source: WorldVistAEHR/trunk/r/INTEGRATED_BILLING-IB-PRQ--IBD--IBQ--PRQS/IBTUBO3.m@ 1464

IBTUBO3 ;ALB/RB - UNBILLED AMOUNTS - GENERATE UNBILLED REPORTS ;03 Aug 2004  9:12 AM

 ;;2.0;INTEGRATED BILLING;**123,159,192,155,277**;21-MAR-94

 ;;Per VHA Directive 10-93-142, this routine should not be modified.

 ;

REPORT ; - Prepare report if requested, send summary bulletin.

 N IBRUN,IBN,IBPAG,IBQ,DFN,DTE,FL,PT,X0,X1

 S IBRUN=$$HTE^XLFDT($H,1)

 D BULL^IBTUBUL G:'IBDET REPRTQ

 ;

REPRT1 S (IBPAG,IBQ,IBX)=0

 I '$D(^TMP($J)) S X0="" D HDR,NIM D:'IBQ PAUSE G REPRTQ

 F X0=1,2,3 I IBSEL[X0 D  Q:IBQ

 . S X1="IBTUB-"_$S(X0=2:"OPT",X0=3:"RX",1:"INPT")

 . D HDR Q:IBQ  I '$D(^TMP($J,X1)) D NIM Q

 . S PT="" F  S PT=$O(^TMP($J,X1,PT)) Q:PT=""  D  Q:IBQ

 . . S DFN=+$P(PT,"@@",2) Q:'DFN

 . . S (DTE,FL)="" F  S DTE=$O(^TMP($J,X1,PT,DTE)) Q:DTE=""  D  Q:IBQ

 . . . S IBX="" F  S IBX=$O(^TMP($J,X1,PT,DTE,IBX)) Q:IBX=""  D  Q:IBQ

 . . . . S IBN=^TMP($J,X1,PT,DTE,IBX) D LINE Q:IBQ  I X1["OPT" D CPTS Q:IBQ

 ;

 D:'IBQ PAUSE

 ;

REPRTQ Q

 ;

HDR ; - Output header.

 N I,X,XTP

 I $E(IOST,1,2)="C-",IBPAG D PAUSE G HDRQ:IBQ

 W:'$G(IBPAG) ! I $E(IOST,1,2)="C-"!$G(IBPAG) W @IOF,*13

 S IBPAG=$G(IBPAG)+1 W !,"Unbilled Amounts Report"

 W ?60,"Run Date: ",IBRUN,?124,"Page ",$J(IBPAG,3)

 S XTP=$S(X0=1:"INPATIENT",X0=2:"OUTPATIENT",X0=3:"PRESCRIPTIONS",1:"")

 S:X0'=3 XTP=XTP_" EPISODES" S X="ALL "_XTP_" FROM "

 S X=X_$$DTE(IBBDT)_" TO "_$$DTE(IBEDT\1)

 I $G(IBCOMP) D

 .S X=X_" / DATA RECOMPILED/STORED FOR "_$$DAT2^IBOUTL(IBTIMON)

 S X=X_" / '*' AFTER THE PATIENT NAME = USUALLY BILLED MEANS TEST COPAYMENT"

 I X0=1 S X=X_" / 'H' AFTER THE ADMISSION DATE = PATIENT CURRENTLY HOSPITALIZED"

 I X0=3 S X=X_" / '$' AFTER THE ORIGINAL FILL DATE = ORIGINAL FILL DATE HAS BEEN BILLED"

 S X=X_" / 'CF' COLUMN = NUMBER OF CLAIMS ON FILE FOR THE EPISODE"

 I X0'=3 D

 .S X=X_" / 'I/P' COLUMN = 'I' - INSTUTIONAL CLAIM MISSING,"

 .S X=X_" 'P' - PROFESSIONAL CLAIM MISSING"

 F I=1:1 W !,$E(X,1,132) S X=$E(X,133,999) Q:X=""

 ;

 I 'X0 W !,$TR($J(" ",IOM)," ","-"),! G HDRQ

 W !!?29,"Last Prim.  Claims" W:X0=3 ?52,"Fill",?123,"Original"

 W !,"Name",?29,"4SSN Elig.  Track.ID#"

 I X0=1 W ?52,"Admission CF Insurance Carrier(s)",?98,"I/P",?102,"MRA"

 I X0=2 W ?52,"Care Dt.  CF Insurance Carrier(s)",?98,"I/P",?102,"MRA",?106,"CPT     I. Rate   P. Rate"

 I X0=3 W ?52,"Date     CF Ins. Carrier(s)     MRA Drug Name        Physician",?123,"Fill Dt."

 W !,$TR($J(" ",IOM)," ","-"),!

 I $D(ZTQUEUED),$$S^%ZTLOAD D

 . W !!,"...Task stoped at user request" S (IBQ,ZTSTOP)=1

 ;

HDRQ Q

 ;

CPTS ; - Outpatient Only (CPTs and Rates)

 N CPT,IBN1

 I $O(^TMP($J,X1,PT,DTE,IBX,""))="" W ?98,"I",?103,$S('$G(IBINMRA):"",$G(^TMP($J,X1_"_MRA",PT,DTE,IBX)):"M",1:"") W ! Q

 S CPT="" F  S CPT=$O(^TMP($J,X1,PT,DTE,IBX,CPT)) Q:CPT=""  D  Q:IBQ

 . S IBN1=^TMP($J,X1,PT,DTE,IBX,CPT)

 . I $Y>(IOSL-5) D HDR Q:IBQ  S FL=0 D LINE

 . W ?98,$P(IBN1,U,3),?103,$S('$G(IBINMRA):"",$G(^TMP($J,X1_"_MRA",PT,DTE,IBX)):"M",1:""),?106,CPT,?113,$J(+IBN1,8,2)

 . W ?124,$J($P(IBN1,U,2),8,2),!

 Q

 ;

LINE ; - Print detail line.

 I $Y>(IOSL-6) D HDR G:IBQ LINQ S FL=0

 I 'FL D

 . W $E($P(PT,"@@"),1,26) I $$BIL^DGMTUB(DFN,+DTE) W " *"

 . W ?29,$$SSN(DFN),?34,$E($$ELIG(DFN),1,5) S FL=1

 ;

 W ?39,$J(IBX,11)

 ; - Inpatient and Outpatient Only

 I X1'["RX" D

 . W ?52,$$DTE(+DTE) W:X1["INPT" $S($P(IBN,U,5):"H",1:"")

 . W ?62,$J($P(IBN,U),2),?65,$$INS(DFN,+DTE,34)

 . I X1["INPT" D

 .. I $P(IBN,U,2)'="" W ?98,$E($P(IBN,U,2),1,3),!

 .. I '$G(^TMP($J,X1_"_MRA",PT,DTE,IBX))!'$G(IBINMRA) W:$P(IBN,U,2)="" ! Q

 .. W ?98,$E($P(^TMP($J,X1_"_MRA",PT,DTE,IBX),U,2),1,3),?103,"M",!

 ;

 ; - Pharmacy Only

 I X1["RX" D  G LINQ

 . W ?52,$$DTE(+DTE),?61,$J($P(IBN,U),2),?64,$$INS(DFN,+DTE,19),?85,$S('$G(IBINMRA):"",$G(^TMP($J,X1_"_MRA",PT,DTE,IBX)):"M",1:"")

 . W ?88,$E($P(IBN,U,6),1,15),?105,$E($P(IBN,U,2),1,14)

 . W ?123,$$DTE($P(IBN,U,3)) W:$P(IBN,"^",5) "$" W !

 ;

LINQ Q

 ;

SSN(DFN) ; - Return last 4 of patient's SSN.

 N SSN,VADM

 D DEM^VADPT S SSN=$P(VADM(2),"^"),SSN=$E(SSN,6,9) D KVA^VADPT

 Q SSN

 ;

ELIG(DFN) ; - Return patient's primary eligibility (1st 10 characters).

 N ELIG,VAEL

 D ELIG^VADPT S ELIG=$E($P(VAEL(1),"^",2),1,10) D KVAR^VADPT

 Q ELIG

 ;

DTE(D) ; - Format date (MM/DD/YY or MM/YY).

 Q $S('$G(D):"",1:$E(D,4,5)_"/"_$S($E(D,6,7)'="00":$E(D,6,7)_"/",1:"")_$E(D,2,3))

 ;

INS(P,D,C) ; - Return patient's insurance carrier(s).

 ;   Input: P=patient IEN, D=event date, C=Size of the Ins.Carrier column

 ;  Output: List of Providers

 ;

 I '$G(P)!('$G(D)) Q ""

 ;

 N INSC,INSL,INSN,LST,TMP,X

 ;

 S INSL="" D ALL^IBCNS1(P,"LST",1,D)

 S X=0 F  S X=$O(LST(X)) Q:'X  D

 . S INSC=+$G(LST(X,0)) Q:$D(TMP(INSC))!'INSC

 . S INSN=$P($G(^DIC(36,INSC,0)),U)

 . I $G(LST(0))>1 S INSN=$E(INSN,1,C\2)

 . S INSL=INSL_","_INSN

 . S TMP(INSC)=""

 ;

 S $E(INSL)=""

 I $L(INSL,",")>1,$L(INSL)>C D

 . S INSL=$E(INSL,1,C-3),$P(INSL,",",$L(INSL,","))="..."

 S INSL=$E(INSL,1,C)

 ;

 Q INSL

 ;

NIM ; - Print 'no info' message.

 W !?3,"No information available for the period specified."

 Q

 ;

PAUSE ; - Page break.

 I $E(IOST,1,2)'="C-" Q

 N IBI,DIR,DIRUT,DUOUT,DTOUT,DIROUT,X,Y

 F IBI=$Y:1:(IOSL-3) W !

 S DIR(0)="E" D ^DIR S:$D(DIRUT)!($D(DUOUT)) IBQ=1

 Q