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Routine: FBPCR3

FBPCR3.m

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  1. FBPCR3 ;AISC/GRR,TET-PHARMACY POTENTIAL COST RECOVERY, SORT/PRINT ;6/30/2006
  1. ;;3.5;FEE BASIS;**48,69,98,163,166**;JAN 30, 1995;Build 21
  1. ;Per VA Directive 6402, this routine should not be modified.
  1. ;
  1. EN ;entry point
  1. S (FBCATC,FBINS,FBPSF)=0
  1. SORT ;sort by date certified for payment, patient, invoice number ien, rx ien
  1. S I=FBBDATE-.1 F S I=$O(^FBAA(162.1,"AA",I)) Q:'I!(I>FBEDATE) S J=0 F S J=$O(^FBAA(162.1,"AA",I,J)) Q:'J D
  1. .S DFN=J D VET^FBPCR
  1. .S K=0 F S K=$O(^FBAA(162.1,"AA",I,J,K)) Q:K'>0 S L=0 F S L=$O(^FBAA(162.1,"AA",I,J,K,L)) Q:L'>0 D S (FBCATC,FBINS,FBPSF)=0
  1. ..D SET Q:'FBPSV&('$D(FBPSV(FBPSF))) I FBCATC!FBINS D SETTMP
  1. KILL ;kill variables set in sort
  1. K A1,A2,DFN,FBAAA,FBAC,FBAP,FBBATCH,FBCATC,FBDA1,FBDRUG,FBFD,FBFD1,FBIN,FBINS,FBINVN,FBLOC,FBPAT,FBPD,FBPSF,FBPV,FBQTY,FBREIM,FBRX,FBSC,FBSTR,FBSUSP,FBVEN,FBVI,I,J,K,L,N,V,Y
  1. K FBVNAME,FBVID,FBVCHAIN,FBPNAME,FBPID,FBDOB
  1. K FBADJLA,FBADJLR,TAMT,FBRRMKL
  1. K FBAUTH,FBIEN,FBX ;FB*3.5*163
  1. D KILL^FBPCR2
  1. Q
  1. SET ;set variables
  1. N FBIEN,FBX ;FB*3.5*163
  1. S Y(0)=$G(^FBAA(162.1,+K,"RX",+L,0)) I Y(0)']""!($P(Y(0),U,9)=1) Q
  1. I $G(^FBAA(162.1,+K,"RX",+L,"FBREJ"))]"" Q
  1. S Y(2)=$G(^FBAA(162.1,+K,0))
  1. S Y(1)=$G(^FBAA(162.1,+K,"RX",+L,2))
  1. S FBX=$$ADJLRA^FBRXFA(+L_","_+K_",")
  1. S FBADJLR=$P(FBX,U) ;adjustment code
  1. S FBADJLA=$P(FBX,U,2) ;adjustment amount
  1. S TAMT=$FN($P(Y(0),"^",7),"",2) ;suspend amount
  1. S FBRRMKL=$$RRL^FBRXFR(+L_","_+K_",") ;remitt remarks
  1. S FBPSF=+$P(Y(1),U,5),FBFD=$P(Y(0),U,3),FBAAA=$P(Y(0),U,5)
  1. Q:'FBPSV&('$D(FBPSV(FBPSF))) S FBCATC=$$CATC^FBPCR(DFN,FBFD)
  1. ;,FBINS=$S($O(^FBAAA("AIC",FBAAA,+$O(^FBAAA("AIC",FBAAA,-FBFD)),0))="Y":1,1:0)
  1. S FBINS=$S($$INSCK(FBFD,FBAAA,FBPI)=1:$$INSURED^FBPCR4(DFN,FBFD),1:0)
  1. Q:'FBCATC&'FBINS
  1. S FBINVN=$P(Y(2),U) D VEN
  1. S FBRX=$P(Y(0),U,1),FBDRUG=$P(Y(0),U,2),FBAC=$P(Y(0),U,4),FBAP=$P(Y(0),U,16),FBSUSP=$P(Y(0),U,8),FBPD=$P(Y(0),U,19),FBBATCH=$P(Y(0),U,17),FBBATCH=$P($G(^FBAA(161.7,+FBBATCH,0)),U)
  1. I FBSUSP]"" S FBSUSP=$P($G(^FBAA(161.27,+FBSUSP,0)),U)
  1. S FBREIM=$S($P(Y(0),U,20)="R":"*",1:""),FBSTR=$P(Y(0),U,12),FBQTY=$P(Y(0),U,13),A1=$J(FBAC,6,2),A2=$J(FBAP,6,2),FBPV=""
  1. S FBPD=$$DATX^FBAAUTL(FBPD),FBFD=$$DATX^FBAAUTL(FBFD)
  1. S FBPV=$S($P(Y(1),U,3)="V":"#",1:""),FBFD1=$S(FBPV="":" ",1:FBPV)_$S(FBREIM="":" ",1:FBREIM)_FBFD,FBRX="Rx: "_FBRX
  1. S FBVEN=FBVNAME_";"_FBVID,FBPAT=FBPNAME_";"_DFN
  1. S FBAUTH=$P(Y(1),U,7) ;Get linked auth FB*3.5*163
  1. I FBAUTH D FBAUTH^FBPCR2(FBAUTH,DFN) ;FB*3.5*163
  1. Q
  1. SETTMP ;sort data by primary service facility, patient, fee program, vendor, date
  1. Q:$$FILTER^FBPCR4()=0
  1. S ^TMP($J,"FB",FBPSF,FBPAT,FBPI,FBVEN,I,K_L)=FBFD1_U_FBRX_U_FBDRUG_U_FBSTR_U_FBQTY_U_A1_U_A2_U_FBSUSP_U_FBINVN_U_FBBATCH_U_FBPD_U_FBDOB_U_FBVCHAIN_U_FBPI_U_FBCATC_U_FBINS
  1. S ^TMP($J,"FB",FBPSF,FBPAT,FBPI,FBVEN,I,K_L,"FBADJ")=FBADJLR_U_FBADJLA_U_FBRRMKL_U_TAMT
  1. S ^TMP($J,"FB",FBPSF,FBPAT,FBPI,FBVEN,I,K_L,"FBAUTH")=$G(FBADX1)_U_$G(FBADX2)_U_$G(FBADX3)_U_$G(FBAICD)_U_$G(FBAREF)_U_$G(FBARNPI)_U_$G(FBAVND)_U_$G(FBAVNPI)_U_$G(FBAVTAX) ; FB*3.5*163
  1. S ^TMP($J,"FB",FBPSF,FBPAT,FBPI,FBVEN)=FBVCHAIN,^TMP($J,"FB",FBPSF,FBPAT)=FBDOB
  1. ;S FBIN(5)=$P(Y(1),U,6) I FBIN(5)]"",$D(^TMP($J,"FB",FBPSF,FBPAT,FBPI,FBVEN,I,L)) D ANC^FBPCR67
  1. Q
  1. VEN ;set variables for vendor
  1. S V=$G(^FBAAV(+$P(Y(2),U,4),0)),FBVNAME=$E($P(V,U),1,23),FBVID=$P(V,U,2),FBVCHAIN=$P(V,U,10)
  1. Q
  1. PRINT ;write output
  1. I FBPG>1&(($Y+10)>IOSL) D HDR Q:FBOUT
  1. E D HDR1 Q:FBOUT
  1. S FBVI="" F S FBVI=$O(^TMP($J,"FB",FBPSF,FBPT,FBPI,FBVI)) Q:FBVI']""!(FBOUT) D SH Q:FBOUT D Q:FBOUT
  1. .S FBDT=0 F S FBDT=$O(^TMP($J,"FB",FBPSF,FBPT,FBPI,FBVI,FBDT)) Q:'FBDT S L=0 F S L=$O(^TMP($J,"FB",FBPSF,FBPT,FBPI,FBVI,FBDT,L)) Q:'L D Q:FBOUT
  1. ..I ($Y+6)>IOSL D PAGE Q:FBOUT
  1. ..S FBDATA=^TMP($J,"FB",FBPSF,FBPT,FBPI,FBVI,FBDT,L),FBCATC=$P(FBDATA,U,15),FBINS=$P(FBDATA,U,16)
  1. ..S FBADJ=^TMP($J,"FB",FBPSF,FBPT,FBPI,FBVI,FBDT,L,"FBADJ")
  1. ..W !,$P(FBDATA,U),?64,$P(FBDATA,U,11),!
  1. ..W ?2,$P(FBDATA,U,2),?15,$P(FBDATA,U,3),?45,$P(FBDATA,U,4),?63,$P(FBDATA,U,5)
  1. ..W !?4,$P(FBDATA,U,6),?12,$P(FBDATA,U,7)
  1. ..W ?20 I $P(FBADJ,U,1)]"" W $P(FBADJ,U,1),?30,$J($P(FBADJ,U,2),14)
  1. ..;If no adjustment code then print suspend cpde amd amount
  1. ..I $P(FBADJ,U,1)="" W $P(FBDATA,U,8),?30,$J($P(FBADJ,U,4),14)
  1. ..W ?47,$P(FBDATA,U,9),?58,$P(FBDATA,U,10),?66,$P(FBADJ,U,3)
  1. ..I FBCATC!FBINS W !?5,">>> Cost recover from "_$S(FBCATC:"means testing",FBINS:"insurance",1:"") W:FBCATC&FBINS " and insurance" W "."
  1. ..W ! D PRTAUTH^FBPCR2(L) ; FB*3.5*163
  1. ..W !
  1. EXIT ;kill and quit
  1. Q
  1. HDR ;main header
  1. D HDR^FBPCR Q:FBOUT
  1. HDR1 W !!?(IOM-(13+$L(FBXPROG))/2),"NVC PROGRAM: ",FBXPROG ;FB*3.5*163 Changed from FEE to NVC
  1. W !?4,"Fill Date",?64,"Date Certified"
  1. W !,?15,"Drug Name",?44,"Strength",?60,"Quantity"
  1. W !?2,"Claimed",?12,"Paid",?20,"Adj Code",?33,"Adj Amounts",?47,"Invoice #",?58,"Batch #",?66,"Remit Remarks",!,FBDASH
  1. Q
  1. SH ;subheader - vendor, prints when name changes
  1. I ($Y+4)>IOSL D HDR Q:FBOUT
  1. W !!,"Vendor: ",$P(FBVI,";"),?41,"Vendor ID: ",$P($P(FBVI,";",2),"/",1),?65,"Chain #: ",$P($G(^TMP($J,"FB",FBPSF,FBPT,FBPI,FBVI)),U)
  1. W !?20,"Fee Basis Billing Provider NPI: ",$P(FBVI,"/",2)
  1. Q
  1. CR ;read for display
  1. S DIR(0)="E" W ! D ^DIR K DIR S:$D(DUOUT)!($D(DTOUT)) FBOUT=1
  1. Q
  1. PAGE ;new page
  1. D HDR Q:FBOUT D SH
  1. Q
  1. ;FB*3.5*163 - modified to process yes or no Potential Cost Recovery value.
  1. INSCK(FBDT,FBDA1,FBPI) ;possible cost recovery fcn call
  1. ;Passed variables: fbdt=fill date or treatment from date
  1. ; fbda1=ien if fee patient file, patient ien
  1. ; fbpi=fee program
  1. ;Output variables: fbins=1 if possible recovery, 0 if no
  1. N FBDA,FBFLAG,FBINS
  1. S FBINS=0,FBFLAG=0,FBDT=FBDT+.1,FBDT=+$O(^FBAAA("AIC",FBDA1,-FBDT))
  1. I FBDT S FBINS=$O(^FBAAA("AIC",FBDA1,FBDT,"N")) I FBINS="Y"!(FBINS="N") D
  1. .S FBDA=0 F S FBDA=$O(^FBAAA("AIC",FBDA1,FBDT,FBINS,FBDA)) Q:'FBDA D ; Get both inpatient and outpatient pcr - FB*3.5*166
  1. ..I $P($G(^FBAAA(FBDA1,1,FBDA,0)),U,3)=FBPI S FBFLAG=1
  1. I 'FBFLAG S FBINS=0
  1. Q $S(FBINS="Y":1,FBINS="N":1,1:0)