Home   Package List   Routine Alphabetical List   Global Alphabetical List   FileMan Files List   FileMan Sub-Files List   Package Component Lists   Package-Namespace Mapping  
Info |  Source |  Call Graph |  Caller Graph |  Entry Points |  External References |  Global Variables Directly Accessed |  Label References |  Local Variables  | All
Print Page as PDF
Routine: IBCEMU4

Package: Integrated Billing

Routine: IBCEMU4


Information

IBCEMU4 ;ALB/ESG - MRA UTILITIES ;25-OCT-2004

Source Information

Source file <IBCEMU4.m>

Call Graph

Call Graph

Call Graph Total: 1

Package Total Call Graph
Integrated Billing 1 ($$COBN,$$INPAT)^IBCEF  

Caller Graph

Legends:

Legend of Colors

Package Component Superscript legend

action A extended action Ea event driver Ed subscriber Su protocol O limited protocol LP run routine RR broker B edit E server Se print P screenman SM inquire I

Caller Graph

Caller Graph Total: 6

Package Total Caller Graph
Integrated Billing 6 IBCAPP2  IBCCCB  IBCECOB1  IBCECOB2  IBCEMQC  IBCEMSR  

Entry Points

Name Comments DBIA/ICR reference
DENDUP(IBEOB,IBMRANOT) ; Denied for Duplicate Function ;WCJ IB*2.0*432
; Function returns true if MRA is Denied AND Reason code 18 is present (Duplicate claim/service)
DENDUPX ;
MSPRE(IBIFN,IBEXF,IBTYPLAN) ; Medicare supplemental PR and Excess calculations
; determine PR amount in order to calculate balance due after medicare for secondary/tertiary
; if type of plan is a Medicare supplemental or EGHP plan secondary to Medicare, PR
; calculations are determined based on the effective date multiple in the TYPE OF PLAN file
; and may or may not included Excess charges (CO-45), based on Plan Type.
; need to pass in:
; IBIFN (REQUIRED) = claim ien
; IBEXF = Excess Flag, set to 1 if NOT to include excess charges in calculation but to
; return "e" (IBE) for excess indicator if plan allows excess and there are
; excess charges. Used by PR column of MRW screen to show PR without excess
; amounts included in calculation.
; IBTYPLAN = ien in TYPE OF PLAN file (355.1)
; returns "" if no effective date for type of plan to calculate on
CALC(EOBADJ,IBTYPLAN,IBPCE,IBEDT,IBEXF) ; FUNCTION - Calculate Medicare Supplemental Balance due
; Sums up Amounts on ALL Reason Codes under ALL Group Codes = 'PR' and CO/Reason code=45.
; If those reason codes have an entry in the effective date mutliple, multiples that
; reason amount by the % the Type of plan will pay. If no entry, assume 100% payment for PR.
; any other Group and reason codes would be 0%.
; Adds up all those sums and returns that value as the total PR&CO the Medicare
; Supplemental plan will pay.
MSEDT(IBIFN,IBTYPLAN) ; does this claim's TYPE OF PLAN have an effective date multiple on or before the
; claim 'statement covers from' date
; IBIFN = claim ien - REQUIRED
; IBTYPLAN = Type of Plan ien
; returns eff.date calculation multiple to use or null
; called from SKIP^IBCCCB, BLD^IBCECOB1, TOT^IBCECOB2, CRIT^IBCEMQC, & SECOND^IBCEMSR
TYPLN(IBIFN) ; find type of plan for claim
; IBIFN = claim ien - REQUIRED
; returns ien from file 355.1 or null if none found

External References

Name Field # of Occurrence
$$COBN^IBCEF TYPLN+6
$$INPAT^IBCEF MSPRE+18

Global Variables Directly Accessed

Name Line Occurrences  (* Changed,  ! Killed)
^DGCR(399 - [#399] MSPRE+19, MSEDT+18, TYPLN+7
^IBA(355.3 - [#355.3] TYPLN+8
^IBE(355.1 - [#355.1] CALC+27, CALC+33, CALC+34, CALC+37, CALC+38, MSEDT+19, MSEDT+20
^IBM(361.1 - [#361.1] DENDUP+3, DENDUP+10, DENDUP+12, DENDUP+13, MSPRE+29, MSPRE+31, MSPRE+39, MSPRE+41, MSPRE+49

Label References

Name Line Occurrences
$$CALC MSPRE+44, MSPRE+50
$$MSEDT MSPRE+17, CALC+22
$$TYPLN MSPRE+16, CALC+21, MSEDT+17
DENDUPX DENDUP+4, DENDUP+5, DENDUP+6

Local Variables

Legend:

>> Not killed explicitly
* Changed
! Killed
~ Newed

Name Field # of Occurrence
ADJ DENDUP+2~, DENDUP+11*, DENDUP+12*, DENDUP+13
CALC CALC+19~, CALC+38*, CALC+39
DUP DENDUP+2~, DENDUP+9*, DENDUP+10, DENDUP+12, DENDUP+13*, DENDUP+17
EOBADJ MSPRE+14~, MSPRE+40!, MSPRE+41*, MSPRE+44, MSPRE+48!, MSPRE+49*, MSPRE+50, CALC~
EOBADJ( CALC+24, CALC+25, CALC+29, CALC+30
GRPCD CALC+19~, CALC+25*, CALC+27, CALC+31, CALC+33, CALC+34, CALC+37, CALC+38
GRPLVL CALC+19~, CALC+23*, CALC+24*, CALC+25, CALC+29, CALC+30
I MSPRE+30~, MSPRE+31*
IBCOBN TYPLN+5~, TYPLN+6*, TYPLN+7
IBE MSPRE+14~, MSPRE+44*, MSPRE+50*, MSPRE+52
IBEDT MSPRE+14~, MSPRE+17*, MSPRE+44, MSPRE+50, CALC~, CALC+22*, CALC+27, CALC+33, CALC+34, CALC+37
, CALC+38
IBEOB DENDUP~, DENDUP+3, DENDUP+10, DENDUP+12, DENDUP+13, MSPRE+14~, MSPRE+28*, MSPRE+29*, MSPRE+31, MSPRE+39
, MSPRE+41, MSPRE+49
IBEOB( MSPRE+31*
IBEOB(0 MSPRE+32
IBEXF MSPRE~, MSPRE+44, MSPRE+50, CALC~, CALC+37
IBFRMTYP MSPRE+14~, MSPRE+19*, MSPRE+22, MSPRE+37
IBGRPNO TYPLN+5~, TYPLN+7*, TYPLN+8
IBIFN MSPRE~, MSPRE+15, MSPRE+16, MSPRE+17, MSPRE+18, MSPRE+19, MSPRE+29, CALC+21, CALC+22, MSEDT~
, MSEDT+16, MSEDT+17, MSEDT+18, TYPLN~, TYPLN+4, TYPLN+6, TYPLN+7
IBIND CALC+19~, CALC+37*, CALC+40
IBINPAT MSPRE+14~, MSPRE+18*, MSPRE+22, MSPRE+37
IBM DENDUP+2~, DENDUP+3*, DENDUP+4, DENDUP+5, DENDUP+6
IBMGBD MSPRE+14~, MSPRE+28*, MSPRE+45*, MSPRE+51*, MSPRE+52
IBMRANOT DENDUP~, DENDUP+4, DENDUP+5
IBPCE MSPRE+14~, MSPRE+27*, MSPRE+44, MSPRE+50, CALC~, CALC+20, CALC+37, CALC+38
IBPNCAT MSPRE+14~, MSPRE+21*, MSPRE+22*, MSPRE+27
IBSVDT MSEDT+15~, MSEDT+18*, MSEDT+19, MSEDT+20
IBTOT MSPRE+14~, MSPRE+44*, MSPRE+45, MSPRE+50*, MSPRE+51
IBTYPLAN MSPRE~, MSPRE+16*, MSPRE+17, MSPRE+44, MSPRE+50, CALC~, CALC+21*, CALC+22, CALC+27, CALC+33
, CALC+34, CALC+37, CALC+38, MSEDT~, MSEDT+17*, MSEDT+19, MSEDT+20
IBX DENDUP+2~, DENDUP+3*, DENDUP+17*, DENDUPX+1
LINE DENDUP+2~, DENDUP+9*, DENDUP+10*, DENDUP+12, DENDUP+13
LNLVL MSPRE+14~, MSPRE+39*, MSPRE+41
MCA CALC+19~, CALC+23*, CALC+33*, CALC+39*, CALC+40
RSN0 CALC+19~, CALC+30*
RSNAMT CALC+19~, CALC+30*, CALC+33, CALC+39
RSNCD CALC+19~, CALC+30*, CALC+31, CALC+33, CALC+34, CALC+37, CALC+38
RSNLVL CALC+19~, CALC+28*, CALC+29*, CALC+30
U DENDUP+4, DENDUP+5, DENDUP+6, MSPRE+19, MSPRE+32, MSPRE+44, MSPRE+45, MSPRE+50, MSPRE+51, CALC+25
, CALC+30, CALC+37, CALC+38, CALC+40, MSEDT+18, TYPLN+7, TYPLN+8
Info |  Source |  Call Graph |  Caller Graph |  Entry Points |  External References |  Global Variables Directly Accessed |  Label References |  Local Variables  | All