| 1 | IBCNERP8 ;DAOU/BHS - IBCNE IIV STATISTICAL REPORT COMPILE ;11-JUN-2002
 | 
|---|
| 2 |  ;;2.0;INTEGRATED BILLING;**184,271,345**;21-MAR-94;Build 28
 | 
|---|
| 3 |  ;;Per VHA Directive 2004-038, this routine should not be modified.
 | 
|---|
| 4 |  ;
 | 
|---|
| 5 |  ; IIV - Insurance Identification and Verification Interface
 | 
|---|
| 6 |  ;
 | 
|---|
| 7 |  ;Input vars from IBCNERP7:
 | 
|---|
| 8 |  ; IBCNERTN = "IBCNERP7"
 | 
|---|
| 9 |  ; **IBCNESPC array ONLY passed by reference **
 | 
|---|
| 10 |  ; IBCNESPC("BEGDTM") = Start Dt/Tm for rpt range
 | 
|---|
| 11 |  ; IBCNESPC("ENDDTM") = End Dt/Tm for rpt range
 | 
|---|
| 12 |  ; IBCNESPC("SECTS")  = 1 - All sections OR ',' sep'd list of 1 or more
 | 
|---|
| 13 |  ;  of the following (not all)
 | 
|---|
| 14 |  ;  2 - Outgoing data, inq trans stats
 | 
|---|
| 15 |  ;  3 - Incoming data, resps rec'd stats
 | 
|---|
| 16 |  ;  4 - Current status, pending resps, queued inqs, deferred inqs, payer
 | 
|---|
| 17 |  ;      stats, ins buf stats
 | 
|---|
| 18 |  ; IBCNESPC("MM") = "" - do not generate MailMan message OR MAILGROUP to
 | 
|---|
| 19 |  ;  send report to Mail Group as defined in the IB site parameters
 | 
|---|
| 20 |  ;Output vars:
 | 
|---|
| 21 |  ; Based on IBCNESPC("SECTS") parameter the following scratch globals
 | 
|---|
| 22 |  ; may be built
 | 
|---|
| 23 |  ; 1 OR contains 2 --> 
 | 
|---|
| 24 |  ; ^TMP($J,RTN,"OUT")=TotInq^InsBufExtSubtotal^PreRegExtSubtotal^...
 | 
|---|
| 25 |  ;  NonVerifInsExtSubtotal^NoActInsExtSubtotal
 | 
|---|
| 26 |  ; 1 OR contains 3 --> 
 | 
|---|
| 27 |  ; ^TMP($J,RTN,"IN")=TotResp^InsBufExtSubtotal^PreRegExtSubtotal^...
 | 
|---|
| 28 |  ;  NonVerifInsExtSubtotal^NoActInsExtSubtotal
 | 
|---|
| 29 |  ; 1 OR contains 4 --> 
 | 
|---|
| 30 |  ; ^TMP($J,RTN,"CUR")=TotPendingResponses^TotQueuedInquiries^...
 | 
|---|
| 31 |  ;  TotDeferredInquiries(Hold)^TotInsCosw/oNationalID^...
 | 
|---|
| 32 |  ;  ToteIIVPyrsDisabldLocally^TotInsBufVerified^TotalManVerified...
 | 
|---|
| 33 |  ;  TotalIIVVerified^TotInsBufUnverified^! InsBufSubtotal^...
 | 
|---|
| 34 |  ;  ? InsBufSubtotal^- InsBufSubtotal^Other InsBufSubtotal
 | 
|---|
| 35 |  ; 1 OR contains 4 -->
 | 
|---|
| 36 |  ; ^TMP($J,RTN,"PYR",PAYER,IEN)=""  (list of new payers)
 | 
|---|
| 37 |  ;
 | 
|---|
| 38 |  ; Must call at EN
 | 
|---|
| 39 |  Q
 | 
|---|
| 40 |  ;
 | 
|---|
| 41 | EN(IBCNERTN,IBCNESPC) ; Entry pt
 | 
|---|
| 42 |  ; Init vars
 | 
|---|
| 43 |  N IBBDT,IBEDT,IBSCT,IBTOT,PIECES,VALUE,CT
 | 
|---|
| 44 |  ;
 | 
|---|
| 45 |  I '$D(ZTQUEUED),$G(IOST)["C-" W !!,"Compiling report data ..."
 | 
|---|
| 46 |  ;
 | 
|---|
| 47 |  S IBTOT=0
 | 
|---|
| 48 |  ;
 | 
|---|
| 49 |  ; Kill scratch global
 | 
|---|
| 50 |  K ^TMP($J,IBCNERTN)
 | 
|---|
| 51 |  ;
 | 
|---|
| 52 |  ; Init looping vars
 | 
|---|
| 53 |  S IBBDT=$G(IBCNESPC("BEGDTM")),IBEDT=$G(IBCNESPC("ENDDTM"))
 | 
|---|
| 54 |  S IBSCT=$G(IBCNESPC("SECTS"))
 | 
|---|
| 55 |  ;
 | 
|---|
| 56 |  I IBSCT=1!$F(IBSCT,",2,") D OUT(IBCNERTN,IBBDT,IBEDT,.IBTOT)
 | 
|---|
| 57 |  I $G(ZTSTOP) G EXIT
 | 
|---|
| 58 |  I IBSCT=1!$F(IBSCT,",3,") D IN(IBCNERTN,IBBDT,IBEDT,.IBTOT)
 | 
|---|
| 59 |  I $G(ZTSTOP) G EXIT
 | 
|---|
| 60 |  I IBSCT=1!$F(IBSCT,",4,") D CUR(IBCNERTN,.IBTOT),PYR^IBCNERP0(IBCNERTN,IBBDT,IBEDT,.IBTOT)
 | 
|---|
| 61 |  ;
 | 
|---|
| 62 | EXIT ; EN Exit pt
 | 
|---|
| 63 |  Q
 | 
|---|
| 64 |  ;
 | 
|---|
| 65 | IN(RTN,BDT,EDT,TOT) ; Determine Incoming Data
 | 
|---|
| 66 |  ; Input params: RTN-routine name for ^TMP($J), BDT-start dt/time,
 | 
|---|
| 67 |  ;  EDT-end dt/time, **TOT-total records searched - used only for status
 | 
|---|
| 68 |  ;  checks when the process is queued (passed by reference)
 | 
|---|
| 69 |  ; Output vars: Set pcs of ^TMP($J,RTN,"IN") as follows:
 | 
|---|
| 70 |  ;  1=total Resps rec'd for date/time range
 | 
|---|
| 71 |  ;  2=Ins Buf extract subtotal
 | 
|---|
| 72 |  ;  3=Pre-Reg extract subtotal
 | 
|---|
| 73 |  ;  4=Non-ver extract subtotal
 | 
|---|
| 74 |  ;  5=No Act Ins subtotal
 | 
|---|
| 75 |  ;
 | 
|---|
| 76 |  ; Init vars
 | 
|---|
| 77 |  N IBDT,PYRIEN,PATIEN,IBPTR,IBTYP,RPTDATA,TRANSIEN
 | 
|---|
| 78 |  ;
 | 
|---|
| 79 |  ; Loop thru the IIV Resp File (#365) x-ref on Date/Time Resp Rec'd
 | 
|---|
| 80 |  S IBDT=$O(^IBCN(365,"AD",BDT),-1)
 | 
|---|
| 81 |  F  S IBDT=$O(^IBCN(365,"AD",IBDT)) Q:IBDT=""!(IBDT>EDT)  D  Q:$G(ZTSTOP)
 | 
|---|
| 82 |  . S PYRIEN=0
 | 
|---|
| 83 |  . F  S PYRIEN=$O(^IBCN(365,"AD",IBDT,PYRIEN)) Q:'PYRIEN  D  Q:$G(ZTSTOP)
 | 
|---|
| 84 |  . . S PATIEN=0
 | 
|---|
| 85 |  . . F  S PATIEN=$O(^IBCN(365,"AD",IBDT,PYRIEN,PATIEN)) Q:'PATIEN  D  Q:$G(ZTSTOP)
 | 
|---|
| 86 |  . . . S IBPTR=0
 | 
|---|
| 87 |  . . . F  S IBPTR=$O(^IBCN(365,"AD",IBDT,PYRIEN,PATIEN,IBPTR)) Q:'IBPTR  D  Q:$G(ZTSTOP)
 | 
|---|
| 88 |  . . . . S TOT=TOT+1
 | 
|---|
| 89 |  . . . . I $D(ZTQUEUED),TOT#100=0,$$S^%ZTLOAD() S ZTSTOP=1 Q
 | 
|---|
| 90 |  . . . . ; Update total
 | 
|---|
| 91 |  . . . . S $P(RPTDATA,U,1)=$P($G(RPTDATA),U,1)+1
 | 
|---|
| 92 |  . . . . ; Update extract type total
 | 
|---|
| 93 |  . . . . ; Get the data for the report - build RPTDATA
 | 
|---|
| 94 |  . . . . S IBTYP=5,TRANSIEN=$P($G(^IBCN(365,IBPTR,0)),U,5)
 | 
|---|
| 95 |  . . . . I TRANSIEN'="" S IBTYP=$P($G(^IBCN(365.1,TRANSIEN,0)),U,10)
 | 
|---|
| 96 |  . . . . S $P(RPTDATA,U,IBTYP+1)=$P($G(RPTDATA),U,IBTYP+1)+1
 | 
|---|
| 97 |  ;
 | 
|---|
| 98 |  I $G(ZTSTOP) G INX
 | 
|---|
| 99 |  ;
 | 
|---|
| 100 |  ; Save data to global
 | 
|---|
| 101 |  S ^TMP($J,RTN,"IN")=$G(RPTDATA)
 | 
|---|
| 102 |  ;
 | 
|---|
| 103 | INX ; IN exit pt
 | 
|---|
| 104 |  Q
 | 
|---|
| 105 |  ;
 | 
|---|
| 106 | OUT(RTN,BDT,EDT,TOT) ; Outgoing Data
 | 
|---|
| 107 |  ;Input params:  RTN-routine name used as subscript in ^TMP($J),
 | 
|---|
| 108 |  ; BDT-start date/time, EDT-end date/time, **TOT-total recs searched-used
 | 
|---|
| 109 |  ; only for status checks when process is queued (passed by reference)
 | 
|---|
| 110 |  ;Output vars: Set pcs of ^TMP($J,RTN,"OUT") as follows:
 | 
|---|
| 111 |  ; 1=total Inqs transmitted for timeframe
 | 
|---|
| 112 |  ; 2=Ins Buffer extract subtotal
 | 
|---|
| 113 |  ; 3=Pre-Reg extract subtotal
 | 
|---|
| 114 |  ; 4=Non-Ver extract subtotal
 | 
|---|
| 115 |  ; 5=No Act Ins subtotal
 | 
|---|
| 116 |  ;
 | 
|---|
| 117 |  ; Init vars
 | 
|---|
| 118 |  N IBDT,IBPTR,IBTYP,RPTDATA,TQIEN
 | 
|---|
| 119 |  ;
 | 
|---|
| 120 |  ; Loop thru the IIV Resp File (#365) by x-ref on Date/Time Resp Created
 | 
|---|
| 121 |  ;  Only count responses for unique HL7 message IDs - filter out
 | 
|---|
| 122 |  ;  unsolicited responses as they artificially inflate the Outgoing Count
 | 
|---|
| 123 |  S IBDT=$O(^IBCN(365,"AE",BDT),-1)
 | 
|---|
| 124 |  F  S IBDT=$O(^IBCN(365,"AE",IBDT)) Q:IBDT=""!(IBDT>EDT)  D  Q:$G(ZTSTOP)
 | 
|---|
| 125 |  . S IBPTR=0
 | 
|---|
| 126 |  . F  S IBPTR=$O(^IBCN(365,"AE",IBDT,IBPTR)) Q:'IBPTR  D  Q:$G(ZTSTOP)
 | 
|---|
| 127 |  . . S TOT=TOT+1
 | 
|---|
| 128 |  . . I $D(ZTQUEUED),TOT#100=0,$$S^%ZTLOAD() S ZTSTOP=1 Q
 | 
|---|
| 129 |  . . ; Quit, if response was not O - original
 | 
|---|
| 130 |  . . I $P($G(^IBCN(365,IBPTR,0)),U,10)'="O" Q
 | 
|---|
| 131 |  . . ; Update total
 | 
|---|
| 132 |  . . S $P(RPTDATA,U,1)=$P($G(RPTDATA),U,1)+1
 | 
|---|
| 133 |  . . ; Update extract type total (1,2,3,4)
 | 
|---|
| 134 |  . . S IBTYP=5
 | 
|---|
| 135 |  . . S TQIEN=$P($G(^IBCN(365,IBPTR,0)),U,5)
 | 
|---|
| 136 |  . . I TQIEN="" Q
 | 
|---|
| 137 |  . . S IBTYP=$P($G(^IBCN(365.1,TQIEN,0)),U,10)
 | 
|---|
| 138 |  . . S $P(RPTDATA,U,IBTYP+1)=$P($G(RPTDATA),U,IBTYP+1)+1
 | 
|---|
| 139 |  ;
 | 
|---|
| 140 |  I $G(ZTSTOP) G OUTX
 | 
|---|
| 141 |  ;
 | 
|---|
| 142 |  ; Save data to global array
 | 
|---|
| 143 |  S ^TMP($J,RTN,"OUT")=$G(RPTDATA)
 | 
|---|
| 144 |  ;
 | 
|---|
| 145 | OUTX ; OUT exit pt
 | 
|---|
| 146 |  Q
 | 
|---|
| 147 |  ;
 | 
|---|
| 148 | CUR(RTN,TOT) ; Current Status - stats - timeframe independent
 | 
|---|
| 149 |  ; Input params: RTN-routine name as subs in ^TMP($J), **TOT-total recs
 | 
|---|
| 150 |  ;  searched - used only for status checks when the process is queued
 | 
|---|
| 151 |  ;  passed by reference
 | 
|---|
| 152 |  ; Output vars: Set pcs of ^TMP($J,RTN,"CUR") as follows:
 | 
|---|
| 153 |  ;  1=total Pending Resps (Transmitted-2)
 | 
|---|
| 154 |  ;  2=total Queued Inqs (Ready to Transmit-1/Retry-6)
 | 
|---|
| 155 |  ;  3=total Deferred Inqs (Hold-4)
 | 
|---|
| 156 |  ;  4=Ins Cos w/o National ID
 | 
|---|
| 157 |  ;  5=Payers w/IIV disabled locally
 | 
|---|
| 158 |  ;  6=total user action required (symbol'='*' or '#' or '!' or '?' or '-')
 | 
|---|
| 159 |  ;  7=total Man. Ver'd Ins Buf entries (symbol='*')
 | 
|---|
| 160 |  ;  8=total IIV Processed Ver. (symbol='+')
 | 
|---|
| 161 |  ;  9=total awaiting processing (symbol='?' or BLANK)
 | 
|---|
| 162 |  ;  10=total Ins Buf entries w/symbol='#'
 | 
|---|
| 163 |  ;  11=total Ins Buf entries w/symbol='!'
 | 
|---|
| 164 |  ;  12=total Ins Buf entries w/symbol='?'
 | 
|---|
| 165 |  ;  13=total Ins Buf entries w/symbol='-'
 | 
|---|
| 166 |  ;  14=total Ins Buffer entries w/symbol not in ('*','#','!','?','-')
 | 
|---|
| 167 |  ;
 | 
|---|
| 168 |  ; Init vars
 | 
|---|
| 169 |  N RIEN,TQIEN,ICIEN,IBIEN,RPTDATA,IEN,IBSYMBOL,PIECE,IBSTS,APPIEN
 | 
|---|
| 170 |  N PIEN,TMP,APPDATA,XDT
 | 
|---|
| 171 |  ;
 | 
|---|
| 172 |  S RPTDATA=""
 | 
|---|
| 173 |  ;
 | 
|---|
| 174 |  ; Responses pending (Transmitted - 2)
 | 
|---|
| 175 |  S RIEN=0
 | 
|---|
| 176 |  F  S RIEN=$O(^IBCN(365,"AC",2,RIEN)) Q:'RIEN  D  Q:$G(ZTSTOP)
 | 
|---|
| 177 |  .  S TOT=TOT+1
 | 
|---|
| 178 |  .  I $D(ZTQUEUED),TOT#100=0,$$S^%ZTLOAD() S ZTSTOP=1 Q
 | 
|---|
| 179 |  .  S $P(RPTDATA,U,1)=$P(RPTDATA,U,1)+1
 | 
|---|
| 180 |  ;
 | 
|---|
| 181 |  I $G(ZTSTOP) G CURX
 | 
|---|
| 182 |  ;
 | 
|---|
| 183 |  ; Queued inquiries (Ready to Transmit - 1/Retry - 6) and 
 | 
|---|
| 184 |  ; Deferred inquiries (Hold - 4)
 | 
|---|
| 185 |  F IBSTS=1,6,4 D  Q:$G(ZTSTOP)
 | 
|---|
| 186 |  . S TQIEN=0
 | 
|---|
| 187 |  . F  S TQIEN=$O(^IBCN(365.1,"AC",IBSTS,TQIEN)) Q:'TQIEN  D  Q:$G(ZTSTOP)
 | 
|---|
| 188 |  . .  S TOT=TOT+1
 | 
|---|
| 189 |  . .  I $D(ZTQUEUED),TOT#100=0,$$S^%ZTLOAD() S ZTSTOP=1 QUIT
 | 
|---|
| 190 |  . .  I IBSTS'=4 S $P(RPTDATA,U,2)=$P(RPTDATA,U,2)+1 Q
 | 
|---|
| 191 |  . .  S $P(RPTDATA,U,3)=$P(RPTDATA,U,3)+1
 | 
|---|
| 192 |  ;
 | 
|---|
| 193 |  I $G(ZTSTOP) G CURX
 | 
|---|
| 194 |  ;
 | 
|---|
| 195 |  ; Payer stats
 | 
|---|
| 196 |  ; Ins cos w/o National ID
 | 
|---|
| 197 |  S ICIEN=0
 | 
|---|
| 198 |  F  S ICIEN=$O(^DIC(36,ICIEN)) Q:'ICIEN  D  Q:$G(ZTSTOP)
 | 
|---|
| 199 |  .  S TOT=TOT+1
 | 
|---|
| 200 |  .  I $D(ZTQUEUED),TOT#100=0,$$S^%ZTLOAD() S ZTSTOP=1 QUIT
 | 
|---|
| 201 |  .  ; Exclude inactive
 | 
|---|
| 202 |  .  S TMP=$$ACTIVE^IBCNEUT4(ICIEN) I 'TMP Q
 | 
|---|
| 203 |  .  ; Exclude Medicare/Medicaid, etc.
 | 
|---|
| 204 |  .  I $$EXCLUDE^IBCNEUT4($P(TMP,U,2)) Q
 | 
|---|
| 205 |  .  ; Determine assoc Payer
 | 
|---|
| 206 |  .  S PIEN=$P($G(^DIC(36,ICIEN,3)),U,10)
 | 
|---|
| 207 |  .  ; Missing payer link
 | 
|---|
| 208 |  .  I 'PIEN S $P(RPTDATA,U,4)=$P(RPTDATA,U,4)+1 Q
 | 
|---|
| 209 |  .  ; Does a VA NATIONAL ID exist?
 | 
|---|
| 210 |  .  I $P($G(^IBE(365.12,PIEN,0)),U,2)'="" Q
 | 
|---|
| 211 |  .  S $P(RPTDATA,U,4)=$P(RPTDATA,U,4)+1
 | 
|---|
| 212 |  ;
 | 
|---|
| 213 |  I $G(ZTSTOP) G CURX
 | 
|---|
| 214 |  ;
 | 
|---|
| 215 |  ; IIV Payers disabled locally
 | 
|---|
| 216 |  S PIEN=0
 | 
|---|
| 217 |  F  S PIEN=$O(^IBE(365.12,PIEN)) Q:'PIEN  D  Q:$G(ZTSTOP)
 | 
|---|
| 218 |  .  S TOT=TOT+1
 | 
|---|
| 219 |  .  I $D(ZTQUEUED),TOT#100=0,$$S^%ZTLOAD() S ZTSTOP=1 Q
 | 
|---|
| 220 |  .  ; Must have National ID
 | 
|---|
| 221 |  .  I $P($G(^IBE(365.12,PIEN,0)),U,2)'="" Q
 | 
|---|
| 222 |  .  ; Get Payer app multiple IEN
 | 
|---|
| 223 |  .  S APPIEN=$$PYRAPP^IBCNEUT5("IIV",PIEN)
 | 
|---|
| 224 |  .  ; Must have eIIV application
 | 
|---|
| 225 |  .  I 'APPIEN Q
 | 
|---|
| 226 |  .  S APPDATA=$G(^IBE(365.12,PIEN,1,APPIEN,0))
 | 
|---|
| 227 |  .  ; Must be Nationally Active
 | 
|---|
| 228 |  .  I '$P(APPDATA,U,2) Q
 | 
|---|
| 229 |  .  ; Must not be Locally Active
 | 
|---|
| 230 |  .  I $P(APPDATA,U,3) Q
 | 
|---|
| 231 |  .  S $P(RPTDATA,U,5)=$P(RPTDATA,U,5)+1
 | 
|---|
| 232 |  ;
 | 
|---|
| 233 |  I $G(ZTSTOP) G CURX
 | 
|---|
| 234 |  ;
 | 
|---|
| 235 |  ; Buffer stats
 | 
|---|
| 236 |  ; Loop thru the Ins Buffer File (#355.33)
 | 
|---|
| 237 |  S IBIEN=0,XDT=0
 | 
|---|
| 238 |  F  S XDT=$O(^IBA(355.33,"AEST","E",XDT)) Q:XDT=""  D  Q:$G(ZTSTOP)
 | 
|---|
| 239 |  . F  S IBIEN=$O(^IBA(355.33,"AEST","E",XDT,IBIEN)) Q:IBIEN=""  D  Q:$G(ZTSTOP)
 | 
|---|
| 240 |  . . S TOT=TOT+1
 | 
|---|
| 241 |  . . I $D(ZTQUEUED),TOT#100=0,$$S^%ZTLOAD() S ZTSTOP=1 Q
 | 
|---|
| 242 |  . . S IBSYMBOL=$$SYMBOL^IBCNBLL(IBIEN)
 | 
|---|
| 243 |  . . ; Determine piece to update based on symbol
 | 
|---|
| 244 |  . . ; ('*') = Man. Verified,  ('#','!','-','?',blank/null) = IIV Processing
 | 
|---|
| 245 |  . . ; ('+') = IIV Processed
 | 
|---|
| 246 |  . . S PIECE=$S(IBSYMBOL="*":7,IBSYMBOL="+":8,IBSYMBOL="#":10,IBSYMBOL="!":11,IBSYMBOL="-":13,IBSYMBOL="?":12,1:14)
 | 
|---|
| 247 |  . . I PIECE=12!(PIECE=14) S $P(RPTDATA,U,9)=$P($G(RPTDATA),U,9)+1
 | 
|---|
| 248 |  . . E  S $P(RPTDATA,U,6)=$P($G(RPTDATA),U,6)+1
 | 
|---|
| 249 |  . . S $P(RPTDATA,U,PIECE)=$P($G(RPTDATA),U,PIECE)+1
 | 
|---|
| 250 |  ;
 | 
|---|
| 251 |  I $G(ZTSTOP) G CURX
 | 
|---|
| 252 |  ;
 | 
|---|
| 253 |  ; Save data to global
 | 
|---|
| 254 |  S ^TMP($J,RTN,"CUR")=$G(RPTDATA)
 | 
|---|
| 255 |  ;
 | 
|---|
| 256 | CURX ; CUR exit point
 | 
|---|
| 257 |  Q
 | 
|---|
| 258 |  ;
 | 
|---|
| 259 |  ;
 | 
|---|