library/invoice_summary.inc.php

   1 <?php
   2 // Copyright (C) 2005-2010 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 returns an associative array keyed on procedure code, representing
  10 // all charge items for one invoice.  This array's values are themselves
  11 // associative arrays having the following keys:
  12 //
  13 //  chg - the sum of line items, including adjustments, for the code
  14 //  bal - the unpaid balance
  15 //  adj - the (positive) sum of inverted adjustments
  16 //  ins - the id of the insurance company that was billed (obsolete)
  17 //  dtl - associative array of details, if requested
  18 //
  19 // Where details are requested, each dtl array is keyed on a string
  20 // beginning with a date in yyyy-mm-dd format, or blanks in the case
  21 // of the original charge items.  The value array is:
  22 //
  23 //  pmt - payment amount as a positive number, only for payments
  24 //  src - check number or other source, only for payments
  25 //  chg - invoice line item amount amount, only for charges or
  26 //        adjustments (adjustments may be zero)
  27 //  rsn - adjustment reason, only for adjustments
  28 //  plv - provided for "integrated A/R" only: 0=pt, 1=Ins1, etc.
  29 //  dsc - for tax charges, a description of the tax
  30 //  arseq - ar_activity.sequence_no when it applies.
  31
  32 require_once("sl_eob.inc.php");
  33 require_once(dirname(__FILE__) . "/../custom/code_types.inc.php");
  34
  35
  36 // for Integrated A/R.
  37 //
  38 function ar_get_invoice_summary($patient_id, $encounter_id, $with_detail = false)
  39 {
  40     $codes = array();
  41     $keysuff1 = 1000;
  42     $keysuff2 = 5000;
  43
  44   // Get charges from services.
  45     $res = sqlStatement("SELECT " .
  46     "date, code_type, code, modifier, code_text, fee " .
  47     "FROM billing WHERE " .
  48     "pid = ? AND encounter = ? AND " .
  49     "activity = 1 AND fee != 0.00 ORDER BY id", array($patient_id,$encounter_id));
  50
  51     while ($row = sqlFetchArray($res)) {
  52         $amount = sprintf('%01.2f', $row['fee']);
  53
  54         $code = $row['code'];
  55         if (! $code) {
  56             $code = "Unknown";
  57         }
  58
  59         if ($row['modifier']) {
  60             $code .= ':' . $row['modifier'];
  61         }
  62
  63         $codes[$code]['chg'] += $amount;
  64         $codes[$code]['bal'] += $amount;
  65
  66         // Pass the code type, code and code_text fields
  67         // Although not all used yet, useful information
  68         // to improve the statement reporting etc.
  69         $codes[$code]['code_type'] = $row['code_type'];
  70         $codes[$code]['code_value'] = $row['code'];
  71         $codes[$code]['modifier'] = $row['modifier'];
  72         $codes[$code]['code_text'] = $row['code_text'];
  73
  74         // Add the details if they want 'em.
  75         if ($with_detail) {
  76             if (! $codes[$code]['dtl']) {
  77                 $codes[$code]['dtl'] = array();
  78             }
  79
  80             $tmp = array();
  81             $tmp['chg'] = $amount;
  82             $tmpkey = "          " . $keysuff1++;
  83             $codes[$code]['dtl'][$tmpkey] = $tmp;
  84         }
  85     }
  86
  87   // Get charges from product sales.
  88     $query = "SELECT s.drug_id, s.sale_date, s.fee, s.quantity " .
  89     "FROM drug_sales AS s " .
  90     "WHERE " .
  91     "s.pid = ? AND s.encounter = ? AND s.fee != 0 " .
  92     "ORDER BY s.sale_id";
  93     $res = sqlStatement($query, array($patient_id,$encounter_id));
  94     while ($row = sqlFetchArray($res)) {
  95         $amount = sprintf('%01.2f', $row['fee']);
  96         $code = 'PROD:' . $row['drug_id'];
  97         $codes[$code]['chg'] += $amount;
  98         $codes[$code]['bal'] += $amount;
  99         // Add the details if they want 'em.
 100         if ($with_detail) {
 101             if (! $codes[$code]['dtl']) {
 102                 $codes[$code]['dtl'] = array();
 103             }
 104
 105             $tmp = array();
 106             $tmp['chg'] = $amount;
 107             $tmpkey = "          " . $keysuff1++;
 108             $codes[$code]['dtl'][$tmpkey] = $tmp;
 109         }
 110     }
 111
 112   // Get payments and adjustments. (includes copays)
 113     $res = sqlStatement("SELECT " .
 114     "a.code_type, a.code, a.modifier, a.memo, a.payer_type, a.adj_amount, a.pay_amount, a.reason_code, " .
 115     "a.post_time, a.session_id, a.sequence_no, a.account_code, " .
 116     "s.payer_id, s.reference, s.check_date, s.deposit_date " .
 117     ",i.name " .
 118     "FROM ar_activity AS a " .
 119     "LEFT OUTER JOIN ar_session AS s ON s.session_id = a.session_id " .
 120     "LEFT OUTER JOIN insurance_companies AS i ON i.id = s.payer_id " .
 121     "WHERE a.pid = ? AND a.encounter = ? " .
 122     "ORDER BY s.check_date, a.sequence_no", array($patient_id,$encounter_id));
 123     while ($row = sqlFetchArray($res)) {
 124         $code = $row['code'];
 125         if (! $code) {
 126             $code = "Unknown";
 127         }
 128
 129         if ($row['modifier']) {
 130             $code .= ':' . $row['modifier'];
 131         }
 132
 133         $ins_id = 0 + $row['payer_id'];
 134         $codes[$code]['bal'] -= $row['pay_amount'];
 135         $codes[$code]['bal'] -= $row['adj_amount'];
 136         $codes[$code]['chg'] -= $row['adj_amount'];
 137         $codes[$code]['adj'] += $row['adj_amount'];
 138         if ($ins_id) {
 139             $codes[$code]['ins'] = $ins_id;
 140         }
 141
 142         // Add the details if they want 'em.
 143         if ($with_detail) {
 144             if (! $codes[$code]['dtl']) {
 145                 $codes[$code]['dtl'] = array();
 146             }
 147
 148             $tmp = array();
 149             $paydate = empty($row['deposit_date']) ? substr($row['post_time'], 0, 10) : $row['deposit_date'];
 150             if ($row['pay_amount'] != 0) {
 151                 $tmp['pmt'] = $row['pay_amount'];
 152             }
 153
 154             if (isset($row['reason_code'])) {
 155                 $tmp['msp'] = $row['reason_code'];
 156             }
 157
 158             if ($row['adj_amount'] != 0 || $row['pay_amount'] == 0) {
 159                 $tmp['chg'] = 0 - $row['adj_amount'];
 160                 // $tmp['rsn'] = (empty($row['memo']) || empty($row['session_id'])) ? 'Unknown adjustment' : $row['memo'];
 161                 $tmp['rsn'] = empty($row['memo']) ? 'Unknown adjustment' : $row['memo'];
 162                 $tmpkey = $paydate . $keysuff1++;
 163             } else {
 164                 $tmpkey = $paydate . $keysuff2++;
 165             }
 166
 167             if ($row['account_code'] == "PCP") {
 168                 //copay
 169                 $tmp['src'] = 'Pt Paid';
 170             } else {
 171                 $tmp['src'] = empty($row['session_id']) ? $row['memo'] : $row['reference'];
 172             }
 173
 174             $tmp['insurance_company'] = substr($row['name'], 0, 10);
 175             if ($ins_id) {
 176                 $tmp['ins'] = $ins_id;
 177             }
 178
 179             $tmp['plv'] = $row['payer_type'];
 180             $tmp['arseq'] = $row['sequence_no'];
 181             $codes[$code]['dtl'][$tmpkey] = $tmp;
 182         }
 183     }
 184
 185     return $codes;
 186 }
 187
 188 // This determines the party from whom payment is currently expected.
 189 // Returns: -1=Nobody, 0=Patient, 1=Ins1, 2=Ins2, 3=Ins3.
 190 // for Integrated A/R.
 191 //
 192 function ar_responsible_party($patient_id, $encounter_id)
 193 {
 194     $row = sqlQuery("SELECT date, last_level_billed, last_level_closed " .
 195     "FROM form_encounter WHERE " .
 196     "pid = ? AND encounter = ? " .
 197     "ORDER BY id DESC LIMIT 1", array($patient_id,$encounter_id));
 198     if (empty($row)) {
 199         return -1;
 200     }
 201
 202     $next_level = $row['last_level_closed'] + 1;
 203     if ($next_level <= $row['last_level_billed']) {
 204         return $next_level;
 205     }
 206
 207     if (arGetPayerID($patient_id, substr($row['date'], 0, 10), $next_level)) {
 208         return $next_level;
 209     }
 210
 211   // There is no unclosed insurance, so see if there is an unpaid balance.
 212   // Currently hoping that form_encounter.balance_due can be discarded.
 213     $balance = 0;
 214     $codes = ar_get_invoice_summary($patient_id, $encounter_id);
 215     foreach ($codes as $cdata) {
 216         $balance += $cdata['bal'];
 217     }
 218
 219     if ($balance > 0) {
 220         return 0;
 221     }
 222
 223     return -1;
 224 }