| 1 | IBTUBO3 ;ALB/RB - UNBILLED AMOUNTS - GENERATE UNBILLED REPORTS ;03 Aug 2004  9:12 AM | 
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| 2 | ;;2.0;INTEGRATED BILLING;**123,159,192,155,277**;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 | REPORT ; - Prepare report if requested, send summary bulletin. | 
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| 6 | N IBRUN,IBN,IBPAG,IBQ,DFN,DTE,FL,PT,X0,X1 | 
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| 7 | S IBRUN=$$HTE^XLFDT($H,1) | 
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| 8 | D BULL^IBTUBUL G:'IBDET REPRTQ | 
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| 9 | ; | 
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| 10 | REPRT1 S (IBPAG,IBQ,IBX)=0 | 
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| 11 | I '$D(^TMP($J)) S X0="" D HDR,NIM D:'IBQ PAUSE G REPRTQ | 
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| 12 | F X0=1,2,3 I IBSEL[X0 D  Q:IBQ | 
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| 13 | . S X1="IBTUB-"_$S(X0=2:"OPT",X0=3:"RX",1:"INPT") | 
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| 14 | . D HDR Q:IBQ  I '$D(^TMP($J,X1)) D NIM Q | 
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| 15 | . S PT="" F  S PT=$O(^TMP($J,X1,PT)) Q:PT=""  D  Q:IBQ | 
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| 16 | . . S DFN=+$P(PT,"@@",2) Q:'DFN | 
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| 17 | . . S (DTE,FL)="" F  S DTE=$O(^TMP($J,X1,PT,DTE)) Q:DTE=""  D  Q:IBQ | 
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| 18 | . . . S IBX="" F  S IBX=$O(^TMP($J,X1,PT,DTE,IBX)) Q:IBX=""  D  Q:IBQ | 
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| 19 | . . . . S IBN=^TMP($J,X1,PT,DTE,IBX) D LINE Q:IBQ  I X1["OPT" D CPTS Q:IBQ | 
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| 20 | ; | 
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| 21 | D:'IBQ PAUSE | 
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| 22 | ; | 
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| 23 | REPRTQ Q | 
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| 24 | ; | 
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| 25 | HDR ; - Output header. | 
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| 26 | N I,X,XTP | 
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| 27 | I $E(IOST,1,2)="C-",IBPAG D PAUSE G HDRQ:IBQ | 
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| 28 | W:'$G(IBPAG) ! I $E(IOST,1,2)="C-"!$G(IBPAG) W @IOF,*13 | 
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| 29 | S IBPAG=$G(IBPAG)+1 W !,"Unbilled Amounts Report" | 
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| 30 | W ?60,"Run Date: ",IBRUN,?124,"Page ",$J(IBPAG,3) | 
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| 31 | S XTP=$S(X0=1:"INPATIENT",X0=2:"OUTPATIENT",X0=3:"PRESCRIPTIONS",1:"") | 
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| 32 | S:X0'=3 XTP=XTP_" EPISODES" S X="ALL "_XTP_" FROM " | 
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| 33 | S X=X_$$DTE(IBBDT)_" TO "_$$DTE(IBEDT\1) | 
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| 34 | I $G(IBCOMP) D | 
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| 35 | .S X=X_" / DATA RECOMPILED/STORED FOR "_$$DAT2^IBOUTL(IBTIMON) | 
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| 36 | S X=X_" / '*' AFTER THE PATIENT NAME = USUALLY BILLED MEANS TEST COPAYMENT" | 
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| 37 | I X0=1 S X=X_" / 'H' AFTER THE ADMISSION DATE = PATIENT CURRENTLY HOSPITALIZED" | 
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| 38 | I X0=3 S X=X_" / '$' AFTER THE ORIGINAL FILL DATE = ORIGINAL FILL DATE HAS BEEN BILLED" | 
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| 39 | S X=X_" / 'CF' COLUMN = NUMBER OF CLAIMS ON FILE FOR THE EPISODE" | 
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| 40 | I X0'=3 D | 
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| 41 | .S X=X_" / 'I/P' COLUMN = 'I' - INSTUTIONAL CLAIM MISSING," | 
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| 42 | .S X=X_" 'P' - PROFESSIONAL CLAIM MISSING" | 
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| 43 | F I=1:1 W !,$E(X,1,132) S X=$E(X,133,999) Q:X="" | 
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| 44 | ; | 
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| 45 | I 'X0 W !,$TR($J(" ",IOM)," ","-"),! G HDRQ | 
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| 46 | W !!?29,"Last Prim.  Claims" W:X0=3 ?52,"Fill",?123,"Original" | 
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| 47 | W !,"Name",?29,"4SSN Elig.  Track.ID#" | 
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| 48 | I X0=1 W ?52,"Admission CF Insurance Carrier(s)",?98,"I/P",?102,"MRA" | 
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| 49 | I X0=2 W ?52,"Care Dt.  CF Insurance Carrier(s)",?98,"I/P",?102,"MRA",?106,"CPT     I. Rate   P. Rate" | 
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| 50 | I X0=3 W ?52,"Date     CF Ins. Carrier(s)     MRA Drug Name        Physician",?123,"Fill Dt." | 
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| 51 | W !,$TR($J(" ",IOM)," ","-"),! | 
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| 52 | I $D(ZTQUEUED),$$S^%ZTLOAD D | 
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| 53 | . W !!,"...Task stoped at user request" S (IBQ,ZTSTOP)=1 | 
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| 54 | ; | 
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| 55 | HDRQ Q | 
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| 56 | ; | 
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| 57 | CPTS ; - Outpatient Only (CPTs and Rates) | 
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| 58 | N CPT,IBN1 | 
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| 59 | I $O(^TMP($J,X1,PT,DTE,IBX,""))="" W ?98,"I",?103,$S('$G(IBINMRA):"",$G(^TMP($J,X1_"_MRA",PT,DTE,IBX)):"M",1:"") W ! Q | 
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| 60 | S CPT="" F  S CPT=$O(^TMP($J,X1,PT,DTE,IBX,CPT)) Q:CPT=""  D  Q:IBQ | 
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| 61 | . S IBN1=^TMP($J,X1,PT,DTE,IBX,CPT) | 
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| 62 | . I $Y>(IOSL-5) D HDR Q:IBQ  S FL=0 D LINE | 
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| 63 | . W ?98,$P(IBN1,U,3),?103,$S('$G(IBINMRA):"",$G(^TMP($J,X1_"_MRA",PT,DTE,IBX)):"M",1:""),?106,CPT,?113,$J(+IBN1,8,2) | 
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| 64 | . W ?124,$J($P(IBN1,U,2),8,2),! | 
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| 65 | Q | 
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| 66 | ; | 
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| 67 | LINE ; - Print detail line. | 
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| 68 | I $Y>(IOSL-6) D HDR G:IBQ LINQ S FL=0 | 
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| 69 | I 'FL D | 
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| 70 | . W $E($P(PT,"@@"),1,26) I $$BIL^DGMTUB(DFN,+DTE) W " *" | 
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| 71 | . W ?29,$$SSN(DFN),?34,$E($$ELIG(DFN),1,5) S FL=1 | 
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| 72 | ; | 
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| 73 | W ?39,$J(IBX,11) | 
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| 74 | ; - Inpatient and Outpatient Only | 
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| 75 | I X1'["RX" D | 
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| 76 | . W ?52,$$DTE(+DTE) W:X1["INPT" $S($P(IBN,U,5):"H",1:"") | 
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| 77 | . W ?62,$J($P(IBN,U),2),?65,$$INS(DFN,+DTE,34) | 
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| 78 | . I X1["INPT" D | 
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| 79 | .. I $P(IBN,U,2)'="" W ?98,$E($P(IBN,U,2),1,3),! | 
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| 80 | .. I '$G(^TMP($J,X1_"_MRA",PT,DTE,IBX))!'$G(IBINMRA) W:$P(IBN,U,2)="" ! Q | 
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| 81 | .. W ?98,$E($P(^TMP($J,X1_"_MRA",PT,DTE,IBX),U,2),1,3),?103,"M",! | 
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| 82 | ; | 
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| 83 | ; - Pharmacy Only | 
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| 84 | I X1["RX" D  G LINQ | 
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| 85 | . 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:"") | 
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| 86 | . W ?88,$E($P(IBN,U,6),1,15),?105,$E($P(IBN,U,2),1,14) | 
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| 87 | . W ?123,$$DTE($P(IBN,U,3)) W:$P(IBN,"^",5) "$" W ! | 
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| 88 | ; | 
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| 89 | LINQ Q | 
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| 90 | ; | 
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| 91 | SSN(DFN) ; - Return last 4 of patient's SSN. | 
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| 92 | N SSN,VADM | 
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| 93 | D DEM^VADPT S SSN=$P(VADM(2),"^"),SSN=$E(SSN,6,9) D KVA^VADPT | 
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| 94 | Q SSN | 
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| 95 | ; | 
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| 96 | ELIG(DFN) ; - Return patient's primary eligibility (1st 10 characters). | 
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| 97 | N ELIG,VAEL | 
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| 98 | D ELIG^VADPT S ELIG=$E($P(VAEL(1),"^",2),1,10) D KVAR^VADPT | 
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| 99 | Q ELIG | 
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| 100 | ; | 
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| 101 | DTE(D) ; - Format date (MM/DD/YY or MM/YY). | 
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| 102 | Q $S('$G(D):"",1:$E(D,4,5)_"/"_$S($E(D,6,7)'="00":$E(D,6,7)_"/",1:"")_$E(D,2,3)) | 
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| 103 | ; | 
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| 104 | INS(P,D,C) ; - Return patient's insurance carrier(s). | 
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| 105 | ;   Input: P=patient IEN, D=event date, C=Size of the Ins.Carrier column | 
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| 106 | ;  Output: List of Providers | 
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| 107 | ; | 
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| 108 | I '$G(P)!('$G(D)) Q "" | 
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| 109 | ; | 
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| 110 | N INSC,INSL,INSN,LST,TMP,X | 
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| 111 | ; | 
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| 112 | S INSL="" D ALL^IBCNS1(P,"LST",1,D) | 
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| 113 | S X=0 F  S X=$O(LST(X)) Q:'X  D | 
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| 114 | . S INSC=+$G(LST(X,0)) Q:$D(TMP(INSC))!'INSC | 
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| 115 | . S INSN=$P($G(^DIC(36,INSC,0)),U) | 
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| 116 | . I $G(LST(0))>1 S INSN=$E(INSN,1,C\2) | 
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| 117 | . S INSL=INSL_","_INSN | 
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| 118 | . S TMP(INSC)="" | 
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| 119 | ; | 
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| 120 | S $E(INSL)="" | 
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| 121 | I $L(INSL,",")>1,$L(INSL)>C D | 
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| 122 | . S INSL=$E(INSL,1,C-3),$P(INSL,",",$L(INSL,","))="..." | 
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| 123 | S INSL=$E(INSL,1,C) | 
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| 124 | ; | 
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| 125 | Q INSL | 
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| 126 | ; | 
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| 127 | NIM ; - Print 'no info' message. | 
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| 128 | W !?3,"No information available for the period specified." | 
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| 129 | Q | 
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| 130 | ; | 
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| 131 | PAUSE ; - Page break. | 
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| 132 | I $E(IOST,1,2)'="C-" Q | 
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| 133 | N IBI,DIR,DIRUT,DUOUT,DTOUT,DIROUT,X,Y | 
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| 134 | F IBI=$Y:1:(IOSL-3) W ! | 
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| 135 | S DIR(0)="E" D ^DIR S:$D(DIRUT)!($D(DUOUT)) IBQ=1 | 
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| 136 | Q | 
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