IBRFN ;ALB/AAS - Supported functions for AR ;5-MAY-1992 ;;2.0;INTEGRATED BILLING;**52,130,183,223,309,276,347**;21-MAR-94;Build 24 ;;Per VHA Directive 2004-038, this routine should not be modified. ; ERR(Y) ; Input Y = -1^error code[;error code...]^literal message ; Output IBRERR = error message 1 ; if more than one code then ; IBRERR(n)=error code n N N,X,X1,X2 K IBRERR S IBRERR="" G:+Y>0 ERRQ S X2=$P(Y,U,2) F N=1:1 S X=$P(X2,";",N) Q:X="" S X1=$P($G(^IBE(350.8,+$O(^IBE(350.8,"AC",X,0)),0)),U,2) D .I N=1 S IBRERR=X1 .I $P(Y,U,3)]""!($P(X2,";",2,99)]"") S IBRERR(N)=X1 I $P(Y,U,3)]"" S N=N+1,IBRERR(N)=$P(Y,U,3) ERRQ Q IBRERR ; MESS(Y) ; -input y=error code - from file 350.8 (piece 3) ; output error message Q $P($G(^IBE(350.8,+$O(^IBE(350.8,"AC",Y,0)),0)),U,2) ; SVDT(BN,VDT) ;returns service dates for a specific bill ; Input: BN bill number (external form) ; VDT name of array to hold outpatient visit dates, pass by value (if needed) ; Output: X function value, string, = 0 if bill not found ; = 1 (Inpt) or 2 (Outpt)^event date^stmt from date^stmt to date^LOS (I)^Number of visit dates (O) ; all are internal form, any piece may be null if not defined for the bill ; array containing outpatient visit dates as subscripts/no data, if VDT passed by value N X,Y,IFN S X=0,BN=$G(BN) I BN'="" S IFN=+$O(^DGCR(399,"B",BN,0)),Y=$G(^DGCR(399,IFN,0)) I Y'="" D . S X=$S(+$P(Y,U,5)<1:"",+$P(Y,U,5)<3:1,+$P(Y,U,5)<5:2,1:"")_U_$P(Y,U,3),Y=$G(^DGCR(399,IFN,"U")) . S X=X_U_$P(Y,U,1)_U_$P(Y,U,2)_U_$P(Y,U,15)_U_$P($G(^DGCR(399,IFN,"OP",0)),U,4) . S Y=0 F S Y=$O(^DGCR(399,IFN,"OP",Y)) Q:'Y S VDT(Y)="" Q X ; ; REC(IBSTR,IBTYPE) ; Find the AR for an Authorization or Rx number ; Input: IBSTR - FI Authorization Number or Rx Number ; Output: IBAR >0 => ptr to claim/AR in files 399/430 ; -1 => No receivable found ; IBTYPE (by ref) - how the IBSTR was recognized: 1-Auth,2-ECME,3-Rx#,0-Unknown ; N IBAR,IBARR,IBRX,IBKEY,IBKEYS,IBREF,IBPREF S IBTYPE=0 S IBAR=-1 I $G(IBSTR)="" G RECQ ; ; extended syntax to indicate the type: ; T.000000 for TRICARE, E.7000000 for ECME, R.50000000 for Rx I $L($P(IBSTR,"."))=1,$P(IBSTR,".",2)'="" D . S IBPREF=$TR($P(IBSTR,"."),"ter","TER") . S IBSTR=$P(IBSTR,".",2,255) . I $E(IBPREF)="T" S IBTYPE=1 ; TRICARE Auth# . I $E(IBPREF)="E" S IBTYPE=2 ; ECME # . I $E(IBPREF)="R" S IBTYPE=3 ; Rx # ; ; look for TRICARE number I (IBTYPE=0)!(IBTYPE=1) S IBAR=$$AREC(IBSTR) I IBAR>0 S IBTYPE=1 G RECQ ; ; - look for ecme number I (IBTYPE=0)!(IBTYPE=2) S IBAR=$$EREC(IBSTR) I IBAR>0 S IBTYPE=2 G RECQ ; I IBTYPE,IBTYPE'=3 G RECQ ; ; - treat as an rx number S IBAR=$$RXREC(IBSTR) I IBAR>0 S IBTYPE=3 ; RECQ Q IBAR ; RXREC(IBRXN) ; Search the Rx N IBR,IBX,IBARR,IBY,IBBIL,IBTRKN,IBFIL,IBRX I $L(IBRXN)<5,'$D(^IBA(362.4,"B",IBRXN)) Q -1 ; Scan 362.4 ; 1) check the exact match: S IBX=0 F S IBX=$O(^IBA(362.4,"B",IBRXN,IBX)) Q:'IBX D . S IBBIL=$P($G(^IBA(362.4,IBX,0)),U,2) Q:'IBBIL . I $P($G(^DGCR(399,IBBIL,0)),U,13)=7 Q ; ignore cancld . S IBARR(IBBIL)="" ; 2) check Rx with postfixes like "A","B" etc S IBR=IBRXN_" " F S IBR=$O(^IBA(362.4,"B",IBR)) Q:$E(IBR,1,$L(IBRXN))'=IBRXN D . I $E(IBR,$L(IBRXN)+1)'?1A Q ; only letters in postfx . S IBX=0 F S IBX=$O(^IBA(362.4,"B",IBR,IBX)) Q:'IBX D . . S IBBIL=$P($G(^IBA(362.4,IBX,0)),U,2) Q:'IBBIL . . I $P($G(^DGCR(399,IBBIL,0)),U,13)=7 Q ; ignore cancld . . S IBARR(IBBIL)="" ; 3) Now scan CT (356): S DIC=52,DIC(0)="BO",X=IBSTR D DIC^PSODI(52,.DIC,X) S IBRX=+Y K DIC,X,Y I IBRX S IBFIL="" F S IBFIL=$O(^IBT(356,"ARXFL",IBRX,IBFIL)) Q:IBFIL="" D . S IBTRKN="" F S IBTRKN=$O(^IBT(356,"ARXFL",IBRX,IBFIL,IBTRKN)) Q:IBTRKN="" D .. S IBBIL=$P($G(^IBT(356,IBTRKN,0)),U,11) Q:'IBBIL .. I $P($G(^DGCR(399,IBBIL,0)),U,13)=7 Q ; ignore cancld .. S IBARR(IBBIL)="" ; S IBY=$O(IBARR("")) I IBY'>0 Q -1 ;not found I '$O(IBARR(IBY)) D DTL(+IBY,"Rx#",IBRXN) Q +IBY ;one only W !!,"More than one fill for Rx# ",IBSTR," has been billed." S IBY=$$SEL(.IBARR) D DTL(IBY,"Rx#",IBRXN) Q IBY ; AREC(AUTH) ; Find the Receivable for a TRICARE FI Authorization Number ; Input: AUTH - Fiscal Intermediary Authorization Number ; Output: IBIFN >0 => ptr to claim/AR in files 399/430 ; -1 => No receivable found N IBIFN S IBIFN=-1 I $G(AUTH)="" G ARECQ S IBIFN=$P($G(^IBA(351.5,+$O(^IBA(351.5,"AUTH",AUTH,0)),0)),U,9) S:'IBIFN IBIFN=-1 ARECQ ; D DTL(IBIFN,"TRICARE#",AUTH) Q IBIFN ; ; EREC(AUTH) ; Find the Receivable for an ECME FI Number ; Input: AUTH - Fiscal Intermediary ECME Number ; Output: IBIFN >0 => ptr to claim/AR in files 399/430 ; -1 => No receivable found ; N IBIFN,IBC,IBX,IBA,IBE,IBES S IBIFN=-1,IBC=0 I $G(AUTH)="" G ARECQ S (IBE,IBES)=+AUTH_";" F S IBE=$O(^DGCR(399,"AG",IBE)) Q:IBE'[IBES D . S IBX=0 F S IBX=$O(^DGCR(399,"AG",IBE,IBX)) Q:'IBX D .. I $P($G(^DGCR(399,IBX,0)),U,13)=7 Q ;exclude cancld .. S IBA(IBX)="",IBC=IBC+1 I IBC'>1 S IBIFN=$O(IBA(0)) G ERECQ ; only one found W !!,"More than one fill for ECME# ",AUTH," has been billed." S IBIFN=$$SEL(.IBA) ERECQ S:'IBIFN IBIFN=-1 D DTL(IBIFN,"ECME#",AUTH) ;details Q IBIFN ; DTL(IBIFN,TYPE,AUTH) ;Details Q:IBIFN'>0 Q:AUTH="" N IBZ,IBBIL,IBPAT,IBPATN,IBRX,IB3624,IBDRUG,IBQTY,IBDAT,DIR S IBZ=$G(^DGCR(399,IBIFN,0)) S IBBIL=$P(IBZ,U),IBPAT=$P(IBZ,U,2),IBDAT=$P(IBZ,U,3) S IBPATN=$P($G(^DPT(+IBPAT,0)),U) S IB3624=$G(^IBA(362.4,+$O(^IBA(362.4,"C",IBIFN,"")),0)) D ZERO^IBRXUTL(+$P(IB3624,U,4)) S IBDRUG=$G(^TMP($J,"IBDRUG",+$P(IB3624,U,4),.01)) K ^TMP($J,"IBDRUG") S IBRX=$$FILE^IBRXUTL(+$P(IB3624,U,5),.01) S IBQTY=+$P(IB3624,U,7) W !!,"Found IB Bill ",IBBIL," matching to "_TYPE_" '",AUTH,"':" W !,"Rx#",IBRX," ",$$DAT3^IBOUTL(IBDAT),", ",IBPATN,", ",IBDRUG I IBQTY W " (",IBQTY,")" Q ; AUD(IBIFN) ; Does the Accounts Receivable need to be audited? ; Input: IBIFN - ptr to claim/AR in files 399/430 ; Output: 0 => Claim does not have to be audited ; (claim was set up automatically) ; 1 => Claim must be audited ; (claim was established manually) ; AUDQ Q $O(^IBA(351.5,"ACL",+$G(IBIFN),0))'>0 ; ; TYP(IBIFN) ; Determine the bill type for an Accounts Receivable. ; Input: IBIFN - ptr to claim/AR in files 399/430 ; Output: I => Inpatient bill ; O => Outpatient bill ; PH => Pharmacy bill ; PR => Prosthetics bill ; ; or -1 if the bill type can't be determined. ; N IBATYP,IBATYPN,IBBG,IBN,IBND,IBTYP,IBX S IBTYP=-1 I '$G(IBIFN) G TYPQ ; ; - see if AR originated from file #399 S IBX=$G(^DGCR(399,IBIFN,0)) I IBX]"" D G TYPQ .S IBTYP=$$BTYP^IBCOIVM1(IBIFN,IBX) .S IBTYP=$S(IBTYP="":-1,IBTYP="P":"PR",IBTYP="R":"PH",1:IBTYP) ; ; - get the bill number S IBX=$P($G(^PRCA(430,IBIFN,0)),U) I IBX="" G TYPQ ; ; - AR must have originated from file #350 S IBN=$O(^IB("ABIL",IBX,0)) I 'IBN G TYPQ S IBND=$G(^IB(IBN,0)) I 'IBND G TYPQ S IBATYP=$G(^IBE(350.1,+$P(IBND,U,3),0)),IBBG=$P(IBATYP,U,11) ; ; - handle TRICARE charges first I IBBG=7 D G TYPQ .S IBATYPN=$P(IBATYP,U) .S IBTYP=$S(IBATYPN["INPT":"I",IBATYPN["OPT":"O",1:"PH") ; S IBTYP=$S(IBBG=4:"O",IBBG=5:"PH",IBBG=8:"O",1:"I") TYPQ Q IBTYP ; RELBILL(IBIFN) ; given a Third Party Bill, find all related Third Party bills, ; then find all First Party bills related to any of the Third Party bills ; Input: IBIFN = internal file number of a Third Party bill ; Output: Third Party Bills (#399) ; ^TMP("IBRBT", $J, selected bill ifn) = PATIENT HAS ANY RX COVERAGE ON FROM DATE OF BILL? ; ^TMP("IBRBT", $J, selected bill ifn, matching bill ifn) = ; BILL FROM ^ BILL TO ^ CANCELLED? ^ AR BILL NUMBER ^ ; PAYER SEQUENCE ^ PAYER IS MEDICARE SUPPLEMENTAL (0/1) ^ PAYER NAME ; Output: First Party Bills (#350) ; ^TMP("IBRBF", $J , selected bill ifn ) = "" ; ^TMP("IBRBF", $J , selected bill ifn , charge ifn) = ; BILL FROM ^ BILL TO ^ CANCELLED? ^ AR BILL NUMBER ^ ; TOTAL CHARGE ^ ACTION TYPE (SHORT) ^ # DAYS ON HOLD ; N IBIFN1 I '$D(^DGCR(399,+$G(IBIFN),0)) Q D TPTP^IBEFUR(IBIFN) S IBIFN1=0 F S IBIFN1=$O(^TMP("IBRBT",$J,IBIFN,IBIFN1)) Q:'IBIFN1 D TPFP^IBEFUR(IBIFN1) Q ; SEL(IBARR) ; Select an rx bill ; Input: IBARR - Array of IBIFN ; Output: IBNUM - One of the bill iens, or -1 ; N DIR,IBIFN,IBRXN,IBDT,IBZ,IBY,IBC,IBBIL,IBLNK,DFN,IBPT,I ; S IBIFN=$O(IBARR("")) I 'IBIFN Q -1 I '$O(IBARR(IBIFN)) Q IBIFN ; no choice ; W !!?4,"Select one of the following:",! W !?11,"BILL",?23,"RX",?33,"DATE",?46,"PATIENT" W !?6 F I=1:1:60 W "-" ; S (IBIFN,IBC)=0 F S IBIFN=$O(IBARR(IBIFN)) Q:'IBIFN D . S IBZ=$G(^DGCR(399,IBIFN,0)) Q:IBZ="" . S DFN=+$P(IBZ,U,2),IBPT=$P($G(^DPT(DFN,0)),U) . S IBBIL=$P(IBZ,U) . S IBDT=$P(IBZ,U,3) . S IBY=$G(^IBA(362.4,+$O(^IBA(362.4,"C",IBIFN,0)),0)) . S IBRXN=$P(IBY,U) . S IBC=IBC+1 . S IBLNK(IBC)=IBIFN . W !?6,IBC,?10,IBBIL," ",?20,IBRXN," ",?32,$$DAT1^IBOUTL(IBDT)," ",?45,IBPT ; ; F R !!?4,"Select one of the bills by number: ",IBY:DTIME Q:'$T Q:"^"[IBY Q:$D(IBLNK(+IBY)) W:(IBY'="")&(IBY'["?") " ??" D . W !!?8,"Enter numeric value from 1 to ",IBC ; S IBIFN=$G(IBLNK(+IBY),-1) Q IBIFN