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Routine: FBUCLET2

Package: Fee Basis

Routine: FBUCLET2


Information

FBUCLET2 ;WOIFO/SAB - UNAUTHORIZED CLAIM LETTER (continued) ;08/15/02

Source Information

Source file <FBUCLET2.m>

Entry Points

Name Comments DBIA/ICR reference
AUTHPR ;print authorized dates and approved amounts on disposition letter
ACT ; print table of adjustment reason descriptions
; Input
; FBACRR( - required, array
; FBACRR(FBADJRE)=""
; where FBADJRE = adjustment reason code, external value
CHDHD ; civil hospital payment detail header
CHD ; civil hospital payment detail
ODHD ; outpatient/ancillary payment header
OD ; outpatient/ancillary payment detail
PDHD ; pharmacy payment detail header
PD ; pharmacy payment detail

Interaction Calls

Name Line Occurrences
Function Call: WRITE
  • Prompt: !?8,"Authorized from: ",$$FMTE^XLFDT($P(FBUCA,U,13))
  • Line Location: AUTHPR+36
Function Call: WRITE
  • Prompt: " Authorized to: ",$$FMTE^XLFDT($P(FBUCA,U,14))
  • Line Location: AUTHPR+37
Function Call: WRITE
  • Prompt: !?8,"Amount approved: "
  • Line Location: AUTHPR+38
Function Call: WRITE
  • Prompt: "$",$FN(FBTAMT,",",2)
  • Condition for execution: FBTAMT
  • Line Location: AUTHPR+38
Function Call: WRITE
  • Prompt: " Itemized list follows:"
  • Line Location: AUTHPR+39
Function Call: WRITE
  • Prompt: !!?8,"Patient Control Number: ",FBSCID
  • Line Location: AUTHPR+44
Function Call: WRITE
  • Prompt: !!?8,"Patient Account Number: ",FBSCID
  • Line Location: AUTHPR+53
Function Call: WRITE
  • Prompt: !!?8,"*Reason(s) for Suspension"
  • Line Location: AUTHPR+75
Function Call: WRITE
  • Prompt: !?8,"(4) Other. Specific reason immediately follows item."
  • Line Location: AUTHPR+78
Function Call: WRITE
  • Prompt: !
  • Line Location: AUTHPR+86
Function Call: WRITE
  • Prompt: !,?8,"*Adjustment Code Text:"
  • Line Location: ACT+7
Function Call: WRITE
  • Prompt: !!?8,"Admission Date",?24,"Discharge Date"
  • Line Location: CHDHD+1
Function Call: WRITE
  • Prompt: ?40,"Amt Claimed",?53,"Amt Approved"
  • Line Location: CHDHD+2
Function Call: WRITE
  • Prompt: ?67,"Adj Code*"
  • Line Location: CHDHD+3
Function Call: WRITE
  • Prompt: !?8,"--------------",?24,"--------------"
  • Line Location: CHDHD+4
Function Call: WRITE
  • Prompt: ?40,"-----------",?53,"------------"
  • Line Location: CHDHD+5
Function Call: WRITE
  • Prompt: ?67,"--------"
  • Line Location: CHDHD+6
Function Call: WRITE
  • Prompt: !!?8,$$FMTE^XLFDT($P(FBY,U,6)),?24,$$FMTE^XLFDT($P(FBY,U,7))
  • Line Location: CHD+8
Function Call: WRITE
  • Prompt: ?40,$J("$"_$FN($P(FBY,U,8),",",2),11)
  • Line Location: CHD+9
Function Call: WRITE
  • Prompt: ?53,$J("$"_$FN($P(FBY,U,9),",",2),12)
  • Line Location: CHD+10
Function Call: WRITE
  • Prompt: ?70,$S(FBADJLR]"":FBADJLR,1:FBSC)
  • Line Location: CHD+13
Function Call: WRITE
  • Prompt: !,?8,"FPPS Claim ID: ",FBFPPSC,?36,"FPPS Line Item: ",FBFPPSL
  • Line Location: CHD+14
Function Call: WRITE
  • Prompt: !!?8,"Service Date",?22,"CPT-MOD"
  • Line Location: ODHD+1
Function Call: WRITE
  • Prompt: ?40,"Amt Claimed",?53,"Amt Approved"
  • Line Location: ODHD+2
Function Call: WRITE
  • Prompt: ?67,"Adj Code*"
  • Line Location: ODHD+3
Function Call: WRITE
  • Prompt: !?8,"------------",?22,"--------"
  • Line Location: ODHD+4
Function Call: WRITE
  • Prompt: ?40,"-----------",?53,"------------"
  • Line Location: ODHD+5
Function Call: WRITE
  • Prompt: ?67,"--------"
  • Line Location: ODHD+6
Function Call: WRITE
  • Prompt: !!?8,$$FMTE^XLFDT(FBDOS)
  • Line Location: OD+15
Function Call: WRITE
  • Prompt: ?22,FBCPT_$S($G(FBMODLE)]"":"-"_$P(FBMODLE,","),1:"")
  • Line Location: OD+16
Function Call: WRITE
  • Prompt: ?40,$J("$"_$FN($P(FBY,U,2),",",2),11)
  • Line Location: OD+17
Function Call: WRITE
  • Prompt: ?53,$J("$"_$FN($P(FBY,U,3),",",2),12)
  • Line Location: OD+18
Function Call: WRITE
  • Prompt: ?70,$S(FBADJLR]"":FBADJLR,1:FBSC)
  • Line Location: OD+21
Function Call: WRITE
  • Prompt: @IOF
  • Line Location: OD+25
Function Call: WRITE
  • Prompt: !," (continued)"
  • Line Location: OD+25
Function Call: WRITE
  • Prompt: !,?27,"-",FBMOD
  • Line Location: OD+26
Function Call: WRITE
  • Prompt: !,?8,"FPPS Claim ID: ",FBFPPSC,?36,"FPPS Line Item: ",FBFPPSL
  • Line Location: OD+27
Function Call: WRITE
  • Prompt: !!?8,"RX Date",?21,"RX #"
  • Line Location: PDHD+1
Function Call: WRITE
  • Prompt: ?40,"Amt Claimed",?53,"Amt Approved"
  • Line Location: PDHD+2
Function Call: WRITE
  • Prompt: ?67,"Adj Code*"
  • Line Location: PDHD+3
Function Call: WRITE
  • Prompt: !?8,"------------",?21,"--------"
  • Line Location: PDHD+4
Function Call: WRITE
  • Prompt: ?40,"-----------",?53,"------------"
  • Line Location: PDHD+5
Function Call: WRITE
  • Prompt: ?67,"--------"
  • Line Location: PDHD+6
Function Call: WRITE
  • Prompt: !!?8,$$FMTE^XLFDT($P(FBY,U,3)),?21,$$FMTE^XLFDT($P(FBY,U,1))
  • Line Location: PD+10
Function Call: WRITE
  • Prompt: ?40,$J("$"_$FN($P(FBY,U,4),",",2),11)
  • Line Location: PD+11
Function Call: WRITE
  • Prompt: ?53,$J("$"_$FN($P(FBY,U,16),",",2),12)
  • Line Location: PD+12
Function Call: WRITE
  • Prompt: ?70,$S(FBADJLR]"":FBADJLR,1:FBSC)
  • Line Location: PD+15
Function Call: WRITE
  • Prompt: !?8,"Drug Name: ",$P(FBY,U,2)
  • Line Location: PD+16
Function Call: WRITE
  • Prompt: !,?8,"FPPS Claim ID: ",FBFPPSC,?36,"FPPS Line Item: ",FBFPPSL
  • Line Location: PD+17

FileMan Files Accessed Via FileMan Db Call

FileNo Call Tags
162.03 GET1^DIQ
162.11 GET1^DIQ
^FBAAI - [#162.5] GET1^DIQ
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