[613] | 1 | IBCNSMR ;ALB/AAS - MEDICARE BILLS ; 02-SEPT-97
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| 2 | ;;2.0;INTEGRATED BILLING;**92,240**;21-MAR-94
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| 3 | ;
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| 4 | % G RPRT^IBCNSMRA
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| 5 | ;
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| 6 | DQ ; -- entry point from task manager
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| 7 | N I,J,X,Y,IBINSCO,INSCO,NODE,CNT,IBI,IBINSNM,IBNM
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| 8 | S IBQUIT=0
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| 9 | K ^TMP("IB-MRA",$J),^TMP("IB-MRA-CNT",$J)
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| 10 | ;
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| 11 | S I=0
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| 12 | F S I=$O(^IBE(350.9,1,99,I)) Q:'I S INSCO(+$G(^IBE(350.9,1,99,I,0)))=""
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| 13 | ;
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| 14 | S IBI=0
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| 15 | F S IBI=$O(^DGCR(399,IBI)) Q:'IBI!(IBQUIT) D
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| 16 | .S IBQUIT=$$STOP Q:IBQUIT
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| 17 | .S IBINSCO="" K NODE
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| 18 | .S NODE(0)=$G(^DGCR(399,IBI,0)) Q:NODE(0)=""
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| 19 | .S NODE("C")=$G(^DGCR(399,IBI,"C"))
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| 20 | .S NODE("M")=$G(^DGCR(399,IBI,"M")) Q:NODE("M")=""
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| 21 | .S NODE("U")=$G(^DGCR(399,IBI,"U")) Q:NODE("U")=""
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| 22 | .I $D(INSCO(+NODE("M"))) S IBINSCO=+NODE("M")
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| 23 | .I 'IBINSCO,$D(INSCO(+$P(NODE("M"),"^",2))) S IBINSCO=$P(NODE("M"),"^",2)
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| 24 | .I 'IBINSCO,$D(INSCO(+$P(NODE("M"),"^",3))) S IBINSCO=$P(NODE("M"),"^",3)
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| 25 | .I IBINSCO S IBINSNM=$P($G(^DIC(36,IBINSCO,0)),"^") D BLDDATA
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| 26 | ;
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| 27 | I 'IBQUIT D PRINT^IBCNSMR0
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| 28 | G END^IBCNSMRA
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| 29 | END Q
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| 30 | ;
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| 31 | BLDDATA ; -- for each bill sent to a selected ins. co. build temp node
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| 32 | N X,YEAR,TYPE,TYPENO,PROC,DIAG,ORGAMNT,BOTH,IBSTAT,DFN,ALIVE,ARSTAT,IBQUIT,RXBILL,PROSBILL,BILLNO,LOCCARE,RATETYP,RN,WHO,TIMEFRM,TOTPAID,REFGC,DATEPR
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| 33 | S IBQUIT=0
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| 34 | S BILLNO=$P(NODE(0),"^")
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| 35 | S YEAR=$E(+NODE("U"),2,3)
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| 36 | S TYPENO=$P(NODE(0),"^",5)
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| 37 | S TYPE=$S(TYPENO<3:"INPATIENT",1:"OUTPATIENT")
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| 38 | S PROC=$$PROC(IBI)
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| 39 | S DIAG=$$DIAG(IBI)
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| 40 | S IBSTAT=$P(NODE(0),"^",13)
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| 41 | S ARSTAT=$$STA^PRCAFN(IBI)
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| 42 | S DFN=$P(NODE(0),"^",2)
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| 43 | S ALIVE=$S(+$G(^DPT(DFN,.35)):"DEAD",1:"ALIVE")
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| 44 | S ORGAMNT=$$ORI^PRCAFN(IBI)
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| 45 | S LOCCARE=$P(NODE(0),"^",4)
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| 46 | S WHO=$P(NODE(0),"^",11)
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| 47 | S RATETYP=$P(NODE(0),"^",7)
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| 48 | S RN=$P($G(^DGCR(399.3,+RATETYP,0)),"^")
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| 49 | S TIMEFRM=$P(NODE(0),"^",6)
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| 50 | S TOTPAID=$$TPR^PRCAFN(IBI)
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| 51 | S REFGC=$P($G(^PRCA(430,IBI,6)),"^",4)'=""
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| 52 | S DATEPR=$P($G(^DGCR(399,IBI,"S")),"^",12)
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| 53 | S BOTH="NONE"
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| 54 | S RXBILL=0
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| 55 | S PROSBILL=0
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| 56 | I $O(^IBA(362.4,"AIFN"_IBI,"")) S RXBILL=1
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| 57 | I $O(^IBA(362.5,"AIFN"_IBI,"")) S PROSBILL=1
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| 58 | D COUNT
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| 59 | D:'IBQUIT SET
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| 60 | Q
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| 61 | ;
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| 62 | COUNT ; -- set totals for all ins, and by ins co.
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| 63 | S CNT=$G(CNT)+1
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| 64 | S CNT(0)=$G(CNT(0))+ORGAMNT
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| 65 | S CNT(3,IBINSNM)=$G(CNT(3,IBINSNM))+1
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| 66 | S CNT(3,IBINSNM,0)=$G(CNT(3,IBINSNM,0))+ORGAMNT
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| 67 | I TYPE="INPATIENT" D
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| 68 | .S CNT("IN")=$G(CNT("IN"))+1
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| 69 | .S CNT("IN",0)=$G(CNT("IN",0))+ORGAMNT
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| 70 | .I TOTPAID>0 D
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| 71 | ..S CNT("IN",1)=$G(CNT("IN",1))+1
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| 72 | ..S CNT("IN",2)=$G(CNT("IN",2))+TOTPAID
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| 73 | I TYPE="OUTPATIENT" D
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| 74 | .S CNT("OP")=$G(CNT("OP"))+1
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| 75 | .S CNT("OP",0)=$G(CNT("OP",0))+ORGAMNT
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| 76 | .I TOTPAID>0 D
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| 77 | ..S CNT("OP",1)=$G(CNT("OP",1))+1
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| 78 | ..S CNT("OP",2)=$G(CNT("OP",2))+TOTPAID
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| 79 | I TOTPAID>0 D
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| 80 | .S CNT(1)=$G(CNT(1))+1
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| 81 | .S CNT(2)=$G(CNT(2))+TOTPAID
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| 82 | .S CNT(3,IBINSNM,1)=$G(CNT(3,IBINSNM,1))+1
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| 83 | .S CNT(3,IBINSNM,2)=$G(CNT(3,IBINSNM,2))+TOTPAID
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| 84 | ;
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| 85 | ;I ALIVE'="ALIVE" D ; decided to keep dead patients in the report 10/28/97
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| 86 | ;.S CNT("A")=$G(CNT("A"))+1
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| 87 | ;.S CNT("A",0)=$G(CNT("A",0))+ORGAMNT
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| 88 | ;.;S IBQUIT=1
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| 89 | ;.I TOTPAID>0 D
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| 90 | ;..S CNT("A",1)=$G(CNT("A",1))+1
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| 91 | ;..S CNT("A",2)=$G(CNT("A",2))+TOTPAID
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| 92 | ;
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| 93 | I DIAG="YES"&(PROC="NO") D
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| 94 | .S BOTH="DIAG"
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| 95 | .S IBQUIT=1
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| 96 | .S CNT("D")=$G(CNT("D"))+1
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| 97 | .S CNT("D",0)=$G(CNT("D",0))+ORGAMNT
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| 98 | .I TOTPAID>0 D
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| 99 | ..S CNT("D",1)=$G(CNT("D",1))+1
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| 100 | ..S CNT("D",2)=$G(CNT("D",2))+TOTPAID
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| 101 | ;
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| 102 | I PROC="YES"&(DIAG="NO") D
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| 103 | .S BOTH="PROC"
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| 104 | .S IBQUIT=1
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| 105 | .S CNT("P")=$G(CNT("P"))+1
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| 106 | .S CNT("P",0)=$G(CNT("P",0))+ORGAMNT
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| 107 | .I TOTPAID>0 D
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| 108 | ..S CNT("P",1)=$G(CNT("P",1))+1
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| 109 | ..S CNT("P",2)=$G(CNT("P",2))+TOTPAID
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| 110 | ;
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| 111 | I PROC="YES"&(DIAG="YES") D
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| 112 | .S BOTH="BOTH"
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| 113 | .S CNT("B")=$G(CNT("B"))+1
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| 114 | .S CNT("B",0)=$G(CNT("B",0))+ORGAMNT
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| 115 | .I TOTPAID>0 D
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| 116 | ..S CNT("B",1)=$G(CNT("B",1))+1
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| 117 | ..S CNT("B",2)=$G(CNT("B",2))+TOTPAID
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| 118 | ;
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| 119 | I BOTH="NONE" D
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| 120 | .S CNT("N")=$G(CNT("N"))+1
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| 121 | .S CNT("N",0)=$G(CNT("N",0))+ORGAMNT
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| 122 | .I TOTPAID>0 D
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| 123 | ..S CNT("N",1)=$G(CNT("N",1))+1
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| 124 | ..S CNT("N",2)=$G(CNT("N",2))+TOTPAID
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| 125 | ;
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| 126 | I BOTH'="BOTH" S IBQUIT=1
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| 127 | ;
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| 128 | I IBSTAT=7,+ARSTAT=210 D ;bill canceled before completion
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| 129 | .S CNT("C")=$G(CNT("C"))+1
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| 130 | .S CNT("C",0)=$G(CNT("C",0))+ORGAMNT
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| 131 | .S IBQUIT=1
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| 132 | .I TOTPAID>0 D
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| 133 | ..S CNT("C",1)=$G(CNT("C",1))+1
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| 134 | ..S CNT("C",2)=$G(CNT("C",2))+TOTPAID
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| 135 | ;
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| 136 | I TYPENO=2!(TYPENO=4) D
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| 137 | .S CNT("T")=$G(CNT("T"))+1
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| 138 | .S CNT("T",0)=$G(CNT("T",0))+ORGAMNT
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| 139 | .S IBQUIT=1
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| 140 | .I TOTPAID>0 D
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| 141 | ..S CNT("T",1)=$G(CNT("T",1))+1
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| 142 | ..S CNT("T",2)=$G(CNT("T",2))+TOTPAID
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| 143 | ;
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| 144 | I WHO'="i" D
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| 145 | .S CNT("W")=$G(CNT("W"))+1
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| 146 | .S CNT("W",0)=$G(CNT("W",0))+ORGAMNT
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| 147 | .S IBQUIT=1
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| 148 | .I TOTPAID>0 D
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| 149 | ..S CNT("W",1)=$G(CNT("W",1))+1
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| 150 | ..S CNT("W",2)=$G(CNT("W",2))+TOTPAID
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| 151 | ;
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| 152 | I DATEPR="",IBSTAT<3 D
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| 153 | .S CNT("F")=$G(CNT("F"))+1
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| 154 | .S CNT("F",0)=$G(CNT("F",0))+ORGAMNT
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| 155 | .S IBQUIT=1
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| 156 | .I TOTPAID>0 D
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| 157 | ..S CNT("F",1)=$G(CNT("F",1))+1
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| 158 | ..S CNT("F",2)=$G(CNT("F",2))+TOTPAID
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| 159 | ;
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| 160 | I $G(RXBILL) D
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| 161 | .S CNT("X")=$G(CNT("X"))+1
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| 162 | .S CNT("X",0)=$G(CNT("X",0))+ORGAMNT
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| 163 | .S IBQUIT=1
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| 164 | .I TOTPAID>0 D
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| 165 | ..S CNT("X",1)=$G(CNT("X",1))+1
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| 166 | ..S CNT("X",2)=$G(CNT("X",2))+TOTPAID
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| 167 | ;
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| 168 | I $G(PROSBILL) D
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| 169 | .S CNT("Z")=$G(CNT("Z"))+1
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| 170 | .S CNT("Z",0)=$G(CNT("Z",0))+ORGAMNT
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| 171 | .S IBQUIT=1
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| 172 | .I TOTPAID>0 D
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| 173 | ..S CNT("Z",1)=$G(CNT("Z",1))+1
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| 174 | ..S CNT("Z",2)=$G(CNT("Z",2))+TOTPAID
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| 175 | ;
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| 176 | I $S(RN["MEANS":1,RN["DENTAL":1,RN["TORT":1,RN["TRICARE":1,RN["CHAMPVA":1,RN["MEDICARE":1,RN["WORKERS":1,RN["CRIME":1,RN["SHARING":1,1:0) D
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| 177 | .S CNT("R")=$G(CNT("R"))+1
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| 178 | .S CNT("R",0)=$G(CNT("R",0))+ORGAMNT
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| 179 | .S IBQUIT=1
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| 180 | .I TOTPAID>0 D
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| 181 | ..S CNT("R",1)=$G(CNT("R",1))+1
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| 182 | ..S CNT("R",2)=$G(CNT("R",2))+TOTPAID
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| 183 | Q
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| 184 | ;
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| 185 | PROC(IBI) ; -- does bill have any procedures
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| 186 | N PROC
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| 187 | S PROC="NO"
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| 188 | I $O(^DGCR(399,IBI,"CP",0)) S PROC="YES"
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| 189 | I +NODE("C")!($P(NODE("C"),"^",4))!($P(NODE("C"),"^",7)) S PROC="YES"
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| 190 | Q PROC
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| 191 | ;
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| 192 | DIAG(IBI) ; -- does bill have any diagnosis
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| 193 | N DIAG
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| 194 | S DIAG="NO"
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| 195 | I $O(^IBA(362.3,"AIFN"_IBI,0)) S DIAG="YES"
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| 196 | I $P(NODE("C"),"^",10)!($P(NODE("C"),"^",14)) S DIAG="YES"
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| 197 | Q DIAG
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| 198 | ;
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| 199 | SET ; -- set up tmp global
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| 200 | S CNT("M")=$G(CNT("M"))+1,CNT("M",0)=$G(CNT("M",0))+ORGAMNT
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| 201 | I REFGC D
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| 202 | .S CNT("M",4)=$G(CNT("M",4))+1
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| 203 | .S CNT("M",5)=$G(CNT("M",5))+ORGAMNT
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| 204 | .I TOTPAID>0 D
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| 205 | ..S CNT("M",6)=$G(CNT("M",6))+1
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| 206 | ..S CNT("M",7)=$G(CNT("M",7))+TOTPAID
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| 207 | I TOTPAID>0 D
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| 208 | .S CNT("M",1)=$G(CNT("M",1))+1
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| 209 | .S CNT("M",2)=$G(CNT("M",2))+TOTPAID
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| 210 | I TYPE="INPATIENT" D
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| 211 | .S CNT("M","IN")=$G(CNT("M","IN"))+1
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| 212 | .S CNT("M","IN",0)=$G(CNT("M","IN",0))+ORGAMNT
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| 213 | .I TOTPAID>0 D
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| 214 | ..S CNT("M","IN",1)=$G(CNT("M","IN",1))+1
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| 215 | ..S CNT("M","IN",2)=$G(CNT("M","IN",2))+TOTPAID
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| 216 | I TYPE="OUTPATIENT" D
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| 217 | .S CNT("M","OP")=$G(CNT("M","OP"))+1
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| 218 | .S CNT("M","OP",0)=$G(CNT("M","OP",0))+ORGAMNT
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| 219 | .I TOTPAID>0 D
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| 220 | ..S CNT("M","OP",1)=$G(CNT("M","OP",1))+1
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| 221 | ..S CNT("M","OP",2)=$G(CNT("M","OP",2))+TOTPAID
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| 222 | ;
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| 223 | S ^TMP("IB-MRA",$J,+$G(IBINSCO),+$G(YEAR),$G(TYPE,"UNKNOWN"),BOTH,$G(ARSTAT,"UNKNOWN"),+$G(IBSTAT),IBI)=BILLNO_"^"_DFN
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| 224 | ;
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| 225 | S ^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT)=(+$G(^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT))+1)
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| 226 | ;
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| 227 | S ^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,0)=+$G(^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,0))+ORGAMNT
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| 228 | ;
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| 229 | I TOTPAID>0 D
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| 230 | .S ^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,1)=+$G(^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,1))+1
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| 231 | .S ^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,2)=+$G(^TMP("IB-MRA-CNT",$J,IBINSCO,YEAR,TYPE,BOTH,ARSTAT,IBSTAT,2))+TOTPAID
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| 232 | Q
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| 233 | ;
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| 234 | STOP() ; -- determine if user requested task to stop
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| 235 | I $D(ZTQUEUED),$$S^%ZTLOAD S ZTSTOP=1 K ZTREQ
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| 236 | Q +$G(ZTSTOP)
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