[613] | 1 | IBCNSMR0 ;ALB/AAS - MEDICARE BILLS ; 02-SEPT-97
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| 2 | ;;2.0; INTEGRATED BILLING ;**92**; 21-MAR-94
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| 3 | ;
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| 4 | % G RPRT^IBCNSMRA
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| 5 | Q
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| 6 | ;
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| 7 | PRINT ;
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| 8 | N IBQUIT,IBPAG,IBHDT
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| 9 | S IBQUIT=0,IBPAG=0,IBHDT=$$HTE^XLFDT($H)
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| 10 | I IBPRNT="D" U IO D HDR(0),TOTALS Q:IBQUIT D HDR(1),SORT Q:IBQUIT D HDR(2),DETAIL Q:IBQUIT
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| 11 | I IBPRNT="S" U IO D HDR(0),TOTALS Q:IBQUIT D HDR(1),SORT
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| 12 | I IBSNDRPT D BULL^IBCNSMR1
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| 13 | Q
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| 14 | ;
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| 15 | TOTALS ; -- prepare report
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| 16 | W !!," Bills Found for Selected Ins. Co.: "_$J(+$G(CNT),6)_$$FORMAT(+$G(CNT(0)),"2$",17)_$J(+$G(CNT(1)),6)_$$FORMAT(+$G(CNT(2)),"2$",14)
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| 17 | W !," Bills for Outpatient Visits: "_$J(+$G(CNT("OP")),6)_$$FORMAT(+$G(CNT("OP",0)),"2$",17)_$J(+$G(CNT("OP",1)),6)_$$FORMAT(+$G(CNT("OP",2)),"2$",14)
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| 18 | W !," Bills for Inpatient Visits: "_$J(+$G(CNT("IN")),6)_$$FORMAT(+$G(CNT("IN",0)),"2$",17)_$J(+$G(CNT("IN",1)),6)_$$FORMAT(+$G(CNT("IN",2)),"2$",14)
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| 19 | ;
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| 20 | W !!," Subtotals by Selected Ins. Co.: "
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| 21 | S IBNM=""
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| 22 | F S IBNM=$O(CNT(3,IBNM)) Q:IBNM="" D
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| 23 | .W !,?(35-$L(IBNM)),IBNM_": "_$J(+$G(CNT(3,IBNM)),6)_$$FORMAT(+$G(CNT(3,IBNM,0)),"2$",17)_$J(+$G(CNT(3,IBNM,1)),6)_$$FORMAT(+$G(CNT(3,IBNM,2)),"2$",14)
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| 24 | ;
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| 25 | W !!,"Bills with Procedures and Diagnosis: "_$J(+$G(CNT("B")),6)_$$FORMAT(+$G(CNT("B",0)),"2$",17)_$J(+$G(CNT("B",1)),6)_$$FORMAT(+$G(CNT("B",2)),"2$",14)
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| 26 | W !," Bills with Diagnosis Codes Only: "_$J(+$G(CNT("D")),6)_$$FORMAT(+$G(CNT("D",0)),"2$",17)_$J(+$G(CNT("D",1)),6)_$$FORMAT(+$G(CNT("D",2)),"2$",14)
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| 27 | W !," Bills with Procedure Codes Only: "_$J(+$G(CNT("P")),6)_$$FORMAT(+$G(CNT("P",0)),"2$",17)_$J(+$G(CNT("P",1)),6)_$$FORMAT(+$G(CNT("P",2)),"2$",14)
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| 28 | W !," Bills with No Proc. or Diag. Codes: "_$J(+$G(CNT("N")),6)_$$FORMAT(+$G(CNT("N",0)),"2$",17)_$J(+$G(CNT("N",1)),6)_$$FORMAT(+$G(CNT("N",2)),"2$",14)
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| 29 | ;
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| 30 | W !!," Bills Canceled before Completion: "_$J(+$G(CNT("C")),6)_$$FORMAT(+$G(CNT("C",0)),"2$",17)_$J(+$G(CNT("C",1)),6)_$$FORMAT(+$G(CNT("C",2)),"2$",14)
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| 31 | W !," Bills Never Printed: "_$J(+$G(CNT("F")),6)_$$FORMAT(+$G(CNT("F",0)),"2$",17)_$J(+$G(CNT("F",1)),6)_$$FORMAT(+$G(CNT("F",2)),"2$",14)
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| 32 | W !," Bills with wrong Rate Type: "_$J(+$G(CNT("R")),6)_$$FORMAT(+$G(CNT("R",0)),"2$",17)_$J(+$G(CNT("R",1)),6)_$$FORMAT(+$G(CNT("R",2)),"2$",14)
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| 33 | W !," Bills with wrong Who's Responsible: "_$J(+$G(CNT("W")),6)_$$FORMAT(+$G(CNT("W",0)),"2$",17)_$J(+$G(CNT("W",1)),6)_$$FORMAT(+$G(CNT("W",2)),"2$",14)
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| 34 | W !," Bills w/ wrong Bill Classification: "_$J(+$G(CNT("T")),6)_$$FORMAT(+$G(CNT("T",0)),"2$",17)_$J(+$G(CNT("T",1)),6)_$$FORMAT(+$G(CNT("T",2)),"2$",14)
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| 35 | W !," Bills for Prescriptions: "_$J(+$G(CNT("X")),6)_$$FORMAT(+$G(CNT("X",0)),"2$",17)_$J(+$G(CNT("X",1)),6)_$$FORMAT(+$G(CNT("X",2)),"2$",14)
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| 36 | W !," Bills for Prosthetics: "_$J(+$G(CNT("Z")),6)_$$FORMAT(+$G(CNT("Z",0)),"2$",17)_$J(+$G(CNT("Z",1)),6)_$$FORMAT(+$G(CNT("Z",2)),"2$",14)
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| 37 | ;W !," Bills with Patients Not Alive: "_$J(+$G(CNT("A")),6)_$$FORMAT(+$G(CNT("A",0)),"2$",17)_$J(+$G(CNT("A",1)),6)_$$FORMAT(+$G(CNT("A",2)),"2$",14)
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| 38 | ;
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| 39 | W !!," Bills Meeting Criteria for MRA: "_$J(+$G(CNT("M")),6)_$$FORMAT(+$G(CNT("M",0)),"2$",17)_$J(+$G(CNT("M",1)),6)_$$FORMAT(+$G(CNT("M",2)),"2$",14)
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| 40 | W !," Outpatient Bills Meeting Criteria: "_$J(+$G(CNT("M","OP")),6)_$$FORMAT(+$G(CNT("M","OP",0)),"2$",17)_$J(+$G(CNT("M","OP",1)),6)_$$FORMAT(+$G(CNT("M","OP",2)),"2$",14)
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| 41 | W !," Inpatient Bills Meeting Criteria: "_$J(+$G(CNT("M","IN")),6)_$$FORMAT(+$G(CNT("M","IN",0)),"2$",17)_$J(+$G(CNT("M","IN",1)),6)_$$FORMAT(+$G(CNT("M","IN",2)),"2$",14)
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| 42 | W !," Bill Meeting Criteria and Referred: "_$J(+$G(CNT("M",4)),6)_$$FORMAT(+$G(CNT("M",5)),"2$",17)_$J(+$G(CNT("M",6)),6)_$$FORMAT(+$G(CNT("M",7)),"2$",14)
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| 43 | ;
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| 44 | Q
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| 45 | ;
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| 46 | SORT ; -- Run through list by insurance company
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| 47 | N I,J,K,L,M,N,P,X,Y,Z,ZZ
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| 48 | ;
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| 49 | I '$D(^TMP("IB-MRA-CNT",$J)) W !!,"There are no summary records to print.",! G SORTQ
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| 50 | ;
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| 51 | S I=0
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| 52 | F S I=$O(^TMP("IB-MRA-CNT",$J,I)) Q:I=""!(IBQUIT) D ;insur. co
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| 53 | .S J=0
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| 54 | .F S J=$O(^TMP("IB-MRA-CNT",$J,I,J)) Q:J=""!(IBQUIT) D ;year
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| 55 | ..S IBQUIT=$$STOP^IBCNSMR Q:IBQUIT
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| 56 | ..S K=""
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| 57 | ..F S K=$O(^TMP("IB-MRA-CNT",$J,I,J,K)) Q:K=""!(IBQUIT) D ;bill type
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| 58 | ...D SUBHDR
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| 59 | ...S L=0
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| 60 | ...F S L=$O(^TMP("IB-MRA-CNT",$J,I,J,K,L)) Q:L=""!(IBQUIT) D ;proc
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| 61 | ....S M=0
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| 62 | ....F S M=$O(^TMP("IB-MRA-CNT",$J,I,J,K,L,M)) Q:M=""!(IBQUIT) D ;ar status
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| 63 | .....S N=0
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| 64 | .....F S N=$O(^TMP("IB-MRA-CNT",$J,I,J,K,L,M,N)) Q:N=""!(IBQUIT) S X=+$G(^(N)),Y=+$G(^(N,0)),Z=+$G(^(1)),ZZ=+$G(^(2)) D LINE ;ibstatus
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| 65 | ;
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| 66 | ;......;S P=0 ;alive
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| 67 | ;......;F S P=$O(^TMP("IB-MRA-CNT",$J,I,J,K,L,M,N,P)) Q:P=""!(IBQUIT) S X=+$G(^(P)),Y=+$G(^(P,0)),Z=+$G(^(1)),ZZ=+$G(^(2)) D LINE
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| 68 | ;
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| 69 | SORTQ I 'IBQUIT,$E(IOST,1,2)="C-",IBPRNT="S" W ! D PAUSE^VALM1 I $D(DIRUT) S IBQUIT=1
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| 70 | Q
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| 71 | ;
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| 72 | SUBHDR ; -- print out sub headers
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| 73 | Q:$G(K)=""
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| 74 | I IOSL<($Y+6) D HDR(1) Q:IBQUIT
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| 75 | W !!,?10,"Insurance Company: ",$P($G(^DIC(36,+I,0)),"^")
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| 76 | W !,?15,"Calendar Year of Bill: ",J
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| 77 | W !,?20,"Type of Bill: ",K
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| 78 | Q
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| 79 | ;
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| 80 | LINE ; -- Write one summary line
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| 81 | I IOSL<($Y+5) D HDR(1) Q:IBQUIT
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| 82 | W !,$E($P(M,"^",2),1,21),?23,$E($$EXTERNAL^DILFD(399,.13,"",N),1,14),?37,$J(+X,6),$$FORMAT(Y,"2$",17),$J(+Z,6),$$FORMAT(ZZ,"2$",14)
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| 83 | ;
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| 84 | Q
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| 85 | ;
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| 86 | ARSTAT(M) ; convert code to ar status
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| 87 | N IEN
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| 88 | S IEN=+$O(^PRCA(430.3,"AC",+M,0))
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| 89 | Q $P($G(^PRCA(430.3,IEN,0)),"^")
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| 90 | ;
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| 91 | DETAIL ; -- do detail report
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| 92 | N I,J,K,L,M,N,P,IBIFN,IBXX
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| 93 | ;
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| 94 | I '$D(^TMP("IB-MRA",$J)) W !!,"There are no detail records to print.",! G DETQ
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| 95 | ;
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| 96 | S I=""
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| 97 | F S I=$O(^TMP("IB-MRA",$J,I)) Q:I=""!(IBQUIT) D ; ins. co.
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| 98 | .S J=""
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| 99 | .F S J=$O(^TMP("IB-MRA",$J,I,J)) Q:J=""!(IBQUIT) D ;year
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| 100 | ..S K=""
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| 101 | ..F S K=$O(^TMP("IB-MRA",$J,I,J,K)) Q:K=""!(IBQUIT) D ;type of bill
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| 102 | ...D SUBHDR
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| 103 | ...S L=""
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| 104 | ...F S L=$O(^TMP("IB-MRA",$J,I,J,K,L)) Q:L=""!(IBQUIT) D ;proc
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| 105 | ....S M=0
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| 106 | ....F S M=$O(^TMP("IB-MRA",$J,I,J,K,L,M)) Q:M=""!(IBQUIT) D ;ar status
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| 107 | .....S N=0
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| 108 | .....F S N=$O(^TMP("IB-MRA",$J,I,J,K,L,M,N)) Q:N=""!(IBQUIT) D ;ibstatus
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| 109 | ......;S P=0 ;alive
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| 110 | ......;F S P=$O(^TMP("IB-MRA",$J,I,J,K,L,M,N,P)) Q:P=""!(IBQUIT) D
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| 111 | ......S IBIFN=""
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| 112 | ......F S IBIFN=$O(^TMP("IB-MRA",$J,I,J,K,L,M,N,IBIFN)) Q:IBIFN=""!(IBQUIT) S IBXX=^(IBIFN) D DLINE
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| 113 | ;
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| 114 | DETQ I 'IBQUIT,$E(IOST,1,2)="C-" W ! D PAUSE^VALM1 I $D(DIRUT) S IBQUIT=1
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| 115 | Q
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| 116 | ;
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| 117 | DLINE ; -- print one detail line
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| 118 | N I,J,K,L,M,N,DFN,ORGAMNT,TOTPAID,FROM,TO
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| 119 | I IOSL<($Y+5) D HDR(2) Q:IBQUIT
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| 120 | S DFN=+$P(IBXX,"^",2)
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| 121 | D DEM^VADPT
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| 122 | S ORGAMNT=+$G(^DGCR(399,IBIFN,"U1"))
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| 123 | S TOTPAID=$$TPR^PRCAFN(IBIFN)
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| 124 | W !,$P(IBXX,"^"),?12,$E(VADM(1),1,20),?34,VA("BID"),?42,VADM(4)
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| 125 | W ?48,$$FMTE^XLFDT(+$G(^DGCR(399,IBIFN,"U")),2)," - ",$$FMTE^XLFDT($P($G(^("U")),"^",2),2)
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| 126 | W ?70,$$FMTE^XLFDT($P($G(^DGCR(399,IBIFN,"S")),"^",12))
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| 127 | W ?82,$$FORMAT(ORGAMNT,"2$",17),$$FORMAT(TOTPAID,"2$",17)
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| 128 | K VA,VADM,VAERR
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| 129 | Q
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| 130 | ;
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| 131 | HDR(L1) ; -- line item header
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| 132 | N X,Y,I,J,K,L,M,N,P,DIR,DIRUT,Z,ZZ
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| 133 | Q:$G(IBQUIT)
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| 134 | I $E(IOST,1,2)="C-",IBPAG D PAUSE^VALM1 I $D(DIRUT) S IBQUIT=1 Q
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| 135 | I $E(IOST,1,2)="C-"!(IBPAG) W @IOF
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| 136 | S IBPAG=IBPAG+1
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| 137 | W !,"Possible Medicare Remittance Advice Claims",?(IOM-33),"Page ",IBPAG," ",IBHDT
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| 138 | W !,$S(L1=2:"Detail Report",L1=1:"Summary Report",1:"Totals Report")
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| 139 | W:L1=2 !,"Bill No.",?12,"Patient Name",?34,"PT ID",?42,"Age",?48,"Bill From-To",?70,"Date Printed",?85,"Amount Billed",?100,"Amount Collected"
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| 140 | W:L1=1 !,?38,"Total",?53,"Amount",?62,"No.",?70,"Amount"
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| 141 | W:L1=1 !,"AR Status",?25,"IB Status",?38,"Number",?53,"Billed",?62,"Coll",?70,"Collected"
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| 142 | W:'L1 !,?38,"Total Amount No. Amount"
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| 143 | W:'L1 !,?38,"Number Billed Coll Collected"
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| 144 | W !,$TR($J(" ",IOM)," ","-")
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| 145 | Q
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| 146 | ;
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| 147 | FORMAT(X,X2,X3) ; -- convert number to formatted number
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| 148 | ; -- input x = number to be converted
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| 149 | ; x2 = format characters (see doc for comma^%dtc)
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| 150 | ; x3 = lenght of formated output (optional)
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| 151 | ; output = formated character string
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| 152 | ;
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| 153 | D COMMA^%DTC
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| 154 | Q X
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