library/edi.inc

   1 <?php
   2 // Copyright (C) 2010 MMF Systems, Inc>
   3 //
   4 // This program is free software; you can redistribute it and/or
   5 // modify it under the terms of the GNU General Public License
   6 // as published by the Free Software Foundation; either version 2
   7 // of the License, or (at your option) any later version.
   8
   9 // SEGMENT FUNCTION START
  10
  11 // ISA Segment  - EDI-270 format
  12
  13 function create_ISA($row,$X12info,$segTer,$compEleSep) {
  14
  15         $ISA     =      array();
  16
  17         $ISA[0] = "ISA";                                                        // Interchange Control Header Segment ID
  18
  19         $ISA[1] = "00";                                                         // Author Info Qualifier
  20
  21         $ISA[2] = str_pad("0000000",10," ");            // Author Information
  22
  23         $ISA[3] = "00";                                                         //   Security Information Qualifier
  24                                                                                                 //   MEDI-CAL NOTE: For Leased-Line & Dial-Up use '01',
  25                                                                                                 //   for BATCH use '00'.
  26                                                                                                 //   '00' No Security Information Present
  27                                                                                                 //   (No Meaningful Information in I04)
  28
  29         $ISA[4] = str_pad("0000000000",10," ");         // Security Information
  30
  31         $ISA[5] = str_pad("ZZ",2," ");                          // Interchange ID Qualifier
  32
  33         $ISA[6] = str_pad($X12info[2],15," ");          // INTERCHANGE SENDER ID
  34
  35         $ISA[7] = str_pad("ZZ",2," ");                          // Interchange ID Qualifier
  36
  37         $ISA[8] = str_pad($X12info[3],15," ");          // INTERCHANGE RECEIVER ID
  38
  39         $ISA[9] = str_pad(date('ymd'),6," ");           // Interchange Date (YYMMDD)
  40
  41         $ISA[10] = str_pad(date('Hi'),4," ");           // Interchange Time (HHMM)
  42
  43         $ISA[11] = "U";                                                         // Interchange Control Standards Identifier
  44
  45         $ISA[12] = str_pad("00401",5," ");                      // Interchange Control Version Number
  46
  47         $ISA[13] = str_pad("000000001",9," ");          // INTERCHANGE CONTROL NUMBER
  48
  49         $ISA[14] = str_pad("1",1," ");                          // Acknowledgment Request [0= not requested, 1= requested]
  50
  51         $ISA[15] =  str_pad("P",1," ");                         // Usage Indicator [ P = Production Data, T = Test Data ]
  52
  53         $ISA['Created'] = implode('*', $ISA);           // Data Element Separator
  54
  55         $ISA['Created'] = $ISA['Created'] ."*";
  56
  57         $ISA['Created'] = $ISA ['Created'] . $segTer . $compEleSep;
  58
  59         return trim($ISA['Created']);
  60
  61 }
  62
  63 // GS Segment  - EDI-270 format
  64
  65 function create_GS($row,$X12info,$segTer,$compEleSep) {
  66
  67         $GS        = array();
  68
  69         $GS[0] = "GS";                                          // Functional Group Header Segment ID
  70
  71         $GS[1] = "HS";                                          // Functional ID Code [ HS = Eligibility, Coverage or Benefit Inquiry (270) ]
  72
  73         $GS[2] =  $X12info[2];                          // Application Sender's ID
  74
  75         $GS[3] =  $X12info[3];                          // Application Receiver's ID
  76
  77         $GS[4] = date('Ymd');                           // Date [CCYYMMDD]
  78
  79         $GS[5] = date('His');                           // Time [HHMM] Group Creation Time
  80
  81         $GS[6] = "000000002";                           // Group Control Number
  82
  83         $GS[7] = "X";                                   // Responsible Agency Code Accredited Standards Committee X12 ]
  84
  85         $GS[8] = "004010X092A1";                        // Version Release / Industry[ Identifier Code Query
  86
  87         $GS['Created'] = implode('*', $GS);             // Data Element Separator
  88
  89         $GS['Created'] = $GS ['Created'] . $compEleSep;
  90
  91         return trim($GS['Created']);
  92
  93 }
  94
  95 // ST Segment  - EDI-270 format
  96
  97 function create_ST($row,$X12info,$segTer,$compEleSep) {
  98
  99         $ST        =    array();
 100
 101         $ST[0] = "ST";                                                          // Transaction Set Header Segment ID
 102
 103         $ST[1] = "270";                                                         // Transaction Set Identifier Code (Inquiry Request)
 104
 105         $ST[2] = "000000003";                                           // Transaction Set Control Number - Must match SE's
 106
 107         $ST['Created'] = implode('*', $ST);                     // Data Element Separator
 108
 109         $ST['Created'] = $ST ['Created'] . $compEleSep;
 110
 111         return trim($ST['Created']);
 112
 113 }
 114
 115 // BHT Segment  - EDI-270 format
 116
 117 function create_BHT($row,$X12info,$segTer,$compEleSep) {
 118
 119         $BHT    =       array();
 120
 121         $BHT[0] = "BHT";                                                // Beginning of Hierarchical Transaction Segment ID
 122
 123         $BHT[1] = "0022";                                               // Subscriber Structure Code
 124
 125         $BHT[2] = "13";                                                 // Purpose Code - This is a Request
 126
 127         $BHT[3] = "PROVTest600";                                //  Submitter Transaction Identifier
 128                                                                                         //This information is required by the information Receiver
 129                                                                                         //when using Real Time transactions.
 130                                                                                         //For BATCH this can be used for optional information.
 131
 132         $BHT[4] = str_pad(date('Ymd'),8," ");                   // Date Transaction Set Created
 133
 134         $BHT[5] = str_pad(date('His'),8," ");                   // Time Transaction Set Created
 135
 136         $BHT['Created'] = implode('*', $BHT);                   // Data Element Separator
 137
 138         $BHT['Created'] = $BHT ['Created'] . $compEleSep;
 139
 140         return trim($BHT['Created']);
 141
 142 }
 143
 144 // HL Segment  - EDI-270 format
 145
 146 function create_HL($row, $nHlCounter,$X12info,$segTer,$compEleSep) {
 147
 148         $HL             = array();
 149
 150         $HL[0]          = "HL";                 // Hierarchical Level Segment ID
 151         $HL_LEN[0]      =  2;
 152
 153         $HL[1] = $nHlCounter;           // Hierarchical ID No.
 154
 155         if($nHlCounter == 1)
 156         {
 157                 $HL[2] = "";
 158                 $HL[3] = 20;                    // Description: Identifies the payor, maintainer, or source of the information.
 159                 $HL[4] = 1;                             // 1 Additional Subordinate HL Data Segment in This Hierarchical Structure.
 160         }
 161         else if($nHlCounter == 2)
 162         {
 163                 $HL[2] = 1;                             // Hierarchical Parent ID Number
 164                 $HL[3] = 21;                    // Hierarchical Level Code. '21' Information Receiver
 165                 $HL[4] = 1;                             // 1 Additional Subordinate HL Data Segment in This Hierarchical Structure.
 166         }
 167         else
 168         {
 169                 $HL[2] = 2;
 170                 $HL[3] = 22;                    // Hierarchical Level Code.'22' Subscriber
 171                 $HL[4] = 0;                             // 0 no Additional Subordinate in the Hierarchical Structure.
 172         }
 173
 174         $HL['Created'] = implode('*', $HL);             // Data Element Separator
 175
 176         $HL['Created'] = $HL ['Created'] . $compEleSep;
 177
 178         return trim($HL['Created']);
 179
 180 }
 181
 182 // NM1 Segment  - EDI-270 format
 183
 184 function create_NM1($row,$nm1Cast,$X12info,$segTer,$compEleSep) {
 185
 186         $NM1            = array();
 187
 188         $NM1[0]         = "NM1";                                        // Subscriber Name Segment ID
 189
 190         if($nm1Cast == 'PR')
 191         {
 192                 $NM1[1] = "PR";                                         // Entity ID Code - Payer [PR Payer]
 193                 $NM1[2] = "2";                                          // Entity Type - Non-Person
 194                 $NM1[3] = $row["payer_name"];           // Organizational Name
 195                 $NM1[4] = "";                                           // Data Element not required.
 196                 $NM1[5] = "";                                           // Data Element not required.
 197                 $NM1[6] = "";                                           // Data Element not required.
 198                 $NM1[7] = "";                                           // Data Element not required.
 199                 $NM1[8] = "46";                                         // 46 - Electronic Transmitter Identification Number (ETIN)
 200                 $NM1[9] = $X12info[3];                          // Application Sender's ID
 201         }
 202         else if($nm1Cast == '1P')
 203         {
 204                 $NM1[1] = "IP";                                         // Entity ID Code - Provider [1P Provider]
 205                 $NM1[2] = "1";                                          // Entity Type - Person
 206                 $NM1[3] = $row['facility_name'];                        // Organizational Name
 207                 $NM1[4] = $row['provider_lname'];                       // Data Element not required.
 208                 $NM1[5] = $row['provider_fname'];                       // Data Element not required.
 209                 $NM1[6] = "";                                           // Data Element not required.
 210                 $NM1[7] = "";                                           // Data Element not required.
 211                 $NM1[8] = "XX";
 212                 $NM1[9] = $row['provider_npi'];
 213         }
 214         else if($nm1Cast == 'IL')
 215         {
 216                 $NM1[1] = "IL";                                         // Insured or Subscriber
 217                 $NM1[2] = "1";                                          // Entity Type - Person
 218                 $NM1[3] = $row['lname'];                                // last Name
 219                 $NM1[4] = $row['fname'];                                // first Name
 220                 $NM1[5] = $row['mname'];                                // middle Name
 221                 $NM1[6] = "";                                           // data element
 222                 $NM1[7] = "";                                           // data element
 223                 $NM1[8] = "MI";                                         // Identification Code Qualifier
 224                 $NM1[9] = $row['subscriber_ss'];                        // Identification Code
 225         }
 226
 227         $NM1['Created'] = implode('*', $NM1);                           // Data Element Separator
 228
 229         $NM1['Created'] = $NM1['Created'] . $compEleSep;
 230
 231         return trim($NM1['Created']);
 232
 233 }
 234
 235 // REF Segment  - EDI-270 format
 236
 237 function create_REF($row,$ref,$X12info,$segTer,$compEleSep) {
 238
 239         $REF    =       array();
 240
 241         $REF[0] = "REF";                                                // Subscriber Additional Identification
 242
 243         if($ref == '1P')
 244         {
 245                 $REF[1] = "4A";                                         // Reference Identification Qualifier
 246                 $REF[2] = $row['provider_pin'];                         // Provider Pin.
 247         }
 248         else
 249         {
 250                 $REF[1] = "EJ";                                         // 'EJ' for Patient Account Number
 251                 $REF[2] = $row['pid'];                                  // Patient Account No.
 252         }
 253         $REF['Created'] = implode('*', $REF);                           // Data Element Separator
 254
 255         $REF['Created'] = $REF['Created'] . $compEleSep;
 256
 257         return trim($REF['Created']);
 258
 259 }
 260
 261 // TRN Segment - EDI-270 format
 262
 263 function create_TRN($row,$tracno,$refiden,$X12info,$segTer,$compEleSep) {
 264
 265         $TRN    =       array();
 266
 267         $TRN[0] = "TRN";                                                // Subscriber Trace Number Segment ID
 268
 269         $TRN[1] = "1";                                                  // Trace Type Code � Current Transaction Trace Numbers
 270
 271         $TRN[2] = $tracno;                                              // Trace Number
 272
 273         $TRN[3] = "9000000000";                                         // Originating Company ID � must be 10 positions in length
 274
 275         $TRN[4] = $refiden;                                             // Additional Entity Identifier (i.e. Subdivision)
 276
 277         $TRN['Created'] = implode('*', $TRN);                           // Data Element Separator
 278
 279         $TRN['Created'] = $TRN['Created'] . $compEleSep;
 280
 281         return trim($TRN['Created']);
 282
 283 }
 284
 285 // DMG Segment - EDI-270 format
 286
 287 function create_DMG($row,$X12info,$segTer,$compEleSep) {
 288
 289         $DMG    =       array();
 290
 291         $DMG[0] = "DMG";                                                        // Date or Time or Period Segment ID
 292
 293         $DMG[1] = "D8";                                                         // Date Format Qualifier - (D8 means CCYYMMDD)
 294
 295         $DMG[2] = $row['dob'];                                          // Subscriber's Birth date
 296
 297         $DMG['Created'] = implode('*', $DMG);           // Data Element Separator
 298
 299         $DMG['Created'] = $DMG['Created'] .  $compEleSep;
 300
 301         return trim($DMG['Created']);
 302 }
 303
 304 // DTP Segment - EDI-270 format
 305
 306 function create_DTP($row,$qual,$X12info,$segTer,$compEleSep) {
 307
 308         $DTP    =       array();
 309
 310         $DTP[0] = "DTP";                                                // Date or Time or Period Segment ID
 311
 312         $DTP[1] = $qual;                                                // Qualifier - Date of Service
 313
 314         $DTP[2] = "D8";                                                 // Date Format Qualifier - (D8 means CCYYMMDD)
 315
 316         if($qual == '102'){
 317                 $DTP[3] = $row['date'];                         // Date
 318         }else{
 319                 $DTP[3] = $row['pc_eventDate'];         // Date of Service
 320         }
 321         $DTP['Created'] = implode('*', $DTP);   // Data Element Separator
 322
 323         $DTP['Created'] = $DTP['Created'] .  $compEleSep;
 324
 325         return trim($DTP['Created']);
 326 }
 327
 328 // EQ Segment - EDI-270 format
 329
 330 function create_EQ($row,$X12info,$segTer,$compEleSep) {
 331
 332         $EQ             =       array();
 333
 334         $EQ[0]  = "EQ";                                                                 // Subscriber Eligibility or Benefit Inquiry Information
 335
 336         $EQ[1]  = "30";                                                                 // Service Type Code
 337
 338         $EQ['Created'] = implode('*', $EQ);                             // Data Element Separator
 339
 340         $EQ['Created'] = $EQ['Created'] . $compEleSep;
 341
 342         return trim($EQ['Created']);
 343 }
 344
 345 // SE Segment - EDI-270 format
 346
 347 function create_SE($row,$segmentcount,$X12info,$segTer,$compEleSep) {
 348
 349         $SE     =       array();
 350
 351         $SE[0] = "SE";                                                          // Transaction Set Trailer Segment ID
 352
 353         $SE[1] = $segmentcount;                                         // Segment Count
 354
 355         $SE[2] = "000000003";                                           // Transaction Set Control Number - Must match ST's
 356
 357         $SE['Created'] = implode('*', $SE);                     // Data Element Separator
 358
 359         $SE['Created'] = $SE['Created'] . $compEleSep;
 360
 361         return trim($SE['Created']);
 362 }
 363
 364 // GE Segment - EDI-270 format
 365
 366 function create_GE($row,$X12info,$segTer,$compEleSep) {
 367
 368         $GE     =       array();
 369
 370         $GE[0]  = "GE";                                                 // Functional Group Trailer Segment ID
 371
 372         $GE[1]  = "1";                                                  // Number of included Transaction Sets
 373
 374         $GE[2]  = "000000002";                                          // Group Control Number
 375
 376         $GE['Created'] = implode('*', $GE);                             // Data Element Separator
 377
 378         $GE['Created'] = $GE['Created'] . $compEleSep;
 379
 380         return trim($GE['Created']);
 381 }
 382
 383 // IEA Segment - EDI-270 format
 384
 385 function create_IEA($row,$X12info,$segTer,$compEleSep) {
 386
 387         $IEA    =       array();
 388
 389         $IEA[0] = "IEA";                                                // Interchange Control Trailer Segment ID
 390
 391         $IEA[1] = "1";                                                  // Number of included Functional Groups
 392
 393         $IEA[2] = "000000001";                                          // Interchange Control Number
 394
 395         $IEA['Created'] = implode('*', $IEA);
 396
 397         $IEA['Created'] = $IEA['Created'] .  $compEleSep;
 398
 399         return trim($IEA['Created']);
 400 }
 401
 402 function translate_relationship($relationship) {
 403         switch ($relationship) {
 404                 case "spouse":
 405                         return "01";
 406                         break;
 407                 case "child":
 408                         return "19";
 409                         break;
 410                 case "self":
 411                 default:
 412                         return "S";
 413         }
 414 }
 415
 416 // EDI-270 Batch file Generation
 417
 418 function print_elig($res,$X12info,$segTer,$compEleSep){
 419
 420         $i=1;
 421
 422         $PATEDI    = "";
 423
 424         // For Header Segment
 425
 426         $nHlCounter = 1;
 427         $rowCount       = 0;
 428         $trcNo          = 1234501;
 429         $refiden        = 5432101;
 430
 431         while ($row = sqlFetchArray($res))
 432         {
 433
 434                 if($nHlCounter == 1)
 435                 {
 436                         // create ISA
 437                         $PATEDI    = create_ISA($row,$X12info,$segTer,$compEleSep);
 438
 439                         // create GS
 440                         $PATEDI   .= create_GS($row,$X12info,$segTer,$compEleSep);
 441
 442                         // create ST
 443                         $PATEDI   .= create_ST($row,$X12info,$segTer,$compEleSep);
 444
 445                         // create BHT
 446                         $PATEDI   .= create_BHT($row,$X12info,$segTer,$compEleSep);
 447
 448                         // For Payer Segment
 449
 450                         $PATEDI  .= create_HL($row,1,$X12info,$segTer,$compEleSep);
 451                         $PATEDI  .= create_NM1($row,'PR',$X12info,$segTer,$compEleSep);
 452
 453                         // For Provider Segment
 454
 455                         $PATEDI  .= create_HL($row,2,$X12info,$segTer,$compEleSep);
 456                         $PATEDI  .= create_NM1($row,'1P',$X12info,$segTer,$compEleSep);
 457                         $PATEDI  .= create_REF($row,'1P',$X12info,$segTer,$compEleSep);
 458
 459                         $nHlCounter = $nHlCounter + 2;
 460                         $segmentcount = 7; // segement counts - start from ST
 461                 }
 462
 463                 // For Subscriber Segment
 464
 465                 $PATEDI  .= create_HL($row,$nHlCounter,$X12info,$segTer,$compEleSep);
 466                 $PATEDI  .= create_TRN($row,$trcNo,$refiden,$X12info,$segTer,$compEleSep);
 467                 $PATEDI  .= create_NM1($row,'IL',$X12info,$segTer,$compEleSep);
 468                 $PATEDI  .= create_REF($row,'IL',$X12info,$segTer,$compEleSep);
 469                 $PATEDI  .= create_DMG($row,$X12info,$segTer,$compEleSep);
 470
 471                 //      $PATEDI  .= create_DTP($row,'102',$X12info,$segTer,$compEleSep);
 472
 473                 $PATEDI  .= create_DTP($row,'472',$X12info,$segTer,$compEleSep);
 474                 $PATEDI  .= create_EQ($row,$X12info,$segTer,$compEleSep);
 475
 476                 $segmentcount   = $segmentcount + 7;
 477                 $nHlCounter     = $nHlCounter + 1;
 478                 $rowCount       = $rowCount + 1;
 479                 $trcNo          = $trcNo + 1;
 480                 $refiden        = $refiden + 1;
 481
 482
 483                 if($rowCount == sqlNumRows($res))
 484                 {
 485                         $segmentcount = $segmentcount + 1;
 486                         $PATEDI   .= create_SE($row,$segmentcount,$X12info,$segTer,$compEleSep);
 487                         $PATEDI   .= create_GE($row,$X12info,$segTer,$compEleSep);
 488                         $PATEDI   .= create_IEA($row,$X12info,$segTer,$compEleSep);
 489                 }
 490         }
 491
 492         echo $PATEDI;
 493 }
 494
 495 // Report Generation
 496
 497 function show_elig($res,$X12info,$segTer,$compEleSep){
 498
 499         $i=0;
 500         echo "  <div id='report_results'>
 501                         <table>
 502                                 <thead>
 503
 504                                         <th style='width:12%;'> ". htmlspecialchars( xl('Facility Name'), ENT_NOQUOTES) ."</th>
 505                                         <th style='width:9%;' > ". htmlspecialchars( xl('Facility NPI'), ENT_NOQUOTES) ."</th>
 506                                         <th style='width:15%;'> ". htmlspecialchars( xl('Insurance Comp'), ENT_NOQUOTES) ."</th>
 507                                         <th style='width:8%;' > ". htmlspecialchars( xl('Policy No'), ENT_NOQUOTES) ."</th>
 508                                         <th style='width:16%;'> ". htmlspecialchars( xl('Patient Name'), ENT_NOQUOTES) ."</th>
 509                                         <th style='width:7%;' > ". htmlspecialchars( xl('DOB'), ENT_NOQUOTES) ."</th>
 510                                         <th style='width:6%;' > ". htmlspecialchars( xl('Gender'), ENT_NOQUOTES) ."</th>
 511                                         <th style='width:9%;' > ". htmlspecialchars( xl('SSN'), ENT_NOQUOTES) ."</th>
 512                                         <th style='width:2%;' > &nbsp;                    </th>
 513                                 </thead>
 514
 515                                 <tbody>
 516
 517                 ";
 518
 519         while ($row = sqlFetchArray($res)) {
 520
 521
 522                 $i= $i+1;
 523
 524                 if($i%2 == 0){
 525                         $background = '#FFF';
 526                 }else{
 527                         $background = '#FFF';
 528                 }
 529
 530                 $elig     = array();
 531                 $elig[0]  = $row['facility_name'];                              // Inquiring Provider Name  calendadr
 532                 $elig[1]  = $row['facility_npi'];                               // Inquiring Provider NPI
 533                 $elig[2]  = $row['payer_name'];                                 // Payer Name  our insurance co name
 534                 $elig[3]  = $row['policy_number'];                              // Subscriber ID
 535                 $elig[4]  = $row['subscriber_lname'];                           // Subscriber Last Name
 536                 $elig[5]  = $row['subscriber_fname'];                           // Subscriber First Name
 537                 $elig[6]  = $row['subscriber_mname'];                           // Subscriber Middle Initial
 538                 $elig[7]  = $row['subscriber_dob'];                             // Subscriber Date of Birth
 539                 $elig[8]  = substr($row['subscriber_sex'], 0, 1);               // Subscriber Sex
 540                 $elig[9]  = $row['subscriber_ss'];                              // Subscriber SSN
 541                 $elig[10] = translate_relationship($row['subscriber_relationship']);    // Pt Relationship to insured
 542                 $elig[11] = $row['lname'];                                      // Dependent Last Name
 543                 $elig[12] = $row['fname'];                                      // Dependent First Name
 544                 $elig[13] = $row['mname'];                                      // Dependent Middle Initial
 545                 $elig[14] = $row['dob'];                                        // Dependent Date of Birth
 546                 $elig[15] = substr($row['sex'], 0, 1);                          // Dependent Sex
 547                 $elig[16] = $row['pc_eventDate'];                               // Date of service
 548                 $elig[17] = "30";                                               // Service Type
 549                 $elig[18] = $row['pubpid'];                                     // Patient Account Number pubpid
 550
 551                 echo "  <tr id='PR".$i."_". htmlspecialchars( $row['policy_number'], ENT_QUOTES)."'>
 552                                 <td class ='detail' style='width:12%;'>". htmlspecialchars( $row['facility_name'], ENT_NOQUOTES) ."</td>
 553                                 <td class ='detail' style='width:9%;'>".  htmlspecialchars( $row['facility_npi'], ENT_NOQUOTES) ."</td>
 554                                 <td class ='detail' style='width:15%;'>". htmlspecialchars( $row['payer_name'], ENT_NOQUOTES) ."</td>
 555                                 <td class ='detail' style='width:8%;'>".  htmlspecialchars( $row['policy_number'], ENT_NOQUOTES) ."</td>
 556                                 <td class ='detail' style='width:16%;'>". htmlspecialchars( $row['subscriber_lname']." ".$row['subscriber_fname'], ENT_NOQUOTES) ."</td>
 557                                 <td class ='detail' style='width:7%;'>".  htmlspecialchars( $row['subscriber_dob'], ENT_NOQUOTES) ."</td>
 558                                 <td class ='detail' style='width:6%;'>".  htmlspecialchars( $row['subscriber_sex'], ENT_NOQUOTES) ."</td>
 559                                 <td class ='detail' style='width:9%;'>".  htmlspecialchars( $row['subscriber_ss'], ENT_NOQUOTES) ."</td>
 560                                 <td class ='detail' style='width:2%;'>
 561                                         <img src='../../images/deleteBtn.png' title=' .htmlspecialchars( xl('Delete Row'), ENT_QUOTES) . ' style='cursor:pointer;cursor:hand;' onclick='deletetherow(\"" . $i."_". htmlspecialchars( $row['policy_number'], ENT_QUOTES) . "\")'>
 562                                 </td>
 563                         </tr>
 564                 ";
 565
 566
 567                 unset($elig);
 568         }
 569
 570         if($i==0){
 571
 572                 echo "  <tr>
 573                                 <td class='norecord' colspan=9>
 574                                         <div style='padding:5px;font-family:arial;font-size:13px;text-align:center;'>". htmlspecialchars( xl('No records found'), ENT_NOQUOTES) . "</div>
 575                                 </td>
 576                         </tr>   ";
 577         }
 578                 echo "  </tbody>
 579                         </table>";
 580 }
 581
 582 // To Show Eligibility Verification data
 583
 584 function show_eligibility_information($pid)
 585 {
 586
 587         $query = "      SELECT          eligr.response_description as ResponseMessage,
 588                                         DATE_FORMAT(eligv.eligibility_check_date, '%d %M %Y') as VerificationDate,
 589                                         eligv.copay, eligv.deductible, eligv.deductiblemet,
 590                                         if(eligr.response_status = 'A','Active','Inactive') as Status,
 591                                         insd.pid, insc.name
 592                         FROM            eligibility_verification eligv
 593                         INNER JOIN      eligibility_response eligr on eligr.response_id = eligv.response_id
 594                         INNER JOIN      insurance_data insd on insd.id = eligv.insurance_id
 595                         INNER JOIN      insurance_companies insc on insc.id = insd.provider
 596                         WHERE           insd.pid = ?
 597                         AND                     eligr.response_status = 'A'
 598                         AND                     eligv.eligibility_check_date = (SELECT max(eligibility_check_date)
 599                                                                                 FROM eligibility_verification
 600                                                                                 WHERE   insurance_id = eligv.insurance_id)";
 601         $result         = sqlStatement($query, array($pid) );
 602
 603         $row = sqlFetchArray($result);
 604
 605         $showString="";
 606         $showString .=  "<br><div class='text'>" .
 607                         "<b>" .
 608                         htmlspecialchars( xl('Insurance Provider'), ENT_NOQUOTES) . ":</b> " .
 609                         (!empty($row['name']) ? htmlspecialchars( $row['name'], ENT_NOQUOTES) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 610                         "<br>\n" .
 611                         "<b>" .
 612                         htmlspecialchars( xl('Status'), ENT_NOQUOTES) . ":</b> " .
 613                         (!empty($row['ResponseMessage']) ? htmlspecialchars( $row['ResponseMessage'], ENT_NOQUOTES) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 614                         "<br>\n" .
 615                         "<b>" .
 616                         htmlspecialchars( xl('Last Verified On'), ENT_NOQUOTES) . ":</b> " .
 617                         (!empty($row['VerificationDate']) ? htmlspecialchars( $row['VerificationDate'], ENT_NOQUOTES) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 618                         "<br>" .
 619                         "<b>" . htmlspecialchars( xl('Copay'), ENT_NOQUOTES) . ":</b> " .
 620                         (!empty($row['copay']) ? htmlspecialchars( $row['copay'], ENT_NOQUOTES) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 621                         "<br><b>" . htmlspecialchars( xl('Deductible'), ENT_NOQUOTES) . ":</b> " .
 622                         (!empty($row['deductible']) ? htmlspecialchars( $row['deductible'], ENT_NOQUOTES) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 623                         "<br><b>" . htmlspecialchars( xl('Deductible Met'), ENT_NOQUOTES) . ":</b> " .
 624                         (!empty($row['deductiblemet']) ? ($row['deductiblemet'] == 'Y' ? htmlspecialchars( xl('Yes'), ENT_NOQUOTES) : htmlspecialchars( xl('No'), ENT_NOQUOTES)) : htmlspecialchars( xl('n/a'), ENT_NOQUOTES)) .
 625                         "</div>";
 626
 627         echo $showString;
 628 }
 629
 630 // For EDI 271
 631
 632
 633 // Function to save the values in eligibility_response table
 634
 635 function eligibility_response_save($segmentVal,$vendorID)
 636 {
 637
 638         $resCount = 0;
 639
 640         $query = "  SELECT   count(*) as RecordsCount
 641                                 FROM     eligibility_response
 642                                 WHERE    response_description = ? and
 643                                          response_vendor_id       = ?";
 644
 645         $resCount = sqlStatement($query, array($segmentVal, $vendorID) );
 646
 647
 648         if(isset($resCount))
 649         {
 650
 651                 $row            = sqlFetchArray($resCount);
 652
 653                 $resCount       = $row['RecordsCount'];
 654
 655         }
 656
 657         if($resCount == 0)
 658         {
 659
 660                 $query = "INSERT into eligibility_response SET  response_description =?,
 661                                                                 response_vendor_id       = ?,
 662                                                                 response_create_date = now(),
 663                                                                 response_modify_date = now()";
 664                 $res    = sqlStatement($query, array($segmentVal, $vendorID) );
 665         }
 666
 667 }
 668
 669 // Function to save the values in eligibility_verification table
 670
 671 function eligibility_verification_save($segmentVal,$x12PartnerId,$patientId)
 672 {
 673
 674         $resCount = 0;
 675
 676         // For fetching the response Id
 677
 678         $query = "  SELECT       response_id
 679                                 FROM     eligibility_response
 680                                 WHERE    response_description = ? and
 681                                                  response_vendor_id       = ?";
 682
 683         $resId  = sqlStatement($query, array($segmentVal, $x12PartnerId) );
 684
 685         // For fetching the insuarace data Id
 686
 687         $query = "  SELECT       id,copay
 688                                 FROM     insurance_data
 689                                 WHERE    type = 'primary' and
 690                                                  pid = ?";
 691
 692         $insId  = sqlStatement($query, array($patientId) );
 693
 694         if(isset($resId))
 695         {
 696
 697                 $row            = sqlFetchArray($resId);
 698
 699                 $responseId     = $row['response_id'];
 700
 701         }
 702         if(isset($insId))
 703         {
 704
 705                 $row            = sqlFetchArray($insId);
 706
 707                 $insuranceId    = $row['id'];
 708                 $copay          = $row['copay'];
 709
 710         }
 711
 712         if($resCount == 0)
 713         {
 714
 715                 if(isset($insuranceId) && !empty($insuranceId)){
 716
 717                         //Set up the sql variable binding array (this prevents sql-injection attacks)
 718                         $sqlBindArray = array();
 719                         $query = "INSERT into eligibility_verification SET      response_id     = ? ,
 720                                                                                 insurance_id    = ?,";
 721                         array_push($sqlBindArray, $responseId, $insuranceId);
 722
 723                         if(!empty($copay))
 724                         {
 725                                 $query .= "copay = ?,";
 726                                 array_push($sqlBindArray, $copay);
 727                         }
 728                         $query .= "eligibility_check_date       = now(),
 729                                    create_date                  = now()";
 730                         $res    = sqlStatement($query, $sqlBindArray);
 731                 }
 732         }
 733 }
 734
 735 // Function to fetch the Patient information - eligibility
 736
 737 function eligibility_information($insuranceId)
 738 {
 739         $insuranceId = 1;
 740
 741         $query = "      SELECT          *
 742                         FROM            eligibility_verification
 743                         WHERE       insuranceid = ?";
 744
 745         $result         = sqlStatement($query, array($insuranceId) );
 746         $row            = sqlFetchArray($result);
 747         return $row;
 748
 749 }
 750 // return array of X12 partners
 751
 752 function getX12Partner() {
 753         $rez = sqlStatement("select * from x12_partners");
 754         for($iter=0; $row=sqlFetchArray($rez); $iter++)
 755                 $returnval[$iter]=$row;
 756
 757         return $returnval;
 758 }
 759
 760 // return array of provider usernames
 761 function getUsernames() {
 762         $rez = sqlStatement("select distinct username, lname, fname,id from users " .
 763                 "where authorized = 1 and username != ''");
 764         for($iter=0; $row=sqlFetchArray($rez); $iter++)
 765                 $returnval[$iter]=$row;
 766
 767         return $returnval;
 768 }
 769
 770 // return formated array
 771
 772 function arrFormated(&$item, $key){
 773         $item = strstr($item, '_');
 774         $item = substr($item,1,strlen($item)-1);
 775         $item = "'".$item;
 776 }
 777 ?>