VistA-WorldVistAEHR/r/INTEGRATED_BILLING-IB-PRQ--.../IBJD1.m

78 lines
2.5 KiB
Mathematica

IBJD1 ;ALB/MR - DIAGNOSTIC MEASURES UTILITIES ;16-DEC-00
;;2.0;INTEGRATED BILLING;**123,159**;21-MAR-94
;
VA(DFN) ; - Is patient a VA employee?
; Input: DFN - Pointer to the Patient file
; IBEXCEL - Optional global Variable (Print to an Excel format)
; Output: VAEMP - "E" (if IBEXCEL) or "*" - VA employee
;
N ELMD,IEN,SSN,VADM,VAEMP
S VAEMP="" G:'$G(DFN) VAQ
D DEM^VADPT S SSN=+$P(VADM(2),"^") G:'SSN VAQ
S IEN=+$O(^PRSPC("SSN",SSN,0)) G:'IEN VAQ
I $P($G(^PRSPC(IEN,1)),U,33)'="Y" S VAEMP=$S($G(IBEXCEL):"E",1:"*")
;
VAQ Q VAEMP
;
PYMT(X) ; - Return most recent bill payment.
; Input: X=Bill pointer to file #399/#430
; Output: Y=Payment date in Fileman format ^ Payment amount
;
N X1,X2,X3,Y S Y="" G:'$G(X) PAYQ
S X1=9999999
F S X1=$O(^PRCA(433,"C",X,X1),-1) Q:'X1 D Q:Y
. S X2=$G(^PRCA(433,X1,0)),X3=$G(^PRCA(433,X1,1))
. I $P(X2,U,4)'=2 Q ; Not complete.
. I "^2^34^"'[(U_$P(X3,U,2)_U) Q ; Not a payment.
. S Y=$S(X3:+X3,1:$P(X3,U,9)\1)_U_+$P(X3,U,5)
PAYQ Q Y
;
INS(DFN,DTE) ; return the Insurance Company for the Patient on DTE (date)
;
N INS,POL,X,X0,Y
S INS="",X=0
F S X=$O(^DPT(DFN,.312,X)) Q:'X I $D(^(X,0)) D
. S X0=^DPT(DFN,.312,X,0)
. I '$$CHK^IBCNS1(X0,DTE) Q
. S POL(0)=$G(POL(0))+1,POL(X,0)=X0
;
I $G(POL(0))<1 G QINS
I $G(POL(0))=1 S Y=+$O(POL(0))
I $G(POL(0))>1 S Y=$$COB^IBCNS1(.POL)
;
S INS=$P($G(^DIC(36,+POL(Y,0),0)),"^")
;
QINS Q INS
;
DIV(CLM) ; Returns the Medical Center Division for the Claim
; Input: CLM - Pointer to Claim Tracking File (#356)
;Output: DIVision for the Claim
;
N ADM,DIV,ENC,PRSC,PRST,X
;
S DIV=0,X=$G(^IBT(356,CLM,0))
S ENC=+$P(X,"^",4) ; Encounter (Pointer to #409.68)
S ADM=+$P(X,"^",5) ; Admission (Pointer to #405)
;
; Inpatient
I ADM S DIV=+$P($G(^DIC(42,+$P($G(^DGPM(+$G(ADM),0)),U,6),0)),U,11)
;
; Outpatient
I 'DIV,ENC S DIV=$P($$SCE^IBSDU(ENC),"^",11)
;
; If Pharmacy/Prosthetics or no Division found assume Primary Division
QDIV S:'DIV DIV=$$PRIM^VASITE() S:DIV'>0 DIV=0
Q DIV
;
CATTYP(IBBCAT) ; - Break down AR Categories into First or Third party
;
N IBFOTP,IBBTYP,IBCATDA0
S IBFOTP="",IBBTYP=""
I (IBBCAT>2&(IBBCAT<6))!(IBBCAT>23&(IBBCAT<27)) Q IBFOTP
I '$D(^PRCA(430.2,IBBCAT,0)) Q IBFOTP
S IBCATDA0=^PRCA(430.2,IBBCAT,0),IBBTYP=$P(IBCATDA0,"^",6)
S IBFOTP=$S((IBBTYP="P")!(IBBTYP="C"):"F",1:"T")
I IBBCAT=15 S IBFOTP="F" ; Exception:Ex-employee is first party
I IBBCAT=16 S IBFOTP="F" ; Exception:Current Emp. is first party
Q IBFOTP