IBRBUL ;ALB/CJM-MEANS TEST HOLD CHARGE BULLETIN ;02-MAR-92 ;;2.0;INTEGRATED BILLING;**70,95,121,153,195,347**;21-MAR-94;Build 24 ;;Per VHA Directive 2004-038, this routine should not be modified. ; This bulletin is sent even if the local site has chosen not to hold ; Means Test charges. In that case, IBHOLDP should be set = 0. ; requires: IBDD() = internal node in patient file of valid ins. ; DUZ ; X = 0 node of IB BILLING ACTION ; IBHOLDP = 1 if charge on hold, = 0 otherwise ; IBSEQNO = 1 if the charges are new, 3 if updated BULL N XMSUB,XMY,XMDUZ,XMTEXT,IBX,IBDUZ,IBNAME,IBPID,IBBID,IBAGE,DFN S IBX=X,IBDUZ=DUZ K ^TMP($J,"IBRBUL") D PAT,HDR,PATLINE,CHRG,INS,BUF,MAIL K ^TMP($J,"IBRBUL") Q MAIL ; Transmit mail N IBGRP S XMDUZ="INTEGRATED BILLING PACKAGE",XMTEXT="^TMP($J,""IBRBUL""," K XMY S IBGRP=$P($G(^XMB(3.8,+$P($G(^IBE(350.9,1,0)),U,11),0)),U) I IBGRP]"" S XMY("G."_IBGRP_"@"_^XMB("NETNAME"))="" D ^XMD Q ;Add a line to the text array ADDLN(IBTXT) N IBC S IBC=$O(^TMP($J,"IBRBUL",""),-1)+1 S ^TMP($J,"IBRBUL",IBC)=$G(IBTXT," ") Q ; MAILTST ; for testing ;N IBC ;W !,XMSUB ;F IBC=1:1 Q:'$D(^TMP($J,"IBRBUL",IBC)) W !,^(IBC) Q HDR ; formated for held charges N IBW,IBU,IBV,SL S IBW=$S('IBHOLDP:"NOT ON HOLD",1:"ON HOLD"),IBU=$S(IBSEQNO=1:"NEW ",IBSEQNO=3:"UPDATED ",1:""),IBV=$S(+$O(IBDD(0)):"active",1:"may have") ; if the parent event should have the soft-link that is needed to find ; the division S SL=$P(X,"^",16) S:SL SL=$G(^IB(SL,0)) S:'SL SL=X S SL=$P(SL,"^",4) S XMSUB=$E(IBNAME,1,8)_"("_IBBID_")"_" PATIENT CHRG W/INS"_"-"_$E($$DIV(SL),1,11) D ADDLN("The following patient has "_IBU_"charges "_IBW_" and "_IBV_" insurance.") D ADDLN("You need to immediately process the charges to the insurance company.") I +$$BUFFER^IBCNBU1(+$P(X,"^",2)) D . D ADDLN() . D ADDLN("This patient has entries in the Insurance Buffer that should be processed") . D ADDLN("before the charges.") Q PAT ; gets patient demographic data N VAERR,VADM,X,VA S DFN=+$P(IBX,"^",2) D DEM^VADPT I VAERR K VADM S IBNAME=$$PR($G(VADM(1)),26),IBAGE=$$PR($G(VADM(4)),3),IBPID=$G(VA("PID")),IBBID=$G(VA("BID")) Q PATLINE ; sets up lines with patient data D ADDLN(),ADDLN("Name: "_IBNAME_" Age : "_IBAGE_" Pt. ID: "_IBPID) Q CHRG ; gets charge data and sets up charge lines N TP,FR,TO,IBND1,IBRXN,IBRX,IBRDT,IBRF,IENS S IBND1=$G(^IB(+$G(IBN),1)),(IBRX,IBRXN,IBRF,IBRDT)=0 S FR=$$DAT1^IBOUTL($S($P(IBX,"^",14)'="":($P(IBX,"^",14)),1:$P(IBND1,"^",2))) S TO=$$DAT1^IBOUTL($S($P(IBX,"^",15)'="":($P(IBX,"^",15)),1:$P(IBND1,"^",2))) I $P(IBX,"^",4)["52:" S IBRXN=$P($P(IBX,"^",4),":",2),IBRX=$P($P(IBX,"^",8),"-"),IBRF=$P($P(IBX,"^",4),":",3) I $P(IBX,"^",4)["52:" D .I IBRF>0 S IENS=+IBRF,IBRDT=$$SUBFILE^IBRXUTL(+IBRXN,IENS,52,.01) .E S IENS=+IBRXN,IBRDT=$$FILE^IBRXUTL(IENS,22) S TP=$P(IBX,"^",3) S:TP TP=$P($G(^IBE(350.1,TP,0)),"^",3) S:TP TP=$P($$CATN^PRCAFN(TP),"^",2) D ADDLN("Type: "_$$PR(TP,28)_" Amount : $"_+$P(IBX,"^",7)) D ADDLN("From: "_$$PR(FR,28)_" To : "_TO) I IBRXN D ADDLN("Rx #: "_$$PR(IBRX_$S(IBRF'="":" ("_IBRF_")",1:""),28)_" Fill Dt: "_$$DAT1^IBOUTL(IBRDT)_" Rls Dt: "_TO) Q INS ; gets insurance data and sets up insurance lines N I,CO,P,G,GNB,W,E,Y,C,COV,COVD,COVFN,LEDT,LIM,PLN,X1,X2,Z0,IBCNT,P1,P2,P3,P4 ;S IBDTIN=$P(IBX,"^",14) D ADDLN(),ADDLN("INSURANCE INFORMATION:") S I="" F S I=$O(IBDD(I)) Q:'I D .S LIM=0 .S CO=$P(IBDD(I),"^",1),CO=$P(^DIC(36,CO,0),"^",1),CO=$$PR(CO,25) .S P=$$PR($P(IBDD(I),"^",2),21) .S P1=2.312,P2=6,P3=$P($G(IBDD(I)),"^",6) S P4=$$EXPAND^IBTRE(P1,P2,P3) S W=$$PR(P4,25) .S Y=$P(IBDD(I),"^",4) D:Y DD^%DT S E=Y .S G=$$PR($P(IBDD(I),"^",15),25) .S GNB=$P(IBDD(I),"^",3) .S PLN=$P(IBDD(I),"^",18) .D ADDLN(),ADDLN("Company: "_CO_" Policy#: "_P) .D ADDLN("Whose : "_W_" Expires: "_E) .D ADDLN("Group : "_G_" Group# : "_GNB) .Q:'PLN .D ADDLN(" Plan Coverage Effective Date Covered? Limit Comments") .D ADDLN(" ------------- -------------- -------- --------------") .F S LIM=$O(^IBE(355.31,LIM)) Q:'LIM S COV=$P($G(^(LIM,0)),U),IBCNT=0,LEDT="" F S LEDT=$O(^IBA(355.32,"APCD",PLN,LIM,LEDT)) Q:$S(LEDT="":IBCNT,1:0) D Q:LEDT="" ..S COVFN=+$O(^IBA(355.32,"APCD",PLN,LIM,+LEDT,"")),COVD=$G(^IBA(355.32,+COVFN,0)) ..I COVD="" D ADDLN(" "_$$PR(COV,32)_"BY DEFAULT") Q ..S IBCNT=IBCNT+1 ..S X1=" "_$S(IBCNT=1:COV,1:"") ;Don't duplicate category ..S X2=$$PR(X1,18)_$$PR($$DAT1^IBOUTL($P(LEDT,"-",2)),16)_$$PR($S($P(COVD,U,4):$S($P(COVD,U,4)<2:"YES",$P(COVD,U,4)=2:"CONDITIONAL",1:"UNKNOWN"),1:"NO"),14) ..I '$O(^IBA(355.32,COVFN,2,0)) D ADDLN(X2) Q ..S Z0=0 F S Z0=$O(^IBA(355.32,COVFN,2,Z0)) Q:'Z0 D ADDLN($S(Z0=1:X2_$G(^IBA(355.32,COVFN,2,Z0,0)),1:$$PR("",48)_$G(^IBA(355.32,COVFN,2,Z0,0)))) Q PR(STR,LEN) ; pad right N B S STR=$E(STR,1,LEN),$P(B," ",LEN-$L(STR))=" " Q STR_$G(B) DIV(SL) ; returns the division with the softlink as input N IBDIV,IBWARD,IBFILE,IBIEN S:SL[";" SL=$P(SL,";",1) S IBFILE=$P(SL,":",1),IBIEN=$P(SL,":",2) S IBDIV="" I IBFILE=409.68,IBIEN S IBDIV=$$SCE^IBSDU(IBIEN,11) I IBFILE=44,IBIEN S IBDIV=$P($G(^SC(IBIEN,0)),"^",15) I IBFILE=405,IBIEN S IBWARD=$P($G(^DGPM(IBIEN,0)),"^",6) I IBWARD S IBDIV=$P($G(^DIC(42,IBWARD,0)),"^",11) I IBDIV S IBDIV=$P($G(^DG(40.8,IBDIV,0)),"^",1) I IBDIV="" S IBDIV="DIV UNKNWN" Q IBDIV ; BUF ; gets insurance buffer entries and sets up lines to add to bulletin N DFN,IBBDA,IBB40,IBB60,IBX1,IBX2 S DFN=$P(IBX,U,2) Q:'DFN I '$$BUFFER^IBCNBU1(DFN) Q ; D ADDLN() D ADDLN("INSURANCE BUFFER:") S IBBDA=0 F S IBBDA=$O(^IBA(355.33,"C",DFN,IBBDA)) Q:'IBBDA D . S IBB40=$G(^IBA(355.33,IBBDA,40)),IBB60=$G(^IBA(355.33,IBBDA,60)) . ; . D ADDLN() . S IBX1=$P($G(^IBA(355.33,IBBDA,20)),U,1),IBX2=$P(IBB60,U,4) . D ADDLN("Company: "_$$PR(IBX1,25)_"Policy#: "_$$PR(IBX2,21)) . S IBX1=$$EXPAND^IBTRE(355.33,60.05,$P(IBB60,U,5)),IBX2=$$FMTE^XLFDT($P(IBB60,U,3)) . D ADDLN("Whose : "_$$PR(IBX1,25)_"Expires: "_IBX2) . S IBX1=$P(IBB40,U,2),IBX2=$P(IBB40,U,3) . D ADDLN("Group : "_$$PR(IBX1,25)_"Group# : "_IBX2) Q