| 1 | IBAMTV2 ;ALB/CPM - CREATE CHARGES FOR BILLABLE EPISODES ; 01-JUN-94
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| 2 | ;;2.0;INTEGRATED BILLING;**15,153,204**;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 | ;
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| 5 | BLD ; Create back charges for an array of episodes.
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| 6 | ;
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| 7 | ; Input: IBSTART -- First date that the patient is Means Test billable
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| 8 | ; IBEND -- Last date that the patient is Means Test billable
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| 9 | ; DFN -- Pointer to the patient in file #2
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| 10 | ;
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| 11 | ; ^TMP("IBAMTV",$J,episode date) = 1^2^3, where
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| 12 | ; 1 = adm date for inpatient care
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| 13 | ; visit date for outpatient care
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| 14 | ; 2 = disch/last bill date for inpatient care
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| 15 | ; null for outpatient care
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| 16 | ; 3 = null for inpatient care
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| 17 | ; softlink for outpatient care
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| 18 | ;
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| 19 | S IBJOB=9,(IBWHER,IBY,Y)=1,IBDUZ=$S($G(DUZ):DUZ,1:.5)
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| 20 | D SITE^IBAUTL I Y<1 S IBY=Y G BLDQ
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| 21 | D SERV^IBAUTL2 I IBY<1 G BLDQ
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| 22 | ;
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| 23 | ; - is there an old clock to use?
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| 24 | S IBCLDA=$$OLDCL(DFN,+$O(^TMP("IBAMTV",$J,0)))
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| 25 | I IBCLDA D CLDATA^IBAUTL3,DED^IBAUTL3
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| 26 | ;
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| 27 | ; - bill all episodes of care
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| 28 | S IBEPDT=0 F S IBEPDT=$O(^TMP("IBAMTV",$J,IBEPDT)) Q:'IBEPDT S IBEPSTR=$G(^(IBEPDT)) I IBEPSTR D @$S($P(IBEPSTR,"^",2):"INPT",1:"OPT") Q:IBY<0
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| 29 | I IBY<0 G BLDQ
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| 30 | ;
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| 31 | ; - close clock if over a year old
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| 32 | I IBCLDA,$$FMDIFF^XLFDT(DT,IBCLDT)>364 K IBCLDOL D CLOCKCL^IBAUTL3
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| 33 | ;
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| 34 | BLDQ I IBY<0 D ^IBAERR1
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| 35 | D KILL1^IBAMTC K IBEPDT,IBEPSTR
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| 36 | Q
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| 37 | ;
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| 38 | ;
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| 39 | INPT ; Bill inpatient care.
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| 40 | S IBEVDA=0
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| 41 | I IBCLDA S IBCLCT=$$FMDIFF^XLFDT(+IBEPSTR,IBCLDT)
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| 42 | S IBBDT=$$FMTH^XLFDT(+IBEPSTR,1)
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| 43 | S IBEDT=$$FMTH^XLFDT($P(IBEPSTR,"^",2),1)-1
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| 44 | D ^IBAUTL4 G:IBY<0 INPTQ
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| 45 | ;
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| 46 | I $G(IBCHPDA) D UPD(IBCHPDA)
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| 47 | I $G(IBCHCDA) D UPD(IBCHCDA)
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| 48 | I IBCLDA D CLUPD^IBAUTL3
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| 49 | I IBEVDA,$D(IBDT) S IBEVCLD=IBDT D @($S($$CLEV():"EVCLOSE",1:"EVUPD")_"^IBAUTL3")
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| 50 | ;
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| 51 | INPTQ K IBCHPDA,IBCHCDA,IBCHG,IBCHFR,IBCHTO,IBCHTOTL,IBBS,IBNH,IBTRAN,IBATYP,IBDATE
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| 52 | K IBEVDA,IBEVDT,IBEVCLD,IBEVCAL,IBEVNEW,IBEVOLD,IBTOTL,IBDESC,IBIL,IBSL
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| 53 | Q
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| 54 | ;
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| 55 | OPT ; Bill the Outpatient copayment.
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| 56 | ; Input: IBEPSTR -- 1^2^3, where
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| 57 | ; 1 => visit date
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| 58 | ; 2 => null
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| 59 | ; 3 => softlink (may be null)
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| 60 | ; DFN -- Pointer to the patient in file #2
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| 61 | ;
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| 62 | N %,IBSTOPDA,IBTYPE
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| 63 | ;
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| 64 | I IBCLDA,$$FMDIFF^XLFDT(+IBEPSTR,IBCLDT)>364 K IBCLDOL D CLOCKCL^IBAUTL3 G:IBY<0 OPTQ
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| 65 | I 'IBCLDA S IBCLDT=+IBEPSTR D CLADD^IBAUTL3 G:IBY<0 OPTQ S (IBCLDAY,IBCLDOL)=0
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| 66 | ;
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| 67 | ; - build the charge
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| 68 | I $P(IBEPSTR,"^",3) S IBSL="409.68:"_$P(IBEPSTR,"^",3)
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| 69 | S IBX="O",(IBFR,IBTO,IBDT,IBEVDT)=+IBEPSTR
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| 70 | ;
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| 71 | ; look up the copay tier info
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| 72 | S %=$$GETSC^IBEMTSCU(IBSL,IBEVDT) I % S IBSTOPDA=%
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| 73 | ; get the rate, ibtype = primary or specialty
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| 74 | S IBTYPE=$P($G(^IBE(352.5,+$G(IBSTOPDA),0)),"^",3) G:IBTYPE=0 OPTQ
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| 75 | ; if the type is not defined, must be a local created sc, set it to primary
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| 76 | I 'IBTYPE S IBTYPE=1
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| 77 | ;
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| 78 | ;
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| 79 | D TYPE^IBAUTL2 G:IBY<0 OPTQ
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| 80 | S IBUNIT=1,IBEVDA="*"
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| 81 | D ADD^IBECEAU3 G:IBY<0 OPTQ
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| 82 | ;
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| 83 | ; - place charge in the 'review' status
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| 84 | D UPD(IBN)
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| 85 | ;
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| 86 | OPTQ K IBUNIT,IBFR,IBTO,IBSL,IBEVDA,IBX,IBDESC,IBATYP,IBCHG,IBRTED,IBN,IBBS,IBEVDT
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| 87 | Q
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| 88 | ;
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| 89 | ;
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| 90 | OLDCL(DFN,IBDT) ; Can an old billing clock be used?
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| 91 | ; Input: DFN -- Pointer to the patient in file #2
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| 92 | ; IBDT -- Date of first potentially billable episode
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| 93 | ; Output: 0 -- No old billing clock available
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| 94 | ; >0 -- Pointer to old billing clock in file #351
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| 95 | I '$G(DFN) G OLDCLQ
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| 96 | N IBX,IBY,IBZ,IBST S IBST=0
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| 97 | S IBX=-(IBDT+.1) F S IBX=$O(^IBE(351,"AIVDT",DFN,IBX)) Q:'IBX D Q:IBST
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| 98 | .S IBY=0 F S IBY=$O(^IBE(351,"AIVDT",DFN,IBX,IBY)) Q:'IBY D Q:IBST
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| 99 | ..S IBZ=$G(^IBE(351,IBY,0)) Q:'IBZ!($P(IBZ,"^",4)=3)
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| 100 | ..I $$FMDIFF^XLFDT(IBDT,$P(IBZ,"^",3))<365 S IBST=1
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| 101 | OLDCLQ Q +$G(IBY)
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| 102 | ;
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| 103 | UPD(IBN) ; Place the charge in a review status.
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| 104 | ; Input: IBN -- Pointer to the charge in file #350
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| 105 | S DIE="^IB(",DA=IBN,DR=".05////21" D ^DIE K DIE,DA,DR
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| 106 | Q
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| 107 | ;
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| 108 | CLEV() ; Should the event record be closed?
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| 109 | ; Input: variables IBEVDA -- Pointer to event in file #350
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| 110 | ; IBEND -- Last date through which to bill
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| 111 | ; Output: 1 -- yes, close event
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| 112 | ; 0 -- don't close event
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| 113 | N IBX,IBZ S IBX=0
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| 114 | I '$G(IBEVDA)!'$G(IBEND) S IBX=1 G CLEVQ
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| 115 | I IBEND<$$FMADD^XLFDT(DT,-1) S IBX=1 G CLEVQ
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| 116 | S IBZ=+$P($P($G(^IB(IBEVDA,0)),"^",4),":",2),IBZ=$P($G(^DGPM(IBZ,0)),"^",14)
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| 117 | I IBZ,$P($G(^DGPM(IBZ,0)),"^",17) S IBX=1
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| 118 | CLEVQ Q IBX
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