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: ' . $landingpage);
  39         exit();
  40     }
  41 }
  42
  43 require_once(dirname(__FILE__) . "/lib/appsql.class.php");
  44 require_once("$srcdir/acl.inc");
  45 require_once("$srcdir/patient.inc");
  46 require_once("$srcdir/billing.inc");
  47 require_once("$srcdir/payment.inc.php");
  48 require_once("$srcdir/forms.inc");
  49 require_once("$srcdir/sl_eob.inc.php");
  50 require_once("$srcdir/invoice_summary.inc.php");
  51 require_once("../custom/code_types.inc.php");
  52 require_once("$srcdir/formatting.inc.php");
  53 require_once("$srcdir/options.inc.php");
  54 require_once("$srcdir/encounter_events.inc.php");
  55
  56 $appsql = new ApplicationTable();
  57
  58 $pid = $_REQUEST['hidden_patient_code'] > 0 ? $_REQUEST['hidden_patient_code'] : $pid;
  59
  60 $edata = $appsql->getPortalAudit($pid, 'review', 'payment');
  61 $ccdata = array();
  62 $invdata = array();
  63
  64 if ($edata) {
  65     $ccdata = json_decode(aes256Decrypt($edata['checksum']), true);
  66     $invdata = json_decode($edata['table_args'], true);
  67     echo "<script  type='text/javascript'>var jsondata='" . $edata['table_args'] . "';var ccdata='" . $edata['checksum'] . "'</script>";
  68 }
  69
  70 function bucks($amount)
  71 {
  72     if ($amount) {
  73         $amount = oeFormatMoney($amount);
  74         return $amount;
  75     }
  76
  77     return '';
  78 }
  79 function rawbucks($amount)
  80 {
  81     if ($amount) {
  82         $amount = sprintf("%.2f", $amount);
  83         return $amount;
  84     }
  85
  86     return '';
  87 }
  88
  89 // Display a row of data for an encounter.
  90 //
  91 $var_index = 0;
  92 function echoLine($iname, $date, $charges, $ptpaid, $inspaid, $duept, $encounter = 0, $copay = 0, $patcopay = 0)
  93 {
  94     global $var_index;
  95     $var_index ++;
  96     $balance = bucks($charges - $ptpaid - $inspaid);
  97     $balance = ( round($duept, 2) != 0 ) ? 0 : $balance; // if balance is due from patient, then insurance balance is displayed as zero
  98     $encounter = $encounter ? $encounter : '';
  99     echo " <tr id='tr_" . attr($var_index) . "' >\n";
 100     echo "  <td class='detail'>" . text(oeFormatShortDate($date)) . "</td>\n";
 101     echo "  <td class='detail' id='" . attr($date) . "' align='left'>" . htmlspecialchars($encounter, ENT_QUOTES) . "</td>\n";
 102     echo "  <td class='detail' align='center' id='td_charges_$var_index' >" . htmlspecialchars(bucks($charges), ENT_QUOTES) . "</td>\n";
 103     echo "  <td class='detail' align='center' id='td_inspaid_$var_index' >" . htmlspecialchars(bucks($inspaid * - 1), ENT_QUOTES) . "</td>\n";
 104     echo "  <td class='detail' align='center' id='td_ptpaid_$var_index' >" . htmlspecialchars(bucks($ptpaid * - 1), ENT_QUOTES) . "</td>\n";
 105     echo "  <td class='detail' align='center' id='td_patient_copay_$var_index' >" . htmlspecialchars(bucks($patcopay), ENT_QUOTES) . "</td>\n";
 106     echo "  <td class='detail' align='center' id='td_copay_$var_index' >" . htmlspecialchars(bucks($copay), ENT_QUOTES) . "</td>\n";
 107     echo "  <td class='detail' align='center' id='balance_$var_index'>" . htmlspecialchars(bucks($balance), ENT_QUOTES) . "</td>\n";
 108     echo "  <td class='detail' align='center' id='duept_$var_index'>" . htmlspecialchars(bucks(round($duept, 2) * 1), ENT_QUOTES) . "</td>\n";
 109     echo "  <td class='detail' align='right'><input class='form-control' style='width:60px;padding:2px 2px;' type='text' name='" . attr($iname) . "'  id='paying_" . attr($var_index) . "' " . " value='" . '' . "' onchange='coloring();calctotal()'  autocomplete='off' " . "onkeyup='calctotal()'/></td>\n";
 110     echo " </tr>\n";
 111 }
 112
 113 // We use this to put dashes, colons, etc. back into a timestamp.
 114 //
 115 function decorateString($fmt, $str)
 116 {
 117     $res = '';
 118     while ($fmt) {
 119         $fc = substr($fmt, 0, 1);
 120         $fmt = substr($fmt, 1);
 121         if ($fc == '.') {
 122             $res .= substr($str, 0, 1);
 123             $str = substr($str, 1);
 124         } else {
 125             $res .= $fc;
 126         }
 127     }
 128
 129     return $res;
 130 }
 131
 132 // Compute taxes from a tax rate string and a possibly taxable amount.
 133 //
 134 function calcTaxes($row, $amount)
 135 {
 136     $total = 0;
 137     if (empty($row['taxrates'])) {
 138         return $total;
 139     }
 140
 141     $arates = explode(':', $row['taxrates']);
 142     if (empty($arates)) {
 143         return $total;
 144     }
 145
 146     foreach ($arates as $value) {
 147         if (empty($value)) {
 148             continue;
 149         }
 150
 151         $trow = sqlQuery("SELECT option_value FROM list_options WHERE " . "list_id = 'taxrate' AND option_id = ? LIMIT 1", array ($value
 152         ));
 153         if (empty($trow['option_value'])) {
 154             echo "<!-- Missing tax rate '" . text($value) . "'! -->\n";
 155             continue;
 156         }
 157
 158         $tax = sprintf("%01.2f", $amount * $trow['option_value']);
 159         // echo "<!-- Rate = '$value', amount = '$amount', tax = '$tax' -->\n";
 160         $total += $tax;
 161     }
 162
 163     return $total;
 164 }
 165
 166 $now = time();
 167 $today = date('Y-m-d', $now);
 168 $timestamp = date('Y-m-d H:i:s', $now);
 169
 170
 171 // $patdata = getPatientData($pid, 'fname,lname,pubpid');
 172
 173 $patdata = sqlQuery("SELECT " . "p.fname, p.mname, p.lname, p.pubpid,p.pid, i.copay " . "FROM patient_data AS p " . "LEFT OUTER JOIN insurance_data AS i ON " . "i.pid = p.pid AND i.type = 'primary' " . "WHERE p.pid = ? ORDER BY i.date DESC LIMIT 1", array ($pid
 174 ));
 175
 176 $alertmsg = ''; // anything here pops up in an alert box
 177
 178 // If the Save button was clicked...
 179 if ($_POST['form_save']) {
 180     // $extra = json_decode($_POST['ajax_mode'], true);
 181     $form_pid = $_POST['form_pid'];
 182     $form_method = trim($_POST['form_method']);
 183     $form_source = trim($_POST['form_source']);
 184     $patdata = getPatientData($form_pid, 'fname,mname,lname,pubpid');
 185     $NameNew = $patdata['fname'] . " " . $patdata['lname'] . " " . $patdata['mname'];
 186
 187     if ($_REQUEST['radio_type_of_payment'] == 'pre_payment') {
 188         $payment_id = idSqlStatement("insert into ar_session set " . "payer_id = ?" . ", patient_id = ?" . ", user_id = ?" . ", closed = ?" . ", reference = ?" . ", check_date =  now() , deposit_date = now() " . ",  pay_total = ?" . ", payment_type = 'patient'" . ", description = ?" . ", adjustment_code = 'pre_payment'" . ", post_to_date = now() " . ", payment_method = ?", array (
 189                 0,$form_pid,$_SESSION['authUserID'],0,$form_source,$_REQUEST['form_prepayment'],$NameNew,$form_method
 190         ));
 191
 192         frontPayment($form_pid, 0, $form_method, $form_source, $_REQUEST['form_prepayment'], 0, $timestamp); // insertion to 'payments' table.
 193     }
 194
 195     if ($_POST['form_upay'] && $_REQUEST['radio_type_of_payment'] != 'pre_payment') {
 196         foreach ($_POST['form_upay'] as $enc => $payment) {
 197             if ($amount = 0 + $payment) {
 198                 $zero_enc = $enc;
 199                 if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance') {
 200                     ;
 201                 } else {
 202                     if (! $enc) {
 203                         $enc = calendar_arrived($form_pid);
 204                     }
 205                 }
 206
 207                 // ----------------------------------------------------------------------------------------------------
 208                 // Fetching the existing code and modifier
 209                 $ResultSearchNew = sqlStatement("SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key " . "WHERE code_types.ct_fee=1 AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier", array ($form_pid,$enc
 210                 ));
 211                 if ($RowSearch = sqlFetchArray($ResultSearchNew)) {
 212                     $Codetype = $RowSearch['code_type'];
 213                     $Code = $RowSearch['code'];
 214                     $Modifier = $RowSearch['modifier'];
 215                 } else {
 216                     $Codetype = '';
 217                     $Code = '';
 218                     $Modifier = '';
 219                 }
 220
 221                 // ----------------------------------------------------------------------------------------------------
 222                 if ($_REQUEST['radio_type_of_payment'] == 'copay') { // copay saving to ar_session and ar_activity tables
 223                     $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 (
 224                             $_SESSION['authId'],$form_source,$amount,$form_pid,$form_method
 225                     ));
 226
 227                     $insrt_id = idSqlStatement("INSERT INTO ar_activity (pid,encounter,code_type,code,modifier,payer_type,post_time,post_user,session_id,pay_amount,account_code)" . " VALUES (?,?,?,?,?,0,now(),?,?,?,'PCP')", array ($form_pid,$enc,$Codetype,$Code,$Modifier,'3',$session_id,$amount
 228                     ));
 229
 230                     frontPayment($form_pid, $enc, $form_method, $form_source, $amount, 0, $timestamp); // insertion to 'payments' table.
 231                 }
 232
 233                 if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance' || $_REQUEST['radio_type_of_payment'] == 'cash') { // Payment by patient after insurance paid, cash patients similar to do not bill insurance in feesheet.
 234                     if ($_REQUEST['radio_type_of_payment'] == 'cash') {
 235                         sqlStatement("update form_encounter set last_level_closed=? where encounter=? and pid=? ", array (4,$enc,$form_pid
 236                         ));
 237                         sqlStatement("update billing set billed=? where encounter=? and pid=?", array (1,$enc,$form_pid
 238                         ));
 239                     }
 240
 241                     $adjustment_code = 'patient_payment';
 242                     $payment_id = idSqlStatement("insert into ar_session set " . "payer_id = ?" . ", patient_id = ?" . ", user_id = ?" . ", closed = ?" . ", reference = ?" . ", check_date =  now() , deposit_date = now() " . ",  pay_total = ?" . ", payment_type = 'patient'" . ", description = ?" . ", adjustment_code = ?" . ", post_to_date = now() " . ", payment_method = ?", array (
 243                             0,$form_pid,$_SESSION['authUserID'],0,$form_source,$amount,$NameNew,$adjustment_code,$form_method
 244                     ));
 245
 246                     // --------------------------------------------------------------------------------------------------------------------
 247
 248                     frontPayment($form_pid, $enc, $form_method, $form_source, 0, $amount, $timestamp); // insertion to 'payments' table.
 249
 250                     // --------------------------------------------------------------------------------------------------------------------
 251
 252                     $resMoneyGot = sqlStatement("SELECT sum(pay_amount) as PatientPay FROM ar_activity where pid =? and " . "encounter =? and payer_type=0 and account_code='PCP'", array ($form_pid,$enc
 253                     )); // new fees screen copay gives account_code='PCP'
 254                     $rowMoneyGot = sqlFetchArray($resMoneyGot);
 255                     $Copay = $rowMoneyGot['PatientPay'];
 256
 257                     // --------------------------------------------------------------------------------------------------------------------
 258
 259                     // Looping the existing code and modifier
 260                     $ResultSearchNew = sqlStatement("SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key WHERE code_types.ct_fee=1 " . "AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier", array ($form_pid,$enc
 261                     ));
 262                     while ($RowSearch = sqlFetchArray($ResultSearchNew)) {
 263                         $Codetype = $RowSearch['code_type'];
 264                         $Code = $RowSearch['code'];
 265                         $Modifier = $RowSearch['modifier'];
 266                         $Fee = $RowSearch['fee'];
 267
 268                         $resMoneyGot = sqlStatement("SELECT sum(pay_amount) as MoneyGot FROM ar_activity where pid =? " . "and code_type=? and code=? and modifier=? and encounter =? and !(payer_type=0 and account_code='PCP')", array ($form_pid,$Codetype,$Code,$Modifier,$enc
 269                         ));
 270                         // new fees screen copay gives account_code='PCP'
 271                         $rowMoneyGot = sqlFetchArray($resMoneyGot);
 272                         $MoneyGot = $rowMoneyGot['MoneyGot'];
 273
 274                         $resMoneyAdjusted = sqlStatement("SELECT sum(adj_amount) as MoneyAdjusted FROM ar_activity where " . "pid =? and code_type=? and code=? and modifier=? and encounter =?", array ($form_pid,$Codetype,$Code,$Modifier,$enc
 275                         ));
 276                         $rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
 277                         $MoneyAdjusted = $rowMoneyAdjusted['MoneyAdjusted'];
 278
 279                         $Remainder = $Fee - $Copay - $MoneyGot - $MoneyAdjusted;
 280                         $Copay = 0;
 281                         if (round($Remainder, 2) != 0 && $amount != 0) {
 282                             if ($amount - $Remainder >= 0) {
 283                                 $insert_value = $Remainder;
 284                                 $amount = $amount - $Remainder;
 285                             } else {
 286                                 $insert_value = $amount;
 287                                 $amount = 0;
 288                             }
 289
 290                             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 (
 291                                     $form_pid,$enc,$Codetype,$Code,$Modifier,0,3,$payment_id,$insert_value,0
 292                             ));
 293                         } // if
 294                     } // while
 295                     if ($amount != 0) { // if any excess is there.
 296                         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 (
 297                                 $form_pid,$enc,$Codetype,$Code,$Modifier,0,3,$payment_id,$amount,0
 298                         ));
 299                     }
 300
 301                     // --------------------------------------------------------------------------------------------------------------------
 302                 } // invoice_balance
 303             } // if ($amount = 0 + $payment)
 304         } // foreach
 305     } // if ($_POST['form_upay'])
 306 } // if ($_POST['form_save'])
 307
 308 if ($_POST['form_save'] || $_REQUEST['receipt']) {
 309     if ($_REQUEST['receipt']) {
 310         $form_pid = $_GET['patient'];
 311         $timestamp = decorateString('....-..-.. ..:..:..', $_GET['time']);
 312     }
 313
 314     // Get details for what we guess is the primary facility.
 315     $frow = sqlQuery("SELECT * FROM facility " . "ORDER BY billing_location DESC, accepts_assignment DESC, id LIMIT 1");
 316
 317     // Get the patient's name and chart number.
 318     $patdata = getPatientData($form_pid, 'fname,mname,lname,pubpid');
 319
 320     // Re-fetch payment info.
 321     $payrow = sqlQuery("SELECT " . "SUM(amount1) AS amount1, " . "SUM(amount2) AS amount2, " . "MAX(method) AS method, " . "MAX(source) AS source, " . "MAX(dtime) AS dtime, " .
 322     // "MAX(user) AS user " .
 323     "MAX(user) AS user, " . "MAX(encounter) as encounter " . "FROM payments WHERE " . "pid = ? AND dtime = ?", array ($form_pid,$timestamp
 324     ));
 325
 326     // Create key for deleting, just in case.
 327     $ref_id = ( $_REQUEST['radio_type_of_payment'] == 'copay' ) ? $session_id : $payment_id;
 328     $payment_key = $form_pid . '.' . preg_replace('/[^0-9]/', '', $timestamp) . '.' . $ref_id;
 329
 330     // get facility from encounter
 331     $tmprow = sqlQuery("
 332     SELECT facility_id
 333     FROM form_encounter
 334     WHERE encounter = ?", array ($payrow['encounter']
 335     ));
 336     $frow = sqlQuery("SELECT * FROM facility " . " WHERE id = ?", array ($tmprow['facility_id']
 337     ));
 338
 339     // Now proceed with printing the receipt.
 340     ?>
 341
 342 <title><?php echo xlt('Receipt for Payment'); ?></title>
 343
 344 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-min-1-11-3/index.js"></script>
 345 <script type="text/javascript">
 346 $( document ).ready();
 347 function goHome(){
 348      window.location.replace("./patient/onsiteactivityviews");
 349 }
 350 function notifyPatient(){
 351     var pid = <?php echo attr($pid);?>;
 352     var note = $('#pop_receipt').text();
 353     var formURL = './messaging/handle_note.php';
 354     $.ajax({
 355         url: formURL,
 356         type: "POST",
 357         data: {'task':'add', 'pid':pid, 'inputBody':note, 'title':'Bill/Collect', 'sendto':'-patient-','noteid':'0'},
 358         success: function(data, textStatus, jqXHR) {
 359             alert('Receipt sent to patient via Messages.')
 360         },
 361         error: function(jqXHR, status, error) {
 362             console.log(status + ": " + error);
 363         }
 364     });
 365 }
 366 </script>
 367 <?php
 368 ob_start();
 369 echo '<htlm><head></head><body style="text-align: center; margin: auto;">';
 370 ?>
 371
 372 <div id='pop_receipt' style='display: block'>
 373         <p>
 374         <h2><?php echo xlt('Receipt for Payment'); ?></h2>
 375         <p><?php echo text($frow['name'])?>
 376         <br><?php echo text($frow['street'])?>
 377         <br><?php echo text($frow['city'] . ', ' . $frow['state']) . ' ' . text($frow['postal_code'])?>
 378         <br><?php echo htmlentities($frow['phone'])?>
 379         <p>
 380         <div style="text-align: center; margin: auto;">
 381             <table border='0' cellspacing='8'
 382                 style="text-align: center; margin: auto;">
 383                 <tr>
 384                     <td><?php echo xlt('Date'); ?>:</td>
 385                     <td><?php echo text(oeFormatSDFT(strtotime($payrow['dtime']))) ?></td>
 386                 </tr>
 387                 <tr>
 388                     <td><?php echo xlt('Patient'); ?>:</td>
 389                     <td><?php echo text($patdata['fname']) . " " . text($patdata['mname']) . " " . text($patdata['lname']) . " (" . text($patdata['pubpid']) . ")"?></td>
 390                 </tr>
 391                 <tr>
 392                     <td><?php echo xlt('Paid Via'); ?>:</td>
 393                     <td><?php echo generate_display_field(array('data_type'=>'1','list_id'=>'payment_method'), $payrow['method']); ?></td>
 394                 </tr>
 395                 <tr>
 396                     <td><?php echo xlt('Authorized Id'); ?>:</td>
 397                     <td><?php echo text($payrow['source']) ?></td>
 398                 </tr>
 399                 <tr>
 400                     <td><?php echo xlt('Amount for This Visit'); ?>:</td>
 401                     <td><?php echo text(oeFormatMoney($payrow['amount1'])) ?></td>
 402                 </tr>
 403                 <tr>
 404                     <td><?php echo xlt('Amount for Past Balance'); ?>:</td>
 405                     <td><?php echo text(oeFormatMoney($payrow['amount2'])) ?></td>
 406                 </tr>
 407                 <tr>
 408                     <td><?php echo xlt('Received By'); ?>:</td>
 409                     <td><?php echo text($payrow['user']) ?></td>
 410                 </tr>
 411             </table>
 412         </div>
 413 </div>
 414         <button class='btn btn-sm' type='button' onclick='goHome()' id='returnhome'><?php echo xla('Return Home'); ?></button>
 415         <button class='btn btn-sm' type='button' onclick="notifyPatient()"><?php echo xla('Notify Patient'); ?></button>
 416 </body></html>
 417 <?php
 418  ob_end_flush();
 419 } else {
 420     //
 421     // Here we display the form for data entry.
 422     //
 423     ?>
 424 <title><?php echo xlt('Record Payment'); ?></title>
 425 <style type="text/css">
 426 body {
 427  /* font-family:sans-serif; font-size:10pt; font-weight:normal */
 428 }
 429
 430 .dehead {
 431     color: #000000; /*font-family:sans-serif; font-size:10pt;*/
 432     font-weight: bold
 433 }
 434
 435 .detail {
 436     padding: 1px 1px;
 437     /* width: 65px; */
 438     color: #000000; /*font-family:sans-serif; font-size:10pt; */
 439     font-weight: normal
 440 }
 441 </style>
 442 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-creditcardvalidator-1-1-0/jquery.creditCardValidator.js"></script>
 443 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/textformat.js?v=<?php echo $v_js_includes; ?>"></script>
 444
 445 <script type="text/javascript">
 446 var mypcc = '1';
 447 function calctotal() {
 448  var flag=0;
 449  var f = document.forms["payfrm"];
 450  var total = 0;
 451  for (var i = 0; i < f.elements.length; ++i) {
 452   var elem = f.elements[i];
 453   var ename = elem.name;
 454   if (ename.indexOf('form_upay[') == 0 || ename.indexOf('form_bpay[') == 0) {
 455    if (elem.value.length > 0){
 456        total += Number(elem.value);
 457         if(total < 0) flag=1;
 458    }
 459   }
 460  }
 461      f.form_paytotal.value = Number(total).toFixed(2);
 462      if(flag){
 463         $('#payfrm')[0].reset();
 464         alert("<?php echo addslashes(xl('Negative payments not accepted')) ?>")
 465     }
 466  return true;
 467 }
 468 function coloring()
 469  {
 470    for (var i = 1; ; ++i)
 471     {
 472       if(document.getElementById('paying_'+i))
 473        {
 474         paying=document.getElementById('paying_'+i).value*1;
 475         patient_balance=document.getElementById('duept_'+i).innerHTML*1;
 476         //balance=document.getElementById('balance_'+i).innerHTML*1;
 477         if(patient_balance>0 && paying>0)
 478          {
 479             if(paying>patient_balance)
 480              {
 481               document.getElementById('paying_'+i).style.background='#FF0000';
 482              }
 483             else if(paying<patient_balance)
 484              {
 485               document.getElementById('paying_'+i).style.background='#99CC00';
 486              }
 487             else if(paying==patient_balance)
 488              {
 489               document.getElementById('paying_'+i).style.background='#ffffff';
 490              }
 491          }
 492         else
 493          {
 494           document.getElementById('paying_'+i).style.background='#ffffff';
 495          }
 496        }
 497       else
 498        {
 499         break;
 500        }
 501     }
 502  }
 503 function CheckVisible(MakeBlank)
 504  {//Displays and hides the check number text box.
 505    if(document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='check_payment' ||
 506          document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='bank_draft'  )
 507    {
 508     document.getElementById('check_number').disabled=false;
 509    }
 510    else
 511    {
 512     document.getElementById('check_number').disabled=true;
 513    }
 514  }
 515 function validate()
 516  {
 517   var f = document.forms["payfrm"];
 518   ok=-1;
 519   //no checks taken here....
 520   issue='no';
 521    /*if(((document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='check_payment' ||
 522          document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='bank_draft') &&
 523        document.getElementById('check_number').value=='' ))
 524    {
 525     alert("<?php //echo addslashes( xl('Please Fill the Check/Ref Number')) ?>");
 526     document.getElementById('check_number').focus();
 527     return false;
 528    }*/
 529
 530    if(document.getElementById('radio_type_of_payment_self1').checked==false &&
 531           document.getElementById('radio_type_of_payment1').checked==false
 532            && document.getElementById('radio_type_of_payment2').checked==false
 533            && document.getElementById('radio_type_of_payment4').checked==false)
 534     {
 535       alert("<?php //echo addslashes( xl('Please Select Type Of Payment.')) ?>");
 536        return false;
 537     }
 538   if(document.getElementById('radio_type_of_payment_self1').checked==true ||  document.getElementById('radio_type_of_payment1').checked==true)
 539    {
 540      for (var i = 0; i < f.elements.length; ++i)
 541      {
 542       var elem = f.elements[i];
 543       var ename = elem.name;
 544       if (ename.indexOf('form_upay[0') == 0) //Today is this text box.
 545       {
 546        if(elem.value*1>0)
 547         {//A warning message, if the amount is posted with out encounter.
 548          if(confirm("<?php echo addslashes(xl('Are you sure to post for today?')) ?>"))
 549           {
 550            ok=1;
 551           }
 552          else
 553           {
 554            elem.focus();
 555            return false;
 556           }
 557         }
 558        break;
 559       }
 560     }
 561    }
 562 //CO-PAY
 563   /* if(document.getElementById('radio_type_of_payment1').checked==true)
 564    {
 565      var total = 0;
 566      for (var i = 0; i < f.elements.length; ++i)
 567      {
 568       var elem = f.elements[i];
 569       var ename = elem.name;
 570       if (ename.indexOf('form_upay[') == 0) //Today is this text box.
 571       {
 572        if(f.form_paytotal.value*1!=elem.value*1)//Total CO-PAY is not posted against today
 573         {//A warning message, if the amount is posted against an old encounter.
 574          if(confirm("<?php //echo addslashes( xl('You are posting against an old encounter?')) ?>"))
 575           {
 576            ok=1;
 577           }
 578         // else
 579           {
 580            elem.focus();
 581            return false;
 582           }
 583         }
 584        break;
 585       }
 586     }
 587    }*///Co Pay
 588  else if( document.getElementsByName('form_paytotal')[0].value <= 0 )//total 0
 589   {
 590     alert("<?php echo addslashes(xl('Invalid Total!')) ?>")
 591     return false;
 592   }
 593  if(ok==-1)
 594   {
 595      //return true;
 596      if(confirm("<?php echo addslashes(xl('Payment Validated: Save?')) ?>"))
 597       {
 598        return true;
 599       }
 600      else
 601       {
 602        return false;
 603       }
 604   }
 605 }
 606 function cursor_pointer()
 607  {//Point the cursor to the latest encounter(Today)
 608      var f = document.forms["payfrm"];
 609      var total = 0;
 610      for (var i = 0; i < f.elements.length; ++i)
 611      {
 612       var elem = f.elements[i];
 613       var ename = elem.name;
 614       if (ename.indexOf('form_upay[') == 0)
 615       {
 616        elem.focus();
 617        break;
 618       }
 619     }
 620  }
 621  //=====================================================
 622 function make_it_hide_enc_pay()
 623  {
 624       document.getElementById('td_head_insurance_payment').style.display="none";
 625       document.getElementById('td_head_patient_co_pay').style.display="none";
 626       document.getElementById('td_head_co_pay').style.display="none";
 627       document.getElementById('td_head_insurance_balance').style.display="none";
 628   for (var i = 1; ; ++i)
 629   {
 630        var td_inspaid_elem = document.getElementById('td_inspaid_'+i)
 631     var td_patient_copay_elem = document.getElementById('td_patient_copay_'+i)
 632        var td_copay_elem = document.getElementById('td_copay_'+i)
 633        var balance_elem = document.getElementById('balance_'+i)
 634    if (td_inspaid_elem)
 635    {
 636     td_inspaid_elem.style.display="none";
 637         td_patient_copay_elem.style.display="none";
 638     td_copay_elem.style.display="none";
 639     balance_elem.style.display="none";
 640    }
 641   else
 642    {
 643     break;
 644    }
 645   }
 646   document.getElementById('td_total_4').style.display="none";
 647   document.getElementById('td_total_7').style.display="none";
 648     document.getElementById('td_total_8').style.display="none";
 649   document.getElementById('td_total_6').style.display="none";
 650
 651   document.getElementById('table_display').width="420px";
 652  }
 653
 654  //=====================================================
 655 function make_visible()
 656  {
 657   document.getElementById('td_head_rep_doc').style.display="";
 658   document.getElementById('td_head_description').style.display="";
 659   document.getElementById('td_head_total_charge').style.display="none";
 660   document.getElementById('td_head_insurance_payment').style.display="none";
 661   document.getElementById('td_head_patient_payment').style.display="none";
 662   document.getElementById('td_head_patient_co_pay').style.display="none";
 663   document.getElementById('td_head_co_pay').style.display="none";
 664   document.getElementById('td_head_insurance_balance').style.display="none";
 665   document.getElementById('td_head_patient_balance').style.display="none";
 666   for (var i = 1; ; ++i)
 667   {
 668    var td_charges_elem = document.getElementById('td_charges_'+i)
 669    var td_inspaid_elem = document.getElementById('td_inspaid_'+i)
 670    var td_ptpaid_elem = document.getElementById('td_ptpaid_'+i)
 671    var td_patient_copay_elem = document.getElementById('td_patient_copay_'+i)
 672    var td_copay_elem = document.getElementById('td_copay_'+i)
 673    var balance_elem = document.getElementById('balance_'+i)
 674    var duept_elem = document.getElementById('duept_'+i)
 675    if (td_charges_elem)
 676    {
 677     td_charges_elem.style.display="none";
 678     td_inspaid_elem.style.display="none";
 679     td_ptpaid_elem.style.display="none";
 680     td_patient_copay_elem.style.display="none";
 681     td_copay_elem.style.display="none";
 682     balance_elem.style.display="none";
 683     duept_elem.style.display="none";
 684    }
 685   else
 686    {
 687     break;
 688    }
 689   }
 690   document.getElementById('td_total_7').style.display="";
 691   document.getElementById('td_total_8').style.display="";
 692   document.getElementById('td_total_1').style.display="none";
 693   document.getElementById('td_total_2').style.display="none";
 694   document.getElementById('td_total_3').style.display="none";
 695   document.getElementById('td_total_4').style.display="none";
 696   document.getElementById('td_total_5').style.display="none";
 697   document.getElementById('td_total_6').style.display="none";
 698
 699   document.getElementById('table_display').width="505px";
 700  }
 701 function make_it_hide()
 702  {
 703   document.getElementById('td_head_rep_doc').style.display="none";
 704   document.getElementById('td_head_description').style.display="none";
 705   document.getElementById('td_head_total_charge').style.display="";
 706   document.getElementById('td_head_insurance_payment').style.display="";
 707   document.getElementById('td_head_patient_payment').style.display="";
 708   document.getElementById('td_head_patient_co_pay').style.display="";
 709     document.getElementById('td_head_co_pay').style.display="";
 710   document.getElementById('td_head_insurance_balance').style.display="";
 711   document.getElementById('td_head_patient_balance').style.display="";
 712   for (var i = 1; ; ++i)
 713   {
 714    var td_charges_elem = document.getElementById('td_charges_'+i)
 715    var td_inspaid_elem = document.getElementById('td_inspaid_'+i)
 716    var td_ptpaid_elem = document.getElementById('td_ptpaid_'+i)
 717    var td_patient_copay_elem = document.getElementById('td_patient_copay_'+i)
 718    var td_copay_elem = document.getElementById('td_copay_'+i)
 719    var balance_elem = document.getElementById('balance_'+i)
 720    var duept_elem = document.getElementById('duept_'+i)
 721    if (td_charges_elem)
 722    {
 723     td_charges_elem.style.display="";
 724     td_inspaid_elem.style.display="";
 725     td_ptpaid_elem.style.display="";
 726         td_patient_copay_elem.style.display="";
 727     td_copay_elem.style.display="";
 728     balance_elem.style.display="";
 729     duept_elem.style.display="";
 730    }
 731   else
 732    {
 733     break;
 734    }
 735   }
 736   document.getElementById('td_total_1').style.display="";
 737   document.getElementById('td_total_2').style.display="";
 738   document.getElementById('td_total_3').style.display="";
 739   document.getElementById('td_total_4').style.display="";
 740   document.getElementById('td_total_5').style.display="";
 741   document.getElementById('td_total_6').style.display="";
 742   document.getElementById('td_total_7').style.display="";
 743   document.getElementById('td_total_8').style.display="";
 744
 745   document.getElementById('table_display').width="100%";
 746  }
 747 function make_visible_radio()
 748  {
 749   document.getElementById('tr_radio1').style.display="";
 750   document.getElementById('tr_radio2').style.display="none";
 751  }
 752 function make_hide_radio()
 753  {
 754   document.getElementById('tr_radio1').style.display="none";
 755   document.getElementById('tr_radio2').style.display="";
 756  }
 757 function make_visible_row()
 758  {
 759   document.getElementById('table_display').style.display="";
 760   document.getElementById('table_display_prepayment').style.display="none";
 761  }
 762 function make_hide_row()
 763  {
 764   document.getElementById('table_display').style.display="none";
 765   document.getElementById('table_display_prepayment').style.display="";
 766  }
 767 function make_self()
 768  {
 769   make_visible_row();
 770   make_it_hide();
 771   make_it_hide_enc_pay();
 772   document.getElementById('radio_type_of_payment_self1').checked=true;
 773   cursor_pointer();
 774  }
 775 function make_insurance()
 776  {
 777   make_visible_row();
 778   make_it_hide();
 779   cursor_pointer();
 780   document.getElementById('radio_type_of_payment1').checked=true;
 781  }
 782  //--------------------------------------------------------------------------------------------------//
 783 $('#paySubmit').click( function(e) {
 784     e.preventDefault()
 785     $("#mode").val( "portal-save" );
 786     var inv_values= JSON.stringify(getFormObj('payfrm'));
 787     var extra_values=JSON.stringify(getFormObj('paycredit'));
 788     var extra = "&inv_values="+inv_values+"&extra_values="+extra_values;
 789
 790     var flag = 0
 791     var liburl = './lib/paylib.php';
 792     $.ajax({
 793         type: "POST",
 794         url: liburl,
 795         data: $("#payfrm").serialize()+extra,
 796         beforeSend: function(xhr){
 797             if( validateCC() !== true) return false;
 798             if( $('#pin').val() == "" || $('#ccname').val() == "" || $('#ccyear').val() == "" || $('#ccmonth').val() == ""){
 799                  alert("<?php echo addslashes(xl('Invalid Credit Card Values: Please correct')) ?>")
 800                  return false;
 801             }
 802             if( validate() != true){
 803                 flag = 1;
 804                 alert("<?php echo addslashes(xl('Validation error: Fix and resubmit. This popup info is preserved!')) ?>")
 805                 return false;
 806             }
 807             $("#openPayModal .close").click()
 808         },
 809         error: function(qXHR, textStatus, errorThrow){
 810             console.log("There was an error:"+errorThrow);
 811         },
 812         success: function(templateHtml, textStatus, jqXHR){
 813             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')) ?>")
 814             window.location.reload(false);
 815         }
 816     });
 817      if(flag)
 818         $("#openPayModal .close").click();
 819 });
 820  //---------------------------------------------------------------------------------------//
 821 $("#payfrm").on('submit', function(e){
 822     e.preventDefault();
 823     var thisform = this;
 824     $("#mode").val( "review-save" );
 825     var inv_values= JSON.stringify(getFormObj('payfrm'));
 826     var extra_values=JSON.stringify(getFormObj('paycredit'));
 827     var extra = "&inv_values="+inv_values+"&extra_values="+extra_values;
 828
 829     var flag = 0
 830     var liburl ='<?php echo $GLOBALS["webroot"] ?>/portal/lib/paylib.php';
 831     $.ajax({
 832         type: "POST",
 833         url: liburl,
 834         data: $("#payfrm").serialize()+extra,
 835         beforeSend: function(xhr){
 836             if( validate() != true){
 837                 flag = 1;
 838                 alert("<?php echo addslashes(xl('Validation error: Fix and resubmit. Payment values are preserved!')) ?>")
 839                 return false;
 840             }
 841         },
 842         error: function(xhr, textStatus, error){
 843             alert("<?php echo addslashes(xl('There is a Post error')) ?>")
 844             console.log("There was an error:"+textStatus);
 845             return false;
 846         },
 847         success: function(templateHtml, textStatus, jqXHR){
 848             thisform.submit();
 849         }
 850     });
 851 });
 852 function getFormObj(formId) {
 853     var formObj = {};
 854     var inputs = $('#'+formId).serializeArray();
 855     $.each(inputs, function (i, input) {
 856         formObj[input.name] = input.value;
 857     });
 858     return formObj;
 859 }
 860 function formRepopulate(jsondata){
 861     data = $.parseJSON(jsondata);
 862     $.each(data, function(name, val){
 863         var $el = $('[name="'+name+'"]'),
 864             type = $el.attr('type');
 865         switch(type){
 866             case 'checkbox':
 867                 $el.prop('checked',true);
 868                 break;
 869             case 'radio':
 870                 $el.filter('[value="'+val+'"]').prop('checked', true);
 871                 break;
 872             default:
 873                 $el.val(val);
 874         }
 875     });
 876 }
 877 function getAuth(){
 878     var authnum = prompt("<?php echo  xlt('Please enter card comfirmation authorization') ?>", "");
 879     if (authnum != null) {
 880         $('#check_number').val(authnum);
 881     }
 882 }
 883 </script>
 884
 885 <body class="body_top" onunload='imclosing()' onLoad="cursor_pointer();"
 886     style="text-align: center; margin: auto;">
 887
 888     <form id="payfrm" method='post'
 889         action='<?php echo $GLOBALS["webroot"] ?>/portal/portal_payment.php'>
 890         <input type='hidden' name='form_pid' value='<?php echo attr($pid) ?>' />
 891         <input type='hidden' name='form_save'
 892             value='<?php echo xlt('Invoice');?>' />
 893
 894         <table>
 895             <tr height="10">
 896                 <td colspan="3">&nbsp;</td>
 897             </tr>
 898
 899             <tr>
 900                 <td colspan='3' align='center' class='text'><b><?php echo xlt('Accept Payment for'); ?>&nbsp;:&nbsp;&nbsp;<?php
 901
 902                 echo htmlspecialchars($patdata['fname'], ENT_QUOTES) . " " . htmlspecialchars($patdata['lname'], ENT_QUOTES) . " " . htmlspecialchars($patdata['mname'], ENT_QUOTES) . " (" . htmlspecialchars($patdata['pid'], ENT_QUOTES) . ")"?></b>
 903     <?php $NameNew=$patdata['fname'] . " " .$patdata['lname']. " " .$patdata['mname'];?>
 904   </td>
 905             </tr>
 906             <tr height="15">
 907                 <td colspan='3'></td>
 908             </tr>
 909             <tr>
 910                 <td class='text'>
 911     <?php echo xlt('Payment Method'); ?>:
 912   </td>
 913                 <td colspan='2'><select name="form_method" id="form_method"
 914                     class="text" onChange='CheckVisible("yes")'>
 915     <?php
 916     $query1112 = "SELECT * FROM list_options where list_id=?  ORDER BY seq, title ";
 917     $bres1112 = sqlStatement($query1112, array ('payment_method'));
 918     while ($brow1112 = sqlFetchArray($bres1112)) {
 919         if ($brow1112['option_id'] != 'credit_card' || $brow1112['option_id'] == 'electronic' || $brow1112['option_id'] == 'bank_draft') {
 920             continue;
 921         }
 922
 923         echo "<option value='" . htmlspecialchars($brow1112['option_id'], ENT_QUOTES) . "'>" . htmlspecialchars(xl_list_label($brow1112['title']), ENT_QUOTES) . "</option>";
 924     }
 925     ?>
 926   </select></td>
 927             </tr>
 928
 929             <tr height="5">
 930                 <td colspan='3'></td>
 931             </tr>
 932
 933             <tr>
 934                 <td class='text'>
 935     <?php echo xla('Authorized'); ?>:
 936   </td>
 937                 <td colspan='2'>
 938     <?php
 939     if (isset($_SESSION['authUserID'])) {
 940         echo "<input type='text'  id='check_number' name='form_source' style='width:120px;' value='" . htmlspecialchars($payrow['source'], ENT_QUOTES) . "'>";
 941     }
 942     ?>
 943   </td>
 944             </tr>
 945             <tr height="5">
 946                 <td colspan='3'></td>
 947             </tr>
 948             <tr>
 949                 <td class='text' valign="middle">
 950     <?php echo xlt('Patient Coverage'); ?>:
 951   </td>
 952                 <td class='text' colspan="2">
 953                     <input type="radio"    name="radio_type_of_coverage" id="radio_type_of_coverage1"
 954                     value="self" onClick="make_visible_radio();make_self();" />
 955                     <?php echo xlt('Self'); ?>
 956                       <input type="radio" name="radio_type_of_coverage"    id="radio_type_of_coverag2" value="insurance" checked="checked"
 957                     onClick="make_hide_radio();make_insurance();" />
 958                     <?php echo xlt('Insurance'); ?>
 959                 </td>
 960             </tr>
 961             <tr height="5">
 962                 <td colspan='3'></td>
 963             </tr>
 964             <tr id="tr_radio1" style="display: none">
 965                 <!-- For radio Insurance -->
 966                 <td class='text' valign="top">
 967     <?php echo xlt('Payment against'); ?>:
 968   </td>
 969                 <td class='text' colspan="2">
 970                     <input type="radio"    name="radio_type_of_payment" id="radio_type_of_payment_self1"
 971                     value="cash" onClick="make_visible_row();make_it_hide_enc_pay();cursor_pointer();" />
 972                     <?php echo xlt('Encounter Payment'); ?>
 973                 </td>
 974             </tr>
 975             <tr id="tr_radio2">
 976                 <!-- For radio self -->
 977                 <td class='text' valign="top"><?php echo xlt('Payment against'); ?>:
 978   </td>
 979                 <td class='text' colspan="2"><input type="radio"    name="radio_type_of_payment" id="radio_type_of_payment1" checked="checked"
 980                     value="copay" onClick="make_visible_row();cursor_pointer();" /><?php echo xlt('Co Pay'); ?>
 981           <input type="radio" name="radio_type_of_payment" id="radio_type_of_payment2"
 982                     value="invoice_balance" onClick="make_visible_row();" /><?php echo xlt('Invoice Balance'); ?><br />
 983         <input type="radio" name="radio_type_of_payment"    id="radio_type_of_payment4" value="pre_payment"
 984                     onClick="make_hide_row();" /><?php echo xlt('Pre Pay'); ?></td>
 985             </tr>
 986             <tr height="15">
 987                 <td colspan='3'></td>
 988             </tr>
 989         </table>
 990         <table width="35%" border="0" cellspacing="0" cellpadding="0" id="table_display_prepayment" style="display: none">
 991             <tr>
 992                 <td class='detail'><?php echo xlt('Pre Payment'); ?></td>
 993                 <td><input class="form-control" type='text' name='form_prepayment' style='width: 100px' /></td>
 994             </tr>
 995         </table>
 996         <table id="table_display" style="width: 100%; background: #eee;" class="table table-striped table-responsive">
 997             <thead>
 998             </thead>
 999             <tbody>
1000                 <!-- <table border='0' id="table_display" cellpadding='0' cellspacing='0' width='100%'> -->
1001     <tr bgcolor="#cccccc" id="tr_head">
1002     <td class="dehead" width="60">
1003     <?php echo xlt('DOS')?>
1004   </td>
1005                     <td class="dehead" width="120">
1006     <?php echo xlt('Visit Reason')?>
1007   </td>
1008                     <td class="dehead" align="center" width="70" id="td_head_total_charge">
1009     <?php echo xlt('Total Charge')?>
1010   </td>
1011                     <td class="dehead" align="center" width="70" id="td_head_rep_doc" style='display: none'>
1012     <?php echo xlt('Report/ Form')?>
1013   </td>
1014                     <td class="dehead" align="center" width="200"    id="td_head_description" style='display: none'>
1015     <?php echo xlt('Description')?>
1016   </td>
1017                     <td class="dehead" align="center" width="70" id="td_head_insurance_payment">
1018     <?php echo xlt('Insurance Payment')?>
1019   </td>
1020                     <td class="dehead" align="center" width="70" id="td_head_patient_payment">
1021     <?php echo xlt('Patient Payment')?>
1022   </td>
1023                     <td class="dehead" align="center" width="55" id="td_head_patient_co_pay">
1024     <?php echo xlt('Co Pay Paid')?>
1025   </td>
1026                     <td class="dehead" align="center" width="55" id="td_head_co_pay">
1027     <?php echo xlt('Required Co Pay')?>
1028   </td>
1029                     <td class="dehead" align="center" width="70" id="td_head_insurance_balance">
1030     <?php echo xlt('Insurance Balance')?>
1031   </td>
1032                     <td class="dehead" align="center" width="70" id="td_head_patient_balance">
1033     <?php echo xlt('Patient Balance')?>
1034   </td>
1035                     <td class="dehead" align="center" width="50">
1036     <?php echo xlt('Paying')?>
1037   </td>
1038                 </tr>
1039 <?php
1040     $encs = array ();
1041     // Get the unbilled service charges and payments by encounter for this patient.
1042     //
1043     $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
1044 "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";
1045     $bres = sqlStatement($query, array ($pid,$pid));
1046     //
1047 while ($brow = sqlFetchArray($bres)) {
1048     $key = 0 + $brow['encounter'];
1049     if (empty($encs[$key])) {
1050         $encs[$key] = array ('encounter' => $brow['encounter'],'date' => $brow['encdate'],'last_level_closed' => $brow['last_level_closed'],'charges' => 0,'payments' => 0,'reason'=>$brow['reason']
1051         );
1052     }
1053
1054     if ($brow['code_type'] === 'COPAY') {
1055         // $encs[$key]['payments'] -= $brow['fee'];
1056     } else {
1057         $encs[$key]['charges'] += $brow['fee'];
1058         // Add taxes.
1059         $sql_array = array ();
1060         $query = "SELECT taxrates FROM codes WHERE " . "code_type = ? AND " . "code = ? AND ";
1061         array_push($sql_array, $code_types[$brow['code_type']]['id'], $brow['code']);
1062         if ($brow['modifier']) {
1063             $query .= "modifier = ?";
1064             array_push($sql_array, $brow['modifier']);
1065         } else {
1066             $query .= "(modifier IS NULL OR modifier = '')";
1067         }
1068
1069         $query .= " LIMIT 1";
1070         $trow = sqlQuery($query, $sql_array);
1071         $encs[$key]['charges'] += calcTaxes($trow, $brow['fee']);
1072     }
1073 }
1074
1075     // Do the same for unbilled product sales.
1076     //
1077     $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
1078 "AND fe.pid = s.pid AND fe.encounter = s.encounter " . "where fe.pid = ? " . "ORDER BY s.encounter";
1079
1080     $dres = sqlStatement($query, array ($pid,$pid));
1081     //
1082 while ($drow = sqlFetchArray($dres)) {
1083     $key = 0 + $drow['encounter'];
1084     if (empty($encs[$key])) {
1085         $encs[$key] = array ('encounter' => $drow['encounter'],'date' => $drow['encdate'],'last_level_closed' => $drow['last_level_closed'],'charges' => 0,'payments' => 0
1086         );
1087     }
1088
1089     $encs[$key]['charges'] += $drow['fee'];
1090     // Add taxes.
1091     $trow = sqlQuery("SELECT taxrates FROM drug_templates WHERE drug_id = ? " . "ORDER BY selector LIMIT 1", array ($drow['drug_id']
1092     ));
1093     $encs[$key]['charges'] += calcTaxes($trow, $drow['fee']);
1094 }
1095
1096     ksort($encs, SORT_NUMERIC);
1097     $gottoday = false;
1098     // Bringing on top the Today always
1099 foreach ($encs as $key => $value) {
1100     $dispdate = $value['date'];
1101     if (strcmp($dispdate, $today) == 0 && ! $gottoday) {
1102         $gottoday = true;
1103         break;
1104     }
1105 }
1106
1107     // If no billing was entered yet for today, then generate a line for
1108     // entering today's co-pay.
1109     //
1110 if (! $gottoday) {
1111     // echoLine("form_upay[0]", date("Y-m-d"), 0, 0, 0, 0 /*$duept*/);//No encounter yet defined.
1112 }
1113
1114     $gottoday = false;
1115 foreach ($encs as $key => $value) {
1116     $enc = $value['encounter'];
1117     $reason = $value['reason'];
1118     $dispdate = $value['date'];
1119     if (strcmp($dispdate, $today) == 0 && ! $gottoday) {
1120         $dispdate = date("Y-m-d");
1121         $gottoday = true;
1122     }
1123
1124     // ------------------------------------------------------------------------------------
1125     $inscopay = getCopay($pid, $dispdate);
1126     $patcopay = getPatientCopay($pid, $enc);
1127     // Insurance Payment
1128     // -----------------
1129     $drow = sqlQuery("SELECT  SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments  FROM ar_activity WHERE " . "pid = ? and encounter = ? and " . "payer_type != 0 and account_code!='PCP' ", array ($pid,$enc
1130     ));
1131     $dpayment = $drow['payments'];
1132     $dadjustment = $drow['adjustments'];
1133 // Patient Payment
1134 // ---------------
1135     $drow = sqlQuery("SELECT  SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments  FROM ar_activity WHERE " . "pid = ? and encounter = ? and " . "payer_type = 0 and account_code!='PCP' ", array ($pid,$enc
1136     ));
1137     $dpayment_pat = $drow['payments'];
1138
1139 // ------------------------------------------------------------------------------------
1140 // NumberOfInsurance
1141     $ResultNumberOfInsurance = sqlStatement("SELECT COUNT( DISTINCT TYPE ) NumberOfInsurance FROM insurance_data
1142             where pid = ? and provider>0 ", array ($pid
1143     ));
1144     $RowNumberOfInsurance = sqlFetchArray($ResultNumberOfInsurance);
1145     $NumberOfInsurance = $RowNumberOfInsurance['NumberOfInsurance'] * 1;
1146 // ------------------------------------------------------------------------------------
1147     $duept = 0;
1148     if (( ( $NumberOfInsurance == 0 || $value['last_level_closed'] == 4 || $NumberOfInsurance == $value['last_level_closed'] ) )) { // Patient balance
1149         $brow = sqlQuery("SELECT SUM(fee) AS amount FROM billing WHERE " . "pid = ? and encounter = ? AND activity = 1", array ($pid,$enc
1150         ));
1151         $srow = sqlQuery("SELECT SUM(fee) AS amount FROM drug_sales WHERE " . "pid = ? and encounter = ? ", array ($pid,$enc
1152         ));
1153         $drow = sqlQuery("SELECT SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments FROM ar_activity WHERE " . "pid = ? and encounter = ? ", array ($pid,$enc
1154         ));
1155         $duept = $brow['amount'] + $srow['amount'] - $drow['payments'] - $drow['adjustments'];
1156     }
1157
1158     echoLine("form_upay[$enc]", $dispdate, $value['charges'], $dpayment_pat, ( $dpayment + $dadjustment ), $duept, ($enc.':'.$reason), $inscopay, $patcopay);
1159 }
1160
1161     // Continue with display of the data entry form.
1162     ?>
1163 <tr>
1164                     <td class="dehead" id='td_total_1'></td>
1165                     <td class="dehead" id='td_total_2'></td>
1166                     <td class="dehead" id='td_total_3'></td>
1167                     <td class="dehead" id='td_total_4'></td>
1168                     <td class="dehead" id='td_total_5'></td>
1169                     <td class="dehead" id='td_total_6'></td>
1170                     <td class="dehead" id='td_total_7'></td>
1171                     <td class="dehead" id='td_total_8'></td>
1172                     <td class="dehead" align="right"><?php echo xlt('Total');?></td>
1173                     <td class="dehead" align="right"><input class="form-control" type='text' name='form_paytotal'
1174                     value='' style='color: #00aa00; width: 65px; padding: 1px 1px;' readonly />
1175                     </td>
1176                 </tr>
1177         </table>
1178 <?php
1179 if (isset($ccdata["name"])) {
1180     echo '<div class="col-xs-12 col-md-4 col-lg-4">
1181         <div class="panel panel-default height">';
1182     if (! isset($_SESSION['authUserID'])) {
1183         echo '<div class="panel-heading">'.xlt("Payment Information").'<span style="color:#cc0000"><em> '.xlt("Pending Auth since").': </em>'.text($edata["date"]).'</span></div>';
1184     } else {
1185         echo '<div class="panel-heading">'.xlt("Payment Information").' <button type="button" class="btn btn-danger btn-sm" onclick="getAuth()">'.xlt("Authorize").'</button></div>';
1186     }
1187 } else {
1188     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>';
1189 }
1190     ?>
1191                      <div class="panel-body">
1192                              <strong><?php echo xlt('Card Name');?>:  </strong><span id="cn"><?php echo attr($ccdata["cc_type"])?></span><br>
1193                             <strong><?php echo xlt('Name On Card');?>:  </strong><span id="nc"><?php echo attr($ccdata["name"])?></span><br>
1194                             <strong><?php echo xlt('Card Number');?>:  </strong><span id="ccn"><?php
1195                             if (isset($_SESSION['authUserID'])) {
1196                                 echo $ccdata["cc_number"] . "</span><br>";
1197                             } else {
1198                                 echo "**********  ".substr($ccdata["cc_number"], -4) . "</span><br>";
1199                             }
1200                                     ?>
1201                             <strong><?php echo xlt('Exp Date');?>:  </strong><span id="ed"><?php echo attr($ccdata["month"])."/".attr($ccdata["year"])?></span><br>
1202                             <strong><?php echo xlt('Charge Total');?>:  </strong><span id="ct"><?php echo attr($invdata["form_paytotal"])?></span><br>
1203                       </div>
1204                   </div>
1205              </div>
1206     <p>
1207 <?php
1208 if (! isset($_SESSION['authUserID'])) {
1209     echo '<button type="button" class="btn btn-primary" data-toggle="modal" data-target="#openPayModal">' . xlt("Pay Invoice") . '</button>';
1210 } else {
1211     echo "<button type='submit' class='btn btn-danger' form='payfrm'>" . xlt('Post Payment') . "</button>";
1212 }
1213     ?>
1214  &nbsp;
1215     </p>
1216         <input type="hidden" name="hidden_patient_code" id="hidden_patient_code" value="<?php echo attr($pid);?>" />
1217         <input type='hidden' name='mode' id='mode' value='' />
1218     </form>
1219
1220 <script type="text/javascript">
1221 if (typeof jsondata !== 'undefined') {
1222      formRepopulate(jsondata);
1223 }
1224  calctotal();
1225 </script>
1226     <!-- credit payment modal -->
1227     <div id="openPayModal" class="modal fade" role="dialog">
1228         <div class="modal-dialog">
1229             <div class="modal-content">
1230                 <div class="modal-header">
1231                     <h3><?php echo xlt('Submit Payment for Authorization');?></h3>
1232                     <button type="button" class="close" data-dismiss="modal">&times;</button>
1233                 </div>
1234                 <div class="modal-body container">
1235                     <form id='paycredit' class="form-horizontal col-xs-12 col-sm-6 col-md-6">
1236                         <fieldset>
1237                             <div class="control-group">
1238                                 <label label-default="label-default" class="control-label"><?php echo xlt('Name on Card');?></label>
1239                                 <div class="controls">
1240                                     <input name="name" id="ccname" type="text" class="form-control"
1241                                         pattern="\w+ \w+.*" title="<?php echo xla('Fill your first and last name'); ?>"
1242                                         required value="" />
1243                                 </div>
1244                             </div>
1245                             <div class="control-group">
1246                                 <label class="control-label"><?php echo xlt('Card Number');?></label>
1247                                 <div class="controls">
1248                                     <div class="row">
1249                                     <div class="col-sm-12">
1250                                             <input name="cc_number" id="cc_number" type="text" class="form-control inline col-sm-3"
1251                                                 autocomplete="off" maxlength="19" pattern="\d" onchange="validateCC()"
1252                                                 title="<?php echo xla('Card Number'); ?>" required value="" />
1253                                             <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="" />
1254                                         </div>
1255                                     </div>
1256                                 </div>
1257                             </div>
1258                             <div class="control-group">
1259                                 <label label-default="label-default" class="control-label"><?php echo xlt('Card Expiry Date');?></label>
1260                                 <div class="controls">
1261                                     <div class="row">
1262                                         <div class="col-md-4">
1263                                             <select name="month" id="ccmonth" class="form-control">
1264                                                 <option value=""><?php echo xlt('Select Month'); ?></option>
1265                                                 <option value="01"><?php echo xlt('January'); ?></option>
1266                                                 <option value="02"><?php echo xlt('February'); ?></option>
1267                                                 <option value="03"><?php echo xlt('March'); ?></option>
1268                                                 <option value="04"><?php echo xlt('April'); ?></option>
1269                                                 <option value="05"><?php echo xlt('May'); ?></option>
1270                                                 <option value="06"><?php echo xlt('June'); ?></option>
1271                                                 <option value="07"><?php echo xlt('July'); ?></option>
1272                                                 <option value="08"><?php echo xlt('August'); ?></option>
1273                                                 <option value="09"><?php echo xlt('September'); ?></option>
1274                                                 <option value="10"><?php echo xlt('October'); ?></option>
1275                                                 <option value="11"><?php echo xlt('November'); ?></option>
1276                                                 <option value="12"><?php echo xlt('December'); ?></option>
1277                                             </select>
1278                                         </div>
1279                                         <div class="col-md-3">
1280                                             <select name="year" id="ccyear" class="form-control">
1281                                                 <option value=""><?php echo xlt('Select Year'); ?></option>
1282                                                 <option value="2017">2017</option>
1283                                                 <option value="2018">2018</option>
1284                                                 <option value="2019">2019</option>
1285                                                 <option value="2020">2020</option>
1286                                                 <option value="2021">2021</option>
1287                                                 <option value="2022">2022</option>
1288                                                 <option value="2023">2023</option>
1289                                                 <option value="2024">2024</option>
1290                                             </select>
1291                                         </div>
1292                                     </div>
1293                                 </div>
1294                             </div>
1295                             <div class="control-group">
1296                                 <label label-default="label-default" class="control-label"><?php echo xlt('Card CVV');?></label>
1297                                 <div class="controls">
1298                                     <div class="row">
1299                                         <div class="col-md-3">
1300                                             <input name="pin" id="pin" type="text" class="form-control"
1301                                                 autocomplete="off" maxlength="4" pattern="\d{3}" onfocus="validateCC()"
1302                                                 title="<?php echo xlt('Three or four digits at back of your card'); ?>" required value="" />
1303                                         </div>
1304                                         <div class="col-md-3">
1305                                             <img src='./images/img_cvc.png' style='height: 58px; width: auto'>
1306                                         </div>
1307                                     </div>
1308                                 </div>
1309                             </div>
1310                             <div class="form-actions">
1311                                 <button id="paySubmit" class="btn btn-danger"><?php echo xlt('Submit');?></button>
1312                                 <button type="button" class="btn btn-default" data-dismiss="modal"><?php echo xlt('Cancel');?></button>
1313                             </div>
1314                         </fieldset>
1315                         <input type='hidden' name='cc_type' id='cc_type' value='' />
1316                     </form>
1317                 </div>
1318                 <!-- Body  -->
1319                 <div class="modal-footer">
1320                     <button type="button" class="btn btn-default" data-dismiss="modal"><?php echo xlt('Close');?></button>
1321                 </div>
1322             </div>
1323         </div>
1324     </div>
1325 <?php echo "<script>var ccerr='". xlt('Invalid Credit Card Number') . "';</script>";?>
1326 <script type="text/javascript">
1327 $('#cc_number').validateCreditCard(function(result){
1328     var r = (result.card_type == null ? '' : result.card_type.name.toUpperCase())
1329     var v = (result.valid== true ? ' Valid #' : ' Invalid #')
1330     $('#cardtype').val(r+v);
1331  });
1332 function validateCC() {
1333     var result = $('#cc_number').validateCreditCard();
1334     var r = (result.card_type == null ? '' : result.card_type.name.toUpperCase())
1335     var v = (result.valid == true ? ' Okay' : ' Invalid #')
1336     $('#cardtype').val(r+v);
1337     $('#cc_type').val(r);
1338     if(!result.valid){
1339          alert(ccerr)
1340          return false;
1341     }
1342     else{
1343         return true;
1344     }
1345 }
1346 </script>
1347 </body>
1348 <?php
1349 }
1350 ?>