interface/billing/billing_process.php

   1 <?php
   2 include_once("../globals.php");
   3 include_once("$srcdir/patient.inc");
   4 include_once("$srcdir/billrep.inc");
   5 include_once("$srcdir/billing.inc");
   6 include_once("$srcdir/gen_x12_837.inc.php");
   7 include_once(dirname(__FILE__) . "/../../library/classes/WSClaim.class.php");
   8
   9 $EXPORT_INC = "$webserver_root/custom/BillingExport.php";
  10 if (file_exists($EXPORT_INC)) {
  11   include_once($EXPORT_INC);
  12   $BILLING_EXPORT = true;
  13 }
  14
  15 // This is a kludge to enter some parameters that are not in the X12
  16 // Partners table, but should be.
  17 //
  18 // The following works for Zirmed:
  19 $ISA07 = 'ZZ'; // ZZ = mutually defined, 01 = Duns, etc.
  20 $ISA14 = '0';  // 1 = Acknowledgment requested, else 0
  21 $ISA15 = 'T';  // T = testing, P = production
  22 $GS02  = '';   // Empty to use the sender ID from the ISA segment
  23 $PER06 = '';   // The submitter's EDI Access Number, if any
  24 /**** For Availity:
  25 $ISA07 = '01'; // ZZ = mutually defined, 01 = Duns, etc.
  26 $ISA14 = '1';  // 1 = Acknowledgment requested, else 0
  27 $ISA15 = 'T';  // T = testing, P = production
  28 $GS02  = 'AV01101957';
  29 $PER06 = 'xxxxxx'; // The submitter's EDI Access Number
  30 ****/
  31
  32 $fconfig = $GLOBALS['oer_config']['freeb'];
  33 $bill_info = array();
  34
  35 $bat_type     = ''; // will be edi or hcfa
  36 $bat_sendid   = '';
  37 $bat_recvid   = '';
  38 $bat_content  = '';
  39 $bat_stcount  = 0;
  40 $bat_time     = time();
  41 $bat_hhmm     = date('Hi' , $bat_time);
  42 $bat_yymmdd   = date('ymd', $bat_time);
  43 $bat_yyyymmdd = date('Ymd', $bat_time);
  44 // Minutes since 1/1/1970 00:00:00 GMT will be our interchange control number:
  45 $bat_icn = sprintf('%09.0f', $bat_time/60);
  46 $bat_filename = date("Y-m-d-Hi", $bat_time) . "-batch.txt";
  47
  48 function append_claim(&$segs) {
  49   global $bat_content, $bat_sendid, $bat_recvid, $bat_sender, $bat_stcount;
  50   global $bat_yymmdd, $bat_yyyymmdd, $bat_hhmm, $bat_icn;
  51   global $GS02, $ISA07, $ISA14, $ISA15, $PER06;
  52
  53   foreach ($segs as $seg) {
  54     if (!$seg) continue;
  55     $elems = explode('*', $seg);
  56     if ($elems[0] == 'ISA') {
  57       if (!$bat_content) {
  58         $bat_sendid = trim($elems[6]);
  59         $bat_recvid = trim($elems[8]);
  60         $bat_sender = $GS02 ? $GS02 : $bat_sendid;
  61         $bat_content = substr($seg, 0, 51) .
  62           $ISA07 . substr($seg, 53, 17) .
  63           "$bat_yymmdd*$bat_hhmm*U*00401*$bat_icn*$ISA14*$ISA15*:~" .
  64           "GS*HC*$bat_sender*$bat_recvid*$bat_yyyymmdd*$bat_hhmm*1*X*004010X098A1~";
  65       }
  66       continue;
  67     } else if (!$bat_content) {
  68       die("Error:<br>\nInput must begin with 'ISA'; " .
  69         "found '" . htmlentities($elems[0]) . "' instead");
  70     }
  71     if ($elems[0] == 'ST') {
  72       ++$bat_stcount;
  73       $bat_content .= sprintf("ST*837*%04d~", $bat_stcount);
  74       continue;
  75     }
  76     if ($elems[0] == 'SE') {
  77       $bat_content .= sprintf("SE*%d*%04d~", $elems[1], $bat_stcount);
  78       continue;
  79     }
  80     if ($elems[0] == 'GS' || $elems[0] == 'GE' || $elems[0] == 'IEA') continue;
  81     if ($elems[0] == 'PER' && $PER06 && !$elems[5]) {
  82       $seg .= "*ED*$PER06";
  83     }
  84     $bat_content .= $seg . '~';
  85   }
  86 }
  87
  88 function append_claim_close() {
  89   global $bat_content, $bat_stcount, $bat_icn;
  90   $bat_content .= "GE*$bat_stcount*1~IEA*1*$bat_icn~";
  91 }
  92
  93 function send_batch() {
  94   global $bat_content, $bat_filename, $webserver_root;
  95   // If a writable edi directory exists, log the batch to it.
  96   // I guarantee you'll be glad we did this.  :-)
  97   $fh = @fopen("$webserver_root/edi/$bat_filename", 'a');
  98   if ($fh) {
  99     fwrite($fh, $bat_content);
 100     fclose($fh);
 101   }
 102   header("Pragma: public");
 103   header("Expires: 0");
 104   header("Cache-Control: must-revalidate, post-check=0, pre-check=0");
 105   header("Content-Type: application/force-download");
 106   header("Content-Disposition: attachment; filename=$bat_filename");
 107   header("Content-Description: File Transfer");
 108   header("Content-Length: " . strlen($bat_content));
 109   echo $bat_content;
 110 }
 111
 112 //////////////////////////////////////////////////////////////////////
 113
 114 if (isset($_POST['bn_electronic_file']) && !empty($_POST['claims'])) {
 115
 116   if (empty($_POST['claims'])) {
 117     $bill_info[] = xl("No claims were selected for inclusion.");
 118   }
 119
 120   foreach ($_POST['claims'] as $claim) {
 121     if (isset($claim['bill'])) {
 122       if (substr($claim['file'],strlen($claim['file']) -4) == '.pdf') {
 123         $fname = substr($claim['file'],0,-4);
 124       }
 125       else {
 126         $fname = $claim['file'];
 127       }
 128
 129       $tmp = substr($fname, strrpos($fname, '.') + 1);
 130       if (!$bat_type) {
 131         $bat_type = $tmp;
 132       } else if ($bat_type != $tmp) {
 133         die("You cannot mix '$bat_type' and '$tmp' formats in the same batch!");
 134       }
 135
 136       $fname = preg_replace("[/]","",$fname);
 137       $fname = preg_replace("[\.\.]","",$fname);
 138       $fname = preg_replace("[\\\\]","",$fname);
 139       $fname = $fconfig['claim_file_dir'] . $fname;
 140
 141       if (file_exists($fname)) {
 142       //less than 500 is almost definitely an error
 143         if (filesize($fname) > 500) {
 144           $bill_info[] = xl("Added: ") . $fname . "\n";
 145
 146           if ($bat_type != 'edi') {
 147             $bat_content .= file_get_contents($fname);
 148             continue;
 149           }
 150
 151           // Begin obsolete section.
 152           //
 153           // If we get here, we are sending X12 837p data.  Strip off the ISA,
 154           // GS, GE, and IEA segments from the individual files and send just
 155           // one set of these for the whole batch.  We think this is what the
 156           // partners are happiest with, and Availity for one requires
 157           // (as of this writing) exactly one ISA/IEA pair per batch.
 158           $segs = explode('~', file_get_contents($fname));
 159           append_claim($segs);
 160           //
 161           // End obsolete section.
 162
 163         }
 164         else {
 165           $bill_info[] = xl("May have an error: ") . $fname . "\n";
 166         }
 167       }
 168       else {
 169         $bill_info[] = xl("Not found: ") . $fname . "\n";
 170       }
 171     }
 172   }
 173
 174   // Begin obsolete section.
 175   if ($bat_type == 'edi' && $bat_content) {
 176     append_claim_close();
 177   }
 178   // End obsolete section.
 179
 180   if ($bat_content) {
 181     $db = $GLOBALS['adodb']['db'];
 182     $error = false;
 183     foreach ($_POST['claims'] as $claimid => $claim) {
 184       if (isset($claim['bill'])) {
 185         $tmpvars = split("-",$claimid);
 186         $pid = $tmpvars[0];
 187         $encounter = $tmpvars[1];
 188         if (!empty($encounter) && !empty($pid)) {
 189           /****
 190           $sql = "UPDATE billing set billed = 1 where encounter = '" . $encounter .
 191             "' and pid = '" . $pid . "' and activity != 0";
 192           $result = $db->execute($sql);
 193           if(!$result) {
 194             $error = true;
 195             $bill_info[] = xl("Marking claim "). $claimid . xl(" had a db error: ") . $db->ErrorMsg() . "\n";
 196           }
 197           // send claim to the web services code to sync to external system if enabled
 198           // remember that in openemr it is only the encounter and patient id that make a group of
 199           // billing line items unique so they can be grouped or associated as 1 claim
 200           $ws = new WSClaim($pid, $encounter);
 201           ****/
 202           if (!updateClaim(false, $pid, $encounter, -1, 2)) {
 203             $bill_info[] = xl("Internal error: claim ") . $claimid . xl(" not found!") . "\n";
 204           }
 205         }
 206       }
 207     }
 208     if (!$error) {
 209       send_batch();
 210       exit;
 211     }
 212   }
 213
 214 }
 215 else {
 216   process_form($_POST);
 217 }
 218
 219 function process_form($ar) {
 220   global $bill_info, $webserver_root, $bat_filename;
 221
 222   if (isset($ar['bn_x12'])) {
 223     $hlog = fopen("$webserver_root/library/freeb/process_bills.log", 'w');
 224   }
 225
 226   if (isset($ar['bn_external'])) {
 227     // Open external billing file for output.
 228     $be = new BillingExport();
 229   }
 230
 231   $db = $GLOBALS['adodb']['db'];
 232
 233   if (empty($ar['claims'])) {
 234     $ar['claims'] = array();
 235   }
 236   foreach ($ar['claims'] as $claimid => $claim_array) {
 237
 238     $ta = split("-",$claimid);
 239     $patient_id = $ta[0];
 240     $encounter = $ta[1];
 241     $payer = $claim_array['payer'];
 242
 243     if (isset($claim_array['bill'])) {
 244
 245       if (isset($ar['bn_external'])) {
 246         // Write external claim.
 247         $be->addClaim($patient_id, $encounter);
 248       }
 249       else {
 250         $sql = "SELECT x.processing_format from x12_partners as x where x.id =" .
 251           $db->qstr($claim_array['partner']);
 252         $result = $db->Execute($sql);
 253         $target = "x12";
 254         if ($result && !$result->EOF) {
 255             $target = $result->fields['processing_format'];
 256         }
 257       }
 258
 259       // $sql = "UPDATE billing set bill_date = NOW(), ";
 260       $tmp = 1;
 261
 262       if (isset($ar['bn_hcfa_print'])) {
 263         // $sql .= " bill_process = 5, target = 'hcfa', ";
 264         $tmp = updateClaim(true, $patient_id, $encounter, $payer, 1, 5, '', 'hcfa');
 265       } else if (isset($ar['bn_hcfa'])) {
 266         // $sql .= " bill_process = 1, target = 'hcfa', ";
 267         $tmp = updateClaim(true, $patient_id, $encounter, $payer, 1, 1, '', 'hcfa');
 268       } else if (isset($ar['bn_ub92_print'])) {
 269         // $sql .= " bill_process = 5, target = 'ub92', ";
 270         $tmp = updateClaim(true, $patient_id, $encounter, $payer, 1, 5, '', 'ub92');
 271       } else if (isset($ar['bn_ub92'])) {
 272         // $sql .= " bill_process = 1, target = 'ub92', ";
 273         $tmp = updateClaim(true, $patient_id, $encounter, $payer, 1, 1, '', 'ub92');
 274       } else if (isset($ar['bn_x12'])) {
 275         // $sql .= " bill_process = 1, target = '" . $target . "', x12_partner_id = '" .
 276         //   mysql_real_escape_string($claim_array['partner']) . "', ";
 277         $tmp = updateClaim(true, $patient_id, $encounter, $payer, 1, 1, '', $target, $claim_array['partner']);
 278       } else if (isset($ar['bn_mark'])) {
 279         // $sql .= " billed = 1, ";
 280         $tmp = updateClaim(true, $patient_id, $encounter, $payer, 2);
 281       } else if (isset($ar['bn_reopen'])) {
 282         $tmp = updateClaim(true, $patient_id, $encounter, $payer, 1, 0);
 283       } else if (isset($ar['bn_external'])) {
 284         // $sql .= " billed = 1, ";
 285         $tmp = updateClaim(true, $patient_id, $encounter, $payer, 2);
 286       }
 287
 288       // $sql .= " payer_id = '$payer' where encounter = " . $encounter . " and pid = " . $patient_id;
 289       // $result = $db->Execute($sql);
 290
 291       // if(!$result) {
 292       //   die(xl("Claim ") . $claimid . xl(" could not be queued due to error: ") . $db->ErrorMsg());
 293       // }
 294
 295       if (!$tmp) {
 296         die(xl("Claim ") . $claimid . xl(" update failed, not in database?"));
 297       }
 298       else {
 299         if(isset($ar['bn_mark'])) {
 300           $bill_info[] = xl("Claim ") . $claimid . xl(" was marked as billed only.") . "\n";
 301         }
 302
 303         else if (isset($ar['bn_reopen'])) {
 304           $bill_info[] = xl("Claim ") . $claimid . xl(" has been re-opened.") . "\n";
 305         }
 306
 307         else if (isset($ar['bn_x12'])) {
 308           $log = '';
 309           $segs = explode("~\n", gen_x12_837($patient_id, $encounter, $log));
 310           fwrite($hlog, $log);
 311           append_claim($segs);
 312
 313           /****
 314           $db->execute("UPDATE billing SET billed = 1, bill_process = 2, " .
 315             "process_date = NOW(), process_file = '' WHERE " .
 316             "encounter = '$encounter' AND pid = '$patient_id' AND activity != 0");
 317           $ws = new WSClaim($patient_id, $encounter); // requires billed=1
 318           ****/
 319           if (!updateClaim(false, $patient_id, $encounter, -1, 2, 2, $bat_filename)) {
 320             $bill_info[] = xl("Internal error: claim ") . $claimid . xl(" not found!") . "\n";
 321           }
 322
 323         }
 324         else {
 325           $bill_info[] = xl("Claim ") . $claimid . xl(" was queued successfully.") . "\n";
 326         }
 327       }
 328
 329       /****
 330       if ($mark_only) {
 331         //send claim to the web services code to sync to external system if enabled
 332         //remeber that in openemr it is only the encounter and patient id that make a group of
 333         //billing line items unique so they can be grouped or associated as 1 claim
 334         $ws = new WSClaim($patient_id,$encounter);
 335       }
 336       ****/
 337
 338     }
 339
 340   }
 341
 342   if (isset($ar['bn_x12'])) {
 343     append_claim_close();
 344     fclose($hlog);
 345     send_batch();
 346     exit;
 347   }
 348
 349   if (isset($ar['bn_external'])) {
 350     // Close external billing file.
 351     $be->close();
 352   }
 353 }
 354 ?>
 355 <html>
 356 <head>
 357
 358 <link rel=stylesheet href="<?echo $css_header;?>" type="text/css">
 359
 360 </head>
 361 <body <?echo $top_bg_line;?> topmargin=0 rightmargin=0 leftmargin=2 bottommargin=0 marginwidth=2 marginheight=0>
 362 <br><p><h3><?php xl('Billing queue results:','e'); ?></h3><a href="billing_report.php">back</a><ul>
 363 <?php
 364 foreach ($bill_info as $infoline) {
 365   echo nl2br($infoline);
 366 }
 367 ?>
 368 </ul></p>
 369 </body>
 370 </html>