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