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1 | eInsurance_IB_2.0_602.zip | TAS eIns US3968 SDD v1.0.docx | Wed Feb 27 18:49:32 2019 UTC |
2 | eInsurance_IB_2.0_602.zip | TAS eIns US3968 SDD v1.0.docx | Wed Mar 20 16:53:10 2019 UTC |
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1 | http | |||||
2 | MCCF EDI T AS EINSURA NCE US3968 | |||||
3 | System Des ign Docume nt | |||||
4 | IB*2.0*602 | |||||
5 | ||||||
6 | ||||||
7 | ||||||
8 | ||||||
9 | Department of Vetera ns Affairs | |||||
10 | April 2018 | |||||
11 | Version 1. 0 | |||||
12 | User Story Number: U S3968 | |||||
13 | User Story Name: Rem ove all ed its from M EDICARE (W NR) Subscr iber ID du ring Fee P atient Inq uiry | |||||
14 | ||||||
15 | ||||||
16 | ||||||
17 | Epic Taxon omy | |||||
18 | eBiz Com pliance Port Upd ate Increase No Touch TAS Apps | |||||
19 | Story: | |||||
20 | As a... | |||||
21 | I want to. .. | |||||
22 | So that... | |||||
23 | Fee Patien t Inquiry user | |||||
24 | be able to enter MED ICARE (WNR ) Subscrib er ID in a ny format, without d ata format validatio n | |||||
25 | I can ente r HICN or MBI withou t conformi ng to any specified format. | |||||
26 | Design | |||||
27 | ||||||
28 | Routines | |||||
29 | Activities | |||||
30 | Routine Na me | |||||
31 | IBCNSMM | |||||
32 | Enhancemen t Category | |||||
33 | New | |||||
34 | Modify | |||||
35 | Delete | |||||
36 | No Change | |||||
37 | RTM | |||||
38 | ||||||
39 | Related Op tions | |||||
40 | Fee Patien t Inquiry” [FBAA PAT IENT INQUI RY] | |||||
41 | Related Ro utines | |||||
42 | Routines “ Called By” | |||||
43 | Routines “ Called” | |||||
44 | ||||||
45 | ||||||
46 | ^DIC | |||||
47 | FILE^DICN | |||||
48 | FIELD^DID | |||||
49 | ^DIR | |||||
50 | DISP^IBCNS | |||||
51 | $$ZND^IBCN S1 | |||||
52 | $$GETWNR^I BCNSMM1 | |||||
53 | BUFF^IBCNS MM1 | |||||
54 | SETP^IBCNS MM1 | |||||
55 | MII^IBCNSM M2 | |||||
56 | $$FMTE^XLF DT | |||||
57 | Routines | |||||
58 | Activities | |||||
59 | Data Dicti onary (DD) Reference s | |||||
60 | ||||||
61 | Related Pr otocols | |||||
62 | ||||||
63 | Related In tegration Control Re gistration s (ICRs) | |||||
64 | ||||||
65 | Data Passi ng | |||||
66 | Input | |||||
67 | Output Re ference | |||||
68 | Both | |||||
69 | Global Re ference | |||||
70 | Local | |||||
71 | Input Attr ibute Name and Defin ition | |||||
72 | Name: | |||||
73 | Definition : | |||||
74 | Output Att ribute Nam e and Defi nition | |||||
75 | Name: | |||||
76 | Definition : | |||||
77 | Current Lo gic | |||||
78 | . IBCNSMM ;ALB/CMS - MEDICARE I NSURANCE I NTAKE ; 18 -OCT-98 ;; 2.0;INTEGR ATED BILLI NG;**103,1 33,184,516 ,601,595** ;21-MAR-94 ;Build 12 ;;Per VA D irective 6 402, this routine sh ould not b e modified . Q | |||||
79 | Modified L ogic (Chan ges are in bold) | |||||
80 | IBCNSMM ;A LB/CMS -ME DICARE INS URANCE INT AKE ; 18-O CT-98 ;;2. 0;INTEGRAT ED BILLING ;**103,133 ,184,516,6 01,595,602 **;21-MAR- 94;Build 1 2 ;;Per VA Directive 6402, thi s routine should not be modifi ed. Q | |||||
81 | Current Lo gic | |||||
82 | ENR(DFN,IB SOUR,IBOPT ) ; -- Ent ry point f rom IBCNBM E Patient Registrati on or Pre- Registrati on ; Input Variable DFN Requir ed and IBS OUR =Sourc e of Infor mation ; I BOPT =1 if coming fr om MII Sta ndalone Op tion ; N D ,DIE,DA,DI R,DIC,E,IB CPOL,IBCNS P,IBCDFN,I BQUIT,IBOK ,IBC0,IBAD ,IBGRP,IBA DPOL N IBN AME,IBHICN ,IBAEFF,IB BEFF,IBCOV P,IBGNA,IB GNU,IBBUF, IBNEW,IBP, X,Y N IBPO LA,IBPOLB, IBARR,IBHI T,IBHITA,I BHITB,IBCO B,IBCOBI ; S (IBAEFF ,IBBEFF,IB CNSP,IBCDF N,IBNEW,IB QUIT)=0,IB ADPOL=1 S (IBNAME,IB HICN)="" | |||||
83 | Modified L ogic (Chan ges are in bold) | |||||
84 | ENR(DFN,IB SOUR,IBOPT ) ; -- Ent ry point f rom IBCNBM E Patient Registrati on or Pre- Registrati on ; Input Variable DFN Requir ed and IBS OUR =Sourc e of Infor mation ; I BOPT =1 if coming fr om MII Sta ndalone Op tion ; N D ,DIE,DA,DI R,DIC,E,IB CPOL,IBCNS P,IBCDFN,I BQUIT,IBOK ,IBC0,IBAD ,IBGRP,IBA DPOL N IBN AME,IBHICN ,IBAEFF,IB BEFF,IBCOV P,IBGNA,IB GNU,IBBUF, IBNEW,IBP, X,Y N IBPO LA,IBPOLB, IBARR,IBHI T,IBHITA,I BHITB,IBCO B,IBCOBI ; ; IB*602 - IBHICN c ould also be a Medic are Benefi ciary ID S (IBAEFF,I BBEFF,IBCN SP,IBCDFN, IBNEW,IBQU IT)=0,IBAD POL=1 S (I BNAME,IBHI CN)="" | |||||
85 | ||||||
86 | ||||||
87 | ||||||
88 | Routines | |||||
89 | Activities | |||||
90 | Routine Na me | |||||
91 | IBCNSMM1 | |||||
92 | Enhancemen t Category | |||||
93 | New | |||||
94 | Modify | |||||
95 | Delete | |||||
96 | No Change | |||||
97 | RTM | |||||
98 | ||||||
99 | Related Op tions | |||||
100 | ||||||
101 | Related Ro utines | |||||
102 | Routines “ Called By” | |||||
103 | Routines “ Called” | |||||
104 | ||||||
105 | ||||||
106 | ^DIE | |||||
107 | ^DIR | |||||
108 | $$ADDSTF^I BCNBES | |||||
109 | ^IBCNSEVT | |||||
110 | AFTER^IBCN SEVT | |||||
111 | BEFORE^IBC NSEVT | |||||
112 | COVERED^IB CNSM31 | |||||
113 | ||||||
114 | Routines | |||||
115 | Activities | |||||
116 | Data Dicti onary (DD) Reference s | |||||
117 | ||||||
118 | Related Pr otocols | |||||
119 | ||||||
120 | Related In tegration Control Re gistration s (ICRs) | |||||
121 | ||||||
122 | Data Passi ng | |||||
123 | Input | |||||
124 | Output Re ference | |||||
125 | Both | |||||
126 | Global Re ference | |||||
127 | Local | |||||
128 | Input Attr ibute Name and Defin ition | |||||
129 | Name: | |||||
130 | Definition : | |||||
131 | Output Att ribute Nam e and Defi nition | |||||
132 | Name: | |||||
133 | Definition : | |||||
134 | Current Lo gic | |||||
135 | IBCNSMM1 ; ALB/CMS -M EDICARE IN SURANCE IN TAKE (CONT ) ; 11/8/0 6 9:32am | |||||
136 | ; ;2.0;INTEG RATED BILL ING;**103, 359,497**; 21-MAR-94; Build 120 | |||||
137 | ; ;Per VHA D irective 1 0-93-142, this routi ne should not be mod ified. | |||||
138 | Modified L ogic (Chan ges are in bold) | |||||
139 | IBCNSMM1 ; ALB/CMS -M EDICARE IN SURANCE IN TAKE (CONT ) ; 11/8/0 6 9:32am ; ;2.0;INTEG RATED BILL ING;**103, 359,497,60 2**;21-MAR -94;Build 120 ;;Per VA Directi ve 6402, t his routin e should n ot be modi fied. ;; | |||||
140 | Current Lo gic | |||||
141 | SETP(IBP) ; -- Stuff data fiel ds in pati ent policy ; Require d Input: ; IBP =A fo r Part A, B for Part B ; DFN = pt. ien ; IBCDFN =pa tient poli cy ien ; I BNAME =Nam e of Insur ed ; IBHIC N =Subscri ber ID ; I BAEFF =Eff ective Dat e of Plan A ; IBBEFF =Effectiv e Date of Plan B ; I BCNSP =Med icare (WNR ) ien ^Par t A ien ^P art B ien ; IBCOBI = Coordinati on of Bene fits (Inte rnal value ) | |||||
142 | Modified L ogic (Chan ges are in bold) | |||||
143 | SETP(IBP) ; -- Stuff data fiel ds in pati ent policy ; Require d Input: ; IBP =A fo r Part A, B for Part B ; DFN = pt. ien ; IBCDFN =pa tient poli cy ien ; I BNAME =Nam e of Insur ed ; IBHIC N =Subscri ber ID - a s of IB*60 1 could al so be a MB I Number ; IBAEFF = Effective Date of Pl an A ; IBB EFF =Effec tive Date of Plan B ; IBCNSP = Medicare ( WNR) ien ^ Part A ien ^Part B i en ; IBCOB I =Coordin ation of B enefits (I nternal va lue) | |||||
144 | ||||||
145 | ||||||
146 | ||||||
147 | Routines | |||||
148 | Activities | |||||
149 | Routine Na me | |||||
150 | IBCNSMM2 | |||||
151 | Enhancemen t Category | |||||
152 | New | |||||
153 | Modify | |||||
154 | Delete | |||||
155 | No Change | |||||
156 | RTM | |||||
157 | ||||||
158 | Related Op tions | |||||
159 | ||||||
160 | Related Ro utines | |||||
161 | Routines “ Called By” | |||||
162 | Routines “ Called” | |||||
163 | ||||||
164 | ||||||
165 | D^DIQ | |||||
166 | ^DIR | |||||
167 | OK^IBCNSMM 1 | |||||
168 | Routines | |||||
169 | Activities | |||||
170 | Data Dicti onary (DD) Reference s | |||||
171 | ||||||
172 | Related Pr otocols | |||||
173 | ||||||
174 | Related In tegration Control Re gistration s (ICRs) | |||||
175 | ||||||
176 | Data Passi ng | |||||
177 | Input | |||||
178 | Output Re ference | |||||
179 | Both | |||||
180 | Global Re ference | |||||
181 | Local | |||||
182 | Input Attr ibute Name and Defin ition | |||||
183 | Name: | |||||
184 | Definition : | |||||
185 | Output Att ribute Nam e and Defi nition | |||||
186 | Name: | |||||
187 | Definition : | |||||
188 | Current Lo gic | |||||
189 | IBCNSMM2 ; ALB/CMS -M EDICARE IN SURANCE IN TAKE (CONT ) ; 18-MAY -99 | |||||
190 | ; ;2.0;INTEG RATED BILL ING;**103, 133**;21-M AR-94 | |||||
191 | ; ;Per VHA D irective 1 0-93-142, this routi ne should not be mod ified. | |||||
192 | Q | |||||
193 | Modified L ogic (Chan ges are in bold) | |||||
194 | IBCNSMM2 ; ALB/CMS -M EDICARE IN SURANCE IN TAKE (CONT ) ; 18-MAY -99 ;;2.0; INTEGRATED BILLING;* *103,133,6 02**;21-MA R-94 ;;Per VA Direct ive 6402, this routi ne should not be mod ified. Q | |||||
195 | Current Lo gic | |||||
196 | MIIA ; -- Ask us er for Inf ormation | |||||
197 | ; | |||||
198 | W ! S DIR(" A")="NAME OF BENEFIC IARY" | |||||
199 | S IBX=$P($G (IBARR("A" ,1)),"^",1 8) I IBX=" " S IBX=$P ($G(IBARR( "B",1)),") | |||||
200 | S DIR("B")= $S($G(IBNA ME)'="":IB NAME,IBX'= "":IBX,1:$ P(^DPT(DFN ,0),U)) | |||||
201 | S DIR(0)="F ^3:30^K:X' ?1E.E1""," ".1E.E X" | |||||
202 | S DIR("?")= "Enter the Name of B eneficiary (Last nam e, First) from the " | |||||
203 | D ^DIR K DI R | |||||
204 | I $D(DTOUT) !$D(DUOUT) K DUOUT,D TOUT,DIROU T,DIRUT S IBQUIT=1 G MIIQ | |||||
205 | S IBNAME=Y | |||||
206 | ; | |||||
207 | S DIR("A")= "MEDICARE CLAIM NUMB ER" | |||||
208 | S IBX=$P($G (IBARR("A" ,1)),"^",3 ) I IBX="" S IBX=$P( $G(IBARR(" B",1)),"^) | |||||
209 | I $G(IBHICN )'="" S DI R("B")=IBH ICN | |||||
210 | I IBX'="",' $D(DIR("B" )) S DIR(" B")=IBX | |||||
211 | S DIR(0)="F ^7:15^I '$ $VALHIC^IB CNSMM($TR( X,""-"")) K X" | |||||
212 | Modified L ogic (Chan ges are in bold) | |||||
213 | MIIA ; -- Ask user f or Informa tion ; W ! S DIR("A" )="NAME OF BENEFICIA RY" S IBX= $P($G(IBAR R("A",1)), "^",18) I IBX="" S I BX=$P($G(I BARR("B",1 )),"^",18) S DIR("B" )=$S($G(IB NAME)'="": IBNAME,IBX '="":IBX,1 :$P(^DPT(D FN,0),U)) S DIR(0)=" F^3:30^K:X '?1E.E1"", "".1E.E X" S DIR("?" )="Enter t he Name of Beneficia ry (Last n ame, First ) from the Medicare Insurance Card. This name shou ld be 3 to 30 charac ters in le ngth." D ^ DIR K DIR I $D(DTOUT )!$D(DUOUT ) K DUOUT, DTOUT,DIRO UT,DIRUT S IBQUIT=1 G MIIQ S I BNAME=Y ; S DIR("A") ="MEDICARE CLAIM NUM BER" S IBX =$P($G(IBA RR("A",1)) ,"^",3) I IBX="" S I BX=$P($G(I BARR("B",1 )),"^",3) I $G(IBHIC N)'="" S D IR("B")=IB HICN I IBX '="",'$D(D IR("B")) S DIR("B")= IBX ;S DIR (0)="F^7:1 5^I '$$VAL HIC^IBCNSM M($TR(X,"" -"")) K X" ; IB*602 S DIR(0)=" F^3:20" ;I B*602 | |||||
214 | ||||||
215 | Current Lo gic | |||||
216 | HICH ; Hel p text for the HIC n umber prom pt. W !,"E nter the M edicare Cl aim Number (Subscrib er ID) exa ctly as it appears" W !,"on th e Medicare Insurance Card, inc luding ALL character s. Valid H ICN " W !, "formats a re: 1-3 al pha charac ters follo wed by 6 o r 9 digits , or " W ! ,"9 digits followed by 1 alpha character optionall y followed by anothe r " W !,"a lpha chara cter or 1 digit." Q | |||||
217 | Modified L ogic (Chan ges are in bold) | |||||
218 | HICH ; Hel p text for the HIC n umber prom pt. W !,"E nter the M edicare Cl aim Number (Subscrib er ID) exa ctly as it appears" ; IB*602 W !,"on the Medicare Insurance Card, excl uding spec ial charac ters." | |||||
219 | W !,"Entry must be 3 -20 charac ters." Q | |||||
220 | ||||||
221 | Revision H istory | |||||
222 | Date | |||||
223 | Version | |||||
224 | Descriptio n | |||||
225 | Author | |||||
226 | 04/01/2018 | |||||
227 | 1.0 | |||||
228 | Initial dr aft | |||||
229 | Henry Norm and | |||||
230 | 11/29/2018 | |||||
231 | 1.2 | |||||
232 | Updated | |||||
233 | Henry Norm and | |||||
234 | ||||||
235 | ||||||
236 |
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