library/invoice_summary.inc.php

   1 <?php
   2 // Copyright (C) 2005-2010 Rod Roark <rod@sunsetsystems.com>
   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 // This returns an associative array keyed on procedure code, representing
  10 // all charge items for one invoice.  This array's values are themselves
  11 // associative arrays having the following keys:
  12 //
  13 //  chg - the sum of line items, including adjustments, for the code
  14 //  bal - the unpaid balance
  15 //  adj - the (positive) sum of inverted adjustments
  16 //  ins - the id of the insurance company that was billed (obsolete)
  17 //  dtl - associative array of details, if requested
  18 //
  19 // Where details are requested, each dtl array is keyed on a string
  20 // beginning with a date in yyyy-mm-dd format, or blanks in the case
  21 // of the original charge items.  The value array is:
  22 //
  23 //  pmt - payment amount as a positive number, only for payments
  24 //  src - check number or other source, only for payments
  25 //  chg - invoice line item amount amount, only for charges or
  26 //        adjustments (adjustments may be zero)
  27 //  rsn - adjustment reason, only for adjustments
  28 //  plv - provided for "integrated A/R" only: 0=pt, 1=Ins1, etc.
  29 //  dsc - for tax charges, a description of the tax
  30 //  arseq - ar_activity.sequence_no when it applies.
  31
  32 require_once("sl_eob.inc.php");
  33 require_once(dirname(__FILE__) . "/../custom/code_types.inc.php");
  34
  35
  36 // for Integrated A/R.
  37 //
  38 function ar_get_invoice_summary($patient_id, $encounter_id, $with_detail = false) {
  39   $codes = array();
  40   $keysuff1 = 1000;
  41   $keysuff2 = 5000;
  42
  43   // Get charges from services.
  44   $res = sqlStatement("SELECT " .
  45     "date, code_type, code, modifier, code_text, fee " .
  46     "FROM billing WHERE " .
  47     "pid = ? AND encounter = ? AND " .
  48     "activity = 1 AND fee != 0.00 ORDER BY id", array($patient_id,$encounter_id) );
  49
  50   while ($row = sqlFetchArray($res)) {
  51     $amount = sprintf('%01.2f', $row['fee']);
  52
  53       $code = $row['code'];
  54       if (! $code) $code = "Unknown";
  55       if ($row['modifier']) $code .= ':' . $row['modifier'];
  56       $codes[$code]['chg'] += $amount;
  57       $codes[$code]['bal'] += $amount;
  58
  59     // Pass the code type, code and code_text fields
  60     // Although not all used yet, useful information
  61     // to improve the statement reporting etc.
  62     $codes[$code]['code_type'] = $row['code_type'];
  63     $codes[$code]['code_value'] = $row['code'];
  64     $codes[$code]['modifier'] = $row['modifier'];
  65     $codes[$code]['code_text'] = $row['code_text'];
  66
  67     // Add the details if they want 'em.
  68     if ($with_detail) {
  69       if (! $codes[$code]['dtl']) $codes[$code]['dtl'] = array();
  70       $tmp = array();
  71       $tmp['chg'] = $amount;
  72       $tmpkey = "          " . $keysuff1++;
  73       $codes[$code]['dtl'][$tmpkey] = $tmp;
  74     }
  75   }
  76
  77   // Get charges from product sales.
  78   $query = "SELECT s.drug_id, s.sale_date, s.fee, s.quantity " .
  79     "FROM drug_sales AS s " .
  80     "WHERE " .
  81     "s.pid = ? AND s.encounter = ? AND s.fee != 0 " .
  82     "ORDER BY s.sale_id";
  83   $res = sqlStatement($query, array($patient_id,$encounter_id) );
  84   while ($row = sqlFetchArray($res)) {
  85     $amount = sprintf('%01.2f', $row['fee']);
  86     $code = 'PROD:' . $row['drug_id'];
  87     $codes[$code]['chg'] += $amount;
  88     $codes[$code]['bal'] += $amount;
  89     // Add the details if they want 'em.
  90     if ($with_detail) {
  91       if (! $codes[$code]['dtl']) $codes[$code]['dtl'] = array();
  92       $tmp = array();
  93       $tmp['chg'] = $amount;
  94       $tmpkey = "          " . $keysuff1++;
  95       $codes[$code]['dtl'][$tmpkey] = $tmp;
  96     }
  97   }
  98
  99   // Get payments and adjustments. (includes copays)
 100   $res = sqlStatement("SELECT " .
 101     "a.code_type, a.code, a.modifier, a.memo, a.payer_type, a.adj_amount, a.pay_amount, a.reason_code, " .
 102     "a.post_time, a.session_id, a.sequence_no, a.account_code, " .
 103     "s.payer_id, s.reference, s.check_date, s.deposit_date " .
 104     ",i.name " .
 105     "FROM ar_activity AS a " .
 106     "LEFT OUTER JOIN ar_session AS s ON s.session_id = a.session_id " .
 107     "LEFT OUTER JOIN insurance_companies AS i ON i.id = s.payer_id " .
 108     "WHERE a.pid = ? AND a.encounter = ? " .
 109     "ORDER BY s.check_date, a.sequence_no", array($patient_id,$encounter_id) );
 110   while ($row = sqlFetchArray($res)) {
 111     $code = $row['code'];
 112     if (! $code) $code = "Unknown";
 113     if ($row['modifier']) $code .= ':' . $row['modifier'];
 114     $ins_id = 0 + $row['payer_id'];
 115     $codes[$code]['bal'] -= $row['pay_amount'];
 116     $codes[$code]['bal'] -= $row['adj_amount'];
 117     $codes[$code]['chg'] -= $row['adj_amount'];
 118     $codes[$code]['adj'] += $row['adj_amount'];
 119     if ($ins_id) $codes[$code]['ins'] = $ins_id;
 120     // Add the details if they want 'em.
 121     if ($with_detail) {
 122       if (! $codes[$code]['dtl']) $codes[$code]['dtl'] = array();
 123       $tmp = array();
 124       $paydate = empty($row['deposit_date']) ? substr($row['post_time'], 0, 10) : $row['deposit_date'];
 125       if ($row['pay_amount'] != 0) $tmp['pmt'] = $row['pay_amount'];
 126       if ( isset($row['reason_code'] ) ) {
 127         $tmp['msp'] = $row['reason_code'];
 128       }
 129       if ($row['adj_amount'] != 0 || $row['pay_amount'] == 0) {
 130         $tmp['chg'] = 0 - $row['adj_amount'];
 131         // $tmp['rsn'] = (empty($row['memo']) || empty($row['session_id'])) ? 'Unknown adjustment' : $row['memo'];
 132         $tmp['rsn'] = empty($row['memo']) ? 'Unknown adjustment' : $row['memo'];
 133         $tmpkey = $paydate . $keysuff1++;
 134       }
 135       else {
 136         $tmpkey = $paydate . $keysuff2++;
 137       }
 138       if ($row['account_code'] == "PCP") {
 139         //copay
 140         $tmp['src'] = 'Pt Paid';
 141       }
 142       else {
 143         $tmp['src'] = empty($row['session_id']) ? $row['memo'] : $row['reference'];
 144       }
 145       $tmp['insurance_company'] = substr($row['name'], 0, 10);
 146       if ($ins_id) $tmp['ins'] = $ins_id;
 147       $tmp['plv'] = $row['payer_type'];
 148       $tmp['arseq'] = $row['sequence_no'];
 149       $codes[$code]['dtl'][$tmpkey] = $tmp;
 150     }
 151   }
 152   return $codes;
 153 }
 154
 155 // This determines the party from whom payment is currently expected.
 156 // Returns: -1=Nobody, 0=Patient, 1=Ins1, 2=Ins2, 3=Ins3.
 157 // for Integrated A/R.
 158 //
 159 function ar_responsible_party($patient_id, $encounter_id) {
 160   $row = sqlQuery("SELECT date, last_level_billed, last_level_closed " .
 161     "FROM form_encounter WHERE " .
 162     "pid = ? AND encounter = ? " .
 163     "ORDER BY id DESC LIMIT 1", array($patient_id,$encounter_id) );
 164   if (empty($row)) return -1;
 165   $next_level = $row['last_level_closed'] + 1;
 166   if ($next_level <= $row['last_level_billed'])
 167     return $next_level;
 168   if (arGetPayerID($patient_id, substr($row['date'], 0, 10), $next_level))
 169     return $next_level;
 170   // There is no unclosed insurance, so see if there is an unpaid balance.
 171   // Currently hoping that form_encounter.balance_due can be discarded.
 172   $balance = 0;
 173   $codes = ar_get_invoice_summary($patient_id, $encounter_id);
 174   foreach ($codes as $cdata) $balance += $cdata['bal'];
 175   if ($balance > 0) return 0;
 176   return -1;
 177 }
 178 ?>