[613] | 1 | IBJDU1 ;ALB/CPM - UTILIZATION WORKLOAD REPORT ; 24-DEC-96
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| 2 | ;;Version 2.0 ; INTEGRATED BILLING ;**69**; 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 measure of the number of Insurance Reviews"
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| 7 | W !,"which are conducted in the Medical Center.",!
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| 8 | ;
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| 9 | D DATE^IBOUTL I IBBDT=""!(IBEDT="") G ENQ
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| 10 | ;
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| 11 | W !!,"This report only requires an 80 column printer."
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| 12 | ;
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| 13 | W !!," Note: This report may take a while to run."
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| 14 | W !?10,"You should queue this report to run after normal business hours.",!
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| 15 | ;
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| 16 | ; - select a device
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| 17 | S %ZIS="QM" D ^%ZIS G:POP ENQ
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| 18 | I $D(IO("Q")) D G ENQ
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| 19 | .S ZTRTN="DQ^IBJDU1",ZTDESC="IB - UTILIZATION WORKLOAD REPORT"
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| 20 | .F I="IBBDT","IBEDT" S ZTSAVE(I)=""
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| 21 | .D ^%ZTLOAD
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| 22 | .W !!,$S($D(ZTSK):"This job has been queued. The task number is "_ZTSK_".",1:"Unable to queue this job.")
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| 23 | .K ZTSK,IO("Q") D HOME^%ZIS
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| 24 | ;
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| 25 | U IO
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| 26 | ;
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| 27 | DQ ; Tasked entry point.
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| 28 | ;
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| 29 | K IB F I=1:1:10 S IB(I)=0
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| 30 | ;
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| 31 | ; - count admissions within the user-specified date range
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| 32 | S IBDT=IBBDT-.000000001,IBQ=0
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| 33 | F S IBDT=$O(^DGPM("AMV1",IBDT)) Q:'IBDT!(IBDT>(IBEDT+.24)) D Q:IBQ
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| 34 | .S DFN=0 F S DFN=$O(^DGPM("AMV1",IBDT,DFN)) Q:'DFN D Q:IBQ
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| 35 | ..S IBPM=0 F S IBPM=$O(^DGPM("AMV1",IBDT,DFN,IBPM)) Q:'IBPM D Q:IBQ
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| 36 | ...;
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| 37 | ...I IBPM#100=0 S IBQ=$$STOP^IBOUTL("Utilization Workload Report") Q:IBQ
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| 38 | ...;
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| 39 | ...S IB(1)=IB(1)+1 ; total admissions
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| 40 | ...;
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| 41 | ...Q:'$$INSURED^IBCNS1(DFN,IBDT)
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| 42 | ...;
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| 43 | ...S IB(2)=IB(2)+1 ; insured admissions
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| 44 | ...D ELIG^VADPT
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| 45 | ...I VAEL(3) S IB(3)=IB(3)+1 Q ; insured SC admissions
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| 46 | ...S IB(4)=IB(4)+1 ; insured NSC admissions
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| 47 | ;
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| 48 | I IBQ G ENQ
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| 49 | ;
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| 50 | ; - count insurance reviews
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| 51 | K ^TMP("IBJDU1",$J)
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| 52 | S IBDT=IBBDT-.000000001
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| 53 | F S IBDT=$O(^IBT(356.2,"B",IBDT)) Q:'IBDT!(IBDT>(IBEDT+.9)) D Q:IBQ
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| 54 | .S IBTRC=0 F S IBTRC=$O(^IBT(356.2,"B",IBDT,IBTRC)) Q:'IBTRC D Q:IBQ
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| 55 | ..;
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| 56 | ..I IBTRC#100=0 S IBQ=$$STOP^IBOUTL("Utilization Workload Report") Q:IBQ
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| 57 | ..;
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| 58 | ..S IBTRCD=$G(^IBT(356.2,+IBTRC,0)) Q:IBTRCD=""
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| 59 | ..S IBTRN=$P(IBTRCD,"^",2)
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| 60 | ..Q:$P(IBTRCD,"^",19)<10 ; review is not complete
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| 61 | ..Q:'IBTRN ; no corresponding CT entry
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| 62 | ..S IBPM=$P($G(^IBT(356,IBTRN,0)),"^",5)
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| 63 | ..Q:'IBPM ; review not for an admission
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| 64 | ..;
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| 65 | ..; - get contact type
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| 66 | ..S IBRTY=$P($G(^IBE(356.11,+$P(IBTRCD,"^",4),0)),"^",2)
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| 67 | ..;
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| 68 | ..; - appeals
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| 69 | ..I IBRTY=60!(IBRTY=65) D Q
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| 70 | ...I '$D(^TMP("IBJDU1",$J,IBTRN)) S ^(IBTRN)="",IB(10)=IB(10)+1
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| 71 | ..;
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| 72 | ..; - admission reviews
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| 73 | ..I IBRTY=10!(IBRTY=15)!(IBRTY=20) D Q
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| 74 | ...S IB(5)=IB(5)+1
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| 75 | ...;
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| 76 | ...; - count reviews where the entire admission was denied
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| 77 | ...Q:'$P($G(^IBT(356.2,IBTRC,1)),"^",7)
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| 78 | ...;
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| 79 | ...S IB(7)=IB(7)+1
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| 80 | ...S X=$G(^DGPM(IBPM,0)),Y=+$G(^DGPM(+$P(X,"^",17),0))\1
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| 81 | ...S:'Y Y=DT
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| 82 | ...S IB(9)=IB(9)+$$FMDIFF^XLFDT(Y,+X\1)
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| 83 | ..;
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| 84 | ..; - continued stay reviews
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| 85 | ..I IBRTY=30 D
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| 86 | ...S IB(6)=IB(6)+1
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| 87 | ...;
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| 88 | ...; - look at denials
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| 89 | ...Q:$P($G(^IBE(356.7,+$P(IBTRCD,"^",11),1)),"^",3)'=20
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| 90 | ...S IB(8)=IB(8)+1
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| 91 | ...S X=$P(IBTRCD,"^",15),Y=$P(IBTRCD,"^",16) S:'Y Y=X
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| 92 | ...I X S IB(9)=IB(9)+$$FMDIFF^XLFDT(Y,X)+1
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| 93 | ;
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| 94 | I IBQ G ENQ
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| 95 | ;
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| 96 | ; - print the reports
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| 97 | S (IBPAG,IBQ)=0 D NOW^%DTC S IBRUN=$$DAT2^IBOUTL(%)
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| 98 | D SUM
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| 99 | ;
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| 100 | ENQ K ^TMP("IBJDU1",$J)
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| 101 | I $D(ZTQUEUED) S ZTREQ="@" G ENQ1
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| 102 | ;
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| 103 | D ^%ZISC
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| 104 | ENQ1 K IB,IBQ,IBBDT,IBEDT,IBDT,IBPM,IBPAG,IBRUN,IBTRC,IBTRCD,IBTRN,IBRTY
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| 105 | K %,%ZIS,DFN,IBPERI,IBPERS,POP,X,Y,VA,VAERR,VAEL,ZTDESC,ZTRTN,ZTSAVE
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| 106 | Q
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| 107 | ;
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| 108 | ;
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| 109 | ;
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| 110 | SUM ; Print the Summary Report.
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| 111 | I $E(IOST,1,2)="C-" W @IOF,*13
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| 112 | ;
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| 113 | ; - print overall summary header
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| 114 | W !!?30,"UTILIZATION WORKLOAD"
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| 115 | W !?33,"SUMMARY REPORT"
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| 116 | W !!?22,"For Reviews from ",$$DAT1^IBOUTL(IBBDT)," - ",$$DAT1^IBOUTL(IBEDT)
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| 117 | W !!?24,"Run Date: ",IBRUN
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| 118 | W !?24,$$DASH(31),!!
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| 119 | ;
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| 120 | ; - print overall summary statistics
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| 121 | S IBPERI=$S('IB(1):0,1:$J(IB(2)/IB(1)*100,0,2))
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| 122 | S IBPERS=$S('IB(2):0,1:$J(IB(3)/IB(2)*100,0,2))
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| 123 | W ?21,"Total Number of Admissions:",?60,$J(IB(1),7)
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| 124 | W !?6,"Total Number of Admissions with Insurance:",?60,$J(IB(2),7)," (",IBPERI,"%)"
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| 125 | W !?39,"SC:",?60,$J(IB(3),7)," (",IBPERS,"%)"
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| 126 | W !?38,"NSC:",?60,$J(IB(4),7)," (",$J(100-IBPERS,0,2),"%)"
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| 127 | ;
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| 128 | W !!?7,"Total Number of Admission Reviews completed"
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| 129 | W !?9,"on Insurance Patients (including pre-certifications):",?65,$J(IB(5),7)
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| 130 | W !?13,"Total Number of Continued Stay Reviews completed:",?65,$J(IB(6),7)
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| 131 | W !?5,"Total Number of Admission Denials by Insurance Companies:",?65,$J(IB(7),7)
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| 132 | W !,"Total Number of Continued Stay Denials by Insurance Companies:",?65,$J(IB(8),7)
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| 133 | W !?11,"Total Number of days denied by Insurance Companies:",?65,$J(IB(9),7)
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| 134 | W !?31,"Total Number of Appealed Cases:",?65,$J(IB(10),7)
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| 135 | ;
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| 136 | D PAUSE
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| 137 | Q
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| 138 | ;
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| 139 | DASH(X) ; Return a dashed line.
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| 140 | Q $TR($J("",X)," ","=")
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| 141 | ;
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| 142 | PAUSE ; Page break
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| 143 | Q:$E(IOST,1,2)'="C-"
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| 144 | N IBX,DIR,DIRUT,DUOUT,DTOUT,DIROUT,X,Y
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| 145 | F IBX=$Y:1:(IOSL-3) W !
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| 146 | S DIR(0)="E" D ^DIR I $D(DIRUT)!($D(DUOUT)) S IBQ=1
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| 147 | Q
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