1 | IBTODD1 ;ALB/AAS - CLAIMS TRACKING DENIED DAYS REPORT ; 27-OCT-93
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2 | ;;Version 2.0 ; INTEGRATED BILLING ;**32**; 21-MAR-94
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3 | ;
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4 | % I '$D(DT) D DT^DICRW
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5 | PRINT ; -- print data
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6 | ; -- ^tmp($j,"ibtodd",primary sort,secondary sort,ibtrc)=DFN ^ attending ^ treating specialty ^ service ^ billing bed section ^ billing rate
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7 | ;
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8 | K IBCNT
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9 | I 'IBSUM D HDR
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10 | I 'IBSUM,$O(^TMP($J,"IBTODD",""))="" W !!,"No Denials Found in Date Range." G PRINTQ
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11 | ;
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12 | S IBI="",IBISV=""
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13 | F S IBI=$O(^TMP($J,"IBTODD",IBI)) Q:IBI=""!(IBQUIT) D
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14 | .I IBSORT'="P",IBISV'=IBI D SUBT^IBTODD2
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15 | .S IBISV=IBI D SUBH^IBTODD2(IBI) Q:IBQUIT
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16 | .S IBJ="" F S IBJ=$O(^TMP($J,"IBTODD",IBI,IBJ)) Q:IBJ=""!(IBQUIT) D
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17 | ..S IBTRC=""
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18 | ..F S IBTRC=$O(^TMP($J,"IBTODD",IBI,IBJ,IBTRC)) Q:IBTRC=""!(IBQUIT) S IBDATA=^(IBTRC) D ONE
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19 | I IBQUIT G PRINTQ
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20 | I 'IBSUM D SUBT^IBTODD2
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21 | D SUM^IBTODD2
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22 | ;
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23 | PRINTQ Q
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24 | ;
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25 | ONE ; -- print one entry
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26 | ; -- ^tmp($j,"ibtodd",primary sort,secondary sort,ibtrc)=DFN ^ attending ^ treating specialty ^ service ^ billing bed section ^ billing rate
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27 | ;
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28 | S IBAPL=$$APPEAL(IBTRC)
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29 | D CNTS
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30 | S IBTALL=+$P($G(^IBT(356.2,+IBTRC,1)),"^",7) ;entire admission denied
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31 | Q:IBSUM
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32 | ;
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33 | I IOSL<($Y+6) D HDR,SUBH^IBTODD2(IBI)
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34 | S DFN=+IBDATA D PID^VADPT
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35 | S IBTRCD=$G(^IBT(356.2,+IBTRC,0))
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36 | L1 W !,$E($P(^DPT(DFN,0),"^"),1,22),?25,VA("PID")
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37 | S IBCDT=$$CDT($P(IBTRCD,"^",2))
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38 | W ?38,$$DAT1^IBOUTL(+IBCDT\1) W:$P(IBCDT,"^",2) " to"
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39 | W ?50,$J($P(IBDATA,"^",2),8)
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40 | I IBTALL W ?64,"ALL"
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41 | I 'IBTALL W ?64,$$DAT1^IBOUTL($P(IBTRCD,"^",15),"2P") W:$P(IBTRCD,"^",16) " to"
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42 | I IBTALL!('$P(IBTRCD,"^",16)) W " (",$P(IBDATA,"^",7),")"
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43 | K IBDEN,IBC S IBDEN=0,IBC=0
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44 | F S IBDEN=$O(^IBT(356.2,+IBTRC,12,IBDEN)) Q:'IBDEN S IBC=IBC+1,IBC(IBC)=^(IBDEN,0)
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45 | W:$G(IBC(1)) ?78,$E($$EXPAND^IBTRE(356.212,.01,+IBC(1)),1,25)
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46 | W ?110,$S(+$P(IBAPL,"^",2):"YES",1:"NO")
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47 | W ?117,$J(+IBAPL,8)
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48 | ;
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49 | ;
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50 | L2 W !?38,$$DAT1^IBOUTL($P(IBCDT,"^",2)\1,"2P")
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51 | W ?64,$$DAT1^IBOUTL($P(IBTRCD,"^",16),"2P")
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52 | I 'IBTALL,$P(IBTRCD,"^",16) W " (",$P(IBDATA,"^",7),")"
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53 | W ?78,$E($$EXPAND^IBTRE(356.212,.01,$G(IBC(2))),1,25)
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54 | ;
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55 | I $O(IBC(2)) S IBDEN=2 F S IBDEN=$O(IBC(IBDEN)) Q:'IBDEN W !?78,$E($$EXPAND^IBTRE(356.212,.01,$G(IBC(IBDEN))),1,25)
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56 | ONEQ W !
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57 | Q
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58 | ;
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59 | ;
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60 | CNTS ; -- develop summary data
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61 | S IBSERV=$P(IBDATA,"^",4)
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62 | I IBSERV="" S IBSERV="UNKNOWN"
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63 | S:'$D(IBCNT(IBSERV)) IBCNT(IBSERV)=""
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64 | S $P(IBCNT(IBSERV),"^")=$P(IBCNT(IBSERV),"^")+$P(IBDATA,"^",7)
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65 | S $P(IBCNT(IBSERV),"^",2)=$P(IBCNT(IBSERV),"^",2)+($P(IBDATA,"^",7)*$P(IBDATA,"^",6))
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66 | S $P(IBCNT(IBSERV),"^",3)=$P(IBCNT(IBSERV),"^",3)+1
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67 | S $P(IBCNT(IBSERV),"^",4)=$P(IBCNT(IBSERV),"^",4)+$G(IBAPL)
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68 | S:$P(IBCNT(IBSERV),"^",6)<$P(IBDATA,"^",6) $P(IBCNT(IBSERV),"^",6)=$P(IBDATA,"^",6)
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69 | S IBSUBT=$G(IBSUBT)+$P(IBDATA,"^",7)
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70 | S IBTOTL=$G(IBTOTL)+$P(IBDATA,"^",7)
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71 | Q
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72 | ;
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73 | HDR ; -- Print header for billing report
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74 | Q:IBQUIT
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75 | I $E(IOST,1,2)="C-",IBPAG D PAUSE^VALM1 I $D(DIRUT) S IBQUIT=1 Q
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76 | I $E(IOST,1,2)="C-"!(IBPAG) W @IOF
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77 | S IBPAG=IBPAG+1
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78 | W !,"MCCR/UR DENIED DAYS Report for Denials Dated ",$$FMTE^XLFDT(IBBDT),$S(IBBDT'=IBEDT:" to "_$$FMTE^XLFDT(IBEDT),1:"")," "
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79 | W ?(IOM-33),"Page ",IBPAG," ",IBHDT
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80 | W !!,?38,"Dates of",?64,"Dates",?117,"Days Approved"
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81 | W !,"Patient",?25,"Pt. ID",?38,"Care",?50,"Attending",?64,"Denied",?78,"Denial Reason",?105,"Appealed",?117,"on Appeal"
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82 | W !,$TR($J(" ",IOM)," ","-")
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83 | Q
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84 | ;
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85 | CDT(IBTRN) ; -- compute dates of care
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86 | N X,Y S X=$G(^IBT(356,+IBTRN,0)),Y=""
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87 | I $P(X,"^",5) S DGPM=$G(^DGPM($P(X,"^",5),0)) D
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88 | .S Y=+DGPM
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89 | .I $P(DGPM,"^",17) S Y=Y_"^"_+$G(^DGPM($P(DGPM,"^",17),0))
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90 | I 'Y S Y=$P(X,"^",6)
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91 | Q Y
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92 | ;
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93 | APPEAL(IBTRC) ; -- Find appeals
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94 | N X,Y,IBAPEAL,IBTRN,IBTRSV S (Y,X)=0
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95 | S IBTRSV=IBTRC
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96 | S IBTRC=0 F S IBTRC=$O(^IBT(356.2,"AP",+IBTRSV,IBTRC)) Q:'IBTRC S Y=1,X=X+$$AP(IBTRC)
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97 | ;
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98 | Q X_"^"_Y
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99 | ;
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100 | AP(IBTRC) ; -- count days approved
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101 | N X,Y,Z
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102 | S (X,Z)=0
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103 | F S X=$O(^IBT(356.2,+IBTRC,14,X)) Q:'X S Y=$G(^(X,0)),Z=Z+$$FMDIFF^XLFDT($P(Y,"^",2),+Y)+1
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104 | Q Z
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