| 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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