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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