RCDPEAD ;ALB/PJH - AUTO DECREASE ;Jun 06, 2014@19:11:19
Source file <RCDPEAD.m>
| Name | Comments | DBIA/ICR reference |
|---|---|---|
| EN | ;Auto Decrease - applies to auto-posted claims only
|
|
| EN1A(RCDAY,PAID,WHICH) | ; Scan ERA's for auto-posted lines on RCDAY
; PRCA*4.5*345 - Added WHICH ; Input: RCDAY - Day to begin search for auto-posted but not decreased lines ; PAID - 1 - Decrease paid lines only, 2 - Decrease no-pay lines only ; WHICH - 1 - Checking for Medical Claims, 2 - Checking for Rx Claims ; Output: Auto-decreases claims (potentially) ; ; Scan F (Auto-Post) index for ERAs within date range |
|
| EN2(RCDATE,RCDAY,PAID,WHICH) | ; Scans the 'F' index of the ERA file for ERA entries with an
; AUTOPOST DATE field (#4.03) matching RCDAY ; PRCA*4.5*345 - Added WHICH ; Input: RCDATE - Auto-Post Date of the ERA ; RCDAY - Day to begin search for auto-posted but not decreased lines ; PAID - 1 - Decrease paid lines, 2 - Decrease no-pay lines ; WHICH - 1 - Checking for Medical Claims ; 2 - Checking for Rx Claims ; 3 - Checking for TRICARE Claims |
|
| EN3(RCDATE,RCERA,RCARRAY,PAID,WHICH) | ; Scan ERA Detail lines in #344.41 for
; auto-posted Medical/Rx claims - PRCA*4.5*345 added WHICH ; Input: RCDATE - Auto-Post Date ; RCERA - IEN of the ERA (#344.4) ; RCARRAY - Array of ERA Scratchpad lines ; PAID - 1 - Decrease paid lines, 2 - Decrease no-pay lines ; WHICH - 1 - Processing Medical Claims, 2 - Processing Rx Claims |
|
| EN4(RCDATE,RCERA,RCARRAY,PAID,RCLINE,WHICH) | ; Auto-decrease selected lines
; PRCA*4.5*345 - Added WHICH ; Input: RCDATE - Auto-Post Date ; RCERA - IEN of the ERA (#344.4) ; RCARRAY - Array of scratch pad lines ; PAID - 1 - Decrease paid lines ; 2 - Decrease no-pay lines ; RCLINE - IEN of the detail ilne in sub-file 344.41 ; WHICH - 1 - Processing Medical Claims, 2 - Processing Rx Claims |
|
| SPLIT(RCSCR,RCLINE,RCBILL,RCARRAY) | ;Check for SPLIT/EDIT in scratchpad
|
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| CARCLMT(RCEOB,RCZERO,WHICH,FROMADP,ADATE) | ;EP from COMPILE^RCDPEADP and AUTO^RCDPEWLZ
; Checks to see if CARCs are included and eligible for auto-decrease ; PRCA*4.5*345 - Added WHICH ; Returns 0 if not, Max Amount ^ CARC if it is. ; Input: RCEOB - Internal IEN for the explanation of benefits field (361.1) ; FROMADP - 1 if being called from COMPILE^RCDPEADP, 0 otherwise ; Optional, default to 0 ; ADATE - Internal Auto-Post Date (only passed if FROMADP=1) ; RCZERO - 0 = ERA Line with payment 1 = ERA Line without payment ; WHICH - 1 - Checking Auto-Decrease for Medical CARCs ; 2 - Checking Auto-Decrease for Rx CARCs ; 3 - Checking Auto-Decrease for TRICARE CARCs ; Optional, defaults to 1 (Medical) ; Returns: A1;A2;A3;A4^B1;B2;B3;B4^...^N1;N2;N3;N4 Where: ; A1 - Auto-Decrease amount of the 1st CARC code in the EOB ; A2 - 1st CARC code in the EOB ; A3 - Deactivation Date of the 1st CARC code in the EOB if ; it has one and is less than today AND FROMADP=0 ; Otherwise Quantity of the first CARC code in the EOB if ; FROMADP=1 ; A4 - Reason of the 1st CARC code in the EOB ; only passed if FROMADP=1 |
|
| OTHER(RCBILLDA,ORIG) | ; Check if APAR/WL entries exist on other ERA for this bill
; INPUT ; RCBILLDA - IEN for claim in #430 or #399 ; ORIG - IEN for current ERA ; OUTPUT ; RCPEND - 1 = Other ERA payments exist 0 - No other ERA payments exit |
|
| FIND(RCERA,RCLINE) | ; Search ORIGINAL ERA SEQUENCES for this line
; Input RCERA - Scratchpad IEN ; RCLINE - ERA line to find ; Output RET - Scratchpad line number |
|
| PAYEX(WHICH,IEN3446) | ; Check if payer is excluded
; Subroutine added for PRCA*4.5*349 ; Input: WHICH - 1=Medical, 2=Rx, 3=TRICARE ; IEN3446 - Internal Entry number of Payer Exclusion file entry ; Returns: 1 if payer is excluded, otherwise 0. |
| FileNo | Call Tags |
|---|---|
| ^RCY(344.4 - [#344.4] | Classic Fileman Calls, GET1^DIQ |
| 344.41 | GET1^DIQ |
| 344.491 | GET1^DIQ |
| ^RCY(344.6 - [#344.6] | GET1^DIQ |
| ^RCY(344.61 - [#344.61] | GET1^DIQ |
| ^RC(345 - [#345] | FIND1^DIC, GET1^DIQ |
