178 lines
7.5 KiB
Mathematica
178 lines
7.5 KiB
Mathematica
IBCE837A ;ALB/TMP - OUTPUT FOR 837 TRANSMISSION - CONTINUED ;8/6/03 10:50am
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;;2.0;INTEGRATED BILLING;**137,191,211,232,296**;21-MAR-94
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;
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UPD(MSGNUM,BATCH,CNT,BILLS,DESC,IBBTYP,IBINS) ; Upd current batch + bills w/new status
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;MSGNUM = mail msg # for batch
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;BATCH = batch #
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;CNT = # of bills in batch
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;BILLS = array BILLS(bill ien in 364) in batch
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;DESC = 1-80 character description of batch
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;IBBTYP = X-Y where X = P for professional or I for institution
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; Y = 1 for test or 0 for live transmission
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; or 2 for live claim resubmitted as test
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;IBINS = ien of single insurance company for the batch (optional)
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;
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N DIC,DIE,DR,DA,IBBATCH,IBIFN,IBIEN,IBYY,IBTXTEST,IBMRA
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S IBBATCH=$O(^IBA(364.1,"B",+BATCH,"")) Q:'IBBATCH
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S IBTXTEST=+$P(IBBTYP,"-",2)
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I '$P($G(^IBE(350.9,1,8)),U,7) S IBINS=""
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;
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S DIE="^IBA(364.1,",DA=IBBATCH,DR=".02////P;.03///"_CNT_";.04///"_MSGNUM_";.05///0;.07////1;.08///^S X="""_DESC_""""_$S($G(IBINS):";.12////"_IBINS,1:"")
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;
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I '$P($G(^TMP("IBRESUBMIT",$J)),U,3) S DR=DR_";1.01///NOW;1.02///.5"
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I $P($G(^TMP("IBRESUBMIT",$J)),U,2) S DR=DR_";.15////"_$P(^($J),U,2)
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;
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S DR=DR_";.14////"_$S('IBTXTEST:0,1:1)_";.06////"_$S($E(IBBTYP)="P":2,1:3) D ^DIE ; Update batch
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;
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I IBTXTEST=2 D ADDTXM^IBCEPTM(.BILLS,IBBATCH,$$NOW^XLFDT()) Q
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I IBTXTEST'=2 S IBIEN=0 F S IBIEN=$O(BILLS(IBIEN)) Q:'IBIEN D ;Update each bill
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.S DA=IBIEN,DIE="^IBA(364,",DR=".02////"_IBBATCH_";.03///P;.04///NOW" D ^DIE
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.S IBIFN=+$G(^IBA(364,IBIEN,0))
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.Q:$D(^TMP("IBRESUBMIT",$J))!($P($G(^DGCR(399,IBIFN,0)),U,13)=4)!(+$$TXMT^IBCEF4(IBIEN)=2)
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.S IBMRA=$$NEEDMRA^IBEFUNC(IBIFN)
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.I IBMRA="C",$P($G(^DGCR(399,IBIFN,0)),U,13)=2 S IBMRA=1
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.I IBIFN D
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..S (DIC,DIE)="^DGCR(399,",DA=$P($G(^IBA(364,IBIEN,0)),U),DR="[IB STATUS]",IBYY=$S('IBMRA:"@91",1:"@911") D:DA ^DIE
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..D BSTAT^IBCDC(IBIFN) ; remove from AB list
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Q
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;
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PRE ; Run before processing a bill entry
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K IBXSAVE,IBXERR,^UTILITY("VAPA",$J),^TMP("IBXSAVE",$J),^TMP($J),^TMP("DIERR",$J)
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Q
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;
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POST ; Run after processing a bill entry for cleanup
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N Q
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I $G(IBXERR)'="" D
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.S ^TMP("IBXERR",$J,IBXIEN)=IBXERR K ^TMP("IBXDATA",$J)
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.K ^TMP("IBHDR1",$J)
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.I $D(^TMP("IBRESUBMIT",$J)),'$G(^TMP("IBEDI_TEST_BATCH",$J)) D ;Set not resub flag for non-test bill
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..N Z,Z0
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..S Z0=$P($G(^TMP("IBRESUBMIT",$J)),U) Q:Z0=""
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..S Z=$O(^IBA(364,"ABABI",+$O(^IBA(364.1,"B",Z0,"")),IBXIEN,""))
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..I Z S ^TMP("IBNOT",$J,Z)=IBXIEN
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K IBXSAVE,IBXNOREQ,^TMP("IBXSAVE",$J),^TMP($J)
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S Q="VA" F S Q=$O(^UTILITY(Q)) Q:$E(Q,1,2)'="VA" I $D(^(Q,$J)) K ^UTILITY(Q,$J)
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D CLEAN^DILF
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Q
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;
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MAILIT(IBQUEUE,IBBILL,IBCTM,IBDUZ,IBDESC,IBBTYP,IBINS) ; Send mail msg, update bills
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;IBQUEUE = mail queue name to send 837 transactions to
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;IBBILL = array of ien's in file 364 of bills in batch - IBBILL(IEN)=""
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;IBCTM = # of bills in batch, returned reset to 0
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;IBDUZ = ien of user 'running' extract (if any)
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;IBDESC = description of batch
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;IBBTYP = X-Y where X = P for professional or I for institution
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; Y = 1 or 2 for test or 0 for live transmission
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;IBINS = ien of insurance company if only one/batch option (optional)
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;
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N DIK,DA,XMTO,XMZ,XMBODY,XMDUZ,XMSUBJ,IBBDA,IBBNO
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;
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S IBBNO=+$P($G(^TMP("IBHDR",$J)),U),IBBDA=$O(^IBA(364.1,"B",IBBNO,""))
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I '$P($G(^IBE(350.9,1,8)),U,7) S IBINS=""
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;
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I IBCTM D
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. I +$G(^TMP("IBEDI_TEST_BATCH",$J)) S IBQUEUE="MCT"
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. I IBQUEUE'="",IBQUEUE'["@" S XMTO("XXX@Q-"_IBQUEUE_".VA.GOV")=""
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. I IBQUEUE["@" S XMTO(IBQUEUE)=""
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. S XMDUZ=$G(IBDUZ),XMBODY="^TMP(""IBXMSG"","_$J_")",XMSUBJ=$S($P(IBBTYP,U,2):"** TEST"_$S($P(IBBTYP,U,2)=2:"/RESUB OF LIVE",1:""),1:"")_" CLAIM BATCH: "_$S(IBQUEUE'["@":IBQUEUE,1:$P(IBQUEUE,"@"))_"/"_IBBNO
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. K XMZ
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. D SENDMSG^XMXAPI(XMDUZ,XMSUBJ,XMBODY,.XMTO,,.XMZ)
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. I $G(XMZ) D
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.. D UPD(XMZ,$P($G(^TMP("IBHDR",$J)),U),IBCTM,.IBBILL,IBDESC,IBBTYP,IBINS) ;Update batch/bills
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.. S ^TMP("IBCE-BATCH",$J,IBBNO)=IBBDA_U_IBCTM_U_$P($G(^TMP("IBRESUBMIT",$J)),U)
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MAILQ S IBCTM=0
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D CHKBTCH(+$G(^TMP("IBHDR",$J)))
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K ^TMP("IBHDR",$J),^TMP("IBHDR1",$J),^TMP("IBXMSG",$J),IBBILL
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Q
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;
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CHKNEW(IBQ,IBBILL,IBCTM,IBDESC,IBBTYP,IBINS,IBSITE,IBSIZE) ;
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; Determine if ok to send msg
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; Check for one insurance per batch if IBINS defined
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; Returns IBSIZE, IBCTM, IBBILL (pass by reference)
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;
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; IBQ = data queue name
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; IBBILL = the 'list' of bill #'s in the batch
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; IBCTM = the # of claims output so far to the batch
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; IBDESC = the batch description text
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; IBBTYP = X-Y where X = P for professional or I for institution
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; Y = 1 for test or 0 for live transmission
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; IBINS = the ien of the single insurance co. for the batch (optional)
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; IBSITE = the '8' node of file 350.9 (IB PARAMETERS)
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; IBSIZE = the 'running' size of the output message
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;
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Q:$S($G(IBINS)="":0,1:'$P(IBSITE,U,7))
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;
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; New batch needed
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I IBCTM D MAILIT(IBQ,.IBBILL,.IBCTM,"",IBDESC,IBBTYP,IBINS) S IBSIZE=0
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Q
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;
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ERRMSG(XMBODY) ; Send bulletin for error message
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N XMTO,XMSUBJ
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S XMTO("I:G.IB EDI")="",XMSUBJ="EDI 837 TRANSMISSION ERRORS"
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;
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D SENDMSG^XMXAPI(,XMSUBJ,XMBODY,.XMTO)
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D ALERT("One or more EDI bills were not transmitted. Check your mail for details","G.IB EDI")
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Q
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;
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CLEANUP ; Cleans up bill transmission environment
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;
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N IBTEST
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S IBTEST=+$G(^TMP("IBEDI_TEST_BATCH",$J))
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L -^IBA(364,0)
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I $D(^TMP("IBRESUBMIT",$J,"IBXERR"))!$D(^TMP("IBONE",$J,"IBXERR"))!$D(^TMP("IBSELX",$J,"IBXERR")) D ;Error message to mail group
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. N XMTO,XMBODY,XMDUZ,XMSUBJ,XMZ,IBFUNC
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. S IBFUNC=$S($D(^TMP("IBRESUBMIT",$J,"IBXERR")):$S('IBTEST:1,1:4),$D(^TMP("IBONE",$J,"IBXERR")):2,1:3)
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. Q:'IBFUNC
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. S XMTO("I:G.IB EDI")="",XMDUZ="",XMBODY="^TMP("""_$S(IBFUNC=1!(IBFUNC=4):"IBRESUBMIT",1:"IBONE")_""","_$J_",""IBXERR"")"
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. S XMSUBJ="EDI 837 B"_$P("ATCH^ILL^ILL(s)^ILL(s)",U,IBFUNC)_" NOT "_$S($G(^TMP("IBONE",$J)):"RE",1:"")_"SUBMITTED"_$S('IBTEST:"",1:" AS TEST CLAIMS")
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. D SENDMSG^XMXAPI(XMDUZ,XMSUBJ,XMBODY,.XMTO,,.XMZ)
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. K ^TMP("IBRESUBMIT",$J),^TMP("IBONE",$J)
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;
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I $D(^TMP("IBRESUBMIT",$J)),'IBTEST D RESUBUP^IBCEM02 ;Upd resubmtd batch bills
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I '$D(^TMP("IBSELX",$J)) K ^TMP("IBCE-BATCH",$J)
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K ^TMP("IBXERR",$J),IBXERR
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I 'IBTEST D CHKBTCH(+$G(^TMP("IBHDR",$J)))
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CLEANP ; Entrypoint for extract data disply
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K ^TMP("IBTXMT",$J),^TMP("IBXINS",$J)
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K ^TMP("IBRESUBMIT",$J),^TMP("IBRESUB",$J),^TMP("IBNOT",$J),^TMP("IBONE",$J),^TMP("IBHDR",$J),^TMP("IBTX",$J),^TMP("IBEDI_TEST_BATCH",$J)
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K ^UTILITY("VADM",$J)
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D CLEAN^DILF
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K ZTREQ S ZTREQ="@"
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Q
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;
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ALERT(XQAMSG,IBGRP) ; Send alert message
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N XQA
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S XQA(IBGRP)=""
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D SETUP^XQALERT
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Q
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CHKBTCH(IBBNO) ; Delete batch whose batch # is IBBNO if no entries in file 364
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; and not a resubmitted batch
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N IBZ,DA,DIK
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S IBZ=+$O(^IBA(364.1,"B",+IBBNO,""))
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I IBZ,'$O(^IBA(364,"C",IBZ,0)),'$P($G(^IBA(364.1,IBZ,0)),U,14) S DA=IBZ,DIK="^IBA(364.1," D ^DIK
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Q
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;
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TESTLIM(IBINS) ; Check for test bill limit per day has been reached
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N IB3,DA,DIK
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S IB3=$G(^DIC(36,IBINS,3))
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I $P(IB3,U,5)'=DT S $P(IB3,U,7)=0
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I ($P(IB3,U,7)+$G(^TMP("IBICT",$J,IBINS))+1)>$P(IB3,U,6) D Q
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. S IBINS="" ;max # hit
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. S DA=IBX,DIK="^IBA(364," D ^DIK
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S ^TMP("IBICT",$J,IBINS)=$G(^TMP("IBICT",$J,IBINS))+1
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Q
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;
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SETVAR(IBXIEN,IBINS,IB0,IBSEC,IBNID,IB837R,IBDIV) ;
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; Set up variables needed for subscripts in sort global
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; ejk added IBSEC logic for patch 296
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; IBSEC=1 if primary bill, 2 if 2nd/non-MRA, 3 if 2nd/MRA
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S IBSEC=$S($$COBN^IBCEF(IBXIEN)=1:1,'$$MRASEC^IBCEF4(IBXIEN):2,1:3)
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S IBNID=$$PAYERID^IBCEF2(IBXIEN)
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S IB837R=$$RECVR^IBCEF2(IBXIEN)
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S IBDIV=$P($S($P(IB0,U,22):$$SITE^VASITE(DT,$P(IB0,U,22)),1:$$SITE^VASITE()),U,3)
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I IBNID'="","RPIHS"[$E(IBNID),$E(IBNID,2,$L(IBNID))="PRNT" S IBNID=IBNID_"*"_IBINS
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I IBNID="" S IBNID="*"_IBINS
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S $P(IBNID,"*",3)=$S($P(IB0,U,22):$P(IB0,U,22),1:"")
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Q
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;
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