IBCNERTU.m

IBCNERTU ;AITC/TAZ - eIV Processing Real-Time Inquiries ;13-MAR-19

 ;;2.0;INTEGRATED BILLING;**631**;;Build 23;

 ;;Per VA Directive 6402, this routine should not be modified.

 ;

TQ(WEXT,IEN,FRESHDT,DFN,PIEN,OVRFRESH,SRVICEDT) ; Determine how many entries to create in the TQ file and set entries

 ;

 ;INPUT:

 ; WEXT - Which Extract Internal Value (#365.1,.1)

 ; IEN - internal # for the buffer record in file #355.33

 ; FRESHDT - (Service Date - Freshday)- used to check verified date

 ; DFN - Patient's IEN (file 2)

 ; PIEN - Payer's IEN (file 365.12)

 ; OVRFRESH - Freshness OvrRd flag (#355.33,13)

 ; SRVICEDT- Service date (#355.33,18)

 ; 

 N BSID,PASSBUF,PATID,PREL,SID,SIDACT,SIDARRAY,SIDDATA

 ;

 K SIDARRAY

 S BSID=$$GET1^DIQ(355.33,IEN_",",90.03)  ; Subscriber ID from buffer

 S PATID=$$GET1^DIQ(355.33,IEN_",",62.01) ; Patient ID from buffer

 S PREL=$$GET1^DIQ(355.33,IEN_",",60.14,"I")  ; Pat. relationship from buffer

 S SIDDATA=$$SIDCHK^IBCNEDE5(PIEN,DFN,BSID,.SIDARRAY,FRESHDT) ;determine rules to follow

 S SIDACT=$P(SIDDATA,U,1)

 ;

 I SIDACT=3 D BUFF^IBCNEUT2(IEN,18) Q   ; update buffer w/ bang & quit - no subscriber id

 I PREL'=18 D  Q   ; Not Equal to Self/Patient

 .I PATID="" D BUFF^IBCNEUT2(IEN,23) Q  ; update buffer w/ bang & quit - no patient id

 .D SET(IEN,OVRFRESH,1,"") ; set TQ entry

 .Q

 S SID=""

 F  S SID=$O(SIDARRAY(SID)) Q:SID=""  D:$P(SID,"_")'="" SET(IEN,OVRFRESH,1,$P(SID,"_")) ; set TQ w/ 'Pass Buffer' flag

 I SIDACT=4 D SET(IEN,OVRFRESH,1,"") ; set TQ w/ 'Pass Buffer' flag w/ blank subscriber ID

 Q

 ;

 ;

SET(BUFFIEN,OVRFRESH,PASSBUF,SID1) ; Set data and check if set already

 N DATA1,DATA2,DATA5,IBMBI,ORIG

 D RET(.ORIG)

 ;

 ; The hard coded '1' in the 3rd piece of DATA1 sets the Transmission

 ; status of file 365.1 to "Ready to Transmit"

 S DATA1=DFN_U_PIEN_U_1_U_$G(BUFFIEN)_U_SID1_U_FRESHDT_U_PASSBUF ; SETTQ parameter 1

 S $P(DATA1,U,8)=PATID

 ;

 S DATA2=WEXT_U_"V"_U_SRVICEDT_U_"" ; SETTQ parameter 2

 ;

 S DATA5=$$GET1^DIQ(355.33,BUFFIEN_",",.03,"I") ;copy SOI IEN to TQ

 S TQIEN=$$SETTQ^IBCNEDE7(DATA1,DATA2,ORIG,$G(OVRFRESH),DATA5) ; File TQ entry

 ;

 Q

 ;

RET(ORIG) ; Record Retrieval - Insurance Buffer

 ;

 S ORIG=$$GET1^DIQ(355.33,IEN_",",20.01) ;Original ins. co.

 S ORIG=ORIG_U_$$GET1^DIQ(355.33,IEN_",",90.02) ;Original group number

 S ORIG=ORIG_U_$$GET1^DIQ(355.33,IEN_",",90.01) ;Original group name

 S ORIG=ORIG_U_$$GET1^DIQ(355.33,IEN_",",90.03) ;; Original subscriber ID

 Q

 ;

--- Routine Detail   --- with STRUCTURED ROUTINE LISTING ---IBCNERTU   2499     printed  Apr 09, 2024@21:14:07                                                                                                                                                                                                    Page 2

IBCNERTU  ;AITC/TAZ - eIV Processing Real-Time Inquiries ;13-MAR-19

 +1       ;;2.0;INTEGRATED BILLING;**631**;;Build 23;

 +2       ;;Per VA Directive 6402, this routine should not be modified.

 +3       ;

TQ(WEXT,IEN,FRESHDT,DFN,PIEN,OVRFRESH,SRVICEDT) ; Determine how many entries to create in the TQ file and set entries

 +1       ;

 +2       ;INPUT:

 +3       ; WEXT - Which Extract Internal Value (#365.1,.1)

 +4       ; IEN - internal # for the buffer record in file #355.33

 +5       ; FRESHDT - (Service Date - Freshday)- used to check verified date

 +6       ; DFN - Patient's IEN (file 2)

 +7       ; PIEN - Payer's IEN (file 365.12)

 +8       ; OVRFRESH - Freshness OvrRd flag (#355.33,13)

 +9       ; SRVICEDT- Service date (#355.33,18)

 +10      ; 

 +11       NEW BSID,PASSBUF,PATID,PREL,SID,SIDACT,SIDARRAY,SIDDATA

 +12      ;

 +13       KILL SIDARRAY

 +14      ; Subscriber ID from buffer

           SET BSID=$$GET1^DIQ(355.33,IEN_",",90.03)

 +15      ; Patient ID from buffer

           SET PATID=$$GET1^DIQ(355.33,IEN_",",62.01)

 +16      ; Pat. relationship from buffer

           SET PREL=$$GET1^DIQ(355.33,IEN_",",60.14,"I")

 +17      ;determine rules to follow

           SET SIDDATA=$$SIDCHK^IBCNEDE5(PIEN,DFN,BSID,.SIDARRAY,FRESHDT)

 +18       SET SIDACT=$PIECE(SIDDATA,U,1)

 +19      ;

 +20      ; update buffer w/ bang & quit - no subscriber id

           IF SIDACT=3

               DO BUFF^IBCNEUT2(IEN,18)

               QUIT 

 +21      ; Not Equal to Self/Patient

           IF PREL'=18

               Begin DoDot:1

 +22      ; update buffer w/ bang & quit - no patient id

                   IF PATID=""

                       DO BUFF^IBCNEUT2(IEN,23)

                       QUIT 

 +23      ; set TQ entry

                   DO SET(IEN,OVRFRESH,1,"")

 +24               QUIT 

               End DoDot:1

               QUIT 

 +25       SET SID=""

 +26      ; set TQ w/ 'Pass Buffer' flag

           FOR 

               SET SID=$ORDER(SIDARRAY(SID))

               if SID=""

                   QUIT 

               if $PIECE(SID,"_")'=""

                   DO SET(IEN,OVRFRESH,1,$PIECE(SID,"_"))

 +27      ; set TQ w/ 'Pass Buffer' flag w/ blank subscriber ID

           IF SIDACT=4

               DO SET(IEN,OVRFRESH,1,"")

 +28       QUIT 

 +29      ;

 +30      ;

SET(BUFFIEN,OVRFRESH,PASSBUF,SID1) ; Set data and check if set already

 +1        NEW DATA1,DATA2,DATA5,IBMBI,ORIG

 +2        DO RET(.ORIG)

 +3       ;

 +4       ; The hard coded '1' in the 3rd piece of DATA1 sets the Transmission

 +5       ; status of file 365.1 to "Ready to Transmit"

 +6       ; SETTQ parameter 1

           SET DATA1=DFN_U_PIEN_U_1_U_$GET(BUFFIEN)_U_SID1_U_FRESHDT_U_PASSBUF

 +7        SET $PIECE(DATA1,U,8)=PATID

 +8       ;

 +9       ; SETTQ parameter 2

           SET DATA2=WEXT_U_"V"_U_SRVICEDT_U_""

 +10      ;

 +11      ;copy SOI IEN to TQ

           SET DATA5=$$GET1^DIQ(355.33,BUFFIEN_",",.03,"I")

 +12      ; File TQ entry

           SET TQIEN=$$SETTQ^IBCNEDE7(DATA1,DATA2,ORIG,$GET(OVRFRESH),DATA5)

 +13      ;

 +14       QUIT 

 +15      ;

RET(ORIG) ; Record Retrieval - Insurance Buffer

 +1       ;

 +2       ;Original ins. co.

           SET ORIG=$$GET1^DIQ(355.33,IEN_",",20.01)

 +3       ;Original group number

           SET ORIG=ORIG_U_$$GET1^DIQ(355.33,IEN_",",90.02)

 +4       ;Original group name

           SET ORIG=ORIG_U_$$GET1^DIQ(355.33,IEN_",",90.01)

 +5       ;; Original subscriber ID

           SET ORIG=ORIG_U_$$GET1^DIQ(355.33,IEN_",",90.03)

 +6        QUIT 

 +7       ;