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Routine: PSOREJU2

Package: Outpatient Pharmacy

Routine: PSOREJU2


Information

PSOREJU2 ;BIRM/MFR - BPS (ECME) - Clinical Rejects Utilities (1) ;10/15/04

Source Information

Source file <PSOREJU2.m>

Call Graph

Call Graph Total: 8

Package Total Call Graph
VA Fileman 4 ^DIC  ^DIE  ($$GET1,GETS)^DIQ  ^DIR  
Outpatient Pharmacy 2 $$LSTRFL^PSOBPSU1  $$RXSITE^PSOBPSUT  
Registration 1 DEM^VADPT  
Uncategorized 1 $$NABP^BPSBUTL  

Caller Graph

Caller Graph Total: 8

Package Total Caller Graph
Outpatient Pharmacy 8 PSOBPSU1  PSOR52  PSOREJP0  PSOREJP1  PSOREJP2  PSOREJU3  PSOREJU4  PSOREJUT  

Entry Points

Name Comments DBIA/ICR reference
PAHLP ; Prior Authorization Type Help
PRT(FIELD,P,L) ; Sets the lines for fields that require text wrapping
PTINFO(RX,LM) ; Returns header displayable Patient Information
DVINFO(RX,RFL,LM) ; Returns header displayable Division Information
HELP(OPTS) ; Display the Help Text for the DUR handling options (OVERRIDE/IGNORE/STOP/QUIT)
RETRXF(RX,RFL,ONOFF) ; - Set/Reset the Re-transmission flag
SETOPN(RX,REJ) ; - Set the Reject RE-OPENED flag to YES
GET(RX,RFL,REJDATA,REJID,OKCL,CODE) ;
; Input: (r) RX - Rx IEN (#52)
; (o) RFL - Refill # (Default: most recent)
; (r) REJDATA(REJECT IEN,FIELD) - Array where these Reject fields will be returned:
; "CODE" - Reject Code (79 or 88)
; "DATE/TIME" - DATE/TIME Reject was detected
; "PAYER MESSAGE" - Message returned by the payer
; "REASON" - Reject Reason description (from payer)
; "INSURANCE NAME" - Patient's Insurance Company Name
; "GROUP NAME" - Patient's Insurance Group Name
; "GROUP NUMBER" - Patient's Insurance Group Number
; "CARDHOLDER ID" - Patient's Insurance Cardholder ID
; "PLAN CONTACT" - Plan's Contact (eg., "1-800-...")
; "PLAN PREVIOUS FILL DATE" - Last time Rx was paid by payer
; "STATUS" - REJECTS status ("OPEN/UNRESOLVED" or "CLOSED/RESOLVED")
; "DUR TEXT" - Payer's DUR description
; "OTHER REJECTS" - Other Rejects on the same response
; "REASON SVC CODE" - Reason for Service Code
; If REJECT is closed, the following fields will be returned:
; "CLA CODE" - Clarification Code submitted
; "PRIOR AUTH TYPE" - Prior Authorization Type
; "PRIOR AUTH NUMBER" - Prior Authorization Type
; "CLOSED DATE/TIME" - DATE/TIME Reject was closed
; "CLOSED BY" - Name of the user responsible for closing Reject
; "CLOSE REASON" - Reason for closing Reject (text)
; "CLOSE COMMENTS" - User entered comments at close
; (o) REJID - REJECT IEN in the PRESCRIPTION file for retrieve this REJECT
; (o) OKCL - If set to 1, CLOSED REJECTs will also be returned
; (o) CODE - Only REJECTs with this CODE should be returned
  • ICR #6749
    • Status: Active
    • Usage: Controlled Subscription
    PA() ; - Ask for Prior Authorization Type and Number
    REASON(TXT) ; Extracts the Reason for service code from the REASON text field
    ; Input: (r) TXT - Reason text (e.g., NN Reason for Service Code Text)
    PANHLP ; Prior Authorization Number Help

    External References

    Name Field # of Occurrence
    $$NABP^BPSBUTL DVINFO+6
    ^DIC REASON+5
    ^DIE RETRXF+8, SETOPN+6
    $$GET1^DIQ DVINFO+5, PTINFO+4
    GETS^DIQ GET+52
    ^DIR PA+8, PA+12
    $$LSTRFL^PSOBPSU1 GET+32
    $$RXSITE^PSOBPSUT DVINFO+5
    DEM^VADPT PTINFO+4

    Interaction Calls

    Name Line Occurrences
    Function Call: WRITE
    • Prompt: !?1,"(O)verride - This option will provide the prompts for the code sets needed to"
    • Line Location: HELP+3
    Function Call: WRITE
    • Prompt: !?1," override this reject and get a payable 3rd party claim. Before"
    • Line Location: HELP+4
    Function Call: WRITE
    • Prompt: !?1," you select this option, you may need to call the 3rd party payer"
    • Line Location: HELP+5
    Function Call: WRITE
    • Prompt: !?1," to determine which code sets are needed to override a particular"
    • Line Location: HELP+6
    Function Call: WRITE
    • Prompt: !?1," reject. Once the proper override is accepted the label will print"
    • Line Location: HELP+7
    Function Call: WRITE
    • Prompt: !?1," and the prescription can be filled."
    • Line Location: HELP+8
    Function Call: WRITE
    • Prompt: !?1,"(I)gnore - Choosing Ignore will by-pass 3rd party processing and will allow"
    • Line Location: HELP+11
    Function Call: WRITE
    • Prompt: !?1," you to print a label and fill the prescription. This essentially"
    • Line Location: HELP+12
    Function Call: WRITE
    • Prompt: !?1," ignores the clinical safety issues suggested by the 3rd party"
    • Line Location: HELP+13
    Function Call: WRITE
    • Prompt: !?1," payer and will NOT result in a payable claim."
    • Line Location: HELP+14
    Function Call: WRITE
    • Prompt: !?1,"(Q)uit - Choosing Quit will postpone the processing of this prescription"
    • Line Location: HELP+17
    Function Call: WRITE
    • Prompt: !?1," until this 3rd party reject is resolved. A label will not be"
    • Line Location: HELP+18
    Function Call: WRITE
    • Prompt: !?1," printed for this prescription and it can not be filled/dispensed"
    • Line Location: HELP+19
    Function Call: WRITE
    • Prompt: !?1," until this reject is resolved. Rejects can be resolved through"
    • Line Location: HELP+20
    Function Call: WRITE
    • Prompt: !?1," the Worklist option under the ePharmacy menu."
    • Line Location: HELP+21
    Function Call: WRITE
    • Prompt: ?P,TXT
    • Line Location: PRT+5
    Function Call: WRITE
    • Prompt: ?P,$E(TXT,1,L),!
    • Line Location: PRT+7
    Function Call: WRITE
    • Prompt: !?9,"EPSDT - Early Periodic Screening Diagnosis Treatment"
    • Line Location: PAHLP+1
    Function Call: WRITE
    • Prompt: !?9,"AFDC - Aid to Family with Dependent Children"
    • Line Location: PAHLP+2
    Function Call: WRITE
    • Prompt: "OR you may leave it blank if the claim does not require a number."
    • Line Location: PANHLP+1
    Routine Call
    • DIE
    • Line Location:
      • RETRXF+8
      • SETOPN+6
    Routine Call
    • DIC
    • Line Location:
      • REASON+5
    Routine Call
    • DIR
    • Line Location:
      • PA+8
      • PA+12

    FileMan Files Accessed Via FileMan Db Call

    FileNo Call Tags
    ^PSRX - [#52] Classic Fileman Calls,  GET1^DIQ
    52.25 GETS^DIQ
    ^PS(59 - [#59] GET1^DIQ

    Global Variables Directly Accessed

    Name Line Occurrences  (* Changed,  ! Killed)
    ^PSRX - [#52] GET+35, GET+39, GET+40, GET+44, GET+45, GET+46, GET+82, GET+83, SETOPN+4

    Local Variables

    Legend:

    >> Not killed explicitly
    * Changed
    ! Killed
    ~ Newed

    Name Field # of Occurrence
    ARRAY GET+30~, GET+52!
    ARRAY( GET+53
    CODE GET~, GET+54
    COM GET+30~, GET+82*, GET+83, GET+84, GET+85, GET+86
    DA RETRXF+4~, RETRXF+6*, RETRXF+7*, SETOPN+5~, SETOPN+6*
    DA(1 RETRXF+7*, SETOPN+6*
    >> DATA( PRT+5
    DFN PTINFO+3~, PTINFO+4*
    DIC REASON+3~, REASON+5*
    DIE RETRXF+4~, RETRXF+6*, RETRXF+7*, SETOPN+5~, SETOPN+6*
    DIR PA+5~, PA+10!
    DIR("?" PA+7*, PA+11*
    DIR("??" PA+7*, PA+11*
    DIR("A" PA+6*, PA+10*
    DIR("B" PA+6*
    DIR(0 PA+6*, PA+10*
    DIROUT PA+5~, PA+8, PA+12
    DIRUT PA+5~, PA+8
    DR RETRXF+4~, RETRXF+5*, SETOPN+5~, SETOPN+6*
    DVINFO DVINFO+4~, DVINFO+5*, DVINFO+7*, DVINFO+8
    FIELD PRT~, PRT+5
    I PRT+4~, PRT+6*, PRT+7
    IDX GET+30~, GET+43*, GET+44*, GET+45, GET+46, GET+47, GET+50*, GET+51*, GET+52, GET+53
    , GET+55, GET+56, GET+57, GET+58, GET+59, GET+60, GET+61, GET+62, GET+63, GET+64
    , GET+65, GET+66, GET+67, GET+68, GET+69, GET+70, GET+72, GET+73, GET+74, GET+75
    , GET+76, GET+77, GET+78, GET+79, GET+80, GET+81, GET+82, GET+83, GET+84, GET+85
    , GET+86
    L PRT~, PRT+5, PRT+7, PRT+8
    LM DVINFO~, DVINFO+7, PTINFO~, PTINFO+5, PTINFO+7
    NCPNPI DVINFO+4~, DVINFO+6*, DVINFO+7
    OKCL GET~, GET+40, GET+46, GET+71
    ONOFF RETRXF~, RETRXF+5
    OPTS HELP~, HELP+2, HELP+10, HELP+16
    P PRT~, PRT+5, PRT+7, PRT+8
    PAN PA+5~, PA+13*, PA+14
    PAT PA+5~, PA+9*, PA+14
    PTINFO PTINFO+3~, PTINFO+5*, PTINFO+6*, PTINFO+7*, PTINFO+8
    REASON REASON+3~, REASON+4*, REASON+5, REASON+6
    REJ SETOPN~, SETOPN+4, SETOPN+6, PRT+5
    REJDATA GET~, GET+34!
    REJDATA( GET+55*, GET+56*, GET+57*, GET+58*, GET+59*, GET+60*, GET+61*, GET+62*, GET+63*, GET+64*
    , GET+65*, GET+66*, GET+67*, GET+68*, GET+69*, GET+70*, GET+72*, GET+73*, GET+74*, GET+75*
    , GET+76*, GET+77*, GET+78*, GET+79*, GET+80*, GET+81*, GET+84*, GET+85*, GET+86*
    REJFLD GET+30~, GET+53!*
    REJFLD( GET+54, GET+55
    REJFLD(1 GET+56
    REJFLD(10 GET+72
    REJFLD(11 GET+73
    REJFLD(12 GET+74
    REJFLD(13 GET+75
    REJFLD(14 GET+69, GET+76
    REJFLD(15 GET+77
    REJFLD(16 GET+70
    REJFLD(17 GET+67
    REJFLD(18 GET+68
    REJFLD(19 GET+78
    REJFLD(2 GET+57
    REJFLD(20 GET+60
    REJFLD(21 GET+62
    REJFLD(22 GET+63
    REJFLD(24 GET+79
    REJFLD(25 GET+80
    REJFLD(26 GET+81
    REJFLD(3 GET+58
    REJFLD(4 GET+59
    REJFLD(6 GET+61
    REJFLD(7 GET+64
    REJFLD(8 GET+65
    REJFLD(9 GET+66
    REJID GET~, GET+38, GET+39, GET+40, GET+41
    REJS GET+30~, GET+37!, GET+48
    REJS( GET+41*, GET+47*, GET+51
    RFL GET~, GET+32*, GET+37*, GET+39, GET+45, DVINFO~, DVINFO+5, DVINFO+6, RETRXF~, RETRXF+6
    , RETRXF+7
    RX GET~, GET+32, GET+35, GET+39, GET+40, GET+44, GET+45, GET+46, GET+52, GET+53
    , GET+82, GET+83, DVINFO~, DVINFO+5, DVINFO+6, PTINFO~, PTINFO+4, RETRXF~, RETRXF+6, RETRXF+7
    , SETOPN~, SETOPN+4, SETOPN+6
    TXT DVINFO+4~, REASON~, REASON+4, PRT+4~, PRT+5*, PRT+6, PRT+7*, PRT+8*
    VADM PTINFO+3~
    VADM(1 PTINFO+5
    VADM(2 PTINFO+5
    VADM(3 PTINFO+7
    VADM(4 PTINFO+7
    VADM(5 PTINFO+6
    X REASON+3~, REASON+5*
    Y REASON+3~, REASON+5, PA+5~, PA+9, PA+12, PA+13
    Z GET+30~, GET+83*, GET+84, GET+85, GET+86
    Info |  Source |  Call Graph |  Caller Graph |  Entry Points |  External References |  Interaction Calls |  FileMan Files Accessed Via FileMan Db Call |  Global Variables Directly Accessed |  Local Variables |  All