library/classes/WSClaim.class.php

   1 <?php
   2
   3 require_once (dirname(__FILE__) . "/WSWrapper.class.php");
   4 include_once (dirname(__FILE__) . "/../sqlconf.php");
   5 include_once (dirname(__FILE__) . "/../sql.inc");
   6 include_once (dirname(__FILE__) . "/../../includes/config.php");
   7
   8 class WSClaim extends WSWrapper{
   9
  10         var $patient_id;
  11         var $foreign_provider_id;
  12         var $foreign_patient_id;
  13         var $payer_id;
  14         var $encounter;
  15         var $foreign_payer_id;
  16         var $claim;
  17         var $_db;
  18
  19         function WSClaim($patient_id, $encounter) {
  20                 if (!is_numeric($patient_id) && is_numeric($encounter)) return;
  21
  22                 parent::WSWrapper(null,false);
  23
  24                 $this->patient_id = $patient_id;
  25                 $this->encounter = $encounter;
  26                 $this->claim = null;
  27                 $this->_db = $GLOBALS['adodb']['db'];
  28                 if (!$this->_config['enabled']) return;
  29
  30                 if ($this->load_claim()) {
  31                         $function['ezybiz.add_invoice'] = array(new xmlrpcval($this->claim,"struct"));
  32                         $this->send($function);
  33                 }
  34
  35                 //print_r($this->claim);
  36
  37         }
  38
  39         function load_claim() {
  40                 if (!$this->load_patient_foreign_id() ||
  41                         !$this->load_payer_foreign_id() ||
  42                         !$this->load_provider_foreign_id() )
  43                         return false;
  44                 $invoice_info = array();
  45
  46                 $sql = "SELECT b.*, CONCAT(pd.fname,' ',pd.mname,' ',pd.lname) as patient_name FROM billing as b LEFT JOIN patient_data as pd on b.pid=pd.pid where "
  47                         ."b.encounter ='" . $this->encounter ."' AND b.pid = '" . $this->patient_id ."' AND b.billed = 1 AND b.activity != '0' AND authorized='1'";
  48
  49                 $result = $this->_db->Execute($sql);
  50
  51                 $invoice_info['salesman'] = $this->foreign_provider_id;
  52                 $invoice_info['customerid'] = $this->foreign_patient_id;
  53                 $invoice_info['payer_id'] = $this->foreign_payer_id;
  54                 $invoice_info['invoicenumber'] = $this->patient_id . "000" . $this->encounter;
  55
  56                 $counter = 0;
  57                 $total = 0;
  58                 $patient_info = array();
  59                 $payer_info = array();
  60                 while ($result && !$result->EOF) {
  61                         if ($result->fields['process_date'] == null) {
  62                                 //don't sync a claim that has not been processed, they may just want to mark this as billed
  63                                         return false;
  64                         }
  65                         // create a paymentline item for each code
  66                         /*
  67                         $invoice_info["invoiceid$counter"] = $result->fields['code'];
  68                         $invoice_info["amount$counter"] = $result->fields['fee'];
  69                         $invoice_info["invoicenumber$counter"] = $this->patient_id . "000" . $this->encounter;
  70                         $invoice_info["interest$counter"] = 0;
  71                         */
  72                         if ($counter == 0) {
  73                                 //unused but supported by ezybiz, helpful in debugging
  74                                 $invoice_info['customer'] = $result->fields['patient_name'];
  75                                 $invoice_info['invoicedate'] = date("m-d-Y",strtotime($result->fields['process_date']));
  76                                 $invoice_info['duedate'] = date("m-d-Y",strtotime($result->fields['process_date']));
  77                                 $invoice_info['items'] = array();
  78                         }
  79
  80                         $tii = array();
  81                         //This is how we set the line items for the invoice, using codes from our encounter
  82                         //if ($result->fields['code_type'] == "CPT4" || $result->fields['code_type'] == "HCPCS") {
  83                         //if( $result->fields['code_type'] != "ICD9" ) {
  84                         if( $result->fields['code_type'] == "COPAY")
  85                         {
  86                                 $patient_info['payment_amount'] += sprintf("%01.2f",$result->fields['fee']);
  87                         }
  88                         else
  89                         {
  90                                 $payer_info['payment_amount'] += sprintf("%01.2f",$result->fields['fee']);
  91                         }
  92                                 $tii['maincode'] = $result->fields['code'];
  93                                 $tii['itemtext'] = $result->fields['code_type'] .":" . $result->fields['code'] . " " . $result->fields['code_text'] . " "
  94                                         . $result->fields['justify'];
  95
  96                                 $tii['qty'] = $result->fields['units'];
  97                                 if (!$tii['qty'] > 0) {
  98                                         $tii['qty'] = 1;
  99                                 }
 100                                 $tii['price'] = sprintf("%01.2f",$result->fields['fee']);
 101                                 $total += $tii['price'];
 102                                 $tii['glaccountid'] = $this->_config['income_acct'];
 103                                 $invoice_info['items'][] = $tii;
 104                         //}
 105
 106                         $result->MoveNext();
 107                         $counter++;
 108                 }
 109
 110
 111                 for($counter = 0; $counter < 2; $counter++)
 112                 {
 113                         $fee = 0;
 114                         $billto = 0;
 115                         if($counter == 0)
 116                         {
 117                                 $fee = $patient_info['payment_amount'];
 118                                 $billto = $this->foreign_patient_id;
 119                         }
 120                         else
 121                         {
 122                                 $fee = $payer_info['payment_amount'];
 123                                 $billto = $this->foreign_payer_id;
 124                         }
 125                         $invoice_info["invoiceid$counter"] = $this->patient_id . "000" . $this->encounter;
 126                         $invoice_info["amount$counter"] = $fee;
 127                         $invoice_info["invoicenumber$counter"] = $this->patient_id . "000" . $this->encounter;
 128                         $invoice_info["interest$counter"] = 0;
 129                         $invoice_info["billtoid$counter"] = $billto;
 130                 }
 131                 $invoice_info['subtotal'] = sprintf("%01.2f",$total);
 132                 $invoice_info['total'] = sprintf("%01.2f",$total);
 133
 134                 $this->claim = $invoice_info;
 135                 return true;
 136         }
 137
 138         function load_provider_foreign_id() {
 139                 $sql = "SELECT foreign_id from integration_mapping as im LEFT JOIN billing as b on im.local_id=b.provider_id where encounter = '" . $this->encounter . "' and b.pid = '" . $this->patient_id . "' and im.local_table='users' and im.foreign_table='salesman'";
 140                 $result = $this->_db->Execute($sql);
 141                 if($result && !$result->EOF) {
 142                                 $this->foreign_provider_id = $result->fields['foreign_id'];
 143                                 return true;
 144                 }
 145                 else {
 146                         echo "Entry has not been previously sent to external system or no entry was found for them in the integration mapping, could not send claim. Provider: '" . $this->patient_id . "'<br>";
 147                         return false;
 148                 }
 149         }
 150         function load_patient_foreign_id() {
 151                 $sql = "SELECT foreign_id from integration_mapping as im LEFT JOIN patient_data as pd on im.local_id=pd.id where pd.pid = '" . $this->patient_id . "' and im.local_table='patient_data' and im.foreign_table='customer'";
 152                 $result = $this->_db->Execute($sql);
 153                 if($result && !$result->EOF) {
 154                                 $this->foreign_patient_id = $result->fields['foreign_id'];
 155                                 return true;
 156                 }
 157                 else {
 158                         echo "Entry has not been previously sent to external system or no entry was found for them in the integration mapping, could not send claim. Patient: '" . $this->patient_id . "'<br>";
 159                         return false;
 160                 }
 161         }
 162         function load_payer_foreign_id() {
 163                 $sql = "SELECT payer_id from billing where encounter = '" . $this->encounter . "' and pid = '" . $this->patient_id . "'";
 164                 $result = $this->_db->Execute($sql);
 165                 if($result && !$result->EOF) {
 166                                 $this->payer_id = $result->fields['payer_id'];
 167                 }
 168                 else {
 169                         echo "No payer id for this claim could be found";
 170                         return false;
 171                 }
 172
 173                 $sql = "SELECT foreign_id from integration_mapping as im LEFT JOIN billing as b on im.local_id=b.payer_id where b.payer_id = '" . $this->payer_id . "' and im.local_table='insurance_companies' and im.foreign_table='customer'";
 174                 $result = $this->_db->Execute($sql);
 175                 if($result && !$result->EOF) {
 176                                 $this->foreign_payer_id = $result->fields['foreign_id'];
 177                                 return true;
 178                 }
 179                 else {
 180                         echo "Entry has not been previously sent to external system or no entry was found for them in the integration mapping, could not send claim. Insurance Company: '" . $this->payer_id . "'<br>";
 181                         return false;
 182                 }
 183         }
 184 }
 185
 186 //$wsc = new WSClaim("3","20040622");
 187
 188 ?>