103 lines
4.2 KiB
Mathematica
103 lines
4.2 KiB
Mathematica
IBTOBI2 ;ALB/AAS - CLAIMS TRACKING BILLING INFORMATION PRINT ;27-OCT-93
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;;2.0;INTEGRATED BILLING;**210**;21-MAR-94
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;
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IR ; -- print insurance review information
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Q:'$O(^IBT(356.2,"C",+IBTRN,0)) ; -no reivews
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I ($Y+11)>IOSL D HDR^IBTOBI Q:IBQUIT
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W !," Insurance Review Information "
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N I,J,IBII,IBTRC,IBTRCD,IBACTION,TCODE
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S IBII="" F S IBII=$O(^IBT(356.2,"ATIDT",IBTRN,IBII)) Q:'IBII!(IBQUIT) S IBTRC=0 F S IBTRC=$O(^IBT(356.2,"ATIDT",IBTRN,IBII,IBTRC)) Q:'IBTRC!(IBQUIT) D
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.N IBJ,IBD
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.D IR1
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.D IR2
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.S IBJ=0 F S IBJ=$O(IBD(IBJ)) Q:'IBJ W !,$E($G(IBD(IBJ,1)),1,39),?40,$E($G(IBD(IBJ,2)),1,39)
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.D COMM2(IBTRC) Q:IBQUIT
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.W !?30,"-----------------------------------"
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.I ($Y+11)>IOSL D HDR^IBTOBI Q:IBQUIT
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W:'IBQUIT !?4,$TR($J(" ",IOM-8)," ","-"),!
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Q
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;
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IR1 ; -- print one review
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S IBTRCD=$G(^IBT(356.2,+IBTRC,0)),IBTRCD1=$G(^(1))
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S IBD(1,1)=" Type Review: "_$$EXPAND^IBTRE(356.2,.04,$P(IBTRCD,"^",4))
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S TCODE=$$TCODE^IBTRC(IBTRC) I TCODE D @TCODE
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Q
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10 ; -- pre-cert contact
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15 ; -- admission review
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20 ; -- urgent/emergent ins. contact
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30 ; -- continued stay contact
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S IBD(2,1)=" Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11))
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S IBACTION=$P($G(^IBE(356.7,+$P(IBTRCD,"^",11),0)),"^",3)
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S IBACTION=IBACTION+100 D @IBACTION
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Q
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;
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40 ; -- Discharge contact
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100 ; -- No type of action
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Q
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50 ; -- outpatient treatment
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S IBD(2,1)=" Opt Treatment: "_$$EXPAND^IBTRE(356.2,.26,$P(IBTRCD,"^",26))
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S IBD(3,1)=" Action: "_$$EXPAND^IBTRE(356.2,.11,$P(IBTRCD,"^",11))
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S IBD(4,1)=" Auth. Number: "_$P(IBTRCD,"^",28)
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Q
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60 ; -- Appeal
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65 ; -- Nth appeal
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S IBD(2,1)=" Appeal Type: "_$$EXPAND^IBTRE(356.2,.23,$P(IBTRCD,"^",23))
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S IBD(3,1)=" Case Status: "_$$EXPAND^IBTRE(356.2,.1,$P(IBTRCD,"^",10))
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S IBD(4,1)="No Days Pending: "_$$EXPAND^IBTRE(356.2,.25,$P(IBTRCD,"^",25))
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S IBD(5,1)=" Final Outcome: "_$$EXPAND^IBTRE(356.2,.29,$P(IBTRCD,"^",29))
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Q
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70 ; -- Patient
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80 ; -- Other
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85 ; -- Insurance verification
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90 ;
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Q
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;
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110 ; -- approval actions
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S IBD(3,1)="Authorized From: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",12)))
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S IBD(4,1)=" Authorized To: "_$S($P(IBTRCD1,"^",8):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",13)))
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S IBD(5,1)="Authorized Diag: "_$$DIAG^IBTRE6($P(IBTRCD,"^",14),1,$$TRNDATE^IBACSV($G(IBTRN)))
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S IBD(6,1)=" Auth. Number: "_$P(IBTRCD,"^",28)
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Q
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120 ; -- denial actions
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S IBD(3,1)=" Denied From: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",15)))
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S IBD(4,1)=" Denied To: "_$S($P(IBTRCD1,"^",7):"ENTIRE VISIT",1:$$DAT1^IBOUTL($P(IBTRCD,"^",16)))
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S IBI=0,IBD=4 F S IBI=$O(^IBT(356.2,IBTRC,12,IBI)) Q:'IBI D
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.S IBD=IBD+1
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.S IBD(IBD,1)=" Denial Reasons: "_$$EXPAND^IBTRE(356.212,.01,+$G(^IBT(356.2,IBTRC,12,IBI,0)))
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Q
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130 ; -- penalty
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S IBI=0,IBD=2 F S IBI=$O(^IBT(356.2,IBTRC,13,IBI)) Q:'IBI D
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.S IBD=IBD+1
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.S IBD(IBD,1)=" Penalty: "_$$EXPAND^IBTRE(356.213,.01,+$G(^IBT(356.2,IBTRC,13,IBI,0)))
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Q
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140 ; -- case pending
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S IBD(3,1)=" Case Pending: "_$$EXPAND^IBTRE(356.2,.2,$P(IBTRCD,"^",20))
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Q
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150 ; -- no coverage
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S IBD(3,1)=" No Coverage: "_$$EXPAND^IBTRE(356.2,.21,$P(IBTRCD,"^",21))
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Q
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;
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IR2 ; -- contact information
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;N IBCDFN,IBCPOL
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;S IBCDFN=$P(IBTRCD1,"^",5),IBCPOL=$P(^DPT(DFN,.312,IBCDFN,0),"^",18)
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S IBD(1,2)=" Review Date: "_$E($$DAT1^IBOUTL(+IBTRCD,"2P"),1,20)
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S IBD(2,2)=" Insurance Co.: "_$E($P($G(^DIC(36,+$G(^DPT(DFN,.312,+$P(IBTRCD1,"^",5),0)),0)),"^"),1,20)
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S IBD(3,2)="Person Contacted: "_$E($P(IBTRCD,"^",6),1,20)
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S IBD(4,2)=" Contact Method: "_$E($$EXPAND^IBTRE(356.2,.17,$P(IBTRCD,"^",17)),1,20)
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S IBD(5,2)="Call Ref. Number: "_$E($P(IBTRCD,"^",9),1,20)
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S IBD(6,2)=" Status: "_$E($$EXPAND^IBTRE(356.2,.19,$P(IBTRCD,"^",19)),1,20)
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S IBD(7,2)=" Last Edited By: "_$E($$EXPAND^IBTRE(356.2,1.04,$P($G(^IBT(356.2,+$G(IBTRC),1)),"^",4)),1,20)
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I '$P(IBTRCD,"^",2) S IBD(2,2)="Patient Contacted: "_$E($P($G(^DPT(+$P(IBTRCD,"^",5),0)),"^"),1,20)
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Q
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;
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COMM2(DA) ; -- print comments from ins. reviews.
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W !,"Comment: "
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Q:'$D(^IBT(356.2,DA,11))
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K ^UTILITY($J,"W")
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S DIWL=10,DIWR=IOM-12,DIWF="W"
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S IBJ=0 F S IBJ=$O(^IBT(356.2,DA,11,IBJ)) Q:'IBJ S X=^(IBJ,0) D ^DIWP I IOSL<($Y+4) Q:IBQUIT D HDR^IBTOBI
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Q:IBQUIT
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D ^DIWW
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K ^UTILITY($J,"W")
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Q
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