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
  60 $pid = $_REQUEST['hidden_patient_code'] > 0 ? $_REQUEST['hidden_patient_code'] : $pid;
  61
  62 $edata = $appsql->getPortalAudit($pid, 'review', 'payment');
  63 $ccdata = array();
  64 $invdata = array();
  65
  66 if ($edata) {
  67     $ccdata = json_decode(aes256Decrypt($edata['checksum']), true);
  68     $invdata = json_decode($edata['table_args'], true);
  69     echo "<script  type='text/javascript'>var jsondata='" . $edata['table_args'] . "';var ccdata='" . $edata['checksum'] . "'</script>";
  70 }
  71
  72 function bucks($amount)
  73 {
  74     if ($amount) {
  75         $amount = oeFormatMoney($amount);
  76         return $amount;
  77     }
  78
  79     return '';
  80 }
  81 function rawbucks($amount)
  82 {
  83     if ($amount) {
  84         $amount = sprintf("%.2f", $amount);
  85         return $amount;
  86     }
  87
  88     return '';
  89 }
  90
  91 // Display a row of data for an encounter.
  92 //
  93 $var_index = 0;
  94 function echoLine($iname, $date, $charges, $ptpaid, $inspaid, $duept, $encounter = 0, $copay = 0, $patcopay = 0)
  95 {
  96     global $var_index;
  97     $var_index ++;
  98     $balance = bucks($charges - $ptpaid - $inspaid);
  99     $balance = ( round($duept, 2) != 0 ) ? 0 : $balance; // if balance is due from patient, then insurance balance is displayed as zero
 100     $encounter = $encounter ? $encounter : '';
 101     echo " <tr id='tr_" . attr($var_index) . "' >\n";
 102     echo "  <td class='detail'>" . text(oeFormatShortDate($date)) . "</td>\n";
 103     echo "  <td class='detail' id='" . attr($date) . "' align='left'>" . htmlspecialchars($encounter, ENT_QUOTES) . "</td>\n";
 104     echo "  <td class='detail' align='center' id='td_charges_$var_index' >" . htmlspecialchars(bucks($charges), ENT_QUOTES) . "</td>\n";
 105     echo "  <td class='detail' align='center' id='td_inspaid_$var_index' >" . htmlspecialchars(bucks($inspaid * - 1), ENT_QUOTES) . "</td>\n";
 106     echo "  <td class='detail' align='center' id='td_ptpaid_$var_index' >" . htmlspecialchars(bucks($ptpaid * - 1), ENT_QUOTES) . "</td>\n";
 107     echo "  <td class='detail' align='center' id='td_patient_copay_$var_index' >" . htmlspecialchars(bucks($patcopay), ENT_QUOTES) . "</td>\n";
 108     echo "  <td class='detail' align='center' id='td_copay_$var_index' >" . htmlspecialchars(bucks($copay), ENT_QUOTES) . "</td>\n";
 109     echo "  <td class='detail' align='center' id='balance_$var_index'>" . htmlspecialchars(bucks($balance), ENT_QUOTES) . "</td>\n";
 110     echo "  <td class='detail' align='center' id='duept_$var_index'>" . htmlspecialchars(bucks(round($duept, 2) * 1), ENT_QUOTES) . "</td>\n";
 111     echo "  <td class='detail' align='right'><input class='form-control' style='width:60px;padding:2px 2px;' type='text' name='" . attr($iname) . "'  id='paying_" . attr($var_index) . "' " . " value='" . '' . "' onchange='coloring();calctotal()'  autocomplete='off' " . "onkeyup='calctotal()'/></td>\n";
 112     echo " </tr>\n";
 113 }
 114
 115 // We use this to put dashes, colons, etc. back into a timestamp.
 116 //
 117 function decorateString($fmt, $str)
 118 {
 119     $res = '';
 120     while ($fmt) {
 121         $fc = substr($fmt, 0, 1);
 122         $fmt = substr($fmt, 1);
 123         if ($fc == '.') {
 124             $res .= substr($str, 0, 1);
 125             $str = substr($str, 1);
 126         } else {
 127             $res .= $fc;
 128         }
 129     }
 130
 131     return $res;
 132 }
 133
 134 // Compute taxes from a tax rate string and a possibly taxable amount.
 135 //
 136 function calcTaxes($row, $amount)
 137 {
 138     $total = 0;
 139     if (empty($row['taxrates'])) {
 140         return $total;
 141     }
 142
 143     $arates = explode(':', $row['taxrates']);
 144     if (empty($arates)) {
 145         return $total;
 146     }
 147
 148     foreach ($arates as $value) {
 149         if (empty($value)) {
 150             continue;
 151         }
 152
 153         $trow = sqlQuery("SELECT option_value FROM list_options WHERE " . "list_id = 'taxrate' AND option_id = ? LIMIT 1", array ($value
 154         ));
 155         if (empty($trow['option_value'])) {
 156             echo "<!-- Missing tax rate '" . text($value) . "'! -->\n";
 157             continue;
 158         }
 159
 160         $tax = sprintf("%01.2f", $amount * $trow['option_value']);
 161         // echo "<!-- Rate = '$value', amount = '$amount', tax = '$tax' -->\n";
 162         $total += $tax;
 163     }
 164
 165     return $total;
 166 }
 167
 168 $now = time();
 169 $today = date('Y-m-d', $now);
 170 $timestamp = date('Y-m-d H:i:s', $now);
 171
 172
 173 // $patdata = getPatientData($pid, 'fname,lname,pubpid');
 174
 175 $patdata = sqlQuery("SELECT " . "p.fname, p.mname, p.lname, p.pubpid,p.pid, i.copay " . "FROM patient_data AS p " . "LEFT OUTER JOIN insurance_data AS i ON " . "i.pid = p.pid AND i.type = 'primary' " . "WHERE p.pid = ? ORDER BY i.date DESC LIMIT 1", array ($pid
 176 ));
 177
 178 $alertmsg = ''; // anything here pops up in an alert box
 179
 180 // If the Save button was clicked...
 181 if ($_POST['form_save']) {
 182     // $extra = json_decode($_POST['ajax_mode'], true);
 183     $form_pid = $_POST['form_pid'];
 184     $form_method = trim($_POST['form_method']);
 185     $form_source = trim($_POST['form_source']);
 186     $patdata = getPatientData($form_pid, 'fname,mname,lname,pubpid');
 187     $NameNew = $patdata['fname'] . " " . $patdata['lname'] . " " . $patdata['mname'];
 188
 189     if ($_REQUEST['radio_type_of_payment'] == 'pre_payment') {
 190         $payment_id = idSqlStatement("insert into ar_session set " . "payer_id = ?" . ", patient_id = ?" . ", user_id = ?" . ", closed = ?" . ", reference = ?" . ", check_date =  now() , deposit_date = now() " . ",  pay_total = ?" . ", payment_type = 'patient'" . ", description = ?" . ", adjustment_code = 'pre_payment'" . ", post_to_date = now() " . ", payment_method = ?", array (
 191                 0,$form_pid,$_SESSION['authUserID'],0,$form_source,$_REQUEST['form_prepayment'],$NameNew,$form_method
 192         ));
 193
 194         frontPayment($form_pid, 0, $form_method, $form_source, $_REQUEST['form_prepayment'], 0, $timestamp); // insertion to 'payments' table.
 195     }
 196
 197     if ($_POST['form_upay'] && $_REQUEST['radio_type_of_payment'] != 'pre_payment') {
 198         foreach ($_POST['form_upay'] as $enc => $payment) {
 199             if ($amount = 0 + $payment) {
 200                 $zero_enc = $enc;
 201                 if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance') {
 202                     ;
 203                 } else {
 204                     if (! $enc) {
 205                         $enc = calendar_arrived($form_pid);
 206                     }
 207                 }
 208
 209                 // ----------------------------------------------------------------------------------------------------
 210                 // Fetching the existing code and modifier
 211                 $ResultSearchNew = sqlStatement("SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key " . "WHERE code_types.ct_fee=1 AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier", array ($form_pid,$enc
 212                 ));
 213                 if ($RowSearch = sqlFetchArray($ResultSearchNew)) {
 214                     $Codetype = $RowSearch['code_type'];
 215                     $Code = $RowSearch['code'];
 216                     $Modifier = $RowSearch['modifier'];
 217                 } else {
 218                     $Codetype = '';
 219                     $Code = '';
 220                     $Modifier = '';
 221                 }
 222
 223                 // ----------------------------------------------------------------------------------------------------
 224                 if ($_REQUEST['radio_type_of_payment'] == 'copay') { // copay saving to ar_session and ar_activity tables
 225                     $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 (
 226                             $_SESSION['authId'],$form_source,$amount,$form_pid,$form_method
 227                     ));
 228
 229                     $insrt_id = idSqlStatement("INSERT INTO ar_activity (pid,encounter,code_type,code,modifier,payer_type,post_time,post_user,session_id,pay_amount,account_code)" . " VALUES (?,?,?,?,?,0,now(),?,?,?,'PCP')", array ($form_pid,$enc,$Codetype,$Code,$Modifier,'3',$session_id,$amount
 230                     ));
 231
 232                     frontPayment($form_pid, $enc, $form_method, $form_source, $amount, 0, $timestamp); // insertion to 'payments' table.
 233                 }
 234
 235                 if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance' || $_REQUEST['radio_type_of_payment'] == 'cash') { // Payment by patient after insurance paid, cash patients similar to do not bill insurance in feesheet.
 236                     if ($_REQUEST['radio_type_of_payment'] == 'cash') {
 237                         sqlStatement("update form_encounter set last_level_closed=? where encounter=? and pid=? ", array (4,$enc,$form_pid
 238                         ));
 239                         sqlStatement("update billing set billed=? where encounter=? and pid=?", array (1,$enc,$form_pid
 240                         ));
 241                     }
 242
 243                     $adjustment_code = 'patient_payment';
 244                     $payment_id = idSqlStatement("insert into ar_session set " . "payer_id = ?" . ", patient_id = ?" . ", user_id = ?" . ", closed = ?" . ", reference = ?" . ", check_date =  now() , deposit_date = now() " . ",  pay_total = ?" . ", payment_type = 'patient'" . ", description = ?" . ", adjustment_code = ?" . ", post_to_date = now() " . ", payment_method = ?", array (
 245                             0,$form_pid,$_SESSION['authUserID'],0,$form_source,$amount,$NameNew,$adjustment_code,$form_method
 246                     ));
 247
 248                     // --------------------------------------------------------------------------------------------------------------------
 249
 250                     frontPayment($form_pid, $enc, $form_method, $form_source, 0, $amount, $timestamp); // insertion to 'payments' table.
 251
 252                     // --------------------------------------------------------------------------------------------------------------------
 253
 254                     $resMoneyGot = sqlStatement("SELECT sum(pay_amount) as PatientPay FROM ar_activity where pid =? and " . "encounter =? and payer_type=0 and account_code='PCP'", array ($form_pid,$enc
 255                     )); // new fees screen copay gives account_code='PCP'
 256                     $rowMoneyGot = sqlFetchArray($resMoneyGot);
 257                     $Copay = $rowMoneyGot['PatientPay'];
 258
 259                     // --------------------------------------------------------------------------------------------------------------------
 260
 261                     // Looping the existing code and modifier
 262                     $ResultSearchNew = sqlStatement("SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key WHERE code_types.ct_fee=1 " . "AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier", array ($form_pid,$enc
 263                     ));
 264                     while ($RowSearch = sqlFetchArray($ResultSearchNew)) {
 265                         $Codetype = $RowSearch['code_type'];
 266                         $Code = $RowSearch['code'];
 267                         $Modifier = $RowSearch['modifier'];
 268                         $Fee = $RowSearch['fee'];
 269
 270                         $resMoneyGot = sqlStatement("SELECT sum(pay_amount) as MoneyGot FROM ar_activity where pid =? " . "and code_type=? and code=? and modifier=? and encounter =? and !(payer_type=0 and account_code='PCP')", array ($form_pid,$Codetype,$Code,$Modifier,$enc
 271                         ));
 272                         // new fees screen copay gives account_code='PCP'
 273                         $rowMoneyGot = sqlFetchArray($resMoneyGot);
 274                         $MoneyGot = $rowMoneyGot['MoneyGot'];
 275
 276                         $resMoneyAdjusted = sqlStatement("SELECT sum(adj_amount) as MoneyAdjusted FROM ar_activity where " . "pid =? and code_type=? and code=? and modifier=? and encounter =?", array ($form_pid,$Codetype,$Code,$Modifier,$enc
 277                         ));
 278                         $rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
 279                         $MoneyAdjusted = $rowMoneyAdjusted['MoneyAdjusted'];
 280
 281                         $Remainder = $Fee - $Copay - $MoneyGot - $MoneyAdjusted;
 282                         $Copay = 0;
 283                         if (round($Remainder, 2) != 0 && $amount != 0) {
 284                             if ($amount - $Remainder >= 0) {
 285                                 $insert_value = $Remainder;
 286                                 $amount = $amount - $Remainder;
 287                             } else {
 288                                 $insert_value = $amount;
 289                                 $amount = 0;
 290                             }
 291
 292                             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 (
 293                                     $form_pid,$enc,$Codetype,$Code,$Modifier,0,3,$payment_id,$insert_value,0
 294                             ));
 295                         } // if
 296                     } // while
 297                     if ($amount != 0) { // if any excess is there.
 298                         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 (
 299                                 $form_pid,$enc,$Codetype,$Code,$Modifier,0,3,$payment_id,$amount,0
 300                         ));
 301                     }
 302
 303                     // --------------------------------------------------------------------------------------------------------------------
 304                 } // invoice_balance
 305             } // if ($amount = 0 + $payment)
 306         } // foreach
 307     } // if ($_POST['form_upay'])
 308 } // if ($_POST['form_save'])
 309
 310 if ($_POST['form_save'] || $_REQUEST['receipt']) {
 311     if ($_REQUEST['receipt']) {
 312         $form_pid = $_GET['patient'];
 313         $timestamp = decorateString('....-..-.. ..:..:..', $_GET['time']);
 314     }
 315
 316     // Get details for what we guess is the primary facility.
 317     $frow = sqlQuery("SELECT * FROM facility " . "ORDER BY billing_location DESC, accepts_assignment DESC, id LIMIT 1");
 318
 319     // Get the patient's name and chart number.
 320     $patdata = getPatientData($form_pid, 'fname,mname,lname,pubpid');
 321
 322     // Re-fetch payment info.
 323     $payrow = sqlQuery("SELECT " . "SUM(amount1) AS amount1, " . "SUM(amount2) AS amount2, " . "MAX(method) AS method, " . "MAX(source) AS source, " . "MAX(dtime) AS dtime, " .
 324     // "MAX(user) AS user " .
 325     "MAX(user) AS user, " . "MAX(encounter) as encounter " . "FROM payments WHERE " . "pid = ? AND dtime = ?", array ($form_pid,$timestamp
 326     ));
 327
 328     // Create key for deleting, just in case.
 329     $ref_id = ( $_REQUEST['radio_type_of_payment'] == 'copay' ) ? $session_id : $payment_id;
 330     $payment_key = $form_pid . '.' . preg_replace('/[^0-9]/', '', $timestamp) . '.' . $ref_id;
 331
 332     // get facility from encounter
 333     $tmprow = sqlQuery("
 334     SELECT facility_id
 335     FROM form_encounter
 336     WHERE encounter = ?", array ($payrow['encounter']
 337     ));
 338     $frow = sqlQuery("SELECT * FROM facility " . " WHERE id = ?", array ($tmprow['facility_id']
 339     ));
 340
 341     // Now proceed with printing the receipt.
 342     ?>
 343
 344 <title><?php echo xlt('Receipt for Payment'); ?></title>
 345
 346 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-min-1-11-3/index.js"></script>
 347 <script type="text/javascript">
 348 $( document ).ready();
 349 function goHome(){
 350      window.location.replace("./patient/onsiteactivityviews");
 351 }
 352 function notifyPatient(){
 353     var pid = <?php echo attr($pid);?>;
 354     var note = $('#pop_receipt').text();
 355     var formURL = './messaging/handle_note.php';
 356     $.ajax({
 357         url: formURL,
 358         type: "POST",
 359         data: {'task':'add', 'pid':pid, 'inputBody':note, 'title':'Bill/Collect', 'sendto':'-patient-','noteid':'0'},
 360         success: function(data, textStatus, jqXHR) {
 361             alert('Receipt sent to patient via Messages.')
 362         },
 363         error: function(jqXHR, status, error) {
 364             console.log(status + ": " + error);
 365         }
 366     });
 367 }
 368 </script>
 369 <?php
 370 ob_start();
 371 echo '<htlm><head></head><body style="text-align: center; margin: auto;">';
 372 ?>
 373
 374 <div id='pop_receipt' style='display: block'>
 375         <p>
 376         <h2><?php echo xlt('Receipt for Payment'); ?></h2>
 377         <p><?php echo text($frow['name'])?>
 378         <br><?php echo text($frow['street'])?>
 379         <br><?php echo text($frow['city'] . ', ' . $frow['state']) . ' ' . text($frow['postal_code'])?>
 380         <br><?php echo htmlentities($frow['phone'])?>
 381         <p>
 382         <div style="text-align: center; margin: auto;">
 383             <table border='0' cellspacing='8'
 384                 style="text-align: center; margin: auto;">
 385                 <tr>
 386                     <td><?php echo xlt('Date'); ?>:</td>
 387                     <td><?php echo text(oeFormatSDFT(strtotime($payrow['dtime']))) ?></td>
 388                 </tr>
 389                 <tr>
 390                     <td><?php echo xlt('Patient'); ?>:</td>
 391                     <td><?php echo text($patdata['fname']) . " " . text($patdata['mname']) . " " . text($patdata['lname']) . " (" . text($patdata['pubpid']) . ")"?></td>
 392                 </tr>
 393                 <tr>
 394                     <td><?php echo xlt('Paid Via'); ?>:</td>
 395                     <td><?php echo generate_display_field(array('data_type'=>'1','list_id'=>'payment_method'), $payrow['method']); ?></td>
 396                 </tr>
 397                 <tr>
 398                     <td><?php echo xlt('Authorized Id'); ?>:</td>
 399                     <td><?php echo text($payrow['source']) ?></td>
 400                 </tr>
 401                 <tr>
 402                     <td><?php echo xlt('Amount for This Visit'); ?>:</td>
 403                     <td><?php echo text(oeFormatMoney($payrow['amount1'])) ?></td>
 404                 </tr>
 405                 <tr>
 406                     <td><?php echo xlt('Amount for Past Balance'); ?>:</td>
 407                     <td><?php echo text(oeFormatMoney($payrow['amount2'])) ?></td>
 408                 </tr>
 409                 <tr>
 410                     <td><?php echo xlt('Received By'); ?>:</td>
 411                     <td><?php echo text($payrow['user']) ?></td>
 412                 </tr>
 413             </table>
 414         </div>
 415 </div>
 416         <button class='btn btn-sm' type='button' onclick='goHome()' id='returnhome'><?php echo xla('Return Home'); ?></button>
 417         <button class='btn btn-sm' type='button' onclick="notifyPatient()"><?php echo xla('Notify Patient'); ?></button>
 418 </body></html>
 419 <?php
 420  ob_end_flush();
 421 } else {
 422     //
 423     // Here we display the form for data entry.
 424     //
 425     ?>
 426 <title><?php echo xlt('Record Payment'); ?></title>
 427 <style type="text/css">
 428 body {
 429  /* font-family:sans-serif; font-size:10pt; font-weight:normal */
 430 }
 431
 432 .dehead {
 433     color: #000000; /*font-family:sans-serif; font-size:10pt;*/
 434     font-weight: bold
 435 }
 436
 437 .detail {
 438     padding: 1px 1px;
 439     /* width: 65px; */
 440     color: #000000; /*font-family:sans-serif; font-size:10pt; */
 441     font-weight: normal
 442 }
 443 </style>
 444 <script type="text/javascript" src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-creditcardvalidator-1-1-0/jquery.creditCardValidator.js"></script>
 445 <script type="text/javascript" src="<?php echo $GLOBALS['webroot'] ?>/library/textformat.js?v=<?php echo $v_js_includes; ?>"></script>
 446
 447 <script type="text/javascript">
 448 var mypcc = '1';
 449 function calctotal() {
 450  var flag=0;
 451  var f = document.forms["payfrm"];
 452  var total = 0;
 453  for (var i = 0; i < f.elements.length; ++i) {
 454   var elem = f.elements[i];
 455   var ename = elem.name;
 456   if (ename.indexOf('form_upay[') == 0 || ename.indexOf('form_bpay[') == 0) {
 457    if (elem.value.length > 0){
 458        total += Number(elem.value);
 459         if(total < 0) flag=1;
 460    }
 461   }
 462  }
 463      f.form_paytotal.value = Number(total).toFixed(2);
 464      if(flag){
 465         $('#payfrm')[0].reset();
 466         alert("<?php echo addslashes(xl('Negative payments not accepted')) ?>")
 467     }
 468  return true;
 469 }
 470 function coloring()
 471  {
 472    for (var i = 1; ; ++i)
 473     {
 474       if(document.getElementById('paying_'+i))
 475        {
 476         paying=document.getElementById('paying_'+i).value*1;
 477         patient_balance=document.getElementById('duept_'+i).innerHTML*1;
 478         //balance=document.getElementById('balance_'+i).innerHTML*1;
 479         if(patient_balance>0 && paying>0)
 480          {
 481             if(paying>patient_balance)
 482              {
 483               document.getElementById('paying_'+i).style.background='#FF0000';
 484              }
 485             else if(paying<patient_balance)
 486              {
 487               document.getElementById('paying_'+i).style.background='#99CC00';
 488              }
 489             else if(paying==patient_balance)
 490              {
 491               document.getElementById('paying_'+i).style.background='#ffffff';
 492              }
 493          }
 494         else
 495          {
 496           document.getElementById('paying_'+i).style.background='#ffffff';
 497          }
 498        }
 499       else
 500        {
 501         break;
 502        }
 503     }
 504  }
 505 function CheckVisible(MakeBlank)
 506  {//Displays and hides the check number text box.
 507    if(document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='check_payment' ||
 508          document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='bank_draft'  )
 509    {
 510     document.getElementById('check_number').disabled=false;
 511    }
 512    else
 513    {
 514     document.getElementById('check_number').disabled=true;
 515    }
 516  }
 517 function validate()
 518  {
 519   var f = document.forms["payfrm"];
 520   ok=-1;
 521   //no checks taken here....
 522   issue='no';
 523    /*if(((document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='check_payment' ||
 524          document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value=='bank_draft') &&
 525        document.getElementById('check_number').value=='' ))
 526    {
 527     alert("<?php //echo addslashes( xl('Please Fill the Check/Ref Number')) ?>");
 528     document.getElementById('check_number').focus();
 529     return false;
 530    }*/
 531
 532    if(document.getElementById('radio_type_of_payment_self1').checked==false &&
 533           document.getElementById('radio_type_of_payment1').checked==false
 534            && document.getElementById('radio_type_of_payment2').checked==false
 535            && document.getElementById('radio_type_of_payment4').checked==false)
 536     {
 537       alert("<?php //echo addslashes( xl('Please Select Type Of Payment.')) ?>");
 538        return false;
 539     }
 540   if(document.getElementById('radio_type_of_payment_self1').checked==true ||  document.getElementById('radio_type_of_payment1').checked==true)
 541    {
 542      for (var i = 0; i < f.elements.length; ++i)
 543      {
 544       var elem = f.elements[i];
 545       var ename = elem.name;
 546       if (ename.indexOf('form_upay[0') == 0) //Today is this text box.
 547       {
 548        if(elem.value*1>0)
 549         {//A warning message, if the amount is posted with out encounter.
 550          if(confirm("<?php echo addslashes(xl('Are you sure to post for today?')) ?>"))
 551           {
 552            ok=1;
 553           }
 554          else
 555           {
 556            elem.focus();
 557            return false;
 558           }
 559         }
 560        break;
 561       }
 562     }
 563    }
 564 //CO-PAY
 565   /* if(document.getElementById('radio_type_of_payment1').checked==true)
 566    {
 567      var total = 0;
 568      for (var i = 0; i < f.elements.length; ++i)
 569      {
 570       var elem = f.elements[i];
 571       var ename = elem.name;
 572       if (ename.indexOf('form_upay[') == 0) //Today is this text box.
 573       {
 574        if(f.form_paytotal.value*1!=elem.value*1)//Total CO-PAY is not posted against today
 575         {//A warning message, if the amount is posted against an old encounter.
 576          if(confirm("<?php //echo addslashes( xl('You are posting against an old encounter?')) ?>"))
 577           {
 578            ok=1;
 579           }
 580         // else
 581           {
 582            elem.focus();
 583            return false;
 584           }
 585         }
 586        break;
 587       }
 588     }
 589    }*///Co Pay
 590  else if( document.getElementsByName('form_paytotal')[0].value <= 0 )//total 0
 591   {
 592     alert("<?php echo addslashes(xl('Invalid Total!')) ?>")
 593     return false;
 594   }
 595  if(ok==-1)
 596   {
 597      //return true;
 598      if(confirm("<?php echo addslashes(xl('Payment Validated: Save?')) ?>"))
 599       {
 600        return true;
 601       }
 602      else
 603       {
 604        return false;
 605       }
 606   }
 607 }
 608 function cursor_pointer()
 609  {//Point the cursor to the latest encounter(Today)
 610      var f = document.forms["payfrm"];
 611      var total = 0;
 612      for (var i = 0; i < f.elements.length; ++i)
 613      {
 614       var elem = f.elements[i];
 615       var ename = elem.name;
 616       if (ename.indexOf('form_upay[') == 0)
 617       {
 618        elem.focus();
 619        break;
 620       }
 621     }
 622  }
 623  //=====================================================
 624 function make_it_hide_enc_pay()
 625  {
 626       document.getElementById('td_head_insurance_payment').style.display="none";
 627       document.getElementById('td_head_patient_co_pay').style.display="none";
 628       document.getElementById('td_head_co_pay').style.display="none";
 629       document.getElementById('td_head_insurance_balance').style.display="none";
 630   for (var i = 1; ; ++i)
 631   {
 632        var td_inspaid_elem = document.getElementById('td_inspaid_'+i)
 633     var td_patient_copay_elem = document.getElementById('td_patient_copay_'+i)
 634        var td_copay_elem = document.getElementById('td_copay_'+i)
 635        var balance_elem = document.getElementById('balance_'+i)
 636    if (td_inspaid_elem)
 637    {
 638     td_inspaid_elem.style.display="none";
 639         td_patient_copay_elem.style.display="none";
 640     td_copay_elem.style.display="none";
 641     balance_elem.style.display="none";
 642    }
 643   else
 644    {
 645     break;
 646    }
 647   }
 648   document.getElementById('td_total_4').style.display="none";
 649   document.getElementById('td_total_7').style.display="none";
 650     document.getElementById('td_total_8').style.display="none";
 651   document.getElementById('td_total_6').style.display="none";
 652
 653   document.getElementById('table_display').width="420px";
 654  }
 655
 656  //=====================================================
 657 function make_visible()
 658  {
 659   document.getElementById('td_head_rep_doc').style.display="";
 660   document.getElementById('td_head_description').style.display="";
 661   document.getElementById('td_head_total_charge').style.display="none";
 662   document.getElementById('td_head_insurance_payment').style.display="none";
 663   document.getElementById('td_head_patient_payment').style.display="none";
 664   document.getElementById('td_head_patient_co_pay').style.display="none";
 665   document.getElementById('td_head_co_pay').style.display="none";
 666   document.getElementById('td_head_insurance_balance').style.display="none";
 667   document.getElementById('td_head_patient_balance').style.display="none";
 668   for (var i = 1; ; ++i)
 669   {
 670    var td_charges_elem = document.getElementById('td_charges_'+i)
 671    var td_inspaid_elem = document.getElementById('td_inspaid_'+i)
 672    var td_ptpaid_elem = document.getElementById('td_ptpaid_'+i)
 673    var td_patient_copay_elem = document.getElementById('td_patient_copay_'+i)
 674    var td_copay_elem = document.getElementById('td_copay_'+i)
 675    var balance_elem = document.getElementById('balance_'+i)
 676    var duept_elem = document.getElementById('duept_'+i)
 677    if (td_charges_elem)
 678    {
 679     td_charges_elem.style.display="none";
 680     td_inspaid_elem.style.display="none";
 681     td_ptpaid_elem.style.display="none";
 682     td_patient_copay_elem.style.display="none";
 683     td_copay_elem.style.display="none";
 684     balance_elem.style.display="none";
 685     duept_elem.style.display="none";
 686    }
 687   else
 688    {
 689     break;
 690    }
 691   }
 692   document.getElementById('td_total_7').style.display="";
 693   document.getElementById('td_total_8').style.display="";
 694   document.getElementById('td_total_1').style.display="none";
 695   document.getElementById('td_total_2').style.display="none";
 696   document.getElementById('td_total_3').style.display="none";
 697   document.getElementById('td_total_4').style.display="none";
 698   document.getElementById('td_total_5').style.display="none";
 699   document.getElementById('td_total_6').style.display="none";
 700
 701   document.getElementById('table_display').width="505px";
 702  }
 703 function make_it_hide()
 704  {
 705   document.getElementById('td_head_rep_doc').style.display="none";
 706   document.getElementById('td_head_description').style.display="none";
 707   document.getElementById('td_head_total_charge').style.display="";
 708   document.getElementById('td_head_insurance_payment').style.display="";
 709   document.getElementById('td_head_patient_payment').style.display="";
 710   document.getElementById('td_head_patient_co_pay').style.display="";
 711     document.getElementById('td_head_co_pay').style.display="";
 712   document.getElementById('td_head_insurance_balance').style.display="";
 713   document.getElementById('td_head_patient_balance').style.display="";
 714   for (var i = 1; ; ++i)
 715   {
 716    var td_charges_elem = document.getElementById('td_charges_'+i)
 717    var td_inspaid_elem = document.getElementById('td_inspaid_'+i)
 718    var td_ptpaid_elem = document.getElementById('td_ptpaid_'+i)
 719    var td_patient_copay_elem = document.getElementById('td_patient_copay_'+i)
 720    var td_copay_elem = document.getElementById('td_copay_'+i)
 721    var balance_elem = document.getElementById('balance_'+i)
 722    var duept_elem = document.getElementById('duept_'+i)
 723    if (td_charges_elem)
 724    {
 725     td_charges_elem.style.display="";
 726     td_inspaid_elem.style.display="";
 727     td_ptpaid_elem.style.display="";
 728         td_patient_copay_elem.style.display="";
 729     td_copay_elem.style.display="";
 730     balance_elem.style.display="";
 731     duept_elem.style.display="";
 732    }
 733   else
 734    {
 735     break;
 736    }
 737   }
 738   document.getElementById('td_total_1').style.display="";
 739   document.getElementById('td_total_2').style.display="";
 740   document.getElementById('td_total_3').style.display="";
 741   document.getElementById('td_total_4').style.display="";
 742   document.getElementById('td_total_5').style.display="";
 743   document.getElementById('td_total_6').style.display="";
 744   document.getElementById('td_total_7').style.display="";
 745   document.getElementById('td_total_8').style.display="";
 746
 747   document.getElementById('table_display').width="100%";
 748  }
 749 function make_visible_radio()
 750  {
 751   document.getElementById('tr_radio1').style.display="";
 752   document.getElementById('tr_radio2').style.display="none";
 753  }
 754 function make_hide_radio()
 755  {
 756   document.getElementById('tr_radio1').style.display="none";
 757   document.getElementById('tr_radio2').style.display="";
 758  }
 759 function make_visible_row()
 760  {
 761   document.getElementById('table_display').style.display="";
 762   document.getElementById('table_display_prepayment').style.display="none";
 763  }
 764 function make_hide_row()
 765  {
 766   document.getElementById('table_display').style.display="none";
 767   document.getElementById('table_display_prepayment').style.display="";
 768  }
 769 function make_self()
 770  {
 771   make_visible_row();
 772   make_it_hide();
 773   make_it_hide_enc_pay();
 774   document.getElementById('radio_type_of_payment_self1').checked=true;
 775   cursor_pointer();
 776  }
 777 function make_insurance()
 778  {
 779   make_visible_row();
 780   make_it_hide();
 781   cursor_pointer();
 782   document.getElementById('radio_type_of_payment1').checked=true;
 783  }
 784  //--------------------------------------------------------------------------------------------------//
 785 $('#paySubmit').click( function(e) {
 786     e.preventDefault()
 787     $("#mode").val( "portal-save" );
 788     var inv_values= JSON.stringify(getFormObj('payfrm'));
 789     var extra_values=JSON.stringify(getFormObj('paycredit'));
 790     var extra = "&inv_values="+inv_values+"&extra_values="+extra_values;
 791
 792     var flag = 0
 793     var liburl = './lib/paylib.php';
 794     $.ajax({
 795         type: "POST",
 796         url: liburl,
 797         data: $("#payfrm").serialize()+extra,
 798         beforeSend: function(xhr){
 799             if( validateCC() !== true) return false;
 800             if( $('#pin').val() == "" || $('#ccname').val() == "" || $('#ccyear').val() == "" || $('#ccmonth').val() == ""){
 801                  alert("<?php echo addslashes(xl('Invalid Credit Card Values: Please correct')) ?>")
 802                  return false;
 803             }
 804             if( validate() != true){
 805                 flag = 1;
 806                 alert("<?php echo addslashes(xl('Validation error: Fix and resubmit. This popup info is preserved!')) ?>")
 807                 return false;
 808             }
 809             $("#openPayModal .close").click()
 810         },
 811         error: function(qXHR, textStatus, errorThrow){
 812             console.log("There was an error:"+errorThrow);
 813         },
 814         success: function(templateHtml, textStatus, jqXHR){
 815             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')) ?>")
 816             window.location.reload(false);
 817         }
 818     });
 819      if(flag)
 820         $("#openPayModal .close").click();
 821 });
 822  //---------------------------------------------------------------------------------------//
 823 $("#payfrm").on('submit', function(e){
 824     e.preventDefault();
 825     var thisform = this;
 826     $("#mode").val( "review-save" );
 827     var inv_values= JSON.stringify(getFormObj('payfrm'));
 828     var extra_values=JSON.stringify(getFormObj('paycredit'));
 829     var extra = "&inv_values="+inv_values+"&extra_values="+extra_values;
 830
 831     var flag = 0
 832     var liburl ='<?php echo $GLOBALS["webroot"] ?>/portal/lib/paylib.php';
 833     $.ajax({
 834         type: "POST",
 835         url: liburl,
 836         data: $("#payfrm").serialize()+extra,
 837         beforeSend: function(xhr){
 838             if( validate() != true){
 839                 flag = 1;
 840                 alert("<?php echo addslashes(xl('Validation error: Fix and resubmit. Payment values are preserved!')) ?>")
 841                 return false;
 842             }
 843         },
 844         error: function(xhr, textStatus, error){
 845             alert("<?php echo addslashes(xl('There is a Post error')) ?>")
 846             console.log("There was an error:"+textStatus);
 847             return false;
 848         },
 849         success: function(templateHtml, textStatus, jqXHR){
 850             thisform.submit();
 851         }
 852     });
 853 });
 854 function getFormObj(formId) {
 855     var formObj = {};
 856     var inputs = $('#'+formId).serializeArray();
 857     $.each(inputs, function (i, input) {
 858         formObj[input.name] = input.value;
 859     });
 860     return formObj;
 861 }
 862 function formRepopulate(jsondata){
 863     data = $.parseJSON(jsondata);
 864     $.each(data, function(name, val){
 865         var $el = $('[name="'+name+'"]'),
 866             type = $el.attr('type');
 867         switch(type){
 868             case 'checkbox':
 869                 $el.prop('checked',true);
 870                 break;
 871             case 'radio':
 872                 $el.filter('[value="'+val+'"]').prop('checked', true);
 873                 break;
 874             default:
 875                 $el.val(val);
 876         }
 877     });
 878 }
 879 function getAuth(){
 880     var authnum = prompt("<?php echo  xlt('Please enter card comfirmation authorization') ?>", "");
 881     if (authnum != null) {
 882         $('#check_number').val(authnum);
 883     }
 884 }
 885 </script>
 886
 887 <body class="skin-blue" onunload='imclosing()' onLoad="cursor_pointer();"
 888     style="text-align: center; margin: auto;">
 889
 890     <form id="payfrm" method='post'
 891         action='<?php echo $GLOBALS["webroot"] ?>/portal/portal_payment.php'>
 892         <input type='hidden' name='form_pid' value='<?php echo attr($pid) ?>' />
 893         <input type='hidden' name='form_save'
 894             value='<?php echo xlt('Invoice');?>' />
 895
 896         <table>
 897             <tr height="10">
 898                 <td colspan="3">&nbsp;</td>
 899             </tr>
 900
 901             <tr>
 902                 <td colspan='3' align='center' class='text'><b><?php echo xlt('Accept Payment for'); ?>&nbsp;:&nbsp;&nbsp;<?php
 903
 904                 echo htmlspecialchars($patdata['fname'], ENT_QUOTES) . " " . htmlspecialchars($patdata['lname'], ENT_QUOTES) . " " . htmlspecialchars($patdata['mname'], ENT_QUOTES) . " (" . htmlspecialchars($patdata['pid'], ENT_QUOTES) . ")"?></b>
 905     <?php $NameNew=$patdata['fname'] . " " .$patdata['lname']. " " .$patdata['mname'];?>
 906   </td>
 907             </tr>
 908             <tr height="15">
 909                 <td colspan='3'></td>
 910             </tr>
 911             <tr>
 912                 <td class='text'>
 913     <?php echo xlt('Payment Method'); ?>:
 914   </td>
 915                 <td colspan='2'><select name="form_method" id="form_method"
 916                     class="text" onChange='CheckVisible("yes")'>
 917     <?php
 918     $query1112 = "SELECT * FROM list_options where list_id=?  ORDER BY seq, title ";
 919     $bres1112 = sqlStatement($query1112, array ('payment_method'));
 920     while ($brow1112 = sqlFetchArray($bres1112)) {
 921         if ($brow1112['option_id'] != 'credit_card' || $brow1112['option_id'] == 'electronic' || $brow1112['option_id'] == 'bank_draft') {
 922             continue;
 923         }
 924
 925         echo "<option value='" . htmlspecialchars($brow1112['option_id'], ENT_QUOTES) . "'>" . htmlspecialchars(xl_list_label($brow1112['title']), ENT_QUOTES) . "</option>";
 926     }
 927     ?>
 928   </select></td>
 929             </tr>
 930
 931             <tr height="5">
 932                 <td colspan='3'></td>
 933             </tr>
 934
 935             <tr>
 936                 <td class='text'>
 937     <?php echo xla('Authorized'); ?>:
 938   </td>
 939                 <td colspan='2'>
 940     <?php
 941     if (isset($_SESSION['authUserID'])) {
 942         echo "<input type='text'  id='check_number' name='form_source' style='width:120px;' value='" . htmlspecialchars($payrow['source'], ENT_QUOTES) . "'>";
 943     }
 944     ?>
 945   </td>
 946             </tr>
 947             <tr height="5">
 948                 <td colspan='3'></td>
 949             </tr>
 950             <tr>
 951                 <td class='text' valign="middle">
 952     <?php echo xlt('Patient Coverage'); ?>:
 953   </td>
 954                 <td class='text' colspan="2">
 955                     <input type="radio"    name="radio_type_of_coverage" id="radio_type_of_coverage1"
 956                     value="self" onClick="make_visible_radio();make_self();" />
 957                     <?php echo xlt('Self'); ?>
 958                       <input type="radio" name="radio_type_of_coverage"    id="radio_type_of_coverag2" value="insurance" checked="checked"
 959                     onClick="make_hide_radio();make_insurance();" />
 960                     <?php echo xlt('Insurance'); ?>
 961                 </td>
 962             </tr>
 963             <tr height="5">
 964                 <td colspan='3'></td>
 965             </tr>
 966             <tr id="tr_radio1" style="display: none">
 967                 <!-- For radio Insurance -->
 968                 <td class='text' valign="top">
 969     <?php echo xlt('Payment against'); ?>:
 970   </td>
 971                 <td class='text' colspan="2">
 972                     <input type="radio"    name="radio_type_of_payment" id="radio_type_of_payment_self1"
 973                     value="cash" onClick="make_visible_row();make_it_hide_enc_pay();cursor_pointer();" />
 974                     <?php echo xlt('Encounter Payment'); ?>
 975                 </td>
 976             </tr>
 977             <tr id="tr_radio2">
 978                 <!-- For radio self -->
 979                 <td class='text' valign="top"><?php echo xlt('Payment against'); ?>:
 980   </td>
 981                 <td class='text' colspan="2"><input type="radio"    name="radio_type_of_payment" id="radio_type_of_payment1" checked="checked"
 982                     value="copay" onClick="make_visible_row();cursor_pointer();" /><?php echo xlt('Co Pay'); ?>
 983           <input type="radio" name="radio_type_of_payment" id="radio_type_of_payment2"
 984                     value="invoice_balance" onClick="make_visible_row();" /><?php echo xlt('Invoice Balance'); ?><br />
 985         <input type="radio" name="radio_type_of_payment"    id="radio_type_of_payment4" value="pre_payment"
 986                     onClick="make_hide_row();" /><?php echo xlt('Pre Pay'); ?></td>
 987             </tr>
 988             <tr height="15">
 989                 <td colspan='3'></td>
 990             </tr>
 991         </table>
 992         <table width="35%" border="0" cellspacing="0" cellpadding="0" id="table_display_prepayment" style="display: none">
 993             <tr>
 994                 <td class='detail'><?php echo xlt('Pre Payment'); ?></td>
 995                 <td><input class="form-control" type='text' name='form_prepayment' style='width: 100px' /></td>
 996             </tr>
 997         </table>
 998         <table id="table_display" style="width: 100%; background: #eee;" class="table table-striped table-responsive">
 999             <thead>
1000             </thead>
1001             <tbody>
1002                 <!-- <table border='0' id="table_display" cellpadding='0' cellspacing='0' width='100%'> -->
1003     <tr bgcolor="#cccccc" id="tr_head">
1004     <td class="dehead" width="60">
1005     <?php echo xlt('DOS')?>
1006   </td>
1007                     <td class="dehead" width="120">
1008     <?php echo xlt('Visit Reason')?>
1009   </td>
1010                     <td class="dehead" align="center" width="70" id="td_head_total_charge">
1011     <?php echo xlt('Total Charge')?>
1012   </td>
1013                     <td class="dehead" align="center" width="70" id="td_head_rep_doc" style='display: none'>
1014     <?php echo xlt('Report/ Form')?>
1015   </td>
1016                     <td class="dehead" align="center" width="200"    id="td_head_description" style='display: none'>
1017     <?php echo xlt('Description')?>
1018   </td>
1019                     <td class="dehead" align="center" width="70" id="td_head_insurance_payment">
1020     <?php echo xlt('Insurance Payment')?>
1021   </td>
1022                     <td class="dehead" align="center" width="70" id="td_head_patient_payment">
1023     <?php echo xlt('Patient Payment')?>
1024   </td>
1025                     <td class="dehead" align="center" width="55" id="td_head_patient_co_pay">
1026     <?php echo xlt('Co Pay Paid')?>
1027   </td>
1028                     <td class="dehead" align="center" width="55" id="td_head_co_pay">
1029     <?php echo xlt('Required Co Pay')?>
1030   </td>
1031                     <td class="dehead" align="center" width="70" id="td_head_insurance_balance">
1032     <?php echo xlt('Insurance Balance')?>
1033   </td>
1034                     <td class="dehead" align="center" width="70" id="td_head_patient_balance">
1035     <?php echo xlt('Patient Balance')?>
1036   </td>
1037                     <td class="dehead" align="center" width="50">
1038     <?php echo xlt('Paying')?>
1039   </td>
1040                 </tr>
1041 <?php
1042     $encs = array ();
1043     // Get the unbilled service charges and payments by encounter for this patient.
1044     //
1045     $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
1046 "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";
1047     $bres = sqlStatement($query, array ($pid,$pid));
1048     //
1049 while ($brow = sqlFetchArray($bres)) {
1050     $key = 0 + $brow['encounter'];
1051     if (empty($encs[$key])) {
1052         $encs[$key] = array ('encounter' => $brow['encounter'],'date' => $brow['encdate'],'last_level_closed' => $brow['last_level_closed'],'charges' => 0,'payments' => 0,'reason'=>$brow['reason']
1053         );
1054     }
1055
1056     if ($brow['code_type'] === 'COPAY') {
1057         // $encs[$key]['payments'] -= $brow['fee'];
1058     } else {
1059         $encs[$key]['charges'] += $brow['fee'];
1060         // Add taxes.
1061         $sql_array = array ();
1062         $query = "SELECT taxrates FROM codes WHERE " . "code_type = ? AND " . "code = ? AND ";
1063         array_push($sql_array, $code_types[$brow['code_type']]['id'], $brow['code']);
1064         if ($brow['modifier']) {
1065             $query .= "modifier = ?";
1066             array_push($sql_array, $brow['modifier']);
1067         } else {
1068             $query .= "(modifier IS NULL OR modifier = '')";
1069         }
1070
1071         $query .= " LIMIT 1";
1072         $trow = sqlQuery($query, $sql_array);
1073         $encs[$key]['charges'] += calcTaxes($trow, $brow['fee']);
1074     }
1075 }
1076
1077     // Do the same for unbilled product sales.
1078     //
1079     $query = "SELECT fe.encounter, fe.reason, s.drug_id, s.fee, " . "LEFT(fe.date, 10) AS encdate,fe.last_level_closed " . "FROM form_encounter AS fe left join drug_sales AS s " . "on s.pid = ? AND s.fee != 0 " . // AND s.billed = 0
1080 "AND fe.pid = s.pid AND fe.encounter = s.encounter " . "where fe.pid = ? " . "ORDER BY s.encounter";
1081
1082     $dres = sqlStatement($query, array ($pid,$pid));
1083     //
1084 while ($drow = sqlFetchArray($dres)) {
1085     $key = 0 + $drow['encounter'];
1086     if (empty($encs[$key])) {
1087         $encs[$key] = array ('encounter' => $drow['encounter'],'date' => $drow['encdate'],'last_level_closed' => $drow['last_level_closed'],'charges' => 0,'payments' => 0
1088         );
1089     }
1090
1091     $encs[$key]['charges'] += $drow['fee'];
1092     // Add taxes.
1093     $trow = sqlQuery("SELECT taxrates FROM drug_templates WHERE drug_id = ? " . "ORDER BY selector LIMIT 1", array ($drow['drug_id']
1094     ));
1095     $encs[$key]['charges'] += calcTaxes($trow, $drow['fee']);
1096 }
1097
1098     ksort($encs, SORT_NUMERIC);
1099     $gottoday = false;
1100     // Bringing on top the Today always
1101 foreach ($encs as $key => $value) {
1102     $dispdate = $value['date'];
1103     if (strcmp($dispdate, $today) == 0 && ! $gottoday) {
1104         $gottoday = true;
1105         break;
1106     }
1107 }
1108
1109     // If no billing was entered yet for today, then generate a line for
1110     // entering today's co-pay.
1111     //
1112 if (! $gottoday) {
1113     // echoLine("form_upay[0]", date("Y-m-d"), 0, 0, 0, 0 /*$duept*/);//No encounter yet defined.
1114 }
1115
1116     $gottoday = false;
1117 foreach ($encs as $key => $value) {
1118     $enc = $value['encounter'];
1119     $reason = $value['reason'];
1120     $dispdate = $value['date'];
1121     if (strcmp($dispdate, $today) == 0 && ! $gottoday) {
1122         $dispdate = date("Y-m-d");
1123         $gottoday = true;
1124     }
1125
1126     // ------------------------------------------------------------------------------------
1127     $inscopay = getCopay($pid, $dispdate);
1128     $patcopay = getPatientCopay($pid, $enc);
1129     // Insurance Payment
1130     // -----------------
1131     $drow = sqlQuery("SELECT  SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments  FROM ar_activity WHERE " . "pid = ? and encounter = ? and " . "payer_type != 0 and account_code!='PCP' ", array ($pid,$enc
1132     ));
1133     $dpayment = $drow['payments'];
1134     $dadjustment = $drow['adjustments'];
1135 // Patient Payment
1136 // ---------------
1137     $drow = sqlQuery("SELECT  SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments  FROM ar_activity WHERE " . "pid = ? and encounter = ? and " . "payer_type = 0 and account_code!='PCP' ", array ($pid,$enc
1138     ));
1139     $dpayment_pat = $drow['payments'];
1140
1141 // ------------------------------------------------------------------------------------
1142 // NumberOfInsurance
1143     $ResultNumberOfInsurance = sqlStatement("SELECT COUNT( DISTINCT TYPE ) NumberOfInsurance FROM insurance_data
1144             where pid = ? and provider>0 ", array ($pid
1145     ));
1146     $RowNumberOfInsurance = sqlFetchArray($ResultNumberOfInsurance);
1147     $NumberOfInsurance = $RowNumberOfInsurance['NumberOfInsurance'] * 1;
1148 // ------------------------------------------------------------------------------------
1149     $duept = 0;
1150     if (( ( $NumberOfInsurance == 0 || $value['last_level_closed'] == 4 || $NumberOfInsurance == $value['last_level_closed'] ) )) { // Patient balance
1151         $brow = sqlQuery("SELECT SUM(fee) AS amount FROM billing WHERE " . "pid = ? and encounter = ? AND activity = 1", array ($pid,$enc
1152         ));
1153         $srow = sqlQuery("SELECT SUM(fee) AS amount FROM drug_sales WHERE " . "pid = ? and encounter = ? ", array ($pid,$enc
1154         ));
1155         $drow = sqlQuery("SELECT SUM(pay_amount) AS payments, " . "SUM(adj_amount) AS adjustments FROM ar_activity WHERE " . "pid = ? and encounter = ? ", array ($pid,$enc
1156         ));
1157         $duept = $brow['amount'] + $srow['amount'] - $drow['payments'] - $drow['adjustments'];
1158     }
1159
1160     echoLine("form_upay[$enc]", $dispdate, $value['charges'], $dpayment_pat, ( $dpayment + $dadjustment ), $duept, ($enc.':'.$reason), $inscopay, $patcopay);
1161 }
1162
1163     // Continue with display of the data entry form.
1164     ?>
1165 <tr>
1166                     <td class="dehead" id='td_total_1'></td>
1167                     <td class="dehead" id='td_total_2'></td>
1168                     <td class="dehead" id='td_total_3'></td>
1169                     <td class="dehead" id='td_total_4'></td>
1170                     <td class="dehead" id='td_total_5'></td>
1171                     <td class="dehead" id='td_total_6'></td>
1172                     <td class="dehead" id='td_total_7'></td>
1173                     <td class="dehead" id='td_total_8'></td>
1174                     <td class="dehead" align="right"><?php echo xlt('Total');?></td>
1175                     <td class="dehead" align="right"><input class="form-control" type='text' name='form_paytotal'
1176                     value='' style='color: #00aa00; width: 65px; padding: 1px 1px;' readonly />
1177                     </td>
1178                 </tr>
1179         </table>
1180 <?php
1181 if (isset($ccdata["name"])) {
1182     echo '<div class="col-xs-12 col-md-4 col-lg-4">
1183         <div class="panel panel-default height">';
1184     if (! isset($_SESSION['authUserID'])) {
1185         echo '<div class="panel-heading">'.xlt("Payment Information").'<span style="color:#cc0000"><em> '.xlt("Pending Auth since").': </em>'.text($edata["date"]).'</span></div>';
1186     } else {
1187         echo '<div class="panel-heading">'.xlt("Payment Information").' <button type="button" class="btn btn-danger btn-sm" onclick="getAuth()">'.xlt("Authorize").'</button></div>';
1188     }
1189 } else {
1190     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>';
1191 }
1192     ?>
1193                      <div class="panel-body">
1194                              <strong><?php echo xlt('Card Name');?>:  </strong><span id="cn"><?php echo attr($ccdata["cc_type"])?></span><br>
1195                             <strong><?php echo xlt('Name on Card');?>:  </strong><span id="nc"><?php echo attr($ccdata["name"])?></span><br>
1196                             <strong><?php echo xlt('Card Number');?>:  </strong><span id="ccn"><?php
1197                             if (isset($_SESSION['authUserID'])) {
1198                                 echo $ccdata["cc_number"] . "</span><br>";
1199                             } else {
1200                                 echo "**********  ".substr($ccdata["cc_number"], -4) . "</span><br>";
1201                             }
1202                                     ?>
1203                             <strong><?php echo xlt('Exp Date');?>:  </strong><span id="ed"><?php echo attr($ccdata["month"])."/".attr($ccdata["year"])?></span><br>
1204                             <strong><?php echo xlt('Charge Total');?>:  </strong><span id="ct"><?php echo attr($invdata["form_paytotal"])?></span><br>
1205                       </div>
1206                   </div>
1207              </div>
1208     <p>
1209 <?php
1210 if (! isset($_SESSION['authUserID'])) {
1211     echo '<button type="button" class="btn btn-primary" data-toggle="modal" data-target="#openPayModal">' . xlt("Pay Invoice") . '</button>';
1212 } else {
1213     echo "<button type='submit' class='btn btn-danger' form='payfrm'>" . xlt('Post Payment') . "</button>";
1214 }
1215     ?>
1216  &nbsp;
1217     </p>
1218         <input type="hidden" name="hidden_patient_code" id="hidden_patient_code" value="<?php echo attr($pid);?>" />
1219         <input type='hidden' name='mode' id='mode' value='' />
1220     </form>
1221
1222 <script type="text/javascript">
1223 if (typeof jsondata !== 'undefined') {
1224      formRepopulate(jsondata);
1225 }
1226  calctotal();
1227 </script>
1228     <!-- credit payment modal -->
1229     <div id="openPayModal" class="modal fade" role="dialog">
1230         <div class="modal-dialog">
1231             <div class="modal-content">
1232                 <div class="modal-header">
1233                     <h3><?php echo xlt('Submit Payment for Authorization');?></h3>
1234                     <button type="button" class="close" data-dismiss="modal">&times;</button>
1235                 </div>
1236                 <div class="modal-body container">
1237                     <form id='paycredit' class="form-horizontal col-xs-12 col-sm-6 col-md-6">
1238                         <fieldset>
1239                             <div class="control-group">
1240                                 <label label-default="label-default" class="control-label"><?php echo xlt('Name on Card');?></label>
1241                                 <div class="controls">
1242                                     <input name="name" id="ccname" type="text" class="form-control"
1243                                         pattern="\w+ \w+.*" title="<?php echo xla('Fill your first and last name'); ?>"
1244                                         required value="" />
1245                                 </div>
1246                             </div>
1247                             <div class="control-group">
1248                                 <label class="control-label"><?php echo xlt('Card Number');?></label>
1249                                 <div class="controls">
1250                                     <div class="row">
1251                                     <div class="col-sm-12">
1252                                             <input name="cc_number" id="cc_number" type="text" class="form-control inline col-sm-3"
1253                                                 autocomplete="off" maxlength="19" pattern="\d" onchange="validateCC()"
1254                                                 title="<?php echo xla('Card Number'); ?>" required value="" />
1255                                             <input disabled name="cardtype" id="cardtype" type="text" class="form-control inline" title="<?php echo xla('Card Type'); ?>" style="max-width:160px;font-weight:bold;color:red;" value="" />
1256                                         </div>
1257                                     </div>
1258                                 </div>
1259                             </div>
1260                             <div class="control-group">
1261                                 <label label-default="label-default" class="control-label"><?php echo xlt('Card Expiry Date');?></label>
1262                                 <div class="controls">
1263                                     <div class="row">
1264                                         <div class="col-md-4">
1265                                             <select name="month" id="ccmonth" class="form-control">
1266                                                 <option value=""><?php echo xlt('Select Month'); ?></option>
1267                                                 <option value="01"><?php echo xlt('January'); ?></option>
1268                                                 <option value="02"><?php echo xlt('February'); ?></option>
1269                                                 <option value="03"><?php echo xlt('March'); ?></option>
1270                                                 <option value="04"><?php echo xlt('April'); ?></option>
1271                                                 <option value="05"><?php echo xlt('May'); ?></option>
1272                                                 <option value="06"><?php echo xlt('June'); ?></option>
1273                                                 <option value="07"><?php echo xlt('July'); ?></option>
1274                                                 <option value="08"><?php echo xlt('August'); ?></option>
1275                                                 <option value="09"><?php echo xlt('September'); ?></option>
1276                                                 <option value="10"><?php echo xlt('October'); ?></option>
1277                                                 <option value="11"><?php echo xlt('November'); ?></option>
1278                                                 <option value="12"><?php echo xlt('December'); ?></option>
1279                                             </select>
1280                                         </div>
1281                                         <div class="col-md-3">
1282                                             <select name="year" id="ccyear" class="form-control">
1283                                                 <option value=""><?php echo xlt('Select Year'); ?></option>
1284                                                 <option value="2017">2017</option>
1285                                                 <option value="2018">2018</option>
1286                                                 <option value="2019">2019</option>
1287                                                 <option value="2020">2020</option>
1288                                                 <option value="2021">2021</option>
1289                                                 <option value="2022">2022</option>
1290                                                 <option value="2023">2023</option>
1291                                                 <option value="2024">2024</option>
1292                                             </select>
1293                                         </div>
1294                                     </div>
1295                                 </div>
1296                             </div>
1297                             <div class="control-group">
1298                                 <label label-default="label-default" class="control-label"><?php echo xlt('Card CVV');?></label>
1299                                 <div class="controls">
1300                                     <div class="row">
1301                                         <div class="col-md-3">
1302                                             <input name="pin" id="pin" type="text" class="form-control"
1303                                                 autocomplete="off" maxlength="4" pattern="\d{3}" onfocus="validateCC()"
1304                                                 title="<?php echo xlt('Three or four digits at back of your card'); ?>" required value="" />
1305                                         </div>
1306                                         <div class="col-md-3">
1307                                             <img src='./images/img_cvc.png' style='height: 58px; width: auto'>
1308                                         </div>
1309                                     </div>
1310                                 </div>
1311                             </div>
1312                             <div class="form-actions">
1313                                 <button id="paySubmit" class="btn btn-danger"><?php echo xlt('Submit');?></button>
1314                                 <button type="button" class="btn btn-default" data-dismiss="modal"><?php echo xlt('Cancel');?></button>
1315                             </div>
1316                         </fieldset>
1317                         <input type='hidden' name='cc_type' id='cc_type' value='' />
1318                     </form>
1319                 </div>
1320                 <!-- Body  -->
1321                 <div class="modal-footer">
1322                     <button type="button" class="btn btn-default" data-dismiss="modal"><?php echo xlt('Close');?></button>
1323                 </div>
1324             </div>
1325         </div>
1326     </div>
1327 <?php echo "<script>var ccerr='". xlt('Invalid Credit Card Number') . "';</script>";?>
1328 <script type="text/javascript">
1329 $('#cc_number').validateCreditCard(function(result){
1330     var r = (result.card_type == null ? '' : result.card_type.name.toUpperCase())
1331     var v = (result.valid== true ? ' Valid #' : ' Invalid #')
1332     $('#cardtype').val(r+v);
1333  });
1334 function validateCC() {
1335     var result = $('#cc_number').validateCreditCard();
1336     var r = (result.card_type == null ? '' : result.card_type.name.toUpperCase())
1337     var v = (result.valid == true ? ' Okay' : ' Invalid #')
1338     $('#cardtype').val(r+v);
1339     $('#cc_type').val(r);
1340     if(!result.valid){
1341          alert(ccerr)
1342          return false;
1343     }
1344     else{
1345         return true;
1346     }
1347 }
1348 </script>
1349 </body>
1350 <?php
1351 }
1352 ?>