| 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)
 | 
|---|