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Routine: ABMEF20

ABMEF20.m

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  1. ABMEF20 ; IHS/ASDST/DMJ - Electronic HCFA-1500 V3.01 ;      
  1.  ;;2.6;IHS 3P BILLING SYSTEM;;NOV 12, 2009
  1.  ;
  1.  ; IHS/ASDS/DMJ - V2.4 P7 - 9/6/01 NOIS HQW-0701-100066
  1.  ;     This is a new routine related to Medicare Part B
  1.  ;
  1.  ; IHS/SD/SDR v2.5 p3 - 2/26/2003 - NDA-0402-180192
  1.  ;     Added new block 19 stuff
  1.  ;
  1. START ;
  1.  ;START HERE
  1.  I '$D(ABMP("INS")) D
  1.  .S ABMP("INS")=$P(^ABMDTXST(DUZ(2),ABMP("XMIT"),0),"^",4)
  1.  .I 'ABMP("INS") D
  1.  ..S DIC="^AUTNINS("
  1.  ..S DIC(0)="AEMQ"
  1.  ..D ^DIC
  1.  ..Q:Y<0
  1.  ..S ABMP("INS")=+Y
  1.  .S ABMP("ITYPE")=$P($G(^AUTNINS(ABMP("INS"),2)),U)
  1.  I 'ABMP("INS") D  Q
  1.  .W !,"Insurer NOT identified.",!
  1.  .D EOP^ABMDUTL(1)
  1.  S ABMP("FTYPE")=$P($G(^ABMDPARM(DUZ(2),1,3)),"^",4)
  1.  S:ABMP("FTYPE")="" ABMP("FTYPE")="H"
  1.  D OPEN
  1.  I $G(POP) W !,"File could not be created/opened.",! Q
  1.  S DIE="^ABMDTXST(DUZ(2),"
  1.  S DA=ABMP("XMIT")
  1.  S DR=".14///"_ABMFN
  1.  D ^DIE
  1.  D LOOP
  1.  D END
  1.  Q
  1.  ;
  1. LOOP ;loop through bills
  1.  S ABMP("L#")=0
  1.  S ABMEF("BATCH#")=0
  1.  S ABMP("MP")=1
  1.  S ABMP("WRITE")=1
  1.  K ABMR,ABMRT
  1.  S ABMOPRV=0
  1.  S ABMAPRV=0
  1.  F  S ABMAPRV=$O(^ABMDTXST(DUZ(2),ABMP("XMIT"),2,"APROV",ABMAPRV)) Q:'ABMAPRV  D
  1.  .S ABMTXIEN=0 F  S ABMTXIEN=$O(^ABMDTXST(DUZ(2),ABMP("XMIT"),2,"APROV",ABMAPRV,ABMTXIEN)) Q:'ABMTXIEN  D CLAIM
  1.  Q
  1. CLAIM ;one claim
  1.  S ABMP("BDFN")=+^ABMDTXST(DUZ(2),ABMP("XMIT"),2,ABMTXIEN,0)
  1.  Q:'$D(^ABMDBILL(DUZ(2),ABMP("BDFN"),0))
  1.  Q:$P(^ABMDBILL(DUZ(2),ABMP("BDFN"),0),"^",4)="X"
  1.  S ABMBIL0=$G(^ABMDBILL(DUZ(2),ABMP("BDFN"),0))
  1.  S ABMP("LDFN")=$P(ABMBIL0,"^",3)
  1.  S ABMP("VTYP")=$P(ABMBIL0,"^",7)
  1.  I 'ABMOPRV D
  1.  .D ^ABME3AA0
  1.  .U 0 W !,"Submission # ",ABMR(1,50),!
  1.  .U 0 W !,"Writing bills to file.",!
  1.  .S ABMEF("LINE")=ABMREC(1)
  1.  .D WRITE
  1.  I ABMAPRV'=ABMOPRV D BATCH
  1.  W "."
  1.  K ABMR
  1.  D ^ABMEH20
  1.  S ABMEF("LINE")=ABMREC(20)
  1.  D WRITE
  1.  K ABMR
  1.  D ^ABME3DA0
  1.  F I=1:1:3 D
  1.  .I $D(ABMREC(30,I)) D
  1.  ..S ABMEF("LINE")=ABMREC(30,I)
  1.  ..D WRITE
  1.  .I $D(ABMREC(31,I)) D
  1.  ..S ABMEF("LINE")=ABMREC(31,I)
  1.  ..D WRITE
  1.  K ABMR
  1.  D ^ABME3EA0
  1.  S ABMEF("LINE")=ABMREC(40)
  1.  D WRITE
  1.  K ABMR
  1.  D ^ABME3EA1
  1.  S ABMEF("LINE")=ABMREC(41)
  1.  D WRITE
  1.  K ABMR
  1.  D ^ABME3FA0
  1.  K ABMR
  1.  D ^ABME3XA0
  1.  S ABMEF("LINE")=ABMREC(90)
  1.  D WRITE
  1.  S DIE="^ABMDBILL(DUZ(2),"
  1.  S DA=ABMP("BDFN")
  1.  S DR=".04////B;.16////A;.17////"_ABMP("XMIT")
  1.  D ^DIE
  1.  Q
  1. BATCH ;new batch
  1.  S ABMEF("BATCH#")=ABMEF("BATCH#")+1
  1.  I ABMOPRV D
  1.  .D ^ABMEH95
  1.  .S ABMEF("LINE")=ABMREC(95)
  1.  .D WRITE
  1.  D ^ABME3BA0
  1.  S ABMEF("LINE")=ABMREC(10)
  1.  D WRITE
  1.  D ^ABMEH15
  1.  S ABMEF("LINE")=ABMREC(15)
  1.  D WRITE
  1.  S ABMOPRV=ABMAPRV
  1.  Q
  1. END ;end of file
  1.  K ABMR
  1.  D ^ABMEH95
  1.  S ABMEF("LINE")=ABMREC(95)
  1.  D WRITE
  1.  K ABMR
  1.  D ^ABMEH99
  1.  S ABMEF("LINE")=ABMREC(99)
  1.  D WRITE
  1.  D CLOSE
  1.  W !!,"Finished.",!!
  1.  K ABME,ABM,ABMEF,ABMREC,ABMR,ABMRV,ABMFN,ABMLF,ABMLNUM,ABMPATH
  1.  Q
  1.  ;
  1. OPEN ;
  1.  ; OPEN FILE
  1.  I ABMP("FTYPE")="K" D
  1.  .S POP=0
  1.  .S DIC="^DIZ(8980,"
  1.  .S DIC(0)="AEMQL"
  1.  .S DIC("S")="I $P(^(0),""^"",5)=DUZ"
  1.  .D ^DIC
  1.  .K DIC
  1.  .I Y<0 S POP=1 Q
  1.  .S ABMP("FILE#")=+Y
  1.  .S ABMFN=$P(Y,"^",2)
  1.  .I $O(^DIZ(8980,ABMP("FILE#"),2,0)) D
  1.  ..W !,*7,"Data already exists in this file!",!
  1.  ..S DIR("A")="Delete"
  1.  ..S DIR(0)="Y"
  1.  ..S DIR("B")="NO"
  1.  ..D ^DIR
  1.  ..K DIR
  1.  ..I Y=1 K ^DIZ(8980,ABMP("FILE#"),2)
  1.  ..I Y=0 S POP=1
  1.  I ABMP("FTYPE")="H" D
  1.  .S DIR(0)="9002274.5,.47"
  1.  .S DIR("A")="Enter Path"
  1.  .S DIR("B")=$P($G(^ABMDPARM(DUZ(2),1,4)),"^",7)
  1.  .D ^DIR K DIR
  1.  .I Y["^" S POP=1 Q
  1.  .S ABMPATH=Y
  1.  .S ABMRCID=$P(^AUTNINS(ABMP("INS"),0),"^",8)
  1.  .I $L(ABMRCID)<5 D
  1.  ..S ABMRCID=$E("00000",1,5-$L(ABMRCID))_ABMRCID
  1.  .S ABMJDT=$$JDT^XBFUNC(DT)
  1.  .S ABMLF=$G(^ABMNINS("ALF",ABMP("INS")))
  1.  .S:$P(ABMLF,".",2)'=ABMJDT ABMLF=""
  1.  .S ABMLNUM=+$E($P(ABMLF,".",1),7,8)
  1.  .S ABMLNUM=ABMLNUM+1
  1.  .I ABMLNUM<10 S ABMLNUM="0"_ABMLNUM
  1.  .S ABMFN="E"_ABMRCID_ABMLNUM_"."_ABMJDT
  1.  .S DIR(0)="F",DIR("A")="Enter File Name: ",DIR("B")=ABMFN
  1.  .D ^DIR K DIR
  1.  .I Y["^" S POP=1 Q
  1.  .S ABMFN=Y
  1.  .D OPEN^%ZISH("EMCFILE",ABMPATH,ABMFN,"W")
  1.  .S:'POP ^ABMNINS("ALF",ABMP("INS"))=ABMFN
  1.  I ABMP("FTYPE")="M" D
  1.  .S ABMP("DOMAIN")=$P($G(^ABMDPARM(DUZ(2),1,3)),"^",9)
  1.  .I 'ABMP("DOMAIN") W !,"MM SEND TO DOMAIN NOT DEFINED.",! S POP=1 Q
  1.  .S ABMP("DOMAIN")=$P(^DIC(4.2,ABMP("DOMAIN"),0),U)
  1.  .S XMSUB="EMC FILE FROM "_$P($G(^AUTTLOC(DUZ(2),0)),"^",2)
  1.  .S XMDUZ=DUZ
  1.  .D XMZ^XMA2
  1.  .I XMZ<1 S POP=1 Q
  1.  .S ABMFN="MAIL MSG# "_XMZ
  1.  .W !!,"MAIL MSG# ",XMZ," CREATED.",!
  1.  Q
  1.  ;
  1. WRITE ;EP - write record to file
  1.  Q:'$G(ABMP("WRITE"))
  1.  I ABMP("FTYPE")="K" D
  1.  .S ABMP("L#")=ABMP("L#")+1
  1.  .S ^DIZ(8980,ABMP("FILE#"),2,ABMP("L#"),0)=ABMEF("LINE")
  1.  I ABMP("FTYPE")="H" D
  1.  .U IO
  1.  .W ABMEF("LINE"),$C(13,10)
  1.  .U IO(0)
  1.  I ABMP("FTYPE")="M" D
  1.  .S ABMP("L#")=ABMP("L#")+1
  1.  .S ^XMB(3.9,XMZ,2,ABMP("L#"),0)=ABMEF("LINE")
  1.  Q
  1.  ;
  1. CLOSE ;
  1.  ;CLOSE FILE
  1.  I ABMP("FTYPE")="H" D ^%ZISC
  1.  I ABMP("FTYPE")="K" S ^DIZ(8980,ABMP("FILE#"),2,0)="^^"_I_"^"_I_"^"_DT
  1.  I ABMP("FTYPE")="M" D
  1.  .S ^XMB(3.9,XMZ,2,0)="^3.92A^"_ABMP("L#")_"^"_ABMP("L#")_"^"_DT
  1.  .S XMY(".5@"_ABMP("DOMAIN"))=""
  1.  .D ENT1^XMD
  1.  Q