library/edi.inc

   1 <?php
   2 /*
   3  * Inc file for the 270 / 271 creation and uploading
   4  *
   5  * This program creates the segments for the x12 270 eligibility file
   6  * It also allows the reading and storing of the x12 271 file
   7  *
   8  * Copyright (C) 2016 Terry Hill <terry@lillysystems.com>
   9  * Copyright (C) 2010 MMF Systems, Inc
  10  *
  11  * LICENSE: This program is free software; you can redistribute it and/or
  12  * modify it under the terms of the GNU General Public License
  13  * as published by the Free Software Foundation; either version 3
  14  * of the License, or (at your option) any later version.
  15  * This program is distributed in the hope that it will be useful,
  16  * but WITHOUT ANY WARRANTY; without even the implied warranty of
  17  * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
  18  * GNU General Public License for more details.
  19  * You should have received a copy of the GNU General Public License
  20  * along with this program. If not, see http://opensource.org/licenses/gpl-license.php.
  21  *
  22  * @package OpenEMR
  23  * @author Terry Hill <terry@lilysystems.com>
  24  * @link http://www.open-emr.org
  25  */
  26
  27 // SEGMENT FUNCTION START
  28
  29 // ISA Segment  - EDI-270 format
  30
  31 function create_ISA($row,$X12info,$segTer,$compEleSep)
  32 {
  33
  34     $ISA     =  array();
  35
  36     $ISA[0] = "ISA";                            // Interchange Control Header Segment ID
  37
  38     $ISA[1] = "00";                                 // Author Info Qualifier
  39
  40     $ISA[2] = str_pad("0000000",10," ");        // Author Information
  41
  42     $ISA[3] = "00";                                 //   Security Information Qualifier
  43                                                 //   MEDI-CAL NOTE: For Leased-Line & Dial-Up use '01',
  44                                                 //   for BATCH use '00'.
  45                                                 //   '00' No Security Information Present
  46                                                 //   (No Meaningful Information in I04)
  47
  48     $ISA[4] = str_pad("0000000000",10," ");         // Security Information
  49
  50     $ISA[5] = str_pad("ZZ",2," ");              // Interchange ID Qualifier
  51
  52     $ISA[6] = str_pad($X12info[2],15," ");      // INTERCHANGE SENDER ID
  53
  54     $ISA[7] = str_pad("ZZ",2," ");              // Interchange ID Qualifier
  55
  56     $ISA[8] = str_pad($X12info[3],15," ");      // INTERCHANGE RECEIVER ID
  57
  58     $ISA[9] = str_pad(date('ymd'),6," ");       // Interchange Date (YYMMDD)
  59
  60     $ISA[10] = str_pad(date('Hi'),4," ");       // Interchange Time (HHMM)
  61
  62     $ISA[11] = "^";                                 // Interchange Control Standards Identifier
  63
  64     $ISA[12] = str_pad("00501",5," ");          // Interchange Control Version Number
  65
  66     $ISA[13] = str_pad("000000001",9," ");      // INTERCHANGE CONTROL NUMBER
  67
  68     $ISA[14] = str_pad("1",1," ");              // Acknowledgment Request [0= not requested, 1= requested]
  69
  70     $ISA[15] =  str_pad("P",1," ");                 // Usage Indicator [ P = Production Data, T = Test Data ]
  71
  72     $ISA['Created'] = implode('*', $ISA);       // Data Element Separator
  73
  74     $ISA['Created'] = $ISA['Created'] ."*";
  75
  76     $ISA['Created'] = $ISA ['Created'] . $compEleSep . $segTer;
  77
  78     return trim($ISA['Created']);
  79
  80 }
  81
  82 // GS Segment  - EDI-270 format
  83
  84 function create_GS($row,$X12info,$segTer,$compEleSep)
  85 {
  86
  87     $GS    = array();
  88
  89     $GS[0] = "GS";                      // Functional Group Header Segment ID
  90
  91     $GS[1] = "HS";                      // Functional ID Code [ HS = Eligibility, Coverage or Benefit Inquiry (270) ]
  92
  93     $GS[2] =  $X12info[2];              // Application Sender's ID
  94
  95     $GS[3] =  $X12info[3];              // Application Receiver's ID
  96
  97     $GS[4] = date('Ymd');               // Date [CCYYMMDD]
  98
  99     $GS[5] = date('His');               // Time [HHMM] Group Creation Time
 100
 101     $GS[6] = "2";                       // Group Control Number No zeros for 5010
 102
 103     $GS[7] = "X";                   // Responsible Agency Code Accredited Standards Committee X12 ]
 104
 105     $GS[8] = "005010X279A1";            // Version Release / Industry[ Identifier Code Query 005010X279A1
 106
 107     $GS['Created'] = implode('*', $GS);         // Data Element Separator
 108
 109     $GS['Created'] = $GS ['Created'] . $segTer;  // change the information in the tag or change the tag
 110
 111     return trim($GS['Created']);
 112
 113 }
 114
 115 // ST Segment  - EDI-270 format
 116
 117 function create_ST($row,$X12info,$segTer,$compEleSep)
 118 {
 119
 120     $ST    =    array();
 121
 122     $ST[0] = "ST";                              // Transaction Set Header Segment ID
 123
 124     $ST[1] = "270";                                 // Transaction Set Identifier Code (Inquiry Request)
 125
 126     $ST[2] = "000000003";                       // Transaction Set Control Number - Must match SE's
 127
 128     $ST[3] = "005010X279A1";                    // Standard 005010X279A1 in $ST[3]
 129
 130     $ST['Created'] = implode('*', $ST);             // Data Element Separator
 131
 132     $ST['Created'] = $ST ['Created'] . $segTer;
 133
 134     return trim($ST['Created']);
 135
 136 }
 137
 138 // BHT Segment  - EDI-270 format
 139
 140 function create_BHT($row,$X12info,$segTer,$compEleSep)
 141 {
 142
 143     $BHT    =   array();
 144
 145     $BHT[0] = "BHT";                        // Beginning of Hierarchical Transaction Segment ID
 146
 147     $BHT[1] = "0022";                       // Subscriber Structure Code
 148
 149     $BHT[2] = "13";                             // Purpose Code - This is a Request
 150
 151     $BHT[3] = "PROVTest600";                //  Submitter Transaction Identifier
 152                                             //This information is required by the information Receiver
 153                                             //when using Real Time transactions.
 154                                             //For BATCH this can be used for optional information.
 155
 156     $BHT[4] = str_pad(date('Ymd'),8," ");           // Date Transaction Set Created
 157
 158     $BHT[5] = str_pad(date('Hi'),4," ");            // Time Transaction Set Created no space after and 1300 is plenty
 159
 160     $BHT['Created'] = implode('*', $BHT);           // Data Element Separator
 161
 162     $BHT['Created'] = $BHT ['Created'] . $segTer;
 163
 164     return trim($BHT['Created']);
 165
 166 }
 167
 168 // HL Segment  - EDI-270 format
 169
 170 function create_HL($row, $nHlCounter,$X12info,$segTer,$compEleSep)
 171 {
 172
 173     $HL         = array();
 174
 175     $HL[0]      = "HL";             // Hierarchical Level Segment ID
 176     $HL_LEN[0]  =  2;
 177
 178     $HL[1] = $nHlCounter;       // Hierarchical ID No.
 179
 180     if($nHlCounter == 1)
 181     {
 182         $HL[2] = "";
 183         $HL[3] = 20;            // Description: Identifies the payor, maintainer, or source of the information.
 184         $HL[4] = 1;                 // 1 Additional Subordinate HL Data Segment in This Hierarchical Structure.
 185     }
 186     else if($nHlCounter == 2)
 187     {
 188         $HL[2] = 1;                 // Hierarchical Parent ID Number
 189         $HL[3] = 21;            // Hierarchical Level Code. '21' Information Receiver
 190         $HL[4] = 1;                 // 1 Additional Subordinate HL Data Segment in This Hierarchical Structure.
 191     }
 192     else
 193     {
 194         $HL[2] = 2;
 195         $HL[3] = 22;            // Hierarchical Level Code.'22' Subscriber
 196         $HL[4] = 0;                 // 0 no Additional Subordinate in the Hierarchical Structure.
 197     }
 198
 199     $HL['Created'] = implode('*', $HL);         // Data Element Separator
 200
 201     $HL['Created'] = $HL ['Created'] . $segTer;
 202
 203     return trim($HL['Created']);
 204
 205 }
 206
 207 // NM1 Segment  - EDI-270 format
 208
 209 function create_NM1($row,$nm1Cast,$X12info,$segTer,$compEleSep)
 210 {
 211
 212     $NM1        = array();
 213
 214     $NM1[0]         = "NM1";                    // Subscriber Name Segment ID
 215
 216     if($nm1Cast == 'PR')
 217     {
 218         $NM1[1] = "PR";                         // Entity ID Code - Payer [PR Payer]
 219         $NM1[2] = "2";                      // Entity Type - Non-Person
 220         $NM1[3] = $row["payer_name"];       // Organizational Name
 221         $NM1[4] = "";                       // Data Element not required.
 222         $NM1[5] = "";                       // Data Element not required.
 223         $NM1[6] = "";                       // Data Element not required.
 224         $NM1[7] = "";                       // Data Element not required.
 225         $NM1[8] = "46";                         // 46 - Electronic Transmitter Identification Number (ETIN)
 226         $NM1[9] = $X12info[3];              // Application Sender's ID
 227     }
 228     else if($nm1Cast == 'FA')
 229     {
 230         $NM1[1] = "FA";                         // Entity ID Code - Facility [FA Facility]
 231         $NM1[2] = "2";                      // Entity Type - Non-Person
 232         $NM1[3] = $row['facility_name'];            // Organizational Name
 233         $NM1[4] = "";           // Data Element not required.
 234         $NM1[5] = "";           // Data Element not required.
 235         $NM1[6] = "";                       // Data Element not required.
 236         $NM1[7] = "";                       // Data Element not required.
 237         $NM1[8] = "FI";
 238         $NM1[9] = $row['facility_npi'];
 239     }
 240     else if($nm1Cast == 'IL')
 241     {
 242         $NM1[1] = "IL";                         // Insured or Subscriber
 243         $NM1[2] = "1";                      // Entity Type - Person
 244         $NM1[3] = $row['lname'];                // last Name
 245         $NM1[4] = $row['fname'];                // first Name
 246         $NM1[5] = $row['mname'];                // middle Name
 247         $NM1[6] = "";                       // data element
 248         $NM1[7] = "";                       // data element
 249         $NM1[8] = "MI";                         // Identification Code Qualifier
 250         $NM1[9] = $row['subscriber_ss'];            // Identification Code
 251     }
 252
 253     $NM1['Created'] = implode('*', $NM1);               // Data Element Separator
 254
 255     $NM1['Created'] = $NM1['Created'] . $segTer;
 256
 257     return trim($NM1['Created']);
 258
 259 }
 260
 261 // REF Segment  - EDI-270 format
 262
 263 function create_REF($row,$ref,$X12info,$segTer,$compEleSep)
 264 {
 265
 266     $REF    =   array();
 267
 268     $REF[0] = "REF";                        // Subscriber Additional Identification    does not want this for anything
 269
 270     if($ref == '1P')
 271     {
 272         $REF[1] = "4A";                         // Reference Identification Qualifier
 273         $REF[2] = $row['provider_pin'];                 // Provider Pin.
 274     }
 275     else
 276     {
 277         $REF[1] = "EJ";                         // 'EJ' for Patient Account Number     does not want this for patient
 278         $REF[2] = $row['pid'];                  // Patient Account No.
 279     }
 280     $REF['Created'] = implode('*', $REF);               // Data Element Separator
 281
 282     $REF['Created'] = $REF['Created'] . $segTer;
 283
 284     return trim($REF['Created']);
 285
 286 }
 287
 288 // TRN Segment - EDI-270 format
 289
 290 function create_TRN($row,$tracno,$refiden,$X12info,$segTer,$compEleSep)
 291 {
 292
 293     $TRN    =   array();
 294
 295     $TRN[0] = "TRN";                        // Subscriber Trace Number Segment ID
 296
 297     $TRN[1] = "1";                          // Trace Type Code � Current Transaction Trace Numbers
 298
 299     $TRN[2] = $tracno;                      // Trace Number
 300
 301     $TRN[3] = "9000000000";                         // Originating Company ID � must be 10 positions in length
 302
 303     $TRN[4] = $refiden;                         // Additional Entity Identifier (i.e. Subdivision)
 304
 305     $TRN['Created'] = implode('*', $TRN);               // Data Element Separator
 306
 307     $TRN['Created'] = $TRN['Created'] . $segTer;
 308
 309     return trim($TRN['Created']);
 310
 311 }
 312
 313 // DMG Segment - EDI-270 format
 314
 315 function create_DMG($row,$X12info,$segTer,$compEleSep)
 316 {
 317
 318     $DMG    =   array();
 319
 320     $DMG[0] = "DMG";                            // Date or Time or Period Segment ID
 321
 322     $DMG[1] = "D8";                                 // Date Format Qualifier - (D8 means CCYYMMDD)
 323
 324     $DMG[2] = $row['dob'];                      // Subscriber's Birth date
 325
 326     $DMG['Created'] = implode('*', $DMG);       // Data Element Separator
 327
 328     $DMG['Created'] = $DMG['Created'] .  $segTer;
 329
 330     return trim($DMG['Created']);
 331 }
 332
 333 // DTP Segment - EDI-270 format
 334
 335 function create_DTP($row,$qual,$X12info,$segTer,$compEleSep)
 336 {
 337
 338     $DTP    =   array();
 339
 340     $DTP[0] = "DTP";                        // Date or Time or Period Segment ID
 341
 342     $DTP[1] = $qual;                        // Qualifier - Date of Service
 343
 344     $DTP[2] = "D8";                             // Date Format Qualifier - (D8 means CCYYMMDD)
 345
 346     if($qual == '102'){
 347         $DTP[3] = $row['date'];                 // Date
 348     }else{
 349         $DTP[3] = $row['pc_eventDate'];         // Date of Service
 350     }
 351     $DTP['Created'] = implode('*', $DTP);   // Data Element Separator
 352
 353     $DTP['Created'] = $DTP['Created'] .  $segTer;
 354
 355     return trim($DTP['Created']);
 356 }
 357
 358 // EQ Segment - EDI-270 format
 359
 360 function create_EQ($row,$X12info,$segTer,$compEleSep)
 361 {
 362
 363     $EQ         =   array();
 364
 365     $EQ[0]  = "EQ";                                     // Subscriber Eligibility or Benefit Inquiry Information
 366
 367     $EQ[1]  = "30";                                     // Service Type Code
 368
 369     $EQ['Created'] = implode('*', $EQ);                 // Data Element Separator
 370
 371     $EQ['Created'] = $EQ['Created'] . $segTer;
 372
 373     return trim($EQ['Created']);
 374 }
 375
 376 // SE Segment - EDI-270 format
 377
 378 function create_SE($row,$segmentcount,$X12info,$segTer,$compEleSep)
 379 {
 380
 381     $SE     =   array();
 382
 383     $SE[0] = "SE";                              // Transaction Set Trailer Segment ID
 384
 385     $SE[1] = $segmentcount;                         // Segment Count
 386
 387     $SE[2] = "000000003";                       // Transaction Set Control Number - Must match ST's
 388
 389     $SE['Created'] = implode('*', $SE);             // Data Element Separator
 390
 391     $SE['Created'] = $SE['Created'] . $segTer;
 392
 393     return trim($SE['Created']);
 394 }
 395
 396 // GE Segment - EDI-270 format
 397
 398 function create_GE($row,$X12info,$segTer,$compEleSep)
 399 {
 400
 401     $GE     =   array();
 402
 403     $GE[0]  = "GE";                             // Functional Group Trailer Segment ID
 404
 405     $GE[1]  = "1";                          // Number of included Transaction Sets
 406
 407     $GE[2]  = "2";                          // Group Control Number
 408
 409     $GE['Created'] = implode('*', $GE);                 // Data Element Separator
 410
 411     $GE['Created'] = $GE['Created'] . $segTer;
 412
 413     return trim($GE['Created']);
 414 }
 415
 416 // IEA Segment - EDI-270 format
 417
 418 function create_IEA($row,$X12info,$segTer,$compEleSep)
 419 {
 420
 421     $IEA    =   array();
 422
 423     $IEA[0] = "IEA";                        // Interchange Control Trailer Segment ID
 424
 425     $IEA[1] = "1";                          // Number of included Functional Groups
 426
 427     $IEA[2] = "000000001";                      // Interchange Control Number
 428
 429     $IEA['Created'] = implode('*', $IEA);
 430
 431     $IEA['Created'] = $IEA['Created'] .  $segTer;
 432
 433     return trim($IEA['Created']);
 434 }
 435
 436 function translate_relationship($relationship)
 437 {
 438     switch ($relationship) {
 439         case "spouse":
 440             return "01";
 441             break;
 442         case "child":
 443             return "19";
 444             break;
 445         case "self":
 446         default:
 447             return "S";
 448     }
 449 }
 450
 451 // EDI-270 Batch file Generation
 452
 453 function print_elig($res,$X12info,$segTer,$compEleSep)
 454 {
 455
 456     $i=1;
 457
 458     $PATEDI    = "";
 459
 460     // For Header Segment
 461
 462     $nHlCounter = 1;
 463     $rowCount   = 0;
 464     $trcNo      = 1234501;
 465     $refiden    = 5432101;
 466
 467     while ($row = sqlFetchArray($res))
 468     {
 469
 470         if($nHlCounter == 1)
 471         {
 472             // create ISA
 473             $PATEDI    = create_ISA($row,$X12info,$segTer,$compEleSep);
 474
 475             // create GS
 476             $PATEDI   .= create_GS($row,$X12info,$segTer,$compEleSep);
 477
 478             // create ST
 479             $PATEDI   .= create_ST($row,$X12info,$segTer,$compEleSep);
 480
 481             // create BHT
 482             $PATEDI   .= create_BHT($row,$X12info,$segTer,$compEleSep);
 483
 484             // For Payer Segment
 485
 486             $PATEDI  .= create_HL($row,1,$X12info,$segTer,$compEleSep);
 487             $PATEDI  .= create_NM1($row,'PR',$X12info,$segTer,$compEleSep);
 488
 489             // For Provider Segment
 490
 491             $PATEDI  .= create_HL($row,2,$X12info,$segTer,$compEleSep);
 492             $PATEDI  .= create_NM1($row,'FA',$X12info,$segTer,$compEleSep);
 493
 494             $nHlCounter = $nHlCounter + 2;
 495             $segmentcount = 7; // segement counts - start from ST
 496         }
 497
 498         // For Subscriber Segment
 499
 500         $PATEDI  .= create_HL($row,$nHlCounter,$X12info,$segTer,$compEleSep);
 501         $PATEDI  .= create_NM1($row,'IL',$X12info,$segTer,$compEleSep);
 502         $PATEDI  .= create_DMG($row,$X12info,$segTer,$compEleSep);
 503
 504         $PATEDI  .= create_DTP($row,'291',$X12info,$segTer,$compEleSep);
 505         $PATEDI  .= create_EQ($row,$X12info,$segTer,$compEleSep);
 506
 507         $segmentcount   = $segmentcount + 7;
 508         $nHlCounter     = $nHlCounter + 1;
 509         $rowCount   = $rowCount + 1;
 510         $trcNo      = $trcNo + 1;
 511         $refiden    = $refiden + 1;
 512
 513
 514         if($rowCount == sqlNumRows($res))
 515         {
 516             $segmentcount = $segmentcount + 1;
 517             $PATEDI   .= create_SE($row,$segmentcount,$X12info,$segTer,$compEleSep);
 518             $PATEDI   .= create_GE($row,$X12info,$segTer,$compEleSep);
 519             $PATEDI   .= create_IEA($row,$X12info,$segTer,$compEleSep);
 520         }
 521     }
 522
 523     echo $PATEDI;
 524 }
 525
 526 // Report Generation
 527
 528 function show_elig($res,$X12info,$segTer,$compEleSep)
 529 {
 530
 531     $i=0;
 532     echo "      <div id='report_results'>
 533                         <table>
 534                                 <thead>
 535
 536                                         <th style='width:12%;'> ". htmlspecialchars( xl('Facility Name'), ENT_NOQUOTES) ."</th>
 537                                         <th style='width:9%;' > ". htmlspecialchars( xl('Facility NPI'), ENT_NOQUOTES) ."</th>
 538                                         <th style='width:15%;'> ". htmlspecialchars( xl('Insurance Comp'), ENT_NOQUOTES) ."</th>
 539                                         <th style='width:8%;' > ". htmlspecialchars( xl('Policy No'), ENT_NOQUOTES) ."</th>
 540                                         <th style='width:16%;'> ". htmlspecialchars( xl('Patient Name'), ENT_NOQUOTES) ."</th>
 541                                         <th style='width:7%;' > ". htmlspecialchars( xl('DOB'), ENT_NOQUOTES) ."</th>
 542                                         <th style='width:6%;' > ". htmlspecialchars( xl('Gender'), ENT_NOQUOTES) ."</th>
 543                                         <th style='width:9%;' > ". htmlspecialchars( xl('SSN'), ENT_NOQUOTES) ."</th>
 544                                         <th style='width:2%;' > &nbsp;                    </th>
 545                                 </thead>
 546
 547                                 <tbody>
 548
 549                 ";
 550
 551     while ($row = sqlFetchArray($res)) {
 552
 553
 554         $i= $i+1;
 555
 556         if($i%2 == 0){
 557             $background = '#FFF';
 558         }else{
 559             $background = '#FFF';
 560         }
 561
 562         $elig     = array();
 563         $elig[0]  = $row['facility_name'];              // Inquiring Provider Name  calendadr
 564         $elig[1]  = $row['facility_npi'];               // Inquiring Provider NPI
 565         $elig[2]  = $row['payer_name'];                     // Payer Name  our insurance co name
 566         $elig[3]  = $row['policy_number'];              // Subscriber ID
 567         $elig[4]  = $row['subscriber_lname'];               // Subscriber Last Name
 568         $elig[5]  = $row['subscriber_fname'];               // Subscriber First Name
 569         $elig[6]  = $row['subscriber_mname'];               // Subscriber Middle Initial
 570         $elig[7]  = $row['subscriber_dob'];                 // Subscriber Date of Birth
 571         $elig[8]  = substr($row['subscriber_sex'], 0, 1);       // Subscriber Sex
 572         $elig[9]  = $row['subscriber_ss'];              // Subscriber SSN
 573         $elig[10] = translate_relationship($row['subscriber_relationship']);    // Pt Relationship to insured
 574         $elig[11] = $row['lname'];                  // Dependent Last Name
 575         $elig[12] = $row['fname'];                  // Dependent First Name
 576         $elig[13] = $row['mname'];                  // Dependent Middle Initial
 577         $elig[14] = $row['dob'];                    // Dependent Date of Birth
 578         $elig[15] = substr($row['sex'], 0, 1);              // Dependent Sex
 579         $elig[16] = $row['pc_eventDate'];               // Date of service
 580         $elig[17] = "30";                       // Service Type
 581         $elig[18] = $row['pubpid'];                     // Patient Account Number pubpid
 582
 583         echo "  <tr id='PR".$i."_". htmlspecialchars( $row['policy_number'], ENT_QUOTES)."'>
 584                                 <td class ='detail' style='width:12%;'>". htmlspecialchars( $row['facility_name'], ENT_NOQUOTES) ."</td>
 585                                 <td class ='detail' style='width:9%;'>".  htmlspecialchars( $row['facility_npi'], ENT_NOQUOTES) ."</td>
 586                                 <td class ='detail' style='width:15%;'>". htmlspecialchars( $row['payer_name'], ENT_NOQUOTES) ."</td>
 587                                 <td class ='detail' style='width:8%;'>".  htmlspecialchars( $row['policy_number'], ENT_NOQUOTES) ."</td>
 588                                 <td class ='detail' style='width:16%;'>". htmlspecialchars( $row['subscriber_lname']." ".$row['subscriber_fname'], ENT_NOQUOTES) ."</td>
 589                                 <td class ='detail' style='width:7%;'>".  htmlspecialchars( $row['subscriber_dob'], ENT_NOQUOTES) ."</td>
 590                                 <td class ='detail' style='width:6%;'>".  htmlspecialchars( $row['subscriber_sex'], ENT_NOQUOTES) ."</td>
 591                                 <td class ='detail' style='width:9%;'>".  htmlspecialchars( $row['subscriber_ss'], ENT_NOQUOTES) ."</td>
 592                                 <td class ='detail' style='width:2%;'>
 593                                         <img src='../../images/deleteBtn.png' title=' .htmlspecialchars( xl('Delete Row'), ENT_QUOTES) . ' style='cursor:pointer;cursor:hand;' onclick='deletetherow(\"" . $i."_". htmlspecialchars( $row['policy_number'], ENT_QUOTES) . "\")'>
 594                                 </td>
 595                         </tr>
 596                 ";
 597
 598
 599         unset($elig);
 600     }
 601
 602     if($i==0){
 603
 604         echo "  <tr>
 605                                 <td class='norecord' colspan=9>
 606                                         <div style='padding:5px;font-family:arial;font-size:13px;text-align:center;'>". htmlspecialchars( xl('No records found'), ENT_NOQUOTES) . "</div>
 607                                 </td>
 608                         </tr>   ";
 609     }
 610         echo "  </tbody>
 611                         </table>";
 612 }
 613
 614 // To Show Eligibility Verification data
 615
 616 function show_eligibility_information($pid)
 617 {
 618
 619     $query = "  SELECT          eligr.response_description as ResponseMessage,
 620                                         DATE_FORMAT(eligv.eligibility_check_date, '%d %M %Y') as VerificationDate,
 621                                         eligv.copay, eligv.deductible, eligv.deductiblemet,
 622                                         if(eligr.response_status = 'A','Active','Inactive') as Status,
 623                                         insd.pid, insc.name
 624                         FROM            eligibility_verification eligv
 625                         INNER JOIN      eligibility_response eligr on eligr.response_id = eligv.response_id
 626                         INNER JOIN      insurance_data insd on insd.id = eligv.insurance_id
 627                         INNER JOIN      insurance_companies insc on insc.id = insd.provider
 628                         WHERE           insd.pid = ?
 629                         AND                     eligr.response_status = 'A'
 630                         AND                     eligv.eligibility_check_date = (SELECT max(eligibility_check_date)
 631                                                                                 FROM eligibility_verification
 632                                                                                 WHERE   insurance_id = eligv.insurance_id)";
 633     $result         = sqlStatement($query, array($pid) );
 634
 635     $row = sqlFetchArray($result);
 636
 637         $showString="";
 638     $showString .=  "<br><div class='text'>" .
 639             "<b>" .
 640             htmlspecialchars( xl('Insurance Provider'), ENT_NOQUOTES) . ":</b> " .
 641             (!empty($row['name']) ? htmlspecialchars( $row['name'], ENT_NOQUOTES) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 642             "<br>\n" .
 643             "<b>" .
 644             htmlspecialchars( xl('Status'), ENT_NOQUOTES) . ":</b> " .
 645             (!empty($row['ResponseMessage']) ? htmlspecialchars( $row['ResponseMessage'], ENT_NOQUOTES) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 646             "<br>\n" .
 647             "<b>" .
 648             htmlspecialchars( xl('Last Verified On'), ENT_NOQUOTES) . ":</b> " .
 649             (!empty($row['VerificationDate']) ? htmlspecialchars( $row['VerificationDate'], ENT_NOQUOTES) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 650             "<br>" .
 651             "<b>" . htmlspecialchars( xl('Copay'), ENT_NOQUOTES) . ":</b> " .
 652             (!empty($row['copay']) ? htmlspecialchars( $row['copay'], ENT_NOQUOTES) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 653             "<br><b>" . htmlspecialchars( xl('Deductible'), ENT_NOQUOTES) . ":</b> " .
 654             (!empty($row['deductible']) ? htmlspecialchars( $row['deductible'], ENT_NOQUOTES) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 655             "<br><b>" . htmlspecialchars( xl('Deductible Met'), ENT_NOQUOTES) . ":</b> " .
 656             (!empty($row['deductiblemet']) ? ($row['deductiblemet'] == 'Y' ? htmlspecialchars( xl('Yes'), ENT_NOQUOTES) : htmlspecialchars( xl('No'), ENT_NOQUOTES)) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 657             "</div>";
 658
 659     echo $showString;
 660 }
 661
 662 // For EDI 271
 663
 664
 665 // Function to save the values in eligibility_response table
 666
 667 function eligibility_response_save($segmentVal,$vendorID)
 668 {
 669
 670     $resCount = 0;
 671
 672     $query = "  SELECT   count(*) as RecordsCount
 673                                 FROM     eligibility_response
 674                                 WHERE    response_description = ? and
 675                                          response_vendor_id       = ?";
 676
 677     $resCount = sqlStatement($query, array($segmentVal, $vendorID) );
 678
 679
 680     if(isset($resCount))
 681     {
 682
 683         $row        = sqlFetchArray($resCount);
 684
 685         $resCount   = $row['RecordsCount'];
 686
 687     }
 688
 689     if($resCount == 0)
 690     {
 691
 692         $query = "INSERT into eligibility_response SET  response_description =?,
 693                                                                 response_vendor_id       = ?,
 694                                                                 response_create_date = now(),
 695                                                                 response_modify_date = now()";
 696         $res    = sqlStatement($query, array($segmentVal, $vendorID) );
 697     }
 698
 699 }
 700
 701 // Function to save the values in eligibility_verification table
 702
 703 function eligibility_verification_save($segmentVal,$x12PartnerId,$patientId)
 704 {
 705
 706     $resCount = 0;
 707
 708     // For fetching the response Id
 709
 710     $query = "  SELECT   response_id
 711                                 FROM     eligibility_response
 712                                 WHERE    response_description = ? and
 713                                                  response_vendor_id       = ?";
 714
 715     $resId  = sqlStatement($query, array($segmentVal, $x12PartnerId) );
 716
 717     // For fetching the insuarace data Id
 718
 719     $query = "  SELECT   id,copay
 720                                 FROM     insurance_data
 721                                 WHERE    type = 'primary' and
 722                                                  pid = ?";
 723
 724     $insId  = sqlStatement($query, array($patientId) );
 725
 726     if(isset($resId))
 727     {
 728
 729         $row        = sqlFetchArray($resId);
 730
 731         $responseId     = $row['response_id'];
 732
 733     }
 734     if(isset($insId))
 735     {
 736
 737         $row        = sqlFetchArray($insId);
 738
 739         $insuranceId    = $row['id'];
 740         $copay      = $row['copay'];
 741
 742     }
 743
 744     if($resCount == 0)
 745     {
 746
 747         if(isset($insuranceId) && !empty($insuranceId)){
 748
 749             //Set up the sql variable binding array (this prevents sql-injection attacks)
 750             $sqlBindArray = array();
 751             $query = "INSERT into eligibility_verification SET  response_id     = ? ,
 752                                                                                 insurance_id    = ?,";
 753             array_push($sqlBindArray, $responseId, $insuranceId);
 754
 755             if(!empty($copay))
 756             {
 757                 $query .= "copay = ?,";
 758                 array_push($sqlBindArray, $copay);
 759             }
 760             $query .= "eligibility_check_date   = now(),
 761                                    create_date                  = now()";
 762             $res    = sqlStatement($query, $sqlBindArray);
 763         }
 764     }
 765 }
 766
 767 // Function to fetch the Patient information - eligibility
 768
 769 function eligibility_information($insuranceId)
 770 {
 771     $insuranceId = 1;
 772
 773     $query = "  SELECT          *
 774                         FROM            eligibility_verification
 775                         WHERE       insuranceid = ?";
 776
 777     $result         = sqlStatement($query, array($insuranceId) );
 778     $row        = sqlFetchArray($result);
 779     return $row;
 780
 781 }
 782 // return array of X12 partners
 783
 784 function getX12Partner()
 785 {
 786     $rez = sqlStatement("select * from x12_partners");
 787     for($iter=0; $row=sqlFetchArray($rez); $iter++)
 788         $returnval[$iter]=$row;
 789
 790     return $returnval;
 791 }
 792
 793 // return array of provider usernames
 794 function getUsernames()
 795 {
 796     $rez = sqlStatement("select distinct username, lname, fname,id from users " .
 797         "where authorized = 1 and username != ''");
 798     for($iter=0; $row=sqlFetchArray($rez); $iter++)
 799         $returnval[$iter]=$row;
 800
 801     return $returnval;
 802 }
 803
 804 // return formated array
 805
 806 function arrFormated(&$item, $key)
 807 {
 808     $item = strstr($item, '_');
 809     $item = substr($item,1,strlen($item)-1);
 810     $item = "'".$item;
 811 }
 812 ?>