library/invoice_summary.inc.php

   1 <?php
   2 // Copyright (C) 2005-2010 Rod Roark <rod@sunsetsystems.com>
   3 //
   4 // This program is free software; you can redistribute it and/or
   5 // modify it under the terms of the GNU General Public License
   6 // as published by the Free Software Foundation; either version 2
   7 // of the License, or (at your option) any later version.
   8
   9 // This returns an associative array keyed on procedure code, representing
  10 // all charge items for one invoice.  This array's values are themselves
  11 // associative arrays having the following keys:
  12 //
  13 //  chg - the sum of line items, including adjustments, for the code
  14 //  bal - the unpaid balance
  15 //  adj - the (positive) sum of inverted adjustments
  16 //  ins - the id of the insurance company that was billed (obsolete)
  17 //  dtl - associative array of details, if requested
  18 //
  19 // Where details are requested, each dtl array is keyed on a string
  20 // beginning with a date in yyyy-mm-dd format, or blanks in the case
  21 // of the original charge items.  The value array is:
  22 //
  23 //  pmt - payment amount as a positive number, only for payments
  24 //  src - check number or other source, only for payments
  25 //  chg - invoice line item amount amount, only for charges or
  26 //        adjustments (adjustments may be zero)
  27 //  rsn - adjustment reason, only for adjustments
  28 //  plv - provided for "integrated A/R" only: 0=pt, 1=Ins1, etc.
  29 //  dsc - for tax charges, a description of the tax
  30 //  arseq - ar_activity.sequence_no when it applies.
  31
  32 require_once("sl_eob.inc.php");
  33
  34 function get_invoice_summary($trans_id, $with_detail = false) {
  35   global $sl_err, $sl_cash_acc;
  36
  37   $codes = array();
  38
  39   $chart_id_cash = SLQueryValue("select id from chart where accno = '$sl_cash_acc'");
  40   if ($sl_err) die($sl_err);
  41   if (! $chart_id_cash) die("There is no COA entry for cash account '$sl_cash_acc'");
  42
  43   // Request all cash entries belonging to the invoice.
  44   $atres = SLQuery("select * from acc_trans where trans_id = $trans_id and chart_id = $chart_id_cash");
  45   if ($sl_err) die($sl_err);
  46
  47   // Deduct payments for each procedure code from the respective balance owed.
  48   $keysuffix = 5000;
  49   for ($irow = 0; $irow < SLRowCount($atres); ++$irow) {
  50     $row = SLGetRow($atres, $irow);
  51     $code = strtoupper($row['memo']);
  52     $ins_id = $row['project_id'];
  53     if (! $code) $code = "Unknown";
  54     $amount = $row['amount'];
  55     $codes[$code]['bal'] += $amount; // amount is negative for a payment
  56     if ($ins_id)
  57       $codes[$code]['ins'] = $ins_id;
  58
  59     // Add the details if they want 'em.
  60     if ($with_detail) {
  61       if (! $codes[$code]['dtl']) $codes[$code]['dtl'] = array();
  62       $tmpkey = $row['transdate'] . $keysuffix++;
  63       $tmp = array();
  64       $tmp['pmt'] = 0 - $amount;
  65       $tmp['src'] = $row['source'];
  66       if ($ins_id) $tmp['ins'] = $ins_id;
  67       $codes[$code]['dtl'][$tmpkey] = $tmp;
  68     }
  69   }
  70
  71   // Request all line items with money or adjustment reasons belonging
  72   // to the invoice.
  73   $inres = SLQuery("SELECT * FROM invoice WHERE trans_id = $trans_id AND " .
  74     "( sellprice != 0 OR description LIKE 'Adjustment%' OR serialnumber = 'Claim' )");
  75   if ($sl_err) die($sl_err);
  76
  77   // Add charges and adjustments for each procedure code into its total and balance.
  78   $keysuffix = 1000;
  79   for ($irow = 0; $irow < SLRowCount($inres); ++$irow) {
  80     $row = SLGetRow($inres, $irow);
  81     // $amount = $row['sellprice'];
  82     $amount = sprintf('%01.2f', $row['sellprice'] * $row['qty']);
  83     $ins_id = $row['project_id'];
  84
  85     $code = "Unknown";
  86     if ($row['serialnumber'] == 'Claim') {
  87       $code = 'Claim';
  88     }
  89     else if (preg_match("/([A-Za-z0-9]\d\d\S*)/", $row['serialnumber'], $matches)) {
  90       $code = strtoupper($matches[1]);
  91     }
  92     else if (preg_match("/([A-Za-z0-9]\d\d\S*)/", $row['description'], $matches)) {
  93       $code = strtoupper($matches[1]);
  94     }
  95     else if (preg_match("/^TAX:/", $row['description'])) {
  96       $code = 'TAX';
  97     }
  98
  99     $codes[$code]['chg'] += $amount;
 100     $codes[$code]['bal'] += $amount;
 101     if ($amount < 0) $codes[$code]['adj'] -= $amount;
 102
 103     if ($ins_id)
 104       $codes[$code]['ins'] = $ins_id;
 105
 106     // Add the details if they want 'em.
 107     if ($with_detail) {
 108       if (! $codes[$code]['dtl']) $codes[$code]['dtl'] = array();
 109       if (preg_match("/^Adjustment\s*(\S*)\s*(.*)/", $row['description'], $matches)) {
 110         $tmpkey = str_pad($matches[1], 10) . $keysuffix++;
 111         $tmp = array();
 112         $tmp['chg'] = $amount;
 113         $tmp['rsn'] = $matches[2];
 114         if ($ins_id) $tmp['ins'] = $ins_id;
 115         $codes[$code]['dtl'][$tmpkey] = $tmp;
 116       }
 117       else {
 118         $tmpkey = "          " . $keysuffix++;
 119         $tmp = array();
 120         $tmp['chg'] = $amount;
 121         if ($code == 'TAX') $tmp['dsc'] = substr($row['description'], 4);
 122         $codes[$code]['dtl'][$tmpkey] = $tmp;
 123       }
 124     }
 125   }
 126
 127   return $codes;
 128 }
 129
 130 // Like the above, but for Integrated A/R.
 131 //
 132 function ar_get_invoice_summary($patient_id, $encounter_id, $with_detail = false) {
 133   $codes = array();
 134   $keysuff1 = 1000;
 135   $keysuff2 = 5000;
 136
 137   // Get charges from services.
 138   $res = sqlStatement("SELECT " .
 139     "date, code_type, code, modifier, code_text, fee " .
 140     "FROM billing WHERE " .
 141     "pid = ? AND encounter = ? AND " .
 142     "activity = 1 AND fee != 0.00 ORDER BY id", array($patient_id,$encounter_id) );
 143
 144   while ($row = sqlFetchArray($res)) {
 145     $amount = sprintf('%01.2f', $row['fee']);
 146
 147     if ($row['code_type'] == 'COPAY') {
 148       $code = 'CO-PAY';
 149       $codes[$code]['bal'] += $amount;
 150     }
 151     else {
 152       $code = strtoupper($row['code']);
 153       if (! $code) $code = "Unknown";
 154       if ($row['modifier']) $code .= ':' . strtoupper($row['modifier']);
 155       $codes[$code]['chg'] += $amount;
 156       $codes[$code]['bal'] += $amount;
 157     }
 158     // Add the details if they want 'em.
 159     if ($with_detail) {
 160       if (! $codes[$code]['dtl']) $codes[$code]['dtl'] = array();
 161       $tmp = array();
 162       if ($row['code_type'] == 'COPAY') {
 163         $tmp['pmt'] = 0 - $amount;
 164         $tmp['src'] = 'Pt Paid';
 165         $tmp['plv'] = 0;
 166         $tmpkey = substr($row['date'], 0, 10) . $keysuff2++;
 167       }
 168       else {
 169         $tmp['chg'] = $amount;
 170         $tmpkey = "          " . $keysuff1++;
 171       }
 172       $codes[$code]['dtl'][$tmpkey] = $tmp;
 173     }
 174   }
 175
 176   // Get charges from product sales.
 177   $query = "SELECT s.drug_id, s.sale_date, s.fee, s.quantity " .
 178     "FROM drug_sales AS s " .
 179     "WHERE " .
 180     "s.pid = ? AND s.encounter = ? AND s.fee != 0 " .
 181     "ORDER BY s.sale_id";
 182   $res = sqlStatement($query, array($patient_id,$encounter_id) );
 183   while ($row = sqlFetchArray($res)) {
 184     $amount = sprintf('%01.2f', $row['fee']);
 185     $code = 'PROD:' . $row['drug_id'];
 186     $codes[$code]['chg'] += $amount;
 187     $codes[$code]['bal'] += $amount;
 188     // Add the details if they want 'em.
 189     if ($with_detail) {
 190       if (! $codes[$code]['dtl']) $codes[$code]['dtl'] = array();
 191       $tmp = array();
 192       $tmp['chg'] = $amount;
 193       $tmpkey = "          " . $keysuff1++;
 194       $codes[$code]['dtl'][$tmpkey] = $tmp;
 195     }
 196   }
 197
 198   // Get payments and adjustments.
 199   $res = sqlStatement("SELECT " .
 200     "a.code, a.modifier, a.memo, a.payer_type, a.adj_amount, a.pay_amount, a.reason_code, " .
 201     "a.post_time, a.session_id, a.sequence_no, " .
 202     "s.payer_id, s.reference, s.check_date, s.deposit_date " .
 203     ",i.name " .
 204     "FROM ar_activity AS a " .
 205     "LEFT OUTER JOIN ar_session AS s ON s.session_id = a.session_id " .
 206     "LEFT OUTER JOIN insurance_companies AS i ON i.id = s.payer_id " .
 207     "WHERE a.pid = ? AND a.encounter = ? " .
 208     "ORDER BY s.check_date, a.sequence_no", array($patient_id,$encounter_id) );
 209   while ($row = sqlFetchArray($res)) {
 210     $code = strtoupper($row['code']);
 211     if (! $code) $code = "Unknown";
 212     if ($row['modifier']) $code .= ':' . strtoupper($row['modifier']);
 213     $ins_id = 0 + $row['payer_id'];
 214     $codes[$code]['bal'] -= $row['pay_amount'];
 215     $codes[$code]['bal'] -= $row['adj_amount'];
 216     $codes[$code]['chg'] -= $row['adj_amount'];
 217     $codes[$code]['adj'] += $row['adj_amount'];
 218     if ($ins_id) $codes[$code]['ins'] = $ins_id;
 219     // Add the details if they want 'em.
 220     if ($with_detail) {
 221       if (! $codes[$code]['dtl']) $codes[$code]['dtl'] = array();
 222       $tmp = array();
 223       $paydate = empty($row['deposit_date']) ? substr($row['post_time'], 0, 10) : $row['deposit_date'];
 224       if ($row['pay_amount'] != 0) $tmp['pmt'] = $row['pay_amount'];
 225       if ( isset($row['reason_code'] ) ) {
 226         $tmp['msp'] = $row['reason_code'];
 227       }
 228       if ($row['adj_amount'] != 0 || $row['pay_amount'] == 0) {
 229         $tmp['chg'] = 0 - $row['adj_amount'];
 230         // $tmp['rsn'] = (empty($row['memo']) || empty($row['session_id'])) ? 'Unknown adjustment' : $row['memo'];
 231         $tmp['rsn'] = empty($row['memo']) ? 'Unknown adjustment' : $row['memo'];
 232         $tmpkey = $paydate . $keysuff1++;
 233       }
 234       else {
 235         $tmpkey = $paydate . $keysuff2++;
 236       }
 237       $tmp['src'] = empty($row['session_id']) ? $row['memo'] : $row['reference'];
 238       $tmp['insurance_company'] = substr($row['name'], 0, 10);
 239       if ($ins_id) $tmp['ins'] = $ins_id;
 240       $tmp['plv'] = $row['payer_type'];
 241       $tmp['arseq'] = $row['sequence_no'];
 242       $codes[$code]['dtl'][$tmpkey] = $tmp;
 243     }
 244   }
 245   return $codes;
 246 }
 247
 248 // This determines the party from whom payment is currently expected.
 249 // Returns: -1=Nobody, 0=Patient, 1=Ins1, 2=Ins2, 3=Ins3.
 250 //
 251 function responsible_party($trans_id) {
 252   global $sl_err;
 253   $arres = SLQuery("select * from ar where id = $trans_id");
 254   if ($sl_err) die($sl_err);
 255   $arrow = SLGetRow($arres, 0);
 256   if (! $arrow) die(xl("There is no match for invoice id = ") . $trans_id);
 257   if ($arrow['paid'] >= $arrow['netamount']) return -1;
 258   $insgot  = strtolower($arrow['notes']);
 259   $insdone = strtolower($arrow['shipvia']);
 260   for ($i = 1; $i <= 3; ++$i) {
 261     $lcvalue = "ins$i";
 262     if (strpos($insgot, $lcvalue) !== false && strpos($insdone, $lcvalue) === false)
 263       return $i;
 264   }
 265   return 0;
 266 }
 267
 268 // As above but for Integrated A/R.
 269 //
 270 function ar_responsible_party($patient_id, $encounter_id) {
 271   $row = sqlQuery("SELECT date, last_level_billed, last_level_closed " .
 272     "FROM form_encounter WHERE " .
 273     "pid = ? AND encounter = ? " .
 274     "ORDER BY id DESC LIMIT 1", array($patient_id,$encounter_id) );
 275   if (empty($row)) return -1;
 276   $next_level = $row['last_level_closed'] + 1;
 277   if ($next_level <= $row['last_level_billed'])
 278     return $next_level;
 279   if (arGetPayerID($patient_id, substr($row['date'], 0, 10), $next_level))
 280     return $next_level;
 281   // There is no unclosed insurance, so see if there is an unpaid balance.
 282   // Currently hoping that form_encounter.balance_due can be discarded.
 283   $balance = 0;
 284   $codes = ar_get_invoice_summary($patient_id, $encounter_id);
 285   foreach ($codes as $cdata) $balance += $cdata['bal'];
 286   if ($balance > 0) return 0;
 287   return -1;
 288 }
 289 ?>