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Routine: PSOREJU3

Package: Outpatient Pharmacy

Routine: PSOREJU3


Information

PSOREJU3 ;BIRM/LJE - BPS (ECME) - Clinical Rejects Utilities (3) ;04/25/08

Source Information

Source file <PSOREJU3.m>

Entry Points

Name Comments DBIA/ICR reference
TRICCHK(RX,RFL,RESP,FROM,RVTX) ;check to see if Rx is non-billable or in an "In Progress" state on ECME
; Input: (r) RX - Rx IEN (#52)
; (r) RFL - REFILL
; (o) RESP - Response from $$EN^BPSNCPDP api
; TRICCHK assumes that the calling routine has validated that the fill is TRICARE or CHAMPVA.
TRIC2 ;
TRIC3 ;
TRIC4
MSG ;
SUSP ;Suspense Rx due to IN PROGRESS status in ECME
TACT ;
DISPLAY(RX,REJ,KEY,RRR) ; - Displays REJECT information
; Input: (r) RX - Rx IEN (#52)
; (r) REJ - REJECT ID (IEN)
; (o) KEY - Display "Press any KEY to continue..." (1-YES/0-NO) (Default: 0)
; (o) RRR - Reject Resolution Required information Flag(0/1)^Threshold Amt^Gross Amt Due (Default: 0)
; If Flag = 0, there is no Reject Resolution Required reject code. Parameter added with PSO*421
;
DISP2 ;
TYPE ;
WRAP(PSOTXT,INDENT) ;
W1
HDR ; Display the reject notification screen header
SUBMIT(RXIEN,RFCNT,PSOTRIC) ;called from PSOCAN2 (routine size exceeded)
TRISTA(RX,RFL,RESP,FROM,RVTX) ;called from suspense
  • ICR #5186
    • Status: Active
    • Usage: Private
    TRIAUD(RXIEN,RXFILL) ;is RXIEN in the TRICARE/CHAMPVA audit and no open rejects ;cnf
    ; RXIEN will only be in TRICARE/CHAMPVA audit if a bypass or override has occurred and rejects are closed
    ; returns 0 if RXIEN is not in TRICARE/CHAMPVA audit at all or not in audit for right fill number
    ; rejects must be closed for 0 to be returned
    ; 1 if RXIEN is in TRICARE/CHAMPVA audit for the right fill number and rejects are closed
    ECMECHK(RX,FILL) ;
    ; This function returns a '1' if any of the conditions below are met:
    ; - RX has an unresolved DUR or Refill Too Soon reject
    ; - RX has an unresolved Reject Resolution Required (RRR) reject (only for Veteran and original fill)
    ; - RX is TRICARE/CHAMPVA and has any unresolved reject
    ; - RX is TRICARE/CHAMPVA and IN PROGRESS
    ; This is used by functions such as PPLADD^PSOSUPOE to determine if
    ; a label should be printed (we do not want a label for the conditions)
    DVINFO(RX,RFL,LM) ; Returns header displayable Division Information

    Interaction Calls

    Name Line Occurrences
    Function Call: WRITE
    • Prompt: !!,PSOBEI_" Prescription "_$$GET1^DIQ(52,RX,".01")_" cannot be released until ECME 'IN PROGRESS'"
    • Line Location: TRICCHK+22
    Function Call: WRITE
    • Prompt: !,"status is resolved payable.",!!
    • Line Location: TRICCHK+23
    Function Call: WRITE
    • Prompt: !!,"This prescription will be suspended. After the third party claim is resolved,"
    • Line Location: TRIC2+21
    Function Call: WRITE
    • Prompt: !,"it may be printed or pulled early from suspense.",!
    • Line Location: TRIC2+22
    Function Call: WRITE
    • Prompt: !
    • Line Location: TRIC4+10
    Function Call: WRITE
    • Prompt: $C(7),!,"Gross Amount Due is $"_$P(PSOIT,"^",2)_". IGNORE requires EPHARMACY SITE MANAGER key."
    • Line Location: TRIC4+18
    Function Call: WRITE
    • Prompt: !!,"This is a non-billable "_$$ELIGDISP^PSOREJP1(RX,RFL)_" prescription."
    • Line Location: MSG+1
    Function Call: WRITE
    • Prompt: !?3,LINE
    • Line Location: DISPLAY+16
    Function Call: WRITE
    • Prompt: !?3,$$DVINFO(RX,RFL)
    • Line Location: DISPLAY+17
    Function Call: WRITE
    • Prompt: !?3,$P(PTINFO,U,1)
    • Line Location: DISPLAY+19
    Function Call: WRITE
    • Prompt: !?3,$P(PTINFO,U,2)
    • Line Location: DISPLAY+20
    Function Call: WRITE
    • Prompt: !?3,"Rx/Drug : ",$$GET1^DIQ(52,RX,.01),"/",RFL," - ",$E($$GET1^DIQ(52,RX,6),1,20),?54
    • Line Location: DISPLAY+21
    Function Call: WRITE
    • Prompt: !?3,"Payer Message: "
    • Line Location: DISPLAY+24
    Function Call: WRITE
    • Prompt: !?3,"DUR Text : ",DATA(REJ,"DUR TEXT")
    • Line Location: DISPLAY+25
    Function Call: WRITE
    • Prompt: !?3,"Insurance : ",DATA(REJ,"INSURANCE NAME"),?50,"Contact: ",DATA(REJ,"PLAN CONTACT")
    • Line Location: DISPLAY+26
    Function Call: WRITE
    • Prompt: !?3,"Group Name : ",$E(DATA(REJ,"GROUP NAME"),1,26)
    • Line Location: DISPLAY+27
    Function Call: WRITE
    • Prompt: ?45,"Group Number: ",$E(DATA(REJ,"GROUP NUMBER"),1,15)
    • Line Location: DISPLAY+28
    Function Call: WRITE
    • Prompt: !?3,"Cardholder ID: ",$E(DATA(REJ,"CARDHOLDER ID"),1,20)
    • Line Location: DISPLAY+29
    Function Call: WRITE
    • Prompt: !?3,"Last Fill Dt.: ",DATA(REJ,"PLAN PREVIOUS FILL DATE")
    • Line Location: DISPLAY+31
    Function Call: WRITE
    • Prompt: !?3,"Patient Billing Comment(s):"
    • Line Location: DISPLAY+63
    Function Call: WRITE
    • Prompt: !?3,PSOCOM
    • Line Location: DISPLAY+82
    Function Call: WRITE
    • Prompt: !!?3,"Reject Resolution Required"
    • Line Location: DISPLAY+86
    Function Call: WRITE
    • Prompt: !?3,"Gross Amount Due ($"_$J($P(RRR,U,3)*100\1/100,0,2)_") is greater than or equal to"
    • Line Location: DISPLAY+87
    Function Call: WRITE
    • Prompt: !?3,"Threshold Dollar Amount ($"_$P(RRR,U,2)_")"
    • Line Location: DISPLAY+88
    Function Call: WRITE
    • Prompt: !?3,"Please select Quit to resolve this reject on the Reject Worklist."
    • Line Location: DISPLAY+89
    Function Call: READ
    • Variable: %
    • Timeout: DTIME
    • Line Location: DISP2+1
    Function Call: WRITE
    • Prompt: !?3,LINE,$C(7)
    • Line Location: DISP2+1
    Function Call: WRITE
    • Prompt: !?3,"Press <RETURN> to continue..."
    • Line Location: DISP2+1
    Function Call: WRITE
    • Prompt: !?3,"Press <RETURN> to continue..."
    • Line Location: DISP2+1
    Function Call: WRITE
    • Prompt: !?3,"Date/Time: "_$$FMTE^XLFDT(Y)
    • Line Location: TYPE+3
    Function Call: WRITE
    • Prompt: !?3,"Reason : ",$S($G(PSONBILL):"Not Billable.",$G(PSONPROG):"ECME Status is in an 'IN PROGRESS' state and cannot be filled",1:"")
    • Line Location: TYPE+4
    Function Call: WRITE
    • Prompt: !?3,"Reason : "
    • Line Location: TYPE+6
    Function Call: WRITE
    • Prompt: !?3,"Reject(s): "
    • Line Location: TYPE+13
    Function Call: WRITE
    • Prompt: ?INDENT,PSOWRAP(K),!
    • Line Location: W1+1
    Function Call: WRITE
    • Prompt: !!?TAB,"*** "_ELDSP_"NON-BILLABLE ***"
    • Line Location: HDR+5
    Function Call: WRITE
    • Prompt: !!?TAB,"*** "_ELDSP_"'IN PROGRESS' ECME status ***"
    • Line Location: HDR+6
    Function Call: WRITE
    • Prompt: !!?TAB,"*** "_ELDSP_"REJECT RECEIVED FROM THIRD PARTY PAYER ***"
    • Line Location: HDR+7

    FileMan Files Accessed Via FileMan Db Call

    FileNo Call Tags
    ^PSRX - [#52] GET1^DIQ
    52.25 GET1^DIQ
    ^PS(52.87 - [#52.87] GET1^DIQ
    55.17 GETS^DIQ
    ^PS(59 - [#59] GET1^DIQ
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