| [613] | 1 | IBTOBI2 ;ALB/AAS - CLAIMS TRACKING BILLING INFORMATION PRINT ;27-OCT-93
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| 2 | ;;2.0;INTEGRATED BILLING;**210**;21-MAR-94
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| 3 | ;
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| 4 | IR ; -- print insurance review information
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| 5 | Q:'$O(^IBT(356.2,"C",+IBTRN,0)) ; -no reivews
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| 6 | I ($Y+11)>IOSL D HDR^IBTOBI Q:IBQUIT
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| 7 | W !," Insurance Review Information "
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| 8 | N I,J,IBII,IBTRC,IBTRCD,IBACTION,TCODE
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| 9 | S IBII="" F S IBII=$O(^IBT(356.2,"ATIDT",IBTRN,IBII)) Q:'IBII!(IBQUIT) S IBTRC=0 F S IBTRC=$O(^IBT(356.2,"ATIDT",IBTRN,IBII,IBTRC)) Q:'IBTRC!(IBQUIT) D
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| 10 | .N IBJ,IBD
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| 11 | .D IR1
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| 12 | .D IR2
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| 13 | .S IBJ=0 F S IBJ=$O(IBD(IBJ)) Q:'IBJ W !,$E($G(IBD(IBJ,1)),1,39),?40,$E($G(IBD(IBJ,2)),1,39)
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| 14 | .D COMM2(IBTRC) Q:IBQUIT
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| 15 | .W !?30,"-----------------------------------"
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| 16 | .I ($Y+11)>IOSL D HDR^IBTOBI Q:IBQUIT
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| 17 | W:'IBQUIT !?4,$TR($J(" ",IOM-8)," ","-"),!
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| 18 | Q
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| 19 | ;
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| 20 | IR1 ; -- print one review
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| 21 | S IBTRCD=$G(^IBT(356.2,+IBTRC,0)),IBTRCD1=$G(^(1))
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| 22 | S IBD(1,1)=" Type Review: "_$$EXPAND^IBTRE(356.2,.04,$P(IBTRCD,"^",4))
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| 23 | S TCODE=$$TCODE^IBTRC(IBTRC) I TCODE D @TCODE
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| 24 | Q
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| 25 | 10 ; -- pre-cert contact
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| 26 | 15 ; -- admission review
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| 27 | 20 ; -- urgent/emergent ins. contact
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| 28 | 30 ; -- continued stay contact
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| 29 | S IBD(2,1)=" Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11))
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| 30 | S IBACTION=$P($G(^IBE(356.7,+$P(IBTRCD,"^",11),0)),"^",3)
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| 31 | S IBACTION=IBACTION+100 D @IBACTION
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| 32 | Q
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| 33 | ;
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| 34 | 40 ; -- Discharge contact
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| 35 | 100 ; -- No type of action
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| 36 | Q
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| 37 | 50 ; -- outpatient treatment
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| 38 | S IBD(2,1)=" Opt Treatment: "_$$EXPAND^IBTRE(356.2,.26,$P(IBTRCD,"^",26))
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| 39 | S IBD(3,1)=" Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11))
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| 40 | S IBD(4,1)=" Auth. Number: "_$P(IBTRCD,"^",28)
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| 41 | Q
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| 42 | 60 ; -- Appeal
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| 43 | 65 ; -- Nth appeal
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| 44 | S IBD(2,1)=" Appeal Type: "_$$EXPAND^IBTRE(356.2,.23,$P(IBTRCD,"^",23))
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| 45 | S IBD(3,1)=" Case Status: "_$$EXPAND^IBTRE(356.2,.1,$P(IBTRCD,"^",10))
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| 46 | S IBD(4,1)="No Days Pending: "_$$EXPAND^IBTRE(356.2,.25,$P(IBTRCD,"^",25))
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| 47 | S IBD(5,1)=" Final Outcome: "_$$EXPAND^IBTRE(356.2,.29,$P(IBTRCD,"^",29))
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| 48 | Q
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| 49 | 70 ; -- Patient
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| 50 | 80 ; -- Other
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| 51 | 85 ; -- Insurance verification
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| 52 | 90 ;
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| 53 | Q
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| 54 | ;
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| 55 | 110 ; -- approval actions
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| 56 | S IBD(3,1)="Authorized From: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",12)))
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| 57 | S IBD(4,1)=" Authorized To: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",13)))
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| 58 | S IBD(5,1)="Authorized Diag: "_$$DIAG^IBTRE6($P(IBTRCD,"^",14),1,$$TRNDATE^IBACSV($G(IBTRN)))
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| 59 | S IBD(6,1)=" Auth. Number: "_$P(IBTRCD,"^",28)
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| 60 | Q
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| 61 | 120 ; -- denial actions
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| 62 | S IBD(3,1)=" Denied From: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",15)))
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| 63 | S IBD(4,1)=" Denied To: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",16)))
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| 64 | S IBI=0,IBD=4 F S IBI=$O(^IBT(356.2,IBTRC,12,IBI)) Q:'IBI D
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| 65 | .S IBD=IBD+1
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| 66 | .S IBD(IBD,1)=" Denial Reasons: "_$$EXPAND^IBTRE(356.212,.01,+$G(^IBT(356.2,IBTRC,12,IBI,0)))
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| 67 | Q
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| 68 | 130 ; -- penalty
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| 69 | S IBI=0,IBD=2 F S IBI=$O(^IBT(356.2,IBTRC,13,IBI)) Q:'IBI D
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| 70 | .S IBD=IBD+1
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| 71 | .S IBD(IBD,1)=" Penalty: "_$$EXPAND^IBTRE(356.213,.01,+$G(^IBT(356.2,IBTRC,13,IBI,0)))
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| 72 | Q
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| 73 | 140 ; -- case pending
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| 74 | S IBD(3,1)=" Case Pending: "_$$EXPAND^IBTRE(356.2,.2,$P(IBTRCD,"^",20))
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| 75 | Q
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| 76 | 150 ; -- no coverage
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| 77 | S IBD(3,1)=" No Coverage: "_$$EXPAND^IBTRE(356.2,.21,$P(IBTRCD,"^",21))
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| 78 | Q
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| 79 | ;
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| 80 | IR2 ; -- contact information
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| 81 | ;N IBCDFN,IBCPOL
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| 82 | ;S IBCDFN=$P(IBTRCD1,"^",5),IBCPOL=$P(^DPT(DFN,.312,IBCDFN,0),"^",18)
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| 83 | S IBD(1,2)=" Review Date: "_$E($$DAT1^IBOUTL(+IBTRCD,"2P"),1,20)
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| 84 | S IBD(2,2)=" Insurance Co.: "_$E($P($G(^DIC(36,+$G(^DPT(DFN,.312,+$P(IBTRCD1,"^",5),0)),0)),"^"),1,20)
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| 85 | S IBD(3,2)="Person Contacted: "_$E($P(IBTRCD,"^",6),1,20)
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| 86 | S IBD(4,2)=" Contact Method: "_$E($$EXPAND^IBTRE(356.2,.17,$P(IBTRCD,"^",17)),1,20)
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| 87 | S IBD(5,2)="Call Ref. Number: "_$E($P(IBTRCD,"^",9),1,20)
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| 88 | S IBD(6,2)=" Status: "_$E($$EXPAND^IBTRE(356.2,.19,$P(IBTRCD,"^",19)),1,20)
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| 89 | S IBD(7,2)=" Last Edited By: "_$E($$EXPAND^IBTRE(356.2,1.04,$P($G(^IBT(356.2,+$G(IBTRC),1)),"^",4)),1,20)
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| 90 | I '$P(IBTRCD,"^",2) S IBD(2,2)="Patient Contacted: "_$E($P($G(^DPT(+$P(IBTRCD,"^",5),0)),"^"),1,20)
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| 91 | Q
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| 92 | ;
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| 93 | COMM2(DA) ; -- print comments from ins. reviews.
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| 94 | W !,"Comment: "
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| 95 | Q:'$D(^IBT(356.2,DA,11))
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| 96 | K ^UTILITY($J,"W")
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| 97 | S DIWL=10,DIWR=IOM-12,DIWF="W"
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| 98 | S IBJ=0 F S IBJ=$O(^IBT(356.2,DA,11,IBJ)) Q:'IBJ S X=^(IBJ,0) D ^DIWP I IOSL<($Y+4) Q:IBQUIT D HDR^IBTOBI
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| 99 | Q:IBQUIT
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| 100 | D ^DIWW
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| 101 | K ^UTILITY($J,"W")
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| 102 | Q
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