1 | IBAECU5 ;WOIFO/SS-LTC PHASE 2 UTILITIES ; 20-FEB-02
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2 | ;;2.0;INTEGRATED BILLING;**171,176**;21-MAR-94
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3 | ;;Per VHA Directive 10-93-142, this routine should not be modified.
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4 | ;check if there is LTC in ^TMP of INPINFO^IBAECU2
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5 | ISLTC(IBDFN,IBLBL) ;
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6 | N IBFL5,IBVA,IBVT,IBVD
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7 | S (IBFL5,IBVA)=0
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8 | F S IBVA=$O(^TMP($J,IBLBL,IBDFN,IBVA)) Q:IBVA=""!(IBFL5>0) D
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9 | . S IBVT=0
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10 | . F S IBVT=$O(^TMP($J,IBLBL,IBDFN,IBVA,IBVT)) Q:IBVT=""!(IBFL5>0) D
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11 | . . S IBVD=0
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12 | . . F S IBVD=$O(^TMP($J,IBLBL,IBDFN,IBVA,IBVT,IBVD)) Q:IBVD=""!(IBFL5>0) D
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13 | . . . S:$P($G(^TMP($J,IBLBL,IBDFN,IBVA,IBVT,IBVD)),"^",1)="L" IBFL5=IBVD
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14 | Q IBFL5
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15 | ;
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16 | ;is C&P exam this date
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17 | ;IBDFN1 - patient's ien #2
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18 | ;IBDT1 -date
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19 | ;returns
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20 | ; 1 - YES, 0 -NO
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21 | ISCOMPEN(IBDFN1,IBDT1) ;
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22 | Q $$CNP^IBECEAU(IBDFN1,IBDT1)
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23 | ;
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24 | ;checks if charge for outpatient visit and then cancels it
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25 | ;IBDFN - Pointer to patient in file #2
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26 | ;IBDATE - Date to check for OPT charges
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27 | CANCVIS(IBDFN,IBDATE) ;
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28 | N IBN,IBCRES,IBDUZ
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29 | S IBDUZ=+$G(DUZ)
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30 | S IBN=$$BFO^IBECEAU(IBDFN,IBDATE)
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31 | Q:'IBN
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32 | S IBCRES=$O(^IBE(350.3,"B","BILLED LTC CHARGE",0))
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33 | S:'IBCRES IBCRES=4 S IBWHER=""
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34 | D CANCH^IBECEAU4(IBN,IBCRES,0)
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35 | Q
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36 | ;
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37 | ;prepares error messages
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38 | ;IBDFN - patient's ien
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39 | ;IBIEN - ien of applicable file
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40 | ;IBACT - action
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41 | ;IBMESS - error message
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42 | ERRLOG(IBDFN,IBIEN,IBACT,IBMESS) ;
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43 | Q:+IBDFN=0!(+IBIEN=0)!(IBACT="")
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44 | N VADM,VA,VAERR,DFN,IBCNT
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45 | S DFN=IBDFN
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46 | D DEM^VADPT
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47 | S ^TMP($J,"IBMJERR")=$G(^TMP($J,"IBMJERR"))+1
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48 | S IBCNT=$G(^TMP($J,"IBMJERR"))
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49 | S ^TMP($J,"IBMJERR",IBCNT,1)=" "
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50 | S ^TMP($J,"IBMJERR",IBCNT,2)="*********************************"
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51 | S ^TMP($J,"IBMJERR",IBCNT,3)=" "_$G(IBMESS)
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52 | S ^TMP($J,"IBMJERR",IBCNT,4)=" Action : "_$G(IBACT)
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53 | S ^TMP($J,"IBMJERR",IBCNT,5)=" Applicable IEN : "_$G(IBIEN)
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54 | S ^TMP($J,"IBMJERR",IBCNT,6)=" Patient : "_$G(VADM(1))
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55 | S ^TMP($J,"IBMJERR",IBCNT,7)=" SSN : "_$P($G(VADM(2)),"^",2)
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56 | Q
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57 | ;
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58 | ;sends all errors in TMP($J,"IBMJERR" to IB ERROR mail group
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59 | SENDERR ;
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60 | N XMSUB,XMTEXT,XMY,XMZ,XMMG,IBL,IBT,XMDUZ,IBV1,IBV2,IBV3
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61 | N IBMAXLN S IBMAXLN=200
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62 | N XMGROUP S XMGROUP=$$GET1^DIQ(350.9,"1,",.09)
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63 | Q:XMGROUP=""
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64 | S XMGROUP="G."_XMGROUP
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65 | S XMSUB="LTC Monthly Job error report",XMY(XMGROUP)=""
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66 | S XMTEXT="IBT(",XMDUZ="INTEGRATED BILLING PACKAGE"
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67 | S IBV1=0,IBV3=1
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68 | F S IBV1=$O(^TMP($J,"IBMJERR",IBV1)) Q:+IBV1=0!(IBV3>IBMAXLN) D
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69 | . S IBV2=0
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70 | . F S IBV2=$O(^TMP($J,"IBMJERR",IBV1,IBV2)) Q:+IBV2=0 D
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71 | . . S IBT(IBV3,0)=$G(^TMP($J,"IBMJERR",IBV1,IBV2)),IBV3=IBV3+1
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72 | S:IBV3>IBMAXLN IBT(IBV3,0)="******* Too many errors! *******"
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73 | D ^XMD
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74 | Q
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75 | ;
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76 | ;sends message to user group if there is no 1010EC form forthe patient
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77 | MESS10EC(DFN,IBDT) ;
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78 | D XMNOEC^IBAECU(DFN,IBDT)
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79 | Q
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80 | ;
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81 | ;Creates charge, sends amount to AR
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82 | ;IBPATDFN - patient DFN
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83 | ;.IBAMOUNT - array with all amounts for each day
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84 | ;array IBMNTH - month info
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85 | ;.IBMNTH - number of days
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86 | ;IBMNTH(0)- first day (in FM format)
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87 | ;IBMNTH(1)- last day (in FM format)
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88 | ;IBMNTH(2)- year_month (like 30201)
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89 | ;IBMONCAP - maximum monthly copay (180 days stuff)
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90 | SEND2AR(IBPATDFN,IBAMOUNT,IBMNTH,IBMONCAP) ;
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91 | ;arrays
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92 | N IBPAYS,IBRCHRGS
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93 | ;vars
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94 | N IBADM,IB350P,IBDD,IBRES,IBTOT,IBV1,IBNOS,IBAMNT
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95 | N IBDAY,IB350,IBRATE,IBTP,IBDT,IBSL,IBPRDAY,IBV1
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96 | N IBINPDS,IBFDAY,IBLDAY,IBEPSSUM,IBFRD,IBTOD
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97 | S IBDAY=0,IBPAYS=0,IBRCHRGS=0
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98 | ;1.outpatient visit charges
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99 | F S IBDAY=$O(IBAMOUNT("A",IBDAY)) Q:+IBDAY=0 I +$G(IBAMOUNT("A",IBDAY,"T"))=1 D
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100 | . S IBRATE=+$G(IBAMOUNT("A",IBDAY,"R"))
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101 | . S IBTP=$P($G(IBAMOUNT("A",IBDAY,"R")),"^",2)
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102 | . S IBDT=$$MKDATE^IBAECU4(IBMNTH(2),IBDAY)
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103 | . S IBSL="409.68:"_$P($G(IBAMOUNT("A",IBDAY,"T")),"^",2)
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104 | . S IBPAYS=$G(IBPAYS)+1,IBPAYS(IBDAY)=IBPATDFN_"^"_IBTP_"^1^"_IBRATE_"^"_IBDT_"^"_IBDT_"^"_IBSL_"^^*^"_IBDT
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105 | ;2.inpatient stay charges
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106 | S IBFDAY=0 ;first day of episode
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107 | S IBLDAY=0 ;last day of episode
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108 | S IBINPDS=0 ;length of each episode (Exmpl. Jan3-Jan5=2days, Jan21-Jan31=10 days)
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109 | S IBEPSSUM=0 ;total for episode
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110 | S IBDAY=0
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111 | F S IBDAY=$O(IBAMOUNT("A",IBDAY)) Q:+IBDAY=0 I +$G(IBAMOUNT("A",IBDAY,"T"))=2 D
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112 | . S:IBFDAY=0 IBFDAY=IBDAY ;set first day
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113 | . S IBINPDS=IBINPDS+1 ;count days
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114 | . S IBRATE=+$G(IBAMOUNT("A",IBDAY,"R"))
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115 | . S IBEPSSUM=IBEPSSUM+IBRATE ;total
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116 | . S IBV1=+$O(IBAMOUNT("A",IBDAY)) ;check the next day
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117 | . ;if next "is the end" OR "if AA/ASIH gap" OR "if another admission"
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118 | . I (IBV1=0)!((IBV1-IBDAY)>1)!($P($G(IBAMOUNT("A",IBDAY,"T")),"^",2)'=$P($G(IBAMOUNT("A",IBV1,"T")),"^",2)) D
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119 | . . S IBLDAY=IBDAY ; set last day
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120 | . . S IBTP=$P($G(IBAMOUNT("A",IBDAY,"R")),"^",2) ;action type
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121 | . . S IBFRD=$$MKDATE^IBAECU4(IBMNTH(2),IBFDAY) ;from
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122 | . . S IBTOD=$$MKDATE^IBAECU4(IBMNTH(2),IBLDAY) ;to
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123 | . . S IBADM=$P($G(IBAMOUNT("A",IBDAY,"T")),"^",2) ;admission
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124 | . . S IBDT=+$P($G(IBAMOUNT("A",IBDAY,"T")),"^",3) ;default is admission date
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125 | . . I IBDT<IBMNTH(0) S IBDT=IBMNTH(0) ;if admission date < begining of month
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126 | . . S IB350P=+$$FIND350^IBAECN1(IBPATDFN,IBFRD+0.9,IBADM,1) ;find INCOMLETE parent event
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127 | . . I IB350P=0 D
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128 | . . . N VAIP,IB350PCL,DFN
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129 | . . . S DFN=IBPATDFN,VAIP("D")=IBFRD_.2359 D IN5^VADPT
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130 | . . . I '$$ASIH^IBAUTL5($G(^DGPM(+VAIP(1),0))) D Q
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131 | . . . . ;find "completed" - ASIH could complete event entry
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132 | . . . . S IB350PCL=+$$FIND350^IBAECN1(IBPATDFN,IBFRD+0.9,+IBADM,2)
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133 | . . . . I IB350PCL>0 S IB350P=IB350PCL
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134 | . . . S IB350P=+$$FIND350^IBAECN1(IBPATDFN,IBFRD+0.9,+VAIP(1),1)
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135 | . . . S IBADM=+VAIP(1),IBDT=+$G(^DGPM(VAIP(1),0))\1
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136 | . . ;if not found - create new one with LTC type
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137 | . . I IB350P=0 S IB350P=$$CREV350^IBAECN1(IBPATDFN,+IBADM,IBDT,93)
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138 | . . S IBSL="405:"_IBADM ;soft link
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139 | . . S IBPAYS=$G(IBPAYS)+1
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140 | . . I $D(IBPAYS(IBDAY)) D ERRLOG(+$G(IBPATDFN),+$G(IB350P),"SEND2AR: charges","Attempt to create more than one charge a day ")
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141 | . . S IBPAYS(IBDAY)=IBPATDFN_"^"_IBTP_"^"_IBINPDS_"^"_IBEPSSUM_"^"_IBFRD_"^"_IBTOD_"^"_IBSL_"^^"_IB350P_"^"_IBDT
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142 | . . S (IBFDAY,IBLDAY,IBINPDS,IBEPSSUM)=0
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143 | ;3. make charges until it less than monthly cap
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144 | ;
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145 | S (IBTOT,IBFL,IBDD)=0
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146 | F S IBDD=$O(IBPAYS(IBDD)) Q:+IBDD=0!(IBFL=1) D
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147 | . S IBRES=$G(IBPAYS(IBDD))
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148 | . S IBAMNT=0
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149 | . I IBTOT'<IBMONCAP S IBFL=1 Q ;don't charge anymore
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150 | . I (IBTOT+$P(IBRES,"^",4))'>IBMONCAP D ;charge whole amount
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151 | . . S IBAMNT=$P(IBRES,"^",4)
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152 | . E S IBAMNT=IBMONCAP-IBTOT ;charge a rest
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153 | . S IBTOT=IBTOT+IBAMNT
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154 | . S IB350=$$CHARGE(IBPATDFN,$P(IBRES,"^",2),$P(IBRES,"^",3),IBAMNT,$P(IBRES,"^",5),$P(IBRES,"^",6),$P(IBRES,"^",7),$P(IBRES,"^",8),$P(IBRES,"^",9),$P(IBRES,"^",10))
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155 | . I IB350>0 S IBRCHRGS=IBRCHRGS+1,IBRCHRGS(IBRCHRGS)=IB350
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156 | . ;Edit parent event in #350 V 11F
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157 | . I +$P(IBRES,"^",9)>0 D STAT350^IBAECN1(+$P(IBRES,"^",9),IBMNTH(1),+$P($P(IBRES,"^",7),":",2))
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158 | ;4. Send to AR
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159 | S IBV1=0,IBNOS=""
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160 | F S IBV1=$O(IBRCHRGS(IBV1)) Q:+IBV1=0 D
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161 | . S:IBNOS'="" IBNOS=IBNOS_"^"_IBRCHRGS(IBV1)
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162 | . S:IBNOS="" IBNOS=IBRCHRGS(IBV1)
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163 | . I (IBV1#5)=0 S IBRES=$$TOAR(IBPATDFN,1,IBNOS,+$G(DUZ)),IBNOS=""
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164 | I IBNOS'="" S IBRES=$$TOAR(IBPATDFN,1,IBNOS,+$G(DUZ)),IBNOS=""
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165 | Q
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166 | ;call ^IBR
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167 | TOAR(DFN,IBSEQNO,IBNOS,IBDUZ) ;
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168 | ;
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169 | N Y,IBERR,IBIL
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170 | D ^IBR
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171 | Q Y
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172 | ;
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173 | ;create outppatient charge
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174 | ; Input:
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175 | ; DFN -- Pointer to patient in file #2
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176 | ; IBATYP -- Pointer to Action Type in file #350.1
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177 | ; IBUNIT -- Number of units of charge (1 day for outpatient, 1 or more for inpatients)
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178 | ; IBCHG -- $$ amount of charge
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179 | ; IBFR -- Bill From date
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180 | ; inpatient: first day of episode
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181 | ; outpatient: date of service
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182 | ; IBTO -- Bill To date
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183 | ; inpatient: last day of episode
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184 | ; outpatient: date of service
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185 | ; IBSL -- Softlink 405:IEN or 409.68:IEN
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186 | ; IBPAR -- placeholder for IBPARNT (see below)
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187 | ; IBEVDA -- Pointer to parent event in #350 for inpatients,
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188 | ; or "*" for outpatients to set ibevda=ibn
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189 | ; IBEVDT -- for outpatient: Event Date
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190 | ; for inpatient:admission date or begining of month if admission began
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191 | ; before the begining of the month
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192 | CHARGE(DFN,IBATYP,IBUNIT,IBCHG,IBFR,IBTO,IBSL,IBPAR,IBEVDA,IBEVDT) ;
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193 | ;
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194 | N IBN,IBDESC,IBSITE,IBFAC,IBXA
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195 | D SITE^IBAUTL
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196 | S IBDESC=$P($G(^IBE(350.1,+$G(IBATYP),0)),"^",8)
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197 | I IBDESC="" S IBDESC=$$ACTNM(+$G(IBATYP)) D ERRLOG(+$G(DFN),+$G(IBATYP),"CHARGE","No USER LOOKUP NAME in #350.1")
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198 | S IBN=0
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199 | ;IBPARNT -- Pointer to parent entry in #350 [OPTIONAL], i.e. to previous record(s)
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200 | ; for the same charge, that were edited or cancelled
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201 | ; Here IBPARNT must be undefined, because we always create "NEW" charges
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202 | N IBPARNT ;undefined
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203 | D ADD^IBECEAU3
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204 | Q IBN
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205 | ;
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206 | ACTNM(X) ;X -input pointer to action type file (350.1)
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207 | S Y=$P($G(^IBE(350.1,+X,0)),"^",9) ;new action type
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208 | Q $S($P($G(^IBE(350.1,+Y,0)),"^",8)]"":$P(^(0),"^",8),$P($G(^IBE(350.1,+X,0)),"^",8)]"":$P(^(0),"^",8),1:$P($G(^IBE(350.1,+X,0)),"^"))
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209 | ;
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