2 // +-----------------------------------------------------------------------------+
3 // Copyright (C) 2010 Z&H Consultancy Services Private Limited <sam@zhservices.com>
6 // This program is free software; you can redistribute it and/or
7 // modify it under the terms of the GNU General Public License
8 // as published by the Free Software Foundation; either version 2
9 // of the License, or (at your option) any later version.
12 // This program is distributed in the hope that it will be useful,
13 // but WITHOUT ANY WARRANTY; without even the implied warranty of
14 // MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
15 // GNU General Public License for more details.
18 // A copy of the GNU General Public License is included along with this program:
19 // openemr/interface/login/GnuGPL.html
20 // For more information write to the Free Software
21 // Foundation, Inc., 59 Temple Place - Suite 330, Boston, MA 02111-1307, USA.
23 // Author: Eldho Chacko <eldho@zhservices.com>
24 // Paul Simon K <paul@zhservices.com>
26 // +------------------------------------------------------------------------------+
27 //===============================================================================
28 //Payments can be edited here.It includes deletion of an allocation,modifying the
29 //same or adding a new allocation.Log is kept for the deleted ones.
30 //===============================================================================
31 require_once("../globals.php");
32 require_once("$srcdir/log.inc");
33 require_once("$srcdir/invoice_summary.inc.php");
34 require_once("$srcdir/sl_eob.inc.php");
35 require_once("$srcdir/parse_era.inc.php");
36 require_once("../../library/acl.inc");
37 require_once("$srcdir/sql.inc");
38 require_once("$srcdir/auth.inc");
39 require_once("$srcdir/formdata.inc.php");
40 require_once("../../custom/code_types.inc.php");
41 require_once("$srcdir/patient.inc");
42 require_once("$srcdir/billrep.inc");
43 require_once(dirname(__FILE__
) . "/../../library/classes/OFX.class.php");
44 require_once(dirname(__FILE__
) . "/../../library/classes/X12Partner.class.php");
45 require_once("$srcdir/options.inc.php");
46 require_once("$srcdir/formatting.inc.php");
47 require_once("$srcdir/payment.inc.php");
48 //===============================================================================
49 $screen='edit_payment';
50 //===============================================================================
51 // deletion of payment distribution code
52 //===============================================================================
53 if (isset($_POST["mode"]))
55 if ($_POST["mode"] == "DeletePaymentDistribution")
57 $DeletePaymentDistributionId=trim(formData('DeletePaymentDistributionId' ));
58 $DeletePaymentDistributionIdArray=split('_',$DeletePaymentDistributionId);
59 $payment_id=$DeletePaymentDistributionIdArray[0];
60 $PId=$DeletePaymentDistributionIdArray[1];
61 $Encounter=$DeletePaymentDistributionIdArray[2];
62 $Code=$DeletePaymentDistributionIdArray[3];
63 $Modifier=$DeletePaymentDistributionIdArray[4];
64 //delete and log that action
65 row_delete("ar_activity", "session_id ='$payment_id' and pid ='$PId' AND " .
66 "encounter='$Encounter' and code='$Code' and modifier='$Modifier'");
69 $_POST["mode"] = "searchdatabase";
72 //===============================================================================
73 //Modify Payment Code.
74 //===============================================================================
75 if (isset($_POST["mode"]))
77 if ($_POST["mode"] == "ModifyPayments" ||
$_POST["mode"] == "FinishPayments")
79 $payment_id=$_REQUEST['payment_id'];
81 //===============================================================================
82 if(trim(formData('type_name' ))=='insurance')
84 $QueryPart="payer_id = '" . trim(formData('hidden_type_code' )) .
85 "', patient_id = '" . 0 ;
87 elseif(trim(formData('type_name' ))=='patient')
89 $QueryPart="payer_id = '" . 0 .
90 "', patient_id = '" . trim(formData('hidden_type_code' )) ;
92 $user_id=$_SESSION['authUserID'];
94 $modified_time = date('Y-m-d H:i:s');
95 $check_date=DateToYYYYMMDD(formData('check_date'));
96 $deposit_date=DateToYYYYMMDD(formData('deposit_date'));
97 $post_to_date=DateToYYYYMMDD(formData('post_to_date'));
99 $post_to_date=date('Y-m-d');
100 if(formData('deposit_date')=='')
101 $deposit_date=$post_to_date;
103 sqlStatement("update ar_session set " .
105 "', user_id = '" . trim($user_id ) .
106 "', closed = '" . trim($closed ) .
107 "', reference = '" . trim(formData('check_number' )) .
108 "', check_date = '" . trim($check_date ) .
109 "', deposit_date = '" . trim($deposit_date ) .
110 "', pay_total = '" . trim(formData('payment_amount')) .
111 "', modified_time = '" . trim($modified_time ) .
112 "', payment_type = '" . trim(formData('type_name' )) .
113 "', description = '" . trim(formData('description' )) .
114 "', adjustment_code = '" . trim(formData('adjustment_code' )) .
115 "', post_to_date = '" . trim($post_to_date ) .
116 "', payment_method = '" . trim(formData('payment_method' )) .
117 "' where session_id='$payment_id'");
118 //===============================================================================
119 $CountIndexAbove=$_REQUEST['CountIndexAbove'];
120 $CountIndexBelow=$_REQUEST['CountIndexBelow'];
121 $hidden_patient_code=$_REQUEST['hidden_patient_code'];
122 $user_id=$_SESSION['authUserID'];
123 $created_time = date('Y-m-d H:i:s');
124 //==================================================================
126 //It is done with out deleting any old entries.
127 //==================================================================
128 for($CountRow=1;$CountRow<=$CountIndexAbove;$CountRow++
)
130 if (isset($_POST["HiddenEncounter$CountRow"]))
132 if (isset($_POST["Payment$CountRow"]) && $_POST["Payment$CountRow"]*1>0)
134 if(trim(formData('type_name' ))=='insurance')
136 if(trim(formData("HiddenIns$CountRow" ))==1)
140 if(trim(formData("HiddenIns$CountRow" ))==2)
144 if(trim(formData("HiddenIns$CountRow" ))==3)
149 elseif(trim(formData('type_name' ))=='patient')
153 $resPayment = sqlStatement("SELECT * from ar_activity " .
154 " where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
155 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
156 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
157 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
158 "' and pay_amount>0");
159 if(sqlNumRows($resPayment)>0)
161 sqlStatement("update ar_activity set " .
162 " post_user = '" . trim($user_id ) .
163 "', modified_time = '" . trim($created_time ) .
164 "', pay_amount = '" . trim(formData("Payment$CountRow" )) .
165 "', account_code = '" . "$AccountCode" .
166 "', payer_type = '" . trim(formData("HiddenIns$CountRow" )) .
167 "' where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
168 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
169 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
170 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
171 "' and pay_amount>0");
175 sqlStatement("insert into ar_activity set " .
176 "pid = '" . trim(formData("HiddenPId$CountRow" )) .
177 "', encounter = '" . trim(formData("HiddenEncounter$CountRow" )) .
178 "', code = '" . trim(formData("HiddenCode$CountRow" )) .
179 "', modifier = '" . trim(formData("HiddenModifier$CountRow" )) .
180 "', payer_type = '" . trim(formData("HiddenIns$CountRow" )) .
181 "', post_time = '" . trim($created_time ) .
182 "', post_user = '" . trim($user_id ) .
183 "', session_id = '" . trim(formData('payment_id')) .
184 "', modified_time = '" . trim($created_time ) .
185 "', pay_amount = '" . trim(formData("Payment$CountRow" )) .
186 "', adj_amount = '" . 0 .
187 "', account_code = '" . "$AccountCode" .
193 sqlStatement("delete from ar_activity " .
194 " where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
195 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
196 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
197 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
198 "' and pay_amount>0");
200 //==============================================================================================================================
201 if (isset($_POST["AdjAmount$CountRow"]) && $_POST["AdjAmount$CountRow"]*1!=0)
203 if(trim(formData('type_name' ))=='insurance')
205 $AdjustString="Ins adjust Ins".trim(formData("HiddenIns$CountRow" ));
208 elseif(trim(formData('type_name' ))=='patient')
210 $AdjustString="Pt adjust";
213 $resPayment = sqlStatement("SELECT * from ar_activity " .
214 " where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
215 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
216 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
217 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
218 "' and adj_amount!=0");
219 if(sqlNumRows($resPayment)>0)
221 sqlStatement("update ar_activity set " .
222 " post_user = '" . trim($user_id ) .
223 "', modified_time = '" . trim($created_time ) .
224 "', adj_amount = '" . trim(formData("AdjAmount$CountRow" )) .
225 "', memo = '" . "$AdjustString" .
226 "', account_code = '" . "$AccountCode" .
227 "', payer_type = '" . trim(formData("HiddenIns$CountRow" )) .
228 "' where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
229 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
230 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
231 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
232 "' and adj_amount!=0");
236 sqlStatement("insert into ar_activity set " .
237 "pid = '" . trim(formData("HiddenPId$CountRow" )) .
238 "', encounter = '" . trim(formData("HiddenEncounter$CountRow" )) .
239 "', code = '" . trim(formData("HiddenCode$CountRow" )) .
240 "', modifier = '" . trim(formData("HiddenModifier$CountRow" )) .
241 "', payer_type = '" . trim(formData("HiddenIns$CountRow" )) .
242 "', post_time = '" . trim($created_time ) .
243 "', post_user = '" . trim($user_id ) .
244 "', session_id = '" . trim(formData('payment_id')) .
245 "', modified_time = '" . trim($created_time ) .
246 "', pay_amount = '" . 0 .
247 "', adj_amount = '" . trim(formData("AdjAmount$CountRow" )) .
248 "', memo = '" . "$AdjustString" .
249 "', account_code = '" . "$AccountCode" .
256 sqlStatement("delete from ar_activity " .
257 " where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
258 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
259 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
260 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
261 "' and adj_amount!=0");
263 //==============================================================================================================================
264 if (isset($_POST["Deductible$CountRow"]) && $_POST["Deductible$CountRow"]*1>0)
266 $resPayment = sqlStatement("SELECT * from ar_activity " .
267 " where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
268 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
269 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
270 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
271 "' and memo like 'Deductable%'");
272 if(sqlNumRows($resPayment)>0)
274 sqlStatement("update ar_activity set " .
275 " post_user = '" . trim($user_id ) .
276 "', modified_time = '" . trim($created_time ) .
277 "', memo = '" . "Deductable $".trim(formData("Deductible$CountRow" )) .
278 "', account_code = '" . "Deduct" .
279 "', payer_type = '" . trim(formData("HiddenIns$CountRow" )) .
280 "' where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
281 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
282 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
283 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
284 "' and memo like 'Deductable%'");
288 sqlStatement("insert into ar_activity set " .
289 "pid = '" . trim(formData("HiddenPId$CountRow" )) .
290 "', encounter = '" . trim(formData("HiddenEncounter$CountRow" )) .
291 "', code = '" . trim(formData("HiddenCode$CountRow" )) .
292 "', modifier = '" . trim(formData("HiddenModifier$CountRow" )) .
293 "', payer_type = '" . trim(formData("HiddenIns$CountRow" )) .
294 "', post_time = '" . trim($created_time ) .
295 "', post_user = '" . trim($user_id ) .
296 "', session_id = '" . trim(formData('payment_id')) .
297 "', modified_time = '" . trim($created_time ) .
298 "', pay_amount = '" . 0 .
299 "', adj_amount = '" . 0 .
300 "', memo = '" . "Deductable $".trim(formData("Deductible$CountRow" )) .
301 "', account_code = '" . "Deduct" .
307 sqlStatement("delete from ar_activity " .
308 " where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
309 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
310 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
311 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
312 "' and memo like 'Deductable%'");
314 //==============================================================================================================================
315 if (isset($_POST["Takeback$CountRow"]) && $_POST["Takeback$CountRow"]*1>0)
317 $resPayment = sqlStatement("SELECT * from ar_activity " .
318 " where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
319 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
320 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
321 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
322 "' and pay_amount < 0");
323 if(sqlNumRows($resPayment)>0)
325 sqlStatement("update ar_activity set " .
326 " post_user = '" . trim($user_id ) .
327 "', modified_time = '" . trim($created_time ) .
328 "', pay_amount = '" . trim(formData("Takeback$CountRow" ))*-1 .
329 "', account_code = '" . "Takeback" .
330 "', payer_type = '" . trim(formData("HiddenIns$CountRow" )) .
331 "' where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
332 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
333 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
334 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
335 "' and pay_amount < 0");
339 sqlStatement("insert into ar_activity set " .
340 "pid = '" . trim(formData("HiddenPId$CountRow" )) .
341 "', encounter = '" . trim(formData("HiddenEncounter$CountRow" )) .
342 "', code = '" . trim(formData("HiddenCode$CountRow" )) .
343 "', modifier = '" . trim(formData("HiddenModifier$CountRow" )) .
344 "', payer_type = '" . trim(formData("HiddenIns$CountRow" )) .
345 "', post_time = '" . trim($created_time ) .
346 "', post_user = '" . trim($user_id ) .
347 "', session_id = '" . trim(formData('payment_id')) .
348 "', modified_time = '" . trim($created_time ) .
349 "', pay_amount = '" . trim(formData("Takeback$CountRow" ))*-1 .
350 "', adj_amount = '" . 0 .
351 "', account_code = '" . "Takeback" .
357 sqlStatement("delete from ar_activity " .
358 " where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
359 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
360 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
361 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
362 "' and pay_amount < 0");
364 //==============================================================================================================================
365 if (isset($_POST["FollowUp$CountRow"]) && $_POST["FollowUp$CountRow"]=='y')
367 $resPayment = sqlStatement("SELECT * from ar_activity " .
368 " where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
369 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
370 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
371 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
372 "' and follow_up ='y'");
373 if(sqlNumRows($resPayment)>0)
375 sqlStatement("update ar_activity set " .
376 " post_user = '" . trim($user_id ) .
377 "', modified_time = '" . trim($created_time ) .
378 "', follow_up = '" . "y" .
379 "', follow_up_note = '" . trim(formData("FollowUpReason$CountRow" )) .
380 "', payer_type = '" . trim(formData("HiddenIns$CountRow" )) .
381 "' where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
382 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
383 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
384 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
385 "' and follow_up ='y'");
389 sqlStatement("insert into ar_activity set " .
390 "pid = '" . trim(formData("HiddenPId$CountRow" )) .
391 "', encounter = '" . trim(formData("HiddenEncounter$CountRow" )) .
392 "', code = '" . trim(formData("HiddenCode$CountRow" )) .
393 "', modifier = '" . trim(formData("HiddenModifier$CountRow" )) .
394 "', payer_type = '" . trim(formData("HiddenIns$CountRow" )) .
395 "', post_time = '" . trim($created_time ) .
396 "', post_user = '" . trim($user_id ) .
397 "', session_id = '" . trim(formData('payment_id')) .
398 "', modified_time = '" . trim($created_time ) .
399 "', pay_amount = '" . 0 .
400 "', adj_amount = '" . 0 .
401 "', follow_up = '" . "y" .
402 "', follow_up_note = '" . trim(formData("FollowUpReason$CountRow" )) .
408 sqlStatement("delete from ar_activity " .
409 " where session_id ='$payment_id' and pid ='" . trim(formData("HiddenPId$CountRow" )) .
410 "' and encounter ='" . trim(formData("HiddenEncounter$CountRow" )) .
411 "' and code ='" . trim(formData("HiddenCode$CountRow" )) .
412 "' and modifier ='" . trim(formData("HiddenModifier$CountRow" )) .
413 "' and follow_up ='y'");
415 //==============================================================================================================================
421 //INSERTION of new entries,continuation of modification.
423 for($CountRow=$CountIndexAbove+
1;$CountRow<=$CountIndexAbove+
$CountIndexBelow;$CountRow++
)
425 if (isset($_POST["HiddenEncounter$CountRow"]))
427 DistributionInsert($CountRow,$created_time,$user_id);
432 if($_REQUEST['global_amount']=='yes')
433 sqlStatement("update ar_session set global_amount=".trim(formData("HidUnappliedAmount" ))*1 ." where session_id ='$payment_id'");
434 if($_POST["mode"]=="FinishPayments")
438 $_POST["mode"] = "searchdatabase";
442 //==============================================================================
444 //===============================================================================
445 $payment_id=$payment_id*1 > 0 ?
$payment_id : $_REQUEST['payment_id'];
446 $ResultSearchSub = sqlStatement("SELECT distinct encounter,code,modifier, pid from ar_activity where session_id ='$payment_id' order by pid,encounter,code,modifier");
447 //==============================================================================
448 $DateFormat=DateFormatRead();
449 //==============================================================================
450 //===============================================================================
455 <?php
if (function_exists('html_header_show')) html_header_show(); ?
>
457 <link rel
="stylesheet" href
="<?php echo $css_header;?>" type
="text/css">
459 <!-- supporting javascript code
-->
461 <script type
="text/javascript" src
="<?php echo $GLOBALS['webroot'] ?>/library/dialog.js"></script
>
465 <link rel
="stylesheet" href
="<?php echo $css_header;?>" type
="text/css">
466 <link rel
="stylesheet" type
="text/css" href
="../../library/js/fancybox/jquery.fancybox-1.2.6.css" media
="screen" />
467 <style type
="text/css">@import
url(../../library
/dynarch_calendar
.css
);</style
>
468 <script type
="text/javascript" src
="../../library/textformat.js"></script
>
469 <script type
="text/javascript" src
="../../library/dynarch_calendar.js"></script
>
470 <?php
include_once("{$GLOBALS['srcdir']}/dynarch_calendar_en.inc.php"); ?
>
471 <script type
="text/javascript" src
="../../library/dynarch_calendar_setup.js"></script
>
472 <script type
="text/javascript" src
="../../library/dialog.js"></script
>
473 <script type
="text/javascript" src
="../../library/js/jquery.1.3.2.js"></script
>
474 <script type
="text/javascript" src
="../../library/js/fancybox/jquery.fancybox-1.2.6.js"></script
>
475 <script language
='JavaScript'>
478 <?php
include_once("{$GLOBALS['srcdir']}/payment_jav.inc.php"); ?
>
479 <?php
include_once("{$GLOBALS['srcdir']}/ajax/payment_ajax_jav.inc.php"); ?
>
480 <script type
="text/javascript" src
="../../library/js/common.js"></script
>
481 <script LANGUAGE
="javascript" TYPE
="text/javascript">
482 function ModifyPayments()
483 {//Used while modifying the allocation
484 if(!FormValidations())//FormValidations contains the form checks
488 if(CompletlyBlankAbove())//The distribution rows already in the database are checked.
490 alert("<?php echo htmlspecialchars( xl('None of the Top Distribution Row Can be Completly Blank.'), ENT_QUOTES);echo htmlspecialchars('\n');echo htmlspecialchars( xl('Use Delete Option to Remove.'), ENT_QUOTES) ?>")
493 if(!CheckPayingEntityAndDistributionPostFor())//Ensures that Insurance payment is distributed under Ins1,Ins2,Ins3 and Patient paymentat under Pat.
497 if(CompletlyBlankBelow())//The newly added distribution rows are checked.
499 alert("<?php echo htmlspecialchars( xl('Fill any of the Below Row.'), ENT_QUOTES) ?>")
502 PostValue
=CheckUnappliedAmount();//Decides TdUnappliedAmount >0, or <0 or =0
505 alert("<?php echo htmlspecialchars( xl('Cannot Modify Payments.Undistributed is Negative.'), ENT_QUOTES) ?>")
508 if(confirm("<?php echo htmlspecialchars( xl('Would you like to Modify Payments?'), ENT_QUOTES) ?>"))
510 document
.getElementById('mode').value
='ModifyPayments';
511 top
.restoreSession();
512 document
.forms
[0].submit();
517 function FinishPayments()
519 if(!FormValidations())//FormValidations contains the form checks
523 if(CompletlyBlankAbove())//The distribution rows already in the database are checked.
525 alert("<?php echo htmlspecialchars( xl('None of the Top Distribution Row Can be Completly Blank.'), ENT_QUOTES);echo htmlspecialchars('\n');echo htmlspecialchars( xl('Use Delete Option to Remove.'), ENT_QUOTES) ?>")
528 if(!CheckPayingEntityAndDistributionPostFor())//Ensures that Insurance payment is distributed under Ins1,Ins2,Ins3 and Patient paymentat under Pat.
532 if(CompletlyBlankBelow())//The newly added distribution rows are checked.
534 alert("<?php echo htmlspecialchars( xl('Fill any of the Below Row.'), ENT_QUOTES) ?>")
537 PostValue
=CheckUnappliedAmount();//Decides TdUnappliedAmount >0, or <0 or =0
540 alert("<?php echo htmlspecialchars( xl('Cannot Modify Payments.UNDISTRIBUTED is Negative.'), ENT_QUOTES) ?>")
545 if(confirm("<?php echo htmlspecialchars( xl('Would you like to Modify and Finish Payments?'), ENT_QUOTES) ?>"))
547 UnappliedAmount
=document
.getElementById('TdUnappliedAmount').innerHTML
*1;
548 if(confirm("<?php echo htmlspecialchars( xl('UNDISTRIBUTED is'), ENT_QUOTES) ?>" +
' ' + UnappliedAmount +
'.' +
"<?php echo htmlspecialchars('\n');echo htmlspecialchars( xl('Would you like the balance amount to apply to Global Account?'), ENT_QUOTES) ?>"))
550 document
.getElementById('mode').value
='FinishPayments';
551 document
.getElementById('global_amount').value
='yes';
552 top
.restoreSession();
553 document
.forms
[0].submit();
557 document
.getElementById('mode').value
='FinishPayments';
558 top
.restoreSession();
559 document
.forms
[0].submit();
567 if(confirm("<?php echo htmlspecialchars( xl('Would you like to Modify and Finish Payments?'), ENT_QUOTES) ?>"))
569 document
.getElementById('mode').value
='FinishPayments';
570 top
.restoreSession();
571 document
.forms
[0].submit();
578 function CompletlyBlankAbove()
579 {//The distribution rows already in the database are checked.
580 //It is not allowed to be made completly empty.If needed delete option need to be used.
581 CountIndexAbove
=document
.getElementById('CountIndexAbove').value
*1;
582 for(RowCount
=1;RowCount
<=CountIndexAbove
;RowCount++
)
584 if(document
.getElementById('Allowed'+RowCount
).value
=='' && document
.getElementById('Payment'+RowCount
).value
=='' && document
.getElementById('AdjAmount'+RowCount
).value
=='' && document
.getElementById('Deductible'+RowCount
).value
=='' && document
.getElementById('Takeback'+RowCount
).value
=='' && document
.getElementById('FollowUp'+RowCount
).checked
==false)
591 function CompletlyBlankBelow()
592 {//The newly added distribution rows are checked.
593 //It is not allowed to be made completly empty.
594 CountIndexAbove
=document
.getElementById('CountIndexAbove').value
*1;
595 CountIndexBelow
=document
.getElementById('CountIndexBelow').value
*1;
596 if(CountIndexBelow
==0)
598 for(RowCount
=CountIndexAbove+
1;RowCount
<=CountIndexAbove+CountIndexBelow
;RowCount++
)
600 if(document
.getElementById('Allowed'+RowCount
).value
=='' && document
.getElementById('Payment'+RowCount
).value
=='' && document
.getElementById('AdjAmount'+RowCount
).value
=='' && document
.getElementById('Deductible'+RowCount
).value
=='' && document
.getElementById('Takeback'+RowCount
).value
=='' && document
.getElementById('FollowUp'+RowCount
).checked
==false)
609 function OnloadAction()
610 {//Displays message while loading after some action.
611 after_value
=document
.getElementById('ActionStatus').value
;
612 if(after_value
=='Delete')
614 alert("<?php echo htmlspecialchars( xl('Successfully Deleted'), ENT_QUOTES) ?>")
617 if(after_value
=='Modify' || after_value
=='Finish')
619 alert("<?php echo htmlspecialchars( xl('Successfully Modified'), ENT_QUOTES) ?>")
622 after_value
=document
.getElementById('after_value').value
;
623 payment_id
=document
.getElementById('payment_id').value
;
624 if(after_value
=='distribute')
627 else if(after_value
=='new_payment')
629 if(document
.getElementById('TablePatientPortion'))
631 document
.getElementById('TablePatientPortion').style
.display
='none';
633 if(confirm("<?php echo htmlspecialchars( xl('Successfully Saved.Would you like to Distribute?'), ENT_QUOTES) ?>"))
635 if(document
.getElementById('TablePatientPortion'))
637 document
.getElementById('TablePatientPortion').style
.display
='';
643 function DeletePaymentDistribution(DeleteId
)
644 {//Confirms deletion of payment distribution.
645 if(confirm("<?php echo htmlspecialchars( xl('Would you like to Delete Payment Distribution?'), ENT_QUOTES) ?>"))
647 document
.getElementById('mode').value
='DeletePaymentDistribution';
648 document
.getElementById('DeletePaymentDistributionId').value
=DeleteId
;
649 top
.restoreSession();
650 document
.forms
[0].submit();
655 //========================================================================================
657 <script language
="javascript" type
="text/javascript">
658 document
.onclick
=HideTheAjaxDivs
;
661 .class1
{width
:125px
;}
662 .class2
{width
:250px
;}
663 .class3
{width
:100px
;}
664 .bottom
{border
-bottom
:1px solid black
;}
665 .top
{border
-top
:1px solid black
;}
666 .left
{border
-left
:1px solid black
;}
667 .right
{border
-right
:1px solid black
;}
668 #ajax_div_insurance {
675 background
-color
: #FBFDD0;
676 border
: 1px solid
#ccc;
686 background
-color
: #FBFDD0;
687 border
: 1px solid
#ccc;
691 <link rel
="stylesheet" href
="<?php echo $css_header; ?>" type
="text/css">
693 <body
class="body_top" onLoad
="OnloadAction()" >
694 <form name
='new_payment' method
='post' action
="edit_payment.php" onsubmit
='
699 top.restoreSession();return SavePayment();
709 ' style
="display:inline" >
710 <table width
="1024" border
="0" cellspacing
="0" cellpadding
="0">
712 if($_REQUEST['ParentPage']=='new_payment')
716 <td colspan
="3" align
="left"><b
><?php
echo htmlspecialchars( xl('Payments'), ENT_QUOTES
) ?
></b
></td
>
719 <td colspan
="3" align
="left" ></td
>
722 <td colspan
="3" align
="left">
724 <li
class='current'><a href
='new_payment.php'><?php
echo htmlspecialchars( xl('New Payment'), ENT_QUOTES
) ?
></a
></li
>
725 <li
><a href
='search_payments.php'><?php
echo htmlspecialchars( xl('Search Payment'), ENT_QUOTES
) ?
></a
></li
>
726 <li
><a href
='era_payments.php'><?php
echo htmlspecialchars( xl('ERA Posting'), ENT_QUOTES
) ?
></a
></li
>
735 <td colspan
="3" align
="left" ></td
>
741 <td colspan
="3" align
="left" >
748 require_once("payment_master.inc.php"); //Check/cash details are entered here.
761 {//Distribution rows already in the database are displayed.
764 <table width
="1024" border
="0" cellspacing
="0" cellpadding
="10" bgcolor
="#DEDEDE"><tr
><td
>
765 <table width
="1004" border
="0" cellspacing
="0" cellpadding
="0">
768 <td colspan
="13" align
="left" >
771 $resCount = sqlStatement("SELECT distinct encounter,code,modifier from ar_activity where session_id ='$payment_id' ");
772 $TotalRows=sqlNumRows($resCount);
781 if($RowSearchSub = sqlFetchArray($ResultSearchSub))
786 $PId=$RowSearchSub['pid'];
787 $EncounterMaster=$RowSearchSub['encounter'];
788 $CodeMaster=$RowSearchSub['code'];
789 $ModifierMaster=$RowSearchSub['modifier'];
790 $res = sqlStatement("SELECT fname,lname,mname FROM patient_data where pid ='$PId'");
791 $row = sqlFetchArray($res);
792 $fname=$row['fname'];
793 $lname=$row['lname'];
794 $mname=$row['mname'];
795 $NameDB=$lname.' '.$fname.' '.$mname;
796 $ResultSearch = sqlStatement("SELECT billing.id,last_level_closed,billing.encounter,form_encounter.`date`,billing.code,billing.modifier,fee
797 FROM billing ,form_encounter
798 where billing.encounter=form_encounter.encounter and billing.pid=form_encounter.pid and
799 code_type!='ICD9' and code_type!='COPAY' and billing.activity!=0 and
800 form_encounter.pid ='$PId' and billing.pid ='$PId' and billing.encounter ='$EncounterMaster'
801 and billing.code ='$CodeMaster'
802 and billing.modifier ='$ModifierMaster'
803 ORDER BY form_encounter.`date`,form_encounter.encounter,billing.code,billing.modifier");
804 if(sqlNumRows($ResultSearch)>0)
810 <table width
="1004" border
="0" cellpadding
="0" cellspacing
="0" align
="center" id
="TableDistributePortion">
811 <tr
class="text" bgcolor
="#dddddd">
812 <td width
="25" class="left top" > 
;</td
>
813 <td width
="144" class="left top" ><?php
echo htmlspecialchars( xl('Patient Name'), ENT_QUOTES
) ?
></td
>
814 <td width
="55" class="left top" ><?php
echo htmlspecialchars( xl('Post For'), ENT_QUOTES
) ?
></td
>
815 <td width
="70" class="left top" ><?php
echo htmlspecialchars( xl('Srv Date'), ENT_QUOTES
) ?
></td
>
816 <td width
="50" class="left top" ><?php
echo htmlspecialchars( xl('Encnter'), ENT_QUOTES
) ?
></td
>
817 <td width
="65" class="left top" ><?php
echo htmlspecialchars( xl('CPT Code'), ENT_QUOTES
) ?
></td
>
818 <td width
="50" class="left top" ><?php
echo htmlspecialchars( xl('Charge'), ENT_QUOTES
) ?
></td
>
819 <td width
="40" class="left top" ><?php
echo htmlspecialchars( xl('Copay'), ENT_QUOTES
) ?
></td
>
820 <td width
="40" class="left top" ><?php
echo htmlspecialchars( xl('Remdr'), ENT_QUOTES
) ?
></td
>
821 <td width
="60" class="left top" ><?php
echo htmlspecialchars( xl('Allowed(c)'), ENT_QUOTES
) ?
></td
><!-- (c
) means it is calculated
.Not stored one
. -->
822 <td width
="60" class="left top" ><?php
echo htmlspecialchars( xl('Payment'), ENT_QUOTES
) ?
></td
>
823 <td width
="70" class="left top" ><?php
echo htmlspecialchars( xl('Adj Amount'), ENT_QUOTES
) ?
></td
>
824 <td width
="60" class="left top" ><?php
echo htmlspecialchars( xl('Deductible'), ENT_QUOTES
) ?
></td
>
825 <td width
="60" class="left top" ><?php
echo htmlspecialchars( xl('Takeback'), ENT_QUOTES
) ?
></td
>
826 <td width
="40" class="left top" ><?php
echo htmlspecialchars( xl('Resn'), ENT_QUOTES
) ?
></td
>
827 <td width
="110" class="left top right" ><?php
echo htmlspecialchars( xl('Follow Up Reason'), ENT_QUOTES
) ?
></td
>
831 while ($RowSearch = sqlFetchArray($ResultSearch))
835 $ServiceDateArray=split(' ',$RowSearch['date']);
836 $ServiceDate=oeFormatShortDate($ServiceDateArray[0]);
837 $Code=$RowSearch['code'];
838 $Modifier =$RowSearch['modifier'];
840 $ModifierString=", $Modifier";
843 $Fee=$RowSearch['fee'];
844 $Encounter=$RowSearch['encounter'];
846 $resPayer = sqlStatement("SELECT payer_type from ar_activity where session_id ='$payment_id' and
847 pid ='$PId' and encounter ='$Encounter' and code='$Code' and modifier='$Modifier' ");
848 $rowPayer = sqlFetchArray($resPayer);
849 $Ins=$rowPayer['payer_type'];
851 //Always associating the copay to a particular charge.
852 $BillingId=$RowSearch['id'];
853 $resId = sqlStatement("SELECT id FROM billing where code_type!='ICD9' and code_type!='COPAY' and
854 pid ='$PId' and encounter ='$Encounter' and billing.activity!=0 order by id");
855 $rowId = sqlFetchArray($resId);
858 if($BillingId!=$Id)//multiple cpt in single encounter
864 $resCopay = sqlStatement("SELECT sum(fee) as copay FROM billing where
865 code_type='COPAY' and pid ='$PId' and encounter ='$Encounter' and billing.activity!=0");
866 $rowCopay = sqlFetchArray($resCopay);
867 $Copay=$rowCopay['copay']*-1;
869 $resMoneyGot = sqlStatement("SELECT sum(pay_amount) as PatientPay FROM ar_activity where
870 pid ='$PId' and encounter ='$Encounter' and payer_type=0 and
871 (code='CO-PAY' or account_code='PCP')");//new fees screen copay gives account_code='PCP'
872 //openemr payment screen copay gives code='CO-PAY'
873 $rowMoneyGot = sqlFetchArray($resMoneyGot);
874 $PatientPay=$rowMoneyGot['PatientPay'];
876 $Copay=$Copay+
$PatientPay;
879 //For calculating Remainder
882 $resMoneyGot = sqlStatement("SELECT sum(pay_amount) as MoneyGot FROM ar_activity where
883 pid ='$PId' and code='$Code' and modifier='$Modifier' and encounter ='$Encounter' and !(payer_type=0 and
884 (code='CO-PAY' or account_code='PCP'))");
885 //new fees screen copay gives account_code='PCP'
886 //openemr payment screen copay gives code='CO-PAY'
887 $rowMoneyGot = sqlFetchArray($resMoneyGot);
888 $MoneyGot=$rowMoneyGot['MoneyGot'];
890 $resMoneyAdjusted = sqlStatement("SELECT sum(adj_amount) as MoneyAdjusted FROM ar_activity where
891 pid ='$PId' and code='$Code' and modifier='$Modifier' and encounter ='$Encounter'");
892 $rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
893 $MoneyAdjusted=$rowMoneyAdjusted['MoneyAdjusted'];
895 else//Fetch till that much got
897 //Fetch the HIGHEST sequence_no till this session.
898 //Used maily in the case if primary/others pays once more.
899 $resSequence = sqlStatement("SELECT sequence_no from ar_activity where session_id ='$payment_id' and
900 pid ='$PId' and encounter ='$Encounter' order by sequence_no desc ");
901 $rowSequence = sqlFetchArray($resSequence);
902 $Sequence=$rowSequence['sequence_no'];
904 $resMoneyGot = sqlStatement("SELECT sum(pay_amount) as MoneyGot FROM ar_activity where
905 pid ='$PId' and code='$Code' and modifier='$Modifier' and encounter ='$Encounter' and
906 payer_type > 0 and payer_type <='$Ins' and sequence_no<='$Sequence'");
907 $rowMoneyGot = sqlFetchArray($resMoneyGot);
908 $MoneyGot=$rowMoneyGot['MoneyGot'];
910 $resMoneyAdjusted = sqlStatement("SELECT sum(adj_amount) as MoneyAdjusted FROM ar_activity where
911 pid ='$PId' and code='$Code' and modifier='$Modifier' and encounter ='$Encounter' and
912 payer_type > 0 and payer_type <='$Ins' and sequence_no<='$Sequence'");
913 $rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
914 $MoneyAdjusted=$rowMoneyAdjusted['MoneyAdjusted'];
916 $Remainder=$Fee-$Copay-$MoneyGot-$MoneyAdjusted;
918 //For calculating RemainderJS.Used while restoring back the values.
920 {//Got just before Patient
921 $resMoneyGot = sqlStatement("SELECT sum(pay_amount) as MoneyGot FROM ar_activity where
922 pid ='$PId' and code='$Code' and modifier='$Modifier' and encounter ='$Encounter' and payer_type !=0");
923 $rowMoneyGot = sqlFetchArray($resMoneyGot);
924 $MoneyGot=$rowMoneyGot['MoneyGot'];
926 $resMoneyAdjusted = sqlStatement("SELECT sum(adj_amount) as MoneyAdjusted FROM ar_activity where
927 pid ='$PId' and code='$Code' and modifier='$Modifier' and encounter ='$Encounter' and payer_type !=0");
928 $rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
929 $MoneyAdjusted=$rowMoneyAdjusted['MoneyAdjusted'];
932 {//Got just before the previous
933 //Fetch the LOWEST sequence_no till this session.
934 //Used maily in the case if primary/others pays once more.
935 $resSequence = sqlStatement("SELECT sequence_no from ar_activity where session_id ='$payment_id' and
936 pid ='$PId' and encounter ='$Encounter' order by sequence_no ");
937 $rowSequence = sqlFetchArray($resSequence);
938 $Sequence=$rowSequence['sequence_no'];
940 $resMoneyGot = sqlStatement("SELECT sum(pay_amount) as MoneyGot FROM ar_activity where
941 pid ='$PId' and code='$Code' and modifier='$Modifier' and encounter ='$Encounter'
942 and payer_type > 0 and payer_type <='$Ins' and sequence_no<'$Sequence'");
943 $rowMoneyGot = sqlFetchArray($resMoneyGot);
944 $MoneyGot=$rowMoneyGot['MoneyGot'];
946 $resMoneyAdjusted = sqlStatement("SELECT sum(adj_amount) as MoneyAdjusted FROM ar_activity where
947 pid ='$PId' and code='$Code' and modifier='$Modifier' and encounter ='$Encounter'
948 and payer_type <='$Ins' and sequence_no<'$Sequence' ");
949 $rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
950 $MoneyAdjusted=$rowMoneyAdjusted['MoneyAdjusted'];
952 //Stored in hidden so that can be used while restoring back the values.
953 $RemainderJS=$Fee-$Copay-$MoneyGot-$MoneyAdjusted;
955 $resPayment = sqlStatement("SELECT pay_amount from ar_activity where session_id ='$payment_id' and
956 pid ='$PId' and encounter ='$Encounter' and code='$Code' and modifier='$Modifier' and pay_amount>0");
957 $rowPayment = sqlFetchArray($resPayment);
958 $PaymentDB=$rowPayment['pay_amount']*1;
959 $PaymentDB=$PaymentDB == 0 ?
'' : $PaymentDB;
961 $resPayment = sqlStatement("SELECT pay_amount from ar_activity where session_id ='$payment_id' and
962 pid ='$PId' and encounter ='$Encounter' and code='$Code' and modifier='$Modifier' and pay_amount<0");
963 $rowPayment = sqlFetchArray($resPayment);
964 $TakebackDB=$rowPayment['pay_amount']*-1;
965 $TakebackDB=$TakebackDB == 0 ?
'' : $TakebackDB;
967 $resPayment = sqlStatement("SELECT adj_amount from ar_activity where session_id ='$payment_id' and
968 pid ='$PId' and encounter ='$Encounter' and code='$Code' and modifier='$Modifier' and adj_amount!=0");
969 $rowPayment = sqlFetchArray($resPayment);
970 $AdjAmountDB=$rowPayment['adj_amount']*1;
971 $AdjAmountDB=$AdjAmountDB == 0 ?
'' : $AdjAmountDB;
973 $resPayment = sqlStatement("SELECT memo from ar_activity where session_id ='$payment_id' and
974 pid ='$PId' and encounter ='$Encounter' and code='$Code' and modifier='$Modifier' and memo like 'Deductable%'");
975 $rowPayment = sqlFetchArray($resPayment);
976 $DeductibleDB=$rowPayment['memo'];
977 $DeductibleDB=str_replace('Deductable $','',$DeductibleDB);
979 $resPayment = sqlStatement("SELECT follow_up,follow_up_note from ar_activity where session_id ='$payment_id' and
980 pid ='$PId' and encounter ='$Encounter' and code='$Code' and modifier='$Modifier' and follow_up = 'y'");
981 $rowPayment = sqlFetchArray($resPayment);
982 $FollowUpDB=$rowPayment['follow_up'];
983 $FollowUpReasonDB=$rowPayment['follow_up_note'];
987 $AllowedDB=number_format($Fee-$AdjAmountDB,2);
993 $AllowedDB=$AllowedDB == 0 ?
'' : $AllowedDB;
995 if($CountIndex==$TotalRows)
997 $StringClass=' bottom left top ';
1001 $StringClass=' left top ';
1020 $paymenttot=$paymenttot+
$PaymentDB;
1021 $adjamttot=$adjamttot+
$AdjAmountDB;
1022 $deductibletot=$deductibletot+
$DeductibleDB;
1023 $takebacktot=$takebacktot+
$TakebackDB;
1024 $allowedtot=$allowedtot+
$AllowedDB;
1026 <tr
class="text" bgcolor
='<?php echo $bgcolor; ?>' id
="trCharges<?php echo $CountIndex; ?>">
1027 <td align
="left" class="<?php echo $StringClass; ?>" ><a href
="#" onClick
="javascript:return DeletePaymentDistribution('<?php echo htmlspecialchars($payment_id.'_'.$PId.'_'.$Encounter.'_'.$Code.'_'.$Modifier); ?>');" ><img src
="../pic/Delete.gif" border
="0"/></a
></td
>
1028 <td align
="left" class="<?php echo $StringClass; ?>" ><?php
echo htmlspecialchars($NameDB); ?
><input name
="HiddenPId<?php echo $CountIndex; ?>" value
="<?php echo htmlspecialchars($PId); ?>" type
="hidden"/></td
>
1029 <td align
="left" class="<?php echo $StringClass; ?>" ><input name
="HiddenIns<?php echo $CountIndex; ?>" id
="HiddenIns<?php echo $CountIndex; ?>" value
="<?php echo htmlspecialchars($Ins); ?>" type
="hidden"/><?php
echo generate_select_list("payment_ins$CountIndex", "payment_ins", "$Ins", "Insurance/Patient",'','','ActionOnInsPat("'.$CountIndex.'")'); ?
></td
>
1030 <td
class="<?php echo $StringClass; ?>" ><?php
echo htmlspecialchars($ServiceDate); ?
></td
>
1031 <td align
="right" class="<?php echo $StringClass; ?>" ><input name
="HiddenEncounter<?php echo $CountIndex; ?>" value
="<?php echo htmlspecialchars($Encounter); ?>" type
="hidden"/><?php
echo htmlspecialchars($Encounter); ?
></td
>
1032 <td
class="<?php echo $StringClass; ?>" ><input name
="HiddenCode<?php echo $CountIndex; ?>" value
="<?php echo htmlspecialchars($Code); ?>" type
="hidden"/><?php
echo htmlspecialchars($Code.$ModifierString); ?
><input name
="HiddenModifier<?php echo $CountIndex; ?>" value
="<?php echo htmlspecialchars($Modifier); ?>" type
="hidden"/></td
>
1033 <td align
="right" class="<?php echo $StringClass; ?>" ><input name
="HiddenChargeAmount<?php echo $CountIndex; ?>" id
="HiddenChargeAmount<?php echo $CountIndex; ?>" value
="<?php echo htmlspecialchars($Fee); ?>" type
="hidden"/><?php
echo htmlspecialchars($Fee); ?
></td
>
1034 <td align
="right" class="<?php echo $StringClass; ?>" ><input name
="HiddenCopayAmount<?php echo $CountIndex; ?>" id
="HiddenCopayAmount<?php echo $CountIndex; ?>" value
="<?php echo htmlspecialchars($Copay); ?>" type
="hidden"/><?php
echo htmlspecialchars(number_format($Copay,2)); ?
></td
>
1035 <td align
="right" id
="RemainderTd<?php echo $CountIndex; ?>" class="<?php echo $StringClass; ?>" ><?php
echo htmlspecialchars(round($Remainder,2)); ?
></td
>
1036 <input name
="HiddenRemainderTd<?php echo $CountIndex; ?>" id
="HiddenRemainderTd<?php echo $CountIndex; ?>" value
="<?php echo htmlspecialchars(round($RemainderJS,2)); ?>" type
="hidden"/>
1037 <td
class="<?php echo $StringClass; ?>" ><input name
="Allowed<?php echo $CountIndex; ?>" id
="Allowed<?php echo $CountIndex; ?>" onKeyDown
="PreventIt(event)" autocomplete
="off" value
="<?php echo htmlspecialchars($AllowedDB); ?>" onChange
="ValidateNumeric(this);ScreenAdjustment(this,<?php echo $CountIndex; ?>);UpdateTotalValues(1,<?php echo $TotalRows; ?>,'Allowed','allowtotal');UpdateTotalValues(1,<?php echo $TotalRows; ?>,'Payment','paymenttotal');UpdateTotalValues(1,<?php echo $TotalRows; ?>,'AdjAmount','AdjAmounttotal');RestoreValues(<?php echo $CountIndex; ?>)" type
="text" style
="width:60px;text-align:right; font-size:12px" /></td
>
1038 <td
class="<?php echo $StringClass; ?>" ><input type
="text" name
="Payment<?php echo $CountIndex; ?>" onKeyDown
="PreventIt(event)" autocomplete
="off" id
="Payment<?php echo $CountIndex; ?>" value
="<?php echo htmlspecialchars($PaymentDB); ?>" onChange
="ValidateNumeric(this);ScreenAdjustment(this,<?php echo $CountIndex; ?>);UpdateTotalValues(1,<?php echo $TotalRows; ?>,'Payment','paymenttotal');RestoreValues(<?php echo $CountIndex; ?>)" style
="width:60px;text-align:right; font-size:12px" /></td
>
1039 <td
class="<?php echo $StringClass; ?>" ><input name
="AdjAmount<?php echo $CountIndex; ?>" onKeyDown
="PreventIt(event)" autocomplete
="off" id
="AdjAmount<?php echo $CountIndex; ?>" value
="<?php echo htmlspecialchars($AdjAmountDB); ?>" onChange
="ValidateNumeric(this);ScreenAdjustment(this,<?php echo $CountIndex; ?>);UpdateTotalValues(1,<?php echo $TotalRows; ?>,'AdjAmount','AdjAmounttotal');RestoreValues(<?php echo $CountIndex; ?>)" type
="text" style
="width:70px;text-align:right; font-size:12px" /></td
>
1040 <td
class="<?php echo $StringClass; ?>" ><input name
="Deductible<?php echo $CountIndex; ?>" id
="Deductible<?php echo $CountIndex; ?>" onKeyDown
="PreventIt(event)" onChange
="ValidateNumeric(this);UpdateTotalValues(1,<?php echo $TotalRows; ?>,'Deductible','deductibletotal');" value
="<?php echo htmlspecialchars($DeductibleDB); ?>" autocomplete
="off" type
="text" style
="width:60px;text-align:right; font-size:12px" /></td
>
1041 <td
class="<?php echo $StringClass; ?>" ><input name
="Takeback<?php echo $CountIndex; ?>" onKeyDown
="PreventIt(event)" autocomplete
="off" id
="Takeback<?php echo $CountIndex; ?>" value
="<?php echo htmlspecialchars($TakebackDB); ?>" onChange
="ValidateNumeric(this);ScreenAdjustment(this,<?php echo $CountIndex; ?>);UpdateTotalValues(1,<?php echo $TotalRows; ?>,'Takeback','takebacktotal');RestoreValues(<?php echo $CountIndex; ?>)" type
="text" style
="width:60px;text-align:right; font-size:12px" /></td
>
1042 <td align
="center" class="<?php echo $StringClass; ?>" ><input type
="checkbox" id
="FollowUp<?php echo $CountIndex; ?>" name
="FollowUp<?php echo $CountIndex; ?>" value
="y" onClick
="ActionFollowUp(<?php echo $CountIndex; ?>)" <?php
echo $FollowUpDB=='y' ?
' checked ' : ''; ?
> /></td
>
1043 <td
class="<?php echo $StringClass; ?> right" ><input onKeyDown
="PreventIt(event)" id
="FollowUpReason<?php echo $CountIndex; ?>" name
="FollowUpReason<?php echo $CountIndex; ?>" <?php
echo $FollowUpDB=='y' ?
'' : ' readonly '; ?
> type
="text" value
="<?php echo htmlspecialchars($FollowUpReasonDB); ?>" style
="width:110px;font-size:12px" /></td
>
1048 }//while ($RowSearch = sqlFetchArray($ResultSearch))
1051 }//if(sqlNumRows($ResultSearch)>0)
1053 }while ($RowSearchSub = sqlFetchArray($ResultSearchSub));
1058 <td align
="left" colspan
="9"> 
;</td
>
1059 <td
class="left bottom" bgcolor
="#6699FF" id
="allowtotal" align
="right" ><?php
echo htmlspecialchars(number_format($allowedtot,2)); ?
></td
>
1060 <td
class="left bottom" bgcolor
="#6699FF" id
="paymenttotal" align
="right" ><?php
echo htmlspecialchars(number_format($paymenttot,2)); ?
></td
>
1061 <td
class="left bottom" bgcolor
="#6699FF" id
="AdjAmounttotal" align
="right" ><?php
echo htmlspecialchars(number_format($adjamttot,2)); ?
></td
>
1062 <td
class="left bottom" bgcolor
="#6699FF" id
="deductibletotal" align
="right"><?php
echo htmlspecialchars(number_format($deductibletot,2)); ?
></td
>
1063 <td
class="left bottom right" bgcolor
="#6699FF" id
="takebacktotal" align
="right"><?php
echo htmlspecialchars(number_format($takebacktot,2)); ?
></td
>
1064 <td align
="center"> 
;</td
>
1065 <td align
="center"> 
;</td
>
1074 }//if($RowSearchSub = sqlFetchArray($ResultSearchSub))
1078 <td colspan
="13" align
="left" >
1080 require_once("payment_pat_sel.inc.php"); //Patient ajax section and listing of charges.
1085 <td colspan
="13" align
="left" >
1086 <table border
="0" cellspacing
="0" cellpadding
="0" width
="217" align
="center">
1093 <td width
="110"><a href
="#" onClick
="javascript:return ModifyPayments();" class="css_button"><span
><?php
echo htmlspecialchars( xl('Modify Payments'), ENT_QUOTES
);?
></span
></a
>
1095 <td width
="107"><a href
="#" onClick
="javascript:return FinishPayments();" class="css_button"><span
><?php
echo htmlspecialchars( xl('Finish Payments'), ENT_QUOTES
);?
></span
></a
>
1101 }//if($payment_id*1>0)
1107 <input type
="hidden" name
="hidden_patient_code" id
="hidden_patient_code" value
="<?php echo htmlspecialchars($hidden_patient_code);?>"/>
1108 <input type
='hidden' name
='mode' id
='mode' value
='' />
1109 <input type
='hidden' name
='ajax_mode' id
='ajax_mode' value
='' />
1110 <input type
="hidden" name
="after_value" id
="after_value" value
="<?php echo htmlspecialchars($_POST["mode
"]);?>"/>
1111 <input type
="hidden" name
="payment_id" id
="payment_id" value
="<?php echo htmlspecialchars($payment_id);?>"/>
1112 <input type
="hidden" name
="hidden_type_code" id
="hidden_type_code" value
="<?php echo htmlspecialchars($TypeCode);?>"/>
1113 <input type
='hidden' name
='global_amount' id
='global_amount' value
='' />
1114 <input type
='hidden' name
='DeletePaymentDistributionId' id
='DeletePaymentDistributionId' value
='' />
1115 <input type
="hidden" name
="ActionStatus" id
="ActionStatus" value
="<?php echo htmlspecialchars($Message);?>"/>
1116 <input type
='hidden' name
='CountIndexAbove' id
='CountIndexAbove' value
='<?php echo htmlspecialchars($CountIndexAbove*1);?>' />
1117 <input type
='hidden' name
='CountIndexBelow' id
='CountIndexBelow' value
='<?php echo htmlspecialchars($CountIndexBelow*1);?>' />
1118 <input type
="hidden" name
="ParentPage" id
="ParentPage" value
="<?php echo htmlspecialchars($_REQUEST['ParentPage']);?>"/>