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