ABMM2PV8 ;IHS/SD/SDR - MU Patient Volume EP Report ;
;;2.6;IHS 3P BILLING SYSTEM;**12,15**;NOV 12, 2009;Build 251
;IHS/SD/SDR - 2.6*15 - HEAT161159 - Made change to correct duplicates; also made changes to resolve summary not reconciling to pt list
;IHS/SD/SDR - 2.6*15 - HEAT183289 - Added code for Tribal self-insured; will look if patient has only one insurer and that insurer is defined
; as tribal self-insured in 3P Insurer file
;
ELIG ;EP
S ABMICNT=0 ;abm*2.6*15 HEAT183289
;mcd
K ABMK,ABML
K ABMILST,ABMP("STATE") ;abm*2.6*15 HEAT161159
K ABMTSI ;abm*2.6*15 HEAT183289
K ABMP("SAVE")
S ABMP("MDFN")=""
F S ABMP("MDFN")=$O(^AUPNMCD("B",ABMPT,ABMP("MDFN"))) Q:'ABMP("MDFN") D
.Q:$P($G(^AUPNMCD(ABMP("MDFN"),0)),U)=""
.Q:$P($G(^AUPNMCD(ABMP("MDFN"),0)),U,2)=""
.Q:$P($G(^AUPNMCD(ABMP("MDFN"),0)),U,4)=""
.S ABM("INS")=+$P($G(^AUPNMCD(ABMP("MDFN"),0)),U,10)
.I 'ABM("INS") S ABM("INS")=$P($G(^AUPNMCD(ABMP("MDFN"),0)),U,2)
.S ABM("ITYP")=$$GET1^DIQ(9999999.181,$$GET1^DIQ(9999999.18,ABM("INS"),".211","I"),1,"I")
.;S ABMGRP=$S(ABM("ITYP")="D":"MCD",ABM("ITYP")="K":"CHIP",(ABM("ITYP")="P"&($D(ABMI("INS",ABM("INS"))))):"CHIP",1:"OTHR")
.S ABMGRP=$S(ABM("ITYP")="D":"MCD",($D(ABMI("INS",ABM("INS")))):"CHIP",1:"OTHR")
.S ABMP("DDFN")=0
.F S ABMP("DDFN")=$O(^AUPNMCD(ABMP("MDFN"),11,ABMP("DDFN"))) Q:'ABMP("DDFN") D
..S ABMP("SDT")=+$P($G(^AUPNMCD(ABMP("MDFN"),11,ABMP("DDFN"),0)),U)
..S ABMP("EDT")=+$P($G(^AUPNMCD(ABMP("MDFN"),11,ABMP("DDFN"),0)),U,2)
..D ENROLL2
I +$G(ABMP("SAVE"))'=0 S ABMP("MDFN")=ABMP("SAVE") ;abm*2.6*15 HEAT164125
;pi
S ABMI=0
F S ABMI=$O(^AUPNPRVT(ABMPT,11,ABMI)) Q:'ABMI D
.S ABM("INS")=+$P($G(^AUPNPRVT(ABMPT,11,ABMI,0)),U)
.S ABM("ITYP")=$$GET1^DIQ(9999999.181,$$GET1^DIQ(9999999.18,ABM("INS"),".211","I"),1,"I")
.;S ABMGRP=$S(ABM("ITYP")="D":"MCD",ABM("ITYP")="K":"CHIP",(ABM("ITYP")="P"&($D(ABMI("INS",ABM("INS"))))):"CHIP",1:"OTHR")
.S ABMGRP=$S(ABM("ITYP")="D":"MCD",($D(ABMI("INS",ABM("INS")))):"CHIP",1:"OTHR")
.S ABMP("SDT")=+$P($G(^AUPNPRVT(ABMPT,11,ABMI,0)),U,6)
.S ABMP("EDT")=+$P($G(^AUPNPRVT(ABMPT,11,ABMI,0)),U,7)
.D ENROLL2
;mcr
S ABM("INS")=+$P($G(^AUPNMCR(ABMPT,0)),U,2)
S ABM("ITYP")=$$GET1^DIQ(9999999.181,$$GET1^DIQ(9999999.18,ABM("INS"),".211","I"),1,"I")
;S ABMGRP=$S(ABM("ITYP")="D":"MCD",ABM("ITYP")="K":"CHIP",(ABM("ITYP")="P"&($D(ABMI("INS",ABM("INS"))))):"CHIP",1:"OTHR")
S ABMGRP=$S(ABM("ITYP")="D":"MCD",($D(ABMI("INS",ABM("INS")))):"CHIP",1:"OTHR")
S ABMI=0
F S ABMI=$O(^AUPNMCR(ABMPT,11,ABMI)) Q:'ABMI D
.S ABMP("SDT")=+$P($G(^AUPNMCR(ABMPT,11,ABMI,0)),U)
.S ABMP("EDT")=+$P($G(^AUPNMCR(ABMPT,11,ABMI,0)),U,2)
.D ENROLL2
;rr
S ABM("INS")=+$P($G(^AUPNRRE(ABMPT,0)),U,2)
S ABM("ITYP")=$$GET1^DIQ(9999999.181,$$GET1^DIQ(9999999.18,ABM("INS"),".211","I"),1,"I")
;S ABMGRP=$S(ABM("ITYP")="D":"MCD",ABM("ITYP")="K":"CHIP",(ABM("ITYP")="P"&($D(ABMI("INS",ABM("INS"))))):"CHIP",1:"OTHR")
S ABMGRP=$S(ABM("ITYP")="D":"MCD",($D(ABMI("INS",ABM("INS")))):"CHIP",1:"OTHR")
S ABMI=0
F S ABMI=$O(^AUPNRRE(ABMPT,11,ABMI)) Q:'ABMI D
.S ABMP("SDT")=+$P($G(^AUPNRRE(ABMPT,11,ABMI,0)),U)
.S ABMP("EDT")=+$P($G(^AUPNRRE(ABMPT,11,ABMI,0)),U,2)
.D ENROLL2
Q
ENROLL2 ;EP
S:($G(ABMTSI)="") ABMTSI=$P($G(^ABMNINS(ABMVLOC,ABM("INS"),0)),U,11) ;tribal self-insured flag ;abm*2.6*15 HEAT183289
I ABM("ITYP")="I"!(ABM("ITYP")="N") Q
I $P(ABMP("VDT"),".")<ABMP("SDT") Q ;vst before start dt
I ABMP("EDT")'=0,($P(ABMP("VDT"),".")>ABMP("EDT")) Q ;vst after end dt
S ABML(ABMGRP)=1
S ABMK($S(($D(ABMI("INS",ABM("INS")))):"K",1:ABM("ITYP")))=1
;I ABMGRP="MCD" S ABMP("SAVE")=ABMP("MDFN") ;abm*2.6*15 HEAT164125
;start new abm*2.6*15 HEAT164125
I ABMGRP="CHIP",+$G(ABMP("SAVE"))'=0 K ABMP("SAVE"),ABMILST("STATE")
I ABMGRP="MCD" D
.I +$G(ABMP("SAVE"))'=0 K ABMP("SAVE"),ABMILST("STATE")
S ABMP("SAVE")=ABMP("MDFN"),ABMILST("STATE",ABM("INS"))=$$GET1^DIQ(5,$$GET1^DIQ(9000004,ABMP("MDFN"),".04","I"),1,"E")
;end new HEAT164125
S ABMILST(ABM("INS"))=ABM("ITYP") ;abm*2.6*15 HEAT161159 - to track pt's insurers
S ABMICNT=+$G(ABMICNT)+1 ;abm*2.6*15 HEAT183289
Q
ABMM2PV8 ;IHS/SD/SDR - MU Patient Volume EP Report ;
+1 ;;2.6;IHS 3P BILLING SYSTEM;**12,15**;NOV 12, 2009;Build 251
+2 ;IHS/SD/SDR - 2.6*15 - HEAT161159 - Made change to correct duplicates; also made changes to resolve summary not reconciling to pt list
+3 ;IHS/SD/SDR - 2.6*15 - HEAT183289 - Added code for Tribal self-insured; will look if patient has only one insurer and that insurer is defined
+4 ; as tribal self-insured in 3P Insurer file
+5 ;
ELIG ;EP
+1 ;abm*2.6*15 HEAT183289
SET ABMICNT=0
+2 ;mcd
+3 KILL ABMK,ABML
+4 ;abm*2.6*15 HEAT161159
KILL ABMILST,ABMP("STATE")
+5 ;abm*2.6*15 HEAT183289
KILL ABMTSI
+6 KILL ABMP("SAVE")
+7 SET ABMP("MDFN")=""
+8 FOR
SET ABMP("MDFN")=$ORDER(^AUPNMCD("B",ABMPT,ABMP("MDFN")))
IF 'ABMP("MDFN")
QUIT
Begin DoDot:1
+9 IF $PIECE($GET(^AUPNMCD(ABMP("MDFN"),0)),U)=""
QUIT
+10 IF $PIECE($GET(^AUPNMCD(ABMP("MDFN"),0)),U,2)=""
QUIT
+11 IF $PIECE($GET(^AUPNMCD(ABMP("MDFN"),0)),U,4)=""
QUIT
+12 SET ABM("INS")=+$PIECE($GET(^AUPNMCD(ABMP("MDFN"),0)),U,10)
+13 IF 'ABM("INS")
SET ABM("INS")=$PIECE($GET(^AUPNMCD(ABMP("MDFN"),0)),U,2)
+14 SET ABM("ITYP")=$$GET1^DIQ(9999999.181,$$GET1^DIQ(9999999.18,ABM("INS"),".211","I"),1,"I")
+15 ;S ABMGRP=$S(ABM("ITYP")="D":"MCD",ABM("ITYP")="K":"CHIP",(ABM("ITYP")="P"&($D(ABMI("INS",ABM("INS"))))):"CHIP",1:"OTHR")
+16 SET ABMGRP=$SELECT(ABM("ITYP")="D":"MCD",($DATA(ABMI("INS",ABM("INS")))):"CHIP",1:"OTHR")
+17 SET ABMP("DDFN")=0
+18 FOR
SET ABMP("DDFN")=$ORDER(^AUPNMCD(ABMP("MDFN"),11,ABMP("DDFN")))
IF 'ABMP("DDFN")
QUIT
Begin DoDot:2
+19 SET ABMP("SDT")=+$PIECE($GET(^AUPNMCD(ABMP("MDFN"),11,ABMP("DDFN"),0)),U)
+20 SET ABMP("EDT")=+$PIECE($GET(^AUPNMCD(ABMP("MDFN"),11,ABMP("DDFN"),0)),U,2)
+21 DO ENROLL2
End DoDot:2
End DoDot:1
+22 ;abm*2.6*15 HEAT164125
IF +$GET(ABMP("SAVE"))'=0
SET ABMP("MDFN")=ABMP("SAVE")
+23 ;pi
+24 SET ABMI=0
+25 FOR
SET ABMI=$ORDER(^AUPNPRVT(ABMPT,11,ABMI))
IF 'ABMI
QUIT
Begin DoDot:1
+26 SET ABM("INS")=+$PIECE($GET(^AUPNPRVT(ABMPT,11,ABMI,0)),U)
+27 SET ABM("ITYP")=$$GET1^DIQ(9999999.181,$$GET1^DIQ(9999999.18,ABM("INS"),".211","I"),1,"I")
+28 ;S ABMGRP=$S(ABM("ITYP")="D":"MCD",ABM("ITYP")="K":"CHIP",(ABM("ITYP")="P"&($D(ABMI("INS",ABM("INS"))))):"CHIP",1:"OTHR")
+29 SET ABMGRP=$SELECT(ABM("ITYP")="D":"MCD",($DATA(ABMI("INS",ABM("INS")))):"CHIP",1:"OTHR")
+30 SET ABMP("SDT")=+$PIECE($GET(^AUPNPRVT(ABMPT,11,ABMI,0)),U,6)
+31 SET ABMP("EDT")=+$PIECE($GET(^AUPNPRVT(ABMPT,11,ABMI,0)),U,7)
+32 DO ENROLL2
End DoDot:1
+33 ;mcr
+34 SET ABM("INS")=+$PIECE($GET(^AUPNMCR(ABMPT,0)),U,2)
+35 SET ABM("ITYP")=$$GET1^DIQ(9999999.181,$$GET1^DIQ(9999999.18,ABM("INS"),".211","I"),1,"I")
+36 ;S ABMGRP=$S(ABM("ITYP")="D":"MCD",ABM("ITYP")="K":"CHIP",(ABM("ITYP")="P"&($D(ABMI("INS",ABM("INS"))))):"CHIP",1:"OTHR")
+37 SET ABMGRP=$SELECT(ABM("ITYP")="D":"MCD",($DATA(ABMI("INS",ABM("INS")))):"CHIP",1:"OTHR")
+38 SET ABMI=0
+39 FOR
SET ABMI=$ORDER(^AUPNMCR(ABMPT,11,ABMI))
IF 'ABMI
QUIT
Begin DoDot:1
+40 SET ABMP("SDT")=+$PIECE($GET(^AUPNMCR(ABMPT,11,ABMI,0)),U)
+41 SET ABMP("EDT")=+$PIECE($GET(^AUPNMCR(ABMPT,11,ABMI,0)),U,2)
+42 DO ENROLL2
End DoDot:1
+43 ;rr
+44 SET ABM("INS")=+$PIECE($GET(^AUPNRRE(ABMPT,0)),U,2)
+45 SET ABM("ITYP")=$$GET1^DIQ(9999999.181,$$GET1^DIQ(9999999.18,ABM("INS"),".211","I"),1,"I")
+46 ;S ABMGRP=$S(ABM("ITYP")="D":"MCD",ABM("ITYP")="K":"CHIP",(ABM("ITYP")="P"&($D(ABMI("INS",ABM("INS"))))):"CHIP",1:"OTHR")
+47 SET ABMGRP=$SELECT(ABM("ITYP")="D":"MCD",($DATA(ABMI("INS",ABM("INS")))):"CHIP",1:"OTHR")
+48 SET ABMI=0
+49 FOR
SET ABMI=$ORDER(^AUPNRRE(ABMPT,11,ABMI))
IF 'ABMI
QUIT
Begin DoDot:1
+50 SET ABMP("SDT")=+$PIECE($GET(^AUPNRRE(ABMPT,11,ABMI,0)),U)
+51 SET ABMP("EDT")=+$PIECE($GET(^AUPNRRE(ABMPT,11,ABMI,0)),U,2)
+52 DO ENROLL2
End DoDot:1
+53 QUIT
ENROLL2 ;EP
+1 ;tribal self-insured flag ;abm*2.6*15 HEAT183289
IF ($GET(ABMTSI)="")
SET ABMTSI=$PIECE($GET(^ABMNINS(ABMVLOC,ABM("INS"),0)),U,11)
+2 IF ABM("ITYP")="I"!(ABM("ITYP")="N")
QUIT
+3 ;vst before start dt
IF $PIECE(ABMP("VDT"),".")<ABMP("SDT")
QUIT
+4 ;vst after end dt
IF ABMP("EDT")'=0
IF ($PIECE(ABMP("VDT"),".")>ABMP("EDT"))
QUIT
+5 SET ABML(ABMGRP)=1
+6 SET ABMK($SELECT(($DATA(ABMI("INS",ABM("INS")))):"K",1:ABM("ITYP")))=1
+7 ;I ABMGRP="MCD" S ABMP("SAVE")=ABMP("MDFN") ;abm*2.6*15 HEAT164125
+8 ;start new abm*2.6*15 HEAT164125
+9 IF ABMGRP="CHIP"
IF +$GET(ABMP("SAVE"))'=0
KILL ABMP("SAVE"),ABMILST("STATE")
+10 IF ABMGRP="MCD"
Begin DoDot:1
+11 IF +$GET(ABMP("SAVE"))'=0
KILL ABMP("SAVE"),ABMILST("STATE")
End DoDot:1
+12 SET ABMP("SAVE")=ABMP("MDFN")
SET ABMILST("STATE",ABM("INS"))=$$GET1^DIQ(5,$$GET1^DIQ(9000004,ABMP("MDFN"),".04","I"),1,"E")
+13 ;end new HEAT164125
+14 ;abm*2.6*15 HEAT161159 - to track pt's insurers
SET ABMILST(ABM("INS"))=ABM("ITYP")
+15 ;abm*2.6*15 HEAT183289
SET ABMICNT=+$GET(ABMICNT)+1
+16 QUIT
