portal/portal_payment.php

   1 <?php
   2 /**
   3  *
   4  * namespace OnsitePortal
   5  *
   6  * Copyright (C) 2006-2015 Rod Roark <rod@sunsetsystems.com>
   7  * Copyright (C) 2016-2017 Jerry Padgett <sjpadgett@gmail.com>
   8  *
   9  * LICENSE: This program is free software; you can redistribute it and/or
  10  * modify it under the terms of the GNU General Public License
  11  * as published by the Free Software Foundation; either version 3
  12  * of the License, or (at your option) any later version.
  13  * This program is distributed in the hope that it will be useful,
  14  * but WITHOUT ANY WARRANTY; without even the implied warranty of
  15  * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
  16  * GNU General Public License for more details.
  17  * You should have received a copy of the GNU General Public License
  18  * along with this program. If not, see <http://opensource.org/licenses/gpl-license.php>;.
  19  *
  20  * @package OpenEMR
  21  * @author Rod Roark <rod@sunsetsystems.com>
  22  * @author Jerry Padgett <sjpadgett@gmail.com>
  23  * @link http://www.open-emr.org
  24  *
  25  */
  26 session_start();
  27
  28 if( isset( $_SESSION['pid'] ) && isset( $_SESSION['patient_portal_onsite_two'] ) ){
  29     $pid = $_SESSION['pid'];
  30     $ignoreAuth = true;
  31     require_once ( dirname( __FILE__ ) . "/../interface/globals.php" );
  32 } else{
  33     session_destroy();
  34     $ignoreAuth = false;
  35     require_once ( dirname( __FILE__ ) . "/../interface/globals.php" );
  36     if( ! isset( $_SESSION['authUserID'] ) ){
  37         $landingpage = "index.php";
  38         header( 'Location: ' . $landingpage );
  39         exit();
  40     }
  41 }
  42 require_once ( dirname( __FILE__ ) . "/lib/appsql.class.php" );
  43 require_once ( "$srcdir/acl.inc" );
  44 require_once ( "$srcdir/patient.inc" );
  45 require_once ( "$srcdir/billing.inc" );
  46 require_once ( "$srcdir/payment.inc.php" );
  47 require_once ( "$srcdir/forms.inc" );
  48 require_once ( "$srcdir/sl_eob.inc.php" );
  49 require_once ( "$srcdir/invoice_summary.inc.php" );
  50 require_once ( "../custom/code_types.inc.php" );
  51 require_once ( "$srcdir/formatting.inc.php" );
  52 require_once ( "$srcdir/options.inc.php" );
  53 require_once ( "$srcdir/encounter_events.inc.php" );
  54
  55 $appsql = new ApplicationTable();
  56
  57 $pid = $_REQUEST['hidden_patient_code'] > 0 ? $_REQUEST['hidden_patient_code'] : $pid;
  58
  59 $edata = $appsql->getPortalAudit( $pid, 'review', 'payment' );
  60 $ccdata = array();
  61 $invdata = array();
  62
  63 if( $edata ){
  64     $ccdata = json_decode(aes256Decrypt($edata['checksum']),true);
  65     $invdata = json_decode($edata['table_args'],true);
  66     echo "<script  type='text/javascript'>var jsondata='" . $edata['table_args'] . "';var ccdata='" . $edata['checksum'] . "'</script>";
  67 }
  68 function bucks( $amount ){
  69     if( $amount ){
  70         $amount = oeFormatMoney( $amount );
  71         return $amount;
  72     }
  73     return '';
  74 }
  75 function rawbucks( $amount ){
  76     if( $amount ){
  77         $amount = sprintf( "%.2f", $amount );
  78         return $amount;
  79     }
  80     return '';
  81 }
  82
  83 // Display a row of data for an encounter.
  84 //
  85 $var_index = 0;
  86 function echoLine( $iname, $date, $charges, $ptpaid, $inspaid, $duept, $encounter = 0, $copay = 0, $patcopay = 0 ){
  87     global $var_index;
  88     $var_index ++;
  89     $balance = bucks( $charges - $ptpaid - $inspaid );
  90     $balance = ( round( $duept, 2 ) != 0 ) ? 0 : $balance; // if balance is due from patient, then insurance balance is displayed as zero
  91     $encounter = $encounter ? $encounter : '';
  92     echo " <tr id='tr_" . attr( $var_index ) . "' >\n";
  93     echo "  <td class='detail'>" . text( oeFormatShortDate( $date ) ) . "</td>\n";
  94     echo "  <td class='detail' id='" . attr( $date ) . "' align='left'>" . htmlspecialchars( $encounter, ENT_QUOTES ) . "</td>\n";
  95     echo "  <td class='detail' align='center' id='td_charges_$var_index' >" . htmlspecialchars( bucks( $charges ), ENT_QUOTES ) . "</td>\n";
  96     echo "  <td class='detail' align='center' id='td_inspaid_$var_index' >" . htmlspecialchars( bucks( $inspaid * - 1 ), ENT_QUOTES ) . "</td>\n";
  97     echo "  <td class='detail' align='center' id='td_ptpaid_$var_index' >" . htmlspecialchars( bucks( $ptpaid * - 1 ), ENT_QUOTES ) . "</td>\n";
  98     echo "  <td class='detail' align='center' id='td_patient_copay_$var_index' >" . htmlspecialchars( bucks( $patcopay ), ENT_QUOTES ) . "</td>\n";
  99     echo "  <td class='detail' align='center' id='td_copay_$var_index' >" . htmlspecialchars( bucks( $copay ), ENT_QUOTES ) . "</td>\n";
 100     echo "  <td class='detail' align='center' id='balance_$var_index'>" . htmlspecialchars( bucks( $balance ), ENT_QUOTES ) . "</td>\n";
 101     echo "  <td class='detail' align='center' id='duept_$var_index'>" . htmlspecialchars( bucks( round( $duept, 2 ) * 1 ), ENT_QUOTES ) . "</td>\n";
 102     echo "  <td class='detail' align='right'><input class='form-control' style='width:60px;padding:2px 2px;' type='text' name='" . attr( $iname ) . "'  id='paying_" . attr( $var_index ) . "' " . " value='" . '' . "' onchange='coloring();calctotal()'  autocomplete='off' " . "onkeyup='calctotal()'/></td>\n";
 103     echo " </tr>\n";
 104 }
 105
 106 // We use this to put dashes, colons, etc. back into a timestamp.
 107 //
 108 function decorateString( $fmt, $str ){
 109     $res = '';
 110     while( $fmt ){
 111         $fc = substr( $fmt, 0, 1 );
 112         $fmt = substr( $fmt, 1 );
 113         if( $fc == '.' ){
 114             $res .= substr( $str, 0, 1 );
 115             $str = substr( $str, 1 );
 116         } else{
 117             $res .= $fc;
 118         }
 119     }
 120     return $res;
 121 }
 122
 123 // Compute taxes from a tax rate string and a possibly taxable amount.
 124 //
 125 function calcTaxes( $row, $amount ){
 126     $total = 0;
 127     if( empty( $row['taxrates'] ) ) return $total;
 128     $arates = explode( ':', $row['taxrates'] );
 129     if( empty( $arates ) ) return $total;
 130     foreach( $arates as $value ){
 131         if( empty( $value ) ) continue;
 132         $trow = sqlQuery( "SELECT option_value FROM list_options WHERE " . "list_id = 'taxrate' AND option_id = ? LIMIT 1", array ($value
 133         ) );
 134         if( empty( $trow['option_value'] ) ){
 135             echo "<!-- Missing tax rate '" . text( $value ) . "'! -->\n";
 136             continue;
 137         }
 138         $tax = sprintf( "%01.2f", $amount * $trow['option_value'] );
 139         // echo "<!-- Rate = '$value', amount = '$amount', tax = '$tax' -->\n";
 140         $total += $tax;
 141     }
 142     return $total;
 143 }
 144
 145 $now = time();
 146 $today = date( 'Y-m-d', $now );
 147 $timestamp = date( 'Y-m-d H:i:s', $now );
 148
 149
 150 // $patdata = getPatientData($pid, 'fname,lname,pubpid');
 151
 152 $patdata = sqlQuery( "SELECT " . "p.fname, p.mname, p.lname, p.pubpid,p.pid, i.copay " . "FROM patient_data AS p " . "LEFT OUTER JOIN insurance_data AS i ON " . "i.pid = p.pid AND i.type = 'primary' " . "WHERE p.pid = ? ORDER BY i.date DESC LIMIT 1", array ($pid
 153 ) );
 154
 155 $alertmsg = ''; // anything here pops up in an alert box
 156
 157 // If the Save button was clicked...
 158 if( $_POST['form_save'] ){
 159     // $extra = json_decode($_POST['ajax_mode'], true);
 160     $form_pid = $_POST['form_pid'];
 161     $form_method = trim( $_POST['form_method'] );
 162     $form_source = trim( $_POST['form_source'] );
 163     $patdata = getPatientData( $form_pid, 'fname,mname,lname,pubpid' );
 164     $NameNew = $patdata['fname'] . " " . $patdata['lname'] . " " . $patdata['mname'];
 165
 166     if( $_REQUEST['radio_type_of_payment'] == 'pre_payment' ){
 167         $payment_id = idSqlStatement( "insert into ar_session set " . "payer_id = ?" . ", patient_id = ?" . ", user_id = ?" . ", closed = ?" . ", reference = ?" . ", check_date =  now() , deposit_date = now() " . ",  pay_total = ?" . ", payment_type = 'patient'" . ", description = ?" . ", adjustment_code = 'pre_payment'" . ", post_to_date = now() " . ", payment_method = ?", array (
 168                 0,$form_pid,$_SESSION['authUserID'],0,$form_source,$_REQUEST['form_prepayment'],$NameNew,$form_method
 169         ) );
 170
 171         frontPayment( $form_pid, 0, $form_method, $form_source, $_REQUEST['form_prepayment'], 0, $timestamp ); // insertion to 'payments' table.
 172     }
 173
 174     if( $_POST['form_upay'] && $_REQUEST['radio_type_of_payment'] != 'pre_payment' ){
 175         foreach( $_POST['form_upay'] as $enc => $payment ){
 176             if( $amount = 0 + $payment ){
 177                 $zero_enc = $enc;
 178                 if( $_REQUEST['radio_type_of_payment'] == 'invoice_balance' ){
 179                     ;
 180                 } else{
 181                     if( ! $enc ){
 182                         $enc = calendar_arrived( $form_pid );
 183                     }
 184                 }
 185                 // ----------------------------------------------------------------------------------------------------
 186                 // Fetching the existing code and modifier
 187                 $ResultSearchNew = sqlStatement( "SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key " . "WHERE code_types.ct_fee=1 AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier", array ($form_pid,$enc
 188                 ) );
 189                 if( $RowSearch = sqlFetchArray( $ResultSearchNew ) ){
 190                     $Codetype = $RowSearch['code_type'];
 191                     $Code = $RowSearch['code'];
 192                     $Modifier = $RowSearch['modifier'];
 193                 } else{
 194                     $Codetype = '';
 195                     $Code = '';
 196                     $Modifier = '';
 197                 }
 198                 // ----------------------------------------------------------------------------------------------------
 199                 if( $_REQUEST['radio_type_of_payment'] == 'copay' ) // copay saving to ar_session and ar_activity tables
 200 {
 201                     $session_id = idSqlStatement( "INSERT INTO ar_session (payer_id,user_id,reference,check_date,deposit_date,pay_total," . " global_amount,payment_type,description,patient_id,payment_method,adjustment_code,post_to_date) " . " VALUES ('0',?,?,now(),now(),?,'','patient','COPAY',?,?,'patient_payment',now())", array (
 202                             $_SESSION['authId'],$form_source,$amount,$form_pid,$form_method
 203                     ) );
 204
 205                     $insrt_id = idSqlStatement( "INSERT INTO ar_activity (pid,encounter,code_type,code,modifier,payer_type,post_time,post_user,session_id,pay_amount,account_code)" . " VALUES (?,?,?,?,?,0,now(),?,?,?,'PCP')", array ($form_pid,$enc,$Codetype,$Code,$Modifier,'3',$session_id,$amount
 206                     ) );
 207
 208                     frontPayment( $form_pid, $enc, $form_method, $form_source, $amount, 0, $timestamp ); // insertion to 'payments' table.
 209                 }
 210                 if( $_REQUEST['radio_type_of_payment'] == 'invoice_balance' || $_REQUEST['radio_type_of_payment'] == 'cash' ){ // Payment by patient after insurance paid, cash patients similar to do not bill insurance in feesheet.
 211                     if( $_REQUEST['radio_type_of_payment'] == 'cash' ){
 212                         sqlStatement( "update form_encounter set last_level_closed=? where encounter=? and pid=? ", array (4,$enc,$form_pid
 213                         ) );
 214                         sqlStatement( "update billing set billed=? where encounter=? and pid=?", array (1,$enc,$form_pid
 215                         ) );
 216                     }
 217                     $adjustment_code = 'patient_payment';
 218                     $payment_id = idSqlStatement( "insert into ar_session set " . "payer_id = ?" . ", patient_id = ?" . ", user_id = ?" . ", closed = ?" . ", reference = ?" . ", check_date =  now() , deposit_date = now() " . ",  pay_total = ?" . ", payment_type = 'patient'" . ", description = ?" . ", adjustment_code = ?" . ", post_to_date = now() " . ", payment_method = ?", array (
 219                             0,$form_pid,$_SESSION['authUserID'],0,$form_source,$amount,$NameNew,$adjustment_code,$form_method
 220                     ) );
 221
 222                     // --------------------------------------------------------------------------------------------------------------------
 223
 224                     frontPayment( $form_pid, $enc, $form_method, $form_source, 0, $amount, $timestamp ); // insertion to 'payments' table.
 225
 226                     // --------------------------------------------------------------------------------------------------------------------
 227
 228                     $resMoneyGot = sqlStatement( "SELECT sum(pay_amount) as PatientPay FROM ar_activity where pid =? and " . "encounter =? and payer_type=0 and account_code='PCP'", array ($form_pid,$enc
 229                     ) ); // new fees screen copay gives account_code='PCP'
 230                     $rowMoneyGot = sqlFetchArray( $resMoneyGot );
 231                     $Copay = $rowMoneyGot['PatientPay'];
 232
 233                     // --------------------------------------------------------------------------------------------------------------------
 234
 235                     // Looping the existing code and modifier
 236                     $ResultSearchNew = sqlStatement( "SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key WHERE code_types.ct_fee=1 " . "AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier", array ($form_pid,$enc
 237                     ) );
 238                     while( $RowSearch = sqlFetchArray( $ResultSearchNew ) ){
 239                         $Codetype = $RowSearch['code_type'];
 240                         $Code = $RowSearch['code'];
 241                         $Modifier = $RowSearch['modifier'];
 242                         $Fee = $RowSearch['fee'];
 243
 244                         $resMoneyGot = sqlStatement( "SELECT sum(pay_amount) as MoneyGot FROM ar_activity where pid =? " . "and code_type=? and code=? and modifier=? and encounter =? and !(payer_type=0 and account_code='PCP')", array ($form_pid,$Codetype,$Code,$Modifier,$enc
 245                         ) );
 246                         // new fees screen copay gives account_code='PCP'
 247                         $rowMoneyGot = sqlFetchArray( $resMoneyGot );
 248                         $MoneyGot = $rowMoneyGot['MoneyGot'];
 249
 250                         $resMoneyAdjusted = sqlStatement( "SELECT sum(adj_amount) as MoneyAdjusted FROM ar_activity where " . "pid =? and code_type=? and code=? and modifier=? and encounter =?", array ($form_pid,$Codetype,$Code,$Modifier,$enc
 251                         ) );
 252                         $rowMoneyAdjusted = sqlFetchArray( $resMoneyAdjusted );
 253                         $MoneyAdjusted = $rowMoneyAdjusted['MoneyAdjusted'];
 254
 255                         $Remainder = $Fee - $Copay - $MoneyGot - $MoneyAdjusted;
 256                         $Copay = 0;
 257                         if( round( $Remainder, 2 ) != 0 && $amount != 0 ){
 258                             if( $amount - $Remainder >= 0 ){
 259                                 $insert_value = $Remainder;
 260                                 $amount = $amount - $Remainder;
 261                             } else{
 262                                 $insert_value = $amount;
 263                                 $amount = 0;
 264                             }
 265                             sqlStatement( "insert into ar_activity set " . "pid = ?" . ", encounter = ?" . ", code_type = ?" . ", code = ?" . ", modifier = ?" . ", payer_type = ?" . ", post_time = now() " . ", post_user = ?" . ", session_id = ?" . ", pay_amount = ?" . ", adj_amount = ?" . ", account_code = 'PP'", array (
 266                                     $form_pid,$enc,$Codetype,$Code,$Modifier,0,3,$payment_id,$insert_value,0
 267                             ) );
 268                         } // if
 269                     } // while
 270                     if( $amount != 0 ){ // if any excess is there.
 271                         sqlStatement( "insert into ar_activity set " . "pid = ?" . ", encounter = ?" . ", code_type = ?" . ", code = ?" . ", modifier = ?" . ", payer_type = ?" . ", post_time = now() " . ", post_user = ?" . ", session_id = ?" . ", pay_amount = ?" . ", adj_amount = ?" . ", account_code = 'PP'", array (
 272                                 $form_pid,$enc,$Codetype,$Code,$Modifier,0,3,$payment_id,$amount,0
 273                         ) );
 274                     }
 275                     // --------------------------------------------------------------------------------------------------------------------
 276                 } // invoice_balance
 277             } // if ($amount = 0 + $payment)
 278         } // foreach
 279     } // if ($_POST['form_upay'])
 280 } // if ($_POST['form_save'])
 281
 282 if( $_POST['form_save'] || $_REQUEST['receipt']){
 283
 284     if( $_REQUEST['receipt'] ){
 285         $form_pid = $_GET['patient'];
 286         $timestamp = decorateString( '....-..-.. ..:..:..', $_GET['time'] );
 287     }
 288
 289     // Get details for what we guess is the primary facility.
 290     $frow = sqlQuery( "SELECT * FROM facility " . "ORDER BY billing_location DESC, accepts_assignment DESC, id LIMIT 1" );
 291
 292     // Get the patient's name and chart number.
 293     $patdata = getPatientData( $form_pid, 'fname,mname,lname,pubpid' );
 294
 295     // Re-fetch payment info.
 296     $payrow = sqlQuery( "SELECT " . "SUM(amount1) AS amount1, " . "SUM(amount2) AS amount2, " . "MAX(method) AS method, " . "MAX(source) AS source, " . "MAX(dtime) AS dtime, " .
 297     // "MAX(user) AS user " .
 298     "MAX(user) AS user, " . "MAX(encounter) as encounter " . "FROM payments WHERE " . "pid = ? AND dtime = ?", array ($form_pid,$timestamp
 299     ) );
 300
 301     // Create key for deleting, just in case.
 302     $ref_id = ( $_REQUEST['radio_type_of_payment'] == 'copay' ) ? $session_id : $payment_id;
 303     $payment_key = $form_pid . '.' . preg_replace( '/[^0-9]/', '', $timestamp ) . '.' . $ref_id;
 304
 305     // get facility from encounter
 306     $tmprow = sqlQuery( "
 307     SELECT facility_id
 308     FROM form_encounter
 309     WHERE encounter = ?", array ($payrow['encounter']
 310     ) );
 311     $frow = sqlQuery( "SELECT * FROM facility " . " WHERE id = ?", array ($tmprow['facility_id']
 312     ) );
 313
 314     // Now proceed with printing the receipt.
 315     ?>
 316
 317 <title><?php echo xlt('Receipt for Payment'); ?></title>
 318
 319 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-min-1-11-3/index.js"></script>
 320 <script type="text/javascript">
 321 $( document ).ready();
 322 function goHome(){
 323      window.location.replace("./patient/onsiteactivityviews");
 324 }
 325 function notifyPatient(){
 326         var pid = <?php echo attr($pid);?>;
 327         var note = $('#pop_receipt').text();
 328     var formURL = './messaging/handle_note.php';
 329     $.ajax({
 330         url: formURL,
 331         type: "POST",
 332         data: {'task':'add', 'pid':pid, 'inputBody':note, 'title':'Bill/Collect', 'sendto':'-patient-','noteid':'0'},
 333         success: function(data, textStatus, jqXHR) {
 334                 alert('Receipt sent to patient via Messages.')
 335         },
 336         error: function(jqXHR, status, error) {
 337             console.log(status + ": " + error);
 338         }
 339     });
 340 }
 341 </script>
 342 <?php
 343 ob_start();
 344 echo '<htlm><head></head><body style="text-align: center; margin: auto;">';
 345 ?>
 346
 347 <div id='pop_receipt' style='display: block'>
 348         <p>
 349         <h2><?php echo xlt('Receipt for Payment'); ?></h2>
 350         <p><?php echo text($frow['name'])?>
 351                 <br><?php echo text($frow['street'])?>
 352                 <br><?php echo text( $frow['city'] . ', ' . $frow['state'] ) . ' ' . text( $frow['postal_code'] )?>
 353                 <br><?php echo htmlentities($frow['phone'])?>
 354         <p>
 355         <div style="text-align: center; margin: auto;">
 356             <table border='0' cellspacing='8'
 357                 style="text-align: center; margin: auto;">
 358                 <tr>
 359                     <td><?php echo xlt('Date'); ?>:</td>
 360                     <td><?php echo text(oeFormatSDFT(strtotime($payrow['dtime']))) ?></td>
 361                 </tr>
 362                 <tr>
 363                     <td><?php echo xlt('Patient'); ?>:</td>
 364                     <td><?php echo text( $patdata['fname'] ) . " " . text( $patdata['mname'] ) . " " . text( $patdata['lname'] ) . " (" . text( $patdata['pubpid'] ) . ")"?></td>
 365                 </tr>
 366                 <tr>
 367                     <td><?php echo xlt('Paid Via'); ?>:</td>
 368                     <td><?php echo generate_display_field(array('data_type'=>'1','list_id'=>'payment_method'),$payrow['method']); ?></td>
 369                 </tr>
 370                 <tr>
 371                     <td><?php echo xlt('Authorized Id'); ?>:</td>
 372                     <td><?php echo text($payrow['source']) ?></td>
 373                 </tr>
 374                 <tr>
 375                     <td><?php echo xlt('Amount for This Visit'); ?>:</td>
 376                     <td><?php echo text(oeFormatMoney($payrow['amount1'])) ?></td>
 377                 </tr>
 378                 <tr>
 379                     <td><?php echo xlt('Amount for Past Balance'); ?>:</td>
 380                     <td><?php echo text(oeFormatMoney($payrow['amount2'])) ?></td>
 381                 </tr>
 382                 <tr>
 383                     <td><?php echo xlt('Received By'); ?>:</td>
 384                     <td><?php echo text($payrow['user']) ?></td>
 385                 </tr>
 386             </table>
 387         </div>
 388 </div>
 389         <button class='btn btn-sm' type='button' onclick='goHome()' id='returnhome'><?php echo xla('Return Home'); ?></button>
 390         <button class='btn btn-sm' type='button' onclick="notifyPatient()"><?php echo xla('Notify Patient'); ?></button>
 391 </body></html>
 392 <?php
 393  ob_end_flush();
 394 } else{
 395     //
 396     // Here we display the form for data entry.
 397     //
 398     ?>
 399 <title><?php echo xlt('Record Payment'); ?></title>
 400 <style type="text/css">
 401 body {
 402  /* font-family:sans-serif; font-size:10pt; font-weight:normal */
 403 }
 404
 405 .dehead {
 406     color: #000000; /*font-family:sans-serif; font-size:10pt;*/
 407     font-weight: bold
 408 }
 409
 410 .detail {
 411     padding: 1px 1px;
 412     /* width: 65px; */
 413     color: #000000; /*font-family:sans-serif; font-size:10pt; */
 414     font-weight: normal
 415 }
 416 </style>
 417 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-creditcardvalidator-1-1-0/jquery.creditCardValidator.js"></script>
 418 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/textformat.js?v=<?php echo $v_js_includes; ?>"></script>
 419
 420 <script type="text/javascript">
 421 var mypcc = '1';
 422 function calctotal() {
 423  var flag=0;
 424  var f = document.forms["payfrm"];
 425  var total = 0;
 426  for (var i = 0; i < f.elements.length; ++i) {
 427   var elem = f.elements[i];
 428   var ename = elem.name;
 429   if (ename.indexOf('form_upay[') == 0 || ename.indexOf('form_bpay[') == 0) {
 430    if (elem.value.length > 0){
 431        total += Number(elem.value);
 432         if(total < 0) flag=1;
 433    }
 434   }
 435  }
 436      f.form_paytotal.value = Number(total).toFixed(2);
 437      if(flag){
 438         $('#payfrm')[0].reset();
 439         alert("<?php echo addslashes( xl('Negative payments not accepted')) ?>")
 440     }
 441  return true;
 442 }
 443 function coloring()
 444  {
 445    for (var i = 1; ; ++i)
 446     {
 447       if(document.getElementById('paying_'+i))
 448        {
 449         paying=document.getElementById('paying_'+i).value*1;
 450         patient_balance=document.getElementById('duept_'+i).innerHTML*1;
 451         //balance=document.getElementById('balance_'+i).innerHTML*1;
 452         if(patient_balance>0 && paying>0)
 453          {
 454             if(paying>patient_balance)
 455              {
 456               document.getElementById('paying_'+i).style.background='#FF0000';
 457              }
 458             else if(paying<patient_balance)
 459              {
 460               document.getElementById('paying_'+i).style.background='#99CC00';
 461              }
 462             else if(paying==patient_balance)
 463              {
 464               document.getElementById('paying_'+i).style.background='#ffffff';
 465              }
 466          }
 467         else
 468          {
 469           document.getElementById('paying_'+i).style.background='#ffffff';
 470          }
 471        }
 472       else
 473        {
 474         break;
 475        }
 476     }
 477  }
 478 function CheckVisible(MakeBlank)
 479  {//Displays and hides the check number text box.
 480    if(document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='check_payment' ||
 481          document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='bank_draft'  )
 482    {
 483     document.getElementById('check_number').disabled=false;
 484    }
 485    else
 486    {
 487     document.getElementById('check_number').disabled=true;
 488    }
 489  }
 490 function validate()
 491  {
 492   var f = document.forms["payfrm"];
 493   ok=-1;
 494   //no checks taken here....
 495   issue='no';
 496    /*if(((document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='check_payment' ||
 497          document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='bank_draft') &&
 498        document.getElementById('check_number').value=='' ))
 499    {
 500     alert("<?php //echo addslashes( xl('Please Fill the Check/Ref Number')) ?>");
 501     document.getElementById('check_number').focus();
 502     return false;
 503    }*/
 504
 505    if(document.getElementById('radio_type_of_payment_self1').checked==false &&
 506           document.getElementById('radio_type_of_payment1').checked==false
 507            && document.getElementById('radio_type_of_payment2').checked==false
 508            && document.getElementById('radio_type_of_payment4').checked==false)
 509     {
 510       alert("<?php //echo addslashes( xl('Please Select Type Of Payment.')) ?>");
 511        return false;
 512     }
 513   if(document.getElementById('radio_type_of_payment_self1').checked==true ||  document.getElementById('radio_type_of_payment1').checked==true)
 514    {
 515      for (var i = 0; i < f.elements.length; ++i)
 516      {
 517       var elem = f.elements[i];
 518       var ename = elem.name;
 519       if (ename.indexOf('form_upay[0') == 0) //Today is this text box.
 520       {
 521        if(elem.value*1>0)
 522         {//A warning message, if the amount is posted with out encounter.
 523          if(confirm("<?php echo addslashes( xl('Are you sure to post for today?')) ?>"))
 524           {
 525            ok=1;
 526           }
 527          else
 528           {
 529            elem.focus();
 530            return false;
 531           }
 532         }
 533        break;
 534       }
 535     }
 536    }
 537 //CO-PAY
 538   /* if(document.getElementById('radio_type_of_payment1').checked==true)
 539    {
 540      var total = 0;
 541      for (var i = 0; i < f.elements.length; ++i)
 542      {
 543       var elem = f.elements[i];
 544       var ename = elem.name;
 545       if (ename.indexOf('form_upay[') == 0) //Today is this text box.
 546       {
 547        if(f.form_paytotal.value*1!=elem.value*1)//Total CO-PAY is not posted against today
 548         {//A warning message, if the amount is posted against an old encounter.
 549          if(confirm("<?php //echo addslashes( xl('You are posting against an old encounter?')) ?>"))
 550           {
 551            ok=1;
 552           }
 553         // else
 554           {
 555            elem.focus();
 556            return false;
 557           }
 558         }
 559        break;
 560       }
 561     }
 562    }*///Co Pay
 563  else if( document.getElementsByName('form_paytotal')[0].value <= 0 )//total 0
 564   {
 565     alert("<?php echo addslashes( xl('Invalid Total!')) ?>")
 566     return false;
 567   }
 568  if(ok==-1)
 569   {
 570      //return true;
 571      if(confirm("<?php echo addslashes( xl('Payment Validated: Save?')) ?>"))
 572       {
 573        return true;
 574       }
 575      else
 576       {
 577        return false;
 578       }
 579   }
 580 }
 581 function cursor_pointer()
 582  {//Point the cursor to the latest encounter(Today)
 583      var f = document.forms["payfrm"];
 584      var total = 0;
 585      for (var i = 0; i < f.elements.length; ++i)
 586      {
 587       var elem = f.elements[i];
 588       var ename = elem.name;
 589       if (ename.indexOf('form_upay[') == 0)
 590       {
 591        elem.focus();
 592        break;
 593       }
 594     }
 595  }
 596  //=====================================================
 597 function make_it_hide_enc_pay()
 598  {
 599       document.getElementById('td_head_insurance_payment').style.display="none";
 600       document.getElementById('td_head_patient_co_pay').style.display="none";
 601       document.getElementById('td_head_co_pay').style.display="none";
 602       document.getElementById('td_head_insurance_balance').style.display="none";
 603   for (var i = 1; ; ++i)
 604   {
 605        var td_inspaid_elem = document.getElementById('td_inspaid_'+i)
 606     var td_patient_copay_elem = document.getElementById('td_patient_copay_'+i)
 607        var td_copay_elem = document.getElementById('td_copay_'+i)
 608        var balance_elem = document.getElementById('balance_'+i)
 609    if (td_inspaid_elem)
 610    {
 611     td_inspaid_elem.style.display="none";
 612         td_patient_copay_elem.style.display="none";
 613     td_copay_elem.style.display="none";
 614     balance_elem.style.display="none";
 615    }
 616   else
 617    {
 618     break;
 619    }
 620   }
 621   document.getElementById('td_total_4').style.display="none";
 622   document.getElementById('td_total_7').style.display="none";
 623     document.getElementById('td_total_8').style.display="none";
 624   document.getElementById('td_total_6').style.display="none";
 625
 626   document.getElementById('table_display').width="420px";
 627  }
 628
 629  //=====================================================
 630 function make_visible()
 631  {
 632   document.getElementById('td_head_rep_doc').style.display="";
 633   document.getElementById('td_head_description').style.display="";
 634   document.getElementById('td_head_total_charge').style.display="none";
 635   document.getElementById('td_head_insurance_payment').style.display="none";
 636   document.getElementById('td_head_patient_payment').style.display="none";
 637   document.getElementById('td_head_patient_co_pay').style.display="none";
 638   document.getElementById('td_head_co_pay').style.display="none";
 639   document.getElementById('td_head_insurance_balance').style.display="none";
 640   document.getElementById('td_head_patient_balance').style.display="none";
 641   for (var i = 1; ; ++i)
 642   {
 643    var td_charges_elem = document.getElementById('td_charges_'+i)
 644    var td_inspaid_elem = document.getElementById('td_inspaid_'+i)
 645    var td_ptpaid_elem = document.getElementById('td_ptpaid_'+i)
 646    var td_patient_copay_elem = document.getElementById('td_patient_copay_'+i)
 647    var td_copay_elem = document.getElementById('td_copay_'+i)
 648    var balance_elem = document.getElementById('balance_'+i)
 649    var duept_elem = document.getElementById('duept_'+i)
 650    if (td_charges_elem)
 651    {
 652     td_charges_elem.style.display="none";
 653     td_inspaid_elem.style.display="none";
 654     td_ptpaid_elem.style.display="none";
 655     td_patient_copay_elem.style.display="none";
 656     td_copay_elem.style.display="none";
 657     balance_elem.style.display="none";
 658     duept_elem.style.display="none";
 659    }
 660   else
 661    {
 662     break;
 663    }
 664   }
 665   document.getElementById('td_total_7').style.display="";
 666   document.getElementById('td_total_8').style.display="";
 667   document.getElementById('td_total_1').style.display="none";
 668   document.getElementById('td_total_2').style.display="none";
 669   document.getElementById('td_total_3').style.display="none";
 670   document.getElementById('td_total_4').style.display="none";
 671   document.getElementById('td_total_5').style.display="none";
 672   document.getElementById('td_total_6').style.display="none";
 673
 674   document.getElementById('table_display').width="505px";
 675  }
 676 function make_it_hide()
 677  {
 678   document.getElementById('td_head_rep_doc').style.display="none";
 679   document.getElementById('td_head_description').style.display="none";
 680   document.getElementById('td_head_total_charge').style.display="";
 681   document.getElementById('td_head_insurance_payment').style.display="";
 682   document.getElementById('td_head_patient_payment').style.display="";
 683   document.getElementById('td_head_patient_co_pay').style.display="";
 684     document.getElementById('td_head_co_pay').style.display="";
 685   document.getElementById('td_head_insurance_balance').style.display="";
 686   document.getElementById('td_head_patient_balance').style.display="";
 687   for (var i = 1; ; ++i)
 688   {
 689    var td_charges_elem = document.getElementById('td_charges_'+i)
 690    var td_inspaid_elem = document.getElementById('td_inspaid_'+i)
 691    var td_ptpaid_elem = document.getElementById('td_ptpaid_'+i)
 692    var td_patient_copay_elem = document.getElementById('td_patient_copay_'+i)
 693    var td_copay_elem = document.getElementById('td_copay_'+i)
 694    var balance_elem = document.getElementById('balance_'+i)
 695    var duept_elem = document.getElementById('duept_'+i)
 696    if (td_charges_elem)
 697    {
 698     td_charges_elem.style.display="";
 699     td_inspaid_elem.style.display="";
 700     td_ptpaid_elem.style.display="";
 701         td_patient_copay_elem.style.display="";
 702     td_copay_elem.style.display="";
 703     balance_elem.style.display="";
 704     duept_elem.style.display="";
 705    }
 706   else
 707    {
 708     break;
 709    }
 710   }
 711   document.getElementById('td_total_1').style.display="";
 712   document.getElementById('td_total_2').style.display="";
 713   document.getElementById('td_total_3').style.display="";
 714   document.getElementById('td_total_4').style.display="";
 715   document.getElementById('td_total_5').style.display="";
 716   document.getElementById('td_total_6').style.display="";
 717   document.getElementById('td_total_7').style.display="";
 718   document.getElementById('td_total_8').style.display="";
 719
 720   document.getElementById('table_display').width="100%";
 721  }
 722 function make_visible_radio()
 723  {
 724   document.getElementById('tr_radio1').style.display="";
 725   document.getElementById('tr_radio2').style.display="none";
 726  }
 727 function make_hide_radio()
 728  {
 729   document.getElementById('tr_radio1').style.display="none";
 730   document.getElementById('tr_radio2').style.display="";
 731  }
 732 function make_visible_row()
 733  {
 734   document.getElementById('table_display').style.display="";
 735   document.getElementById('table_display_prepayment').style.display="none";
 736  }
 737 function make_hide_row()
 738  {
 739   document.getElementById('table_display').style.display="none";
 740   document.getElementById('table_display_prepayment').style.display="";
 741  }
 742 function make_self()
 743  {
 744   make_visible_row();
 745   make_it_hide();
 746   make_it_hide_enc_pay();
 747   document.getElementById('radio_type_of_payment_self1').checked=true;
 748   cursor_pointer();
 749  }
 750 function make_insurance()
 751  {
 752   make_visible_row();
 753   make_it_hide();
 754   cursor_pointer();
 755   document.getElementById('radio_type_of_payment1').checked=true;
 756  }
 757  //--------------------------------------------------------------------------------------------------//
 758 $('#paySubmit').click( function(e) {
 759     e.preventDefault()
 760     $("#mode").val( "portal-save" );
 761     var inv_values= JSON.stringify(getFormObj('payfrm'));
 762     var extra_values=JSON.stringify(getFormObj('paycredit'));
 763     var extra = "&inv_values="+inv_values+"&extra_values="+extra_values;
 764
 765     var flag = 0
 766     var liburl = './lib/paylib.php';
 767     $.ajax({
 768         type: "POST",
 769         url: liburl,
 770         data: $("#payfrm").serialize()+extra,
 771         beforeSend: function(xhr){
 772                 if( validateCC() !== true) return false;
 773                 if( $('#pin').val() == "" || $('#ccname').val() == "" || $('#ccyear').val() == "" || $('#ccmonth').val() == ""){
 774                  alert("<?php echo addslashes( xl('Invalid Credit Card Values: Please correct')) ?>")
 775                  return false;
 776                 }
 777             if( validate() != true){
 778                 flag = 1;
 779                 alert("<?php echo addslashes( xl('Validation error: Fix and resubmit. This popup info is preserved!')) ?>")
 780                 return false;
 781             }
 782             $("#openPayModal .close").click()
 783         },
 784         error: function(qXHR, textStatus, errorThrow){
 785             console.log("There was an error:"+errorThrow);
 786         },
 787         success: function(templateHtml, textStatus, jqXHR){
 788                 alert("<?php echo addslashes( xl('Payment successfully sent for authorization. You will be notified when payment is posted. Until payment is accepted and you are notified, you may resubmit this payment at anytime with new amounts or different credit card. Thank you')) ?>")
 789             window.location.reload(false);
 790         }
 791     });
 792      if(flag)
 793         $("#openPayModal .close").click();
 794 });
 795  //---------------------------------------------------------------------------------------//
 796 $("#payfrm").on('submit', function(e){
 797     e.preventDefault();
 798     var thisform = this;
 799     $("#mode").val( "review-save" );
 800     var inv_values= JSON.stringify(getFormObj('payfrm'));
 801     var extra_values=JSON.stringify(getFormObj('paycredit'));
 802     var extra = "&inv_values="+inv_values+"&extra_values="+extra_values;
 803
 804     var flag = 0
 805     var liburl ='<?php echo $GLOBALS["webroot"] ?>/portal/lib/paylib.php';
 806     $.ajax({
 807         type: "POST",
 808         url: liburl,
 809         data: $("#payfrm").serialize()+extra,
 810         beforeSend: function(xhr){
 811             if( validate() != true){
 812                 flag = 1;
 813                 alert("<?php echo addslashes( xl('Validation error: Fix and resubmit. Payment values are preserved!')) ?>")
 814                 return false;
 815             }
 816         },
 817         error: function(xhr, textStatus, error){
 818             alert("<?php echo addslashes( xl('There is a Post error')) ?>")
 819             console.log("There was an error:"+textStatus);
 820             return false;
 821         },
 822         success: function(templateHtml, textStatus, jqXHR){
 823             thisform.submit();
 824         }
 825     });
 826 });
 827 function getFormObj(formId) {
 828     var formObj = {};
 829     var inputs = $('#'+formId).serializeArray();
 830     $.each(inputs, function (i, input) {
 831         formObj[input.name] = input.value;
 832     });
 833     return formObj;
 834 }
 835 function formRepopulate(jsondata){
 836     data = $.parseJSON(jsondata);
 837     $.each(data, function(name, val){
 838         var $el = $('[name="'+name+'"]'),
 839             type = $el.attr('type');
 840         switch(type){
 841             case 'checkbox':
 842                 $el.prop('checked',true);
 843                 break;
 844             case 'radio':
 845                 $el.filter('[value="'+val+'"]').prop('checked', true);
 846                 break;
 847             default:
 848                 $el.val(val);
 849         }
 850     });
 851 }
 852 function getAuth(){
 853     var authnum = prompt("<?php echo  xlt('Please enter card comfirmation authorization') ?>", "");
 854     if (authnum != null) {
 855         $('#check_number').val(authnum);
 856     }
 857 }
 858 </script>
 859
 860 <body class="body_top" onunload='imclosing()' onLoad="cursor_pointer();"
 861     style="text-align: center; margin: auto;">
 862
 863     <form id="payfrm" method='post'
 864         action='<?php echo $GLOBALS["webroot"] ?>/portal/portal_payment.php'>
 865         <input type='hidden' name='form_pid' value='<?php echo attr($pid) ?>' />
 866         <input type='hidden' name='form_save'
 867             value='<?php echo xlt('Invoice');?>' />
 868
 869         <table>
 870             <tr height="10">
 871                 <td colspan="3">&nbsp;</td>
 872             </tr>
 873
 874             <tr>
 875                 <td colspan='3' align='center' class='text'><b><?php echo xlt('Accept Payment for'); ?>&nbsp;:&nbsp;&nbsp;<?php
 876
 877 echo htmlspecialchars( $patdata['fname'], ENT_QUOTES ) . " " . htmlspecialchars( $patdata['lname'], ENT_QUOTES ) . " " . htmlspecialchars( $patdata['mname'], ENT_QUOTES ) . " (" . htmlspecialchars( $patdata['pid'], ENT_QUOTES ) . ")"?></b>
 878     <?php $NameNew=$patdata['fname'] . " " .$patdata['lname']. " " .$patdata['mname'];?>
 879   </td>
 880             </tr>
 881             <tr height="15">
 882                 <td colspan='3'></td>
 883             </tr>
 884             <tr>
 885                 <td class='text'>
 886    <?php echo xlt('Payment Method'); ?>:
 887   </td>
 888                 <td colspan='2'><select name="form_method" id="form_method"
 889                     class="text" onChange='CheckVisible("yes")'>
 890   <?php
 891     $query1112 = "SELECT * FROM list_options where list_id=?  ORDER BY seq, title ";
 892     $bres1112 = sqlStatement( $query1112, array ('payment_method') );
 893     while( $brow1112 = sqlFetchArray( $bres1112 ) ){
 894         if( $brow1112['option_id'] != 'credit_card' || $brow1112['option_id'] == 'electronic' || $brow1112['option_id'] == 'bank_draft' ) continue;
 895         echo "<option value='" . htmlspecialchars( $brow1112['option_id'], ENT_QUOTES ) . "'>" . htmlspecialchars( xl_list_label( $brow1112['title'] ), ENT_QUOTES ) . "</option>";
 896     }
 897     ?>
 898   </select></td>
 899             </tr>
 900
 901             <tr height="5">
 902                 <td colspan='3'></td>
 903             </tr>
 904
 905             <tr>
 906                 <td class='text'>
 907    <?php echo xla('Authorized'); ?>:
 908   </td>
 909                 <td colspan='2'>
 910   <?php
 911     if( isset( $_SESSION['authUserID'] ) )
 912         echo "<input type='text'  id='check_number' name='form_source' style='width:120px;' value='" . htmlspecialchars( $payrow['source'], ENT_QUOTES ) . "'>";
 913     ?>
 914   </td>
 915             </tr>
 916             <tr height="5">
 917                 <td colspan='3'></td>
 918             </tr>
 919             <tr>
 920                 <td class='text' valign="middle">
 921    <?php echo xlt('Patient Coverage'); ?>:
 922   </td>
 923                 <td class='text' colspan="2">
 924                     <input type="radio"    name="radio_type_of_coverage" id="radio_type_of_coverage1"
 925                     value="self" onClick="make_visible_radio();make_self();" />
 926                     <?php echo xlt('Self'); ?>
 927                       <input type="radio" name="radio_type_of_coverage"    id="radio_type_of_coverag2" value="insurance" checked="checked"
 928                     onClick="make_hide_radio();make_insurance();" />
 929                     <?php echo xlt('Insurance'); ?>
 930                 </td>
 931             </tr>
 932             <tr height="5">
 933                 <td colspan='3'></td>
 934             </tr>
 935             <tr id="tr_radio1" style="display: none">
 936                 <!-- For radio Insurance -->
 937                 <td class='text' valign="top">
 938    <?php echo xlt('Payment against'); ?>:
 939   </td>
 940                 <td class='text' colspan="2">
 941                     <input type="radio"    name="radio_type_of_payment" id="radio_type_of_payment_self1"
 942                     value="cash" onClick="make_visible_row();make_it_hide_enc_pay();cursor_pointer();" />
 943                     <?php echo xlt('Encounter Payment'); ?>
 944                 </td>
 945             </tr>
 946             <tr id="tr_radio2">
 947                 <!-- For radio self -->
 948                 <td class='text' valign="top"><?php echo xlt('Payment against'); ?>:
 949   </td>
 950                 <td class='text' colspan="2"><input type="radio"    name="radio_type_of_payment" id="radio_type_of_payment1" checked="checked"
 951                     value="copay" onClick="make_visible_row();cursor_pointer();" /><?php echo xlt('Co Pay'); ?>
 952           <input type="radio" name="radio_type_of_payment" id="radio_type_of_payment2"
 953                     value="invoice_balance" onClick="make_visible_row();" /><?php echo xlt('Invoice Balance'); ?><br />
 954         <input type="radio" name="radio_type_of_payment"    id="radio_type_of_payment4" value="pre_payment"
 955                     onClick="make_hide_row();" /><?php echo xlt('Pre Pay'); ?></td>
 956             </tr>
 957             <tr height="15">
 958                 <td colspan='3'></td>
 959             </tr>
 960         </table>
 961         <table width="35%" border="0" cellspacing="0" cellpadding="0" id="table_display_prepayment" style="display: none">
 962             <tr>
 963                 <td class='detail'><?php echo xlt('Pre Payment'); ?></td>
 964                 <td><input class="form-control" type='text' name='form_prepayment' style='width: 100px' /></td>
 965             </tr>
 966         </table>
 967         <table id="table_display" style="width: 100%; background: #eee;" class="table table-striped table-responsive">
 968             <thead>
 969             </thead>
 970             <tbody>
 971                 <!-- <table border='0' id="table_display" cellpadding='0' cellspacing='0' width='100%'> -->
 972     <tr bgcolor="#cccccc" id="tr_head">
 973     <td class="dehead" width="60">
 974    <?php echo xlt('DOS')?>
 975   </td>
 976                     <td class="dehead" width="120">
 977    <?php echo xlt('Visit Reason')?>
 978   </td>
 979                     <td class="dehead" align="center" width="70" id="td_head_total_charge">
 980    <?php echo xlt('Total Charge')?>
 981   </td>
 982                     <td class="dehead" align="center" width="70" id="td_head_rep_doc" style='display: none'>
 983    <?php echo xlt('Report/ Form')?>
 984   </td>
 985                     <td class="dehead" align="center" width="200"    id="td_head_description" style='display: none'>
 986    <?php echo xlt('Description')?>
 987   </td>
 988                     <td class="dehead" align="center" width="70" id="td_head_insurance_payment">
 989    <?php echo xlt('Insurance Payment')?>
 990   </td>
 991                     <td class="dehead" align="center" width="70" id="td_head_patient_payment">
 992    <?php echo xlt('Patient Payment')?>
 993   </td>
 994                     <td class="dehead" align="center" width="55" id="td_head_patient_co_pay">
 995    <?php echo xlt('Co Pay Paid')?>
 996   </td>
 997                     <td class="dehead" align="center" width="55" id="td_head_co_pay">
 998    <?php echo xlt('Required Co Pay')?>
 999   </td>
1000                     <td class="dehead" align="center" width="70" id="td_head_insurance_balance">
1001    <?php echo xlt('Insurance Balance')?>
1002   </td>
1003                     <td class="dehead" align="center" width="70" id="td_head_patient_balance">
1004    <?php echo xlt('Patient Balance')?>
1005   </td>
1006                     <td class="dehead" align="center" width="50">
1007    <?php echo xlt('Paying')?>
1008   </td>
1009                 </tr>
1010 <?php
1011     $encs = array ();
1012     // Get the unbilled service charges and payments by encounter for this patient.
1013     //
1014     $query = "SELECT fe.encounter, fe.reason, b.code_type, b.code, b.modifier, b.fee, " . "LEFT(fe.date, 10) AS encdate ,fe.last_level_closed " . "FROM  form_encounter AS fe left join billing AS b  on " . "b.pid = ? AND b.activity = 1  AND " . // AND b.billed = 0
1015 "b.code_type != 'TAX' AND b.fee != 0 " . "AND fe.pid = b.pid AND fe.encounter = b.encounter " . "where fe.pid = ? " . "ORDER BY b.encounter";
1016     $bres = sqlStatement( $query, array ($pid,$pid) );
1017     //
1018     while( $brow = sqlFetchArray( $bres ) ){
1019         $key = 0 + $brow['encounter'];
1020         if( empty( $encs[$key] ) ){
1021             $encs[$key] = array ('encounter' => $brow['encounter'],'date' => $brow['encdate'],'last_level_closed' => $brow['last_level_closed'],'charges' => 0,'payments' => 0,'reason'=>$brow['reason']
1022             );
1023         }
1024         if( $brow['code_type'] === 'COPAY' ){
1025             // $encs[$key]['payments'] -= $brow['fee'];
1026         } else{
1027             $encs[$key]['charges'] += $brow['fee'];
1028             // Add taxes.
1029             $sql_array = array ();
1030             $query = "SELECT taxrates FROM codes WHERE " . "code_type = ? AND " . "code = ? AND ";
1031             array_push( $sql_array, $code_types[$brow['code_type']]['id'], $brow['code'] );
1032             if( $brow['modifier'] ){
1033                 $query .= "modifier = ?";
1034                 array_push( $sql_array, $brow['modifier'] );
1035             } else{
1036                 $query .= "(modifier IS NULL OR modifier = '')";
1037             }
1038             $query .= " LIMIT 1";
1039             $trow = sqlQuery( $query, $sql_array );
1040             $encs[$key]['charges'] += calcTaxes( $trow, $brow['fee'] );
1041         }
1042     }
1043     // Do the same for unbilled product sales.
1044     //
1045     $query = "SELECT fe.encounter, fe.reason, s.drug_id, s.fee, " . "LEFT(fe.date, 10) AS encdate,fe.last_level_closed " . "FROM form_encounter AS fe left join drug_sales AS s " . "on s.pid = ? AND s.fee != 0 " . // AND s.billed = 0
1046 "AND fe.pid = s.pid AND fe.encounter = s.encounter " . "where fe.pid = ? " . "ORDER BY s.encounter";
1047
1048     $dres = sqlStatement( $query, array ($pid,$pid) );
1049     //
1050     while( $drow = sqlFetchArray( $dres ) ){
1051         $key = 0 + $drow['encounter'];
1052         if( empty( $encs[$key] ) ){
1053             $encs[$key] = array ('encounter' => $drow['encounter'],'date' => $drow['encdate'],'last_level_closed' => $drow['last_level_closed'],'charges' => 0,'payments' => 0
1054             );
1055         }
1056         $encs[$key]['charges'] += $drow['fee'];
1057         // Add taxes.
1058         $trow = sqlQuery( "SELECT taxrates FROM drug_templates WHERE drug_id = ? " . "ORDER BY selector LIMIT 1", array ($drow['drug_id']
1059         ) );
1060         $encs[$key]['charges'] += calcTaxes( $trow, $drow['fee'] );
1061     }
1062
1063     ksort( $encs, SORT_NUMERIC );
1064     $gottoday = false;
1065     // Bringing on top the Today always
1066     foreach( $encs as $key => $value ){
1067         $dispdate = $value['date'];
1068         if( strcmp( $dispdate, $today ) == 0 && ! $gottoday ){
1069             $gottoday = true;
1070             break;
1071         }
1072     }
1073
1074     // If no billing was entered yet for today, then generate a line for
1075     // entering today's co-pay.
1076     //
1077     if( ! $gottoday ){
1078         // echoLine("form_upay[0]", date("Y-m-d"), 0, 0, 0, 0 /*$duept*/);//No encounter yet defined.
1079     }
1080     $gottoday = false;
1081     foreach( $encs as $key => $value ){
1082         $enc = $value['encounter'];
1083         $reason = $value['reason'];
1084         $dispdate = $value['date'];
1085         if( strcmp( $dispdate, $today ) == 0 && ! $gottoday ){
1086             $dispdate = date( "Y-m-d" );
1087             $gottoday = true;
1088         }
1089         // ------------------------------------------------------------------------------------
1090         $inscopay = getCopay( $pid, $dispdate );
1091         $patcopay = getPatientCopay( $pid, $enc );
1092         // Insurance Payment
1093         // -----------------
1094         $drow = sqlQuery( "SELECT  SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments  FROM ar_activity WHERE " . "pid = ? and encounter = ? and " . "payer_type != 0 and account_code!='PCP' ", array ($pid,$enc
1095         ) );
1096         $dpayment = $drow['payments'];
1097         $dadjustment = $drow['adjustments'];
1098         // Patient Payment
1099         // ---------------
1100         $drow = sqlQuery( "SELECT  SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments  FROM ar_activity WHERE " . "pid = ? and encounter = ? and " . "payer_type = 0 and account_code!='PCP' ", array ($pid,$enc
1101         ) );
1102         $dpayment_pat = $drow['payments'];
1103
1104         // ------------------------------------------------------------------------------------
1105         // NumberOfInsurance
1106         $ResultNumberOfInsurance = sqlStatement( "SELECT COUNT( DISTINCT TYPE ) NumberOfInsurance FROM insurance_data
1107             where pid = ? and provider>0 ", array ($pid
1108         ) );
1109         $RowNumberOfInsurance = sqlFetchArray( $ResultNumberOfInsurance );
1110         $NumberOfInsurance = $RowNumberOfInsurance['NumberOfInsurance'] * 1;
1111         // ------------------------------------------------------------------------------------
1112         $duept = 0;
1113         if( ( ( $NumberOfInsurance == 0 || $value['last_level_closed'] == 4 || $NumberOfInsurance == $value['last_level_closed'] ) ) ){ // Patient balance
1114             $brow = sqlQuery( "SELECT SUM(fee) AS amount FROM billing WHERE " . "pid = ? and encounter = ? AND activity = 1", array ($pid,$enc
1115             ) );
1116             $srow = sqlQuery( "SELECT SUM(fee) AS amount FROM drug_sales WHERE " . "pid = ? and encounter = ? ", array ($pid,$enc
1117             ) );
1118             $drow = sqlQuery( "SELECT SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments FROM ar_activity WHERE " . "pid = ? and encounter = ? ", array ($pid,$enc
1119             ) );
1120             $duept = $brow['amount'] + $srow['amount'] - $drow['payments'] - $drow['adjustments'];
1121         }
1122         echoLine( "form_upay[$enc]", $dispdate, $value['charges'], $dpayment_pat, ( $dpayment + $dadjustment ), $duept, ($enc.':'.$reason), $inscopay, $patcopay );
1123     }
1124
1125     // Continue with display of the data entry form.
1126     ?>
1127 <tr>
1128                     <td class="dehead" id='td_total_1'></td>
1129                     <td class="dehead" id='td_total_2'></td>
1130                     <td class="dehead" id='td_total_3'></td>
1131                     <td class="dehead" id='td_total_4'></td>
1132                     <td class="dehead" id='td_total_5'></td>
1133                     <td class="dehead" id='td_total_6'></td>
1134                     <td class="dehead" id='td_total_7'></td>
1135                     <td class="dehead" id='td_total_8'></td>
1136                     <td class="dehead" align="right"><?php echo xlt('Total');?></td>
1137                     <td class="dehead" align="right"><input class="form-control" type='text' name='form_paytotal'
1138                     value='' style='color: #00aa00; width: 65px; padding: 1px 1px;' readonly />
1139                     </td>
1140                 </tr>
1141         </table>
1142 <?php
1143     if( isset( $ccdata["name"] ) ){
1144         echo '<div class="col-xs-12 col-md-4 col-lg-4">
1145         <div class="panel panel-default height">';
1146         if( ! isset( $_SESSION['authUserID'] ) )
1147             echo '<div class="panel-heading">'.xlt("Payment Information").'<span style="color:#cc0000"><em> '.xlt("Pending Auth since").': </em>'.text($edata["date"]).'</span></div>';
1148         else
1149             echo '<div class="panel-heading">'.xlt("Payment Information").' <button type="button" class="btn btn-danger btn-sm" onclick="getAuth()">'.xlt("Authorize").'</button></div>';
1150     }
1151     else{
1152         echo '<div style="display:none" class="col-xs-12 col-md-6 col-lg-6"><div class="panel panel-default height"><div class="panel-heading">'.xlt("Payment Information").' </div>';
1153     }
1154     ?>
1155                      <div class="panel-body">
1156                              <strong><?php echo xlt('Card Name');?>:  </strong><span id="cn"><?php echo attr($ccdata["cc_type"])?></span><br>
1157                             <strong><?php echo xlt('Name On Card');?>:  </strong><span id="nc"><?php echo attr($ccdata["name"])?></span><br>
1158                             <strong><?php echo xlt('Card Number');?>:  </strong><span id="ccn"><?php
1159                             if( isset( $_SESSION['authUserID'] ) )
1160                                 echo $ccdata["cc_number"] . "</span><br>";
1161                                 else
1162                                     echo "**********  ".substr($ccdata["cc_number"],-4) . "</span><br>";
1163                                     ?>
1164                             <strong><?php echo xlt('Exp Date');?>:  </strong><span id="ed"><?php echo attr($ccdata["month"])."/".attr($ccdata["year"])?></span><br>
1165                             <strong><?php echo xlt('Charge Total');?>:  </strong><span id="ct"><?php echo attr($invdata["form_paytotal"])?></span><br>
1166                       </div>
1167                   </div>
1168              </div>
1169     <p>
1170 <?php
1171     if( ! isset( $_SESSION['authUserID'] ) )
1172         echo '<button type="button" class="btn btn-primary" data-toggle="modal" data-target="#openPayModal">' . xlt("Pay Invoice") . '</button>';
1173     else
1174         echo "<button type='submit' class='btn btn-danger' form='payfrm'>" . xlt('Post Payment') . "</button>";
1175     ?>
1176  &nbsp;
1177     </p>
1178         <input type="hidden" name="hidden_patient_code" id="hidden_patient_code" value="<?php echo attr($pid);?>" />
1179         <input type='hidden' name='mode' id='mode' value='' />
1180     </form>
1181
1182 <script type="text/javascript">
1183 if (typeof jsondata !== 'undefined') {
1184      formRepopulate(jsondata);
1185 }
1186  calctotal();
1187 </script>
1188     <!-- credit payment modal -->
1189     <div id="openPayModal" class="modal fade" role="dialog">
1190         <div class="modal-dialog">
1191             <div class="modal-content">
1192                 <div class="modal-header">
1193                     <h3><?php echo xlt('Submit Payment for Authorization');?></h3>
1194                     <button type="button" class="close" data-dismiss="modal">&times;</button>
1195                 </div>
1196                 <div class="modal-body container">
1197                     <form id='paycredit' class="form-horizontal col-xs-12 col-sm-6 col-md-6">
1198                         <fieldset>
1199                             <div class="control-group">
1200                                 <label label-default="label-default" class="control-label"><?php echo xlt('Name on Card');?></label>
1201                                 <div class="controls">
1202                                     <input name="name" id="ccname" type="text" class="form-control"
1203                                         pattern="\w+ \w+.*" title="<?php echo xla('Fill your first and last name'); ?>"
1204                                         required value="" />
1205                                 </div>
1206                             </div>
1207                             <div class="control-group">
1208                                 <label class="control-label"><?php echo xlt('Card Number');?></label>
1209                                 <div class="controls">
1210                                     <div class="row">
1211                                     <div class="col-sm-12">
1212                                             <input name="cc_number" id="cc_number" type="text" class="form-control inline col-sm-3"
1213                                                 autocomplete="off" maxlength="19" pattern="\d" onchange="validateCC()"
1214                                                 title="<?php echo xla('Card Number'); ?>" required value="" />
1215                                             <input disabled name="cardtype" id="cardtype" type="text" class="form-control inline" title="<?php echo xla('Card Type'); ?>" style="max-width:160px;font-weight:bold;color:red;" value="" />
1216                                         </div>
1217                                     </div>
1218                                 </div>
1219                             </div>
1220                             <div class="control-group">
1221                                 <label label-default="label-default" class="control-label"><?php echo xlt('Card Expiry Date');?></label>
1222                                 <div class="controls">
1223                                     <div class="row">
1224                                         <div class="col-md-4">
1225                                             <select name="month" id="ccmonth" class="form-control">
1226                                                 <option value=""><?php echo xlt('Select Month'); ?></option>
1227                                                 <option value="01"><?php echo xlt('January'); ?></option>
1228                                                 <option value="02"><?php echo xlt('February'); ?></option>
1229                                                 <option value="03"><?php echo xlt('March'); ?></option>
1230                                                 <option value="04"><?php echo xlt('April'); ?></option>
1231                                                 <option value="05"><?php echo xlt('May'); ?></option>
1232                                                 <option value="06"><?php echo xlt('June'); ?></option>
1233                                                 <option value="07"><?php echo xlt('July'); ?></option>
1234                                                 <option value="08"><?php echo xlt('August'); ?></option>
1235                                                 <option value="09"><?php echo xlt('September'); ?></option>
1236                                                 <option value="10"><?php echo xlt('October'); ?></option>
1237                                                 <option value="11"><?php echo xlt('November'); ?></option>
1238                                                 <option value="12"><?php echo xlt('December'); ?></option>
1239                                             </select>
1240                                         </div>
1241                                         <div class="col-md-3">
1242                                             <select name="year" id="ccyear" class="form-control">
1243                                                 <option value=""><?php echo xlt('Select Year'); ?></option>
1244                                                 <option value="2017">2017</option>
1245                                                 <option value="2018">2018</option>
1246                                                 <option value="2019">2019</option>
1247                                                 <option value="2020">2020</option>
1248                                                 <option value="2021">2021</option>
1249                                                 <option value="2022">2022</option>
1250                                                 <option value="2023">2023</option>
1251                                                 <option value="2024">2024</option>
1252                                             </select>
1253                                         </div>
1254                                     </div>
1255                                 </div>
1256                             </div>
1257                             <div class="control-group">
1258                                 <label label-default="label-default" class="control-label"><?php echo xlt('Card CVV');?></label>
1259                                 <div class="controls">
1260                                     <div class="row">
1261                                         <div class="col-md-3">
1262                                             <input name="pin" id="pin" type="text" class="form-control"
1263                                                 autocomplete="off" maxlength="4" pattern="\d{3}" onfocus="validateCC()"
1264                                                 title="<?php echo xlt('Three or four digits at back of your card'); ?>" required value="" />
1265                                         </div>
1266                                         <div class="col-md-3">
1267                                             <img src='./images/img_cvc.png' style='height: 58px; width: auto'>
1268                                         </div>
1269                                     </div>
1270                                 </div>
1271                             </div>
1272                             <div class="form-actions">
1273                                 <button id="paySubmit" class="btn btn-danger"><?php echo xlt('Submit');?></button>
1274                                 <button type="button" class="btn btn-default" data-dismiss="modal"><?php echo xlt('Cancel');?></button>
1275                             </div>
1276                         </fieldset>
1277                         <input type='hidden' name='cc_type' id='cc_type' value='' />
1278                     </form>
1279                 </div>
1280                 <!-- Body  -->
1281                 <div class="modal-footer">
1282                     <button type="button" class="btn btn-default" data-dismiss="modal"><?php echo xlt('Close');?></button>
1283                 </div>
1284             </div>
1285         </div>
1286     </div>
1287 <?php echo "<script>var ccerr='". xlt('Invalid Credit Card Number') . "';</script>";?>
1288 <script type="text/javascript">
1289 $('#cc_number').validateCreditCard(function(result){
1290     var r = (result.card_type == null ? '' : result.card_type.name.toUpperCase())
1291     var v = (result.valid== true ? ' Valid #' : ' Invalid #')
1292     $('#cardtype').val(r+v);
1293  });
1294 function validateCC() {
1295     var result = $('#cc_number').validateCreditCard();
1296     var r = (result.card_type == null ? '' : result.card_type.name.toUpperCase())
1297     var v = (result.valid == true ? ' Okay' : ' Invalid #')
1298     $('#cardtype').val(r+v);
1299     $('#cc_type').val(r);
1300     if(!result.valid){
1301          alert(ccerr)
1302          return false;
1303     }
1304     else{
1305                 return true;
1306     }
1307 }
1308 </script>
1309 </body>
1310 <?php
1311 }
1312 ?>