interface/billing/sl_eob_invoice.php

   1 <?
   2   // Copyright (C) 2005 Rod Roark <rod@sunsetsystems.com>
   3   //
   4   // This program is free software; you can redistribute it and/or
   5   // modify it under the terms of the GNU General Public License
   6   // as published by the Free Software Foundation; either version 2
   7   // of the License, or (at your option) any later version.
   8
   9   // This is the second of two pages to support posting of EOBs.
  10   // The first is sl_eob_search.php.
  11
  12   include_once("../globals.php");
  13   include_once("../../library/patient.inc");
  14   include_once("../../library/forms.inc");
  15   include_once("../../library/sql-ledger.inc");
  16   include_once("../../library/invoice_summary.inc.php");
  17   include_once("../../custom/code_types.inc.php");
  18
  19   $debug = 0; // set to 1 for debugging mode
  20
  21   $reasons = array(
  22     xl("Ins adjust"),
  23     xl("Coll w/o"),
  24     xl("Pt released"),
  25     xl("Sm debt w/o"),
  26     xl("To ded'ble"),
  27     xl("To copay"),
  28     xl("Bad check"),
  29     xl("Bad debt"),
  30     xl("Discount"),
  31     xl("Hardship w/o"),
  32     xl("Ins refund"),
  33     xl("Pt refund"),
  34     xl("Ins overpaid"),
  35     xl("Pt overpaid")
  36   );
  37
  38   $info_msg = "";
  39
  40   // Format money for display.
  41   //
  42   function bucks($amount) {
  43     if ($amount)
  44       printf("%.2f", $amount);
  45   }
  46
  47   // Insert a row into the acc_trans table.
  48   //
  49   function addTransaction($invid, $chartid, $amount, $date, $source, $memo, $insplan) {
  50     global $sl_err, $debug;
  51     $date = fixDate($date);
  52     $query = "INSERT INTO acc_trans ( " .
  53       "trans_id, "     .
  54       "chart_id, "     .
  55       "amount, "       .
  56       "transdate, "    .
  57       "source, "       .
  58       "project_id, "   .
  59       "memo "          .
  60       ") VALUES ( "    .
  61       "$invid, "       . // trans_id
  62       "$chartid, "     . // chart_id
  63       "$amount, "      . // amount
  64       "'$date', "      . // transdate
  65       "'$source', "    . // source
  66       "$insplan, "     . // project_id
  67       "'$memo' "       . // memo
  68       ")";
  69     if ($debug) {
  70       echo $query . "<br>\n";
  71     } else {
  72       SLQuery($query);
  73       if ($sl_err) die($sl_err);
  74     }
  75   }
  76
  77   // Insert a row into the invoice table.
  78   //
  79   function addLineItem($invid, $serialnumber, $amount, $adjdate, $insplan, $reason) {
  80     global $sl_err, $services_id, $debug;
  81     $adjdate = fixDate($adjdate);
  82     $description = "Adjustment $adjdate $reason";
  83     $query = "INSERT INTO invoice ( " .
  84       "trans_id, "          .
  85       "parts_id, "          .
  86       "description, "       .
  87       "qty, "               .
  88       "allocated, "         .
  89       "sellprice, "         .
  90       "fxsellprice, "       .
  91       "discount, "          .
  92       "unit, "              .
  93       "project_id, "        .
  94       "serialnumber "       .
  95       ") VALUES ( "         .
  96       "$invid, "            . // trans_id
  97       "$services_id, "      . // parts_id
  98       "'$description', "    . // description
  99       "1, "                 . // qty
 100       "0, "                 . // allocated
 101       "$amount, "           . // sellprice
 102       "$amount, "           . // fxsellprice
 103       "0, "                 . // discount
 104       "'', "                . // unit
 105       "$insplan, "          . // project_id
 106       "'$serialnumber'"     . // serialnumber
 107       ")";
 108     if ($debug) {
 109       echo $query . "<br>\n";
 110     } else {
 111       SLQuery($query);
 112       if ($sl_err) die($sl_err);
 113     }
 114   }
 115
 116   // Update totals and payment date in the invoice header.  Dollar amounts are
 117   // stored as double precision floats so we have to be careful about rounding.
 118   //
 119   function updateAR($invid, $amount, $paid = 0, $paydate = "") {
 120     global $sl_err, $debug;
 121     $paydate = fixDate($paydate);
 122     $query = "UPDATE ar SET amount = round(CAST (amount AS numeric) + $amount, 2), " .
 123       "netamount = round(CAST (netamount AS numeric) + $amount, 2)";
 124     if ($paid) $query .= ", paid = round(CAST (paid AS numeric) + $paid, 2), datepaid = '$paydate'";
 125     $query .= " WHERE id = $invid";
 126     if ($debug) {
 127       echo $query . "<br>\n";
 128     } else {
 129       SLQuery($query);
 130       if ($sl_err) die($sl_err);
 131     }
 132   }
 133
 134   // Do whatever is necessary to make this invoice re-billable.
 135   //
 136   function setupSecondary($invid) {
 137     global $sl_err, $debug, $info_msg, $GLOBALS;
 138
 139     // Get some needed items from the SQL-Ledger invoice.
 140     $arres = SLQuery("select invnumber, transdate, customer_id, employee_id " .
 141       "from ar where ar.id = $invid");
 142     if ($sl_err) die($sl_err);
 143     $arrow = SLGetRow($arres, 0);
 144     if (! $arrow) die(xl('There is no match for invoice id').' = '."$trans_id.");
 145     $customer_id = $arrow['customer_id'];
 146     list($trash, $encounter) = explode(".", $arrow['invnumber']);
 147
 148     // Get the OpenEMR PID corresponding to the customer.
 149     $pdrow = sqlQuery("SELECT patient_data.pid " .
 150       "FROM integration_mapping, patient_data WHERE " .
 151       "integration_mapping.foreign_id = $customer_id AND " .
 152       "integration_mapping.foreign_table = 'customer' AND " .
 153       "patient_data.id = integration_mapping.local_id");
 154     $pid = $pdrow['pid'];
 155     if (! $pid) die(xl("Cannot find patient from SQL-Ledger customer id" )." = $customer_id.");
 156
 157     // Find out if the encounter exists.
 158     $ferow = sqlQuery("SELECT pid FROM form_encounter WHERE " .
 159       "encounter = $encounter");
 160     $encounter_pid = $ferow['pid'];
 161
 162     // If it exists, just update the billing items.
 163     if ($encounter_pid) {
 164       if ($encounter_pid != $pid)
 165         die(xl("Expected form_encounter.pid to be"). $pid.', '. xl('but was'). $encounter_pid);
 166       $query = "UPDATE billing SET billed = 0, bill_process = 0, payer_id = -1, " .
 167         "bill_date = NULL, process_date = NULL, process_file = NULL " .
 168         "WHERE encounter = $encounter AND pid = $pid AND activity = 1";
 169       if ($debug) {
 170         echo $query . "<br>\n";
 171       } else {
 172         sqlQuery($query);
 173       }
 174       $info_msg = xl("Encounter ") . $encounter . xl(" is ready for re-billing.");
 175       return;
 176     }
 177
 178     // It does not exist then it better be a date.
 179     if (! preg_match("/^20\d\d\d\d\d\d$/", $encounter))
 180       die(xl("Internal error: encounter '").$encounter. xl("' should exist but does not."));
 181
 182     $employee_id = $arrow['employee_id'];
 183
 184     // Get the OpenEMR provider info corresponding to the SQL-Ledger salesman.
 185     $drrow = sqlQuery("SELECT users.id, users.username, users.facility " .
 186       "FROM integration_mapping, users WHERE " .
 187       "integration_mapping.foreign_id = $employee_id AND " .
 188       "integration_mapping.foreign_table = 'salesman' AND " .
 189       "users.id = integration_mapping.local_id");
 190     $provider_id = $drrow['id'];
 191     if (! $provider_id) die(xl("Cannot find provider from SQL-Ledger employee = ") . $employee_id );
 192
 193     $date_of_service = $arrow['transdate'];
 194     if (! $date_of_service) die(xl("Invoice has no date!"));
 195
 196     // Generate a new encounter number.
 197     $conn = $GLOBALS['adodb']['db'];
 198     $new_encounter = $conn->GenID("sequences");
 199
 200     // Create the "new encounter".
 201     $encounter_id = 0;
 202     $query = "INSERT INTO form_encounter ( " .
 203       "date, reason, facility, pid, encounter, onset_date " .
 204       ") VALUES ( " .
 205       "'$date_of_service', " .
 206       "xl('Imported from Accounting','e'), " .
 207       "'" . addslashes($drrow['facility']) . "', " .
 208       "$pid, " .
 209       "$new_encounter, " .
 210       "'$date_of_service' " .
 211       ")";
 212     if ($debug) {
 213       echo $query . "<br>\n";
 214       echo xl("Call to addForm() goes here.<br>")."\n";
 215     } else {
 216       $encounter_id = idSqlStatement($query);
 217       if (! $encounter_id) die(xl("Insert failed: " . $query));
 218       addForm($new_encounter, xl("New Patient Encounter"), $encounter_id,
 219         "newpatient", $pid, 1, $date_of_service);
 220       $info_msg = xl("Encounter ") . $new_encounter . xl(" has been created. ");
 221     }
 222
 223     // For each invoice line item with a billing code we will insert
 224     // a billing row with payer_id set to -1.  Order the line items
 225     // chronologically so that each procedure code will be followed by
 226     // its associated icd9 code.
 227
 228     $inres = SLQuery("SELECT * FROM invoice WHERE trans_id = $invid " .
 229       "ORDER BY id");
 230     if ($sl_err) die($sl_err);
 231
 232     // When nonzero, this will be the ID of a billing row that needs to
 233     // have its justify field set.
 234     $proc_ins_id = 0;
 235
 236     for ($irow = 0; $irow < SLRowCount($inres); ++$irow) {
 237       $row = SLGetRow($inres, $irow);
 238       $amount   = $row['sellprice'];
 239
 240       // Extract the billing code.
 241       $code = xl("Unknown");
 242       if (preg_match("/([A-Za-z0-9]\d\d\S*)/", $row['serialnumber'], $matches)) {
 243         $code = strtoupper($matches[1]);
 244       }
 245       else if (preg_match("/([A-Za-z0-9]\d\d\S*)/", $row['description'], $matches)) {
 246         $code = strtoupper($matches[1]);
 247       }
 248
 249       list($code, $modifier) = explode("-", $code);
 250
 251       // Set the billing code type and description.
 252       $code_type = "";
 253       $code_text = "";
 254
 255       /****
 256       if (preg_match("/CPT/", $row['serialnumber'])) {
 257         $code_type = "CPT4";
 258         $code_text = "Procedure $code";
 259       }
 260       else if (preg_match("/HCPCS/", $row['serialnumber'])) {
 261         $code_type = "HCPCS";
 262         $code_text = "Procedure $code";
 263       }
 264       else if (preg_match("/ICD/", $row['serialnumber'])) {
 265         $code_type = "ICD9";
 266         $code_text = "Diagnosis $code";
 267         if ($proc_ins_id) {
 268           $query = "UPDATE billing SET justify = '$code' WHERE id = $proc_ins_id";
 269           if ($debug) {
 270             echo $query . "<br>\n";
 271           } else {
 272             sqlQuery($query);
 273           }
 274           $proc_ins_id = 0;
 275         }
 276       }
 277       ****/
 278
 279       foreach ($code_types as $key => $value) {
 280         if (preg_match("/$key/", $row['serialnumber'])) {
 281           $code_type = $key;
 282           if ($value['fee']) {
 283             $code_text = xl("Procedure")." $code";
 284           } else {
 285             $code_text = xl("Diagnosis")." $code";
 286             if ($proc_ins_id) {
 287               $query = "UPDATE billing SET justify = '$code' WHERE id = $proc_ins_id";
 288               if ($debug) {
 289                 echo $query . "<br>\n";
 290               } else {
 291                 sqlQuery($query);
 292               }
 293               $proc_ins_id = 0;
 294             }
 295           }
 296           break;
 297         }
 298       }
 299
 300       // Skip adjustments.
 301       if (! $code_type) continue;
 302
 303       // Insert the billing item.  If this for a procedure code then save
 304       // the row ID so that we can update the "justify" field with the ICD9
 305       // code, which should come next in the loop.
 306       //
 307       $query = "INSERT INTO billing ( " .
 308         "date, code_type, code, pid, provider_id, user, groupname, authorized, " .
 309         "encounter, code_text, activity, payer_id, billed, bill_process, " .
 310         "modifier, units, fee, justify " .
 311         ") VALUES ( " .
 312         "NOW(), " .
 313         "'$code_type', " .
 314         "'$code', " .
 315         "$pid, " .
 316         "$provider_id, " .
 317         "'" . $_SESSION['authId'] . "', " .
 318         "'" . $_SESSION['authProvider'] . "', " .
 319         "1, " .
 320         "$new_encounter, " .
 321         "'$code_text', " .
 322         "1, " .
 323         "-1, " .
 324         "0, " .
 325         "0, " .
 326         "'$modifier', " .
 327         "0, " .
 328         "$amount, " .
 329         "'' " .
 330         ")";
 331       if ($debug) {
 332         echo $query . "<br>\n";
 333       } else {
 334         $proc_ins_id = idSqlStatement($query);
 335         if ($code_type != "CPT4" && $code_type != "HCPCS")
 336           $proc_ins_id = 0;
 337       }
 338     }
 339
 340     // Finally, change this invoice number to contain the new encounter number.
 341     //
 342     $new_invnumber = "$pid.$new_encounter";
 343     $query = "UPDATE ar SET invnumber = '$new_invnumber' WHERE id = $invid";
 344     if ($debug) {
 345       echo $query . "<br>\n";
 346     } else {
 347       SLQuery($query);
 348       if ($sl_err) die($sl_err);
 349       $info_msg .= xl("This invoice number has been changed to ").$new_invnumber;
 350     }
 351   }
 352 ?>
 353 <html>
 354 <head>
 355 <link rel=stylesheet href="<?echo $css_header;?>" type="text/css">
 356 <title><?xl('EOB Posting - Invoice','e')?></title>
 357 <script language="JavaScript">
 358
 359 // An insurance radio button is selected.
 360 function setins(istr) {
 361  var f = document.forms[0];
 362  for (var i = 0; i < f.elements.length; ++i) {
 363   var ename = f.elements[i].name;
 364   if (ename.indexOf('[src]') < 0) continue;
 365   var evalue = f.elements[i].value;
 366   var tmp = evalue.substring(0, 4).toLowerCase();
 367   if (tmp >= 'ins1' && tmp <= 'ins3')
 368    evalue = evalue.substring(4);
 369   else if (evalue.substring(0, 2).toLowerCase() == 'pt')
 370    evalue = evalue.substring(2);
 371   while (evalue.substring(0, 1) == '/')
 372    evalue = evalue.substring(1);
 373   f.elements[i].value = istr + '/' + evalue;
 374  }
 375  return true;
 376 }
 377
 378 // Compute an adjustment that writes off the balance:
 379 function writeoff(code) {
 380  var f = document.forms[0];
 381  var tmp =
 382   f['form_line[' + code + '][bal]'].value -
 383   f['form_line[' + code + '][pay]'].value;
 384  f['form_line[' + code + '][adj]'].value = Number(tmp).toFixed(2);
 385  return false;
 386 }
 387
 388 // Onsubmit handler.  A good excuse to write some JavaScript.
 389 function validate(f) {
 390  for (var i = 0; i < f.elements.length; ++i) {
 391   var ename = f.elements[i].name;
 392   var pfxlen = ename.indexOf('[pay]');
 393   if (pfxlen < 0) continue;
 394   var pfx = ename.substring(0, pfxlen);
 395   var code = pfx.substring(pfx.indexOf('[')+1, pfxlen-1);
 396   if (f[pfx+'[pay]'].value || f[pfx+'[adj]'].value) {
 397    var srcobj = f[pfx+'[src]'];
 398    while (srcobj.value.length) {
 399     var tmp = srcobj.value.substring(srcobj.value.length - 1);
 400     if (tmp > ' ' && tmp != '/') break;
 401     srcobj.value = srcobj.value.substring(0, srcobj.value.length - 1);
 402    }
 403    var svalue = srcobj.value;
 404    if (! svalue) {
 405     alert(<? xl('Source is missing for code ','e')?> + code);
 406     return false;
 407    } else {
 408     var tmp = svalue.substring(0, 4).toLowerCase();
 409     if (tmp >= 'ins1' && tmp <= 'ins3') {
 410      svalue = svalue.substring(4);
 411     } else if (svalue.substring(0, 2).toLowerCase() == 'pt') {
 412      svalue = svalue.substring(2);
 413     } else {
 414      alert(<?xl('Invalid or missing payer in source for code ','e')?> + code);
 415      return false;
 416     }
 417     if (svalue) {
 418      if (svalue.substring(0, 1) != '/') {
 419       alert(<?xl('Missing slash after payer in source for code ','e')?> + code);
 420       return false;
 421      }
 422      tmp = svalue.substring(1, 3).toLowerCase();
 423      if (tmp != 'nm' && tmp != 'ci' && tmp != 'cp' && tmp != 'ne' &&
 424          tmp != 'it' && tmp != 'pf' && tmp != 'pp' && tmp != 'ok')
 425      {
 426       alert(<?xl('Invalid source designation "','e')?> + tmp + <?xl('" for code ','e')?> + code);
 427       return false;
 428      }
 429     }
 430    }
 431    if (! f[pfx+'[date]'].value) {
 432     alert(<?xl('Date is missing for code ','e')?> + code);
 433     return false;
 434    }
 435   }
 436   if (f[pfx+'[pay]'].value && isNaN(parseFloat(f[pfx+'[pay]'].value))) {
 437    alert(<?xl('Payment value for code ','e')?> + code + <?xl(' is not a number','e')?>);
 438    return false;
 439   }
 440   if (f[pfx+'[adj]'].value && isNaN(parseFloat(f[pfx+'[adj]'].value))) {
 441    alert(<?xl('Adjustment value for code ','e')?> + code + <?xl(' is not a number','e')?>);
 442    return false;
 443   }
 444   // TBD: validate the date format
 445  }
 446  return true;
 447 }
 448
 449 </script>
 450 </head>
 451 <body leftmargin='0' topmargin='0' marginwidth='0' marginheight='0'>
 452 <?
 453   $trans_id = $_GET['id'];
 454   if (! $trans_id) die(xl("You cannot access this page directly."));
 455
 456   SLConnect();
 457
 458   $chart_id_cash = SLQueryValue("select id from chart where accno = '$sl_cash_acc'");
 459   if ($sl_err) die($sl_err);
 460   if (! $chart_id_cash) die(xl("There is no COA entry for cash account ").'$sl_cash_acc');
 461
 462   $chart_id_ar = SLQueryValue("select id from chart where accno = '$sl_ar_acc'");
 463   if ($sl_err) die($sl_err);
 464   if (! $chart_id_ar) die(xl("There is no COA entry for AR account ").'$sl_ar_acc');
 465
 466   $chart_id_income = SLQueryValue("select id from chart where accno = '$sl_income_acc'");
 467   if ($sl_err) die($sl_err);
 468   if (! $chart_id_income) die(xl("There is no COA entry for income account ").'$sl_income_acc');
 469
 470   $services_id = SLQueryValue("select id from parts where partnumber = '$sl_services_id'");
 471   if ($sl_err) die($sl_err);
 472   if (! $services_id) die(xl("There is no parts entry for services ID ").'$sl_services_id');
 473
 474   if ($_POST['form_save'] || $_POST['form_cancel']) {
 475     if ($_POST['form_save']) {
 476       if ($debug) {
 477         echo xl("This module is in test mode. The database will not be changed.",'','<p><b>',"</b><p>\n");
 478       }
 479       $paytotal = 0;
 480       foreach ($_POST['form_line'] as $code => $cdata) {
 481         $thissrc  = trim($cdata['src']);
 482         $thisdate = trim($cdata['date']);
 483         $thispay  = trim($cdata['pay']);
 484         $thisadj  = trim($cdata['adj']);
 485         $thisins  = trim($cdata['ins']);
 486         $reason   = trim($cdata['reason']);
 487         if (strpos(strtolower($reason), 'ins') !== false)
 488           $reason .= ' ' . $_POST['form_insurance'];
 489         if (! $thisins) $thisins = 0;
 490         if ($thispay) {
 491           // Post a payment: add to ar, subtract from cash.
 492           addTransaction($trans_id, $chart_id_ar, $thispay, $thisdate, $thissrc, $code, $thisins);
 493           addTransaction($trans_id, $chart_id_cash, 0 - $thispay, $thisdate, $thissrc, $code, $thisins);
 494           updateAR($trans_id, 0, $thispay, $thisdate);
 495           $paytotal += $thispay;
 496         }
 497         if ($thisadj) {
 498           // Post an adjustment: add negative invoice item, add to ar, subtract from income
 499           addLineItem($trans_id, $code, 0 - $thisadj, $thisdate, $thisins, $reason);
 500           addTransaction($trans_id, $chart_id_ar, $thisadj, $thisdate, "InvAdj $thissrc", $code, $thisins);
 501           addTransaction($trans_id, $chart_id_income, 0 - $thisadj, $thisdate, "InvAdj $thissrc", $code, $thisins);
 502           updateAR($trans_id, 0 - $thisadj);
 503         }
 504       }
 505       $form_duedate = fixDate($_POST['form_duedate']);
 506       $form_notes = trim($_POST['form_notes']);
 507
 508       // Maintain the list of insurances that we mark as finished.
 509       // We use the "Ship Via" field of the invoice to hold these.
 510       //
 511       $form_eobs = "";
 512       foreach (array('Ins1', 'Ins2', 'Ins3') as $value) {
 513         if ($_POST["form_done_$value"]) {
 514           if ($form_eobs) $form_eobs .= ","; else $form_eobs = "Done: ";
 515           $form_eobs .= $value;
 516         }
 517       }
 518
 519       $query = "UPDATE ar SET duedate = '$form_duedate', notes = '$form_notes', " .
 520         "shipvia = '$form_eobs' WHERE id = $trans_id";
 521
 522       if ($debug) {
 523         echo $query . "<br>\n";
 524       } else {
 525         SLQuery($query);
 526         if ($sl_err) die($sl_err);
 527       }
 528       if ($_POST['form_secondary']) {
 529         setupSecondary($trans_id);
 530       }
 531       echo "<script language='JavaScript'>\n";
 532       echo " var tmp = opener.document.forms[0].form_amount.value - $paytotal;\n";
 533       echo " opener.document.forms[0].form_amount.value = Number(tmp).toFixed(2);\n";
 534     } else {
 535       echo "<script language='JavaScript'>\n";
 536     }
 537     if ($info_msg) echo " alert('$info_msg');\n";
 538     if (! $debug) echo " window.close();\n";
 539     echo "</script></body></html>\n";
 540     SLClose();
 541     exit();
 542   }
 543
 544   // Get invoice data into $arrow.
 545   $arres = SLQuery("select ar.*, customer.name, employee.name as doctor " .
 546     "from ar, customer, employee where ar.id = $trans_id and " .
 547     "customer.id = ar.customer_id and employee.id = ar.employee_id");
 548   if ($sl_err) die($sl_err);
 549   $arrow = SLGetRow($arres, 0);
 550   if (! $arrow) die(xl("There is no match for invoice id = ") . $trans_id);
 551
 552   // Determine the date of service.  An 8-digit encounter number is
 553   // presumed to be a date of service imported during conversion.
 554   // Otherwise look it up in the form_encounter table.
 555   //
 556   $svcdate = "";
 557   list($trash, $encounter) = explode(".", $arrow['invnumber']);
 558   if (strlen($encounter) == 8) {
 559     $svcdate = substr($encounter, 0, 4) . "-" . substr($encounter, 4, 2) .
 560       "-" . substr($encounter, 6, 2);
 561   }
 562   else if ($encounter) {
 563     $tmp = sqlQuery("SELECT date FROM form_encounter WHERE " .
 564       "encounter = $encounter");
 565     $svcdate = substr($tmp['date'], 0, 10);
 566   }
 567
 568   // Get invoice charge details.
 569   $codes = get_invoice_summary($trans_id, true);
 570 ?>
 571 <center>
 572
 573 <form method='post' action='sl_eob_invoice.php?id=<? echo $trans_id ?>'
 574  onsubmit='return validate(this)'>
 575
 576 <table border='0' cellpadding='3'>
 577  <tr>
 578   <td>
 579    <?xl('Patient:','e')?>
 580   </td>
 581   <td>
 582    <?echo $arrow['name'] ?>
 583   </td>
 584   <td colspan="2" rowspan="3">
 585    <textarea name="form_notes" cols="50" style="height:100%"><?echo $arrow['notes'] ?></textarea>
 586   </td>
 587  </tr>
 588  <tr>
 589   <td>
 590    <?xl('Provider:','e')?>
 591   </td>
 592   <td>
 593    <?echo $arrow['doctor'] ?>
 594   </td>
 595  </tr>
 596  <tr>
 597   <td>
 598    <?xl('Invoice:','e')?>
 599   </td>
 600   <td>
 601    <?echo $arrow['invnumber'] ?>
 602   </td>
 603  </tr>
 604
 605  <tr>
 606   <td>
 607    <?xl('Svc Date:','e')?>
 608   </td>
 609   <td>
 610    <?echo $svcdate ?>
 611   </td>
 612   <td colspan="2">
 613    <!-- <?echo $arrow['shipvia'] ?> -->
 614    <?xl('Done with:','e','',"&nbsp")?>;
 615 <?
 616  // Write a checkbox for each insurance.  It is to be checked when
 617  // we no longer expect any payments from that company for the claim.
 618  // The information is stored in the 'shipvia' field of the invoice.
 619  //
 620  $insgot  = strtolower($arrow['notes']);
 621  $insdone = strtolower($arrow['shipvia']);
 622  foreach (array('Ins1', 'Ins2', 'Ins3') as $value) {
 623   $lcvalue = strtolower($value);
 624   $checked  = (strpos($insdone, $lcvalue) === false) ? "" : " checked";
 625   if (strpos($insgot, $lcvalue) !== false) {
 626    echo "   <input type='checkbox' name='form_done_$value' value='1'$checked />$value&nbsp;\n";
 627   }
 628  }
 629 ?>
 630   </td>
 631  </tr>
 632
 633  <tr>
 634   <td>
 635    <?php xl('Bill Date:','e') ?>
 636   </td>
 637   <td>
 638    <?echo $arrow['transdate'] ?>
 639   </td>
 640   <td colspan="2">
 641    <?xl('Now posting for:','e','',"&nbsp")?>;
 642    <input type='radio' name='form_insurance' value='Ins1' onclick='setins("Ins1")' checked /><?xl('Ins1','e')?>&nbsp;
 643    <input type='radio' name='form_insurance' value='Ins2' onclick='setins("Ins2")' /><?xl('Ins2','e')?>&nbsp;
 644    <input type='radio' name='form_insurance' value='Ins3' onclick='setins("Ins3")' /><?xl('Ins3','e')?>&nbsp;
 645    <input type='radio' name='form_insurance' value='Pt'   onclick='setins("Pt")'   /><?xl('Patient','e')?>
 646    <input type='hidden' name='form_eobs' value='<?echo addslashes($arrow['shipvia']) ?>' />
 647   </td>
 648  </tr>
 649  <tr>
 650   <td>
 651    <?xl('Due Date:','e')?>
 652   </td>
 653   <td>
 654    <input type='text' name='form_duedate' size='10' value='<?echo $arrow['duedate'] ?>'
 655     title='<?xl('Due date mm/dd/yyyy or yyyy-mm-dd','e')?>'>
 656   </td>
 657   <td colspan="2">
 658    <input type="checkbox" name="form_secondary" value="1"> <?xl('Needs secondary billing','e')?>
 659    &nbsp;&nbsp;
 660    <input type='submit' name='form_save' value='<?xl('Save','e')?>'>
 661    &nbsp;
 662    <input type='button' value='<?xl('Cancel','e')?>' onclick='window.close()'>
 663   </td>
 664  </tr>
 665  <tr>
 666   <td height="1">
 667   </td>
 668  </tr>
 669 </table>
 670
 671 <table border='0' cellpadding='2' cellspacing='0' width='98%'>
 672
 673  <tr bgcolor="#cccccc">
 674   <td class="dehead">
 675    <?xl('Code','e')?>
 676   </td>
 677   <td class="dehead" align="right">
 678    <?xl('Charge','e')?>
 679   </td>
 680   <td class="dehead" align="right">
 681    <?xl('Balance','e')?>&nbsp;
 682   </td>
 683   <td class="dehead">
 684    <?xl('Source','e')?>
 685   </td>
 686   <td class="dehead">
 687    <?xl('Date','e')?>
 688   </td>
 689   <td class="dehead">
 690    <?xl('Pay','e')?>
 691   </td>
 692   <td class="dehead">
 693    <?xl('Adjust','e')?>
 694   </td>
 695   <td class="dehead">
 696    <?xl('Reason','e')?>
 697   </td>
 698  </tr>
 699 <?
 700   $encount = 0;
 701   foreach ($codes as $code => $cdata) {
 702    ++$encount;
 703    $bgcolor = "#" . (($encount & 1) ? "ddddff" : "ffdddd");
 704    $dispcode = $code;
 705    // this sorts the details more or less chronologically:
 706    ksort($cdata['dtl']);
 707    foreach ($cdata['dtl'] as $dkey => $ddata) {
 708     $ddate = substr($dkey, 0, 10);
 709     if (preg_match('/^(\d\d\d\d)(\d\d)(\d\d)\s*$/', $ddate, $matches)) {
 710      $ddate = $matches[1] . '-' . $matches[2] . '-' . $matches[3];
 711     }
 712     $tmpchg = "";
 713     $tmpadj = "";
 714     if ($ddata['chg'] > 0)
 715      $tmpchg = $ddata['chg'];
 716     else if ($ddata['chg'] < 0)
 717      $tmpadj = 0 - $ddata['chg'];
 718 ?>
 719  <tr bgcolor='<? echo $bgcolor ?>'>
 720   <td class="detail">
 721    <? echo $dispcode; $dispcode = "" ?>
 722   </td>
 723   <td class="detail" align="right">
 724    <? bucks($tmpchg) ?>
 725   </td>
 726   <td class="detail" align="right">
 727    &nbsp;
 728   </td>
 729   <td class="detail">
 730    <? echo $ddata['src'] ?>
 731   </td>
 732   <td class="detail">
 733    <? echo $ddate ?>
 734   </td>
 735   <td class="detail">
 736    <? bucks($ddata['pmt']) ?>
 737   </td>
 738   <td class="detail">
 739    <? bucks($tmpadj) ?>
 740   </td>
 741   <td class="detail">
 742    <? echo $ddata['rsn'] ?>
 743   </td>
 744  </tr>
 745 <?
 746    } // end of prior detail line
 747 ?>
 748  <tr bgcolor='<? echo $bgcolor ?>'>
 749   <td class="detail">
 750    <? echo $dispcode; $dispcode = "" ?>
 751   </td>
 752   <td class="detail" align="right">
 753    &nbsp;
 754   </td>
 755   <td class="detail" align="right">
 756    <input type="hidden" name="form_line[<? echo $code ?>][bal]" value="<? bucks($cdata['bal']) ?>">
 757    <input type="hidden" name="form_line[<? echo $code ?>][ins]" value="<? echo $cdata['ins'] ?>">
 758    <? printf("%.2f", $cdata['bal']) ?>&nbsp;
 759   </td>
 760   <td class="detail">
 761    <input type="text" name="form_line[<? echo $code ?>][src]" size="10"
 762     style="background-color:<? echo $bgcolor ?>"
 763     title="NM=notmet, CI=coins, CP=copay, NE=notelig, IT=insterm, PF=ptfull, PP=ptpart" />
 764   </td>
 765   <td class="detail">
 766    <input type="text" name="form_line[<? echo $code ?>][date]" size="10" style="background-color:<? echo $bgcolor ?>" />
 767   </td>
 768   <td class="detail">
 769    <input type="text" name="form_line[<? echo $code ?>][pay]" size="10" style="background-color:<? echo $bgcolor ?>" />
 770   </td>
 771   <td class="detail">
 772    <input type="text" name="form_line[<? echo $code ?>][adj]" size="10" style="background-color:<? echo $bgcolor ?>" />
 773    &nbsp; <a href="" onclick="return writeoff('<? echo $code ?>')">W</a>
 774   </td>
 775   <td class="detail">
 776    <select name="form_line[<? echo $code ?>][reason]" style="background-color:<? echo $bgcolor ?>">
 777 <?
 778  foreach ($reasons as $value) {
 779   echo "    <option value=\"$value\">$value</option>\n";
 780  }
 781 ?>
 782    </select>
 783   </td>
 784  </tr>
 785 <?
 786   } // end of code
 787   SLClose();
 788 ?>
 789
 790 </table>
 791 </form>
 792 </center>
 793 <script language="JavaScript">
 794  var f1 = opener.document.forms[0];
 795  var f2 = document.forms[0];
 796 <?
 797   foreach ($codes as $code => $cdata) {
 798     echo " f2['form_line[$code][src]'].value  = f1.form_source.value;\n";
 799     echo " f2['form_line[$code][date]'].value = f1.form_paydate.value;\n";
 800   }
 801 ?>
 802  setins("Ins1");
 803 </script>
 804 </body>
 805 </html>