1 | IBTOBI2 ;ALB/AAS - CLAIMS TRACKING BILLING INFORMATION PRINT ;27-OCT-93
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2 | ;;2.0;INTEGRATED BILLING;**210**;21-MAR-94
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3 | ;
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4 | IR ; -- print insurance review information
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5 | Q:'$O(^IBT(356.2,"C",+IBTRN,0)) ; -no reivews
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6 | I ($Y+11)>IOSL D HDR^IBTOBI Q:IBQUIT
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7 | W !," Insurance Review Information "
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8 | N I,J,IBII,IBTRC,IBTRCD,IBACTION,TCODE
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9 | S IBII="" F S IBII=$O(^IBT(356.2,"ATIDT",IBTRN,IBII)) Q:'IBII!(IBQUIT) S IBTRC=0 F S IBTRC=$O(^IBT(356.2,"ATIDT",IBTRN,IBII,IBTRC)) Q:'IBTRC!(IBQUIT) D
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10 | .N IBJ,IBD
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11 | .D IR1
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12 | .D IR2
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13 | .S IBJ=0 F S IBJ=$O(IBD(IBJ)) Q:'IBJ W !,$E($G(IBD(IBJ,1)),1,39),?40,$E($G(IBD(IBJ,2)),1,39)
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14 | .D COMM2(IBTRC) Q:IBQUIT
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15 | .W !?30,"-----------------------------------"
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16 | .I ($Y+11)>IOSL D HDR^IBTOBI Q:IBQUIT
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17 | W:'IBQUIT !?4,$TR($J(" ",IOM-8)," ","-"),!
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18 | Q
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19 | ;
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20 | IR1 ; -- print one review
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21 | S IBTRCD=$G(^IBT(356.2,+IBTRC,0)),IBTRCD1=$G(^(1))
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22 | S IBD(1,1)=" Type Review: "_$$EXPAND^IBTRE(356.2,.04,$P(IBTRCD,"^",4))
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23 | S TCODE=$$TCODE^IBTRC(IBTRC) I TCODE D @TCODE
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24 | Q
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25 | 10 ; -- pre-cert contact
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26 | 15 ; -- admission review
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27 | 20 ; -- urgent/emergent ins. contact
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28 | 30 ; -- continued stay contact
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29 | S IBD(2,1)=" Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11))
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30 | S IBACTION=$P($G(^IBE(356.7,+$P(IBTRCD,"^",11),0)),"^",3)
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31 | S IBACTION=IBACTION+100 D @IBACTION
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32 | Q
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33 | ;
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34 | 40 ; -- Discharge contact
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35 | 100 ; -- No type of action
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36 | Q
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37 | 50 ; -- outpatient treatment
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38 | S IBD(2,1)=" Opt Treatment: "_$$EXPAND^IBTRE(356.2,.26,$P(IBTRCD,"^",26))
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39 | S IBD(3,1)=" Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11))
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40 | S IBD(4,1)=" Auth. Number: "_$P(IBTRCD,"^",28)
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41 | Q
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42 | 60 ; -- Appeal
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43 | 65 ; -- Nth appeal
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44 | S IBD(2,1)=" Appeal Type: "_$$EXPAND^IBTRE(356.2,.23,$P(IBTRCD,"^",23))
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45 | S IBD(3,1)=" Case Status: "_$$EXPAND^IBTRE(356.2,.1,$P(IBTRCD,"^",10))
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46 | S IBD(4,1)="No Days Pending: "_$$EXPAND^IBTRE(356.2,.25,$P(IBTRCD,"^",25))
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47 | S IBD(5,1)=" Final Outcome: "_$$EXPAND^IBTRE(356.2,.29,$P(IBTRCD,"^",29))
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48 | Q
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49 | 70 ; -- Patient
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50 | 80 ; -- Other
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51 | 85 ; -- Insurance verification
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52 | 90 ;
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53 | Q
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54 | ;
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55 | 110 ; -- approval actions
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56 | S IBD(3,1)="Authorized From: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",12)))
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57 | S IBD(4,1)=" Authorized To: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",13)))
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58 | S IBD(5,1)="Authorized Diag: "_$$DIAG^IBTRE6($P(IBTRCD,"^",14),1,$$TRNDATE^IBACSV($G(IBTRN)))
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59 | S IBD(6,1)=" Auth. Number: "_$P(IBTRCD,"^",28)
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60 | Q
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61 | 120 ; -- denial actions
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62 | S IBD(3,1)=" Denied From: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",15)))
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63 | S IBD(4,1)=" Denied To: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",16)))
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64 | S IBI=0,IBD=4 F S IBI=$O(^IBT(356.2,IBTRC,12,IBI)) Q:'IBI D
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65 | .S IBD=IBD+1
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66 | .S IBD(IBD,1)=" Denial Reasons: "_$$EXPAND^IBTRE(356.212,.01,+$G(^IBT(356.2,IBTRC,12,IBI,0)))
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67 | Q
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68 | 130 ; -- penalty
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69 | S IBI=0,IBD=2 F S IBI=$O(^IBT(356.2,IBTRC,13,IBI)) Q:'IBI D
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70 | .S IBD=IBD+1
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71 | .S IBD(IBD,1)=" Penalty: "_$$EXPAND^IBTRE(356.213,.01,+$G(^IBT(356.2,IBTRC,13,IBI,0)))
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72 | Q
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73 | 140 ; -- case pending
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74 | S IBD(3,1)=" Case Pending: "_$$EXPAND^IBTRE(356.2,.2,$P(IBTRCD,"^",20))
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75 | Q
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76 | 150 ; -- no coverage
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77 | S IBD(3,1)=" No Coverage: "_$$EXPAND^IBTRE(356.2,.21,$P(IBTRCD,"^",21))
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78 | Q
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79 | ;
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80 | IR2 ; -- contact information
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81 | ;N IBCDFN,IBCPOL
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82 | ;S IBCDFN=$P(IBTRCD1,"^",5),IBCPOL=$P(^DPT(DFN,.312,IBCDFN,0),"^",18)
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83 | S IBD(1,2)=" Review Date: "_$E($$DAT1^IBOUTL(+IBTRCD,"2P"),1,20)
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84 | S IBD(2,2)=" Insurance Co.: "_$E($P($G(^DIC(36,+$G(^DPT(DFN,.312,+$P(IBTRCD1,"^",5),0)),0)),"^"),1,20)
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85 | S IBD(3,2)="Person Contacted: "_$E($P(IBTRCD,"^",6),1,20)
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86 | S IBD(4,2)=" Contact Method: "_$E($$EXPAND^IBTRE(356.2,.17,$P(IBTRCD,"^",17)),1,20)
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87 | S IBD(5,2)="Call Ref. Number: "_$E($P(IBTRCD,"^",9),1,20)
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88 | S IBD(6,2)=" Status: "_$E($$EXPAND^IBTRE(356.2,.19,$P(IBTRCD,"^",19)),1,20)
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89 | S IBD(7,2)=" Last Edited By: "_$E($$EXPAND^IBTRE(356.2,1.04,$P($G(^IBT(356.2,+$G(IBTRC),1)),"^",4)),1,20)
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90 | I '$P(IBTRCD,"^",2) S IBD(2,2)="Patient Contacted: "_$E($P($G(^DPT(+$P(IBTRCD,"^",5),0)),"^"),1,20)
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91 | Q
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92 | ;
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93 | COMM2(DA) ; -- print comments from ins. reviews.
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94 | W !,"Comment: "
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95 | Q:'$D(^IBT(356.2,DA,11))
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96 | K ^UTILITY($J,"W")
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97 | S DIWL=10,DIWR=IOM-12,DIWF="W"
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98 | S IBJ=0 F S IBJ=$O(^IBT(356.2,DA,11,IBJ)) Q:'IBJ S X=^(IBJ,0) D ^DIWP I IOSL<($Y+4) Q:IBQUIT D HDR^IBTOBI
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99 | Q:IBQUIT
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100 | D ^DIWW
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101 | K ^UTILITY($J,"W")
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102 | Q
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