interface/billing/sl_eob_patient_note.php

   1 <?php
   2 /**
   3  * This allows entry and editing of a "billing note" for the patient.
   4  *
   5  * @package   OpenEMR
   6  * @link      http://www.open-emr.org
   7  * @author    Rod Roark <rod@sunsetsystems.com>
   8  * @author    Roberto Vasquez <robertogagliotta@gmail.com>
   9  * @author    Brady Miller <brady.g.miller@gmail.com>
  10  * @copyright Copyright (c) 2005 Rod Roark <rod@sunsetsystems.com>
  11  * @copyright Copyright (c) 2019 Brady Miller <brady.g.miller@gmail.com>
  12  * @license   https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
  13  */
  14
  15
  16 require_once("../globals.php");
  17 require_once("../../library/patient.inc");
  18 require_once("../../library/forms.inc");
  19
  20 use OpenEMR\Core\Header;
  21
  22 $info_msg = "";
  23 ?>
  24 <html>
  25 <head>
  26 <?php Header::setupHeader();?>
  27 <title><?php echo xlt('EOB Posting - Patient Note'); ?></title>
  28 </head>
  29 <body>
  30 <?php
  31   $patient_id = $_GET['patient_id'];
  32 if (! $patient_id) {
  33     die(xlt("You cannot access this page directly."));
  34 }
  35
  36 if ($_POST['form_save']) {
  37     if (!verifyCsrfToken($_POST["csrf_token_form"])) {
  38         csrfNotVerified();
  39     }
  40
  41     $thevalue = trim($_POST['form_note']);
  42
  43     sqlStatement("UPDATE patient_data SET " .
  44     "billing_note = ? " .
  45     "WHERE pid = ? ", array($thevalue, $patient_id));
  46
  47     echo "<script language='JavaScript'>\n";
  48     if ($info_msg) {
  49         echo " alert(" . js_escape($info_msg) . ");\n";
  50     }
  51     echo " window.close();\n";
  52     echo "</script></body></html>\n";
  53     exit();
  54 }
  55
  56   $row = sqlQuery("select fname, lname, billing_note " .
  57     "from patient_data where pid = ? limit 1", array($patient_id));
  58 ?>
  59 <div class="container">
  60     <div class = "row">
  61         <div class="page-header">
  62                 <h2><?php echo xlt('Billing Note for '). text($row['fname']) . " " . text($row['lname']); ?></h2>
  63             </div>
  64     </div>
  65     <div class = "row">
  66         <form method='post' action='sl_eob_patient_note.php?patient_id=<?php echo attr_url($patient_id); ?>'>
  67             <input type="hidden" name="csrf_token_form" value="<?php echo attr(collectCsrfToken()); ?>" />
  68             <div class="col-xs-12" style="padding-bottom:5px">
  69
  70             </div>
  71             <div class="col-xs-12" style="padding-bottom:5px">
  72                 <div class="col-xs-12">
  73                     <input type='text' name='form_note' class='form-control' value='<?php echo attr($row['billing_note']) ?>' placeholder ='<?php echo xla('Max 255 characters')?>' />
  74                 </div>
  75             </div>
  76             <?php //can change position of buttons by creating a class 'position-override' and adding rule text-alig:center or right as the case may be in individual stylesheets ?>
  77             <div class="form-group clearfix">
  78                 <div class="col-sm-12 text-left position-override" id="search-btn">
  79                     <div class="btn-group" role="group">
  80                         <button type='submit' class="btn btn-default btn-save" name='form_save' id="btn-save" ><?php echo xlt("Save"); ?></button>
  81                         <button type='submit' class="btn btn-link btn-cancel btn-separate-left" name='form_cancel' id="btn-cancel"  onclick='window.close();'><?php echo xlt("Cancel"); ?></button>
  82                     </div>
  83                 </div>
  84             </div>
  85         </form>
  86     </div>
  87 </div><!--end of container div-->
  88
  89 </body>
  90 </html>