1 | IBTOUR4 ;ALB/AAS - CLAIMS TRACKING UR ACTIVITY REPORT ; 27-OCT-93
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2 | ;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
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3 | ;
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4 | % I '$D(DT) D DT^DICRW
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5 | INS ; -- print data
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6 | ; -- ^tmp($j,"ibtour",primary sort,secondary sort,patient, ibtrc)=ibtrcd
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7 | ;
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8 | N IBCNT
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9 | D HDR
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10 | I $O(^TMP($J,"IBTOUR",""))="" W !!,"No Insurance Reviews Found in Date Range." G PRINTQ
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11 | ;
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12 | S IBH="" F S IBH=$O(^TMP($J,"IBTOUR",IBH)) Q:IBH=""!(IBQUIT) D
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13 | .D SUBHDR^IBTOUR5
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14 | .S IBI="" F S IBI=$O(^TMP($J,"IBTOUR",IBH,IBI)) Q:IBI=""!(IBQUIT) D
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15 | ..D SSUBHDR^IBTOUR5
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16 | ..S IBJ="" F S IBJ=$O(^TMP($J,"IBTOUR",IBH,IBI,IBJ)) Q:IBJ=""!(IBQUIT) D
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17 | ...S IBTRC="" F S IBTRC=$O(^TMP($J,"IBTOUR",IBH,IBI,IBJ,IBTRC)) Q:IBTRC=""!(IBQUIT) S IBTRCD=^(IBTRC) D ONE
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18 | ;
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19 | PRINTQ I 'IBQUIT,$E(IOST,1,2)="C-" D PAUSE^VALM1 I $D(DIRUT) S IBQUIT=1
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20 | Q
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21 | ;
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22 | ONE ; -- print one entry
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23 | ; -- ^tmp($j,"ibtour",primary sort,secondary sort,ibtrc)=^IBT(IBTRC)
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24 | ;
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25 | S IBAPL=$$APPEAL^IBTODD1(IBTRC)
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26 | ;
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27 | I IOSL<($Y+4) D HDR Q:IBQUIT
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28 | S DFN=+$P(IBTRCD,"^",5) D PID^VADPT
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29 | S IBTRCD=$G(^IBT(356.2,+IBTRC,0))
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30 | L1 W !,$E($P(^DPT(DFN,0),"^"),1,22),?25,VA("PID")
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31 | S IBCDT=$$CDT^IBTODD1($P(IBTRCD,"^",2))
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32 | W ?38,$$DAT1^IBOUTL(+IBCDT\1) W:$P(IBCDT,"^",2) " to"
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33 | W ?50,$P($G(^IBE(356.11,+$P(IBTRCD,"^",4),0)),"^",3) ;review type abbrev
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34 | W ?64,$$DAT1^IBOUTL(+IBTRCD) ;review date
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35 | W ?78,$E($$EXPAND^IBTRE(356.2,.08,$P(IBTRCD,"^",8)),1,20) ; ins co
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36 | W ?100,$E($$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11)),1,10) ;ins co action
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37 | W ?112,$E($$EXPAND^IBTRE(356.2,1.04,$P($G(^IBT(356.2,+IBTRC,1)),"^",4)),1,19) ; last reviewer
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38 | ;
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39 | L2 W !?38,$$DAT1^IBOUTL($P(IBCDT,"^",2)\1,"2P")
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40 | Q
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41 | ;
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42 | HDR ; -- Print header for billing report
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43 | Q:IBQUIT
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44 | I $E(IOST,1,2)="C-",IBPAG D PAUSE^VALM1 I $D(DIRUT) S IBQUIT=1 Q
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45 | I $E(IOST,1,2)="C-"!(IBPAG) W @IOF
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46 | S IBPAG=IBPAG+1
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47 | W !,"UR Insurance Review Activity Report",?(IOM-33),"Page ",IBPAG," ",IBHDT
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48 | W !,"For Insurance Reviews Dated ",$$DAT1^IBOUTL(IBBDT)," to ",$$DAT1^IBOUTL(IBEDT)
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49 | W !!,?38,"Dates of",?64,"Review"
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50 | W !,"Patient",?25,"Pt. ID",?38,"Care",?50,"Review Type",?64,"Date",?78,"Ins. Co.",?100," Action",?112,"Last Reviewer"
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51 | W !,$TR($J(" ",IOM)," ","-")
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52 | Q
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53 | ;
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54 | HOSP ; -- print hospital report
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55 | N IBCNT
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56 | D HHDR
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57 | I $O(^TMP($J,"IBTOUR3",""))="" W !!,"No Hospital Reviews Found in Date Range." G HOSPQ
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58 | ;
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59 | S IBH="" F S IBH=$O(^TMP($J,"IBTOUR3",IBH)) Q:IBH=""!(IBQUIT) D
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60 | .D SUBHDR^IBTOUR5
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61 | .S IBI="" F S IBI=$O(^TMP($J,"IBTOUR3",IBH,IBI)) Q:IBI=""!(IBQUIT) D
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62 | ..D SSUBHDR^IBTOUR5
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63 | ..S IBJ="" F S IBJ=$O(^TMP($J,"IBTOUR3",IBH,IBI,IBJ)) Q:IBJ=""!(IBQUIT) D
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64 | ...S IBTRN="" F S IBTRN=$O(^TMP($J,"IBTOUR3",IBH,IBI,IBJ,IBTRN)) Q:IBTRN=""!(IBQUIT) S IBDATA=^(IBTRN) D HOSPONE
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65 | ;
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66 | HOSPQ I 'IBQUIT,$E(IOST,1,2)="C-" D PAUSE^VALM1 I $D(DIRUT) S IBQUIT=1
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67 | Q
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68 | ;
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69 | HOSPONE ; -print one case line
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70 | I IOSL<($Y+4) D HHDR Q:IBQUIT
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71 | S IBTRND=$G(^IBT(356,+IBTRN,0))
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72 | S DFN=+$P(IBTRND,"^",2) D PID^VADPT
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73 | HL1 W !,$E($P(^DPT(DFN,0),"^"),1,22),?25,VA("PID")
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74 | S IBCDT=$$CDT^IBTODD1(IBTRN)
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75 | W ?38,$$DAT1^IBOUTL(+IBCDT\1) W:$P(IBCDT,"^",2) " to"
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76 | S TYPE="" I $P(IBTRND,"^",25) S TYPE="RANDOM"
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77 | I $P(IBTRND,"^",26) S:$L(TYPE) TYPE=TYPE_"/" S TYPE=TYPE_$$EXPAND^IBTRE(356,.26,$P(IBTRND,"^",26))
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78 | I $P(IBTRND,"^",27) S:$L(TYPE) TYPE=TYPE_"/LOCAL"
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79 | W ?51,TYPE
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80 | W ?70,$S($P(IBDATA,"^"):"YES",$P(IBDATA,"^")=0:"NO",1:"")
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81 | W ?84,$J($P(IBDATA,"^",2),8)
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82 | W ?98,$J($P(IBDATA,"^",3),8)
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83 | ;
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84 | W ?112,$E($$EXPAND^IBTRE(356,1.05,$P($G(^IBT(356,+IBTRN,1)),"^",5)),1,19) ; last reviewer
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85 | ;
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86 | HL2 I $P(IBCDT,"^",2)'="" W !?38,$$DAT1^IBOUTL($P(IBCDT,"^",2)\1,"2P")
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87 | W ! Q
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88 | ;
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89 | HHDR ; -- hospital review header
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90 | Q:IBQUIT
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91 | I $E(IOST,1,2)="C-",IBPAG D PAUSE^VALM1 I $D(DIRUT) S IBQUIT=1 Q
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92 | I $E(IOST,1,2)="C-"!(IBPAG) W @IOF
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93 | S IBPAG=IBPAG+1
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94 | W !,"UR Hospital Review Activity Report",?(IOM-33),"Page ",IBPAG," ",IBHDT
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95 | W !,"For Hospital Reviews Dated ",$$DAT1^IBOUTL(IBBDT)," to ",$$DAT1^IBOUTL(IBEDT)
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96 | W !!,?38,"Dates of",?69,"Admission",?84,"Days Met",?98,"Days Not Met"
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97 | W !,"Patient",?25,"Pt. ID",?38,"Care",?51,"Review Type",?69,"Met Criteria",?84,"Criteria",?98,"Criteria",?112,"Assigned Reviewer"
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98 | W !,$TR($J(" ",IOM)," ","-")
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99 | Q
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