FBUCMBS ;LEX/WRC - MILLENNIUM ACT EMERGENCY CARE SUMMARY REPORT ;07/07/03 ;;3.5;FEE BASIS;**62,90**;JAN 30, 1995 ; SDT S %DT="EA",%DT("A")="Start Date: " D ^%DT S FBSDT=Y I FBSDT<0 D KIL Q I FBSDT>DT W !,"Start date cannot be in the future." G SDT ; EDT S %DT="EA",%DT("A")="End Date: " D ^%DT S FBEDT=Y I FBEDT<0 D KIL Q I FBEDTFBEDT!(FBSDT="") D . F S FBDA=$O(^FB583("B",FBSDT,FBDA)) Q:FBDA="" D .. I $P($G(^FB583(FBDA,0)),"^",28)'=1 Q .. S FBUCL0=$G(^FB583(FBDA,0)) .. S FBTNCL=FBTNCL+1 .. S FBAMTCL=$P(FBUCL0,"^",9) .. S FBTDCL=FBTDCL+FBAMTCL .. S FBCLMT=$P(FBUCL0,"^",23) .. I FBCLMT'="",($D(^TMP($J,"FBUCMBS","CLMT",FBCLMT))=0) S ^TMP($J,"FBUCMBS","CLMT",FBCLMT)="",FBTCLMTS=FBTCLMTS+1 .. S FBDISPO=$P(FBUCL0,"^",11) .. I FBDISPO="" S FBTNCLPN=FBTNCLPN+1,FBTDCLPN=FBTDCLPN+$P(FBUCL0,"^",9) Q .. I $D(^FB(162.91,FBDISPO,0))=0 S FBTNCLPN=FBTNCLPN+1,FBTDCLPN=FBTDCLPN+$P(FBUCL0,"^",9) Q .. S FBDIS0=$P($G(^FB(162.91,FBDISPO,0)),"^",1) .. I $E($P(FBDIS0,"^",1),1,8)="APPROVED" D Q ... S FBPD1=$$AMTPD(FBDA) ... S FBTNCLPD=FBTNCLPD+1,FBTDCLPD=FBTDCLPD+FBPD1,FBTDSUPD=FBTDSUPD+FBAMTCL D AVGTM .. S FBTNCLR=FBTNCLR+1,FBTDCLR=FBTDCLR+$P(FBUCL0,"^",9) .. D REAS,ADD,STATUS,AVGTM D PRT S FBDENIAL="" D DENIAL I $D(FBQ) D KIL Q D PAVG I $D(FBQ) D KIL Q D KIL Q ; REAS N X S FBREAS="" S X=$O(^FB583(FBDA,"D",0)) I X S X=+$G(^FB583(FBDA,"D",X,0)) I X S FBREAS=$P($G(^FB(162.94,X,0)),"^") S FBREAS=$S(FBREAS="":"OTHER",1:FBREAS) Q ADD ; I $D(^TMP($J,"FBUCMBS","REAS",FBREAS))=1 S $P(^TMP($J,"FBUCMBS","REAS",FBREAS),"^",1)=$P(^TMP($J,"FBUCMBS","REAS",FBREAS),"^",1)+1 Q S ^TMP($J,"FBUCMBS","REAS",FBREAS)=1 Q ; STATUS I $P(FBUCL0,"^",24)="" Q S FBSIEN=$P(FBUCL0,"^",24) I $D(^FB(162.92,FBSIEN,0))=0 Q I $P(^FB(162.92,FBSIEN,0),"^",1)["PENDING" S FBTNCLPN=FBTNCLPN+1,FBTDCLPN=FBTDCLPN+$P(FBUCL0,"^",9) Q ; AVGTM ; I $P(FBUCL0,"^",1)="" Q I $P(FBUCL0,"^",12)="" Q S FBNCLMS=FBNCLMS+1,X1=$P(FBUCL0,"^",12),X2=$P(FBUCL0,"^",1) D ^%DTC S FBDAYS=FBDAYS+X Q ; PRT ; S Y=DT D DD^%DT S FBPRDT=Y S Y=FBEDT D DD^%DT S FBPEDT=Y W @IOF,!,?25,"MILLENNIUM ACT EMERGENCY CARE" S FBTDSU=FBTDSUPD-FBTDCLPD W !,?32,"SUMMARY REPORT" W !,?23,FBPSDT," THROUGH ",FBPEDT W !,?29,"RUN DATE: ",FBPRDT,!! W !,"Total Number Claims Received: " S X=FBTNCL,X2=0,X3=20 D COMMA^%DTC W ?50,X W !,"Total Dollars Claims Received: " S X=FBTDCL,X2="2$",X3=20 D COMMA^%DTC W ?50,X W !!,"Total Claimants: " S X=FBTCLMTS,X2=0,X3=20 D COMMA^%DTC W ?50,X W !!,"Total Claims Paid: " S X=FBTNCLPD,X2=0,X3=20 D COMMA^%DTC W ?50,X W !,"Total Dollars Claims Paid: " S X=FBTDCLPD,X2="2$",X3=20 D COMMA^%DTC W ?50,X W !!,"Total Dollars Suspended: " S X=FBTDSU,X2="2$",X3=20 D COMMA^%DTC W ?50,X W !!,"Total Number Claims Rejected: " S X=FBTNCLR,X2=0,X3=20 D COMMA^%DTC W ?50,X W !,"Total Dollars Claims Rejected: " S X=FBTDCLR,X2="2$",X3=20 D COMMA^%DTC W ?50,X,! W !,?32,"REASONS REJECTED",! Q ; DENIAL F S FBDENIAL=$O(^TMP($J,"FBUCMBS","REAS",FBDENIAL)) Q:FBDENIAL=""!($D(FBQ)) D . W !,?5,FBDENIAL,":" S X=$P(^TMP($J,"FBUCMBS","REAS",FBDENIAL),"^",1),X2=0,X3=20 D COMMA^%DTC W ?50,X . I $Y>(IOSL-2) D PAUSE Q:$D(FBQ) . S FBTREAS=FBTREAS+$P(^TMP($J,"FBUCMBS","REAS",FBDENIAL),"^",1) Q ; PAVG W !,?59,"----------" I $Y>(IOSL-2) D PAUSE S FBPSW=1 Q:$D(FBQ) S X=FBTREAS,X2=0,X3=20 D COMMA^%DTC W !,?50,X I $Y>(IOSL-2) D PAUSE S FBPSW=1 Q:$D(FBQ) W !!,"Total Number Claims Pending: " S X=FBTNCLPN,X2=0,X3=20 D COMMA^%DTC W ?50,X I $Y>(IOSL-2) D PAUSE S FBPSW=1 Q:$D(FBQ) W !,"Total Dollars Claims Pending: " S X=FBTDCLPN,X2="2$",X3=20 D COMMA^%DTC W ?50,X I $Y>(IOSL-2) D PAUSE S FBPSW=1 Q:$D(FBQ) I FBNCLMS=0 W !!,"Average Processing Time: ",$J(0,3,2)," Days" D:$Y>(IOSL-14) PAUSE Q S FBAVGD=FBDAYS/FBNCLMS W !!,"Average Processing Time: ",$J(FBAVGD,3,2)," Days" I $Y>(IOSL-2) D PAUSE S FBPSW=1 Q:$D(FBQ) I '$D(FBPSW) D PAUSE Q ; KIL ; K FBTNCL,FBTDCL,FBTCLMTS,FBTNCLPD,FBTDCLPD,FBTNCLR,FBTDCLR,FBTNCLPN,FBTDCLPN,FBTREAS,FBNCLMS,FBDAYS,FBPSDT,FBSDT,FBPEDT,FBEDT,FBDA,FBAMTCL,FBDISPO,FBREAS,FBSIEN K %DT,%IS,POP,ZTIO,ZTQUEUED,ZTRTN,ZTSAVE,ZTSK,FBAVGD,FBCLMT,FBCLMTS,FBDENIAL,FBPRDT,FBRDT,X,X1,X2,X3,Y,FBPSW,FBQ,DIR,DIRUT,DUOUT,FBPD1,FBTDSUPD,FBUCL0,FBDIS0,FBTDSU K ^TMP($J) D ^%ZISC Q ; AMTPD(FBDA) ;Determine the amount paid an unauthorized claim ;Input: FBDA -- IEN of record in the unauthorized claim file 162.7 ;Output: Amount paid, or 0 if the claim cannot be identified ; N FBTAMT,FBX,FBUCPAY,FBFILE,FBIENS,FBAMT ; ; - initialize total amount paid S FBTAMT=0 ; ; - check for valid input I '$G(^FB583(FBDA,0)) G AMTPDQ ; ; - get list of payments for the claim S FBX=$$PAYST^FBUCUTL(FBDA,"FBUCPAY") ; ; - loop thru payments to get total amount approved S FBTAMT=0 F FBFILE=162.03,162.11,162.5 D . S FBIENS="" F S FBIENS=$O(FBUCPAY(FBDA,FBFILE,FBIENS)) Q:FBIENS="" D .. I FBFILE=162.03 Q:$P($G(^FBAAC($P(FBIENS,",",4),1,$P(FBIENS,",",3),1,$P(FBIENS,",",2),1,$P(FBIENS,",",1),"FBREJ")),"^",1)'="" S FBAMT=$$GET1^DIQ(FBFILE,FBIENS,2) .. I FBFILE=162.11 Q:$P($G(^FBAA(162.1,$P(FBIENS,",",2),"RX",$P(FBIENS,",",1),"FBREJ")),"^",1)'="" S FBAMT=$$GET1^DIQ(FBFILE,FBIENS,16.5) .. I FBFILE=162.5 Q:$P($G(^FBAAI(+FBIENS,"FBREJ")),"^",1)'="" S FBAMT=$$GET1^DIQ(FBFILE,FBIENS,8) .. S FBTAMT=FBTAMT+FBAMT ; AMTPDQ Q FBTAMT ; PAUSE ; - Page break I $E(IOST,1,2)'="C-" Q S DIR(0)="E" D ^DIR I $D(DIRUT) S FBQ=1 Q W @IOF Q