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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