interface/billing/sl_eob_invoice.php

   1 <?php
   2 /**
   3  * This provides for manual posting of EOBs.  It is invoked from
   4  * sl_eob_search.php.  For automated (X12 835) remittance posting
   5  * see sl_eob_process.php.
   6  *
   7  * Copyright (C) 2005-2016 Rod Roark <rod@sunsetsystems.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 2
  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  Roberto Vasquez <robertogagliotta@gmail.com>
  23  * @author  Terry Hill <terry@lillysystems.com>
  24  * @link    http://www.open-emr.org
  25  */
  26
  27   require_once("../globals.php");
  28   require_once("$srcdir/log.inc");
  29   require_once("$srcdir/patient.inc");
  30   require_once("$srcdir/forms.inc");
  31   require_once("$srcdir/sl_eob.inc.php");
  32   require_once("$srcdir/invoice_summary.inc.php");
  33   require_once("../../custom/code_types.inc.php");
  34
  35   $debug = 0; // set to 1 for debugging mode
  36
  37
  38   // If we permit deletion of transactions.  Might change this later.
  39   $ALLOW_DELETE = true;
  40
  41   $info_msg = "";
  42
  43   // Format money for display.
  44   //
  45 function bucks($amount)
  46 {
  47     if ($amount) {
  48         printf("%.2f", $amount);
  49     }
  50 }
  51
  52   // Delete rows, with logging, for the specified table using the
  53   // specified WHERE clause.  Borrowed from deleter.php.
  54   //
  55 function row_delete($table, $where)
  56 {
  57     $tres = sqlStatement("SELECT * FROM $table WHERE $where");
  58     $count = 0;
  59     while ($trow = sqlFetchArray($tres)) {
  60         $logstring = "";
  61         foreach ($trow as $key => $value) {
  62             if (! $value || $value == '0000-00-00 00:00:00') {
  63                 continue;
  64             }
  65
  66             if ($logstring) {
  67                 $logstring .= " ";
  68             }
  69
  70             $logstring .= $key . "='" . addslashes($value) . "'";
  71         }
  72
  73         newEvent("delete", $_SESSION['authUser'], $_SESSION['authProvider'], 1, "$table: $logstring");
  74         ++$count;
  75     }
  76
  77     if ($count) {
  78         $query = "DELETE FROM $table WHERE $where";
  79         echo $query . "<br>\n";
  80         sqlStatement($query);
  81     }
  82 }
  83 ?>
  84 <html>
  85 <head>
  86 <?php html_header_show(); ?>
  87 <link rel=stylesheet href="<?php echo $css_header;?>" type="text/css">
  88 <title><?php xl('EOB Posting - Invoice', 'e')?></title>
  89 <script language="JavaScript">
  90
  91 // An insurance radio button is selected.
  92 function setins(istr) {
  93  return true;
  94 }
  95
  96 // Compute an adjustment that writes off the balance:
  97 function writeoff(code) {
  98  var f = document.forms[0];
  99  var belement = f['form_line[' + code + '][bal]'];
 100  var pelement = f['form_line[' + code + '][pay]'];
 101  var aelement = f['form_line[' + code + '][adj]'];
 102  var relement = f['form_line[' + code + '][reason]'];
 103  var tmp = belement.value - pelement.value;
 104  aelement.value = Number(tmp).toFixed(2);
 105  if (aelement.value && ! relement.value) relement.selectedIndex = 1;
 106  return false;
 107 }
 108
 109 // Onsubmit handler.  A good excuse to write some JavaScript.
 110 function validate(f) {
 111  var delcount = 0;
 112  for (var i = 0; i < f.elements.length; ++i) {
 113   var ename = f.elements[i].name;
 114   // Count deletes.
 115   if (ename.substring(0, 9) == 'form_del[') {
 116    if (f.elements[i].checked) ++delcount;
 117    continue;
 118   }
 119   var pfxlen = ename.indexOf('[pay]');
 120   if (pfxlen < 0) continue;
 121   var pfx = ename.substring(0, pfxlen);
 122   var code = pfx.substring(pfx.indexOf('[')+1, pfxlen-1);
 123   if (f[pfx+'[pay]'].value || f[pfx+'[adj]'].value) {
 124    if (! f[pfx+'[date]'].value) {
 125     alert('<?php xl('Date is missing for code ', 'e')?>' + code);
 126     return false;
 127    }
 128   }
 129   if (f[pfx+'[pay]'].value && isNaN(parseFloat(f[pfx+'[pay]'].value))) {
 130    alert('<?php xl('Payment value for code ', 'e') ?>' + code + '<?php xl(' is not a number', 'e') ?>');
 131    return false;
 132   }
 133   if (f[pfx+'[adj]'].value && isNaN(parseFloat(f[pfx+'[adj]'].value))) {
 134    alert('<?php xl('Adjustment value for code ', 'e') ?>' + code + '<?php xl(' is not a number', 'e') ?>');
 135    return false;
 136   }
 137   if (f[pfx+'[adj]'].value && ! f[pfx+'[reason]'].value) {
 138    alert('<?php xl('Please select an adjustment reason for code ', 'e') ?>' + code);
 139    return false;
 140   }
 141   // TBD: validate the date format
 142  }
 143  // Demand confirmation if deleting anything.
 144  if (delcount > 0) {
 145   if (!confirm('<?php echo xl('Really delete'); ?> ' + delcount +
 146    ' <?php echo xl('transactions'); ?>?' +
 147    ' <?php echo xl('This action will be logged'); ?>!')
 148   ) return false;
 149  }
 150  return true;
 151 }
 152
 153 <!-- Get current date -->
 154
 155 function getFormattedToday()
 156 {
 157    var today = new Date();
 158    var dd = today.getDate();
 159    var mm = today.getMonth()+1; //January is 0!
 160    var yyyy = today.getFullYear();
 161    if(dd<10){dd='0'+dd}
 162    if(mm<10){mm='0'+mm}
 163
 164    return (yyyy + '-' + mm + '-' + dd);
 165 }
 166
 167 <!-- Update Payment Fields -->
 168
 169 function updateFields(payField, adjField, balField, coPayField, isFirstProcCode)
 170 {
 171    var payAmount = 0.0;
 172    var adjAmount = 0.0;
 173    var balAmount = 0.0;
 174    var coPayAmount = 0.0;
 175
 176    // coPayFiled will be null if there is no co-pay entry in the fee sheet
 177    if (coPayField)
 178       coPayAmount = coPayField.value;
 179
 180    // if balance field is 0.00, its value comes back as null, so check for nul-ness first
 181    if (balField)
 182       balAmount = (balField.value) ? balField.value : 0;
 183    if (payField)
 184       payAmount = (payField.value) ? payField.value : 0;
 185
 186    //alert('balance = >' + balAmount +'<  payAmount = ' + payAmount + '  copay = ' + coPayAmount + '  isFirstProcCode = ' + isFirstProcCode);
 187
 188    // subtract the co-pay only from the first procedure code
 189    if (isFirstProcCode == 1)
 190       balAmount = parseFloat(balAmount) + parseFloat(coPayAmount);
 191
 192    adjAmount = balAmount - payAmount;
 193
 194    // Assign rounded adjustment value back to TextField
 195    adjField.value = adjAmount = Math.round(adjAmount*100)/100;
 196 }
 197
 198 </script>
 199 </head>
 200 <body leftmargin='0' topmargin='0' marginwidth='0' marginheight='0'>
 201 <?php
 202   $trans_id = 0 + $_GET['id'];
 203 if (! $trans_id) {
 204     die(xl("You cannot access this page directly."));
 205 }
 206
 207     // A/R case, $trans_id matches form_encounter.id.
 208     $ferow = sqlQuery("SELECT e.*, p.fname, p.mname, p.lname " .
 209       "FROM form_encounter AS e, patient_data AS p WHERE " .
 210       "e.id = '$trans_id' AND p.pid = e.pid");
 211     if (empty($ferow)) {
 212         die("There is no encounter with form_encounter.id = '$trans_id'.");
 213     }
 214
 215     $patient_id        = 0 + $ferow['pid'];
 216     $encounter_id      = 0 + $ferow['encounter'];
 217     $svcdate           = substr($ferow['date'], 0, 10);
 218     $form_payer_id     = 0 + $_POST['form_payer_id'];
 219     $form_reference    = $_POST['form_reference'];
 220     $form_check_date   = fixDate($_POST['form_check_date'], date('Y-m-d'));
 221     $form_deposit_date = fixDate($_POST['form_deposit_date'], $form_check_date);
 222     $form_pay_total    = 0 + $_POST['form_pay_total'];
 223
 224     $payer_type = 0;
 225     if (preg_match('/^Ins(\d)/i', $_POST['form_insurance'], $matches)) {
 226         $payer_type = $matches[1];
 227     }
 228
 229     if ($_POST['form_save'] || $_POST['form_cancel']) {
 230         if ($_POST['form_save']) {
 231             if ($debug) {
 232                 echo xl("This module is in test mode. The database will not be changed.", '', '<p><b>', "</b><p>\n");
 233             }
 234
 235             $session_id = arGetSession(
 236                 $form_payer_id,
 237                 $form_reference,
 238                 $form_check_date,
 239                 $form_deposit_date,
 240                 $form_pay_total
 241             );
 242               // The sl_eob_search page needs its invoice links modified to invoke
 243               // javascript to load form parms for all the above and submit.
 244               // At the same time that page would be modified to work off the
 245               // openemr database exclusively.
 246               // And back to the sl_eob_invoice page, I think we may want to move
 247               // the source input fields from row level to header level.
 248
 249               // Handle deletes. row_delete() is borrowed from deleter.php.
 250             if ($ALLOW_DELETE && !$debug) {
 251                 if (is_array($_POST['form_del'])) {
 252                     foreach ($_POST['form_del'] as $arseq => $dummy) {
 253                         row_delete("ar_activity", "pid = '$patient_id' AND " .
 254                           "encounter = '$encounter_id' AND sequence_no = '$arseq'");
 255                     }
 256                 }
 257             }
 258
 259             $paytotal = 0;
 260             foreach ($_POST['form_line'] as $code => $cdata) {
 261                     $thispay  = trim($cdata['pay']);
 262                     $thisadj  = trim($cdata['adj']);
 263                     $thisins  = trim($cdata['ins']);
 264                     $thiscodetype = trim($cdata['code_type']);
 265                     $reason   = strip_escape_custom($cdata['reason']);
 266
 267                     // Get the adjustment reason type.  Possible values are:
 268                     // 1 = Charge adjustment
 269                     // 2 = Coinsurance
 270                     // 3 = Deductible
 271                     // 4 = Other pt resp
 272                     // 5 = Comment
 273                     $reason_type = '1';
 274                 if ($reason) {
 275                     $tmp = sqlQuery("SELECT option_value FROM list_options WHERE " .
 276                     "list_id = 'adjreason' AND activity = 1 AND " .
 277                     "option_id = '" . add_escape_custom($reason) . "'");
 278                     if (empty($tmp['option_value'])) {
 279                                   // This should not happen but if it does, apply old logic.
 280                         if (preg_match("/To copay/", $reason)) {
 281                             $reason_type = 2;
 282                         } else if (preg_match("/To ded'ble/", $reason)) {
 283                             $reason_type = 3;
 284                         }
 285
 286                                   $info_msg .= xl("No adjustment reason type found for") . " \"$reason\". ";
 287                     } else {
 288                                   $reason_type = $tmp['option_value'];
 289                     }
 290                 }
 291
 292                 if (! $thisins) {
 293                     $thisins = 0;
 294                 }
 295
 296                 if ($thispay) {
 297                     arPostPayment(
 298                         $patient_id,
 299                         $encounter_id,
 300                         $session_id,
 301                         $thispay,
 302                         $code,
 303                         $payer_type,
 304                         '',
 305                         $debug,
 306                         '',
 307                         $thiscodetype
 308                     );
 309                     $paytotal += $thispay;
 310                 }
 311
 312                     // Be sure to record adjustment reasons, even for zero adjustments if
 313                     // they happen to be comments.
 314                 if ($thisadj || ($reason && $reason_type == 5)) {
 315                     // "To copay" and "To ded'ble" need to become a comment in a zero
 316                     // adjustment, formatted just like sl_eob_process.php.
 317                     if ($reason_type == '2') {
 318                         $reason = $_POST['form_insurance'] . " coins: $thisadj";
 319                         $thisadj = 0;
 320                     } else if ($reason_type == '3') {
 321                         $reason = $_POST['form_insurance'] . " dedbl: $thisadj";
 322                         $thisadj = 0;
 323                     } else if ($reason_type == '4') {
 324                         $reason = $_POST['form_insurance'] . " ptresp: $thisadj $reason";
 325                         $thisadj = 0;
 326                     } else if ($reason_type == '5') {
 327                         $reason = $_POST['form_insurance'] . " note: $thisadj $reason";
 328                         $thisadj = 0;
 329                     } else {
 330                         // An adjustment reason including "Ins" is assumed to be assigned by
 331                         // insurance, and in that case we identify which one by appending
 332                         // Ins1, Ins2 or Ins3.
 333                         if (strpos(strtolower($reason), 'ins') !== false) {
 334                             $reason .= ' ' . $_POST['form_insurance'];
 335                         }
 336                     }
 337
 338                     arPostAdjustment(
 339                         $patient_id,
 340                         $encounter_id,
 341                         $session_id,
 342                         $thisadj,
 343                         $code,
 344                         $payer_type,
 345                         $reason,
 346                         $debug,
 347                         '',
 348                         $thiscodetype
 349                     );
 350                 }
 351             }
 352
 353             // Maintain which insurances are marked as finished.
 354
 355             $form_done = 0 + $_POST['form_done'];
 356             $form_stmt_count = 0 + $_POST['form_stmt_count'];
 357             sqlStatement("UPDATE form_encounter " .
 358               "SET last_level_closed = $form_done, " .
 359               "stmt_count = $form_stmt_count WHERE " .
 360               "pid = '$patient_id' AND encounter = '$encounter_id'");
 361
 362             if ($_POST['form_secondary']) {
 363                   arSetupSecondary($patient_id, $encounter_id, $debug);
 364             }
 365
 366             echo "<script language='JavaScript'>\n";
 367             echo " if (opener.document.forms[0] !== undefined) {\n";
 368             echo "   if (opener.document.forms[0].form_amount) {\n";
 369             echo "     var tmp = opener.document.forms[0].form_amount.value - $paytotal;\n";
 370             echo "     opener.document.forms[0].form_amount.value = Number(tmp).toFixed(2);\n";
 371             echo "   }\n";
 372             echo " }\n";
 373         } else {
 374             echo "<script language='JavaScript'>\n";
 375         }
 376
 377         if ($info_msg) {
 378             echo " alert('" . addslashes($info_msg) . "');\n";
 379         }
 380
 381         if (! $debug) {
 382             echo " window.close();\n";
 383         }
 384
 385         echo "</script></body></html>\n";
 386         exit();
 387     }
 388
 389     // Get invoice charge details.
 390     $codes = ar_get_invoice_summary($patient_id, $encounter_id, true);
 391
 392     $pdrow = sqlQuery("select billing_note " .
 393     "from patient_data where pid = '$patient_id' limit 1");
 394 ?>
 395 <center>
 396
 397 <form method='post' action='sl_eob_invoice.php?id=<?php echo $trans_id ?>'
 398  onsubmit='return validate(this)'>
 399
 400 <table border='0' cellpadding='3'>
 401  <tr>
 402   <td>
 403     <?php xl('Patient:', 'e')?>
 404   </td>
 405   <td>
 406 <?php
 407     echo $ferow['fname'] . ' ' . $ferow['mname'] . ' ' . $ferow['lname'];
 408 ?>
 409   </td>
 410   <td colspan="2" rowspan="3">
 411 <?php
 412 for ($i = 1; $i <= 3; ++$i) {
 413     $payerid = arGetPayerID($patient_id, $svcdate, $i);
 414     if ($payerid) {
 415         $tmp = sqlQuery("SELECT name FROM insurance_companies WHERE id = $payerid");
 416         echo "Ins$i: " . $tmp['name'] . "<br />";
 417     }
 418 }
 419 ?>
 420   </td>
 421 <?php
 422     echo "<td rowspan='3' valign='bottom'>\n";
 423     echo xl('Statements Sent:');
 424     echo "</td>\n";
 425     echo "<td rowspan='3' valign='bottom'>\n";
 426     echo "<input type='text' name='form_stmt_count' size='10' value='" .
 427       (0 + $ferow['stmt_count']) . "' />\n";
 428     echo "</td>\n";
 429 ?>
 430  </tr>
 431  <tr>
 432   <td>
 433     <?php xl('Provider:', 'e')?>
 434   </td>
 435   <td>
 436     <?php
 437     $tmp = sqlQuery("SELECT fname, mname, lname " .
 438       "FROM users WHERE id = " . $ferow['provider_id']);
 439     echo text($tmp['fname']) . ' ' . text($tmp['mname']) . ' ' . text($tmp['lname']);
 440     $tmp = sqlQuery("SELECT bill_date FROM billing WHERE " .
 441       "pid = '$patient_id' AND encounter = '$encounter_id' AND " .
 442       "activity = 1 ORDER BY fee DESC, id ASC LIMIT 1");
 443     $billdate = substr(($tmp['bill_date'] . "Not Billed"), 0, 10);
 444 ?>
 445   </td>
 446  </tr>
 447  <tr>
 448   <td>
 449     <?php xl('Invoice:', 'e')?>
 450   </td>
 451   <td>
 452 <?php
 453     echo "$patient_id.$encounter_id";
 454 ?>
 455   </td>
 456  </tr>
 457
 458  <tr>
 459   <td>
 460 <?php xl('Svc Date:', 'e'); ?>
 461   </td>
 462   <td>
 463 <?php
 464     echo $svcdate;
 465 ?>
 466   </td>
 467   <td colspan="2">
 468     <?php xl('Done with:', 'e', '', "&nbsp")?>;
 469 <?php
 470   // Write a checkbox for each insurance.  It is to be checked when
 471   // we no longer expect any payments from that company for the claim.
 472     $last_level_closed = 0 + $ferow['last_level_closed'];
 473 foreach (array(0 => 'None', 1 => 'Ins1', 2 => 'Ins2', 3 => 'Ins3') as $key => $value) {
 474     if ($key && !arGetPayerID($patient_id, $svcdate, $key)) {
 475         continue;
 476     }
 477
 478     $checked = ($last_level_closed == $key) ? " checked" : "";
 479     echo "   <input type='radio' name='form_done' value='$key'$checked />$value&nbsp;\n";
 480 }
 481 ?>
 482   </td>
 483 <?php
 484     echo "<td>\n";
 485     echo xl('Check/EOB No.:');
 486     echo "</td>\n";
 487     echo "<td>\n";
 488     echo "<input type='text' name='form_reference' size='10' value='' />\n";
 489     echo "</td>\n";
 490 ?>
 491  </tr>
 492
 493  <tr>
 494   <td>
 495     <?php xl('Last Bill Date:', 'e') ?>
 496   </td>
 497   <td>
 498     <?php
 499     echo $billdate;
 500 ?>
 501   </td>
 502   <td colspan="2">
 503     <?php xl('Now posting for:', 'e', '', "&nbsp")?>;
 504
 505 <?php
 506   // TBD: check the first not-done-with insurance, not always Ins1!
 507 ?>
 508    <input type='radio' name='form_insurance' value='Ins1' onclick='setins("Ins1")' checked /><?php xl('Ins1', 'e')?>&nbsp;
 509    <input type='radio' name='form_insurance' value='Ins2' onclick='setins("Ins2")' /><?php xl('Ins2', 'e')?>&nbsp;
 510    <input type='radio' name='form_insurance' value='Ins3' onclick='setins("Ins3")' /><?php xl('Ins3', 'e')?>&nbsp;
 511    <input type='radio' name='form_insurance' value='Pt'   onclick='setins("Pt")'   /><?php xl('Patient', 'e')?>
 512
 513 <?php
 514   // TBD: I think the following is unused and can be removed.
 515 ?>
 516    <input type='hidden' name='form_eobs' value='<?php echo addslashes($arrow['shipvia']) ?>' />
 517
 518   </td>
 519 <?php
 520     echo "<td>\n";
 521     echo xl('Check/EOB Date:');
 522     echo "</td>\n";
 523     echo "<td>\n";
 524     echo "<input type='text' name='form_check_date' size='10' value='' />\n";
 525     echo "</td>\n";
 526 ?>
 527  </tr>
 528  <tr>
 529   <td>
 530   </td>
 531   <td>
 532   </td>
 533   <td colspan="2">
 534    <input type="checkbox" name="form_secondary" value="1"> <?php xl('Needs secondary billing', 'e')?>
 535    &nbsp;&nbsp;
 536    <input type='submit' name='form_save' value='<?php xl('Save', 'e')?>'>
 537    &nbsp;
 538    <input type='button' value='<?php xl('Cancel', 'e')?>' onclick='window.close()'>
 539   </td>
 540 <?php
 541     echo "<td>\n";
 542     echo xl('Deposit Date:');
 543     echo "</td>\n";
 544     echo "<td>\n";
 545     echo "<input type='text' name='form_deposit_date' size='10' value='' />\n";
 546     echo "<input type='hidden' name='form_payer_id' value='' />\n";
 547     echo "<input type='hidden' name='form_orig_reference' value='' />\n";
 548     echo "<input type='hidden' name='form_orig_check_date' value='' />\n";
 549     echo "<input type='hidden' name='form_orig_deposit_date' value='' />\n";
 550     echo "<input type='hidden' name='form_pay_total' value='' />\n";
 551     echo "</td>\n";
 552 ?>
 553  </tr>
 554 <?php if (!empty($pdrow['billing_note'])) { ?>
 555  <tr>
 556   <td>
 557     <?php xl('Billing Note:', 'e')?>
 558   </td>
 559   <td colspan='3' style='color:red'>
 560     <?php echo $pdrow['billing_note'] ?>
 561   </td>
 562  </tr>
 563 <?php } ?>
 564  <tr>
 565   <td height="1">
 566   </td>
 567  </tr>
 568 </table>
 569
 570 <table border='0' cellpadding='2' cellspacing='0' width='98%'>
 571
 572  <tr bgcolor="#cccccc">
 573   <td class="dehead">
 574     <?php xl('Code', 'e')?>
 575   </td>
 576   <td class="dehead" align="right">
 577     <?php xl('Charge', 'e')?>
 578   </td>
 579   <td class="dehead" align="right">
 580     <?php xl('Balance', 'e')?>&nbsp;
 581   </td>
 582   <td class="dehead">
 583     <?php xl('By/Source', 'e')?>
 584   </td>
 585   <td class="dehead">
 586     <?php xl('Date', 'e')?>
 587   </td>
 588   <td class="dehead">
 589     <?php xl('Pay', 'e')?>
 590   </td>
 591   <td class="dehead">
 592     <?php xl('Adjust', 'e')?>
 593   </td>
 594   <td class="dehead">
 595     <?php xl('Reason', 'e')?>
 596   </td>
 597 <?php if ($ALLOW_DELETE) { ?>
 598   <td class="dehead">
 599     <?php xl('Del', 'e')?>
 600   </td>
 601 <?php } ?>
 602  </tr>
 603 <?php
 604   $firstProcCodeIndex = -1;
 605   $encount = 0;
 606 foreach ($codes as $code => $cdata) {
 607     ++$encount;
 608     $bgcolor = "#" . (($encount & 1) ? "ddddff" : "ffdddd");
 609     $dispcode = $code;
 610
 611    // remember the index of the first entry whose code is not "CO-PAY", i.e. it's a legitimate proc code
 612     if ($firstProcCodeIndex == -1 && strcmp($code, "CO-PAY") !=0) {
 613         $firstProcCodeIndex = $encount;
 614     }
 615
 616    // this sorts the details more or less chronologically:
 617     ksort($cdata['dtl']);
 618     foreach ($cdata['dtl'] as $dkey => $ddata) {
 619         $ddate = substr($dkey, 0, 10);
 620         if (preg_match('/^(\d\d\d\d)(\d\d)(\d\d)\s*$/', $ddate, $matches)) {
 621             $ddate = $matches[1] . '-' . $matches[2] . '-' . $matches[3];
 622         }
 623
 624         $tmpchg = "";
 625         $tmpadj = "";
 626       /*****************************************************************
 627      if ($ddata['chg'] > 0)
 628       $tmpchg = $ddata['chg'];
 629      else if ($ddata['chg'] < 0)
 630       $tmpadj = 0 - $ddata['chg'];
 631       *****************************************************************/
 632         if ($ddata['chg'] != 0) {
 633             if (isset($ddata['rsn'])) {
 634                 $tmpadj = 0 - $ddata['chg'];
 635             } else {
 636                 $tmpchg = $ddata['chg'];
 637             }
 638         }
 639     ?>
 640    <tr bgcolor='<?php echo $bgcolor ?>'>
 641   <td class="detail">
 642     <?php echo $dispcode; $dispcode = "" ?>
 643   </td>
 644   <td class="detail" align="right">
 645     <?php bucks($tmpchg) ?>
 646   </td>
 647   <td class="detail" align="right">
 648    &nbsp;
 649   </td>
 650   <td class="detail">
 651     <?php
 652     if (isset($ddata['plv'])) {
 653         if (!$ddata['plv']) {
 654             echo 'Pt/';
 655         } else {
 656             echo 'Ins' . $ddata['plv'] . '/';
 657         }
 658     }
 659
 660     echo $ddata['src'];
 661     ?>
 662    </td>
 663    <td class="detail">
 664     <?php echo $ddate ?>
 665    </td>
 666    <td class="detail">
 667     <?php bucks($ddata['pmt']) ?>
 668    </td>
 669    <td class="detail">
 670     <?php bucks($tmpadj) ?>
 671    </td>
 672    <td class="detail">
 673     <?php echo $ddata['rsn'] ?>
 674    </td>
 675     <?php if ($ALLOW_DELETE) { ?>
 676    <td class="detail">
 677     <?php if (!empty($ddata['arseq'])) { ?>
 678     <input type="checkbox" name="form_del[<?php echo $ddata['arseq']; ?>]" />
 679     <?php } else { ?>
 680     &nbsp;
 681     <?php } ?>
 682    </td>
 683     <?php } ?>
 684   </tr>
 685     <?php
 686     } // end of prior detail line
 687 ?>
 688 <tr bgcolor='<?php echo $bgcolor ?>'>
 689 <td class="detail">
 690 <?php echo $dispcode; $dispcode = "" ?>
 691 </td>
 692 <td class="detail" align="right">
 693  &nbsp;
 694 </td>
 695 <td class="detail" align="right">
 696 <input type="hidden" name="form_line[<?php echo $code ?>][bal]" value="<?php bucks($cdata['bal']) ?>">
 697 <input type="hidden" name="form_line[<?php echo $code ?>][ins]" value="<?php echo $cdata['ins'] ?>">
 698 <input type="hidden" name="form_line[<?php echo $code ?>][code_type]" value="<?php echo $cdata['code_type'] ?>">
 699 <?php printf("%.2f", $cdata['bal']) ?>&nbsp;
 700 </td>
 701 <td class="detail">
 702
 703
 704 </td>
 705 <td class="detail">
 706
 707
 708 </td>
 709 <td class="detail">
 710 <input type="text" name="form_line[<?php echo $code ?>][pay]" size="10"
 711 style="background-color:<?php echo $bgcolor ?>"
 712 onKeyUp="updateFields(document.forms[0]['form_line[<?php echo $code ?>][pay]'],
 713                       document.forms[0]['form_line[<?php echo $code ?>][adj]'],
 714                       document.forms[0]['form_line[<?php echo $code ?>][bal]'],
 715                         document.forms[0]['form_line[CO-PAY][bal]'],
 716                         <?php echo ($firstProcCodeIndex == $encount) ? 1 : 0 ?>)"/>
 717 </td>
 718 <td class="detail">
 719 <input type="text" name="form_line[<?php echo $code ?>][adj]" size="10"
 720 value='<?php echo $totalAdjAmount ?>'
 721 style="background-color:<?php echo $bgcolor ?>" />
 722 &nbsp; <a href="" onclick="return writeoff('<?php echo $code ?>')">W</a>
 723 </td>
 724 <td class="detail">
 725 <select name="form_line[<?php echo $code ?>][reason]"
 726 style="background-color:<?php echo $bgcolor ?>">
 727 <?php
 728 // Adjustment reasons are now taken from the list_options table.
 729 echo "    <option value=''></option>\n";
 730 $ores = sqlStatement("SELECT option_id, title, is_default FROM list_options " .
 731 "WHERE list_id = 'adjreason' AND activity = 1 ORDER BY seq, title");
 732 while ($orow = sqlFetchArray($ores)) {
 733     echo "    <option value='" . htmlspecialchars($orow['option_id'], ENT_QUOTES) . "'";
 734     if ($orow['is_default']) {
 735         echo " selected";
 736     }
 737
 738     echo ">" . htmlspecialchars($orow['title']) . "</option>\n";
 739 }
 740 ?>
 741
 742  </select>
 743 <?php
 744 // TBD: Maybe a comment field would be good here, for appending
 745 // to the reason.
 746 ?>
 747 </td>
 748
 749 <?php if ($ALLOW_DELETE) { ?>
 750   <td class="detail">
 751    &nbsp;
 752   </td>
 753 <?php } ?>
 754
 755 </tr>
 756 <?php
 757 } // end of code
 758 ?>
 759
 760 </table>
 761 </form>
 762 </center>
 763 <script language="JavaScript">
 764  var f1 = opener.document.forms[0];
 765  var f2 = document.forms[0];
 766  if (f1.form_source) {
 767 <?php
 768     // These support creation and lookup of ar_session table entries:
 769     echo "  f2.form_reference.value         = f1.form_source.value;\n";
 770     echo "  f2.form_check_date.value        = f1.form_paydate.value;\n";
 771     echo "  //f2.form_deposit_date.value      = f1.form_deposit_date.value;\n";
 772     echo "  if (f1.form_deposit_date.value != '')\n";
 773     echo "     f2.form_deposit_date.value      = f1.form_deposit_date.value;\n";
 774     echo "  else\n";
 775     echo "     f2.form_deposit_date.value      = getFormattedToday();\n";
 776     echo "  f2.form_payer_id.value          = f1.form_payer_id.value;\n";
 777     echo "  f2.form_pay_total.value         = f1.form_amount.value;\n";
 778     echo "  f2.form_orig_reference.value    = f1.form_source.value;\n";
 779     echo "  f2.form_orig_check_date.value   = f1.form_paydate.value;\n";
 780     echo "  f2.form_orig_deposit_date.value = f1.form_deposit_date.value;\n";
 781
 782     // While I'm thinking about it, some notes about eob sessions.
 783     // If they do not have all of the session key fields in the search
 784     // page, then show a warning at the top of the invoice page.
 785     // Also when they go to save the invoice page and a session key
 786     // field has changed, alert them to that and allow a cancel.
 787
 788     // Another point... when posting EOBs, the incoming payer ID might
 789     // not match the payer ID for the patient's insurance.  This is
 790     // because the same payer might be entered more than once into the
 791     // insurance_companies table.  I don't think it matters much.
 792 ?>
 793  }
 794  setins("Ins1");
 795 </script>
 796 </body>
 797 </html>