IBCEU1 ;ALB/TMP - EDI UTILITIES FOR EOB PROCESSING ;10-FEB-99
Source file <IBCEU1.m>
| Name | Comments | DBIA/ICR reference |
|---|---|---|
| CCOB1(IBIFN,NODE,SEQ,IBRSBTST) | ; Extract Claim level COB data
; for a bill IBIFN ; NODE = the file 361.1 node(s) to be returned, separated by commas ; SEQ = the specific insurance sequence you want returned. If not = ; 1, 2, or 3, all are returned ; Returns IBXDATA(COB,n,node) where COB = COB insurance sequence, ; n is the entry number in file 361.1 and node is the node requested ; = the requested node's data ; IBRSBTST=1, this indicates the claim is being resubmitted as a "TEST" ; claim and should be used be the OUTPUT FORMATTER entries ; to determine what COB information is going out. - IB*2*608 (vd) |
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| CCAS1(IBIFN,SEQ,IBRSBTST) | ; Extract all MEDICARE COB claim level adjustment data
; for a bill IBIFN (subfile 361.11 in file 361.1) ; SEQ = the specific insurance sequence you want returned. If not = ; 1, 2, or 3, all are returned ; Returns IBXDATA(COB,n) where COB = COB insurance sequence, ; n is the entry number in file 361.1 and ; = the 0-node of the subfile entry (361.11) ; and IBXDATA(COB,n,m) where m is a sequential # and ; = this level's 0-node ; IBRSBTST=1, this indicates the claim is being resubmitted as a "TEST" ; claim and should be used be the OUTPUT FORMATTER entries ; to determine what COB information is going out. - IB*2*608 (vd) |
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| SEQ(A) | ; Translate sequence # A into corresponding letter representation
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| EOBTOT(IBIFN,IBCOBN) | ; Total all EOB's for a bill's COB sequence
; Function returns the total of all EOB's for a specific COB seq ; IBIFN = ien of bill in file 399 ; IBCOBN = the # of the COB sequence you want EOB/MRA total for (1-3) |
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| LCOBOUT(IBXSAVE,IBXDATA,COL) | ; Output the line adjustment reasons COB
; line # data for an electronic claim ; IBXSAVE,IBXDATA = arrays holding formatter information for claim - ; pass by reference ; COL = the column in the 837 flat file being output for LCAS record |
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| CCOBOUT(IBXSAVE,IBXDATA,COL) | ; Output the claim adjustment reasons COB
; data for an electronic claim ; IBXSAVE,IBXDATA = arrays holding formatter information for claim - ; pass by reference ; COL = the column in the 837 flat file being output for CCAS record |
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| COBOUT(IBXSAVE,IBXDATA,CL) | ; build LCOB segment data
; The IBXSAVE array used here is built by INS-2, then LCOB-1.9 ; This is basically the 361.115, but all the piece numbers here in this ; local array are one higher than the pieces in subfile 361.115. |
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| XCOBOUT(IBXSAVE,IBXDATA,CL) | ; build LCOB segment data
; The IBXSAVE array used here is built by INS-2, then LCOB-1.9 ; This is basically the 361.115, but all the piece numbers here in this ; local array are one higher than the pieces in subfile 361.115. |
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| COBPYRID(IBXIEN,IBXSAVE,IBXDATA) | ; cob insurance company payer id
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| COBPYRX | ;
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| EOBELIG(IBEOB,IBMRAF,IBCURR) | ; EOB eligibility for secondary claim
; Function to decide if EOB entry in file 361.1 (ien=IBEOB) is ; eligible to be included for secondary claim creation process ; The EOB is not eligible if the review status is not 3, or if there ; is no insurance sequence indicator, or if the EOB has been DENIED ; and the patient responsibility for that EOB is $0 and that EOB is ; not a split EOB. Split EOB's need to be included (IB*2*371). |
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| EOBELIGX | ;
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| EOBCNT(IBIFN) | ; This function counts up the number of EOBs that are eligible
; for the secondary claim creation process for a given bill#. |
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| EOBCNTX | ;
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| LPTRESP(IBIFN,IBXSAVE,IBXDATA,CL) | ||
| LPREXIST(EOBIEN) | ||
| CHKCCOB1(IBIFN,IBS) | ||
| CKCOBTST(IBXIEN,IBXSAVE,Z0,Z,IBRSBTST) |
