[613] | 1 | IBAMTV ;ALB/CPM - BACK-BILLING SUPPORT FOR IVM ; 31-MAY-94
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| 2 | ;;2.0;INTEGRATED BILLING;**15,153**;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 | ;
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| 5 | ; Input: DFN -- Pointer to the patient in file #2
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| 6 | ; DGMTP -- Zeroth node of previous MT in file #408.31
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| 7 | ; DGMTA -- Zeroth node of verified MT in file #408.31
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| 8 | ;
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| 9 | ; - begin back-billing from the original completed date.
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| 10 | S IBSTART=$P(DGMTA,"^",7) G:'IBSTART!(IBSTART'<DT) END
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| 11 | S IBEND=$$FMADD^XLFDT(IBSTART\1,364)
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| 12 | S:IBEND'<DT IBEND=$$FMADD^XLFDT(DT,-1)
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| 13 | ;
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| 14 | ; - build array of episodes of care to be billed
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| 15 | D CARE^IBAMTV1
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| 16 | ;
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| 17 | ; - analyze the array and build charges
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| 18 | I $D(^TMP("IBAMTV",$J)) D BLD^IBAMTV2
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| 19 | ;
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| 20 | ; - send a message if any charges need to be reviewed
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| 21 | I '$D(^IB("AJ",DFN)) G END
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| 22 | ;
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| 23 | K IBT S IBPT=$$PT^IBEFUNC(DFN)
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| 24 | S XMSUB="BACK-BILLING OF MEANS TEST CHARGES"
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| 25 | S IBT(1)="A verified Means Test has just been received from the IVM Center."
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| 26 | S IBT(2)="Means Test charges have been back-billed for the following patient:"
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| 27 | S IBT(3)=" " S IBC=3
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| 28 | S IBDUZ=DUZ D PAT^IBAERR1
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| 29 | S IBC=IBC+1,IBT(IBC)=" "
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| 30 | S IBC=IBC+1,IBT(IBC)="Please note that these charges are on hold, pending a manual review before"
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| 31 | S IBC=IBC+1,IBT(IBC)="being passed to Accounts Receivable. Please use the option 'Release Charges"
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| 32 | S IBC=IBC+1,IBT(IBC)="Pending Review' to review the charges and pass them to Accounts Receivable."
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| 33 | D SEND^IBACVA2
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| 34 | ;
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| 35 | END K IBDUZ,IBEND,IBSTART,^TMP("IBAMTV",$J)
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| 36 | Q
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| 37 | ;
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| 38 | ;
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| 39 | CANC ; Cancel Means Test charges if an IVM-verified Means Test is deleted.
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| 40 | ; Input: DFN -- Pointer to the patient in file #2
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| 41 | ; DGMTP -- Zeroth node of previous MT in file #408.31
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| 42 | ; DGMTA -- Zeroth node of verified MT in file #408.31
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| 43 | ;
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| 44 | Q:'$$CHECK^IBECEAU
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| 45 | S IBCRES=+$O(^IBE(350.3,"B","MT STATUS CHANGED FROM YES",0))
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| 46 | S:'IBCRES IBCRES=22 S IBJOB=9,IBWHER=30,IBDUZ=DUZ,IBFOUND=0
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| 47 | S IBST=+DGMTA,IBEND=$$FMADD^XLFDT(IBST,364) S:IBEND>DT IBEND=DT
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| 48 | S IBZ="" F S IBZ=$O(^IB("AFDT",DFN,IBZ)) Q:'IBZ I -IBZ'>IBEND S IBZ1=0 F S IBZ1=$O(^IB("AFDT",DFN,IBZ,IBZ1)) Q:'IBZ1 D
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| 49 | .S IBDA=0 F S IBDA=$O(^IB("AF",IBZ1,IBDA)) Q:'IBDA D
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| 50 | ..Q:'$D(^IB(IBDA,0)) S IBX=^(0)
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| 51 | ..Q:$P(IBX,"^",8)["ADMISSION" ; skip event records
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| 52 | ..Q:$P(IBX,"^",9)'=IBDA ; look only at original actions
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| 53 | ..S (IBN,IBORIG)=$$LAST^IBECEAU(IBDA),IBND=$G(^IB(IBN,0)),IBND1=$G(^(1))
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| 54 | ..I IBN=IBDA&($P(IBX,"^",5)=10)!($P($G(^IBE(350.1,+$P(IBND,"^",3),0)),"^",5)=2) Q ; already cancelled
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| 55 | ..I $P(IBND,"^",15)<IBST!($P(IBND,"^",14)>IBEND) Q ; out of range
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| 56 | ..Q:$$BIL^DGMTUB(DFN,$P(IBND,"^",14)) ; still Means Test billable
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| 57 | ..D CANCH^IBECEAU4(IBN,IBCRES)
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| 58 | ..S IBN=$$LAST^IBECEAU(IBDA),IBND=$G(^IB(IBN,0)),IBX=$G(^IB(IBORIG,0))
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| 59 | ..I IBN=IBDA&($P(IBX,"^",5)=10)!($P($G(^IBE(350.1,+$P(IBND,"^",3),0)),"^",5)=2) S IBFOUND=1 D ADJCL
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| 60 | ;
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| 61 | I IBFOUND D CANBULL
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| 62 | K IBCRES,IBST,IBEND,IBZ,IBZ1,IBDA,IBX,IBN,IBND,IBND1,IBJOB,IBWHER,IBDUZ,IBFOUND,IBORIG
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| 63 | Q
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| 64 | ;
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| 65 | CANBULL ; Generate the cancellation bulletin.
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| 66 | K IBT S IBPT=$$PT^IBEFUNC(DFN)
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| 67 | S XMSUB="CANCELLATION OF BACK-BILLED MEANS TEST CHARGES"
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| 68 | S IBT(1)="An IVM-verified Means Test was just deleted for the following patient:"
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| 69 | S IBT(2)=" " S IBC=2
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| 70 | S IBDUZ=DUZ D PAT^IBAERR1
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| 71 | S IBC=IBC+1,IBT(IBC)=" "
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| 72 | S IBC=IBC+1,IBT(IBC)="All back-billed Means Test charges for this patient were cancelled."
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| 73 | S IBC=IBC+1,IBT(IBC)="You should review this patient's Means Test billing history and billing"
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| 74 | S IBC=IBC+1,IBT(IBC)="clock for accuracy, starting on "_$$DAT1^IBOUTL(+DGMTA)_"."
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| 75 | D SEND^IBACVA2
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| 76 | K IBDUZ
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| 77 | Q
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| 78 | ;
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| 79 | ADJCL ; Roll back the billing clock for cancelled charges.
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| 80 | ; Input: IBX -- Zeroth node of charge which has been cancelled.
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| 81 | ; DFN -- Pointer to the patient in file #2
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| 82 | ;
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| 83 | N IBCL,IBCLD,IBUN,IBCLDAY,IBCHG,IBCLP,IBAP
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| 84 | Q:$P(IBX,"^",8)["OPT COPAY" ; no adjustments needed for opt copays
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| 85 | S IBCL=$$OLDCL^IBAMTV2(DFN,$P(IBX,"^",14)) Q:'IBCL ; no clock
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| 86 | S IBCLD=$G(^IBE(351,IBCL,0)) Q:'IBCLD
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| 87 | ;
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| 88 | ; - handle per diem charges
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| 89 | I $P($G(^IBE(350.1,+$P(IBX,"^",3),0)),"^",11)=3 D
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| 90 | .S IBUN=$P(IBX,"^",6),IBCLDAY=$P(IBCLD,"^",9)
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| 91 | .S $P(^IBE(351,IBCL,0),"^",9)=$S(IBCLDAY>IBUN:IBCLDAY-IBUN,1:0) D UPD
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| 92 | ;
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| 93 | ; - handle inpt copay charges
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| 94 | I $P($G(^IBE(350.1,+$P(IBX,"^",3),0)),"^",11)=2 D
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| 95 | .S IBCHG=$P(IBX,"^",7) Q:'IBCHG
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| 96 | .F IBCLP=8:-1:5 S IBAP=$P(IBCLD,"^",IBCLP) D Q:'IBCHG
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| 97 | ..I IBCHG>IBAP S IBCHG=IBCHG-IBAP,$P(^IBE(351,IBCL,0),"^",IBCLP)=0 D UPD Q
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| 98 | ..S $P(^IBE(351,IBCL,0),"^",IBCLP)=IBAP-IBCHG,IBCHG=0 D UPD
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| 99 | ;
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| 100 | Q
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| 101 | ;
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| 102 | UPD ; Update user and edit date on the Billing Clock.
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| 103 | D NOW^%DTC S $P(^IBE(351,IBCL,1),"^",3,4)=DUZ_"^"_%
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| 104 | Q
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