IBCONS1 ;ALB/AAS - NSC PATIENTS W/ INS BACKGROUND PRINTS ;7 JUN 90 ;;2.0;INTEGRATED BILLING;**66,80,137**;21-MAR-94 ; ;MAP TO DGCRONS1 ; EN ; Inpatient Discharge entry to que background once weekly S IBINPT=2,IBSUB="AMV3" G QUEUE ; EN1 ; Inpatient Admission entry to que background once weekly S IBINPT=1,IBSUB="AMV1" G QUEUE ; EN2 ; Outpatient entry to que background once weekly S IBINPT=0,IBSUB="" ; QUEUE ; Set up the background job to run for the previous week ; o For All Divisions ; o For Insured veterans with unbilled episodes of care ; o With the output sorted by Terminal Digit ; K ^TMP($J) S X="T",%DT="" D ^%DT S IBEND=+Y S X="T-7",%DT="" D ^%DT S IBBEG=+Y K %DT S (VAUTD,IBSELUBL,IBSELTRM,IBSELRNB)=1 U IO G BEGIN^IBCONSC ; ; LOOP25 ; Print all NSC w/Insurance reports. S IBQUIT=0,IBFL=1,IBHDRDV="",IBSUM=0 I +$G(IBSELCDV) D HDRDV^IBCONSC S IBDV="" F S IBDV=$O(^TMP($J,IBDV)) Q:IBDV="" I IBDV'="TOTAL" D LOOP3 Q:IBQUIT ; G:IBQUIT Q S IBSUM=1,IBPAGE=0 D HEAD Q:IBQUIT S IBDV="" F S IBDV=$O(^TMP($J,"TOTAL",IBDV)) Q:IBDV="" D PRNSUM D PAUSE ; Q K %,%DT,B,I,J,K,L,M,X,X1,X2,Y,DFN,IBCNT,IBIFN,IBBILL,IBDATE,IBFLAG,IBI,IBDT,IBPAGE,IBL,IBHD,IBBEG1,IBHDRDV,IBSUM K IBBEG,IBEND,IBINPT,IBFLAG,IBNAME,IBAPPT,IBDC,IBDAT,IBDFN,POP,IBNEWPT,^TMP($J) ;I '$D(ZTQUEUED) D ^%ZISC Q ; ; LOOP3 ; Loop through billed, unbilled, or both types of episodes of care. I +$G(IBSELUBL) S IBBILL=1,IBNAME="",IBPAGE=0 K IBFLAG D HEAD Q:IBQUIT D LOOP31 Q:IBQUIT I +$G(IBSELBNA)!+$G(IBSELBIL) S IBBILL=2,IBNAME="",IBPAGE=0 K IBFLAG D HEAD Q:IBQUIT D LOOP31 Q:IBQUIT Q ; LOOP31 ; Loop through each name or terminal digit (and associated DFN). F S IBNAME=$O(^TMP($J,IBDV,IBBILL,IBNAME)) D Q:IBNAME=""!(IBQUIT) . I IBNAME="",'$D(IBFLAG) W !!,"No matches found.",! . Q:IBNAME="" . S DFN=0 F S DFN=$O(^TMP($J,IBDV,IBBILL,IBNAME,DFN)) Q:'DFN S IBNEWPT=1 D LOOP4 Q:IBQUIT Q ; LOOP4 ; Loop through each episode of care for a patient. S IBDAT="" F I=0:0 S IBDAT=$O(^TMP($J,IBDV,IBBILL,IBNAME,DFN,IBDAT)) Q:IBDAT=""!(IBQUIT) D PRINT I $Y>$S($D(IOSL):(IOSL-6),1:6) W ! D HEAD Q:IBQUIT Q ; PRINT ; Print each detail line. I '$G(IBSELRNB),$D(^TMP($J,IBDV,IBBILL,IBNAME,DFN,IBDAT,2)) Q ; exclude episodes with reason not billable I +$G(IBSELRNB)=2,'$D(^TMP($J,IBDV,IBBILL,IBNAME,DFN,IBDAT,2)) Q ; exclude episode w/o RNB ** PATCH 66 I IBBILL=2,'$G(IBSELBNA),+$G(^TMP($J,IBDV,IBBILL,IBNAME,DFN,IBDAT))=1 Q ; non-auth episodes ** PATCH 66 I IBBILL=2,'$G(IBSELBIL),+$G(^TMP($J,IBDV,IBBILL,IBNAME,DFN,IBDAT))=2 Q ; auth episodes ** PATCH 66 ; I +$G(IBNEWPT) W ! D PTPRNT S IBNEWPT=0 D SUMTOT S IBFLAG=1 D PID^VADPT6 W !,VA("BID"),?6,$E($P(^DPT(DFN,0),"^"),1,20),?28,VA("PID"),?42,$E($P($G(^DIC(8,+$G(^(.36)),0)),"^",6),1,16) K VA,VAERR S Y=IBDAT X ^DD("DD") W ?60,Y ; ; -- print insurance, use ibcns1 calls S X=$$INSP(DFN,IBDAT) W ?82,X ; ;S IBCNT=0 F II=0:0 S II=$O(^DPT(DFN,.312,II)) Q:'II S IBCNT=IBCNT+1,X=+^(II,0) D ;. I $D(^DIC(36,X,0)) W:IBCNT=2!(IBCNT=3) ", " W:IBCNT<4 $E($P(^(0),"^"),1,14) W:IBCNT=4 " " W:IBCNT>3 "*" ; ; -- print reason not billable I $G(^TMP($J,IBDV,IBBILL,IBNAME,DFN,IBDAT,2))]"" W ?115,$E(^(2),1,16) ; S X=$G(^TMP($J,IBDV,IBBILL,IBNAME,DFN,IBDAT,1)) I X]"" W !?10,$P(X,"^") I $P(X,"^",2)]"" W " with " F IBDC=2:1 Q:$P(X,"^",IBDC)="" W $P(X,"^",IBDC),", " S X=^TMP($J,IBDV,IBBILL,IBNAME,DFN,IBDAT) Q:'$L(X) F K=2:1 S IBIFN=$P(X,"^",K) Q:IBIFN="" D PRINT1 Q ; PRINT1 ; If an episode of care has been billed, display billing information. D GVAR^IBCBB W !?10,$P(^DGCR(399,IBIFN,0),"^"),?20,$P($G(^DGCR(399.3,+IBAT,0)),"^",4),"-",$S(IBCL<3:"INPT",IBCL>2:"OUTP",1:"") W ?37,$S(IBST=1:"Entered",IBST=2:"Request MRA",IBST=3:"Authorized",IBST=4:"Prnt/Trans",IBST=7:"Cancelled",IBST=0:"Closed",1:"") W ?50,"From: ",$E(IBFDT,4,5)_"/"_$E(IBFDT,6,7)_"/"_$E(IBFDT,2,3) W ?68,"To: ",$E(IBTDT,4,5)_"/"_$E(IBTDT,6,7)_"/"_$E(IBTDT,2,3) W ?88,$S($P(IBND0,U,21)="S":"s",$P(IBND0,U,21)="T":"t",1:"") W ?91,"Debtor: " I IBWHO="i",$D(^DIC(36,+IBNDMP,0)) W $P(^(0),"^") I IBWHO="o",$D(^DIC(4,+$P(IBNDM,"^",11),0)) W $P(^(0),"^") I IBWHO="p" W $P(^DPT(DFN,0),"^") D END^IBCBB1 Q ; HEAD ; Print header; don't pause on first pass through. I $D(ZTQUEUED),$$S^%ZTLOAD S (ZTSTOP,IBQUIT)=1 Q D:'IBFL PAUSE Q:IBQUIT S IBFL=0 N IBI S IBPAGE=IBPAGE+1 ; -- ibformfd = skip only intial form feed, need ffs for each div. I $E(IOST,1,2)["C-"!(IBPAGE>1)!($G(IBFORMFD)) W @IOF S IBFORMFD=1 S IBI=$S(IBBILL=2:"PREVIOUSLY ",1:"UN")_"BILLED PATIENTS" I '$G(IBSELCDV) S IBI=IBI_" for Division "_$P($G(^DG(40.8,+IBDV,0)),"^") I +$G(IBSELCDV) S IBI=IBI_IBHDRDV I +$G(IBSUM) S IBI="Summary" W IBHD,!,IBI W:$L(IBI)>78 ! W ?80,"Printed: ",IBDATE,?118,"Page: ",IBPAGE I +$G(IBSUM) W !,?40,"Unbilled",?53,"Unbilled w/RNB",?70,"Billed/Not Auth",?88,"Billed/Auth",?103,"# Visits",?117,"# Patients",!,IBL Q W !,"PT ID PATIENT",?28,"SSN",?42,"ELIGIBILITY",?60,"DATE OF ",$S(IBINPT=2:"DISCHARGE",1:"CARE"),?82,"INSURANCE COMPANIES" W:+$G(IBSELRNB) ?115,"NOT BILLABLE" W !,IBL Q ; INSP(DFN,IBDAT) ; -- print ins. company on report logic N X,IBDD,IBDDINS,IBCNT S IBCNT=0,IBDDINS="" I '$G(DFN)!('$G(IBDAT)) G INSPQ S IBDD="" D ALL^IBCNS1(DFN,"IBDD",4,IBDAT) S X=0 F S X=$O(IBDD(X)) Q:'X!(IBCNT>2) D .S IBCNT=IBCNT+1 .I IBCNT>1 S IBDDINS=IBDDINS_"," .S IBDDINS=IBDDINS_$E($P($G(^DIC(36,+$G(IBDD(X,0)),0)),"^"),1,10) S IBDDINS=$E(IBDDINS,1,30) I $G(IBDD(0))>3 S IBDDINS=IBDDINS_"*" INSPQ Q IBDDINS ; PAUSE Q:$E(IOST,1,2)'="C-" F J=$Y:1:(IOSL-5) W ! S DIR(0)="E" D ^DIR K DIR I $D(DIRUT)!($D(DUOUT)) S IBQUIT=1 K DIRUT,DTOUT,DUOUT Q PRNSUM ; print 1 line of the summary N IBSUM S IBSUM=$G(^TMP($J,"TOTAL",IBDV)) Q:IBSUM="" W !,$S(IBDV="TOTAL":IBDV,1:$P($G(^DG(40.8,+IBDV,0)),U,1)) W ?40,$P(IBSUM,U,2),?58,$P(IBSUM,U,3),?75,$P(IBSUM,U,4),?91,$P(IBSUM,U,5),?105,$P(IBSUM,U,1),?120,$P(IBSUM,U,6) Q DATE(X) ; N Y S Y="" I +$G(X) S Y=$E(X,4,5)_"/"_$E(X,6,7)_"/"_$E(X,2,3) Q Y ; SUMTOT ; total cnt of visits ^ cnt unbilled ^ cnt unbilled w/RNB ^ cnt billed/not auth ^ cnt billed/auth ^ cnt of pats N IBSUM,IBTOT,IBBILLED,IBRMARK S IBBILLED=$G(^TMP($J,IBDV,IBBILL,IBNAME,DFN,IBDAT)),IBRMARK=$G(^TMP($J,IBDV,IBBILL,IBNAME,DFN,IBDAT,2)) S IBSUM=$G(^TMP($J,"TOTAL",+IBDV)),IBTOT=$G(^TMP($J,"TOTAL","TOTAL")) S $P(IBSUM,U,1)=+$P(IBSUM,U,1)+1,$P(IBTOT,U,1)=+$P(IBTOT,U,1)+1 I 'IBBILLED,IBRMARK="" S $P(IBSUM,U,2)=$P(IBSUM,U,2)+1,$P(IBTOT,U,2)=$P(IBTOT,U,2)+1 I 'IBBILLED,IBRMARK'="" S $P(IBSUM,U,3)=$P(IBSUM,U,3)+1,$P(IBTOT,U,3)=$P(IBTOT,U,3)+1 I +IBBILLED=1 S $P(IBSUM,U,4)=$P(IBSUM,U,4)+1,$P(IBTOT,U,4)=$P(IBTOT,U,4)+1 I +IBBILLED=2 S $P(IBSUM,U,5)=$P(IBSUM,U,5)+1,$P(IBTOT,U,5)=$P(IBTOT,U,5)+1 I '$D(^TMP($J,"TOTAL",+IBDV,DFN)) S $P(IBSUM,U,6)=$P(IBSUM,U,6)+1 I '$D(^TMP($J,"TOTAL","TOTAL",DFN)) S $P(IBTOT,U,6)=$P(IBTOT,U,6)+1 I +IBDV S ^TMP($J,"TOTAL",+IBDV)=IBSUM,^TMP($J,"TOTAL",+IBDV,DFN)="" S ^TMP($J,"TOTAL","TOTAL")=IBTOT,^TMP($J,"TOTAL","TOTAL",DFN)="" Q ; PTPRNT ; print patient specific data is requested: Rate Disabilities and expanded insurance Info ; N IBLN1,IBI,IBX,IBY,IBD,IBLN2,IBLN3,IBY1,IBJ,IBY3,IBRIDE,IBPLAN,IBCVG S IBLN1=$P($G(^DPT(+DFN,0)),U,1) I $Y>(IOSL-6) W ! D HEAD Q:IBQUIT ; I +$G(IBPRTRDS) S IBLN2="Rated Disabilities:" D Q:+$G(IBQUIT) K IBX,IBY . I '$O(^DPT(DFN,.372,0)) W !,IBLN1,?33,IBLN2," None" S (IBLN1,IBLN2)="" Q . S IBI=0 F S IBI=$O(^DPT(DFN,.372,IBI)) Q:'IBI D I $Y>(IOSL-6) W ! D HEAD Q:IBQUIT .. S IBX=$G(^DPT(DFN,.372,IBI,0)),IBY=$G(^DIC(31,+IBX,0)) .. S IBD=$S($P(IBY,U,4)="":$P(IBY,U,1),1:$P(IBY,U,4))_" ("_$P(IBX,U,2)_"%-"_$S(+$P(IBX,U,3):"SC",1:"NSC")_")" .. W !,IBLN1,?33,IBLN2,?57,IBD S (IBLN1,IBLN2)="" ; I '$G(IBPRTIEX),'$G(IBPRTIPC),'$G(IBPRTIGC),'$G(IBPRTICR) Q ; W:IBLN1'="" !,IBLN1 D ALL^IBCNS1(DFN,"IBX",4,IBBEG),ALL^IBCNS1(DFN,"IBX",4,IBEND) ; S IBI=0 F S IBI=$O(IBX(IBI)) Q:'IBI D Q:+$G(IBQUIT) I $Y>(IOSL-6) W ! D HEAD Q:IBQUIT . S IBY=IBX(IBI,0),IBY1=IBX(IBI,1) . S IBLN1=$E($P($G(^DIC(36,+IBY,0)),U,1),1,25),IBPLAN=+$P(IBY,U,18) . ; . I +$G(IBPRTIEX) W !,?5,IBLN1,?33,"Group #: ",$P($G(^IBA(355.3,+IBPLAN,0)),U,4),?65,"Effective: ",$$DATE(+$P(IBY,U,8))," - ",$$DATE(+$P(IBY,U,4)),?100,"Last Ver: ",$$DATE($P(IBY1,U,3)) S IBLN1="" . ; . I +$G(IBPRTIPC) S IBLN2="Policy Comment: " D I $Y>(IOSL-6) W ! D HEAD Q:IBQUIT .. I $P(IBY1,U,8)'="" W !,?5,IBLN1,?33,IBLN2,?51,$P(IBY1,U,8) S (IBLN1,IBLN2)="" . ; . I +$G(IBPRTIGC) S IBLN2="Group Comments: " D .. S IBJ=0 F S IBJ=$O(^IBA(355.3,+IBPLAN,11,IBJ)) Q:'IBJ D I $Y>(IOSL-6) W ! D HEAD Q:IBQUIT ... S IBY3=$G(^IBA(355.3,+IBPLAN,11,IBJ,0)) W !,?5,IBLN1,?33,IBLN2,?51,IBY3 S (IBLN1,IBLN2)="" . ; . I +$G(IBPRTICR) S IBLN2="Coverage Limits:" D .. S IBCVG=0 F S IBCVG=$O(^IBA(355.32,"B",IBPLAN,IBCVG)) Q:'IBCVG D I $Y>(IOSL-6) W ! D HEAD Q:IBQUIT ... S IBY3=$G(^IBA(355.32,IBCVG,0)) Q:IBY3="" ... S IBLN3=$E($P($G(^IBE(355.31,+$P(IBY3,U,2),0)),U,1),1,20)_" "_$$DDSET(355.32,.04,+$P(IBY3,U,4))_" "_$$DATE(+$P(IBY3,U,3)) ... S IBJ=0 F S IBJ=$O(^IBA(355.32,IBCVG,2,IBJ)) Q:'IBJ D I $Y>(IOSL-6) W ! D HEAD Q:IBQUIT .... W !,?5,IBLN1,?33,IBLN2,?51,IBLN3,?104,$G(^IBA(355.32,IBCVG,2,IBJ,0)) S (IBLN1,IBLN2,IBLN3)="" ... I IBLN3'="" W !,?5,IBLN1,?33,IBLN2,?51,IBLN3 S (IBLN1,IBLN2,IBLN3)="" . ; . I +$G(IBPRTICR) S IBLN2="Riders: " D .. S IBRIDE=0 F S IBRIDE=$O(^IBA(355.7,"APP",DFN,IBI,IBRIDE)) Q:'IBRIDE D I $Y>(IOSL-6) W ! D HEAD Q:IBQUIT ... W !,?5,IBLN1,?33,IBLN2,?51,$P($G(^IBE(355.6,+IBRIDE,0)),U,1) S (IBLN1,IBLN2)="" ; W ! Q ; DDSET(FILE,FLD,X) ; returns external value for a set N Y,Z,T S Z="",Y=$G(^DD(+$G(FILE),+$G(FLD),0)) S T=$G(X)_":",Z=$P($P(Y,T,2),";",1) Q Z