IBCEMU2 ;ALB/DSM - IB MRA Utility ;01-MAY-2003
Source file <IBCEMU2.m>
action | A | extended action | Ea | event driver | Ed | subscriber | Su | protocol | O | limited protocol | LP | run routine | RR | broker | B | edit | E | server | Se | P | screenman | SM | inquire | I |
Name | Comments | DBIA/ICR reference |
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QMRA | ; This is a background procedure that is spun off of the IB BATCH
; Print option. This process scans a queue in ^XTMP("IBMRA"_#,$J) and checks ; each Bill to see if a printable MRA exist, if so, prints them. MRA's print ; on the device associated with the 'Bill Addendum' Form Type. ; This process doesn't interact with users. |
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STOP() | ;determine if user has requested the queued report to stop
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STAT(IBIFN,STATUS,MRAONLY) | ; Update the review status in the EOB file
; This procedure updates field .16 in file 361.1 for all EOB's for ; the given bill# ; ; IBIFN - Internal Bill# (required) ; STATUS - Internal Value of the Review Status field (required) ; MRAONLY - Optional Flag with a default of 0 if not passed in ; 1:only update MRA EOB's for this bill ; 0:update all EOB's for this bill ; 2:only update non-MRA EOB's for this bill (IB*2.0*547) |
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STATX | ;
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MRAWL(IBIFN) | ; Do any MRA EOB's for this bill appear on the worklist?
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MRAWLX | ;
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TXSTS(IBIFN,IB364,REJFLG,IBZ) | ; Claim transmission status information
; Input IBIFN - required ; IB364 - optional (defaults to most recent transmission#) ; Output REJFLG (pass by reference) - 1/0 flag if any rejection status ; messages on file ; IBZ (pass by reference) - array of information |
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TXSTSX | ;
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MRACALC(IBEOB,IBIFN,AR,PRCASV) | ; Calculates Two Amounts:
; Unreimbursable Medicare Expense and Medicare Contract Adjustment ; Amount for a given EOB. |
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MEDCARE(IBEOB,PRCASV) | ; If Outpatient Calculate from Service Line level data
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CALCMCA(EOBADJ) | ; FUNCTION - Calculate Medicare Contract Adjustment
; Sums up Amounts on ALL Reason Codes under ALL Group Codes = 'CO' and ; returns that value (which is Medicare Contract Adjustment). |
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ALLOWED(IBEOB) | ; Returns Total Allowed Amount by summing up all Allowed Amounts
; from Line Level Adjustment ; Input: IBEOB = ien of EOB file (361.1) ; |
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MRATYPE(BILL,ARDATE) | ; Function - determines the MRA Receivable Type for a Third
; Party Receivable. This is accomplished by comparing DATE MRA FIRST ACTIVATED ; with AR Activation Date for the Bill. ; ; Input BILL= ien of a given Bill Number (Required) ; ARDATE= Date Account Receivable was Activated - date only (Required) |
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MRADTACT() | ; Function - returns DATE MRA FIRST ACTIVATED at site
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MRACALC2(IBIFN) | ; Function - This tag will add all EOB's for a given claim number.
; Returns the sum of the Medicare Contractual Adj Amt |
Name | Field # of Occurrence |
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$$S^%ZTLOAD | STOP+1 |
^DIE | STAT+27 |
CHK^DIE | STAT+17 |
$$ELIG^IBCECOB1 | MRAWL+11 |
$$COBN^IBCEF | MRACALC+20, MRACALC2+21 |
$$FT^IBCEF | MRACALC+15, MRACALC2+14 |
$$INPAT^IBCEF | MRACALC+16, MRACALC2+15 |
$$LAST364^IBCEF4 | TXSTS+11 |
PROC^IBCEMRAA | QMRA+19 |
$$MRAEXIST^IBCEMU1 | QMRA+19, MRATYPE+31 |
$$CRIT^IBRFN2 | MRATYPE+33 |
Name | Line Occurrences |
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Function Call: WRITE |
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Function Call: WRITE |
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Routine Call |
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Routine Call |
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FileNo | Call Tags |
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^IBM(361.1 - [#361.1] | CHK^DIE |
Name | Line Occurrences (* Changed, ! Killed) |
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^IBA(364 - [#364] | TXSTS+12, TXSTS+19, TXSTS+25 |
^IBA(364.1 - [#364.1] | TXSTS+20, TXSTS+21 |
^IBE(350.9 - [#350.9] | MRADTACT+1 |
^IBM(361 - [#361] | TXSTS+14, TXSTS+16 |
^IBM(361.1 - [#361.1] | STAT+16, STAT+21, STAT+22, MRAWL+8, MRAWL+10, MRACALC+18, MRACALC+34, MEDCARE+3, MEDCARE+5, ALLOWED+6 , MRACALC2+18, MRACALC2+19, MRACALC2+29 |
^PRCA(430 - [#430] | MRATYPE+25 |
^XTMP( | QMRA+15, QMRA+16, QMRA+17, QMRA+18, QMRA+20! |
Name | Field # of Occurrence |
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^( | ALLOWED+6 |
>> | Not killed explicitly |
* | Changed |
! | Killed |
~ | Newed |
Name | Field # of Occurrence |
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ALWD | ALLOWED+4~, ALLOWED+7* |
AR | MRACALC~, MRACALC+17*, MRACALC+22 |
ARDATE | MRATYPE~, MRATYPE+13, MRATYPE+22 |
BCH | TXSTS+7~, TXSTS+19*, TXSTS+20, TXSTS+21 |
BCHD0 | TXSTS+7~, TXSTS+20*, TXSTS+24 |
BCHD1 | TXSTS+7~, TXSTS+21*, TXSTS+22 |
BILL | MRATYPE~, MRATYPE+13, MRATYPE+25, MRATYPE+31, MRATYPE+33 |
D | STAT+12~ |
D0 | STAT+12~ |
DA | STAT+12~, STAT+27* |
DI | STAT+12~ |
DIC | STAT+12~ |
DICR | STAT+12~ |
DIE | STAT+12~, STAT+27* |
DIERR | STAT+12~ |
DIG | STAT+12~ |
DIH | STAT+12~ |
DISYS | STAT+12~ |
DIU | STAT+12~ |
DIV | STAT+12~ |
DIW | STAT+12~ |
DQ | STAT+12~ |
DR | STAT+12~, STAT+27* |
EOBADJ | MRACALC+13~, MRACALC+34!*, MRACALC+35, MEDCARE+1~, MEDCARE+4!, MEDCARE+5*, MEDCARE+7, CALCMCA~, MRACALC2+11~, MRACALC2+29!* , MRACALC2+30 |
EOBADJ( | CALCMCA+10, CALCMCA+11, CALCMCA+13, CALCMCA+14 |
FRMTYP | MRACALC+13~, MRACALC+15*, MRACALC+29, MRACALC2+11~, MRACALC2+14*, MRACALC2+24 |
GRPLVL | CALCMCA+8~, CALCMCA+9*, CALCMCA+10*, CALCMCA+11, CALCMCA+13, CALCMCA+14 |
I | MRACALC+13~, MRACALC+18*, MRACALC2+11~, MRACALC2+19* |
IB364 | TXSTS~, TXSTS+10*, TXSTS+11*, TXSTS+12, TXSTS+14, TXSTS+19, TXSTS+25 |
IBCOBN | MRACALC+13~, MRACALC+20*, MRACALC+22, MRACALC2+11~, MRACALC2+21* |
IBEOB | STAT+11~, STAT+20*, STAT+21*, STAT+22, STAT+27, MRAWL+6~, MRAWL+9*, MRAWL+10*, MRAWL+11, MRACALC~ , MRACALC+18, MRACALC+29, MRACALC+34, MRACALC+38, MEDCARE~, MEDCARE+3, MEDCARE+5, ALLOWED~, ALLOWED+6, MRACALC2+11~ , MRACALC2+17*, MRACALC2+18*, MRACALC2+19, MRACALC2+24, MRACALC2+29, MRACALC2+32 |
IBEOB( | MRACALC+18*, MRACALC2+19* |
IBEOB(0 | MRACALC+19, MRACALC+22, MRACALC2+20 |
IBEOB(1 | MRACALC+26 |
>> IBFTP | QMRA+15, QMRA+16, QMRA+17, QMRA+18, QMRA+20 |
IBIFN | QMRA+13~, QMRA+14*, QMRA+18*, QMRA+19, STAT~, STAT+13*, STAT+16, STAT+21, MRAWL~, MRAWL+7* , MRAWL+8, MRAWL+10, TXSTS~, TXSTS+9*, TXSTS+11, TXSTS+12, MRACALC~, MRACALC+15, MRACALC+16, MRACALC+20 , MRACALC2~, MRACALC2+14, MRACALC2+15, MRACALC2+18, MRACALC2+21 |
>> IBJ | QMRA+15, QMRA+16, QMRA+17, QMRA+18, QMRA+20 |
IBM | STAT+11~, STAT+22*, STAT+23, STAT+25, STAT+26 |
IBPGN | QMRA+13~, STOP+1 |
IBQ | QMRA+13~, QMRA+14*, QMRA+15, QMRA+16, QMRA+17, QMRA+18* |
IBS1 | QMRA+13~, QMRA+14*, QMRA+15*, QMRA+16, QMRA+17, QMRA+18 |
IBS2 | QMRA+13~, QMRA+16*, QMRA+17, QMRA+18 |
IBS3 | QMRA+13~, QMRA+17*, QMRA+18 |
IBZ | TXSTS~, TXSTS+8! |
IBZ("BATCH NU | MBER" , TXSTS+24* |
IBZ("DATE LAS | T SENT" , TXSTS+22* |
IBZ("NUMBER O | F STATUS MESSAGES" , TXSTS+23* |
IBZ("TRANSMIS | SION STATUS" , TXSTS+25* |
IEN | TXSTS+7~, TXSTS+13*, TXSTS+14*, TXSTS+16 |
INPAT | MRACALC+13~, MRACALC+16*, MRACALC+33, MRACALC2+11~, MRACALC2+15*, MRACALC2+28 |
IOF | QMRA+19 |
LNLVL | MRACALC+13~, MEDCARE+1~, MEDCARE+2*, MEDCARE+3*, MEDCARE+5, ALLOWED+4~, ALLOWED+5*, ALLOWED+6*, MRACALC2+11~ |
LNLVLD | ALLOWED+4~, ALLOWED+6*, ALLOWED+7 |
MCA | CALCMCA+8~, CALCMCA+9*, CALCMCA+15*, CALCMCA+16 |
MRADTACT | MRATYPE+12~, MRATYPE+16*, MRATYPE+19, MRATYPE+22 |
MRAMT | MRATYPE+12~, MRATYPE+25*, MRATYPE+27, MRATYPE+29 |
MRAONLY | STAT~, STAT+14*, STAT+25, STAT+26 |
OK | MRAWL+6~, MRAWL+7*, MRAWL+10, MRAWL+11*, MRAWLX+1 |
PRCASV | MRACALC~, MRACALC+29, MRACALC+38, MEDCARE~, MRACALC2+11~, MRACALC2+24, MRACALC2+32 |
PRCASV("MEDCA" | MRACALC+35*, MEDCARE+7*, MRACALC2+13*, MRACALC2+30*, MRACALC2+33 |
PRCASV("MEDURE" | MRACALC+26* |
REJFLG | TXSTS~, TXSTS+8*, TXSTS+17* |
RESULT | STAT+11~, STAT+17, STAT+18 |
RSNAMT | CALCMCA+8~, CALCMCA+14*, CALCMCA+15 |
RSNLVL | CALCMCA+8~, CALCMCA+12*, CALCMCA+13*, CALCMCA+14 |
SEV | TXSTS+7~, TXSTS+16*, TXSTS+17 |
SMCNT | TXSTS+7~, TXSTS+13*, TXSTS+15*, TXSTS+23 |
STATUS | STAT~, STAT+13*, STAT+17, STAT+23, STAT+27 |
TOTALWD | ALLOWED+4~, ALLOWED+5*, ALLOWED+7*, ALLOWED+8 |
U | STAT+23, STAT+25, STAT+26, TXSTS+12, TXSTS+16, TXSTS+19, TXSTS+22, TXSTS+24, TXSTS+25, MRACALC+19 , MRACALC+22, CALCMCA+11, CALCMCA+14, ALLOWED+7, MRATYPE+27, MRATYPE+29, MRATYPE+33, MRADTACT+1, MRACALC2+20 |
X | STAT+12~ |
Y | STAT+12~ |
>> ZTQUEUED | STOP+1 |
ZTREQ | QMRA+20*, STOP+1! |
>> ZTSTOP | STOP+1*, STOP+2 |