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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