IBCNS1 ;ALB/AAS - INSURANCE MANAGEMENT SUPPORTED FUNCTIONS ;22-JULY-91
Source file <IBCNS1.m>
| Package | Total | Call Graph |
|---|---|---|
| Integrated Billing | 3 | $$GRP^IBCNS $$MCRWNR^IBEFUNC $$DAT1^IBOUTL |
| VA FileMan | 1 | $$GET1^DIQ |
| Name | Comments | DBIA/ICR reference |
|---|---|---|
| INSURED(DFN,IBINDT) | ; -- Is patient insured
; --Input DFN = patient ; IBINDT = (optional) date insured (default = today) ; -- Output = 0 - not insured ; = 1 - insured |
|
| INSQ | ||
| PRE(DFN,IBINDT) | ; -- is pre-certification required for patient
|
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| PREQ | ||
| UR(DFN,IBINDT) | ; -- is ur required for patient
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| URQ | ||
| CHK(X,Z,Y) | ; -- check one entry for active
; -- Input X = Zeroth node of entry in insurance multiple (2.312) ; Z = date to check ; Y = 2 if want will not reimburse ; = 3 if want will not reimburse AND indemnity plans ; = 4 if want will not reimburse, but only if it's ; MEDICARE ; -- Output 1 = Insurance Active ; 0 = Inactive |
|
| CHKQ | ||
| ACTIVE(IBCIFN) | ; -- is this company active for this patient for this date
; -- called from input transform and x-refs for fields 101,102,103 ; -- input |
|
| ACTIVEQ | ||
| DD | ; - called from input transform and x-refs for field 101,102,103
; - input requires da=internal entry number in 399 ; - outputs IBdd(ins co.) array |
|
| DDQ | ||
| ALLACT | ; -- return active insurance zeroth nodes in ibdd(ins co,entry in mult)
|
|
| ALLACTQ | ||
| HDR | ||
| D1 | ||
| ALL(DFN,VAR,ACT,ADT,SOP) | ; -- find all insurance data on a patient
|
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| ALLQ | ||
| ALLWNR(DFN,VAR,ADT) | ; Returns 'all active and MEDICARE WNR'
|
|
| ZND(DFN,NODE,ZNDFILE) | ; -- Pull zeroth node from Patient's Insurance Type
; subfile. This function returns the zeroth node of the Insurance Type ; subfile of the Patient file, i.e. ^DPT(DFN,.312,NODE,0). Both DFN ; and NODE must be passed in. Pieces 3 (Group Number) and 15 (Group ; Name) will be pulled from file# 355.3, Group Insurance Plan, based ; on the Group Plan field on the zeroth node (piece 18). If the ; ZNDFILE/399 flag is not set to '399', then the Subscriber ID and Name ; of Insured will be overwritten with the values in the new HIPAA- ; compliant fields, which are on the seven node. |
|
| ZNDQ | ||
| INDEM(X) | ; -- is this an indemnity plan
; -- input zeroth node if insurance type field |
|
| INDEMQ | ||
| INSTYP(DFN,DATE) | ; -- return type of insurance policy for patient
|
|
| INSTYPQ | ||
| COB(POL) | ; -- find policy with high coordination of benefits
|
| Name | Line Occurrences |
|---|---|
| Function Call: WRITE |
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| Function Call: WRITE |
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| Function Call: WRITE |
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| Function Call: WRITE |
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| Function Call: WRITE |
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| Function Call: WRITE |
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| Function Call: WRITE |
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| FileNo | Call Tags |
|---|---|
| 2.312 | GET1^DIQ |
| ^IBA(355.3 - [#355.3] | GET1^DIQ |
| Name | Line Occurrences (* Changed, ! Killed) |
|---|---|
| ^DGCR(399 - [#399] | ACTIVE+4, DD+3 |
| ^DIC(36 - [#36] | CHK+13, D1+1, INDEM+4 |
| ^DPT - [#2] | INSURED+9, PRE+4, UR+4, ALLACT+3, ALL+29, ALL+30, ALL+33, ALL+34, ALL+35, ALL+36 , ALL+37, ALL+38, ALL+39, ZND+21 |
| ^IBA(355.3 - [#355.3] | PRE+4, UR+4, CHK+16, ALL+40, INDEM+5 |
| ^IBE(355.1 - [#355.1] | INDEM+6, INSTYP+30 |
| Name | Line Occurrences |
|---|---|
| $$CHK | INSURED+9, PRE+4, UR+4, ALLACT+3, ALL+30 |
| $$COB | INSTYP+28 |
| $$INDEM | CHK+12 |
| $$ZND | ALL+32 |
| ALL | ALLWNR+1, INSTYP+25 |
| ALLACT | DD+4 |
| CHKQ | CHK+12, CHK+13, CHK+14, CHK+15, CHK+16, CHK+17, CHK+18, CHK+19 |
| INDEMQ | INDEM+4, INDEM+6 |
| INSQ | INSURED+7 |
| INSTYPQ | INSTYP+23, INSTYP+26 |
| ZNDQ | ZND+20, ZND+31 |
| >> | Not killed explicitly |
| * | Changed |
| ! | Killed |
| ~ | Newed |
| Name | Field # of Occurrence |
|---|---|
| ACT | ALL~, ALL+27, ALL+30 |
| ACTIVE | ACTIVE+3~, ACTIVEQ |
| ADT | ALL~, ALL+27*, ALL+30, ALLWNR~, ALLWNR+1 |
| COB | ALL+44~, ALL+45*, ALL+48*, ALL+49*, ALL+50, COB+1~, COB+5*, COB+6 |
| >> DA | ACTIVE+4, DD+3 |
| DATE | INSTYP~, INSTYP+24*, INSTYP+25 |
| DFN | INSURED~, INSURED+7, INSURED+9, PRE~, PRE+4, UR~, UR+4, ACTIVE+3~, ACTIVE+4*, DD+3~* , ALLACT+3, ALL~, ALL+29, ALL+30, ALL+32, ALL+33, ALL+34, ALL+35, ALL+36, ALL+37 , ALL+38, ALL+39, ALLWNR~, ALLWNR+1, ZND~, ZND+20, ZND+21, ZND+28, INSTYP~, INSTYP+23 , INSTYP+25 |
| DT | INSURED+8, PRE+3, UR+3, ACTIVE+4, DD+3, ALL+27, INSTYP+24 |
| I | COB+1~, COB+4*, COB+5, COB+7, COB+8 |
| IBC | COB+1~, COB+3*, COB+7*, COB+8*, COB+9 |
| IBCIFN | ACTIVE~ |
| IBCOB | COB+1~, COB+7*, COB+8* |
| IBCPOL | INSTYP+21~, INSTYP+27*, INSTYP+28*, INSTYP+30 |
| IBCTP | INDEM+2~, INDEM+5*, INDEM+6 |
| >> IBDD | ALLACT+2* |
| >> IBDD( | ALLACT+3* |
| IBIENS | ALL+26~, ALL+39*, ALL+40, ALL+42, ZND+18~, ZND+28*, ZND+29, ZND+30, ZND+31*, ZND+32 , ZND+33 |
| IBINDEM | INDEM+2~, INDEM+3*, INDEM+7*, INDEMQ |
| IBINDT | INSURED~, INSURED+8*, INSURED+9, PRE~, PRE+3*, PRE+4, UR~, UR+3*, UR+4, ACTIVE+3~ , ACTIVE+4*, DD+3*, DDQ!, ALLACT+3 |
| IBINS | INSURED+6~*, INSURED+9*, INSQ, D1, D1+1, D1+2, D1+3, D1+4, D1+5 |
| IBMRA | ALL+26~, ALL+28*, ALL+48*, ALL+49, ALL+53 |
| IBPRE | PRE+1~, PRE+2*, PRE+4*, PREQ, UR+1~ |
| IBSP | ALL+26~, ALL+28*, ALL+46*, ALL+53 |
| >> IBUR | UR+2*, UR+4*, URQ |
| IOM | HDR |
| J | INSURED+6~*, INSURED+9*, PRE+1~, PRE+2*, PRE+4*, UR+1~, UR+2*, UR+4* |
| NODE | ZND~, ZND+20, ZND+21, ZND+28 |
| POL | INSTYP+21~, INSTYP+28, COB~ |
| POL( | INSTYP+30, COB+4, COB+5 |
| POL(0 | INSTYP+26, INSTYP+27, INSTYP+28 |
| SOP | ALL~, ALL+43, ALL+53 |
| TYPE | INSTYP+21~, INSTYP+22*, INSTYP+30*, INSTYP+31*, INSTYPQ |
| U | ALL+42, ALL+45, ALL+46, ALL+56, ZND+29, ZND+30, ZND+31, ZND+32, ZND+33 |
| VAR | ALL~, ALL+31, ALL+32, ALL+33, ALL+34, ALL+35, ALL+36, ALL+37, ALL+38, ALL+40 , ALL+42*, ALL+45, ALL+46, ALL+47, ALL+50, ALL+55, ALL+56, ALLWNR~, ALLWNR+1 |
| WHO | ALL+44~, ALL+46*, ALL+49, COB+1~, COB+5*, COB+6 |
| X | INSURED+6~, INSURED+9*, PRE+1~, PRE+4*, UR+1~, UR+4*, CHK~, CHK+12, CHK+13, CHK+14 , CHK+15, CHK+16, CHK+19, ALLACT+1~, ALLACT+3*, HDR*, D1~, D1+4*, ALL+26~, ALL+27* , ALL+29*, ALL+30, ALL+32, ALL+33, ALL+34, ALL+35, ALL+36, ALL+37, ALL+38, ALL+39 , ALL+40, ALL+42, ALL+45, ALL+46, ALL+47, ALL+50, ALL+55*, ALL+56*, ZND+18~, ZND+19* , ZND+21*, ZND+29*, ZND+30*, ZND+31, ZND+32*, ZND+33*, ZNDQ, INDEM~, INDEM+4, INDEM+5 , COB+1~, COB+6*, COB+7, COB+8 |
| X1 | CHK+10~, CHK+13*, CHK+17, CHK+18, CHK+19, ALLACT+1~, ALLACT+2*, ALLACT+3* |
| Y | PRE+1~, UR+1~, CHK~, CHK+11*, CHK+12, CHK+18, CHK+19 |
| Z | CHK~, CHK+14, CHK+15 |
| Z1 | CHK+10~, CHK+11*, CHK+20*, CHKQ |
| ZNDFILE | ZND~, ZND+27 |