[613] | 1 | IBJDB22 ;ALB/RB - REASONS NOT BILLABLE REPORT (PRINT) ;19-JUN-00
|
---|
| 2 | ;;2.0;INTEGRATED BILLING;**123,159**;21-MAR-94
|
---|
| 3 | ;
|
---|
| 4 | EN ; - Entry point from IBJDB21.
|
---|
| 5 | ;
|
---|
| 6 | ; - Extract summary data.
|
---|
| 7 | I $G(IBXTRACT) D EXTMO(.IB) G ENQ
|
---|
| 8 | ;
|
---|
| 9 | S (IBQ,ECNT,ETOT,SCNT,STOT)=0 D NOW^%DTC S IBRUN=$$DAT2^IBOUTL(%)
|
---|
| 10 | ;
|
---|
| 11 | S IBDIV="" I 'IBSD S VAUTD(0)=""
|
---|
| 12 | F S IBDIV=$O(VAUTD(IBDIV)) Q:IBDIV="" D I IBQ Q
|
---|
| 13 | . F IBEP=1:1:4 I IBSEL[IBEP D I IBQ Q
|
---|
| 14 | . . D @($S(IBRPT="D":"DET",1:"SUM"))
|
---|
| 15 | ;
|
---|
| 16 | I IBQ G ENQ
|
---|
| 17 | ;
|
---|
| 18 | I 'IBQ,IBRPT="D" D
|
---|
| 19 | . S IBDIV="" I 'IBSD S VAUTD(0)=""
|
---|
| 20 | . F S IBDIV=$O(VAUTD(IBDIV)) Q:IBDIV="" D I IBQ Q
|
---|
| 21 | . . F IBEP=1:1:4 I IBSEL[IBEP D SUM I IBQ Q
|
---|
| 22 | ;
|
---|
| 23 | ENQ K %,IB0,IBDH,IBDIV,IBEP,IBEPH,IBN,IBP,IBPAG,IBPT,IBQ,IBRT,IBRUN,IBSORT
|
---|
| 24 | K IBT1,IBU,GTOT,ECNT,ETOT,SCNT,STOT
|
---|
| 25 | Q
|
---|
| 26 | ;
|
---|
| 27 | DET ; - Print detailed report.
|
---|
| 28 | I '$D(^TMP("IBJDB2",$J,IBDIV,IBEP)) D D PAUSE Q
|
---|
| 29 | . D HDR Q:IBQ W !!,"No entries for this episode.",!
|
---|
| 30 | S IBT1=0,(IBSORT1,IBPT,IB0)=""
|
---|
| 31 | F S IBSORT1=$O(^TMP("IBJDB2",$J,IBDIV,IBEP,IBSORT1)) Q:IBSORT1="" D Q:IBQ
|
---|
| 32 | . D HDR Q:IBQ
|
---|
| 33 | . F S IBPT=$O(^TMP("IBJDB2",$J,IBDIV,IBEP,IBSORT1,IBPT)) Q:IBPT="" S IBP=$G(^(IBPT)) D Q:IBQ
|
---|
| 34 | . . I $Y>(IOSL-8) D PAUSE Q:IBQ D HDR Q:IBQ
|
---|
| 35 | . . D WPAT
|
---|
| 36 | . . F S IB0=$O(^TMP("IBJDB2",$J,IBDIV,IBEP,IBSORT1,IBPT,IB0)) Q:IB0="" S IBN=$G(^(IB0)) D Q:IBQ
|
---|
| 37 | . . . I $Y>(IOSL-8) D PAUSE Q:IBQ D HDR Q:IBQ D WPAT
|
---|
| 38 | . . . W ?45,$$DTE(+IBN),?55,$$DTE($P(IBN,U,2))
|
---|
| 39 | . . . I $P(IBN,U,4)'="" W ?65,$$DTE($P(IBN,U,3)),?76,$E($P(IBN,U,4),1,19)
|
---|
| 40 | . . . E W ?65,$$DTE($P(IBN,U,2)) W ?76,"POSTMASTER"
|
---|
| 41 | . . . S IBU=5 S:12[IBEP IBU=$S(IBSORT="R":6,1:IBU)
|
---|
| 42 | . . . I 12[IBEP W ?97,$E($P(IBN,U,IBU),1,25),?124,$J($P(IBN,U,8),8,2),!
|
---|
| 43 | . . . I 34[IBEP W ?99,$J($P(IBN,U,8),8,2),!
|
---|
| 44 | . . . I $P(IBN,U,9)]"" W ?15,"Comments: ",$P(IBN,U,9) W:12'[IBEP !
|
---|
| 45 | . . . I 12[IBEP W ?97,$E($P(IBN,U,$S("PR"[IBSORT:7,1:6)),1,25),!
|
---|
| 46 | . . . S SCNT=SCNT+1,ECNT=ECNT+1
|
---|
| 47 | . . . S STOT=STOT+$P(IBN,U,8),ETOT=ETOT+$P(IBN,U,8)
|
---|
| 48 | . I 'IBQ D TOT2 I $O(^TMP("IBJDB2",$J,IBDIV,IBEP,IBSORT1))'="" D PAUSE Q
|
---|
| 49 | I 'IBQ D TOT1,PAUSE
|
---|
| 50 | ;
|
---|
| 51 | DETQ Q
|
---|
| 52 | ;
|
---|
| 53 | EXTMO(IBSM) ; Extract/transmit data to DM Extract Module
|
---|
| 54 | ; IBSM - Array containing the summary information
|
---|
| 55 | ;
|
---|
| 56 | N I,IB,IBI,IBJ,IBLST,IBR,IBRNB,IBSQ,IBTR,IBTP,IBZ,RNBC,RNBN
|
---|
| 57 | ;
|
---|
| 58 | F I=1:1 S RNBN=$P($T(RNB+I),";;",2,99) Q:RNBN="" D
|
---|
| 59 | . S RNBC=$O(^IBE(356.8,"B",RNBN,0)) Q:'RNBC
|
---|
| 60 | . S IBTR(RNBC)=I
|
---|
| 61 | ;
|
---|
| 62 | S IBRNB="",IBLST=$O(^IBE(356.8,999),-1)*2
|
---|
| 63 | F IBTP=1:1:4 D
|
---|
| 64 | . F IBJ=1:1:IBLST,999,1000 S IB(IBTP,IBJ)=$S(IBJ#2:0,1:"0.00")
|
---|
| 65 | . F S IBRNB=$O(IBSM(0,IBTP,IBRNB)) Q:IBRNB="" D
|
---|
| 66 | . . I '$D(IBTR(IBRNB)) Q
|
---|
| 67 | . . S IBSQ=$S(IBRNB<999:IBTR(IBRNB)*2-1,1:999)
|
---|
| 68 | . . S IBZ=$G(IBSM(0,IBTP,IBRNB))
|
---|
| 69 | . . S IB(IBTP,IBSQ)=+IBZ
|
---|
| 70 | . . S IB(IBTP,IBSQ+1)=$FN(+$P(IBZ,"^",2),"",2)
|
---|
| 71 | . F I=1:1:3 D E^IBJDE(21+(IBTP*3)+I,0)
|
---|
| 72 | . K IB(IBTP)
|
---|
| 73 | ;
|
---|
| 74 | Q
|
---|
| 75 | ;
|
---|
| 76 | SUM ; - Print summary line(s).
|
---|
| 77 | I '$D(IB(IBDIV,IBEP)) D D PAUSE Q
|
---|
| 78 | . D SUMH W !!?14,"No statistics available."
|
---|
| 79 | D SUMH Q:IBQ
|
---|
| 80 | S IBRNB=0 F S IBRNB=$O(IB(IBDIV,IBEP,IBRNB)) Q:'IBRNB D Q:IBQ
|
---|
| 81 | . S IBN=IB(IBDIV,IBEP,IBRNB)
|
---|
| 82 | . W !?14,$P($G(^IBE(356.8,IBRNB,0)),U),?48,$J(+IBN,5),?57,$J($P(IBN,U,2),9,2)
|
---|
| 83 | . S $P(GTOT,U)=$P(GTOT,U)+IBN,$P(GTOT,U,2)=$P(GTOT,U,2)+$P(IBN,U,2)
|
---|
| 84 | D SUMT
|
---|
| 85 | ;
|
---|
| 86 | Q
|
---|
| 87 | ;
|
---|
| 88 | SUMH ; - Print summary header.
|
---|
| 89 | I $E(IOST,1,2)="C-"!$G(IBPAG) W @IOF,*13
|
---|
| 90 | S IBPAG=$G(IBPAG)+1 W ?68,"Page: ",IBPAG
|
---|
| 91 | S IBEPH="REASONS NOT BILLABLE SUMMARY/"_IBEPS(IBEP)
|
---|
| 92 | W !!?(80-$L(IBEPH))\2,IBEPH
|
---|
| 93 | I IBDIV D
|
---|
| 94 | .S IBDH="Division: "_$P($G(^DG(40.8,IBDIV,0)),U)
|
---|
| 95 | .W !?(80-$L(IBDH)\2),IBDH
|
---|
| 96 | ;
|
---|
| 97 | W !?22,"Period : from ",$$DTE(IBBDT)," thru ",$$DTE(IBEDT),!
|
---|
| 98 | W !?24,"Run Date: ",IBRUN
|
---|
| 99 | W !!?46,"No. of",?61,"Total",!?14,"RNB Category",?46,"Entries"
|
---|
| 100 | W ?60,"Amount",!?14,$$DASH(52)
|
---|
| 101 | S GTOT="0^0",IBQ=$$STOP^IBOUTL("Reasons Not Billable Summary")
|
---|
| 102 | Q
|
---|
| 103 | ;
|
---|
| 104 | SUMT ; - Print summary totals.
|
---|
| 105 | W !?47,"-------------------"
|
---|
| 106 | W !?33,"Grand Totals:",?47,$J(+GTOT,6),?56,$J($P(GTOT,U,2),10,2) D PAUSE
|
---|
| 107 | Q
|
---|
| 108 | ;
|
---|
| 109 | HDR ; - Write the detailed report header.
|
---|
| 110 | I $E(IOST,1,2)="C-"!$G(IBPAG) W @IOF,*13
|
---|
| 111 | S IBPAG=$G(IBPAG)+1 W "Reasons Not Billable (RNB) Report "
|
---|
| 112 | W ?88,"Run Date: ",IBRUN,?123,"Page: ",$J(IBPAG,3)
|
---|
| 113 | S X=IBE(IBEP)_" events by "
|
---|
| 114 | I 1234[IBEP D
|
---|
| 115 | . S X=X_$S(IBSORT="P":"provider",IBSORT="S":"specialty",1:"RNB category")
|
---|
| 116 | . I $G(IBSORT1)'="" S X=X_" ("_IBSORT1_")"
|
---|
| 117 | E S X=X_"RNB category"
|
---|
| 118 | S X=X_" from "_$$DTE(IBBDT)_" thru "_$$DTE(IBEDT)_" ("_IBD_")"
|
---|
| 119 | I 12[IBEP D
|
---|
| 120 | . I IBSORT'="R" D
|
---|
| 121 | . . S X=X_" / "_$S(IBSRNB="S":"SPECIFIC",1:"ALL")_" REASONS NOT BILLABLE"
|
---|
| 122 | . I IBSORT'="P" D
|
---|
| 123 | . . S X=X_" / "_$S(IBSPRV="S":"SPECIFIC",1:"ALL")_" PROVIDERS"
|
---|
| 124 | . I IBSORT'="S",IBEP=1 D
|
---|
| 125 | . . S X=X_" / "_$S(IBSISP="S":"SPECIFIC",1:"ALL")_" SPECIALTIES"
|
---|
| 126 | . I IBSORT'="S",IBEP=2 D
|
---|
| 127 | . . S X=X_" / "_$S(IBSOSP="S":"SPECIFIC",1:"ALL")_" SPECIALTIES"
|
---|
| 128 | F I=1:1 W !,$E(X,1,132) S X=$E(X,133,999) I X="" Q
|
---|
| 129 | ;
|
---|
| 130 | I IBDIV W !,"Division: ",$P($G(^DG(40.8,IBDIV,0)),U)
|
---|
| 131 | W !!?26,"Last",?32,"Insurance",?45,"Episode Date Dte Last"
|
---|
| 132 | I 12[IBEP W ?97,$S("PS"[IBSORT:"RNB Category",1:"Provider")
|
---|
| 133 | W !,"Patient",?26,"4SSN",?32,"Carrier"
|
---|
| 134 | W ?45,"Date Entered Edited Last Edited By"
|
---|
| 135 | I 12[IBEP W ?97,$S("PR"[IBSORT:"Specialty",1:"Provider")
|
---|
| 136 | ;
|
---|
| 137 | I 34[IBEP W ?101,"Amount",!,$$DASH(IOM-25),!
|
---|
| 138 | E W ?126,"Amount",!,$$DASH(IOM),!
|
---|
| 139 | S IBQ=$$STOP^IBOUTL("Reasons Not Billable Report")
|
---|
| 140 | Q
|
---|
| 141 | ;
|
---|
| 142 | WPAT ; - Write patient data.
|
---|
| 143 | W $P(IBPT,"@@"),?26,$P(IBPT,"@@",2),?32,$E($P(IBP,U),1,12)
|
---|
| 144 | Q
|
---|
| 145 | ;
|
---|
| 146 | TOT1 ; - Print episode totals.
|
---|
| 147 | I 34[IBEP W !?97,"----------",!
|
---|
| 148 | E W !?122,"----------",!
|
---|
| 149 | I 34[IBEP W ?55
|
---|
| 150 | E W ?80
|
---|
| 151 | W "TOTAL FOR EPISODE - Count: ",$J(ECNT,5)," Amount: ",$J(ETOT,10,2)
|
---|
| 152 | S (ECNT,ETOT)=0
|
---|
| 153 | Q
|
---|
| 154 | ;
|
---|
| 155 | TOT2 ; - Print sub-totals.
|
---|
| 156 | I 34[IBEP W ?98,"---------",!
|
---|
| 157 | E W ?123,"---------",!
|
---|
| 158 | I 34[IBEP W ?60
|
---|
| 159 | E W ?85
|
---|
| 160 | W "TOTAL EVENTS - Count: ",$J(SCNT,4)," Amount: ",$J(STOT,9,2),!
|
---|
| 161 | S (SCNT,STOT)=0
|
---|
| 162 | Q
|
---|
| 163 | ;
|
---|
| 164 | DASH(X) ; - Return a dashed line.
|
---|
| 165 | Q $TR($J("",X)," ","=")
|
---|
| 166 | ;
|
---|
| 167 | PAUSE ; - Page break.
|
---|
| 168 | I $E(IOST,1,2)'="C-" Q
|
---|
| 169 | N IBX,DIR,DIRUT,DUOUT,DTOUT,DIROUT,X,Y
|
---|
| 170 | F IBX=$Y:1:(IOSL-3) W !
|
---|
| 171 | S DIR(0)="E" D ^DIR S:$D(DIRUT)!($D(DUOUT)) IBQ=1
|
---|
| 172 | Q
|
---|
| 173 | ;
|
---|
| 174 | DTE(X) ; - Format the date.
|
---|
| 175 | Q $S(X:$E(X,4,5)_"/"_$E(X,6,7)_"/"_$E(X,2,3),1:"")
|
---|
| 176 | ;
|
---|
| 177 | RNB ; - Reasons Not Billable
|
---|
| 178 | ;;NOT INSURED
|
---|
| 179 | ;;SC TREATMENT
|
---|
| 180 | ;;AGENT ORANGE
|
---|
| 181 | ;;IONIZING RADIATION
|
---|
| 182 | ;;ENV. CONTAM.
|
---|
| 183 | ;;SERVICE NOT COVERED
|
---|
| 184 | ;;COVERAGE CANCELED
|
---|
| 185 | ;;NEEDS SC DETERMINATION
|
---|
| 186 | ;;NON-BILLABLE APPOINTMENT TYPE
|
---|
| 187 | ;;INVALID PRESCRIPTION ENTRY
|
---|
| 188 | ;;REFILL ON VISIT DATE
|
---|
| 189 | ;;PRESCRIPTION DELETED
|
---|
| 190 | ;;PRESCRIPTION NOT RELEASED
|
---|
| 191 | ;;DRUG NOT BILLABLE
|
---|
| 192 | ;;HMO POLICY
|
---|
| 193 | ;;REFUSES TO SIGN RELEASE (ROI)
|
---|
| 194 | ;;NON-BILLABLE STOP CODE
|
---|
| 195 | ;;RESEARCH VISIT
|
---|
| 196 | ;;BILL PURGED
|
---|
| 197 | ;;NON-BILLABLE CLINIC
|
---|
| 198 | ;;MILITARY SEXUAL TRAUMA
|
---|
| 199 | ;;CREDENTIALING ISSUE
|
---|
| 200 | ;;INSUFFICIENT DOCUMENTATION
|
---|
| 201 | ;;NO DOCUMENTATION
|
---|
| 202 | ;;NON-BILLABLE PROVIDER (RESID.)
|
---|
| 203 | ;;NON-BILLABLE PROVIDER (OTHER)
|
---|
| 204 | ;;OTHER COMPLIANCE
|
---|
| 205 | ;;OUT OF NETWORK (PPO)
|
---|