interface/practice/ins_search.php

   1 <?php
   2  // Copyright (C) 2005 Rod Roark <rod@sunsetsystems.com>
   3  //
   4  // This program is free software; you can redistribute it and/or
   5  // modify it under the terms of the GNU General Public License
   6  // as published by the Free Software Foundation; either version 2
   7  // of the License, or (at your option) any later version.
   8
   9  // This module is used to find and add insurance companies.
  10  // It is opened as a popup window.  The opener may have a
  11  // JavaScript function named set_insurance(id, name), in which
  12  // case selecting or adding an insurance company will cause the
  13  // function to be called passing the ID and name of that company.
  14
  15  // When used for searching, this module will in turn open another
  16  // popup window ins_list.php, which lists the matched results and
  17  // permits selection of one of them via the same set_insurance()
  18  // function.
  19
  20  include_once("../globals.php");
  21  include_once("$srcdir/acl.inc");
  22
  23  // Putting a message here will cause a popup window to display it.
  24  $info_msg = "";
  25
  26  // This is copied from InsuranceCompany.class.php.  It should
  27  // really be in a SQL table.
  28  $freeb_type_array = array(''
  29   ,'Other HCFA'
  30   ,'Medicare Part B'
  31   ,'Medicaid'
  32   ,'ChampUSVA'
  33   ,'ChampUS'
  34   ,'Blue Cross Blue Shield'
  35   ,'FECA'
  36   ,'Self Pay'
  37   ,'Central Certification'
  38   ,'Other Non-Federal Programs'
  39   ,'Preferred Provider Organization (PPO)'
  40   ,'Point of Service (POS)'
  41   ,'Exclusive Provider Organization (EPO)'
  42   ,'Indemnity Insurance'
  43   ,'Health Maintenance Organization (HMO) Medicare Risk'
  44   ,'Automobile Medical'
  45   ,'Commercial Insurance Co.'
  46   ,'Disability'
  47   ,'Health Maintenance Organization'
  48   ,'Liability'
  49   ,'Liability Medical'
  50   ,'Other Federal Program'
  51   ,'Title V'
  52   ,'Veterans Administration Plan'
  53   ,'Workers Compensation Health Plan'
  54   ,'Mutually Defined'
  55  );
  56
  57 ?>
  58 <html>
  59 <head>
  60 <title>Insurance Company Search/Add</title>
  61 <link rel=stylesheet href='<? echo $css_header ?>' type='text/css'>
  62
  63 <style>
  64 td { font-size:10pt; }
  65 .search { background-color:#aaffaa }
  66 </style>
  67
  68 <script type="text/javascript" src="../../library/topdialog.js"></script>
  69 <script type="text/javascript" src="../../library/dialog.js"></script>
  70
  71 <script language="JavaScript">
  72
  73  var mypcc = '<? echo $GLOBALS['phone_country_code'] ?>';
  74
  75  function doescape(value) {
  76   return escape(value);
  77  }
  78
  79  // This is invoked when our Search button is clicked.
  80  function dosearch() {
  81   var f = document.forms[0];
  82   dlgopen('ins_list.php' +
  83    '?form_name='   + doescape(f.form_name.value  ) +
  84    '&form_attn='   + doescape(f.form_attn.value  ) +
  85    '&form_addr1='  + doescape(f.form_addr1.value ) +
  86    '&form_addr2='  + doescape(f.form_addr2.value ) +
  87    '&form_city='   + doescape(f.form_city.value  ) +
  88    '&form_state='  + doescape(f.form_state.value ) +
  89    '&form_zip='    + doescape(f.form_zip.value   ) +
  90    '&form_phone='  + doescape(f.form_phone.value ) +
  91    '&form_cms_id=' + doescape(f.form_cms_id.value) +
  92    '', '_blank', 780, 500);
  93
  94   return false;
  95  }
  96
  97  // The ins_list.php window calls this to set the selected insurance.
  98  function set_insurance(ins_id, ins_name) {
  99   if (opener.closed || ! opener.set_insurance)
 100    alert('The target form was closed; I cannot apply your selection.');
 101   else
 102    opener.set_insurance(ins_id, ins_name);
 103   window.close();
 104  }
 105
 106  // This is set to true on a mousedown of the Save button.  The
 107  // reason is so we can distinguish between clicking on the Save
 108  // button vs. hitting the Enter key, as we prefer the "default"
 109  // action to be search and not save.
 110  var save_clicked = false;
 111
 112  // Onsubmit handler.
 113  function validate(f) {
 114   // If save was not clicked then default to searching.
 115   if (! save_clicked) return dosearch();
 116   save_clicked = false;
 117
 118   msg = '';
 119   if (! f.form_name.value.length ) msg += 'Company name is missing. ';
 120   if (! f.form_addr1.value.length) msg += 'Address is missing. ';
 121   if (! f.form_city.value.length ) msg += 'City is missing. ';
 122   if (! f.form_state.value.length) msg += 'State is missing. ';
 123   if (! f.form_zip.value.length  ) msg += 'Zip is missing.';
 124
 125   if (msg) {
 126    alert(msg);
 127    return false;
 128   }
 129   return true;
 130  }
 131
 132 </script>
 133
 134 </head>
 135
 136 <body <?echo $top_bg_line;?> onunload='imclosing()'>
 137 <?php
 138  // If we are saving, then save and close the window.
 139  //
 140  if ($_POST['form_save']) {
 141   $ins_id = '';
 142   $ins_name = $_POST['form_name'];
 143
 144   if ($ins_id) {
 145    // sql for updating could go here if this script is enhanced to support
 146    // editing of existing insurance companies.
 147   } else {
 148    $ins_id = generate_id();
 149
 150    sqlInsert("INSERT INTO insurance_companies ( " .
 151     "id, name, attn, cms_id, freeb_type, x12_receiver_id, x12_default_partner_id " .
 152     ") VALUES ( " .
 153     $ins_id                         . ", "  .
 154     "'" . $ins_name                 . "', " .
 155     "'" . $_POST['form_attn']       . "', " .
 156     "'" . $_POST['form_cms_id']     . "', " .
 157     "'" . $_POST['form_freeb_type'] . "', " .
 158     "'" . $_POST['form_partner']    . "', " .
 159     "'" . $_POST['form_partner']    . "' "  .
 160    ")");
 161
 162    sqlInsert("INSERT INTO addresses ( " .
 163     "id, line1, line2, city, state, zip, country, foreign_id " .
 164     ") VALUES ( " .
 165     generate_id()                . ", "  .
 166     "'" . $_POST['form_addr1']   . "', " .
 167     "'" . $_POST['form_addr2']   . "', " .
 168     "'" . $_POST['form_city']    . "', " .
 169     "'" . $_POST['form_state']   . "', " .
 170     "'" . $_POST['form_zip']     . "', " .
 171     "'" . $_POST['form_country'] . "', " .
 172     $ins_id                      . " "   .
 173    ")");
 174
 175    $phone_parts = array();
 176    preg_match("/(\d\d\d)\D*(\d\d\d)\D*(\d\d\d\d)/", $_POST['form_phone'],
 177     $phone_parts);
 178
 179    sqlInsert("INSERT INTO phone_numbers ( " .
 180     "id, country_code, area_code, prefix, number, type, foreign_id " .
 181     ") VALUES ( " .
 182     generate_id()         . ", "  .
 183     "'+1'"                . ", "  .
 184     "'" . $phone_parts[1] . "', " .
 185     "'" . $phone_parts[2] . "', " .
 186     "'" . $phone_parts[3] . "', " .
 187     "'2'"                 . ", "  .
 188     $ins_id               . " "   .
 189    ")");
 190   }
 191
 192   // Close this window and tell our opener to select the new company.
 193   //
 194   echo "<script language='JavaScript'>\n";
 195   if ($info_msg) echo " alert('$info_msg');\n";
 196   echo " window.close();\n";
 197   echo " if (opener.set_insurance) opener.set_insurance($ins_id,'$ins_name');\n";
 198   echo "</script></body></html>\n";
 199   exit();
 200  }
 201
 202  // Query x12_partners.
 203  $xres = sqlStatement(
 204   "SELECT id, name FROM x12_partners ORDER BY name"
 205  );
 206 ?>
 207 <form method='post' name='theform' action='ins_search.php'
 208  onsubmit='return validate(this)'>
 209 <center>
 210
 211 <p>
 212 <table border='0' width='100%'>
 213
 214  <!--
 215  <tr>
 216   <td valign='top' width='1%' nowrap>&nbsp;</td>
 217   <td>
 218    Note: Green fields are searchable.
 219   </td>
 220  </tr>
 221  -->
 222
 223  <tr>
 224   <td valign='top' width='1%' nowrap><b>Name:</b></td>
 225   <td>
 226    <input type='text' size='20' name='form_name' maxlength='35'
 227     class='search' style='width:100%' title='Name of insurance company' />
 228   </td>
 229  </tr>
 230
 231  <tr>
 232   <td valign='top' nowrap><b>Attention:</b></td>
 233   <td>
 234    <input type='text' size='20' name='form_attn' maxlength='35'
 235     class='search' style='width:100%' title='Contact name' />
 236   </td>
 237  </tr>
 238
 239  <tr>
 240   <td valign='top' nowrap><b>Address1:</b></td>
 241   <td>
 242    <input type='text' size='20' name='form_addr1' maxlength='35'
 243     class='search' style='width:100%' title='First address line' />
 244   </td>
 245  </tr>
 246
 247  <tr>
 248   <td valign='top' nowrap><b>Address2:</b></td>
 249   <td>
 250    <input type='text' size='20' name='form_addr2' maxlength='35'
 251     class='search' style='width:100%' title='Second address line, if any' />
 252   </td>
 253  </tr>
 254
 255  <tr>
 256   <td valign='top' nowrap><b>City/State:</b></td>
 257   <td>
 258    <input type='text' size='20' name='form_city' maxlength='25'
 259     class='search' title='City name' />
 260    &nbsp;
 261    <input type='text' size='3' name='form_state' maxlength='35'
 262     class='search' title='State or locality' />
 263   </td>
 264  </tr>
 265
 266  <tr>
 267   <td valign='top' nowrap><b>Zip/Country:</b></td>
 268   <td>
 269    <input type='text' size='20' name='form_zip' maxlength='10'
 270     class='search' title='Postal code' />
 271    &nbsp;
 272    <input type='text' size='20' name='form_country' value='USA' maxlength='35'
 273     title='Country name' />
 274   </td>
 275  </tr>
 276
 277  <tr>
 278   <td valign='top' nowrap><b>Phone:</b></td>
 279   <td>
 280    <input type='text' size='20' name='form_phone' maxlength='20'
 281     class='search' title='Telephone number' />
 282   </td>
 283  </tr>
 284
 285  <!--
 286  <tr>
 287   <td valign='top' width='1%' nowrap>&nbsp;</td>
 288   <td>
 289    &nbsp;<br><b>Other data:</b>
 290   </td>
 291  </tr>
 292  -->
 293
 294  <tr>
 295   <td valign='top' nowrap><b>CMS ID:</b></td>
 296   <td>
 297    <input type='text' size='20' name='form_cms_id' maxlength='15'
 298     class='search' title='Identifier assigned by CMS' />
 299   </td>
 300  </tr>
 301
 302  <tr>
 303   <td valign='top' nowrap><b>Payer Type:</b></td>
 304   <td>
 305    <select name='form_freeb_type'>
 306 <?php
 307  for ($i = 1; $i < count($freeb_type_array); ++$i) {
 308   echo "   <option value='$i'";
 309   // if ($i == $row['freeb_type']) echo " selected";
 310   echo ">" . $freeb_type_array[$i] . "\n";
 311  }
 312 ?>
 313    </select>
 314   </td>
 315  </tr>
 316
 317  <tr>
 318   <td valign='top' nowrap><b>X12 Partner:</b></td>
 319   <td>
 320    <select name='form_partner' title='Default X12 Partner'>
 321     <option value="">-- None --</option>
 322 <?php
 323  while ($xrow = sqlFetchArray($xres)) {
 324   echo "   <option value='" . $xrow['id'] . "'";
 325   // if ($xrow['id'] == $row['x12_default_partner_id']) echo " selected";
 326   echo ">" . $xrow['name'] . "</option>\n";
 327  }
 328 ?>
 329    </select>
 330   </td>
 331  </tr>
 332
 333 </table>
 334
 335 <p>&nbsp;<br>
 336 <input type='button' value='Search' class='search' onclick='dosearch()' />
 337 &nbsp;
 338 <input type='submit' value='Save as New' name='form_save' onmousedown='save_clicked=true' />
 339 &nbsp;
 340 <input type='button' value='Cancel' onclick='window.close()' />
 341 </p>
 342
 343 </center>
 344 </form>
 345 </body>
 346 </html>