| 1 | IBTOSUM1 ;ALB/AAS - CLAIMS TRACKING BILLING INFORMATION PRINT ; 29-OCT-93
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| 2 |  ;;2.0;INTEGRATED BILLING;**23,52,118**;21-MAR-94
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| 3 |  ;
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| 4 | REV ; - Count reviews.
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| 5 |  D CHK^IBTOSUM2 I $G(ZTSTOP) Q
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| 6 |  ;
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| 7 |  ; - Count review for same period.
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| 8 |  S IBDT=IBBDT-.000000001
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| 9 |  F  S IBDT=$O(^IBT(356.2,"B",IBDT)) Q:'IBDT!(IBDT>(IBEDT+.24))  S IBTRC=0 F  S IBTRC=$O(^IBT(356.2,"B",IBDT,IBTRC)) Q:'IBTRC  D RCNT
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| 10 |  ;
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| 11 | RCNT ; - Process each review.
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| 12 |  N IBDAY,IBETYP,IBAC,IBNOD,IBTALL,IBPEND
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| 13 |  S IBTRCD=$G(^IBT(356.2,+IBTRC,0))
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| 14 |  S IBETYP=$G(^IBE(356.11,+$P(IBTRCD,U,4),0))
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| 15 |  I $P(IBETYP,U,2)>65 Q  ; Is a patient/other/ins. verification call.
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| 16 |  I $P(IBETYP,U,2)=60 S IBCNT(81)=IBCNT(81)+1 Q  ; Initial appeals.
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| 17 |  I $P(IBETYP,U,2)=65 S IBCNT(82)=IBCNT(82)+1 Q  ; Subsequent appeals.
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| 18 |  I $P(IBTRCD,U,19)'=10 Q  ; Must be completed to include in report.
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| 19 |  S IBSPEC=$$SPEC(IBTRC),IBBBS=$$BBS(+IBSPEC)
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| 20 |  S IBRATE=$$RATE(IBBBS,+IBTRCD)
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| 21 |  S IBPCNT(IBTRN,+$P(^IBT(356.2,+IBTRC,1),U,5))=""
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| 22 |  S IBCNT(5)=$G(IBCNT(5))+1 ; Count of total reviews done.
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| 23 |  S IBCNT(5,+IBSPEC)=$G(IBCNT(5,+IBSPEC))+1
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| 24 |  S IBAC=+$$ACTION(IBTRC),IBDAY=0
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| 25 |  I IBAC=10 D
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| 26 |  .S IBTALL=+$P($G(^IBT(356.2,IBTRC,1)),U,8) ; Approved all days.
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| 27 |  .S IBCDT=$$CDT^IBTODD1(IBTRN)
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| 28 |  .S IBMAX=$S($D(IBDCNT(IBTRN))#2:IBDCNT(IBTRN),1:$$DAY^IBTUTL3(+IBCDT,$S($P(IBCDT,U,2):$P(IBCDT,U,2),1:IBEDT)))
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| 29 |  .I '$D(IBDCNT(IBTRN))#2 S IBDCNT(IBTRN)=IBMAX
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| 30 |  .I 'IBTALL S IBDAY=$$DAY^IBTUTL3(+$P(IBTRCD,U,12),+$P(IBTRCD,U,13),IBTRN)
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| 31 |  .I IBTALL S IBDAY=$$DAY^IBTUTL3(+IBCDT,$S($P(IBCDT,U,2):$P(IBCDT,U,2),1:DT),IBTRN)
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| 32 |  .I IBDAY>IBMAX S IBDAY=IBMAX
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| 33 |  .S IBDCNT(IBTRN)=IBDCNT(IBTRN)-IBDAY ; Count can't excede total days.
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| 34 |  I IBAC=20 D
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| 35 |  .S IBTALL=+$P($G(^IBT(356.2,IBTRC,1)),U,7) ; Denied all days.
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| 36 |  .S IBCDT=$$CDT^IBTODD1(IBTRN)
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| 37 |  .S IBMAX=$S($D(IBDCNT(IBTRN))#2:IBDCNT(IBTRN),1:$$DAY^IBTUTL3(+IBCDT,$S($P(IBCDT,U,2):$P(IBCDT,U,2),1:IBEDT)))
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| 38 |  .I '$D(IBDCNT(IBTRN))#2 S IBDCNT(IBTRN)=IBMAX
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| 39 |  .I 'IBTALL S IBDAY=$$DAY^IBTUTL3(+$P(IBTRCD,U,15),+$P(IBTRCD,U,16),IBTRN)
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| 40 |  .I IBTALL S IBDAY=$$DAY^IBTUTL3(+IBCDT,$S($P(IBCDT,U,2):$P(IBCDT,U,2),1:DT),IBTRN)
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| 41 |  .I IBDAY>IBMAX S IBDAY=$S(IBMAX<0:0,1:IBMAX)
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| 42 |  .S IBDCNT(IBTRN)=IBDCNT(IBTRN)-IBDAY ; Count can't excede total days.
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| 43 |  S IBCNT(IBAC)=$G(IBCNT(IBAC))+IBDAY,IBCNT(IBAC,+IBSPEC)=$G(IBCNT(IBAC,+IBSPEC))+IBDAY
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| 44 |  S IBCNT(IBAC+1)=$G(IBCNT(IBAC+1))+(IBDAY*IBRATE)
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| 45 |  S IBCNT(IBAC+1,+IBSPEC)=$G(IBCNT(IBAC+1,+IBSPEC))+(IBDAY*IBRATE)
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| 46 |  I IBAC=30 S IBPEN=0 F  S IBPEN=$O(^IBT(356.2,+IBTRC,13,IBPEN)) Q:'IBPEN  S IBPEND=$G(^(IBPEN,0)) D
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| 47 |  .S IBNOD=IBPEND+30,$P(IBCNT(IBNOD),U)=$P(IBCNT(IBNOD),U)+1
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| 48 |  .S $P(IBCNT(IBNOD),U,2)=$P(IBCNT(IBNOD),U,2)+$P(IBPEND,U,2)
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| 49 |  .S $P(IBCNT(IBNOD,+IBSPEC),U)=+$G(IBCNT(IBNOD,+IBSPEC))+1
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| 50 |  .S $P(IBCNT(IBNOD,+IBSPEC),U,2)=$P($G(IBCNT(IBNOD,+IBSPEC)),U,2)+$P(IBPEND,U,2)
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| 51 |  ;
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| 52 |  Q
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| 53 |  ;
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| 54 | ACTION(IBTRC) ; - Compute action code for a review.
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| 55 |  Q $P($G(^IBE(356.7,+$P($G(^IBT(356.2,+$G(IBTRC),0)),U,11),0)),U,3)
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| 56 |  ;
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| 57 | SPEC(IBTRC) ; - Compute treating specialty on review date.
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| 58 |  N VAERR,VAIN,VAINDT,X,Y,I,J,DFN,IBTRN,IBCDT
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| 59 |  S VAINDT=+$G(^IBT(356.2,+IBTRC,0))+.2359,DFN=$P(^(0),U,5)
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| 60 |  S IBTRN=$P($G(^IBT(356.2,+IBTRC,0)),U,2),IBCDT=$$CDT^IBTODD1(IBTRN)
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| 61 |  I VAINDT,+IBCDT,VAINDT<(+IBCDT) S VAINDT=IBCDT+.2359
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| 62 |  I VAINDT,+$P(IBCDT,U,2),VAINDT>$P(IBCDT,U,2) S VAINDT=$P(IBCDT,U,2)\1
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| 63 |  D:DFN INP^VADPT
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| 64 |  Q $G(VAIN(3))
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| 65 |  ;
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| 66 | BBS(IBSPEC) ; - Compute billing bedsection from specialty.
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| 67 |  N X
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| 68 |  S X=$P($G(^DIC(42.4,+$P($G(^DIC(45.7,+$G(IBSPEC),0)),U,2),0)),U,5)
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| 69 |  I X'="" S X=+$$MCCRUTL^IBCRU1(X,5)
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| 70 |  Q X
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| 71 |  ;
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| 72 | RATE(IBBBS,IBDT) ; - Compute daily bed section rate for date.
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| 73 |  N IBAMT,IBCS
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| 74 |  S IBAMT=0 I '$G(IBBBS)!('$G(IBDT)) G RATEQ
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| 75 |  S IBCS=+$$CSN^IBCRU3("TL-INPT (INCLUSIVE)"),IBDT=IBDT\1
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| 76 |  I +IBCS S IBAMT=+$$ITCHG^IBCRCI(IBCS,IBBBS,IBDT)
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| 77 | RATEQ Q IBAMT
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