| 1 | IBJDI5 ;ALB/CPM - INSURANCE POLICIES NOT VERIFIED ; 18-DEC-96 | 
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| 2 | ;;2.0;INTEGRATED BILLING;**69,98,100,118,123**;21-MAR-94 | 
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| 3 | ; | 
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| 4 | EN ; - Option entry point. | 
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| 5 | ; | 
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| 6 | W !!,"This report provides a number of the insurance policies which were" | 
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| 7 | W !,"entered into the system within a given timeframe, but were never verified.",! | 
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| 8 | ; | 
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| 9 | DATE D DATE^IBOUTL I IBBDT=""!(IBEDT="") G ENQ | 
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| 10 | ; | 
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| 11 | ; - Select a detailed or summary report. | 
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| 12 | D DS^IBJD I IBRPT["^" G ENQ | 
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| 13 | ; | 
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| 14 | ; - Select print/not print verified policies/totals. | 
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| 15 | S DIR(0)="YO" | 
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| 16 | S DIR("A",1)="Do you want to print a "_$S(IBRPT="D":"separate report for",1:"total number of")_" policies that were verified" | 
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| 17 | S DIR("A")="  over a year ago" | 
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| 18 | S DIR("B")="NO" D ^DIR K DIR S IBVER=Y I IBVER["^" G ENQ | 
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| 19 | ; | 
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| 20 | I IBRPT="D" W !!,"You will need a 132 column printer for this report!" | 
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| 21 | E  W !!,"This report only requires an 80 column printer." | 
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| 22 | ; | 
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| 23 | W !!,"Note: This report may take a while to run." | 
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| 24 | W !?6,"You should queue this report to run after normal business hours.",! | 
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| 25 | ; | 
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| 26 | ; - Select a device. | 
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| 27 | S %ZIS="QM" D ^%ZIS G:POP ENQ | 
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| 28 | I $D(IO("Q")) D  G ENQ | 
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| 29 | .S ZTRTN="DQ^IBJDI5",ZTDESC="IB - INSURANCE POLICIES NOT VERIFIED" | 
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| 30 | .F I="IBBDT","IBEDT","IBRPT","IBVER" S ZTSAVE(I)="" | 
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| 31 | .D ^%ZTLOAD | 
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| 32 | .W !!,$S($D(ZTSK):"This job has been queued. The task number is "_ZTSK_".",1:"Unable to queue this job.") | 
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| 33 | .K ZTSK,IO("Q") D HOME^%ZIS | 
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| 34 | ; | 
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| 35 | U IO | 
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| 36 | ; | 
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| 37 | DQ ; - Tasked entry point. | 
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| 38 | ; | 
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| 39 | I $G(IBXTRACT) D E^IBJDE(5,1) ; Change extract status. | 
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| 40 | ; | 
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| 41 | N IBQUERY | 
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| 42 | K IB,^TMP("IBJDI51",$J),^TMP("IBJDI52",$J) | 
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| 43 | S (IB("NOT"),IB("TOT"),IB("VER"),IBQ)=0 S:IBVER IB("VERO")=0 | 
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| 44 | ; | 
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| 45 | ; - Find inpatients treated within the user-specified date range. | 
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| 46 | S IBD=IBBDT-.01 F  S IBD=$O(^DGPM("ATT3",IBD)) Q:'IBD!(IBD\1>IBEDT)  D  Q:IBQ | 
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| 47 | .S IBPM=0 F  S IBPM=$O(^DGPM("ATT3",IBD,IBPM)) Q:'IBPM  D  Q:IBQ | 
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| 48 | ..I IBPM#100=0 S IBQ=$$STOP^IBOUTL("Insurance Policies Not Verified") Q:IBQ | 
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| 49 | ..S IBPMD=$G(^DGPM(IBPM,0)) Q:'IBPMD | 
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| 50 | ..S DFN=+$P(IBPMD,U,3) Q:'DFN | 
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| 51 | ..; | 
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| 52 | ..; - Process patient. | 
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| 53 | ..I '$D(^TMP("IBJDI51",$J,DFN)) D PROC(DFN,"*",IBD) | 
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| 54 | ; | 
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| 55 | I IBQ G ENQ | 
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| 56 | ; | 
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| 57 | ; - Find outpatients treated within the user-specified date range. | 
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| 58 | D CLOSE^IBSDU(.IBQUERY) | 
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| 59 | D OUTPT^IBJDI21("",IBBDT,IBEDT,"S:IBQ SDSTOP=1 I 'IBQ,$$ENCHK^IBJDI5(Y0) D ENC^IBJDI5(Y0)","Insurance Policies Not Verified",.IBQ,"IBJDI51",.IBQUERY) | 
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| 60 | D CLOSE^IBSDU(.IBQUERY) | 
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| 61 | ; | 
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| 62 | I IBQ G ENQ | 
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| 63 | ; | 
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| 64 | ; - Find data required for the report. | 
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| 65 | S IBC=0 F  S IBC=$O(^TMP("IBJDI51",$J,IBC)) Q:'IBC  D  Q:IBQ | 
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| 66 | .I IBC#100=0 S IBQ=$$STOP^IBOUTL("Insurance Policies Not Verified") Q:IBQ | 
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| 67 | .; | 
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| 68 | .; - Get the patient's active insurance policies. | 
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| 69 | .K IBINS S IBC1=$G(^TMP("IBJDI51",$J,IBC)) | 
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| 70 | .D ALL^IBCNS1(IBC,"IBINS",1,+IBC1) Q:'$D(IBINS) | 
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| 71 | .S IBC2=0 F  S IBC2=$O(IBINS(IBC2)) Q:'IBC2  D | 
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| 72 | ..; | 
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| 73 | ..; - Make sure the insurance company reimburses VA. | 
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| 74 | ..S IBC3=$G(^DIC(36,+$G(IBINS(IBC2,0)),0)) | 
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| 75 | ..Q:$P(IBC3,U)=""  Q:$P(IBC3,U,2)="N" | 
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| 76 | ..; | 
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| 77 | ..S IBCDFND=$G(IBINS(IBC2,1)) | 
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| 78 | ..; | 
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| 79 | ..S IB("TOT")=IB("TOT")+1 ; Count all. | 
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| 80 | ..; | 
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| 81 | ..; - Check if policy is verified, verified over a year, or neither. | 
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| 82 | ..S IBVFLG=0 | 
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| 83 | ..I $P(IBCDFND,U,3) D  Q:'IBVFLG | 
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| 84 | ...S IB("VER")=IB("VER")+1 Q:'IBVER | 
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| 85 | ...S X1=DT,X2=$P(IBCDFND,U,3) D ^%DTC | 
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| 86 | ...I X>365 S IB("VERO")=IB("VERO")+1,IBVFLG=1 | 
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| 87 | ..E  S IB("NOT")=IB("NOT")+1 | 
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| 88 | ..; | 
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| 89 | ..; - Build line for detailed report. | 
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| 90 | ..I IBRPT="D" D | 
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| 91 | ...S IBDOD=$S(+$G(^DPT(IBC,.35)):$$DAT2^IBOUTL(+$G(^(.35))\1),1:"") | 
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| 92 | ...S X=$G(^DPT(IBC,0)),IBEBY=$P(IBCDFND,U,2) | 
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| 93 | ...S IBVDTE=$S(IBVFLG:$P(IBCDFND,U,3),1:"") | 
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| 94 | ...S IBVBY=$S(IBVFLG:$P(IBCDFND,U,4),1:"") | 
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| 95 | ...S ^TMP("IBJDI52",$J,IBVFLG,$P(X,U)_$P(IBC1,U,2)_"@@"_$P(X,U,9)_"@@"_IBDOD_"@@"_IBC,IBC2)=$P(IBC3,U)_U_IBEBY_U_$S(+IBCDFND>0:+IBCDFND\1,1:"")_U_IBVBY_U_$S(+IBVDTE>0:IBVDTE\1,1:"") | 
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| 96 | ; | 
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| 97 | I IBQ G ENQ | 
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| 98 | ; | 
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| 99 | I $G(IBXTRACT) D E^IBJDE(5,0) G ENQ ; Extract summary data. | 
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| 100 | ; | 
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| 101 | ; - Print the reports. | 
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| 102 | S (IBPAG,IBQ)=0 D NOW^%DTC S IBRUN=$$DAT2^IBOUTL(%) | 
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| 103 | I IBRPT="D" D DET | 
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| 104 | I 'IBQ D SUM | 
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| 105 | ; | 
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| 106 | I 'IBQ D PAUSE | 
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| 107 | ; | 
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| 108 | ENQ K ^TMP("IBJDI51",$J),^TMP("IBJDI52",$J) | 
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| 109 | I $D(ZTQUEUED) S ZTREQ="@" G ENQ1 | 
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| 110 | ; | 
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| 111 | D ^%ZISC | 
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| 112 | ENQ1 K IB,IBQ,IBBDT,IBEDT,IBRPT,IBD,IBDN,IBPH,IBPM,IBINS,IBPMD,IBPAG,IBRUN,% | 
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| 113 | K IBEBY,IBVBY,IBVDTE,IBDOD,IBPER,IBC,IBC1,IBC2,IBC3,IBCDFN,IBVER,IBVFLG | 
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| 114 | K IBCDFND,IBX,IBX1,IBX2,IBX3,DFN,POP,X,X1,X2,Y,ZTDESC,ZTRTN,ZTSAVE,%ZIS | 
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| 115 | Q | 
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| 116 | ; | 
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| 117 | ENC(IBOED) ; - Encounter extract for outpatient loop. | 
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| 118 | ; Input: IBOED = Outpatient encounter in file #409.68 | 
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| 119 | ; | 
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| 120 | D PROC(+$P(IBOED,U,2),"",+IBOED) ; Process patient. | 
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| 121 | Q | 
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| 122 | ; | 
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| 123 | PROC(DFN,IBIPC,IBDTE) ; - Process each specific patient. | 
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| 124 | ;  Input:   DFN = Pointer to the patient in file #2 | 
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| 125 | ;         IBIPC = Inpatient treatment marker | 
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| 126 | ;                 ("*"=Had inpat. treatment, null=No inpat. treatment) | 
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| 127 | ;         IBDTE = Patient's checkout or discharge date | 
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| 128 | ; | 
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| 129 | I $$TESTP^IBJDI1(DFN) Q  ;       Test patient. | 
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| 130 | D ELIG^VADPT I 'VAEL(4) G PRCQ ; Patient is not a vet. | 
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| 131 | ; | 
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| 132 | ; - Set patient index. | 
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| 133 | S ^TMP("IBJDI51",$J,DFN)=IBDTE\1_U_IBIPC | 
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| 134 | ; | 
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| 135 | PRCQ K VA,VAERR,VAEL | 
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| 136 | Q | 
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| 137 | ; | 
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| 138 | ENCHK(IBOED) ; - Check outpatient's encounter record. | 
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| 139 | ;  Input: IBOED = Outpatient encounter in file #409.68 | 
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| 140 | ; Output:     1 = OK for processing | 
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| 141 | ;             0 = Not OK for processing | 
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| 142 | ; | 
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| 143 | N X,X1 S Y=0 I '$G(IBOED) G ENCKQ | 
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| 144 | ; | 
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| 145 | ; - Check if encounter was a registration/cancellation without exam. | 
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| 146 | S X=+$P(IBOED,U,2) | 
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| 147 | S X1=+$P($G(^DPT(X,"DIS",+$O(^DPT("ADIS",+IBOED,X,0)),0)),U,7) | 
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| 148 | I $D(^DIC(37,"B","CANCEL WITHOUT EXAM",X1)) G ENCKQ | 
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| 149 | I $D(^DIC(37,"B","NO CARE OR TREATMENT REQUIRED",X1)) G ENCKQ | 
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| 150 | ; | 
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| 151 | I "^1^4^7^"[("^"_+$P(IBOED,U,10)_"^") G ENCKQ ; C&P/collat/emply visit. | 
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| 152 | I $P(IBOED,U,12)'=2 G ENCKQ ;                   Not checked out. | 
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| 153 | ; | 
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| 154 | S Y=1 | 
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| 155 | ENCKQ Q Y | 
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| 156 | ; | 
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| 157 | DET ; - Print the detailed report. | 
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| 158 | I '$D(^TMP("IBJDI52",$J,0)) S IBX=0 D HDET W !,"All policies within the selected date range have been verified." D PAUSE | 
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| 159 | S IBX="" F  S IBX=$O(^TMP("IBJDI52",$J,IBX)) Q:IBX=""  D  Q:IBQ | 
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| 160 | .D HDET Q:IBQ | 
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| 161 | .S IBX1="" F  S IBX1=$O(^TMP("IBJDI52",$J,IBX,IBX1)) Q:IBX1=""  D  Q:IBQ | 
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| 162 | ..I $Y>(IOSL-4) D PAUSE Q:IBQ  D HDET Q:IBQ | 
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| 163 | ..W $P(IBX1,"@@"),?33,$$SSN($P(IBX1,"@@",2)),?47,$P(IBX1,"@@",3) | 
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| 164 | ..S IBX2=0 F  S IBX2=$O(^TMP("IBJDI52",$J,IBX,IBX1,IBX2)) Q:'IBX2  S IBX3=^(IBX2) D | 
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| 165 | ...I $Y>(IOSL-4) D PAUSE Q:IBQ  D HDET Q:IBQ | 
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| 166 | ...W ?62,$P(IBX3,U),?94,$E($P($G(^VA(200,+$P(IBX3,U,2),0)),U),1,24) | 
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| 167 | ...W ?120,$$DAT2^IBOUTL($P(IBX3,U,3)),! | 
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| 168 | ...I IBX W ?94,$E($P($G(^VA(200,+$P(IBX3,U,4),0)),U),1,24),?120,$$DAT2^IBOUTL($P(IBX3,U,5)),! | 
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| 169 | .; | 
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| 170 | .I 'IBQ D PAUSE | 
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| 171 | ; | 
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| 172 | I '$D(^TMP("IBJDI52",$J,1)),IBVER S IBX=1 D HDET W !,"All policies within the selected date range have been verified less than a year ago." D PAUSE | 
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| 173 | Q | 
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| 174 | ; | 
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| 175 | HDET ; - Write the detail report header. | 
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| 176 | I $E(IOST,1,2)="C-"!(IBPAG) W @IOF,*13 | 
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| 177 | S IBPAG=IBPAG+1 | 
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| 178 | W !,"Insurance Policies ",$S(IBX:"Verified Over a Year Ago",1:"Not Verified"),?80,"Run Date: ",IBRUN,?123,"Page: ",IBPAG | 
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| 179 | W !,"For Patients treated for the period "_$$DAT1^IBOUTL(IBBDT)_" to "_$$DAT1^IBOUTL(IBEDT)_"  ('*' = Had inpatient care)" | 
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| 180 | I IBX W !?94,"Policy Entered By         Date Entered" | 
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| 181 | W !,"Patient",?33,"SSN",?47,"Date of Death" | 
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| 182 | W ?62,"Insurance Company",?94,"Policy ",$S(IBX:"Verified",1:"Entered")," By",?120,"Date ",$S(IBX:"Verif'd",1:"Entered") | 
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| 183 | W !,$$DASH(132),!! | 
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| 184 | S IBQ=$$STOP^IBOUTL("Insurance Policies Not Verified") | 
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| 185 | Q | 
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| 186 | ; | 
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| 187 | SUM ; - Print the summary report. | 
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| 188 | I $E(IOST,1,2)="C-"!(IBPAG) W @IOF,*13 | 
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| 189 | S IBPAG=IBPAG+1 | 
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| 190 | W !!?$S(IBVER:14,1:24),"INSURANCE POLICIES NOT VERIFIED",$S(IBVER:"/VERIFIED OVER 1 YEAR",1:"") | 
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| 191 | W !?32,"SUMMARY REPORT",!!?17,"For Patients treated from ",$$DAT1^IBOUTL(IBBDT)," - ",$$DAT1^IBOUTL(IBEDT) | 
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| 192 | W !!?24,"Run Date: ",IBRUN,!?24,$$DASH(31),!! | 
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| 193 | ; | 
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| 194 | S IBPER=$S('IB("TOT"):0,1:$J(IB("VER")/IB("TOT")*100,0,2)) | 
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| 195 | W ?24,"Number of Patients Treated:",?53,$J(IB("TOT"),5) | 
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| 196 | W !?23,"Number of Policies Verified:",?53,$J(IB("VER"),5),?62,"(",IBPER,"%)" | 
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| 197 | I IBVER W !?7,"Number of Policies Verified Over a Year Ago:",?53,$J(IB("VERO"),5),?62,"(",$S('IB("VERO"):0,1:$J(IB("VERO")/IB("TOT")*100,0,2)),"%)" | 
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| 198 | W !?19,"Number of Policies Not Verified:",?53,$J(IB("NOT"),5),?62,"(",$S('IB("TOT"):0,1:$J(100-IBPER,0,2)),"%)" | 
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| 199 | Q | 
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| 200 | ; | 
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| 201 | DASH(X) ; - Return a dashed line. | 
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| 202 | Q $TR($J("",X)," ","=") | 
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| 203 | ; | 
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| 204 | PAUSE ; - Page break. | 
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| 205 | I $E(IOST,1,2)'="C-" Q | 
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| 206 | N IBX,DIR,DIRUT,DUOUT,DTOUT,DIROUT,X,Y | 
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| 207 | F IBX=$Y:1:(IOSL-3) W ! | 
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| 208 | S DIR(0)="E" D ^DIR I $D(DIRUT)!($D(DUOUT)) S IBQ=1 | 
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| 209 | Q | 
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| 210 | ; | 
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| 211 | SSN(X) ; - Format the SSN. | 
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| 212 | Q $S(X]"":$E(X,1,3)_"-"_$E(X,4,5)_"-"_$E(X,6,10),1:"") | 
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