IBJDI6 ;ALB/CPM - SC VETS W/ NSC EPISODES OF INPT CARE ; 18-DEC-96 ;;2.0;INTEGRATED BILLING;**69,83,98,100**;21-MAR-94 ; EN ; - Option entry point. ; W !!,"This report provides a number of the NSC inpatient episodes for SC veterans" W !,"which have and have not been billed.",! ; DATE D DATE^IBOUTL I IBBDT=""!(IBEDT="") G ENQ ; ; - Select a detailed or summary report. D DS^IBJD I IBRPT["^" G ENQ ; 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 $D(IO("Q")) D G ENQ .S ZTRTN="DQ^IBJDI6",ZTDESC="IB - SC VETS W/ NSC EPISODES" .F I="IBBDT","IBEDT","IBRPT" S ZTSAVE(I)="" .D ^%ZTLOAD .W !!,$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 $G(IBXTRACT) D E^IBJDE(6,1) ; Change extract status. ; K IB,^TMP("IBJDI6",$J) S IBQ=0 F X="NSC","NSCB","NSCR","NSCU","SC","TOT" S IB(X)=0 F X=0:1:3 S IB("NSCU",X)=0 ; ; - Find data required for the report. 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=$$STOP^IBOUTL("SC Vets w/NSC Episodes") Q:IBQ ..S IBPMD=$G(^DGPM(IBPM,0)) Q:'IBPMD ..S DFN=+$P(IBPMD,U,3) Q:'DFN ..I $$TESTP^IBJDI1(DFN) Q ; Test patient. ..S IBDIS=+IBPMD\1 ..; ..; - Patient must be insured, and SC. ..I '$$INSURED^IBCNS1(DFN,IBDIS) Q ..D ELIG^VADPT Q:'VAEL(3) ..; ..; - Set 'totals' accumulator. ..S IB("TOT")=IB("TOT")+1 ..; ..; - See if associated PTF record has NSC movements. ..S IBADMD=$G(^DGPM(+$P(IBPMD,U,14),0)) ..S IBPTF=+$P(IBADMD,U,16),IBSTAT=$P($G(^DGPT(IBPTF,0)),U,6) ..I '$$PTF(IBPTF) S IB("SC")=IB("SC")+1 Q ..S IB("NSC")=IB("NSC")+1 ..; ..; - See if there is a claim for the NSC episode. ..S IBADM=+IBADMD\1 ..I $$BILL(IBPTF,DFN,IBADM,IBDIS) S IB("NSCB")=IB("NSCB")+1 Q ..; ..; - Has episode been flagged as non-billable? ..S IBCT=$O(^IBT(356,"AD",+$P(IBPMD,U,14),0)) ..I IBCT,$P($G(^IBT(356,IBCT,0)),U,19) S IB("NSCR")=IB("NSCR")+1 Q ..; ..S IB("NSCU")=IB("NSCU")+1 ..S IB("NSCU",IBSTAT)=IB("NSCU",IBSTAT)+1 ..I IBRPT="D" D ...S X=$G(^DPT(DFN,0)) ...S ^TMP("IBJDI6",$J,$P(X,U)_"@@"_DFN)=$P(X,U,9) ...S ^TMP("IBJDI6",$J,$P(X,U)_"@@"_DFN,IBADM)=$S(IBSTAT=0:"OPEN",IBSTAT=1:"CLOSED",IBSTAT=2:"RELEASED",1:"TRANSMITTED")_U_IBDIS ; I IBQ G ENQ ; I $G(IBXTRACT) D E^IBJDE(6,0) G ENQ ; Extract summary data. ; ; - Print the reports. S (IBPAG,IBQ)=0 D NOW^%DTC S IBRUN=$$DAT2^IBOUTL(%) I IBRPT="D" D DET I 'IBQ D SUM ; I 'IBQ D PAUSE ; ENQ K ^TMP("IBJDI6",$J) I $D(ZTQUEUED) S ZTREQ="@" G ENQ1 ; D ^%ZISC ENQ1 K IB,IBQ,IBBDT,IBEDT,IBRPT,IBD,IBDN,IBPAG,IBRUN,IBX,IBX1,IBX2 K IBADM,IBDIS,IBCT,IBH,IBPER,IBPM,IBPMD,IBPMDT,IBPTF,IBSTAT,IBADMD K %,%ZIS,DFN,POP,VA,VAERR,VAEL,X,Y,ZTDESC,ZTRTN,ZTSAVE Q ; DET ; - Print the detailed report. D HDET Q:IBQ I '$D(^TMP("IBJDI6",$J)) D G DETQ .I IB("NSC") W !!,"All NSC episodes for SC veterans in the selected date range have been billed." Q .W !!,"There were no NSC episodes found in the selected date range." ; S IBX="" F S IBX=$O(^TMP("IBJDI6",$J,IBX)) Q:IBX="" S IBX1=^(IBX) D Q:IBQ .S (IBH,IBADM)=0 F S IBADM=$O(^TMP("IBJDI6",$J,IBX,IBADM)) Q:'IBADM S IBX2=^(IBADM) D Q:IBQ ..I $Y>(IOSL-2) D PAUSE Q:IBQ D HDET Q:IBQ S IBH=0 ..W ! I 'IBH D PAT S IBH=1 ..W ?46,$P(IBX2,U),?59,$$DAT1^IBOUTL(IBADM),?69,$$DAT1^IBOUTL($P(IBX2,U,2)) ; DETQ I 'IBQ D PAUSE Q ; PAT ; - Write the patient information. W $P(IBX,"@@"),?32,$$SSN(IBX1) Q ; HDET ; - Write the detail report header. I $E(IOST,1,2)="C-"!(IBPAG) W @IOF,*13 S IBPAG=IBPAG+1 W !,"Insured SC Vets w/ Unbilled NSC Care",?38,"Run Date: ",IBRUN,?70,"Page: ",IBPAG W !,"For Patients discharged in the period "_$$DAT1^IBOUTL(IBBDT)_" to "_$$DAT1^IBOUTL(IBEDT) W !,"Patient",?32,"SSN",?46,"PTF Status",?59,"Adm Date",?69,"Disc Date" W !,$$DASH(80) S IBQ=$$STOP^IBOUTL("SC Vets w/NSC Episodes") Q ; SUM ; - Print the summary report. I $E(IOST,1,2)="C-"!(IBPAG) W @IOF,*13 S IBPAG=IBPAG+1 W !!?13,"INSURED SC VETERANS W/ UNBILLED NSC INPATIENT EPISODES" W !?33,"SUMMARY REPORT" W !!?16,"For Patients discharged from ",$$DAT1^IBOUTL(IBBDT)," - ",$$DAT1^IBOUTL(IBEDT) W !!?24,"Run Date: ",IBRUN,!?24,$$DASH(31),!! ; S IBPER(1)=$S('IB("TOT"):0,1:$J(IB("SC")/IB("TOT")*100,0,2)) S IBPER(2)=$S('IB("NSC"):0,1:$J(IB("NSCB")/IB("NSC")*100,0,2)) S IBPER(3)=$S('IB("NSC"):0,1:$J(IB("NSCR")/IB("NSC")*100,0,2)) W ?9,"Number of Discharges of Insured SC Veterans:",?54,$J(IB("TOT"),4) W !?5,"Discharges Which were totally Service-Connected:",?54,$J(IB("SC"),4),?62,"(",IBPER(1),"%)" W !,"Discharges Which included Non-Service Connected Care:",?54,$J(IB("NSC"),4),?62,"(",$J($S('IB("TOT"):0,1:100-IBPER(1)),0,2),"%)" W !?10,"Number of NSC Discharges Which were Billed:",?54,$J(IB("NSCB"),4),?62,"(",IBPER(2),"%)" W !?4,"Number of NSC Discharges Flagged as Non-Billable:",?54,$J(IB("NSCR"),4),?62,"(",IBPER(3),"%)" W !?19,"Number of Unbilled NSC Discharges:",?54,$J(IB("NSCU"),4),?62,"(",$J($S('IB("NSC"):0,1:100-IBPER(2)-IBPER(3)),0,2),"%)",!?54,"----" F X=0:1:3 D .I X=0 W !,"Unbilled NSC Discharges w/ PTF Status of" .W ?41,$S(X=0:"Open",X=1:"Closed",X=2:"Released",1:"Transmitted"),":",?54,$J(IB("NSCU",X),4),?62,"(",$J($S('IB("NSCU",X):0,1:IB("NSCU",X)/IB("NSCU")*100),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:"") ; PTF(IBPTF) ; - Does the PTF record have an NSC-related movement? ; Input: IBPTF = Pointer to the PTF record in file #45 ; Output: IBNSC = 1 (NSC movement) or 0 (No NSC movement) ; N IBNSC,X,Y S (IBNSC,X)=0 I '$G(IBPTF) G PTFQ ; ; - Check PTF movements for a movement not related to SC care. F S X=$O(^DGPT(IBPTF,"M",X)) Q:'X S Y=$P($G(^(X,0)),U,18) I Y'=1 S IBNSC=1 Q ; PTFQ Q IBNSC ; BILL(IBPTF,DFN,IBADM,IBDIS) ; - Has this episode of care been billed? ; Input: IBPTF = Pointer to the PTF record in file #45 ; DFN = Pointer to the patient in file #2 ; IBADM = Episode admission date ; IBDIS = Episode discharge date ; Output: BILL = 1 (Episode has been billed) ; 0 (Episode has not been billed) ; N BILL,X,X1,XU,Y S BILL=0 ; ; - See if there is a claim based on the PTF record. I $G(IBPTF) D G:BILL BILLQ .S X=0 F S X=$O(^DGCR(399,"APTF",IBPTF,X)) Q:'X S Y=$P($G(^DGCR(399,X,0)),U,13) I Y,Y<7 S BILL=1 Q ; ; - Check other inpatient bills for care provided in the adm/dis period. S X=0 F S X=$O(^DGCR(399,"C",+$G(DFN),X)) Q:'X D Q:BILL .S X1=$G(^DGCR(399,X,0)),XU=$G(^("U")) Q:X1="" .I $P(X1,U,5)>2 Q ; Outpatient care. .I $P(X1,U,13)=7 Q ; Bill is cancelled. .I +XU\1IBEDT) Q ; Care outside of range. .S BILL=1 ; BILLQ Q BILL