| [613] | 1 | IBCU81 ;ALB/ARH - THIRD PARTY BILLING UTILITIES (AUTOMATED BILLER) ;02 JUL 93
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| 2 | ;;2.0;INTEGRATED BILLING;**55,91,106,124,160,174,260,347**;21-MAR-94;Build 24
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| 3 | ;;Per VHA Directive 2004-038, this routine should not be modified.
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| 4 | ;
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| 5 | EABD(IBETYP,IBTDT) ; -- compute earliest auto bill date: date entered plus days delay for event type
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| 6 | ;the difference betwieen this and EABD^IBTUTL is that the autobill of the event type may be turned off
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| 7 | ;and this procedure will still return a date
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| 8 | ; -- input IBETYPE = pointer to type of entry file
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| 9 | ; IBTDT = episode date, if not passed in uses DT
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| 10 | ;
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| 11 | N X,X1,X2,Y,IBETYPD S Y="" I '$G(IBETYP) G EABDQ
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| 12 | S IBETYPD=$G(^IBE(356.6,+IBETYP,0)) I '$G(IBTDT) S IBTDT=DT
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| 13 | S X2=+$P(IBETYPD,"^",6) ;set earliest autobill date to entered date plus days delay
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| 14 | S X1=IBTDT D C^%DTC S Y=X\1
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| 15 | EABDQ Q Y
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| 16 | ;
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| 17 | EVBILL(IBTRN) ;check if event is auto billable, return EABD if it is, the difference between this and BILL^IBTUTL is that
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| 18 | ;this procedure will return a date if the auto biller is turned off for this event type
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| 19 | ;returns "^error message" if it is not billable
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| 20 | N X,Y,Z,E,IBTRND S (X,Y,E)="" S IBTRND=$G(^IBT(356,+$G(IBTRN),0)) I IBTRND="" G BILLQ
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| 21 | ;
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| 22 | ; -- billed and bill not cancelled and not inpt interim first or continuous
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| 23 | S Z=$$BILLED^IBCU8(IBTRN),Y=$P(Z,U,2) I +Z,'Y S E="^Event already billed on "_$P($G(^DGCR(399,+Z,0)),U,1)_"." G BILLQ
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| 24 | ;
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| 25 | ; -- special type (not riem. ins), not billable, inactive
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| 26 | I +$P(IBTRND,U,12) S E="^Bill may not be Reimbursable Insurance, possibly "_$$EXSET^IBEFUNC(+$P(IBTRND,U,12),356,.12)_"." G BILLQ
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| 27 | I +$P(IBTRND,U,19) S E="^Event has a Reason Not Billable: "_$P($G(^IBE(356.8,+$P(IBTRND,U,19),0)),U,1)_"." G BILLQ
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| 28 | I '$P(IBTRND,U,20) S E="^Event is Inactive." G BILLQ
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| 29 | I 'Y S Y=+$G(^IBT(356,+$G(IBTRN),1)) I 'Y S Y=DT
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| 30 | S X=$$EABD(+$P(IBTRND,U,18),Y)
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| 31 | BILLQ Q X_E
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| 32 | ;
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| 33 | RXRF(IBTRN) ; returns rx # and fill date for given claims tracking rx entry
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| 34 | N IBX,IBY,IBZ,X S (X,IBY)=""
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| 35 | S IBX=$G(^IBT(356,+$G(IBTRN),0)) I IBX'="" S IBY=$$FILE^IBRXUTL(+$P(IBX,U,8),.01)
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| 36 | I IBY'="",$P(IBX,U,10)=0 S IBZ=$$FILE^IBRXUTL(+$P(IBX,U,8),"22","I") I +IBZ S X=IBY_"^"_IBZ
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| 37 | I IBY'="",+$P(IBX,U,10) S IBZ=+$$ZEROSUB^IBRXUTL(+$P(IBX,U,2),+$P(IBX,U,8),+$P(IBX,U,10)) I +IBZ S X=IBY_"^"_IBZ
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| 38 | Q X
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| 39 | ;
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| 40 | NABSCT(IBTRN) ; -- true if CT outpatient visit should NOT be auto billed, based only on stop (1) and clinic (2) auto billable
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| 41 | ; returns true only for those stops (352.3) and clinics (352.4) specifically flagged as not auto billable
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| 42 | N IBX,IBY,IBTRND S IBX=0,IBTRND="" I +$G(IBTRN) S IBTRND=$G(^IBT(356,+IBTRN,0))
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| 43 | I +$P(IBTRND,U,4) S IBY=$$SCE^IBSDU(+$P(IBTRND,U,4)) I +IBY D
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| 44 | . I +$P(IBY,U,3),$$NABST^IBEFUNC($P(IBY,U,3),DT) S IBX=1 Q
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| 45 | . I +$P(IBY,U,4),$$NABCT^IBEFUNC($P(IBY,U,4),DT) S IBX=2
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| 46 | Q IBX
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| 47 | ;
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| 48 | NBOE(IBOE,IBOE0) ; returns true if outpatient encounter is non-billable, "" otherwise
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| 49 | ; input: IBOE - pointer to encounter (409.68)
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| 50 | ; IBOE0 - 0-node of the encounter (optional)
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| 51 | ; output: "" or x^message, where x=1 if SC, x=2 if NB Stop code, x=3 if NB Clinic, x=4 if NB Appt Status
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| 52 | N IBOED,IBOEP,IBX,IBCK,IBZ,IBPB,IBAPST,IBDT,DFN
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| 53 | S IBX=""
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| 54 | I $G(IBOE0)="" S IBOE0=$$SCE^IBSDU(IBOE)
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| 55 | I 'IBOE0 G NBOEQ
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| 56 | S DFN=$P(IBOE0,"^",2),IBDT=+IBOE0
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| 57 | F IBZ=7,12,13 S IBCK(IBZ)=""
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| 58 | S IBZ=$$BILLCK^IBAMTEDU(IBOE,IBOE0,.IBCK,.IBPB)
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| 59 | S IBAPST="" I $G(IBPB)=13 S IBAPST=$E($$EXPAND^IBTRE(409.68,.12,$P(IBOE0,U,12)),1,10)
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| 60 | ; check out sc and other questions
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| 61 | I $G(IBPB)="" S IBAPST=$$CL^IBTRKR41(IBOE0) I $L(IBAPST) S IBPB=$S(IBAPST="SC TREATMENT":11,1:13)
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| 62 | S:$G(IBPB)'="" IBX=$S(IBPB=11:"1^SC VISIT",IBPB=7:"2^NB STOP CODE",IBPB=12:"3^NB CLINIC",IBPB=13:"4^"_IBAPST,1:"")
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| 63 | NBOEQ Q IBX
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| 64 | ;
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| 65 | OEDX(IBOE,IBDXA,IBDXB) ; returns arrays containing encounters diagnosis (includes duplicates)
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| 66 | ; IBDXA(ORDER,DATE/TIME,IBOE,DX IFN)=DX ^ PCE ORDER ^ IBOE ^ DATE/TIME ^ TRUE IF NON-BILLABLE ^ NB MES ^ CLINIC
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| 67 | ; IBDXB(IBDX) = 1 for each billable dx found
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| 68 | ;
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| 69 | N IBNBOE,X,IBPOV,IBDXN,IBPCE,IBPCEI,IBDT,IBOE0,IBZERR
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| 70 | Q:'$G(IBOE)
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| 71 | S IBOE0=$$SCE^IBSDU(+IBOE),IBDT=+IBOE0 Q:'IBDT
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| 72 | I '$$BDSRC^IBEFUNC3($P(IBOE0,U,5)) Q ; non-billable visit data source
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| 73 | S IBNBOE=$$NBOE(IBOE,IBOE0)
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| 74 | ;
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| 75 | D GETDX^SDOE(IBOE,"IBPOV","IBZERR")
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| 76 | S IBDXN=0 F S IBDXN=$O(IBPOV(IBDXN)) Q:'IBDXN D
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| 77 | . S IBPCE=IBPOV(IBDXN),IBPCEI=$P(IBPCE,U,12)
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| 78 | . S IBDXA($S(IBPCEI="P":1,IBPCEI="S":2,1:999),IBDT,IBOE,IBDXN)=+IBPCE_U_IBPCEI_U_IBOE_U_IBDT_U_$P(IBNBOE,U,1)_U_$P(IBNBOE,U,2)_U_+$P(IBOE0,U,4)
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| 79 | . I 'IBNBOE S IBDXB(+IBPCE)=1
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| 80 | ;
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| 81 | Q
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| 82 | ;
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