[623] | 1 | IBJDB11 ;ALB/CPM - BILLING LAG TIME REPORT (COMPILE) ; 27-DEC-96
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| 2 | ;;2.0;INTEGRATED BILLING;**69,100,118**;21-MAR-94
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| 3 | ;
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| 4 | EN ; - Entry point from IBJDB1.
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| 5 | ;
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| 6 | ; -
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| 7 | I IBRPT="D" F X=2,3,4,6,7,8 S:IBSEL[X IBSEL=IBSEL_X_"I,"
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| 8 | I 'IBSORT D INIT(0) G REV
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| 9 | S X=0 F S X=$S('VAUTD:$O(VAUTD(X)),1:$O(^DG(40.8,X))) Q:'X D INIT(X)
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| 10 | ;
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| 11 | REV ; - Review all claims in file #399.
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| 12 | S IBN=0 F S IBN=$O(^DGCR(399,IBN)) Q:'IBN S IBN0=$G(^(IBN,0)) D Q:IBQ
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| 13 | .I IBN#100=0 S IBQ=$$STOP^IBOUTL("Billing Lag Time Report") Q:IBQ
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| 14 | .;
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| 15 | .I $P($G(^PRCA(430,IBN,0)),U,2)'=9 Q ; Not an RI claim.
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| 16 | .I $P(IBN0,U,13)<3 Q ; Not authorized.
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| 17 | .I $P(IBN0,U,13)=7 Q ; Cancelled in IB.
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| 18 | .S X=$P($G(^PRCA(430,IBN,0)),U,8) I X=26!(X=39) Q ; Cancelled in AR.
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| 19 | .;
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| 20 | .; - Does claim meet report criteria?
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| 21 | .S IBAUTH=$$AUTH(IBN) I 'IBAUTH Q
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| 22 | .;
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| 23 | .; - Get division, if necessary.
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| 24 | .I 'IBSORT S IBDIV=0
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| 25 | .E S IBDIV=$$DIV^IBJDF2(IBN) I 'IBDIV S IBDIV=+$$PRIM^VASITE()
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| 26 | .I IBSORT,'VAUTD,'$D(VAUTD(IBDIV)) Q ; Not a selected division.
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| 27 | .;
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| 28 | .S IBTY=$S($P(IBN0,U,5)<3:"IN",1:"OP") ; Inpatient or outpatient claim?
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| 29 | .;
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| 30 | .; - Get most recent date PTF transmitted.
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| 31 | .I IBTY="IN" D Q:'IBPTF!('IBPTF&($P(IBAUTH,U,2)))
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| 32 | ..S IBPTF=$P(IBN0,U,8) I 'IBPTF Q
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| 33 | ..S IBPTF=$O(^DGP(45.83,"C",IBPTF,9999999),-1)\1 I IBPTF Q
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| 34 | ..S IBPTF=$P($G(^DGP(45.83,IBPTF,0)),U,2)\1
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| 35 | .;
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| 36 | .; - Get other claim info and build date line.
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| 37 | .S IBDAT=$P(IBAUTH,U,2,5),DFN=+$P(IBN0,U,2),IBDFN=$G(^DPT(DFN,0))
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| 38 | .S IBPOL=+$G(^DPT(DFN,.312,+$P($G(^DGCR(399,IBN,"MP")),U,2),1))
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| 39 | .;
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| 40 | .; - Get care dates; quit if there are none.
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| 41 | .K IBDR S IBNU=$G(^DGCR(399,IBN,"U")) D
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| 42 | ..I IBTY="IN" S X=+$P(IBNU,U,2) S:'X X=+IBNU S:X IBDR(X)="" Q
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| 43 | ..I '$D(^DGCR(399,IBN,"OP")) D Q
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| 44 | ...S X=+$P(IBNU,U,2) S:X IBDR(X)="" S:+IBNU&(+IBNU'=X) IBDR(+IBNU)=""
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| 45 | ..S X=0 F S X=$O(^DGCR(399,IBN,"OP",X)) Q:'X S IBDR(X)=""
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| 46 | .I '$D(IBDR) Q
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| 47 | .;
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| 48 | .; - Calculate statistics for each care date.
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| 49 | .S IBX=0 F S IBX=$O(IBDR(IBX)) Q:'IBX D
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| 50 | ..;
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| 51 | ..; - Get discharge date.
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| 52 | ..I IBTY="IN" D
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| 53 | ...S IBX1=+$G(^DGPT(+$P(IBN0,U,8),70))\1 I IBX1 Q
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| 54 | ...S IBX1=+$O(^DGPM("APTT3",DFN,(IBX-.0001)))\1 I 'IBX1 S IBX1=IBX
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| 55 | ..;
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| 56 | ..; - Get most recent check out date that has not been marked as non
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| 57 | ..; billable by Claims Tracking; quit if there isn't one.
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| 58 | ..I IBTY="OP" D Q:'IBCHK
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| 59 | ...S IBCHK=0,IBX1=IBX-.0001
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| 60 | ...F S IBX1=$O(^SCE("ADFN",DFN,IBX1)) Q:'IBX1!((IBX1\1)>IBX) D
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| 61 | ....S IBX2=0 F S IBX2=$O(^SCE("ADFN",DFN,IBX1,IBX2)) Q:'IBX2 D
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| 62 | .....I $P($G(^IBT(356,+$O(^IBT(356,"ASCE",IBX2,0)),0)),U,19) Q
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| 63 | .....S IBX3=$P($G(^SCE(IBX2,0)),U,7)\1 I IBX3 S IBCHK=IBX3
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| 64 | ..;
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| 65 | ..S X=$S(IBTY="IN":IBX1_U_IBPTF,1:IBX_U_IBCHK)_U_IBDAT
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| 66 | ..S IBPOL1=$S(IBPOL>+X:1,1:0) ; Policy found after treatment.
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| 67 | ..;
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| 68 | ..; - Check date line for at least one date within the user specified
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| 69 | ..; range; quit if there isn't any.
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| 70 | ..S IBDCHK=0 F Y=2:1:6 I $$DL(0,$P(X,U,Y)) S IBDCHK=1 Q
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| 71 | ..I 'IBDCHK Q
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| 72 | ..;
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| 73 | ..K D,Y,Z S IBSEL1=""
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| 74 | ..F Y=1:1:5 S Z(1)=$P(X,U,Y),Z(2)=$P(X,U,Y+1) D
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| 75 | ...;
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| 76 | ...; - Check out date/PTF transmission date.
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| 77 | ...I Y=1 D:Z(2) Q
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| 78 | ....S D(0)=$$FMDIFF^XLFDT(Z(2),Z(1)),Z=$S(IBTY="IN":5,1:1)
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| 79 | ....I $$DL(Z,Z(2)) S IBSEL1=IBSEL1_Z_",",Y(Z)=$S(IBRPT="D":Z(1)_U_Z(2)_U_D(0),1:D(0))
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| 80 | ...;
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| 81 | ...; - Date authorized.
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| 82 | ...I Y=2 D:Z(1) Q
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| 83 | ....S D(1)=$$FMDIFF^XLFDT(Z(2),Z(1)),Z=$S(IBTY="IN":6,1:2)
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| 84 | ....I $$DL(Z,Z(2)) D
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| 85 | .....S Z1=$S(IBPOL1:Z_"I",1:Z),IBSEL1=IBSEL1_Z1_",",Y(Z1)=$S(IBRPT="D":Z(1)_U_Z(2)_U_D(1),1:D(1))
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| 86 | .....I Z1=Z D
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| 87 | ......S Z2=Z_"I",IBSEL1=IBSEL1_Z2_",",Y(Z2)=$S(IBRPT="D":Z(1)_U_Z(2)_U_D(1),1:D(1))
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| 88 | ...;
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| 89 | ...; - Date activated.
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| 90 | ...I Y=3 D:Z(2) Q
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| 91 | ....S D(2)=$$FMDIFF^XLFDT(Z(2),Z(1)) I $$DL(9,Z(2)) S IBSEL1=IBSEL1_"9,",Y(9)=$S(IBRPT="D":Z(1)_U_Z(2)_U_D(2),1:D(2))
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| 92 | ...;
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| 93 | ...; - Payment date.
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| 94 | ...I Y=4 D:Z(2) Q
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| 95 | ....S D(3)=$$FMDIFF^XLFDT(Z(2),Z(1)),D(6)=$$FMDIFF^XLFDT(Z(2),+X)
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| 96 | ....F Z=$S(IBTY="IN":7,1:3),10 I $$DL(Z,Z(2)) D
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| 97 | .....S Z1=$S(IBPOL1&(Z<10):Z_"I",1:Z),Z2=$S(Z<10:6,1:3)
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| 98 | .....S IBSEL1=IBSEL1_Z1_",",Y(Z1)=$S(IBRPT="D":$S(Z2=3:Z(1),1:+X)_U_Z(2)_U_D(Z2),1:D(Z2))
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| 99 | .....I Z1=Z,Z<10 S Z3=Z_"I",IBSEL1=IBSEL1_Z3_",",Y(Z3)=$S(IBRPT="D":$S(Z2=3:Z(1),1:+X)_U_Z(2)_U_D(Z2),1:D(Z2))
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| 100 | ...;
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| 101 | ...; - Date closed.
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| 102 | ...I Z(2) D
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| 103 | ....S D(4)=$$FMDIFF^XLFDT(Z(2),Z(1)),D(5)=$$FMDIFF^XLFDT(Z(2),+X)
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| 104 | ....F Z=$S(IBTY="IN":8,1:4),11 I $$DL(Z,Z(2)) D
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| 105 | .....S Z1=$S(IBPOL1&(Z<11):Z_"I",1:Z),Z2=$S(Z<11:5,1:4)
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| 106 | .....S IBSEL1=IBSEL1_Z1_",",Y(Z1)=$S(IBRPT="D":$S(Z2=4:Z(1),1:+X)_U_Z(2)_U_D(Z2),1:D(Z2))
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| 107 | .....I Z1=Z,Z<11 S Z3=Z_"I",IBSEL1=IBSEL1_Z3_",",Y(Z3)=$S(IBRPT="D":$S(Z2=4:Z(1),1:+X)_U_Z(2)_U_D(Z2),1:D(Z2))
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| 108 | ..;
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| 109 | ..; - Save data for detail or summary report(s).
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| 110 | ..F Y=1:1 S Z=$P(IBSEL1,",",Y) Q:'Z D
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| 111 | ...I IBRPT="D" D
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| 112 | ....S Y(Z)=$P(IBN0,U)_U_Y(Z)_U_$S(IBPOL1:"*",1:""),Y1(Z)=$G(Y1(Z))+1
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| 113 | ....S ^TMP("IBJDB1",$J,IBDIV,IBTY,Z,$P(IBDFN,U)_"@@"_$P(IBDFN,U,9),Y1(Z))=Y(Z)
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| 114 | ...E S IBCT(IBDIV,IBTY,Z)=IBCT(IBDIV,IBTY,Z)+1,IBTL(IBDIV,IBTY,Z)=IBTL(IBDIV,IBTY,Z)+Y(Z)
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| 115 | ;
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| 116 | Q
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| 117 | ;
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| 118 | INIT(X) ; - Initialize summary accumulators/detail division nodes.
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| 119 | I IBRPT="D" S ^TMP("IBJDB1",$J,X)="" Q
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| 120 | F Y=1:1:4,9,10,11,"2I","3I","4I" S (IBCT(X,"OP",Y),IBTL(X,"OP",Y))=0
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| 121 | F Y=5:1:11,"6I","7I","8I" S (IBCT(X,"IN",Y),IBTL(X,"IN",Y))=0
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| 122 | Q
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| 123 | ;
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| 124 | AUTH(IBN) ; - Is this an authorized claim?
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| 125 | ; Input: IBN=Pointer to the AR in file #430
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| 126 | ; Output: VAL=1^2^3^4^5, where:
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| 127 | ; 1=1-Authorized claim
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| 128 | ; 0-Not an authorized claim
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| 129 | ; 2=Date AR was authorized
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| 130 | ; 3=Date AR was activated
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| 131 | ; 4=AR first payment date
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| 132 | ; 5=Date AR was closed
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| 133 | ;
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| 134 | N IBPAY,IBT,IBT0,IBT1,VAL,X
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| 135 | S VAL=0 I '$G(IBN) G AUTHQ
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| 136 | ;
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| 137 | ; - Get date authorized (required).
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| 138 | S X=$P($G(^DGCR(399,IBN,"S")),U,10) G:'X AUTHQ S VAL="1^"_X
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| 139 | ;
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| 140 | ; - Get date activated, if available.
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| 141 | S X=$P($G(^PRCA(430,IBN,6)),U,21) I X S $P(VAL,U,3)=X\1 G FP
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| 142 | S X=$P($G(^PRCA(430,IBN,9)),U,3) I X S $P(VAL,U,3)=X\1 G FP
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| 143 | S X=$P($G(^PRCA(430,IBN,0)),U,10) I X S $P(VAL,U,3)=X\1
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| 144 | ;
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| 145 | FP ; - Get first payment date, if available.
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| 146 | I '$P($G(^PRCA(430,IBN,7)),U,7) G CL ; No payments made.
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| 147 | S (IBPAY,IBT)=0 F S IBT=$O(^PRCA(433,"C",IBN,IBT)) Q:'IBT D Q:IBPAY
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| 148 | .S IBT0=$G(^PRCA(433,IBT,0)),IBT1=$G(^(1))
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| 149 | .I $P(IBT0,U,4)'=2 Q ; Not complete.
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| 150 | .I $P(IBT1,U,2)'=2,$P(IBT1,U,2)'=34 Q ; Not a payment.
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| 151 | .S X=$S(+IBT1:+IBT1,1:$P(IBT1,U,9)\1),$P(VAL,U,4)=X,IBPAY=1
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| 152 | ;
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| 153 | CL ; - Get date AR closed.
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| 154 | S X=$$CLO^PRCAFN(IBN) I X>0 S $P(VAL,U,5)=X
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| 155 | ;
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| 156 | ; - Is there a payment date AND a closed date for this claim?
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| 157 | I '$P(VAL,U,4),$P(VAL,U,5) S $P(VAL,U)=0
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| 158 | ;
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| 159 | AUTHQ Q VAL
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| 160 | ;
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| 161 | DL(X,X1) ; - Is line item date valid for report?
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| 162 | ; Input: X=Line item number (or 0), X1=Line item date
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| 163 | ; Output: 1=valid, 0=invalid
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| 164 | ; *Requires pre-defined variables IBBDT, IBEDT, and IBSEL
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| 165 | S X2=0 I 'X1 G DLQ
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| 166 | I 'X S:X1'<IBBDT&(X1'>IBEDT) X2=1 G DLQ
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| 167 | I IBSEL[(","_X_","),X1'<IBBDT,X1'>IBEDT S X2=1
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| 168 | DLQ Q X2
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