1 | IBJDB22 ;ALB/RB - REASONS NOT BILLABLE REPORT (PRINT) ;19-JUN-00
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2 | ;;2.0;INTEGRATED BILLING;**123,159**;21-MAR-94
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3 | ;
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4 | EN ; - Entry point from IBJDB21.
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5 | ;
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6 | ; - Extract summary data.
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7 | I $G(IBXTRACT) D EXTMO(.IB) G ENQ
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8 | ;
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9 | S (IBQ,ECNT,ETOT,SCNT,STOT)=0 D NOW^%DTC S IBRUN=$$DAT2^IBOUTL(%)
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10 | ;
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11 | S IBDIV="" I 'IBSD S VAUTD(0)=""
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12 | F S IBDIV=$O(VAUTD(IBDIV)) Q:IBDIV="" D I IBQ Q
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13 | . F IBEP=1:1:4 I IBSEL[IBEP D I IBQ Q
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14 | . . D @($S(IBRPT="D":"DET",1:"SUM"))
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15 | ;
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16 | I IBQ G ENQ
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17 | ;
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18 | I 'IBQ,IBRPT="D" D
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19 | . S IBDIV="" I 'IBSD S VAUTD(0)=""
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20 | . F S IBDIV=$O(VAUTD(IBDIV)) Q:IBDIV="" D I IBQ Q
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21 | . . F IBEP=1:1:4 I IBSEL[IBEP D SUM I IBQ Q
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22 | ;
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23 | ENQ K %,IB0,IBDH,IBDIV,IBEP,IBEPH,IBN,IBP,IBPAG,IBPT,IBQ,IBRT,IBRUN,IBSORT
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24 | K IBT1,IBU,GTOT,ECNT,ETOT,SCNT,STOT
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25 | Q
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26 | ;
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27 | DET ; - Print detailed report.
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28 | I '$D(^TMP("IBJDB2",$J,IBDIV,IBEP)) D D PAUSE Q
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29 | . D HDR Q:IBQ W !!,"No entries for this episode.",!
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30 | S IBT1=0,(IBSORT1,IBPT,IB0)=""
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31 | F S IBSORT1=$O(^TMP("IBJDB2",$J,IBDIV,IBEP,IBSORT1)) Q:IBSORT1="" D Q:IBQ
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32 | . D HDR Q:IBQ
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33 | . F S IBPT=$O(^TMP("IBJDB2",$J,IBDIV,IBEP,IBSORT1,IBPT)) Q:IBPT="" S IBP=$G(^(IBPT)) D Q:IBQ
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34 | . . I $Y>(IOSL-8) D PAUSE Q:IBQ D HDR Q:IBQ
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35 | . . D WPAT
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36 | . . F S IB0=$O(^TMP("IBJDB2",$J,IBDIV,IBEP,IBSORT1,IBPT,IB0)) Q:IB0="" S IBN=$G(^(IB0)) D Q:IBQ
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37 | . . . I $Y>(IOSL-8) D PAUSE Q:IBQ D HDR Q:IBQ D WPAT
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38 | . . . W ?45,$$DTE(+IBN),?55,$$DTE($P(IBN,U,2))
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39 | . . . I $P(IBN,U,4)'="" W ?65,$$DTE($P(IBN,U,3)),?76,$E($P(IBN,U,4),1,19)
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40 | . . . E W ?65,$$DTE($P(IBN,U,2)) W ?76,"POSTMASTER"
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41 | . . . S IBU=5 S:12[IBEP IBU=$S(IBSORT="R":6,1:IBU)
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42 | . . . I 12[IBEP W ?97,$E($P(IBN,U,IBU),1,25),?124,$J($P(IBN,U,8),8,2),!
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43 | . . . I 34[IBEP W ?99,$J($P(IBN,U,8),8,2),!
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44 | . . . I $P(IBN,U,9)]"" W ?15,"Comments: ",$P(IBN,U,9) W:12'[IBEP !
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45 | . . . I 12[IBEP W ?97,$E($P(IBN,U,$S("PR"[IBSORT:7,1:6)),1,25),!
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46 | . . . S SCNT=SCNT+1,ECNT=ECNT+1
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47 | . . . S STOT=STOT+$P(IBN,U,8),ETOT=ETOT+$P(IBN,U,8)
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48 | . I 'IBQ D TOT2 I $O(^TMP("IBJDB2",$J,IBDIV,IBEP,IBSORT1))'="" D PAUSE Q
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49 | I 'IBQ D TOT1,PAUSE
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50 | ;
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51 | DETQ Q
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52 | ;
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53 | EXTMO(IBSM) ; Extract/transmit data to DM Extract Module
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54 | ; IBSM - Array containing the summary information
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55 | ;
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56 | N I,IB,IBI,IBJ,IBLST,IBR,IBRNB,IBSQ,IBTR,IBTP,IBZ,RNBC,RNBN
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57 | ;
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58 | F I=1:1 S RNBN=$P($T(RNB+I),";;",2,99) Q:RNBN="" D
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59 | . S RNBC=$O(^IBE(356.8,"B",RNBN,0)) Q:'RNBC
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60 | . S IBTR(RNBC)=I
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61 | ;
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62 | S IBRNB="",IBLST=$O(^IBE(356.8,999),-1)*2
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63 | F IBTP=1:1:4 D
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64 | . F IBJ=1:1:IBLST,999,1000 S IB(IBTP,IBJ)=$S(IBJ#2:0,1:"0.00")
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65 | . F S IBRNB=$O(IBSM(0,IBTP,IBRNB)) Q:IBRNB="" D
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66 | . . I '$D(IBTR(IBRNB)) Q
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67 | . . S IBSQ=$S(IBRNB<999:IBTR(IBRNB)*2-1,1:999)
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68 | . . S IBZ=$G(IBSM(0,IBTP,IBRNB))
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69 | . . S IB(IBTP,IBSQ)=+IBZ
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70 | . . S IB(IBTP,IBSQ+1)=$FN(+$P(IBZ,"^",2),"",2)
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71 | . F I=1:1:3 D E^IBJDE(21+(IBTP*3)+I,0)
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72 | . K IB(IBTP)
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73 | ;
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74 | Q
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75 | ;
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76 | SUM ; - Print summary line(s).
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77 | I '$D(IB(IBDIV,IBEP)) D D PAUSE Q
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78 | . D SUMH W !!?14,"No statistics available."
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79 | D SUMH Q:IBQ
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80 | S IBRNB=0 F S IBRNB=$O(IB(IBDIV,IBEP,IBRNB)) Q:'IBRNB D Q:IBQ
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81 | . S IBN=IB(IBDIV,IBEP,IBRNB)
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82 | . W !?14,$P($G(^IBE(356.8,IBRNB,0)),U),?48,$J(+IBN,5),?57,$J($P(IBN,U,2),9,2)
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83 | . S $P(GTOT,U)=$P(GTOT,U)+IBN,$P(GTOT,U,2)=$P(GTOT,U,2)+$P(IBN,U,2)
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84 | D SUMT
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85 | ;
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86 | Q
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87 | ;
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88 | SUMH ; - Print summary header.
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89 | I $E(IOST,1,2)="C-"!$G(IBPAG) W @IOF,*13
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90 | S IBPAG=$G(IBPAG)+1 W ?68,"Page: ",IBPAG
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91 | S IBEPH="REASONS NOT BILLABLE SUMMARY/"_IBEPS(IBEP)
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92 | W !!?(80-$L(IBEPH))\2,IBEPH
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93 | I IBDIV D
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94 | .S IBDH="Division: "_$P($G(^DG(40.8,IBDIV,0)),U)
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95 | .W !?(80-$L(IBDH)\2),IBDH
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96 | ;
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97 | W !?22,"Period : from ",$$DTE(IBBDT)," thru ",$$DTE(IBEDT),!
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98 | W !?24,"Run Date: ",IBRUN
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99 | W !!?46,"No. of",?61,"Total",!?14,"RNB Category",?46,"Entries"
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100 | W ?60,"Amount",!?14,$$DASH(52)
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101 | S GTOT="0^0",IBQ=$$STOP^IBOUTL("Reasons Not Billable Summary")
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102 | Q
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103 | ;
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104 | SUMT ; - Print summary totals.
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105 | W !?47,"-------------------"
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106 | W !?33,"Grand Totals:",?47,$J(+GTOT,6),?56,$J($P(GTOT,U,2),10,2) D PAUSE
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107 | Q
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108 | ;
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109 | HDR ; - Write the detailed report header.
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110 | I $E(IOST,1,2)="C-"!$G(IBPAG) W @IOF,*13
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111 | S IBPAG=$G(IBPAG)+1 W "Reasons Not Billable (RNB) Report "
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112 | W ?88,"Run Date: ",IBRUN,?123,"Page: ",$J(IBPAG,3)
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113 | S X=IBE(IBEP)_" events by "
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114 | I 1234[IBEP D
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115 | . S X=X_$S(IBSORT="P":"provider",IBSORT="S":"specialty",1:"RNB category")
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116 | . I $G(IBSORT1)'="" S X=X_" ("_IBSORT1_")"
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117 | E S X=X_"RNB category"
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118 | S X=X_" from "_$$DTE(IBBDT)_" thru "_$$DTE(IBEDT)_" ("_IBD_")"
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119 | I 12[IBEP D
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120 | . I IBSORT'="R" D
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121 | . . S X=X_" / "_$S(IBSRNB="S":"SPECIFIC",1:"ALL")_" REASONS NOT BILLABLE"
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122 | . I IBSORT'="P" D
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123 | . . S X=X_" / "_$S(IBSPRV="S":"SPECIFIC",1:"ALL")_" PROVIDERS"
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124 | . I IBSORT'="S",IBEP=1 D
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125 | . . S X=X_" / "_$S(IBSISP="S":"SPECIFIC",1:"ALL")_" SPECIALTIES"
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126 | . I IBSORT'="S",IBEP=2 D
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127 | . . S X=X_" / "_$S(IBSOSP="S":"SPECIFIC",1:"ALL")_" SPECIALTIES"
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128 | F I=1:1 W !,$E(X,1,132) S X=$E(X,133,999) I X="" Q
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129 | ;
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130 | I IBDIV W !,"Division: ",$P($G(^DG(40.8,IBDIV,0)),U)
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131 | W !!?26,"Last",?32,"Insurance",?45,"Episode Date Dte Last"
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132 | I 12[IBEP W ?97,$S("PS"[IBSORT:"RNB Category",1:"Provider")
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133 | W !,"Patient",?26,"4SSN",?32,"Carrier"
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134 | W ?45,"Date Entered Edited Last Edited By"
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135 | I 12[IBEP W ?97,$S("PR"[IBSORT:"Specialty",1:"Provider")
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136 | ;
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137 | I 34[IBEP W ?101,"Amount",!,$$DASH(IOM-25),!
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138 | E W ?126,"Amount",!,$$DASH(IOM),!
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139 | S IBQ=$$STOP^IBOUTL("Reasons Not Billable Report")
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140 | Q
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141 | ;
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142 | WPAT ; - Write patient data.
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143 | W $P(IBPT,"@@"),?26,$P(IBPT,"@@",2),?32,$E($P(IBP,U),1,12)
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144 | Q
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145 | ;
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146 | TOT1 ; - Print episode totals.
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147 | I 34[IBEP W !?97,"----------",!
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148 | E W !?122,"----------",!
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149 | I 34[IBEP W ?55
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150 | E W ?80
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151 | W "TOTAL FOR EPISODE - Count: ",$J(ECNT,5)," Amount: ",$J(ETOT,10,2)
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152 | S (ECNT,ETOT)=0
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153 | Q
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154 | ;
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155 | TOT2 ; - Print sub-totals.
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156 | I 34[IBEP W ?98,"---------",!
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157 | E W ?123,"---------",!
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158 | I 34[IBEP W ?60
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159 | E W ?85
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160 | W "TOTAL EVENTS - Count: ",$J(SCNT,4)," Amount: ",$J(STOT,9,2),!
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161 | S (SCNT,STOT)=0
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162 | Q
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163 | ;
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164 | DASH(X) ; - Return a dashed line.
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165 | Q $TR($J("",X)," ","=")
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166 | ;
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167 | PAUSE ; - Page break.
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168 | I $E(IOST,1,2)'="C-" Q
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169 | N IBX,DIR,DIRUT,DUOUT,DTOUT,DIROUT,X,Y
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170 | F IBX=$Y:1:(IOSL-3) W !
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171 | S DIR(0)="E" D ^DIR S:$D(DIRUT)!($D(DUOUT)) IBQ=1
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172 | Q
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173 | ;
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174 | DTE(X) ; - Format the date.
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175 | Q $S(X:$E(X,4,5)_"/"_$E(X,6,7)_"/"_$E(X,2,3),1:"")
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176 | ;
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177 | RNB ; - Reasons Not Billable
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178 | ;;NOT INSURED
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179 | ;;SC TREATMENT
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180 | ;;AGENT ORANGE
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181 | ;;IONIZING RADIATION
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182 | ;;ENV. CONTAM.
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183 | ;;SERVICE NOT COVERED
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184 | ;;COVERAGE CANCELED
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185 | ;;NEEDS SC DETERMINATION
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186 | ;;NON-BILLABLE APPOINTMENT TYPE
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187 | ;;INVALID PRESCRIPTION ENTRY
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188 | ;;REFILL ON VISIT DATE
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189 | ;;PRESCRIPTION DELETED
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190 | ;;PRESCRIPTION NOT RELEASED
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191 | ;;DRUG NOT BILLABLE
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192 | ;;HMO POLICY
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193 | ;;REFUSES TO SIGN RELEASE (ROI)
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194 | ;;NON-BILLABLE STOP CODE
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195 | ;;RESEARCH VISIT
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196 | ;;BILL PURGED
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197 | ;;NON-BILLABLE CLINIC
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198 | ;;MILITARY SEXUAL TRAUMA
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199 | ;;CREDENTIALING ISSUE
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200 | ;;INSUFFICIENT DOCUMENTATION
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201 | ;;NO DOCUMENTATION
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202 | ;;NON-BILLABLE PROVIDER (RESID.)
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203 | ;;NON-BILLABLE PROVIDER (OTHER)
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204 | ;;OTHER COMPLIANCE
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205 | ;;OUT OF NETWORK (PPO)
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