PSOREJUT ;BIRM/MFR - BPS (ECME) - Clinical Rejects Utilities ;06/07/05
Source file <PSOREJUT.m>
| Package | Total | Call Graph | 
|---|---|---|
| Outpatient Pharmacy | 7 | $$LSTRFL^PSOBPSU1 ($$RXSITE,$$STATUS)^PSOBPSUT $$TRIC^PSOREJP1 SAVECOM^PSOREJP3 ($$CLEAN,$$DAT,$$DUP,$$OTH)^PSOREJU1 $$REASON^PSOREJU2 ($$EVAL,$$MULTI,$$SINGLE)^PSOREJU4 | 
| VA Fileman | 4 | NOW^%DTC FILE^DICN ^DIE $$GET1^DIQ | 
| Uncategorized | 2 | $$ADDCOMM^BPSBUTL DUR1^BPSNCPD3 | 
| Name | Comments | DBIA/ICR reference | 
|---|---|---|
| FEND | ; | |
| CLOSE(RX,RFL,REJ,USR,REA,COM,COD1,COD2,COD3,CLA,PA) | ; - Mark a DUR/REFILL TOO SOON reject RESOLVED ; Input: (r) RX - Rx IEN (#52) ; (o) RFL - Refill # (Default: most recent) ; (r) REJ - REJECT ID (IEN) ; (o) USR - User (file #200 IEN) responsible for closing the REJECT ; (r) REA - Reason for closing the REJECT: ; 1:CLAIM RE-SUBMITTED ; 2:RX ON HOLD ; 3:RX SUSPENDED ; 4:RX RETURNED TO STOCK ; 5:RX DELETED ; 6:OVERRIDEN W/OUT RE-SUBMISSION ; 7:DISCONTINUED ; 8:RX EDIT ; 99:OTHER ; (o) COM - Close comments manually entered by the user ; (o) COD1 - NCPDP Reason for Service Code for overriding DUR REJECTS ; (o) COD2 - NCPDP Professional Service Code for overriding DUR REJECTS ; (o) COD3 - NCPDP Result of Service Code for overriding DUR REJECTS ; (o) CLA - NCPDP Clarification Code for overriding RTS and DUR REJECTS ; (o) PA - NCPDP Prior Authorization Type and Number (separated by "^") | |
| FIND(RX,RFL,REJDATA,CODE) | ; - Returns whether a prescription/fill contains UNRESOLVED rejects ; Input: (r) RX - Rx IEN (#52) ; (o) RFL - Refill # (If not passed, look original and all refills) ; (o) CODE - Can be null, a specific Reject Code(s) to be checked or multiple codes separated by comma's ; ; Output: 1 - Rx contains unresolved Rejects ; 0 - Rx does not contain unresolved Rejects ; .REJDATA - Array containing the Reject(s) data (see ; GET^PSOREJU2 for fields documentation) | 
 
 | 
| SYNC2 | ; | |
| CLSALL(RX,RFL,USR,REA,COM,COD1,COD2,COD3,CLA,PA) | ; Close/Resolve All Rejects | |
| SAVE(RX,RFL,REJ,REOPEN) | ; - Saves DUR Information in the PRESCRIPTION file ; Input: (r) RX - Rx IEN (#52) ; (o) RFL - Refill # (Default: most recent) ; (o) REOPEN - value of 1 means claim being reopened; null or no value passed means reopen claim functionality not being used ; (r) REJ - Array containing information about the REJECT on the following ; subscripts: ; "CODE" - Reject Code (79 or 88) ; "DATE/TIME" - Date/Time Reject Detected ; "PAYER MESSAGE" - Message returned by Payer (up to 140 chars long) ; "REASON" - Reject Reason (up to 100 chars long) ; "DUR TEXT" - Payer's DUR description ; "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" - Patient's Insurance Plan Contact (1-800) ; "PREVIOUS FILL" - Plan's Previous Fill Date ; "OTHER REJECTS" - Other Rejects with same Response ; "PHARMACIST" - Pharmacist DUZ ; "RESPONSE IEN" - Pointer to the RESPONSE file in ECME ; "REASON SVC CODE" - Reason for Service Code (pointer to BPS NCPDP REASON FOR SERVICE CODE) ; "RE-OPENED" - Re-Open Flag | |
| SYNC(RX,RFL,USR) | ; ; Input: (r) RX - Rx IEN (#52) ; (o) RFL - Refill # (Default: most recent) ; (o) USR - User using the system when this routine is called | 
 
 | 
| Name | Field # of Occurrence | 
|---|---|
| NOW^%DTC | SAVE+38, CLOSE+29 | 
| $$ADDCOMM^BPSBUTL | CLOSE+35 | 
| DUR1^BPSNCPD3 | SYNC+9 | 
| FILE^DICN | SAVE+51 | 
| ^DIE | CLOSE+35 | 
| $$GET1^DIQ | CLOSE+25 | 
| $$LSTRFL^PSOBPSU1 | SAVE+26, CLSALL+12, CLOSE+23, SYNC+7 | 
| $$RXSITE^PSOBPSUT | SAVE+27, SYNC+8 | 
| $$STATUS^PSOBPSUT | FIND+13 | 
| $$TRIC^PSOREJP1 | SYNC+11 | 
| SAVECOM^PSOREJP3 | SAVE+53 | 
| $$CLEAN^PSOREJU1 | SYNC+19, SYNC2+7, SYNC2+8, SYNC2+9, SYNC2+11, SYNC2+13, SYNC2+14, SYNC2+15, SYNC2+16, SYNC2+17 , SYNC2+18, SYNC2+19, SYNC2+20 | 
| $$DAT^PSOREJU1 | SYNC2+18 | 
| $$DUP^PSOREJU1 | SYNC+19 | 
| $$OTH^PSOREJU1 | SYNC2+19 | 
| $$REASON^PSOREJU2 | SYNC2+21 | 
| $$EVAL^PSOREJU4 | SAVE+31, SYNC+17 | 
| $$MULTI^PSOREJU4 | FIND+14 | 
| $$SINGLE^PSOREJU4 | FIND+15 | 
| Name | Line Occurrences (* Changed, ! Killed) | 
|---|---|
| ^PSRX - [#52] | SAVE+43, SAVE+50, SAVE+55, CLOSE+24 | 
| ^PSRX("REJ" | SYNC+6, SYNC+21, SYNC2+23 | 
| Name | Line Occurrences | 
|---|---|
| $$FIND | CLSALL+15 | 
| CLOSE | CLSALL+17 | 
| FEND | FIND+14 | 
| SAVE | SYNC2+22 | 
| >> | Not killed explicitly | 
| * | Changed | 
| ! | Killed | 
| ~ | Newed | 
| Name | Field # of Occurrence | 
|---|---|
| % | SAVE+24~, SAVE+38, CLOSE+32 | 
| CLA | CLSALL~, CLSALL+17, CLOSE~, CLOSE+33 | 
| COD1 | CLSALL~, CLSALL+17, CLOSE~, CLOSE+32 | 
| COD2 | CLSALL~, CLSALL+17, CLOSE~, CLOSE+32 | 
| COD3 | CLSALL~, CLSALL+17, CLOSE~, CLOSE+33 | 
| CODE | FIND~, FIND+14, FIND+15, SYNC+5~, SYNC+16*, SYNC+17, SYNC+20, SYNC2+1*, SYNC2+3*, SYNC2+5 , SYNC2+6, SYNC2+10, SYNC2+19 | 
| COM | CLSALL~, CLSALL+17, CLOSE~, CLOSE+26*, CLOSE+30, CLOSE+35 | 
| >> COMMTXT | SYNC2+7 | 
| DA | SAVE+24~, CLSALL+11~, CLOSE+28~, CLOSE+31* | 
| DA(1 | SAVE+40*, CLOSE+31* | 
| DATA | SYNC+5~, SYNC2+4!, SYNC2+22 | 
| DATA("CARDHOL | DER ID" , SYNC2+16* | 
| DATA("CODE" | SYNC2+10* | 
| DATA("DUR TEX | T" , SYNC2+8* | 
| DATA("GROUP N | AME" , SYNC2+14*, UMBER" , SYNC2+15* | 
| DATA("INSURAN | CE NAME" , SYNC2+13* | 
| DATA("OTHER R | EJECTS" , SYNC2+19* | 
| DATA("OVERRID | E MSG" , SAVE+52, SYNC2+5*, SYNC2+6*, SYNC2+7* | 
| DATA("PAYER M | ESSAGE" , SYNC2+9* | 
| DATA("PHARMACIST" | SYNC2+12* | 
| DATA("PLAN CO | NTACT" , SYNC2+17* | 
| DATA("PREVIOU | S FILL" , SYNC2+18* | 
| DATA("REASON | SVC CODE" , SYNC2+21* | 
| DATA("REASON" | SYNC2+11* | 
| DATA("RESPONS | E IEN" , SYNC2+20* | 
| DD | SAVE+24~, SAVE+51! | 
| DIC | SAVE+24~, SAVE+40* | 
| DIC("DR" | SAVE+44*, SAVE+45*, SAVE+46*, SAVE+47*, SAVE+48* | 
| DIC(0 | SAVE+40* | 
| DIE | CLSALL+11~, CLOSE+28~, CLOSE+31* | 
| DINUM | SAVE+24~, SAVE+43* | 
| DLAYGO | SAVE+24~ | 
| DO | SAVE+24~, SAVE+51! | 
| DQ | CLOSE+28~ | 
| DR | SAVE+24~, CLSALL+11~, CLOSE+28~, CLOSE+32*, CLOSE+33* | 
| DUZ | SAVE+53 | 
| ERR | SAVE+31*, SAVE+54!, SYNC+5~, SYNC+12*, SYNC+17*, SYNC+18 | 
| I | FIND+10~, SYNC+5~, SYNC+15*, SYNC+16 | 
| IDX | SYNC+5~, SYNC+12*, SYNC+13*, SYNC+14, SYNC+19, SYNC+20, SYNC2+1*, SYNC2+2*, SYNC2+3, SYNC2+8 , SYNC2+9, SYNC2+11, SYNC2+13, SYNC2+14, SYNC2+15, SYNC2+16, SYNC2+17, SYNC2+18, SYNC2+19, SYNC2+20 , SYNC2+21 | 
| OPECC | SAVE+31, SYNC+5~, SYNC+12*, SYNC+17, SYNC2+5, SYNC2+6 | 
| OVREJ | SYNC+5~, SYNC+16*, SYNC+18*, SYNC+20 | 
| PA | CLSALL~, CLSALL+17, CLOSE~, CLOSE+33 | 
| PSODIV | SAVE+27*, SAVE+31, SYNC+5~, SYNC+8*, SYNC+17 | 
| PSOTRIC | SAVE+31, SYNC+5~, SYNC+10*, SYNC+11*, SYNC+17 | 
| RCODE | FIND+10~, FIND+11* | 
| REA | CLSALL~, CLSALL+17, CLOSE~, CLOSE+26*, CLOSE+30, CLOSE+32 | 
| REJ | SAVE~, CLSALL+11~, CLSALL+16*, CLSALL+17, CLOSE~, CLOSE+22, CLOSE+24, CLOSE+25, CLOSE+31, SYNC+5~ , SYNC+9 | 
| REJ( | SYNC+13, SYNC+14, SYNC+19, SYNC2+8, SYNC2+9, SYNC2+11, SYNC2+13, SYNC2+14, SYNC2+15, SYNC2+16 , SYNC2+17, SYNC2+18, SYNC2+19, SYNC2+20, SYNC2+21 | 
| REJ("CARDHOLD | ER ID" , SAVE+37*, SAVE+48 | 
| REJ("CODE" | SAVE+30*, SAVE+31, SAVE+42 | 
| REJ("DATE/TIME" | SAVE+38*, SAVE+44, SAVE+53 | 
| REJ("DUR TEXT | " , SAVE+34*, SAVE+47 | 
| REJ("GROUP NA | ME" , SAVE+34*, SAVE+45 | 
| REJ("GROUP NU | MBER" , SAVE+36*, SAVE+48 | 
| REJ("INSURANC | E NAME" , SAVE+35*, SAVE+47 | 
| REJ("OTHER RE | JECTS" , SAVE+36*, SAVE+47 | 
| REJ("OVERRIDE | MSG" , SAVE+52*, SAVE+53 | 
| REJ("PAYER ME | SSAGE" , SAVE+33*, SAVE+44 | 
| REJ("PHARMACIST" | SAVE+44 | 
| REJ("PLAN CON | TACT" , SAVE+35*, SAVE+45 | 
| REJ("PREVIOUS | FILL" , SAVE+45 | 
| REJ("RE-OPENED" | SAVE+48 | 
| REJ("REASON S | VC CODE" , SAVE+46 | 
| REJ("REASON" | SAVE+33*, SAVE+44 | 
| REJ("REJECT I | EN" , SAVE+51*, SAVE+53 | 
| REJ("RESPONSE | IEN" , SAVE+46 | 
| REJ(1 | SYNC+10 | 
| REJCOM | CLOSE+28~, CLOSE+30*, CLOSE+32 | 
| REJDATA | CLSALL+11~, CLSALL+15, FIND~, FIND+12!, FIND+14, FIND+15 | 
| REJDATA( | CLSALL+16 | 
| REJLST | SYNC+5~ | 
| REJS | FIND+10~, FIND+11*, FIND+14*, FIND+15*, FEND+1, SYNC+5~, SYNC+12!, SYNC+21 | 
| REJS( | SYNC+20*, SYNC2+2, SYNC2+3 | 
| REOPEN | SAVE~, SAVE+31 | 
| RFL | SAVE~, SAVE+26*, SAVE+27, SAVE+44, CLSALL~, CLSALL+12*, CLSALL+15, CLSALL+17, CLOSE~, CLOSE+23* , CLOSE+25, CLOSE+35, FIND~, FIND+13, FIND+14, FIND+15, SYNC~, SYNC+7*, SYNC+8, SYNC+9 , SYNC+11, SYNC2+22 | 
| RX | SAVE~, SAVE+26, SAVE+27, SAVE+40, SAVE+43, SAVE+50, SAVE+53, SAVE+55, CLSALL~, CLSALL+12 , CLSALL+15, CLSALL+17, CLOSE~, CLOSE+22, CLOSE+23, CLOSE+24, CLOSE+25, CLOSE+31, CLOSE+35, FIND~ , FIND+13, FIND+14, FIND+15, SYNC~, SYNC+6, SYNC+7, SYNC+8, SYNC+9, SYNC+11, SYNC+19 , SYNC+21, SYNC2+22, SYNC2+23 | 
| TXT | SYNC+5~, SYNC+14*, SYNC+15, SYNC+16 | 
| USR | CLSALL~, CLSALL+17, CLOSE~, CLOSE+32, SYNC~, SYNC2+12 | 
| X | SAVE+24~, SAVE+42*, CLOSE+28~, CLOSE+35* | 
| Y | SAVE+51, CLOSE+28~ |