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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

Call Graph Total: 9

Package Total Call Graph
VA FileMan 4 ^DIC  ^DIE  ($$GET1,GETS)^DIQ  ^DIR  
Outpatient Pharmacy 2 $$LSTRFL^PSOBPSU1  $$RXSITE^PSOBPSUT  
E Claims Management Engine 1 $$DIVNCPDP^BPSBUTL  
Integrated Billing 1 $$TAXID^IBCEF75  
Registration 1 DEM^VADPT  

Caller Graph

Legends:

Legend of Colors

Package Component Superscript legend

protocol O screenman SM broker B event driver Ed print P extended action Ea limited protocol LP edit E server Se subscriber Su inquire I run routine RR action A

Caller Graph

Caller Graph Total: 10

Package Total Caller Graph
Outpatient Pharmacy 10 PSOBPSU1  PSOR52  PSOREJP0  PSOREJP1  PSOREJP2  PSOREJP3  PSOREJP5  PSOREJU3  
PSOREJU4  PSOREJUT  

Entry Points

Name Comments DBIA/ICR reference
PANHLP ; Prior Authorization Number Help
GET(RX,RFL,REJDATA,REJID,OKCL,CODE,RRRFLG) ; get reject data from subfile 52.25
; 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:
; "BIN" - Payer BIN number
; "PCN" - Processor Control Number
; "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
; "INSURANCE POINTER" - Patient Insurance Company Pointer
; "COB" - Coordination of Benefits
; "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
; "DUR ADD MSG TEXT" - Payer's DUR additional 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
; (o) RRRFLG - If set to 1 with CODE present, also return Reject Resolution Required REJECTs
; If set to 1 and CODE not passed, then only return RRR REJECTs
  • ICR #6749
    • Status: Active
    • Usage: Controlled Subscription
    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
    PA() ; - Ask for Prior Authorization Type and Number
    ; Called by PA^PSOREJP1 (PA acton) and SMA^PSOREJP1 (SMA action)
    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)
    PRT(FIELD,P,L) ; Sets the lines for fields that require text wrapping

    External References

    Name Field # of Occurrence
    $$DIVNCPDP^BPSBUTL DVINFO+8
    ^DIC REASON+5, PA+10
    ^DIE RETRXF+9, SETOPN+6
    $$GET1^DIQ DVINFO+6, PTINFO+4
    GETS^DIQ GET+60
    ^DIR PA+17
    $$TAXID^IBCEF75 DVINFO+11
    $$LSTRFL^PSOBPSU1 GET+39
    $$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: "OR you may leave it blank if the claim does not require a number."
    • Line Location: PANHLP+1
    Routine Call
    • DIE
    • Line Location:
      • RETRXF+9
      • SETOPN+6
    Routine Call
    • DIC
    • Line Location:
      • REASON+5
      • PA+10
    Routine Call
    • DIR
    • Line Location:
      • PA+17

    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+42, GET+46, GET+47, GET+51, GET+52, GET+53, GET+105, GET+106, RETRXF+4, SETOPN+4

    Local Variables

    Legend:

    >> Not killed explicitly
    * Changed
    ! Killed
    ~ Newed

    Name Field # of Occurrence
    ARRAY GET+37~, GET+60!
    ARRAY( GET+61
    CODE GET~, GET+65, GET+67
    COM GET+37~, GET+105*, GET+106, GET+107, GET+108, GET+109
    DA RETRXF+5~, RETRXF+7*, RETRXF+8*, SETOPN+5~, SETOPN+6*
    DA(1 RETRXF+8*, SETOPN+6*
    >> DATA( PRT+5
    DFN PTINFO+3~, PTINFO+4*
    DIC REASON+3~, REASON+5*, PA+7~, PA+9*, PA+14!
    DIC("A" PA+9*
    DIC("B" PA+8*
    DIC(0 PA+9*
    DIE RETRXF+5~, RETRXF+7*, RETRXF+8*, SETOPN+5~, SETOPN+6*
    DIR PA+7~, PA+14!
    DIR("?" PA+16*
    DIR("??" PA+16*
    DIR("A" PA+15*
    DIR(0 PA+15*
    DIROUT PA+7~
    DIRUT PA+7~
    DR RETRXF+5~, RETRXF+6*, SETOPN+5~, SETOPN+6*
    DTOUT PA+7~, PA+11, PA+17
    DUOUT PA+7~, PA+11
    DVIEN DVINFO+4~, DVINFO+5*, DVINFO+6, DVINFO+8
    DVINFO DVINFO+4~, DVINFO+6*, DVINFO+9*, DVINFO+10*, DVINFO+12*, DVINFO+13
    FIELD PRT~, PRT+5
    I PRT+4~, PRT+6*, PRT+7
    IDX GET+37~, GET+50*, GET+51*, GET+52, GET+53, GET+54, GET+57*, GET+58*, GET+60, GET+61
    , GET+70, GET+71, 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, GET+87, GET+88, GET+89
    , GET+90, GET+91, GET+92, GET+93, GET+95, GET+96, GET+97, GET+98, GET+99, GET+100
    , GET+101, GET+102, GET+103, GET+104, GET+105, GET+106, GET+107, GET+108, GET+109
    L PRT~, PRT+5, PRT+7, PRT+8
    LM DVINFO~, PTINFO~, PTINFO+5, PTINFO+7
    NCPNPI DVINFO+4~, DVINFO+8*, DVINFO+9, DVINFO+10
    OKCL GET~, GET+47, GET+53, GET+94
    ONOFF RETRXF~, RETRXF+6
    OPTS HELP~, HELP+2, HELP+10, HELP+16
    P PRT~, PRT+5, PRT+7, PRT+8
    PAN PA+7~, PA+18*, PA+19
    PAT PA+7~, PA+12*, PA+19
    PSOTAXID DVINFO+4~, DVINFO+11*, DVINFO+12
    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+41!
    REJDATA( GET+70*, GET+71*, 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*, GET+87*, GET+88*, GET+89*
    , GET+90*, GET+91*, GET+92*, GET+93*, GET+95*, GET+96*, GET+97*, GET+98*, GET+99*, GET+100*
    , GET+101*, GET+102*, GET+103*, GET+104*, GET+107*, GET+108*, GET+109*
    REJFLD GET+37~, GET+61!*
    REJFLD( GET+65, GET+70
    REJFLD(1 GET+71
    REJFLD(10 GET+95
    REJFLD(11 GET+96
    REJFLD(12 GET+97
    REJFLD(13 GET+98
    REJFLD(14 GET+89, GET+99
    REJFLD(15 GET+100
    REJFLD(16 GET+90
    REJFLD(17 GET+86
    REJFLD(18 GET+87
    REJFLD(19 GET+101
    REJFLD(2 GET+72
    REJFLD(20 GET+75
    REJFLD(21 GET+79
    REJFLD(22 GET+82
    REJFLD(24 GET+102
    REJFLD(25 GET+103
    REJFLD(26 GET+104
    REJFLD(27 GET+77
    REJFLD(28 GET+88
    REJFLD(29 GET+80
    REJFLD(3 GET+73
    REJFLD(30 GET+66, GET+67, GET+91
    REJFLD(31 GET+92
    REJFLD(32 GET+93
    REJFLD(33 GET+76
    REJFLD(34 GET+81
    REJFLD(4 GET+74
    REJFLD(6 GET+78
    REJFLD(7 GET+83
    REJFLD(8 GET+84
    REJFLD(9 GET+85
    REJID GET~, GET+45, GET+46, GET+47, GET+48
    REJS GET+37~, GET+44!, GET+55
    REJS( GET+48*, GET+54*, GET+58
    RFL GET~, GET+39*, GET+44*, GET+46, GET+52, DVINFO~, DVINFO+5, RETRXF~, RETRXF+4, RETRXF+7
    , RETRXF+8
    RRRFLG GET~, GET+66, GET+67
    RX GET~, GET+39, GET+42, GET+46, GET+47, GET+51, GET+52, GET+53, GET+60, GET+61
    , GET+105, GET+106, DVINFO~, DVINFO+5, PTINFO~, PTINFO+4, RETRXF~, RETRXF+4, RETRXF+7, RETRXF+8
    , SETOPN~, SETOPN+4, SETOPN+6
    SKIP GET+59~, GET+64*, GET+65*, GET+66*, GET+67*, GET+68
    SSN4 PTINFO+3~, PTINFO+4*, PTINFO+5
    TXT DVINFO+4~, REASON~, REASON+4, PRT+4~, PRT+5*, PRT+6, PRT+7*, PRT+8*
    U DVINFO+9, DVINFO+10, DVINFO+11, PA+12
    VADM PTINFO+3~
    VADM(1 PTINFO+5
    VADM(2 PTINFO+4
    VADM(3 PTINFO+7
    VADM(4 PTINFO+7
    VADM(5 PTINFO+6
    X REASON+3~, REASON+5*, PA+7~, PA+14!
    Y REASON+3~, REASON+5, PA+7~, PA+11, PA+12, PA+14!, PA+17, PA+18
    Z GET+37~, GET+106*, GET+107, GET+108, GET+109
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