1 | IBJDI5 ;ALB/CPM - INSURANCE POLICIES NOT VERIFIED ; 18-DEC-96
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2 | ;;2.0;INTEGRATED BILLING;**69,98,100,118,123**;21-MAR-94
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3 | ;
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4 | EN ; - Option entry point.
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5 | ;
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6 | W !!,"This report provides a number of the insurance policies which were"
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7 | W !,"entered into the system within a given timeframe, but were never verified.",!
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8 | ;
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9 | DATE D DATE^IBOUTL I IBBDT=""!(IBEDT="") G ENQ
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10 | ;
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11 | ; - Select a detailed or summary report.
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12 | D DS^IBJD I IBRPT["^" G ENQ
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13 | ;
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14 | ; - Select print/not print verified policies/totals.
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15 | S DIR(0)="YO"
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16 | S DIR("A",1)="Do you want to print a "_$S(IBRPT="D":"separate report for",1:"total number of")_" policies that were verified"
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17 | S DIR("A")=" over a year ago"
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18 | S DIR("B")="NO" D ^DIR K DIR S IBVER=Y I IBVER["^" G ENQ
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19 | ;
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20 | I IBRPT="D" W !!,"You will need a 132 column printer for this report!"
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21 | E W !!,"This report only requires an 80 column printer."
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22 | ;
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23 | W !!,"Note: This report may take a while to run."
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24 | W !?6,"You should queue this report to run after normal business hours.",!
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25 | ;
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26 | ; - Select a device.
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27 | S %ZIS="QM" D ^%ZIS G:POP ENQ
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28 | I $D(IO("Q")) D G ENQ
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29 | .S ZTRTN="DQ^IBJDI5",ZTDESC="IB - INSURANCE POLICIES NOT VERIFIED"
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30 | .F I="IBBDT","IBEDT","IBRPT","IBVER" S ZTSAVE(I)=""
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31 | .D ^%ZTLOAD
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32 | .W !!,$S($D(ZTSK):"This job has been queued. The task number is "_ZTSK_".",1:"Unable to queue this job.")
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33 | .K ZTSK,IO("Q") D HOME^%ZIS
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34 | ;
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35 | U IO
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36 | ;
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37 | DQ ; - Tasked entry point.
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38 | ;
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39 | I $G(IBXTRACT) D E^IBJDE(5,1) ; Change extract status.
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40 | ;
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41 | N IBQUERY
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42 | K IB,^TMP("IBJDI51",$J),^TMP("IBJDI52",$J)
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43 | S (IB("NOT"),IB("TOT"),IB("VER"),IBQ)=0 S:IBVER IB("VERO")=0
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44 | ;
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45 | ; - Find inpatients treated within the user-specified date range.
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46 | S IBD=IBBDT-.01 F S IBD=$O(^DGPM("ATT3",IBD)) Q:'IBD!(IBD\1>IBEDT) D Q:IBQ
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47 | .S IBPM=0 F S IBPM=$O(^DGPM("ATT3",IBD,IBPM)) Q:'IBPM D Q:IBQ
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48 | ..I IBPM#100=0 S IBQ=$$STOP^IBOUTL("Insurance Policies Not Verified") Q:IBQ
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49 | ..S IBPMD=$G(^DGPM(IBPM,0)) Q:'IBPMD
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50 | ..S DFN=+$P(IBPMD,U,3) Q:'DFN
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51 | ..;
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52 | ..; - Process patient.
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53 | ..I '$D(^TMP("IBJDI51",$J,DFN)) D PROC(DFN,"*",IBD)
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54 | ;
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55 | I IBQ G ENQ
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56 | ;
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57 | ; - Find outpatients treated within the user-specified date range.
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58 | D CLOSE^IBSDU(.IBQUERY)
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59 | D OUTPT^IBJDI21("",IBBDT,IBEDT,"S:IBQ SDSTOP=1 I 'IBQ,$$ENCHK^IBJDI5(Y0) D ENC^IBJDI5(Y0)","Insurance Policies Not Verified",.IBQ,"IBJDI51",.IBQUERY)
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60 | D CLOSE^IBSDU(.IBQUERY)
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61 | ;
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62 | I IBQ G ENQ
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63 | ;
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64 | ; - Find data required for the report.
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65 | S IBC=0 F S IBC=$O(^TMP("IBJDI51",$J,IBC)) Q:'IBC D Q:IBQ
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66 | .I IBC#100=0 S IBQ=$$STOP^IBOUTL("Insurance Policies Not Verified") Q:IBQ
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67 | .;
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68 | .; - Get the patient's active insurance policies.
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69 | .K IBINS S IBC1=$G(^TMP("IBJDI51",$J,IBC))
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70 | .D ALL^IBCNS1(IBC,"IBINS",1,+IBC1) Q:'$D(IBINS)
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71 | .S IBC2=0 F S IBC2=$O(IBINS(IBC2)) Q:'IBC2 D
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72 | ..;
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73 | ..; - Make sure the insurance company reimburses VA.
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74 | ..S IBC3=$G(^DIC(36,+$G(IBINS(IBC2,0)),0))
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75 | ..Q:$P(IBC3,U)="" Q:$P(IBC3,U,2)="N"
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76 | ..;
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77 | ..S IBCDFND=$G(IBINS(IBC2,1))
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78 | ..;
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79 | ..S IB("TOT")=IB("TOT")+1 ; Count all.
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80 | ..;
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81 | ..; - Check if policy is verified, verified over a year, or neither.
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82 | ..S IBVFLG=0
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83 | ..I $P(IBCDFND,U,3) D Q:'IBVFLG
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84 | ...S IB("VER")=IB("VER")+1 Q:'IBVER
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85 | ...S X1=DT,X2=$P(IBCDFND,U,3) D ^%DTC
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86 | ...I X>365 S IB("VERO")=IB("VERO")+1,IBVFLG=1
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87 | ..E S IB("NOT")=IB("NOT")+1
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88 | ..;
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89 | ..; - Build line for detailed report.
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90 | ..I IBRPT="D" D
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91 | ...S IBDOD=$S(+$G(^DPT(IBC,.35)):$$DAT2^IBOUTL(+$G(^(.35))\1),1:"")
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92 | ...S X=$G(^DPT(IBC,0)),IBEBY=$P(IBCDFND,U,2)
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93 | ...S IBVDTE=$S(IBVFLG:$P(IBCDFND,U,3),1:"")
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94 | ...S IBVBY=$S(IBVFLG:$P(IBCDFND,U,4),1:"")
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95 | ...S ^TMP("IBJDI52",$J,IBVFLG,$P(X,U)_$P(IBC1,U,2)_"@@"_$P(X,U,9)_"@@"_IBDOD_"@@"_IBC,IBC2)=$P(IBC3,U)_U_IBEBY_U_$S(+IBCDFND>0:+IBCDFND\1,1:"")_U_IBVBY_U_$S(+IBVDTE>0:IBVDTE\1,1:"")
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96 | ;
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97 | I IBQ G ENQ
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98 | ;
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99 | I $G(IBXTRACT) D E^IBJDE(5,0) G ENQ ; Extract summary data.
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100 | ;
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101 | ; - Print the reports.
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102 | S (IBPAG,IBQ)=0 D NOW^%DTC S IBRUN=$$DAT2^IBOUTL(%)
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103 | I IBRPT="D" D DET
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104 | I 'IBQ D SUM
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105 | ;
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106 | I 'IBQ D PAUSE
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107 | ;
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108 | ENQ K ^TMP("IBJDI51",$J),^TMP("IBJDI52",$J)
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109 | I $D(ZTQUEUED) S ZTREQ="@" G ENQ1
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110 | ;
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111 | D ^%ZISC
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112 | ENQ1 K IB,IBQ,IBBDT,IBEDT,IBRPT,IBD,IBDN,IBPH,IBPM,IBINS,IBPMD,IBPAG,IBRUN,%
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113 | K IBEBY,IBVBY,IBVDTE,IBDOD,IBPER,IBC,IBC1,IBC2,IBC3,IBCDFN,IBVER,IBVFLG
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114 | K IBCDFND,IBX,IBX1,IBX2,IBX3,DFN,POP,X,X1,X2,Y,ZTDESC,ZTRTN,ZTSAVE,%ZIS
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115 | Q
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116 | ;
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117 | ENC(IBOED) ; - Encounter extract for outpatient loop.
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118 | ; Input: IBOED = Outpatient encounter in file #409.68
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119 | ;
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120 | D PROC(+$P(IBOED,U,2),"",+IBOED) ; Process patient.
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121 | Q
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122 | ;
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123 | PROC(DFN,IBIPC,IBDTE) ; - Process each specific patient.
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124 | ; Input: DFN = Pointer to the patient in file #2
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125 | ; IBIPC = Inpatient treatment marker
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126 | ; ("*"=Had inpat. treatment, null=No inpat. treatment)
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127 | ; IBDTE = Patient's checkout or discharge date
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128 | ;
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129 | I $$TESTP^IBJDI1(DFN) Q ; Test patient.
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130 | D ELIG^VADPT I 'VAEL(4) G PRCQ ; Patient is not a vet.
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131 | ;
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132 | ; - Set patient index.
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133 | S ^TMP("IBJDI51",$J,DFN)=IBDTE\1_U_IBIPC
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134 | ;
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135 | PRCQ K VA,VAERR,VAEL
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136 | Q
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137 | ;
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138 | ENCHK(IBOED) ; - Check outpatient's encounter record.
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139 | ; Input: IBOED = Outpatient encounter in file #409.68
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140 | ; Output: 1 = OK for processing
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141 | ; 0 = Not OK for processing
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142 | ;
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143 | N X,X1 S Y=0 I '$G(IBOED) G ENCKQ
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144 | ;
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145 | ; - Check if encounter was a registration/cancellation without exam.
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146 | S X=+$P(IBOED,U,2)
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147 | S X1=+$P($G(^DPT(X,"DIS",+$O(^DPT("ADIS",+IBOED,X,0)),0)),U,7)
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148 | I $D(^DIC(37,"B","CANCEL WITHOUT EXAM",X1)) G ENCKQ
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149 | I $D(^DIC(37,"B","NO CARE OR TREATMENT REQUIRED",X1)) G ENCKQ
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150 | ;
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151 | I "^1^4^7^"[("^"_+$P(IBOED,U,10)_"^") G ENCKQ ; C&P/collat/emply visit.
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152 | I $P(IBOED,U,12)'=2 G ENCKQ ; Not checked out.
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153 | ;
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154 | S Y=1
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155 | ENCKQ Q Y
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156 | ;
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157 | DET ; - Print the detailed report.
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158 | I '$D(^TMP("IBJDI52",$J,0)) S IBX=0 D HDET W !,"All policies within the selected date range have been verified." D PAUSE
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159 | S IBX="" F S IBX=$O(^TMP("IBJDI52",$J,IBX)) Q:IBX="" D Q:IBQ
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160 | .D HDET Q:IBQ
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161 | .S IBX1="" F S IBX1=$O(^TMP("IBJDI52",$J,IBX,IBX1)) Q:IBX1="" D Q:IBQ
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162 | ..I $Y>(IOSL-4) D PAUSE Q:IBQ D HDET Q:IBQ
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163 | ..W $P(IBX1,"@@"),?33,$$SSN($P(IBX1,"@@",2)),?47,$P(IBX1,"@@",3)
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164 | ..S IBX2=0 F S IBX2=$O(^TMP("IBJDI52",$J,IBX,IBX1,IBX2)) Q:'IBX2 S IBX3=^(IBX2) D
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165 | ...I $Y>(IOSL-4) D PAUSE Q:IBQ D HDET Q:IBQ
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166 | ...W ?62,$P(IBX3,U),?94,$E($P($G(^VA(200,+$P(IBX3,U,2),0)),U),1,24)
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167 | ...W ?120,$$DAT2^IBOUTL($P(IBX3,U,3)),!
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168 | ...I IBX W ?94,$E($P($G(^VA(200,+$P(IBX3,U,4),0)),U),1,24),?120,$$DAT2^IBOUTL($P(IBX3,U,5)),!
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169 | .;
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170 | .I 'IBQ D PAUSE
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171 | ;
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172 | I '$D(^TMP("IBJDI52",$J,1)),IBVER S IBX=1 D HDET W !,"All policies within the selected date range have been verified less than a year ago." D PAUSE
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173 | Q
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174 | ;
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175 | HDET ; - Write the detail report header.
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176 | I $E(IOST,1,2)="C-"!(IBPAG) W @IOF,*13
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177 | S IBPAG=IBPAG+1
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178 | W !,"Insurance Policies ",$S(IBX:"Verified Over a Year Ago",1:"Not Verified"),?80,"Run Date: ",IBRUN,?123,"Page: ",IBPAG
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179 | W !,"For Patients treated for the period "_$$DAT1^IBOUTL(IBBDT)_" to "_$$DAT1^IBOUTL(IBEDT)_" ('*' = Had inpatient care)"
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180 | I IBX W !?94,"Policy Entered By Date Entered"
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181 | W !,"Patient",?33,"SSN",?47,"Date of Death"
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182 | W ?62,"Insurance Company",?94,"Policy ",$S(IBX:"Verified",1:"Entered")," By",?120,"Date ",$S(IBX:"Verif'd",1:"Entered")
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183 | W !,$$DASH(132),!!
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184 | S IBQ=$$STOP^IBOUTL("Insurance Policies Not Verified")
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185 | Q
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186 | ;
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187 | SUM ; - Print the summary report.
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188 | I $E(IOST,1,2)="C-"!(IBPAG) W @IOF,*13
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189 | S IBPAG=IBPAG+1
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190 | W !!?$S(IBVER:14,1:24),"INSURANCE POLICIES NOT VERIFIED",$S(IBVER:"/VERIFIED OVER 1 YEAR",1:"")
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191 | W !?32,"SUMMARY REPORT",!!?17,"For Patients treated from ",$$DAT1^IBOUTL(IBBDT)," - ",$$DAT1^IBOUTL(IBEDT)
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192 | W !!?24,"Run Date: ",IBRUN,!?24,$$DASH(31),!!
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193 | ;
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194 | S IBPER=$S('IB("TOT"):0,1:$J(IB("VER")/IB("TOT")*100,0,2))
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195 | W ?24,"Number of Patients Treated:",?53,$J(IB("TOT"),5)
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196 | W !?23,"Number of Policies Verified:",?53,$J(IB("VER"),5),?62,"(",IBPER,"%)"
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197 | I IBVER W !?7,"Number of Policies Verified Over a Year Ago:",?53,$J(IB("VERO"),5),?62,"(",$S('IB("VERO"):0,1:$J(IB("VERO")/IB("TOT")*100,0,2)),"%)"
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198 | W !?19,"Number of Policies Not Verified:",?53,$J(IB("NOT"),5),?62,"(",$S('IB("TOT"):0,1:$J(100-IBPER,0,2)),"%)"
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199 | Q
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200 | ;
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201 | DASH(X) ; - Return a dashed line.
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202 | Q $TR($J("",X)," ","=")
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203 | ;
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204 | PAUSE ; - Page break.
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205 | I $E(IOST,1,2)'="C-" Q
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206 | N IBX,DIR,DIRUT,DUOUT,DTOUT,DIROUT,X,Y
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207 | F IBX=$Y:1:(IOSL-3) W !
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208 | S DIR(0)="E" D ^DIR I $D(DIRUT)!($D(DUOUT)) S IBQ=1
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209 | Q
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210 | ;
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211 | SSN(X) ; - Format the SSN.
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212 | Q $S(X]"":$E(X,1,3)_"-"_$E(X,4,5)_"-"_$E(X,6,10),1:"")
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