| 1 | IBJDI6 ;ALB/CPM - SC VETS W/ NSC EPISODES OF INPT CARE ; 18-DEC-96
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| 2 |  ;;2.0;INTEGRATED BILLING;**69,83,98,100**;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 NSC inpatient episodes for SC veterans"
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| 7 |  W !,"which have and have not been billed.",!
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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 |  W !!,"This report only requires an 80 column printer."
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| 15 |  ;
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| 16 |  W !!,"Note: This report may take a while to run."
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| 17 |  W !?6,"You should queue this report to run after normal business hours.",!
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| 18 |  ;
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| 19 |  ; - Select a device.
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| 20 |  S %ZIS="QM" D ^%ZIS G:POP ENQ
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| 21 |  I $D(IO("Q")) D  G ENQ
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| 22 |  .S ZTRTN="DQ^IBJDI6",ZTDESC="IB - SC VETS W/ NSC EPISODES"
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| 23 |  .F I="IBBDT","IBEDT","IBRPT" S ZTSAVE(I)=""
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| 24 |  .D ^%ZTLOAD
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| 25 |  .W !!,$S($D(ZTSK):"This job has been queued. The task number is "_ZTSK_".",1:"Unable to queue this job.")
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| 26 |  .K ZTSK,IO("Q") D HOME^%ZIS
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| 27 |  ;
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| 28 |  U IO
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| 29 |  ;
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| 30 | DQ ; - Tasked entry point.
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| 31 |  ;
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| 32 |  I $G(IBXTRACT) D E^IBJDE(6,1) ; Change extract status.
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| 33 |  ;
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| 34 |  K IB,^TMP("IBJDI6",$J)
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| 35 |  S IBQ=0 F X="NSC","NSCB","NSCR","NSCU","SC","TOT" S IB(X)=0
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| 36 |  F X=0:1:3 S IB("NSCU",X)=0
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| 37 |  ;
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| 38 |  ; - Find data required for the report.
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| 39 |  S IBD=IBBDT-.01 F  S IBD=$O(^DGPM("ATT3",IBD)) Q:'IBD!(IBD\1>IBEDT)  D  Q:IBQ
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| 40 |  .S IBPM=0 F  S IBPM=$O(^DGPM("ATT3",IBD,IBPM)) Q:'IBPM  D  Q:IBQ
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| 41 |  ..I IBPM#100=0 S IBQ=$$STOP^IBOUTL("SC Vets w/NSC Episodes") Q:IBQ
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| 42 |  ..S IBPMD=$G(^DGPM(IBPM,0)) Q:'IBPMD
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| 43 |  ..S DFN=+$P(IBPMD,U,3) Q:'DFN
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| 44 |  ..I $$TESTP^IBJDI1(DFN) Q  ; Test patient.
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| 45 |  ..S IBDIS=+IBPMD\1
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| 46 |  ..;
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| 47 |  ..; - Patient must be insured, and SC.
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| 48 |  ..I '$$INSURED^IBCNS1(DFN,IBDIS) Q
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| 49 |  ..D ELIG^VADPT Q:'VAEL(3)
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| 50 |  ..;
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| 51 |  ..; - Set 'totals' accumulator.
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| 52 |  ..S IB("TOT")=IB("TOT")+1
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| 53 |  ..;
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| 54 |  ..; - See if associated PTF record has NSC movements.
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| 55 |  ..S IBADMD=$G(^DGPM(+$P(IBPMD,U,14),0))
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| 56 |  ..S IBPTF=+$P(IBADMD,U,16),IBSTAT=$P($G(^DGPT(IBPTF,0)),U,6)
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| 57 |  ..I '$$PTF(IBPTF) S IB("SC")=IB("SC")+1 Q
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| 58 |  ..S IB("NSC")=IB("NSC")+1
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| 59 |  ..;
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| 60 |  ..; - See if there is a claim for the NSC episode.
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| 61 |  ..S IBADM=+IBADMD\1
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| 62 |  ..I $$BILL(IBPTF,DFN,IBADM,IBDIS) S IB("NSCB")=IB("NSCB")+1 Q
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| 63 |  ..;
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| 64 |  ..; - Has episode been flagged as non-billable?
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| 65 |  ..S IBCT=$O(^IBT(356,"AD",+$P(IBPMD,U,14),0))
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| 66 |  ..I IBCT,$P($G(^IBT(356,IBCT,0)),U,19) S IB("NSCR")=IB("NSCR")+1 Q
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| 67 |  ..;
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| 68 |  ..S IB("NSCU")=IB("NSCU")+1
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| 69 |  ..S IB("NSCU",IBSTAT)=IB("NSCU",IBSTAT)+1
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| 70 |  ..I IBRPT="D" D
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| 71 |  ...S X=$G(^DPT(DFN,0))
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| 72 |  ...S ^TMP("IBJDI6",$J,$P(X,U)_"@@"_DFN)=$P(X,U,9)
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| 73 |  ...S ^TMP("IBJDI6",$J,$P(X,U)_"@@"_DFN,IBADM)=$S(IBSTAT=0:"OPEN",IBSTAT=1:"CLOSED",IBSTAT=2:"RELEASED",1:"TRANSMITTED")_U_IBDIS
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| 74 |  ;
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| 75 |  I IBQ G ENQ
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| 76 |  ;
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| 77 |  I $G(IBXTRACT) D E^IBJDE(6,0) G ENQ ; Extract summary data.
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| 78 |  ;
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| 79 |  ; - Print the reports.
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| 80 |  S (IBPAG,IBQ)=0 D NOW^%DTC S IBRUN=$$DAT2^IBOUTL(%)
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| 81 |  I IBRPT="D" D DET
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| 82 |  I 'IBQ D SUM
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| 83 |  ;
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| 84 |  I 'IBQ D PAUSE
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| 85 |  ;
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| 86 | ENQ K ^TMP("IBJDI6",$J)
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| 87 |  I $D(ZTQUEUED) S ZTREQ="@" G ENQ1
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| 88 |  ;
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| 89 |  D ^%ZISC
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| 90 | ENQ1 K IB,IBQ,IBBDT,IBEDT,IBRPT,IBD,IBDN,IBPAG,IBRUN,IBX,IBX1,IBX2
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| 91 |  K IBADM,IBDIS,IBCT,IBH,IBPER,IBPM,IBPMD,IBPMDT,IBPTF,IBSTAT,IBADMD
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| 92 |  K %,%ZIS,DFN,POP,VA,VAERR,VAEL,X,Y,ZTDESC,ZTRTN,ZTSAVE
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| 93 |  Q
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| 94 |  ;
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| 95 | DET ; - Print the detailed report.
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| 96 |  D HDET Q:IBQ
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| 97 |  I '$D(^TMP("IBJDI6",$J)) D  G DETQ
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| 98 |  .I IB("NSC") W !!,"All NSC episodes for SC veterans in the selected date range have been billed." Q
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| 99 |  .W !!,"There were no NSC episodes found in the selected date range."
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| 100 |  ;
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| 101 |  S IBX="" F  S IBX=$O(^TMP("IBJDI6",$J,IBX)) Q:IBX=""  S IBX1=^(IBX) D  Q:IBQ
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| 102 |  .S (IBH,IBADM)=0 F  S IBADM=$O(^TMP("IBJDI6",$J,IBX,IBADM)) Q:'IBADM  S IBX2=^(IBADM) D  Q:IBQ
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| 103 |  ..I $Y>(IOSL-2) D PAUSE Q:IBQ  D HDET Q:IBQ  S IBH=0
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| 104 |  ..W ! I 'IBH D PAT S IBH=1
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| 105 |  ..W ?46,$P(IBX2,U),?59,$$DAT1^IBOUTL(IBADM),?69,$$DAT1^IBOUTL($P(IBX2,U,2))
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| 106 |  ;
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| 107 | DETQ I 'IBQ D PAUSE
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| 108 |  Q
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| 109 |  ;
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| 110 | PAT ; - Write the patient information.
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| 111 |  W $P(IBX,"@@"),?32,$$SSN(IBX1)
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| 112 |  Q
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| 113 |  ;
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| 114 | HDET ; - Write the detail report header.
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| 115 |  I $E(IOST,1,2)="C-"!(IBPAG) W @IOF,*13
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| 116 |  S IBPAG=IBPAG+1
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| 117 |  W !,"Insured SC Vets w/ Unbilled NSC Care",?38,"Run Date: ",IBRUN,?70,"Page: ",IBPAG
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| 118 |  W !,"For Patients discharged in the period "_$$DAT1^IBOUTL(IBBDT)_" to "_$$DAT1^IBOUTL(IBEDT)
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| 119 |  W !,"Patient",?32,"SSN",?46,"PTF Status",?59,"Adm Date",?69,"Disc Date"
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| 120 |  W !,$$DASH(80)
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| 121 |  S IBQ=$$STOP^IBOUTL("SC Vets w/NSC Episodes")
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| 122 |  Q
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| 123 |  ;
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| 124 | SUM ; - Print the summary report.
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| 125 |  I $E(IOST,1,2)="C-"!(IBPAG) W @IOF,*13
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| 126 |  S IBPAG=IBPAG+1
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| 127 |  W !!?13,"INSURED SC VETERANS W/ UNBILLED NSC INPATIENT EPISODES"
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| 128 |  W !?33,"SUMMARY REPORT"
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| 129 |  W !!?16,"For Patients discharged from ",$$DAT1^IBOUTL(IBBDT)," - ",$$DAT1^IBOUTL(IBEDT)
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| 130 |  W !!?24,"Run Date: ",IBRUN,!?24,$$DASH(31),!!
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| 131 |  ;
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| 132 |  S IBPER(1)=$S('IB("TOT"):0,1:$J(IB("SC")/IB("TOT")*100,0,2))
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| 133 |  S IBPER(2)=$S('IB("NSC"):0,1:$J(IB("NSCB")/IB("NSC")*100,0,2))
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| 134 |  S IBPER(3)=$S('IB("NSC"):0,1:$J(IB("NSCR")/IB("NSC")*100,0,2))
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| 135 |  W ?9,"Number of Discharges of Insured SC Veterans:",?54,$J(IB("TOT"),4)
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| 136 |  W !?5,"Discharges Which were totally Service-Connected:",?54,$J(IB("SC"),4),?62,"(",IBPER(1),"%)"
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| 137 |  W !,"Discharges Which included Non-Service Connected Care:",?54,$J(IB("NSC"),4),?62,"(",$J($S('IB("TOT"):0,1:100-IBPER(1)),0,2),"%)"
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| 138 |  W !?10,"Number of NSC Discharges Which were Billed:",?54,$J(IB("NSCB"),4),?62,"(",IBPER(2),"%)"
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| 139 |  W !?4,"Number of NSC Discharges Flagged as Non-Billable:",?54,$J(IB("NSCR"),4),?62,"(",IBPER(3),"%)"
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| 140 |  W !?19,"Number of Unbilled NSC Discharges:",?54,$J(IB("NSCU"),4),?62,"(",$J($S('IB("NSC"):0,1:100-IBPER(2)-IBPER(3)),0,2),"%)",!?54,"----"
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| 141 |  F X=0:1:3 D
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| 142 |  .I X=0 W !,"Unbilled NSC Discharges w/ PTF Status of"
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| 143 |  .W ?41,$S(X=0:"Open",X=1:"Closed",X=2:"Released",1:"Transmitted"),":",?54,$J(IB("NSCU",X),4),?62,"(",$J($S('IB("NSCU",X):0,1:IB("NSCU",X)/IB("NSCU")*100),0,2),"%)",!
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| 144 |  Q
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| 145 |  ;
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| 146 | DASH(X) ; - Return a dashed line.
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| 147 |  Q $TR($J("",X)," ","=")
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| 148 |  ;
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| 149 | PAUSE ; - Page break.
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| 150 |  I $E(IOST,1,2)'="C-" Q
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| 151 |  N IBX,DIR,DIRUT,DUOUT,DTOUT,DIROUT,X,Y
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| 152 |  F IBX=$Y:1:(IOSL-3) W !
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| 153 |  S DIR(0)="E" D ^DIR I $D(DIRUT)!($D(DUOUT)) S IBQ=1
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| 154 |  Q
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| 155 |  ;
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| 156 | SSN(X) ; - Format the SSN.
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| 157 |  Q $S(X]"":$E(X,1,3)_"-"_$E(X,4,5)_"-"_$E(X,6,10),1:"")
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| 158 |  ;
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| 159 | PTF(IBPTF) ; - Does the PTF record have an NSC-related movement?
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| 160 |  ;  Input: IBPTF = Pointer to the PTF record in file #45
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| 161 |  ; Output: IBNSC = 1 (NSC movement) or 0 (No NSC movement)
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| 162 |  ;
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| 163 |  N IBNSC,X,Y
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| 164 |  S (IBNSC,X)=0
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| 165 |  I '$G(IBPTF) G PTFQ
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| 166 |  ;
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| 167 |  ; - Check PTF movements for a movement not related to SC care.
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| 168 |  F  S X=$O(^DGPT(IBPTF,"M",X)) Q:'X  S Y=$P($G(^(X,0)),U,18) I Y'=1 S IBNSC=1 Q
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| 169 |  ;
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| 170 | PTFQ Q IBNSC
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| 171 |  ;
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| 172 | BILL(IBPTF,DFN,IBADM,IBDIS) ; - Has this episode of care been billed?
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| 173 |  ;  Input: IBPTF = Pointer to the PTF record in file #45
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| 174 |  ;           DFN = Pointer to the patient in file #2
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| 175 |  ;         IBADM = Episode admission date
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| 176 |  ;         IBDIS = Episode discharge date
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| 177 |  ; Output:  BILL = 1 (Episode has been billed)
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| 178 |  ;                 0 (Episode has not been billed)
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| 179 |  ;
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| 180 |  N BILL,X,X1,XU,Y
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| 181 |  S BILL=0
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| 182 |  ;
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| 183 |  ; - See if there is a claim based on the PTF record.
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| 184 |  I $G(IBPTF) D  G:BILL BILLQ
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| 185 |  .S X=0 F  S X=$O(^DGCR(399,"APTF",IBPTF,X)) Q:'X  S Y=$P($G(^DGCR(399,X,0)),U,13) I Y,Y<7 S BILL=1 Q
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| 186 |  ;
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| 187 |  ; - Check other inpatient bills for care provided in the adm/dis period.
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| 188 |  S X=0 F  S X=$O(^DGCR(399,"C",+$G(DFN),X)) Q:'X  D  Q:BILL
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| 189 |  .S X1=$G(^DGCR(399,X,0)),XU=$G(^("U")) Q:X1=""
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| 190 |  .I $P(X1,U,5)>2 Q  ;                     Outpatient care.
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| 191 |  .I $P(X1,U,13)=7 Q  ;                    Bill is cancelled.
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| 192 |  .I +XU\1<IBADM!($P(XU,U,2)\1>IBEDT) Q  ; Care outside of range.
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| 193 |  .S BILL=1
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| 194 |  ;
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| 195 | BILLQ Q BILL
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