source: FOIAVistA/trunk/r/FEE_BASIS-FB/FBPCR.m@ 1076

Last change on this file since 1076 was 628, checked in by George Lilly, 15 years ago

initial load of FOIAVistA 6/30/08 version
File size: 8.3 KB
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1FBPCR ;AISC/DMK,GRR,TET-POTENTIAL COST RECOVERY OUTPUT DRIVER ;23 May 2006 10:06 AM
2 ;;3.5;FEE BASIS;**12,48,76,98**;JAN 30, 1995;Build 54
3 ;;Per VHA Directive 10-93-142, this routine should not be modified.
4DOC ;Refer to fbdoc, tag fbpcr, for documentation of fbpcr* routines
5PSF ;select one/many/all primary service failities
6 S FBARRLTC=""
7 W !! S DIC="^DIC(4,",VAUTSTR="Primary Service Facility",VAUTNI=2,VAUTVB="FBPSV" D FIRST^VAUTOMA K DIC I Y=-1 G EXIT
8ARRAY ;set fee program array for all programs
9 S FBPI=0 F S FBPI=$O(^FBAA(161.8,FBPI)) Q:'FBPI S FBPIN=$G(^(FBPI,0)) I $P(FBPIN,U,3) S FBPROG(FBPI)=$P(FBPIN,U)
10 I '$D(FBPROG) G EXIT
11 ;prepare array with LTC POV codes
12 D MKARRLTC^FBPCR4
13 ;what party to include
14 K DIR
15 S DIR(0)="SO^P:Patient;I:Insurance;B:Both",DIR("A")="Include (P)atient Co-pays / (I)nsurance / (B)oth",DIR("B")="Both"
16 S DIR("?")=" Select type of recover to include",DIR("?",1)=" P - include only recover from patient copays",DIR("?",2)=" I - include only recover from insurance",DIR("?",3)=" B - include both",DIR("L")=""
17 D ^DIR S FBPARTY=$S($G(Y(0))="Patient":1,$G(Y(0))="Insurance":2,$G(Y(0))="Both":3,X="Both":3,1:0)
18 K DIR
19 G:FBPARTY=0 EXIT
20 ;what type of copay to include
21 S FBCOPAY=3
22 I FBPARTY'=2 D
23 . S DIR(0)="SO^M:MeansTest;L:LTC;B:Both",DIR("A")="Include (M)eans Test Co-pays /(L)TC Co-pays /(B)oth",DIR("B")="Both"
24 . S DIR("?")=" Select services to include",DIR("?",1)=" M - include only Means Test copays",DIR("?",2)=" L - include only LTC copays",DIR("?",3)=" B - include both",DIR("L")=""
25 . D ^DIR S FBCOPAY=$S($G(Y(0))="LTC":1,$G(Y(0))="MeansTest":2,$G(Y(0))="Both":3,X="Both":3,1:0)
26 . K DIR
27 G:FBCOPAY=0 EXIT
28 ;
29 ;include patients if their insurance informations is unavailable?
30 S FBINCUNK=0
31 I FBPARTY=2!(FBPARTY=3) D
32 . S FBINCUNK=1
33 . N Y,X
34 . W !!
35 . S DIR("A")="Do you want to include patients whose insurance status is unavailable? "
36 . S DIR("?")="Please answer Yes or No."
37 . S DIR("B")="YES",DIR(0)="YA^^"
38 . D ^DIR K DIR
39 . I $G(DIRUT) S FBINCUNK=-1 Q
40 . I $G(Y)=0 S FBINCUNK=0
41 I FBINCUNK=-1 G EXIT ;uparrow - exit
42 ;
43DATE ;select date range
44 D DATE^FBAAUTL I FBPOP G PSF
45 S FBBDATE=BEGDATE,FBEDATE=ENDDATE
46 S Z=9999999.9999,FBBEG=Z-FBEDATE,FBEND=Z-FBBDATE
47Q K ^TMP($J,"FB"),^TMP($J,"FBINSIBAPI"),DIC
48 ;
49 S VAR="FBINCUNK^FBARRLTC^FBARRLTC(^FBPARTY^FBCOPAY^FBNAME^FBIEN^FBID^FBBEG^FBEND^FBBDATE^FBEDATE^FBPSV^FBPSV(^FBPROG(",VAL=VAR,PGM="DQ^FBPCR",IOP="Q" D ZIS^FBAAUTL G:FBPOP EXIT
50DQ S $P(FBDASH,"=",80)="",$P(FBDASH1,"-",80)="",FBPG=0,FBCRT=$S($E(IOST,1,2)="C-":1,1:0),FBOUT=0,FBBEG=FBBEG-.9 U IO
51SORT ;sort driver for payment output(s)
52 S FBPI=0 F S FBPI=$O(FBPROG(FBPI)) Q:'FBPI S FBXPROG=FBPROG(FBPI) D
53 .I FBPI=2 D EN^FBPCR2 ;outpatient payments
54 .I FBPI=3 D EN^FBPCR3 ;pharmacy payments
55 .I FBPI=6!(FBPI=7) S:FBPI=6&($D(FBPROG(7))) FBPI=67 D EN^FBPCR67 S:FBPI=67 FBPI=7 ;civil hospital/cnh payments
56PRINT ;print driver for payment output(s)
57 I $G(^TMP($J,"FBINSIBAPI"))>0 D HDRUNK
58 S FBPI=$O(^TMP($J,"FB",0)) I FBPI']"" D WMSG G OUT
59 S FBSTA=0
60 S FBPSF=0 F S FBPSF=$O(^TMP($J,"FB",FBPSF)) Q:'FBPSF!FBOUT D STA S FBPT="" F S FBPT=$O(^TMP($J,"FB",FBPSF,FBPT)) Q:FBPT']""!FBOUT S DFN=$P(FBPT,";",2) D VET S FBPI=0 F S FBPI=$O(FBPROG(FBPI)) Q:'FBPI S FBXPROG=FBPROG(FBPI) D Q:FBOUT
61 .I FBPSF_FBPT'=FBSTA D HDR Q:FBOUT
62 .I FBPI=2,$D(^TMP($J,"FB",FBPSF,FBPT,FBPI)) D PRINT^FBPCR2 Q
63 .I FBPI=3 D:$D(^TMP($J,"FB",FBPSF,FBPT,FBPI)) PRINT^FBPCR3 Q
64 .I FBPI=6!(FBPI=7) D:$D(^TMP($J,"FB",FBPSF,FBPT,FBPI)) PRINT^FBPCR671 Q
65OUT I $G(^TMP($J,"FBINSIBAPI"))>0 D ERRHDL^FBPCR4
66 I FBOUT!$D(ZTQUEUED) G EXIT
67 D EXIT G PSF
68 Q
69EXIT ;kill and quit
70KILL ;kill all variables set in the FBPCR* routines, other than fbx
71 D CLOSE^FBAAUTL K ^TMP($J,"FB")
72 K A1,A2,A3,BEGDATE,C,D,D2,DFN,DIC,DIR,DTOUT,DUOUT,ENDDATE,FBPDXC,FBPARTY,FBCOPAY,FBARRLTC,FBINCUNK
73 K FBAAA,FBAACPTC,FBAC,FBAP,FBBATCH,FBBDATE,FBBEG,FBBN,FBCATC,FBCNT,FBCP,FBCRT,FBDA1,FBDASH,FBDASH1,FBDATA,FBDOB,FBDRUG,FBDT,FBDT1,FBDOS,FBDX,FBDX1,FBEDATE,FBEND,FBERR,FBFD,FBFD1,FBHEAD
74 K FBI,FBID,FBIEN,FBIN,FBINS,FBINVN,FBIX,FBJ,FBLOC,FBM,FBNAME,FBOB,FBOPI,FBOUT,FBOV,FBP,FBPAT,FBPD,FBPDX,FBPG,FBPI,FBPID,FBPIN,FBPNAME,FBPROC,FBPROC1,FBPROG,FBPSF,FBPSFNAM,FBPSFNUM,FBPSV,FBPT,FBPV,FBQTY,FBREIM,FBRX
75 K FBSC,FBSL,FBSTA,FBSTR,FBSUSP,FBTA,FBTYPE,FBV,FBVCHAIN,FBVEN,FBVENID,FBVNAME,FBVI,FBVID,FBVP,FBXPROG,FBY,FBZ,I,IOP,J,K,L,M,N,PGM,T,V,VA,VAERR,VAL,VAR,VAUTNI,VAUTSTR,VAUTVB,X,Y,Z,FBSTANPI,FBXX
76 Q
77WMSG ;write message if no matches found
78 D HDR W !!?3,"There are no potential cost recoveries on file"
79 W !?5,"for specified date range: ",$$DATX^FBAAUTL(FBBDATE)," through ",$$DATX^FBAAUTL(FBEDATE)
80 I 'FBPSV D
81 .W ",",!?5,"and selected Primary Service Area(s):"
82 .S FBPSF=0 F S FBPSF=$O(FBPSV(FBPSF)) Q:'FBPSF W !?31,$G(FBPSV(FBPSF))
83 E W !?5,"and ALL Primary Service Areas "
84 W ".",*7,!!
85 Q
86 ;
87CATC(DFN,FBDT,FBPOV) ;
88 ;treats all copays as Means test for date < 3020705 (JULY 5,2002)
89 ;check if patient is liable for copay
90 ;INPUT:
91 ; DFN = IEN of Patient file
92 ; FBDT= Date
93 ; FBPOV = POV code (for LTC determination)
94 ;OUTPUT:
95 ;0 - the patient is not liable for any co-pay;
96 ;1 - if Means test catc or pending adjudication and agree to pay deduc
97 ;2 - the patient is liable for LTC co-pay;
98 ;3 - no 1010EC on file
99 ;4 - more analysis is needed to determine the patient liability
100 N FBLTC,FBISLTC
101 S FBCATC=$$BIL^DGMTUB(DFN,FBDT)
102 I '$D(FBPOV)!(FBDT<3020705) Q $S(FBCATC:1,1:0)
103 S FBISLTC=$$ISLTC^FBPCR4(FBPOV)
104 I FBISLTC=0 Q $S(FBCATC:1,1:0) ;Means test
105 I FBISLTC=2 Q 0 ;LTC-service, but LTC-copay is not applicable
106 S FBLTC=$$LTCST^FBPCR4(DFN,FBDT)
107 I FBLTC=2 Q 2 ;LTC copay
108 I FBLTC=0 Q 3 ;no 1010EC on file
109 I FBLTC=4 Q 4 ;more info needed
110 Q 0 ;exemption from LTC -copay
111 ;
112VET ;set vet name/ssn/dob info
113 ;INPUT: DFN = IEN of Patient file
114 ; FBPI = IEN of fee program (optional)
115 ;OUTPUT: FBPNAME = Patient's name
116 ; FBPID = Patient's pid
117 ; FBDOB = Patient's dob (if pharmacy fee program)
118 N N
119 S N=$G(^DPT(DFN,0)),FBPNAME=$P(N,U),FBPID=$$SSN^FBAAUTL(DFN),FBDOB=$$FMTE^XLFDT($P(N,U,3))
120 Q
121STA ;set station name & number
122 ;INPUT = FBPSF - IEN to institution file
123 ;OUTPUT = FBPSFNAM = station name
124 ; FBPSFNUM = station number
125 S FBPSFNAM=$P($G(^DIC(4,FBPSF,0)),U),FBPSFNUM=$P($G(^DIC(4,FBPSF,99)),U)
126 S:FBPSFNAM=+FBPSFNAM FBPSFNAM="UNKNOWN"
127 S FBSTANPI=$S($G(FBPSFNAM)="":"",FBPSFNAM="UNKNOWN":"",1:$P($$NPI^XUSNPI("Organization_ID",FBPSF),U,1))
128 Q
129PAGE ;form feed when new station/patient
130 S FBSTA=$G(FBPSF)_$G(FBPT)
131 I FBCRT&(FBPG'=0) D CR Q:FBOUT
132 I FBPG>0!FBCRT W @IOF
133 S FBPG=FBPG+1
134 Q
135CR ;read for display
136 S DIR(0)="E" W ! D ^DIR K DIR S:$D(DUOUT)!($D(DTOUT)) FBOUT=1
137 Q
138HDR ;general header for potential recoveries
139 D PAGE Q:FBOUT
140 W !?(IOM-30/2),"POTENTIAL COST RECOVERY REPORT"
141 W !?(IOM-(11+$L($G(FBPSFNAM))+$L($G(FBPSFNUM)))/2),"Division: ",$G(FBPSFNUM)," ",$G(FBPSFNAM)
142 W !?(IOM-14/2),"NPI: ",$S($G(FBSTANPI)="":"",$G(FBSTANPI)=-1:"",1:$G(FBSTANPI))
143 W !?(IOM-19/2),$$DATX^FBAAUTL(FBBDATE)," - ",$$DATX^FBAAUTL(FBEDATE)
144 W !?71,"Page: ",FBPG
145 W !,"Patient: ",$G(FBPNAME),?40,"Pat. ID: ",$G(FBPID),?62,"DOB: ",$G(FBDOB)
146 W !
147 I FBINCUNK=1,$D(^TMP($J,"FBINSIBAPI",+$G(DFN))) W ">> Warning: accurate insurance information for the patient is unavailable"
148 W !?3,"('*' Represents Reimbursement to Patient",?50,"'#' Represents Voided Payment)"
149 W !,FBDASH
150 W ! D:$D(DFN) INS^DGRPDB
151 Q
152HDRUNK ;Warning message if patient's insurance status is unknown
153 D PAGE Q:FBOUT
154 W !?(IOM-30/2),"POTENTIAL COST RECOVERY REPORT"
155 W !?(IOM-(11+$L($G(FBPSFNAM))+$L($G(FBPSFNUM)))/2),"Division: ",$G(FBPSFNUM)," ",$G(FBPSFNAM)
156 W !?(IOM-19/2),$$DATX^FBAAUTL(FBBDATE)," - ",$$DATX^FBAAUTL(FBEDATE)
157 W !?71,"Page: ",FBPG
158 W !,"------------------------------ !!! WARNING !!! --------------------------------"
159 W !,"This report is incomplete due to problems with obtaining insurance information"
160 W !,"for those patients listed in a separate section in the end of the report. You"
161 W !,"may want to rerun the report again to get more accurate results."
162 W !,FBDASH
163 I FBINCUNK=1 D
164 . W !,"Note: You have chosen to include patients with unknown insurance status in"
165 . W !,"this report. Please be aware that these patients will be treated as if they"
166 . W !,"have billable insurance and their treatment details will be marked accordingly."
167 . W !,"The names of these patients will be accompanied with the following message"
168 . W !,"to order to identify them:"
169 . W !,">> Warning: accurate insurance information for the patient is unavailable"
170 . W !,FBDASH
171 Q
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