[613] | 1 | IBTOUR2 ;ALB/AAS - CLAIMS TRACKING UR/ACTIVITY REPORT ; 27-OCT-93
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| 2 | ;;Version 2.0 ; INTEGRATED BILLING ;**45**; 21-MAR-94
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| 3 | ;
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| 4 | % ;
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| 5 | ; -- insurance: ^tmp($j,"ibtour", $s(pt. name/specialty/review date) ,pt. name,sort3,ibtrc)=^ibt(ibtrc,0)
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| 6 | ; ^tmp($j,"ibtour0,ibtrn)=ibtrn (case list)
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| 7 | ; ^tmp($j,"ibtour1",specialty)=days approved ^ days denied ^ $approved ^ $denied
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| 8 | ;
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| 9 | ; -- hospital: ^tmp($j,"ibtour3",$s...
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| 10 | ; ^tmp($j,"ibtour2",specialty)= adm. met ^ adm not met ^ days met ^ days not met
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| 11 | ; ^tmp($j,"ibtour4",ibtrn)=ibtrn (case list)
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| 12 | ;
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| 13 | ;
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| 14 | IREV ; -- count and sort reviews
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| 15 | N IBDT,J
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| 16 | S IBDT=IBBDT-.00001
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| 17 | F S IBDT=$O(^IBT(356.2,"B",IBDT)) Q:'IBDT!(IBDT>(IBEDT+.9))!(IBQUIT) D
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| 18 | .S IBTRC=0 F S IBTRC=$O(^IBT(356.2,"B",IBDT,IBTRC)) Q:'IBTRC!(IBQUIT) D
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| 19 | ..S IBTRCD=$G(^IBT(356.2,+IBTRC,0)) Q:IBTRCD=""
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| 20 | ..S IBTRN=$P(IBTRCD,"^",2)
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| 21 | ..Q:$P(IBTRCD,"^",19)<10
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| 22 | ..D SET
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| 23 | Q
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| 24 | ;
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| 25 | SET ; -- set utility array
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| 26 | Q:'$G(IBTRN)
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| 27 | N DFN,SORT1,SORT2,SORT3,IBSPEC,IBBBS,RATE,IBAC,IBDAY,IBDA,IBDD,IBCDT
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| 28 | S DFN=+$P(IBTRCD,"^",5) Q:'DFN
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| 29 | ;
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| 30 | S IBSPEC=$$SPEC^IBTOSUM1(IBTRC)
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| 31 | S IBBBS=$$BBS^IBTOSUM1(+IBSPEC)
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| 32 | S RATE=$$RATE^IBTOSUM1(IBBBS,+IBTRCD)
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| 33 | S IBAC=$$ACTION^IBTOSUM1(IBTRC)
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| 34 | S IBSPEC=$P(IBSPEC,"^",2) S:IBSPEC="" IBSPEC="Unknown"
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| 35 | ;
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| 36 | I $P(^IBT(356,+$P(IBTRCD,"^",2),0),"^",4) S IBSPEC="OUTPATIENT VISIT",RATE=178
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| 37 | ;
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| 38 | I $P(^IBT(356,+$P(IBTRCD,"^",2),0),"^",8) S IBSPEC="PRESCRIPTION",RATE=20
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| 39 | I $P(^IBT(356,+$P(IBTRCD,"^",2),0),"^",9) S IBSPEC="PROSTHETICS",RATE=0
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| 40 | ;
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| 41 | S SORT3=$P($G(^DPT(DFN,0)),"^")
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| 42 | I IBHOW="P" S (SORT1,SORT2)=SORT3
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| 43 | I IBHOW="S" S SORT1=IBSPEC,SORT2=SORT3
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| 44 | I IBHOW="R" S SORT1=$P($G(^VA(200,+$P($G(^IBT(356.2,+IBTRC,1)),"^",4),0)),"^"),SORT2=$P($G(^IBE(356.11,+$P(IBTRCD,"^",4),0)),"^")
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| 45 | S:SORT1="" SORT1="Unknown"
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| 46 | S:SORT2="" SORT2="Unknown"
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| 47 | S:SORT3="" SORT2="Unknown"
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| 48 | S ^TMP($J,"IBTOUR",SORT1,SORT2,SORT3,IBTRC)=IBTRCD
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| 49 | ;
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| 50 | S IBDAY=""
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| 51 | ;I $P(^IBT(356,IBTRN,0),"^",5),$P(^IBT(356.2,+IBTRC,1),"^",7) S IBCDT=$$CDT^IBTODD1(IBTRN),IBDAY=$$DAY^IBTUTL3(+IBCDT,$S(+$P(IBCDT,"^",2):$P(IBCDT,"^",2),1:DT),IBTRN)
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| 52 | ; -- replace the above line with the following line to add in admissions
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| 53 | ; approved for the entire stay to report
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| 54 | I $P(^IBT(356,IBTRN,0),"^",5),($P(^IBT(356.2,+IBTRC,1),"^",7)!($P(^(1),"^",8))) S IBCDT=$$CDT^IBTODD1(IBTRN),IBDAY=$$DAY^IBTUTL3(+IBCDT,$S(+$P(IBCDT,"^",2):$P(IBCDT,"^",2),1:DT),IBTRN)
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| 55 | ;
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| 56 | I IBAC=10,'IBDAY S IBDAY=$$DAY^IBTUTL3(+$P(IBTRCD,"^",12),+$P(IBTRCD,"^",13),IBTRN)
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| 57 | I IBAC=20,'IBDAY S IBDAY=$$DAY^IBTUTL3(+$P(IBTRCD,"^",15),+$P(IBTRCD,"^",16),IBTRN)
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| 58 | I 'IBDAY,$P(^IBT(356,IBTRN,0),"^",4) S IBDAY=1 ;opt encounter =1 day
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| 59 | S IBDA=$S(IBAC=10:IBDAY,1:0)
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| 60 | S IBDD=$S(IBAC=20:IBDAY,1:0)
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| 61 | S ^TMP($J,"IBTOUR0",+IBTRN)=IBTRN
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| 62 | ;
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| 63 | I $P(^IBT(356,+IBTRN,0),"^",5),IBSPEC'="Unknown" D
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| 64 | .I '$D(^TMP($J,"IBTOUR1",IBSPEC)) S ^TMP($J,"IBTOUR1",IBSPEC)="0^0^0^0^"
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| 65 | .S X=$G(^TMP($J,"IBTOUR1",IBSPEC))
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| 66 | .S ^TMP($J,"IBTOUR1",IBSPEC)=($P(X,"^")+IBDA)_"^"_($P(X,"^",2)+IBDD)_"^"_($P(X,"^",3)+(IBDA*RATE))_"^"_($P(X,"^",4)+(IBDD*RATE))
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| 67 | Q
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| 68 | ;
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| 69 | HREV ; -- count and sort reviews
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| 70 | N IBDT,J
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| 71 | S IBDT=IBBDT-.00001
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| 72 | F S IBDT=$O(^IBT(356.1,"B",IBDT)) Q:'IBDT!(IBDT>(IBEDT+.9))!(IBQUIT) D
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| 73 | .S IBTRV=0 F S IBTRV=$O(^IBT(356.1,"B",IBDT,IBTRV)) Q:'IBTRV!(IBQUIT) D
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| 74 | ..S IBTRVD=$G(^IBT(356.1,+IBTRV,0)) Q:IBTRVD=""
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| 75 | ..S IBTRN=$P(IBTRVD,"^",2)
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| 76 | ..I $P(IBTRVD,"^",21)=10 D HSET
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| 77 | Q
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| 78 | ;
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| 79 | HSET ; -- set up review cases
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| 80 | S ^TMP($J,"IBTOUR4",IBTRN)=IBTRN
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| 81 | Q
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| 82 | ;
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| 83 | HSET1 ; -- build by specialy report for hosp. reviews.
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| 84 | I $G(IBSPEC)="" D
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| 85 | .N VAIN,DFN
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| 86 | .S DFN=$P(^IBT(356,IBTRN,0),"^",2)
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| 87 | .S VAINDT=$P(^IBT(356,IBTRN,0),"^",6)\1+.2359 D INP^VADPT S IBSPEC=$P(VAIN(3),"^",2)
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| 88 | .I $G(IBSPEC)="" S IBSPEC="Unknown"
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| 89 | I '$D(^TMP($J,"IBTOUR2",IBSPEC)) S ^TMP($J,"IBTOUR2",IBSPEC)="0^0^0^0^"
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| 90 | S X=$G(^TMP($J,"IBTOUR2",IBSPEC))
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| 91 | S ^TMP($J,"IBTOUR2",IBSPEC)=($P(X,"^")+IBP1)_"^"_($P(X,"^",2)+IBP2)_"^"_($P(X,"^",3)+IBP3)_"^"_($P(X,"^",4)+IBP4)
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| 92 | Q
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| 93 | ;
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| 94 | HSET2 ; -- set utility array
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| 95 | N DFN,SORT1,SORT2,SORT3
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| 96 | S DFN=+$P(IBTRND,"^",2) Q:'DFN
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| 97 | ;
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| 98 | S SORT3=$P($G(^DPT(DFN,0)),"^")
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| 99 | I IBHOW="P" S (SORT1,SORT2)=SORT3
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| 100 | I IBHOW="S" S SORT1=IBSPEC,SORT2=SORT3
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| 101 | I IBHOW="R" S SORT1=$P($G(^VA(200,+$P($G(^IBT(356,+IBTRN,1)),"^",5),0)),"^"),SORT2=$P($G(^IBE(356.11,+$P(IBTRVD,"^",22),0)),"^")
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| 102 | S:SORT1="" SORT1="Unknown"
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| 103 | S:SORT2="" SORT2="Unknown"
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| 104 | S:SORT3="" SORT2="Unknown"
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| 105 | ;
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| 106 | S ^TMP($J,"IBTOUR3",SORT1,SORT2,SORT3,IBTRN)=IBADM_"^"_IBDAYS_"^"_IBDAYN
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| 107 | Q
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