| 1 | IBCD2 ;ALB/ARH - AUTOMATED BILLER (CREATE - SETUP/GATHER DATA FIELDS) ; 8/6/93
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| 2 |  ;;2.0;INTEGRATED BILLING;**4,55,91,106**;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 | FIND ;
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| 6 |  S IBX=$$CHKSYS^IBCD4 I 'IBX D TERR(0,0,$P(IBX,U,2)) G EXIT
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| 7 |  S IBS="IBC0" F  S IBS=$O(^TMP(IBS)) Q:IBS=""  S IBX=$E(IBS,4,99) Q:$E(IBS,1,3)'="IBC"!'+IBX  D
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| 8 |  . N IBQUERY
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| 9 |  . S IBDFN=0 F  S IBDFN=$O(^TMP(IBS,$J,IBDFN)) Q:'IBDFN  D
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| 10 |  .. S IBSTDT="" F  S IBSTDT=$O(^TMP(IBS,$J,IBDFN,IBSTDT)) Q:IBSTDT=""  D  I $D(IBCT)>9 D CREATE(.IBQUERY)
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| 11 |  ... K IBCT S IBTRN=0 F  S IBTRN=$O(^TMP(IBS,$J,IBDFN,IBSTDT,IBTRN)) Q:'IBTRN  S IBCT(IBTRN)="",IBTF=^TMP(IBS,$J,IBDFN,IBSTDT,IBTRN)
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| 12 |  .I $G(IBQUERY) D CLOSE^IBSDU(IBQUERY)
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| 13 | EXIT K IBS,IBDFN,IBSTDT,IBCT,IBTRN,IBTF,IBX,X,DFN
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| 14 |  Q
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| 15 |  ;
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| 16 | CREATE(IBQUERY) ;set up a bill,  required: IBCT(IBTRN),IBDFN,IBSTDT
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| 17 |  ; IBQUERY, if defined, will be used to activate the outpt visit QUERY
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| 18 |  Q:$D(IBCT)<9  K IB
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| 19 |  S IBSP=$G(^IBE(350.9,1,1)),IBDIV=$P(IBSP,U,25),IBTRN=+$O(IBCT(0))
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| 20 |  S IBTRND=$G(^IBT(356,IBTRN,0)) I 'IBTRND D TERR(+IBTRN,0,"Claims Tracking Record not found or not complete.") G QUIT
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| 21 |  S IBTYPE=$P(IBTRND,U,18) S IBX=$$CHK I 'IBX D TERR(+IBTRN,0,$P(IBX,U,2)) G QUIT
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| 22 |  ;
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| 23 |  S IBX=$$ARSET I 'IBX D TERR(IBTRN,0,$P(IBX,U,2)) G QUIT
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| 24 |  S IBIFN=+IBX,IB(.01)=$P(IBX,U,2),IB(.17)=$P(IBX,U,3),IB(.2)=1,IB(.22)=IBDIV
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| 25 |  S (IB(.02),DFN)=IBDFN,IB(.06)=IBTF
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| 26 |  S IB(.07)=$O(^DGCR(399.3,"B","REIMBURSABLE INS.",0)) I 'IB(.07) S IB(.07)=8
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| 27 |  S IBX=$O(^IBT(356.2,"ATRTP",IBTRN,1,"")) I +IBX S IB(163)=$P($G(^IBT(356.2,IBX,0)),U,28) ;pre-cert #
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| 28 |  ;
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| 29 |  S IBX=$P($G(^IBE(356.6,+IBTYPE,0)),U,1)
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| 30 |  I IBX="INPATIENT ADMISSION" D INPT^IBCD5 G CONT
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| 31 |  I IBX="PRESCRIPTION REFILL" D RXRF G CONT
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| 32 |  I IBX="OUTPATIENT VISIT" D OUTPT G CONT
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| 33 |  G QUIT
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| 34 |  ;
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| 35 | CONT S IBX=$$BDT^IBCU3(IBDFN,IB(.03)) S IB(.17)=$S(+IBX:IBX,1:IBIFN) ; continuing episode of care
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| 36 |  ;Note if a primary bill is found for an outpatient bill then it allows them to choose the bill during bill creation,  .17 is not editable on the screens
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| 37 |  S IB(.18)=$$SC^IBCU3(IBDFN) ; SC at time of care
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| 38 |  ;
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| 39 |  ; Note: variable IBQUERY used in this call to ^IBCD3
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| 40 |  D EN^IBCD3(.IBQUERY) ; create bill
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| 41 |  ;
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| 42 |  S IBTRN=0 F  S IBTRN=$O(IBCT(IBTRN)) Q:'IBTRN  D
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| 43 |  . D TERR(IBTRN,IBIFN,"") ; bill created
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| 44 |  . I ",2,3,"'[+$G(IB(.06)) D TEABD(IBTRN,0) ; remove eabd for final bills
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| 45 |  . D TBILL(IBTRN,IBIFN) ; set index for bill and event (356.399)
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| 46 |  . I $O(IB(43,0)),$$NABSCT^IBCU81(IBTRN) D TERR(IBTRN,IBIFN,"Stop/Clinic flagged to be ignored by auto biller but another visit is billed on same date.")
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| 47 |  . I $O(IB(43,0)),$$NBOE^IBCU81(+$P($G(^IBT(356,+IBTRN,0)),U,4)) D TERR(IBTRN,IBIFN,"Visit flagged as SC in source file but has no RNB.")
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| 48 |  ;
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| 49 |  S IBTRN=$O(IBCT(IBTRN)) Q:'IBTRN  D
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| 50 |  . I $G(IB(.05))>2,$G(IB(.27))=1,+$G(^DGCR(399,IBIFN,"MP")),'$O(^DGCR(399,IBIFN,"RC",0)) D TERR(IBTRN,IBIFN,"This RC Opt bill appears to have no institutional charges but may have professional charges.")
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| 51 |  ;
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| 52 |  S X=$$PRCDIV^IBCU71(IBIFN) ; reset bill division from site default to first procedures division
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| 53 |  ;
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| 54 | QUIT K X,Y,IBX,IBY,IBSP,IBDIV,IBTRN,IBTRND,IBTYPE,IB
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| 55 |  Q
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| 56 |  ;
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| 57 | OUTPT S IB(.04)=$S(+$P($G(^DG(40.8,+IBDIV,0)),U,3):7,1:1) ;division outpatient only or hospital
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| 58 |  S IB(.05)=3,IB(.06)=1,IB(.09)=4
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| 59 |  ;event dt is date of first visit, stmt from is first visit dt, stmt to is last visit dt on bill
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| 60 |  S (IB(.03),IB(151))=9999999,IB(152)=""
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| 61 |  S IBTRNX=0 F  S IBTRNX=$O(IBCT(IBTRNX)) Q:'IBTRNX  S IBX=$P($G(^IBT(356,IBTRNX,0)),U,6)\1 D
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| 62 |  . S IB(43,+IBX)="" S:IB(152)<IBX IB(152)=IBX F IBI=.03,151 I IB(IBI)>IBX S IB(IBI)=IBX
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| 63 |  I +$$BILLRATE^IBCRU3(+$G(IB(.07)),IB(.05),IB(.03),"RC") S IB(.27)=1 ; reasonable charges institutional bill
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| 64 |  K IBI,IBX,IBTRNX
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| 65 |  Q
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| 66 | RXRF S IB(.04)=$S(+$P($G(^DG(40.8,+IBDIV,0)),U,3):7,1:1) ;division outpatient only or hospital
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| 67 |  S IB(.05)=3,IB(.06)=1
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| 68 |  ;event dt is date of first visit, stmt from is first visit dt, stmt to is last visit dt on bill
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| 69 |  S (IB(.03),IB(151))=9999999,IB(152)=""
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| 70 |  S IBTRNX=0 F  S IBTRNX=$O(IBCT(IBTRNX)) Q:'IBTRNX  S IBRX=$G(^IBT(356,IBTRNX,0)) D
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| 71 |  . S IBX=$$RXRF^IBCD4(+$P(IBRX,U,8),+$P(IBRX,U,10)),IB(362.4,+$P(IBRX,U,8),+$P(IBRX,U,10))=IBX,IBX=$P(IBX,U,4)
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| 72 |  . S:IB(152)<IBX IB(152)=IBX F IBI=.03,151 I IB(IBI)>IBX S IB(IBI)=IBX
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| 73 |  K IBI,IBX,IBTRNX,IBRX
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| 74 |  Q
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| 75 |  ;
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| 76 | ARSET() ; set up entry for new bill in AR returns IFN, bill number
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| 77 |  ;otherwise "0^error meaasge"
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| 78 |  N X S X="0^Can not set up bill in AR."
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| 79 |  S PRCASV("SER")=$P($G(^IBE(350.9,1,1)),U,14),PRCASV("SITE")=+$P($$SITE^VASITE,U,3)
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| 80 |  D SETUP^PRCASVC3
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| 81 |  I $P(PRCASV("ARBIL"),U)=-1 S X="0^"_$P(PRCASV("ARBIL"),U,2)_" - "_$$ETXT^IBEFUNC($P(PRCASV("ARBIL"),U,2)) G ARSETQ
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| 82 |  I $P(PRCASV("ARREC"),U)=-1 S X="0^"_$P(PRCASV("ARREC"),U,2)_" - "_$$ETXT^IBEFUNC($P(PRCASV("ARREC"),U,2)) G ARSETQ
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| 83 |  S X=PRCASV("ARREC")_U_$P(PRCASV("ARBIL"),"-",2)
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| 84 | ARSETQ K PRCASV
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| 85 |  Q X
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| 86 |  ;
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| 87 | CHK() ;other checks
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| 88 |  N X S X=1 I $G(^DPT(+$G(IBDFN),0))="" S X="0^Patient information lacking."
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| 89 |  Q X
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| 90 |  ;
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| 91 | TEABD(TRN,IBDT) ;
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| 92 |  S IBDT=+$G(IBDT),^TMP("IBEABD",$J,+TRN,+IBDT)=""
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| 93 |  Q
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| 94 | TERR(TRN,IFN,ER) ;
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| 95 |  N X S TRN=+$G(TRN),IFN=+$G(IFN),X=+$G(^TMP("IBCE",$J,DT,TRN,IFN))+1
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| 96 |  S ^TMP("IBCE",$J,DT,TRN,IFN,X)=$G(ER),^TMP("IBCE",$J,DT,TRN,IFN)=X
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| 97 |  Q
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| 98 | TBILL(TRN,IFN) ;
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| 99 |  I '$D(^IBT(356,+$G(TRN),0))!('$D(^DGCR(399,+$G(IFN),0))) Q
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| 100 |  S ^TMP("IBILL",$J,TRN,IFN)=""
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| 101 |  Q
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