1 | IBTRD1 ;ALB/AAS - CLAIMS TRACKING - APPEAL/DENIAL ACTIONS ; 10-AUG-93
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2 | ;;Version 2.0 ; INTEGRATED BILLING ;; 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 | % G EN^IBTRD
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6 | ;
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7 | AA ; -- Add Appeal entry
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8 | N X,Y,I,J,DA,DR,DIC,DIE,DR,DD,DO,IBQUIT,IBTRCDT,IBXX,VALMY,IBTRN,IBTRC
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9 | D EN^VALM2($G(XQORNOD(0)))
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10 | I $D(VALMY) D FULL^VALM1 S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX!$D(DIRUT) D
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11 | .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXX,0)))),"^",2)
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12 | .; -- must be a denial or a penalty
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13 | .S IBDENIAL=$O(^IBE(356.7,"ACODE",20,0))
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14 | .S IBPENAL=$O(^IBE(356.7,"ACODE",30,0))
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15 | .I '$D(^IBT(356.2,"ACT",IBDENIAL,IBTRC))&('$D(^IBT(356.2,"ACT",IBPENAL,IBTRC))) W !!,"You can only appeal a denial or an penalty." D PAUSE^VALM1 Q
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16 | .D AA1
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17 | D BLD^IBTRD
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18 | S VALMBCK="R"
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19 | Q
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20 | ;
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21 | AA1 ; -- select date
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22 | N DIR,IBTRCDT
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23 | S DIR(0)="356.2,.01",DIR("A")="Select Appeal Date",DIR("B")="NOW"
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24 | D ^DIR K DIR
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25 | I $D(DIRUT)!($E(+Y,1,7)'?7N) G AA1Q
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26 | S IBTRCDT=+Y
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27 | ;
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28 | ; -- if not tracking id allow selecting
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29 | S IBTRDD=$G(^IBT(356.2,+IBTRC,0))
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30 | S IBTRN=$P(IBTRDD,"^",2)
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31 | S DFN=$P(IBTRDD,"^",5)
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32 | S IBPARNT=IBTRC
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33 | S IBCDFN=$P($G(^IBT(356.2,IBTRC,1)),"^",5)
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34 | ;
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35 | ; -- add entry
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36 | S IBTCOD=$S('$D(^IBT(356.2,"AP",IBTRC)):60,1:65)
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37 | D COM^IBTUTL3(IBTRCDT,$G(IBTRN),IBTCOD,$G(IBTRV))
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38 | ; -- ibtrc now entry of new appeal
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39 | ;
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40 | ; -- edit based on
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41 | S DIE="^IBT(356.2,",DA=IBTRC
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42 | L +^IBT(356.2,+IBTRC):5 I '$T D LOCKED^IBTRCD1 G AA1Q
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43 | S DR="[IBT ADD APPEAL]"
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44 | ;S DR=".18////"_IBPARNT_";1.05////"_IBCDFN_";.04;.23;.1;.25;11;.24;.19"
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45 | D ^DIE K DIE
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46 | L -^IBT(356.2,+IBTRC)
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47 | AA1Q Q
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48 | ;
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49 | DT ; -- Delete Insurance Action entry
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50 | I '$D(^XUSEC("IB CLAIMS SUPERVISOR",DUZ)) D SORRY^IBTRE1 G DTQ
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51 | D EN^VALM2($G(XQORNOD(0)))
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52 | N I,J,IBXX,DIR,DIRUT,IBTRN
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53 | I $D(VALMY) D FULL^VALM1 S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX!$D(DIRUT) D
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54 | .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXX,0)))),"^",2),IBTRN=$P($G(^IBT(356.2,+IBTRC,0)),"^",2)
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55 | .I $O(^IBT(356.2,"AP",IBTRC,0)) W !,"Must first delete appeals associate* d with Denials" D PAUSE^VALM1 Q
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56 | .;
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57 | .W ! S DIR(0)="Y",DIR("B")="NO",DIR("A")="Are You Sure you want to delete entry #"_IBXX
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58 | .D ^DIR I Y'=1 W !,"Entry #",IBXX," not Deleted!" Q
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59 | .D DP1^IBTRC1
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60 | .Q
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61 | DTQ D BLD^IBTRD
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62 | S VALMBCK="R" Q
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63 | ;
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64 | QE ; -- Quick edit Review entry
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65 | D EN^VALM2($G(XQORNOD(0)))
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66 | N I,J,IBXX,IBTRN,IBTRC
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67 | I $D(VALMY) S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX D
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68 | .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXX,0)))),"^",2),IBTRN=$P($G(^IBT(356.2,+IBTRC,0)),"^",2)
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69 | .D QE1
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70 | QEQ S VALMBCK="R"
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71 | D BLD^IBTRD
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72 | Q
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73 | ;
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74 | QE1 N X,Y,DA,DR,DIC,DIE
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75 | D EDIT^IBTRCD1("[IBT QUICK EDIT]",1)
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76 | Q
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77 | ;
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78 | NX(IBTMPNM) ; -- Go to next template
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79 | ; -- Input template name
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80 | N I,J,IBXXC,VALMY,IBTRN
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81 | D EN^VALM2($G(XQORNOD(0)))
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82 | I $D(VALMY) S IBXXC=0 F S IBXXC=$O(VALMY(IBXXC)) Q:'IBXXC D
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83 | .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXXC,0)))),"^",2),IBTRN=$P($G(^IBT(356.2,+IBTRC,0)),"^",2)
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84 | .S:'$D(DFN) DFN=$P($G(^IBT(356.2,+IBTRC,0)),"^",5)
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85 | .S:'$D(IBCNS) IBCNS=$P($G(^IBT(356.2,+IBTRC,0)),"^",8)
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86 | .D EN^VALM(IBTMPNM)
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87 | .K IBAMT,IBAPR,IBADG,IBDA,IBDGCR,IBDGCRU1,IBDV,IBETYP,IBETYPD,IBI,IBICD,IBLCNT,IBSEL,IBT,IBTEXT,IBTNOD,IBTSAV,VAUTD
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88 | .K IBAPEAL,IBCDFN,IBCNT,IBDEN,IBDENIAL,IBDENIAL,IBPARNT,IBPEN,IBPENAL,IBTCOD,IBTRDD,IBTRSV,IBTYPE,VAINDT,VA
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89 | .D KVAR^VADPT
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90 | .Q
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91 | I '$D(IBFASTXT) D BLD^IBTRD
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92 | S VALMBCK="R"
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93 | Q
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94 | ;
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95 | EDIT(IBTEMP) ; -- Edit entries
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96 | N VALMY
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97 | D EN^VALM2($G(XQORNOD(0)))
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98 | N I,J,IBXX
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99 | I $D(VALMY) D FULL^VALM1 S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX D
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100 | .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXX,0)))),"^",2)
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101 | .W !!,"Editing Entry #",IBXX,!
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102 | .D EDIT^IBTRCD1(IBTEMP,1)
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103 | S VALMBCK="R"
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104 | D BLD^IBTRD
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105 | Q
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106 | SHOWSC ; -- show sc conditions
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107 | N VALMY
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108 | D FULL^VALM1
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109 | I IBTRD["DPT",$D(DFN) D SHOWSC^IBTRC1 G SHOWQ
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110 | ;
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111 | D EN^VALM2($G(XQORNOD(0)))
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112 | N I,J,IBXX,DFN,IBTRC
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113 | I $D(VALMY) D FULL^VALM1 S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX D
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114 | .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXX,0)))),"^",2)
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115 | .S DFN=$P($G(^IBT(356.2,+IBTRC,0)),"^",5)
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116 | .D SHOWSC^IBTRC1
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117 | SHOWQ S VALMBCK="R"
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118 | Q
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