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