RCDPEAP1 ;ALB/KML - AUTO POST MATCHING EFT ERA PAIR - CONT. ;Jun 06, 2014@19:11:19
Source file <RCDPEAP1.m>
| action | A | extended action | Ea | event driver | Ed | subscriber | Su | protocol | O | limited protocol | LP | run routine | RR | broker | B | edit | E | server | Se | P | screenman | SM | inquire | I |
| Name | Comments | DBIA/ICR reference |
|---|---|---|
| AUTOCHK(RCERA) | ;Verify if ERA can be auto-posted - PRE-CHECK USED IN RCDPEM0
; Input: RCERA - IEN for file 344.4 ; Returns: 1 - Auto-Post candidate, 0 - Not an Auto-Post candidate ; Many checks done by this are also done AUTOCHK2 below so if these are changed, ; may also need to be changed |
|
| AUTOCHK2(RCERA,RCTYP) | ; RCTYP added PRCA*4.5*321
; Check if this entry is an auto-post candidate ; This has the same/similar checks as MATCH^RCDPEM0 and AUTOCHK above. If those procedures are ; changed, this may need to updated as well. ; ; Input: RCERA - IEN for file 344.4 ; RCTYP - 0 - Called from Worklist/Mark for autopost ; 1 - Called from Manual match ; Returns: 1 - Auto-Post candidate ; 0^Reason - Not an auto-post candidate and reason ; Validate Parameter |
|
| EXCLUDE(RCERA) | ; Verify if auto-posting is allowed for this Payer - PRECHECK USED IN RCDPEM0
; Not allowed if medical auto-posting is switched off ; Input: RCERA - IEN for file 344.4 ; Returns: 1 - Exclude ERA becaus Payer is in exclusion table, 0 otherwise ; PRCA*4.5*345 - changed to $$GET1^DIQ calls below |
|
| PHARM(RCERA) | ;Check if ERA is for Pharmacy only (ECME number on first line) - CALLED FROM RCDPEM0
|
|
| ERADET(RCERA,RCRCPTDA,RCLINES) | ; called on subsequent attempts of auto-post for a given ERA (DAY 2, DAY 3, ex.)
; update ERA with receipt or if not posted then update the AUTO-POST REJECTION REASON (#5) |
|
| ZEROBAL(RCSCR) | ;
; per requirements, only positive/negative payment pairs where payment ; calculates to zero are allowed for auto-post ; if payment ends up less than zero or greater than zero then ERA cannot ; be autoposted. ; ERA gets sent to the standard worklist for manual receipt processing ; note: a payment pair represents 2 EEOB sequences with the same claim ; RCSCR - 344.49 ien ; X - returns 1 or 0 ; |
|
| EXCLDRX(RCERA) | ; Verify if auto-posting is allowed for Pharmacy claims
; and for the Payer - PRECHECK USED IN RCDPEM0. Not allowed if pharmacy ; auto-posting is switched off ; Input: RCERA - IEN for file 344.4 ; Returns: 1 - ERA is excluded from Auto-Posting, 0 otherwise |
|
| EXCLDTR(RCERA) | ; Verify if auto-posting is allowed for TRICARE claims
; and for the Payer - PRECHECK USED IN RCDPEM0. Not allowed if TRICARE ; auto-posting is switched off ; PRCA*4.5*349 - Added function ; Input: RCERA - IEN for file 344.4 ; Returns: 1 - ERA is excluded from Auto-Posting, 0 otherwise |
|
| VALID(RCERA,RCLINES) | ;
|
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| UNBAL(RCERA) | ; PRCA*4.5*318 added method
; Determine if the ERA total matches the EFT total for the selected ERA ; Input: RCERA - Internal IEN of the selected ERA ; Returns: 1 - ERA is unbalanced, 0 otherwise |
|
| MATCHED(IEN) | ; Check if ERA is matched
; Input IEN - Internal entry number of ERA #344.4 ; Returns 1 if ERA is matched, otherwise 0 |
|
| ISZERO(IEN) | ; Check is ERA is zero balance (EP)
; Input IEN - Internal entry number of ERA #344.4 ; Returns 1 if ERA is zero balance, otherwise 0 |
| Name | Field # of Occurrence |
|---|---|
| FILE^DICN | ERADET+13 |
| ^DIE | ERADET+14, ERADET+29, VALID+55 |
| $$GET1^DIQ | AUTOCHK+24, AUTOCHK+34, AUTOCHK2+22, AUTOCHK2+34, AUTOCHK2+38, AUTOCHK2+39, AUTOCHK2+45, AUTOCHK2+49, AUTOCHK2+53, EXCLUDE+5 , EXCLUDE+9, EXCLUDE+11, EXCLUDE+19, EXCLDRX+5, EXCLDRX+9, EXCLDRX+11, EXCLDRX+18, EXCLDTR+6, EXCLDTR+10, EXCLDTR+12 , EXCLDTR+19, VALID+26, UNBAL+6, UNBAL+10, UNBAL+14 |
| $$CHECKPAY^RCDPEAP | VALID+44 |
| $$SCRPAD^RCDPEAP | AUTOCHK+39, AUTOCHK2+92 |
| CLEAR^RCDPEAP | AUTOCHK+46, AUTOCHK+53, AUTOCHK+56, AUTOCHK2+100, AUTOCHK2+103, AUTOCHK2+106 |
| $$PHARM^RCDPEAP1 | AUTOCHK2+42 |
| $$CHKTYPE^RCDPEU1 | AUTOCHK2+41 |
| $$GETPAY^RCDPEU1 | AUTOCHK2+40 |
| FileNo | Call Tags |
|---|---|
| ^RCY(344.4 - [#344.4] | Classic Fileman Calls, GET1^DIQ |
| 344.41 | GET1^DIQ |
| 344.42 | GET1^DIQ |
| ^RCY(344.6 - [#344.6] | GET1^DIQ |
| ^RCY(344.61 - [#344.61] | GET1^DIQ |
| Name | Line Occurrences (* Changed, ! Killed) |
|---|---|
| ^PRCA(430 - [#430] | VALID+35, VALID+38 |
| ^RCY(344.31 - [#344.31] | AUTOCHK2+86, MATCHED+3 |
| ^RCY(344.4 - [#344.4] | AUTOCHK+10, AUTOCHK+13, AUTOCHK+19, AUTOCHK2+19, AUTOCHK2+29, AUTOCHK2+65, AUTOCHK2+66, AUTOCHK2+71, PHARM+1, PHARM+2 , ERADET+13, VALID+28, UNBAL+9, UNBAL+13, ISZERO+3 |
| ^RCY(344.49 - [#344.49] | AUTOCHK2+91, ZEROBAL+12, ZEROBAL+14, VALID+11, VALID+15, VALID+17, VALID+19 |
| ^RCY(344.6 - [#344.6] | EXCLUDE+15, EXCLDRX+15, EXCLDTR+16 |
| ^TMP($J | AUTOCHK+6!, AUTOCHK+46, AUTOCHK2+16!, AUTOCHK2+100 |
| Name | Line Occurrences |
|---|---|
| $$EXCLDRX | AUTOCHK2+59 |
| $$EXCLDTR | AUTOCHK2+60 |
| $$EXCLUDE | AUTOCHK2+58 |
| $$ISZERO | AUTOCHK+29, AUTOCHK2+31 |
| $$MATCHED | AUTOCHK+28, AUTOCHK2+30 |
| $$ZEROBAL | AUTOCHK+53, AUTOCHK2+103 |
| >> | Not killed explicitly |
| * | Changed |
| ! | Killed |
| ~ | Newed |
| Name | Field # of Occurrence |
|---|---|
| AUTOPOST | VALID+14~, VALID+27*, VALID+28*, VALID+30 |
| CLAIM | VALID+14~, VALID+32*, VALID+33, VALID+35, VALID+38, VALID+43, VALID+44 |
| CLARRAY | VALID+14~, VALID+44 |
| CLARRAY( | VALID+43*, VALID+44* |
| DA | ERADET+10~, ERADET+14*, ERADET+25*, VALID+49~, VALID+53* |
| DA(1 | ERADET+13*, ERADET+25*, VALID+53* |
| DIC | ERADET+10~, ERADET+13* |
| DIC(0 | ERADET+13* |
| DIE | ERADET+10~, ERADET+14*, ERADET+25*, VALID+49~, VALID+53* |
| DLAYGO | ERADET+10~ |
| DO | ERADET+10~ |
| DR | ERADET+10~, ERADET+14*, ERADET+27*, ERADET+28*, VALID+49~, VALID+54* |
| DT | ERADET+28 |
| ERALINE | ZEROBAL+10~, ZEROBAL+11*, ZEROBAL+16*, ZEROBAL+19, VALID+14~, VALID+22*, VALID+24, VALID+26, VALID+28, VALID+33 , VALID+36, VALID+38, VALID+40, VALID+44, VALID+46 |
| IEN | MATCHED~, ISZERO~, ISZERO+3 |
| NOTOK | AUTOCHK+5~, AUTOCHK+9*, AUTOCHK+10, AUTOCHK+13*, AUTOCHK+16, AUTOCHK2+15~, AUTOCHK2+64*, AUTOCHK2+65, AUTOCHK2+67*, AUTOCHK2+68 |
| PIECE | VALID+14~, VALID+28* |
| PNAM | AUTOCHK2+15~, AUTOCHK2+38*, AUTOCHK2+40 |
| PTIN | AUTOCHK2+15~, AUTOCHK2+39*, AUTOCHK2+40 |
| RC0 | AUTOCHK2+15~, AUTOCHK2+29*, AUTOCHK2+74, AUTOCHK2+80, AUTOCHK2+86 |
| RCCREATE | AUTOCHK2+15~, AUTOCHK2+90*, AUTOCHK2+92*, AUTOCHK2+100, AUTOCHK2+103, AUTOCHK2+106 |
| RCD0 | AUTOCHK+5~, AUTOCHK+13*, AUTOCHK2+66*, AUTOCHK2+67 |
| RCDSUB | AUTOCHK+5~, AUTOCHK+9*, AUTOCHK+10*, AUTOCHK+13, AUTOCHK2+15~, AUTOCHK2+64*, AUTOCHK2+65*, AUTOCHK2+66 |
| RCERA | AUTOCHK~, AUTOCHK+10, AUTOCHK+13, AUTOCHK+19, AUTOCHK+24, AUTOCHK+28, AUTOCHK+29, AUTOCHK+39, AUTOCHK2~, AUTOCHK2+10 , AUTOCHK2+19, AUTOCHK2+22, AUTOCHK2+29, AUTOCHK2+30, AUTOCHK2+31, AUTOCHK2+38, AUTOCHK2+39, AUTOCHK2+42, AUTOCHK2+58, AUTOCHK2+59 , AUTOCHK2+60, AUTOCHK2+65, AUTOCHK2+66, AUTOCHK2+71, AUTOCHK2+86, AUTOCHK2+91, AUTOCHK2+92, EXCLUDE~, EXCLUDE+9, EXCLUDE+11 , PHARM~, PHARM+1, PHARM+2, ERADET~, ERADET+7, ERADET+13, ERADET+14, ERADET+25, EXCLDRX~, EXCLDRX+9 , EXCLDRX+11, EXCLDTR~, EXCLDTR+10, EXCLDTR+12, VALID~, VALID+11, VALID+26, VALID+28, VALID+53, UNBAL~ , UNBAL+6, UNBAL+9, UNBAL+10, UNBAL+13, UNBAL+14, MATCHED+3 |
| RCERATYP | AUTOCHK2+15~, AUTOCHK2+41*, AUTOCHK2+42*, AUTOCHK2+46, AUTOCHK2+50, AUTOCHK2+54, AUTOCHK2+58, AUTOCHK2+59, AUTOCHK2+60, AUTOCHK2+61 |
| RCI | VALID+49~ |
| RCLIN | ERADET+18~, ERADET+19*, ERADET+20*, ERADET+22, ERADET+25, ERADET+27, VALID+49~, VALID+50*, VALID+51, VALID+53 |
| RCLINES | ERADET~, VALID~, VALID+12*, VALID+50*, VALID+51* |
| RCLINES( | ERADET+20, ERADET+22, ERADET+27, VALID+33*, VALID+36*, VALID+38*, VALID+40*, VALID+44*, VALID+46*, VALID+50 , VALID+51 |
| RCLTOT | UNBAL+4~, UNBAL+8*, UNBAL+10*, UNBAL+14*, UNBAL+16 |
| RCMATCH | AUTOCHK+5~, AUTOCHK+28*, AUTOCHK+30, AUTOCHK2+15~, AUTOCHK2+30*, AUTOCHK2+32 |
| RCPID | EXCLUDE+8~, EXCLUDE+11*, EXCLUDE+12, EXCLUDE+15, EXCLDRX+6~, EXCLDRX+11*, EXCLDRX+12, EXCLDRX+15, EXCLDTR+7~, EXCLDTR+12* , EXCLDTR+13, EXCLDTR+16 |
| RCPNM | EXCLUDE+8~, EXCLUDE+9*, EXCLUDE+10, EXCLUDE+15, EXCLDRX+6~, EXCLDRX+9*, EXCLDRX+10, EXCLDRX+15, EXCLDTR+7~, EXCLDTR+10* , EXCLDTR+11, EXCLDTR+16 |
| RCPXDA | EXCLUDE+8~, EXCLUDE+15*, EXCLUDE+16, EXCLUDE+19, EXCLDRX+6~, EXCLDRX+15*, EXCLDRX+18, EXCLDTR+7~, EXCLDTR+16*, EXCLDTR+19 |
| RCRCPTDA | ERADET~, ERADET+8*, ERADET+12, ERADET+13, ERADET+14, ERADET+26, ERADET+28 |
| RCSCR | AUTOCHK+5~, AUTOCHK+39*, AUTOCHK+46, AUTOCHK+53, AUTOCHK+56, AUTOCHK2+15~, AUTOCHK2+91*, AUTOCHK2+92*, AUTOCHK2+93, AUTOCHK2+100 , AUTOCHK2+103, AUTOCHK2+106, ZEROBAL~, ZEROBAL+12, ZEROBAL+14, VALID+10~, VALID+11*, VALID+12, VALID+15, VALID+17 , VALID+19 |
| RCSUB | UNBAL+4~, UNBAL+8*, UNBAL+9*, UNBAL+10, UNBAL+12*, UNBAL+13*, UNBAL+14 |
| RCTOT | UNBAL+4~, UNBAL+6*, UNBAL+16 |
| RCTYP | AUTOCHK2~, AUTOCHK2+11, AUTOCHK2+12 |
| RCXCLDE | AUTOCHK2+15~, AUTOCHK2+57*, AUTOCHK2+58*, AUTOCHK2+59*, AUTOCHK2+60*, AUTOCHK2+61 |
| RCZERO | AUTOCHK+5~, AUTOCHK+29*, AUTOCHK+30, AUTOCHK+34, AUTOCHK+39, AUTOCHK+49, AUTOCHK2+15~, AUTOCHK2+31*, AUTOCHK2+32, AUTOCHK2+34 , AUTOCHK2+86, AUTOCHK2+92, AUTOCHK2+93 |
| REJECT | ERADET+18~, ERADET+22*, ERADET+26, ERADET+27 |
| SEQ | VALID+14~, VALID+28* |
| STATUS | AUTOCHK2+15~, AUTOCHK2+22*, AUTOCHK2+23, AUTOCHK2+24, AUTOCHK2+25, VALID+14~, VALID+35*, VALID+36 |
| SUB | PHARM+1~*, PHARM+2, ZEROBAL+10~, ZEROBAL+11*, ZEROBAL+12*, ZEROBAL+14, VALID+14~, VALID+15*, VALID+17, VALID+24* , VALID+26*, VALID+30*, VALID+36*, VALID+38*, VALID+40*, VALID+44* |
| SUB1 | ZEROBAL+10~, ZEROBAL+14*, VALID+14~, VALID+17*, VALID+18, VALID+19 |
| U | AUTOCHK+13, AUTOCHK+24, AUTOCHK2+67, AUTOCHK2+74, AUTOCHK2+80, AUTOCHK2+86, PHARM+2, ERADET+13, ERADET+22, ERADET+27 , ZEROBAL+16, ZEROBAL+19, ZEROBAL+21, VALID+21, VALID+22, VALID+28, VALID+32, VALID+38, VALID+40, VALID+43 , VALID+44, ISZERO+3 |
| WLINE | ZEROBAL+10~, ZEROBAL+14*, ZEROBAL+16, ZEROBAL+19, ZEROBAL+21, VALID+14~, VALID+19*, VALID+21, VALID+22, VALID+32 , VALID+40, VALID+43, VALID+44 |
| X | ERADET+10~, ERADET+13*, ZEROBAL+10~, ZEROBAL+11*, ZEROBAL+19*, ZEROBAL+21*, ZEROBAL+22 |
| XX | AUTOCHK2+15~, AUTOCHK2+40*, AUTOCHK2+41, AUTOCHK2+45*, AUTOCHK2+46, AUTOCHK2+49*, AUTOCHK2+50, AUTOCHK2+53*, AUTOCHK2+54 |
