public function listInsurersAction()
{
$patientId = (int) $this->_getParam('patientId');
$rows = array();
$insurancePrograms = InsuranceProgram::getInsurancePrograms();
$insuredRelationship = new InsuredRelationship();
$insuredRelationshipIterator = $insuredRelationship->getIteratorByPersonId($patientId);
$subscribers = array();
// TODO: get the actual subscribers;
foreach ($insuredRelationshipIterator as $item) {
$company = '';
$program = '';
if (isset($insurancePrograms[$item->insuranceProgramId])) {
$exp = explode('->', $insurancePrograms[$item->insuranceProgramId]);
$company = $exp[0];
$program = $exp[1];
}
$subscriber = '';
if (isset($subscribers[$item->subscriberId])) {
$subscriber = $subscribers[$item->subscriberId];
}
$effectiveEnd = date('m/d/Y', strtotime($item->effectiveEnd));
$effective = 'Until';
$effectiveToTime = strtotime($effectiveEnd);
if ($effectiveToTime <= strtotime(date('m/d/Y'))) {
$effective = 'Ended';
}
$effective .= ' ' . $effectiveEnd;
$tmp = array();
$tmp['id'] = $item->insuredRelationshipId;
$tmp['data'][] = $company;
$tmp['data'][] = $program;
$tmp['data'][] = $item->groupName;
$tmp['data'][] = $item->groupNumber;
$tmp['data'][] = $item->copay;
$tmp['data'][] = $subscriber;
$tmp['data'][] = $effective;
$tmp['data'][] = $item->active ? __('Yes') : __('No');
$rows[] = $tmp;
}
$json = Zend_Controller_Action_HelperBroker::getStaticHelper('json');
$json->suppressExit = true;
$json->direct(array('rows' => $rows));
}
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 listEligibilityAction()
{
$appointmentId = (int) $this->_getParam('appointmentId');
$rows = array();
$appointment = new Appointment();
$appointment->appointmentId = $appointmentId;
$appointment->populate();
$personId = (int) $appointment->patientId;
$insuredRelationship = new InsuredRelationship();
$insuredRelationship->personId = $personId;
$insuredRelationshipIterator = $insuredRelationship->getActiveEligibility();
foreach ($insuredRelationshipIterator as $item) {
$rows[] = $this->_generateEligibilityRowData($item);
}
$json = Zend_Controller_Action_HelperBroker::getStaticHelper('json');
$json->suppressExit = true;
$json->direct(array('rows' => $rows));
}
public function claimAction()
{
$visitId = (int) $this->_getParam('visitId');
$insurancePrograms = array();
$insuranceProgramId = 0;
if ($visitId > 0) {
$visit = new Visit();
$visit->visitId = $visitId;
$visit->populate();
$insuredRelationship = new InsuredRelationship();
$insuredRelationship->personId = (int) $visit->patientId;
$insurancePrograms = $insuredRelationship->getProgramList();
$insuranceProgramId = (int) $visit->activePayerId;
}
$this->view->visitId = $visitId;
$this->view->insurancePrograms = $insurancePrograms;
$this->view->insuranceProgramId = $insuranceProgramId;
$this->render();
}
public static function patient($personId)
{
$newPatient = true;
$db = Zend_Registry::get('dbAdapter');
$sqlSelect = $db->select()->from('audits', 'COUNT(*) AS ctr')->where("objectClass = 'Patient' AND objectId = ?", (int) $personId);
if (($row = $db->fetchRow($sqlSelect)) && $row['ctr'] > 1) {
$newPatient = false;
}
$data = self::_getPatientData($personId);
$subscribersEnum = 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 ($enum->key != InsuranceProgram::INSURANCE_SUBSCRIBER_ENUM_KEY) {
continue;
}
foreach ($rowset as $row) {
$subscribersEnum[$row->key] = $row->name;
}
}
$insuredRelationship = new InsuredRelationship();
$sqlSelect = $db->select()->from($insuredRelationship->_table)->where('person_id = ?', $personId)->where('active = 1')->order('program_order');
$insuredRelationshipIterator = $insuredRelationship->getIterator($sqlSelect);
$subscribers = array();
$insurances = array();
$guarantors = array();
foreach ($insuredRelationshipIterator as $item) {
$subscriberId = (int) $item->subscriberId;
$subscriberToPatientRelationship = $item->subscriberToPatientRelationship;
if (!$subscriberId > 0) {
$subscriberId = $personId;
$subscriberToPatientRelationship = 'SELF';
}
if (isset($subscribersEnum[$subscriberToPatientRelationship])) {
$subscriberToPatientRelationship = $subscribersEnum[$subscriberToPatientRelationship];
}
if (!isset($subscribers[$subscriberId])) {
$patient = new Patient();
$patient->personId = $subscriberId;
$patient->populate();
$subscribers[$subscriberId] = $patient;
}
$subscriber = self::_getPatientData($subscribers[$subscriberId], false);
$subscriber['relation'] = strtoupper(substr($subscriberToPatientRelationship, 0, 1));
$insuranceProgram = $item->insuranceProgram;
$companyId = (int) $insuranceProgram->companyId;
$phoneNumber = new PhoneNumber();
$sqlSelect = $db->select()->from(array('cn' => 'company_number'))->join(array('n' => 'number'), 'n.number_id = cn.number_id')->where('n.active = 1')->where('cn.company_id = ?', $companyId)->order('n.displayOrder')->limit(1);
$phoneNumber->populateWithSql($sqlSelect->__toString());
$insurance = array();
$insurance['companyId'] = $companyId;
$insurance['companyName'] = $insuranceProgram->company->name;
$address = $insuranceProgram->address;
$insurance['line1'] = $address->line1;
$insurance['line2'] = $address->line2;
$insurance['city'] = $address->city;
$insurance['state'] = $address->state;
$insurance['zip'] = $address->postalCode;
$insurance['phoneNumber'] = $phoneNumber->number;
$insurance['groupNumber'] = $item->groupName;
$insurance['groupName'] = '';
$insurance['policyNumber'] = $item->groupNumber;
//$insurance['ssn'] = $insuranceProgram->payerIdentifier;
$insurances[] = array('subscriber' => $subscriber, 'insurance' => $insurance);
$guarantors[] = $subscriber;
}
$adt = $newPatient ? 'A04' : 'A08';
$t = microtime();
$x = explode(' ', $t);
$date = date('YmdHis', $x[1]);
$messageId = $date . str_replace('.', '0', $x[0]);
$id = 0;
$hl7Guarantors = array();
foreach ($guarantors as $key => $guarantor) {
$ctr = $key + 1;
$hl7Guarantors[] = "GT1|{$ctr}|{$guarantor['recordNumber']}|{$guarantor['lastName']}^{$guarantor['firstName']}^{$guarantor['middleName']}^{$guarantor['suffix']}^^||{$guarantor['line1']}^{$guarantor['line2']}^{$guarantor['city']}^{$guarantor['state']}^{$guarantor['zip']}|{$guarantor['homePhone']}|{$guarantor['businessPhone']}|{$guarantor['dateOfBirth']}|{$guarantor['gender']}||S|{$guarantor['ssn']}|";
}
$hl7Insurances = array();
foreach ($insurances as $key => $value) {
$ctr = $key + 1;
$subscriber = $value['subscriber'];
$insurance = $value['insurance'];
$hl7Insurances[] = "IN1|{$ctr}|{$insurance['companyId']}^{$insurance['companyName']}|{$insurance['companyId']}|{$insurance['companyName']}|{$insurance['line1']}^{$insurance['line2']}^{$insurance['city']}^{$insurance['state']}^{$insurance['zip']}||{$insurance['phoneNumber']}|{$insurance['groupNumber']}|{$insurance['groupName']}|||||||{$subscriber['lastName']}^{$subscriber['firstName']}^{$subscriber['middleName']}^{$subscriber['suffix']}^^|{$subscriber['relation']}|{$subscriber['dateOfBirth']}|{$subscriber['line1']}^{$subscriber['line2']}^{$subscriber['city']}^{$subscriber['state']}^{$subscriber['zip']}|Y||{$ctr}||||||||||||||{$insurance['policyNumber']}|0||||||{$subscriber['gender']}||||||{$subscriber['ssn']}|";
if (!strlen($subscriber['ssn']) > 0) {
continue;
}
$hl7Insurances[] = "IN2|{$ctr}|{$subscriber['ssn']}";
}
$patient = $data['patient'];
$provider = $data['provider'];
$hl7Message = array();
$hl7Message[] = "MSH|^~\\&|MedMgr|989801|aroeshl7_prod|HEST|{$date}||ADT^{$adt}|{$messageId}|P|2.3|{$id}|";
$hl7Message[] = "EVN|{$adt}|{$date}|||38|";
$hl7Message[] = self::_PID($patient);
$hl7Message[] = self::_PV1($provider);
foreach ($hl7Guarantors as $hl7Guarantor) {
$hl7Message[] = $hl7Guarantor;
}
foreach ($hl7Insurances as $hl7Insurance) {
$hl7Message[] = $hl7Insurance;
}
$separator = "\r\n";
return implode($separator, $hl7Message);
}
public function populateXML(SimpleXMLElement $xml = null, $checked = true)
{
if ($xml === null) {
$xml = new SimpleXMLElement('<data/>');
}
$personId = (int) $this->person_id;
$person = $this->person;
$picture = '';
if ($person->activePhoto > 0) {
$attachment = new Attachment();
$attachment->attachmentId = (int) $person->activePhoto;
$attachment->populate();
$picture = base64_encode($attachment->rawData);
}
$xmlPatient = $xml->addChild('patient');
$xmlPerson = $xmlPatient->addChild('person');
$this->_addChild($xmlPerson, 'picture', $picture, $checked);
$this->_addChild($xmlPerson, 'lastName', $person->lastName, $checked);
$this->_addChild($xmlPerson, 'firstName', $person->firstName, $checked);
$this->_addChild($xmlPerson, 'middleName', $person->middleName, $checked);
$identifier = '';
if ($person->identifierType == 'SSN') {
$identifier = $person->identifier;
}
$this->_addChild($xmlPerson, 'identifier', $identifier, $checked);
$this->_addChild($xmlPerson, 'gender', $person->gender, $checked);
$dateOfBirth = explode(' ', date('m d Y', strtotime($person->dateOfBirth)));
$this->_addChild($xmlPerson, 'dobMonth', $dateOfBirth[0], $checked);
$this->_addChild($xmlPerson, 'dobDay', $dateOfBirth[1], $checked);
$this->_addChild($xmlPerson, 'dobYear', $dateOfBirth[2], $checked);
$statistics = PatientStatisticsDefinition::getPatientStatistics($personId);
$race = '';
if (isset($statistics['Race'])) {
$race = $statistics['Race'];
} else {
if (isset($statistics['race'])) {
$race = $statistics['race'];
}
}
$this->_addChild($xmlPerson, 'race', $race, $checked);
$maritalStatus = $person->maritalStatus ? $person->maritalStatus : 'Other';
$this->_addChild($xmlPerson, 'maritalStatus', $maritalStatus, $checked);
$addresses = Address::listAddresses($personId);
foreach ($addresses as $address) {
switch ($address->type) {
case Address::TYPE_MAIN:
$type = 'mainAddress';
break;
case Address::TYPE_SEC:
$type = 'secondaryAddress';
break;
case Address::TYPE_HOME:
$type = 'homeAddress';
break;
case Address::TYPE_EMPLOYER:
$type = 'employerAddress';
break;
case Address::TYPE_BILLING:
$type = 'billingAddress';
break;
case Address::TYPE_OTHER:
default:
$type = 'otherAddress';
break;
}
$xmlAddress = $xmlPatient->addChild($type);
$this->_addChild($xmlAddress, 'line1', $address->line1, $checked);
$this->_addChild($xmlAddress, 'city', $address->city, $checked);
$this->_addChild($xmlAddress, 'state', $address->state, $checked);
$this->_addChild($xmlAddress, 'zip', $address->postalCode, $checked);
}
$phoneNumbers = PhoneNumber::listPhoneNumbers($personId);
foreach ($phoneNumbers as $phoneNumber) {
switch ($phoneNumber->type) {
case PhoneNumber::TYPE_HOME:
$type = 'homePhone';
break;
case PhoneNumber::TYPE_WORK:
$type = 'workPhone';
break;
case PhoneNumber::TYPE_BILLING:
$type = 'billingPhone';
break;
case PhoneNumber::TYPE_EMPLOYER:
$type = 'employerPhone';
break;
case PhoneNumber::TYPE_MOBILE:
$type = 'mobilePhone';
break;
case PhoneNumber::TYPE_EMERGENCY:
$type = 'emergencyPhone';
break;
case PhoneNumber::TYPE_FAX:
$type = 'faxPhone';
break;
case PhoneNumber::TYPE_HOME_EVE:
$type = 'homeEvePhone';
break;
case PhoneNumber::TYPE_HOME_DAY:
$type = 'homeDayPhone';
break;
case PhoneNumber::TYPE_BEEPER:
$type = 'beeperPhone';
break;
default:
$type = 'otherPhone';
break;
}
$xmlPhone = $xmlPatient->addChild($type);
$this->_addChild($xmlPhone, 'number', $phoneNumber->number, $checked);
}
if ($person->primaryPracticeId > 0) {
$practice = new Practice();
$practice->practiceId = (int) $person->primaryPracticeId;
$practice->populate();
$address = $practice->primaryAddress;
$xmlPractice = $xmlPatient->addChild('practice');
$this->_addChild($xmlPractice, 'name', $practice->name, $checked);
$xmlPrimaryAddress = $xmlPractice->addChild('primaryAddress');
$this->_addChild($xmlPrimaryAddress, 'line1', $address->line1, $checked);
$this->_addChild($xmlPrimaryAddress, 'city', $address->city, $checked);
$this->_addChild($xmlPrimaryAddress, 'state', $address->state, $checked);
$this->_addChild($xmlPrimaryAddress, 'zip', $address->postalCode, $checked);
$this->_addChild($xmlPractice, 'mainPhone', $practice->mainPhone->number, $checked);
$this->_addChild($xmlPractice, 'faxNumber', $practice->fax->number, $checked);
}
$insuredRelationship = new InsuredRelationship();
$insuredRelationshipIterator = $insuredRelationship->getIteratorByPersonId($personId);
$primary = null;
$secondary = null;
foreach ($insuredRelationshipIterator as $item) {
if (!$item->active) {
continue;
}
if ($primary === null) {
$primary = $item;
} else {
if ($secondary === null) {
$secondary = $item;
} else {
break;
}
}
}
$xmlPayer = $xmlPatient->addChild('payer');
if ($primary !== null) {
$this->_addChild($xmlPayer, 'medicareNumber', $primary->insuranceProgram->payerIdentifier, $checked);
}
if ($secondary !== null) {
$this->_addChild($xmlPayer, 'medicaidNumber', $secondary->insuranceProgram->payerIdentifier, $checked);
}
return $xml;
}
public function defaultPatientHeaderAction()
{
$personId = (int) $this->_getParam('personId');
// e76f18cd-d388-4c53-b940-53cb81b80c5e
$referenceId = $this->_getParam('referenceId');
$data = $this->_getAttachmentData($referenceId);
$patient = new Patient();
$patient->personId = $personId;
$patient->populate();
$person = $patient->person;
$picture = '';
if ($person->activePhoto > 0) {
$attachment = new Attachment();
$attachment->attachmentId = (int) $person->activePhoto;
$attachment->populate();
$picture = base64_encode($attachment->rawData);
}
$xml = new SimpleXMLElement('<patientHeader/>');
$xmlPatient = $xml->addChild('patient');
$this->_addChild($xmlPatient, 'picture', $picture);
$this->_addChild($xmlPatient, 'lastName', $person->lastName);
$this->_addChild($xmlPatient, 'firstName', $person->firstName);
$this->_addChild($xmlPatient, 'dateOfBirth', $person->dateOfBirth);
$this->_addChild($xmlPatient, 'gender', $person->gender);
$statistics = PatientStatisticsDefinition::getPatientStatistics($personId);
$race = '';
if (isset($statistics['Race'])) {
$race = $statistics['Race'];
} else {
if (isset($statistics['race'])) {
$race = $statistics['race'];
}
}
$this->_addChild($xmlPatient, 'race', $race);
$this->_addChild($xmlPatient, 'maritalStatus', $person->displayMaritalStatus);
$addresses = Address::listAddresses($personId);
$phoneNumbers = PhoneNumber::listPhoneNumbers($personId);
$address = null;
if (isset($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 = $addresses[Address::TYPE_OTHER];
}
}
}
}
}
if ($address !== null) {
$phone = '';
if (isset($phoneNumbers[PhoneNumber::TYPE_BILLING])) {
$phone = $phoneNumbers[PhoneNumber::TYPE_BILLING]->number;
} else {
if (isset($phoneNumbers[PhoneNumber::TYPE_HOME])) {
$phone = $phoneNumbers[PhoneNumber::TYPE_HOME]->number;
} else {
if (isset($phoneNumbers[PhoneNumber::TYPE_WORK])) {
$phone = $phoneNumbers[PhoneNumber::TYPE_WORK]->number;
} else {
if (isset($phoneNumbers[PhoneNumber::TYPE_HOME_DAY])) {
$phone = $phoneNumbers[PhoneNumber::TYPE_HOME_DAY]->number;
} else {
if (isset($phoneNumbers[PhoneNumber::TYPE_HOME_EVE])) {
$phone = $phoneNumbers[PhoneNumber::TYPE_HOME_EVE]->number;
} else {
if (isset($phoneNumbers[PhoneNumber::TYPE_MOBILE])) {
$phone = $phoneNumbers[PhoneNumber::TYPE_MOBILE]->number;
} else {
if (isset($phoneNumbers[PhoneNumber::TYPE_BEEPER])) {
$phone = $phoneNumbers[PhoneNumber::TYPE_BEEPER]->number;
}
}
}
}
}
}
}
$this->_addChild($xmlPatient, 'billingLine1', $address->line1);
$this->_addChild($xmlPatient, 'billingCity', $address->city);
$this->_addChild($xmlPatient, 'billingState', $address->state);
$this->_addChild($xmlPatient, 'billingZip', $address->postalCode);
$this->_addChild($xmlPatient, 'phoneNumber', $phone);
}
if ($person->primaryPracticeId > 0) {
$practice = new Practice();
$practice->practiceId = (int) $person->primaryPracticeId;
$practice->populate();
$address = $practice->primaryAddress;
$xmlPractice = $xml->addChild('practice');
$this->_addChild($xmlPractice, 'name', $practice->name);
$this->_addChild($xmlPractice, 'primaryLine1', $address->line1);
$this->_addChild($xmlPractice, 'primaryCity', $address->city);
$this->_addChild($xmlPractice, 'primaryState', $address->state);
$this->_addChild($xmlPractice, 'primaryZip', $address->postalCode);
$this->_addChild($xmlPractice, 'mainPhone', $practice->mainPhone->number);
$this->_addChild($xmlPractice, 'faxNumber', $practice->fax->number);
}
$insuredRelationship = new InsuredRelationship();
$insuredRelationshipIterator = $insuredRelationship->getIteratorByPersonId($personId);
$primary = null;
$secondary = null;
foreach ($insuredRelationshipIterator as $item) {
if (!$item->active) {
continue;
}
if ($primary === null) {
$primary = $item;
} else {
if ($secondary === null) {
$secondary = $item;
} else {
break;
}
}
}
$xmlPayer = $xml->addChild('payer');
if ($primary !== null) {
$this->_addChild($xmlPayer, 'primary', $primary->insuranceProgram->name);
}
if ($secondary !== null) {
$this->_addChild($xmlPayer, 'secondary', $secondary->insuranceProgram->name);
}
/*$xmlGuarantor = $xml->addChild('guarantor');
$this->_addChild($xmlGuarantor,'lastName','');
$this->_addChild($xmlGuarantor,'firstName','');
$this->_addChild($xmlGuarantor,'dateOfBirth','');
$this->_addChild($xmlGuarantor,'phone','');*/
// get the current visit
$xmlProvider = $xml->addChild('provider');
$lastName = '';
$firstName = '';
$dateOfBirth = '';
$phone = '';
$visit = new Visit();
$visit->populateLatestVisit($personId);
if ($visit->visitId > 0) {
$provider = new Provider();
$provider->personId = $visit->providerId;
$provider->populate();
$person = $provider->person;
$lastName = $person->lastName;
$firstName = $person->firstName;
$dateOfBirth = $person->dateOfBirth;
$phone = $person->phoneNumber->number;
}
$this->_addChild($xmlProvider, 'lastName', $lastName);
$this->_addChild($xmlProvider, 'firstName', $firstName);
$this->_addChild($xmlProvider, 'dateOfBirth', $dateOfBirth);
$this->_addChild($xmlProvider, 'phone', $phone);
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;
$this->render('binary-template');
}
protected static function _generate4010A1($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;
}
protected function _populateCMS1500XML(SimpleXMLElement $xml, ClaimLine $claimLine)
{
$claimId = (int) $claimLine->claimId;
$visitId = (int) $claimLine->visitId;
$payerId = (int) $claimLine->insuranceProgramId;
$visit = new Visit();
$visit->visitId = $visitId;
$visit->populate();
$dateOfTreatment = $visit->dateOfTreatment;
$patientId = (int) $visit->patientId;
$providerId = (int) $visit->treatingPersonId;
$insuranceProgram = new InsuranceProgram();
$insuranceProgram->insuranceProgramId = $payerId;
$insuranceProgram->populate();
$insuranceAddress = $insuranceProgram->address;
$insuredRelationship = InsuredRelationship::filterByPayerPersonIds($payerId, $patientId);
$patient = new Patient();
$patient->personId = $patientId;
$patient->populate();
$patientAddress = $patient->address;
$patientPhone = $patient->phoneNumber;
$provider = new Provider();
$provider->personId = $providerId;
$provider->populate();
$providerAddress = $provider->person->address;
$providerPhone = $provider->phoneNumber;
$buildingId = (int) $visit->buildingId;
$building = new Building();
$building->buildingId = $buildingId;
$building->populate();
$address = $building->practice->primaryAddress;
$amountTotal = 0;
$claimLines = array();
$iterator = new ClaimLineIterator();
$iterator->setFilters(array('claimId' => $claimId));
foreach ($iterator as $orm) {
$amount = (double) $orm->baseFee;
$amountTotal += $amount;
$row = array();
$row['procedure'] = $orm->procedureCode;
$modifiers = array();
for ($i = 1; $i <= 4; $i++) {
$field = 'modifier' . $i;
$key = $orm->{$field};
if (strlen($key) > 0) {
$modifiers[$i] = $key;
}
}
$row['modifier'] = implode(',', $modifiers);
$row['amount'] = $amount;
$row['units'] = $orm->units;
$diagnoses = array();
for ($i = 1; $i <= 8; $i++) {
$field = 'diagnosisCode' . $i;
$key = $orm->{$field};
if (strlen($key) > 0) {
$diagnoses[$key] = $key;
}
}
$row['diagnoses'] = $diagnoses;
$row['diagnosis_pointer'] = '';
// TODO: need to resolve on the issue of multiple diagnoses per claimLine
$claimLines[] = $row;
}
$amountPaid = $claimLine->paid;
$netAmountTotal = $amountTotal - $amountPaid;
if ($payerId > 0) {
$xmlPayer = $xml->addChild('payer');
$this->_addChild($xmlPayer, 'name', InsuranceProgram::getInsuranceProgram($payerId));
if ($insuranceAddress->addressId > 0) {
$xmlFbaddress = $xmlPayer->addChild('fbaddress');
$this->_addChild($xmlFbaddress, 'line1', $insuranceAddress->line1);
$this->_addChild($xmlFbaddress, 'line2', $insuranceAddress->line2);
$this->_addChild($xmlFbaddress, 'city', $insuranceAddress->city);
$this->_addChild($xmlFbaddress, 'state', $insuranceAddress->state);
$this->_addChild($xmlFbaddress, 'zip', $insuranceAddress->zipCode);
}
}
$xmlPatient = $xml->addChild('patient');
$this->_addChild($xmlPatient, 'record_number', $patient->recordNumber);
$this->_addChild($xmlPatient, 'last_name', $patient->lastName);
$this->_addChild($xmlPatient, 'first_name', $patient->firstName);
$this->_addChild($xmlPatient, 'middle_name', $patient->middleName);
if ($patientAddress->addressId > 0) {
$xmlFbaddress = $xmlPatient->addChild('fbaddress');
$this->_addChild($xmlFbaddress, 'line1', $patientAddress->line1);
$this->_addChild($xmlFbaddress, 'line2', $patientAddress->line2);
$this->_addChild($xmlFbaddress, 'city', $patientAddress->city);
$this->_addChild($xmlFbaddress, 'state', $patientAddress->state);
$this->_addChild($xmlFbaddress, 'zip', $patientAddress->zipCode);
}
$this->_addChild($xmlPatient, 'phone_number', $patientPhone->number);
$this->_addChild($xmlPatient, 'date_of_birth', $patient->dateOfBirth);
$subscriber = $insuredRelationship->subscriber;
$subscriberAddress = $subscriber->address;
if ($subscriber->personId > 0) {
$xmlSubscriber = $xml->addChild('subscriber');
$this->_addChild($xmlSubscriber, 'phone_number', $subscriber->phoneNumber->number);
if ($subscriberAddress->addressId > 0) {
$xmlFbaddress = $xmlSubscriber->addChild('fbaddress');
$this->_addChild($xmlFbaddress, 'line1', $subscriberAddress->line1);
$this->_addChild($xmlFbaddress, 'line2', $subscriberAddress->line2);
$this->_addChild($xmlFbaddress, 'city', $subscriberAddress->city);
$this->_addChild($xmlFbaddress, 'state', $subscriberAddress->state);
$this->_addChild($xmlFbaddress, 'zip', $subscriberAddress->zipCode);
}
$this->_addChild($xmlSubscriber, 'last_name', $subscriber->lastName);
$this->_addChild($xmlSubscriber, 'first_name', $subscriber->firstName);
$this->_addChild($xmlSubscriber, 'middle_name', $subscriber->middleName);
$this->_addChild($xmlSubscriber, 'group_number', $insuredRelationship->groupNumber);
$this->_addChild($xmlSubscriber, 'gender', $subscriber->gender);
$this->_addChild($xmlSubscriber, 'date_of_birth', $subscriber->dateOfBirth);
}
if ($building->buildingId > 0) {
$xmlPractice = $xml->addChild('practice');
$this->_addChild($xmlPractice, 'identifier', $building->practice->identifier);
$xmlTreatingFacility = $xml->addChild('treating_facility');
$this->_addChild($xmlTreatingFacility, 'identifier', $building->identifier);
$this->_addChild($xmlTreatingFacility, 'name', $building->name);
$xmlFbaddress = $xmlTreatingFacility->addChild('fbaddress');
$this->_addChild($xmlFbaddress, 'line1', $building->line1);
$this->_addChild($xmlFbaddress, 'line2', $building->line2);
$this->_addChild($xmlFbaddress, 'city', $building->city);
$this->_addChild($xmlFbaddress, 'state', $building->state);
$this->_addChild($xmlFbaddress, 'zip', $building->zipCode);
}
$xmlProvider = $xml->addChild('provider');
$this->_addChild($xmlProvider, 'identifier', $provider->identifier);
$this->_addChild($xmlProvider, 'first_name', $provider->firstName);
$this->_addChild($xmlProvider, 'last_name', $provider->lastName);
if ($providerAddress->addressId > 0) {
$xmlFbaddress = $xmlProvider->addChild('fbaddress');
$this->_addChild($xmlFbaddress, 'line1', $providerAddress->line1);
$this->_addChild($xmlFbaddress, 'line2', $providerAddress->line2);
$this->_addChild($xmlFbaddress, 'city', $providerAddress->city);
$this->_addChild($xmlFbaddress, 'state', $providerAddress->state);
$this->_addChild($xmlFbaddress, 'zip', $providerAddress->zipCode);
}
$xmlDiagnoses = null;
foreach ($claimLines as $row) {
foreach ($row['diagnoses'] as $diagnosis) {
if ($xmlDiagnoses === null) {
$xmlDiagnoses = $xml->addChild('diagnoses');
}
$this->_addChild($xmlDiagnoses, 'array', $diagnosis);
}
}
$xmlClaimLine = null;
$dateOfService = date('m d y', strtotime($dateOfTreatment));
foreach ($claimLines as $row) {
if ($xmlClaimLine === null) {
$xmlClaimLine = $xml->addChild('claim_lines');
}
// 0 - 5 ONLY
$xmlClaimLineArr = $xmlClaimLine->addChild('array');
$this->_addChild($xmlClaimLineArr, 'date_of_treatment', $dateOfService);
$this->_addChild($xmlClaimLineArr, 'procedure', $row['procedure']);
$this->_addChild($xmlClaimLineArr, 'modifier', $row['modifier']);
$this->_addChild($xmlClaimLineArr, 'diagnosis_pointer', $row['diagnosis_pointer']);
$this->_addChild($xmlClaimLineArr, 'amount', $row['amount']);
$this->_addChild($xmlClaimLineArr, 'units', $row['units']);
}
$xmlClaim = $xml->addChild('claim');
$this->_addChild($xmlClaim, 'amount_total', $amountTotal);
$this->_addChild($xmlClaim, 'amount_paid', $amountPaid);
$this->_addChild($xmlClaim, 'net_amount_total', $netAmountTotal);
//$doc = new DOMDocument();
//$doc->formatOutput = true;
//$doc->loadXML($xml->asXML());
//file_put_contents('/tmp/claims.xml',$doc->saveXML());
}
public function processReorderPayersAction()
{
$from = (int) $this->_getParam('from');
$to = (int) $this->_getParam('to');
$ret = false;
if ($from > 0 && $to > 0) {
$payerFrom = new InsuredRelationship();
$payerFrom->insuredRelationshipId = $from;
$payerFrom->populate();
$payerTo = new InsuredRelationship();
$payerTo->insuredRelationshipId = $to;
$payerTo->populate();
$ret = InsuredRelationship::reorder($payerFrom, $payerTo);
}
$json = Zend_Controller_Action_HelperBroker::getStaticHelper('json');
$json->suppressExit = true;
$json->direct($ret);
}
