VistA-FOIAVistA/r/E_CLAIMS_MGMT_ENGINE-BPS/BPSRPT8.m

273 lines
8.6 KiB
Mathematica

BPSRPT8 ;BHAM ISC/BEE - ECME REPORTS ;14-FEB-05
;;1.0;E CLAIMS MGMT ENGINE;**1,3,5**;JUN 2004;Build 45
;;Per VHA Directive 2004-038, this routine should not be modified.
;
Q
;
;Routine to Display the Reports in Excel
;
;Print Report Line 1
;
; Input Variable -> BPRTYPE,BPDIV,BPGRPLAN,BPDFN,BPRX,BPREF,BPX,BPSRTDT
; BPBIL,BPINS,BPCOLL
;
WRLINE1(BPRTYPE,BPREC,BPDIV,BPGRPLAN,BPDFN,BPRX,BPREF,BPX,BPSRTDT,BPBIL,BPINS,BPCOLL) ;
;
;Division
S BPREC=$S(BPDIV=0:"BLANK",$$DIVNAME^BPSSCRDS(BPDIV)]"":$$DIVNAME^BPSSCRDS(BPDIV),1:BPDIV)_U
;Insurance
I BPRTYPE'=5,BPRTYPE'=6 S BPREC=BPREC_$E(BPGRPLAN,1,90)_U
S BPREC=BPREC_$$PATNAME^BPSRPT6(BPDFN)_U ;Patient Name
S BPREC=BPREC_"("_$$SSN4^BPSRPT6(BPDFN)_")"_U ;L4SSN
S BPREC=BPREC_$$RXNUM^BPSRPT6(BPRX)_$$COPAY^BPSRPT6(BPRX)_U ;RX Number
S BPREC=BPREC_BPREF_"/"_$$ECMENUM^BPSRPT1($P(BPX,U,3))_U ;Refill/ECME Number
;
I (BPRTYPE=1)!(BPRTYPE=4) D Q
. S BPREC=BPREC_$$DATTIM^BPSRPT1(BPSRTDT)_U ;Date
. S BPREC=BPREC_$TR($J(BPBIL,10,2)," ")_U ;$Billed
. S BPREC=BPREC_$TR($J(BPINS,10,2)," ")_U ;$Ins. Paid
. S BPREC=BPREC_$S(BPCOLL]"":$TR($J(BPCOLL,10,2)," "),1:"")_U ;$Collected
;
I BPRTYPE=2 D Q
. S BPREC=BPREC_$$DATTIM^BPSRPT1(BPSRTDT)_U ;Date
. S BPREC=BPREC_$$DATTIM^BPSRPT1(+BPX)_U ;Released On
. ;RX INFO
. S BPREC=BPREC_$$MWC^BPSRPT6(BPRX,BPREF)_U ;Fill Location
. S BPREC=BPREC_$$RTBCKNAM^BPSRPT1($$RTBCK^BPSRPT1($P(BPX,U,3)))_U ;Fill Type
. S BPREC=BPREC_$$RXSTATUS^BPSRPT6($P(BPX,U,3)) ;Status
. S BPREC=BPREC_$S($P(BPX,U):"/RL",1:"/NR")_U ;RL/NR
;
I BPRTYPE=3 D Q
. S BPREC=BPREC_$$DATTIM^BPSRPT1(BPSRTDT)_U ;Date
. S BPREC=BPREC_$TR($J(BPBIL,10,2)," ")_U ;$Billed
. S BPREC=BPREC_$TR($J(BPINS,10,2)," ")_U ;Insurance Response
;
I BPRTYPE=5 D Q
. S BPREC=BPREC_$$DATTIM^BPSRPT1($$TRANDT^BPSRPT2($P(BPX,U,3),1))_U ;Completed
. S BPREC=BPREC_$$TTYPE^BPSRPT7($P(BPX,U,4),$P(BPX,U,5))_U ;Trans Type
. S BPREC=BPREC_$$RESPONSE^BPSRPT7($P(BPX,U,4),$P(BPX,U,5))_U ;Payer Response
;
I BPRTYPE=7 D Q
. ;RX INFO
. S BPREC=BPREC_$$MWC^BPSRPT6(BPRX,BPREF)_U ;Fill Location
. S BPREC=BPREC_$$RTBCKNAM^BPSRPT1($$RTBCK^BPSRPT1($P(BPX,U,3)))_U ;Fill Type
. S BPREC=BPREC_$$RXSTATUS^BPSRPT6($P(BPX,U,3)) ;Status
. S BPREC=BPREC_$S($P(BPX,U):"/RL",1:"/NR")_U ;RL/NR
. S BPREC=BPREC_$S($P(BPX,U,13):"REJ",1:"")_U
. S BPREC=BPREC_$$DRGNAM^BPSRPT6($P(BPX,U,14),32)_U ;Drug
. S BPREC=BPREC_$TR($$GETNDC^BPSRPT6(BPRX,BPREF),"-")_U
Q
;
;Print Report Line 2
;
; Input Variable -> BPRTYPE,BPX,BPRX,BPREF,BPBIL,BPGRPLAN
;
WRLINE2(BPRTYPE,BPREC,BPX,BPRX,BPREF,BPBIL,BPGRPLAN) ;
I (BPRTYPE=1)!(BPRTYPE=4) D Q
. ;Drug, Released On
. S BPREC=BPREC_$$DRGNAM^BPSRPT6($P(BPX,U,14),32)_U_$TR($$GETNDC^BPSRPT6(BPRX,BPREF),"-")_U
. S BPREC=BPREC_$$DATTIM^BPSRPT1(+BPX)_U
. ;RX INFO
. S BPREC=BPREC_$$MWC^BPSRPT6(BPRX,BPREF)_U ;Fill Location
. S BPREC=BPREC_$$RTBCKNAM^BPSRPT1($$RTBCK^BPSRPT1($P(BPX,U,3)))_U ;Fill Type
. S BPREC=BPREC_$$RXSTATUS^BPSRPT6($P(BPX,U,3)) ;Status
. S BPREC=BPREC_$S($P(BPX,U):"/RL",1:"/NR")_U ;RL/NR
. S BPREC=BPREC_$S($P(BPX,U,13):"REJ",1:"")
. I BPRTYPE=1 S BPREC=BPREC_U_$$BILL^BPSRPT6(BPRX,BPREF) ;Bill #
;
I BPRTYPE=2 D Q
. S BPREC=BPREC_$E($$CRDHLDID^BPSRPT2(+$P(BPX,U,3)),3,23)_U ;Cardholder ID
. S BPREC=BPREC_$E($$GRPID^BPSRPT2(+$P(BPX,U,3)),3,10)_U ;Group ID
. S BPREC=BPREC_$TR($J(BPBIL,10,2)," ")_U ;$Billed
. S BPREC=BPREC_$$QTY^BPSRPT6($P(BPX,U,3))_U ;Qty
. S BPREC=BPREC_$$GETNDC^BPSRPT6(BPRX,BPREF)_U ;NDC#
. S BPREC=BPREC_$$DRGNAM^BPSRPT6($P(BPX,U,14),32)_U ;Drug
;
I BPRTYPE=3 D Q
. S BPREC=BPREC_$$DRGNAM^BPSRPT6($P(BPX,U,14),32)_U ;Drug
. S BPREC=BPREC_$TR($$GETNDC^BPSRPT6(BPRX,BPREF),"-")_U
. ;RX INFO
. S BPREC=BPREC_$$MWC^BPSRPT6(BPRX,BPREF)_U ;Fill Location
. S BPREC=BPREC_$$RTBCKNAM^BPSRPT1($$RTBCK^BPSRPT1($P(BPX,U,3)))_U ;Fill Type
. S BPREC=BPREC_$$RXSTATUS^BPSRPT6($P(BPX,U,3)) ;Status
. S BPREC=BPREC_$S($P(BPX,U):"/RL",1:"/NR")_U ;RL/NR
. S BPREC=BPREC_$S($P(BPX,U,13):"REJ",1:"")
;
I BPRTYPE=5 D Q
. S BPREC=BPREC_$$DRGNAM^BPSRPT6($P(BPX,U,14),32)_U ;Drug
. S BPREC=BPREC_$TR($$GETNDC^BPSRPT6(BPRX,BPREF),"-")_U
. ;RX INFO
. S BPREC=BPREC_$$MWC^BPSRPT6(BPRX,BPREF)_U ;Fill Location
. S BPREC=BPREC_$$RTBCKNAM^BPSRPT1($$RTBCK^BPSRPT1($P(BPX,U,3)))_U ;Fill Type
. S BPREC=BPREC_$$RXSTATUS^BPSRPT6($P(BPX,U,3)) ;Status
. S BPREC=BPREC_$S($P(BPX,U):"/RL",1:"/NR")_U ;RL/NR
. S BPREC=BPREC_$S($P(BPX,U,13):"REJ",1:"")_U
. I $P(BPGRPLAN,U,2)]"" S BPREC=BPREC_$E($P(BPGRPLAN,U,2),1,30) ;Insurance
. S BPREC=BPREC_U_$$ELAPSE^BPSRPT6($P(BPX,U,3)) ;Elapsed Time
;
I BPRTYPE=7 D Q
. S BPREC=BPREC_$E($$CRDHLDID^BPSRPT2(+$P(BPX,U,3)),3,23)_U ;Cardholder ID
. S BPREC=BPREC_$E($$GRPID^BPSRPT2(+$P(BPX,U,3)),3,10)_U ;Group ID
. S BPREC=BPREC_$$DATTIM^BPSRPT1(+$$CLOSEDT^BPSRPT2(+$P(BPX,U,3)))_U ;Close Dt/Time
. S BPREC=BPREC_$E($$CLSBY^BPSRPT6(+$P(BPX,U,3)),1,25)_U ;Close By
. S BPREC=BPREC_$E($P($$CLRSN^BPSRPT7(+$P(BPX,U,3)),U,2),1,30)_U ;Close Reason
Q
;
;Print Report Line 3
;
; Input Variable -> BPRTYPE,BPX
;
WRLINE3(BPRTYPE,BPREC,BPX) N BP59,BPSARR,BPRJCNT,BPZZ
S BP59=+$P(BPX,U,3)
;
I (",2,7,")[BPRTYPE D Q
.S BPREC=BPREC_$$CLAIMID^BPSRPT2(BP59)_U ;Claim ID
.S BPRJCNT=$$REJTEXT^BPSRPT2(BP59,.BPSARR)
.F BPZZ=1:1:BPRJCNT S:BPZZ'=1 BPREC=BPREC_"," S BPREC=BPREC_$P(BPSARR(BPZZ),":")
.;
.;Write one record per reject/close code
.S:+BPRJCNT=0 BPRJCNT=1
.F BPZZ=1:1:BPRJCNT W !,$G(BPREC),U,$P($G(BPSARR(BPZZ)),":"),U,$P($G(BPSARR(BPZZ)),":",2)
;
I BPRTYPE=4 D
. ;Method
. I $$AUTOREV^BPSRPT1(BP59) S BPREC=BPREC_U_"AUTO"_U
. E S BPREC=BPREC_U_"REGULAR"_U
. ;Return Status
. I $P(BPX,U,15)["ACCEPTED" S BPREC=BPREC_"ACCEPTED"_U
. E S BPREC=BPREC_"REJECTED"_U
. ;Reason
. S BPREC=BPREC_$$RVSRSN^BPSRPT7(+$P(BPX,U,3))
;
;Write the record
W !,$G(BPREC)
Q
;
;Print Excel Header
;
HDR(BPRTYPE) ;
;
;Check if header already printed
I $G(BPSDATA) Q
S BPSDATA=1
;
;Division
W !,"DIVISION",U
;
I BPRTYPE'=5,BPRTYPE'=6 W "INSURANCE",U
;
I (",1,2,3,4,5,7,")[BPRTYPE W "PATIENT NAME",U,"Pt.ID",U,"RX#",U,"REF/ECME#",U
;
I (BPRTYPE=1)!(BPRTYPE=4) D Q
. W "DATE",U
. W "$BILLED",U
. W "$INS RESPONSE",U
. W "$COLLECT",U
. W "DRUG",U
. W "NDC",U
. W "RELEASED ON",U
. W "FILL LOCATION",U
. W "FILL TYPE",U
. W "STATUS",U
. W "REJECTED"
. I BPRTYPE=1 W U,"BILL#"
. I BPRTYPE=4 W U,"REVERSAL METHOD",U,"RETURN STATUS",U,"REASON"
;
I BPRTYPE=2 D Q
. W "DATE",U
. W "RELEASED ON",U
. W "FILL LOCATION",U
. W "FILL TYPE",U
. W "STATUS",U
. W "CARDHOLD.ID",U
. W "GROUP ID",U
. W "$BILLED",U
. W "QTY",U
. W "NDC#",U
. W "DRUG",U
. W "CLAIM ID",U
. W "REJECT CODE(S)",U
. W "REJECT CODE",U
. W "REJECT EXPLANATION"
;
I BPRTYPE=3 D Q
. W "DATE",U
. W "$BILLED",U
. W "$INS RESPONSE",U
. W "DRUG",U
. W "NDC",U
. W "FILL LOCATION",U
. W "FILL TYPE",U
. W "STATUS",U
. W "REJECTED"
;
I BPRTYPE=5 D Q
. W "COMPLETED",U
. W "TRANS TYPE",U
. W "PAYER RESPONSE",U
. W "DRUG",U
. W "NDC",U
. W "FILL LOCATION",U
. W "FILL TYPE",U
. W "STATUS",U
. W "REJECTED",U
. W "INSURANCE",U
. W "ELAP TIME IN SECONDS"
;
I BPRTYPE=6 D Q
.W "DATE",U
.W "#CLAIMS",U
.W "AMOUNT SUBMITTED",U
.W "RETURNED REJECTED",U
.W "RETURNED PAYABLE",U
.W "AMOUNT TO RECEIVE",U
.W "DIFFERENCE"
;
I BPRTYPE=7 D Q
. W "FILL LOCATION",U
. W "FILL TYPE",U
. W "STATUS",U
. W "REJECTED",U
. W "DRUG",U
. W "NDC",U
. W "CARDHOLD.ID",U
. W "GROUP ID",U
. W "CLOSE DATE/TIME",U
. W "CLOSED BY",U
. W "CLOSE REASON",U
. W "CLAIM ID",U
. W "REJECT CODE(S)",U
. W "REJECT CODE",U
. W "REJECT EXPLANATION"
Q
;
;Print Report Insurance Subtotals
;
ITOT(BPRTYPE,BPDIV,BPGRPLAN,BPTBIL,BPTINS,BPTCOLL,BPCNT) N BPNP
I (BPRTYPE=1)!(BPRTYPE=4) D Q
.W !!,?78,"----------",?100,"----------",?122,"----------"
.W !,"SUBTOTALS for INS:",$E(BPGRPLAN,1,50),?78,$J(BPTBIL,10,2),?100,$J(BPTINS,10,2),?122,$J(BPTCOLL,10,2)
.W !,"COUNT",?78,$J(BPCNT,10),?100,$J(BPCNT,10),?122,$J(BPCNT,10)
.W:BPCNT !,"MEAN",?78,$J(BPTBIL/BPCNT,10,2),?100,$J(BPTINS/BPCNT,10,2),?122,$J(BPTCOLL/BPCNT,10,2)
I BPRTYPE=3 D Q
.W !!,?100,"----------",?122,"----------"
.W !,"SUBTOTALS for INS:",$E(BPGRPLAN,1,50),?100,$J(BPTBIL,10,2),?122,$J(BPTINS,10,2)
.W !,"COUNT",?100,$J(BPCNT,10),?122,$J(BPCNT,10)
.W:BPCNT !,"MEAN",?100,$J(BPTBIL/BPCNT,10,2),?122,$J(BPTINS/BPCNT,10,2)
I BPRTYPE=2 D Q
.W !!,?41,"----------"
.W !,"SUBTOTALS for INS:",$E(BPGRPLAN,1,22),?41,$J(BPTBIL,10,2)
.W !,"COUNT",?41,$J(BPCNT,10)
.W:BPCNT !,"MEAN",?41,$J(BPTBIL/BPCNT,10,2)
I (BPRTYPE=7) D Q
.W !!,"SUBTOTALS for INS:",$E(BPGRPLAN,1,50)
.N BPBILR
.S BPBILR="" F S BPBILR=$O(BPCNT(BPBILR)) Q:BPBILR="" D Q:BPQ
..S BPNP=$$CHKP^BPSRPT5(1) Q:BPQ
..W !,?3,BPBILR,?65,$J($G(BPCNT(BPBILR)),5)
.Q:$G(BPQ)
.W !,?65,"-----"
.W !,"CLOSED CLAIMS SUBTOTAL",?65,$J(BPCNT,5)
;
Q