protected function _edit($groupId = null)
{
$groupId = (int) $groupId;
$claimRule = new ClaimRule();
$claimRule->event = ClaimRule::EVENT_WARNING;
$action = 'add';
if ($groupId > 0) {
$claimRule->groupId = $groupId;
$claimRule->populateWithGroupId();
$claim = new ClaimRule();
$claim->title = $claimRule->title;
$claim->message = $claimRule->message;
$claim->groupId = $claimRule->groupId;
$claim->event = $claimRule->event;
$claimRule = $claim;
// swap, we only need the hidden fields
$action = 'edit';
}
$this->view->action = $action;
$form = new WebVista_Form(array('name' => 'claimRule'));
$form->setAction(Zend_Registry::get('baseUrl') . 'claim-rules.raw/process-' . $action);
$form->loadORM($claimRule, 'claimRule');
$form->setWindow('windowEditClaimRuleId');
$this->view->form = $form;
$this->view->claimRule = $claimRule;
$modifiers = array('' => '');
$enumeration = new Enumeration();
$enumeration->populateByUniqueName('Procedure Modifiers');
$closure = new EnumerationClosure();
$descendants = $closure->getAllDescendants($enumeration->enumerationId, 1, true);
foreach ($descendants as $row) {
$modifiers[$row->key] = $row->key . ': ' . $row->name;
}
$this->view->modifiers = $modifiers;
$insurancePrograms = array('' => '');
foreach (InsuranceProgram::getInsurancePrograms() as $key => $value) {
$insurancePrograms[$key] = $value;
}
$this->view->insurancePrograms = $insurancePrograms;
$this->render('edit');
}
public function editInsurerAction()
{
$patientId = (int) $this->_getParam('patientId');
$id = (int) $this->_getParam('id');
$this->_insurer = new InsuredRelationship();
$this->_insurer->personId = $patientId;
if ($id > 0) {
$this->_insurer->insuredRelationshipId = $id;
$this->_insurer->populate();
}
$this->_form = new WebVista_Form(array('name' => 'edit-insurer'));
$this->_form->setAction(Zend_Registry::get('baseUrl') . "patient.raw/process-edit-insurer");
$this->_form->loadORM($this->_insurer, "Insurer");
$this->_form->setWindow('winEditInsurerId');
$this->view->form = $this->_form;
$insuranceProgram = new InsuranceProgram();
$insurancePrograms = array('' => '');
foreach (InsuranceProgram::getInsurancePrograms() as $id => $val) {
$insurancePrograms[$id] = $val;
}
$this->view->insurancePrograms = $insurancePrograms;
$assignings = array('' => '');
$this->view->assignings = $assignings;
$subscribers = array('' => '');
$this->view->subscribers = $subscribers;
$this->render('edit-insurer');
}
public function populatePayers(SimpleXMLElement $xml)
{
$component = $xml->addChild('component');
$section = $component->addChild('section');
$templateId = $section->addChild('templateId');
$templateId->addAttribute('root', '2.16.840.1.113883.10.20.1.9');
// <!-- Payers section template -->
$code = $section->addChild('code');
$code->addAttribute('code', '48768-6');
$code->addAttribute('codeSystem', '2.16.840.1.113883.6.1');
$section->addChild('title', 'Payers');
$rows = array();
$insurancePrograms = InsuranceProgram::getInsurancePrograms();
$insuredRelationship = new InsuredRelationship();
$insuredRelationshipIterator = $insuredRelationship->getIteratorByPersonId($this->_patientId);
foreach ($insuredRelationshipIterator as $item) {
$company = '';
$program = '';
if (isset($insurancePrograms[$item->insuranceProgramId])) {
$exp = explode('->', $insurancePrograms[$item->insuranceProgramId]);
$company = html_convert_entities($exp[0]);
$program = html_convert_entities($exp[1]);
}
$rows[] = array('company' => $company, 'program' => $program, 'groupNumber' => html_convert_entities($item->groupNumber));
}
$text = $section->addChild('text');
if ($rows) {
$table = $text->addChild('table');
$thead = $table->addChild('thead');
$tr = $thead->addChild('tr');
$tr->addChild('th', 'Payer name');
$tr->addChild('th', 'Policy type / Coverage type');
$tr->addChild('th', 'Covered party ID');
$tr->addChild('th', 'Authorization(s)');
$tbody = $table->addChild('tbody');
foreach ($rows as $row) {
$tr = $tbody->addChild('tr');
$tr->addChild('td', $row['company']);
$tr->addChild('td', $row['program']);
$tr->addChild('td', $row['groupNumber']);
$tr->addChild('td', '');
}
}
}
public function processAddProgramAction()
{
$params = $this->_getParam('program');
$program = new InsuranceProgram();
$program->populateWithArray($params);
$program->persist();
$ret = true;
$json = Zend_Controller_Action_HelperBroker::getStaticHelper('json');
$json->suppressExit = true;
$json->direct($ret);
}
public function editProgramAction()
{
$id = (int) $this->_getParam('id');
$companyId = (int) $this->_getParam('companyId');
$this->_program = new InsuranceProgram();
if ($id > 0) {
$this->_program->insuranceProgramId = $id;
$this->_program->populate();
} else {
$this->_program->companyId = $companyId;
}
$this->_form = new WebVista_Form(array('name' => 'edit-program'));
$this->_form->setAction(Zend_Registry::get('baseUrl') . 'insurance-manager.raw/process-edit-program');
$this->_form->loadORM($this->_program, 'program');
$this->_form->setWindow('winEditProgramId');
$this->view->form = $this->_form;
$this->view->buildings = $this->_getBuildings();
$insurancePrefList = InsuranceProgram::getListInsurancePreferences();
$payerTypes = array('' => '');
if (isset($insurancePrefList[InsuranceProgram::INSURANCE_PAYER_TYPE_ENUM_KEY])) {
foreach ($insurancePrefList[InsuranceProgram::INSURANCE_PAYER_TYPE_ENUM_KEY] as $key => $value) {
$payerTypes[$key] = $value;
}
}
$this->view->payerTypes = $payerTypes;
$programTypes = array('' => '');
if (isset($insurancePrefList[InsuranceProgram::INSURANCE_PROGRAM_TYPE_ENUM_KEY])) {
foreach ($insurancePrefList[InsuranceProgram::INSURANCE_PROGRAM_TYPE_ENUM_KEY] as $key => $value) {
$programTypes[$key] = $value;
}
}
$this->view->programTypes = $programTypes;
$fundsSources = array('' => '');
if (isset($insurancePrefList[InsuranceProgram::INSURANCE_FUNDS_SOURCE_ENUM_KEY])) {
foreach ($insurancePrefList[InsuranceProgram::INSURANCE_FUNDS_SOURCE_ENUM_KEY] as $key => $value) {
$fundsSources[$key] = $value;
}
}
$this->view->fundsSources = $fundsSources;
$this->view->feeScheduleDisplay = $this->_program->displayFeeSchedule;
$company = new Company();
$addressIterator = $company->getAddressIterator($companyId);
$addresses = array('' => '');
foreach ($addressIterator as $addr) {
$addresses[$addr->addressId] = $addr->name;
}
$this->view->addresses = $addresses;
$this->render('edit-program');
}
public function listInsuranceProgramsAction()
{
$guid = $this->_getParam('fid');
$fs = new FeeSchedule();
$fs->guid = $guid;
$fs->populateByGuid();
$ids = array();
foreach (explode(',', $fs->insuranceProgramIds) as $id) {
$ids[$id] = $id;
}
$rows = array();
foreach (InsuranceProgram::getInsurancePrograms() as $id => $value) {
$checked = '';
if (isset($ids[$id])) {
$checked = '1';
}
$rows[] = array('id' => $id, 'data' => array($checked, $value), 'userdata' => array('program' => $value));
}
$json = Zend_Controller_Action_HelperBroker::getStaticHelper('json');
$json->suppressExit = true;
$json->direct(array('rows' => $rows));
}
public function getAccountDetails()
{
$visitId = (int) $this->encounter_id;
$ret = array('claimFiles' => array('details' => array(), 'totals' => array()), 'charges' => array('details' => array(), 'totals' => array()), 'miscCharges' => array('details' => array(), 'totals' => array()), 'payments' => array('details' => array(), 'totals' => array()), 'writeOffs' => array('details' => array(), 'totals' => array()));
$totalBilled = 0;
$totalPaid = 0;
$totalWO = 0;
$totalBalance = 0;
foreach (ClaimFile::listClaims(array('visitId' => $visitId)) as $data) {
$claimFile = $data['claimFile'];
$totalBilled += (double) $claimFile->billed;
$totalPaid += (double) $claimFile->paid;
$totalWO += (double) $claimFile->writeOff;
$totalBalance += (double) $claimFile->balance;
$ret['claimFiles']['details'][] = $data;
}
$ret['claimFiles']['totals'] = array('billed' => $totalBilled, 'paid' => $totalPaid, 'writeOff' => $totalWO, 'balance' => $totalBalance);
$totalBilled = 0;
if ($this->closed) {
$iterator = ClaimLine::mostRecentClaims($visitId);
foreach ($iterator as $claimLine) {
$totalBilled += (double) $claimLine->baseFee;
$ret['charges']['details'][] = $claimLine;
}
} else {
$fees = $this->calculateFees();
$totalBilled += $fees['total'];
$totalWO += $fees['discounted'];
$discount = $fees['total'] - $fees['discounted'];
if ($discount < 0) {
$discount = 0;
}
$claimLine = new ClaimLine();
$claimLine->baseFee = $fees['total'];
$claimLine->adjustedFee = $fees['discounted'];
$claimLine->visitId = $visitId;
$claimLine->dateTime = $this->date_of_treatment;
$claimLine->insuranceProgramId = $this->activePayerId;
$claimLine->enteredBy = $this->getEnteredBy();
$ret['charges']['details'][] = $claimLine;
if ($discount > 0) {
$writeOff = new WriteOff();
$writeOff->amount = $discount;
$writeOff->writeOffId = time();
$writeOff->payerId = InsuranceProgram::lookupSystemId('Discounts');
// ID of System->Discounts
$writeOff->timestamp = $this->date_of_treatment;
$writeOff->userId = $this->last_change_user_id > 0 ? $this->last_change_user_id : $this->created_by_user_id;
$ret['writeOffs']['details'][] = $writeOff;
}
}
$ret['charges']['totals'] = array('billed' => $totalBilled, 'paid' => 0, 'writeOff' => 0, 'balance' => 0);
// misc charges
$miscCharge = new MiscCharge();
$totalBilled = 0;
foreach ($miscCharge->getIteratorByVisitId($visitId) as $row) {
$totalBilled += (double) $row->amount;
$ret['miscCharges']['details'][] = $row;
}
$ret['miscCharges']['totals'] = array('billed' => $totalBilled, 'paid' => 0, 'writeOff' => 0, 'balance' => 0);
$iterators = ClaimLine::getPaymentHistory(array('visitId' => $visitId, 'unposted' => true));
$totalPaid = 0;
$totalWO = 0;
foreach ($iterators as $iterator) {
foreach ($iterator as $item) {
if ($item instanceof PostingJournal) {
$totalPaid += (double) $item->amount;
$ret['payments']['details'][] = $item;
} else {
if ($item instanceof Payment) {
$totalPaid += (double) $item->unallocated;
$ret['payments']['details'][] = $item;
} else {
$totalWO += (double) $item->amount;
$ret['writeOffs']['details'][] = $item;
}
}
}
}
// payments
$ret['payments']['totals'] = array('billed' => 0, 'paid' => $totalPaid, 'writeOff' => 0, 'balance' => 0);
// writeoffs
$ret['writeOffs']['totals'] = array('billed' => 0, 'paid' => 0, 'writeOff' => $totalWO, 'balance' => 0);
return $ret;
}
public function listPatientAccountDetailsAction()
{
$visitId = (int) $this->_getParam('visitId');
$visit = new Visit();
$visit->visitId = $visitId;
$visit->populate();
$facility = $visit->facility;
// Facility
$providerDisplayName = $visit->providerDisplayName;
// Provider
$summary = $visit->accountDetails;
$rows = array();
foreach ($summary['claimFiles']['details'] as $data) {
$claimFile = $data['claimFile'];
$visit = $data['visit'];
$claimFileId = (int) $claimFile->claimFileId;
$row = array();
$row['id'] = $visitId;
$row['data'] = array();
$row['data'][] = $claimFileId;
// Id
$row['data'][] = InsuranceProgram::getInsuranceProgram($claimFile->payerId);
// Payer Name
$row['data'][] = substr($claimFile->dateBilled, 0, 10);
// Date Billed
$row['data'][] = substr($claimFile->dateTime, 0, 10);
// Date
$row['data'][] = '$' . $claimFile->billed;
// Billed
$row['data'][] = '$' . $claimFile->paid;
// Paid
$row['data'][] = '$' . $claimFile->writeOff;
// Write Off
$row['data'][] = '$' . $claimFile->balance;
// Balance
$row['data'][] = '';
// Chk #
$row['data'][] = $facility;
// Facility
$row['data'][] = $providerDisplayName;
// Provider
$row['data'][] = $claimFile->enteredBy;
// Entered By
if (!isset($rows[$id])) {
$rows[$id] = array();
}
$rows[$id][] = $row;
}
$ctr = 0;
// charges
foreach ($summary['charges']['details'] as $row) {
$amount = (double) $row->baseFee;
$id = $row->visitId;
if (!isset($rows[$id])) {
$rows[$id] = array();
}
$rows[$id]['info'][] = array('amount' => $amount, 'type' => 'debit');
$rows[$id][] = array('id' => $id . '-' . $ctr++, 'data' => array('Charge', InsuranceProgram::getInsuranceProgram($row->insuranceProgramId), substr($row->dateTime, 0, 10), '', '$' . $amount, '', '', '', '', $facility, $providerDisplayName, $row->enteredBy));
}
// misc charges
foreach ($summary['miscCharges']['details'] as $row) {
$amount = (double) $row->amount;
$id = $row->miscChargeId;
if (!isset($rows[$id])) {
$rows[$id] = array();
}
$rows[$id]['info'][] = array('amount' => $amount, 'type' => 'debit');
$rows[$id][] = array('id' => $id, 'data' => array('Misc Charge', '', substr($row->chargeDate, 0, 10), '', '$' . $amount, '', '', '', '', $facility, $providerDisplayName, $row->enteredBy));
}
// payments
foreach ($summary['payments']['details'] as $row) {
if ($row instanceof PostingJournal) {
$amount = (double) $row->amount;
$id = $row->postingJournalId;
$datePosted = $row->datePosted;
$refNum = $row->payment->refNum;
} else {
$amount = (double) $row->unallocated;
$id = $row->paymentId;
$datePosted = $row->paymentDate;
$refNum = $row->refNum;
}
if (!isset($rows[$id])) {
$rows[$id] = array();
}
$rows[$id]['info'][] = array('amount' => $amount, 'type' => 'credit');
$rows[$id][] = array('id' => $id, 'data' => array('Payment', InsuranceProgram::getInsuranceProgram($row->payerId), '', substr($datePosted, 0, 10), '', '$' . $amount, '', '', $refNum, $facility, $providerDisplayName, $row->enteredBy));
}
// writeoffs
foreach ($summary['writeOffs']['details'] as $row) {
$amount = (double) $row->amount;
$id = $row->writeOffId;
if (!isset($rows[$id])) {
$rows[$id] = array();
}
$rows[$id]['info'][] = array('amount' => $amount, 'type' => 'credit');
$rows[$id][] = array('id' => $id, 'data' => array('Write Off', InsuranceProgram::getInsuranceProgram($row->payerId), '', substr($row->timestamp, 0, 10), '', '', '$' . $amount, '', '', $facility, $providerDisplayName, $row->enteredBy));
}
ksort($rows);
$data = array('rows' => array());
$balance = 0;
foreach ($rows as $values) {
$info = $values['info'];
unset($values['info']);
foreach ($values as $key => $value) {
$amount = $info[$key]['amount'];
if ($info[$key]['type'] == 'debit') {
$balance += $amount;
} else {
$balance -= $amount;
}
$value['data'][7] = '$' . abs($balance);
$data['rows'][] = $value;
}
}
$json = Zend_Controller_Action_HelperBroker::getStaticHelper('json');
$json->suppressExit = true;
$json->direct($data);
}
public function getInsuranceDisplay()
{
$payerId = (int) $this->payer_id;
$ret = '';
if ($payerId > 0) {
$ret = InsuranceProgram::getInsuranceProgram($payerId);
}
return $ret;
}
public static function listCharges(array $filters)
{
$db = Zend_Registry::get('dbAdapter');
$sqlSelect = $db->select()->from('claimLines')->join('encounter', 'encounter.encounter_id = claimLines.visitId', array('SUM(claimLines.baseFee) AS totalBaseFee', 'SUM(claimLines.adjustedFee) AS totalAdjustedFee'))->order('claimLines.dateTime DESC')->order('claimLines.claimId DESC')->order('encounter.appointmentId')->group('encounter.encounter_id');
$sqlSelect = $db->select()->from('encounter')->order('encounter.date_of_treatment DESC');
$mscSelect = $db->select()->from('misc_charge', array('misc_charge.misc_charge_id AS id', 'misc_charge.amount AS billed', 'CONCAT(\'0\') AS paid', 'CONCAT(\'0\') AS writeOff', 'CONCAT(\'Misc Charge\') AS payer', 'encounter.date_of_treatment AS dateOfTreatment', 'misc_charge.charge_date AS dateBilled', 'CONCAT(patient.last_name,\', \',patient.first_name,\' \',patient.middle_name) AS patientName', 'CONCAT(\'\') AS facility', 'CONCAT(provider.last_name,\', \',provider.first_name,\' \',provider.middle_name) AS providerName'))->join('encounter', 'encounter.encounter_id = misc_charge.encounter_id')->join(array('patient' => 'person'), 'patient.person_id = encounter.patient_id')->join(array('provider' => 'person'), 'provider.person_id = encounter.treating_person_id')->order('misc_charge.charge_date DESC');
foreach ($filters as $key => $value) {
switch ($key) {
case 'dateRange':
$sqlSelect->where("encounter.date_of_treatment BETWEEN '{$value['start']} 00:00:00' AND '{$value['end']} 23:59:59'");
$mscSelect->where("encounter.date_of_treatment BETWEEN '{$value['start']} 00:00:00' AND '{$value['end']} 23:59:59'");
break;
case 'facilities':
// practice, building, room
if (!is_array($value)) {
$value = array($value);
}
$facilities = array();
foreach ($value as $val) {
$facilities[] = 'encounter.practice_id = ' . (int) $val['practice'] . ' AND encounter.building_id = ' . (int) $val['building'] . ' AND encounter.room_id = ' . (int) $val['room'];
}
$sqlSelect->where(implode(' OR ', $facilities));
$mscSelect->where(implode(' OR ', $facilities));
break;
case 'payers':
$payers = array();
foreach ($value as $payerId) {
$payers[] = (int) $payerId;
}
$payers = implode(',', $payers);
$sqlSelect->where('encounter.activePayerId IN (' . $payers . ')');
$mscSelect->where('encounter.activePayerId IN (' . $payers . ')');
break;
case 'facility':
// practice, building, room
$sqlSelect->where('encounter.practice_id = ?', (int) $value['practice']);
$sqlSelect->where('encounter.building_id = ?', (int) $value['building']);
$sqlSelect->where('encounter.room_id = ?', (int) $value['room']);
// practice, building, room
$mscSelect->where('encounter.practice_id = ?', (int) $value['practice']);
$mscSelect->where('encounter.building_id = ?', (int) $value['building']);
$mscSelect->where('encounter.room_id = ?', (int) $value['room']);
break;
case 'insurer':
$sqlSelect->where('encounter.activePayerId = ?', (int) $value);
$mscSelect->where('encounter.activePayerId = ?', (int) $value);
break;
case 'visitId':
$sqlSelect->where('encounter.encounter_id = ?', (int) $value);
$mscSelect->where('encounter.encounter_id = ?', (int) $value);
break;
case 'provider':
$value = array($value);
case 'providers':
$providers = array();
foreach ($value as $providerId) {
$providers[] = (int) $providerId;
}
$providers = implode(',', $providers);
$sqlSelect->where('encounter.treating_person_id IN (' . $providers . ')');
$mscSelect->where('encounter.treating_person_id IN (' . $providers . ')');
break;
case 'closed':
$sqlSelect->where('encounter.closed = ?', (int) $value);
$mscSelect->where('encounter.closed = ?', (int) $value);
break;
case 'void':
$sqlSelect->where('encounter.void = ?', (int) $value);
$mscSelect->where('encounter.void = ?', (int) $value);
break;
}
}
$rows = array();
$visits = array();
$payers = array();
$facilities = array();
$patients = array();
$providers = array();
$stmt = $db->query($sqlSelect);
$stmt->setFetchMode(Zend_Db::FETCH_ASSOC);
while ($row = $stmt->fetch()) {
$visit = new Visit();
$visit->populateWithArray($row);
$visitId = (int) $visit->visitId;
$acct = $visit->accountSummary;
$paid = $acct['payment'];
$writeoff = $acct['writeoff'];
$total = $acct['total'];
$billed = $acct['billed'];
$balance = $acct['balance'];
$payerId = isset($acct['claimLine']) ? $acct['claimLine']->insuranceProgramId : $visit->activePayerId;
if (!isset($payers[$payerId])) {
$payers[$payerId] = InsuranceProgram::getInsuranceProgram($payerId);
}
$patientId = (int) $visit->patientId;
if (!isset($patients[$patientId])) {
$patient = new Patient();
$patient->personId = $patientId;
$patient->populate();
$patients[$patientId] = $patient;
}
$facilityId = (int) $visit->roomId;
if (!isset($facilities[$facilityId])) {
$facilities[$facilityId] = $visit->facility;
}
$providerId = (int) $visit->providerId;
if (!isset($providers[$providerId])) {
$provider = new Provider();
$provider->personId = $providerId;
$provider->populate();
$providers[$providerId] = $provider;
}
$tmp = array();
$tmp['id'] = $visitId;
$tmp['total'] = $total;
$tmp['billed'] = $billed;
$tmp['paid'] = $paid;
$tmp['writeOff'] = $writeoff;
$tmp['balance'] = $balance;
$tmp['payer'] = $payers[$payerId];
$tmp['dateOfTreatment'] = $visit->dateOfTreatment;
$tmp['dateBilled'] = isset($acct['claimLine']) ? $acct['claimLine']->dateTime : $visit->dateOfTreatment;
$patientName = $patients[$patientId]->personId > 0 ? $patients[$patientId]->person->displayName : '';
$tmp['patientName'] = $patientName;
$tmp['facility'] = $facilities[$facilityId];
$providerName = $providers[$providerId]->personId > 0 ? $providers[$providerId]->person->displayName : '';
$tmp['providerName'] = $providerName;
$rows[] = $tmp;
}
$stmt = $db->query($mscSelect);
$stmt->setFetchMode(Zend_Db::FETCH_ASSOC);
while ($row = $stmt->fetch()) {
$row['balance'] = (double) $row['billed'] - ((double) $row['paid'] + (double) $row['writeOff']);
$rows[] = $row;
}
return $rows;
}
protected static function _generate4010A1($claimId, array $claim)
{
static $ctr = 0;
static $visits = array();
static $practices = array();
static $insurancePrograms = array();
static $providers = array();
static $patients = array();
$claimId = (int) $claimId;
$claimLine = new ClaimLine();
$claimLine->populateByClaimId($claimId);
$visitId = (int) $claimLine->visitId;
if (!isset($visits[$visitId])) {
$visit = new Visit();
$visit->visitId = $visitId;
$visit->populate();
$visits[$visitId] = $visit;
}
$visit = $visits[$visitId];
$patientId = (int) $visit->patientId;
if (!isset($patients[$patientId])) {
$patient = new Patient();
$patient->personId = $patientId;
$patient->populate();
$patients[$patientId] = $patient;
}
$patient = $patients[$patientId];
$practiceId = (int) $visit->practiceId;
if (!isset($practices[$practiceId])) {
$practice = new Practice();
$practice->practiceId = $practiceId;
$practice->populate();
$practices[$practiceId] = $practice;
}
$practice = $practices[$practiceId];
$insuranceProgramId = (int) $visit->activePayerId;
if (!isset($insurancePrograms[$insuranceProgramId])) {
$insurance = new InsuranceProgram();
$insurance->insuranceProgramId = $insuranceProgramId;
$insurance->populate();
$insurancePrograms[$insuranceProgramId] = $insurance;
}
$insuranceProgram = $insurancePrograms[$insuranceProgramId];
$providerId = (int) $visit->treatingPersonId;
if (!isset($providers[$providerId])) {
$provider = new Provider();
$provider->personId = $providerId;
$provider->populate();
$providers[$providerId] = $provider;
}
$provider = $providers[$providerId];
$billAs = (int) $provider->billAs;
if ($billAs > 0) {
$providerId = $billAs;
if (!isset($providers[$providerId])) {
$provider = new Provider();
$provider->personId = $providerId;
$provider->populate();
$providers[$providerId] = $provider;
}
$provider = $providers[$providerId];
}
$subscribers = array();
$enumeration = new Enumeration();
$enumeration->populateByUniqueName(InsuranceProgram::INSURANCE_ENUM_NAME);
$enumerationClosure = new EnumerationClosure();
foreach ($enumerationClosure->getAllDescendants($enumeration->enumerationId, 1, true) as $enum) {
$rowset = $enumerationClosure->getAllDescendants($enum->enumerationId, 1, true);
if ($enum->key == InsuranceProgram::INSURANCE_SUBSCRIBER_ENUM_KEY) {
foreach ($rowset as $row) {
$subscribers[$row->key] = $row->name;
}
break;
}
}
$insuredRelationship = new InsuredRelationship();
$db = Zend_Registry::get('dbAdapter');
$sqlSelect = $db->select()->from($insuredRelationship->_table)->where('insurance_program_id = ?', (int) $insuranceProgram->insuranceProgramId)->where('person_id = ?', (int) $patientId)->where('active = 1')->order('program_order')->limit(1);
if ($row = $db->fetchRow($sqlSelect)) {
$insuredRelationship->populateWithArray($row);
}
$subs = $insuredRelationship->subscriber;
$subscriberAddr = $subs->address;
$relationship = null;
$relationshipCode = $insuredRelationship->subscriberToPatientRelationship;
if (isset($subscribers[$relationshipCode])) {
$relationship = $subscribers[$relationshipCode];
}
if ($relationship === null) {
$relationship = 'Self';
$relationshipCode = 18;
$subs = new Person();
$subs->personId = $insuredRelationship->personId;
$subs->populate();
}
$subscriber = array('id' => (int) $subs->personId, 'relationship_code' => $relationshipCode, 'group_number' => $insuredRelationship->groupNumber, 'group_name' => $insuredRelationship->groupName, 'relationship' => $relationship, 'last_name' => $subs->lastName, 'first_name' => $subs->firstName, 'middle_name' => $subs->middleName, 'address' => array('line1' => $subscriberAddr->line1, 'line2' => $subscriberAddr->line2, 'city' => $subscriberAddr->city, 'state' => $subscriberAddr->state, 'zip' => $subscriberAddr->zipCode), 'date_of_birth' => date('Ymd', strtotime($subs->dateOfBirth)), 'gender' => $subs->gender, 'contract_type_code' => '', 'contract_amount' => '', 'contract_percent' => '', 'contract_code' => '', 'contract_discount_percent' => '', 'contract_version' => '');
$practiceAddr = $practice->primaryAddress;
$room = new Room();
$room->roomId = (int) $visit->roomId;
$room->populate();
$facility = $room->building;
$phoneNumber = PhoneNumber::autoFixNumber($practice->mainPhone->number);
$phoneLen = strlen($phoneNumber);
if ($phoneLen < 10) {
$phoneNumber = str_pad($phoneNumber, 10, '0', STR_PAD_LEFT);
} else {
if ($phoneLen > 10) {
$phoneNumber = substr($phoneNumber, -10);
}
}
$identifierType = '';
$identifier = $practice->identifier;
if (strlen($identifier) > 0) {
$identifierType = 'XX';
}
//24';
$data = array('hlCount' => ++$ctr);
$data['practice'] = array('name' => $practice->name, 'identifier_type' => $identifierType, 'identifier' => $identifier, 'address' => array('line1' => $practiceAddr->line1, 'line2' => $practiceAddr->line2, 'city' => $practiceAddr->city, 'state' => $practiceAddr->state, 'zip' => $practiceAddr->zipCode), 'phoneNumber' => $phoneNumber);
$data['treating_facility'] = array('identifier' => $facility->identifier);
$dateOfTreatment = date('Ymd', strtotime($visit->dateOfTreatment));
$payer2Id = $insuranceProgram->insuranceProgramId;
if (strlen($payer2Id) < 2) {
$payer2Id = str_pad($payer2Id, 2, '0', STR_PAD_LEFT);
}
$identifierType = '';
$identifier = $provider->person->identifier;
if (strlen($identifier) > 0) {
$identifierType = 'XX';
}
//34';
$claimData = array('claim' => $claim, 'patient' => array('date_of_initial_treatment' => $dateOfTreatment, 'date_of_onset' => $dateOfTreatment, 'comment_type' => '', 'comment' => ''), 'treating_facility' => array('facility_code' => $facility->facilityCodeId, 'name' => $facility->name, 'address' => array('line1' => $facility->line1, 'line2' => $facility->line2, 'city' => $facility->city, 'state' => $facility->state, 'zip' => $facility->zipCode)), 'provider' => array('signature_on_file' => 'Y', 'accepts_assignment' => 'A', 'last_name' => $provider->person->lastName, 'first_name' => $provider->person->firstName, 'identifier_type' => $identifierType, 'identifier' => $identifier, 'identifier_2' => ''), 'billing_facility' => array('clia_number' => ''), 'subscriber' => $subscriber, 'clearing_house' => array('credit_max_amount' => '', 'repricing_method' => '', 'allowed_amount' => '', 'savings_amount' => '', 'identifier' => '', 'rate' => '', 'apg_code' => '', 'apg_amount' => '', 'reject_code' => '', 'compliance_code' => '', 'exception_code' => ''), 'referring_provider' => array('last_name' => '', 'first_name' => '', 'referral_type' => '', 'identifier_type' => '', 'identifier' => '', 'taxonomy_code' => ''), 'supervising_provider' => array('last_name' => '', 'first_name' => '', 'identifier_type' => '', 'identifier' => ''), 'payer2' => array('id' => $payer2Id, 'name' => $insuranceProgram->name));
$clm = array();
$iterator = new ClaimLineIterator();
$iterator->setFilters(array('claimId' => $claimId));
foreach ($iterator as $row) {
$baseFee = (double) $row->baseFee;
$adjustedFee = (double) $row->adjustedFee;
$paid = (double) $row->paid;
$billed = $row->totalMiscCharge;
if ($baseFee > 0) {
$billed += $baseFee - $adjustedFee;
}
$balance = abs($billed) - $paid;
$clm[] = array('claim' => $claimData['claim'], 'patient' => $claimData['patient'], 'claim_line' => array('amount' => $balance, 'diagnosis1' => preg_replace('/[\\.]/', '', $row->diagnosisCode1), 'diagnosis2' => preg_replace('/[\\.]/', '', $row->diagnosisCode2), 'diagnosis3' => preg_replace('/[\\.]/', '', $row->diagnosisCode3), 'diagnosis4' => preg_replace('/[\\.]/', '', $row->diagnosisCode4), 'diagnosis5' => preg_replace('/[\\.]/', '', $row->diagnosisCode5), 'diagnosis6' => preg_replace('/[\\.]/', '', $row->diagnosisCode6), 'diagnosis7' => preg_replace('/[\\.]/', '', $row->diagnosisCode7), 'diagnosis8' => preg_replace('/[\\.]/', '', $row->diagnosisCode8), 'procedure' => $row->procedureCode, 'modifier1' => $row->modifier1, 'modifier2' => $row->modifier2, 'modifier3' => $row->modifier3, 'modifier4' => $row->modifier4, 'units' => str_replace('.00', '', $row->units), 'date_of_treatment' => $dateOfTreatment, 'clia_number' => ''), 'treating_facility' => $claimData['treating_facility'], 'provider' => $claimData['provider'], 'billing_facility' => $claimData['billing_facility'], 'subscriber' => $subscriber, 'clearing_house' => $claimData['clearing_house'], 'referring_provider' => $claimData['referring_provider'], 'supervising_provider' => $claimData['supervising_provider'], 'payer2' => $claimData['payer2']);
}
$hl2 = array();
$hl2[] = array('hlCount' => $ctr, 'hlCount2' => ++$ctr, 'payer' => array('responsibility' => 'P'), 'subscriber' => $subscriber, 'patient' => array('weight' => '', 'last_name' => $patient->lastName, 'first_name' => $patient->firstName), 'responsible_party' => array('last_name' => '', 'first_name' => '', 'address' => array('line1' => '', 'line2' => '', 'city' => '', 'state' => '', 'zip' => '')), 'CLM' => $clm);
$data['HL2'] = $hl2;
return $data;
}
public function processPaymentSendToAction()
{
$claimId = (int) $this->_getParam('claimId');
$payerId = 0;
$insurance = $this->_getParam('insurance');
switch ($insurance) {
case 'Collections':
case 'Patient Responsibility':
foreach (InsuranceProgram::getInsurancePrograms() as $key => $value) {
if ($value == 'System->' . $insurance) {
$payerId = (int) $key;
break;
}
}
break;
}
$ret = false;
if ($claimId > 0 && $payerId > 0) {
$this->_sendToPayer($claimId, $payerId);
$ret = true;
}
$json = Zend_Controller_Action_HelperBroker::getStaticHelper('json');
$json->suppressExit = true;
$json->direct($ret);
}
public function editInsurerAction()
{
$patientId = (int) $this->_getParam('patientId');
$id = (int) $this->_getParam('id');
$insurer = new InsuredRelationship();
$insurer->personId = $patientId;
$time = time();
$insurer->effectiveStart = date('Y-m-d', $time);
$insurer->effectiveEnd = date('Y-m-d', strtotime('+1 year', $time));
if ($id > 0) {
$insurer->insuredRelationshipId = $id;
$insurer->populate();
}
$this->view->subscriber = $insurer->subscriber;
$this->view->subscriberPhone = $insurer->subscriber->phoneNumber;
$this->view->subscriberAddress = $insurer->subscriber->address;
$this->_form = new WebVista_Form(array('name' => 'edit-insurer'));
$this->_form->setAction(Zend_Registry::get('baseUrl') . 'patient.raw/process-edit-insurer');
$this->_form->loadORM($insurer, 'Insurer');
$this->_form->setWindow('winEditInsurerId');
$this->view->form = $this->_form;
$insuranceProgram = new InsuranceProgram();
$insurancePrograms = array('' => '');
foreach (InsuranceProgram::getInsurancePrograms() as $id => $val) {
$insurancePrograms[$id] = $val;
}
$this->view->insurancePrograms = $insurancePrograms;
$assignings = array();
$subscribers = array();
$enumeration = new Enumeration();
$enumeration->populateByUniqueName(InsuranceProgram::INSURANCE_ENUM_NAME);
$enumerationClosure = new EnumerationClosure();
foreach ($enumerationClosure->getAllDescendants($enumeration->enumerationId, 1, true) as $enum) {
$rowset = $enumerationClosure->getAllDescendants($enum->enumerationId, 1, true);
if ($enum->key == InsuranceProgram::INSURANCE_ASSIGNING_ENUM_KEY) {
foreach ($rowset as $row) {
$assignings[$row->key] = $row->name;
}
} else {
if ($enum->key == InsuranceProgram::INSURANCE_SUBSCRIBER_ENUM_KEY) {
foreach ($rowset as $row) {
$subscribers[$row->key] = $row->name;
}
}
}
}
$this->view->assignings = $assignings;
$this->view->subscribers = $subscribers;
$this->view->listVerified = InsuredRelationship::getVerifiedOptions();
$this->render('edit-insurer');
}
