interface/billing/sl_eob_invoice.php

   1 <?php
   2 /**
   3  * This provides for manual posting of EOBs.  It is invoked from
   4  * sl_eob_search.php.  For automated (X12 835) remittance posting
   5  * see sl_eob_process.php.
   6  *
   7  * Copyright (C) 2005-2010 Rod Roark <rod@sunsetsystems.com>
   8  *
   9  * LICENSE: This program is free software; you can redistribute it and/or
  10  * modify it under the terms of the GNU General Public License
  11  * as published by the Free Software Foundation; either version 2
  12  * of the License, or (at your option) any later version.
  13  * This program is distributed in the hope that it will be useful,
  14  * but WITHOUT ANY WARRANTY; without even the implied warranty of
  15  * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
  16  * GNU General Public License for more details.
  17  * You should have received a copy of the GNU General Public License
  18  * along with this program. If not, see <http://opensource.org/licenses/gpl-license.php>;.
  19  *
  20  * @package OpenEMR
  21  * @author  Rod Roark <rod@sunsetsystems.com>
  22  * @author  Roberto Vasquez <robertogagliotta@gmail.com>
  23  * @author  Terry Hill <terry@lillysystems.com>
  24  * @link    http://www.open-emr.org
  25  */
  26
  27
  28
  29   require_once("../globals.php");
  30   require_once("$srcdir/log.inc");
  31   require_once("$srcdir/patient.inc");
  32   require_once("$srcdir/forms.inc");
  33   require_once("$srcdir/sl_eob.inc.php");
  34   require_once("$srcdir/invoice_summary.inc.php");
  35   require_once("../../custom/code_types.inc.php");
  36   require_once("$srcdir/formdata.inc.php");
  37
  38   $debug = 0; // set to 1 for debugging mode
  39
  40
  41   // If we permit deletion of transactions.  Might change this later.
  42   $ALLOW_DELETE = true;
  43
  44   $info_msg = "";
  45
  46   // Format money for display.
  47   //
  48   function bucks($amount) {
  49     if ($amount)
  50       printf("%.2f", $amount);
  51   }
  52
  53   // Delete rows, with logging, for the specified table using the
  54   // specified WHERE clause.  Borrowed from deleter.php.
  55   //
  56   function row_delete($table, $where) {
  57     $tres = sqlStatement("SELECT * FROM $table WHERE $where");
  58     $count = 0;
  59     while ($trow = sqlFetchArray($tres)) {
  60       $logstring = "";
  61       foreach ($trow as $key => $value) {
  62         if (! $value || $value == '0000-00-00 00:00:00') continue;
  63         if ($logstring) $logstring .= " ";
  64         $logstring .= $key . "='" . addslashes($value) . "'";
  65       }
  66       newEvent("delete", $_SESSION['authUser'], $_SESSION['authProvider'], 1, "$table: $logstring");
  67       ++$count;
  68     }
  69     if ($count) {
  70       $query = "DELETE FROM $table WHERE $where";
  71       echo $query . "<br>\n";
  72       sqlStatement($query);
  73     }
  74   }
  75 ?>
  76 <html>
  77 <head>
  78 <?php html_header_show(); ?>
  79 <link rel=stylesheet href="<?php echo $css_header;?>" type="text/css">
  80 <title><?php xl('EOB Posting - Invoice','e')?></title>
  81 <script language="JavaScript">
  82
  83 // An insurance radio button is selected.
  84 function setins(istr) {
  85  return true;
  86 }
  87
  88 // Compute an adjustment that writes off the balance:
  89 function writeoff(code) {
  90  var f = document.forms[0];
  91  var belement = f['form_line[' + code + '][bal]'];
  92  var pelement = f['form_line[' + code + '][pay]'];
  93  var aelement = f['form_line[' + code + '][adj]'];
  94  var relement = f['form_line[' + code + '][reason]'];
  95  var tmp = belement.value - pelement.value;
  96  aelement.value = Number(tmp).toFixed(2);
  97  if (aelement.value && ! relement.value) relement.selectedIndex = 1;
  98  return false;
  99 }
 100
 101 // Onsubmit handler.  A good excuse to write some JavaScript.
 102 function validate(f) {
 103  var delcount = 0;
 104  for (var i = 0; i < f.elements.length; ++i) {
 105   var ename = f.elements[i].name;
 106   // Count deletes.
 107   if (ename.substring(0, 9) == 'form_del[') {
 108    if (f.elements[i].checked) ++delcount;
 109    continue;
 110   }
 111   var pfxlen = ename.indexOf('[pay]');
 112   if (pfxlen < 0) continue;
 113   var pfx = ename.substring(0, pfxlen);
 114   var code = pfx.substring(pfx.indexOf('[')+1, pfxlen-1);
 115   if (f[pfx+'[pay]'].value || f[pfx+'[adj]'].value) {
 116    if (! f[pfx+'[date]'].value) {
 117     alert('<?php xl('Date is missing for code ','e')?>' + code);
 118     return false;
 119    }
 120   }
 121   if (f[pfx+'[pay]'].value && isNaN(parseFloat(f[pfx+'[pay]'].value))) {
 122    alert('<?php xl('Payment value for code ','e') ?>' + code + '<?php xl(' is not a number','e') ?>');
 123    return false;
 124   }
 125   if (f[pfx+'[adj]'].value && isNaN(parseFloat(f[pfx+'[adj]'].value))) {
 126    alert('<?php xl('Adjustment value for code ','e') ?>' + code + '<?php xl(' is not a number','e') ?>');
 127    return false;
 128   }
 129   if (f[pfx+'[adj]'].value && ! f[pfx+'[reason]'].value) {
 130    alert('<?php xl('Please select an adjustment reason for code ','e') ?>' + code);
 131    return false;
 132   }
 133   // TBD: validate the date format
 134  }
 135  // Demand confirmation if deleting anything.
 136  if (delcount > 0) {
 137   if (!confirm('<?php echo xl('Really delete'); ?> ' + delcount +
 138    ' <?php echo xl('transactions'); ?>?' +
 139    ' <?php echo xl('This action will be logged'); ?>!')
 140   ) return false;
 141  }
 142  return true;
 143 }
 144
 145 <!-- Get current date -->
 146
 147 function getFormattedToday()
 148 {
 149    var today = new Date();
 150    var dd = today.getDate();
 151    var mm = today.getMonth()+1; //January is 0!
 152    var yyyy = today.getFullYear();
 153    if(dd<10){dd='0'+dd}
 154    if(mm<10){mm='0'+mm}
 155
 156    return (yyyy + '-' + mm + '-' + dd);
 157 }
 158
 159 <!-- Update Payment Fields -->
 160
 161 function updateFields(payField, adjField, balField, coPayField, isFirstProcCode)
 162 {
 163    var payAmount = 0.0;
 164    var adjAmount = 0.0;
 165    var balAmount = 0.0;
 166    var coPayAmount = 0.0;
 167
 168    // coPayFiled will be null if there is no co-pay entry in the fee sheet
 169    if (coPayField)
 170       coPayAmount = coPayField.value;
 171
 172    // if balance field is 0.00, its value comes back as null, so check for nul-ness first
 173    if (balField)
 174       balAmount = (balField.value) ? balField.value : 0;
 175    if (payField)
 176       payAmount = (payField.value) ? payField.value : 0;
 177
 178    //alert('balance = >' + balAmount +'<  payAmount = ' + payAmount + '  copay = ' + coPayAmount + '  isFirstProcCode = ' + isFirstProcCode);
 179
 180    // subtract the co-pay only from the first procedure code
 181    if (isFirstProcCode == 1)
 182       balAmount = parseFloat(balAmount) + parseFloat(coPayAmount);
 183
 184    adjAmount = balAmount - payAmount;
 185
 186    // Assign rounded adjustment value back to TextField
 187    adjField.value = adjAmount = Math.round(adjAmount*100)/100;
 188 }
 189
 190 </script>
 191 </head>
 192 <body leftmargin='0' topmargin='0' marginwidth='0' marginheight='0'>
 193 <?php
 194   $trans_id = 0 + $_GET['id'];
 195   if (! $trans_id) die(xl("You cannot access this page directly."));
 196
 197     // A/R case, $trans_id matches form_encounter.id.
 198     $ferow = sqlQuery("SELECT e.*, p.fname, p.mname, p.lname " .
 199       "FROM form_encounter AS e, patient_data AS p WHERE " .
 200       "e.id = '$trans_id' AND p.pid = e.pid");
 201     if (empty($ferow)) die("There is no encounter with form_encounter.id = '$trans_id'.");
 202     $patient_id        = 0 + $ferow['pid'];
 203     $encounter_id      = 0 + $ferow['encounter'];
 204     $svcdate           = substr($ferow['date'], 0, 10);
 205     $form_payer_id     = 0 + $_POST['form_payer_id'];
 206     $form_reference    = $_POST['form_reference'];
 207     $form_check_date   = fixDate($_POST['form_check_date'], date('Y-m-d'));
 208     $form_deposit_date = fixDate($_POST['form_deposit_date'], $form_check_date);
 209     $form_pay_total    = 0 + $_POST['form_pay_total'];
 210
 211   $payer_type = 0;
 212   if (preg_match('/^Ins(\d)/i', $_POST['form_insurance'], $matches)) {
 213     $payer_type = $matches[1];
 214   }
 215
 216   if ($_POST['form_save'] || $_POST['form_cancel']) {
 217     if ($_POST['form_save']) {
 218       if ($debug) {
 219         echo xl("This module is in test mode. The database will not be changed.",'','<p><b>',"</b><p>\n");
 220       }
 221
 222         $session_id = arGetSession($form_payer_id, $form_reference,
 223           $form_check_date, $form_deposit_date, $form_pay_total);
 224         // The sl_eob_search page needs its invoice links modified to invoke
 225         // javascript to load form parms for all the above and submit.
 226         // At the same time that page would be modified to work off the
 227         // openemr database exclusively.
 228         // And back to the sl_eob_invoice page, I think we may want to move
 229         // the source input fields from row level to header level.
 230
 231         // Handle deletes. row_delete() is borrowed from deleter.php.
 232         if ($ALLOW_DELETE && !$debug) {
 233           foreach ($_POST['form_del'] as $arseq => $dummy) {
 234             row_delete("ar_activity", "pid = '$patient_id' AND " .
 235               "encounter = '$encounter_id' AND sequence_no = '$arseq'");
 236           }
 237         }
 238
 239       $paytotal = 0;
 240       foreach ($_POST['form_line'] as $code => $cdata) {
 241         $thispay  = trim($cdata['pay']);
 242         $thisadj  = trim($cdata['adj']);
 243         $thisins  = trim($cdata['ins']);
 244         $thiscodetype = trim($cdata['code_type']);
 245         $reason   = strip_escape_custom($cdata['reason']);
 246
 247         // Get the adjustment reason type.  Possible values are:
 248         // 1 = Charge adjustment
 249         // 2 = Coinsurance
 250         // 3 = Deductible
 251         // 4 = Other pt resp
 252         // 5 = Comment
 253         $reason_type = '1';
 254         if ($reason) {
 255           $tmp = sqlQuery("SELECT option_value FROM list_options WHERE " .
 256             "list_id = 'adjreason' AND " .
 257             "option_id = '" . add_escape_custom($reason) . "'");
 258           if (empty($tmp['option_value'])) {
 259             // This should not happen but if it does, apply old logic.
 260             if (preg_match("/To copay/", $reason)) {
 261               $reason_type = 2;
 262             }
 263             else if (preg_match("/To ded'ble/", $reason)) {
 264               $reason_type = 3;
 265             }
 266             $info_msg .= xl("No adjustment reason type found for") . " \"$reason\". ";
 267           }
 268           else {
 269             $reason_type = $tmp['option_value'];
 270           }
 271         }
 272
 273         if (! $thisins) $thisins = 0;
 274
 275         if ($thispay) {
 276             arPostPayment($patient_id, $encounter_id, $session_id,
 277               $thispay, $code, $payer_type, '', $debug, '', $thiscodetype);
 278           $paytotal += $thispay;
 279         }
 280
 281         // Be sure to record adjustment reasons, even for zero adjustments if
 282         // they happen to be comments.
 283         if ($thisadj || ($reason && $reason_type == 5)) {
 284           // "To copay" and "To ded'ble" need to become a comment in a zero
 285           // adjustment, formatted just like sl_eob_process.php.
 286           if ($reason_type == '2') {
 287             $reason = $_POST['form_insurance'] . " coins: $thisadj";
 288             $thisadj = 0;
 289           }
 290           else if ($reason_type == '3') {
 291             $reason = $_POST['form_insurance'] . " dedbl: $thisadj";
 292             $thisadj = 0;
 293           }
 294           else if ($reason_type == '4') {
 295             $reason = $_POST['form_insurance'] . " ptresp: $thisadj $reason";
 296             $thisadj = 0;
 297           }
 298           else if ($reason_type == '5') {
 299             $reason = $_POST['form_insurance'] . " note: $thisadj $reason";
 300             $thisadj = 0;
 301           }
 302           else {
 303             // An adjustment reason including "Ins" is assumed to be assigned by
 304             // insurance, and in that case we identify which one by appending
 305             // Ins1, Ins2 or Ins3.
 306             if (strpos(strtolower($reason), 'ins') !== false)
 307               $reason .= ' ' . $_POST['form_insurance'];
 308           }
 309             arPostAdjustment($patient_id, $encounter_id, $session_id,
 310               $thisadj, $code, $payer_type, $reason, $debug, '', $thiscodetype);
 311         }
 312       }
 313
 314       // Maintain which insurances are marked as finished.
 315
 316         $form_done = 0 + $_POST['form_done'];
 317         $form_stmt_count = 0 + $_POST['form_stmt_count'];
 318         sqlStatement("UPDATE form_encounter " .
 319           "SET last_level_closed = $form_done, " .
 320           "stmt_count = $form_stmt_count WHERE " .
 321           "pid = '$patient_id' AND encounter = '$encounter_id'");
 322
 323       if ($_POST['form_secondary']) {
 324           arSetupSecondary($patient_id, $encounter_id, $debug);
 325         }
 326
 327       echo "<script language='JavaScript'>\n";
 328       echo " if (opener.document.forms[0].form_amount) {\n";
 329       echo "  var tmp = opener.document.forms[0].form_amount.value - $paytotal;\n";
 330       echo "  opener.document.forms[0].form_amount.value = Number(tmp).toFixed(2);\n";
 331       echo " }\n";
 332     } else {
 333       echo "<script language='JavaScript'>\n";
 334     }
 335     if ($info_msg) echo " alert('" . addslashes($info_msg) . "');\n";
 336     if (! $debug) echo " window.close();\n";
 337     echo "</script></body></html>\n";
 338     exit();
 339   }
 340
 341     // Get invoice charge details.
 342     $codes = ar_get_invoice_summary($patient_id, $encounter_id, true);
 343
 344   $pdrow = sqlQuery("select billing_note " .
 345     "from patient_data where pid = '$patient_id' limit 1");
 346 ?>
 347 <center>
 348
 349 <form method='post' action='sl_eob_invoice.php?id=<?php echo $trans_id ?>'
 350  onsubmit='return validate(this)'>
 351
 352 <table border='0' cellpadding='3'>
 353  <tr>
 354   <td>
 355    <?php xl('Patient:','e')?>
 356   </td>
 357   <td>
 358 <?php
 359     echo $ferow['fname'] . ' ' . $ferow['mname'] . ' ' . $ferow['lname'];
 360 ?>
 361   </td>
 362   <td colspan="2" rowspan="3">
 363 <?php
 364     for ($i = 1; $i <= 3; ++$i) {
 365       $payerid = arGetPayerID($patient_id, $svcdate, $i);
 366       if ($payerid) {
 367         $tmp = sqlQuery("SELECT name FROM insurance_companies WHERE id = $payerid");
 368         echo "Ins$i: " . $tmp['name'] . "<br />";
 369       }
 370     }
 371 ?>
 372   </td>
 373 <?php
 374     echo "<td rowspan='3' valign='bottom'>\n";
 375     echo xl('Statements Sent:');
 376     echo "</td>\n";
 377     echo "<td rowspan='3' valign='bottom'>\n";
 378     echo "<input type='text' name='form_stmt_count' size='10' value='" .
 379       (0 + $ferow['stmt_count']) . "' />\n";
 380     echo "</td>\n";
 381 ?>
 382  </tr>
 383  <tr>
 384   <td>
 385    <?php xl('Provider:','e')?>
 386   </td>
 387   <td>
 388    <?php
 389     $tmp = sqlQuery("SELECT fname, mname, lname " .
 390       "FROM users WHERE id = " . $ferow['provider_id']);
 391     echo text($tmp['fname']) . ' ' . text($tmp['mname']) . ' ' . text($tmp['lname']);
 392     $tmp = sqlQuery("SELECT bill_date FROM billing WHERE " .
 393       "pid = '$patient_id' AND encounter = '$encounter_id' AND " .
 394       "activity = 1 ORDER BY fee DESC, id ASC LIMIT 1");
 395     $billdate = substr(($tmp['bill_date'] . "Not Billed"), 0, 10);
 396 ?>
 397   </td>
 398  </tr>
 399  <tr>
 400   <td>
 401    <?php xl('Invoice:','e')?>
 402   </td>
 403   <td>
 404 <?php
 405     echo "$patient_id.$encounter_id";
 406 ?>
 407   </td>
 408  </tr>
 409
 410  <tr>
 411   <td>
 412 <?php xl('Svc Date:','e'); ?>
 413   </td>
 414   <td>
 415 <?php
 416     echo $svcdate;
 417 ?>
 418   </td>
 419   <td colspan="2">
 420    <?php xl('Done with:','e','',"&nbsp")?>;
 421 <?php
 422   // Write a checkbox for each insurance.  It is to be checked when
 423   // we no longer expect any payments from that company for the claim.
 424     $last_level_closed = 0 + $ferow['last_level_closed'];
 425     foreach (array(0 => 'None', 1 => 'Ins1', 2 => 'Ins2', 3 => 'Ins3') as $key => $value) {
 426       if ($key && !arGetPayerID($patient_id, $svcdate, $key)) continue;
 427       $checked = ($last_level_closed == $key) ? " checked" : "";
 428       echo "   <input type='radio' name='form_done' value='$key'$checked />$value&nbsp;\n";
 429     }
 430 ?>
 431   </td>
 432 <?php
 433     echo "<td>\n";
 434     echo xl('Check/EOB No.:');
 435     echo "</td>\n";
 436     echo "<td>\n";
 437     echo "<input type='text' name='form_reference' size='10' value='' />\n";
 438     echo "</td>\n";
 439 ?>
 440  </tr>
 441
 442  <tr>
 443   <td>
 444    <?php xl('Last Bill Date:','e') ?>
 445   </td>
 446   <td>
 447    <?php
 448     echo $billdate;
 449 ?>
 450   </td>
 451   <td colspan="2">
 452    <?php xl('Now posting for:','e','',"&nbsp")?>;
 453
 454 <?php
 455   // TBD: check the first not-done-with insurance, not always Ins1!
 456 ?>
 457    <input type='radio' name='form_insurance' value='Ins1' onclick='setins("Ins1")' checked /><?php xl('Ins1','e')?>&nbsp;
 458    <input type='radio' name='form_insurance' value='Ins2' onclick='setins("Ins2")' /><?php xl('Ins2','e')?>&nbsp;
 459    <input type='radio' name='form_insurance' value='Ins3' onclick='setins("Ins3")' /><?php xl('Ins3','e')?>&nbsp;
 460    <input type='radio' name='form_insurance' value='Pt'   onclick='setins("Pt")'   /><?php xl('Patient','e')?>
 461
 462 <?php
 463   // TBD: I think the following is unused and can be removed.
 464 ?>
 465    <input type='hidden' name='form_eobs' value='<?php echo addslashes($arrow['shipvia']) ?>' />
 466
 467   </td>
 468 <?php
 469     echo "<td>\n";
 470     echo xl('Check/EOB Date:');
 471     echo "</td>\n";
 472     echo "<td>\n";
 473     echo "<input type='text' name='form_check_date' size='10' value='' />\n";
 474     echo "</td>\n";
 475 ?>
 476  </tr>
 477  <tr>
 478   <td>
 479   </td>
 480   <td>
 481   </td>
 482   <td colspan="2">
 483    <input type="checkbox" name="form_secondary" value="1"> <?php xl('Needs secondary billing','e')?>
 484    &nbsp;&nbsp;
 485    <input type='submit' name='form_save' value='<?php xl('Save','e')?>'>
 486    &nbsp;
 487    <input type='button' value='<?php xl('Cancel','e')?>' onclick='window.close()'>
 488   </td>
 489 <?php
 490     echo "<td>\n";
 491     echo xl('Deposit Date:');
 492     echo "</td>\n";
 493     echo "<td>\n";
 494     echo "<input type='text' name='form_deposit_date' size='10' value='' />\n";
 495     echo "<input type='hidden' name='form_payer_id' value='' />\n";
 496     echo "<input type='hidden' name='form_orig_reference' value='' />\n";
 497     echo "<input type='hidden' name='form_orig_check_date' value='' />\n";
 498     echo "<input type='hidden' name='form_orig_deposit_date' value='' />\n";
 499     echo "<input type='hidden' name='form_pay_total' value='' />\n";
 500     echo "</td>\n";
 501 ?>
 502  </tr>
 503 <?php if (!empty($pdrow['billing_note'])) { ?>
 504  <tr>
 505   <td>
 506    <?php xl('Billing Note:','e')?>
 507   </td>
 508   <td colspan='3' style='color:red'>
 509    <?php echo $pdrow['billing_note'] ?>
 510   </td>
 511  </tr>
 512 <?php } ?>
 513  <tr>
 514   <td height="1">
 515   </td>
 516  </tr>
 517 </table>
 518
 519 <table border='0' cellpadding='2' cellspacing='0' width='98%'>
 520
 521  <tr bgcolor="#cccccc">
 522   <td class="dehead">
 523    <?php xl('Code','e')?>
 524   </td>
 525   <td class="dehead" align="right">
 526    <?php xl('Charge','e')?>
 527   </td>
 528   <td class="dehead" align="right">
 529    <?php xl('Balance','e')?>&nbsp;
 530   </td>
 531   <td class="dehead">
 532    <?php xl('By/Source','e')?>
 533   </td>
 534   <td class="dehead">
 535    <?php xl('Date','e')?>
 536   </td>
 537   <td class="dehead">
 538    <?php xl('Pay','e')?>
 539   </td>
 540   <td class="dehead">
 541    <?php xl('Adjust','e')?>
 542   </td>
 543   <td class="dehead">
 544    <?php xl('Reason','e')?>
 545   </td>
 546 <?php if ($ALLOW_DELETE) { ?>
 547   <td class="dehead">
 548    <?php xl('Del','e')?>
 549   </td>
 550 <?php } ?>
 551  </tr>
 552 <?php
 553   $firstProcCodeIndex = -1;
 554   $encount = 0;
 555   foreach ($codes as $code => $cdata) {
 556    ++$encount;
 557    $bgcolor = "#" . (($encount & 1) ? "ddddff" : "ffdddd");
 558    $dispcode = $code;
 559
 560    // remember the index of the first entry whose code is not "CO-PAY", i.e. it's a legitimate proc code
 561    if ($firstProcCodeIndex == -1 && strcmp($code, "CO-PAY") !=0)
 562     $firstProcCodeIndex = $encount;
 563
 564    // this sorts the details more or less chronologically:
 565    ksort($cdata['dtl']);
 566    foreach ($cdata['dtl'] as $dkey => $ddata) {
 567     $ddate = substr($dkey, 0, 10);
 568     if (preg_match('/^(\d\d\d\d)(\d\d)(\d\d)\s*$/', $ddate, $matches)) {
 569      $ddate = $matches[1] . '-' . $matches[2] . '-' . $matches[3];
 570     }
 571     $tmpchg = "";
 572     $tmpadj = "";
 573     /*****************************************************************
 574     if ($ddata['chg'] > 0)
 575      $tmpchg = $ddata['chg'];
 576     else if ($ddata['chg'] < 0)
 577      $tmpadj = 0 - $ddata['chg'];
 578     *****************************************************************/
 579     if ($ddata['chg'] != 0) {
 580       if (isset($ddata['rsn'])) $tmpadj = 0 - $ddata['chg'];
 581       else $tmpchg = $ddata['chg'];
 582     }
 583 ?>
 584  <tr bgcolor='<?php echo $bgcolor ?>'>
 585   <td class="detail">
 586    <?php echo $dispcode; $dispcode = "" ?>
 587   </td>
 588   <td class="detail" align="right">
 589    <?php bucks($tmpchg) ?>
 590   </td>
 591   <td class="detail" align="right">
 592    &nbsp;
 593   </td>
 594   <td class="detail">
 595    <?php
 596     if (isset($ddata['plv'])) {
 597       if (!$ddata['plv']) echo 'Pt/';
 598       else echo 'Ins' . $ddata['plv'] . '/';
 599     }
 600     echo $ddata['src'];
 601    ?>
 602   </td>
 603   <td class="detail">
 604    <?php echo $ddate ?>
 605   </td>
 606   <td class="detail">
 607    <?php bucks($ddata['pmt']) ?>
 608   </td>
 609   <td class="detail">
 610    <?php bucks($tmpadj) ?>
 611   </td>
 612   <td class="detail">
 613    <?php echo $ddata['rsn'] ?>
 614   </td>
 615 <?php if ($ALLOW_DELETE) { ?>
 616   <td class="detail">
 617 <?php if (!empty($ddata['arseq'])) { ?>
 618    <input type="checkbox" name="form_del[<?php echo $ddata['arseq']; ?>]" />
 619 <?php } else { ?>
 620    &nbsp;
 621 <?php } ?>
 622   </td>
 623 <?php } ?>
 624  </tr>
 625 <?php
 626    } // end of prior detail line
 627 ?>
 628  <tr bgcolor='<?php echo $bgcolor ?>'>
 629   <td class="detail">
 630    <?php echo $dispcode; $dispcode = "" ?>
 631   </td>
 632   <td class="detail" align="right">
 633    &nbsp;
 634   </td>
 635   <td class="detail" align="right">
 636    <input type="hidden" name="form_line[<?php echo $code ?>][bal]" value="<?php bucks($cdata['bal']) ?>">
 637    <input type="hidden" name="form_line[<?php echo $code ?>][ins]" value="<?php echo $cdata['ins'] ?>">
 638    <input type="hidden" name="form_line[<?php echo $code ?>][code_type]" value="<?php echo $cdata['code_type'] ?>">
 639    <?php printf("%.2f", $cdata['bal']) ?>&nbsp;
 640   </td>
 641   <td class="detail">
 642
 643
 644   </td>
 645   <td class="detail">
 646
 647
 648   </td>
 649   <td class="detail">
 650    <input type="text" name="form_line[<?php echo $code ?>][pay]" size="10"
 651     style="background-color:<?php echo $bgcolor ?>"
 652     onKeyUp="updateFields(document.forms[0]['form_line[<?php echo $code ?>][pay]'],
 653                           document.forms[0]['form_line[<?php echo $code ?>][adj]'],
 654                           document.forms[0]['form_line[<?php echo $code ?>][bal]'],
 655                           document.forms[0]['form_line[CO-PAY][bal]'],
 656                           <?php echo ($firstProcCodeIndex == $encount) ? 1 : 0 ?>)"/>
 657   </td>
 658   <td class="detail">
 659    <input type="text" name="form_line[<?php echo $code ?>][adj]" size="10"
 660     value='<?php echo $totalAdjAmount ?>'
 661     style="background-color:<?php echo $bgcolor ?>" />
 662    &nbsp; <a href="" onclick="return writeoff('<?php echo $code ?>')">W</a>
 663   </td>
 664   <td class="detail">
 665    <select name="form_line[<?php echo $code ?>][reason]"
 666     style="background-color:<?php echo $bgcolor ?>">
 667 <?php
 668 // Adjustment reasons are now taken from the list_options table.
 669 echo "    <option value=''></option>\n";
 670 $ores = sqlStatement("SELECT option_id, title, is_default FROM list_options " .
 671   "WHERE list_id = 'adjreason'  ORDER BY seq, title");
 672 while ($orow = sqlFetchArray($ores)) {
 673   echo "    <option value='" . htmlspecialchars($orow['option_id'], ENT_QUOTES) . "'";
 674   if ($orow['is_default']) echo " selected";
 675   echo ">" . htmlspecialchars($orow['title']) . "</option>\n";
 676 }
 677 ?>
 678
 679    </select>
 680 <?php
 681     // TBD: Maybe a comment field would be good here, for appending
 682     // to the reason.
 683 ?>
 684   </td>
 685
 686 <?php if ($ALLOW_DELETE) { ?>
 687   <td class="detail">
 688    &nbsp;
 689   </td>
 690 <?php } ?>
 691
 692  </tr>
 693 <?php
 694   } // end of code
 695 ?>
 696
 697 </table>
 698 </form>
 699 </center>
 700 <script language="JavaScript">
 701  var f1 = opener.document.forms[0];
 702  var f2 = document.forms[0];
 703  if (f1.form_source) {
 704 <?php
 705     // These support creation and lookup of ar_session table entries:
 706     echo "  f2.form_reference.value         = f1.form_source.value;\n";
 707     echo "  f2.form_check_date.value        = f1.form_paydate.value;\n";
 708     echo "  //f2.form_deposit_date.value      = f1.form_deposit_date.value;\n";
 709     echo "  if (f1.form_deposit_date.value != '')\n";
 710     echo "     f2.form_deposit_date.value      = f1.form_deposit_date.value;\n";
 711     echo "  else\n";
 712     echo "     f2.form_deposit_date.value      = getFormattedToday();\n";
 713     echo "  f2.form_payer_id.value          = f1.form_payer_id.value;\n";
 714     echo "  f2.form_pay_total.value         = f1.form_amount.value;\n";
 715     echo "  f2.form_orig_reference.value    = f1.form_source.value;\n";
 716     echo "  f2.form_orig_check_date.value   = f1.form_paydate.value;\n";
 717     echo "  f2.form_orig_deposit_date.value = f1.form_deposit_date.value;\n";
 718
 719     // While I'm thinking about it, some notes about eob sessions.
 720     // If they do not have all of the session key fields in the search
 721     // page, then show a warning at the top of the invoice page.
 722     // Also when they go to save the invoice page and a session key
 723     // field has changed, alert them to that and allow a cancel.
 724
 725     // Another point... when posting EOBs, the incoming payer ID might
 726     // not match the payer ID for the patient's insurance.  This is
 727     // because the same payer might be entered more than once into the
 728     // insurance_companies table.  I don't think it matters much.
 729 ?>
 730  }
 731  setins("Ins1");
 732 </script>
 733 </body>
 734 </html>