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# | Location | File | Last Modified |
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1 | MCCF_EDI_TAS_P2_PRCA_4_5_332.zip\MCCF_EDI_TAS_P2_PRCA_4_5_332\PRCA_4_5_332_IB_2_0_633.zip | TAS ePay US4866 SDD.docx | Fri Jan 25 13:53:04 2019 UTC |
2 | MCCF_EDI_TAS_P2_PRCA_4_5_332.zip\MCCF_EDI_TAS_P2_PRCA_4_5_332\PRCA_4_5_332_IB_2_0_633.zip | TAS ePay US4866 SDD.docx | Tue Feb 26 14:14:16 2019 UTC |
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1 | MCCF EDI T AS US4866 | |
2 | System Des ign Docume nt | |
3 | PRCA*4.5*x xx | |
4 | ||
5 | ||
6 | ||
7 | ||
8 | Department of Vetera ns Affairs | |
9 | September 2018 | |
10 | Version 1 | |
11 | User Story ID: US486 6 | |
12 | User Story Name: At tach corre ct EEOBs t o payments that have been post ed to susp ense | |
13 | Sizing: 8 | |
14 | Story | |
15 | As a... | |
16 | I need... | |
17 | So that... | |
18 | ePay user | |
19 | Attach cor rect EEOBs to paymen ts that ha ve been po sted to su spense | |
20 | As payment s are post ed as dupl icates, ov erpayments , etc., th e correct EEOB infor mation is attached t o the clai m for a co mplete aud it trail | |
21 | ||
22 | Conversati on (if des ired by de velopers) | |
23 | ||
24 | Summary | |
25 | When a pay ment is pu t into sus pense, the EEOB is r emoved (US 317). Howe ver, when payments a re actual VA payment s but not appropriat e to apply to the cl aim (overp ayment, du plicate pa yment) the payment i nformation should be attached to the cla im and ava ilable for user view ing. The u sers need capability to re-att ach the EE OB after t he payment was poste d to suspe nse when a ppropriate . Note: No t all paym ents in su spense sho uld have a n EEOB att ached so t he user ne eds the ab ility to s elect whic h payment should hav e an EEOB. | |
26 | ||
27 | After a me eting with an ePayme nts user t he followi ng was dec ided: | |
28 | The EEOB w ill remain attached to the ori ginal clai m as long as there i s money re maining on the claim or money remaining in suspens e. | |
29 | If all the money fro m the orig inal claim is distri buted to o ther claim (s), the E EOB will n o longer b e attached to the or iginal cla im. It wi ll be auto matically removed fr om the ori ginal clai m(s) and t hen attach ed to the to the cla im(s) it i s moved to . | |
30 | In the eve nt all mon ey is sent back to t he payer ( refund), t hen the EE OB will st ay on the original c laim. | |
31 | ||
32 | ||
33 | Changed Ro utines | |
34 | ||
35 | RCDPEM5 | |
36 | Change AUT O subrouti ne so that the origi nal EEOB i s not remo ved if mon ey remains in suspen se. (The o riginal EE OB is alre ady kept i f a balanc e remains on the ori ginal clai m). | |
37 | Draft modi fied code can be fou nd in RCDP EM5us4866 | |
38 | ||
39 | Resolution – Added C hanged Obj ects | |
40 | ||
41 | Routines | |
42 | Activities | |
43 | Routine Na me | |
44 | RCDPEM5 | |
45 | Enhancemen t Category | |
46 | New | |
47 | Modify | |
48 | Delete | |
49 | No Change | |
50 | RTM | |
51 | ||
52 | Related Op tions | |
53 | RCDPE APAR | |
54 | RCDPE EDI LOCKBOX WO RKLIST | |
55 | NIGHTLY PR OCESS | |
56 | ||
57 | Related Ro utines | |
58 | Routines “ Called By” | |
59 | Routines “ Called” | |
60 | ||
61 | ^RCDPEM | |
62 | ^RCDPEMA | |
63 | ^RCDPEWL3 | |
64 | ^RCDPEWL8 | |
65 | ^RCDPLPL3 | |
66 | ^RCDPRPL1 | |
67 | ||
68 | $$LOCK^ IBCEOB4 | |
69 | COPY^IB CEOB4 | |
70 | MOVE^IB CEOB4 | |
71 | REMOVE^ IBCEOB4 | |
72 | RESTORE ^IBCEOB4 | |
73 | UNLOCK^ IBCEOB4 | |
74 | ||
75 | Current Lo gic | |
76 | RCDPEM5 ;A LB/PJH - E PAYMENTS M OVE EEOB T O NEW CLAI M ;Oct 29, 2014@16:4 3:51 ;;4.5 ;Accounts Receivable ;**173,208 ,276,298,3 21**;Mar 2 0, 1995;Bu ild 121 ;P er VA Dire ctive 6402 , this rou tine shoul d not be m odified. Q ; | |
77 | . | |
78 | . | |
79 | . | |
80 | ; BEGIN - PRCA*4.5* 321AUTO(OB ILL,RCSPLI T,RCERA,SR C,ORIG) ; Automatic move copy of EOB - E P for RCDP EM and RCD PEMA ; Inp ut - OBILL - Origina l Bill num ber in #39 9 ; - RCS PLIT - Arr ay of spli t lines ; - RCERA - ERA ien #3 44.4 ; - S RC - "W" = Worklist "A" = APAR /Autopost ; - ORIG - IEN of EO B in file #361.1 ; O utput - Up date EOBs and audit trail N CC LAIM,IFN,N CLAIM,SUB, SUB1,NBILL ,MOVE,JUST ,JUST1,VAL ID ; EOB f or the ori ginal clai m must be present I 'ORIG Q 1 ; Default operation is move S (SUB,SUB1) =0,MOVE=1, VALID=1 ; Loop throu gh split l ines F S SUB=$O(RC SPLIT(SUB) ) Q:'SUB D .; Bill Number on split line .S NBILL= $P(RCSPLIT (SUB),U,2) .; Ignore suspense claims, pi ece 7 is p ointer to AR claim f ile 430 .S IFN=$P(RC SPLIT(SUB) ,U,7) Q:'I FN .; Igno re split l ines with zero value .Q:+$P(RC SPLIT(SUB) ,U,3)=0 .; If origin al bill is in the ar ray then d efault ope ration is copy .I OB ILL=NBILL S MOVE=0 . ; Save POI NTER to AR Claim fil e 430 (DIN UM to 399) .S SUB1=S UB1+1,NCLA IM(SUB1)=I FN .; Buil d list of new claims to copy . S:OBILL'=N BILL CCLAI M(IFN)=IFN ; ; If sp lit is bet ween origi nal claim and suspen se (and no other cla ims) - do nothing I SUB1=1,MOV E=0 Q 1 ; If split w as to move entire cl aim paymen t to suspe nse - mark EOB as re moved I SU B1=0 D AUT OREM(ORIG, $$JUST(ORI G,"","R",0 ,SRC)) Q 1 ; ; Lock Original E OB I '$$LO CK(ORIG) Q 0 ; ; If split to s ingle new claim move EOB - i.e . change c laim numbe r on EOB I MOVE,SUB1 =1 D Q 1 .S JUST=$$ JUST(ORIG, .NCLAIM,"C ",0,SRC) ; Just. Text for origi nal EOB .; Change cl aim number on origin al EOB att ached to E RA .D MOVE ^IBCEOB4(O RIG,NCLAIM (1),DUZ,$$ NOW^XLFDT, JUST,"M") .; Update AR Transac tion for o riginal cl aim .D AUD IT^RCDPAYE R(ORIG,JUS T,"W") ; ; If split was to new claims - copy origi nal EOB to new claim s and then mark orig inal EOB a s removed I MOVE,SUB 1>1 D .S J UST=$$JUST (ORIG,.NCL AIM,"C",0, SRC) ;Just . Text for original EEOB (copi ed to clai ms x,y,z - then remo ved) .S JU ST1=$$JUST (ORIG,.NCL AIM,"C",1, SRC) ;Just . Text for copied to EEOB (cop ied from c laim w) .; Copy EOB to new EOB s for "to" claims .; ;D AUTOCOP Y^IBCEOB5( ORIG,.CCLA IM,DUZ,$$N OW^XLFDT,J UST1,"C") .D COPY^IB CEOB4(ORIG ,.CCLAIM,D UZ,$$NOW^X LFDT,JUST1 ,"C") .; M ark origin al EOB rem oved but w ith text o f 'copied to claims. ...' .D AU TOREM(ORIG ,JUST) ; ; If split was betwee n original claim and other cla ims - copy all new c laims to n ew EOBs I 'MOVE D .S JUST=$$JU ST(ORIG,.N CLAIM,"C", 0,SRC) ;Ju st. Text f or origina l EEOB .S JUST1=$$JU ST(ORIG,.N CLAIM,"C", 1,SRC) ;Ju st. Text f or copied to EEOB .D COPY^IBCE OB4(ORIG,. CCLAIM,DUZ ,$$NOW^XLF DT,JUST,"C ") .; Upda te AR Tran saction fo r 'from cl aim' .D AU DIT^RCDPAY ER(ORIG,JU ST,"W") ; D UNLOCK(O RIG) Q 1 ; | |
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82 | . | |
83 | . | |
84 | ||
85 | Modified L ogic (Chan ges are in bold) | |
86 | RCDPEM5 ;A LB/PJH - E PAYMENTS M OVE EEOB T O NEW CLAI M ;Oct 29, 2014@16:4 3:51 ;;4.5 ;Accounts Receivable ;**173,208 ,276,298,3 21**;Mar 2 0, 1995;Bu ild 121 ;P er VA Dire ctive 6402 , this rou tine shoul d not be m odified. Q ; | |
87 | . | |
88 | . | |
89 | . | |
90 | ; BEGIN - PRCA*4.5* 321AUTO(OB ILL,RCSPLI T,RCERA,SR C,ORIG) ; Automatic move copy of EOB - E P for RCDP EM and RCD PEMA ; Inp ut - OBILL - Origina l Bill num ber in #39 9 ; - RCS PLIT - Arr ay of spli t lines ; - RCERA - ERA ien #3 44.4 ; - S RC - "W" = Worklist "A" = APAR /Autopost ; - ORIG - IEN of EO B in file #361.1 ; O utput - Up date EOBs and audit trail N CC LAIM,FLAG, IFN,J,NCLA IM,SUB,SUB 1,MOVE,NBI LL,JUST,JU ST1,VALID ; EOB for the origin al claim m ust be pre sent I 'OR IG Q 1 S ( SUB,SUB1)= 0,MOVE=1,V ALID=1 F J ="O","N"," S" S FLAG( J)=0 ; Ini tialize fl ags for or iginal, ne w and susp ense EEOBs ; Loop th rough spli t lines F S SUB=$O (RCSPLIT(S UB)) Q:'SU B D . ; B ill Number on split line . S N BILL=$P(RC SPLIT(SUB) ,U,2) . ; S IFN=$P(R CSPLIT(SUB ),U,7) Q:' IFN . S IF N=$P(RCSPL IT(SUB),U, 7) Q:'IFN . ; Ignore split lin es with ze ro value . Q:+$P(RCS PLIT(SUB), U,3)=0 . ; Suspense claims, pi ece 7 is p ointer to AR claim f ile 430 . I 'IFN S F LAG("S")=1 Q . ; Is original b ill is in the array? . I OBILL =NBILL S F LAG("O")=1 . ; Save POINTER to AR Claim file 430 ( DINUM to 3 99) . S SU B1=SUB1+1, NCLAIM(SUB 1)=IFN . ; Build lis t of new c laims to c opy . I OB ILL'=NBILL D ; . . S CCLAIM(I FN)=IFN . . S FLAG(" N")=1 ; ; If split i s between original c laim and s uspense (a nd no othe r claims) - do nothi ng I FLAG( "O"),FLAG( "S"),'FLAG ("N") Q 1 ; If split was to mo ve entire claim paym ent to sus pense - do nothing ( until fund s are dist ributed or refunded) I FLAG("S "),'FLAG(" N") Q 1 ; ; Lock Ori ginal EOB I '$$LOCK( ORIG) Q 0 ; ; If spl it entirel y to new c laims I 'F LAG("O"),' FLAG("S"), FLAG("N") D Q 1 . ; If split to single new claim move EOB - i.e. chan ge claim n umber on E OB . I SUB 1=1 D Q ; . . S JU ST=$$JUST( ORIG,.NCLA IM,"C",0,S RC) ;Just. Text for original E OB . . ; C hange clai m number o n original EOB attac hed to ERA . . D MOV E^IBCEOB4( ORIG,NCLAI M(1),DUZ,$ $NOW^XLFDT ,JUST,"M") . . ; Upd ate AR Tra nsaction f or origina l claim . . D AUDIT^ RCDPAYER(O RIG,JUST," W") . ; If split was to multip le new cla ims - copy original EOB to new claims an d then mar k original EOB as re moved . I SUB1>1 D . . S JUST= $$JUST(ORI G,.NCLAIM, "C",0,SRC) ;Just. Te xt for ori ginal EEOB (copied t o claims x ,y,z - the n removed) . . S JUS T1=$$JUST( ORIG,.NCLA IM,"C",1,S RC) ;Just. Text for copied to EEOB (copi ed from cl aim w) . . ; Copy EO B to new E OBs for "t o" claims . . D COPY ^IBCEOB4(O RIG,.CCLAI M,DUZ,$$NO W^XLFDT,JU ST1,"C") . . ; Mark original E OB removed but with text of 'c opied to c laims....' . . D AUT OREM(ORIG, JUST) ; ; If split w as between original claim and other clai ms - copy all new cl aims to ne w EOBs I F LAG("O"),F LAG("N") D ; .S JUS T=$$JUST(O RIG,.NCLAI M,"C",0,SR C) ;Just. Text for o riginal EE OB .S JUST 1=$$JUST(O RIG,.NCLAI M,"C",1,SR C) ;Just. Text for c opied to E EOB .D COP Y^IBCEOB4( ORIG,.CCLA IM,DUZ,$$N OW^XLFDT,J UST,"C") . ; Update A R Transact ion for 'f rom claim' .D AUDIT^ RCDPAYER(O RIG,JUST," W") ; D UN LOCK(ORIG) Q 1 ; | |
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