| 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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