IBCNSMR ;ALB/AAS - MEDICARE BILLS ; 02-SEPT-97 ;;2.0;INTEGRATED BILLING;**92,240**;21-MAR-94 ; % G RPRT^IBCNSMRA ; DQ ; -- entry point from task manager N I,J,X,Y,IBINSCO,INSCO,NODE,CNT,IBI,IBINSNM,IBNM S IBQUIT=0 K ^TMP("IB-MRA",$J),^TMP("IB-MRA-CNT",$J) ; S I=0 F S I=$O(^IBE(350.9,1,99,I)) Q:'I S INSCO(+$G(^IBE(350.9,1,99,I,0)))="" ; S IBI=0 F S IBI=$O(^DGCR(399,IBI)) Q:'IBI!(IBQUIT) D .S IBQUIT=$$STOP Q:IBQUIT .S IBINSCO="" K NODE .S NODE(0)=$G(^DGCR(399,IBI,0)) Q:NODE(0)="" .S NODE("C")=$G(^DGCR(399,IBI,"C")) .S NODE("M")=$G(^DGCR(399,IBI,"M")) Q:NODE("M")="" .S NODE("U")=$G(^DGCR(399,IBI,"U")) Q:NODE("U")="" .I $D(INSCO(+NODE("M"))) S IBINSCO=+NODE("M") .I 'IBINSCO,$D(INSCO(+$P(NODE("M"),"^",2))) S IBINSCO=$P(NODE("M"),"^",2) .I 'IBINSCO,$D(INSCO(+$P(NODE("M"),"^",3))) S IBINSCO=$P(NODE("M"),"^",3) .I IBINSCO S IBINSNM=$P($G(^DIC(36,IBINSCO,0)),"^") D BLDDATA ; I 'IBQUIT D PRINT^IBCNSMR0 G END^IBCNSMRA END Q ; BLDDATA ; -- for each bill sent to a selected ins. co. build temp node N X,YEAR,TYPE,TYPENO,PROC,DIAG,ORGAMNT,BOTH,IBSTAT,DFN,ALIVE,ARSTAT,IBQUIT,RXBILL,PROSBILL,BILLNO,LOCCARE,RATETYP,RN,WHO,TIMEFRM,TOTPAID,REFGC,DATEPR S IBQUIT=0 S BILLNO=$P(NODE(0),"^") S YEAR=$E(+NODE("U"),2,3) S TYPENO=$P(NODE(0),"^",5) S TYPE=$S(TYPENO<3:"INPATIENT",1:"OUTPATIENT") S PROC=$$PROC(IBI) S DIAG=$$DIAG(IBI) S IBSTAT=$P(NODE(0),"^",13) S ARSTAT=$$STA^PRCAFN(IBI) S DFN=$P(NODE(0),"^",2) S ALIVE=$S(+$G(^DPT(DFN,.35)):"DEAD",1:"ALIVE") S ORGAMNT=$$ORI^PRCAFN(IBI) S LOCCARE=$P(NODE(0),"^",4) S WHO=$P(NODE(0),"^",11) S RATETYP=$P(NODE(0),"^",7) S RN=$P($G(^DGCR(399.3,+RATETYP,0)),"^") S TIMEFRM=$P(NODE(0),"^",6) S TOTPAID=$$TPR^PRCAFN(IBI) S REFGC=$P($G(^PRCA(430,IBI,6)),"^",4)'="" S DATEPR=$P($G(^DGCR(399,IBI,"S")),"^",12) S BOTH="NONE" S RXBILL=0 S PROSBILL=0 I $O(^IBA(362.4,"AIFN"_IBI,"")) S RXBILL=1 I $O(^IBA(362.5,"AIFN"_IBI,"")) S PROSBILL=1 D COUNT D:'IBQUIT SET Q ; COUNT ; -- set totals for all ins, and by ins co. S CNT=$G(CNT)+1 S CNT(0)=$G(CNT(0))+ORGAMNT S CNT(3,IBINSNM)=$G(CNT(3,IBINSNM))+1 S CNT(3,IBINSNM,0)=$G(CNT(3,IBINSNM,0))+ORGAMNT I TYPE="INPATIENT" D .S CNT("IN")=$G(CNT("IN"))+1 .S CNT("IN",0)=$G(CNT("IN",0))+ORGAMNT .I TOTPAID>0 D ..S CNT("IN",1)=$G(CNT("IN",1))+1 ..S CNT("IN",2)=$G(CNT("IN",2))+TOTPAID I TYPE="OUTPATIENT" D .S CNT("OP")=$G(CNT("OP"))+1 .S CNT("OP",0)=$G(CNT("OP",0))+ORGAMNT .I TOTPAID>0 D ..S CNT("OP",1)=$G(CNT("OP",1))+1 ..S CNT("OP",2)=$G(CNT("OP",2))+TOTPAID I TOTPAID>0 D .S CNT(1)=$G(CNT(1))+1 .S CNT(2)=$G(CNT(2))+TOTPAID .S CNT(3,IBINSNM,1)=$G(CNT(3,IBINSNM,1))+1 .S CNT(3,IBINSNM,2)=$G(CNT(3,IBINSNM,2))+TOTPAID ; ;I ALIVE'="ALIVE" D ; decided to keep dead patients in the report 10/28/97 ;.S CNT("A")=$G(CNT("A"))+1 ;.S CNT("A",0)=$G(CNT("A",0))+ORGAMNT ;.;S IBQUIT=1 ;.I TOTPAID>0 D ;..S CNT("A",1)=$G(CNT("A",1))+1 ;..S CNT("A",2)=$G(CNT("A",2))+TOTPAID ; I DIAG="YES"&(PROC="NO") D .S BOTH="DIAG" .S IBQUIT=1 .S CNT("D")=$G(CNT("D"))+1 .S CNT("D",0)=$G(CNT("D",0))+ORGAMNT .I TOTPAID>0 D ..S CNT("D",1)=$G(CNT("D",1))+1 ..S CNT("D",2)=$G(CNT("D",2))+TOTPAID ; I PROC="YES"&(DIAG="NO") D .S BOTH="PROC" .S IBQUIT=1 .S CNT("P")=$G(CNT("P"))+1 .S CNT("P",0)=$G(CNT("P",0))+ORGAMNT .I TOTPAID>0 D ..S CNT("P",1)=$G(CNT("P",1))+1 ..S CNT("P",2)=$G(CNT("P",2))+TOTPAID ; I PROC="YES"&(DIAG="YES") D .S BOTH="BOTH" .S CNT("B")=$G(CNT("B"))+1 .S CNT("B",0)=$G(CNT("B",0))+ORGAMNT .I TOTPAID>0 D ..S CNT("B",1)=$G(CNT("B",1))+1 ..S CNT("B",2)=$G(CNT("B",2))+TOTPAID ; I BOTH="NONE" D .S CNT("N")=$G(CNT("N"))+1 .S CNT("N",0)=$G(CNT("N",0))+ORGAMNT .I TOTPAID>0 D ..S CNT("N",1)=$G(CNT("N",1))+1 ..S CNT("N",2)=$G(CNT("N",2))+TOTPAID ; I BOTH'="BOTH" S IBQUIT=1 ; I IBSTAT=7,+ARSTAT=210 D ;bill canceled before completion .S CNT("C")=$G(CNT("C"))+1 .S CNT("C",0)=$G(CNT("C",0))+ORGAMNT .S IBQUIT=1 .I TOTPAID>0 D ..S CNT("C",1)=$G(CNT("C",1))+1 ..S CNT("C",2)=$G(CNT("C",2))+TOTPAID ; I TYPENO=2!(TYPENO=4) D .S CNT("T")=$G(CNT("T"))+1 .S CNT("T",0)=$G(CNT("T",0))+ORGAMNT .S IBQUIT=1 .I TOTPAID>0 D ..S CNT("T",1)=$G(CNT("T",1))+1 ..S CNT("T",2)=$G(CNT("T",2))+TOTPAID ; I WHO'="i" D .S CNT("W")=$G(CNT("W"))+1 .S CNT("W",0)=$G(CNT("W",0))+ORGAMNT .S IBQUIT=1 .I TOTPAID>0 D ..S CNT("W",1)=$G(CNT("W",1))+1 ..S CNT("W",2)=$G(CNT("W",2))+TOTPAID ; I DATEPR="",IBSTAT<3 D .S CNT("F")=$G(CNT("F"))+1 .S CNT("F",0)=$G(CNT("F",0))+ORGAMNT .S IBQUIT=1 .I TOTPAID>0 D ..S CNT("F",1)=$G(CNT("F",1))+1 ..S CNT("F",2)=$G(CNT("F",2))+TOTPAID ; I $G(RXBILL) D .S CNT("X")=$G(CNT("X"))+1 .S CNT("X",0)=$G(CNT("X",0))+ORGAMNT .S IBQUIT=1 .I TOTPAID>0 D ..S CNT("X",1)=$G(CNT("X",1))+1 ..S CNT("X",2)=$G(CNT("X",2))+TOTPAID ; I $G(PROSBILL) D .S CNT("Z")=$G(CNT("Z"))+1 .S CNT("Z",0)=$G(CNT("Z",0))+ORGAMNT .S IBQUIT=1 .I TOTPAID>0 D ..S CNT("Z",1)=$G(CNT("Z",1))+1 ..S CNT("Z",2)=$G(CNT("Z",2))+TOTPAID ; I $S(RN["MEANS":1,RN["DENTAL":1,RN["TORT":1,RN["TRICARE":1,RN["CHAMPVA":1,RN["MEDICARE":1,RN["WORKERS":1,RN["CRIME":1,RN["SHARING":1,1:0) D .S CNT("R")=$G(CNT("R"))+1 .S CNT("R",0)=$G(CNT("R",0))+ORGAMNT .S IBQUIT=1 .I TOTPAID>0 D ..S CNT("R",1)=$G(CNT("R",1))+1 ..S CNT("R",2)=$G(CNT("R",2))+TOTPAID Q ; PROC(IBI) ; -- does bill have any procedures N PROC S PROC="NO" I $O(^DGCR(399,IBI,"CP",0)) S PROC="YES" I +NODE("C")!($P(NODE("C"),"^",4))!($P(NODE("C"),"^",7)) S PROC="YES" Q PROC ; DIAG(IBI) ; -- does bill have any diagnosis N DIAG S DIAG="NO" I $O(^IBA(362.3,"AIFN"_IBI,0)) S DIAG="YES" I $P(NODE("C"),"^",10)!($P(NODE("C"),"^",14)) S DIAG="YES" Q DIAG ; SET ; -- set up tmp global S CNT("M")=$G(CNT("M"))+1,CNT("M",0)=$G(CNT("M",0))+ORGAMNT I REFGC D .S CNT("M",4)=$G(CNT("M",4))+1 .S CNT("M",5)=$G(CNT("M",5))+ORGAMNT .I TOTPAID>0 D ..S CNT("M",6)=$G(CNT("M",6))+1 ..S CNT("M",7)=$G(CNT("M",7))+TOTPAID I TOTPAID>0 D .S CNT("M",1)=$G(CNT("M",1))+1 .S CNT("M",2)=$G(CNT("M",2))+TOTPAID I TYPE="INPATIENT" D .S CNT("M","IN")=$G(CNT("M","IN"))+1 .S CNT("M","IN",0)=$G(CNT("M","IN",0))+ORGAMNT .I TOTPAID>0 D ..S CNT("M","IN",1)=$G(CNT("M","IN",1))+1 ..S CNT("M","IN",2)=$G(CNT("M","IN",2))+TOTPAID I TYPE="OUTPATIENT" D .S CNT("M","OP")=$G(CNT("M","OP"))+1 .S CNT("M","OP",0)=$G(CNT("M","OP",0))+ORGAMNT .I TOTPAID>0 D ..S CNT("M","OP",1)=$G(CNT("M","OP",1))+1 ..S CNT("M","OP",2)=$G(CNT("M","OP",2))+TOTPAID ; S ^TMP("IB-MRA",$J,+$G(IBINSCO),+$G(YEAR),$G(TYPE,"UNKNOWN"),BOTH,$G(ARSTAT,"UNKNOWN"),+$G(IBSTAT),IBI)=BILLNO_"^"_DFN ; S ^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT)=(+$G(^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT))+1) ; S ^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,0)=+$G(^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,0))+ORGAMNT ; I TOTPAID>0 D .S ^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,1)=+$G(^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,1))+1 .S ^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,2)=+$G(^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,2))+TOTPAID Q ; STOP() ; -- determine if user requested task to stop I $D(ZTQUEUED),$$S^%ZTLOAD S ZTSTOP=1 K ZTREQ Q +$G(ZTSTOP)