Home   Package List   Routine Alphabetical List   Global Alphabetical List   FileMan Files List   FileMan Sub-Files List   Package Component Lists   Package-Namespace Mapping  
Info |  Source |  Call Graph |  Caller Graph |  Entry Points |  External References |  FileMan Files Accessed Via FileMan Db Call |  Global Variables Directly Accessed |  Label References |  Local Variables |  All
Print Page as PDF
Routine: PSOREJUT

Package: Outpatient Pharmacy

Routine: PSOREJUT


Information

PSOREJUT ;BIRM/MFR - BPS (ECME) - Clinical Rejects Utilities ;06/07/05

Source Information

Source file <PSOREJUT.m>

Call Graph

Call Graph

Call Graph Total: 15

Package Total Call Graph
Outpatient Pharmacy 9 $$LSTRFL^PSOBPSU1  $$DUR^PSOBPSU2  ($$RXSITE,$$STATUS)^PSOBPSUT  $$TRIC^PSOREJP1  ($$PSOET,SAVECOM)^PSOREJP3  $$PSOETEC^PSOREJP5  ($$CLEAN,$$DAT,$$DUP,$$OTH)^PSOREJU1  $$REASON^PSOREJU2  
($$EVAL,$$MULTI,$$SINGLE)^PSOREJU4  
VA FileMan 4 NOW^%DTC  FILE^DICN  ^DIE  $$GET1^DIQ  
E Claims Management Engine 2 $$ADDCOMM^BPSBUTL  DUR1^BPSNCPD3  

Caller Graph

Caller Graph Total: 36

Package Total Caller Graph
Outpatient Pharmacy 31 PSOBPSU1  PSOBPSU2  PSOBPSU3  PSOBPSUT  PSOCAN2  PSODRG  PSOHLD  PSOLBLN  
PSON52  PSOORED2  PSOORED7  PSOORUT1  PSOPMP0  PSOPROD2  PSOR52  PSOREJP1  
PSOREJP2  PSOREJP3  PSOREJU1  PSOREJU3  PSOREJU4  PSORN52  PSORXED  PSORXED1  
PSORXL1  PSORXRP2  PSOSULBL  PSOSUPAT  PSOSUPOE  PSOSUPRX  PSOVER1  
E Claims Management Engine 3 BPSECMP2  BPSRES  BPSSCRCL  
CMOP 2 PSXRPPL1  PSXRPPL2  

Entry Points

Name Comments DBIA/ICR reference
FEND ;
CLOSE(RX,RFL,REJ,USR,REA,COM,COD1,COD2,COD3,CLA,PA,IGNR) ; - 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 (52.25,12):
; 1:CLAIM RE-SUBMITTED
; 2:RX ON HOLD
; 3:RX SUSPENDED
; 4:RX RETURNED TO STOCK
; 5:RX DELETED
; 6:IGNORED - NO RESUBMISSION
; 7:RX DISCONTINUED
; 8:RX EDITED
; 99:OTHER
; (o) COM - Close comments manually entered by the user
; (o) COD1 - First set of DUR overrides (Reason Code^Professional Code^Result Code)
; (o) COD2 - Second set of DUR overrides (Reason Code^Professional Code^Result Code)
; (o) COD3 - Third set of DUR overrides (Reason Code^Professional Code^Result Code)
; (o) CLA - NCPDP Clarification Code for overriding RTS and DUR REJECTS
; (o) PA - NCPDP Prior Authorization Type and Number (separated by "^")
; (o) IGNR - Ignore Flag; 1=IGNORE, 0=NOT IGNORE
SYNC2 ;
SYNC(RX,RFL,USR,RXCOB) ;
; Input: (r) RX - Rx IEN (#52)
; (o) RFL - Refill # (Default: most recent)
; (o) USR - User using the system when this routine is called
; (o) RXCOB - Coordination of Benefits code
  • ICR #4706
    • Status: Active
    • Usage: Controlled Subscription
    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 file 52
    ; 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:
    ; "BIN" - BIN Number
    ; "PCN" - PCN Number
    ; "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
    ; "DUR ADD MSG TEXT" - Payer's DUR additional message text description
    ; "INSURANCE NAME" - Patient's Insurance Company Name
    ; "INSURANCE POINTER" - Patient's Insurance Company IEN
    ; "GROUP NAME" - Patient's Insurance Group Name
    ; "GROUP NUMBER" - Patient's Insurance Group Number
    ; "CARDHOLDER ID" - Patient's Insurance Cardholder ID
    ; "COB" - Coordination of Benefits
    ; "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
    ; "RRR FLAG" - Reject Resolution Required indicator (expecting 1/0 into SAVE)
    ; "RRR THRESHOLD AMT" - Reject Resolution Required Dollar Threshold
    ; "RRR GROSS AMT DUE" - Reject Resolution Required Gross Amount Due
    FIND(RX,RFL,REJDATA,CODE,BESC,RRRFLG) ; - Returns whether a Rx/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
    ; (o) BESC - Bypass ECME Status Check (default behavior is to do the check); pass 1 to skip the check below
    ; We need to skip this check when looking for non-ECME billable rejects (eT or eC for example)
    ; (o) RRRFLG - Pass a 1 in this parameter to also look for any unresolved Reject Resolution Required (RRR)
    ; rejects when CODE is also passed. If CODE is not passed in, then pass a 1 here to ONLY look for
    ; unresolved RRR rejects.
    ; The default here is 0 if not passed.
  • ICR #4706
    • Status: Active
    • Usage: Controlled Subscription

    External References

    Name Field # of Occurrence
    NOW^%DTC SAVE+49, CLOSE+29
    $$ADDCOMM^BPSBUTL SAVE+81, CLOSE+48, CLOSE+51, CLOSE+54, CLOSE+56, CLOSE+60
    DUR1^BPSNCPD3 SYNC+11
    FILE^DICN SAVE+68
    ^DIE CLOSE+34
    $$GET1^DIQ CLOSE+26
    $$LSTRFL^PSOBPSU1 SAVE+31, CLSALL+12, CLOSE+24, SYNC+9
    $$DUR^PSOBPSU2 SYNC+17
    $$RXSITE^PSOBPSUT SAVE+32, SYNC+10
    $$STATUS^PSOBPSUT FIND+18
    $$TRIC^PSOREJP1 SYNC+12
    $$PSOET^PSOREJP3 CLOSE+36
    SAVECOM^PSOREJP3 SAVE+74
    $$PSOETEC^PSOREJP5 CLSALL+14
    $$CLEAN^PSOREJU1 SYNC+21, SYNC2+12, SYNC2+13, SYNC2+14, SYNC2+21, SYNC2+24, SYNC2+25, SYNC2+26, SYNC2+27, SYNC2+28
    , SYNC2+29, SYNC2+30, SYNC2+31, SYNC2+32, SYNC2+34, SYNC2+35, SYNC2+36, SYNC2+37
    $$DAT^PSOREJU1 SYNC2+30
    $$DUP^PSOREJU1 SYNC+21
    $$OTH^PSOREJU1 SYNC2+31
    $$REASON^PSOREJU2 SYNC2+33
    $$EVAL^PSOREJU4 SAVE+43, SYNC+19
    $$MULTI^PSOREJU4 FIND+19
    $$SINGLE^PSOREJU4 FIND+20

    FileMan Files Accessed Via FileMan Db Call

    FileNo Call Tags
    52.25 GET1^DIQ

    Global Variables Directly Accessed

    Name Line Occurrences  (* Changed,  ! Killed)
    ^PSRX - [#52] SAVE+51, SAVE+67, SAVE+82, CLOSE+25
    ^PSRX("REJ" SYNC+8, SYNC+23, SYNC2+39

    Label References

    Name Line Occurrences
    $$FIND CLSALL+16
    CLOSE CLSALL+18
    FEND FIND+19
    SAVE SYNC2+38

    Local Variables

    Legend:

    >> Not killed explicitly
    * Changed
    ! Killed
    ~ Newed

    Name Field # of Occurrence
    % SAVE+30~, SAVE+49, CLOSE+32
    BESC FIND~, FIND+18
    CLA CLSALL~, CLSALL+18, CLOSE~, CLOSE+33, CLOSE+42, CLOSE+44, CLOSE+49, CLOSE+50
    CNT SYNC2+18~, SYNC2+19*, SYNC2+20*, SYNC2+21
    COD1 CLSALL~, CLSALL+18, CLOSE~, CLOSE+32, CLOSE+33, CLOSE+42, CLOSE+43, CLOSE+46, CLOSE+47
    COD2 CLSALL~, CLSALL+18, CLOSE~, CLOSE+47
    COD3 CLSALL~, CLSALL+18, CLOSE~, CLOSE+47
    CODE FIND~, FIND+19, FIND+20, SYNC+6~, SYNC+15*, SYNC+16, SYNC+17, SYNC+19, SYNC+22, SYNC2+1*
    , SYNC2+2*, SYNC2+4, SYNC2+11, SYNC2+25, SYNC2+31
    COM CLSALL~, CLSALL+18, CLOSE~, CLOSE+27*, CLOSE+30, CLOSE+60
    >> COMMTXT SYNC2+12
    DA SAVE+30~, CLSALL+11~, CLOSE+28~, CLOSE+31*
    DA(1 SAVE+50*, CLOSE+31*
    DATA SYNC+6~, SYNC2+2!, SYNC2+38
    DATA("BIN" SYNC2+36*
    DATA("CARDHOL DER ID" , SYNC2+29*
    DATA("COB" SYNC2+33*
    DATA("CODE" SYNC2+25*
    DATA("DUR ADD MSG TEXT" , SYNC2+14*
    DATA("DUR RES PONSE DATA" , SYNC2+35*
    DATA("DUR TEX T" , SYNC2+13*
    DATA("GROUP N AME" , SYNC2+28*, UMBER" , SYNC2+28*
    DATA("INSURAN CE NAME" , SYNC2+26*, CE POINTER" , SYNC2+27*
    DATA("MESSAGE" SYNC2+34*
    DATA("OTHER R EJECTS" , SYNC2+31*
    DATA("OVERRID E MSG" , SAVE+69, SYNC2+5*, SYNC2+10*, SYNC2+11*, SYNC2+12*
    DATA("PAYER M ESSAGE" , SYNC2+19*, SYNC2+20, SYNC2+22*, SYNC2+24*
    DATA("PCN" SYNC2+37*
    DATA("PHARMACIST" SYNC2+26*
    DATA("PLAN CO NTACT" , SYNC2+29*
    DATA("PREVIOU S FILL" , SYNC2+30*
    DATA("REASON SVC CODE" , SYNC2+33*
    DATA("REASON" SYNC2+25*
    DATA("RESPONS E IEN" , SYNC2+32*
    DATA("RRR FLA G" , SYNC2+7*
    DATA("RRR GRO SS AMT DUE" , SYNC2+8*
    DATA("RRR THR ESHOLD AMT" , SYNC2+9*
    DD SAVE+30~, SAVE+68!
    DIC SAVE+30~, SAVE+50*
    DIC("DR" SAVE+52*, SAVE+53*, SAVE+54*, SAVE+55*, SAVE+56*, SAVE+57*, SAVE+58*, SAVE+59*, SAVE+60*, SAVE+63*
    , SAVE+64*, SAVE+65*, SAVE+66*
    DIC(0 SAVE+50*
    DIE CLSALL+11~, CLOSE+28~, CLOSE+31*
    DINUM SAVE+30~, SAVE+51*
    DLAYGO SAVE+30~
    DO SAVE+30~, SAVE+68!
    DQ CLOSE+28~
    DR SAVE+30~, CLSALL+11~, CLOSE+28~, CLOSE+32*, CLOSE+33*
    DUZ SAVE+72
    ERR SAVE+30~, SAVE+43*, SYNC+6~, SYNC+13*, SYNC+19*, SYNC+20
    ESH SYNC+6~, SYNC+17*
    I CLOSE+28~, FIND+15~, SYNC+6~, SYNC+15*
    IDX SYNC+6~, SYNC+13*, SYNC+14*, SYNC+20, SYNC+21, SYNC+22, SYNC2+1*, SYNC2+2, SYNC2+5, SYNC2+8
    , SYNC2+9, SYNC2+13, SYNC2+14, SYNC2+20, SYNC2+21, SYNC2+25, SYNC2+26, SYNC2+27, SYNC2+28, SYNC2+29
    , SYNC2+30, SYNC2+31, SYNC2+32, SYNC2+33, SYNC2+34, SYNC2+35, SYNC2+36, SYNC2+37
    IGNR CLOSE~, CLOSE+60
    MSG SYNC2+18~, SYNC2+21*, SYNC2+22
    OPECC SAVE+43, SYNC+6~, SYNC+13*, SYNC+19, SYNC2+4, SYNC2+11
    ORIGIN SAVE+72~*, SAVE+73*, SAVE+74
    OVREJ SYNC+6~, SYNC+15*, SYNC+20*, SYNC+22
    PA CLSALL~, CLSALL+18, CLOSE~, CLOSE+33, CLOSE+43, CLOSE+44, CLOSE+52, CLOSE+53
    PSODIV SAVE+32*, SAVE+43, SYNC+6~, SYNC+10*, SYNC+19
    PSOTRIC SAVE+43, SAVE+80, SYNC+6~, SYNC+12*, SYNC+17, SYNC+19
    RCODE FIND+15~, FIND+16*
    REA CLSALL~, CLSALL+14, CLSALL+18, CLOSE~, CLOSE+27*, CLOSE+30, CLOSE+32
    REJ SAVE~, CLSALL+11~, CLSALL+17*, CLSALL+18, CLOSE~, CLOSE+23, CLOSE+25, CLOSE+26, CLOSE+31, SYNC+6~
    , SYNC+11
    REJ( SYNC+14, SYNC+21, SYNC2+13, SYNC2+14, SYNC2+20, SYNC2+21, SYNC2+25, SYNC2+26, SYNC2+27, SYNC2+28
    , SYNC2+29, SYNC2+30, SYNC2+31, SYNC2+32, SYNC2+33, SYNC2+34, SYNC2+35, SYNC2+36, SYNC2+37
    REJ("BIN" SAVE+33*, SAVE+59
    REJ("CARDHOLD ER ID" , SAVE+48*, SAVE+56
    REJ("COB" SAVE+48*, SAVE+57
    REJ("CODE" SAVE+35*, SAVE+43, SAVE+51
    REJ("DATE/TIME" SAVE+49*, SAVE+52, SAVE+74
    REJ("DUR ADD MSG TEXT" , SAVE+45*, SAVE+58
    REJ("DUR TEXT " , SAVE+45*, SAVE+55
    REJ("GROUP NA ME" , SAVE+45*, SAVE+53
    REJ("GROUP NU MBER" , SAVE+47*, SAVE+56
    REJ("INSURANC E NAME" , SAVE+46*, SAVE+55, E POINTER" , SAVE+66
    REJ("OTHER RE JECTS" , SAVE+47*, SAVE+55
    REJ("OVERRIDE MSG" , SAVE+69*, SAVE+71, SAVE+73, SAVE+74, SAVE+76
    REJ("PAYER ME SSAGE" , SAVE+44*, SAVE+52
    REJ("PCN" SAVE+34*, SAVE+60
    REJ("PHARMACIST" SAVE+52
    REJ("PLAN CON TACT" , SAVE+46*, SAVE+53
    REJ("PREVIOUS FILL" , SAVE+53
    REJ("RE-OPENED" SAVE+56
    REJ("REASON S VC CODE" , SAVE+54
    REJ("REASON" SAVE+44*, SAVE+52
    REJ("REJECT I EN" , SAVE+68*, SAVE+74
    REJ("RESPONSE IEN" , SAVE+54
    REJ("RRR FLAG " , SAVE+39*, SAVE+40*, SAVE+43, SAVE+62, SAVE+63, SAVE+79
    REJ("RRR GROS S AMT DUE" , SAVE+65
    REJ("RRR THRE SHOLD AMT" , SAVE+64
    REJ(1 SYNC+12
    REJCOM CLOSE+28~, CLOSE+30*, CLOSE+32
    REJDATA CLSALL+11~, CLSALL+16, FIND~, FIND+17!, FIND+19, FIND+20
    REJDATA( CLSALL+17
    REJLST SYNC+6~
    REJRRR SYNC+7~
    REJRRR( SYNC+20*, SYNC2+5, SYNC2+8, SYNC2+9
    REJS FIND+15~, FIND+16*, FIND+19*, FIND+20*, FEND+1, SYNC+6~, SYNC+13!, SYNC+23
    REJS( SYNC+22*, SYNC2+1, SYNC2+2
    REOPEN SAVE~, SAVE+43
    RFL SAVE~, SAVE+31*, SAVE+32, SAVE+52, SAVE+81, CLSALL~, CLSALL+12*, CLSALL+14, CLSALL+16, CLSALL+18
    , CLOSE~, CLOSE+24*, CLOSE+26, CLOSE+36, CLOSE+48, CLOSE+51, CLOSE+54, CLOSE+56, CLOSE+60, FIND~
    , FIND+18, FIND+19, FIND+20, SYNC~, SYNC+9*, SYNC+10, SYNC+11, SYNC+12, SYNC+17, SYNC+19
    , SYNC2+38
    RRRFLG FIND~, FIND+19, FIND+20
    RRRVAL SYNC+7~, SYNC+19, SYNC+20
    RX SAVE~, SAVE+31, SAVE+32, SAVE+50, SAVE+51, SAVE+67, SAVE+74, SAVE+81, SAVE+82, CLSALL~
    , CLSALL+12, CLSALL+14, CLSALL+16, CLSALL+18, CLOSE~, CLOSE+23, CLOSE+24, CLOSE+25, CLOSE+26, CLOSE+31
    , CLOSE+36, CLOSE+48, CLOSE+51, CLOSE+54, CLOSE+56, CLOSE+60, FIND~, FIND+18, FIND+19, FIND+20
    , SYNC~, SYNC+8, SYNC+9, SYNC+10, SYNC+11, SYNC+12, SYNC+17, SYNC+19, SYNC+21, SYNC+23
    , SYNC2+38, SYNC2+39
    RXCOB SYNC~, SYNC+5*, SYNC+11, SYNC+19
    SMA CLOSE+28~, CLOSE+41*, CLOSE+42*, CLOSE+43*, CLOSE+44*, CLOSE+45
    SMACOM CLOSE+28~, CLOSE+47*, CLOSE+48, CLOSE+50*, CLOSE+51, CLOSE+53*, CLOSE+54, CLOSE+55*, CLOSE+56
    TXT SAVE+77~, SAVE+78*, SAVE+79*, SAVE+80*, SAVE+81, SYNC+6~, SYNC+14*, SYNC+15
    U SYNC2+8, SYNC2+9
    USR CLSALL~, CLSALL+18, CLOSE~, CLOSE+32, SYNC~, SYNC2+26
    X SAVE+30~, SAVE+51*, SAVE+77~, SAVE+81*, CLOSE+28~, CLOSE+48*, CLOSE+51*, CLOSE+54*, CLOSE+56*, CLOSE+60*
    Y SAVE+68, CLOSE+28~
    Info |  Source |  Call Graph |  Caller Graph |  Entry Points |  External References |  FileMan Files Accessed Via FileMan Db Call |  Global Variables Directly Accessed |  Label References |  Local Variables |  All