IBEFUR ;ALB/ARH - UTILITY: FIND RELATED FIRST AND THIRD PARTY BILLS ; 3/7/00 ;;2.0;INTEGRATED BILLING;**130**;21-MAR-94 ;;Per VHA Directive 10-93-142, this routine should not be modified. ; ; Called by Accounts Receivable report option ; ; for a specific Third Party bill, return all related Third Party bills ; matchs with the selected bill are based on: (selected bill is included in list returned) ; 1) Event Date (399,.03), returns all bills with same Event Date ; ; 2) PTF # (399,.08), returns all bills with the same PTF number ; 3) PTF # (399,.08), returns all bills with Outpatient Visit Dates (399,43) within the admission date range ; ; 4) Opt Visit Dates (399,43), returns all bills with one or more matching Opt Visit Dates ; 5) Opt Visit Dates (399,43), returns all bills for any PTF (399,.08) stay covering any of the Opt Visit Dates ; ; 6) Prescriptions (362.4): returns all bills with one or more matching Rx # and fill date ; ; ^TMP("IBRBT", $J, selected bill ifn) = PATIENT HAS ANY RX COVERAGE ON FROM DATE OF BILL (0/1) ; ^TMP("IBRBT", $J, selected bill ifn, matching bill ifn) = ; BILL FROM ^ BILL TO ^ CANCELLED (0/1) ^ AR BILL NUMBER ^ ; PAYER SEQUENCE ^ PAYER IS MEDICARE SUPPLEMENTAL (0/1) ^ PAYER NAME ; TPTP(IBIFN) ; given a specific Third Party bill, find all related Third Party Bills N IB0,DFN,IBEVDT,IBPTF,IBADM,IBDIS,IBOPV,IBPTF1,IBXRF,IBRXN,IBRXDT,IBX Q:'$G(IBIFN) S IB0=$G(^DGCR(399,+IBIFN,0)) Q:IB0="" S DFN=$P(IB0,U,2),IBEVDT=$P(IB0,U,3),IBPTF=$P(IB0,U,8) ; K ^TMP("IBRBT",$J,IBIFN) S IBX=$$LN1^IBEFURT(IBIFN) D SAVELN1^IBEFURT(IBIFN,IBX) ; I +IBEVDT D TPEVDT^IBEFURT(DFN,IBEVDT,IBIFN) ; find all bills with the same Event Date (399,.03) ; IT I +IBPTF D TPPTF^IBEFURT(IBPTF,IBIFN) ; find all bills with the same PTF number (399,.08) ; ; find any bills with Outpatient Visit Dates within the date range of the admission (PTF) I +IBPTF S IBADM=$P($G(^DGPT(+IBPTF,0)),U,2),IBDIS=+$G(^DGPT(+IBPTF,70)) S:'IBDIS IBDIS=DT D . D TPOPV^IBEFURT(DFN,IBADM,IBDIS,IBIFN) ; OT ; find all bills that have one or more of the same Opt Visit Dates (399,43) S IBX=0 F S IBX=$O(^DGCR(399,+IBIFN,"OP",IBX)) Q:'IBX S IBOPV=+$G(^DGCR(399,+IBIFN,"OP",IBX,0)) D . D TPOPV^IBEFURT(DFN,IBOPV,IBOPV,IBIFN) ; ; find any bills for inpatient admissions whose date range includes one or more of the Opt Visit Dates S IBX=0 F S IBX=$O(^DGCR(399,+IBIFN,"OP",IBX)) Q:'IBX S IBOPV=+$G(^DGCR(399,+IBIFN,"OP",IBX,0)) D . S IBADM=$$ADM^IBCU64(DFN,IBOPV) I +IBADM S IBPTF1=$P(IBADM,U,4) I +IBPTF1 D .. D TPPTF^IBEFURT(IBPTF1,IBIFN) ; RT ; find all bills that have one or more of the same Prescription: same Rx number and fill date (362.4,.01,.03) S IBXRF="AIFN"_IBIFN,IBRXN="" F S IBRXN=$O(^IBA(362.4,IBXRF,IBRXN)) Q:'IBRXN D . S IBX=0 F S IBX=$O(^IBA(362.4,IBXRF,IBRXN,IBX)) Q:'IBX S IBRXDT=$P($G(^IBA(362.4,IBX,0)),U,3) D .. D TPRX^IBEFURT(DFN,IBRXN,IBRXDT,IBIFN) Q ; ; ============================================================================================================== ; ; Called by Accounts Receivable report option ; ; for a specific Third Party bill, return all related First Party Charges ; only a single record of a charge event is returned, defining the charges current status, although there may ; have been cancellations or updates to the original charge ; o Inpatient Events may have multiple charge events (Copay and Per Diem) ; o Opt and Rx Events have only a single charge event (Copay) ; ; matchs with the selected bill are based on: ; 1) Event Date (399,.03), returns Inpatient charges whose Parent Event (350,.16) has that Event Date (350,.17) ; 2) PTF # (399,.08), returns Outpatient charge for Opt Visits Dates within timeframe of admission ; ; 3) Opt Visit Date (399,43), returns the Outpatient charge for that Event Date (350,.17) ; 4) Opt Visit Date (399,43), returns Inpatient charges for any admission that includes that Opt Visit Date ; ; 5) Rx Record (362.4,.05) and Rx Date (362.4,.03) and Outpatient Pharmacy, returns the Rx charge for the fill ; 6) Opt Visit Date (399,43) and Outpatient Pharmacy, returns any First Party Rx charge on one of the ; selected bills Opt Visit Dates that is not billed on any Third Party bill ; ; ^TMP("IBRBF", $J , selected bill ifn ) = "" ; ^TMP("IBRBF", $J , selected bill ifn , charge ifn) = ; BILL FROM ^ BILL TO ^ CANCELLED? (1/0)^ AR BILL NUMBER ^ TOTAL CHARGE ^ ACTION TYPE (SHORT) ^ # DAYS ON HOLD ; TPFP(IBIFN) ; given a specific Third Party Bill, find all related First Party Bills N IBX,IBY,IB0,DFN,IBEVDT,IBPTF,IBADM,IBOPV,IBXRF,IBRXN,IBRXIFN,IBRXDT,IBFROM,IBTO Q:'$G(IBIFN) S IB0=$G(^DGCR(399,+IBIFN,0)) Q:IB0="" S DFN=$P(IB0,U,2),IBEVDT=$P(IB0,U,3) ; K ^TMP("IBRBF",$J,IBIFN) D SAVELN1^IBEFURF(IBIFN) ; IF ; find all First Party charges for the Inpatient Event Date (Admission Date) on the Third Party bill D FPINPT^IBEFURF(DFN,IBEVDT,IBIFN) ; ; find any First Party Outpatient charges for Visit Dates within the date range of the admission (PTF) S IBPTF=$P(IB0,U,8) I +IBPTF S IBADM=$$PTFADM^IBCU64(+IBPTF) I +IBADM S IBADM=$$AD^IBCU64(IBADM) D . S IBX=$P(IBADM,U,2)\1 I 'IBX S IBX=DT . D FPOPV^IBEFURF(DFN,+IBADM\1,IBX,IBIFN) ; OF ; find First Party charges for the Opt Visit Dates on the Third Party Bill S IBX=0 F S IBX=$O(^DGCR(399,+IBIFN,"OP",IBX)) Q:'IBX S IBOPV=+$G(^DGCR(399,+IBIFN,"OP",IBX,0)) D . D FPOPV^IBEFURF(DFN,IBOPV,IBOPV,IBIFN) ; ; find any charges for inpatient admissions whose date range includes one or more of the Opt Visit Dates S IBX=0 F S IBX=$O(^DGCR(399,+IBIFN,"OP",IBX)) Q:'IBX S IBOPV=+$G(^DGCR(399,+IBIFN,"OP",IBX,0)) D . S IBADM=$$ADM^IBCU64(DFN,IBOPV) I 'IBADM Q . D FPINPT^IBEFURF(DFN,+IBADM,IBIFN) ; RF ; find First Party charges for any Rx's on the selected Third Party bill ; based on Rx IFN (52) and fill date (362.4,.05,.03) S IBXRF="AIFN"_IBIFN,IBRXN="" F S IBRXN=$O(^IBA(362.4,IBXRF,IBRXN)) Q:'IBRXN D . S IBX=0 F S IBX=$O(^IBA(362.4,IBXRF,IBRXN,IBX)) Q:'IBX D .. S IBY=$G(^IBA(362.4,IBX,0)),IBRXIFN=$P(IBY,U,5),IBRXDT=$P(IBY,U,3) Q:'IBRXIFN .. D FPRX^IBEFURF(IBRXIFN,IBRXDT,IBIFN) ; ; find First Party Charges for any RX filled on one of the Third Party bill's Opt Visit Dates ; that is not billed on any Third Party bill S IBFROM=$G(^DGCR(399,IBIFN,"U")),IBTO=$P(IBFROM,U,2),IBFROM=+IBFROM K IBX D RXDISP^IBCSC5C(DFN,IBFROM,IBTO,.IBX,"","",1,1) ; get all Rx's for patient in date range S IBRXN="" F S IBRXN=$O(IBX(IBRXN)) Q:IBRXN="" S IBRXDT=0 F S IBRXDT=$O(IBX(IBRXN,IBRXDT)) Q:'IBRXDT D . I '$D(^DGCR(399,"AOPV",DFN,IBRXDT,IBIFN)) Q ; rx not on bills opt visit date . I +$$RXTP^IBEFURT(DFN,IBRXN,IBRXDT) Q ; rx billed on a third party bill . S IBRXIFN=$P(IBX(IBRXN,IBRXDT),U,1) . D FPRX^IBEFURF(IBRXIFN,IBRXDT,IBIFN) Q