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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