IBTRCD ;ALB/AAS - CLAIMS TRACKING - EXPAND CONTACTS SCREEN ; 02-JUL-1993 ;;2.0;INTEGRATED BILLING;**210**;21-MAR-94 ;;Per VHA Directive 10-93-142, this routine should not be modified. ; % ; EN ; -- main entry point for IBT EXPAND/EDIT COMMUNICATIONS I '$D(DT) D DT^DICRW K XQORS,VALMEVL,IBTRC,IBTRD,IBTRV,IBTRN,DFN I '$G(IBTRC) G EN^IBTRC D EN^VALM("IBT EXPAND/EDIT COMMUNICATIONS") Q ; HDR ; -- header code D PID^VADPT S VALMHDR(1)="Expanded Insurance Reviews for: "_$$PT^IBTUTL1(DFN)_" ROI: "_$$EXPAND^IBTRE(356,.31,$P($G(^IBT(356,+$G(IBTRN),0)),"^",31)) S VALMHDR(2)=" for: "_$$EXPAND^IBTRE(356,.18,$P(IBTRND,"^",18))_" on "_$$DAT1^IBOUTL($P(IBTRND,"^",6),"2P") Q ; INIT ; -- init variables and list array N IBTRCD,IBTRCD1 K VALMQUIT S VALMCNT=0,VALMBG=1 D BLD,HDR Q ; BLD ; -- build display K ^TMP("IBTRCD",$J),^TMP("IBTRCDDX",$J) D KILL^VALM10() S IBTRCD=$G(^IBT(356.2,IBTRC,0)),IBTRCD1=$G(^IBT(356.2,IBTRC,1)) S IBTRND=$G(^IBT(356,IBTRN,0)) F I=1:1:27 D BLANK^IBTRED(.I) S VALMCNT=27 D ACTION,EN^IBTRCD0 Q ; ; ACTION ; -- Ins. Action infomation display N OFFSET,START,TCODE,IBACTION,IBLCNT S START=1,OFFSET=45,IBLCNT=0 D SET^IBCNSP(START,OFFSET," Action Information ",IORVON,IORVOFF) D SET^IBCNSP(START+1,OFFSET," Type Contact: "_$$EXPAND^IBTRE(356.2,.04,$P(IBTRCD,"^",4))) S TCODE=$$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 IBLCNT=2 D SET^IBCNSP(START+IBLCNT,OFFSET," Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11))) S IBACTION=$P($G(^IBE(356.7,+$P(IBTRCD,"^",11),0)),"^",3) S IBACTION=IBACTION+100 D @IBACTION S IBLCNT=IBLCNT+1 Q ; 40 ; -- Discharge contact 100 ; -- No type of action Q 50 ; -- outpatient treatment S IBLCNT=2 D SET^IBCNSP(START+IBLCNT,OFFSET," Opt Treatment: "_$$EXPAND^IBTRE(356.2,.26,$P(IBTRCD,"^",26))) S IBLCNT=IBLCNT+1 D SET^IBCNSP(START+IBLCNT,OFFSET," Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11))) S IBLCNT=IBLCNT+1 D SET^IBCNSP(START+IBLCNT,OFFSET," Auth. Number: "_$P(IBTRCD,"^",28)) ;D SET^IBCNSP(START+IBLCNT,OFFSET,"Treatment Auth: "_$$EXPAND^IBTRE(356.2,.27,$P(IBTRCD,"^",27))) Q 60 ; -- Appeal 65 ; -- Nth appeal D SET^IBCNSP(START+2,OFFSET," Appeal Type: "_$$EXPAND^IBTRE(356.2,.23,$P(IBTRCD,"^",23))) D SET^IBCNSP(START+3,OFFSET," Case Status: "_$$EXPAND^IBTRE(356.2,.1,$P(IBTRCD,"^",10))) D SET^IBCNSP(START+4,OFFSET,"No Days Pending: "_$$EXPAND^IBTRE(356.2,.25,$P(IBTRCD,"^",25))) D SET^IBCNSP(START+5,OFFSET," Final Outcome: "_$$EXPAND^IBTRE(356.2,.29,$P(IBTRCD,"^",29))) Q 70 ; -- Patient 80 ; -- Other 85 ; -- Insurance verification Q ; 110 ; -- approval actions S IBLCNT=IBLCNT+1 D SET^IBCNSP(START+IBLCNT,OFFSET,"Authorized From: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",12)))) S IBLCNT=IBLCNT+1 D SET^IBCNSP(START+IBLCNT,OFFSET," Authorized To: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",13)))) S IBLCNT=IBLCNT+1 D SET^IBCNSP(START+IBLCNT,OFFSET,"Authorized Diag: "_$$DIAG^IBTRE6($P(IBTRCD,"^",14),1,$$TRNDATE^IBACSV($G(IBTRN)))) S IBLCNT=IBLCNT+1 D SET^IBCNSP(START+IBLCNT,OFFSET," Auth. Number: "_$P(IBTRCD,"^",28)) Q 120 ; -- denial actions S IBLCNT=IBLCNT+1 D SET^IBCNSP(START+IBLCNT,OFFSET," Denied From: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",15)))) S IBLCNT=IBLCNT+1 D SET^IBCNSP(START+IBLCNT,OFFSET," Denied To: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",16)))) S IBI=0 F S IBI=$O(^IBT(356.2,IBTRC,12,IBI)) Q:'IBI!(IBLCNT>6) D .S IBLCNT=IBLCNT+1 .D SET^IBCNSP(START+IBLCNT,OFFSET," Denial Reasons: "_$$EXPAND^IBTRE(356.212,.01,+$G(^IBT(356.2,IBTRC,12,IBI,0)))) Q 130 ; -- penalty S IBI=0 F S IBI=$O(^IBT(356.2,IBTRC,13,IBI)) Q:'IBI!(IBLCNT>6) D .S IBLCNT=IBLCNT+1 .D SET^IBCNSP(START+IBLCNT,OFFSET," Penalty: "_$$EXPAND^IBTRE(356.213,.01,+$G(^IBT(356.2,IBTRC,13,IBI,0)))) Q 140 ; -- case pending S IBLCNT=IBLCNT+1 D SET^IBCNSP(START+IBLCNT,OFFSET," Case Pending: "_$$EXPAND^IBTRE(356.2,.2,$P(IBTRCD,"^",20))) Q 150 ; -- no coverage S IBLCNT=IBLCNT+1 D SET^IBCNSP(START+IBLCNT,OFFSET," No Coverage: "_$$EXPAND^IBTRE(356.2,.21,$P(IBTRCD,"^",21))) Q ; ; HELP ; -- help code S X="?" D DISP^XQORM1 W !! Q ; EXIT ; -- exit code K VALMQUIT,IBTRC,IBTRCD,IBTRCD1 K ^TMP("IBTRCD",$J),^TMP("IBTRCDDX",$J) D CLEAN^VALM10,FULL^VALM1 Q