ABMPSPLT.m

ABMPSPLT ; IHS/SD/SDR - Split claim based on Insurer setup ;     

 ;;2.6;IHS 3P BILLING SYSTEM;**22**;NOV 12, 2009;Build 418

 ;

 ;IHS/SD/SDR 2.6*22 HEAT335246 New routine; uses setup from 3P Insurer file to see if claim should be split so

 ; there is one charge per claim or one page (from the claim editor) per claim.

 ;

 I "^H^I^"[("^"_SERVCAT_"^") Q  ;skip claims that have a service category of H or I

 I $O(^ABMNINS(ABMP("LDFN"),ABMP("INS"),6,"B",""))="" Q  ;there aren't any splits setup for this insurer

 ;build list of pages that should be split with dates and how to split them

 S ABMP("PG")=""

 F  S ABMP("PG")=$O(^ABMNINS(ABMP("LDFN"),ABMP("INS"),6,"B",ABMP("PG"))) Q:$G(ABMP("PG"))=""  D

 .S ABMP("PGIEN")=0

 .F  S ABMP("PGIEN")=$O(^ABMNINS(ABMP("LDFN"),ABMP("INS"),6,"B",ABMP("PG"),ABMP("PGIEN"))) Q:'ABMP("PGIEN")  D

 ..S ABMPREC=$G(^ABMNINS(ABMP("LDFN"),ABMP("INS"),6,ABMP("PGIEN"),0))

 ..I $P(ABMPREC,U,2)'="",$P(ABMPREC,U,3)'="",$P(ABMPREC,U,2)=$P(ABMPREC,U,3) Q  ;there is a start and end date but they are the same; entry is 'deleted'

 ..Q:$P(ABMPREC,U,3)=0  ;don't split

 ..S ABMP("SPGS",ABMP("PG"))=$P(ABMPREC,U,2)_U_$P(ABMPREC,U,4)_U_$P(ABMPREC,U,3)  ;start date ^ end date ^ split how (by charge or by claim-editor-page)

 ;

 ;check that there's actually something in the what-should-split array, and split the claim if there is

 I $O(ABMP("SPGS",""))="" Q  ;nothing to split

 S ABMPGS=""

 F  S ABMPGS=$O(ABMP("SPGS",ABMPGS)) Q:$G(ABMPGS)=""  D

 .S ABMMLT=$S(ABMPGS="8D":23,ABMPGS="8E":37,ABMPGS="8F":35,1:43)

 .I +$O(^ABMDCLM(ABMP("LDFN"),ABMP("CDFN"),ABMMLT,0))=0 Q  ;no entries for multiple

 .I ABMP("VDT")<($P(ABMP("SPGS",ABMPGS),U)) Q  ;visit date is before start date

 .I $P(ABMP("SPGS",ABMPGS),U,2)'=""&(ABMP("VDT")>$P(ABMP("SPGS",ABMPGS),U,2)) Q  ;there is an end date and the visit date is after that

 .I $P($G(^ABMDCLM(DUZ(2),ABMP("CDFN"),ABMMLT,0)),U,4)<2 Q  ;must have multiple entries on a split page that need to be split

 .;if it gets here there is data on this page to split

 .S ABMY("SPLITHOW")=$P(ABMP("SPGS",ABMPGS),U,3)

 .S ABMY("INS")=ABMP("INS")

 .S ABMY("PGS")="^"_ABMPGS_"^"

 .S ^TMP("ABM-SPIN",$J,"VLST",ABMP("CDFN"),ABMPGS)=$P($G(^ABMDCLM(ABMP("LDFN"),ABMP("CDFN"),ABMMLT,0)),U,4)

 .S ABMY("SPLIT")="A"  ;this makes it label the split claims as auto-split, not manual

 .I +$G(ABMY("AUTODT"))=0 D

 ..D NOW^%DTC

 ..S ABMY("AUTODT")=%

 .S ABMY("INS",ABMY("INS"))=""

 .S ABMY("DT")="C"

 .D SPLITCLM^ABMRSTI2  ;split claim

 .D INSSTMP^ABMRSTI4

 .K ^TMP("ABM-SPIN",$J)

 Q

ABMPSPLT  ; IHS/SD/SDR - Split claim based on Insurer setup ;     

 +1       ;;2.6;IHS 3P BILLING SYSTEM;**22**;NOV 12, 2009;Build 418

 +2       ;

 +3       ;IHS/SD/SDR 2.6*22 HEAT335246 New routine; uses setup from 3P Insurer file to see if claim should be split so

 +4       ; there is one charge per claim or one page (from the claim editor) per claim.

 +5       ;

 +6       ;skip claims that have a service category of H or I

           IF "^H^I^"[("^"_SERVCAT_"^")

               QUIT 

 +7       ;there aren't any splits setup for this insurer

           IF $ORDER(^ABMNINS(ABMP("LDFN"),ABMP("INS"),6,"B",""))=""

               QUIT 

 +8       ;build list of pages that should be split with dates and how to split them

 +9        SET ABMP("PG")=""

 +10       FOR 

               SET ABMP("PG")=$ORDER(^ABMNINS(ABMP("LDFN"),ABMP("INS"),6,"B",ABMP("PG")))

               IF $GET(ABMP("PG"))=""

                   QUIT 

               Begin DoDot:1

 +11               SET ABMP("PGIEN")=0

 +12               FOR 

                       SET ABMP("PGIEN")=$ORDER(^ABMNINS(ABMP("LDFN"),ABMP("INS"),6,"B",ABMP("PG"),ABMP("PGIEN")))

                       IF 'ABMP("PGIEN")

                           QUIT 

                       Begin DoDot:2

 +13                       SET ABMPREC=$GET(^ABMNINS(ABMP("LDFN"),ABMP("INS"),6,ABMP("PGIEN"),0))

 +14      ;there is a start and end date but they are the same; entry is 'deleted'

                           IF $PIECE(ABMPREC,U,2)'=""

                               IF $PIECE(ABMPREC,U,3)'=""

                                   IF $PIECE(ABMPREC,U,2)=$PIECE(ABMPREC,U,3)

                                       QUIT 

 +15      ;don't split

                           IF $PIECE(ABMPREC,U,3)=0

                               QUIT 

 +16      ;start date ^ end date ^ split how (by charge or by claim-editor-page)

                           SET ABMP("SPGS",ABMP("PG"))=$PIECE(ABMPREC,U,2)_U_$PIECE(ABMPREC,U,4)_U_$PIECE(ABMPREC,U,3)

                       End DoDot:2

               End DoDot:1

 +17      ;

 +18      ;check that there's actually something in the what-should-split array, and split the claim if there is

 +19      ;nothing to split

           IF $ORDER(ABMP("SPGS",""))=""

               QUIT 

 +20       SET ABMPGS=""

 +21       FOR 

               SET ABMPGS=$ORDER(ABMP("SPGS",ABMPGS))

               IF $GET(ABMPGS)=""

                   QUIT 

               Begin DoDot:1

 +22               SET ABMMLT=$SELECT(ABMPGS="8D":23,ABMPGS="8E":37,ABMPGS="8F":35,1:43)

 +23      ;no entries for multiple

                   IF +$ORDER(^ABMDCLM(ABMP("LDFN"),ABMP("CDFN"),ABMMLT,0))=0

                       QUIT 

 +24      ;visit date is before start date

                   IF ABMP("VDT")<($PIECE(ABMP("SPGS",ABMPGS),U))

                       QUIT 

 +25      ;there is an end date and the visit date is after that

                   IF $PIECE(ABMP("SPGS",ABMPGS),U,2)'=""&(ABMP("VDT")>$PIECE(ABMP("SPGS",ABMPGS),U,2))

                       QUIT 

 +26      ;must have multiple entries on a split page that need to be split

                   IF $PIECE($GET(^ABMDCLM(DUZ(2),ABMP("CDFN"),ABMMLT,0)),U,4)<2

                       QUIT 

 +27      ;if it gets here there is data on this page to split

 +28               SET ABMY("SPLITHOW")=$PIECE(ABMP("SPGS",ABMPGS),U,3)

 +29               SET ABMY("INS")=ABMP("INS")

 +30               SET ABMY("PGS")="^"_ABMPGS_"^"

 +31               SET ^TMP("ABM-SPIN",$JOB,"VLST",ABMP("CDFN"),ABMPGS)=$PIECE($GET(^ABMDCLM(ABMP("LDFN"),ABMP("CDFN"),ABMMLT,0)),U,4)

 +32      ;this makes it label the split claims as auto-split, not manual

                   SET ABMY("SPLIT")="A"

 +33               IF +$GET(ABMY("AUTODT"))=0

                       Begin DoDot:2

 +34                       DO NOW^%DTC

 +35                       SET ABMY("AUTODT")=%

                       End DoDot:2

 +36               SET ABMY("INS",ABMY("INS"))=""

 +37               SET ABMY("DT")="C"

 +38      ;split claim

                   DO SPLITCLM^ABMRSTI2

 +39               DO INSSTMP^ABMRSTI4

 +40               KILL ^TMP("ABM-SPIN",$JOB)

               End DoDot:1

 +41       QUIT