IBCE837A ;ALB/TMP - OUTPUT FOR 837 TRANSMISSION - CONTINUED ;8/6/03 10:50am
;;2.0;INTEGRATED BILLING;**137,191,211,232,296,377,592,623,641,718**;21-MAR-94;Build 73
;;Per VA Directive 6402, this routine should not be modified.
;
UPD(MSGNUM,BATCH,CNT,BILLS,DESC,IBBTYP,IBINS) ; Upd current batch + bills w/new status
;MSGNUM = mail msg # for batch
;BATCH = batch #
;CNT = # of bills in batch
;BILLS = array BILLS(bill ien in 364) in batch
;DESC = 1-80 character description of batch
;IBBTYP = X-Y where X = P for professional, I for institution, or D for Dental ;JWS;IB*2.0*592;US131
; Y = 1 for test or 0 for live transmission
; or 2 for live claim resubmitted as test
;IBINS = ien of single insurance company for the batch (optional)
;
N DIC,DIE,DR,DA,IBBATCH,IBIFN,IBIEN,IBYY,IBTXTEST,IBMRA
S IBBATCH=$O(^IBA(364.1,"B",+BATCH,"")) Q:'IBBATCH
S IBTXTEST=+$P(IBBTYP,"-",2)
I '$P($G(^IBE(350.9,1,8)),U,7) S IBINS=""
;
;JWS;IB*2.0*641v14 update status to A0 for FHIR claims
S DIE="^IBA(364.1,",DA=IBBATCH,DR=".02////"_$S($$GET1^DIQ(350.9,"1,",8.21,"I"):"A0",1:"P")_";.03///"_CNT_";.04///"_MSGNUM_";.05///0;.07////1;.08///^S X="""_DESC_""""_$S($G(IBINS):";.12////"_IBINS,1:"")
;
I '$P($G(^TMP("IBRESUBMIT",$J)),U,3) S DR=DR_";1.01///NOW;1.02///.5"
I $P($G(^TMP("IBRESUBMIT",$J)),U,2) S DR=DR_";.15////"_$P(^($J),U,2)
;JWS;IB*2.0*592;US131
S DR=DR_";.14////"_$S('IBTXTEST:0,1:1)_";.06////"_$S($E(IBBTYP)="P":2,$E(IBBTYP)="D":7,1:3) D ^DIE ; Update batch
;
I IBTXTEST=2 D ADDTXM^IBCEPTM(.BILLS,IBBATCH,$$NOW^XLFDT()) Q
I IBTXTEST'=2 S IBIEN=0 F S IBIEN=$O(BILLS(IBIEN)) Q:'IBIEN D ;Update each bill
. ;JWS;IB*2.0*623;update field .09 837 FHIR ReQUEST if using 837 FHIR trans method
. ;JWS;IB*2.0*641v14 update status to A0 for FHIR claims
. S DA=IBIEN,DIE="^IBA(364,",DR=".02////"_IBBATCH_";.03///"_$S($$GET1^DIQ(350.9,"1,",8.21,"I"):"A0",1:"P")_";.04///NOW"
. I $D(^IBA(364,"AC",1,DA)) S DR=DR_";.09////2"
. D ^DIE
. S IBIFN=+$G(^IBA(364,IBIEN,0))
. ; If this claim has just been retransmitted, set the .06 field for the previous transmission entry
. N PRVTXI,PRVTXD
. S PRVTXI=$O(^IBA(364,"B",IBIFN,IBIEN),-1) ; previous transmission for this claim
. I PRVTXI D
.. S PRVTXD=$G(^IBA(364,PRVTXI,0))
.. I '$F(".R.E.","."_$P(PRVTXD,U,3)_".") Q ; prev trans must have status of "R" or "E"
.. I $P(PRVTXD,U,7,8)'=$P($G(^IBA(364,IBIEN,0)),U,7,8) Q ; test bill and COB must be the same
.. S DA=PRVTXI,DIE=364,DR=".06///"_IBBATCH D ^DIE ; update the resubmit batch number
.. Q
. ;
.Q:$D(^TMP("IBRESUBMIT",$J))!($P($G(^DGCR(399,IBIFN,0)),U,13)=4)!(+$$TXMT^IBCEF4(IBIEN)=2)
.S IBMRA=$$NEEDMRA^IBEFUNC(IBIFN)
.I IBMRA="C",$P($G(^DGCR(399,IBIFN,0)),U,13)=2 S IBMRA=1
.I IBIFN D
..S (DIC,DIE)="^DGCR(399,",DA=$P($G(^IBA(364,IBIEN,0)),U),DR="[IB STATUS]",IBYY=$S('IBMRA:"@91",1:"@911") D:DA ^DIE
..D BSTAT^IBCDC(IBIFN) ; remove from AB list
Q
;
PRE ; Run before processing a bill entry
K IBXSAVE,IBXERR,^UTILITY("VAPA",$J),^TMP("IBXSAVE",$J),^TMP($J),^TMP("DIERR",$J)
Q
;
POST ; Run after processing a bill entry for cleanup
N Q
I $G(IBXERR)'="" D
.S ^TMP("IBXERR",$J,IBXIEN)=IBXERR K ^TMP("IBXDATA",$J)
.K ^TMP("IBHDR1",$J)
.I $D(^TMP("IBRESUBMIT",$J)),'$G(^TMP("IBEDI_TEST_BATCH",$J)) D ;Set not resub flag for non-test bill
..N Z,Z0
..S Z0=$P($G(^TMP("IBRESUBMIT",$J)),U) Q:Z0=""
..S Z=$O(^IBA(364,"ABABI",+$O(^IBA(364.1,"B",Z0,"")),IBXIEN,""))
..I Z S ^TMP("IBNOT",$J,Z)=IBXIEN
K IBXSAVE,IBXNOREQ,^TMP("IBXSAVE",$J),^TMP($J)
;;IB*2.0*718;JWS;12/27/21;EBILL-1629;Incorporate FSC Overrides
D POST^IBCE837P
S Q="VA" F S Q=$O(^UTILITY(Q)) Q:$E(Q,1,2)'="VA" I $D(^(Q,$J)) K ^UTILITY(Q,$J)
D CLEAN^DILF
Q
;
MAILIT(IBQUEUE,IBBILL,IBCTM,IBDUZ,IBDESC,IBBTYP,IBINS) ; Send mail msg, update bills
;IBQUEUE = mail queue name to send 837 transactions to
;IBBILL = array of ien's in file 364 of bills in batch - IBBILL(IEN)=""
;IBCTM = # of bills in batch, returned reset to 0
;IBDUZ = ien of user 'running' extract (if any)
;IBDESC = description of batch
;IBBTYP = X-Y where X = P for professional, I for institution, or D for Dental ;JWS;IB*2.0*592;US131
; Y = 1 or 2 for test or 0 for live transmission
;IBINS = ien of insurance company if only one/batch option (optional)
;
N DIK,DA,XMTO,XMZ,XMBODY,XMDUZ,XMSUBJ,IBBDA,IBBNO
;
S IBBNO=+$P($G(^TMP("IBHDR",$J)),U),IBBDA=$O(^IBA(364.1,"B",IBBNO,""))
I '$P($G(^IBE(350.9,1,8)),U,7) S IBINS=""
;
I IBCTM D
. ;JWS;IB*2.0*623
. I $$GET1^DIQ(350.9,"1,",8.21,"I") Q ;G MAILQ
. I +$G(^TMP("IBEDI_TEST_BATCH",$J)) S IBQUEUE="MCT"
. I IBQUEUE'="",IBQUEUE'["@" S XMTO("XXX@Q-"_IBQUEUE_".DOMAIN.EXT")=""
. ;
. ; ******Note to self - remove when going to sites although it shouldn't hurt if you forget - WCJ **********
. I '$$PROD^XUPROD(1) S XMTO("G.CLAIMS4US")=""
. ;
. I IBQUEUE["@" S XMTO(IBQUEUE)=""
. S XMDUZ=$G(IBDUZ),XMBODY="^TMP(""IBXMSG"","_$J_")",XMSUBJ=$S($P(IBBTYP,U,2):"** TEST"_$S($P(IBBTYP,U,2)=2:"/RESUB OF LIVE",1:""),1:"")_" CLAIM BATCH: "_$S(IBQUEUE'["@":IBQUEUE,1:$P(IBQUEUE,"@"))_"/"_IBBNO
. K XMZ
. D SENDMSG^XMXAPI(XMDUZ,XMSUBJ,XMBODY,.XMTO,,.XMZ)
. I $G(XMZ) D
.. D UPD(XMZ,$P($G(^TMP("IBHDR",$J)),U),IBCTM,.IBBILL,IBDESC,IBBTYP,IBINS) ;Update batch/bills
.. S ^TMP("IBCE-BATCH",$J,IBBNO)=IBBDA_U_IBCTM_U_$P($G(^TMP("IBRESUBMIT",$J)),U)
MAILQ ;
S IBCTM=0
;JWS;IB*2.0*623;do not do for FHIR transmissions
I '$$GET1^DIQ(350.9,"1,",8.21,"I") D CHKBTCH(+$G(^TMP("IBHDR",$J)))
K ^TMP("IBHDR",$J),^TMP("IBHDR1",$J),^TMP("IBXMSG",$J),IBBILL
Q
;
CHKNEW(IBQ,IBBILL,IBCTM,IBDESC,IBBTYP,IBINS,IBSITE,IBSIZE) ;
; Determine if ok to send msg
; Check for one insurance per batch if IBINS defined
; Returns IBSIZE, IBCTM, IBBILL (pass by reference)
;
; IBQ = data queue name
; IBBILL = the 'list' of bill #'s in the batch
; IBCTM = the # of claims output so far to the batch
; IBDESC = the batch description text
; IBBTYP = X-Y where X = P for professional, I for institution, or D for Dental
; Y = 1 for test or 0 for live transmission
; IBINS = the ien of the single insurance co. for the batch (optional)
; IBSITE = the '8' node of file 350.9 (IB PARAMETERS)
; IBSIZE = the 'running' size of the output message
;
Q:$S($G(IBINS)="":0,1:'$P(IBSITE,U,7))
;
; New batch needed
I IBCTM D MAILIT(IBQ,.IBBILL,.IBCTM,"",IBDESC,IBBTYP,IBINS) S IBSIZE=0
Q
;
ERRMSG(XMBODY) ; Send bulletin for error message
N XMTO,XMSUBJ
S XMTO("I:G.IB EDI")="",XMSUBJ="EDI 837 TRANSMISSION ERRORS"
;
D SENDMSG^XMXAPI(,XMSUBJ,XMBODY,.XMTO)
D ALERT("One or more EDI bills were not transmitted. Check your mail for details","G.IB EDI")
Q
;
CLEANUP ; Cleans up bill transmission environment
;
N IBTEST
S IBTEST=+$G(^TMP("IBEDI_TEST_BATCH",$J))
L -^IBA(364,0)
I $D(^TMP("IBRESUBMIT",$J,"IBXERR"))!$D(^TMP("IBONE",$J,"IBXERR"))!$D(^TMP("IBSELX",$J,"IBXERR")) D ;Error message to mail group
. N XMTO,XMBODY,XMDUZ,XMSUBJ,XMZ,IBFUNC
. S IBFUNC=$S($D(^TMP("IBRESUBMIT",$J,"IBXERR")):$S('IBTEST:1,1:4),$D(^TMP("IBONE",$J,"IBXERR")):2,1:3)
. Q:'IBFUNC
. S XMTO("I:G.IB EDI")="",XMDUZ="",XMBODY="^TMP("""_$S(IBFUNC=1!(IBFUNC=4):"IBRESUBMIT",1:"IBONE")_""","_$J_",""IBXERR"")"
. S XMSUBJ="EDI 837 B"_$P("ATCH^ILL^ILL(s)^ILL(s)",U,IBFUNC)_" NOT "_$S($G(^TMP("IBONE",$J)):"RE",1:"")_"SUBMITTED"_$S('IBTEST:"",1:" AS TEST CLAIMS")
. D SENDMSG^XMXAPI(XMDUZ,XMSUBJ,XMBODY,.XMTO,,.XMZ)
. K ^TMP("IBRESUBMIT",$J),^TMP("IBONE",$J)
;
I $D(^TMP("IBRESUBMIT",$J)),'IBTEST D RESUBUP^IBCEM02 ;Upd resubmtd batch bills
I '$D(^TMP("IBSELX",$J)) K ^TMP("IBCE-BATCH",$J)
K ^TMP("IBXERR",$J),IBXERR
I 'IBTEST D CHKBTCH(+$G(^TMP("IBHDR",$J)))
CLEANP ; Entrypoint for extract data disply
K ^TMP("IBTXMT",$J),^TMP("IBXINS",$J)
K ^TMP("IBRESUBMIT",$J),^TMP("IBRESUB",$J),^TMP("IBNOT",$J),^TMP("IBONE",$J),^TMP("IBHDR",$J),^TMP("IBTX",$J),^TMP("IBEDI_TEST_BATCH",$J)
K ^UTILITY("VADM",$J)
D CLEAN^DILF
K ZTREQ S ZTREQ="@"
Q
;
ALERT(XQAMSG,IBGRP) ; Send alert message
N XQA
S XQA(IBGRP)=""
D SETUP^XQALERT
Q
CHKBTCH(IBBNO) ; Delete batch whose batch # is IBBNO if no entries in file 364
; and not a resubmitted batch
N IBZ,DA,DIK
S IBZ=+$O(^IBA(364.1,"B",+IBBNO,""))
I IBZ,'$O(^IBA(364,"C",IBZ,0)),'$P($G(^IBA(364.1,IBZ,0)),U,14) S DA=IBZ,DIK="^IBA(364.1," D ^DIK
Q
;
TESTLIM(IBINS) ; Check for test bill limit per day has been reached
N IB3,DA,DIK
S IB3=$G(^DIC(36,IBINS,3))
I $P(IB3,U,5)'=DT S $P(IB3,U,7)=0
;JWS;IB*2.0*623v24;for test env don't skip
I '$$PROD^XUPROD(1) G 1
I ($P(IB3,U,7)+$G(^TMP("IBICT",$J,IBINS))+1)>$P(IB3,U,6) D Q
. S IBINS="" ;max # hit
. S DA=IBX,DIK="^IBA(364," D ^DIK
1 S ^TMP("IBICT",$J,IBINS)=$G(^TMP("IBICT",$J,IBINS))+1
Q
;
SETVAR(IBXIEN,IBINS,IB0,IBSEC,IBNID,IB837R,IBDIV) ;
; Set up variables needed for subscripts in sort global
; ejk added IBSEC logic for patch 296
; IBSEC=1 if primary bill, 2 if 2nd/non-MRA, 3 if 2nd/MRA
S IBSEC=$S($$COBN^IBCEF(IBXIEN)=1:1,'$$MRASEC^IBCEF4(IBXIEN):2,1:3)
S IBNID=$$PAYERID^IBCEF2(IBXIEN)
S IB837R=$$RECVR^IBCEF2(IBXIEN)
S IBDIV=$P($S($P(IB0,U,22):$$SITE^VASITE(DT,$P(IB0,U,22)),1:$$SITE^VASITE()),U,3)
I IBNID'="","RPIHS"[$E(IBNID),$E(IBNID,2,$L(IBNID))="PRNT" S IBNID=IBNID_"*"_IBINS
I IBNID="" S IBNID="*"_IBINS
S $P(IBNID,"*",3)=$S($P(IB0,U,22):$P(IB0,U,22),1:"")
Q
;
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIBCE837A 9523 printed Dec 13, 2024@02:09:26 Page 2
IBCE837A ;ALB/TMP - OUTPUT FOR 837 TRANSMISSION - CONTINUED ;8/6/03 10:50am
+1 ;;2.0;INTEGRATED BILLING;**137,191,211,232,296,377,592,623,641,718**;21-MAR-94;Build 73
+2 ;;Per VA Directive 6402, this routine should not be modified.
+3 ;
UPD(MSGNUM,BATCH,CNT,BILLS,DESC,IBBTYP,IBINS) ; Upd current batch + bills w/new status
+1 ;MSGNUM = mail msg # for batch
+2 ;BATCH = batch #
+3 ;CNT = # of bills in batch
+4 ;BILLS = array BILLS(bill ien in 364) in batch
+5 ;DESC = 1-80 character description of batch
+6 ;IBBTYP = X-Y where X = P for professional, I for institution, or D for Dental ;JWS;IB*2.0*592;US131
+7 ; Y = 1 for test or 0 for live transmission
+8 ; or 2 for live claim resubmitted as test
+9 ;IBINS = ien of single insurance company for the batch (optional)
+10 ;
+11 NEW DIC,DIE,DR,DA,IBBATCH,IBIFN,IBIEN,IBYY,IBTXTEST,IBMRA
+12 SET IBBATCH=$ORDER(^IBA(364.1,"B",+BATCH,""))
if 'IBBATCH
QUIT
+13 SET IBTXTEST=+$PIECE(IBBTYP,"-",2)
+14 IF '$PIECE($GET(^IBE(350.9,1,8)),U,7)
SET IBINS=""
+15 ;
+16 ;JWS;IB*2.0*641v14 update status to A0 for FHIR claims
+17 SET DIE="^IBA(364.1,"
SET DA=IBBATCH
SET DR=".02////"_$SELECT($$GET1^DIQ(350.9,"1,",8.21,"I"):"A0",1:"P")_";.03///"_CNT_";.04///"_MSGNUM_";.05///0;.07////1;.08///^S X="""_DESC_""""_$SELECT($GET(IBINS):";.12////"_IBINS,1:"")
+18 ;
+19 IF '$PIECE($GET(^TMP("IBRESUBMIT",$JOB)),U,3)
SET DR=DR_";1.01///NOW;1.02///.5"
+20 IF $PIECE($GET(^TMP("IBRESUBMIT",$JOB)),U,2)
SET DR=DR_";.15////"_$PIECE(^($JOB),U,2)
+21 ;JWS;IB*2.0*592;US131
+22 ; Update batch
SET DR=DR_";.14////"_$SELECT('IBTXTEST:0,1:1)_";.06////"_$SELECT($EXTRACT(IBBTYP)="P":2,$EXTRACT(IBBTYP)="D":7,1:3)
DO ^DIE
+23 ;
+24 IF IBTXTEST=2
DO ADDTXM^IBCEPTM(.BILLS,IBBATCH,$$NOW^XLFDT())
QUIT
+25 ;Update each bill
IF IBTXTEST'=2
SET IBIEN=0
FOR
SET IBIEN=$ORDER(BILLS(IBIEN))
if 'IBIEN
QUIT
Begin DoDot:1
+26 ;JWS;IB*2.0*623;update field .09 837 FHIR ReQUEST if using 837 FHIR trans method
+27 ;JWS;IB*2.0*641v14 update status to A0 for FHIR claims
+28 SET DA=IBIEN
SET DIE="^IBA(364,"
SET DR=".02////"_IBBATCH_";.03///"_$SELECT($$GET1^DIQ(350.9,"1,",8.21,"I"):"A0",1:"P")_";.04///NOW"
+29 IF $DATA(^IBA(364,"AC",1,DA))
SET DR=DR_";.09////2"
+30 DO ^DIE
+31 SET IBIFN=+$GET(^IBA(364,IBIEN,0))
+32 ; If this claim has just been retransmitted, set the .06 field for the previous transmission entry
+33 NEW PRVTXI,PRVTXD
+34 ; previous transmission for this claim
SET PRVTXI=$ORDER(^IBA(364,"B",IBIFN,IBIEN),-1)
+35 IF PRVTXI
Begin DoDot:2
+36 SET PRVTXD=$GET(^IBA(364,PRVTXI,0))
+37 ; prev trans must have status of "R" or "E"
IF '$FIND(".R.E.","."_$PIECE(PRVTXD,U,3)_".")
QUIT
+38 ; test bill and COB must be the same
IF $PIECE(PRVTXD,U,7,8)'=$PIECE($GET(^IBA(364,IBIEN,0)),U,7,8)
QUIT
+39 ; update the resubmit batch number
SET DA=PRVTXI
SET DIE=364
SET DR=".06///"_IBBATCH
DO ^DIE
+40 QUIT
End DoDot:2
+41 ;
+42 if $DATA(^TMP("IBRESUBMIT",$JOB))!($PIECE($GET(^DGCR(399,IBIFN,0)),U,13)=4)!(+$$TXMT^IBCEF4(IBIEN)=2)
QUIT
+43 SET IBMRA=$$NEEDMRA^IBEFUNC(IBIFN)
+44 IF IBMRA="C"
IF $PIECE($GET(^DGCR(399,IBIFN,0)),U,13)=2
SET IBMRA=1
+45 IF IBIFN
Begin DoDot:2
+46 SET (DIC,DIE)="^DGCR(399,"
SET DA=$PIECE($GET(^IBA(364,IBIEN,0)),U)
SET DR="[IB STATUS]"
SET IBYY=$SELECT('IBMRA:"@91",1:"@911")
if DA
DO ^DIE
+47 ; remove from AB list
DO BSTAT^IBCDC(IBIFN)
End DoDot:2
End DoDot:1
+48 QUIT
+49 ;
PRE ; Run before processing a bill entry
+1 KILL IBXSAVE,IBXERR,^UTILITY("VAPA",$JOB),^TMP("IBXSAVE",$JOB),^TMP($JOB),^TMP("DIERR",$JOB)
+2 QUIT
+3 ;
POST ; Run after processing a bill entry for cleanup
+1 NEW Q
+2 IF $GET(IBXERR)'=""
Begin DoDot:1
+3 SET ^TMP("IBXERR",$JOB,IBXIEN)=IBXERR
KILL ^TMP("IBXDATA",$JOB)
+4 KILL ^TMP("IBHDR1",$JOB)
+5 ;Set not resub flag for non-test bill
IF $DATA(^TMP("IBRESUBMIT",$JOB))
IF '$GET(^TMP("IBEDI_TEST_BATCH",$JOB))
Begin DoDot:2
+6 NEW Z,Z0
+7 SET Z0=$PIECE($GET(^TMP("IBRESUBMIT",$JOB)),U)
if Z0=""
QUIT
+8 SET Z=$ORDER(^IBA(364,"ABABI",+$ORDER(^IBA(364.1,"B",Z0,"")),IBXIEN,""))
+9 IF Z
SET ^TMP("IBNOT",$JOB,Z)=IBXIEN
End DoDot:2
End DoDot:1
+10 KILL IBXSAVE,IBXNOREQ,^TMP("IBXSAVE",$JOB),^TMP($JOB)
+11 ;;IB*2.0*718;JWS;12/27/21;EBILL-1629;Incorporate FSC Overrides
+12 DO POST^IBCE837P
+13 SET Q="VA"
FOR
SET Q=$ORDER(^UTILITY(Q))
if $EXTRACT(Q,1,2)'="VA"
QUIT
IF $DATA(^(Q,$JOB))
KILL ^UTILITY(Q,$JOB)
+14 DO CLEAN^DILF
+15 QUIT
+16 ;
MAILIT(IBQUEUE,IBBILL,IBCTM,IBDUZ,IBDESC,IBBTYP,IBINS) ; Send mail msg, update bills
+1 ;IBQUEUE = mail queue name to send 837 transactions to
+2 ;IBBILL = array of ien's in file 364 of bills in batch - IBBILL(IEN)=""
+3 ;IBCTM = # of bills in batch, returned reset to 0
+4 ;IBDUZ = ien of user 'running' extract (if any)
+5 ;IBDESC = description of batch
+6 ;IBBTYP = X-Y where X = P for professional, I for institution, or D for Dental ;JWS;IB*2.0*592;US131
+7 ; Y = 1 or 2 for test or 0 for live transmission
+8 ;IBINS = ien of insurance company if only one/batch option (optional)
+9 ;
+10 NEW DIK,DA,XMTO,XMZ,XMBODY,XMDUZ,XMSUBJ,IBBDA,IBBNO
+11 ;
+12 SET IBBNO=+$PIECE($GET(^TMP("IBHDR",$JOB)),U)
SET IBBDA=$ORDER(^IBA(364.1,"B",IBBNO,""))
+13 IF '$PIECE($GET(^IBE(350.9,1,8)),U,7)
SET IBINS=""
+14 ;
+15 IF IBCTM
Begin DoDot:1
+16 ;JWS;IB*2.0*623
+17 ;G MAILQ
IF $$GET1^DIQ(350.9,"1,",8.21,"I")
QUIT
+18 IF +$GET(^TMP("IBEDI_TEST_BATCH",$JOB))
SET IBQUEUE="MCT"
+19 IF IBQUEUE'=""
IF IBQUEUE'["@"
SET XMTO("XXX@Q-"_IBQUEUE_".DOMAIN.EXT")=""
+20 ;
+21 ; ******Note to self - remove when going to sites although it shouldn't hurt if you forget - WCJ **********
+22 IF '$$PROD^XUPROD(1)
SET XMTO("G.CLAIMS4US")=""
+23 ;
+24 IF IBQUEUE["@"
SET XMTO(IBQUEUE)=""
+25 SET XMDUZ=$GET(IBDUZ)
SET XMBODY="^TMP(""IBXMSG"","_$JOB_")"
SET XMSUBJ=$SELECT($PIECE(IBBTYP,U,2):"** TEST"_$SELECT($PIECE(IBBTYP,U,2)=2:"/RESUB OF LIVE",1:""),1:"")_" CLAIM BATCH: "_$SELECT(IBQUEUE'["@":IBQUEUE,1:$PIECE(IBQUEUE,"@"))_"/"_IBBNO
+26 KILL XMZ
+27 DO SENDMSG^XMXAPI(XMDUZ,XMSUBJ,XMBODY,.XMTO,,.XMZ)
+28 IF $GET(XMZ)
Begin DoDot:2
+29 ;Update batch/bills
DO UPD(XMZ,$PIECE($GET(^TMP("IBHDR",$JOB)),U),IBCTM,.IBBILL,IBDESC,IBBTYP,IBINS)
+30 SET ^TMP("IBCE-BATCH",$JOB,IBBNO)=IBBDA_U_IBCTM_U_$PIECE($GET(^TMP("IBRESUBMIT",$JOB)),U)
End DoDot:2
End DoDot:1
MAILQ ;
+1 SET IBCTM=0
+2 ;JWS;IB*2.0*623;do not do for FHIR transmissions
+3 IF '$$GET1^DIQ(350.9,"1,",8.21,"I")
DO CHKBTCH(+$GET(^TMP("IBHDR",$JOB)))
+4 KILL ^TMP("IBHDR",$JOB),^TMP("IBHDR1",$JOB),^TMP("IBXMSG",$JOB),IBBILL
+5 QUIT
+6 ;
CHKNEW(IBQ,IBBILL,IBCTM,IBDESC,IBBTYP,IBINS,IBSITE,IBSIZE) ;
+1 ; Determine if ok to send msg
+2 ; Check for one insurance per batch if IBINS defined
+3 ; Returns IBSIZE, IBCTM, IBBILL (pass by reference)
+4 ;
+5 ; IBQ = data queue name
+6 ; IBBILL = the 'list' of bill #'s in the batch
+7 ; IBCTM = the # of claims output so far to the batch
+8 ; IBDESC = the batch description text
+9 ; IBBTYP = X-Y where X = P for professional, I for institution, or D for Dental
+10 ; Y = 1 for test or 0 for live transmission
+11 ; IBINS = the ien of the single insurance co. for the batch (optional)
+12 ; IBSITE = the '8' node of file 350.9 (IB PARAMETERS)
+13 ; IBSIZE = the 'running' size of the output message
+14 ;
+15 if $SELECT($GET(IBINS)=""
QUIT
+16 ;
+17 ; New batch needed
+18 IF IBCTM
DO MAILIT(IBQ,.IBBILL,.IBCTM,"",IBDESC,IBBTYP,IBINS)
SET IBSIZE=0
+19 QUIT
+20 ;
ERRMSG(XMBODY) ; Send bulletin for error message
+1 NEW XMTO,XMSUBJ
+2 SET XMTO("I:G.IB EDI")=""
SET XMSUBJ="EDI 837 TRANSMISSION ERRORS"
+3 ;
+4 DO SENDMSG^XMXAPI(,XMSUBJ,XMBODY,.XMTO)
+5 DO ALERT("One or more EDI bills were not transmitted. Check your mail for details","G.IB EDI")
+6 QUIT
+7 ;
CLEANUP ; Cleans up bill transmission environment
+1 ;
+2 NEW IBTEST
+3 SET IBTEST=+$GET(^TMP("IBEDI_TEST_BATCH",$JOB))
+4 LOCK -^IBA(364,0)
+5 ;Error message to mail group
IF $DATA(^TMP("IBRESUBMIT",$JOB,"IBXERR"))!$DATA(^TMP("IBONE",$JOB,"IBXERR"))!$DATA(^TMP("IBSELX",$JOB,"IBXERR"))
Begin DoDot:1
+6 NEW XMTO,XMBODY,XMDUZ,XMSUBJ,XMZ,IBFUNC
+7 SET IBFUNC=$SELECT($DATA(^TMP("IBRESUBMIT",$JOB,"IBXERR")):$SELECT('IBTEST:1,1:4),$DATA(^TMP("IBONE",$JOB,"IBXERR")):2,1:3)
+8 if 'IBFUNC
QUIT
+9 SET XMTO("I:G.IB EDI")=""
SET XMDUZ=""
SET XMBODY="^TMP("""_$SELECT(IBFUNC=1!(IBFUNC=4):"IBRESUBMIT",1:"IBONE")_""","_$JOB_",""IBXERR"")"
+10 SET XMSUBJ="EDI 837 B"_$PIECE("ATCH^ILL^ILL(s)^ILL(s)",U,IBFUNC)_" NOT "_$SELECT($GET(^TMP("IBONE",$JOB)):"RE",1:"")_"SUBMITTED"_$SELECT('IBTEST:"",1:" AS TEST CLAIMS")
+11 DO SENDMSG^XMXAPI(XMDUZ,XMSUBJ,XMBODY,.XMTO,,.XMZ)
+12 KILL ^TMP("IBRESUBMIT",$JOB),^TMP("IBONE",$JOB)
End DoDot:1
+13 ;
+14 ;Upd resubmtd batch bills
IF $DATA(^TMP("IBRESUBMIT",$JOB))
IF 'IBTEST
DO RESUBUP^IBCEM02
+15 IF '$DATA(^TMP("IBSELX",$JOB))
KILL ^TMP("IBCE-BATCH",$JOB)
+16 KILL ^TMP("IBXERR",$JOB),IBXERR
+17 IF 'IBTEST
DO CHKBTCH(+$GET(^TMP("IBHDR",$JOB)))
CLEANP ; Entrypoint for extract data disply
+1 KILL ^TMP("IBTXMT",$JOB),^TMP("IBXINS",$JOB)
+2 KILL ^TMP("IBRESUBMIT",$JOB),^TMP("IBRESUB",$JOB),^TMP("IBNOT",$JOB),^TMP("IBONE",$JOB),^TMP("IBHDR",$JOB),^TMP("IBTX",$JOB),^TMP("IBEDI_TEST_BATCH",$JOB)
+3 KILL ^UTILITY("VADM",$JOB)
+4 DO CLEAN^DILF
+5 KILL ZTREQ
SET ZTREQ="@"
+6 QUIT
+7 ;
ALERT(XQAMSG,IBGRP) ; Send alert message
+1 NEW XQA
+2 SET XQA(IBGRP)=""
+3 DO SETUP^XQALERT
+4 QUIT
CHKBTCH(IBBNO) ; Delete batch whose batch # is IBBNO if no entries in file 364
+1 ; and not a resubmitted batch
+2 NEW IBZ,DA,DIK
+3 SET IBZ=+$ORDER(^IBA(364.1,"B",+IBBNO,""))
+4 IF IBZ
IF '$ORDER(^IBA(364,"C",IBZ,0))
IF '$PIECE($GET(^IBA(364.1,IBZ,0)),U,14)
SET DA=IBZ
SET DIK="^IBA(364.1,"
DO ^DIK
+5 QUIT
+6 ;
TESTLIM(IBINS) ; Check for test bill limit per day has been reached
+1 NEW IB3,DA,DIK
+2 SET IB3=$GET(^DIC(36,IBINS,3))
+3 IF $PIECE(IB3,U,5)'=DT
SET $PIECE(IB3,U,7)=0
+4 ;JWS;IB*2.0*623v24;for test env don't skip
+5 IF '$$PROD^XUPROD(1)
GOTO 1
+6 IF ($PIECE(IB3,U,7)+$GET(^TMP("IBICT",$JOB,IBINS))+1)>$PIECE(IB3,U,6)
Begin DoDot:1
+7 ;max # hit
SET IBINS=""
+8 SET DA=IBX
SET DIK="^IBA(364,"
DO ^DIK
End DoDot:1
QUIT
1 SET ^TMP("IBICT",$JOB,IBINS)=$GET(^TMP("IBICT",$JOB,IBINS))+1
+1 QUIT
+2 ;
SETVAR(IBXIEN,IBINS,IB0,IBSEC,IBNID,IB837R,IBDIV) ;
+1 ; Set up variables needed for subscripts in sort global
+2 ; ejk added IBSEC logic for patch 296
+3 ; IBSEC=1 if primary bill, 2 if 2nd/non-MRA, 3 if 2nd/MRA
+4 SET IBSEC=$SELECT($$COBN^IBCEF(IBXIEN)=1:1,'$$MRASEC^IBCEF4(IBXIEN):2,1:3)
+5 SET IBNID=$$PAYERID^IBCEF2(IBXIEN)
+6 SET IB837R=$$RECVR^IBCEF2(IBXIEN)
+7 SET IBDIV=$PIECE($SELECT($PIECE(IB0,U,22):$$SITE^VASITE(DT,$PIECE(IB0,U,22)),1:$$SITE^VASITE()),U,3)
+8 IF IBNID'=""
IF "RPIHS"[$EXTRACT(IBNID)
IF $EXTRACT(IBNID,2,$LENGTH(IBNID))="PRNT"
SET IBNID=IBNID_"*"_IBINS
+9 IF IBNID=""
SET IBNID="*"_IBINS
+10 SET $PIECE(IBNID,"*",3)=$SELECT($PIECE(IB0,U,22):$PIECE(IB0,U,22),1:"")
+11 QUIT
+12 ;
