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