 1558 | D FULL^VA LM1 | |
| 1559 | ; | |
| 1560 | D SEL(.IB DA,1) | |
| 1561 | S IBDA=+$ O(IBDA("") ) | |
| 1562 | S IBIFN=+ $G(IBDA(IB DA)),IB364 =+$P($G(IB DA(IBDA)), U,2),DFN=$ P($G(^DGCR (399,IBIFN ,0)),U,2) | |
| 1563 | G:'IBIFN EDITQ | |
| 1564 | S IBV=1 D VIEW^IBCB 2 | |
| 1565 | I '$D(IOU ON)!'$D(IO RVON) D EN S^%ZISS | |
| 1566 | D BLD^IBC ECOB1 | |
| 1567 | EDITQ S VA LMBCK="R" | |
| 1568 | Q | |
| 1569 | ; | |
| 1570 | SEL(IBDA,O NE) ; Sele ct entry(s ) from lis t | |
| 1571 | ; IBDA = array retu rned if se lections m ade | |
| 1572 | ; IBDA (n)=ien of bill sele cted (file 399) | |
| 1573 | ; ONE = i f set to 1 , only one selection can be ma de at a ti me | |
| 1574 | N IB | |
| 1575 | K IBDA | |
| 1576 | D FULL^VA LM1 | |
| 1577 | D EN^VALM 2($G(XQORN OD(0)),$S( '$G(ONE):" ",1:"S")) | |
| 1578 | S IBDA=0 F S IBDA= $O(VALMY(I BDA)) Q:'I BDA S IBD A(IBDA)=$P ($G(^TMP(" IBCECOB",$ J,+IBDA)), U,2,6) | |
| 1579 | Q | |
| 1580 | ; | |
| 1581 | EXIT ; Exi t out of C OB | |
| 1582 | D FASTEXI T^IBCEFG4 | |
| 1583 | I $G(IBFA STXT)=1 S IBFASTXT=5 | |
| 1584 | Q | |
| 1585 | ; | |
| 1586 | TOT(IBIFN, IBMRANOT) ; calculat e if any b alance rem aining on non-MRA cl aim | |
| 1587 | ; IBIFN = claim ien | |
| 1588 | ; IBMRANO T = MRW/CB W flag (1= user came from CBW) added wit h IB*2.0*4 47 | |
| 1589 | N IBPRTOT ,IBBLD,IBC BN,IBU2 | |
| 1590 | I $G(IBMR ANOT)'=1 Q $S($$MSED T^IBCEMU4( IBIFN)'="" :$$MSPRE^I BCEMU4(IBI FN),1:$$PR EOBTOT^IBC EU0(IBIFN) ) | |
| 1591 | ; total u p the paye r paid amo unts, if t his is a 2 ndary clai m, be sure to accoun t for what the prima ry paid al so | |
| 1592 | S IBU2=$G (^DGCR(399 ,IBIFN,"U2 ")),IBCBN= $$COBN^IBC EF(IBIFN), IBPRTOT=$$ EOBTOT^IBC EU1(IBIFN, IBCBN) | |
| 1593 | S:IBPRTOT <0 IBPRTOT =0 ; don't allo w negative prior pay ment or of fset | |
| 1594 | S:IBCBN=2 IBPRTOT=I BPRTOT+$P( IBU2,U,4) | |
| 1595 | S:IBCBN=3 IBPRTOT=I BPRTOT+$P( IBU2,U,4)+ $P(IBU2,U, 5) | |
| 1596 | S:IBPRTOT <0 IBPRTOT =0 ; don't allo w negative prior pay ment or of fset | |
| 1597 | ; Subtrac t payer pa id amount from Total Charges f rom BILLS/ CLAIMS (#3 99) file, don't allo w neg | |
| 1598 | S IBBLD=$ P($G(^DGCR (399,IBIFN ,"U1")),U, 1)-IBPRTOT | |
| 1599 | S:IBBLD<0 IBBLD=0 | |
| 1600 | Q IBBLD | |
| 1601 | ; | |
| 1602 | CCCHK(IBIF N) ; If th ere are mu ltiple EOB S on file for this c laim, then one of th em must be processed and AR st atus must be collect ed closed to process . | |
| 1603 | ; returns 1 if true | |
| 1604 | ; 0 if ther e are not multiple E OBs or mul itple EOBs and none are proces sed (all d enials) | |
| 1605 | ; -1 if fals e | |
| 1606 | N IBDA,IB CT,IBPROC, IBARSTAT,I BEOBNDX,IB EOB | |
| 1607 | S IBCT=0, IBPROC=0 | |
| 1608 | F IBEOBND X="B","C" D | |
| 1609 | .S IBDA=0 F S IBDA =$O(^IBM(3 61.1,IBEOB NDX,IBIFN, IBDA)) Q:' +IBDA D | |
| 1610 | ..Q:$D(IB EOB(IBDA)) | |
| 1611 | ..Q:$P($G (^IBM(361. 1,IBDA,0)) ,U,4)=1 ; only co unt EOBs | |
| 1612 | ..S IBEOB (IBDA)="", IBCT=IBCT+ 1 | |
| 1613 | ..I $P($G (^IBM(361. 1,IBDA,0)) ,U,13)=1 S IBPROC=1 | |
| 1614 | I IBCT<2 Q 0 ; les s than 2 E OBs | |
| 1615 | I 'IBPROC Q 0 ; no EOBs with status pr ocessed | |
| 1616 | S IBARSTA T=$$ARSTAT A^IBJTU4(I BIFN) ; g et status of AR | |
| 1617 | I $P(IBAR STAT,U)="C OLLECTED/C LOSED" Q 1 | |
| 1618 | Q -1 | |
| 1619 | ; | |
| 1620 | DENCHK(IBI FN,IBCT) ; Make sure all EOBs from this claim are denied. | |
| 1621 | ; Input: IBIFN - IE N to 399 | |
| 1622 | ; IBCT - by reference. Return co unt of EOB s. | |
| 1623 | ; Output: returns 1 if there is at leas t one EOB and that n one of the EOBS are processed. | |
| 1624 | ; otherwi se 0 | |
| 1625 | ; | |
| 1626 | N IBDA,IB PROC,IBEOB NDX,IBEOB | |
| 1627 | S IBCT=0, IBPROC=0 | |
| 1628 | F IBEOBND X="B","C" D | |
| 1629 | .S IBDA=0 F S IBDA =$O(^IBM(3 61.1,IBEOB NDX,IBIFN, IBDA)) Q:' +IBDA D | |
| 1630 | ..Q:$D(IB EOB(IBDA)) | |
| 1631 | ..Q:$P($G (^IBM(361. 1,IBDA,0)) ,U,4)=1 ; only co unt EOBs | |
| 1632 | ..S IBEOB (IBDA)="", IBCT=IBCT+ 1 | |
| 1633 | ..I $P($G (^IBM(361. 1,IBDA,0)) ,U,13)=1 S IBPROC=1 | |
| 1634 | I IBCT,'I BPROC Q 1 ; there i s at least one EOB a nd none of the EOBS are proces sed. | |
| 1635 | Q 0 ; | |
| 1636 | ; | |
| 1637 | WARNMSE() ; Display MSE Warnin g and chec k if we sh ould conti nue. | |
| 1638 | D FULL^VA LM1 | |
| 1639 | N DIR,X,Y | |
| 1640 | S DIR("A" ,1)="WARNI NG : The M RA for thi s claim ca used a Dat a Mismatch /Message S torage Err or." | |
| 1641 | S DIR("A" ,2)="If yo u continue , the seco ndary clai m may not contain th e correct data." | |
| 1642 | S DIR("A" )="Do you wish to co ntinue? ", DIR("B")=" NO",DIR(0) ="YA" D ^D IR | |
| 1643 | I Y>0 Q 1 ; Okay to continu e. | |
| 1644 | Q 0 ; | |
| 1645 | Modified L ogic (Chan ges are in bold) | |
| 1646 | IBCECOB2 ; ALB/CXW - IB COB MAN AGEMENT SC REEN ;16-J UN-1999 | |
| 1647 | ;;2.0;INT EGRATED BI LLING;**13 7,155,433, 432,447,48 8,516**;21 -MAR-1994; Build 123 | |
| 1648 | ;;Per VA Directive 6402, this routine s hould not be modifie d. | |
| 1649 | ; | |
| 1650 | EDI ;histo ry detail display | |
| 1651 | N IBIFN,I BDA | |
| 1652 | D SEL(.IB DA,1) | |
| 1653 | S IBDA=+$ O(IBDA(0)) ,IBIFN=+$G (IBDA(IBDA )) | |
| 1654 | D EDI1(IB IFN) | |
| 1655 | S VALMBCK ="R" | |
| 1656 | Q | |
| 1657 | ; | |
| 1658 | EDI1(IBIFN ) ; | |
| 1659 | N DFN | |
| 1660 | Q:'IBIFN | |
| 1661 | S DFN=$P( $G(^DGCR(3 99,IBIFN,0 )),U,2) | |
| 1662 | D EN^VALM ("IBJT EDI STATUS") | |
| 1663 | K:$D(IBFA STXT) IBFA STXT | |
| 1664 | Q | |
| 1665 | ; | |
| 1666 | EDI2(IBIFN ) ; | |
| 1667 | N DFN | |
| 1668 | Q:'IBIFN | |
| 1669 | S DFN=$P( $G(^DGCR(3 99,IBIFN,0 )),U,2) | |
| 1670 | D EN^VALM ("IBJT EDI STATUS AL ONE") | |
| 1671 | K:$D(IBFA STXT) IBFA STXT | |
| 1672 | Q | |
| 1673 | ; | |
| 1674 | CSA ;claim s status a waiting re solution | |
| 1675 | N IBDAX | |
| 1676 | D EN^IBCE CSA | |
| 1677 | I $D(IBFA STXT) K IB FASTXT | |
| 1678 | S VALMBCK ="R" | |
| 1679 | Q | |
| 1680 | ; | |
| 1681 | RVEOB ;Rev iew EOB | |
| 1682 | D FULL^VA LM1 W ! | |
| 1683 | N IBDA,IB IFN,IBCMT, IBSEL | |
| 1684 | D SEL(.IB DA,1) | |
| 1685 | S IBSEL=+ $O(IBDA(0) ) | |
| 1686 | S IBDA=$G (IBDA(IBSE L)) | |
| 1687 | S IBIFN=$ P(IBDA,U), IBDA=$P(IB DA,U,3) | |
| 1688 | I 'IBIFN G VEOBQ | |
| 1689 | S IBCMT=$ G(^TMP("IB CECOB1",$J ,IBSEL)) | |
| 1690 | I IBCMT'= "" D EN^VA LM("IBCEM MRA REVIEW ") | |
| 1691 | VEOBQ K ^T MP("IBCECO C",$J) | |
| 1692 | S VALMBCK ="R" | |
| 1693 | Q | |
| 1694 | ; | |
| 1695 | TPJI ;Thir d Party jo int Inquir y | |
| 1696 | N IBDA,IB IFN | |
| 1697 | D SEL(.IB DA,1) | |
| 1698 | S IBDA=+$ O(IBDA(0)) ,IBIFN=+$G (IBDA(IBDA )) | |
| 1699 | I IBDA="" G TPJIQ | |
| 1700 | D TPJI1(I BIFN) | |
| 1701 | TPJIQ S VA LMBCK="R" | |
| 1702 | Q | |
| 1703 | ; | |
| 1704 | TPJI1(IBIF N) ; | |
| 1705 | N DFN,IBN OTPJI | |
| 1706 | Q:'IBIFN | |
| 1707 | S DFN=$P( $G(^DGCR(3 99,IBIFN,0 )),U,2),IB NOTPJI=1 | |
| 1708 | D EN^VALM ("IBJT CLA IM INFO") | |
| 1709 | K:$D(IBFA STXT) IBFA STXT | |
| 1710 | Q | |
| 1711 | ; | |
| 1712 | PBILL ;Pri nt bill | |
| 1713 | N IBIFN,I BDA,IBRESU B | |
| 1714 | D SEL(.IB DA,1) | |
| 1715 | S IBDA=$O (IBDA(0)), IBIFN=+$G( IBDA(+IBDA )) | |
| 1716 | I IBDA="" G PBOUT | |
| 1717 | S IBRESUB =$$RESUB^I BCECSA4(IB IFN,1,"P") | |
| 1718 | I IBRESUB '>0 W !,*7 ,"This is not a tran smittable bill or re view not n eeded" D P AUSE^VALM1 G PBOUT | |
| 1719 | I IBRESUB =2 D G PB OUT | |
| 1720 | . N IB364 | |
| 1721 | . S IB364 =+$P($G(IB DA(IBDA)), U,2) | |
| 1722 | . D PRINT 1^IBCEM03( IBIFN,.IBD A,IB364) | |
| 1723 | D PBILL1( IBIFN) | |
| 1724 | PBOUT S VA LMBCK="R" | |
| 1725 | Q | |
| 1726 | ; | |
| 1727 | PMRA ;Prin t MRA | |
| 1728 | N IBIFN,I BDA,IBDAX | |
| 1729 | D SEL(.IB DA,1) | |
| 1730 | ;JRA Fix <UNDEFINED > error oc curring wh en IBDA(+I BDA) does not exist. Also, ens ure that I BDAX'="" | |
| 1731 | ; since i t's used a s a subscr ipt to ^IB M. | |
| 1732 | ;S IBDA=$ O(IBDA(0)) ,IBIFN=+$G (IBDA(+IBD A)),IBDAX= $P(IBDA(+I BDA),U,3) ;JRA ';' | |
| 1733 | S IBDA=$O (IBDA(0)), IBIFN=+$G( IBDA(+IBDA )),IBDAX=+ $P($G(IBDA (+IBDA)),U ,3) ;JRA Add $G to SET of IBD AX - also +$P | |
| 1734 | G:'IBIFN PRMQ | |
| 1735 | I '$G(IBM RANOT),$D( ^IBM(361.1 ,IBDAX,"ER R")),'$$WA RNMSE G PR MQ ; Cla im contain s Message Storage Er rors | |
| 1736 | D MRA^IBC EMRAA(.IBI FN) | |
| 1737 | PRMQ S VAL MBCK="R" | |
| 1738 | Q | |
| 1739 | PBILL1(IBI FN) ; | |
| 1740 | N IBAC1,I BAC,DFN | |
| 1741 | Q:'IBIFN | |
| 1742 | S DFN=$P( $G(^DGCR(3 99,IBIFN,0 )),U,2) | |
| 1743 | S IBAC=4, IBAC1=1 | |
| 1744 | D 4^IBCB1 | |
| 1745 | D FULL^VA LM1,PAUSE^ VALM1 | |
| 1746 | Q | |
| 1747 | ; | |
| 1748 | CANCEL ;Ca ncel bill | |
| 1749 | ; IBDA(IB DA)=IBIFN^ IB364^ien of 361.1^u ser select ion seq^us er name~du z# | |
| 1750 | ; | |
| 1751 | N IBIFN,I BDA,IB364, IBEOBIFN,X ,IBDENCT | |
| 1752 | ; | |
| 1753 | ; Check f or securit y key | |
| 1754 | I '$$KCHK ^XUSRB("IB AUTHORIZE ") D G CA NCELQ | |
| 1755 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1756 | . W !!?5, "You don't hold the proper sec urity key to access this funct ion." | |
| 1757 | . W !?5," The necess ary key is IB AUTHOR IZE. Plea se see you r manager. " | |
| 1758 | . D PAUSE ^VALM1 | |
| 1759 | . Q | |
| 1760 | ; | |
| 1761 | D SEL(.IB DA,1) | |
| 1762 | S IBDA=$O (IBDA(0)), IBIFN=+$G( IBDA(+IBDA )),IB364=$ P($G(IBDA( +IBDA)),U, 2) | |
| 1763 | S IBEOBIF N=$P($G(IB DA(+IBDA)) ,U,3) | |
| 1764 | ; | |
| 1765 | ; IB*2.0* 432 - if n ot mra, on ly allow c ancel of d enied clai ms. If no EOB, chec k AR statu s instead | |
| 1766 | I 'IBEOBI FN,$G(IBMR ANOT)=1,$P ($$ARSTATA ^IBJTU4(IB IFN),U)="C OLLECTED/C LOSED" D G CANCELQ | |
| 1767 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1768 | . W !!,*7 ,"You can only cance l denied c laims. Th is claim i s in a COL LECTED/CLO SED status " | |
| 1769 | . W !,"Us e Remove A ction to r emove clai m from thi s worklist ." | |
| 1770 | . D PAUSE ^VALM1 | |
| 1771 | . Q | |
| 1772 | ; | |
| 1773 | ; IB*2.0* 432 - if n ot mra, on ly allow c ancel of c laims with multiple EOBS if no ne have pr ocessed. | |
| 1774 | I $G(IBMR ANOT)=1,'$ $DENCHK(IB IFN,.IBDEN CT),$G(IBD ENCT)>1 D G CANCELQ | |
| 1775 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1776 | . W !!,*7 ,"Multiple EOBs exis t for this claim and at least one has EO B status o f PROCESSE D." | |
| 1777 | . W !,"Us e Remove A ction to r emove clai m from thi s worklist ." | |
| 1778 | . D PAUSE ^VALM1 | |
| 1779 | . Q | |
| 1780 | ; | |
| 1781 | ; IB*2.0* 432 - if n ot mra, on ly allow c ancel of d enied clai ms | |
| 1782 | I IBEOBIF N,$G(IBMRA NOT)=1,$P( $G(^IBM(36 1.1,IBEOBI FN,0)),U,1 3)'=2 D G CANCELQ | |
| 1783 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1784 | . W !!?5, *7,"You ca n only can cel denied claims." | |
| 1785 | . D PAUSE ^VALM1 | |
| 1786 | . Q | |
| 1787 | ; | |
| 1788 | I IBDA D | |
| 1789 | . I '$$LO CK^IBCEU0( 361.1,IBEO BIFN) Q | |
| 1790 | . D CANCE L^IBCEM3(. IBDA,IBIFN ,IB364) | |
| 1791 | . D UNLOC K^IBCEU0(3 61.1,IBEOB IFN) | |
| 1792 | S VALMBCK ="R" | |
| 1793 | ; | |
| 1794 | ; for non -MRA claim s cancelle d from wor klist, set field 38 | |
| 1795 | I $G(IBMR ANOT)=1,$P ($G(^DGCR( 399,IBIFN, 0)),U,13)= 7 S X=$$WL RMVF^IBCEC OB1($S($G( IBIFN)'="" :IBIFN,1:+ $G(IBDA(IB DA))),"CA" ) | |
| 1796 | I $G(IBDA )'="" D BL D^IBCECOB1 | |
| 1797 | CANCELQ Q | |
| 1798 | ; | |
| 1799 | CRD ; Corr ect Reject ed/Denied claim prot ocol actio n | |
| 1800 | N IBCNCRD | |
| 1801 | S IBCNCRD =1 | |
| 1802 | CLONE ; 'C opy/cancel bill' pro tocol acti on | |
| 1803 | N IBDA,IB Q,IBEOBIFN ,IBKEY,X,I BDENCT | |
| 1804 | ; | |
| 1805 | ; Check f or securit y key | |
| 1806 | ;IB*2.0*5 16/TAZ - R emove chec k for IB C LON | |
| 1807 | ;I '$$KCH K^XUSRB("I B AUTHORIZ E") D G C LONEQ | |
| 1808 | ;S IBKEY= $S($G(IBCN CRD)=1:"IB AUTHORIZE ",1:"IB CL ON") | |
| 1809 | S IBKEY=" IB AUTHORI ZE" | |
| 1810 | I '$$KCHK ^XUSRB(IBK EY) D G C LONEQ | |
| 1811 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1812 | . ;W !!?5 ,"You don' t hold the proper se curity key to access this func tion." | |
| 1813 | . ;W !?5, "The neces sary key i s IB AUTHO RIZE. Ple ase see yo ur manager ." | |
| 1814 | . W !!?5, "You must hold the " _IBKEY_" s ecurity ke y to acces s this fun ction." | |
| 1815 | . W !?5," Please see your mana ger." | |
| 1816 | . D PAUSE ^VALM1 | |
| 1817 | . Q | |
| 1818 | ; | |
| 1819 | D SEL(.IB DA,1) | |
| 1820 | S IBDA=$O (IBDA("")) | |
| 1821 | I IBDA="" G CLONEQ | |
| 1822 | ; | |
| 1823 | ; IB*2.0* 432 - if n ot mra, on ly allow c ancel of c laims with multiple EOBS if no ne have pr ocessed. | |
| 1824 | I $G(IBMR ANOT)=1,'$ $DENCHK(+I BDA(IBDA), .IBDENCT), $G(IBDENCT )>1 D G C ANCELQ | |
| 1825 | . D FULL^ VALM1 S VA LMBCK="R" | |
| 1826 | . W !!,*7 ,"Multiple EOBs exis t for this claim and at least one has EO B status o f PROCESSE D." | |
| 1827 | . W !,"Us e Remove A ction to r emove clai m from thi s worklist ." | |
| 1828 | . D PAUSE ^VALM1 | |
| 1829 | . Q | |
| 1830 | ; | |
| 1831 | S IBEOBIF N=$P($G(IB DA(+IBDA)) ,U,3) | |
| 1832 | I '$$LOCK ^IBCEU0(36 1.1,IBEOBI FN) G CLON EQ | |
| 1833 | D COPYCLO N(+$G(IBDA (IBDA)),$P ($G(IBDA(+ IBDA)),U,2 ),.IBQ) | |
| 1834 | D UNLOCK^ IBCEU0(361 .1,IBEOBIF N) | |
| 1835 | ; | |
| 1836 | ; for non -MRA claim s cloned o r correcte d from wor klist, set field 38 | |
| 1837 | I $G(IBMR ANOT)=1,$G (IBQ)'="" S X=$$WLRM VF^IBCECOB 1(+$G(IBDA (IBDA)),$S ($G(IBCNCR D)=1:"CR", 1:"CL")) | |
| 1838 | ; | |
| 1839 | CLONEQ ; | |
| 1840 | S VALMBCK ="R" | |
| 1841 | D:$G(IBQ) '="" BLD^I BCECOB1 | |
| 1842 | Q | |
| 1843 | ; | |
| 1844 | COPYCLON(I BIFN,IB364 ,IBQ) ; Ge neric entr y point fo r clone a bill from EDI proces sing | |
| 1845 | ; IBIFN = original bill ien | |
| 1846 | ; IB364 = the ien o f the tran smission b ill entry in file 36 4 | |
| 1847 | ; IBQ = I f bill is not cancel led, this is returne d as null | |
| 1848 | ; - pass by reference - | |
| 1849 | ; | |
| 1850 | N IBQUIT, IBCCCC,IBH V,Y,IBCAN, IBCE,IBDA, IBCNCOPY | |
| 1851 | ;I '$$CAN CKS^IBCEM3 ("CC",IBIF N) S IBQ=" " G CCQ | |
| 1852 | I $G(IBCN CRD)'=1,'$ $CANCKS^IB CEM3("CC", IBIFN) S I BQ="" G CC Q | |
| 1853 | ; | |
| 1854 | ;S IBCAN= 2,IBCE("ED I")=1,Y=IB IFN,IBCCCC =0,IBHV("I BIFN")=IBI FN,IBHV("I BIFN1")="" ,IBCNCOPY= 1 | |
| 1855 | S IBCAN=2 ,IBCE("EDI ")=1,Y=IBI FN,IBCCCC= 0,IBHV("IB IFN")=IBIF N,IBHV("IB IFN1")="" | |
| 1856 | I $G(IBCN CRD)'=1 S IBCNCOPY=1 D ^IBCCC | |
| 1857 | I $G(IBCN CRD)=1 D C RD^IBCCC | |
| 1858 | ;D ^IBCCC | |
| 1859 | S IBIFN=I BHV("IBIFN ") | |
| 1860 | K IBCE("E DI") S IBQ =1 | |
| 1861 | I $P($G(^ DGCR(399,I BIFN,0)),U ,13)'=7 S IBQ="" | |
| 1862 | I IBHV("I BIFN1") D | |
| 1863 | . N IBU | |
| 1864 | . S IBU=" R" | |
| 1865 | . S IBNIE N=+IBHV("I BIFN1") | |
| 1866 | . I "23"' [$P($G(^DG CR(399,+IB HV("IBIFN1 "),0)),U,1 3) D | |
| 1867 | .. W:'$G( IBCEAUTO) !,*7,"Plea se note: t he new bil l was not AUTHORIZED .",!,"It c an only be accessed now via th e normal, non-EDI fu nctions.", !,"Status of new bil l is ",$$E XPAND^IBTR E(399,.13, $P(^DGCR(3 99,IBHV("I BIFN1"),0) ,U,13)) S IBU="C" | |
| 1868 | . D UPDED I^IBCEM(IB 364,IBU) | |
| 1869 | ; | |
| 1870 | I '$G(IBC EAUTO) D P AUSE^VALM1 | |
| 1871 | CCQ Q | |
| 1872 | ; | |
| 1873 | PRO ; Copy for secon dary/terti ary bill | |
| 1874 | N VALMY,I BDA,Z,IBIF N,IBIFNH,I B364,IBCE, IBNCN | |
| 1875 | ;I '$P($G (^IBE(350. 9,1,8)),U, 12) D G P ROQ | |
| 1876 | I '$P($G( ^IBE(350.9 ,1,8)),U,1 2),$G(IBMR ANOT)'=1 D G PROQ | |
| 1877 | . D FULL^ VALM1 | |
| 1878 | . W !!?5, "MRA's may not be pr ocessed at this time ." | |
| 1879 | . W !?5," The IB sit e paramete r ""Allow MRA Proces sing?"" is set to NO ." | |
| 1880 | . D PAUSE ^VALM1 | |
| 1881 | . Q | |
| 1882 | D SEL(.IB DA,1) | |
| 1883 | S Z=$O(IB DA(0)),Z=$ G(IBDA(+Z) ) G:'Z PRO Q | |
| 1884 | S IBIFN=$ P(Z,U),IB3 64=$P(Z,U, 2),IBDA=$P (Z,U,3),IB IFNH=IBIFN | |
| 1885 | I 'IBIFN G PROQ | |
| 1886 | I '$G(IBM RANOT),$D( ^IBM(361.1 ,IBDA,"ERR ")),'$$WAR NMSE G PRO Q ; Claim con tains Mess age Storag e Errors | |
| 1887 | I '$$LOCK ^IBCEU0(36 1.1,IBDA) G PROQ | |
| 1888 | D COBCOPY (IBIFN,IB3 64,2,IBDA, "BLD^IBCEC OB1",.IBNC N) | |
| 1889 | D UNLOCK^ IBCEU0(361 .1,IBDA) | |
| 1890 | ; | |
| 1891 | ; for non -MRA claim s copied f rom work l ist, set f ield 38 | |
| 1892 | I $G(IBMR ANOT)=1,$G (IBNCN)'=" ",($G(IBNC N)'=$G(IBI FN)) D | |
| 1893 | .S X=$$WL RMVF^IBCEC OB1($G(IBI FN),"PC") | |
| 1894 | .;I $P($G (^DGCR(399 ,+IBNCN,"S ")),U,9)'= 1 D | |
| 1895 | .;.W:'$G( IBCEAUTO) !,*7,"Plea se note: t he new bil l was not AUTHORIZED .",!,"It c an only be accessed now via th e normal, non-EDI fu nctions.", !,"Status of new bil l is ",$$E XPAND^IBTR E(399,.13, $P(^DGCR(3 99,IBNCN,0 ),U,13)) | |
| 1896 | .;.D PAUS E^VALM1 | |
| 1897 | .D:$G(IBM RANOT)=1 B LD^IBCECOB 1 | |
| 1898 | .Q | |
| 1899 | ; | |
| 1900 | PROQ S VAL MBCK="R" | |
| 1901 | Q | |
| 1902 | ; | |
| 1903 | COBCOPY(IB IFN,IB364, IBFROM,IBI EN,IBBLD,I BNCN) ; Ge neric entr y point fo r EDI COB copy | |
| 1904 | ; IBIFN = original bill ien | |
| 1905 | ; IB364 = the ien o f the tran smission b ill entry in file 36 4 | |
| 1906 | ; IBFROM = 1 if cal led from C SA, 2 if c alled from COB/EOB p rocessing | |
| 1907 | ; IBIEN = entry in 361 (IBFRO M=1) or 36 1.1 (IBFRO M=2) being processed | |
| 1908 | ; IBBLD = the name of the ent rypoint th at will re build the display | |
| 1909 | ; IBNCN = by refere nce, retur ns the new claim ien if user c ompleted t he Copy pr ocess | |
| 1910 | ; | |
| 1911 | N IBCBASK ,IBCBCOPY, IBCAN,IBIF NH,IBNSTAT ,IBOSTAT,I BPRCOB,IBS ECHK,IBLMV AR,IBAC,IB MRAIEN,IBD A,IBAUTO | |
| 1912 | N IBCOB,I BCOBIL,IBC OBN,IBINS, IBINSN,IBI NSOLD,IBMR AIO,IBMRAO ,IBNMOLD,I BQUIT | |
| 1913 | S (IBCBAS K,IBCBCOPY ,IBCAN,IBA UTO)=1,(IB PRCOB,IBSE CHK)=0,(IB MRAIEN,IBD A)=IBIEN | |
| 1914 | I $G(IBMR ANOT)'=1,' IB364!'IBI FN W !,"Tr ansmission record is missing f or this bi ll" D PAUS E^VALM1 G COBCOPX | |
| 1915 | ; | |
| 1916 | S IBIFNH= IBIFN | |
| 1917 | I IBFROM= 2 S IBPRCO B=1 | |
| 1918 | ; IB*2.0* 447 Check PR to incl ude excess and perce ntages whe re applica ble | |
| 1919 | ;I $S($G( IBMRANOT)= 1:$$TOT(IB IFN)'>0,1: $$PREOBTOT ^IBCEU0(IB IFN,$G(IBM RANOT))'>0 ) D G COB COPX | |
| 1920 | I $$TOT(I BIFN,$G(IB MRANOT))'> 0 D G COB COPX | |
| 1921 | . D FULL^ VALM1 | |
| 1922 | . W !!?5, "There is no "_$S($G (IBMRANOT) =1:"balanc e remainin g",1:"pati ent respon sibility a nd/or exce ss charges ")_" for t his claim. " | |
| 1923 | . W !?5," This claim may not b e processe d." | |
| 1924 | . D PAUSE ^VALM1 | |
| 1925 | . Q | |
| 1926 | ; | |
| 1927 | I $G(IBDA )'="",$P($ G(^IBM(361 .1,IBDA,0) ),U,16)="1 .5" D G C OBCOPX | |
| 1928 | . W !!,"T his claim has alread y been pro cessed as a sec/tert claim." | |
| 1929 | . W !,"Yo u will nee d to compl ete the au thorizatio n process for this c laim." | |
| 1930 | . D PAUSE ^VALM1 | |
| 1931 | . D AUTH | |
| 1932 | . Q | |
| 1933 | ; | |
| 1934 | ; If mult iple EOBs and one is processed , make sur e collecte d closed. | |
| 1935 | I $G(IBMR ANOT),$$CC CHK(IBIFN) <0 D G CO BCOPX | |
| 1936 | . W !,"Mu ltiple EOB s exist fo r this cla im and at least one has EOB st atus of PR OCESSED." | |
| 1937 | . W !,"Cl aim cannot be sent t o next pay er until A R status i s Collecte d/Closed." | |
| 1938 | . D PAUSE ^VALM1 | |
| 1939 | . Q | |
| 1940 | ; | |
| 1941 | ; Get out if no nex t payer | |
| 1942 | I '$P($G( ^DGCR(399, IBIFN,"I"_ ($$COBN^IB CEF(IBIFN) +1))),U,1) D G COBC OPX | |
| 1943 | . W !,"Th ere is no next payer for this bill" | |
| 1944 | . D PAUSE ^VALM1 | |
| 1945 | . Q | |
| 1946 | ; | |
| 1947 | D DSPRB^I BCCCB0(IBI FN) ; display related b ills | |
| 1948 | S IBCE("E DI")=1 | |
| 1949 | D CHKB^IB CCCB ; process COB, crea te seconda ry bill | |
| 1950 | S IBNCN=$ G(IBCE("ED I","NEW")) ; get new claim ien | |
| 1951 | S IBIFN=I BIFNH | |
| 1952 | I IBSECHK G COBCOPX | |
| 1953 | ; | |
| 1954 | ; if user came from CBW, no n eed to vie w and auth orize a 2n d time (al ready happ ens in IBC CCB) | |
| 1955 | Q:$G(IBMR ANOT)=1 | |
| 1956 | S IBV=1 D VIEW^IBCB 2 ; display billing s creens | |
| 1957 | D AUTH ; authori ze bill | |
| 1958 | COBCOPX ; | |
| 1959 | Q | |
| 1960 | ; | |
| 1961 | AUTH ; pro cedure to authorize the claim and refres h the scre en | |
| 1962 | K ^UTILIT Y($J) S IB AC=1,IBQUI T=0 D 3^IB CB1 | |
| 1963 | I '$D(IOU ON)!'$D(IO RVON) D EN S^%ZISS | |
| 1964 | I $P($G(^ IBM(361.1, IBMRAIEN,0 )),U,16)=3 D UPDEDI^ IBCEM(IB36 4,"Z") | |
| 1965 | I $G(IBBL D)'="" D @ IBBLD | |
| 1966 | D PAUSE^V ALM1 | |
| 1967 | AUTHX ; | |
| 1968 | Q | |
| 1969 | ; | |
| 1970 | RES ;Resub mit bill b y print | |
| 1971 | N IBDA,IB IFN,IB364 | |
| 1972 | D SEL(.IB DA,1) | |
| 1973 | S IBDA=+$ O(IBDA(0)) ,IBIFN=+$G (IBDA(+IBD A)),IB364= +$P($G(IBD A(IBDA)),U ,2) | |
| 1974 | I 'IBIFN G RESQ | |
| 1975 | D PRINT1^ IBCEM03(IB IFN,.IBDA, IB364) | |
| 1976 | D PAUSE^V ALM1 | |
| 1977 | I $G(IBDA )'="" D BL D^IBCECOB1 | |
| 1978 | RESQ S VAL MBCK="R" | |
| 1979 | Q | |
| 1980 | ; | |
| 1981 | EBI ;View an unautho rized tran smitted bi ll | |
| 1982 | N IBFLG,I BDA,IBIFN, IB364,DFN | |
| 1983 | K ^TMP($J ,"IBBILL") | |
| 1984 | D FULL^VA LM1 | |
| 1985 | ; | |
| 1986 | D SEL(.IB DA,1) | |
| 1987 | S IBDA=+$ O(IBDA("") ) | |
| 1988 | S IBIFN=+ $G(IBDA(IB DA)),IB364 =+$P($G(IB DA(IBDA)), U,2),DFN=$ P($G(^DGCR (399,IBIFN ,0)),U,2) | |
| 1989 | G:'IBIFN EDITQ | |
| 1990 | S IBV=1 D VIEW^IBCB 2 | |
| 1991 | I '$D(IOU ON)!'$D(IO RVON) D EN S^%ZISS | |
| 1992 | D BLD^IBC ECOB1 | |
| 1993 | EDITQ S VA LMBCK="R" | |
| 1994 | Q | |
| 1995 | ; | |
| 1996 | SEL(IBDA,O NE) ; Sele ct entry(s ) from lis t | |
| 1997 | ; IBDA = array retu rned if se lections m ade | |
| 1998 | ; IBDA (n)=ien of bill sele cted (file 399) | |
| 1999 | ; ONE = i f set to 1 , only one selection can be ma de at a ti me | |
| 2000 | N IB | |
| 2001 | K IBDA | |
| 2002 | D FULL^VA LM1 | |
| 2003 | D EN^VALM 2($G(XQORN OD(0)),$S( '$G(ONE):" ",1:"S")) | |
| 2004 | S IBDA=0 F S IBDA= $O(VALMY(I BDA)) Q:'I BDA S IBD A(IBDA)=$P ($G(^TMP(" IBCECOB",$ J,+IBDA)), U,2,6) | |
| 2005 | Q | |
| 2006 | ; | |
| 2007 | EXIT ; Exi t out of C OB | |
| 2008 | D FASTEXI T^IBCEFG4 | |
| 2009 | I $G(IBFA STXT)=1 S IBFASTXT=5 | |
| 2010 | Q | |
| 2011 | ; | |
| 2012 | TOT(IBIFN, IBMRANOT) ; calculat e if any b alance rem aining on non-MRA cl aim | |
| 2013 | ; IBIFN = claim ien | |
| 2014 | ; IBMRANO T = MRW/CB W flag (1= user came from CBW) added wit h IB*2.0*4 47 | |
| 2015 | N IBPRTOT ,IBBLD,IBC BN,IBU2 | |
| 2016 | I $G(IBMR ANOT)'=1 Q $S($$MSED T^IBCEMU4( IBIFN)'="" :$$MSPRE^I BCEMU4(IBI FN),1:$$PR EOBTOT^IBC EU0(IBIFN) ) | |
| 2017 | ; total u p the paye r paid amo unts, if t his is a 2 ndary clai m, be sure to accoun t for what the prima ry paid al so | |
| 2018 | S IBU2=$G (^DGCR(399 ,IBIFN,"U2 ")),IBCBN= $$COBN^IBC EF(IBIFN), IBPRTOT=$$ EOBTOT^IBC EU1(IBIFN, IBCBN) | |
| 2019 | S:IBPRTOT <0 IBPRTOT =0 ; don't allo w negative prior pay ment or of fset | |
| 2020 | S:IBCBN=2 IBPRTOT=I BPRTOT+$P( IBU2,U,4) | |
| 2021 | S:IBCBN=3 IBPRTOT=I BPRTOT+$P( IBU2,U,4)+ $P(IBU2,U, 5) | |
| 2022 | S:IBPRTOT <0 IBPRTOT =0 ; don't allo w negative prior pay ment or of fset | |
| 2023 | ; Subtrac t payer pa id amount from Total Charges f rom BILLS/ CLAIMS (#3 99) file, don't allo w neg | |
| 2024 | S IBBLD=$ P($G(^DGCR (399,IBIFN ,"U1")),U, 1)-IBPRTOT | |
| 2025 | S:IBBLD<0 IBBLD=0 | |
| 2026 | Q IBBLD | |
| 2027 | ; | |
| 2028 | CCCHK(IBIF N) ; If th ere are mu ltiple EOB S on file for this c laim, then one of th em must be processed and AR st atus must be collect ed closed to process . | |
| 2029 | ; returns 1 if true | |
| 2030 | ; 0 if ther e are not multiple E OBs or mul itple EOBs and none are proces sed (all d enials) | |
| 2031 | ; -1 if fals e | |
| 2032 | N IBDA,IB CT,IBPROC, IBARSTAT,I BEOBNDX,IB EOB | |
| 2033 | S IBCT=0, IBPROC=0 | |
| 2034 | F IBEOBND X="B","C" D | |
| 2035 | .S IBDA=0 F S IBDA =$O(^IBM(3 61.1,IBEOB NDX,IBIFN, IBDA)) Q:' +IBDA D | |
| 2036 | ..Q:$D(IB EOB(IBDA)) | |
| 2037 | ..Q:$P($G (^IBM(361. 1,IBDA,0)) ,U,4)=1 ; only co unt EOBs | |
| 2038 | ..S IBEOB (IBDA)="", IBCT=IBCT+ 1 | |
| 2039 | ..I $P($G (^IBM(361. 1,IBDA,0)) ,U,13)=1 S IBPROC=1 | |
| 2040 | I IBCT<2 Q 0 ; les s than 2 E OBs | |
| 2041 | I 'IBPROC Q 0 ; no EOBs with status pr ocessed | |
| 2042 | S IBARSTA T=$$ARSTAT A^IBJTU4(I BIFN) ; g et status of AR | |
| 2043 | I $P(IBAR STAT,U)="C OLLECTED/C LOSED" Q 1 | |
| 2044 | Q -1 | |
| 2045 | ; | |
| 2046 | DENCHK(IBI FN,IBCT) ; Make sure all EOBs from this claim are denied. | |
| 2047 | ; Input: IBIFN - IE N to 399 | |
| 2048 | ; IBCT - by reference. Return co unt of EOB s. | |
| 2049 | ; Output: returns 1 if there is at leas t one EOB and that n one of the EOBS are processed. | |
| 2050 | ; otherwi se 0 | |
| 2051 | ; | |
| 2052 | N IBDA,IB PROC,IBEOB NDX,IBEOB | |
| 2053 | S IBCT=0, IBPROC=0 | |
| 2054 | F IBEOBND X="B","C" D | |
| 2055 | .S IBDA=0 F S IBDA =$O(^IBM(3 61.1,IBEOB NDX,IBIFN, IBDA)) Q:' +IBDA D | |
| 2056 | ..Q:$D(IB EOB(IBDA)) | |
| 2057 | ..Q:$P($G (^IBM(361. 1,IBDA,0)) ,U,4)=1 ; only co unt EOBs | |
| 2058 | ..S IBEOB (IBDA)="", IBCT=IBCT+ 1 | |
| 2059 | ..I $P($G (^IBM(361. 1,IBDA,0)) ,U,13)=1 S IBPROC=1 | |
| 2060 | I IBCT,'I BPROC Q 1 ; there i s at least one EOB a nd none of the EOBS are proces sed. | |
| 2061 | Q 0 ; | |
| 2062 | ; | |
| 2063 | WARNMSE() ; Display MSE Warnin g and chec k if we sh ould conti nue. | |
| 2064 | D FULL^VA LM1 | |
| 2065 | N DIR,X,Y | |
| 2066 | S DIR("A" ,1)="WARNI NG : The M RA for thi s claim ca used a Dat a Mismatch /Message S torage Err or." | |
| 2067 | S DIR("A" ,2)="If yo u continue , the seco ndary clai m may not contain th e correct data." | |
| 2068 | S DIR("A" )="Do you wish to co ntinue? ", DIR("B")=" NO",DIR(0) ="YA" D ^D IR | |
| 2069 | I Y>0 Q 1 ; Okay to continu e. | |
| 2070 | Q 0 ; |
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