IBJDI41 ;ALB/CPM - PATIENTS WITH UNIDENTIFIED INSURANCE (CONT'D) ; 17-DEC-96 ;;2.0;INTEGRATED BILLING;**98,100,118**;21-MAR-94 ; EN ; - Entry point from IBJDI4. ; ; - Find inpatients treated within the user-specified date range. S IBD=IBBDT-.01 F S IBD=$O(^DGPM("ATT3",IBD)) Q:'IBD!(IBD\1>IBEDT) D Q:IBQ .S IBPM=0 F S IBPM=$O(^DGPM("ATT3",IBD,IBPM)) Q:'IBPM D Q:IBQ ..I IBPM#100=0 S IBQ=$$STOP^IBOUTL("Patients with Unidentified Insurance Report") Q:IBQ ..S IBPMD=$G(^DGPM(IBPM,0)) I 'IBPMD Q ..I IBSORT S IBDIV=$$DIV^IBJDI21(1,+$P(IBPMD,U,6)) Q:'$D(IB(IBDIV)) ..S DFN=+$P(IBPMD,U,3) Q:'DFN ..; ..; - Process patient. ..I '$D(^TMP("IBJDI41",$J,DFN)) D PROC(DFN,IBD\1,"*") ; I IBQ G ENQ ; ; - Find outpatients treated within the user-specified date range. D CLOSE^IBSDU(.IBQUERY) D OUTPT^IBJDI21("",IBBDT,IBEDT,"S:IBQ SDSTOP=1 I 'IBQ,$$ENCHK^IBJDI5(Y0) D ENC^IBJDI41(Y0)","Patients with Unidentified Insurance Report",.IBQ,"IBJDI41",.IBQUERY) D CLOSE^IBSDU(.IBQUERY) ; I IBQ G ENQ ; I IBRPT'="D" G PRT ; ; - Find data required for the report. S DFN=0 F S DFN=$O(^TMP("IBJDI41",$J,DFN)) Q:'DFN S IBX=^(DFN) D Q:IBQ .I IBSEL=0,$P(IBX,U,4)'="*" Q .I DFN#100=0 S IBQ=$$STOP^IBOUTL("Patients with Unidentified Insurance Report") Q:IBQ .; .; - Set patient eligibilities for report. .D ELIG^VADPT S IBELIG=+$G(VAEL(1))_";" .I +IBELIG>0 S X=0 F S X=$O(VAEL(1,X)) Q:'X S IBELIG=IBELIG_X_";" .; .; - Set up detailed information to appear on the report. .S IBDN=$G(^DPT(DFN,0)),IBPAT=$P(IBDN,U)_$P(IBX,U,2) .S IBPH=$P($G(^DPT(DFN,.13)),U,1,2),IBSEL1=$P(IBX,U,3) .S IBDOD=$S(+$G(^DPT(DFN,.35)):$$DAT1^IBOUTL(+$G(^(.35))\1),1:"") .F X=1:1 S X1=$P(IBSEL1,",",X) Q:X1="" D ..S ^TMP("IBJDI42",$J,$P(IBX,U),X1,IBPAT_"@@"_DFN)=$P(IBDN,U,9)_U_$P(IBPH,U)_U_$P(IBPH,U,2)_U_$S(+IBELIG>0:IBELIG,1:"")_U_$P(IBX,U,4)_U_IBDOD_U_$S(IBRMK:$P(IBDN,U,10),1:"") .; .K VA,VAEL,VAERR ; I IBQ G ENQ ; PRT ; - Print the reports. ; ; - Extract summary data. I $G(IBXTRACT) D G ENQ .F X="BILL","DEC","HMO","IND","MEDC","MEDG","NO","NULL","TOT","UNK","YES" S IB(X)=$G(IB("ALL",X)) .D E^IBJDE(4,0) ; S IBQ=0 D NOW^%DTC S IBRUN=$$DAT2^IBOUTL(%) S IBDIV="" F S IBDIV=$O(IB(IBDIV)) Q:IBDIV="" D Q:IBQ .I IBRPT="D" D DET .I 'IBQ D SUM,PAUSE ; ENQ Q ; ENC(IBOED) ; - Encounter extract for all patients loop. ; Input: IBOED = Outpatient encounter in file #409.68 ; Pre-set variables IB array, IBSORT also required. ; I IBSORT S IBDIV=$$DIV^IBJDI21(0,+$P(IBOED,U,11)) Q:'$D(IB(IBDIV)) D PROC(+$P(IBOED,U,2),+IBOED\1,"") ; Process patient. Q ; PROC(DFN,IBINDT,IBIPC) ; - Process each specific patient. ; Input: DFN = Pointer to the patient in file #2 ; IBINDT = Encounter or discharge date ; IBIPC = Inpatient treatment marker ; ("*"=Had inpat. treatment, null=No inpat. treatment) ; ; Pre-set variables IB array, IBDIV, IBRPT, IBSEL also required. ; I $$TESTP^IBJDI1(DFN) Q ; Test patient. D ELIG^VADPT I 'VAEL(4) G PRCQ ; Patient is not a vet. ; ; - Find 'Covered by Insurance' indicator and set flags. S IBINSC="",IBSEL1=$S(IBSEL=0:"0,",1:""),IBX=$P($G(^DPT(DFN,.31)),U,11) I IBX="Y"!(IBX="N") D .I IBX="Y" D ..S IB(IBDIV,"YES")=IB(IBDIV,"YES")+1 S:IBSEL[1 IBSEL1=IBSEL1_"1," .E S IB(IBDIV,"NO")=IB(IBDIV,"NO")+1 S:IBSEL[7 IBSEL1=IBSEL1_"7," .; .S (IBOUTP,IBWNR)=1 D ^IBCNS Q:'IBINS F X=0:1:4 S IBFL(X)=0 .S X=0 F S X=$O(IBDD(X)) Q:'X D ..I IBRPT="D",IBSEL'=0 S IBINSC=IBINSC_X_";" ..I $P($G(^DIC(36,X,0)),U,2)'="N",'IBFL(0) D ...S IB(IBDIV,"BILL")=IB(IBDIV,"BILL")+1,IBFL(0)=1 ...I IBSEL[2 S IBSEL1=IBSEL1_"2," ..S IBTYP=$$TYPE^IBJDI4(IBDD(X)) ..I IBTYP=1,'IBFL(1) D ...S IB(IBDIV,"HMO")=IB(IBDIV,"HMO")+1,IBFL(1)=1 ...I IBSEL[3 S IBSEL1=IBSEL1_"3," ..I IBTYP=2,'IBFL(2) D ...S IB(IBDIV,"MEDC")=IB(IBDIV,"MEDC")+1,IBFL(2)=1 ...I IBSEL[4 S IBSEL1=IBSEL1_"4," ..I IBTYP=3,'IBFL(3) D ...S IB(IBDIV,"MEDG")=IB(IBDIV,"MEDG")+1,IBFL(3)=1 ...I IBSEL[5 S IBSEL1=IBSEL1_"5," ..I IBTYP=4,'IBFL(4) D ...S IB(IBDIV,"IND")=IB(IBDIV,"IND")+1,IBFL(4)=1 ...I IBSEL[6 S IBSEL1=IBSEL1_"6," I IBX="U" D .S IB(IBDIV,"UNK")=IB(IBDIV,"UNK")+1 S:IBSEL[8 IBSEL1=IBSEL1_"8," I IBX="" D .S IB(IBDIV,"NULL")=IB(IBDIV,"NULL")+1 S:IBSEL[9 IBSEL1=IBSEL1_"9," I IBRPT="D",IBSEL=0,(IBX="U"!(IBX="")) S IBINSC="*" ; ; - Set patient index and 'total patients' accumulator. S ^TMP("IBJDI41",$J,DFN)=IBDIV_U_$S(IBRPT="D":IBIPC_U_IBSEL1_U_IBINSC,1:"") S IB(IBDIV,"TOT")=IB(IBDIV,"TOT")+1 I +$G(^DPT(DFN,.35)) S IB(IBDIV,"DEC")=IB(IBDIV,"DEC")+1 ; Deceased. ; PRCQ K IBDD,IBFL,IBINS,IBINSC,IBOUTP,IBTYP,IBWNR,IBX,VA,VAERR,VAEL,X Q ; DIV(X) ; - Return division name. S Y=$P($G(^DG(40.8,X,0)),U) I Y="" S Y=0 Q Y ; DET ; - Print the detailed report. I IBSEL=0,'$D(^TMP("IBJDI42",$J,IBDIV,0)) S IBX=0 D HDET W !!,"There were no ",$$TITLE^IBJDI4(0)," during this period." G DETQ I IBSEL'=0 F X=1:1 S IBX=$P(IBSEL,",",X) Q:IBX="" D .I '$D(^TMP("IBJDI42",$J,IBDIV,IBX)) S IBPAG=0 D HDET W !!,"There were no ",$$TITLE^IBJDI4(IBX)," during this period." ; S IBX="" F S IBX=$O(^TMP("IBJDI42",$J,IBDIV,IBX)) Q:IBX="" D Q:IBQ .S IBPAG=0 D HDET Q:IBQ .S IBX1="" F S IBX1=$O(^TMP("IBJDI42",$J,IBDIV,IBX,IBX1)) Q:IBX1="" S IBX2=^(IBX1) D Q:IBQ ..I $Y>(IOSL-3) D PAUSE Q:IBQ D HDET Q:IBQ ..W $P(IBX1,"@@"),?27,$$SSN($P(IBX2,U)),?41,$E($P(IBX2,U,2),1,15),?58,$P(IBX2,U,3) ..S IBELIG=$P(IBX2,U,4) W ?80,$$ELIG(+IBELIG) ..S IBINSC=$P(IBX2,U,5) W ?102,$$INSC(+IBINSC),?124,$P(IBX2,U,6),! ..I IBRMK,$P(IBX2,U,7)]"" W ?2,"Remarks: ",$P(IBX2,U,7) ..I '$P(IBELIG,";",2),'$P(IBINSC,";",2),$P(IBX2,U,7)]"" W ! Q ..F X=2:1 Q:'$P(IBELIG,";",X)&('$P(IBINSC,";",X)) D ...W ?80,$$ELIG($P(IBELIG,";",X)),?102,$$INSC($P(IBINSC,";",X)),! ; DETQ I 'IBQ D PAUSE Q ; HDET ; - Write the detail report header. W @IOF,*13 S IBPAG=$G(IBPAG)+1 W !,$$TITLE^IBJDI4(IBX),$S(IBDIV'="ALL":" for "_IBDIV,1:""),?80,"Run Date: ",IBRUN,?123,"Page: ",IBPAG W !,"Patients treated in the period "_$$DAT1^IBOUTL(IBBDT)_" to "_$$DAT1^IBOUTL(IBEDT)," NOTE: *=Had inpatient care, +=Billable insurance" W !!?45,"Home",?62,"Work",?124,"Date of" W !,"Patient",?27,"SSN",?41,"Phone Number",?58,"Phone Number",?80,"Eligibility",?102,"Insurance",?125,"Death" W !,$$DASH(132),!! S IBQ=$$STOP^IBOUTL("Patients with Unidentified Insurance Report") Q ; SUM ; - Print the summary report. W @IOF,*13 S IBPAG=$G(IBPAG)+1 W !!?26,"PATIENT INSURANCE STATISTICS",! I IBDIV'="ALL" W ?(61-$L(IBDIV))\2,"SUMMARY REPORT for ",IBDIV E W ?33,"SUMMARY REPORT" W !!?19,"Patients treated from ",$$DAT1^IBOUTL(IBBDT)," - ",$$DAT1^IBOUTL(IBEDT) W !!?24,"Run Date: ",IBRUN,!?20,$$DASH(40),!! ; S IBPER(1)=$J($S('IB(IBDIV,"TOT"):0,1:IB(IBDIV,"YES")/IB(IBDIV,"TOT")*100),0,2) S IBPER(2)=$J($S('IB(IBDIV,"TOT"):0,1:IB(IBDIV,"BILL")/IB(IBDIV,"TOT")*100),0,2) S IBPER(3)=$J($S('IB(IBDIV,"YES"):0,1:IB(IBDIV,"BILL")/IB(IBDIV,"YES")*100),0,2) S IBPER(4)=$J($S('IB(IBDIV,"TOT"):0,1:IB(IBDIV,"HMO")/IB(IBDIV,"TOT")*100),0,2) S IBPER(5)=$J($S('IB(IBDIV,"YES"):0,1:IB(IBDIV,"HMO")/IB(IBDIV,"YES")*100),0,2) S IBPER(6)=$J($S('IB(IBDIV,"BILL"):0,1:IB(IBDIV,"HMO")/IB(IBDIV,"BILL")*100),0,2) S IBPER(7)=$J($S('IB(IBDIV,"TOT"):0,1:IB(IBDIV,"MEDC")/IB(IBDIV,"TOT")*100),0,2) S IBPER(8)=$J($S('IB(IBDIV,"YES"):0,1:IB(IBDIV,"MEDC")/IB(IBDIV,"YES")*100),0,2) S IBPER(9)=$J($S('IB(IBDIV,"TOT"):0,1:IB(IBDIV,"MEDG")/IB(IBDIV,"TOT")*100),0,2) S IBPER(10)=$J($S('IB(IBDIV,"YES"):0,1:IB(IBDIV,"MEDG")/IB(IBDIV,"YES")*100),0,2) S IBPER(11)=$J($S('IB(IBDIV,"BILL"):0,1:IB(IBDIV,"MEDG")/IB(IBDIV,"BILL")*100),0,2) S IBPER(12)=$J($S('IB(IBDIV,"TOT"):0,1:IB(IBDIV,"IND")/IB(IBDIV,"TOT")*100),0,2) S IBPER(13)=$J($S('IB(IBDIV,"TOT"):0,1:IB(IBDIV,"NO")/IB(IBDIV,"TOT")*100),0,2) S IBPER(14)=$J($S('IB(IBDIV,"TOT"):0,1:IB(IBDIV,"UNK")/IB(IBDIV,"TOT")*100),0,2) S IBPER(15)=$J($S('IB(IBDIV,"TOT"):0,1:IB(IBDIV,"NULL")/IB(IBDIV,"TOT")*100),0,2) S IBPER(16)=$J($S('IB(IBDIV,"TOT"):0,1:IB(IBDIV,"DEC")/IB(IBDIV,"TOT")*100),0,2) W ?22,"Number of Patients Treated:",?50,$J(IB(IBDIV,"TOT"),5) W !?9,"Number of Patients Covered by Insurance:",?50,$J(IB(IBDIV,"YES"),5)," (",IBPER(1),"%)" W !?3,"No. of Patients Covered by Billable Insurance:",?50,$J(IB(IBDIV,"BILL"),5)," (",IBPER(2),"%-",IBPER(3),"%)*" W !?12,"Number of Patients Covered by an HMO:",?50,$J(IB(IBDIV,"HMO"),5)," (",IBPER(4),"%-",IBPER(5),"%-",IBPER(6),"%)**" W !?10,"Number of Patients Covered by Medicare:",?50,$J(IB(IBDIV,"MEDC"),5)," (",IBPER(7),"%-",IBPER(8),"%)*" W !?11,"Number of Patients Covered by Medigap:",?50,$J(IB(IBDIV,"MEDG"),5)," (",IBPER(9),"%-",IBPER(10),"%-",IBPER(11),"%)**" W !?2,"No. of Patients Covered by an Indemnity Policy:",?50,$J(IB(IBDIV,"IND"),5)," (",IBPER(12),"%)" W !?5,"Number of Patients Not Covered by Insurance:",?50,$J(IB(IBDIV,"NO"),5)," (",IBPER(13),"%)" W !?7,"Number of Patients with Unknown Insurance:",?50,$J(IB(IBDIV,"UNK"),5)," (",IBPER(14),"%)" W !," No. of Patients w/Insurance Question Unanswered:",?50,$J(IB(IBDIV,"NULL"),5)," (",IBPER(15),"%)" W !?21,"Number of Deceased Patients:",?50,$J(IB(IBDIV,"DEC"),5)," (",IBPER(16),"%)" W !!," *(% from patients treated-% from patients with insurance)" W !,"**(% from patients treated-% from patients w/ins-% from patients w/billable ins)" Q ; DASH(X) ; - Return a dashed line. Q $TR($J("",X)," ","=") ; ELIG(X) ; - Return eligibility code name. Q $E($P($G(^DIC(8,+X,0)),U),1,20) ; INSC(X) ; - Return insurance company. S X=$G(^DIC(36,+X,0)) Q $E($P(X,U),1,20)_$S($P(X,U,2)["Y"!($P(X,U,2)["*"):"+",1:"") ; PAUSE ; - Page break. I $E(IOST,1,2)'="C-" Q N IBX,DIR,DIRUT,DUOUT,DTOUT,DIROUT,X,Y F IBX=$Y:1:(IOSL-3) W ! S DIR(0)="E" D ^DIR I $D(DIRUT)!($D(DUOUT)) S IBQ=1 Q ; SSN(X) ; - Format the SSN. Q $S(X]"":$E(X,1,3)_"-"_$E(X,4,5)_"-"_$E(X,6,10),1:"")