188 lines
9.4 KiB
Mathematica
188 lines
9.4 KiB
Mathematica
PSOCIDC2 ;BIR/LE-continuation of Copay Correction of erroneous billed copays ;11/8/05 12:50pm
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;;7.0;OUTPATIENT PHARMACY;**226**;DEC 1997
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;External reference to ^XUSEC supported by DBIA 10076
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;External reference to IBARX supported by DBIA 125
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;External reference to $$PROD^XUPROD(1) supported by DBIA 4440
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;
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TOTAL ;
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N COUNT,COUNTED,UCOUNT,UCOUNTED,CCOUNT,CCOUNTED
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I '$D(PSOVETS) S PSOVETS=0
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N I,J
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F I=1:1:3 S (PSOCNT("YR2004",I),PSOCNT("YR2005",I),PSOCNT("YR2006",I))=0
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S PSODFN=0 F S PSODFN=$O(^XTMP(NAMSP,"TOT REL",PSODFN)) Q:'PSODFN D
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.S COUNTED=0
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.F J="YR2004","YR2005","YR2006" F I=1:1:3 S COUNT=$G(^XTMP(NAMSP,"TOT REL",PSODFN,J,I)) I COUNT>0 S:'$G(COUNTED) COUNTED=1,PSOVETS=PSOVETS+1 S PSOCNT(J,I)=PSOCNT(J,I)+COUNT
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F I=1:1:3 S PSOCNT=PSOCNT+$G(PSOCNT("YR2004",I))+$G(PSOCNT("YR2005",I))+$G(PSOCNT("YR2006",I))
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;
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S (I,J)=-""
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I '$D(PSOCVETS) S PSOCVETS=0
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F I=1:1:3 S (PSOCCNT("YR2004",I),PSOCCNT("YR2005",I),PSOCCNT("YR2006",I))=0
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S PSODFN=0 F S PSODFN=$O(^XTMP(NAMSP,"TOT CAN",PSODFN)) Q:'PSODFN D
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.S CCOUNTED=0
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.F J="YR2004","YR2005","YR2006" F I=1:1:3 S CCOUNT=$G(^XTMP(NAMSP,"TOT CAN",PSODFN,J,I)) I CCOUNT>0 S:'$G(CCOUNTED) CCOUNTED=1,PSOCVETS=PSOCVETS+1 S PSOCCNT(J,I)=PSOCCNT(J,I)+CCOUNT
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F I=1:1:3 S PSOCCNT=PSOCCNT+$G(PSOCCNT("YR2004",I))+$G(PSOCCNT("YR2005",I))+$G(PSOCCNT("YR2006",I))
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;
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S (I,J)=""
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I '$D(PSOUVETS) S PSOUVETS=0
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F I=1:1:3 S (PSOUCNT("YR2004",I),PSOUCNT("YR2005",I),PSOUCNT("YR2006",I))=0
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S PSOUDFN=0 F S PSOUDFN=$O(^XTMP(NAMSP,"TOT UNREL",PSOUDFN)) Q:'PSOUDFN D
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.S UCOUNTED=0
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.F J="YR2004","YR2005","YR2006" F I=1:1:3 S UCOUNT=$G(^XTMP(NAMSP,"TOT UNREL",PSOUDFN,J,I)) I UCOUNT>0 S:'$G(UCOUNTED) UCOUNTED=1,PSOUVETS=PSOUVETS+1 S PSOUCNT(J,I)=PSOUCNT(J,I)+UCOUNT
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F I=1:1:3 S PSOUCNT=PSOUCNT+$G(PSOUCNT("YR2004",I))+$G(PSOUCNT("YR2005",I))+$G(PSOUCNT("YR2006",I))
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;
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Q
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;
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CHECK ;check for ICD and IB nodes
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;
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N PSOREF,PSOIB,PSOOICD,PSOBILLD
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S PSOREF=YY
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S PSOOICD=$P($G(^PSRX(RXP,"ICD",1,0)),"^",2,8)
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; see if bill already exists
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I PSOREF=0 D
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. I +$P($G(^PSRX(RXP,"IB")),"^",2)>0 D CHKIB^PSOCP1
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. S PSOREL=$P($G(^PSRX(RXP,2)),"^",13)
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I PSOREF>0 D
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. I +$G(^PSRX(RXP,1,PSOREF,"IB")) D CHKIB^PSOCP1
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. S PSOREL=$P($G(^PSRX(RXP,1,YY,0)),"^",18)
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I $G(PSOIB)=1!($G(PSOIB)=3) S PSOBILLD=1
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; if billed/RELEASED and no IBQ node for both sc<50 and nsc
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I $G(PSOBILLD)&('$D(^PSRX(RXP,"IBQ"))) D
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. I $TR(PSOOICD,"^")[1 S ^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)=$P(PSOREL,".")_"^"_PSODT_"^"_PSOSCP
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. I $TR(PSOOICD,"^")[0 S ^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)=$P(PSOREL,".")_"^"_PSODT_"^"_PSOSCP
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; find unbilled ones with an ICD node and no IBQ node.
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I '$G(PSOBILLD)&('$D(^PSRX(RXP,"IBQ"))) D
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. Q:$TR(PSOOICD,"^")=""
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. S ^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)=$P(PSOREL,".")_"^"_PSODT_"^"_PSOSCP
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I YY S PSOTRF=PSOTRF+1
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Q
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;
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CANCEL ;Cancel erroneous copays/set IBQ node if not there
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;released rx's
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N PSOCAP,PSODIV,PSODV,PSOFILL,PSOLOG,PSONAM,PSOOUT,PSOPAR,PSOPAR7,PSOSITE
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N PSOSITE7,PSOSQ,PSOTOT,PSOYEAR,PSOYR,SSN,SAVCPUN,SAVREF,PSOIB,PSOOIBQ,PSONIBQ,PSOOICD,PSOOIB
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N I,IFN,PSOANSQ,PSOTYP,COM,CC,PREA,PSONW,PSOOLD,PSOREL,PSO,PSOCPUN,PSOFLD,PSOTYPE,CANCEL
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S PSOTYPE="CAN"
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S PSODFN=0 F CC=1:1 S PSODFN=$O(^XTMP(NAMSP,"CANCEL",PSODFN)) Q:'PSODFN D Q:STOP
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.I CC#100=0,$D(^XTMP(NAMSP,0,"STOP")) D Q
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.. S $P(^XTMP(NAMSP,0,"LAST"),"^",1,2)="STOP^"_$$NOW^XLFDT,STOP=1
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.S (PSOCAP(304),PSOCAP(305),PSOCAP(306))=0 ; INITIAL ANNUAL CAP FOR 2004 & 2005
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.F RXP=0:0 S RXP=$O(^XTMP(NAMSP,"CANCEL",PSODFN,RXP)) Q:'RXP D
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..S (SAVCPUN,PSOCPUN)=($P(^PSRX(RXP,0),"^",8)+29)\30
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..S YY="" F S YY=$O(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)) Q:YY="" D
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...S (SAVREF,PSOREF)=YY
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...; verify again that it was billed and not already cancelled
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...S PSOBILLD=0
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...I YY=0,+$P($G(^PSRX(RXP,"IB")),"^",2)>0 D CHKIB^PSOCP1 I $G(PSOIB)=1!($G(PSOIB)=3) S PSOBILLD=1
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...I YY>0,+$P($G(^PSRX(RXP,1,PSOREF,"IB")),"^")>0 D CHKIB^PSOCP1 I $G(PSOIB)=1!($G(PSOIB)=3) S PSOBILLD=1
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...Q:'PSOBILLD
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...S PSOREL=$P($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)),"^"),PSOFLD=$P($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)),"^",2),PSOSCP=$P($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)),"^",3)
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...S PSO=3 D NOW^%DTC S PSODT=%,PSODA=RXP,PSOCOMM="-BKGD CIDC COPAY CANCEL",PSOOLD="",PSONW="",PREA=""
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...D CHKACT
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...S PSOIB="",PSOIB=$S(PSOREF>0:$G(^PSRX(RXP,1,YY,"IB")),'PSOREF:$G(^PSRX(PSODA,"IB")),1:"")
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...S (PSOOIBQ,PSOOICD,PSOOIB)=""
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...S PSOOICD=$P($G(^PSRX(RXP,"ICD",1,0)),"^",2,8),PSOOIB=$G(^PSRX(RXP,"IB")),PSOOIBQ=$G(^PSRX(RXP,"IBQ"))
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...I PSOOIBQ=""&($TR(PSOOICD,"^")[0!($TR(PSOOICD,"^")[1)) D SETIBQ
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...D SITE S PSOCOMM="-BKGD CIDC COPAY CANCEL" D RXED^PSOCPA S:PSOOICD[1&($D(^PSRX(RXP,"IB"))) $P(^PSRX(RXP,"IB"),"^")=""
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...S PSOCPUN=SAVCPUN,PSOREF=SAVREF
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...D ACCUM
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;
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;ICD NODES WITHOUT IBQ NODE; set IBQ node but only set 1st piece of IB node if unreleased.
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S PSOTYP="IBQ"
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S PSODFN=0 F CC=1:1 S PSODFN=$O(^XTMP(NAMSP,"NOIBQ",PSODFN)) Q:'PSODFN D Q:STOP
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.I CC#100=0,$D(^XTMP(NAMSP,0,"STOP")) D Q
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.. S $P(^XTMP(NAMSP,0,"LAST"),"^",1,2)="STOP^"_$$NOW^XLFDT,STOP=1
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.S (PSOCAP(304),PSOCAP(305),PSOCAP(306))=0 ; INITIAL ANNUAL CAP FOR 2004 & 2005
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.F RXP=0:0 S RXP=$O(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP)) Q:'RXP D
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..S (SAVCPUN,PSOCPUN)=($P(^PSRX(RXP,0),"^",8)+29)\30
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..S YY="" F S YY=$O(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)) Q:YY="" D
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...S (SAVREF,PSOREF)=YY
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...D SITE
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...S PSOREL=$P($G(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)),"^"),PSOFLD=$P($G(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)),"^",2),PSOSCP=$P($G(^XTMP(NAMSP,"NOIBQ",PSODFN,RXP,YY)),"^",3)
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...S (PSOOIBQ,PSOOICD,PSOOIB)=""
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...S PSOOICD=$P($G(^PSRX(RXP,"ICD",1,0)),"^",2,8),PSOOIB=$G(^PSRX(RXP,"IB")),PSOOIBQ=$G(^PSRX(RXP,"IBQ"))
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...I PSOOIBQ=""&($TR(PSOOICD,"^")[0!($TR(PSOOICD,"^")[1)) D SETIBQ D ;don't want to set again if already did it as part of copay cancel
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....S I="",IFN=0 F I=0:0 S I=$O(^PSRX(RXP,"A",I)) Q:'I S IFN=I
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....S COM=" BKGD CIDC UPDATE"
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....D NOW^%DTC S IFN=IFN+1,^PSRX(RXP,"A",0)="^52.3DA^"_IFN_"^"_IFN,^PSRX(RXP,"A",IFN,0)=%_"^I^.5^"_YY_"^"_COM
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....K DA
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....S:PSOOICD[1&($D(^PSRX(RXP,"IB"))) $P(^PSRX(RXP,"IB"),"^")=""
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...D:'$G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY)) ACCUM
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...S PSOCPUN=SAVCPUN,PSOREF=SAVREF
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Q
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;
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CHKACT ;check activity log for prev entry
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N ZACT,ZPSI,ZACTI
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S ZPSI=0 F S ZPSI=$O(^PSRX(PSODA,"COPAY",ZPSI)) Q:ZPSI="" S ZACTI="",ZACTI=$G(^PSRX(PSODA,"COPAY",ZPSI,0)) D Q:$G(ZACT)
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. I ZACTI["BKGD CIDC COPAY CANCEL"&($P(ZACTI,"^",2)="R") S PSOOLD="",PSONW="",PREA="C",ZACT=1 Q
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I '$G(ZACT) S PSOOLD="Copay",PSONW="No Copay",PREA="R" K PSOREF D ACTLOG^PSOCPA S PSOREF=YY,PSOOLD="",PSONW="",PREA="C"
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Q
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;
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SETIBQ ; get data from IBQ node, set IBQ node, and 1st piece of IB node
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K PSOANSQ
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N PSONIBQ
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F PSOTYP=1:1:7 D
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. I PSOTYP=1 S PSOANSQ("VEH")=$P(PSOOICD,"^",PSOTYP)
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. I PSOTYP=2 S PSOANSQ("RAD")=$P(PSOOICD,"^",PSOTYP)
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. I PSOTYP=3 S PSOANSQ("SC")=$P(PSOOICD,"^",PSOTYP)
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. I PSOTYP=4 S PSOANSQ("PGW")=$P(PSOOICD,"^",PSOTYP)
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. I PSOTYP=5 S PSOANSQ("MST")=$P(PSOOICD,"^",PSOTYP)
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. I PSOTYP=6 S PSOANSQ("HNC")=$P(PSOOICD,"^",PSOTYP)
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. I PSOTYP=7 S PSOANSQ("CV")=$P(PSOOICD,"^",PSOTYP)
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S ^PSRX(RXP,"IBQ")=PSOANSQ("SC")_"^"_PSOANSQ("MST")_"^"_PSOANSQ("VEH")_"^"_PSOANSQ("RAD")_"^"_PSOANSQ("PGW")_"^"_PSOANSQ("HNC")_"^"_PSOANSQ("CV")
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Q
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;
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ACCUM ; ACCUMULATE TOTALS
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S (PSOTOT,PSOYR,PSOYEAR,PSOLOG,PSONAM,PSOCHRG)=""
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; get finished, but unreleased totals
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I PSOREL="" S PSOYR=$E(PSOFLD,1,3) Q:PSOYR="" D S PSOYEAR="" Q
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.S PSOYEAR=$S(PSOYR="304":"YR2004",PSOYR="305":"YR2005",PSOYR="306":"YR2006",1:"") Q:PSOYEAR=""
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.S PSOCHRG=7
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.I PSOYEAR="YR2006" S PSOCHRG=8
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.S PSOTOT=$G(^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR))
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.S ^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR)=PSOTOT+(PSOCPUN*PSOCHRG)
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.S ^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR,PSOCPUN)=$G(^XTMP(NAMSP,"TOT UNREL",PSODFN,PSOYEAR,PSOCPUN))+1
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.S PSONAM=$P($G(^DPT(PSODFN,0)),"^"),PSONAM=$P(PSONAM,",")
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.S PSONAM=$E(PSONAM,1,6)
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.S ^XTMP(NAMSP,"IBQ UPD",PSONAM,PSODFN,RXP,PSOREF)=PSOFLD
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;for released ones
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S PSOYR=$E(PSOREL,1,3)
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S:PSOYR'="" PSOYEAR=$S(PSOYR="304":"YR2004",PSOYR="305":"YR2005",PSOYR="306":"YR2006",1:"")
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Q:PSOYEAR=""
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S PSOCHRG=7
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I PSOYEAR="YR2006" S PSOCHRG=8
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;
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;get Xtmp billing amt which would be IBAM tot + any previous refills
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S PSOTOT=$G(^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR))
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;
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;if none yet then init to the IBAM total for the year
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I 'PSOTOT D
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.F PSOSQ=0:0 S PSOSQ=$O(^IBAM(354.7,PSODFN,1,PSOSQ)) Q:'PSOSQ D
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..S PSOLOG=$G(^IBAM(354.7,PSODFN,1,PSOSQ,0))
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..I $E(PSOLOG,1,3)=PSOYR S PSOTOT=PSOTOT+$P(PSOLOG,"^",2)
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;
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;update Xtmp tot nodes with current fill amounts
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; note: cancel copays and updated IBQ node released prescription are collected under TOT REL for the RPT^PSOCIDC3
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; routine. Cancelled copays are denoted with an asterisk.
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S ^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR)=PSOTOT+(PSOCPUN*PSOCHRG)
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S ^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR,PSOCPUN)=$G(^XTMP(NAMSP,"TOT REL",PSODFN,PSOYEAR,PSOCPUN))+1
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;
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;indicate COPAY CANCEL for this fill
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; ;by adding to Xtmp "BILLED"
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S PSONAM=$P($G(^DPT(PSODFN,0)),"^"),PSONAM=$P(PSONAM,",")
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S PSONAM=$E(PSONAM,1,6)
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S ^XTMP(NAMSP,"REL",PSONAM,PSODFN,RXP,PSOREF)=PSOREL
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;
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CAN I PSOTYPE="CAN"&($G(^XTMP(NAMSP,"CANCEL",PSODFN,RXP,YY))) N PSOFILL S CANCEL="" S PSOFILL=YY D CHK^PSOCIDC3 I CANCEL D
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. S ^XTMP(NAMSP,"TOT CAN",PSODFN,PSOYEAR)=PSOTOT+(PSOCPUN*PSOCHRG)
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. S ^XTMP(NAMSP,"TOT CAN",PSODFN,PSOYEAR,PSOCPUN)=$G(^XTMP(NAMSP,"TOT CAN",PSODFN,PSOYEAR,PSOCPUN))+1
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Q
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;
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SITE ; SET UP VARIABLES NEEDED BY BILLING
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S PSOSITE=$S(YY=0:$P(^PSRX(RXP,2),"^",9),1:$P($G(^PSRX(RXP,1,YY,0)),"^",9))
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Q:PSOSITE=""
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S PSOPAR=$G(^PS(59,PSOSITE,1))
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S PSOPAR7=$G(^PS(59,PSOSITE,"IB"))
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S PSOSITE7=$P($G(^PS(59,PSOSITE,"IB")),"^")
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Q
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;
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