library/invoice_summary.inc.php

   1 <?php
   2 /**
   3  * @package OpenEMR
   4  * @author Rod Roark <rod@sunsetsystems.com>
   5  * @author Stephen Waite <stephen.waite@cmsvt.com>
   6  * @copyright Copyright (c) 2005-2010 Rod Roark <rod@sunsetsystems.com>
   7  * @copyright Copyright (c) 2018 Stephen Waite <stephen.waite@cmsvt.com>
   8  * @link http://www.open-emr.org
   9  * @license https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
  10  */
  11
  12 // This returns an associative array keyed on procedure code, representing
  13 // all charge items for one invoice.  This array's values are themselves
  14 // associative arrays having the following keys:
  15 //
  16 //  chg - the sum of line items, including adjustments, for the code
  17 //  bal - the unpaid balance
  18 //  adj - the (positive) sum of inverted adjustments
  19 //  ins - the id of the insurance company that was billed (obsolete)
  20 //  dtl - associative array of details, if requested
  21 //
  22 // Where details are requested, each dtl array is keyed on a string
  23 // beginning with a date in yyyy-mm-dd format, or blanks in the case
  24 // of the original charge items.  The value array is:
  25 //
  26 //  pmt - payment amount as a positive number, only for payments
  27 //  src - check number or other source, only for payments
  28 //  chg - invoice line item amount amount, only for charges or
  29 //        adjustments (adjustments may be zero)
  30 //  rsn - adjustment reason, only for adjustments
  31 //  plv - provided for "integrated A/R" only: 0=pt, 1=Ins1, etc.
  32 //  dsc - for tax charges, a description of the tax
  33 //  arseq - ar_activity.sequence_no when it applies.
  34
  35 require_once(dirname(__FILE__) . "/../custom/code_types.inc.php");
  36
  37 use OpenEMR\Billing\SLEOB;
  38
  39 // for Integrated A/R.
  40 //
  41 function ar_get_invoice_summary($patient_id, $encounter_id, $with_detail = false)
  42 {
  43     $codes = array();
  44     $keysuff1 = 1000;
  45     $keysuff2 = 5000;
  46
  47   // Get charges from services.
  48     $res = sqlStatement("SELECT " .
  49     "date, code_type, code, modifier, code_text, fee " .
  50     "FROM billing WHERE " .
  51     "pid = ? AND encounter = ? AND " .
  52     "activity = 1 AND fee != 0.00 ORDER BY id", array($patient_id,$encounter_id));
  53
  54     while ($row = sqlFetchArray($res)) {
  55         $amount = sprintf('%01.2f', $row['fee']);
  56
  57         $code = $row['code'];
  58         if (! $code) {
  59             $code = "Unknown";
  60         }
  61
  62         if ($row['modifier']) {
  63             $code .= ':' . $row['modifier'];
  64         }
  65
  66         $codes[$code]['chg'] += $amount;
  67         $codes[$code]['bal'] += $amount;
  68
  69         // Pass the code type, code and code_text fields
  70         // Although not all used yet, useful information
  71         // to improve the statement reporting etc.
  72         $codes[$code]['code_type'] = $row['code_type'];
  73         $codes[$code]['code_value'] = $row['code'];
  74         $codes[$code]['modifier'] = $row['modifier'];
  75         $codes[$code]['code_text'] = $row['code_text'];
  76
  77         // Add the details if they want 'em.
  78         if ($with_detail) {
  79             if (! $codes[$code]['dtl']) {
  80                 $codes[$code]['dtl'] = array();
  81             }
  82
  83             $tmp = array();
  84             $tmp['chg'] = $amount;
  85             $tmpkey = "          " . $keysuff1++;
  86             $codes[$code]['dtl'][$tmpkey] = $tmp;
  87         }
  88     }
  89
  90   // Get charges from product sales.
  91     $query = "SELECT s.drug_id, s.sale_date, s.fee, s.quantity " .
  92     "FROM drug_sales AS s " .
  93     "WHERE " .
  94     "s.pid = ? AND s.encounter = ? AND s.fee != 0 " .
  95     "ORDER BY s.sale_id";
  96     $res = sqlStatement($query, array($patient_id,$encounter_id));
  97     while ($row = sqlFetchArray($res)) {
  98         $amount = sprintf('%01.2f', $row['fee']);
  99         $code = 'PROD:' . $row['drug_id'];
 100         $codes[$code]['chg'] += $amount;
 101         $codes[$code]['bal'] += $amount;
 102         // Add the details if they want 'em.
 103         if ($with_detail) {
 104             if (! $codes[$code]['dtl']) {
 105                 $codes[$code]['dtl'] = array();
 106             }
 107
 108             $tmp = array();
 109             $tmp['chg'] = $amount;
 110             $tmpkey = "          " . $keysuff1++;
 111             $codes[$code]['dtl'][$tmpkey] = $tmp;
 112         }
 113     }
 114     // Get insurance data for stuff
 115     $ins_data = array();
 116     $res = sqlStatement("SELECT insurance_data.type as type, insurance_companies.name as name " .
 117         "FROM insurance_data " .
 118         "INNER JOIN insurance_companies ON insurance_data.provider = insurance_companies.id " .
 119         "WHERE insurance_data.pid = ?", array($patient_id));
 120     while ($row = sqlFetchArray($res)) {
 121         $ins_data[$row['type']] = $row['name'];
 122     }
 123   // Get payments and adjustments. (includes copays)
 124     $res = sqlStatement("SELECT " .
 125     "a.code_type, a.code, a.modifier, a.memo, a.payer_type, a.adj_amount, a.pay_amount, a.reason_code, " .
 126     "a.post_time, a.session_id, a.sequence_no, a.account_code, " .
 127     "s.payer_id, s.reference, s.check_date, s.deposit_date " .
 128     ",i.name " .
 129     "FROM ar_activity AS a " .
 130     "LEFT OUTER JOIN ar_session AS s ON s.session_id = a.session_id " .
 131     "LEFT OUTER JOIN insurance_companies AS i ON i.id = s.payer_id " .
 132     "WHERE a.pid = ? AND a.encounter = ? " .
 133     "ORDER BY s.check_date, a.sequence_no", array($patient_id,$encounter_id));
 134     while ($row = sqlFetchArray($res)) {
 135         $code = $row['code'];
 136         if (! $code) {
 137             $code = "Unknown";
 138         }
 139
 140         if ($row['modifier']) {
 141             $code .= ':' . $row['modifier'];
 142         }
 143
 144         $ins_id = 0 + $row['payer_id'];
 145         $codes[$code]['bal'] -= $row['pay_amount'];
 146         $codes[$code]['bal'] -= $row['adj_amount'];
 147         $codes[$code]['chg'] -= $row['adj_amount'];
 148         $codes[$code]['adj'] += $row['adj_amount'];
 149         if ($ins_id) {
 150             $codes[$code]['ins'] = $ins_id;
 151         }
 152
 153         // Add the details if they want 'em.
 154         if ($with_detail) {
 155             if (! $codes[$code]['dtl']) {
 156                 $codes[$code]['dtl'] = array();
 157             }
 158
 159             $tmp = array();
 160             $paydate = empty($row['deposit_date']) ? substr($row['post_time'], 0, 10) : $row['deposit_date'];
 161             if ($row['pay_amount'] != 0) {
 162                 $tmp['pmt'] = $row['pay_amount'];
 163             }
 164
 165             if (isset($row['reason_code'])) {
 166                 $tmp['msp'] = $row['reason_code'];
 167             }
 168
 169             if ($row['adj_amount'] != 0 || $row['pay_amount'] == 0) {
 170                 $tmp['chg'] = 0 - $row['adj_amount'];
 171                 // $tmp['rsn'] = (empty($row['memo']) || empty($row['session_id'])) ? 'Unknown adjustment' : $row['memo'];
 172                 $tmp['rsn'] = empty($row['memo']) ? 'Unknown adjustment' : $row['memo'];
 173                 $tmp['rsn'] = str_replace("Ins1", $ins_data['primary'], $tmp['rsn']);
 174                 $tmp['rsn'] = str_replace("Ins2", $ins_data['secondary'], $tmp['rsn']);
 175                 $tmp['rsn'] = str_replace("Ins3", $ins_data['tertiary'], $tmp['rsn']);
 176                 $tmpkey = $paydate . $keysuff1++;
 177             } else {
 178                 $tmpkey = $paydate . $keysuff2++;
 179             }
 180
 181             if ($row['account_code'] == "PCP") {
 182                 //copay
 183                 $tmp['src'] = 'Pt Paid';
 184             } else {
 185                 $tmp['src'] = empty($row['session_id']) ? $row['memo'] : $row['reference'];
 186             }
 187
 188             $tmp['insurance_company'] = substr($row['name'], 0, 10);
 189             if ($ins_id) {
 190                 $tmp['ins'] = $ins_id;
 191             }
 192
 193             $tmp['plv'] = $row['payer_type'];
 194             $tmp['arseq'] = $row['sequence_no'];
 195             $codes[$code]['dtl'][$tmpkey] = $tmp;
 196         }
 197     }
 198
 199     return $codes;
 200 }
 201
 202 // This determines the party from whom payment is currently expected.
 203 // Returns: -1=Nobody, 0=Patient, 1=Ins1, 2=Ins2, 3=Ins3.
 204 // for Integrated A/R.
 205 //
 206 function ar_responsible_party($patient_id, $encounter_id)
 207 {
 208     $row = sqlQuery("SELECT date, last_level_billed, last_level_closed " .
 209     "FROM form_encounter WHERE " .
 210     "pid = ? AND encounter = ? " .
 211     "ORDER BY id DESC LIMIT 1", array($patient_id,$encounter_id));
 212     if (empty($row)) {
 213         return -1;
 214     }
 215
 216     $next_level = $row['last_level_closed'] + 1;
 217     if ($next_level <= $row['last_level_billed']) {
 218         return $next_level;
 219     }
 220
 221     if (SLEOB::arGetPayerID($patient_id, substr($row['date'], 0, 10), $next_level)) {
 222         return $next_level;
 223     }
 224
 225   // There is no unclosed insurance, so see if there is an unpaid balance.
 226   // Currently hoping that form_encounter.balance_due can be discarded.
 227     $balance = 0;
 228     $codes = ar_get_invoice_summary($patient_id, $encounter_id);
 229     foreach ($codes as $cdata) {
 230         $balance += $cdata['bal'];
 231     }
 232
 233     if ($balance > 0) {
 234         return 0;
 235     }
 236
 237     return -1;
 238 }