| 1 | IBECEAU5 ;ALB/BGA - Cancel/Edit/Add CALC Observation COPAY ; 17-MAY-2000 | 
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| 2 | ;;2.0;INTEGRATED BILLING;**132,153,156,167,247**;21-MAR-94 | 
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| 3 | ;;Per VHA Directive 10-93-142, this routine should not be modified. | 
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| 4 | ; | 
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| 5 | ; Find the IB action type and outpatient copay rate for an inpatient Observation | 
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| 6 | ; | 
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| 7 | OBS ; Called from EN^IBAMTD when adding an Inpatient Observation Copay | 
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| 8 | ; | 
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| 9 | ; Check to see if you have a clock | 
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| 10 | I '$G(IBCLDA) S IBCLDT=$P(IBADMDT,".") D CLADD^IBAUTL3 G:IBY<1 END | 
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| 11 | ; Calculate Outpatient COPAY Charge return IBATYP,IBCHG,IBDESC,IBRTED | 
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| 12 | ; setting IBTYPE=2 to designate all observation is specialty care | 
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| 13 | S (IBDT,IBADMDT)=$P(IBADMDT,"."),IBX="O",IBTYPE=2 D CHRG G:IBY<1 END | 
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| 14 | ; Set the SOFTLINK field = Admission Movment:405 | 
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| 15 | S IBSL="405:"_IBA,IBUNIT=1,(IBFR,IBEVDT)=IBADMDT,IBTO=$P(IBDISDT,"."),IBEVDA="*" | 
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| 16 | ; Add the charge to ^IB set IBN= new charge's IEN | 
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| 17 | D ADD^IBECEAU3 G:IBY<1 END | 
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| 18 | ; Pass the charge to AR set IBTRAN and IBIL | 
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| 19 | S IBDUZ=DUZ D IBFLR^IBAMTS1 | 
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| 20 | END K IBFR,IBTO,IBTYPE | 
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| 21 | Q | 
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| 22 | ; | 
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| 23 | CHRG ; Called from OPT^IBECEA33 when adding a obs copay from CANCEL/EDIT/ADD | 
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| 24 | ; | 
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| 25 | ;     Input: Optional if no IBDT than default to DT | 
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| 26 | ;     Output:  IBATYP, IBCHG, IBDESC, IBRTED | 
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| 27 | ; | 
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| 28 | I '$D(IBDT) S IBDT=DT | 
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| 29 | D TYPE^IBAUTL2 ; Sets IBCHRG=Outpat Copay $ and IBRTED=effective DT of rate | 
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| 30 | Q:'IBCHG  ; Error occurred sets IBY in TYPE^IBAUTL2 | 
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| 31 | S IBBS=$$MCCRUTL^IBCRU1("OBSERVATION CARE",5) | 
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| 32 | S IBATYP=$P($G(^DGCR(399.1,+IBBS,0)),"^",7) I 'IBATYP S IBY="-1^IB008" Q | 
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| 33 | I $D(^IBE(350.1,+IBATYP,20)) X ^(20) ; sets IBDESC | 
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| 34 | Q | 
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| 35 | ; | 
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| 36 | CLSF(DGMVP) ; | 
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| 37 | ; This Subroutine evaluates an Inpatient Admission for an Observation Speciality | 
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| 38 | ; where the patient has claimed exposure. The Special Inpatient Billing | 
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| 39 | ; case record is evaluated to detemine the status of the disposition | 
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| 40 | ; the results are than displayed on the Outpatient Events Reports | 
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| 41 | ; | 
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| 42 | N DGIEN,DG0,IBDISP,IBOUT,IBREAS,IBTYP | 
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| 43 | Q:'DGMVP!('$D(^IBE(351.2,"AC",DGMVP)))  ; no special case record on file | 
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| 44 | S DGIEN=0,DGIEN=$O(^IBE(351.2,"AC",DGMVP,DGIEN)) Q:'DGIEN | 
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| 45 | S DG0=$G(^IBE(351.2,DGIEN,0)) ; Special Inpatient Billing Case Record | 
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| 46 | Q:$P(DG0,U,8)&('$P(DG0,U,7))  ; Case disposed care not related to Condition | 
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| 47 | S IBTYP=$P(DG0,U,3) | 
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| 48 | S IBTYP=$$UCCL^IBAMTI(IBTYP) S:IBTYP="SPECIAL" IBTYP="SPECIAL CASE" | 
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| 49 | S IBOUT="* Patient Claims EPISODE OF CARE related to: "_IBTYP | 
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| 50 | I '$P(DG0,U,8) S IBDISP="** STATUS - Case has not been DISPOSITIONED" D PRINT Q | 
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| 51 | I $P(DG0,U,8),$P(DG0,U,7) D | 
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| 52 | . S IBDISP="** Case has been DIPOSITIONED and Care is NOT BILLABLE" | 
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| 53 | . S IBREAS=$G(^IBE(351.2,DGIEN,1,0)) | 
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| 54 | . D PRINT | 
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| 55 | Q | 
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| 56 | ; | 
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| 57 | PRINT ; | 
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| 58 | I IBLINE>55 D HDR^IBOVOP2 W !,IBFLD1,!?5,IBFLD2 | 
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| 59 | I $Y>(IOSL-5) D PAUSE^IBOUTL Q:IBQUIT  D HDR^IBOVOP2 W !,IBFLD1,!?5,IBFLD2 | 
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| 60 | W !!,?5,IBOUT | 
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| 61 | W:$G(IBDISP)]"" !,?5,IBDISP ; Writes the status of the disposition | 
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| 62 | I $G(IBREAS)]"" D | 
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| 63 | . W !,?5,"Reason Not Billable: ",$E(IBREAS,1,55) ; Writes Reason Not Billed | 
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| 64 | Q | 
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| 65 | ; | 
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| 66 | FEE ; This Subroutine permits a Clerk to add a DG FEE SERVICE (OPT) | 
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| 67 | ; when the value of the fee for service is less than the normal | 
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| 68 | ; Outpatient Copayment. | 
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| 69 | ; | 
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| 70 | Q:'$G(IBAFEE)!('$G(IBCHG)) | 
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| 71 | ; Reset ibdesc="DG FEE SERVICE (OPT) NEW", ibatyp=57 | 
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| 72 | ;  before adding entry from ADD^IBECEAU3 to ^IB | 
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| 73 | S IBATYP=IBAFEE I $D(^IBE(350.1,+IBATYP,20)) X ^(20) | 
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| 74 | N DIR,X,Y,DIRUT | 
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| 75 | S DIR(0)="350,.07",DIR("A")="Fee Amount" | 
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| 76 | S DIR("B")=$S(IBCHG?1N.N1"."1N:IBCHG_0,1:IBCHG) | 
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| 77 | S DIR("T")=180,DIR("?")=" " | 
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| 78 | S DIR("?",1)="     *** The Fee for Service can not be LESS than $1.00 or" | 
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| 79 | S DIR("?",2)="     *** GREATER than $"_$S(IBCHG?1N.N1"."1N:IBCHG_0,1:IBCHG)_"." | 
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| 80 | D ^DIR I $G(DIRUT) S IBY=-1 Q | 
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| 81 | I $G(Y)>50.8!($G(Y)<1) D  G FEE | 
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| 82 | . W !,?10,"*** The Fee for Service can not be GREATER than $"_$S(IBCHG?1N.N1"."1N:IBCHG_0,1:IBCHG) | 
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| 83 | . W !,?10,"*** AND must be GREATER than $.99==> Please try Again" | 
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| 84 | S:$G(Y) IBCHG=Y | 
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| 85 | Q | 
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| 86 | ; | 
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| 87 | IBOVOP(IBDATE) ; | 
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| 88 | ; This Subroutine expands the functions of the Outpatient Events Report | 
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| 89 | ; by adding Inpatient Observation Admissions/Discharges to the the report. | 
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| 90 | ; Find Admissions or Discharges Associated with Inpatient Observation | 
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| 91 | ; Specialities and Load them into ^TMP("IBOVOP",$J) to be printed | 
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| 92 | ; by ^IBOVOP the Outpatient Events Report. | 
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| 93 | ; | 
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| 94 | Q:'$G(IBDATE) | 
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| 95 | N DGPM0,DGMVP,IBDATE1,IBDFN,IBI,IBENDDT,IBSPEC | 
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| 96 | N IBFLD1,IBFLD2,IBFLD3,IBFLD4,IBFLD5,IBSUB3,IBSUB4,IBSUB5,IBSUB6 | 
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| 97 | S IBDATE1=$P(IBDATE,"."),IBI=($P(IBDATE,".")-1)+.99999 | 
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| 98 | S IBENDDT=IBDATE1+.9999 | 
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| 99 | F  S IBI=$O(^DGPM("B",IBI)) Q:'IBI!(IBI>IBENDDT)  D | 
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| 100 | . S DGMVP=0 F  S DGMVP=$O(^DGPM("B",IBI,DGMVP)) Q:'DGMVP  D | 
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| 101 | . . S DGPM0=$G(^DGPM(DGMVP,0)) Q:$P(DGPM0,U,2)'=1 | 
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| 102 | . . S IBTYP=$P(DGPM0,U,2) ; 1=Admission | 
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| 103 | . . S IBSPEC=$$MVT^DGPMOBS(DGMVP) Q:+IBSPEC<1  ; quite not OBS | 
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| 104 | . . S IBDFN=$P(DGPM0,U,3) Q:'IBDFN | 
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| 105 | . . Q:$$BILST^DGMTUB(IBDFN)<($P(+DGPM0,"."))  ; quite not MT billable | 
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| 106 | . . S IBSUB3=$$FLD1^IBOVOP1(IBDFN) Q:IBSUB3=""  ; subscript 3 PT name | 
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| 107 | . . S IBSUB4="OBS ADMIS" | 
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| 108 | . . S IBSUB5=$$FLD3^IBOVOP1(+DGPM0) Q:IBSUB5="" | 
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| 109 | . . S IBSUB6=0 | 
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| 110 | . . S IBFLD1=$E($P(IBSPEC,U,3),U,30) ; Treating Speciality | 
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| 111 | . . S IBFLD2="" | 
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| 112 | . . S IBFLD3=$S($P(DGPM0,U,17):"DISCHARGED",1:"ADMISSION") | 
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| 113 | . . S IBFLD4=IBDFN,IBFLD5="",IBFLD6=DGMVP | 
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| 114 | . . ; Set the Global for the Outpatient Event Report | 
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| 115 | . . S ^TMP("IBOVOP",$J,IBSUB3,IBSUB4,IBSUB5,IBSUB6)=IBFLD1_U_IBFLD2_U_IBFLD3_U_IBFLD4_U_IBFLD5_U_IBFLD6 | 
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| 116 | Q | 
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