Routine: DGMTP4

DGMTP4 ;ALB/RMO,CAW,LD - Print Means Test 10-10F Cont. ;16 APR 1992 2:35 pm

 ;;5.3;Registration;**33,182,300,1015**;Aug 13, 1993;Build 21

EN ;Entry point to print signature block and special notes

 ; Set category, status and type of care variables from means test file.

 ; These are initially set in DGMTP with the call to SET^DGMTSCU2, but

 ; are calculated by the data available.  For this portion of the

 ; printout they should be set to the means test file entry.

 N DGCAT,DGMTS,DGTYC,X

 S DGMTS=$P(DGMT0,"^",3),DGCAT=$P($$MTS^DGMTU(DFN,$S(DGMTS=2:6,1:DGMTS)),"^",2),DGTYC=$P($G(^DG(408.32,DGMTS,0)),"^",3)

 D SIG,NOTE

Q Q

SIG ;Print signature block

 W $$UL^DGMTSCU1(DGUL,DGLNE1),!?30,"Completion of this form with signature of veteran is certification",!?30,"that the veteran has received a copy of the privacy act statement."

 W $$UL^DGMTSCU1(DGUL,DGLNE1),!?1,"THE ABOVE INFORMATION IS CORRECT",?63,"| Signature of Veteran or Designee",?109,"| Date",!?1,"TO THE BEST OF MY KNOWLEDGE.",?63,"|",?109,"|"

 W $$UL^DGMTSCU1(DGUL,DGLNE1),!,?37,"F.  TO BE COMPLETED BY DISCRETIONARY VETERANS WHO",!,?41,"ARE REQUIRED TO MAKE COPAYMENTS"

 W $$UL^DGMTSCU1(DGUL,DGLNE1),!?1,"Eligibility Category",?30,"| Veterans in Category C must agree to pay VA a Deductible not to exceed the Medicare"

 W !?30,"| Deductible plus a per diem for Hospital and Nursing Home care.  A per Visit",!

 W:DGMTYPT=1 ?11,DGCAT

 W ?30,"| Deductible is required for Category C Veterans to receive Outpatient care."

 W !?30,"| The Billing Period and Rates are specified in 38 U.S.C."

 W $$UL^DGMTSCU1(DGUL,DGLNE1),!?1,"I AGREE TO PAY THE VA THE APPLICABLE",?63,"| Signature of Veteran or Designee",?109,"| Date"

 W !?1,"DEDUCTIBLE FOR MY MEDICAL CARE.",?63,"|        ",$S(DGTYC'="D":"NOT APPLICABLE",'$P(DGMT0,"^",11):"HAS NOT AGREED",1:""),?109,"|"

NOTE ;Print any special notes

 W !,DGLNE,!?1,"Special Note(s):"

 S X=+$P(DGMT0,"^",23) I (X>1) W ?30,"This means test was administered by the ",$S(X<4:"IVM",1:$$SR^DGMTAUD1(DGMT0,DGMTI)_" Medical")," Center.",!

 I DGMTS=2 W ?30,"Patient's means test is Pending Adjudication.",!

 I DGMTS=3 W ?30,"Patient's means test is No Longer Required.",!

 I $P(DGMT0,"^",14),DGMTS=6 W ?30,"Patient has declined to provide income information.",!

 I $P(DGMT0,"^",16) W ?30,"Previous years thresholds were used to determine the patient's eligibility for care.",!?30,"The means test must be re-applied once the correct thresholds are available.",!

 I $P(DGMT0,"^",4)'=DGINT W ?30,"Patient's annual income does not match the income associated with the means test." W:DGTYC'="N" !?30,"Please edit and complete the means test again.",!

 I $P(DGMT0,"^",19)=2 W ?30,"Copay Exemption Test Status is: "_$S($P(DGMT0,U,3)=7:"EXEMPT",$P(DGMT0,U,3)=8:"NON-EXEMPT",$P(DGMT0,U,3)=9:"INCOMPLETE",$P(DGMT0,U,3)=10:"NO LONGER APPLICABLE",$P(DGMT0,U,3)=11:"PENDING ADJUDICATION",1:"")

 W ! S DGPGE=2 D FT^DGMTP ;end of second page of form

DGMTP4    ;ALB/RMO,CAW,LD - Print Means Test 10-10F Cont. ;16 APR 1992 2:35 pm

 +1       ;;5.3;Registration;**33,182,300,1015**;Aug 13, 1993;Build 21

 +2       ;

EN        ;Entry point to print signature block and special notes

 +1       ; Set category, status and type of care variables from means test file.

 +2       ; These are initially set in DGMTP with the call to SET^DGMTSCU2, but

 +3       ; are calculated by the data available.  For this portion of the

 +4       ; printout they should be set to the means test file entry.

 +5        NEW DGCAT,DGMTS,DGTYC,X

 +6        SET DGMTS=$PIECE(DGMT0,"^",3)

           SET DGCAT=$PIECE($$MTS^DGMTU(DFN,$SELECT(DGMTS=2:6,1:DGMTS)),"^",2)

           SET DGTYC=$PIECE($GET(^DG(408.32,DGMTS,0)),"^",3)

 +7        DO SIG

           DO NOTE

Q          QUIT

 +1       ;

SIG       ;Print signature block

 +1        WRITE $$UL^DGMTSCU1(DGUL,DGLNE1),!?30,"Completion of this form with signature of veteran is certification",!?30,"that the veteran has received a copy of the privacy act statement."

 +2        WRITE $$UL^DGMTSCU1(DGUL,DGLNE1),!?1,"THE ABOVE INFORMATION IS CORRECT",?63,"| Signature of Veteran or Designee",?109,"| Date",!?1,"TO THE BEST OF MY KNOWLEDGE.",?63,"|",?109,"|"

 +3        WRITE $$UL^DGMTSCU1(DGUL,DGLNE1),!,?37,"F.  TO BE COMPLETED BY DISCRETIONARY VETERANS WHO",!,?41,"ARE REQUIRED TO MAKE COPAYMENTS"

 +4        WRITE $$UL^DGMTSCU1(DGUL,DGLNE1),!?1,"Eligibility Category",?30,"| Veterans in Category C must agree to pay VA a Deductible not to exceed the Medicare"

 +5        WRITE !?30,"| Deductible plus a per diem for Hospital and Nursing Home care.  A per Visit",!

 +6        IF DGMTYPT=1

               WRITE ?11,DGCAT

 +7        WRITE ?30,"| Deductible is required for Category C Veterans to receive Outpatient care."

 +8        WRITE !?30,"| The Billing Period and Rates are specified in 38 U.S.C."

 +9        WRITE $$UL^DGMTSCU1(DGUL,DGLNE1),!?1,"I AGREE TO PAY THE VA THE APPLICABLE",?63,"| Signature of Veteran or Designee",?109,"| Date"

 +10       WRITE !?1,"DEDUCTIBLE FOR MY MEDICAL CARE.",?63,"|        ",$SELECT(DGTYC'="D":"NOT APPLICABLE",'$PIECE(DGMT0,"^",11):"HAS NOT AGREED",1:""),?109,"|"

 +11       QUIT

 +12      ;

NOTE      ;Print any special notes

 +1        WRITE !,DGLNE,!?1,"Special Note(s):"

 +2        SET X=+$PIECE(DGMT0,"^",23)

           IF (X>1)

               WRITE ?30,"This means test was administered by the ",$SELECT(X<4:"IVM",1:$$SR^DGMTAUD1(DGMT0,DGMTI)_" Medical")," Center.",!

 +3        IF DGMTS=2

               WRITE ?30,"Patient's means test is Pending Adjudication.",!

 +4        IF DGMTS=3

               WRITE ?30,"Patient's means test is No Longer Required.",!

 +5        IF $PIECE(DGMT0,"^",14)

               IF DGMTS=6

                   WRITE ?30,"Patient has declined to provide income information.",!

 +6        IF $PIECE(DGMT0,"^",16)

               WRITE ?30,"Previous years thresholds were used to determine the patient's eligibility for care.",!?30,"The means test must be re-applied once the correct thresholds are available.",!

 +7        IF $PIECE(DGMT0,"^",4)'=DGINT

               WRITE ?30,"Patient's annual income does not match the income associated with the means test."

               IF DGTYC'="N"

                   WRITE !?30,"Please edit and complete the means test again.",!

 +8        IF $PIECE(DGMT0,"^",19)=2

               WRITE ?30,"Copay Exemption Test Status is: "_$SELECT($PIECE(DGMT0,U,3)=7:"EXEMPT",$PIECE(DGMT0,U,3)=8:"NON-EXEMPT",$PIECE(DGMT0,U,3)=9:"INCOMPLETE",$PIECE(DGMT0,U,3)=10:"NO LONGER APPLICABLE",$PIECE(DGMT0,U,3)=11:"PENDING ADJUDICATION",1:""

 +9       ;end of second page of form

           WRITE !

           SET DGPGE=2

           DO FT^DGMTP

 +10       QUIT

DGMTP4.m