| [613] | 1 | IBAECU5 ;WOIFO/SS-LTC PHASE 2 UTILITIES ; 20-FEB-02
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| 2 | ;;2.0;INTEGRATED BILLING;**171,176**;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 | ;check if there is LTC in ^TMP of INPINFO^IBAECU2
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| 5 | ISLTC(IBDFN,IBLBL) ;
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| 6 | N IBFL5,IBVA,IBVT,IBVD
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| 7 | S (IBFL5,IBVA)=0
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| 8 | F S IBVA=$O(^TMP($J,IBLBL,IBDFN,IBVA)) Q:IBVA=""!(IBFL5>0) D
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| 9 | . S IBVT=0
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| 10 | . F S IBVT=$O(^TMP($J,IBLBL,IBDFN,IBVA,IBVT)) Q:IBVT=""!(IBFL5>0) D
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| 11 | . . S IBVD=0
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| 12 | . . F S IBVD=$O(^TMP($J,IBLBL,IBDFN,IBVA,IBVT,IBVD)) Q:IBVD=""!(IBFL5>0) D
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| 13 | . . . S:$P($G(^TMP($J,IBLBL,IBDFN,IBVA,IBVT,IBVD)),"^",1)="L" IBFL5=IBVD
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| 14 | Q IBFL5
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| 15 | ;
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| 16 | ;is C&P exam this date
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| 17 | ;IBDFN1 - patient's ien #2
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| 18 | ;IBDT1 -date
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| 19 | ;returns
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| 20 | ; 1 - YES, 0 -NO
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| 21 | ISCOMPEN(IBDFN1,IBDT1) ;
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| 22 | Q $$CNP^IBECEAU(IBDFN1,IBDT1)
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| 23 | ;
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| 24 | ;checks if charge for outpatient visit and then cancels it
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| 25 | ;IBDFN - Pointer to patient in file #2
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| 26 | ;IBDATE - Date to check for OPT charges
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| 27 | CANCVIS(IBDFN,IBDATE) ;
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| 28 | N IBN,IBCRES,IBDUZ
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| 29 | S IBDUZ=+$G(DUZ)
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| 30 | S IBN=$$BFO^IBECEAU(IBDFN,IBDATE)
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| 31 | Q:'IBN
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| 32 | S IBCRES=$O(^IBE(350.3,"B","BILLED LTC CHARGE",0))
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| 33 | S:'IBCRES IBCRES=4 S IBWHER=""
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| 34 | D CANCH^IBECEAU4(IBN,IBCRES,0)
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| 35 | Q
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| 36 | ;
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| 37 | ;prepares error messages
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| 38 | ;IBDFN - patient's ien
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| 39 | ;IBIEN - ien of applicable file
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| 40 | ;IBACT - action
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| 41 | ;IBMESS - error message
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| 42 | ERRLOG(IBDFN,IBIEN,IBACT,IBMESS) ;
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| 43 | Q:+IBDFN=0!(+IBIEN=0)!(IBACT="")
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| 44 | N VADM,VA,VAERR,DFN,IBCNT
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| 45 | S DFN=IBDFN
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| 46 | D DEM^VADPT
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| 47 | S ^TMP($J,"IBMJERR")=$G(^TMP($J,"IBMJERR"))+1
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| 48 | S IBCNT=$G(^TMP($J,"IBMJERR"))
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| 49 | S ^TMP($J,"IBMJERR",IBCNT,1)=" "
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| 50 | S ^TMP($J,"IBMJERR",IBCNT,2)="*********************************"
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| 51 | S ^TMP($J,"IBMJERR",IBCNT,3)=" "_$G(IBMESS)
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| 52 | S ^TMP($J,"IBMJERR",IBCNT,4)=" Action : "_$G(IBACT)
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| 53 | S ^TMP($J,"IBMJERR",IBCNT,5)=" Applicable IEN : "_$G(IBIEN)
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| 54 | S ^TMP($J,"IBMJERR",IBCNT,6)=" Patient : "_$G(VADM(1))
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| 55 | S ^TMP($J,"IBMJERR",IBCNT,7)=" SSN : "_$P($G(VADM(2)),"^",2)
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| 56 | Q
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| 57 | ;
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| 58 | ;sends all errors in TMP($J,"IBMJERR" to IB ERROR mail group
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| 59 | SENDERR ;
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| 60 | N XMSUB,XMTEXT,XMY,XMZ,XMMG,IBL,IBT,XMDUZ,IBV1,IBV2,IBV3
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| 61 | N IBMAXLN S IBMAXLN=200
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| 62 | N XMGROUP S XMGROUP=$$GET1^DIQ(350.9,"1,",.09)
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| 63 | Q:XMGROUP=""
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| 64 | S XMGROUP="G."_XMGROUP
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| 65 | S XMSUB="LTC Monthly Job error report",XMY(XMGROUP)=""
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| 66 | S XMTEXT="IBT(",XMDUZ="INTEGRATED BILLING PACKAGE"
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| 67 | S IBV1=0,IBV3=1
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| 68 | F S IBV1=$O(^TMP($J,"IBMJERR",IBV1)) Q:+IBV1=0!(IBV3>IBMAXLN) D
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| 69 | . S IBV2=0
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| 70 | . F S IBV2=$O(^TMP($J,"IBMJERR",IBV1,IBV2)) Q:+IBV2=0 D
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| 71 | . . S IBT(IBV3,0)=$G(^TMP($J,"IBMJERR",IBV1,IBV2)),IBV3=IBV3+1
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| 72 | S:IBV3>IBMAXLN IBT(IBV3,0)="******* Too many errors! *******"
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| 73 | D ^XMD
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| 74 | Q
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| 75 | ;
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| 76 | ;sends message to user group if there is no 1010EC form forthe patient
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| 77 | MESS10EC(DFN,IBDT) ;
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| 78 | D XMNOEC^IBAECU(DFN,IBDT)
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| 79 | Q
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| 80 | ;
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| 81 | ;Creates charge, sends amount to AR
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| 82 | ;IBPATDFN - patient DFN
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| 83 | ;.IBAMOUNT - array with all amounts for each day
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| 84 | ;array IBMNTH - month info
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| 85 | ;.IBMNTH - number of days
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| 86 | ;IBMNTH(0)- first day (in FM format)
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| 87 | ;IBMNTH(1)- last day (in FM format)
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| 88 | ;IBMNTH(2)- year_month (like 30201)
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| 89 | ;IBMONCAP - maximum monthly copay (180 days stuff)
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| 90 | SEND2AR(IBPATDFN,IBAMOUNT,IBMNTH,IBMONCAP) ;
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| 91 | ;arrays
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| 92 | N IBPAYS,IBRCHRGS
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| 93 | ;vars
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| 94 | N IBADM,IB350P,IBDD,IBRES,IBTOT,IBV1,IBNOS,IBAMNT
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| 95 | N IBDAY,IB350,IBRATE,IBTP,IBDT,IBSL,IBPRDAY,IBV1
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| 96 | N IBINPDS,IBFDAY,IBLDAY,IBEPSSUM,IBFRD,IBTOD
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| 97 | S IBDAY=0,IBPAYS=0,IBRCHRGS=0
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| 98 | ;1.outpatient visit charges
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| 99 | F S IBDAY=$O(IBAMOUNT("A",IBDAY)) Q:+IBDAY=0 I +$G(IBAMOUNT("A",IBDAY,"T"))=1 D
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| 100 | . S IBRATE=+$G(IBAMOUNT("A",IBDAY,"R"))
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| 101 | . S IBTP=$P($G(IBAMOUNT("A",IBDAY,"R")),"^",2)
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| 102 | . S IBDT=$$MKDATE^IBAECU4(IBMNTH(2),IBDAY)
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| 103 | . S IBSL="409.68:"_$P($G(IBAMOUNT("A",IBDAY,"T")),"^",2)
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| 104 | . S IBPAYS=$G(IBPAYS)+1,IBPAYS(IBDAY)=IBPATDFN_"^"_IBTP_"^1^"_IBRATE_"^"_IBDT_"^"_IBDT_"^"_IBSL_"^^*^"_IBDT
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| 105 | ;2.inpatient stay charges
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| 106 | S IBFDAY=0 ;first day of episode
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| 107 | S IBLDAY=0 ;last day of episode
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| 108 | S IBINPDS=0 ;length of each episode (Exmpl. Jan3-Jan5=2days, Jan21-Jan31=10 days)
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| 109 | S IBEPSSUM=0 ;total for episode
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| 110 | S IBDAY=0
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| 111 | F S IBDAY=$O(IBAMOUNT("A",IBDAY)) Q:+IBDAY=0 I +$G(IBAMOUNT("A",IBDAY,"T"))=2 D
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| 112 | . S:IBFDAY=0 IBFDAY=IBDAY ;set first day
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| 113 | . S IBINPDS=IBINPDS+1 ;count days
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| 114 | . S IBRATE=+$G(IBAMOUNT("A",IBDAY,"R"))
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| 115 | . S IBEPSSUM=IBEPSSUM+IBRATE ;total
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| 116 | . S IBV1=+$O(IBAMOUNT("A",IBDAY)) ;check the next day
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| 117 | . ;if next "is the end" OR "if AA/ASIH gap" OR "if another admission"
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| 118 | . I (IBV1=0)!((IBV1-IBDAY)>1)!($P($G(IBAMOUNT("A",IBDAY,"T")),"^",2)'=$P($G(IBAMOUNT("A",IBV1,"T")),"^",2)) D
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| 119 | . . S IBLDAY=IBDAY ; set last day
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| 120 | . . S IBTP=$P($G(IBAMOUNT("A",IBDAY,"R")),"^",2) ;action type
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| 121 | . . S IBFRD=$$MKDATE^IBAECU4(IBMNTH(2),IBFDAY) ;from
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| 122 | . . S IBTOD=$$MKDATE^IBAECU4(IBMNTH(2),IBLDAY) ;to
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| 123 | . . S IBADM=$P($G(IBAMOUNT("A",IBDAY,"T")),"^",2) ;admission
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| 124 | . . S IBDT=+$P($G(IBAMOUNT("A",IBDAY,"T")),"^",3) ;default is admission date
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| 125 | . . I IBDT<IBMNTH(0) S IBDT=IBMNTH(0) ;if admission date < begining of month
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| 126 | . . S IB350P=+$$FIND350^IBAECN1(IBPATDFN,IBFRD+0.9,IBADM,1) ;find INCOMLETE parent event
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| 127 | . . I IB350P=0 D
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| 128 | . . . N VAIP,IB350PCL,DFN
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| 129 | . . . S DFN=IBPATDFN,VAIP("D")=IBFRD_.2359 D IN5^VADPT
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| 130 | . . . I '$$ASIH^IBAUTL5($G(^DGPM(+VAIP(1),0))) D Q
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| 131 | . . . . ;find "completed" - ASIH could complete event entry
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| 132 | . . . . S IB350PCL=+$$FIND350^IBAECN1(IBPATDFN,IBFRD+0.9,+IBADM,2)
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| 133 | . . . . I IB350PCL>0 S IB350P=IB350PCL
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| 134 | . . . S IB350P=+$$FIND350^IBAECN1(IBPATDFN,IBFRD+0.9,+VAIP(1),1)
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| 135 | . . . S IBADM=+VAIP(1),IBDT=+$G(^DGPM(VAIP(1),0))\1
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| 136 | . . ;if not found - create new one with LTC type
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| 137 | . . I IB350P=0 S IB350P=$$CREV350^IBAECN1(IBPATDFN,+IBADM,IBDT,93)
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| 138 | . . S IBSL="405:"_IBADM ;soft link
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| 139 | . . S IBPAYS=$G(IBPAYS)+1
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| 140 | . . I $D(IBPAYS(IBDAY)) D ERRLOG(+$G(IBPATDFN),+$G(IB350P),"SEND2AR: charges","Attempt to create more than one charge a day ")
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| 141 | . . S IBPAYS(IBDAY)=IBPATDFN_"^"_IBTP_"^"_IBINPDS_"^"_IBEPSSUM_"^"_IBFRD_"^"_IBTOD_"^"_IBSL_"^^"_IB350P_"^"_IBDT
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| 142 | . . S (IBFDAY,IBLDAY,IBINPDS,IBEPSSUM)=0
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| 143 | ;3. make charges until it less than monthly cap
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| 144 | ;
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| 145 | S (IBTOT,IBFL,IBDD)=0
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| 146 | F S IBDD=$O(IBPAYS(IBDD)) Q:+IBDD=0!(IBFL=1) D
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| 147 | . S IBRES=$G(IBPAYS(IBDD))
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| 148 | . S IBAMNT=0
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| 149 | . I IBTOT'<IBMONCAP S IBFL=1 Q ;don't charge anymore
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| 150 | . I (IBTOT+$P(IBRES,"^",4))'>IBMONCAP D ;charge whole amount
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| 151 | . . S IBAMNT=$P(IBRES,"^",4)
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| 152 | . E S IBAMNT=IBMONCAP-IBTOT ;charge a rest
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| 153 | . S IBTOT=IBTOT+IBAMNT
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| 154 | . S IB350=$$CHARGE(IBPATDFN,$P(IBRES,"^",2),$P(IBRES,"^",3),IBAMNT,$P(IBRES,"^",5),$P(IBRES,"^",6),$P(IBRES,"^",7),$P(IBRES,"^",8),$P(IBRES,"^",9),$P(IBRES,"^",10))
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| 155 | . I IB350>0 S IBRCHRGS=IBRCHRGS+1,IBRCHRGS(IBRCHRGS)=IB350
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| 156 | . ;Edit parent event in #350 V 11F
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| 157 | . I +$P(IBRES,"^",9)>0 D STAT350^IBAECN1(+$P(IBRES,"^",9),IBMNTH(1),+$P($P(IBRES,"^",7),":",2))
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| 158 | ;4. Send to AR
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| 159 | S IBV1=0,IBNOS=""
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| 160 | F S IBV1=$O(IBRCHRGS(IBV1)) Q:+IBV1=0 D
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| 161 | . S:IBNOS'="" IBNOS=IBNOS_"^"_IBRCHRGS(IBV1)
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| 162 | . S:IBNOS="" IBNOS=IBRCHRGS(IBV1)
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| 163 | . I (IBV1#5)=0 S IBRES=$$TOAR(IBPATDFN,1,IBNOS,+$G(DUZ)),IBNOS=""
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| 164 | I IBNOS'="" S IBRES=$$TOAR(IBPATDFN,1,IBNOS,+$G(DUZ)),IBNOS=""
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| 165 | Q
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| 166 | ;call ^IBR
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| 167 | TOAR(DFN,IBSEQNO,IBNOS,IBDUZ) ;
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| 168 | ;
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| 169 | N Y,IBERR,IBIL
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| 170 | D ^IBR
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| 171 | Q Y
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| 172 | ;
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| 173 | ;create outppatient charge
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| 174 | ; Input:
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| 175 | ; DFN -- Pointer to patient in file #2
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| 176 | ; IBATYP -- Pointer to Action Type in file #350.1
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| 177 | ; IBUNIT -- Number of units of charge (1 day for outpatient, 1 or more for inpatients)
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| 178 | ; IBCHG -- $$ amount of charge
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| 179 | ; IBFR -- Bill From date
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| 180 | ; inpatient: first day of episode
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| 181 | ; outpatient: date of service
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| 182 | ; IBTO -- Bill To date
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| 183 | ; inpatient: last day of episode
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| 184 | ; outpatient: date of service
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| 185 | ; IBSL -- Softlink 405:IEN or 409.68:IEN
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| 186 | ; IBPAR -- placeholder for IBPARNT (see below)
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| 187 | ; IBEVDA -- Pointer to parent event in #350 for inpatients,
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| 188 | ; or "*" for outpatients to set ibevda=ibn
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| 189 | ; IBEVDT -- for outpatient: Event Date
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| 190 | ; for inpatient:admission date or begining of month if admission began
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| 191 | ; before the begining of the month
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| 192 | CHARGE(DFN,IBATYP,IBUNIT,IBCHG,IBFR,IBTO,IBSL,IBPAR,IBEVDA,IBEVDT) ;
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| 193 | ;
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| 194 | N IBN,IBDESC,IBSITE,IBFAC,IBXA
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| 195 | D SITE^IBAUTL
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| 196 | S IBDESC=$P($G(^IBE(350.1,+$G(IBATYP),0)),"^",8)
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| 197 | I IBDESC="" S IBDESC=$$ACTNM(+$G(IBATYP)) D ERRLOG(+$G(DFN),+$G(IBATYP),"CHARGE","No USER LOOKUP NAME in #350.1")
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| 198 | S IBN=0
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| 199 | ;IBPARNT -- Pointer to parent entry in #350 [OPTIONAL], i.e. to previous record(s)
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| 200 | ; for the same charge, that were edited or cancelled
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| 201 | ; Here IBPARNT must be undefined, because we always create "NEW" charges
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| 202 | N IBPARNT ;undefined
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| 203 | D ADD^IBECEAU3
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| 204 | Q IBN
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| 205 | ;
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| 206 | ACTNM(X) ;X -input pointer to action type file (350.1)
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| 207 | S Y=$P($G(^IBE(350.1,+X,0)),"^",9) ;new action type
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| 208 | Q $S($P($G(^IBE(350.1,+Y,0)),"^",8)]"":$P(^(0),"^",8),$P($G(^IBE(350.1,+X,0)),"^",8)]"":$P(^(0),"^",8),1:$P($G(^IBE(350.1,+X,0)),"^"))
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| 209 | ;
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