IBJDI5 ;ALB/CPM - INSURANCE POLICIES NOT VERIFIED ; 18-DEC-96 ;;2.0;INTEGRATED BILLING;**69,98,100,118,123**;21-MAR-94 ; EN ; - Option entry point. ; W !!,"This report provides a number of the insurance policies which were" W !,"entered into the system within a given timeframe, but were never verified.",! ; DATE D DATE^IBOUTL I IBBDT=""!(IBEDT="") G ENQ ; ; - Select a detailed or summary report. D DS^IBJD I IBRPT["^" G ENQ ; ; - Select print/not print verified policies/totals. S DIR(0)="YO" S DIR("A",1)="Do you want to print a "_$S(IBRPT="D":"separate report for",1:"total number of")_" policies that were verified" S DIR("A")=" over a year ago" S DIR("B")="NO" D ^DIR K DIR S IBVER=Y I IBVER["^" G ENQ ; I IBRPT="D" W !!,"You will need a 132 column printer for this report!" E W !!,"This report only requires an 80 column printer." ; W !!,"Note: This report may take a while to run." W !?6,"You should queue this report to run after normal business hours.",! ; ; - Select a device. S %ZIS="QM" D ^%ZIS G:POP ENQ I $D(IO("Q")) D G ENQ .S ZTRTN="DQ^IBJDI5",ZTDESC="IB - INSURANCE POLICIES NOT VERIFIED" .F I="IBBDT","IBEDT","IBRPT","IBVER" S ZTSAVE(I)="" .D ^%ZTLOAD .W !!,$S($D(ZTSK):"This job has been queued. The task number is "_ZTSK_".",1:"Unable to queue this job.") .K ZTSK,IO("Q") D HOME^%ZIS ; U IO ; DQ ; - Tasked entry point. ; I $G(IBXTRACT) D E^IBJDE(5,1) ; Change extract status. ; N IBQUERY K IB,^TMP("IBJDI51",$J),^TMP("IBJDI52",$J) S (IB("NOT"),IB("TOT"),IB("VER"),IBQ)=0 S:IBVER IB("VERO")=0 ; ; - Find inpatients treated within the user-specified date range. S IBD=IBBDT-.01 F S IBD=$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=$$STOP^IBOUTL("Insurance Policies Not Verified") Q:IBQ ..S IBPMD=$G(^DGPM(IBPM,0)) Q:'IBPMD ..S DFN=+$P(IBPMD,U,3) Q:'DFN ..; ..; - Process patient. ..I '$D(^TMP("IBJDI51",$J,DFN)) D PROC(DFN,"*",IBD) ; I IBQ G ENQ ; ; - Find outpatients treated within the user-specified date range. D CLOSE^IBSDU(.IBQUERY) D OUTPT^IBJDI21("",IBBDT,IBEDT,"S:IBQ SDSTOP=1 I 'IBQ,$$ENCHK^IBJDI5(Y0) D ENC^IBJDI5(Y0)","Insurance Policies Not Verified",.IBQ,"IBJDI51",.IBQUERY) D CLOSE^IBSDU(.IBQUERY) ; I IBQ G ENQ ; ; - Find data required for the report. S IBC=0 F S IBC=$O(^TMP("IBJDI51",$J,IBC)) Q:'IBC D Q:IBQ .I IBC#100=0 S IBQ=$$STOP^IBOUTL("Insurance Policies Not Verified") Q:IBQ .; .; - Get the patient's active insurance policies. .K IBINS S IBC1=$G(^TMP("IBJDI51",$J,IBC)) .D ALL^IBCNS1(IBC,"IBINS",1,+IBC1) Q:'$D(IBINS) .S IBC2=0 F S IBC2=$O(IBINS(IBC2)) Q:'IBC2 D ..; ..; - Make sure the insurance company reimburses VA. ..S IBC3=$G(^DIC(36,+$G(IBINS(IBC2,0)),0)) ..Q:$P(IBC3,U)="" Q:$P(IBC3,U,2)="N" ..; ..S IBCDFND=$G(IBINS(IBC2,1)) ..; ..S IB("TOT")=IB("TOT")+1 ; Count all. ..; ..; - Check if policy is verified, verified over a year, or neither. ..S IBVFLG=0 ..I $P(IBCDFND,U,3) D Q:'IBVFLG ...S IB("VER")=IB("VER")+1 Q:'IBVER ...S X1=DT,X2=$P(IBCDFND,U,3) D ^%DTC ...I X>365 S IB("VERO")=IB("VERO")+1,IBVFLG=1 ..E S IB("NOT")=IB("NOT")+1 ..; ..; - Build line for detailed report. ..I IBRPT="D" D ...S IBDOD=$S(+$G(^DPT(IBC,.35)):$$DAT2^IBOUTL(+$G(^(.35))\1),1:"") ...S X=$G(^DPT(IBC,0)),IBEBY=$P(IBCDFND,U,2) ...S IBVDTE=$S(IBVFLG:$P(IBCDFND,U,3),1:"") ...S IBVBY=$S(IBVFLG:$P(IBCDFND,U,4),1:"") ...S ^TMP("IBJDI52",$J,IBVFLG,$P(X,U)_$P(IBC1,U,2)_"@@"_$P(X,U,9)_"@@"_IBDOD_"@@"_IBC,IBC2)=$P(IBC3,U)_U_IBEBY_U_$S(+IBCDFND>0:+IBCDFND\1,1:"")_U_IBVBY_U_$S(+IBVDTE>0:IBVDTE\1,1:"") ; I IBQ G ENQ ; I $G(IBXTRACT) D E^IBJDE(5,0) G ENQ ; Extract summary data. ; ; - Print the reports. S (IBPAG,IBQ)=0 D NOW^%DTC S IBRUN=$$DAT2^IBOUTL(%) I IBRPT="D" D DET I 'IBQ D SUM ; I 'IBQ D PAUSE ; ENQ K ^TMP("IBJDI51",$J),^TMP("IBJDI52",$J) I $D(ZTQUEUED) S ZTREQ="@" G ENQ1 ; D ^%ZISC ENQ1 K IB,IBQ,IBBDT,IBEDT,IBRPT,IBD,IBDN,IBPH,IBPM,IBINS,IBPMD,IBPAG,IBRUN,% K IBEBY,IBVBY,IBVDTE,IBDOD,IBPER,IBC,IBC1,IBC2,IBC3,IBCDFN,IBVER,IBVFLG K IBCDFND,IBX,IBX1,IBX2,IBX3,DFN,POP,X,X1,X2,Y,ZTDESC,ZTRTN,ZTSAVE,%ZIS Q ; ENC(IBOED) ; - Encounter extract for outpatient loop. ; Input: IBOED = Outpatient encounter in file #409.68 ; D PROC(+$P(IBOED,U,2),"",+IBOED) ; Process patient. Q ; PROC(DFN,IBIPC,IBDTE) ; - Process each specific patient. ; Input: DFN = Pointer to the patient in file #2 ; IBIPC = Inpatient treatment marker ; ("*"=Had inpat. treatment, null=No inpat. treatment) ; IBDTE = Patient's checkout or discharge date ; I $$TESTP^IBJDI1(DFN) Q ; Test patient. D ELIG^VADPT I 'VAEL(4) G PRCQ ; Patient is not a vet. ; ; - Set patient index. S ^TMP("IBJDI51",$J,DFN)=IBDTE\1_U_IBIPC ; PRCQ K VA,VAERR,VAEL Q ; ENCHK(IBOED) ; - Check outpatient's encounter record. ; Input: IBOED = Outpatient encounter in file #409.68 ; Output: 1 = OK for processing ; 0 = Not OK for processing ; N X,X1 S Y=0 I '$G(IBOED) G ENCKQ ; ; - Check if encounter was a registration/cancellation without exam. S X=+$P(IBOED,U,2) S X1=+$P($G(^DPT(X,"DIS",+$O(^DPT("ADIS",+IBOED,X,0)),0)),U,7) I $D(^DIC(37,"B","CANCEL WITHOUT EXAM",X1)) G ENCKQ I $D(^DIC(37,"B","NO CARE OR TREATMENT REQUIRED",X1)) G ENCKQ ; I "^1^4^7^"[("^"_+$P(IBOED,U,10)_"^") G ENCKQ ; C&P/collat/emply visit. I $P(IBOED,U,12)'=2 G ENCKQ ; Not checked out. ; S Y=1 ENCKQ Q Y ; DET ; - Print the detailed report. I '$D(^TMP("IBJDI52",$J,0)) S IBX=0 D HDET W !,"All policies within the selected date range have been verified." D PAUSE S IBX="" F S IBX=$O(^TMP("IBJDI52",$J,IBX)) Q:IBX="" D Q:IBQ .D HDET Q:IBQ .S IBX1="" F S IBX1=$O(^TMP("IBJDI52",$J,IBX,IBX1)) Q:IBX1="" D Q:IBQ ..I $Y>(IOSL-4) D PAUSE Q:IBQ D HDET Q:IBQ ..W $P(IBX1,"@@"),?33,$$SSN($P(IBX1,"@@",2)),?47,$P(IBX1,"@@",3) ..S IBX2=0 F S IBX2=$O(^TMP("IBJDI52",$J,IBX,IBX1,IBX2)) Q:'IBX2 S IBX3=^(IBX2) D ...I $Y>(IOSL-4) D PAUSE Q:IBQ D HDET Q:IBQ ...W ?62,$P(IBX3,U),?94,$E($P($G(^VA(200,+$P(IBX3,U,2),0)),U),1,24) ...W ?120,$$DAT2^IBOUTL($P(IBX3,U,3)),! ...I IBX W ?94,$E($P($G(^VA(200,+$P(IBX3,U,4),0)),U),1,24),?120,$$DAT2^IBOUTL($P(IBX3,U,5)),! .; .I 'IBQ D PAUSE ; I '$D(^TMP("IBJDI52",$J,1)),IBVER S IBX=1 D HDET W !,"All policies within the selected date range have been verified less than a year ago." D PAUSE Q ; HDET ; - Write the detail report header. I $E(IOST,1,2)="C-"!(IBPAG) W @IOF,*13 S IBPAG=IBPAG+1 W !,"Insurance Policies ",$S(IBX:"Verified Over a Year Ago",1:"Not Verified"),?80,"Run Date: ",IBRUN,?123,"Page: ",IBPAG W !,"For Patients treated for the period "_$$DAT1^IBOUTL(IBBDT)_" to "_$$DAT1^IBOUTL(IBEDT)_" ('*' = Had inpatient care)" I IBX W !?94,"Policy Entered By Date Entered" W !,"Patient",?33,"SSN",?47,"Date of Death" W ?62,"Insurance Company",?94,"Policy ",$S(IBX:"Verified",1:"Entered")," By",?120,"Date ",$S(IBX:"Verif'd",1:"Entered") W !,$$DASH(132),!! S IBQ=$$STOP^IBOUTL("Insurance Policies Not Verified") Q ; SUM ; - Print the summary report. I $E(IOST,1,2)="C-"!(IBPAG) W @IOF,*13 S IBPAG=IBPAG+1 W !!?$S(IBVER:14,1:24),"INSURANCE POLICIES NOT VERIFIED",$S(IBVER:"/VERIFIED OVER 1 YEAR",1:"") W !?32,"SUMMARY REPORT",!!?17,"For Patients treated from ",$$DAT1^IBOUTL(IBBDT)," - ",$$DAT1^IBOUTL(IBEDT) W !!?24,"Run Date: ",IBRUN,!?24,$$DASH(31),!! ; S IBPER=$S('IB("TOT"):0,1:$J(IB("VER")/IB("TOT")*100,0,2)) W ?24,"Number of Patients Treated:",?53,$J(IB("TOT"),5) W !?23,"Number of Policies Verified:",?53,$J(IB("VER"),5),?62,"(",IBPER,"%)" I IBVER W !?7,"Number of Policies Verified Over a Year Ago:",?53,$J(IB("VERO"),5),?62,"(",$S('IB("VERO"):0,1:$J(IB("VERO")/IB("TOT")*100,0,2)),"%)" W !?19,"Number of Policies Not Verified:",?53,$J(IB("NOT"),5),?62,"(",$S('IB("TOT"):0,1:$J(100-IBPER,0,2)),"%)" Q ; DASH(X) ; - Return a dashed line. Q $TR($J("",X)," ","=") ; 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:"")