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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 US333 SDD.docx | Fri Jan 25 13:47:44 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 US333 SDD.docx | Mon Feb 25 18:40:49 2019 UTC |
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1 | MCCF EDI T AS US333 | |
2 | System Des ign Docume nt | |
3 | PRCA*4.5*x xx | |
4 | ||
5 | ||
6 | ||
7 | ||
8 | Department of Vetera ns Affairs | |
9 | May 2018 | |
10 | Version 1 | |
11 | User Story ID: US333 | |
12 | User Story Name: Re work AB – Active Bil ls with EE OB Report | |
13 | Sizing: | |
14 | ||
15 | Epic Taxon omy | |
16 | eBiz Comp liance | |
17 | Port | |
18 | Update | |
19 | Increa se No Touc h | |
20 | TAS Apps | |
21 | Story | |
22 | As a... | |
23 | I need... | |
24 | So that... | |
25 | Cash/Acct mgmt. cler k or a lea d/supervis or | |
26 | The AB –Ac tive Bills with EEOB Report to accuratel y reflect all Active Bills/Cla ims, with a balance of .01 or more AND a n EEOB/835 attached to show up on the re port | |
27 | I can see the outsta nding work load/, age d receivab les that h ave receiv ed an 835 response f rom the pa yer. This will prov ide me wit h a defini tive list to find cl aims with posted pay ments and residual b alances, c laims with payments to be post ed and cla ims that h ave receiv ed a zero dollar EEO B or denia l. | |
28 | ||
29 | Conversati on (if des ired by de velopers) | |
30 | Currently not showin g all clai ms that it should, u nclear as to what is not showi ng. | |
31 | Verify act ive bills/ claims wit h zero dol lar EEOB ( denial) at tached, ar e on the r eport | |
32 | The option to show o nly zero b alance was added as a filter i n patch PR CA*4.5*303 (Subrouti ne INCLUDE ). It loo ks like th ere might be a bug i n the logi c or maybe bad wordi ng of the prompt, wh en “ALL” E EOBs is se lected at the filter it only s hows ones with payme nts. | |
33 | ||
34 | Per USD&P – make fil ter 3 way: | |
35 | ||
36 | RUN REPORT FOR or (Z )ERO PAYME NT, (P)AYM ENT or (A) LL EEOBs: ALL// | |
37 | Verify act ive bills/ claims wit h EEOB att ached, but payment y et to be p osted, are on the re port | |
38 | *No – Only includes lines wher e ERA Deta il post st atus is 1, 2 or 5. P osted, man ually post ed or part ial (Subro utine EEOB ). | |
39 | ||
40 | Per USD&P – remove t his check on post st atus. | |
41 | ||
42 | Verify act ive bills/ claims wit h EEOB att ached, pay ment poste d but bill /claim sti ll has a r esidual ba lance, are on the re port. | |
43 | According to the ePa yments Use r Manual w hen a clai m is succe ssfully au to-posted, the claim status is changed t o “Collect ed/Closed or Open (w ith residu al balance )”. Since the repor t only sho ws claims with curre nt status of “Active ” claims w ith residu al balance would not appear on the repor t if the s tatus has been chang ed to Open . | |
44 | ||
45 | Per USD&P – Business team to c heck if Cl aims with residual b alance hav e Active s tatus. | |
46 | ||
47 | Summary | |
48 | ||
49 | RCDPEAC (e xisting ro utine) – M ake ZERO P AYMENT fil ter 3 way. Z, P or A. Remove filter on ERA detai l line pos t status. | |
50 | ||
51 | Resoluti on – Added Changed O bjects | |
52 | ||
53 | ||
54 | Routines | |
55 | Activities | |
56 | Routine Na me | |
57 | RCDPEAC | |
58 | Enhancemen t Category | |
59 | New | |
60 | Modify | |
61 | Delete | |
62 | No Change | |
63 | RTM | |
64 | ||
65 | Related Op tions | |
66 | RCDPE ACTI VE WITH EE OB REPORT | |
67 | ||
68 | ||
69 | Related Ro utines | |
70 | Routines “ Called By” | |
71 | Routines “ Called” | |
72 | ||
73 | None | |
74 | $$ASKLM^RC DPEARL | |
75 | $$ENDORPRT ^RCDPEARL | |
76 | $$NOW^RCDP EARL | |
77 | ASK^RCDPEA RL | |
78 | HDRLST^RCD PEARL | |
79 | LMRPT^RCDP EARL | |
80 | SL^RCDPEAR L | |
81 | $$DISPTY^R CDPEM3 | |
82 | INFO^RCDPE M6 | |
83 | $$EOBERA^R CDPEU1 | |
84 | $$GETNAME^ RCDPEU1 | |
85 | $$ISSEL^RC DPEU1 | |
86 | $$ISTYPE^R CDPEU1 | |
87 | $$PAYRNG^R CDPEU1 | |
88 | $$RTYPE^RC DPEU1 | |
89 | $$SELPAY^R CDPEU1 | |
90 | ||
91 | Current Lo gic - RCDP EAC | |
92 | RCDPEAC ;A LB/TMK/PJH - ACTIVE BILLS WITH EEOB ON F ILE ;Jun 0 6, 2014@19 :11:19 ;;4 .5;Account s Receivab le;**208,2 69,276,298 ,303,326** ;Mar 20, 1 995;Build 84 ;;Per V A Directiv e 6402, th is routine should no t be modif ied. ;EN ; Entry poi nt for Act ive Bills With EEOB Report [RC DPE ACTIVE WITH EEOB REPORT] | |
93 | . | |
94 | . | |
95 | . | |
96 | ;EEOB(RCZ ,RCEOB,RCZ RO) ; Find all non-M RA EEOBs f or bill ie n RCZ ; Fu nction ret urns 1 if any valid EEOBs foun d, 0 if no ne ; RCEOB (eob ien)= date poste d returned for valid EEOBs fou nd - ; pas s by refer ence N OK, Z,Z0,Z00,D ET,SN,ZPD, ZINC K RCE OB ; S (Z, OK,SN,ZINC )=0 ; IA 4 051 for Fi le #361.1 F S Z=$O( ^IBM(361.1 ,"B",RCZ,Z )) Q:'Z I $P($G(^IB M(361.1,Z, 0)),U,4)'= 1 D . ; re trieve the EEOB data from ERA Detail sub -entry . S (Z0,DET)= 0 . F S Z 0=$O(^RCY( 344.4,"ADE T",Z,Z0)) Q:'Z0 F S DET=$O(^ RCY(344.4, "ADET",Z,Z 0,DET)) Q: 'DET D ; ERA Detai l . . ; PR CA*4.5*303 - added c heck for Z ero paid o r Paid > 0 check for report. . . S ZINC= 0,ZPD=+$P( $G(^RCY(34 4.4,Z0,1,D ET,0)),U,3 ) . . I (R CZRO="Z"), (ZPD=0) S ZINC=1 . . I (RCZRO= "A"),(ZPD> 0) S ZINC= 1 . . ; PR CA*4.5*303 - Removed looking f or Receipt , include record bas ed on ERA DETAIL POS T STATUS . . S Z00=$ P($G(^RCY( 344.4,Z0,0 )),U,14) . . ; PRCA* 4.5*303 - Removed ch eck for Re ceipt (If Z1 is not empty) Cha nged date to Piece 7 and . . ; added che ck for eit her 0 paid or paid > 0 dependin g on selec tion. Adde d ERA PD A MOUNT as s econd piec e of RCEOB array . . I (ZINC)& ((Z00=0)!( Z00=1)!(Z0 0=2)!(Z00= 5)) S SN=S N+1,RCEOB( Z,SN)=+$P( $G(^RCY(34 4.4,Z0,0)) ,U,7)_U_ZP D,OK=1 ; Q OK ;SL1(R CSORT,RCZ) ; Functio n returns 1st sort l evel data from ien R CZ in file 430 ; RCS ORT = "PN" for patie nt name so rt = "L4" for SSN la st 4 sort N DAT I RC SORT="PN" S DAT=$P($ G(^DPT(+$P ($G(^PRCA( 430,RCZ,0) ),U,7),0)) ,U) I RCSO RT="L4" S DAT=$P($G( ^DPT(+$P($ G(^PRCA(43 0,RCZ,0)), U,7),0)),U ,9),DAT=$E (DAT,$L(DA T)-3,$L(DA T)) Q $S($ G(DAT)'="" :DAT,1:" " ) ;SELECT( RCINS,RCSO RT,RCZRO,R CTYPE) ; S elect insu rance co, sort crite ria, Zero Payment, B ill type ( Med/RX) an d if outpu t for EXCE L format i s selected ; Functio n returns values sel ected for RCSORT and RCINS - p assed by r ef N RCQUI T,DONE,DIR ,X,Y,%DT S (RCQUIT,D ONE,RCLSTM GR)=0 ; PR CA*4.5*326 - Begin c hanged blo ck - Ask t o show Med ical/Pharm acy Tricar e or All S RCTYPE=$$ RTYPE^RCDP EU1("") I RCTYPE=-1 G SELQ ; S RCINS=$$P AYRNG^RCDP EU1() I RC INS=-1 G S ELQ ; I RC INS'="A" D I XX=-1 G SELQ . S RCPAR("TY PE")=RCTYP E . S RCPA R("SELC")= RCINS . S RCPAR("DIC A")="SELEC T INSURANC E COMPANY: " . S XX= $$SELPAY^R CDPEU1(.RC PAR) ; PRC A*4.5*326 - End chan ged block ; ; PRCA*4 .5*303 - A dd Zero $ Prompt and Medical/P harmacy EE OBs Prompt S DIR(0)= "SA^A:ALL; Z:ZERO PAY MENT EEOBs ",DIR("A") ="RUN REPO RT FOR (A) LL EEOBs o r (Z)ERO P AYMENT EEO Bs only: " ,DIR("B")= "ALL" W ! D ^DIR K D IR I $D(DT OUT)!$D(DU OUT) G SEL Q S RCZRO= $E(Y,1) ; S DIR(0)=" SA^P:PATIE NT NAME;L: LAST 4 OF PATIENT SS N",DIR("A" )="WITHIN INS CO, SO RT BY (P)A TIENT NAME OR (L)AST 4 OF SSN? : ",DIR("B ")="PATIEN T NAME" W ! D ^DIR K DIR I $D( DTOUT)!$D( DUOUT) G S ELQ S RCSO RT=$S(Y="P ":"PN",1:" L4") S DIR (0)="SA^F: FIRST TO L AST;L:LAST TO FIRST" ,DIR("A")= "SORT "_$S (RCSORT="P N":"PATIEN T NAME",1: "LAST 4")_ " (F)IRST TO LAST OR (L)AST TO FIRST?: " ,DIR("B")= "FIRST TO LAST" D ^D IR K DIR I $D(DTOUT) !$D(DUOUT) G SELQ I Y="L" S RC SORT=RCSOR T_";-" ; ; PRCA*4.5* 298 - Add Date Range Prompts K DIR S DIR ("?")="ENT ER THE EAR LIEST RECE IVED DATE TO INCLUDE ON THE RE PORT" S DI R(0)="DAO^ :"_DT_":AP E",DIR("A" )="START D ATE (RECEI VED): ",DI R("B")="T" D ^DIR K DIR I $D(D TOUT)!$D(D UOUT)!(Y=" ") G SELQ S START=Y K DIR S DI R("?")="EN TER THE LA TEST RECEI VED DATE T O INCLUDE ON THE REP ORT" S DIR ("B")="T" S DIR(0)=" DAO^"_STAR T_":"_DT_" :APE",DIR( "A")="END DATE (RECE IVED): " D ^DIR K DI R I $D(DTO UT)!$D(DUO UT)!(Y="") G SELQ S END=Y ; PR CA*4.5*326 - Remove old Tricar e and CHAM PVA prompt s ; ; PRCA *4.5*276 - Determine whether t o gather d ata for Ex cel report . S RCDISP TY=$$DISPT Y^RCDPEM3 G SELQ:RCD ISPTY<0 I RCDISPTY D INFO^RCDP EM6 S DONE =1 G SELQ ; ; PRCA*4 .5*298 - A dd ListMan ager Promp ts S RCLST MGR=$$ASKL M^RCDPEARL G:RCLSTMG R<0 SELQ ; S DONE=1 ;SELQ ; Q DONE ; | |
97 | ||
98 | ||
99 | Modified L ogic (Chan ges are in bold) - R CDPEAC | |
100 | RCDPEAC ;A LB/TMK/PJH - ACTIVE BILLS WITH EEOB ON F ILE ;Jun 0 6, 2014@19 :11:19 ;;4 .5;Account s Receivab le;**208,2 69,276,298 ,303,326,X XX**;Mar 2 0, 1995;Bu ild 84 ;;P er VA Dire ctive 6402 , this rou tine shoul d not be m odified. ; EN ; Entry point for Active Bi lls With E EOB Report [RCDPE AC TIVE WITH EEOB REPOR T] | |
101 | . | |
102 | . | |
103 | . | |
104 | ;EEOB(RCZ ,RCEOB,RCZ RO) ; Find all non-M RA EEOBs f or bill ie n RCZ ; Fu nction ret urns 1 if any valid EEOBs foun d, 0 if no ne ; RCEOB (eob ien)= date poste d returned for valid EEOBs fou nd - ; pas s by refer ence N OK, Z,Z0,Z00,D ET,SN,ZPD, ZINC K RCE OB ; S (Z, OK,SN,ZINC )=0 ; IA 4 051 for Fi le #361.1 F S Z=$O( ^IBM(361.1 ,"B",RCZ,Z )) Q:'Z I $P($G(^IB M(361.1,Z, 0)),U,4)'= 1 D . ; re trieve the EEOB data from ERA Detail sub -entry . S (Z0,DET)= 0 . F S Z 0=$O(^RCY( 344.4,"ADE T",Z,Z0)) Q:'Z0 F S DET=$O(^ RCY(344.4, "ADET",Z,Z 0,DET)) Q: 'DET D ; ERA Detai l . . ; PR CA*4.5*303 - added c heck for Z ero paid o r Paid > 0 check for report. . . S ZINC= 0,ZPD=+$P( $G(^RCY(34 4.4,Z0,1,D ET,0)),U,3 ) . . I (R CZRO="A") S ZINC=1 | |
105 | . . I (RC ZRO="Z"),( ZPD=0) S Z INC=1 . . I (RCZRO=" P"),(ZPD>0 ) S ZINC=1 . . ; PRC A*4.5*303 - Removed looking fo r Receipt, include r ecord base d on ERA D ETAIL POST STATUS . . S Z00=$P ($G(^RCY(3 44.4,Z0,0) ),U,14) . . ; PRCA*4 .5*303 - R emoved che ck for Rec eipt (If Z 1 is not e mpty) Chan ged date t o Piece 7 and . . ; added chec k for eith er 0 paid or paid >0 depending on select ion. Added ERA PD AM OUNT as se cond piece of RCEOB array . . I (ZINC)&( (Z00=0)!(Z 00=1)!(Z00 =2)!(Z00=5 )) S SN=SN +1,RCEOB(Z ,SN)=+$P($ G(^RCY(344 .4,Z0,0)), U,7)_U_ZPD ,OK=1 ; Q OK ;SL1(RC SORT,RCZ) ; Function returns 1 st sort le vel data f rom ien RC Z in file 430 ; RCSO RT = "PN" for patien t name sor t = "L4" f or SSN las t 4 sort N DAT I RCS ORT="PN" S DAT=$P($G (^DPT(+$P( $G(^PRCA(4 30,RCZ,0)) ,U,7),0)), U) I RCSOR T="L4" S D AT=$P($G(^ DPT(+$P($G (^PRCA(430 ,RCZ,0)),U ,7),0)),U, 9),DAT=$E( DAT,$L(DAT )-3,$L(DAT )) Q $S($G (DAT)'="": DAT,1:" ") ;SELECT(R CINS,RCSOR T,RCZRO,RC TYPE) ; Se lect insur ance co, s ort criter ia, Zero P ayment, Bi ll type (M ed/RX) and if output for EXCEL format is selected ; Function returns v alues sele cted for R CSORT and RCINS - pa ssed by re f N RCQUIT ,DONE,DIR, X,Y,%DT S (RCQUIT,DO NE,RCLSTMG R)=0 ; PRC A*4.5*326 - Begin ch anged bloc k - Ask to show Medi cal/Pharma cy Tricare or All S RCTYPE=$$R TYPE^RCDPE U1("") I R CTYPE=-1 G SELQ ; S RCINS=$$PA YRNG^RCDPE U1() I RCI NS=-1 G SE LQ ; I RCI NS'="A" D I XX=-1 G SELQ . S RCPAR("TYP E")=RCTYPE . S RCPAR ("SELC")=R CINS . S R CPAR("DICA ")="SELECT INSURANCE COMPANY: " . S XX=$ $SELPAY^RC DPEU1(.RCP AR) ; PRCA *4.5*326 - End chang ed block ; ; PRCA*4. 5*303 - Ad d Zero $ P rompt and Medical/Ph armacy EEO Bs Prompt S DIR(0)=" SA^P:PAYME NT EEOBs;Z :ZERO PAYM ENT EEOBs; A:ALL",DI R("A")="RU N REPORT F OR (P)AYME NT EEOBs, (Z)ERO PAY MENT EEOBs or (A)LL: ",DIR("B" )="ALL" W ! D ^DIR K DIR I $D( DTOUT)!$D( DUOUT) G S ELQ S RCZR O=$E(Y,1) ; S DIR(0) ="SA^P:PAT IENT NAME; L:LAST 4 O F PATIENT SSN",DIR(" A")="WITHI N INS CO, SORT BY (P )ATIENT NA ME OR (L)A ST 4 OF SS N?: ",DIR( "B")="PATI ENT NAME" W ! D ^DIR K DIR I $ D(DTOUT)!$ D(DUOUT) G SELQ S RC SORT=$S(Y= "P":"PN",1 :"L4") S D IR(0)="SA^ F:FIRST TO LAST;L:LA ST TO FIRS T",DIR("A" )="SORT "_ $S(RCSORT= "PN":"PATI ENT NAME", 1:"LAST 4" )_" (F)IRS T TO LAST OR (L)AST TO FIRST?: ",DIR("B" )="FIRST T O LAST" D ^DIR K DIR I $D(DTOU T)!$D(DUOU T) G SELQ I Y="L" S RCSORT=RCS ORT_";-" ; ; PRCA*4. 5*298 - Ad d Date Ran ge Prompts K DIR S D IR("?")="E NTER THE E ARLIEST RE CEIVED DAT E TO INCLU DE ON THE REPORT" S DIR(0)="DA O^:"_DT_": APE",DIR(" A")="START DATE (REC EIVED): ", DIR("B")=" T" D ^DIR K DIR I $D (DTOUT)!$D (DUOUT)!(Y ="") G SEL Q S START= Y K DIR S DIR("?")=" ENTER THE LATEST REC EIVED DATE TO INCLUD E ON THE R EPORT" S D IR("B")="T " S DIR(0) ="DAO^"_ST ART_":"_DT _":APE",DI R("A")="EN D DATE (RE CEIVED): " D ^DIR K DIR I $D(D TOUT)!$D(D UOUT)!(Y=" ") G SELQ S END=Y ; PRCA*4.5*3 26 - Remov e old Tric are and CH AMPVA prom pts ; ; PR CA*4.5*276 - Determi ne whether to gather data for Excel repo rt. S RCDI SPTY=$$DIS PTY^RCDPEM 3 G SELQ:R CDISPTY<0 I RCDISPTY D INFO^RC DPEM6 S DO NE=1 G SEL Q ; ; PRCA *4.5*298 - Add ListM anager Pro mpts S RCL STMGR=$$AS KLM^RCDPEA RL G:RCLST MGR<0 SELQ ; S DONE= 1 ;SELQ ; Q DONE ; | |
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