public static function recalculateClaims(self $visit, $newClaim = false)
{
$fees = $visit->calculateFees(true);
$hasProcedure = false;
if ($newClaim) {
$claimId = WebVista_Model_ORM::nextSequenceId('claimSequences');
}
$copay = $visit->getCopay();
$totalPaid = 0;
$personId = (int) $visit->patientId;
$userId = (int) Zend_Auth::getInstance()->getIdentity()->personId;
$visitId = (int) $visit->visitId;
$discountPayerId = InsuranceProgram::lookupSystemId('Discounts');
// ID of System->Discounts
$creditPayerId = InsuranceProgram::lookupSystemId('Credit');
// ID of System->Credit
$payerId = InsuranceProgram::lookupSystemId('Self Pay');
// ID of System->Self Pay
foreach ($fees['details'] as $id => $values) {
// update claim or create if not exists
$fee = (double) $values['fee'];
$feeDiscounted = (double) $values['feeDiscounted'];
$claimLine = new ClaimLine();
$claimLine->populateWithPatientProcedure($values['orm'], $visit);
if ($newClaim) {
$claimLine->claimLineId = 0;
$claimLine->claimId = $claimId;
}
$claimLine->baseFee = $fee;
$claimLine->adjustedFee = $feeDiscounted;
$claimLine->persist();
$claimLineId = (int) $claimLine->claimLineId;
$billable = $feeDiscounted;
/*$discount = 0;
if ($feeDiscounted > 0) $discount = $fee - $feeDiscounted;
if ($discount < 0) $discount = 0;*/
$discount = (double) $values['writeoff'];
if ($newClaim && $discount > 0) {
// add writeoffs
$writeOff = new WriteOff();
$writeOff->personId = $personId;
$writeOff->claimLineId = $claimLineId;
$writeOff->visitId = $visitId;
$writeOff->appointmentId = $visit->appointmentId;
$writeOff->amount = $discount;
$writeOff->userId = $userId;
$writeOff->timestamp = date('Y-m-d H:i:s');
$writeOff->title = 'discount';
$writeOff->payerId = $discountPayerId;
$writeOff->persist();
$billable -= $discount;
}
if ($newClaim && $billable > 0) {
foreach ($copay['details'] as $paymentId => $payment) {
$amount = (double) $payment->unallocated;
if (!$amount > 0) {
unset($copay['details'][$paymentId]);
continue;
}
if ($amount > $billable) {
$amount = $billable;
}
$payment->allocated += $amount;
$payment->payerId = $payerId;
$payment->persist();
$copay['details'][$paymentId] = $payment;
$totalPaid += $amount;
$postingJournal = new PostingJournal();
$postingJournal->paymentId = (int) $payment->paymentId;
$postingJournal->patientId = $personId;
$postingJournal->payerId = $payerId;
$postingJournal->claimLineId = $claimLineId;
$postingJournal->visitId = $visitId;
$postingJournal->amount = $amount;
$postingJournal->note = 'copay posting';
$postingJournal->userId = $userId;
$dateTime = date('Y-m-d H:i:s');
$postingJournal->datePosted = $dateTime;
$postingJournal->dateTime = $dateTime;
$postingJournal->persist();
$billable -= $amount;
if ($billable <= 0) {
break;
}
}
}
$hasProcedure = true;
}
if ($newClaim && $copay['total'] > $totalPaid) {
// if copay is greater than all claimlines reamining dollars are posted to credit program
foreach ($copay['details'] as $paymentId => $payment) {
$amount = (double) $payment->unallocated;
$payment->allocated += $amount;
$payment->persist();
$postingJournal = new PostingJournal();
$postingJournal->paymentId = (int) $payment->paymentId;
$postingJournal->patientId = $personId;
$postingJournal->payerId = $creditPayerId;
$postingJournal->visitId = $visitId;
$postingJournal->amount = $amount;
$postingJournal->note = 'remaining copay balance';
$postingJournal->userId = $userId;
$dateTime = date('Y-m-d H:i:s');
$postingJournal->datePosted = $dateTime;
$postingJournal->dateTime = $dateTime;
$postingJournal->persist();
}
}
if (!$hasProcedure) {
$visitId = $visit->visitId;
$payment = new Payment();
foreach ($payment->getIteratorByVisitId($visitId) as $row) {
// If visit has copay then at closing copay should be turned into unallocated payment (not associated with visit).
$row->visitId = 0;
$row->persist();
}
} else {
$visit = ClaimRule::checkRules($visit, $fees);
}
return $visit;
}
public static function checkRules(Visit $visit, array $fees = array())
{
if (!isset($fees['details'])) {
$fees = $visit->calculateFees(true);
}
$visitId = (int) $visit->visitId;
$payerId = (int) $visit->activePayerId;
$procedures = null;
$iterator = new ClaimRuleIterator();
foreach (self::listGroups() as $groupId => $values) {
// TODO: use operators
$matched = false;
$iterator->setFilters(array('groupId' => $groupId));
foreach ($iterator as $claimRule) {
$type = $claimRule->type;
switch ($type) {
case self::TYPE_PROCEDURE:
case self::TYPE_DIAGNOSIS:
if ($procedures === null) {
$procedures = array();
$patientProcedureIterator = new PatientProcedureIterator();
$patientProcedureIterator->setFilters(array('visitId' => $visitId));
foreach ($patientProcedureIterator as $patientProcedure) {
$procedures[] = $patientProcedure;
}
}
$code = $claimRule->code;
foreach ($procedures as $procedure) {
if ($type == self::TYPE_PROCEDURE) {
if ($procedure->code == $code) {
$matched = true;
break;
}
} else {
for ($i = 1; $i <= 8; $i++) {
$key = 'diagnosisCode' . $i;
if ($procedure->{$key} == $code) {
$matched = true;
break 2;
}
}
}
}
break;
case self::TYPE_INSURANCE_PROGRAM:
if ($claimRule->value == $payerId) {
$matched = true;
}
break;
case self::TYPE_MODIFIER:
break;
case self::TYPE_LINE_AMOUNT:
break;
case self::TYPE_CLAIM_TOTAL:
break;
}
}
if ($matched) {
$visit->_claimRule = $values;
}
}
return $visit;
}
public function paymentReceiptAction()
{
// d96de46c-be90-45b0-b5f9-0b4abee76483
$referenceId = $this->_getParam('referenceId');
$personId = (int) $this->_getParam('personId');
$visitId = (int) $this->_getParam('visitId');
$data = $this->_getAttachmentData($referenceId);
$patient = new Patient();
$patient->personId = $personId;
if ($personId > 0) {
$patient->populate();
}
$person = $patient->person;
$visit = new Visit();
$visit->visitId = $visitId;
if ($visitId > 0) {
$visit->populate();
}
$practiceId = (int) $visit->practiceId;
if (!$practiceId > 0) {
$buildingId = (int) $visit->buildingId;
if ($buildingId > 0) {
$building = new Building();
$building->buildingId = $buildingId;
$building->populate();
$practiceId = (int) $building->practiceId;
} else {
$roomId = (int) $visit->roomId;
if ($roomId > 0) {
$room = new Room();
$room->roomId = $roomId;
$room->populate();
$practiceId = (int) $room->building->practiceId;
}
}
}
$practice = new Practice();
$practice->practiceId = $practiceId;
if ($practiceId > 0) {
$practice->populate();
}
$primaryAddress = $practice->primaryAddress;
$xml = new SimpleXMLElement('<data/>');
$xmlPractice = $xml->addChild('practice');
$this->_addChild($xmlPractice, 'name', $practice->name);
$this->_addChild($xmlPractice, 'primaryLine1', $primaryAddress->line1);
$primaryCityStateZip = $primaryAddress->city . ' ' . $primaryAddress->state . ' ' . $primaryAddress->postalCode;
$this->_addChild($xmlPractice, 'primaryCityStateZip', $primaryCityStateZip);
$this->_addChild($xmlPractice, 'mainPhone', $practice->mainPhone->number);
$xmlPatient = $xml->addChild('patient');
$name = $person->firstName . ' ' . $person->middleName . ' ' . $person->lastName;
$this->_addChild($xmlPatient, 'name', $name);
$addresses = Address::listAddresses($personId);
if (isset($addresses[Address::TYPE_BILLING])) {
$address = $addresses[Address::TYPE_BILLING];
} else {
if (isset($addresses[Address::TYPE_HOME])) {
$address = $addresses[Address::TYPE_HOME];
} else {
if (isset($addresses[Address::TYPE_MAIN])) {
$address = $addresses[Address::TYPE_MAIN];
} else {
if (isset($addresses[Address::TYPE_SEC])) {
$address = $addresses[Address::TYPE_SEC];
} else {
if (isset($addresses[Address::TYPE_OTHER])) {
$address = $addresses[Address::TYPE_OTHER];
} else {
$address = array_pop($addresses);
}
}
}
}
}
$billingCityStateZip = $address->city . ' ' . $address->state . ' ' . $address->postalCode;
$this->_addChild($xmlPatient, 'billingLine1', $address->line1);
$this->_addChild($xmlPatient, 'billingCityStateZip', $billingCityStateZip);
$iterator = new PatientProcedureIterator();
$iterator->setFilters(array('visitId' => $visitId));
$procedures = array();
foreach ($iterator as $row) {
$procedures[] = $row->code;
}
$iterator = new PatientDiagnosisIterator();
$iterator->setFilters(array('visitId' => $visitId));
$diagnoses = array();
foreach ($iterator as $row) {
$diagnoses[] = $row->code;
}
$xmlNotes = $xmlPatient->addChild('notes');
$note = implode(',', $procedures) . " \t " . implode(',', $diagnoses) . " \t " . date('m/d/y', strtotime($visit->dateOfTreatment));
$this->_addChild($xmlNotes, 'note', $note);
$today = date('Y-m-d');
$todaysTotal = 0;
$iterator = new PaymentIterator();
$iterator->setFilters(array('visitId' => $visitId, 'company' => 'System', 'paymentDate' => $today));
$payments = array();
foreach ($iterator as $row) {
$payments[] = $row;
}
$iterator->setFilters(array('personId' => $personId, 'unallocated' => true, 'paymentDate' => $today));
foreach ($iterator as $row) {
$payments[] = $row;
}
foreach ($payments as $row) {
$xmlPayment = $xmlPatient->addChild('payments');
$paymentDate = date('m/d/y', strtotime($row->paymentDate));
$this->_addChild($xmlPayment, 'date', $paymentDate);
$this->_addChild($xmlPayment, 'description', $row->title . ' .... Thank You');
$this->_addChild($xmlPayment, 'method', $row->paymentType);
$amount = (double) $row->amount;
$todaysTotal += $amount;
$this->_addChild($xmlPayment, 'amount', '-' . number_format($amount, 2));
$this->_addChild($xmlPayment, 'insurance', $row->insuranceDisplay);
}
$fees = $visit->calculateFees();
$previousBalance = $fees['total'];
$this->_addChild($xmlPatient, 'previousBalance', number_format($previousBalance, 2));
$this->_addChild($xmlPatient, 'todaysTotal', '-' . number_format($todaysTotal, 2));
$totalDue = $previousBalance - $todaysTotal;
$this->_addChild($xmlPatient, 'totalDue', number_format($totalDue, 2));
$totalDueFromPatient = $previousBalance;
$this->_addChild($xmlPatient, 'totalDueFromPatient', number_format($totalDueFromPatient, 2));
try {
$content = ReportBase::mergepdfset($xml, $data);
$this->getResponse()->setHeader('Content-Type', 'application/pdf');
} catch (Exception $e) {
$content = '<script>alert("' . $e->getMessage() . '")</script>';
}
$this->view->content = $content;
$this->render('binary-template');
}
public function listCodesAction()
{
$claimId = (int) $this->_getParam('claimId');
$visitId = (int) $this->_getParam('visitId');
$rows = array();
$visit = new Visit();
$visit->visitId = $visitId;
$visit->populate();
$fees = $visit->calculateFees();
foreach ($fees['details'] as $patientProcedureId => $values) {
$patientProcedure = $values['orm'];
$claimLine = $patientProcedure->claimLine;
$fee = $values['fee'];
$feeDiscounted = $values['feeDiscounted'];
$paid = $claimLine->totalPaid($claimId);
$writeoff = $claimLine->totalWriteOff($claimId);
$carry = $fee - ($paid + $writeoff);
$row = array();
$row['id'] = $patientProcedureId;
$row['data'] = array();
$row['data'][] = $claimLine->procedureCode . ' : ' . $claimLine->procedure;
$row['data'][] = abs($fee);
$row['data'][] = '';
$row['data'][] = '';
$row['data'][] = abs($carry);
$row['data'][] = abs($paid);
$row['data'][] = abs($writeoff);
$rows[] = $row;
}
$json = Zend_Controller_Action_HelperBroker::getStaticHelper('json');
$json->suppressExit = true;
$json->direct(array('rows' => $rows));
}
