portal/portal_payment.php

   1 <?php
   2 /**
   3  *
   4  * namespace OnsitePortal
   5  *
   6  * Copyright (C) 2006-2015 Rod Roark <rod@sunsetsystems.com>
   7  * Copyright (C) 2016-2017 Jerry Padgett <sjpadgett@gmail.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 3
  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 Jerry Padgett <sjpadgett@gmail.com>
  23  * @link http://www.open-emr.org
  24  *
  25  */
  26 session_start();
  27
  28 if (isset($_SESSION['pid']) && isset($_SESSION['patient_portal_onsite_two'])) {
  29     $pid = $_SESSION['pid'];
  30     $ignoreAuth = true;
  31     require_once(dirname(__FILE__) . "/../interface/globals.php");
  32 } else {
  33     session_destroy();
  34     $ignoreAuth = false;
  35     require_once(dirname(__FILE__) . "/../interface/globals.php");
  36     if (!isset($_SESSION['authUserID'])) {
  37         $landingpage = "index.php";
  38         header('Location: ' . $landingpage);
  39         exit();
  40     }
  41 }
  42
  43 require_once(dirname(__FILE__) . "/lib/appsql.class.php");
  44 require_once("$srcdir/acl.inc");
  45 require_once("$srcdir/patient.inc");
  46 require_once("$srcdir/billing.inc");
  47 require_once("$srcdir/payment.inc.php");
  48 require_once("$srcdir/forms.inc");
  49 require_once("$srcdir/sl_eob.inc.php");
  50 require_once("$srcdir/invoice_summary.inc.php");
  51 require_once("../custom/code_types.inc.php");
  52 require_once("$srcdir/formatting.inc.php");
  53 require_once("$srcdir/options.inc.php");
  54 require_once("$srcdir/encounter_events.inc.php");
  55 require_once("$srcdir/log.inc");
  56 require_once("$srcdir/crypto.php");
  57
  58 $appsql = new ApplicationTable();
  59 $pid = isset($_REQUEST['pid']) ? $_REQUEST['pid'] : $pid;
  60 $pid = $_REQUEST['hidden_patient_code'] > 0 ? $_REQUEST['hidden_patient_code'] : $pid;
  61 $adminUser = '';
  62 $portalPatient = '';
  63
  64 $query = "SELECT pao.portal_username as recip_id, Concat_Ws(' ', patient_data.fname, patient_data.lname) as username FROM patient_data " .
  65     "LEFT JOIN patient_access_onsite pao ON pao.pid = patient_data.pid " .
  66     "WHERE patient_data.pid = ? AND pao.portal_pwd_status = 1";
  67 $portalPatient = sqlQueryNoLog($query, $pid);
  68 if ($_SESSION['authUserID']) {
  69     $query = "SELECT users.username as recip_id, users.authorized as dash, CONCAT(users.fname,' ',users.lname) as username  " .
  70         "FROM users WHERE id = ?";
  71     $adminUser = sqlQueryNoLog($query, $_SESSION['authUserID']);
  72 }
  73 $edata = $appsql->getPortalAudit($pid, 'review', 'payment');
  74 $ccdata = array();
  75 $invdata = array();
  76
  77 if ($edata) {
  78     $ccdata = json_decode(aes256Decrypt($edata['checksum']), true);
  79     $invdata = json_decode($edata['table_args'], true);
  80     echo "<script  type='text/javascript'>var jsondata='" . $edata['table_args'] . "';var ccdata='" . $edata['checksum'] . "'</script>";
  81 }
  82
  83 function bucks($amount)
  84 {
  85     if ($amount) {
  86         $amount = oeFormatMoney($amount);
  87         return $amount;
  88     }
  89
  90     return '';
  91 }
  92
  93 function rawbucks($amount)
  94 {
  95     if ($amount) {
  96         $amount = sprintf("%.2f", $amount);
  97         return $amount;
  98     }
  99
 100     return '';
 101 }
 102
 103 // Display a row of data for an encounter.
 104 //
 105 $var_index = 0;
 106 function echoLine($iname, $date, $charges, $ptpaid, $inspaid, $duept, $encounter = 0, $copay = 0, $patcopay = 0)
 107 {
 108     global $var_index;
 109     $var_index++;
 110     $balance = bucks($charges - $ptpaid - $inspaid);
 111     $balance = (round($duept, 2) != 0) ? 0 : $balance; // if balance is due from patient, then insurance balance is displayed as zero
 112     $encounter = $encounter ? $encounter : '';
 113     echo " <tr id='tr_" . attr($var_index) . "' >\n";
 114     echo "  <td class='detail'>" . text(oeFormatShortDate($date)) . "</td>\n";
 115     echo "  <td class='detail' id='" . attr($date) . "' align='left'>" . htmlspecialchars($encounter, ENT_QUOTES) . "</td>\n";
 116     echo "  <td class='detail' align='center' id='td_charges_$var_index' >" . htmlspecialchars(bucks($charges), ENT_QUOTES) . "</td>\n";
 117     echo "  <td class='detail' align='center' id='td_inspaid_$var_index' >" . htmlspecialchars(bucks($inspaid * -1), ENT_QUOTES) . "</td>\n";
 118     echo "  <td class='detail' align='center' id='td_ptpaid_$var_index' >" . htmlspecialchars(bucks($ptpaid * -1), ENT_QUOTES) . "</td>\n";
 119     echo "  <td class='detail' align='center' id='td_patient_copay_$var_index' >" . htmlspecialchars(bucks($patcopay), ENT_QUOTES) . "</td>\n";
 120     echo "  <td class='detail' align='center' id='td_copay_$var_index' >" . htmlspecialchars(bucks($copay), ENT_QUOTES) . "</td>\n";
 121     echo "  <td class='detail' align='center' id='balance_$var_index'>" . htmlspecialchars(bucks($balance), ENT_QUOTES) . "</td>\n";
 122     echo "  <td class='detail' align='center' id='duept_$var_index'>" . htmlspecialchars(bucks(round($duept, 2) * 1), ENT_QUOTES) . "</td>\n";
 123     echo "  <td class='detail' align='right'><input class='form-control' style='width:60px;padding:2px 2px;' type='text' name='" . attr($iname) . "'  id='paying_" . attr($var_index) . "' " . " value='" . '' . "' onchange='coloring();calctotal()'  autocomplete='off' " . "onkeyup='calctotal()'/></td>\n";
 124     echo " </tr>\n";
 125 }
 126
 127 // We use this to put dashes, colons, etc. back into a timestamp.
 128 //
 129 function decorateString($fmt, $str)
 130 {
 131     $res = '';
 132     while ($fmt) {
 133         $fc = substr($fmt, 0, 1);
 134         $fmt = substr($fmt, 1);
 135         if ($fc == '.') {
 136             $res .= substr($str, 0, 1);
 137             $str = substr($str, 1);
 138         } else {
 139             $res .= $fc;
 140         }
 141     }
 142
 143     return $res;
 144 }
 145
 146 // Compute taxes from a tax rate string and a possibly taxable amount.
 147 //
 148 function calcTaxes($row, $amount)
 149 {
 150     $total = 0;
 151     if (empty($row['taxrates'])) {
 152         return $total;
 153     }
 154
 155     $arates = explode(':', $row['taxrates']);
 156     if (empty($arates)) {
 157         return $total;
 158     }
 159
 160     foreach ($arates as $value) {
 161         if (empty($value)) {
 162             continue;
 163         }
 164
 165         $trow = sqlQuery("SELECT option_value FROM list_options WHERE " . "list_id = 'taxrate' AND option_id = ? LIMIT 1", array($value
 166         ));
 167         if (empty($trow['option_value'])) {
 168             echo "<!-- Missing tax rate '" . text($value) . "'! -->\n";
 169             continue;
 170         }
 171
 172         $tax = sprintf("%01.2f", $amount * $trow['option_value']);
 173 // echo "<!-- Rate = '$value', amount = '$amount', tax = '$tax' -->\n";
 174         $total += $tax;
 175     }
 176
 177     return $total;
 178 }
 179
 180 $now = time();
 181 $today = date('Y-m-d', $now);
 182 $timestamp = date('Y-m-d H:i:s', $now);
 183
 184
 185 // $patdata = getPatientData($pid, 'fname,lname,pubpid');
 186
 187 $patdata = sqlQuery("SELECT " . "p.fname, p.mname, p.lname, p.pubpid,p.pid, i.copay " . "FROM patient_data AS p " . "LEFT OUTER JOIN insurance_data AS i ON " . "i.pid = p.pid AND i.type = 'primary' " . "WHERE p.pid = ? ORDER BY i.date DESC LIMIT 1", array($pid
 188 ));
 189
 190 $alertmsg = ''; // anything here pops up in an alert box
 191
 192 // If the Save button was clicked...
 193 if ($_POST['form_save']) {
 194 // $extra = json_decode($_POST['ajax_mode'], true);
 195     $form_pid = $_POST['form_pid'];
 196     $form_method = trim($_POST['form_method']);
 197     $form_source = trim($_POST['form_source']);
 198     $patdata = getPatientData($form_pid, 'fname,mname,lname,pubpid');
 199     $NameNew = $patdata['fname'] . " " . $patdata['lname'] . " " . $patdata['mname'];
 200
 201     if ($_REQUEST['radio_type_of_payment'] == 'pre_payment') {
 202         $payment_id = idSqlStatement("insert into ar_session set " . "payer_id = ?" . ", patient_id = ?" . ", user_id = ?" . ", closed = ?" . ", reference = ?" . ", check_date =  now() , deposit_date = now() " . ",  pay_total = ?" . ", payment_type = 'patient'" . ", description = ?" . ", adjustment_code = 'pre_payment'" . ", post_to_date = now() " . ", payment_method = ?", array(
 203             0, $form_pid, $_SESSION['authUserID'], 0, $form_source, $_REQUEST['form_prepayment'], $NameNew, $form_method
 204         ));
 205
 206         frontPayment($form_pid, 0, $form_method, $form_source, $_REQUEST['form_prepayment'], 0, $timestamp); // insertion to 'payments' table.
 207     }
 208
 209     if ($_POST['form_upay'] && $_REQUEST['radio_type_of_payment'] != 'pre_payment') {
 210         foreach ($_POST['form_upay'] as $enc => $payment) {
 211             if ($amount = 0 + $payment) {
 212                 $zero_enc = $enc;
 213                 if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance') {
 214                     ;
 215                 } else {
 216                     if (!$enc) {
 217                         $enc = calendar_arrived($form_pid);
 218                     }
 219                 }
 220
 221 // ----------------------------------------------------------------------------------------------------
 222 // Fetching the existing code and modifier
 223                 $ResultSearchNew = sqlStatement("SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key " . "WHERE code_types.ct_fee=1 AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier", array($form_pid, $enc
 224                 ));
 225                 if ($RowSearch = sqlFetchArray($ResultSearchNew)) {
 226                     $Codetype = $RowSearch['code_type'];
 227                     $Code = $RowSearch['code'];
 228                     $Modifier = $RowSearch['modifier'];
 229                 } else {
 230                     $Codetype = '';
 231                     $Code = '';
 232                     $Modifier = '';
 233                 }
 234
 235 // ----------------------------------------------------------------------------------------------------
 236                 if ($_REQUEST['radio_type_of_payment'] == 'copay') { // copay saving to ar_session and ar_activity tables
 237                     $session_id = idSqlStatement("INSERT INTO ar_session (payer_id,user_id,reference,check_date,deposit_date,pay_total," . " global_amount,payment_type,description,patient_id,payment_method,adjustment_code,post_to_date) " . " VALUES ('0',?,?,now(),now(),?,'','patient','COPAY',?,?,'patient_payment',now())", array(
 238                         $_SESSION['authId'], $form_source, $amount, $form_pid, $form_method
 239                     ));
 240
 241                     $insrt_id = idSqlStatement("INSERT INTO ar_activity (pid,encounter,code_type,code,modifier,payer_type,post_time,post_user,session_id,pay_amount,account_code)" . " VALUES (?,?,?,?,?,0,now(),?,?,?,'PCP')", array($form_pid, $enc, $Codetype, $Code, $Modifier, '3', $session_id, $amount
 242                     ));
 243
 244                     frontPayment($form_pid, $enc, $form_method, $form_source, $amount, 0, $timestamp); // insertion to 'payments' table.
 245                 }
 246
 247                 if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance' || $_REQUEST['radio_type_of_payment'] == 'cash') { // Payment by patient after insurance paid, cash patients similar to do not bill insurance in feesheet.
 248                     if ($_REQUEST['radio_type_of_payment'] == 'cash') {
 249                         sqlStatement("update form_encounter set last_level_closed=? where encounter=? and pid=? ", array(4, $enc, $form_pid
 250                         ));
 251                         sqlStatement("update billing set billed=? where encounter=? and pid=?", array(1, $enc, $form_pid
 252                         ));
 253                     }
 254
 255                     $adjustment_code = 'patient_payment';
 256                     $payment_id = idSqlStatement("insert into ar_session set " . "payer_id = ?" . ", patient_id = ?" . ", user_id = ?" . ", closed = ?" . ", reference = ?" . ", check_date =  now() , deposit_date = now() " . ",  pay_total = ?" . ", payment_type = 'patient'" . ", description = ?" . ", adjustment_code = ?" . ", post_to_date = now() " . ", payment_method = ?", array(
 257                         0, $form_pid, $_SESSION['authUserID'], 0, $form_source, $amount, $NameNew, $adjustment_code, $form_method
 258                     ));
 259
 260 // --------------------------------------------------------------------------------------------------------------------
 261
 262                     frontPayment($form_pid, $enc, $form_method, $form_source, 0, $amount, $timestamp); // insertion to 'payments' table.
 263
 264 // --------------------------------------------------------------------------------------------------------------------
 265
 266                     $resMoneyGot = sqlStatement("SELECT sum(pay_amount) as PatientPay FROM ar_activity where pid =? and " . "encounter =? and payer_type=0 and account_code='PCP'", array($form_pid, $enc
 267                     )); // new fees screen copay gives account_code='PCP'
 268                     $rowMoneyGot = sqlFetchArray($resMoneyGot);
 269                     $Copay = $rowMoneyGot['PatientPay'];
 270
 271 // --------------------------------------------------------------------------------------------------------------------
 272
 273 // Looping the existing code and modifier
 274                     $ResultSearchNew = sqlStatement("SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key WHERE code_types.ct_fee=1 " . "AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier", array($form_pid, $enc
 275                     ));
 276                     while ($RowSearch = sqlFetchArray($ResultSearchNew)) {
 277                         $Codetype = $RowSearch['code_type'];
 278                         $Code = $RowSearch['code'];
 279                         $Modifier = $RowSearch['modifier'];
 280                         $Fee = $RowSearch['fee'];
 281
 282                         $resMoneyGot = sqlStatement("SELECT sum(pay_amount) as MoneyGot FROM ar_activity where pid =? " . "and code_type=? and code=? and modifier=? and encounter =? and !(payer_type=0 and account_code='PCP')", array($form_pid, $Codetype, $Code, $Modifier, $enc
 283                         ));
 284 // new fees screen copay gives account_code='PCP'
 285                         $rowMoneyGot = sqlFetchArray($resMoneyGot);
 286                         $MoneyGot = $rowMoneyGot['MoneyGot'];
 287
 288                         $resMoneyAdjusted = sqlStatement("SELECT sum(adj_amount) as MoneyAdjusted FROM ar_activity where " . "pid =? and code_type=? and code=? and modifier=? and encounter =?", array($form_pid, $Codetype, $Code, $Modifier, $enc
 289                         ));
 290                         $rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
 291                         $MoneyAdjusted = $rowMoneyAdjusted['MoneyAdjusted'];
 292
 293                         $Remainder = $Fee - $Copay - $MoneyGot - $MoneyAdjusted;
 294                         $Copay = 0;
 295                         if (round($Remainder, 2) != 0 && $amount != 0) {
 296                             if ($amount - $Remainder >= 0) {
 297                                 $insert_value = $Remainder;
 298                                 $amount = $amount - $Remainder;
 299                             } else {
 300                                 $insert_value = $amount;
 301                                 $amount = 0;
 302                             }
 303
 304                             sqlStatement("insert into ar_activity set " . "pid = ?" . ", encounter = ?" . ", code_type = ?" . ", code = ?" . ", modifier = ?" . ", payer_type = ?" . ", post_time = now() " . ", post_user = ?" . ", session_id = ?" . ", pay_amount = ?" . ", adj_amount = ?" . ", account_code = 'PP'", array(
 305                                 $form_pid, $enc, $Codetype, $Code, $Modifier, 0, 3, $payment_id, $insert_value, 0
 306                             ));
 307                         } // if
 308                     } // while
 309                     if ($amount != 0) { // if any excess is there.
 310                         sqlStatement("insert into ar_activity set " . "pid = ?" . ", encounter = ?" . ", code_type = ?" . ", code = ?" . ", modifier = ?" . ", payer_type = ?" . ", post_time = now() " . ", post_user = ?" . ", session_id = ?" . ", pay_amount = ?" . ", adj_amount = ?" . ", account_code = 'PP'", array(
 311                             $form_pid, $enc, $Codetype, $Code, $Modifier, 0, 3, $payment_id, $amount, 0
 312                         ));
 313                     }
 314
 315 // --------------------------------------------------------------------------------------------------------------------
 316                 } // invoice_balance
 317             } // if ($amount = 0 + $payment)
 318         } // foreach
 319     } // if ($_POST['form_upay'])
 320 } // if ($_POST['form_save'])
 321
 322 if ($_POST['form_save'] || $_REQUEST['receipt']) {
 323     if ($_REQUEST['receipt']) {
 324         $form_pid = $_GET['patient'];
 325         $timestamp = decorateString('....-..-.. ..:..:..', $_GET['time']);
 326     }
 327
 328 // Get details for what we guess is the primary facility.
 329     $frow = sqlQuery("SELECT * FROM facility " . "ORDER BY billing_location DESC, accepts_assignment DESC, id LIMIT 1");
 330
 331 // Get the patient's name and chart number.
 332     $patdata = getPatientData($form_pid, 'fname,mname,lname,pubpid');
 333
 334 // Re-fetch payment info.
 335     $payrow = sqlQuery("SELECT " . "SUM(amount1) AS amount1, " . "SUM(amount2) AS amount2, " . "MAX(method) AS method, " . "MAX(source) AS source, " . "MAX(dtime) AS dtime, " .
 336 // "MAX(user) AS user " .
 337         "MAX(user) AS user, " . "MAX(encounter) as encounter " . "FROM payments WHERE " . "pid = ? AND dtime = ?", array($form_pid, $timestamp
 338     ));
 339
 340 // Create key for deleting, just in case.
 341     $ref_id = ($_REQUEST['radio_type_of_payment'] == 'copay') ? $session_id : $payment_id;
 342     $payment_key = $form_pid . '.' . preg_replace('/[^0-9]/', '', $timestamp) . '.' . $ref_id;
 343
 344 // get facility from encounter
 345     $tmprow = sqlQuery("
 346 SELECT facility_id
 347 FROM form_encounter
 348 WHERE encounter = ?", array($payrow['encounter']
 349     ));
 350     $frow = sqlQuery("SELECT * FROM facility " . " WHERE id = ?", array($tmprow['facility_id']
 351     ));
 352
 353 // Now proceed with printing the receipt.
 354     ?>
 355
 356     <title><?php echo xlt('Receipt for Payment'); ?></title>
 357
 358     <script type="text/javascript"
 359             src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-1-11-3/dist/jquery.js"></script>
 360     <script type="text/javascript">
 361         $(document).ready();
 362
 363         function goHome() {
 364             window.location.replace("./patient/onsiteactivityviews");
 365         }
 366
 367         function notifyPatient() {
 368             let pid = <?php echo attr($pid);?>;
 369             let note = $('#pop_receipt').html();
 370             let formURL = './messaging/handle_note.php';
 371             let owner = '<?php echo attr($adminUser['recip_id']); ?>';
 372             let sn = '<?php echo attr($adminUser['username']); ?>';
 373             let rid = '<?php echo attr($portalPatient['recip_id']); ?>';
 374             let rn = '<?php echo attr($portalPatient['username']); ?>';
 375             $.ajax({
 376                 url: formURL,
 377                 type: "POST",
 378                 data: {
 379                     'task': 'add',
 380                     'owner': owner,
 381                     'pid': pid,
 382                     'inputBody': note,
 383                     'title': 'Bill/Collect',
 384                     'recipient_name': rn,
 385                     'recipient_id': rid,
 386                     'sender_id': owner,
 387                     'sender_name': sn
 388                 },
 389                 success: function (data, textStatus, jqXHR) {
 390                     alert('Receipt sent to patient via Messages.')
 391                 },
 392                 error: function (jqXHR, status, error) {
 393                     console.log(status + ": " + error);
 394                 }
 395             });
 396         }
 397     </script>
 398     <?php
 399     ob_start();
 400     echo '<htlm><head></head><body style="text-align: center; margin: auto;">';
 401     ?>
 402
 403     <div id='pop_receipt' style='display: block'>
 404         <p>
 405         <h2><?php echo xlt('Receipt for Payment'); ?></h2>
 406         <p><?php echo text($frow['name']) ?>
 407             <br><?php echo text($frow['street']) ?>
 408             <br><?php echo text($frow['city'] . ', ' . $frow['state']) . ' ' . text($frow['postal_code']) ?>
 409             <br><?php echo htmlentities($frow['phone']) ?>
 410         <p>
 411         <div style="text-align: center; margin: auto;">
 412             <table border='0' cellspacing='8'
 413                    style="text-align: center; margin: auto;">
 414                 <tr>
 415                     <td><?php echo xlt('Date'); ?>:</td>
 416                     <td><?php echo text(oeFormatSDFT(strtotime($payrow['dtime']))) ?></td>
 417                 </tr>
 418                 <tr>
 419                     <td><?php echo xlt('Patient'); ?>:</td>
 420                     <td><?php echo text($patdata['fname']) . " " . text($patdata['mname']) . " " . text($patdata['lname']) . " (" . text($patdata['pubpid']) . ")" ?></td>
 421                 </tr>
 422                 <tr>
 423                     <td><?php echo xlt('Paid Via'); ?>:</td>
 424                     <td><?php echo generate_display_field(array('data_type' => '1', 'list_id' => 'payment_method'), $payrow['method']); ?></td>
 425                 </tr>
 426                 <tr>
 427                     <td><?php echo xlt('Authorized Id'); ?>:</td>
 428                     <td><?php echo text($payrow['source']) ?></td>
 429                 </tr>
 430                 <tr>
 431                     <td><?php echo xlt('Amount for This Visit'); ?>:</td>
 432                     <td><?php echo text(oeFormatMoney($payrow['amount1'])) ?></td>
 433                 </tr>
 434                 <tr>
 435                     <td><?php echo xlt('Amount for Past Balance'); ?>:</td>
 436                     <td><?php echo text(oeFormatMoney($payrow['amount2'])) ?></td>
 437                 </tr>
 438                 <tr>
 439                     <td><?php echo xlt('Received By'); ?>:</td>
 440                     <td><?php echo text($payrow['user']) ?></td>
 441                 </tr>
 442             </table>
 443         </div>
 444     </div>
 445     <button class='btn btn-sm' type='button' onclick='goHome()'
 446             id='returnhome'><?php echo xla('Return Home'); ?></button>
 447     <button class='btn btn-sm' type='button' onclick="notifyPatient()"><?php echo xla('Notify Patient'); ?></button>
 448     </body></html>
 449     <?php
 450     ob_end_flush();
 451 } else {
 452 //
 453 // Here we display the form for data entry.
 454 //
 455     ?>
 456     <title><?php echo xlt('Record Payment'); ?></title>
 457     <style type="text/css">
 458         body {
 459             /* font-family:sans-serif; font-size:10pt; font-weight:normal */
 460         }
 461
 462         .dehead {
 463             color: #000000; /*font-family:sans-serif; font-size:10pt;*/
 464             font-weight: bold
 465         }
 466
 467         .detail {
 468             padding: 1px 1px;
 469             /* width: 65px; */
 470             color: #000000; /*font-family:sans-serif; font-size:10pt; */
 471             font-weight: normal
 472         }
 473     </style>
 474     <script type="text/javascript"
 475             src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-creditcardvalidator/jquery.creditCardValidator.js"></script>
 476     <script type="text/javascript"
 477             src="<?php echo $GLOBALS['webroot'] ?>/library/textformat.js?v=<?php echo $v_js_includes; ?>"></script>
 478
 479     <script type="text/javascript">
 480         var mypcc = '1';
 481
 482         function calctotal() {
 483             var flag = 0;
 484             var f = document.forms["payfrm"];
 485             var total = 0;
 486             for (var i = 0; i < f.elements.length; ++i) {
 487                 var elem = f.elements[i];
 488                 var ename = elem.name;
 489                 if (ename.indexOf('form_upay[') == 0 || ename.indexOf('form_bpay[') == 0) {
 490                     if (elem.value.length > 0) {
 491                         total += Number(elem.value);
 492                         if (total < 0) flag = 1;
 493                     }
 494                 }
 495             }
 496             f.form_paytotal.value = Number(total).toFixed(2);
 497             if (flag) {
 498                 $('#payfrm')[0].reset();
 499                 alert("<?php echo addslashes(xl('Negative payments not accepted')) ?>")
 500             }
 501             return true;
 502         }
 503
 504         function coloring() {
 505             for (var i = 1; ; ++i) {
 506                 if (document.getElementById('paying_' + i)) {
 507                     paying = document.getElementById('paying_' + i).value * 1;
 508                     patient_balance = document.getElementById('duept_' + i).innerHTML * 1;
 509 //balance=document.getElementById('balance_'+i).innerHTML*1;
 510                     if (patient_balance > 0 && paying > 0) {
 511                         if (paying > patient_balance) {
 512                             document.getElementById('paying_' + i).style.background = '#FF0000';
 513                         }
 514                         else if (paying < patient_balance) {
 515                             document.getElementById('paying_' + i).style.background = '#99CC00';
 516                         }
 517                         else if (paying == patient_balance) {
 518                             document.getElementById('paying_' + i).style.background = '#ffffff';
 519                         }
 520                     }
 521                     else {
 522                         document.getElementById('paying_' + i).style.background = '#ffffff';
 523                     }
 524                 }
 525                 else {
 526                     break;
 527                 }
 528             }
 529         }
 530
 531         function CheckVisible(MakeBlank) {//Displays and hides the check number text box.
 532             if (document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value == 'check_payment' ||
 533                 document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value == 'bank_draft') {
 534                 document.getElementById('check_number').disabled = false;
 535             }
 536             else {
 537                 document.getElementById('check_number').disabled = true;
 538             }
 539         }
 540
 541         function validate() {
 542             var f = document.forms["payfrm"];
 543             ok = -1;
 544 //no checks taken here....
 545             issue = 'no';
 546             if (document.getElementById('radio_type_of_payment_self1').checked == false &&
 547                 document.getElementById('radio_type_of_payment1').checked == false
 548                 && document.getElementById('radio_type_of_payment2').checked == false
 549                 && document.getElementById('radio_type_of_payment4').checked == false) {
 550                 alert("<?php //echo addslashes( xl('Please Select Type Of Payment.')) ?>");
 551                 return false;
 552             }
 553             if (document.getElementById('radio_type_of_payment_self1').checked == true || document.getElementById('radio_type_of_payment1').checked == true) {
 554                 for (var i = 0; i < f.elements.length; ++i) {
 555                     var elem = f.elements[i];
 556                     var ename = elem.name;
 557                     if (ename.indexOf('form_upay[0') == 0) //Today is this text box.
 558                     {
 559                         if (elem.value * 1 > 0) {//A warning message, if the amount is posted with out encounter.
 560                             if (confirm("<?php echo addslashes(xl('Are you sure to post for today?')) ?>")) {
 561                                 ok = 1;
 562                             }
 563                             else {
 564                                 elem.focus();
 565                                 return false;
 566                             }
 567                         }
 568                         break;
 569                     }
 570                 }
 571             }
 572             else if (document.getElementsByName('form_paytotal')[0].value <= 0)//total 0
 573             {
 574                 alert("<?php echo addslashes(xl('Invalid Total!')) ?>")
 575                 return false;
 576             }
 577             if (ok == -1) {
 578 //return true;
 579                 if (confirm("<?php echo addslashes(xl('Payment Validated: Save?')) ?>")) {
 580                     return true;
 581                 }
 582                 else {
 583                     return false;
 584                 }
 585             }
 586         }
 587
 588         function cursor_pointer() {//Point the cursor to the latest encounter(Today)
 589             var f = document.forms["payfrm"];
 590             var total = 0;
 591             for (var i = 0; i < f.elements.length; ++i) {
 592                 var elem = f.elements[i];
 593                 var ename = elem.name;
 594                 if (ename.indexOf('form_upay[') == 0) {
 595                     elem.focus();
 596                     break;
 597                 }
 598             }
 599         }
 600
 601         //=====================================================
 602         function make_it_hide_enc_pay() {
 603             document.getElementById('td_head_insurance_payment').style.display = "none";
 604             document.getElementById('td_head_patient_co_pay').style.display = "none";
 605             document.getElementById('td_head_co_pay').style.display = "none";
 606             document.getElementById('td_head_insurance_balance').style.display = "none";
 607             for (var i = 1; ; ++i) {
 608                 var td_inspaid_elem = document.getElementById('td_inspaid_' + i)
 609                 var td_patient_copay_elem = document.getElementById('td_patient_copay_' + i)
 610                 var td_copay_elem = document.getElementById('td_copay_' + i)
 611                 var balance_elem = document.getElementById('balance_' + i)
 612                 if (td_inspaid_elem) {
 613                     td_inspaid_elem.style.display = "none";
 614                     td_patient_copay_elem.style.display = "none";
 615                     td_copay_elem.style.display = "none";
 616                     balance_elem.style.display = "none";
 617                 }
 618                 else {
 619                     break;
 620                 }
 621             }
 622             document.getElementById('td_total_4').style.display = "none";
 623             document.getElementById('td_total_7').style.display = "none";
 624             document.getElementById('td_total_8').style.display = "none";
 625             document.getElementById('td_total_6').style.display = "none";
 626
 627             document.getElementById('table_display').width = "420px";
 628         }
 629
 630         //=====================================================
 631         function make_visible() {
 632             document.getElementById('td_head_rep_doc').style.display = "";
 633             document.getElementById('td_head_description').style.display = "";
 634             document.getElementById('td_head_total_charge').style.display = "none";
 635             document.getElementById('td_head_insurance_payment').style.display = "none";
 636             document.getElementById('td_head_patient_payment').style.display = "none";
 637             document.getElementById('td_head_patient_co_pay').style.display = "none";
 638             document.getElementById('td_head_co_pay').style.display = "none";
 639             document.getElementById('td_head_insurance_balance').style.display = "none";
 640             document.getElementById('td_head_patient_balance').style.display = "none";
 641             for (var i = 1; ; ++i) {
 642                 var td_charges_elem = document.getElementById('td_charges_' + i)
 643                 var td_inspaid_elem = document.getElementById('td_inspaid_' + i)
 644                 var td_ptpaid_elem = document.getElementById('td_ptpaid_' + i)
 645                 var td_patient_copay_elem = document.getElementById('td_patient_copay_' + i)
 646                 var td_copay_elem = document.getElementById('td_copay_' + i)
 647                 var balance_elem = document.getElementById('balance_' + i)
 648                 var duept_elem = document.getElementById('duept_' + i)
 649                 if (td_charges_elem) {
 650                     td_charges_elem.style.display = "none";
 651                     td_inspaid_elem.style.display = "none";
 652                     td_ptpaid_elem.style.display = "none";
 653                     td_patient_copay_elem.style.display = "none";
 654                     td_copay_elem.style.display = "none";
 655                     balance_elem.style.display = "none";
 656                     duept_elem.style.display = "none";
 657                 }
 658                 else {
 659                     break;
 660                 }
 661             }
 662             document.getElementById('td_total_7').style.display = "";
 663             document.getElementById('td_total_8').style.display = "";
 664             document.getElementById('td_total_1').style.display = "none";
 665             document.getElementById('td_total_2').style.display = "none";
 666             document.getElementById('td_total_3').style.display = "none";
 667             document.getElementById('td_total_4').style.display = "none";
 668             document.getElementById('td_total_5').style.display = "none";
 669             document.getElementById('td_total_6').style.display = "none";
 670
 671             document.getElementById('table_display').width = "505px";
 672         }
 673
 674         function make_it_hide() {
 675             document.getElementById('td_head_rep_doc').style.display = "none";
 676             document.getElementById('td_head_description').style.display = "none";
 677             document.getElementById('td_head_total_charge').style.display = "";
 678             document.getElementById('td_head_insurance_payment').style.display = "";
 679             document.getElementById('td_head_patient_payment').style.display = "";
 680             document.getElementById('td_head_patient_co_pay').style.display = "";
 681             document.getElementById('td_head_co_pay').style.display = "";
 682             document.getElementById('td_head_insurance_balance').style.display = "";
 683             document.getElementById('td_head_patient_balance').style.display = "";
 684             for (var i = 1; ; ++i) {
 685                 var td_charges_elem = document.getElementById('td_charges_' + i)
 686                 var td_inspaid_elem = document.getElementById('td_inspaid_' + i)
 687                 var td_ptpaid_elem = document.getElementById('td_ptpaid_' + i)
 688                 var td_patient_copay_elem = document.getElementById('td_patient_copay_' + i)
 689                 var td_copay_elem = document.getElementById('td_copay_' + i)
 690                 var balance_elem = document.getElementById('balance_' + i)
 691                 var duept_elem = document.getElementById('duept_' + i)
 692                 if (td_charges_elem) {
 693                     td_charges_elem.style.display = "";
 694                     td_inspaid_elem.style.display = "";
 695                     td_ptpaid_elem.style.display = "";
 696                     td_patient_copay_elem.style.display = "";
 697                     td_copay_elem.style.display = "";
 698                     balance_elem.style.display = "";
 699                     duept_elem.style.display = "";
 700                 }
 701                 else {
 702                     break;
 703                 }
 704             }
 705             document.getElementById('td_total_1').style.display = "";
 706             document.getElementById('td_total_2').style.display = "";
 707             document.getElementById('td_total_3').style.display = "";
 708             document.getElementById('td_total_4').style.display = "";
 709             document.getElementById('td_total_5').style.display = "";
 710             document.getElementById('td_total_6').style.display = "";
 711             document.getElementById('td_total_7').style.display = "";
 712             document.getElementById('td_total_8').style.display = "";
 713
 714             document.getElementById('table_display').width = "100%";
 715         }
 716
 717         function make_visible_radio() {
 718             document.getElementById('tr_radio1').style.display = "";
 719             document.getElementById('tr_radio2').style.display = "none";
 720         }
 721
 722         function make_hide_radio() {
 723             document.getElementById('tr_radio1').style.display = "none";
 724             document.getElementById('tr_radio2').style.display = "";
 725         }
 726
 727         function make_visible_row() {
 728             document.getElementById('table_display').style.display = "";
 729             document.getElementById('table_display_prepayment').style.display = "none";
 730         }
 731
 732         function make_hide_row() {
 733             document.getElementById('table_display').style.display = "none";
 734             document.getElementById('table_display_prepayment').style.display = "";
 735         }
 736
 737         function make_self() {
 738             make_visible_row();
 739             make_it_hide();
 740             make_it_hide_enc_pay();
 741             document.getElementById('radio_type_of_payment_self1').checked = true;
 742             cursor_pointer();
 743         }
 744
 745         function make_insurance() {
 746             make_visible_row();
 747             make_it_hide();
 748             cursor_pointer();
 749             document.getElementById('radio_type_of_payment1').checked = true;
 750         }
 751
 752         //--------------------------------------------------------------------------------------------------//
 753         $('#paySubmit').click(function (e) {
 754             e.preventDefault()
 755             $("#mode").val("portal-save");
 756             var inv_values = JSON.stringify(getFormObj('payfrm'));
 757             var extra_values = JSON.stringify(getFormObj('paycredit'));
 758             var extra = "&inv_values=" + inv_values + "&extra_values=" + extra_values;
 759
 760             var flag = 0
 761             var liburl = './lib/paylib.php';
 762             $.ajax({
 763                 type: "POST",
 764                 url: liburl,
 765                 data: $("#payfrm").serialize() + extra,
 766                 beforeSend: function (xhr) {
 767                     if (validateCC() !== true) return false;
 768                     if ($('#pin').val() == "" || $('#ccname').val() == "" || $('#ccyear').val() == "" || $('#ccmonth').val() == "") {
 769                         alert("<?php echo addslashes(xl('Invalid Credit Card Values: Please correct')) ?>")
 770                         return false;
 771                     }
 772                     if (validate() != true) {
 773                         flag = 1;
 774                         alert("<?php echo addslashes(xl('Validation error: Fix and resubmit. This popup info is preserved!')) ?>")
 775                         return false;
 776                     }
 777                     $("#openPayModal .close").click()
 778                 },
 779                 error: function (qXHR, textStatus, errorThrow) {
 780                     console.log("There was an error:" + errorThrow);
 781                 },
 782                 success: function (templateHtml, textStatus, jqXHR) {
 783                     alert("<?php echo addslashes(xl('Payment successfully sent for authorization. You will be notified when payment is posted. Until payment is accepted and you are notified, you may resubmit this payment at anytime with new amounts or different credit card. Thank you')) ?>")
 784                     window.location.reload(false);
 785                 }
 786             });
 787             if (flag)
 788                 $("#openPayModal .close").click();
 789         });
 790         //---------------------------------------------------------------------------------------//
 791         $("#payfrm").on('submit', function (e) {
 792             e.preventDefault();
 793             var thisform = this;
 794             $("#mode").val("review-save");
 795             var inv_values = JSON.stringify(getFormObj('payfrm'));
 796             var extra_values = JSON.stringify(getFormObj('paycredit'));
 797             var extra = "&inv_values=" + inv_values + "&extra_values=" + extra_values;
 798
 799             var flag = 0
 800             var liburl = '<?php echo $GLOBALS["webroot"] ?>/portal/lib/paylib.php';
 801             $.ajax({
 802                 type: "POST",
 803                 url: liburl,
 804                 data: $("#payfrm").serialize() + extra,
 805                 beforeSend: function (xhr) {
 806                     if (validate() != true) {
 807                         flag = 1;
 808                         alert("<?php echo addslashes(xl('Validation error: Fix and resubmit. Payment values are preserved!')) ?>")
 809                         return false;
 810                     }
 811                 },
 812                 error: function (xhr, textStatus, error) {
 813                     alert("<?php echo addslashes(xl('There is a Post error')) ?>")
 814                     console.log("There was an error:" + textStatus);
 815                     return false;
 816                 },
 817                 success: function (templateHtml, textStatus, jqXHR) {
 818                     thisform.submit();
 819                 }
 820             });
 821         });
 822
 823         function getFormObj(formId) {
 824             var formObj = {};
 825             var inputs = $('#' + formId).serializeArray();
 826             $.each(inputs, function (i, input) {
 827                 formObj[input.name] = input.value;
 828             });
 829             return formObj;
 830         }
 831
 832         function formRepopulate(jsondata) {
 833             data = $.parseJSON(jsondata);
 834             $.each(data, function (name, val) {
 835                 var $el = $('[name="' + name + '"]'),
 836                     type = $el.attr('type');
 837                 switch (type) {
 838                     case 'checkbox':
 839                         $el.prop('checked', true);
 840                         break;
 841                     case 'radio':
 842                         $el.filter('[value="' + val + '"]').prop('checked', true);
 843                         break;
 844                     default:
 845                         $el.val(val);
 846                 }
 847             });
 848         }
 849
 850         function getAuth() {
 851             var authnum = prompt("<?php echo xlt('Please enter card comfirmation authorization') ?>", "");
 852             if (authnum != null) {
 853                 $('#check_number').val(authnum);
 854             }
 855         }
 856     </script>
 857
 858     <body class="skin-blue" onunload='imclosing()' onLoad="cursor_pointer();"
 859           style="text-align: center; margin: auto;">
 860
 861     <form id="payfrm" method='post'
 862           action='<?php echo $GLOBALS["webroot"] ?>/portal/portal_payment.php'>
 863         <input type='hidden' name='form_pid' value='<?php echo attr($pid) ?>'/>
 864         <input type='hidden' name='form_save'
 865                value='<?php echo xlt('Invoice'); ?>'/>
 866
 867         <table>
 868             <tr height="10">
 869                 <td colspan="3">&nbsp;</td>
 870             </tr>
 871
 872             <tr>
 873                 <td colspan='3' align='center' class='text'><b><?php echo xlt('Accept Payment for'); ?>&nbsp;:&nbsp;&nbsp;<?php
 874
 875                         echo htmlspecialchars($patdata['fname'], ENT_QUOTES) . " " . htmlspecialchars($patdata['lname'], ENT_QUOTES) . " " . htmlspecialchars($patdata['mname'], ENT_QUOTES) . " (" . htmlspecialchars($patdata['pid'], ENT_QUOTES) . ")" ?></b>
 876                     <?php $NameNew = $patdata['fname'] . " " . $patdata['lname'] . " " . $patdata['mname']; ?>
 877                 </td>
 878             </tr>
 879             <tr height="15">
 880                 <td colspan='3'></td>
 881             </tr>
 882             <tr>
 883                 <td class='text'>
 884                     <?php echo xlt('Payment Method'); ?>:
 885                 </td>
 886                 <td colspan='2'><select name="form_method" id="form_method"
 887                                         class="text" onChange='CheckVisible("yes")'>
 888                         <?php
 889                         $query1112 = "SELECT * FROM list_options where list_id=?  ORDER BY seq, title ";
 890                         $bres1112 = sqlStatement($query1112, array('payment_method'));
 891                         while ($brow1112 = sqlFetchArray($bres1112)) {
 892                             if ($brow1112['option_id'] != 'credit_card' || $brow1112['option_id'] == 'electronic' || $brow1112['option_id'] == 'bank_draft') {
 893                                 continue;
 894                             }
 895
 896                             echo "<option value='" . htmlspecialchars($brow1112['option_id'], ENT_QUOTES) . "'>" . htmlspecialchars(xl_list_label($brow1112['title']), ENT_QUOTES) . "</option>";
 897                         }
 898                         ?>
 899                     </select></td>
 900             </tr>
 901
 902             <tr height="5">
 903                 <td colspan='3'></td>
 904             </tr>
 905
 906             <tr>
 907                 <td class='text'>
 908                     <?php echo xla('Authorized'); ?>:
 909                 </td>
 910                 <td colspan='2'>
 911                     <?php
 912                     if (isset($_SESSION['authUserID'])) {
 913                         echo "<input type='text'  id='check_number' name='form_source' style='width:120px;' value='" . htmlspecialchars($payrow['source'], ENT_QUOTES) . "'>";
 914                     }
 915                     ?>
 916                 </td>
 917             </tr>
 918             <tr height="5">
 919                 <td colspan='3'></td>
 920             </tr>
 921             <tr>
 922                 <td class='text' valign="middle">
 923                     <?php echo xlt('Patient Coverage'); ?>:
 924                 </td>
 925                 <td class='text' colspan="2">
 926                     <input type="radio" name="radio_type_of_coverage" id="radio_type_of_coverage1"
 927                            value="self" onClick="make_visible_radio();make_self();"/>
 928                     <?php echo xlt('Self'); ?>
 929                     <input type="radio" name="radio_type_of_coverage" id="radio_type_of_coverag2" value="insurance"
 930                            checked="checked"
 931                            onClick="make_hide_radio();make_insurance();"/>
 932                     <?php echo xlt('Insurance'); ?>
 933                 </td>
 934             </tr>
 935             <tr height="5">
 936                 <td colspan='3'></td>
 937             </tr>
 938             <tr id="tr_radio1" style="display: none">
 939                 <!-- For radio Insurance -->
 940                 <td class='text' valign="top">
 941                     <?php echo xlt('Payment against'); ?>:
 942                 </td>
 943                 <td class='text' colspan="2">
 944                     <input type="radio" name="radio_type_of_payment" id="radio_type_of_payment_self1"
 945                            value="cash" onClick="make_visible_row();make_it_hide_enc_pay();cursor_pointer();"/>
 946                     <?php echo xlt('Encounter Payment'); ?>
 947                 </td>
 948             </tr>
 949             <tr id="tr_radio2">
 950                 <!-- For radio self -->
 951                 <td class='text' valign="top"><?php echo xlt('Payment against'); ?>:
 952                 </td>
 953                 <td class='text' colspan="2"><input type="radio" name="radio_type_of_payment"
 954                                                     id="radio_type_of_payment1" checked="checked"
 955                                                     value="copay"
 956                                                     onClick="make_visible_row();cursor_pointer();"/><?php echo xlt('Co Pay'); ?>
 957                     <input type="radio" name="radio_type_of_payment" id="radio_type_of_payment2"
 958                            value="invoice_balance" onClick="make_visible_row();"/><?php echo xlt('Invoice Balance'); ?>
 959                     <br/>
 960                     <input type="radio" name="radio_type_of_payment" id="radio_type_of_payment4" value="pre_payment"
 961                            onClick="make_hide_row();"/><?php echo xlt('Pre Pay'); ?></td>
 962             </tr>
 963             <tr height="15">
 964                 <td colspan='3'></td>
 965             </tr>
 966         </table>
 967         <table width="35%" border="0" cellspacing="0" cellpadding="0" id="table_display_prepayment"
 968                style="display: none">
 969             <tr>
 970                 <td class='detail'><?php echo xlt('Pre Payment'); ?></td>
 971                 <td><input class="form-control" type='text' name='form_prepayment' style='width: 100px'/></td>
 972             </tr>
 973         </table>
 974         <table id="table_display" style="width: 100%; background: #eee;" class="table table-striped table-responsive">
 975             <thead>
 976             </thead>
 977             <tbody>
 978             <!-- <table border='0' id="table_display" cellpadding='0' cellspacing='0' width='100%'> -->
 979             <tr bgcolor="#cccccc" id="tr_head">
 980                 <td class="dehead" width="60">
 981                     <?php echo xlt('DOS') ?>
 982                 </td>
 983                 <td class="dehead" width="120">
 984                     <?php echo xlt('Visit Reason') ?>
 985                 </td>
 986                 <td class="dehead" align="center" width="70" id="td_head_total_charge">
 987                     <?php echo xlt('Total Charge') ?>
 988                 </td>
 989                 <td class="dehead" align="center" width="70" id="td_head_rep_doc" style='display: none'>
 990                     <?php echo xlt('Report/ Form') ?>
 991                 </td>
 992                 <td class="dehead" align="center" width="200" id="td_head_description" style='display: none'>
 993                     <?php echo xlt('Description') ?>
 994                 </td>
 995                 <td class="dehead" align="center" width="70" id="td_head_insurance_payment">
 996                     <?php echo xlt('Insurance Payment') ?>
 997                 </td>
 998                 <td class="dehead" align="center" width="70" id="td_head_patient_payment">
 999                     <?php echo xlt('Patient Payment') ?>
1000                 </td>
1001                 <td class="dehead" align="center" width="55" id="td_head_patient_co_pay">
1002                     <?php echo xlt('Co Pay Paid') ?>
1003                 </td>
1004                 <td class="dehead" align="center" width="55" id="td_head_co_pay">
1005                     <?php echo xlt('Required Co Pay') ?>
1006                 </td>
1007                 <td class="dehead" align="center" width="70" id="td_head_insurance_balance">
1008                     <?php echo xlt('Insurance Balance') ?>
1009                 </td>
1010                 <td class="dehead" align="center" width="70" id="td_head_patient_balance">
1011                     <?php echo xlt('Patient Balance') ?>
1012                 </td>
1013                 <td class="dehead" align="center" width="50">
1014                     <?php echo xlt('Paying') ?>
1015                 </td>
1016             </tr>
1017             <?php
1018             $encs = array();
1019             // Get the unbilled service charges and payments by encounter for this patient.
1020             //
1021             $query = "SELECT fe.encounter, fe.reason, b.code_type, b.code, b.modifier, b.fee, " . "LEFT(fe.date, 10) AS encdate ,fe.last_level_closed " . "FROM  form_encounter AS fe left join billing AS b  on " . "b.pid = ? AND b.activity = 1  AND " . // AND b.billed = 0
1022                 "b.code_type != 'TAX' AND b.fee != 0 " . "AND fe.pid = b.pid AND fe.encounter = b.encounter " . "where fe.pid = ? " . "ORDER BY b.encounter";
1023             $bres = sqlStatement($query, array($pid, $pid));
1024             //
1025             while ($brow = sqlFetchArray($bres)) {
1026                 $key = 0 + $brow['encounter'];
1027                 if (empty($encs[$key])) {
1028                     $encs[$key] = array('encounter' => $brow['encounter'], 'date' => $brow['encdate'], 'last_level_closed' => $brow['last_level_closed'], 'charges' => 0, 'payments' => 0, 'reason' => $brow['reason']
1029                     );
1030                 }
1031
1032                 if ($brow['code_type'] === 'COPAY') {
1033 // $encs[$key]['payments'] -= $brow['fee'];
1034                 } else {
1035                     $encs[$key]['charges'] += $brow['fee'];
1036 // Add taxes.
1037                     $sql_array = array();
1038                     $query = "SELECT taxrates FROM codes WHERE " . "code_type = ? AND " . "code = ? AND ";
1039                     array_push($sql_array, $code_types[$brow['code_type']]['id'], $brow['code']);
1040                     if ($brow['modifier']) {
1041                         $query .= "modifier = ?";
1042                         array_push($sql_array, $brow['modifier']);
1043                     } else {
1044                         $query .= "(modifier IS NULL OR modifier = '')";
1045                     }
1046
1047                     $query .= " LIMIT 1";
1048                     $trow = sqlQuery($query, $sql_array);
1049                     $encs[$key]['charges'] += calcTaxes($trow, $brow['fee']);
1050                 }
1051             }
1052
1053             // Do the same for unbilled product sales.
1054             //
1055             $query = "SELECT fe.encounter, fe.reason, s.drug_id, s.fee, " .
1056                 "LEFT(fe.date, 10) AS encdate,fe.last_level_closed " .
1057                 "FROM form_encounter AS fe left join drug_sales AS s " .
1058                 "on s.pid = ? AND s.fee != 0 " .
1059                 "AND fe.pid = s.pid AND fe.encounter = s.encounter " .
1060                 "where fe.pid = ? " . "ORDER BY s.encounter";
1061
1062             $dres = sqlStatement($query, array($pid, $pid));
1063             //
1064             while ($drow = sqlFetchArray($dres)) {
1065                 $key = 0 + $drow['encounter'];
1066                 if (empty($encs[$key])) {
1067                     $encs[$key] = array('encounter' => $drow['encounter'], 'date' => $drow['encdate'], 'last_level_closed' => $drow['last_level_closed'], 'charges' => 0, 'payments' => 0
1068                     );
1069                 }
1070
1071                 $encs[$key]['charges'] += $drow['fee'];
1072 // Add taxes.
1073                 $trow = sqlQuery("SELECT taxrates FROM drug_templates WHERE drug_id = ? " . "ORDER BY selector LIMIT 1", array($drow['drug_id']
1074                 ));
1075                 $encs[$key]['charges'] += calcTaxes($trow, $drow['fee']);
1076             }
1077
1078             ksort($encs, SORT_NUMERIC);
1079             $gottoday = false;
1080             // Bringing on top the Today always
1081             foreach ($encs as $key => $value) {
1082                 $dispdate = $value['date'];
1083                 if (strcmp($dispdate, $today) == 0 && !$gottoday) {
1084                     $gottoday = true;
1085                     break;
1086                 }
1087             }
1088
1089             // If no billing was entered yet for today, then generate a line for
1090             // entering today's co-pay.
1091             //
1092             if (!$gottoday) {
1093 // echoLine("form_upay[0]", date("Y-m-d"), 0, 0, 0, 0 /*$duept*/);//No encounter yet defined.
1094             }
1095
1096             $gottoday = false;
1097             foreach ($encs as $key => $value) {
1098                 $enc = $value['encounter'];
1099                 $reason = $value['reason'];
1100                 $dispdate = $value['date'];
1101                 if (strcmp($dispdate, $today) == 0 && !$gottoday) {
1102                     $dispdate = date("Y-m-d");
1103                     $gottoday = true;
1104                 }
1105
1106 // ------------------------------------------------------------------------------------
1107                 $inscopay = getCopay($pid, $dispdate);
1108                 $patcopay = getPatientCopay($pid, $enc);
1109 // Insurance Payment
1110 // -----------------
1111                 $drow = sqlQuery("SELECT  SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments  FROM ar_activity WHERE " . "pid = ? and encounter = ? and " . "payer_type != 0 and account_code!='PCP' ", array($pid, $enc
1112                 ));
1113                 $dpayment = $drow['payments'];
1114                 $dadjustment = $drow['adjustments'];
1115 // Patient Payment
1116 // ---------------
1117                 $drow = sqlQuery("SELECT  SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments  FROM ar_activity WHERE " . "pid = ? and encounter = ? and " . "payer_type = 0 and account_code!='PCP' ", array($pid, $enc
1118                 ));
1119                 $dpayment_pat = $drow['payments'];
1120
1121 // ------------------------------------------------------------------------------------
1122 // NumberOfInsurance
1123                 $ResultNumberOfInsurance = sqlStatement("SELECT COUNT( DISTINCT TYPE ) NumberOfInsurance FROM insurance_data
1124 where pid = ? and provider>0 ", array($pid
1125                 ));
1126                 $RowNumberOfInsurance = sqlFetchArray($ResultNumberOfInsurance);
1127                 $NumberOfInsurance = $RowNumberOfInsurance['NumberOfInsurance'] * 1;
1128 // ------------------------------------------------------------------------------------
1129                 $duept = 0;
1130                 if ((($NumberOfInsurance == 0 || $value['last_level_closed'] == 4 || $NumberOfInsurance == $value['last_level_closed']))) { // Patient balance
1131                     $brow = sqlQuery("SELECT SUM(fee) AS amount FROM billing WHERE " . "pid = ? and encounter = ? AND activity = 1", array($pid, $enc
1132                     ));
1133                     $srow = sqlQuery("SELECT SUM(fee) AS amount FROM drug_sales WHERE " . "pid = ? and encounter = ? ", array($pid, $enc
1134                     ));
1135                     $drow = sqlQuery("SELECT SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments FROM ar_activity WHERE " . "pid = ? and encounter = ? ", array($pid, $enc
1136                     ));
1137                     $duept = $brow['amount'] + $srow['amount'] - $drow['payments'] - $drow['adjustments'];
1138                 }
1139
1140                 echoLine("form_upay[$enc]", $dispdate, $value['charges'], $dpayment_pat, ($dpayment + $dadjustment), $duept, ($enc . ':' . $reason), $inscopay, $patcopay);
1141             }
1142
1143             // Continue with display of the data entry form.
1144             ?>
1145             <tr>
1146                 <td class="dehead" id='td_total_1'></td>
1147                 <td class="dehead" id='td_total_2'></td>
1148                 <td class="dehead" id='td_total_3'></td>
1149                 <td class="dehead" id='td_total_4'></td>
1150                 <td class="dehead" id='td_total_5'></td>
1151                 <td class="dehead" id='td_total_6'></td>
1152                 <td class="dehead" id='td_total_7'></td>
1153                 <td class="dehead" id='td_total_8'></td>
1154                 <td class="dehead" align="right"><?php echo xlt('Total'); ?></td>
1155                 <td class="dehead" align="right"><input class="form-control" type='text' name='form_paytotal'
1156                                                         value='' style='color: #00aa00; width: 65px; padding: 1px 1px;'
1157                                                         readonly/>
1158                 </td>
1159             </tr>
1160         </table>
1161         <?php
1162         if (isset($ccdata["name"])) {
1163             echo '<div class="col-xs-12 col-md-4 col-lg-4">
1164 <div class="panel panel-default height">';
1165             if (!isset($_SESSION['authUserID'])) {
1166                 echo '<div class="panel-heading">' . xlt("Payment Information") . '<span style="color:#cc0000"><em> ' . xlt("Pending Auth since") . ': </em>' . text($edata["date"]) . '</span></div>';
1167             } else {
1168                 echo '<div class="panel-heading">' . xlt("Payment Information") . ' <button type="button" class="btn btn-danger btn-sm" onclick="getAuth()">' . xlt("Authorize") . '</button></div>';
1169             }
1170         } else {
1171             echo '<div style="display:none" class="col-xs-12 col-md-6 col-lg-6"><div class="panel panel-default height"><div class="panel-heading">' . xlt("Payment Information") . ' </div>';
1172         }
1173         ?>
1174         <div class="panel-body">
1175             <strong><?php echo xlt('Card Name'); ?>: </strong><span
1176                 id="cn"><?php echo attr($ccdata["cc_type"]) ?></span><br>
1177             <strong><?php echo xlt('Name on Card'); ?>: </strong><span
1178                 id="nc"><?php echo attr($ccdata["name"]) ?></span><br>
1179             <strong><?php echo xlt('Card Number'); ?>: </strong><span id="ccn">
1180 <?php
1181 if (isset($_SESSION['authUserID'])) {
1182     echo $ccdata["cc_number"] . "</span><br>";
1183 } else {
1184     echo "**********  " . substr($ccdata["cc_number"], -4) . "</span><br>";
1185 }
1186 ?>
1187                 <strong><?php echo xlt('Exp Date'); ?>:  </strong><span
1188                     id="ed"><?php echo attr($ccdata["month"]) . "/" . attr($ccdata["year"]) ?></span>
1189 <strong><?php echo xlt('CVV'); ?>:  </strong><span id="pin"><?php echo attr($ccdata["pin"]) ?></span><br>
1190 <strong><?php echo xlt('Charge Total'); ?>:  </strong><span id="ct"><?php echo attr($invdata["form_paytotal"]) ?></span><br>
1191         </div>
1192         </div>
1193         </div>
1194         <p>
1195             <?php
1196             if (!isset($_SESSION['authUserID'])) {
1197                 echo '<button type="button" class="btn btn-primary" data-toggle="modal" data-target="#openPayModal">' . xlt("Pay Invoice") . '</button>';
1198             } else {
1199                 echo "<button type='submit' class='btn btn-danger' form='payfrm'>" . xlt('Post Payment') . "</button>";
1200             }
1201             ?>
1202             &nbsp;
1203         </p>
1204         <input type="hidden" name="hidden_patient_code" id="hidden_patient_code" value="<?php echo attr($pid); ?>"/>
1205         <input type='hidden' name='mode' id='mode' value=''/>
1206     </form>
1207
1208     <script type="text/javascript">
1209         if (typeof jsondata !== 'undefined') {
1210             formRepopulate(jsondata);
1211         }
1212         calctotal();
1213     </script>
1214     <!-- credit payment modal -->
1215     <div id="openPayModal" class="modal fade" role="dialog">
1216         <div class="modal-dialog">
1217             <div class="modal-content">
1218                 <div class="modal-header">
1219                     <h3><?php echo xlt('Submit Payment for Authorization'); ?></h3>
1220                     <button type="button" class="close" data-dismiss="modal">&times;</button>
1221                 </div>
1222                 <div class="modal-body container">
1223                     <form id='paycredit' class="form-horizontal col-xs-12 col-sm-6 col-md-6">
1224                         <fieldset>
1225                             <div class="control-group">
1226                                 <label label-default="label-default"
1227                                        class="control-label"><?php echo xlt('Name on Card'); ?></label>
1228                                 <div class="controls">
1229                                     <input name="name" id="ccname" type="text" class="form-control"
1230                                            pattern="\w+ \w+.*"
1231                                            title="<?php echo xla('Fill your first and last name'); ?>"
1232                                            required value=""/>
1233                                 </div>
1234                             </div>
1235                             <div class="control-group">
1236                                 <label class="control-label"><?php echo xlt('Card Number'); ?></label>
1237                                 <div class="controls">
1238                                     <div class="row">
1239                                         <div class="col-sm-12">
1240                                             <input name="cc_number" id="cc_number" type="text"
1241                                                    class="form-control inline col-sm-3"
1242                                                    autocomplete="off" maxlength="19" pattern="\d"
1243                                                    onchange="validateCC()"
1244                                                    title="<?php echo xla('Card Number'); ?>" required value=""/>
1245                                             <input disabled name="cardtype" id="cardtype" type="text"
1246                                                    class="form-control inline" title="<?php echo xla('Card Type'); ?>"
1247                                                    style="max-width:160px;font-weight:bold;color:red;" value=""/>
1248                                         </div>
1249                                     </div>
1250                                 </div>
1251                             </div>
1252                             <div class="control-group">
1253                                 <label label-default="label-default"
1254                                        class="control-label"><?php echo xlt('Card Expiry Date'); ?></label>
1255                                 <div class="controls">
1256                                     <div class="row">
1257                                         <div class="col-md-4">
1258                                             <select name="month" id="ccmonth" class="form-control">
1259                                                 <option value=""><?php echo xlt('Select Month'); ?></option>
1260                                                 <option value="01"><?php echo xlt('January'); ?></option>
1261                                                 <option value="02"><?php echo xlt('February'); ?></option>
1262                                                 <option value="03"><?php echo xlt('March'); ?></option>
1263                                                 <option value="04"><?php echo xlt('April'); ?></option>
1264                                                 <option value="05"><?php echo xlt('May'); ?></option>
1265                                                 <option value="06"><?php echo xlt('June'); ?></option>
1266                                                 <option value="07"><?php echo xlt('July'); ?></option>
1267                                                 <option value="08"><?php echo xlt('August'); ?></option>
1268                                                 <option value="09"><?php echo xlt('September'); ?></option>
1269                                                 <option value="10"><?php echo xlt('October'); ?></option>
1270                                                 <option value="11"><?php echo xlt('November'); ?></option>
1271                                                 <option value="12"><?php echo xlt('December'); ?></option>
1272                                             </select>
1273                                         </div>
1274                                         <div class="col-md-3">
1275                                             <select name="year" id="ccyear" class="form-control">
1276                                                 <option value=""><?php echo xlt('Select Year'); ?></option>
1277                                                 <option value="2018">2018</option>
1278                                                 <option value="2019">2019</option>
1279                                                 <option value="2020">2020</option>
1280                                                 <option value="2021">2021</option>
1281                                                 <option value="2022">2022</option>
1282                                                 <option value="2023">2023</option>
1283                                                 <option value="2024">2024</option>
1284                                                 <option value="2025">2017</option>
1285                                             </select>
1286                                         </div>
1287                                     </div>
1288                                 </div>
1289                             </div>
1290                             <div class="control-group">
1291                                 <label label-default="label-default"
1292                                        class="control-label"><?php echo xlt('Card CVV'); ?></label>
1293                                 <div class="controls">
1294                                     <div class="row">
1295                                         <div class="col-md-3">
1296                                             <input name="pin" id="pin" type="text" class="form-control"
1297                                                    autocomplete="off" maxlength="4" pattern="\d{3}"
1298                                                    onfocus="validateCC()"
1299                                                    title="<?php echo xlt('Three or four digits at back of your card'); ?>"
1300                                                    required value=""/>
1301                                         </div>
1302                                         <div class="col-md-3">
1303                                             <img src='./images/img_cvc.png' style='height: 58px; width: auto'>
1304                                         </div>
1305                                     </div>
1306                                 </div>
1307                             </div>
1308                             <div class="form-actions">
1309                                 <button id="paySubmit" class="btn btn-danger"><?php echo xlt('Submit'); ?></button>
1310                                 <button type="button" class="btn btn-default"
1311                                         data-dismiss="modal"><?php echo xlt('Cancel'); ?></button>
1312                             </div>
1313                         </fieldset>
1314                         <input type='hidden' name='cc_type' id='cc_type' value=''/>
1315                     </form>
1316                 </div>
1317                 <!-- Body  -->
1318                 <div class="modal-footer">
1319                     <button type="button" class="btn btn-default"
1320                             data-dismiss="modal"><?php echo xlt('Close'); ?></button>
1321                 </div>
1322             </div>
1323         </div>
1324     </div>
1325     <?php echo "<script>var ccerr='" . xlt('Invalid Credit Card Number') . "';</script>"; ?>
1326     <script type="text/javascript">
1327         $('#cc_number').validateCreditCard(function (result) {
1328             var r = (result.card_type == null ? '' : result.card_type.name.toUpperCase())
1329             var v = (result.valid == true ? ' Valid #' : ' Invalid #')
1330             $('#cardtype').val(r + v);
1331         });
1332
1333         function validateCC() {
1334             var result = $('#cc_number').validateCreditCard();
1335             var r = (result.card_type == null ? '' : result.card_type.name.toUpperCase())
1336             var v = (result.valid == true ? ' Okay' : ' Invalid #')
1337             $('#cardtype').val(r + v);
1338             $('#cc_type').val(r);
1339             if (!result.valid) {
1340                 alert(ccerr)
1341                 return false;
1342             }
1343             else {
1344                 return true;
1345             }
1346         }
1347     </script>
1348     </body>
1349     <?php
1350 }
1351 ?>