ABSPOSQS ; IHS/FCS/DRS - special queuing considerations ; [ 08/28/2002 2:25 PM ]
;;1.0;PHARMACY POINT OF SALE;**1,2,3,37,40**;JUN 21, 2001;Build 38
;
; IHS/DSD/lwj 4/18/02 on behalf of Patrick Cox
; IHS/OKCAO/POC 10/2/01 In Oklahoma there is a general 3 punch
; a month limitation. However, there are no limitation for kids
; under the age of 18, or for patients in a nursing home. This
; change will simply address the limitation on the kids under 18.
; The maximum number of prescriptions will simply be set to 999
; to reflect no limitation.
;
; IHS/SD/lwj 6/17/02 on behalf of Patrick Cox
; IHS/OKCAO/POC 5/22/02 In the subroutine CAIDPAID, the routine
; attempts to count how many Medicaid paid repsonses have been
; received for a given month. The script count could be incorrectly
; inflatted if a script was flled/reflled in a prev month, but was
; sbmtd/resbmtd in the current month. Original logic was only
; looking at the month of the claim - not the DOS. Logic
; changed to use the scripts fill dt/refill dt instead of clm dt.
; (effected back billing, or resubmittal of previous month scripts
; when current month limitation had been reached)
;
; IHS/SD/lwj 8/28/02 on behalf of Patrick Cox (OKCAO/POC)
; Cache systems do not allow the reverse dollar order on arrays.
; Patrick simply reversed the sign in the PRICEORD array, which
; allowed the values to appear in descending order - this eliminated
; the need for the reverse $O on the PRICEORD array.
;
Q
STAT19() ;EP - is called at the bottom of ABSPOSQ1
; if there are any claims of status 19 - waiting for special
; Oklahoma Medicaid rule to run its course
N ROU S ROU=$T(+0)
L +^TMP("ABSPOSQS"):0 Q:'$T 0 ; only one of these running
N COUNT30 S COUNT30=0 ; count how many 19s got pushed to status 30
D RULE19
L -^TMP("ABSPOSQS")
; If there are still any claims with status = 19,
; then you need to schedule ABSPOSQ1 to run again in a little while.
I $D(^ABSPT("AD",19)) D
. N WAIT S WAIT=$P(^ABSP(9002313.99,1,"SPECIAL"),U,2)
. S:'WAIT WAIT=60
. S WAIT="."_$TR($J(WAIT\3600,2)_$J(WAIT#3600\60,2)_$J(WAIT#60,2)," ","0")
. D TASKAT^ABSPOSIZ($$TADDNOW^ABSPOSUD(WAIT))
Q COUNT30
RULE19 ;
N INCYCLE,NLIMIT,SINCEDAT,PAT,IEN59,STAT,LASTUPD,I,X,Y
;
; Gather all the claims with status 19 into ^TMP("ABSPOSQS",$J,PAT,19,IEN59)
; Medicaid claims only - already taken care of, in that only
; Medicaid claims can ever be in status 19
; For any status, just set ^TMP("ABSPOSQS",$J,PAT,status)=latest last-update
; to make it easy to detect if a given patient has any non-19's.
;
K ^TMP("ABSPOSQS")
S STAT="",IEN59=0
F S STAT=$O(^ABSPT("AD",STAT)) Q:STAT="" Q:STAT=99 D
. S IEN59=0
. F S IEN59=$O(^ABSPT("AD",STAT,IEN59)) Q:'IEN59 D
. . ; $G() in next line guards against corrupt index
. . S PAT=$P($G(^ABSPT(IEN59,0)),U,6) Q:'PAT
. . S LASTUPD=$P(^ABSPT(IEN59,0),U,8)
. . S X=$G(^TMP("ABSPOSQS",$J,PAT,STAT))
. . I LASTUPD>X S ^TMP("ABSPOSQS",$J,PAT,STAT)=LASTUPD
. . I STAT=19 S ^TMP("ABSPOSQS",$J,PAT,STAT,IEN59)=""
;
; Loop for each such patient:
S PAT="" F S PAT=$O(^TMP("ABSPOSQS",$J,PAT)) Q:'PAT D
. I '$D(^TMP("ABSPOSQS",$J,PAT,19)) Q ; no 19's for this patient; nothing to do
. D PAT19
Q
PAT19 ; Then look at each patient's situation:
;
; If the patient has any claims with status 20-98 (i.e., actively
; going through POS right now) then leave their 19s as 19 for now.
; What we do with these depends on how the others turn out.
;
; Also, if the patient has any with status <19, wait for those to
; catch up - because apparently, data entry is still going on
; and we want to wait, so we just pick off the three highest-priced.
;
I $O(^TMP("ABSPOSQS",$J,PAT,""))'=19 Q ; there are some w/status < 19
I $O(^TMP("ABSPOSQS",$J,PAT,19))'="" Q ; there are some w/status > 19
;
; IHS/DSD/lwj 04/18/02 on behalf of IHS/OKCAO/POC 10/2/2001
; begin changes
;
;N LIMIT,MAX S MAX=3 S LIMIT=MAX-$$CAIDPAID ;IHS/OKCAO/POC rmkd out
N ABSPINS,ABSPERR,LIMIT,MAX,DFN ;IHS/OKCAO/POC new def
;
; In the ABSP setup file, there is a special node:
; ^ABSP(9002313.99,1,"SPECIAL")=OK MEDICAID INS NAME^OK MEDICAID
; CYCLE^OK MEDICAID LIMIT
; This portion of the code is retrieving the INS name, and the limits
; If the insurer is Oklahoma, we will adjust the limits for kids
;
S ABSPINS=$$GET1^DIQ(9002313.99,"1,",1960.01,"","","ABSPERR")
S MAX=+$P($G(^ABSP(9002313.99,1,"SPECIAL")),U,3) ;IHS/OKCAO/POC def
S:'MAX MAX=3 ;IHS/OKCAO/POC use def when pos
;
;If this is for Oklahoma and patient is under 18 extend limits
; (insurance name is either Oklahoma Medicaid or Oklahoma)
I ($G(ABSPINS)["OKLAHOMA")&($$AGE^AUPNPAT(PAT)<18) S MAX=999
;
S LIMIT=MAX-$$CAIDPAID
;
; IHS/DSD/lwj 04/18/02 for IHS/OKCAO/POC 10/2/01 end changes
;
;
; LIMIT = how many more paid responses we're allowed for this month
;
; If LIMIT=0, we've used up our limit of Medicaid prescriptions
; for the month. Each of these will have to bump to the next
; insurer. (For now, just reject them
;
I LIMIT=0 D Q
. S IEN59=0 F S IEN59=$O(^TMP("ABSPOSQS",$J,PAT,19,IEN59)) Q:'IEN59 D
. . D SETSLOT^ABSPOSL(IEN59)
. . N MSG S MSG="Medicaid monthly limit of "_MAX_" reached."
. . D LOG^ABSPOSL(MSG)
. . I $$BUMPINS^ABSPOSQA(IEN59) D ; bump to next insurer
. . . ; Succeeded, there is more insurance ;
. . . ; And $$BUMPINS reset status to 0
. . . D LOG^ABSPOSL(" We will try the next insurer.")
. . E D
. . . ; Failed - no more insurance - $$BUMPINS set status to 99
. . . N ABSBRXI S ABSBRXI=IEN59 ; unfortunate variable naming
. . . D SETRESU^ABSPOSU(19,MSG)
. . D RELSLOT^ABSPOSL
;
; We can still submit some Medicaid prescriptions, but let's
; make sure we have all the ones that we're going to get at
; this visit - make sure that the most recent activity on
; any of the status 19 claims is at least 2 minutes old.
; Otherwise, there may be some more coming, and we would rather
; wait and make sure we get the more expensive ones.
I $$TDIFNOW^ABSPOSUD(^TMP("ABSPOSQS",$J,PAT,19))<$P(^ABSP(9002313.99,1,"SPECIAL"),U,2) Q
;
; If LIMIT>0, then take this many of the patient's status 19 claims
; and change them to status 30. Any other 19s stay as 19s,
; as we need to wait and see how the others turn out. If they're
; rejected, we could still submit a few of the other 19s.
;
N PRICEORD ; set PRICEORD(price,ien59)="" for each of this pat's 19s
N PRICE,N
S IEN59=0
F S IEN59=$O(^TMP("ABSPOSQS",$J,PAT,19,IEN59)) Q:'IEN59 D
. N PRICE S PRICE=$P(^ABSPT(IEN59,5),U,5)
. ;IHS/SD/lwj 8/28/02 on behalf of IHS/OKCAO/POS nxt line remarked
. ; out, following line added
. ; S PRICEORD(PRICE,IEN59)="" ;IHS/OKCAO/POS 8/28/02
. S PRICEORD(0-PRICE,IEN59)="" ;IHS/OKCAO/POC 8/28/02 reverse order
S PRICE="",N=0
F D Q:PRICE="" Q:N=LIMIT
. ;IHS/SD/lwj 8/28/02 on behalf of IHS/OKCAO/POC nxt line remarked
. ;out, following line added (reverse $O does not work on arrays
. ;Cache)
. ;S PRICE=$O(PRICEORD(PRICE),-1) Q:PRICE="" ; from highest to lowest
. S PRICE=$O(PRICEORD(PRICE)) Q:PRICE="" ; from highest to lowest
. S IEN59=0
. F S IEN59=$O(PRICEORD(PRICE,IEN59)) Q:IEN59="" Q:N=LIMIT D
. . N ABSBRXI S ABSBRXI=IEN59 D SETSTAT^ABSPOSU(30)
. . S N=N+1 ; how many submitted for this patient
. . S COUNT30=COUNT30+1 ; how many submitted in total by this routine
Q
CAIDPAID() ; count how many Medicaid paid responses for this patient
; this month, up to 3 maximum
; given PAT = patient IEN; MAX=3
;
; IHS/OKCAO/POS 5/22/02 (IHS/SD/lwj 6/17/02) changed to look
; at month script was filled/refilled for considering script in cnt
;
N INS S INS=$P(^ABSP(9002313.99,1,"SPECIAL"),U) ; insurer we seek
N FOUND S FOUND=0 ; count how many are found
N SINCE S SINCE=DT,$E(SINCE,6,7)="00" ; yyymm00
N IEN59,STOP S IEN59=0,STOP=0
F S IEN59=$O(^ABSPT("AC",PAT,IEN59)) D Q:STOP
. I 'IEN59 S STOP=1 Q
. S X=^ABSPT(IEN59,0)
. ; IHS/OKCAO/POC 05/22/02 (IHS/SD/lwj 6/17/02) begin changes
. ;I $P(X,U,8)<SINCE Q ; previous month
. N DATE
. D
. . N RXIEN,REFIEN
. . S RXIEN=$P($G(^ABSPT(IEN59,1)),U,11),REFIEN=$P($G(^ABSPT(IEN59,1)),U,1)
. . S DATE=$S(+REFIEN=0:$P($G(^PSRX(RXIEN,2)),U,2),1:$P($G(^PSRX(RXIEN,1,+REFIEN,0)),U,1))
. I +DATE Q:DATE<SINCE
. ; IHS/OKCAO/POS 05/22/02 (IHS/SD/lwj 6/17/02) end changes
. I 99'=$P(X,U,2) Q ; not completed yet
. I INS'=$P(^ABSPT(IEN59,1),U,6) Q ; not this insurer
. ;IHS/OIT/RAN 021710 patch 37 Do not count if claim has been reversed -BEGIN
. ;N Y S Y=$$RXPAID^ABSPOSNC(IEN59) Q:$P(Y,U,3)="Accepted reversal" ;IHS/OIT/CNI/SCR patch 40 OKC - replaced with next three lines
. N ABSPINFO
. S ABSPINFO=$$RXPAID^ABSPOSNC(IEN59)
. Q:$P(ABSPINFO,U,1)=0 ;there are a lot of reasons not to count this
. ;IHS/OIT/RAN 021710 patch 37 Do not count if claim has been reversed -END
. I $$PAID^ABSPOSQ4(IEN59) D
. . S FOUND=FOUND+1
. . I FOUND=MAX S STOP=1
Q FOUND
ABSPOSQS ; IHS/FCS/DRS - special queuing considerations ; [ 08/28/2002 2:25 PM ]
+1 ;;1.0;PHARMACY POINT OF SALE;**1,2,3,37,40**;JUN 21, 2001;Build 38
+2 ;
+3 ; IHS/DSD/lwj 4/18/02 on behalf of Patrick Cox
+4 ; IHS/OKCAO/POC 10/2/01 In Oklahoma there is a general 3 punch
+5 ; a month limitation. However, there are no limitation for kids
+6 ; under the age of 18, or for patients in a nursing home. This
+7 ; change will simply address the limitation on the kids under 18.
+8 ; The maximum number of prescriptions will simply be set to 999
+9 ; to reflect no limitation.
+10 ;
+11 ; IHS/SD/lwj 6/17/02 on behalf of Patrick Cox
+12 ; IHS/OKCAO/POC 5/22/02 In the subroutine CAIDPAID, the routine
+13 ; attempts to count how many Medicaid paid repsonses have been
+14 ; received for a given month. The script count could be incorrectly
+15 ; inflatted if a script was flled/reflled in a prev month, but was
+16 ; sbmtd/resbmtd in the current month. Original logic was only
+17 ; looking at the month of the claim - not the DOS. Logic
+18 ; changed to use the scripts fill dt/refill dt instead of clm dt.
+19 ; (effected back billing, or resubmittal of previous month scripts
+20 ; when current month limitation had been reached)
+21 ;
+22 ; IHS/SD/lwj 8/28/02 on behalf of Patrick Cox (OKCAO/POC)
+23 ; Cache systems do not allow the reverse dollar order on arrays.
+24 ; Patrick simply reversed the sign in the PRICEORD array, which
+25 ; allowed the values to appear in descending order - this eliminated
+26 ; the need for the reverse $O on the PRICEORD array.
+27 ;
+28 QUIT
STAT19() ;EP - is called at the bottom of ABSPOSQ1
+1 ; if there are any claims of status 19 - waiting for special
+2 ; Oklahoma Medicaid rule to run its course
+3 NEW ROU
SET ROU=$TEXT(+0)
+4 ; only one of these running
LOCK +^TMP("ABSPOSQS"):0
IF '$TEST
QUIT 0
+5 ; count how many 19s got pushed to status 30
NEW COUNT30
SET COUNT30=0
+6 DO RULE19
+7 LOCK -^TMP("ABSPOSQS")
+8 ; If there are still any claims with status = 19,
+9 ; then you need to schedule ABSPOSQ1 to run again in a little while.
+10 IF $DATA(^ABSPT("AD",19))
Begin DoDot:1
+11 NEW WAIT
SET WAIT=$PIECE(^ABSP(9002313.99,1,"SPECIAL"),U,2)
+12 IF 'WAIT
SET WAIT=60
+13 SET WAIT="."_$TRANSLATE($JUSTIFY(WAIT\3600,2)_$JUSTIFY(WAIT#3600\60,2)_$JUSTIFY(WAIT#60,2)," ","0")
+14 DO TASKAT^ABSPOSIZ($$TADDNOW^ABSPOSUD(WAIT))
End DoDot:1
+15 QUIT COUNT30
RULE19 ;
+1 NEW INCYCLE,NLIMIT,SINCEDAT,PAT,IEN59,STAT,LASTUPD,I,X,Y
+2 ;
+3 ; Gather all the claims with status 19 into ^TMP("ABSPOSQS",$J,PAT,19,IEN59)
+4 ; Medicaid claims only - already taken care of, in that only
+5 ; Medicaid claims can ever be in status 19
+6 ; For any status, just set ^TMP("ABSPOSQS",$J,PAT,status)=latest last-update
+7 ; to make it easy to detect if a given patient has any non-19's.
+8 ;
+9 KILL ^TMP("ABSPOSQS")
+10 SET STAT=""
SET IEN59=0
+11 FOR
SET STAT=$ORDER(^ABSPT("AD",STAT))
IF STAT=""
QUIT
IF STAT=99
QUIT
Begin DoDot:1
+12 SET IEN59=0
+13 FOR
SET IEN59=$ORDER(^ABSPT("AD",STAT,IEN59))
IF 'IEN59
QUIT
Begin DoDot:2
+14 ; $G() in next line guards against corrupt index
+15 SET PAT=$PIECE($GET(^ABSPT(IEN59,0)),U,6)
IF 'PAT
QUIT
+16 SET LASTUPD=$PIECE(^ABSPT(IEN59,0),U,8)
+17 SET X=$GET(^TMP("ABSPOSQS",$JOB,PAT,STAT))
+18 IF LASTUPD>X
SET ^TMP("ABSPOSQS",$JOB,PAT,STAT)=LASTUPD
+19 IF STAT=19
SET ^TMP("ABSPOSQS",$JOB,PAT,STAT,IEN59)=""
End DoDot:2
End DoDot:1
+20 ;
+21 ; Loop for each such patient:
+22 SET PAT=""
FOR
SET PAT=$ORDER(^TMP("ABSPOSQS",$JOB,PAT))
IF 'PAT
QUIT
Begin DoDot:1
+23 ; no 19's for this patient; nothing to do
IF '$DATA(^TMP("ABSPOSQS",$JOB,PAT,19))
QUIT
+24 DO PAT19
End DoDot:1
+25 QUIT
PAT19 ; Then look at each patient's situation:
+1 ;
+2 ; If the patient has any claims with status 20-98 (i.e., actively
+3 ; going through POS right now) then leave their 19s as 19 for now.
+4 ; What we do with these depends on how the others turn out.
+5 ;
+6 ; Also, if the patient has any with status <19, wait for those to
+7 ; catch up - because apparently, data entry is still going on
+8 ; and we want to wait, so we just pick off the three highest-priced.
+9 ;
+10 ; there are some w/status < 19
IF $ORDER(^TMP("ABSPOSQS",$JOB,PAT,""))'=19
QUIT
+11 ; there are some w/status > 19
IF $ORDER(^TMP("ABSPOSQS",$JOB,PAT,19))'=""
QUIT
+12 ;
+13 ; IHS/DSD/lwj 04/18/02 on behalf of IHS/OKCAO/POC 10/2/2001
+14 ; begin changes
+15 ;
+16 ;N LIMIT,MAX S MAX=3 S LIMIT=MAX-$$CAIDPAID ;IHS/OKCAO/POC rmkd out
+17 ;IHS/OKCAO/POC new def
NEW ABSPINS,ABSPERR,LIMIT,MAX,DFN
+18 ;
+19 ; In the ABSP setup file, there is a special node:
+20 ; ^ABSP(9002313.99,1,"SPECIAL")=OK MEDICAID INS NAME^OK MEDICAID
+21 ; CYCLE^OK MEDICAID LIMIT
+22 ; This portion of the code is retrieving the INS name, and the limits
+23 ; If the insurer is Oklahoma, we will adjust the limits for kids
+24 ;
+25 SET ABSPINS=$$GET1^DIQ(9002313.99,"1,",1960.01,"","","ABSPERR")
+26 ;IHS/OKCAO/POC def
SET MAX=+$PIECE($GET(^ABSP(9002313.99,1,"SPECIAL")),U,3)
+27 ;IHS/OKCAO/POC use def when pos
IF 'MAX
SET MAX=3
+28 ;
+29 ;If this is for Oklahoma and patient is under 18 extend limits
+30 ; (insurance name is either Oklahoma Medicaid or Oklahoma)
+31 IF ($GET(ABSPINS)["OKLAHOMA")&($$AGE^AUPNPAT(PAT)<18)
SET MAX=999
+32 ;
+33 SET LIMIT=MAX-$$CAIDPAID
+34 ;
+35 ; IHS/DSD/lwj 04/18/02 for IHS/OKCAO/POC 10/2/01 end changes
+36 ;
+37 ;
+38 ; LIMIT = how many more paid responses we're allowed for this month
+39 ;
+40 ; If LIMIT=0, we've used up our limit of Medicaid prescriptions
+41 ; for the month. Each of these will have to bump to the next
+42 ; insurer. (For now, just reject them
+43 ;
+44 IF LIMIT=0
Begin DoDot:1
+45 SET IEN59=0
FOR
SET IEN59=$ORDER(^TMP("ABSPOSQS",$JOB,PAT,19,IEN59))
IF 'IEN59
QUIT
Begin DoDot:2
+46 DO SETSLOT^ABSPOSL(IEN59)
+47 NEW MSG
SET MSG="Medicaid monthly limit of "_MAX_" reached."
+48 DO LOG^ABSPOSL(MSG)
+49 ; bump to next insurer
IF $$BUMPINS^ABSPOSQA(IEN59)
Begin DoDot:3
+50 ; Succeeded, there is more insurance ;
+51 ; And $$BUMPINS reset status to 0
+52 DO LOG^ABSPOSL(" We will try the next insurer.")
End DoDot:3
+53 IF '$TEST
Begin DoDot:3
+54 ; Failed - no more insurance - $$BUMPINS set status to 99
+55 ; unfortunate variable naming
NEW ABSBRXI
SET ABSBRXI=IEN59
+56 DO SETRESU^ABSPOSU(19,MSG)
End DoDot:3
+57 DO RELSLOT^ABSPOSL
End DoDot:2
End DoDot:1
QUIT
+58 ;
+59 ; We can still submit some Medicaid prescriptions, but let's
+60 ; make sure we have all the ones that we're going to get at
+61 ; this visit - make sure that the most recent activity on
+62 ; any of the status 19 claims is at least 2 minutes old.
+63 ; Otherwise, there may be some more coming, and we would rather
+64 ; wait and make sure we get the more expensive ones.
+65 IF $$TDIFNOW^ABSPOSUD(^TMP("ABSPOSQS",$JOB,PAT,19))<$PIECE(^ABSP(9002313.99,1,"SPECIAL"),U,2)
QUIT
+66 ;
+67 ; If LIMIT>0, then take this many of the patient's status 19 claims
+68 ; and change them to status 30. Any other 19s stay as 19s,
+69 ; as we need to wait and see how the others turn out. If they're
+70 ; rejected, we could still submit a few of the other 19s.
+71 ;
+72 ; set PRICEORD(price,ien59)="" for each of this pat's 19s
NEW PRICEORD
+73 NEW PRICE,N
+74 SET IEN59=0
+75 FOR
SET IEN59=$ORDER(^TMP("ABSPOSQS",$JOB,PAT,19,IEN59))
IF 'IEN59
QUIT
Begin DoDot:1
+76 NEW PRICE
SET PRICE=$PIECE(^ABSPT(IEN59,5),U,5)
+77 ;IHS/SD/lwj 8/28/02 on behalf of IHS/OKCAO/POS nxt line remarked
+78 ; out, following line added
+79 ; S PRICEORD(PRICE,IEN59)="" ;IHS/OKCAO/POS 8/28/02
+80 ;IHS/OKCAO/POC 8/28/02 reverse order
SET PRICEORD(0-PRICE,IEN59)=""
End DoDot:1
+81 SET PRICE=""
SET N=0
+82 FOR
Begin DoDot:1
+83 ;IHS/SD/lwj 8/28/02 on behalf of IHS/OKCAO/POC nxt line remarked
+84 ;out, following line added (reverse $O does not work on arrays
+85 ;Cache)
+86 ;S PRICE=$O(PRICEORD(PRICE),-1) Q:PRICE="" ; from highest to lowest
+87 ; from highest to lowest
SET PRICE=$ORDER(PRICEORD(PRICE))
IF PRICE=""
QUIT
+88 SET IEN59=0
+89 FOR
SET IEN59=$ORDER(PRICEORD(PRICE,IEN59))
IF IEN59=""
QUIT
IF N=LIMIT
QUIT
Begin DoDot:2
+90 NEW ABSBRXI
SET ABSBRXI=IEN59
DO SETSTAT^ABSPOSU(30)
+91 ; how many submitted for this patient
SET N=N+1
+92 ; how many submitted in total by this routine
SET COUNT30=COUNT30+1
End DoDot:2
End DoDot:1
IF PRICE=""
QUIT
IF N=LIMIT
QUIT
+93 QUIT
CAIDPAID() ; count how many Medicaid paid responses for this patient
+1 ; this month, up to 3 maximum
+2 ; given PAT = patient IEN; MAX=3
+3 ;
+4 ; IHS/OKCAO/POS 5/22/02 (IHS/SD/lwj 6/17/02) changed to look
+5 ; at month script was filled/refilled for considering script in cnt
+6 ;
+7 ; insurer we seek
NEW INS
SET INS=$PIECE(^ABSP(9002313.99,1,"SPECIAL"),U)
+8 ; count how many are found
NEW FOUND
SET FOUND=0
+9 ; yyymm00
NEW SINCE
SET SINCE=DT
SET $EXTRACT(SINCE,6,7)="00"
+10 NEW IEN59,STOP
SET IEN59=0
SET STOP=0
+11 FOR
SET IEN59=$ORDER(^ABSPT("AC",PAT,IEN59))
Begin DoDot:1
+12 IF 'IEN59
SET STOP=1
QUIT
+13 SET X=^ABSPT(IEN59,0)
+14 ; IHS/OKCAO/POC 05/22/02 (IHS/SD/lwj 6/17/02) begin changes
+15 ;I $P(X,U,8)<SINCE Q ; previous month
+16 NEW DATE
+17 Begin DoDot:2
+18 NEW RXIEN,REFIEN
+19 SET RXIEN=$PIECE($GET(^ABSPT(IEN59,1)),U,11)
SET REFIEN=$PIECE($GET(^ABSPT(IEN59,1)),U,1)
+20 SET DATE=$SELECT(+REFIEN=0:$PIECE($GET(^PSRX(RXIEN,2)),U,2),1:$PIECE($GET(^PSRX(RXIEN,1,+REFIEN,0)),U,1))
End DoDot:2
+21 IF +DATE
IF DATE<SINCE
QUIT
+22 ; IHS/OKCAO/POS 05/22/02 (IHS/SD/lwj 6/17/02) end changes
+23 ; not completed yet
IF 99'=$PIECE(X,U,2)
QUIT
+24 ; not this insurer
IF INS'=$PIECE(^ABSPT(IEN59,1),U,6)
QUIT
+25 ;IHS/OIT/RAN 021710 patch 37 Do not count if claim has been reversed -BEGIN
+26 ;N Y S Y=$$RXPAID^ABSPOSNC(IEN59) Q:$P(Y,U,3)="Accepted reversal" ;IHS/OIT/CNI/SCR patch 40 OKC - replaced with next three lines
+27 NEW ABSPINFO
+28 SET ABSPINFO=$$RXPAID^ABSPOSNC(IEN59)
+29 ;there are a lot of reasons not to count this
IF $PIECE(ABSPINFO,U,1)=0
QUIT
+30 ;IHS/OIT/RAN 021710 patch 37 Do not count if claim has been reversed -END
+31 IF $$PAID^ABSPOSQ4(IEN59)
Begin DoDot:2
+32 SET FOUND=FOUND+1
+33 IF FOUND=MAX
SET STOP=1
End DoDot:2
End DoDot:1
IF STOP
QUIT
+34 QUIT FOUND
