| 1 | IBAMTI ;ALB/CPM - SPECIAL INPATIENT BILLING CASES ; 11-AUG-93
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| 2 |  ;;2.0;INTEGRATED BILLING;**52,132,153,156,234,247,339**;21-MAR-94;Build 2
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| 3 |  ;;Per VHA Directive 2004-038, this routine should not be modified.
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| 4 |  ;
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| 5 | ADM(DFN,IBPM,IBCL) ; Create a new case record upon admission
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| 6 |  ;  Input:     DFN  --  Pointer to the patient in file #2
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| 7 |  ;            IBPM  --  Pointer to the adm movement in file #405
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| 8 |  ;            IBCL  --  Patient class [1-ao|2-ir|3-sc|4-swa|5-mst|6-hnc|7-cv|8-shad]
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| 9 |  I '$G(DFN)!'$G(IBPM)!'$G(IBCL) G ADMQ
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| 10 |  N DA,DIC,DIE,DR,IBC,X,Y
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| 11 |  ;
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| 12 |  ; - need to swap the input of 3 (SC) to 4, and 4 (EC) to 3
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| 13 |  S IBCL=$S(IBCL=3:4,IBCL=4:3,IBCL=5:5,1:IBCL)
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| 14 |  ;
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| 15 |  K DD,DO S DIC="^IBE(351.2,",DIC(0)="",X=DFN D FILE^DICN S IBC=+Y
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| 16 |  S DR=".02////"_IBPM_";.03////"_IBCL_";.05////1;2.01////"_DUZ_";2.02///NOW;2.03////"_DUZ_";2.04///NOW"
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| 17 |  S DA=IBC,DIE=DIC D ^DIE
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| 18 |  D BULL(1,IBCL) ; send admission bulletin
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| 19 | ADMQ Q
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| 20 |  ;
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| 21 | DIS(IBPM) ; Update the case record upon discharge
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| 22 |  ;  Input:    IBPM  --  Pointer to the adm movement in file #405
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| 23 |  N DA,DIE,DR,IBC
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| 24 |  S IBC=$O(^IBE(351.2,"AC",+$G(IBPM),0)) I 'IBC G DISQ
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| 25 |  S DR=".05////2;.06////"_DT_";2.03////"_DUZ_";2.04///NOW"
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| 26 |  S DA=IBC,DIE="^IBE(351.2," D ^DIE
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| 27 |  D BULL(2,+$P($G(^IBE(351.2,IBC,0)),"^",3)) ; send discharge bulletin
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| 28 | DISQ Q
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| 29 |  ;
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| 30 | BGJ ; Perform nightly background monitoring of all case records.
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| 31 |  N IBC,IBCD,IBNUM
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| 32 |  S IBC=0 F  S IBC=$O(^IBE(351.2,IBC)) Q:'IBC  S IBCD=$G(^(IBC,0)) D
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| 33 |  .Q:$P(IBCD,"^",8)  ; case has been dispositioned
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| 34 |  .Q:$P(IBCD,"^",5)=1  ; patient still admitted
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| 35 |  .I '$P(IBCD,"^",6) S $P(^IBE(351.2,IBC,0),"^",6)=DT Q  ; no disch date
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| 36 |  .S IBNUM=$$FMDIFF^XLFDT(DT,$P(IBCD,"^",6))
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| 37 |  .Q:IBNUM<45  ; still time to disposition the case
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| 38 |  .D NOTICE(IBNUM,+IBCD,+$P(IBCD,"^",2),+$P(IBCD,"^",3)) ; send reminder to disposition
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| 39 |  Q
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| 40 |  ;
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| 41 | BULL(IBEV,IBCL) ; Send a bulletin at admission and discharge.
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| 42 |  ;  Input:    IBEV  --  Event [1:admission|2:discharge]
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| 43 |  ;            IBCL  --  Patient class [1-ao|2-ir|3-swa|4-sc|5-mst|6-hnc|7-cv|8-shad]
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| 44 |  K IBT S IBPT=$$PT^IBEFUNC(DFN)
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| 45 |  S XMSUB=$E($P(IBPT,"^"),1,14)_"  "_$P(IBPT,"^",3)_" - "_$$UCCL(IBCL)_$S($G(IBEV)=1:" ADM",1:" DISCH")
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| 46 |  S IBT(1)="The following Means Test copay "_$$LCCL(IBCL)_" patient was just "_$S($G(IBEV)=1:"admitted:",1:"discharged:")
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| 47 |  S IBT(2)=" " S IBC=2
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| 48 |  S IBDUZ=DUZ D PAT^IBAERR1
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| 49 |  S IBC=IBC+1,IBT(IBC)=" "
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| 50 |  S IBC=IBC+1,IBT(IBC)=$S($G(IBEV)=1:"Please note that a special inpatient case record has been created for",1:"Please note that you have 45 days to determine if this episode of care")
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| 51 |  S IBC=IBC+1,IBT(IBC)=$S($G(IBEV)=1:"this admission.",1:"should be billed.")
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| 52 |  ;---CV
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| 53 |  I IBCL=7,$G(IBEV)=2 D 
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| 54 |  . N Y,X,IBZ,IBFL,IBEXP,IBTODAY,IBDIS
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| 55 |  . S (Y,X,IBZ,IBFL,IBEXP,IBTODAY,IBDIS)=0
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| 56 |  . D NOW^%DTC S IBTODAY=%\1
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| 57 |  . S IBZ=$$CVEDT^IBACV(DFN,IBTODAY)
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| 58 |  . I +IBZ=1 Q  ;patient is still CV
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| 59 |  . S IBEXP=+$P(IBZ,"^",2)\1
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| 60 |  . S IBDIS=+$G(^DGPM(+$P($G(^DGPM(+$G(IBPM),0)),"^",17),0))\1
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| 61 |  . ; if CV expired during inpatient stay
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| 62 |  . I IBDIS>0,IBEXP'>IBDIS D
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| 63 |  . . S IBFL=1
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| 64 |  . . S Y=IBEXP D DD^%DT S IBEXP=Y
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| 65 |  . . S IBC=IBC+1,IBT(IBC)=""
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| 66 |  . . S IBC=IBC+1,IBT(IBC)="WARNING: Patient's CV status has expired on "_IBEXP_" during the"
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| 67 |  . . S IBC=IBC+1,IBT(IBC)="inpatient stay. Billing needs to be adjusted accordingly."
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| 68 |  . ; if discharge move was entered after actual discharge date
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| 69 |  . I IBFL=0 D
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| 70 |  . . S Y=IBEXP D DD^%DT S IBEXP=Y
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| 71 |  . . S IBC=IBC+1,IBT(IBC)=""
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| 72 |  . . S IBC=IBC+1,IBT(IBC)="WARNING: Patient CV status has expired on "_IBEXP_""
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| 73 |  ;---
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| 74 |  I IBEV=2 D
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| 75 |  .I '$$BIL^DGMTUB(DFN,DT) S IBC=IBC+1,IBT(IBC)=" ",IBC=IBC+1,IBT(IBC)="Note: This patient, who was MT copay at admission, is no longer MT billable."
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| 76 |  .I $$BFO^IBECEAU(DFN,+$G(^DGPM(IBPM,0))\1) S IBC=IBC+1,IBT(IBC)=" ",IBC=IBC+1,IBT(IBC)="Note: This patient was billed the outpatient copayment at admission."
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| 77 |  D SEND^IBACVA2
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| 78 |  Q
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| 79 |  ;
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| 80 | NOTICE(IBNUM,DFN,IBPM,IBCL) ; Notice to disposition billing case
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| 81 |  ;  Input:   IBNUM  --  Number of days since discharge
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| 82 |  ;             DFN  --  Pointer to the patient in file #2
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| 83 |  ;            IBPM  --  Pointer to the admission in file #405
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| 84 |  ;            IBCL  --  Patient class [1-ao|2-ir|3-swa|4-sc|5-mst|6-hnc|7-cv|8-shad]
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| 85 |  ;
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| 86 |  Q:IBNUM#15  ; send notice every 15 days only
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| 87 |  N IBC K IBT S IBPT=$$PT^IBEFUNC(DFN)
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| 88 |  S XMSUB="NOTICE TO DISPOSITION SPECIAL INPATIENT BILLING CASE"
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| 89 |  S IBT(1)="The case record for this Means Test copay "_$$LCCL(IBCL)_" patient"
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| 90 |  S IBT(2)="is now "_IBNUM_" days old and should be dispositioned:"
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| 91 |  S IBT(3)=" " S IBC=3
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| 92 |  S IBDUZ=DUZ D PAT^IBAERR1
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| 93 |  S Y=+$G(^DGPM(+$G(IBPM),0)) D DD^%DT
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| 94 |  S IBC=IBC+1,IBT(IBC)=" Adm Date: "_Y
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| 95 |  S Y=+$G(^DGPM(+$P($G(^DGPM(+$G(IBPM),0)),"^",17),0)) D DD^%DT
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| 96 |  S IBC=IBC+1,IBT(IBC)="Disc Date: "_Y
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| 97 |  S IBC=IBC+1,IBT(IBC)=" "
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| 98 |  S IBC=IBC+1,IBT(IBC)="Please determine if this episode of care should be billed, and use"
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| 99 |  S IBC=IBC+1,IBT(IBC)="the Cancel/Edit/Add Patient Charges option to add charges, or the"
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| 100 |  S IBC=IBC+1,IBT(IBC)="Disposition Special Inpatient Billing Cases option to enter the reason"
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| 101 |  S IBC=IBC+1,IBT(IBC)="for not billing."
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| 102 |  D SEND^IBACVA2
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| 103 |  Q
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| 104 |  ;
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| 105 | UCCL(X) ; Return the upper case classification description.
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| 106 |  ;  Input:       X  --  Patient class [1-ao|2-ir|3-swa|4-sc|5-mst|6-hnc|7-cv|8-shad]
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| 107 |  Q $S('$G(X):"SPECIAL",1:$$PATTYPE^IBACV(X))
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| 108 |  ;
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| 109 | LCCL(X) ; Return the lower case classification description.
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| 110 |  ;  Input:       X  --  Patient class [1-ao|2-ir|3-swa|4-sc|5-mst|6-hnc|7-cv|8-shad]
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| 111 |  Q $S('$G(X):"Special",1:$$PATTYPE^IBACV(X,"M"))
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| 112 |  ;
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