VistA-WorldVistAEHR/r/INTEGRATED_BILLING-IB-PRQ--.../IBCEP7B.m

83 lines
2.4 KiB
Mathematica

IBCEP7B ;ALB/TMP - Functions for PROVIDER ID ;1-16-05
;;2.0;INTEGRATED BILLING;**320,348,349**;16-JAN-2005;Build 46
;;Per VHA Directive 2004-038, this routine should not be modified.
Q
;
GETID(CLAIM,COB) ;
N DIR,X,Y,DTOUT,DUOUT,WHICH,ID,IBMAIN,IBDIV,DIC,IBINS,DA,DIC,Z,Z0,IBCU,OK,IBCU
;
S ID=""
S IBINS=$P($G(^DGCR(399,CLAIM,"I"_COB)),U)
I IBINS="" Q ID
;
; Make sure they have careunits IDS defined for this insurance company before we bother asking
S OK=0
S Z=0 F S Z=$O(^IBA(355.92,"B",IBINS,Z)) Q:'Z D Q:OK
. S Z0=$G(^IBA(355.92,Z,0))
. Q:$P(Z0,U,8)'="E"
. Q:$P(Z0,U,3)=""
. S OK=1
I 'OK Q ID
;
S WHICH=$S(COB=1:"Primary",COB=2:"Secondary",1:"Tertiary")
S DIR("A")="Define "_WHICH_" Payer ID by Care Unit? "
S DIR("B")="No"
S DIR(0)="YA"
S DIR("?",1)="Enter No to select "_WHICH_" Provider # by Division."
S DIR("?")="Enter Yes to select "_WHICH_" Provider # for a specific Care Unit."
D ^DIR
I Y'=1 Q ID
;
; Get the Division
S IBMAIN=$$MAIN^IBCEP2B()
S IBDIV=$$EXTERNAL^DILFD(399,.22,"",$P($G(^DGCR(399,CLAIM,0)),U,22))
S DIR("A")="Division: ",DIR(0)="355.92,.05AOr"
; Default Division
S DIR("B")=$S(IBDIV]"":IBDIV,1:IBMAIN)
D ^DIR K DIR
S IBDIV=+$S(Y>0:+Y,1:0)
I Y<0 Q ID
;
; Get the Care Unit
S DIC("A")="Care Unit: "
S DIC("W")="W "" "",$P(^(0),U,2)"
S DIC=355.95,DIC("S")="I $P(^(0),U,3)=+$G(IBINS),$P(^(0),U,4)=+$G(IBDIV)",DIC(0)="AEMQ"
D ^DIC
I Y<0 Q ID
S IBCU=+Y
;
; Compile the appropriate list of IDs
S Z=0 F S Z=$O(^IBA(355.92,"B",IBINS,Z)) Q:'Z D Q:ID]""
. S Z0=$G(^IBA(355.92,Z,0))
. Q:$P(Z0,U,8)'="E"
. Q:$P(Z0,U,3)'=IBCU
. S ID=$P(Z0,U,7)_U_$P(Z0,U,6)
Q ID
;
; See if the insurance company flag is set to send the ATT/REND ID as the Billing Provider
ATTREND(CLAIM,COB) ;
N ID,IBINS
S ID=""
S IBINS=$P($G(^DGCR(399,CLAIM,"I"_COB)),U)
I IBINS="" Q 0
;
I $$FT^IBCEF(CLAIM)=2,$$GET1^DIQ(36,IBINS,4.06,"I") Q 1 ; 1500
I $$FT^IBCEF(CLAIM)=3,$$GET1^DIQ(36,IBINS,4.08,"I") Q 1 ; ub
Q 0
;
; Get a list of the plan types that supress Billing Provider Secondary IDs for this Insurance Co
; and see if the current plan type is one of them.
SUPPPT(CLAIM,COB) ;
N IBINS,SUPPFL
S SUPPFL=0
S IBINS=$P($G(^DGCR(399,CLAIM,"I"_COB)),U)
I IBINS="" Q SUPPFL
;
I $D(^DIC(36,IBINS,13)) D
. N PLAN,PLANTYPE
. S PLAN=$P($G(^DGCR(399,CLAIM,"I"_COB)),U,18) Q:'PLAN
. S PLANTYPE=$P($G(^IBA(355.3,PLAN,0)),U,15) Q:PLANTYPE=""
. Q:'$D(^DIC(36,IBINS,13,"B",PLANTYPE))
. S SUPPFL=1
Q SUPPFL