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