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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