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; }