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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 US801 SDD.docx | Fri Jan 25 13:55:08 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 US801 SDD.docx | Mon Feb 25 20:51:53 2019 UTC |
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1 | MCCF EDI T AS US801 | |
2 | System Des ign Docume nt | |
3 | PRCA*4.5*x xx | |
4 | ||
5 | ||
6 | ||
7 | ||
8 | Department of Vetera ns Affairs | |
9 | August 201 8 | |
10 | Version 1 | |
11 | User Story ID: US801 | |
12 | User Story Name: Ne ed the abi lity to au to-audit T ricare cla ims | |
13 | Sizing: 5 | |
14 | Story | |
15 | As a... | |
16 | I need... | |
17 | So that... | |
18 | As a ePaym ents/Trica re user | |
19 | I want the ability t o auto aud it Tricare claims th rough the auto audit ing proces s | |
20 | I don’t ha ve to manu ally audit Tricare c laims to m ake them a ctive | |
21 | ||
22 | Conversati on (if des ired by de velopers) | |
23 | As a ePaym ents/Trica re user, I want the ability to auto audi t Tricare claims thr ough the a uto auditi ng process . All cla ims must b e audited in order f or ERA/EFT s to auto- post. I need a sep arate para meter to e nable/disa ble auto a uditing of Tricare a nd it shou ld be lock ed with th e existing security key RCDPE Auto Dec. Tricare cl aims are b illed with a Tricare rate type where reg ular medic al claims are billed as reimbu rsable hea lth. Tric are claims are trans mitted to FMS as ind ividual cl aims, into fund 0160 R1 - MCCF transmits to FMS as a bulk amo unt, into fund 52870 4. | |
24 | ||
25 | Summary | |
26 | This user story is v ery simila r and rela ted to pen ding user story US32 6. It wou ld be bene ficial if US326 were to be com pleted fir st in the same build . | |
27 | ||
28 | This user story note s that edi t of the T ricare aud it flag sh ould be lo cked with existing k ey RCDP AU TO DEC. T his key is already i n use to l ock the wh ole EDI Lo ckbox para meters men u option. | |
29 | ||
30 | Data field s needed: | |
31 | New field | |
32 | ||
33 | STANDARD D ATA DICTIO NARY #342 -- AR SITE PARAMETER FILE 4/12/17 PAGE 1 | |
34 | STORED IN ^RC(342, (1 ENTRY) SITE:
|
|
35 | (VERSION 4 .5) | |
36 | ||
37 | DATA NAME GLOB AL DATA | |
38 | ELEMENT TITLE LOCA TION TYPE | |
39 | ---------- ---------- ---------- ---------- ---------- ---------- ---------- --------- | |
40 | ||
41 | 342,7.09 AUTO-A UDIT TRICA RE EDI BIL LS 7;9 SET | |
42 | ||
43 | ENABLE AUTO-AUDI T TRICARE BILLS | |
44 | '0' FOR No; | |
45 | '1' FOR Yes; | |
46 | LAST E DITED: NOV 04, 2015 | |
47 | HELP-P ROMPT: Enter 1 to allow A uto-auditi ng of Tric are EDI | |
48 | bills, 0 to disall ow. | |
49 | DESCRI PTION: A Yes/No prompt to allow a s ite to aud it their | |
50 | Tricare EDI Bills during the AR Nightl y | |
51 | Process. | |
52 | ||
53 | TECHNI CAL DESCR: A Yes/No prompt to see if th e site wis hes to | |
54 | audit th eir Tricar e EDI bill s during t he AR | |
55 | Nightly Process [P RCA NIGHTL Y PROCESS] . | |
56 | ||
57 | ||
58 | ||
59 | Changed Ro utines | |
60 | ||
61 | PRCABJ2 | |
62 | Auto audit Tricare b ills if pa rameter fl ag is set | |
63 | ||
64 | RCDPESP5 | |
65 | Enter/edit Tricare a uto audit flag. No c hanges to this routi ne but the report mu st be unit tested | |
66 | ||
67 | RCDPESP2 | |
68 | EDI Lockbo x Paramete rs Audit R eport – Ad ded new Au to-Audit T ricare fie ld | |
69 | Resolution – Added C hanged Obj ects | |
70 | ||
71 | Routines | |
72 | Activities | |
73 | Routine Na me | |
74 | PRCABJ2 | |
75 | Enhancemen t Category | |
76 | New | |
77 | Modify | |
78 | Delete | |
79 | No Change | |
80 | RTM | |
81 | ||
82 | Related Op tions | |
83 | PRCA NIGHT LY PROCESS | |
84 | ||
85 | Related Ro utines | |
86 | Routines “ Called By” | |
87 | Routines “ Called” | |
88 | ||
89 | PRCABJ | |
90 | AUDITX^PRC AUDT $$GETECME^ RCDPENR1 | |
91 | ||
92 | Current Lo gic | |
93 | PRCABJ2 ;A LB/SAB - N IGHTLY PRO CESS FOR A CCOUNTS RE CEIVABLE ; 07-JUL-15 ;;4.5;Acco unts Recei vable;**30 4,321,326* *;Mar 20, 1995;Build 104 ;Per VA Directi ve 6402, t his routin e should n ot be modi fied. ; ; read of DG CR(399.2 a llowed by DBIA 3822 ; Q ; Auto -audit Pap er and Ele ctronic (E DI) bills if readyAB AUDIT ; ; Local Vari ables ; AP IEN - Acco unts Payab le (file # 430) ien ; N APIEN,B ILLTYP,BIL LTYPF,BILL VAL,DIE,DA ,DR,DIR,DI RUT,DTOUT, DUOUT,X,Y N APD0,APD 202,FLG1,F LG2,FLG1E, FLG2E,NBLI EN ; PRCA* 4.5*321 N PRCABLNO,P RCAECME,RA TEIEN,RCPA PER,XX ; P RCA*4.5*32 1 ; S APIE N="" ; ;Ch eck parame ters to se e if it ne eds to run . S FLG1=$ $GET1^DIQ( 342,"1,",7 .05,"I") ; Get the v alue of th e auto-aud it medical paper bil l flag S F LG2=$$GET1 ^DIQ(342," 1,",7.06," I") ; Get the value of the aut o-audit ph armacy pap er bill fl ag S FLG1E =$$GET1^DI Q(342,"1," ,7.07,"I") ; Get the value of the auto-a udit medic al EDI bil l flag - P RCA*4.5*32 1 S FLG2E= $$GET1^DIQ (342,"1,", 7.08,"I") ; Get the value of t he auto-au dit pharma cy EDI bil l flag - P RCA*4.5*32 1 ; ; Quit if all au to-audit p arameters are set to 'No' Q:(' FLG1)&('FL G2)&('FLG1 E)&('FLG2E ) ; PRCA*4 .5*321 ; ; retrieve D B values S NBLIEN=$O (^PRCA(430 .3,"B","NE W BILL","" )) ; New B ill Status IEN ;S CA TIEN=$O(^P RCA(430.2, "C","RI"," ")) ; Reim bursable I nsurance I EN ; remov ed PRCA*4. 5*321 ;S H ICD=$O(^PR CA(430.6," B","HI","" )) ; Healt h insuranc e IEN ; re moved PRCA *4.5*321 ; S ACTIVE=$ O(^PRCA(43 0.3,"B","A CTIVE","") ) ; New Bi ll Status IEN ; remo ved PRCA*4 .5*321 S B ILLTYP=$O( ^DGCR(399. 3,"B","REI MBURSABLE INS.","")) ; Bill Ty pe IEN S B ILLTYPF=$O (^DGCR(399 .3,"B","FE E REIMB IN S","")) ; Re-Imb. Fe e Bill Typ e IEN - PR CA*4.5*326 ;S RCPAPE R=1 ; Fiel d 27 in ^D GCR(399 ; 0 - is ele ctronic, 1 - FORCE L OCAL PRINT ; removed PRCA*4.5* 321 ; Q:NB LIEN="" ; F S APIEN =$O(^PRCA( 430,"AC",N BLIEN,APIE N)) Q:'API EN D . S APD0=$G(^P RCA(430,AP IEN,0)) ; Patient in fo . S APD 202=$G(^PR CA(430,API EN,202)) ; Insured in fo . S BIL LVAL=$$GET 1^DIQ(399, APIEN_",", .07,"I") ; PRCA*4.5* 326 . I BI LLVAL'=BIL LTYP,BILLV AL'=BILLTY PF Q ; Ra te Type mu st be Reim bursable I nsurance - PRCA*4.5* 326 . ; BE GIN - PRCA *4.5*321 . Q:$$GET1^ DIQ(430,AP IEN_",",7, "I")="" ; Quit if no PAT IENT IEN . Q:$$GET1^ DIQ(430,AP IEN_",",9, "I")="" ; Quit if no DEB TOR inform ation . Q: $$GET1^DIQ (430,APIEN _",",239," I")="" ; quit if no subscr iber name stored . Q :$$GET1^DI Q(430,APIE N_",",243, "I")="" ; quit i f no group name stor ed . Q:$$G ET1^DIQ(43 0,APIEN_", ",244,"I") ="" ; quit if no group num ber stored . Q:$$BIL LREJ^PRCAU DT(APIEN) ; PRCA*4.5 *321 - cla im has rej ect messag es, do not audit . ; . S RATEI EN=$$GET1^ DIQ(399,AP IEN_",",.0 7,"I") ; G et bill's rate type ; IA 4118 . Q:'RATEI EN . ; A r ate type i s auto-aud ited if BI LL RESULTI NG FROM fi eld is non -null . Q: '$$GET1^DI Q(399.3,RA TEIEN_",", .11,"I") ; Quit if n ot an auto -audit rat e type . ; Read on IB file #399 field #27 covered b y ICR #382 0 . S RCPA PER=$$GET1 ^DIQ(399,A PIEN_",",2 7,"I") ; 0 - is elec tronic, 1 - is paper . ;Get th e Bill num ber to che ck if it i s a Pharma cy bill . S PRCABLNO =$$GET1^DI Q(430,APIE N_",",.01, "I") . S P RCAECME=$$ GETECME^RC DPENR1(PRC ABLNO) . I PRCAECME= "",'FLG1,R CPAPER Q ;Skip t his paper bill if No Medical p rocessing . I PRCAEC ME'="",'FL G2,RCPAPER Q ;Ski p this pap er bill if No Pharma cy process ing . I PR CAECME="", 'FLG1E,'RC PAPER Q ;Skip th is EDI bil l if No Me dical proc essing . I PRCAECME' ="",'FLG2E ,'RCPAPER Q ;Skip this EDI bill if No Pharmacy processing . ; . ; B ill Passed all check s now call auto-audi t for this Bill numb er . D AUD ITX^PRCAUD T(APIEN) Q | |
94 | ||
95 | Modified L ogic (Chan ges are in bold) | |
96 | PRCABJ2 ;A LB/SAB - N IGHTLY PRO CESS FOR A CCOUNTS RE CEIVABLE ; 07-JUL-15 ;;4.5;Acco unts Recei vable;**30 4,321,326* *;Mar 20, 1995;Build 104 ;Per VA Directi ve 6402, t his routin e should n ot be modi fied. ; ; read of DG CR(399.2 a llowed by DBIA 3822 ; Q ; Auto -audit Pap er and Ele ctronic (E DI) bills if readyAB AUDIT ; ; Local Vari ables ; AP IEN - Acco unts Payab le (file # 430) ien ; N APIEN,B ILLTYP,BIL LTYPF,BILL VAL,DIE,DA ,DR,DIR,DI RUT,DTOUT, DUOUT,X,Y N APD0,APD 202,FLG1,F LG2,FLG1E, FLG2E,FLGT R,NBLIEN ; PRCA*4.5* 321 N PRCA BLNO,PRCAE CME,RATEIE N,RCPAPER, THISTYP,XX ; PRCA*4. 5*321 ; S APIEN="" ; ;Check pa rameters t o see if i t needs to run. S FL G1=$$GET1^ DIQ(342,"1 ,",7.05,"I ") ; Get t he value o f the auto -audit med ical paper bill flag S FLG2=$$ GET1^DIQ(3 42,"1,",7. 06,"I") ; Get the va lue of the auto-audi t pharmacy paper bil l flag S F LG1E=$$GET 1^DIQ(342, "1,",7.07, "I") ; Get the value of the au to-audit m edical EDI bill flag - PRCA*4. 5*321 S FL G2E=$$GET1 ^DIQ(342," 1,",7.08," I") ; Get the value of the aut o-audit ph armacy EDI bill flag - PRCA*4. 5*321 S FL GTR=$$GET1 ^DIQ(342," 1,",7.09," I") ; Get the value of the Tri care audit flag ; ; Quit if al l auto-aud it paramet ers are se t to 'No' Q:('FLG1)& ('FLG2)&(' FLG1E)&('F LG2E)&(FLG TR) ; PRCA *4.5*321 ; ;retrieve DB values S NBLIEN= $O(^PRCA(4 30.3,"B"," NEW BILL", "")) ; New Bill Stat us IEN ;S CATIEN=$O( ^PRCA(430. 2,"C","RI" ,"")) ; Re imbursable Insurance IEN ; rem oved PRCA* 4.5*321 ;S HICD=$O(^ PRCA(430.6 ,"B","HI", "")) ; Hea lth insura nce IEN ; removed PR CA*4.5*321 ;S ACTIVE =$O(^PRCA( 430.3,"B", "ACTIVE"," ")) ; New Bill Statu s IEN ; re moved PRCA *4.5*321 S BILLTYP=$ O(^DGCR(39 9.3,"B","R EIMBURSABL E INS.","" )) ; Bill Type IEN S BILLTYPF= $O(^DGCR(3 99.3,"B"," FEE REIMB INS","")) ; Re-Imb. Fee Bill T ype IEN - PRCA*4.5*3 26 ;S RCPA PER=1 ; Fi eld 27 in ^DGCR(399 ; 0 - is e lectronic, 1 - FORCE LOCAL PRI NT ; remov ed PRCA*4. 5*321 ; Q: NBLIEN="" ; F S API EN=$O(^PRC A(430,"AC" ,NBLIEN,AP IEN)) Q:'A PIEN D . S APD0=$G( ^PRCA(430, APIEN,0)) ; Patient info . S A PD202=$G(^ PRCA(430,A PIEN,202)) ;Insured info . S B ILLVAL=$$G ET1^DIQ(39 9,APIEN_", ",.07,"I") ; PRCA*4. 5*326 . I BILLVAL'=B ILLTYP,BIL LVAL'=BILL TYPF Q ; Rate Type must be Re imbursable Insurance - PRCA*4. 5*326 . ; BEGIN - PR CA*4.5*321 . Q:$$GET 1^DIQ(430, APIEN_",", 7,"I")="" ; Qu it if no P ATIENT IEN . Q:$$GET 1^DIQ(430, APIEN_",", 9,"I")="" ; Qu it if no D EBTOR info rmation . Q:$$GET1^D IQ(430,API EN_",",239 ,"I")="" ; quit if no subs criber nam e stored . Q:$$GET1^ DIQ(430,AP IEN_",",24 3,"I")="" ; quit if no gro up name st ored . Q:$ $GET1^DIQ( 430,APIEN_ ",",244,"I ")="" ; quit if no group n umber stor ed . Q:$$B ILLREJ^PRC AUDT(APIEN ) ; PRCA*4 .5*321 - c laim has r eject mess ages, do n ot audit . ; . S RAT EIEN=$$GET 1^DIQ(399, APIEN_",", .07,"I") ; Get bill' s rate typ e ; IA 411 8 . Q:'RAT EIEN . ; A rate type is auto-a udited if BILL RESUL TING FROM field is n on-null . Q:'$$GET1^ DIQ(399.3, RATEIEN_", ",.11,"I") ; Quit if not an au to-audit r ate type . ;Read on IB file #3 99 field # 27 covered by ICR #3 820 . S RC PAPER=$$GE T1^DIQ(399 ,APIEN_"," ,27,"I") ; 0 - is el ectronic, 1 - is pap er. S THIS TYP=$$GET1 ^DIQ(399,A PIEN_",",. 07,"E") | |
97 | . ;Get th e Bill num ber to che ck if it i s a Pharma cy bill . S PRCABLNO =$$GET1^DI Q(430,APIE N_",",.01, "I") . S P RCAECME=$$ GETECME^RC DPENR1(PRC ABLNO) . I PRCAECME= "",'FLG1,R CPAPER Q ;Skip t his paper bill if No Medical p rocessing . I PRCAEC ME'="",'FL G2,RCPAPER Q ;Ski p this pap er bill if No Pharma cy process ing . I PR CAECME="", 'FLG1E,'RC PAPER Q ;Skip th is EDI bil l if No Me dical proc essing . I PRCAECME' ="",'FLG2E ,'RCPAPER Q ;Skip this EDI bill if No Pharmacy processing . I THISTY P["TRICARE ",THISTYP’ [“CHAMPVA” ,’FLGTR Q ; Skip if no no aut o audit of Tricare b ills | |
98 | . ; . ; B ill Passed all check s now call auto-audi t for this Bill numb er . D AUD ITX^PRCAUD T(APIEN) Q | |
99 | ||
100 | ||
101 | Routines | |
102 | Activities | |
103 | Routine Na me | |
104 | RCDPESP5 | |
105 | Enhancemen t Category | |
106 | New | |
107 | Modify | |
108 | Delete | |
109 | No Change | |
110 | RTM | |
111 | ||
112 | Related Op tions | |
113 | RCDPE EDI LOCKBOX PA RAMETERS | |
114 | ||
115 | Related Ro utines | |
116 | Routines “ Called By” | |
117 | Routines “ Called” | |
118 | ||
119 | RCDPESP | |
120 | $$VAL^RCDP CRR | |
121 | GETCODES^R CDPCRR | |
122 | AUDIT^RCDP ESP | |
123 | $$ACT^RCDP RU | |
124 | ||
125 | Current Lo gic | |
126 | . | |
127 | . | |
128 | . | |
129 | AUDIT() ; ; N EMEDAN S,EOLDMED, EOLDRX,ERX ANS,MEDANS ,OLDMED,OL DRX,RXANS ; PRCA*4.5 *321 ; ; G et existin g answers for Medica l and Phar macy paper bills S O LDMED=$$GE T1^DIQ(342 ,"1,",7.05 ,"I") S OL DRX=$$GET1 ^DIQ(342," 1,",7.06," I") ; ; Ge t existing answers f or Medical and Pharm acy EDI (e lectronic) bills ; P RCA*4.5*32 1 S EOLDME D=$$GET1^D IQ(342,"1, ",7.07,"I" ) ; PRCA*4 .5*321 S E OLDRX=$$GE T1^DIQ(342 ,"1,",7.08 ,"I") ; PR CA*4.5*321 ; ; Get M edical pap er bills S MEDANS=$$ GETAUDIT(1 ) Q:MEDANS =-1 1 ; Fi le Medical paper bil ls I MEDAN S'=OLDMED D . N RCAU DVAL . D F ILEANS(7.0 5,MEDANS) . ; FILE N UMBER^FIEL D NUMBER^I EN^NEW VAL UE^OLD VAL UE^COMMENT . S RCAUD VAL(1)="34 2^7.05^1^" _MEDANS_U_ OLDMED_U_" Updating t he Medical Auto-Audi t of paper bills" . D AUDIT^RC DPESP(.RCA UDVAL) ; ; Get Pharm acy paper bills S RX ANS=$$GETA UDIT(2) Q: RXANS=-1 1 ; ; File Pharmacy p aper bills I RXANS'= OLDRX D . N RCAUDVAL . D FILEA NS(7.06,RX ANS) . S R CAUDVAL(1) ="342^7.06 ^1^"_RXANS _U_OLDRX_U _"Updating the Pharm acy Auto-A udit of pa per bills" . D AUDIT ^RCDPESP(. RCAUDVAL) ; ; BEGIN PRCA*4.5* 321 ; Get Medical el ectronic b ills S EME DANS=$$GET AUDIT(3) Q :EMEDANS=- 1 1 ; File Medical e lectronic bills I EM EDANS'=EOL DMED D . N RCAUDVAL . D FILEAN S(7.07,EME DANS) . ; FILE NUMBE R^FIELD NU MBER^IEN^N EW VALUE^O LD VALUE^C OMMENT . S RCAUDVAL( 1)="342^7. 07^1^"_EME DANS_U_EOL DMED_U_"Up dating the Medical A uto-Audit of electro nic bills" . D AUDIT ^RCDPESP(. RCAUDVAL) ; ; Get Ph armacy ele ctronic bi lls S ERXA NS=$$GETAU DIT(4) Q:E RXANS=-1 1 ; ; File Pharmacy e lectronic bills I ER XANS'=EOLD RX D . N R CAUDVAL . D FILEANS( 7.08,ERXAN S) . S RCA UDVAL(1)=" 342^7.08^1 ^"_ERXANS_ U_EOLDRX_U _"Updating the Pharm acy Auto-A udit of el ectronic b ills" . D AUDIT^RCDP ESP(.RCAUD VAL) ; END PRCA*4.5* 321 ; Q 0 ; ;Retriev e the para meter for the bill t ypeGETAUDI T(FLAG) ; ; BEGIN PR CA*4.5*321 ;FLAG - W hat audit type (1=Me d Paper, 2 =RX Paper, 3=Med EDI , 4=Rx EDI ) Q:'$G(FL AG) -1 N D IR,DIROUT, DIRUT,DTOU T,DUOUT,FL DNO,RCANS, TYPL,TYPU, X,Y S TYPL =$S(FLAG>2 :"electron ic",1:"pap er") S TYP U=$S(FLAG> 2:"ELECTRO NIC",1:"PA PER") S FL DNO=$S(FLA G=1:7.05,F LAG=2:7.06 ,FLAG=3:7. 07,FLAG=4: 7.08,1:0) Q:'FLDNO - 1 ; ; Prom pt for Med ical Auto- audit D:$G (FLAG)#2=1 . S DIR(" A")="ENABL E AUTO-AUD IT FOR MED ICAL "_TYP U_" BILLS (Y/N): " . S DIR("?" ,1)="Allow a site to automatic ally audit their Med ical "_TYP L_" Bills" . S DIR(" ?",2)="dur ing the AR Nightly P rocess." . S DIR("?" ,3)=" " . S RCANS=$$ GET1^DIQ(3 42,"1,",FL DNO) ; ; P rompt for Pharmacy A uto-audit D:$G(FLAG) #2=0 . S D IR("A")="E NABLE AUTO -AUDIT FOR PHARMACY "_TYPU_" B ILLS (Y/N) : " . S DI R("?",1)=" Allow a si te to auto matically audit thei r Pharmacy "_TYPL_" Bills" . S DIR("?",2 )="during the AR Nig htly Proce ss." . S D IR("?",3)= " " . S RC ANS=$$GET1 ^DIQ(342," 1,",FLDNO) ; END PRC A*4.5*321 ; S DIR(0) ="YAO" S D IR("?")="E nter Yes o r No to se lect autom atic proce ssing of " _TYPL_" bi lls." ; PR CA*4.5*321 S DIR("B" )=$S($G(RC ANS)'="":R CANS,1:"No ") D ^DIR K DIR I Y= "" Q "" I $D(DTOUT)! $D(DUOUT)! (Y="") Q - 1 Q Y | |
130 | ||
131 | Modified L ogic (Chan ges are in bold) | |
132 | . | |
133 | . | |
134 | . | |
135 | AUDIT() ; ; N EMEDAN S,EOLDMED, EOLDRX,ERX ANS,MEDANS ,OLDMED,OL DRX,OLDTR, RXANS,TRAN S ; PRCA*4 .5*321 ; ; Get exist ing answer s for Medi cal and Ph armacy pap er bills S OLDMED=$$ GET1^DIQ(3 42,"1,",7. 05,"I") S OLDRX=$$GE T1^DIQ(342 ,"1,",7.06 ,"I") | |
136 | ;; Get ex isting ans wer for Tr icare bill s | |
137 | S OLDTR=$$ GET1^DIQ(3 42,"1,",7. 09,"I") ; ; Get exis ting answe rs for Med ical and P harmacy ED I (electro nic) bills ; PRCA*4. 5*321 S EO LDMED=$$GE T1^DIQ(342 ,"1,",7.07 ,"I") ; PR CA*4.5*321 S EOLDRX= $$GET1^DIQ (342,"1,", 7.08,"I") ; PRCA*4.5 *321 ; ; G et Medical paper bil ls S MEDAN S=$$GETAUD IT(1) Q:ME DANS=-1 1 ; File Med ical paper bills I M EDANS'=OLD MED D . N RCAUDVAL . D FILEANS (7.05,MEDA NS) . ; FI LE NUMBER^ FIELD NUMB ER^IEN^NEW VALUE^OLD VALUE^COM MENT . S R CAUDVAL(1) ="342^7.05 ^1^"_MEDAN S_U_OLDMED _U_"Updati ng the Med ical Auto- Audit of p aper bills " . D AUDI T^RCDPESP( .RCAUDVAL) ; ; Get P harmacy pa per bills S RXANS=$$ GETAUDIT(2 ) Q:RXANS= -1 1 ; ; F ile Pharma cy paper b ills I RXA NS'=OLDRX D . N RCAU DVAL . D F ILEANS(7.0 6,RXANS) . S RCAUDVA L(1)="342^ 7.06^1^"_R XANS_U_OLD RX_U_"Upda ting the P harmacy Au to-Audit o f paper bi lls" . D A UDIT^RCDPE SP(.RCAUDV AL) | |
138 | ; S TRANS =$$GETAUDI T(5) Q:TRA NS=-1 1 ; File Trica re bills I TRANS'=OL DTR D . N RCAUDVAL . D FILEANS (7.09,TRAN S) . ; FIL E NUMBER^F IELD NUMBE R^IEN^NEW VALUE^OLD VALUE^COMM ENT . S RC AUDVAL(1)= "342^7.09^ 1^"_TRANS_ U_OLDTR_U_ "Updating the Auto-A udit of Tr icare bill s" . D AUD IT^RCDPESP (.RCAUDVAL ); ; BEGI N PRCA*4.5 *321 ; Get Medical e lectronic bills S EM EDANS=$$GE TAUDIT(3) Q:EMEDANS= -1 1 ; Fil e Medical electronic bills I E MEDANS'=EO LDMED D . N RCAUDVAL . D FILEA NS(7.07,EM EDANS) . ; FILE NUMB ER^FIELD N UMBER^IEN^ NEW VALUE^ OLD VALUE^ COMMENT . S RCAUDVAL (1)="342^7 .07^1^"_EM EDANS_U_EO LDMED_U_"U pdating th e Medical Auto-Audit of electr onic bills " . D AUDI T^RCDPESP( .RCAUDVAL) ; ; Get P harmacy el ectronic b ills S ERX ANS=$$GETA UDIT(4) Q: ERXANS=-1 1 ; ; File Pharmacy electronic bills I E RXANS'=EOL DRX D . N RCAUDVAL . D FILEANS (7.08,ERXA NS) . S RC AUDVAL(1)= "342^7.08^ 1^"_ERXANS _U_EOLDRX_ U_"Updatin g the Phar macy Auto- Audit of e lectronic bills" . D AUDIT^RCD PESP(.RCAU DVAL) ; EN D PRCA*4.5 *321 ; Q 0 ; ;Retrie ve the par ameter for the bill typeGETAUD IT(FLAG) ; ; BEGIN P RCA*4.5*32 1 ;FLAG - What audit type (1=M ed Paper, 2=RX Paper , 3=Med ED I, 4=Rx ED I), 5=Tric are Q:'$G( FLAG) -1 N DIR,DIROU T,DIRUT,DT OUT,DUOUT, FLDNO,RCAN S,TYPL,TYP U,X,Y S TY PL=$S(FLAG >2:"electr onic",1:"p aper") S T YPU=$S(FLA G>2:"ELECT RONIC",1:" PAPER") S FLDNO=$S(F LAG=1:7.05 ,FLAG=2:7. 06,FLAG=3: 7.07,FLAG= 4:7.08,1:0 ) Q:'FLDNO -1 ; ; Pr ompt for M edical Aut o-audit D: $G(FLAG)#2 =1 . S DIR ("A")="ENA BLE AUTO-A UDIT FOR M EDICAL "_T YPU_" BILL S (Y/N): " . S DIR(" ?",1)="All ow a site to automat ically aud it their M edical "_T YPL_" Bill s" . S DIR ("?",2)="d uring the AR Nightly Process." . S DIR(" ?",3)=" " . S RCANS= $$GET1^DIQ (342,"1,", FLDNO) ; ; Prompt fo r Pharmacy Auto-audi t D:$G(FLA G)#2=0 . S DIR("A")= "ENABLE AU TO-AUDIT F OR PHARMAC Y "_TYPU_" BILLS (Y/ N): " . S DIR("?",1) ="Allow a site to au tomaticall y audit th eir Pharma cy "_TYPL_ " Bills" . S DIR("?" ,2)="durin g the AR N ightly Pro cess." . S DIR("?",3 )=" " . S RCANS=$$GE T1^DIQ(342 ,"1,",FLDN O) ; END P RCA*4.5*32 1 ; | |
139 | ; Prompt for Tricar e Auto-aud it D:$G(FL AG)=5 . S DIR("A")=" ENABLE AUT O-AUDIT FO R TRICARE BILLS (Y/N ): " . S D IR("?",1)= "Allow a s ite to aut omatically audit the ir Tricare Bills" . S DIR("?", 2)="during the AR Ni ghtly Proc ess." . S DIR("?",3) =" " . S R CANS=$$GET 1^DIQ(342, "1,",7.09) ; S DIR(0) ="YAO" S D IR("?")="E nter Yes o r No to se lect autom atic proce ssing of " _TYPL_" bi lls." ; PR CA*4.5*321 S DIR("B" )=$S($G(RC ANS)'="":R CANS,1:"No ") D ^DIR K DIR I Y= "" Q "" I $D(DTOUT)! $D(DUOUT)! (Y="") Q - 1 Q Y |
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