- IBCEMSR6 ;ALB/VAD - IB PRINTED CLAIMS REPORT - Sort ;09-SEP-2015
- ;;2.0;INTEGRATED BILLING;**547,759**;21-MAR-94;Build 24
- ;;Per VA Directive 6402, this routine should not be modified.
- ;
- SRCH ; Collect Information
- ; Use the existing AP x-ref to narrow down the list of claims by date,
- ; then check field 27 to see if it's appropriate to put it on the report (1=LOCAL PRINT)
- ;The following line is used to find Bills in the Printed Date Range and the FORCE TO PRINT field
- N BILLNO,IBBILZ,IBDV,IBDT,IBIFN,IBFTYP,IBTOP,IBRTN,IBRVCDS,IBSRT,IBTYPE,INSADD,LOCCNT,RCX,TOTCNT
- N INSCO,IBSFLD,IBULD,IBINS,X,RTDSC,IBRVCD,IBTOPN,VARRAY,IBRTDS,IBPTYP,IBBLLR
- K ^TMP($J,"IBCEMSRP-DATA")
- D INIT
- S IBDT=IBBDT-.1,IBSRT=$P(IBSORT,U)
- S (TOTCNT,LOCCNT)=0
- F S IBDT=$O(^DGCR(399,"AP",IBDT)) Q:'IBDT!(IBDT>IBEDT) D ; Identify those claims within the selected date range
- . S IBIFN=0 F S IBIFN=$O(^DGCR(399,"AP",IBDT,IBIFN)) Q:'IBIFN D
- . . S IBBILZ=$G(^DGCR(399,IBIFN,0)),IBRTN=$P(IBBILZ,U,7),IBDV=+$P(IBBILZ,U,22) ; Get Rate Type and division
- . . Q:$P(IBBILZ,U,13)'=4 ; don't include canceled claims
- . . Q:'$D(IBDIVS(IBDV)) ; Not one of the selected Divisions
- . . S TOTCNT=TOTCNT+1 ; Accumulate Total Printed for selected divisions.
- . . I $P($G(^DGCR(399,IBIFN,"TX")),U,8)'=1 Q ; Is the Bill "FORCE LOCAL PRINT"?
- . . ; don't include US Labor Dept claims; 5/1/23;IB*2.0*759v2;EBILL-3377;Patient resp claims may have no insurance, Q:IBINS=""
- . . S IBINS=$$CURR^IBCEF2(IBIFN) Q:IBINS="" Q:$D(VARRAY("IBULD",IBINS))
- . . ; don't count claims where EDI is inactive (user has to print those)
- . . Q:$$INSOK^IBCEF4(IBINS)'=1
- . . Q:'$D(VARRAY("RTYPES",IBRTN)) ;Is this one of the selected Rate Types?
- . . S IBTOP=+$P($G(^IBA(355.3,+$$POLICY^IBCEF(IBIFN,18),0)),U,9) ; Get Plan Type
- . . Q:'$D(VARRAY("IBTOP",IBTOP)) ;Is this one of the selected Plan Types?
- . . S RCX=0
- . . S (IBRVCDS,X)="" F S X=$O(^DGCR(399,IBIFN,"RC","B",X)) Q:X="" D Q:RCX
- . . . I $D(VARRAY("XRVCDS",X)) S RCX=1 Q ; Bill contains a Revenue Code Exclusion.
- . . . S IBRVCDS=$S(IBRVCDS="":X,1:IBRVCDS_","_X) ; Get Revenue Codes.
- . . Q:RCX=1 ; bill contains at least one of the excluded revenue codes
- . . S LOCCNT=LOCCNT+1 ; Accumulate Only Locally Printed that could have gone electronically and meet all the search criteria.
- . . S IBRTDS=$G(VARRAY("RTYPES",IBRTN)) ; Get the Rate Type Description
- . . S IBPTYP=$G(VARRAY("IBTOP",IBTOP)) ; Get Plan Type name
- . . S BILLNO=$$BN1^PRCAFN(IBIFN) ; Get external CLAIM # DBIA #380
- . . S INSCO=$P($G(^DIC(36,IBINS,0)),U) ; Get Insurance Company Name
- . . S INSADD=$$CURRINS^IBCEPTC2(IBIFN) ; Get Insurance Company Address
- . . S IBFTYP=$P($G(^IBE(353,+$P(IBBILZ,U,19),0)),U) I IBFTYP="" S IBFTYP="UNKNOWN" ; Get the Bill's Form Type.
- . . S IBTYPE=$S($P(IBBILZ,U,5)>2:"O",1:"I")_"/"_$S($P(IBBILZ,U,27)=1:"I",$P(IBBILZ,U,27)=2:"P",1:"") ; Patient Status / Bill Charge Type
- . . S IBBLLR=$P($$BILLER^IBCIUT5(IBIFN),U,2) ; Get Biller
- . . ; GATHER REPORTABLE DATA AND STORE ACCORDING TO THE VALUE OF IBSORT INTO ^TMP($J,"IBCEMSRP-DATA")!!!
- . . S IBSFLD=$S(IBSRT="I":INSCO,IBSRT="R":IBRTDS,IBSRT="F":IBFTYP,IBSRT="P":IBPTYP,1:IBBLLR)
- . . ; if sorted by insurance company, add address to subheader
- . . S:IBSRT="I" ^TMP($J,"IBCEMSRP-DATA",INSCO)=INSADD
- . . S ^TMP($J,"IBCEMSRP-DATA",IBSFLD,BILLNO)=IBTYPE_U_IBRTDS_U_IBPTYP_U_$G(IBDIVS(IBDV))_U_IBBLLR_U_INSCO_U_INSADD
- . . S ^TMP($J,"IBCEMSRP-DATA",IBSFLD,BILLNO,"RVCDS")=IBRVCDS
- S ^TMP($J,"IBCEMSRP-DATA")=LOCCNT_U_TOTCNT
- Q
- ;
- INIT ; come here to set up search criteria
- ; Get ien of US Labor Department payer (cover all possible name variations)
- S IBULD=$O(^DIC(36,"B","US LABOR DEPARTMENT","")) S:IBULD'="" VARRAY("IBULD",IBULD)=""
- S IBULD=$O(^DIC(36,"B","US DEPT OF LABOR","")) S:IBULD'="" VARRAY("IBULD",IBULD)=""
- S IBULD=$O(^DIC(36,"B","US DEPARTMENT OF LABOR","")) S:IBULD'="" VARRAY("IBULD",IBULD)=""
- ; handle claims that do not have a type of plan
- S VARRAY("IBTOP",0)="UNKNOWN"
- ; Claim does not contain excluded revenue codes from IB Site parameters
- S IBRVCD="" F S IBRVCD=$O(^IBE(350.9,1,15,"B",IBRVCD)) Q:'IBRVCD S VARRAY("XRVCDS",IBRVCD)=""
- ; Tricare Rate Type is one of the following and type of plan is one of the following:
- I IBCOT="T" D Q
- .F RTDSC="CHAMPVA REIMB. INS.","CHAMPVA","TRICARE REIMB. INS.","TRICARE" S IBRTN=$O(^DGCR(399.3,"B",RTDSC,"")) I IBRTN S VARRAY("RTYPES",IBRTN)=RTDSC
- .F IBTOPN="TRICARE","CHAMPVA","TRICARE SUPPLEMENTAL" S IBTOP=$O(^IBE(355.1,"B",IBTOPN,"")) I IBTOP S VARRAY("IBTOP",IBTOP)=IBTOPN
- ; CPAC Rate Type is one of the following and type of plan is one of the following:
- I IBCOT="C" D Q
- .F RTDSC="CRIME VICTIM","NO FAULT INS.","REIMBURSABLE INS.","TORT FEASOR","WORKERS' COMP." S IBRTN=$O(^DGCR(399.3,"B",RTDSC,"")) I IBRTN S VARRAY("RTYPES",IBRTN)=RTDSC
- .F IBTOPN="ACCIDENT AND HEALTH INSURANCE","AUTOMOBILE","CARVE-OUT","CATASTROPHIC INSURANCE","COMPREHENSIVE MAJOR MEDICAL" S IBTOP=$O(^IBE(355.1,"B",IBTOPN,"")) I IBTOP S VARRAY("IBTOP",IBTOP)=IBTOPN
- .F IBTOPN="HEALTH MAINTENANCE ORGANIZ","INCOME PROTECTION (INDEMNITY)","INDIVIDUAL PRACTICE ASSOCATION (IPA)" S IBTOP=$O(^IBE(355.1,"B",IBTOPN,"")) I IBTOP S VARRAY("IBTOP",IBTOP)=IBTOPN
- .F IBTOPN="INPATIENT (BASIC HOSPITAL)","LABS, PROCEDURES, X-RAY, ETC. (ONLY)","MANAGED CARE SYSTEM (MCS)","MEDI-CAL","MEDICAID" S IBTOP=$O(^IBE(355.1,"B",IBTOPN,"")) I IBTOP S VARRAY("IBTOP",IBTOP)=IBTOPN
- .F IBTOPN="MEDICAL EXPENSE (OPT/PROF)","MEDICARE SECONDARY (B EXC)","MEDICARE SECONDARY (NO B EXC)","MEDICARE SUPPLEMENTAL" S IBTOP=$O(^IBE(355.1,"B",IBTOPN,"")) I IBTOP S VARRAY("IBTOP",IBTOP)=IBTOPN
- .F IBTOPN="MEDICARE/MEDICAID (MEDI-CAL)","MEDIGAP PLAN A","MEDIGAP PLAN B","MEDIGAP PLAN C","MEDIGAP PLAN D","MEDIGAP PLAN F" S IBTOP=$O(^IBE(355.1,"B",IBTOPN,"")) I IBTOP S VARRAY("IBTOP",IBTOP)=IBTOPN
- .F IBTOPN="MEDIGAP PLAN G","MEDIGAP PLAN K","MEDIGAP PLAN L","MEDIGAP PLAN M","MEDIGAP PLAN N","MENTAL HEALTH","POINT OF SERVICE" S IBTOP=$O(^IBE(355.1,"B",IBTOPN,"")) I IBTOP S VARRAY("IBTOP",IBTOP)=IBTOPN
- .F IBTOPN="PREFERRED PROVIDER ORGANIZATION (PPO)","PREPAID GROUP PRACTICE PLAN","PRESCRIPTION","RETIREE","SPECIAL CLASS INSURANCE" S IBTOP=$O(^IBE(355.1,"B",IBTOPN,"")) I IBTOP S VARRAY("IBTOP",IBTOP)=IBTOPN
- .F IBTOPN="SPECIAL RISK INSURANCE","SPECIFIED DISEASE INSURANCE","SURGICAL EXPENSE INSURANCE","WORKERS' COMPENSATION INSURANCE" S IBTOP=$O(^IBE(355.1,"B",IBTOPN,"")) I IBTOP S VARRAY("IBTOP",IBTOP)=IBTOPN
- Q
- ;
- --- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HIBCEMSR6 6517 printed Feb 18, 2025@23:37:33 Page 2
- IBCEMSR6 ;ALB/VAD - IB PRINTED CLAIMS REPORT - Sort ;09-SEP-2015
- +1 ;;2.0;INTEGRATED BILLING;**547,759**;21-MAR-94;Build 24
- +2 ;;Per VA Directive 6402, this routine should not be modified.
- +3 ;
- SRCH ; Collect Information
- +1 ; Use the existing AP x-ref to narrow down the list of claims by date,
- +2 ; then check field 27 to see if it's appropriate to put it on the report (1=LOCAL PRINT)
- +3 ;The following line is used to find Bills in the Printed Date Range and the FORCE TO PRINT field
- +4 NEW BILLNO,IBBILZ,IBDV,IBDT,IBIFN,IBFTYP,IBTOP,IBRTN,IBRVCDS,IBSRT,IBTYPE,INSADD,LOCCNT,RCX,TOTCNT
- +5 NEW INSCO,IBSFLD,IBULD,IBINS,X,RTDSC,IBRVCD,IBTOPN,VARRAY,IBRTDS,IBPTYP,IBBLLR
- +6 KILL ^TMP($JOB,"IBCEMSRP-DATA")
- +7 DO INIT
- +8 SET IBDT=IBBDT-.1
- SET IBSRT=$PIECE(IBSORT,U)
- +9 SET (TOTCNT,LOCCNT)=0
- +10 ; Identify those claims within the selected date range
- FOR
- SET IBDT=$ORDER(^DGCR(399,"AP",IBDT))
- if 'IBDT!(IBDT>IBEDT)
- QUIT
- Begin DoDot:1
- +11 SET IBIFN=0
- FOR
- SET IBIFN=$ORDER(^DGCR(399,"AP",IBDT,IBIFN))
- if 'IBIFN
- QUIT
- Begin DoDot:2
- +12 ; Get Rate Type and division
- SET IBBILZ=$GET(^DGCR(399,IBIFN,0))
- SET IBRTN=$PIECE(IBBILZ,U,7)
- SET IBDV=+$PIECE(IBBILZ,U,22)
- +13 ; don't include canceled claims
- if $PIECE(IBBILZ,U,13)'=4
- QUIT
- +14 ; Not one of the selected Divisions
- if '$DATA(IBDIVS(IBDV))
- QUIT
- +15 ; Accumulate Total Printed for selected divisions.
- SET TOTCNT=TOTCNT+1
- +16 ; Is the Bill "FORCE LOCAL PRINT"?
- IF $PIECE($GET(^DGCR(399,IBIFN,"TX")),U,8)'=1
- QUIT
- +17 ; don't include US Labor Dept claims; 5/1/23;IB*2.0*759v2;EBILL-3377;Patient resp claims may have no insurance, Q:IBINS=""
- +18 SET IBINS=$$CURR^IBCEF2(IBIFN)
- if IBINS=""
- QUIT
- if $DATA(VARRAY("IBULD",IBINS))
- QUIT
- +19 ; don't count claims where EDI is inactive (user has to print those)
- +20 if $$INSOK^IBCEF4(IBINS)'=1
- QUIT
- +21 ;Is this one of the selected Rate Types?
- if '$DATA(VARRAY("RTYPES",IBRTN))
- QUIT
- +22 ; Get Plan Type
- SET IBTOP=+$PIECE($GET(^IBA(355.3,+$$POLICY^IBCEF(IBIFN,18),0)),U,9)
- +23 ;Is this one of the selected Plan Types?
- if '$DATA(VARRAY("IBTOP",IBTOP))
- QUIT
- +24 SET RCX=0
- +25 SET (IBRVCDS,X)=""
- FOR
- SET X=$ORDER(^DGCR(399,IBIFN,"RC","B",X))
- if X=""
- QUIT
- Begin DoDot:3
- +26 ; Bill contains a Revenue Code Exclusion.
- IF $DATA(VARRAY("XRVCDS",X))
- SET RCX=1
- QUIT
- +27 ; Get Revenue Codes.
- SET IBRVCDS=$SELECT(IBRVCDS="":X,1:IBRVCDS_","_X)
- End DoDot:3
- if RCX
- QUIT
- +28 ; bill contains at least one of the excluded revenue codes
- if RCX=1
- QUIT
- +29 ; Accumulate Only Locally Printed that could have gone electronically and meet all the search criteria.
- SET LOCCNT=LOCCNT+1
- +30 ; Get the Rate Type Description
- SET IBRTDS=$GET(VARRAY("RTYPES",IBRTN))
- +31 ; Get Plan Type name
- SET IBPTYP=$GET(VARRAY("IBTOP",IBTOP))
- +32 ; Get external CLAIM # DBIA #380
- SET BILLNO=$$BN1^PRCAFN(IBIFN)
- +33 ; Get Insurance Company Name
- SET INSCO=$PIECE($GET(^DIC(36,IBINS,0)),U)
- +34 ; Get Insurance Company Address
- SET INSADD=$$CURRINS^IBCEPTC2(IBIFN)
- +35 ; Get the Bill's Form Type.
- SET IBFTYP=$PIECE($GET(^IBE(353,+$PIECE(IBBILZ,U,19),0)),U)
- IF IBFTYP=""
- SET IBFTYP="UNKNOWN"
- +36 ; Patient Status / Bill Charge Type
- SET IBTYPE=$SELECT($PIECE(IBBILZ,U,5)>2:"O",1:"I")_"/"_$SELECT($PIECE(IBBILZ,U,27)=1:"I",$PIECE(IBBILZ,U,27)=2:"P",1:"")
- +37 ; Get Biller
- SET IBBLLR=$PIECE($$BILLER^IBCIUT5(IBIFN),U,2)
- +38 ; GATHER REPORTABLE DATA AND STORE ACCORDING TO THE VALUE OF IBSORT INTO ^TMP($J,"IBCEMSRP-DATA")!!!
- +39 SET IBSFLD=$SELECT(IBSRT="I":INSCO,IBSRT="R":IBRTDS,IBSRT="F":IBFTYP,IBSRT="P":IBPTYP,1:IBBLLR)
- +40 ; if sorted by insurance company, add address to subheader
- +41 if IBSRT="I"
- SET ^TMP($JOB,"IBCEMSRP-DATA",INSCO)=INSADD
- +42 SET ^TMP($JOB,"IBCEMSRP-DATA",IBSFLD,BILLNO)=IBTYPE_U_IBRTDS_U_IBPTYP_U_$GET(IBDIVS(IBDV))_U_IBBLLR_U_INSCO_U_INSADD
- +43 SET ^TMP($JOB,"IBCEMSRP-DATA",IBSFLD,BILLNO,"RVCDS")=IBRVCDS
- End DoDot:2
- End DoDot:1
- +44 SET ^TMP($JOB,"IBCEMSRP-DATA")=LOCCNT_U_TOTCNT
- +45 QUIT
- +46 ;
- INIT ; come here to set up search criteria
- +1 ; Get ien of US Labor Department payer (cover all possible name variations)
- +2 SET IBULD=$ORDER(^DIC(36,"B","US LABOR DEPARTMENT",""))
- if IBULD'=""
- SET VARRAY("IBULD",IBULD)=""
- +3 SET IBULD=$ORDER(^DIC(36,"B","US DEPT OF LABOR",""))
- if IBULD'=""
- SET VARRAY("IBULD",IBULD)=""
- +4 SET IBULD=$ORDER(^DIC(36,"B","US DEPARTMENT OF LABOR",""))
- if IBULD'=""
- SET VARRAY("IBULD",IBULD)=""
- +5 ; handle claims that do not have a type of plan
- +6 SET VARRAY("IBTOP",0)="UNKNOWN"
- +7 ; Claim does not contain excluded revenue codes from IB Site parameters
- +8 SET IBRVCD=""
- FOR
- SET IBRVCD=$ORDER(^IBE(350.9,1,15,"B",IBRVCD))
- if 'IBRVCD
- QUIT
- SET VARRAY("XRVCDS",IBRVCD)=""
- +9 ; Tricare Rate Type is one of the following and type of plan is one of the following:
- +10 IF IBCOT="T"
- Begin DoDot:1
- +11 FOR RTDSC="CHAMPVA REIMB. INS.","CHAMPVA","TRICARE REIMB. INS.","TRICARE"
- SET IBRTN=$ORDER(^DGCR(399.3,"B",RTDSC,""))
- IF IBRTN
- SET VARRAY("RTYPES",IBRTN)=RTDSC
- +12 FOR IBTOPN="TRICARE","CHAMPVA","TRICARE SUPPLEMENTAL"
- SET IBTOP=$ORDER(^IBE(355.1,"B",IBTOPN,""))
- IF IBTOP
- SET VARRAY("IBTOP",IBTOP)=IBTOPN
- End DoDot:1
- QUIT
- +13 ; CPAC Rate Type is one of the following and type of plan is one of the following:
- +14 IF IBCOT="C"
- Begin DoDot:1
- +15 FOR RTDSC="CRIME VICTIM","NO FAULT INS.","REIMBURSABLE INS.","TORT FEASOR","WORKERS' COMP."
- SET IBRTN=$ORDER(^DGCR(399.3,"B",RTDSC,""))
- IF IBRTN
- SET VARRAY("RTYPES",IBRTN)=RTDSC
- +16 FOR IBTOPN="ACCIDENT AND HEALTH INSURANCE","AUTOMOBILE","CARVE-OUT","CATASTROPHIC INSURANCE","COMPREHENSIVE MAJOR MEDICAL"
- SET IBTOP=$ORDER(^IBE(355.1,"B",IBTOPN,""))
- IF IBTOP
- SET VARRAY("IBTOP",IBTOP)=IBTOPN
- +17 FOR IBTOPN="HEALTH MAINTENANCE ORGANIZ","INCOME PROTECTION (INDEMNITY)","INDIVIDUAL PRACTICE ASSOCATION (IPA)"
- SET IBTOP=$ORDER(^IBE(355.1,"B",IBTOPN,""))
- IF IBTOP
- SET VARRAY("IBTOP",IBTOP)=IBTOPN
- +18 FOR IBTOPN="INPATIENT (BASIC HOSPITAL)","LABS, PROCEDURES, X-RAY, ETC. (ONLY)","MANAGED CARE SYSTEM (MCS)","MEDI-CAL","MEDICAID"
- SET IBTOP=$ORDER(^IBE(355.1,"B",IBTOPN,""))
- IF IBTOP
- SET VARRAY("IBTOP",IBTOP)=IBTOPN
- +19 FOR IBTOPN="MEDICAL EXPENSE (OPT/PROF)","MEDICARE SECONDARY (B EXC)","MEDICARE SECONDARY (NO B EXC)","MEDICARE SUPPLEMENTAL"
- SET IBTOP=$ORDER(^IBE(355.1,"B",IBTOPN,""))
- IF IBTOP
- SET VARRAY("IBTOP",IBTOP)=IBTOPN
- +20 FOR IBTOPN="MEDICARE/MEDICAID (MEDI-CAL)","MEDIGAP PLAN A","MEDIGAP PLAN B","MEDIGAP PLAN C","MEDIGAP PLAN D","MEDIGAP PLAN F"
- SET IBTOP=$ORDER(^IBE(355.1,"B",IBTOPN,""))
- IF IBTOP
- SET VARRAY("IBTOP",IBTOP)=IBTOPN
- +21 FOR IBTOPN="MEDIGAP PLAN G","MEDIGAP PLAN K","MEDIGAP PLAN L","MEDIGAP PLAN M","MEDIGAP PLAN N","MENTAL HEALTH","POINT OF SERVICE"
- SET IBTOP=$ORDER(^IBE(355.1,"B",IBTOPN,""))
- IF IBTOP
- SET VARRAY("IBTOP",IBTOP)=IBTOPN
- +22 FOR IBTOPN="PREFERRED PROVIDER ORGANIZATION (PPO)","PREPAID GROUP PRACTICE PLAN","PRESCRIPTION","RETIREE","SPECIAL CLASS INSURANCE"
- SET IBTOP=$ORDER(^IBE(355.1,"B",IBTOPN,""))
- IF IBTOP
- SET VARRAY("IBTOP",IBTOP)=IBTOPN
- +23 FOR IBTOPN="SPECIAL RISK INSURANCE","SPECIFIED DISEASE INSURANCE","SURGICAL EXPENSE INSURANCE","WORKERS' COMPENSATION INSURANCE"
- SET IBTOP=$ORDER(^IBE(355.1,"B",IBTOPN,""))
- IF IBTOP
- SET VARRAY("IBTOP",IBTOP)=IBTOPN
- End DoDot:1
- QUIT
- +24 QUIT
- +25 ;
