| 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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