VistA-WorldVistAEHR/r/INTEGRATED_BILLING-IB-PRQ--.../IBCNSM32.m

112 lines
5.3 KiB
Mathematica

IBCNSM32 ;ALB/AAS - INSURANCE MANAGEMENT - POLICY EDIT ; 23-JAN-95
;;2.0;INTEGRATED BILLING;**28,40,52,85,103,133,361**;21-MAR-94;Build 9
;;Per VHA Directive 2004-038, this routine should not be modified.
;
PATPOL(IBCDFN) ; -- edit patient specific policy info
I '$G(IBCDFN) G PATPOLQ
D SAVEPT^IBCNSP3(DFN,IBCDFN)
D POL^IBCNSU41(DFN)
;
; -- give warning if expired or inactive co.
I $P(^DPT(DFN,.312,IBCDFN,0),"^",4),$P(^(0),"^",4)'>DT W !,"WARNING: This appears to be an expired policy!",!
I $P(^DIC(36,+$P(^DPT(DFN,.312,IBCDFN,0),"^"),0),"^",5) W !,*7,"WARNING: This insurance company is INACTIVE!",!
;
N IBAD,IBDIF,DA,DR,DIC,DIE,DGSENFLG S DGSENFLG=1
S DIE="^DPT("_DFN_",.312,",DA(1)=DFN,DA=IBCDFN
S DR="S IBAD="""";8;@333;3;D FUTURE^IBCNSM31;6;S IBAD=X;K X I '$$VET^IBCNSU1() S Y=""@10"";17///^S X=$P(^DPT(DFN,0),U);16///^S X=""01"""
;S DR="S IBAD="""";8;@333;3;D FUTURE^IBCNSM31;6;S IBAD=X;I IBAD'=""v"" S Y=""@10"";17"_$S($$VET^IBCNSU1():"///^S X="""_$P(^DPT(DFN,0),U,1)_"""",1:"//"_);16///^S X=""01"""
S DR=DR_";S Y=""@20"";@10;17;16//^S X=$S(IBAD=""s"":""02"",1:"""");@20;1;3.01;3.12;1.09//;I $G(IBREG) S Y=""@99"";.2;4.01;4.02;@99"
I $G(IBREG),$D(^XUSEC("IB INSURANCE SUPERVISOR",DUZ)) S DR=".01//;"_DR
L +^DPT(DFN,.312,+IBCDFN):5 I '$T D LOCKED^IBTRCD1 G PATPOLQ
D ^DIE I $D(Y)!($D(DTOUT)) S IBQUIT=1
I '$D(DA) S IBQUIT=1 G PATPOLQ
;
; -- if the company was changed, change the policy plan
I $G(IBREG),$G(IBCNS),+$G(^DPT(DFN,.312,IBCDFN,0))'=IBCNS D CHPL
;
K IBFUTUR
D COMPPT^IBCNSP3(DFN,IBCDFN)
I IBDIF D UPDATPT^IBCNSP3(DFN,IBCDFN)
L -^DPT(DFN,.312,+IBCDFN)
;
D FUTURE^IBCNSM31 K Y,IBFUTUR
PATPOLQ Q
;
CHPL ; Change policy plan if the policy company differs from plan company.
; Required variable input:
; DFN -- pointer to the patient in file #2
; IBCDFN -- pointer to the policy in file #2.312
; IBCNS -- pointer to the plan company in file #36
;
N IBBU,IBCNS1,IBCPOL1,IBNEWP1,IBPLAN,IBIP,IBT,X
S X=$G(^DPT(DFN,.312,IBCDFN,0)),IBCNS1=+X
S IBPLAN=$P(X,"^",18),IBIP='$P($G(^IBA(355.3,IBPLAN,0)),"^",2)
W !!,"Since you have changed the Insurance Company to ",$E($P($G(^DIC(36,IBCNS1,0)),"^"),1,25),","
W !,"you must now change the Insurance Plan to which this veteran"
W !,"is subscribing to one which is offered by this company!",!
;
; - warn about benefits used
D BU^IBCNSJ21 I $O(IBBU(0)) D
.W !,"The current policy plan has Benefits Used associated with it!"
.W !,"If you add or select another plan to associate with this policy,"
.W !,"these Benefits Used will be deleted!",!
;
; - warn about Individual Plans
I IBIP D
.W !," *** Please note: Since the veteran's current plan is an Individual Plan,"
.W !?21,"this plan will be deleted if you add or select a new"
.W !?21,"plan to associate with this policy.",!
;
; - select or add a new plan
S IBCPOL1=$$LK^IBCNSM31(IBCNS1)
I 'IBCPOL1 D NEW^IBCNSJ3(IBCNS1,.IBCPOL1) S:IBCPOL1 IBNEWP1=1
I 'IBCPOL1 D G CHPLQ
.W !!,"A new plan was not added or selected!"
.W !,"Changing the policy company back to ",$E($P($G(^DIC(36,IBCNS,0)),"^"),1,25),"..."
.S DIE="^DPT(DFN,.312,",DA(1)=DFN,DA=IBCDFN,DR=".01////"_IBCNS_";1.05///NOW;1.06////"_DUZ D ^DIE K DA,DIE,DR
;
W !!,"Changing the policy plan..."
S DIE="^DPT(DFN,.312,",DA(1)=DFN,DA=IBCDFN,DR=".18////"_IBCPOL1_";1.05///NOW;1.06////"_DUZ D ^DIE K DA,DIE,DR
I IBIP!$G(IBNEWP) W !!,"Deleting the ",$S(IBIP:"current Individual",1:"previously-added")," plan for ",$E($P($G(^DIC(36,IBCNS,0)),"^"),1,25),"..." D DEL^IBCNSJ(IBPLAN)
;
; - delete any dangling benefits used
I $O(IBBU(0)) D
.N IBDAT
.W !!,"Deleting current Benefits Used... "
.S IBDAT="" F S IBDA=$O(IBBU(IBDAT)) Q:IBDAT="" D DBU^IBCNSJ(IBBU(IBDAT))
;
; - repoint all Insurance Reviews to new company
I $$IR^IBCNSJ21(DFN,IBCDFN) D
.W !!,"Repointing all Insurance Reviews to ",$E($P($G(^DIC(36,IBCNS1,0)),"^"),1,25),"... "
.S IBT=0 F S IBT=$O(^IBT(356.2,"D",DFN,IBT)) Q:'IBT I $P($G(^IBT(356.2,IBT,1)),"^",5)=IBCDFN,$P($G(^(0)),"^",8)'=IBCNS1 S DA=IBT,DR=".08////"_IBCNS1,DIE="^IBT(356.2," D ^DIE K DA,DR,DIE W "."
;
S IBCNS=IBCNS1,IBNEWP=$G(IBNEWP1)
CHPLQ Q
;
PLAN(DFN,IBCDFN,IBCNS) ; Fix policies when identified.
;
; This function is invoked from Inactivate Plan or Change Policy Plan,
; when it is recognized that the policy and plan companies are out
; of synch. If the user doesn't select a new plan to associate with
; the policy, the policy company will be changed to the plan company.
;
; The input parameters are defined above.
;
N IBNEWP
I '$G(DFN)!'$G(IBCDFN)!'$G(IBCNS) G PLANQ
W !!,*7,"The policy company and plan company are not the same!!"
W !,"This inconsistency probably occurred in the past when changing"
W !,"the policy company through Screen 5 of Registration."
W !!,"You must resolve this inconsistency. If you do not choose a new plan"
W !,"offered by the policy company, the policy company will be changed to"
W !,"the plan company (",$P($G(^DIC(36,IBCNS,0)),"^"),") ...."
D CHPL
PLANQ Q
HLP ; -- help text for subscriber id
W !,?5,"Enter Medicare Claim Number (Subscriber ID) exactly as it"
W !,?5,"appears on the Medicare Insurance Card including All Characters."
W !,?5,"Valid HICN formats are: 1-3 alpha characters followed by 6 or 9 digits, "
W !,?5,"or 9 digits followed by 1 alpha character optionally followed by another "
W !,?5,"alpha character or 1 digit."
Q