function InsuranceCompany($insco = 0)
{
if ($insco == 0) {
return false;
}
// error checking
if (!isset($GLOBALS['__freemed']['cache']['insco'][$insco])) {
// Get record
$this->local_record = $GLOBALS['sql']->get_link('insco', $insco);
// Cache it
$GLOBALS['__freemed']['cache']['insco'][$insco] = $this->local_record;
} else {
// Retrieve from the cache
$this->local_record = $GLOBALS['__freemed']['cache']['insco'][$insco];
}
$this->id = $this->local_record["id"];
$this->insconame = $this->local_record["insconame"];
$this->inscoalias = $this->local_record["inscoalias"];
$this->modifiers = fm_split_into_array($this->local_record["inscomod"]);
}
public function CalculateCharge($covid, $procunits, $cptid, $phyid, $patid)
{
global $display_buffer;
// id of coverage record, cpt record, physician record
// and patient record
// charge calculation routine lies here
// charge = units * relative_value(cpt) *
// base_value(physician/provider)
// standard_fee = standard_fee [insurance co] unless 0 then
// = default_standard_fee
// (we display "standard fee" as what the bastards (insurance companies)
// are actually going to pay -- be sure to check for divide by zeros...)
// step one:
// calculate the standard fee
//if ($covid==0)
// return 0;
$primary = CreateObject('org.freemedsoftware.core.Coverage', $covid);
$insid = $primary->local_record[covinsco];
$cpt_code = $GLOBALS['sql']->get_link('cpt', $cptid);
// cpt code
$cpt_code_fees = unserialize($cpt_code["cptstdfee"]);
$cpt_code_stdfee = $cpt_code_fees[$insid];
// grab proper std fee
if (empty($cpt_code_stdfee) or $cpt_code_stdfee == 0) {
$cpt_code_stdfee = $cpt_code["cptdefstdfee"];
}
// if none, do default
$cpt_code_stdfee = bcadd($cpt_code_stdfee, 0, 2);
// step two:
// grab the relative value from the CPT db
$relative_value = $cpt_code["cptrelval"];
if ($debug) {
$display_buffer .= " (relative_value = \"{$relative_value}\")\n";
}
// step three:
// calculate the base value
$internal_type = $cpt_code["cpttype"];
// grab internal type
if ($debug) {
$display_buffer .= " (inttype = {$internal_type}) (procphysician = {$procphysician}) ";
}
$this_physician = $GLOBALS['sql']->get_link('physician', $physid);
$charge_map = fm_split_into_array($this_physician["phychargemap"]);
$base_value = $charge_map[$internal_type];
if ($debug) {
$display_buffer .= "<BR>base value = \"{$base_value}\"\n";
}
// step four:
// check for patient discount percentage
$this_patient = CreateObject('org.freemedsoftware.core.Patient', $patid);
$percentage = $this_patient->local_record["ptdisc"];
if ($percentage > 0) {
$discount = $percentage / 100;
} else {
$discount = 0;
}
if ($debug) {
$display_buffer .= "<BR>discount = \"{$discount}\"\n";
}
// step five:
// calculate formula...
$charge = $base_value * $procunits * $relative_value - $discount;
if ($charge == 0) {
$charge = $cpt_code_stdfee * $procunits;
}
if ($debug) {
$display_buffer .= " (charge = \"{$charge}\") \n";
}
// step six:
// adjust values to proper precision
$charge = bcadd($charge, 0, 2);
return $charge + 0;
}
function fm_value_in_string($cur_string, $value)
{
// Check for "," separator indicating hash'd array
if (!(strpos($cur_string, ",") === false)) {
// Split it out...
$this_array = fm_split_into_array($cur_string);
// ... then use fm_value_in_array to return the value
return fm_value_in_array($this_array, $value);
}
// end checking for ","
// Otherwise do a simple substring match check
//if (strstr($cur_string,$value) != "") return true;
if (trim($cur_string) == trim($value)) {
return true;
}
// If it hasn't been found, return false
return false;
}
