1 | IBTRCD ;ALB/AAS - CLAIMS TRACKING - EXPAND CONTACTS SCREEN ; 02-JUL-1993
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2 | ;;2.0;INTEGRATED BILLING;**210**;21-MAR-94
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3 | ;;Per VHA Directive 10-93-142, this routine should not be modified.
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4 | ;
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5 | % ;
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6 | EN ; -- main entry point for IBT EXPAND/EDIT COMMUNICATIONS
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7 | I '$D(DT) D DT^DICRW
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8 | K XQORS,VALMEVL,IBTRC,IBTRD,IBTRV,IBTRN,DFN
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9 | I '$G(IBTRC) G EN^IBTRC
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10 | D EN^VALM("IBT EXPAND/EDIT COMMUNICATIONS")
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11 | Q
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12 | ;
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13 | HDR ; -- header code
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14 | D PID^VADPT
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15 | S VALMHDR(1)="Expanded Insurance Reviews for: "_$$PT^IBTUTL1(DFN)_" ROI: "_$$EXPAND^IBTRE(356,.31,$P($G(^IBT(356,+$G(IBTRN),0)),"^",31))
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16 | S VALMHDR(2)=" for: "_$$EXPAND^IBTRE(356,.18,$P(IBTRND,"^",18))_" on "_$$DAT1^IBOUTL($P(IBTRND,"^",6),"2P")
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17 | Q
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18 | ;
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19 | INIT ; -- init variables and list array
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20 | N IBTRCD,IBTRCD1
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21 | K VALMQUIT
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22 | S VALMCNT=0,VALMBG=1
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23 | D BLD,HDR
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24 | Q
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25 | ;
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26 | BLD ; -- build display
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27 | K ^TMP("IBTRCD",$J),^TMP("IBTRCDDX",$J)
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28 | D KILL^VALM10()
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29 | S IBTRCD=$G(^IBT(356.2,IBTRC,0)),IBTRCD1=$G(^IBT(356.2,IBTRC,1))
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30 | S IBTRND=$G(^IBT(356,IBTRN,0))
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31 | F I=1:1:27 D BLANK^IBTRED(.I)
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32 | S VALMCNT=27
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33 | D ACTION,EN^IBTRCD0
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34 | Q
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35 | ;
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36 | ;
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37 | ACTION ; -- Ins. Action infomation display
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38 | N OFFSET,START,TCODE,IBACTION,IBLCNT
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39 | S START=1,OFFSET=45,IBLCNT=0
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40 | D SET^IBCNSP(START,OFFSET," Action Information ",IORVON,IORVOFF)
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41 | D SET^IBCNSP(START+1,OFFSET," Type Contact: "_$$EXPAND^IBTRE(356.2,.04,$P(IBTRCD,"^",4)))
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42 | S TCODE=$$TCODE^IBTRC(IBTRC) I TCODE D @TCODE
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43 | Q
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44 | 10 ; -- pre-cert contact
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45 | 15 ; -- admission review
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46 | 20 ; -- urgent/emergent ins. contact
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47 | 30 ; -- continued stay contact
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48 | S IBLCNT=2
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49 | D SET^IBCNSP(START+IBLCNT,OFFSET," Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11)))
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50 | S IBACTION=$P($G(^IBE(356.7,+$P(IBTRCD,"^",11),0)),"^",3)
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51 | S IBACTION=IBACTION+100 D @IBACTION
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52 | S IBLCNT=IBLCNT+1
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53 | Q
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54 | ;
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55 | 40 ; -- Discharge contact
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56 | 100 ; -- No type of action
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57 | Q
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58 | 50 ; -- outpatient treatment
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59 | S IBLCNT=2
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60 | D SET^IBCNSP(START+IBLCNT,OFFSET," Opt Treatment: "_$$EXPAND^IBTRE(356.2,.26,$P(IBTRCD,"^",26)))
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61 | S IBLCNT=IBLCNT+1
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62 | D SET^IBCNSP(START+IBLCNT,OFFSET," Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11)))
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63 | S IBLCNT=IBLCNT+1
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64 | D SET^IBCNSP(START+IBLCNT,OFFSET," Auth. Number: "_$P(IBTRCD,"^",28))
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65 | ;D SET^IBCNSP(START+IBLCNT,OFFSET,"Treatment Auth: "_$$EXPAND^IBTRE(356.2,.27,$P(IBTRCD,"^",27)))
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66 | Q
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67 | 60 ; -- Appeal
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68 | 65 ; -- Nth appeal
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69 | D SET^IBCNSP(START+2,OFFSET," Appeal Type: "_$$EXPAND^IBTRE(356.2,.23,$P(IBTRCD,"^",23)))
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70 | D SET^IBCNSP(START+3,OFFSET," Case Status: "_$$EXPAND^IBTRE(356.2,.1,$P(IBTRCD,"^",10)))
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71 | D SET^IBCNSP(START+4,OFFSET,"No Days Pending: "_$$EXPAND^IBTRE(356.2,.25,$P(IBTRCD,"^",25)))
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72 | D SET^IBCNSP(START+5,OFFSET," Final Outcome: "_$$EXPAND^IBTRE(356.2,.29,$P(IBTRCD,"^",29)))
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73 | Q
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74 | 70 ; -- Patient
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75 | 80 ; -- Other
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76 | 85 ; -- Insurance verification
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77 | Q
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78 | ;
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79 | 110 ; -- approval actions
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80 | S IBLCNT=IBLCNT+1
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81 | D SET^IBCNSP(START+IBLCNT,OFFSET,"Authorized From: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",12))))
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82 | S IBLCNT=IBLCNT+1
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83 | D SET^IBCNSP(START+IBLCNT,OFFSET," Authorized To: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",13))))
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84 | S IBLCNT=IBLCNT+1
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85 | D SET^IBCNSP(START+IBLCNT,OFFSET,"Authorized Diag: "_$$DIAG^IBTRE6($P(IBTRCD,"^",14),1,$$TRNDATE^IBACSV($G(IBTRN))))
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86 | S IBLCNT=IBLCNT+1
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87 | D SET^IBCNSP(START+IBLCNT,OFFSET," Auth. Number: "_$P(IBTRCD,"^",28))
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88 | Q
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89 | 120 ; -- denial actions
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90 | S IBLCNT=IBLCNT+1
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91 | D SET^IBCNSP(START+IBLCNT,OFFSET," Denied From: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",15))))
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92 | S IBLCNT=IBLCNT+1
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93 | D SET^IBCNSP(START+IBLCNT,OFFSET," Denied To: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",16))))
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94 | S IBI=0 F S IBI=$O(^IBT(356.2,IBTRC,12,IBI)) Q:'IBI!(IBLCNT>6) D
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95 | .S IBLCNT=IBLCNT+1
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96 | .D SET^IBCNSP(START+IBLCNT,OFFSET," Denial Reasons: "_$$EXPAND^IBTRE(356.212,.01,+$G(^IBT(356.2,IBTRC,12,IBI,0))))
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97 | Q
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98 | 130 ; -- penalty
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99 | S IBI=0 F S IBI=$O(^IBT(356.2,IBTRC,13,IBI)) Q:'IBI!(IBLCNT>6) D
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100 | .S IBLCNT=IBLCNT+1
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101 | .D SET^IBCNSP(START+IBLCNT,OFFSET," Penalty: "_$$EXPAND^IBTRE(356.213,.01,+$G(^IBT(356.2,IBTRC,13,IBI,0))))
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102 | Q
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103 | 140 ; -- case pending
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104 | S IBLCNT=IBLCNT+1
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105 | D SET^IBCNSP(START+IBLCNT,OFFSET," Case Pending: "_$$EXPAND^IBTRE(356.2,.2,$P(IBTRCD,"^",20)))
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106 | Q
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107 | 150 ; -- no coverage
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108 | S IBLCNT=IBLCNT+1
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109 | D SET^IBCNSP(START+IBLCNT,OFFSET," No Coverage: "_$$EXPAND^IBTRE(356.2,.21,$P(IBTRCD,"^",21)))
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110 | Q
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111 | ;
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112 | ;
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113 | HELP ; -- help code
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114 | S X="?" D DISP^XQORM1 W !!
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115 | Q
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116 | ;
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117 | EXIT ; -- exit code
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118 | K VALMQUIT,IBTRC,IBTRCD,IBTRCD1
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119 | K ^TMP("IBTRCD",$J),^TMP("IBTRCDDX",$J)
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120 | D CLEAN^VALM10,FULL^VALM1
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121 | Q
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