source: WorldVistAEHR/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBCNSMR.m@ 1800

IBCNSMR ;ALB/AAS - MEDICARE BILLS ; 02-SEPT-97

 ;;2.0;INTEGRATED BILLING;**92,240**;21-MAR-94

 ;

% G RPRT^IBCNSMRA

 ;

DQ ; -- entry point from task manager

 N I,J,X,Y,IBINSCO,INSCO,NODE,CNT,IBI,IBINSNM,IBNM

 S IBQUIT=0

 K ^TMP("IB-MRA",$J),^TMP("IB-MRA-CNT",$J)

 ;

 S I=0

 F  S I=$O(^IBE(350.9,1,99,I)) Q:'I  S INSCO(+$G(^IBE(350.9,1,99,I,0)))=""

 ;

 S IBI=0

 F  S IBI=$O(^DGCR(399,IBI)) Q:'IBI!(IBQUIT)  D

 .S IBQUIT=$$STOP Q:IBQUIT

 .S IBINSCO="" K NODE

 .S NODE(0)=$G(^DGCR(399,IBI,0)) Q:NODE(0)=""

 .S NODE("C")=$G(^DGCR(399,IBI,"C"))

 .S NODE("M")=$G(^DGCR(399,IBI,"M")) Q:NODE("M")=""

 .S NODE("U")=$G(^DGCR(399,IBI,"U")) Q:NODE("U")=""

 .I $D(INSCO(+NODE("M"))) S IBINSCO=+NODE("M")

 .I 'IBINSCO,$D(INSCO(+$P(NODE("M"),"^",2))) S IBINSCO=$P(NODE("M"),"^",2)

 .I 'IBINSCO,$D(INSCO(+$P(NODE("M"),"^",3))) S IBINSCO=$P(NODE("M"),"^",3)

 .I IBINSCO S IBINSNM=$P($G(^DIC(36,IBINSCO,0)),"^") D BLDDATA

 ;

 I 'IBQUIT D PRINT^IBCNSMR0

 G END^IBCNSMRA

END Q

 ;

BLDDATA ; -- for each bill sent to a selected ins. co. build temp node

 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

 S IBQUIT=0

 S BILLNO=$P(NODE(0),"^")

 S YEAR=$E(+NODE("U"),2,3)

 S TYPENO=$P(NODE(0),"^",5)

 S TYPE=$S(TYPENO<3:"INPATIENT",1:"OUTPATIENT")

 S PROC=$$PROC(IBI)

 S DIAG=$$DIAG(IBI)

 S IBSTAT=$P(NODE(0),"^",13)

 S ARSTAT=$$STA^PRCAFN(IBI)

 S DFN=$P(NODE(0),"^",2)

 S ALIVE=$S(+$G(^DPT(DFN,.35)):"DEAD",1:"ALIVE")

 S ORGAMNT=$$ORI^PRCAFN(IBI)

 S LOCCARE=$P(NODE(0),"^",4)

 S WHO=$P(NODE(0),"^",11)

 S RATETYP=$P(NODE(0),"^",7)

 S RN=$P($G(^DGCR(399.3,+RATETYP,0)),"^")

 S TIMEFRM=$P(NODE(0),"^",6)

 S TOTPAID=$$TPR^PRCAFN(IBI)

 S REFGC=$P($G(^PRCA(430,IBI,6)),"^",4)'=""

 S DATEPR=$P($G(^DGCR(399,IBI,"S")),"^",12)

 S BOTH="NONE"

 S RXBILL=0

 S PROSBILL=0

 I $O(^IBA(362.4,"AIFN"_IBI,"")) S RXBILL=1

 I $O(^IBA(362.5,"AIFN"_IBI,"")) S PROSBILL=1

 D COUNT

 D:'IBQUIT SET

 Q

 ;

COUNT ; -- set totals for all ins, and by ins co.

 S CNT=$G(CNT)+1

 S CNT(0)=$G(CNT(0))+ORGAMNT

 S CNT(3,IBINSNM)=$G(CNT(3,IBINSNM))+1

 S CNT(3,IBINSNM,0)=$G(CNT(3,IBINSNM,0))+ORGAMNT

 I TYPE="INPATIENT" D

 .S CNT("IN")=$G(CNT("IN"))+1

 .S CNT("IN",0)=$G(CNT("IN",0))+ORGAMNT

 .I TOTPAID>0 D

 ..S CNT("IN",1)=$G(CNT("IN",1))+1

 ..S CNT("IN",2)=$G(CNT("IN",2))+TOTPAID

 I TYPE="OUTPATIENT" D

 .S CNT("OP")=$G(CNT("OP"))+1

 .S CNT("OP",0)=$G(CNT("OP",0))+ORGAMNT

 .I TOTPAID>0 D

 ..S CNT("OP",1)=$G(CNT("OP",1))+1

 ..S CNT("OP",2)=$G(CNT("OP",2))+TOTPAID

 I TOTPAID>0 D

 .S CNT(1)=$G(CNT(1))+1

 .S CNT(2)=$G(CNT(2))+TOTPAID

 .S CNT(3,IBINSNM,1)=$G(CNT(3,IBINSNM,1))+1

 .S CNT(3,IBINSNM,2)=$G(CNT(3,IBINSNM,2))+TOTPAID

 ;

 ;I ALIVE'="ALIVE" D  ; decided to keep dead patients in the report 10/28/97

 ;.S CNT("A")=$G(CNT("A"))+1

 ;.S CNT("A",0)=$G(CNT("A",0))+ORGAMNT

 ;.;S IBQUIT=1

 ;.I TOTPAID>0 D

 ;..S CNT("A",1)=$G(CNT("A",1))+1

 ;..S CNT("A",2)=$G(CNT("A",2))+TOTPAID

 ;

 I DIAG="YES"&(PROC="NO") D

 .S BOTH="DIAG"

 .S IBQUIT=1

 .S CNT("D")=$G(CNT("D"))+1

 .S CNT("D",0)=$G(CNT("D",0))+ORGAMNT

 .I TOTPAID>0 D

 ..S CNT("D",1)=$G(CNT("D",1))+1

 ..S CNT("D",2)=$G(CNT("D",2))+TOTPAID

 ;

 I PROC="YES"&(DIAG="NO") D

 .S BOTH="PROC"

 .S IBQUIT=1

 .S CNT("P")=$G(CNT("P"))+1

 .S CNT("P",0)=$G(CNT("P",0))+ORGAMNT

 .I TOTPAID>0 D

 ..S CNT("P",1)=$G(CNT("P",1))+1

 ..S CNT("P",2)=$G(CNT("P",2))+TOTPAID

 ;

 I PROC="YES"&(DIAG="YES") D

 .S BOTH="BOTH"

 .S CNT("B")=$G(CNT("B"))+1

 .S CNT("B",0)=$G(CNT("B",0))+ORGAMNT

 .I TOTPAID>0 D

 ..S CNT("B",1)=$G(CNT("B",1))+1

 ..S CNT("B",2)=$G(CNT("B",2))+TOTPAID

 ;

 I BOTH="NONE" D

 .S CNT("N")=$G(CNT("N"))+1

 .S CNT("N",0)=$G(CNT("N",0))+ORGAMNT

 .I TOTPAID>0 D

 ..S CNT("N",1)=$G(CNT("N",1))+1

 ..S CNT("N",2)=$G(CNT("N",2))+TOTPAID

 ;

 I BOTH'="BOTH" S IBQUIT=1

 ;

 I IBSTAT=7,+ARSTAT=210 D  ;bill canceled before completion

 .S CNT("C")=$G(CNT("C"))+1

 .S CNT("C",0)=$G(CNT("C",0))+ORGAMNT

 .S IBQUIT=1

 .I TOTPAID>0 D

 ..S CNT("C",1)=$G(CNT("C",1))+1

 ..S CNT("C",2)=$G(CNT("C",2))+TOTPAID

 ;

 I TYPENO=2!(TYPENO=4) D

 .S CNT("T")=$G(CNT("T"))+1

 .S CNT("T",0)=$G(CNT("T",0))+ORGAMNT

 .S IBQUIT=1

 .I TOTPAID>0 D

 ..S CNT("T",1)=$G(CNT("T",1))+1

 ..S CNT("T",2)=$G(CNT("T",2))+TOTPAID

 ;

 I WHO'="i" D

 .S CNT("W")=$G(CNT("W"))+1

 .S CNT("W",0)=$G(CNT("W",0))+ORGAMNT

 .S IBQUIT=1

 .I TOTPAID>0 D

 ..S CNT("W",1)=$G(CNT("W",1))+1

 ..S CNT("W",2)=$G(CNT("W",2))+TOTPAID

 ;

 I DATEPR="",IBSTAT<3 D

 .S CNT("F")=$G(CNT("F"))+1

 .S CNT("F",0)=$G(CNT("F",0))+ORGAMNT

 .S IBQUIT=1

 .I TOTPAID>0 D

 ..S CNT("F",1)=$G(CNT("F",1))+1

 ..S CNT("F",2)=$G(CNT("F",2))+TOTPAID

 ;

 I $G(RXBILL) D

 .S CNT("X")=$G(CNT("X"))+1

 .S CNT("X",0)=$G(CNT("X",0))+ORGAMNT

 .S IBQUIT=1

 .I TOTPAID>0 D

 ..S CNT("X",1)=$G(CNT("X",1))+1

 ..S CNT("X",2)=$G(CNT("X",2))+TOTPAID

 ;

 I $G(PROSBILL) D

 .S CNT("Z")=$G(CNT("Z"))+1

 .S CNT("Z",0)=$G(CNT("Z",0))+ORGAMNT

 .S IBQUIT=1

 .I TOTPAID>0 D

 ..S CNT("Z",1)=$G(CNT("Z",1))+1

 ..S CNT("Z",2)=$G(CNT("Z",2))+TOTPAID

 ;

 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

 .S CNT("R")=$G(CNT("R"))+1

 .S CNT("R",0)=$G(CNT("R",0))+ORGAMNT

 .S IBQUIT=1

 .I TOTPAID>0 D

 ..S CNT("R",1)=$G(CNT("R",1))+1

 ..S CNT("R",2)=$G(CNT("R",2))+TOTPAID

 Q

 ;

PROC(IBI) ; -- does bill have any procedures

 N PROC

 S PROC="NO"

 I $O(^DGCR(399,IBI,"CP",0)) S PROC="YES"

 I +NODE("C")!($P(NODE("C"),"^",4))!($P(NODE("C"),"^",7)) S PROC="YES"

 Q PROC

 ;

DIAG(IBI) ; -- does bill have any diagnosis

 N DIAG

 S DIAG="NO"

 I $O(^IBA(362.3,"AIFN"_IBI,0)) S DIAG="YES"

 I $P(NODE("C"),"^",10)!($P(NODE("C"),"^",14)) S DIAG="YES"

 Q DIAG

 ;

SET ; -- set up tmp global

 S CNT("M")=$G(CNT("M"))+1,CNT("M",0)=$G(CNT("M",0))+ORGAMNT

 I REFGC D

 .S CNT("M",4)=$G(CNT("M",4))+1

 .S CNT("M",5)=$G(CNT("M",5))+ORGAMNT

 .I TOTPAID>0 D

 ..S CNT("M",6)=$G(CNT("M",6))+1

 ..S CNT("M",7)=$G(CNT("M",7))+TOTPAID

 I TOTPAID>0 D

 .S CNT("M",1)=$G(CNT("M",1))+1

 .S CNT("M",2)=$G(CNT("M",2))+TOTPAID

 I TYPE="INPATIENT" D

 .S CNT("M","IN")=$G(CNT("M","IN"))+1

 .S CNT("M","IN",0)=$G(CNT("M","IN",0))+ORGAMNT

 .I TOTPAID>0 D

 ..S CNT("M","IN",1)=$G(CNT("M","IN",1))+1

 ..S CNT("M","IN",2)=$G(CNT("M","IN",2))+TOTPAID

 I TYPE="OUTPATIENT" D

 .S CNT("M","OP")=$G(CNT("M","OP"))+1

 .S CNT("M","OP",0)=$G(CNT("M","OP",0))+ORGAMNT

 .I TOTPAID>0 D

 ..S CNT("M","OP",1)=$G(CNT("M","OP",1))+1

 ..S CNT("M","OP",2)=$G(CNT("M","OP",2))+TOTPAID

 ;

 S ^TMP("IB-MRA",$J,+$G(IBINSCO),+$G(YEAR),$G(TYPE,"UNKNOWN"),BOTH,$G(ARSTAT,"UNKNOWN"),+$G(IBSTAT),IBI)=BILLNO_"^"_DFN

 ;

 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)

 ;

 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

 ;

 I TOTPAID>0 D

 .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

 .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

 Q

 ;

STOP() ; -- determine if user requested task to stop

 I $D(ZTQUEUED),$$S^%ZTLOAD S ZTSTOP=1 K ZTREQ

 Q +$G(ZTSTOP)