AGMSP2.m

AGMSP2 ; IHS/ASDS/EFG - PRINT PAGE 2 OF MSP FORM ;   

 ;;7.1;PATIENT REGISTRATION;;AUG 25,2005

 ;

 ;I AG("MSPPRINT") EXISTS, MAP DATA FROM AUPNMSP TO THE FORM

EN ;EP

 W !,"PART II",!

 I '$D(AG("MSPPRINT")) D BLANK1

 I $D(AG("MSPPRINT")) D MAP1

 W !

 W !,?50,"Continued on next page ==>"

 W !,AGLINE("EQ")

 W !,$P($G(^DIC(4,DUZ(2),0)),U),?73,"PAGE 2"

 Q

BLANK1 ;THIS SECTION IS USED TO PRINT THE BLANK PAGE 2

 W !,?2,"1. Was the illness/injury due to a non-work-related accident ? ",!

 W !,?5,"[ ] YES  Date of accident :  _______________",!

 W !,?5,"[ ] NO - GO TO PART III",!

 W !,?2,"2. What type of accident caused the illness/injury ? ",!

 W !,?5,"[ ] Automobile",!

 W !,?5,"[ ] Non-Automobile",!

 W !,?14,"Name and address of no-fault or liability insurer : ",!

 W !,?14,$E(AGLINE("_"),1,50),!

 W !,?14,$E(AGLINE("_"),1,50),!

 W !,?14,$E(AGLINE("_"),1,50),!

 W !,?5,"Insurance claim number : _______________",!

 W !,"No-fault insurer is primary payer only for those claims related to the accident."

 W !,"GO TO PART III.",!

 W !,?5,"[ ] Other",!

 W !?2,"3. Was another party responsible for this accident ? ",!

 W !,?5,"[ ] YES",!

 W !,?14,"Name and address of any liability insurer : ",!

 W !,?14,$E(AGLINE("_"),1,50),!

 W !,?14,$E(AGLINE("_"),1,50),!

 W !,?14,$E(AGLINE("_"),1,50),!

 W !,?14,"Insurance claim number : _______________",!

 W !?2,"The liability insurer is primary only for those claims related to"

 W !?2,"the accident. GO TO PART III.",!

 W !,?5,"[ ] NO - GO TO PART III",!

 Q

MAP1 ;THIS SECTION IS USED TO PRINT THE PATIENT'S DATA ON THE FORM

 W !,?2,"1. Was the illness/injury due to a non-work related accident ? ",!

 I $P(MSPRES(9000037,AG("DA"),.16),U)="" D

 . W !,?5,"[ ] YES  Date of accident :  _______________",!

 . W !,?5,"[ ] NO - GO TO PART III",!

 I $P(MSPRES(9000037,AG("DA"),.16),U)="NO" D

 . W !,?5,"[ ] YES  Date of accident :  _______________",!

 . W !,?5,"[X] NO - GO TO PART III",!

 I $P(MSPRES(9000037,AG("DA"),.16),U)="YES" D

 . W !,?5,"[X] YES  Date of accident : "

 . W $P(MSPRES(9000037,AG("DA"),.17),U)

 . W !,?5,"[ ] NO - GO TO PART III",!

 ;

 W !,?2,"2. What type of accident caused the illness/injury ? ",!

 I $P(MSPRES(9000037,AG("DA"),.18),U)=""!($P(MSPRES(9000037,AG("DA"),.18),U)="OTHER") D

 . W !,?5,"[ ] Automobile",!

 . W !,?5,"[ ] Non-Automobile",!

 . W !,?5,"Name and address of no-fault or liability insurer : ",!

 . W !,?5,$E(AGLINE("_"),1,50),!

 . W !,?5,$E(AGLINE("_"),1,50),!

 . W !,?5,$E(AGLINE("_"),1,50),!

 . W !,?5,"Insurance claim number : _______________",!

 . I $P(MSPRES(9000037,AG("DA"),.18),U)="" W !,?5,"[ ] Other",!

 . I $P(MSPRES(9000037,AG("DA"),.18),U)="OTHER" W !,?5,"[X] Other",!

 I $P(MSPRES(9000037,AG("DA"),.18),U)="AUTOMOBILE"!($P(MSPRES(9000037,AG("DA"),.18),U)="NON-AUTOMOBILE") D

 . I $P(MSPRES(9000037,AG("DA"),.18),U)="AUTOMOBILE" D

 .. W !,?5,"[X] Automobile",!

 .. W !,?5,"[ ] Non-Automobile",!

 . I $P(MSPRES(9000037,AG("DA"),.18),U)="NON-AUTOMOBILE" D

 .. W !,?5,"[ ] Automobile",!

 .. W !,?5,"[X] Non-Automobile",!

 . W !,?5,"Name and address of no-fault or liability insurer : ",!

 . I $P(MSPRES(9000037,AG("DA"),.19),U)="" D

 .. W !,?5,$E(AGLINE("_"),1,50),!

 .. W !,?5,$E(AGLINE("_"),1,50),!

 .. W !,?5,$E(AGLINE("_"),1,50),!

 . I $P(MSPRES(9000037,AG("DA"),.19),U)'="" D

 .. S AG("INSPTR")=$P($G(^AUPNMSP(AG("DA"),2)),U,4)

 .. S AG("INSADDR")=$G(^AUTNINS(AG("INSPTR"),0))

 .. W !,?5,$P(AG("INSADDR"),U),!  ;INSURER NAME

 .. W !,?5,$P(AG("INSADDR"),U,2),!  ;INSURER STREET

 .. W !,?5,$P(AG("INSADDR"),U,3)  ;INSURER CITY

 .. I $P(AG("INSADDR"),U,4)'="" D

 ... W ", ",$P($G(^DIC(5,$P(AG("INSADDR"),U,4),0)),U,2)  ;INSURER STATE

 .. W ", ",$P(AG("INSADDR"),U,5),!  ;INSURER ZIP

 . I $P(MSPRES(9000037,AG("DA"),.21),U)="" D

 .. W !,?5,"Insurance claim number : _______________",!

 . I $P(MSPRES(9000037,AG("DA"),.21),U)'="" D

 .. W !,?5,"Insurance claim number : ",$P(MSPRES(9000037,AG("DA"),.21),U),!

 . W !,?5,"[ ] Other",!

 ;

 W !?2,"3. Was another party responsible for this accident ? ",!

 I $P(MSPRES(9000037,AG("DA"),.22),U)=""!($P(MSPRES(9000037,AG("DA"),.22),U)="NO") D

 . W !,?5,"[ ] YES",!

 . W !,?14,"Name and address of any liability insurer : ",!

 . W !,?14,$E(AGLINE("_"),1,50),!

 . W !,?14,$E(AGLINE("_"),1,50),!

 . W !,?14,$E(AGLINE("_"),1,50),!

 . W !,?14,"Insurance claim number : _______________",!

 . I $P(MSPRES(9000037,AG("DA"),.22),U)="" W !,?5,"[ ] NO - GO TO PART III",!

 . I $P(MSPRES(9000037,AG("DA"),.22),U)="NO" W !,?5,"[X] NO - GO TO PART III",!

 I $P(MSPRES(9000037,AG("DA"),.22),U)="YES" D

 . W !,?5,"[X] YES",!

 . W !,?14,"Name and address of any liability insurer : ",!

 . I $P(MSPRES(9000037,AG("DA"),.23),U)="" D

 .. W !,?14,$E(AGLINE("_"),1,50),!

 .. W !,?14,$E(AGLINE("_"),1,50),!

 .. W !,?14,$E(AGLINE("_"),1,50),!

 . I $P(MSPRES(9000037,AG("DA"),.23),U)'="" D

 .. S AG("INSPTR")=$P($G(^AUPNMSP(AG("DA"),2)),U,7)

 .. S AG("INSADDR")=$G(^AUTNINS(AG("INSPTR"),0))

 .. W !,?14,$P(AG("INSADDR"),U),!  ;INSURER NAME

 .. W !,?14,$P(AG("INSADDR"),U,2),!  ;INSURER STREET

 .. W !,?14,$P(AG("INSADDR"),U,3)  ;INSURER CITY

 .. I $P(AG("INSADDR"),U,4)'="" D

 ... W ", ",$P($G(^DIC(5,$P(AG("INSADDR"),U,4)),0),U,2)  ;INSURER STATE

 .. W ", ",$P(AG("INSADDR"),U,5),!  ;INSURER ZIP

 . I $P(MSPRES(9000037,AG("DA"),.24),U)="" D

 .. W !,?5,"Insurance claim number : _______________",!

 . I $P(MSPRES(9000037,AG("DA"),.24),U)'="" D

 .. W !,?5,"Insurance claim number : ",$P(MSPRES(9000037,AG("DA"),.24),U),!

 . W !,?5,"[ ] NO - GO TO PART III",!

 K AG("INSPTR"),AG("INSADDR")

 Q

AGMSP2    ; IHS/ASDS/EFG - PRINT PAGE 2 OF MSP FORM ;   

 +1       ;;7.1;PATIENT REGISTRATION;;AUG 25,2005

 +2       ;

 +3       ;I AG("MSPPRINT") EXISTS, MAP DATA FROM AUPNMSP TO THE FORM

EN        ;EP

 +1        WRITE !,"PART II",!

 +2        IF '$DATA(AG("MSPPRINT"))

               DO BLANK1

 +3        IF $DATA(AG("MSPPRINT"))

               DO MAP1

 +4        WRITE !

 +5        WRITE !,?50,"Continued on next page ==>"

 +6        WRITE !,AGLINE("EQ")

 +7        WRITE !,$PIECE($GET(^DIC(4,DUZ(2),0)),U),?73,"PAGE 2"

 +8        QUIT 

BLANK1    ;THIS SECTION IS USED TO PRINT THE BLANK PAGE 2

 +1        WRITE !,?2,"1. Was the illness/injury due to a non-work-related accident ? ",!

 +2        WRITE !,?5,"[ ] YES  Date of accident :  _______________",!

 +3        WRITE !,?5,"[ ] NO - GO TO PART III",!

 +4        WRITE !,?2,"2. What type of accident caused the illness/injury ? ",!

 +5        WRITE !,?5,"[ ] Automobile",!

 +6        WRITE !,?5,"[ ] Non-Automobile",!

 +7        WRITE !,?14,"Name and address of no-fault or liability insurer : ",!

 +8        WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

 +9        WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

 +10       WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

 +11       WRITE !,?5,"Insurance claim number : _______________",!

 +12       WRITE !,"No-fault insurer is primary payer only for those claims related to the accident."

 +13       WRITE !,"GO TO PART III.",!

 +14       WRITE !,?5,"[ ] Other",!

 +15       WRITE !?2,"3. Was another party responsible for this accident ? ",!

 +16       WRITE !,?5,"[ ] YES",!

 +17       WRITE !,?14,"Name and address of any liability insurer : ",!

 +18       WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

 +19       WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

 +20       WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

 +21       WRITE !,?14,"Insurance claim number : _______________",!

 +22       WRITE !?2,"The liability insurer is primary only for those claims related to"

 +23       WRITE !?2,"the accident. GO TO PART III.",!

 +24       WRITE !,?5,"[ ] NO - GO TO PART III",!

 +25       QUIT 

MAP1      ;THIS SECTION IS USED TO PRINT THE PATIENT'S DATA ON THE FORM

 +1        WRITE !,?2,"1. Was the illness/injury due to a non-work related accident ? ",!

 +2        IF $PIECE(MSPRES(9000037,AG("DA"),.16),U)=""

               Begin DoDot:1

 +3                WRITE !,?5,"[ ] YES  Date of accident :  _______________",!

 +4                WRITE !,?5,"[ ] NO - GO TO PART III",!

               End DoDot:1

 +5        IF $PIECE(MSPRES(9000037,AG("DA"),.16),U)="NO"

               Begin DoDot:1

 +6                WRITE !,?5,"[ ] YES  Date of accident :  _______________",!

 +7                WRITE !,?5,"[X] NO - GO TO PART III",!

               End DoDot:1

 +8        IF $PIECE(MSPRES(9000037,AG("DA"),.16),U)="YES"

               Begin DoDot:1

 +9                WRITE !,?5,"[X] YES  Date of accident : "

 +10               WRITE $PIECE(MSPRES(9000037,AG("DA"),.17),U)

 +11               WRITE !,?5,"[ ] NO - GO TO PART III",!

               End DoDot:1

 +12      ;

 +13       WRITE !,?2,"2. What type of accident caused the illness/injury ? ",!

 +14       IF $PIECE(MSPRES(9000037,AG("DA"),.18),U)=""!($PIECE(MSPRES(9000037,AG("DA"),.18),U)="OTHER")

               Begin DoDot:1

 +15               WRITE !,?5,"[ ] Automobile",!

 +16               WRITE !,?5,"[ ] Non-Automobile",!

 +17               WRITE !,?5,"Name and address of no-fault or liability insurer : ",!

 +18               WRITE !,?5,$EXTRACT(AGLINE("_"),1,50),!

 +19               WRITE !,?5,$EXTRACT(AGLINE("_"),1,50),!

 +20               WRITE !,?5,$EXTRACT(AGLINE("_"),1,50),!

 +21               WRITE !,?5,"Insurance claim number : _______________",!

 +22               IF $PIECE(MSPRES(9000037,AG("DA"),.18),U)=""

                       WRITE !,?5,"[ ] Other",!

 +23               IF $PIECE(MSPRES(9000037,AG("DA"),.18),U)="OTHER"

                       WRITE !,?5,"[X] Other",!

               End DoDot:1

 +24       IF $PIECE(MSPRES(9000037,AG("DA"),.18),U)="AUTOMOBILE"!($PIECE(MSPRES(9000037,AG("DA"),.18),U)="NON-AUTOMOBILE")

               Begin DoDot:1

 +25               IF $PIECE(MSPRES(9000037,AG("DA"),.18),U)="AUTOMOBILE"

                       Begin DoDot:2

 +26                       WRITE !,?5,"[X] Automobile",!

 +27                       WRITE !,?5,"[ ] Non-Automobile",!

                       End DoDot:2

 +28               IF $PIECE(MSPRES(9000037,AG("DA"),.18),U)="NON-AUTOMOBILE"

                       Begin DoDot:2

 +29                       WRITE !,?5,"[ ] Automobile",!

 +30                       WRITE !,?5,"[X] Non-Automobile",!

                       End DoDot:2

 +31               WRITE !,?5,"Name and address of no-fault or liability insurer : ",!

 +32               IF $PIECE(MSPRES(9000037,AG("DA"),.19),U)=""

                       Begin DoDot:2

 +33                       WRITE !,?5,$EXTRACT(AGLINE("_"),1,50),!

 +34                       WRITE !,?5,$EXTRACT(AGLINE("_"),1,50),!

 +35                       WRITE !,?5,$EXTRACT(AGLINE("_"),1,50),!

                       End DoDot:2

 +36               IF $PIECE(MSPRES(9000037,AG("DA"),.19),U)'=""

                       Begin DoDot:2

 +37                       SET AG("INSPTR")=$PIECE($GET(^AUPNMSP(AG("DA"),2)),U,4)

 +38                       SET AG("INSADDR")=$GET(^AUTNINS(AG("INSPTR"),0))

 +39      ;INSURER NAME

                           WRITE !,?5,$PIECE(AG("INSADDR"),U),!

 +40      ;INSURER STREET

                           WRITE !,?5,$PIECE(AG("INSADDR"),U,2),!

 +41      ;INSURER CITY

                           WRITE !,?5,$PIECE(AG("INSADDR"),U,3)

 +42                       IF $PIECE(AG("INSADDR"),U,4)'=""

                               Begin DoDot:3

 +43      ;INSURER STATE

                                   WRITE ", ",$PIECE($GET(^DIC(5,$PIECE(AG("INSADDR"),U,4),0)),U,2)

                               End DoDot:3

 +44      ;INSURER ZIP

                           WRITE ", ",$PIECE(AG("INSADDR"),U,5),!

                       End DoDot:2

 +45               IF $PIECE(MSPRES(9000037,AG("DA"),.21),U)=""

                       Begin DoDot:2

 +46                       WRITE !,?5,"Insurance claim number : _______________",!

                       End DoDot:2

 +47               IF $PIECE(MSPRES(9000037,AG("DA"),.21),U)'=""

                       Begin DoDot:2

 +48                       WRITE !,?5,"Insurance claim number : ",$PIECE(MSPRES(9000037,AG("DA"),.21),U),!

                       End DoDot:2

 +49               WRITE !,?5,"[ ] Other",!

               End DoDot:1

 +50      ;

 +51       WRITE !?2,"3. Was another party responsible for this accident ? ",!

 +52       IF $PIECE(MSPRES(9000037,AG("DA"),.22),U)=""!($PIECE(MSPRES(9000037,AG("DA"),.22),U)="NO")

               Begin DoDot:1

 +53               WRITE !,?5,"[ ] YES",!

 +54               WRITE !,?14,"Name and address of any liability insurer : ",!

 +55               WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

 +56               WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

 +57               WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

 +58               WRITE !,?14,"Insurance claim number : _______________",!

 +59               IF $PIECE(MSPRES(9000037,AG("DA"),.22),U)=""

                       WRITE !,?5,"[ ] NO - GO TO PART III",!

 +60               IF $PIECE(MSPRES(9000037,AG("DA"),.22),U)="NO"

                       WRITE !,?5,"[X] NO - GO TO PART III",!

               End DoDot:1

 +61       IF $PIECE(MSPRES(9000037,AG("DA"),.22),U)="YES"

               Begin DoDot:1

 +62               WRITE !,?5,"[X] YES",!

 +63               WRITE !,?14,"Name and address of any liability insurer : ",!

 +64               IF $PIECE(MSPRES(9000037,AG("DA"),.23),U)=""

                       Begin DoDot:2

 +65                       WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

 +66                       WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

 +67                       WRITE !,?14,$EXTRACT(AGLINE("_"),1,50),!

                       End DoDot:2

 +68               IF $PIECE(MSPRES(9000037,AG("DA"),.23),U)'=""

                       Begin DoDot:2

 +69                       SET AG("INSPTR")=$PIECE($GET(^AUPNMSP(AG("DA"),2)),U,7)

 +70                       SET AG("INSADDR")=$GET(^AUTNINS(AG("INSPTR"),0))

 +71      ;INSURER NAME

                           WRITE !,?14,$PIECE(AG("INSADDR"),U),!

 +72      ;INSURER STREET

                           WRITE !,?14,$PIECE(AG("INSADDR"),U,2),!

 +73      ;INSURER CITY

                           WRITE !,?14,$PIECE(AG("INSADDR"),U,3)

 +74                       IF $PIECE(AG("INSADDR"),U,4)'=""

                               Begin DoDot:3

 +75      ;INSURER STATE

                                   WRITE ", ",$PIECE($GET(^DIC(5,$PIECE(AG("INSADDR"),U,4)),0),U,2)

                               End DoDot:3

 +76      ;INSURER ZIP

                           WRITE ", ",$PIECE(AG("INSADDR"),U,5),!

                       End DoDot:2

 +77               IF $PIECE(MSPRES(9000037,AG("DA"),.24),U)=""

                       Begin DoDot:2

 +78                       WRITE !,?5,"Insurance claim number : _______________",!

                       End DoDot:2

 +79               IF $PIECE(MSPRES(9000037,AG("DA"),.24),U)'=""

                       Begin DoDot:2

 +80                       WRITE !,?5,"Insurance claim number : ",$PIECE(MSPRES(9000037,AG("DA"),.24),U),!

                       End DoDot:2

 +81               WRITE !,?5,"[ ] NO - GO TO PART III",!

               End DoDot:1

 +82       KILL AG("INSPTR"),AG("INSADDR")

 +83       QUIT