function era_callback(&$out)
{
global $encount, $debug, $claim_status_codes, $adjustment_reasons, $remark_codes;
global $invoice_total, $last_code, $paydate, $INTEGRATED_AR;
global $InsertionId;
//last inserted ID of
// Some heading information.
$chk_123 = $out['check_number'];
$chk_123 = str_replace(' ', '_', $chk_123);
if (isset($_REQUEST['chk' . $chk_123])) {
if ($encount == 0) {
writeMessageLine('#ffffff', 'infdetail', "Payer: " . htmlspecialchars($out['payer_name'], ENT_QUOTES));
if ($debug) {
writeMessageLine('#ffffff', 'infdetail', "WITHOUT UPDATE is selected; no changes will be applied.");
}
}
$last_code = '';
$invoice_total = 0.0;
$bgcolor = ++$encount & 1 ? "#ddddff" : "#ffdddd";
list($pid, $encounter, $invnumber) = slInvoiceNumber($out);
// Get details, if we have them, for the invoice.
$inverror = true;
$codes = array();
if ($pid && $encounter) {
// Get invoice data into $arrow or $ferow.
if ($INTEGRATED_AR) {
$ferow = sqlQuery("SELECT e.*, p.fname, p.mname, p.lname " . "FROM form_encounter AS e, patient_data AS p WHERE " . "e.pid = '{$pid}' AND e.encounter = '{$encounter}' AND " . "p.pid = e.pid");
if (empty($ferow)) {
$pid = $encounter = 0;
$invnumber = $out['our_claim_id'];
} else {
$inverror = false;
$codes = ar_get_invoice_summary($pid, $encounter, true);
// $svcdate = substr($ferow['date'], 0, 10);
}
} else {
$arres = SLQuery("SELECT ar.id, ar.notes, ar.shipvia, customer.name " . "FROM ar, customer WHERE ar.invnumber = '{$invnumber}' AND " . "customer.id = ar.customer_id");
if ($sl_err) {
die($sl_err);
}
$arrow = SLGetRow($arres, 0);
if ($arrow) {
$inverror = false;
$codes = get_invoice_summary($arrow['id'], true);
} else {
// oops, no such invoice
$pid = $encounter = 0;
$invnumber = $out['our_claim_id'];
}
}
// end not internal a/r
}
// Show the claim status.
$csc = $out['claim_status_code'];
$inslabel = 'Ins1';
if ($csc == '1' || $csc == '19') {
$inslabel = 'Ins1';
}
if ($csc == '2' || $csc == '20') {
$inslabel = 'Ins2';
}
if ($csc == '3' || $csc == '21') {
$inslabel = 'Ins3';
}
$primary = $inslabel == 'Ins1';
writeMessageLine($bgcolor, 'infdetail', "Claim status {$csc}: " . $claim_status_codes[$csc]);
// Show an error message if the claim is missing or already posted.
if ($inverror) {
writeMessageLine($bgcolor, 'errdetail', "The following claim is not in our database");
} else {
// Skip this test. Claims can get multiple CLPs from the same payer!
//
// $insdone = strtolower($arrow['shipvia']);
// if (strpos($insdone, 'ins1') !== false) {
// $inverror = true;
// writeMessageLine($bgcolor, 'errdetail',
// "Primary insurance EOB was already posted for the following claim");
// }
}
if ($csc == '4') {
//Denial case, code is stored in the claims table for display in the billing manager screen with reason explained.
$inverror = true;
if (!$debug) {
if ($pid && $encounter) {
$code_value = '';
foreach ($out['svc'] as $svc) {
foreach ($svc['adj'] as $adj) {
//Per code and modifier the reason will be showed in the billing manager.
$code_value .= $svc['code'] . '_' . $svc['mod'] . '_' . $adj['group_code'] . '_' . $adj['reason_code'] . ',';
}
}
$code_value = substr($code_value, 0, -1);
//We store the reason code to display it with description in the billing manager screen.
//process_file is used as for the denial case file name will not be there, and extra field(to store reason) can be avoided.
updateClaim(true, $pid, $encounter, $_REQUEST['InsId'], substr($inslabel, 3), 7, 0, $code_value);
}
}
writeMessageLine($bgcolor, 'errdetail', "Not posting adjustments for denied claims, please follow up manually!");
} else {
if ($csc == '22') {
$inverror = true;
writeMessageLine($bgcolor, 'errdetail', "Payment reversals are not automated, please enter manually!");
}
}
if ($out['warnings']) {
writeMessageLine($bgcolor, 'infdetail', nl2br(rtrim($out['warnings'])));
}
// Simplify some claim attributes for cleaner code.
$service_date = parse_date($out['dos']);
$check_date = $paydate ? $paydate : parse_date($out['check_date']);
$production_date = $paydate ? $paydate : parse_date($out['production_date']);
if ($INTEGRATED_AR) {
$insurance_id = arGetPayerID($pid, $service_date, substr($inslabel, 3));
if (empty($ferow['lname'])) {
$patient_name = $out['patient_fname'] . ' ' . $out['patient_lname'];
} else {
$patient_name = $ferow['fname'] . ' ' . $ferow['lname'];
}
} else {
$insurance_id = 0;
foreach ($codes as $cdata) {
if ($cdata['ins']) {
$insurance_id = $cdata['ins'];
break;
}
}
$patient_name = $arrow['name'] ? $arrow['name'] : $out['patient_fname'] . ' ' . $out['patient_lname'];
}
$error = $inverror;
// This loops once for each service item in this claim.
foreach ($out['svc'] as $svc) {
// Treat a modifier in the remit data as part of the procedure key.
// This key will then make its way into SQL-Ledger.
$codekey = $svc['code'];
if ($svc['mod']) {
$codekey .= ':' . $svc['mod'];
}
$prev = $codes[$codekey];
$codetype = '';
//will hold code type, if exists
// This reports detail lines already on file for this service item.
if ($prev) {
$codetype = $codes[$codekey]['code_type'];
//store code type
writeOldDetail($prev, $patient_name, $invnumber, $service_date, $codekey, $bgcolor);
// Check for sanity in amount charged.
$prevchg = sprintf("%.2f", $prev['chg'] + $prev['adj']);
if ($prevchg != abs($svc['chg'])) {
writeMessageLine($bgcolor, 'errdetail', "EOB charge amount " . $svc['chg'] . " for this code does not match our invoice");
$error = true;
}
// Check for already-existing primary remittance activity.
// Removed this check because it was not allowing for copays manually
// entered into the invoice under a non-copay billing code.
/****
if ((sprintf("%.2f",$prev['chg']) != sprintf("%.2f",$prev['bal']) ||
$prev['adj'] != 0) && $primary)
{
writeMessageLine($bgcolor, 'errdetail',
"This service item already has primary payments and/or adjustments!");
$error = true;
}
****/
unset($codes[$codekey]);
} else {
// This is not an error. If we are not in error mode and not debugging,
// insert the service item into SL. Then display it (in green if it
// was inserted, or in red if we are in error mode).
$description = "CPT4:{$codekey} Added by {$inslabel} {$production_date}";
if (!$error && !$debug) {
if ($INTEGRATED_AR) {
arPostCharge($pid, $encounter, 0, $svc['chg'], 1, $service_date, $codekey, $description, $debug, '', $codetype);
} else {
slPostCharge($arrow['id'], $svc['chg'], 1, $service_date, $codekey, $insurance_id, $description, $debug);
}
$invoice_total += $svc['chg'];
}
$class = $error ? 'errdetail' : 'newdetail';
writeDetailLine($bgcolor, $class, $patient_name, $invnumber, $codekey, $production_date, $description, $svc['chg'], $error ? '' : $invoice_total);
}
$class = $error ? 'errdetail' : 'newdetail';
// Report Allowed Amount.
if ($svc['allowed']) {
// A problem here is that some payers will include an adjustment
// reflecting the allowed amount, others not. So here we need to
// check if the adjustment exists, and if not then create it. We
// assume that any nonzero CO (Contractual Obligation) or PI
// (Payer Initiated) adjustment is good enough.
$contract_adj = sprintf("%.2f", $svc['chg'] - $svc['allowed']);
foreach ($svc['adj'] as $adj) {
if (($adj['group_code'] == 'CO' || $adj['group_code'] == 'PI') && $adj['amount'] != 0) {
$contract_adj = 0;
}
}
if ($contract_adj > 0) {
$svc['adj'][] = array('group_code' => 'CO', 'reason_code' => 'A2', 'amount' => $contract_adj);
}
writeMessageLine($bgcolor, 'infdetail', 'Allowed amount is ' . sprintf("%.2f", $svc['allowed']));
}
// Report miscellaneous remarks.
if ($svc['remark']) {
$rmk = $svc['remark'];
writeMessageLine($bgcolor, 'infdetail', "{$rmk}: " . $remark_codes[$rmk]);
}
// Post and report the payment for this service item from the ERA.
// By the way a 'Claim' level payment is probably going to be negative,
// i.e. a payment reversal.
if ($svc['paid']) {
if (!$error && !$debug) {
if ($INTEGRATED_AR) {
arPostPayment($pid, $encounter, $InsertionId[$out['check_number']], $svc['paid'], $codekey, substr($inslabel, 3), $out['check_number'], $debug, '', $codetype);
} else {
slPostPayment($arrow['id'], $svc['paid'], $check_date, "{$inslabel}/" . $out['check_number'], $codekey, $insurance_id, $debug);
}
$invoice_total -= $svc['paid'];
}
$description = "{$inslabel}/" . $out['check_number'] . ' payment';
if ($svc['paid'] < 0) {
$description .= ' reversal';
}
writeDetailLine($bgcolor, $class, $patient_name, $invnumber, $codekey, $check_date, $description, 0 - $svc['paid'], $error ? '' : $invoice_total);
}
// Post and report adjustments from this ERA. Posted adjustment reasons
// must be 25 characters or less in order to fit on patient statements.
foreach ($svc['adj'] as $adj) {
$description = $adj['reason_code'] . ': ' . $adjustment_reasons[$adj['reason_code']];
if ($adj['group_code'] == 'PR' || !$primary) {
// Group code PR is Patient Responsibility. Enter these as zero
// adjustments to retain the note without crediting the claim.
if ($primary) {
/****
$reason = 'Pt resp: '; // Reasons should be 25 chars or less.
if ($adj['reason_code'] == '1') $reason = 'To deductible: ';
else if ($adj['reason_code'] == '2') $reason = 'Coinsurance: ';
else if ($adj['reason_code'] == '3') $reason = 'Co-pay: ';
****/
$reason = "{$inslabel} ptresp: ";
// Reasons should be 25 chars or less.
if ($adj['reason_code'] == '1') {
$reason = "{$inslabel} dedbl: ";
} else {
if ($adj['reason_code'] == '2') {
$reason = "{$inslabel} coins: ";
} else {
if ($adj['reason_code'] == '3') {
$reason = "{$inslabel} copay: ";
}
}
}
} else {
$reason = "{$inslabel} note " . $adj['reason_code'] . ': ';
/****
$reason .= sprintf("%.2f", $adj['amount']);
****/
}
$reason .= sprintf("%.2f", $adj['amount']);
// Post a zero-dollar adjustment just to save it as a comment.
if (!$error && !$debug) {
if ($INTEGRATED_AR) {
arPostAdjustment($pid, $encounter, $InsertionId[$out['check_number']], 0, $codekey, substr($inslabel, 3), $reason, $debug, '', $codetype);
} else {
slPostAdjustment($arrow['id'], 0, $production_date, $out['check_number'], $codekey, $insurance_id, $reason, $debug);
}
}
writeMessageLine($bgcolor, $class, $description . ' ' . sprintf("%.2f", $adj['amount']));
} else {
if (!$error && !$debug) {
if ($INTEGRATED_AR) {
arPostAdjustment($pid, $encounter, $InsertionId[$out['check_number']], $adj['amount'], $codekey, substr($inslabel, 3), "Adjust code " . $adj['reason_code'], $debug, '', $codetype);
} else {
slPostAdjustment($arrow['id'], $adj['amount'], $production_date, $out['check_number'], $codekey, $insurance_id, "{$inslabel} adjust code " . $adj['reason_code'], $debug);
}
$invoice_total -= $adj['amount'];
}
writeDetailLine($bgcolor, $class, $patient_name, $invnumber, $codekey, $production_date, $description, 0 - $adj['amount'], $error ? '' : $invoice_total);
}
}
}
// End of service item
// Report any existing service items not mentioned in the ERA, and
// determine if any of them are still missing an insurance response
// (if so, then insurance is not yet done with the claim).
$insurance_done = true;
foreach ($codes as $code => $prev) {
// writeOldDetail($prev, $arrow['name'], $invnumber, $service_date, $code, $bgcolor);
writeOldDetail($prev, $patient_name, $invnumber, $service_date, $code, $bgcolor);
$got_response = false;
foreach ($prev['dtl'] as $ddata) {
if ($ddata['pmt'] || $ddata['rsn']) {
$got_response = true;
}
}
if (!$got_response) {
$insurance_done = false;
}
}
// Cleanup: If all is well, mark Ins<x> done and check for secondary billing.
if (!$error && !$debug && $insurance_done) {
if ($INTEGRATED_AR) {
$level_done = 0 + substr($inslabel, 3);
if ($out['crossover'] == 1) {
//Automatic forward case.So need not again bill from the billing manager screen.
sqlStatement("UPDATE form_encounter " . "SET last_level_closed = {$level_done},last_level_billed=" . $level_done . " WHERE " . "pid = '{$pid}' AND encounter = '{$encounter}'");
writeMessageLine($bgcolor, 'infdetail', 'This claim is processed by Insurance ' . $level_done . ' and automatically forwarded to Insurance ' . ($level_done + 1) . ' for processing. ');
} else {
"UPDATE form_encounter " . "SET last_level_closed = {$level_done} WHERE " . "pid = '{$pid}' AND encounter = '{$encounter}'";
}
// Check for secondary insurance.
if ($primary && arGetPayerID($pid, $service_date, 2)) {
arSetupSecondary($pid, $encounter, $debug, $out['crossover']);
if ($out['crossover'] != 1) {
writeMessageLine($bgcolor, 'infdetail', 'This claim is now re-queued for secondary paper billing');
}
}
} else {
$shipvia = 'Done: Ins1';
if ($inslabel != 'Ins1') {
$shipvia .= ',Ins2';
}
if ($inslabel == 'Ins3') {
$shipvia .= ',Ins3';
}
$query = "UPDATE ar SET shipvia = '{$shipvia}' WHERE id = " . $arrow['id'];
SLQuery($query);
if ($sl_err) {
die($sl_err);
}
// Check for secondary insurance.
$insgot = strtolower($arrow['notes']);
if ($primary && strpos($insgot, 'ins2') !== false) {
slSetupSecondary($arrow['id'], $debug);
if ($out['crossover'] != 1) {
writeMessageLine($bgcolor, 'infdetail', 'This claim is now re-queued for secondary paper billing');
}
}
}
}
}
}
function slSetupSecondary($invid, $debug)
{
global $sl_err, $GLOBALS;
if ($GLOBALS['oer_config']['ws_accounting']['enabled'] === 2) {
die("Internal error calling slSetupSecondary()");
}
$info_msg = '';
// Get some needed items from the SQL-Ledger invoice.
$arres = SLQuery("select invnumber, transdate, customer_id, employee_id, " . "shipvia from ar where ar.id = {$invid}");
if ($sl_err) {
die($sl_err);
}
$arrow = SLGetRow($arres, 0);
if (!$arrow) {
die(xl('There is no match for invoice id') . ' = ' . "{$trans_id}.");
}
$customer_id = $arrow['customer_id'];
$date_of_service = $arrow['transdate'];
list($trash, $encounter) = explode(".", $arrow['invnumber']);
// Get the OpenEMR PID corresponding to the customer.
$pdrow = sqlQuery("SELECT patient_data.pid " . "FROM integration_mapping, patient_data WHERE " . "integration_mapping.foreign_id = {$customer_id} AND " . "integration_mapping.foreign_table = 'customer' AND " . "patient_data.id = integration_mapping.local_id");
$pid = $pdrow['pid'];
if (!$pid) {
die(xl("Cannot find patient from SQL-Ledger customer id") . " = {$customer_id}.");
}
// Determine the ID of the next insurance company (if any) to be billed.
$new_payer_id = -1;
$new_payer_type = -1;
$insdone = strtolower($arrow['shipvia']);
foreach (array('ins1' => 'primary', 'ins2' => 'secondary', 'ins3' => 'tertiary') as $key => $value) {
if (strpos($insdone, $key) === false) {
$nprow = sqlQuery("SELECT provider FROM insurance_data WHERE " . "pid = '{$pid}' AND type = '{$value}' AND date <= '{$date_of_service}' " . "ORDER BY date DESC LIMIT 1");
if (!empty($nprow['provider'])) {
$new_payer_id = $nprow['provider'];
$new_payer_type = substr($key, 3);
}
break;
}
}
// Find out if the encounter exists.
$ferow = sqlQuery("SELECT pid FROM form_encounter WHERE " . "encounter = {$encounter}");
$encounter_pid = $ferow['pid'];
// If it exists, just update the billing items.
if ($encounter_pid) {
if ($encounter_pid != $pid) {
die(xl("Expected form_encounter.pid to be ") . $pid . ', ' . xl(' but was ') . $encounter_pid);
}
// If there's a payer ID queue it up, otherwise just reopen it.
if ($new_payer_id > 0) {
// TBD: implement a default bill_process and target in config.php,
// it should not really be hard-coded here.
if (!$debug) {
updateClaim(true, $pid, $encounter, $new_payer_id, $new_payer_type, 1, 5, '', 'hcfa');
}
} else {
if (!$debug) {
updateClaim(true, $pid, $encounter, -1, -1, 1, 0, '');
}
}
$info_msg = xl("Encounter ") . $encounter . xl(" is ready for re-billing.");
return;
}
// If we get here then the encounter does not already exist. This should
// only happen if A/R was converted from an earlier system. In this case
// the encounter ID should be the date of service, and we will create the
// encounter.
// If it does not exist then it better be (or start with) a date.
if (!preg_match("/^20\\d\\d\\d\\d\\d\\d/", $encounter)) {
die(xl("Internal error: encounter '") . $encounter . xl("' should exist but does not."));
}
$employee_id = $arrow['employee_id'];
// Get the OpenEMR provider info corresponding to the SQL-Ledger salesman.
$drrow = sqlQuery("SELECT users.id, users.username, users.facility_id " . "FROM integration_mapping, users WHERE " . "integration_mapping.foreign_id = {$employee_id} AND " . "integration_mapping.foreign_table = 'salesman' AND " . "users.id = integration_mapping.local_id");
$provider_id = $drrow['id'];
if (!$provider_id) {
die(xl("Cannot find provider from SQL-Ledger employee = ") . $employee_id);
}
if (!$date_of_service) {
die(xl("Invoice has no date!"));
}
// Generate a new encounter number.
$conn = $GLOBALS['adodb']['db'];
$new_encounter = $conn->GenID("sequences");
// Create the "new encounter".
$encounter_id = 0;
$query = "INSERT INTO form_encounter ( " . "date, reason, facility_id, pid, encounter, onset_date, provider_id " . ") VALUES ( " . "'{$date_of_service}', " . "'" . xl('Imported from Accounting') . "', " . "'" . addslashes($drrow['facility_id']) . "', " . "{$pid}, " . "{$new_encounter}, " . "'{$date_of_service}', " . "'{$provider_id}' " . ")";
if ($debug) {
echo $query . "<br>\n";
echo xl("Call to addForm() goes here.<br>") . "\n";
} else {
$encounter_id = idSqlStatement($query);
if (!$encounter_id) {
die(xl("Insert failed: ") . $query);
}
addForm($new_encounter, xl("New Patient Encounter"), $encounter_id, "newpatient", $pid, 1, $date_of_service);
$info_msg = xl("Encounter ") . $new_encounter . xl(" has been created. ");
}
// For each invoice line item with a billing code we will insert
// a billing row with payer_id set to -1. Order the line items
// chronologically so that each procedure code will be followed by
// its associated icd9 code.
$inres = SLQuery("SELECT * FROM invoice WHERE trans_id = {$invid} " . "ORDER BY id");
if ($sl_err) {
die($sl_err);
}
// When nonzero, this will be the ID of a billing row that needs to
// have its justify field set.
$proc_ins_id = 0;
for ($irow = 0; $irow < SLRowCount($inres); ++$irow) {
$row = SLGetRow($inres, $irow);
$amount = sprintf('%01.2f', $row['sellprice'] * $row['qty']);
// Extract the billing code.
$code = xl("Unknown");
if (preg_match("/([A-Za-z0-9]\\d\\d\\S*)/", $row['serialnumber'], $matches)) {
$code = strtoupper($matches[1]);
} else {
if (preg_match("/([A-Za-z0-9]\\d\\d\\S*)/", $row['description'], $matches)) {
$code = strtoupper($matches[1]);
}
}
list($code, $modifier) = explode("-", $code);
// Set the billing code type and description.
$code_type = "";
$code_text = "";
foreach ($code_types as $key => $value) {
if (preg_match("/{$key}/", $row['serialnumber'])) {
$code_type = $key;
if ($value['fee']) {
$code_text = xl("Procedure") . " {$code}";
} else {
$code_text = xl("Diagnosis") . " {$code}";
if ($proc_ins_id) {
$query = "UPDATE billing SET justify = '{$code}' WHERE id = {$proc_ins_id}";
if ($debug) {
echo $query . "<br>\n";
} else {
sqlQuery($query);
}
$proc_ins_id = 0;
}
}
break;
}
}
// Skip adjustments.
if (!$code_type) {
continue;
}
// Insert the billing item. If this for a procedure code then save
// the row ID so that we can update the "justify" field with the ICD9
// code, which should come next in the loop.
//
$query = "INSERT INTO billing ( " . "date, code_type, code, pid, provider_id, user, groupname, authorized, " . "encounter, code_text, activity, payer_id, billed, bill_process, " . "bill_date, modifier, units, fee, justify, target " . ") VALUES ( " . "NOW(), " . "'{$code_type}', " . "'{$code}', " . "{$pid}, " . "0, " . "'" . $_SESSION['authId'] . "', " . "'" . $_SESSION['authProvider'] . "', " . "1, " . "{$new_encounter}, " . "'{$code_text}', " . "1, " . "{$new_payer_id}, " . ($new_payer_id > 0 ? "1, " : "0, ") . ($new_payer_id > 0 ? "5, " : "0, ") . ($new_payer_id > 0 ? "NOW(), " : "NULL, ") . "'{$modifier}', " . "0, " . "{$amount}, " . "'', " . ($new_payer_id > 0 ? "'hcfa' " : "NULL ") . ")";
if ($debug) {
echo $query . "<br>\n";
} else {
$proc_ins_id = idSqlStatement($query);
if ($code_type != "CPT4" && $code_type != "HCPCS") {
$proc_ins_id = 0;
}
}
}
// Finally, change this invoice number to contain the new encounter number.
//
$new_invnumber = "{$pid}.{$new_encounter}";
$query = "UPDATE ar SET invnumber = '{$new_invnumber}' WHERE id = {$invid}";
if ($debug) {
echo $query . "<br>\n";
} else {
SLQuery($query);
if ($sl_err) {
die($sl_err);
}
$info_msg .= xl("This invoice number has been changed to ") . $new_invnumber;
}
return $info_msg;
}
function process_form($ar)
{
global $bill_info, $webserver_root, $bat_filename, $pdf;
if (isset($ar['bn_x12']) || isset($ar['bn_x12_encounter']) || isset($ar['bn_process_hcfa']) || isset($ar['bn_hcfa_txt_file'])) {
$hlog = fopen("{$webserver_root}/library/freeb/process_bills.log", 'w');
}
if (isset($ar['bn_external'])) {
// Open external billing file for output.
$be = new BillingExport();
}
$db = $GLOBALS['adodb']['db'];
if (empty($ar['claims'])) {
$ar['claims'] = array();
}
$claim_count = 0;
foreach ($ar['claims'] as $claimid => $claim_array) {
$ta = split("-", $claimid);
$patient_id = $ta[0];
$encounter = $ta[1];
$payer_id = substr($claim_array['payer'], 1);
$payer_type = substr($claim_array['payer'], 0, 1);
$payer_type = $payer_type == 'T' ? 3 : $payer_type == 'S' ? 2 : 1;
if (isset($claim_array['bill'])) {
if (isset($ar['bn_external'])) {
// Write external claim.
$be->addClaim($patient_id, $encounter);
} else {
$sql = "SELECT x.processing_format from x12_partners as x where x.id =" . $db->qstr($claim_array['partner']);
$result = $db->Execute($sql);
$target = "x12";
if ($result && !$result->EOF) {
$target = $result->fields['processing_format'];
}
}
$tmp = 1;
if (isset($ar['HiddenMarkAsCleared']) && $ar['HiddenMarkAsCleared'] == 'yes') {
$tmp = updateClaim(true, $patient_id, $encounter, $payer_id, $payer_type, 2);
// $sql .= " billed = 1, ";
}
if (isset($ar['bn_x12']) || isset($ar['bn_x12_encounter'])) {
$tmp = updateClaim(true, $patient_id, $encounter, $payer_id, $payer_type, 1, 1, '', $target, $claim_array['partner']);
} else {
if (isset($ar['bn_process_hcfa']) || isset($ar['bn_hcfa_txt_file'])) {
$tmp = updateClaim(true, $patient_id, $encounter, $payer_id, $payer_type, 1, 1, '', 'hcfa');
} else {
if (isset($ar['bn_mark'])) {
// $sql .= " billed = 1, ";
$tmp = updateClaim(true, $patient_id, $encounter, $payer_id, $payer_type, 2);
} else {
if (isset($ar['bn_reopen'])) {
$tmp = updateClaim(true, $patient_id, $encounter, $payer_id, $payer_type, 1, 0);
} else {
if (isset($ar['bn_external'])) {
// $sql .= " billed = 1, ";
$tmp = updateClaim(true, $patient_id, $encounter, $payer_id, $payer_type, 2);
}
}
}
}
}
if (!$tmp) {
die(xl("Claim ") . $claimid . xl(" update failed, not in database?"));
} else {
if (isset($ar['bn_mark'])) {
$bill_info[] = xl("Claim ") . $claimid . xl(" was marked as billed only.") . "\n";
} else {
if (isset($ar['bn_reopen'])) {
$bill_info[] = xl("Claim ") . $claimid . xl(" has been re-opened.") . "\n";
} else {
if (isset($ar['bn_x12']) || isset($ar['bn_x12_encounter'])) {
$log = '';
$segs = explode("~\n", gen_x12_837($patient_id, $encounter, $log, isset($ar['bn_x12_encounter'])));
fwrite($hlog, $log);
append_claim($segs);
if (!updateClaim(false, $patient_id, $encounter, -1, -1, 2, 2, $bat_filename)) {
$bill_info[] = xl("Internal error: claim ") . $claimid . xl(" not found!") . "\n";
}
} else {
if (isset($ar['bn_process_hcfa'])) {
$log = '';
$lines = gen_hcfa_1500($patient_id, $encounter, $log);
fwrite($hlog, $log);
$alines = explode("\f", $lines);
// form feeds may separate pages
foreach ($alines as $tmplines) {
if ($claim_count++) {
$pdf->ezNewPage();
}
$pdf->ezSetY($pdf->ez['pageHeight'] - $pdf->ez['topMargin']);
$pdf->ezText($tmplines, 12, array('justification' => 'left', 'leading' => 12));
}
if (!updateClaim(false, $patient_id, $encounter, -1, -1, 2, 2, $bat_filename)) {
$bill_info[] = xl("Internal error: claim ") . $claimid . xl(" not found!") . "\n";
}
} else {
if (isset($ar['bn_hcfa_txt_file'])) {
$log = '';
$lines = gen_hcfa_1500($patient_id, $encounter, $log);
fwrite($hlog, $log);
$bat_content .= $lines;
if (!updateClaim(false, $patient_id, $encounter, -1, -1, 2, 2, $bat_filename)) {
$bill_info[] = xl("Internal error: claim ") . $claimid . xl(" not found!") . "\n";
}
} else {
$bill_info[] = xl("Claim ") . $claimid . xl(" was queued successfully.") . "\n";
}
}
}
}
}
}
}
// end if this claim has billing
}
// end foreach
if (isset($ar['bn_x12']) || isset($ar['bn_x12_encounter'])) {
append_claim_close();
fclose($hlog);
send_batch();
exit;
}
if (isset($ar['bn_process_hcfa'])) {
fclose($hlog);
// If a writable edi directory exists (and it should), write the pdf to it.
$fh = @fopen($GLOBALS['OE_SITE_DIR'] . "/edi/{$bat_filename}", 'a');
if ($fh) {
fwrite($fh, $pdf->ezOutput());
fclose($fh);
}
// Send the PDF download.
$pdf->ezStream(array('Content-Disposition' => $bat_filename));
exit;
}
if (isset($ar['bn_hcfa_txt_file'])) {
fclose($hlog);
$fh = @fopen($GLOBALS['OE_SITE_DIR'] . "/edi/{$bat_filename}", 'a');
if ($fh) {
fwrite($fh, $bat_content);
fclose($fh);
}
header("Pragma: public");
header("Expires: 0");
header("Cache-Control: must-revalidate, post-check=0, pre-check=0");
header("Content-Type: application/force-download");
header("Content-Disposition: attachment; filename={$bat_filename}");
header("Content-Description: File Transfer");
header("Content-Length: " . strlen($bat_content));
echo $bat_content;
exit;
}
if (isset($ar['bn_external'])) {
// Close external billing file.
$be->close();
}
}
function arSetupSecondary($patient_id, $encounter_id, $debug, $crossover = 0)
{
if ($crossover == 1) {
//if claim forwarded setting a new status
$status = 6;
} else {
$status = 1;
}
// Determine the next insurance level to be billed.
$ferow = sqlQuery("SELECT date, last_level_billed " . "FROM form_encounter WHERE " . "pid = '{$patient_id}' AND encounter = '{$encounter_id}'");
$date_of_service = substr($ferow['date'], 0, 10);
$new_payer_type = 0 + $ferow['last_level_billed'];
if ($new_payer_type < 3 && !empty($ferow['last_level_billed']) || $new_payer_type == 0) {
++$new_payer_type;
}
$new_payer_id = arGetPayerID($patient_id, $date_of_service, $new_payer_type);
if ($new_payer_id) {
// Queue up the claim.
if (!$debug) {
updateClaim(true, $patient_id, $encounter_id, $new_payer_id, $new_payer_type, $status, 5, '', 'hcfa', '', $crossover);
}
} else {
// Just reopen the claim.
if (!$debug) {
updateClaim(true, $patient_id, $encounter_id, -1, -1, $status, 0, '', '', '', $crossover);
}
}
return xl("Encounter ") . $encounter . xl(" is ready for re-billing.");
}
}
SLQuery("DELETE FROM invoice WHERE trans_id = '{$trans_id}'");
if ($sl_err) {
die($sl_err);
}
SLQuery("DELETE FROM ar WHERE id = '{$trans_id}'");
if ($sl_err) {
die($sl_err);
}
} else {
$info_msg .= "Invoice '{$billing}' not found!";
}
SLClose();
}
sqlStatement("UPDATE drug_sales SET billed = 0 WHERE " . "pid = '{$patient_id}' AND encounter = '{$encounter_id}'");
updateClaim(true, $patient_id, $encounter_id, -1, -1, 1, 0, '');
// clears for rebilling
} else {
if ($transaction) {
if (!acl_check('admin', 'super')) {
die("Not authorized!");
}
row_delete("transactions", "id = '{$transaction}'");
} else {
die("Nothing was recognized to delete!");
}
}
}
}
}
}
fwrite($ofh, fread($ifh, 8192));
}
fclose($ofh);
fclose($ifh);
// chmod($fconfig['copy_pdfs_to'] . $fbase, 0666);
}
if ($billkey['bill_process'] == 5) {
//the bill was generated without an error now print it
$estring = $fconfig['print_command'] . " -P " . $fconfig['printer_name'] . " " . $fconfig['printer_extras'] . " " . $fname;
$rstring = exec(escapeshellcmd($estring));
}
}
} else {
$presult = "Code: " . $r->faultCode() . " Reason '" . $r->faultString() . "'<BR>";
echo "Claim for PatientID: {$patient_id}, Encounter: {$billkey['key']} failed due to: \n " . basename("/" . $presult) . "\n";
/****
$sql = "UPDATE billing set process_date = now(), bill_process = 3, process_file = '" .
mysql_real_escape_string(basename("/" . $presult)) .
"' where encounter = $encounter AND pid = '" . $patient_id . "'";
$results = $db->Execute($sql);
if (!$results) {
echo "There was an error with the database.\n";
echo $db->ErrorMsg() . "\n";
}
****/
if (!updateClaim(false, $patient_id, $encounter, -1, -1, 3, basename("/" . $presult))) {
echo "Internal error: failed to update claim {$patient_id}-{$encounter}\n";
}
}
}
echo "\n\n";
