IBTOBI2 ;ALB/AAS - CLAIMS TRACKING BILLING INFORMATION PRINT ;27-OCT-93 ;;2.0;INTEGRATED BILLING;**210**;21-MAR-94 ; IR ; -- print insurance review information Q:'$O(^IBT(356.2,"C",+IBTRN,0)) ; -no reivews I ($Y+11)>IOSL D HDR^IBTOBI Q:IBQUIT W !," Insurance Review Information " N I,J,IBII,IBTRC,IBTRCD,IBACTION,TCODE S IBII="" F S IBII=$O(^IBT(356.2,"ATIDT",IBTRN,IBII)) Q:'IBII!(IBQUIT) S IBTRC=0 F S IBTRC=$O(^IBT(356.2,"ATIDT",IBTRN,IBII,IBTRC)) Q:'IBTRC!(IBQUIT) D .N IBJ,IBD .D IR1 .D IR2 .S IBJ=0 F S IBJ=$O(IBD(IBJ)) Q:'IBJ W !,$E($G(IBD(IBJ,1)),1,39),?40,$E($G(IBD(IBJ,2)),1,39) .D COMM2(IBTRC) Q:IBQUIT .W !?30,"-----------------------------------" .I ($Y+11)>IOSL D HDR^IBTOBI Q:IBQUIT W:'IBQUIT !?4,$TR($J(" ",IOM-8)," ","-"),! Q ; IR1 ; -- print one review S IBTRCD=$G(^IBT(356.2,+IBTRC,0)),IBTRCD1=$G(^(1)) S IBD(1,1)=" Type Review: "_$$EXPAND^IBTRE(356.2,.04,$P(IBTRCD,"^",4)) S TCODE=$$TCODE^IBTRC(IBTRC) I TCODE D @TCODE Q 10 ; -- pre-cert contact 15 ; -- admission review 20 ; -- urgent/emergent ins. contact 30 ; -- continued stay contact S IBD(2,1)=" Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11)) S IBACTION=$P($G(^IBE(356.7,+$P(IBTRCD,"^",11),0)),"^",3) S IBACTION=IBACTION+100 D @IBACTION Q ; 40 ; -- Discharge contact 100 ; -- No type of action Q 50 ; -- outpatient treatment S IBD(2,1)=" Opt Treatment: "_$$EXPAND^IBTRE(356.2,.26,$P(IBTRCD,"^",26)) S IBD(3,1)=" Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11)) S IBD(4,1)=" Auth. Number: "_$P(IBTRCD,"^",28) Q 60 ; -- Appeal 65 ; -- Nth appeal S IBD(2,1)=" Appeal Type: "_$$EXPAND^IBTRE(356.2,.23,$P(IBTRCD,"^",23)) S IBD(3,1)=" Case Status: "_$$EXPAND^IBTRE(356.2,.1,$P(IBTRCD,"^",10)) S IBD(4,1)="No Days Pending: "_$$EXPAND^IBTRE(356.2,.25,$P(IBTRCD,"^",25)) S IBD(5,1)=" Final Outcome: "_$$EXPAND^IBTRE(356.2,.29,$P(IBTRCD,"^",29)) Q 70 ; -- Patient 80 ; -- Other 85 ; -- Insurance verification 90 ; Q ; 110 ; -- approval actions S IBD(3,1)="Authorized From: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",12))) S IBD(4,1)=" Authorized To: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",13))) S IBD(5,1)="Authorized Diag: "_$$DIAG^IBTRE6($P(IBTRCD,"^",14),1,$$TRNDATE^IBACSV($G(IBTRN))) S IBD(6,1)=" Auth. Number: "_$P(IBTRCD,"^",28) Q 120 ; -- denial actions S IBD(3,1)=" Denied From: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",15))) S IBD(4,1)=" Denied To: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",16))) S IBI=0,IBD=4 F S IBI=$O(^IBT(356.2,IBTRC,12,IBI)) Q:'IBI D .S IBD=IBD+1 .S IBD(IBD,1)=" Denial Reasons: "_$$EXPAND^IBTRE(356.212,.01,+$G(^IBT(356.2,IBTRC,12,IBI,0))) Q 130 ; -- penalty S IBI=0,IBD=2 F S IBI=$O(^IBT(356.2,IBTRC,13,IBI)) Q:'IBI D .S IBD=IBD+1 .S IBD(IBD,1)=" Penalty: "_$$EXPAND^IBTRE(356.213,.01,+$G(^IBT(356.2,IBTRC,13,IBI,0))) Q 140 ; -- case pending S IBD(3,1)=" Case Pending: "_$$EXPAND^IBTRE(356.2,.2,$P(IBTRCD,"^",20)) Q 150 ; -- no coverage S IBD(3,1)=" No Coverage: "_$$EXPAND^IBTRE(356.2,.21,$P(IBTRCD,"^",21)) Q ; IR2 ; -- contact information ;N IBCDFN,IBCPOL ;S IBCDFN=$P(IBTRCD1,"^",5),IBCPOL=$P(^DPT(DFN,.312,IBCDFN,0),"^",18) S IBD(1,2)=" Review Date: "_$E($$DAT1^IBOUTL(+IBTRCD,"2P"),1,20) S IBD(2,2)=" Insurance Co.: "_$E($P($G(^DIC(36,+$G(^DPT(DFN,.312,+$P(IBTRCD1,"^",5),0)),0)),"^"),1,20) S IBD(3,2)="Person Contacted: "_$E($P(IBTRCD,"^",6),1,20) S IBD(4,2)=" Contact Method: "_$E($$EXPAND^IBTRE(356.2,.17,$P(IBTRCD,"^",17)),1,20) S IBD(5,2)="Call Ref. Number: "_$E($P(IBTRCD,"^",9),1,20) S IBD(6,2)=" Status: "_$E($$EXPAND^IBTRE(356.2,.19,$P(IBTRCD,"^",19)),1,20) S IBD(7,2)=" Last Edited By: "_$E($$EXPAND^IBTRE(356.2,1.04,$P($G(^IBT(356.2,+$G(IBTRC),1)),"^",4)),1,20) I '$P(IBTRCD,"^",2) S IBD(2,2)="Patient Contacted: "_$E($P($G(^DPT(+$P(IBTRCD,"^",5),0)),"^"),1,20) Q ; COMM2(DA) ; -- print comments from ins. reviews. W !,"Comment: " Q:'$D(^IBT(356.2,DA,11)) K ^UTILITY($J,"W") S DIWL=10,DIWR=IOM-12,DIWF="W" S IBJ=0 F S IBJ=$O(^IBT(356.2,DA,11,IBJ)) Q:'IBJ S X=^(IBJ,0) D ^DIWP I IOSL<($Y+4) Q:IBQUIT D HDR^IBTOBI Q:IBQUIT D ^DIWW K ^UTILITY($J,"W") Q