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