| 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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