257 lines
9.3 KiB
Mathematica
257 lines
9.3 KiB
Mathematica
PSOCPBK4 ;BIR/GN-Copay Back Bill for Automated-release refills cont. ;10/12/05 9:55am
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;;7.0;OUTPATIENT PHARMACY;**217**;DEC 1997
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;External reference to ^PSDRUG supported by DBIA 221
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;External reference to ^IBAM(354.7 supported by DBIA 3877
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;External reference to $$PROD^XUPROD(1) supported by DBIA 4440
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;External reference to $$PTCOV^IBCNSU3 supported by DBIA 4115
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;External reference to ^IBARX supported by DBIA 125
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;
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Q
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;
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ADDBILL ;add to billable ^XTMP if ok, quit if not
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S PSOTRF=PSOTRF+1
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S PSOREL=$P($G(^PSRX(RXP,1,YY,0)),"^",18)
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Q:'PSOREL ;not released
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Q:'YY ;orig fill
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Q:+$$RXST^IBARXEU(PSODFN,$P(PSOREL,".")) ;Exempt on Rel dte
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;check refill
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Q:$P($G(^PSRX(RXP,1,YY,"IB")),"^",1)'="" ;already billed
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Q:$P($G(^PSRX(RXP,1,YY,"IB")),"^",2)'="" ;exceeded ann. cap
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;
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;look for Activity log entry per refill # with the below text
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S FOUND=0
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F XX=999:0 S XX=$O(^PSRX(RXP,"A",XX),-1) Q:'XX D Q:FOUND
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.Q:$P(^PSRX(RXP,"A",XX,0),"^",4)'=YY
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.Q:^PSRX(RXP,"A",XX,0)'["External Interface Dispensing is Complete"
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.S FOUND=1
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Q:'FOUND
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;
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S ^XTMP(NAMSP,PSODFN,RXP,YY)=$P(PSOREL,".") ;add to XTMP to be bill
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Q
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;
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XTYPE ;
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N Y,VADM,I,J,X,SAVY,DFN
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S DFN=PSODFN D DEM^VADPT I +$G(VADM(6)) S PSOSCMX="" Q ; DECEASED
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S (X,PSOSCMX,SAVY)=""
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S J=0 F S J=$O(^PS(59,J)) Q:'J I +$G(^(J,"IB")) S X=+^("IB") Q
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I 'X Q
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S X=X_"^"_PSODFN D XTYPE^IBARX
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I $G(Y)'=1 Q
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S J="" F S J=$O(Y(J)) Q:'J S I="" F S SAVY=I,I=$O(Y(J,I)) Q:I="" S:I>0 PSOSCMX=I
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I PSOSCMX="",SAVY=0 Q ; INCOME EXEMPT OR SERVICE-CONNECTED
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I PSOSCMX=2 Q ; NEED TO ASK SC QUESTION
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Q
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;
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TOTAL ;
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N COUNT,COUNTED
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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))=0
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S PSODFN=0 F S PSODFN=$O(^XTMP(NAMSP,PSODFN)) Q:'PSODFN D
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.S COUNTED=0
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.F J="YR2004","YR2005" F I=1:1:3 S COUNT=$G(^XTMP(NAMSP,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+PSOCNT("YR2004",I)+PSOCNT("YR2005",I)
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Q
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;
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BILLIT ;
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; IF NO IB NUMBER FOR THIS FILL, SET UP VARIABLES AND TALLY
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N PSOCAP,PSODIV,PSODV,PSOFILL,PSOLOG,PSOOUT,PSOPAR,PSOPATID,PSOSITE
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N PSOSITE7,PSOSQ,PSOTOT,PSOYEAR,PSOYR,SSN,SAVCPUN,SAVREF
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S PSODFN=0
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F CC=1:1 S PSODFN=$O(^XTMP(NAMSP,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))=0 ; INITIAL ANNUAL CAP FOR 2004 & 2005
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.F RXP=0:0 S RXP=$O(^XTMP(NAMSP,PSODFN,RXP)) Q:'RXP D
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..;calc number of 30-day units eligible to bill
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..S (SAVCPUN,PSOCPUN)=($P(^PSRX(RXP,0),"^",8)+29)\30
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..F YY=0:0 S YY=$O(^XTMP(NAMSP,PSODFN,RXP,YY)) Q:YY="" D
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...S (SAVREF,PSOREF)=YY
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...S PSOREL=$G(^XTMP(NAMSP,PSODFN,RXP,YY))
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...I PSOCAP($E(PSOREL,1,3)) Q ; MET ANNUAL CAP FOR 2004 OR 2005
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...I $P($G(^PSRX(RXP,1,YY,"IB")),"^",1)="" D ; REFILL LEVEL
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....D SITE
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....D CP^PSOCP ;call back billing
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....S PSOCPUN=SAVCPUN,PSOREF=SAVREF
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....I $P($G(^PSRX(RXP,1,YY,"IB")),"^",1) D ACCUM ;Do if was billed?
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....D CP I +$G(PSOREF) D ACCUM
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Q
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;
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CP ; Entry point to Check if COPAY - Requires RXP,PSOSITE7
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I '$D(PSOPAR) D ^PSOLSET G CP
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K PSOCP
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S PSOCPN=$P(^PSRX(RXP,0),"^",2) ; Set COPAY dfn PTR TO PATIENT
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S PSOCP=$P($G(^PSRX(RXP,"IB")),"^") ; IB action type
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S PSOSAVE=$S(PSOCP:1,1:"") ; save current copay status
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; Set x=service^dfn^actiontype^user duz
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I +$G(PSOSITE7)'>0 S PSOSITE7=$P(^PS(59,PSOSITE,"IB"),"^")
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S X=PSOSITE7_"^"_PSOCPN_"^"_PSOCP_"^"_$P(^PSRX(RXP,0),"^",16)
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;
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RX ; Determine Original or Refill for RX
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N PSOIB
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S PSOIB=0
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S PSOREF=0
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;set refill number if this is a refill
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I $G(^PSRX(RXP,1,+$G(YY),0))]"" S PSOREF=YY
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;
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;Orig fill -check if bill # already exists
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I 'PSOREF,+$P($G(^PSRX(RXP,"IB")),"^",2)>0 D CHKIB^PSOCP1
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I PSOIB D QUIT Q
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;already attempted to bill, but exceeded Anuual Cap
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I 'PSOREF,+$P($G(^PSRX(RXP,"IB")),"^",4)>0 D QUIT Q
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;
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;Refill -check if bill # already exists
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I PSOREF,+$G(^PSRX(RXP,1,PSOREF,"IB")) D CHKIB^PSOCP1
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I PSOIB D QUIT Q
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;already attempted to bill, but exceeded Anuual Cap
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I PSOREF,+$P($G(^PSRX(RXP,1,PSOREF,"IB")),"^",2) G QUIT
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;
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;set temporary variable to copay and then look for exceptions
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S PSOCHG=1
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D COPAYREL
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I 'PSOCHG D QUIT Q ;not billable
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I PSOCHG=2,'PSOCP D QUIT
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Q
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QUIT ;
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K Y,PSOCP1,PSOREF,PSOCPUN,PSOCP2,PSOCPN,X,PSOCHG,PSOSAVE,PREA,PSORSN
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Q
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;
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COPAYREL ; Recheck copay status at release
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;
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; check Rx patient status
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I $P(^PSRX(RXP,0),"^",3)'="",$P($G(^PS(53,$P(^PSRX(RXP,0),"^",3),0)),"^",7)=1 S PSOCHG=0 Q
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; see if drug is investigational or supply
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N DRG,DRGTYP
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S DRG=+$P(^PSRX(RXP,0),"^",6),DRGTYP=$P($G(^PSDRUG(DRG,0)),"^",3)
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I DRGTYP["I" S PSOCHG=0 Q
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I DRGTYP["S" S PSOCHG=0 Q
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K PSOTG,CHKXTYPE
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I +$G(^PSRX(RXP,"IBQ")) D XTYPE1^PSOCP1
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I $G(^PSRX(RXP,"IBQ"))["1" S PSOCHG=0 Q
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Q
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;
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ACCUM ; ACCUMULATE TOTALS AND SEE IF PATIENT MET ANNUAL CAP
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S PSOYR=$E(PSOREL,1,3) I PSOYR="" Q
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S PSOYEAR=$S(PSOYR="304":"YR2004",PSOYR="305":"YR2005",1:"")
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Q:PSOYEAR=""
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;
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;get Xtmp billing amt which would be IBAM tot + any previous refills
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S PSOTOT=$G(^XTMP(NAMSP,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 refill amounts
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S ^XTMP(NAMSP,PSODFN,PSOYEAR)=PSOTOT+(PSOCPUN*7)
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S ^XTMP(NAMSP,PSODFN,PSOYEAR,PSOCPUN)=$G(^XTMP(NAMSP,PSODFN,PSOYEAR,PSOCPUN))+1
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;
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;indicate this refill may be billable or (was billed, if BILLING run)
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;by adding to Xtmp "BILLED"
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N PSONAM
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S PSONAM=$P($G(^DPT(PSODFN,0)),"^"),PSONAM=$P(PSONAM,",")
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S PSONAM=$E(PSONAM,1,6)
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S ^XTMP(NAMSP,"BILLED",PSONAM,PSODFN,RXP,PSOREF)=PSOREL
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Q
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;
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SITE ; SET UP VARIABLES NEEDED BY BILLING
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S PSOSITE=$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 PSOSITE7=$P($G(^PS(59,PSOSITE,"IB")),"^")
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Q
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;
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RPT ;
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N JOBN,NAMSP,ZTDESC,ZTRTN
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S NAMSP=$$NAMSP^PSOCPBK3
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S JOBN=$S(^XTMP(NAMSP,0)["BACK":"Back Billing",1:"Tally")
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L +^XTMP(NAMSP):0 I '$T D Q
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.W !,JOBN_" job for PSO*7*217 is still running. Halting..."
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L -^XTMP(NAMSP)
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W !!,"This report shows the patient name and prescription information for refills"
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W:JOBN["Tally" !,"that were identified as billable by the patch PSO*7*217"
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W:JOBN["Back" !,"that were back-billed by the patch PSO*7*217"
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W !!,"You may queue the report to print, if you wish.",!
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;
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DVC K %ZIS,POP,IOP S %ZIS="QM" D ^%ZIS I $G(POP) W !!,"Nothing queued to print.",! G DONE
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QUEUE I $D(IO("Q")) S ZTRTN="START^PSOCPBK4",ZTDESC=JOBN_" copay report" D ^%ZTLOAD K %ZSI W !,"Report queued to print.",! G DONE
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START ;
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U IO
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N BLDT,RXO,NAMSP,PSOFILL,PSODFN,PSONAM,PSOOUT,PSODV,RXP,SSN,PSODIV
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N JOBN,PSOPATID
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S NAMSP=$$NAMSP^PSOCPBK3
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S JOBN=$S(^XTMP(NAMSP,0)["BACK":"Back Billing",1:"Tally")
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S PSOOUT=0,PSODV=$S($E(IOST)="C":"C",1:"P")
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S PSOPGCT=0,PSOPGLN=IOSL-7,PSOPGCT=1
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S BLDT=$P($G(^XTMP(NAMSP,0,"LAST")),"^",2)
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D TITLE
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S PSONAM=""
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F S PSONAM=$O(^XTMP(NAMSP,"BILLED",PSONAM)) Q:PSONAM="" D
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.S PSODFN=""
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.F S PSODFN=$O(^XTMP(NAMSP,"BILLED",PSONAM,PSODFN)) Q:PSODFN="" D
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..S RXP=""
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..F S RXP=$O(^XTMP(NAMSP,"BILLED",PSONAM,PSODFN,RXP)) Q:RXP="" D
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...S PSOFILL=""
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...F S PSOFILL=$O(^XTMP(NAMSP,"BILLED",PSONAM,PSODFN,RXP,PSOFILL)) Q:PSOFILL="" D
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....N XX,RXO,Y,PSONAME
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....S XX=$G(^XTMP(NAMSP,"BILLED",PSONAM,PSODFN,RXP,PSOFILL)) D
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.....D FULL Q:$G(PSOOUT) S PSONAME=$P($G(^DPT(PSODFN,0)),"^")
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.....W !,$E(PSONAME,1,14)
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.....D PRTSSN
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.....S RXO=$P($G(^PSRX(RXP,0)),"^")
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.....W ?42," ",RXO," (",PSOFILL,")"
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.....S Y=XX I Y>0 X ^DD("DD")
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.....W ?55," ",Y
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.....W ?69,$S($$PTCOV^IBCNSU3(PSODFN,XX,"PHARMACY"):"YES",1:" NO")
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.....W ?75,$S($$PTCOV^IBCNSU3(PSODFN,BLDT,"PHARMACY"):"YES",1:" NO")
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G END
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;
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FULL ;
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I ($Y+7)>IOSL&('$G(PSOOUT)) D TITLE
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Q
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;
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TITLE ;
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I $G(PSODV)="C",$G(PSOPGCT)'=1 W ! K DIR S DIR(0)="E" D ^DIR K DIR I 'Y S PSOOUT=1 Q
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;
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W @IOF D
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. W !,"Patch PSO*7*217 -COPAY PRESCRIPTION REFILLS "_JOBN
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S Y=DT X ^DD("DD") W !,"Date printed: ",Y,?70,"Page: ",PSOPGCT,!
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F MJT=1:1:79 W "="
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W !,?69,"INS ON DTE"
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W !,"PATIENT NAME (SSN) DIV",?43,"RX# (FILL)",?55,"RELEASE DATE",?69,"REL BILL"
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W !,"-------------- ------- ----------------",?42,"------------"
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W ?55,"------------",?69,"---- -----"
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S PSOPGCT=PSOPGCT+1
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Q
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END ;
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I '$G(PSOOUT),$G(PSODV)="C" W !!,"** End of Report **" K DIR S DIR(0)="E",DIR("A")="Press Return to continue" D ^DIR K DIR
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I $G(PSODV)="C" W !
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E W @IOF
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DONE ;
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K MJT,PSOPGCT,PSOPGLN,Y,DIR,X,IOP,POP,IO("Q"),DIRUT,DUOUT,DTOUT
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D ^%ZISC S:$D(ZTQUEUED) ZTREQ="@"
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Q
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;
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PRTSSN ;
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S SSN=$P(^DPT(PSODFN,0),"^",9),SSN=$E(SSN,$L(SSN)-3,$L(SSN))
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S PSOPATID=$E(PSONAM,1)_SSN
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S PSODIV=$P($G(^PSRX(RXP,2)),"^",9)
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S:PSODIV'="" PSODIV=$P($G(^PS(59,PSODIV,0)),"^",1)
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W ?16,"("_PSOPATID_")"_" "_PSODIV
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Q
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;
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ETIME(SECTIME) ;convert seconds to day:hr:min:sec
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N DAY,HR,MIN,SEC,ETIM
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S (DAY,HR,MIN,SEC)=""
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I SECTIME>86400 S DAY=SECTIME\86400,SECTIME=SECTIME#86400
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I SECTIME>3600 S HR=SECTIME\3600,SECTIME=SECTIME#3600
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I SECTIME>60 S MIN=SECTIME\60,SECTIME=SECTIME#60
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S SEC=SECTIME
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S ETIM=""
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S:$L(HR)=1 HR=0_HR S:$L(MIN)=1 MIN=0_MIN S:$L(SEC)=1 SEC=0_SEC
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S:DAY ETIM=DAY_" Day " S:HR ETIM=ETIM_HR_":" S:MIN ETIM=ETIM_MIN
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S ETIM=ETIM_":"_SEC
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Q ETIM
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