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1736 lines
89 KiB
1736 lines
89 KiB
2 years ago
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<?php
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/**
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* Front payment gui.
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*
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* @package OpenEMR
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* @link http://www.open-emr.org
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* @author Rod Roark <rod@sunsetsystems.com>
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* @author Brady Miller <brady.g.miller@gmail.com>
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* @copyright Copyright (c) 2006-2020 Rod Roark <rod@sunsetsystems.com>
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* @copyright Copyright (c) 2017-2018 Brady Miller <brady.g.miller@gmail.com>
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* @license https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
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*/
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require_once("../globals.php");
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require_once("$srcdir/patient.inc");
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require_once("$srcdir/payment.inc.php");
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require_once("$srcdir/forms.inc");
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require_once("../../custom/code_types.inc.php");
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require_once("$srcdir/options.inc.php");
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require_once("$srcdir/encounter_events.inc.php");
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use OpenEMR\Billing\BillingUtilities;
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use OpenEMR\Common\Acl\AclMain;
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use OpenEMR\Common\Csrf\CsrfUtils;
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use OpenEMR\Common\Twig\TwigContainer;
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use OpenEMR\Core\Header;
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use OpenEMR\OeUI\OemrUI;
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use OpenEMR\PaymentProcessing\Sphere\SpherePayment;
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use OpenEMR\Services\FacilityService;
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if (!empty($_REQUEST['receipt']) && empty($_POST['form_save'])) {
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if (!AclMain::aclCheckCore('acct', 'bill') && !AclMain::aclCheckCore('acct', 'rep_a') && !AclMain::aclCheckCore('patients', 'rx')) {
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echo (new TwigContainer(null, $GLOBALS['kernel']))->getTwig()->render('core/unauthorized.html.twig', ['pageTitle' => xl("Receipt for Payment")]);
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exit;
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}
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} else {
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if (!AclMain::aclCheckCore('acct', 'bill', '', 'write')) {
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if (!empty($_POST['form_save'])) {
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$pageTitle = xl("Receipt for Payment");
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} else {
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$pageTitle = xl("Record Payment");
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}
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echo (new TwigContainer(null, $GLOBALS['kernel']))->getTwig()->render('core/unauthorized.html.twig', ['pageTitle' => $pageTitle]);
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exit;
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}
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}
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$pid = (!empty($_REQUEST['hidden_patient_code']) && ($_REQUEST['hidden_patient_code'] > 0)) ? $_REQUEST['hidden_patient_code'] : $pid;
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$facilityService = new FacilityService();
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?>
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<!DOCTYPE html>
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<html>
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<head>
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<?php Header::setupHeader(['opener']);?>
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<?php if ($GLOBALS['payment_gateway'] == 'Stripe') { ?>
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<script src="https://js.stripe.com/v3/"></script>
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<?php } ?>
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<?php if ($GLOBALS['payment_gateway'] == 'AuthorizeNet') {
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// Must be loaded from their server
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$script = "https://jstest.authorize.net/v1/Accept.js"; // test script
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if ($GLOBALS['gateway_mode_production']) {
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$script = "https://js.authorize.net/v1/Accept.js"; // Production script
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} ?>
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<script src=<?php echo $script; ?> charset="utf-8"></script>
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<?php } ?>
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<?php
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// Format dollars for display.
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function bucks($amount)
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{
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if ($amount) {
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$amount = oeFormatMoney($amount);
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return $amount;
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}
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return '';
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}
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function rawbucks($amount)
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{
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if ($amount) {
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$amount = sprintf("%.2f", $amount);
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return $amount;
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}
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return '';
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}
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// Display a row of data for an encounter.
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//
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$var_index = 0;
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function echoLine($iname, $date, $charges, $ptpaid, $inspaid, $duept, $encounter = 0, $copay = 0, $patcopay = 0)
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{
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global $var_index;
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$var_index++;
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$balance = bucks($charges - $ptpaid - $inspaid);
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$balance = (round($duept, 2) != 0) ? 0 : $balance;//if balance is due from patient, then insurance balance is displayed as zero
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$encounter = $encounter ? $encounter : '';
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echo " <tr id='tr_" . attr($var_index) . "' >\n";
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echo " <td>" . text(oeFormatShortDate($date)) . "</td>\n";
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echo " <td class='text-center' id='" . attr($date) . "'>" . text($encounter) . "</td>\n";
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echo " <td class='text-center' id='td_charges_$var_index' >" . text(bucks($charges)) . "</td>\n";
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echo " <td class='text-center' id='td_inspaid_$var_index' >" . text(bucks($inspaid * -1)) . "</td>\n";
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echo " <td class='text-center' id='td_ptpaid_$var_index' >" . text(bucks($ptpaid * -1)) . "</td>\n";
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echo " <td class='text-center' id='td_patient_copay_$var_index' >" . text(bucks($patcopay)) . "</td>\n";
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echo " <td class='text-center' id='td_copay_$var_index' >" . text(bucks($copay)) . "</td>\n";
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echo " <td class='text-center' id='balance_$var_index'>" . text(bucks($balance)) . "</td>\n";
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echo " <td class='text-center' id='duept_$var_index'>" . text(bucks(round($duept, 2) * 1)) . "</td>\n";
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echo " <td class='text-right'><input type='text' class='form-control' name='" . attr($iname) . "' id='paying_" . attr($var_index) . "' " .
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" value='' onchange='coloring();calctotal()' autocomplete='off' " .
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"onkeyup='calctotal()'/></td>\n";
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echo " </tr>\n";
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}
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// We use this to put dashes, colons, etc. back into a timestamp.
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//
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function decorateString($fmt, $str)
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{
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$res = '';
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while ($fmt) {
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$fc = substr($fmt, 0, 1);
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$fmt = substr($fmt, 1);
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if ($fc == '.') {
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$res .= substr($str, 0, 1);
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$str = substr($str, 1);
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} else {
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$res .= $fc;
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}
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}
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return $res;
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}
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// Compute taxes from a tax rate string and a possibly taxable amount.
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//
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function calcTaxes($row, $amount)
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{
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$total = 0;
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if (empty($row['taxrates'])) {
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return $total;
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}
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$arates = explode(':', $row['taxrates']);
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if (empty($arates)) {
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return $total;
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}
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foreach ($arates as $value) {
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if (empty($value)) {
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continue;
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}
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$trow = sqlQuery("SELECT option_value FROM list_options WHERE " .
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"list_id = 'taxrate' AND option_id = ? AND activity = 1 LIMIT 1", array($value));
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if (empty($trow['option_value'])) {
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echo "<!-- Missing tax rate '" . text($value) . "'! -->\n";
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continue;
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}
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$tax = sprintf("%01.2f", $amount * $trow['option_value']);
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// echo "<!-- Rate = '$value', amount = '$amount', tax = '$tax' -->\n";
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$total += $tax;
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}
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return $total;
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}
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$now = time();
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$today = date('Y-m-d', $now);
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$timestamp = date('Y-m-d H:i:s', $now);
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$patdata = sqlQuery("SELECT " .
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"p.fname, p.mname, p.lname, p.pubpid,p.pid, i.copay " .
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"FROM patient_data AS p " .
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"LEFT OUTER JOIN insurance_data AS i ON " .
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"i.pid = p.pid AND i.type = 'primary' " .
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"WHERE p.pid = ? ORDER BY i.date DESC LIMIT 1", array($pid));
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$alertmsg = ''; // anything here pops up in an alert box
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// If the Save button was clicked...
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if (!empty($_POST['form_save'])) {
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if (!CsrfUtils::verifyCsrfToken($_POST["csrf_token_form"])) {
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CsrfUtils::csrfNotVerified();
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}
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$form_pid = $_POST['form_pid'];
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$form_method = trim($_POST['form_method']);
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$form_source = trim($_POST['form_source']);
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$patdata = getPatientData($form_pid, 'fname,mname,lname,pubpid');
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$NameNew = $patdata['fname'] . " " . $patdata['lname'] . " " . $patdata['mname'];
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if ($_REQUEST['radio_type_of_payment'] == 'pre_payment') {
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$payment_id = sqlInsert(
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"insert into ar_session set " .
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"payer_id = ?" .
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", patient_id = ?" .
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", user_id = ?" .
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", closed = ?" .
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", reference = ?" .
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", check_date = now() , deposit_date = now() " .
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", pay_total = ?" .
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", payment_type = 'patient'" .
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", description = ?" .
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", adjustment_code = 'pre_payment'" .
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", post_to_date = now() " .
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", payment_method = ?",
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array(0, $form_pid, $_SESSION['authUserID'], 0, $form_source, $_REQUEST['form_prepayment'], $NameNew, $form_method)
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);
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frontPayment($form_pid, 0, $form_method, $form_source, $_REQUEST['form_prepayment'], 0, $timestamp);//insertion to 'payments' table.
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}
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if ($_POST['form_upay'] && $_REQUEST['radio_type_of_payment'] != 'pre_payment') {
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foreach ($_POST['form_upay'] as $enc => $payment) {
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$payment = floatval($payment);
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if ($amount = $payment) {
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$zero_enc = $enc;
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if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance') {
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if (!$enc) {
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$enc = calendar_arrived($form_pid);
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}
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} else {
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if (!$enc) {
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$enc = calendar_arrived($form_pid);
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}
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}
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//----------------------------------------------------------------------------------------------------
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//Fetching the existing code and modifier
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$ResultSearchNew = sqlStatement(
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"SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key " .
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"WHERE code_types.ct_fee=1 AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier",
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array($form_pid, $enc)
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);
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if ($RowSearch = sqlFetchArray($ResultSearchNew)) {
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$Codetype = $RowSearch['code_type'];
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$Code = $RowSearch['code'];
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$Modifier = $RowSearch['modifier'];
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} else {
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$Codetype = '';
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$Code = '';
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$Modifier = '';
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}
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//----------------------------------------------------------------------------------------------------
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if ($_REQUEST['radio_type_of_payment'] == 'copay') {//copay saving to ar_session and ar_activity tables
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$session_id = sqlInsert(
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"INSERT INTO ar_session (payer_id,user_id,reference,check_date,deposit_date,pay_total," .
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" global_amount,payment_type,description,patient_id,payment_method,adjustment_code,post_to_date) " .
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" VALUES ('0',?,?,now(),now(),?,'','patient','COPAY',?,?,'patient_payment',now())",
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array($_SESSION['authUserID'], $form_source, $amount, $form_pid, $form_method)
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);
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sqlBeginTrans();
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$sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment FROM ar_activity WHERE pid = ? AND encounter = ?", array($form_pid, $enc));
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$insrt_id = sqlInsert(
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"INSERT INTO ar_activity (pid,encounter,sequence_no,code_type,code,modifier,payer_type,post_time,post_user,session_id,pay_amount,account_code)" .
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" VALUES (?,?,?,?,?,?,0,now(),?,?,?,'PCP')",
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array($form_pid, $enc, $sequence_no['increment'], $Codetype, $Code, $Modifier, $_SESSION['authUserID'], $session_id, $amount)
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);
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sqlCommitTrans();
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frontPayment($form_pid, $enc, $form_method, $form_source, $amount, 0, $timestamp);//insertion to 'payments' table.
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}
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if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance' || $_REQUEST['radio_type_of_payment'] == 'cash') { //Payment by patient after insurance paid, cash patients similar to do not bill insurance in feesheet.
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if ($_REQUEST['radio_type_of_payment'] == 'cash') {
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sqlStatement(
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"update form_encounter set last_level_closed=? where encounter=? and pid=? ",
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array(4, $enc, $form_pid)
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);
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sqlStatement(
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"update billing set billed=? where encounter=? and pid=?",
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array(1, $enc, $form_pid)
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);
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}
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$adjustment_code = 'patient_payment';
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$payment_id = sqlInsert(
|
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"insert into ar_session set " .
|
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|
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"payer_id = ?" .
|
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", patient_id = ?" .
|
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", user_id = ?" .
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", closed = ?" .
|
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", reference = ?" .
|
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", check_date = now() , deposit_date = now() " .
|
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", pay_total = ?" .
|
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|
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", payment_type = 'patient'" .
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", description = ?" .
|
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", adjustment_code = ?" .
|
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", post_to_date = now() " .
|
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|
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", payment_method = ?",
|
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array(0, $form_pid, $_SESSION['authUserID'], 0, $form_source, $amount, $NameNew, $adjustment_code, $form_method)
|
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);
|
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//--------------------------------------------------------------------------------------------------------------------
|
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frontPayment($form_pid, $enc, $form_method, $form_source, 0, $amount, $timestamp);//insertion to 'payments' table.
|
||
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|
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//--------------------------------------------------------------------------------------------------------------------
|
||
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$resMoneyGot = sqlStatement(
|
||
|
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"SELECT sum(pay_amount) as PatientPay FROM ar_activity where pid =? and " .
|
||
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"encounter = ? and payer_type = 0 and account_code = 'PCP' AND deleted IS NULL",
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array($form_pid, $enc)
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);//new fees screen copay gives account_code='PCP'
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$rowMoneyGot = sqlFetchArray($resMoneyGot);
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$Copay = $rowMoneyGot['PatientPay'];
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||
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//--------------------------------------------------------------------------------------------------------------------
|
||
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|
||
|
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//Looping the existing code and modifier
|
||
|
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$ResultSearchNew = sqlStatement(
|
||
|
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"SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key WHERE code_types.ct_fee=1 " .
|
||
|
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"AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier",
|
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|
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array($form_pid, $enc)
|
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);
|
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while ($RowSearch = sqlFetchArray($ResultSearchNew)) {
|
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$Codetype = $RowSearch['code_type'];
|
||
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$Code = $RowSearch['code'];
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$Modifier = $RowSearch['modifier'];
|
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$Fee = $RowSearch['fee'];
|
||
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|
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$resMoneyGot = sqlStatement(
|
||
|
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"SELECT sum(pay_amount) as MoneyGot FROM ar_activity where pid = ? AND deleted IS NULL " .
|
||
|
|
"and code_type=? and code=? and modifier=? and encounter =? and !(payer_type=0 and account_code='PCP')",
|
||
|
|
array($form_pid, $Codetype, $Code, $Modifier, $enc)
|
||
|
|
);
|
||
|
|
//new fees screen copay gives account_code='PCP'
|
||
|
|
$rowMoneyGot = sqlFetchArray($resMoneyGot);
|
||
|
|
$MoneyGot = $rowMoneyGot['MoneyGot'];
|
||
|
|
|
||
|
|
$resMoneyAdjusted = sqlStatement(
|
||
|
|
"SELECT sum(adj_amount) as MoneyAdjusted FROM ar_activity where " .
|
||
|
|
"pid = ? and code_type = ? and code = ? and modifier = ? and encounter = ? AND deleted IS NULL",
|
||
|
|
array($form_pid, $Codetype, $Code, $Modifier, $enc)
|
||
|
|
);
|
||
|
|
$rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
|
||
|
|
$MoneyAdjusted = $rowMoneyAdjusted['MoneyAdjusted'];
|
||
|
|
|
||
|
|
$Remainder = $Fee - $Copay - $MoneyGot - $MoneyAdjusted;
|
||
|
|
$Copay = 0;
|
||
|
|
if (round($Remainder, 2) != 0 && $amount != 0) {
|
||
|
|
if ($amount - $Remainder >= 0) {
|
||
|
|
$insert_value = $Remainder;
|
||
|
|
$amount = $amount - $Remainder;
|
||
|
|
} else {
|
||
|
|
$insert_value = $amount;
|
||
|
|
$amount = 0;
|
||
|
|
}
|
||
|
|
|
||
|
|
sqlBeginTrans();
|
||
|
|
$sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment FROM ar_activity WHERE pid = ? AND encounter = ?", array($form_pid, $enc));
|
||
|
|
sqlStatement(
|
||
|
|
"insert into ar_activity set " .
|
||
|
|
"pid = ?" .
|
||
|
|
", encounter = ?" .
|
||
|
|
", sequence_no = ?" .
|
||
|
|
", code_type = ?" .
|
||
|
|
", code = ?" .
|
||
|
|
", modifier = ?" .
|
||
|
|
", payer_type = ?" .
|
||
|
|
", post_time = now() " .
|
||
|
|
", post_user = ?" .
|
||
|
|
", session_id = ?" .
|
||
|
|
", pay_amount = ?" .
|
||
|
|
", adj_amount = ?" .
|
||
|
|
", account_code = 'PP'",
|
||
|
|
array($form_pid, $enc, $sequence_no['increment'], $Codetype, $Code, $Modifier, 0, $_SESSION['authUserID'], $payment_id, $insert_value, 0)
|
||
|
|
);
|
||
|
|
sqlCommitTrans();
|
||
|
|
}//if
|
||
|
|
}//while
|
||
|
|
if ($amount != 0) {//if any excess is there.
|
||
|
|
sqlBeginTrans();
|
||
|
|
$sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment FROM ar_activity WHERE pid = ? AND encounter = ?", array($form_pid, $enc));
|
||
|
|
sqlStatement(
|
||
|
|
"insert into ar_activity set " .
|
||
|
|
"pid = ?" .
|
||
|
|
", encounter = ?" .
|
||
|
|
", sequence_no = ?" .
|
||
|
|
", code_type = ?" .
|
||
|
|
", code = ?" .
|
||
|
|
", modifier = ?" .
|
||
|
|
", payer_type = ?" .
|
||
|
|
", post_time = now() " .
|
||
|
|
", post_user = ?" .
|
||
|
|
", session_id = ?" .
|
||
|
|
", pay_amount = ?" .
|
||
|
|
", adj_amount = ?" .
|
||
|
|
", account_code = 'PP'",
|
||
|
|
array($form_pid, $enc, $sequence_no['increment'], $Codetype, $Code, $Modifier, 0, $_SESSION['authUserID'], $payment_id, $amount, 0)
|
||
|
|
);
|
||
|
|
sqlCommitTrans();
|
||
|
|
}
|
||
|
|
|
||
|
|
//--------------------------------------------------------------------------------------------------------------------
|
||
|
|
}//invoice_balance
|
||
|
|
}//if ($amount = 0 + $payment)
|
||
|
|
}//foreach
|
||
|
|
}//if ($_POST['form_upay'])
|
||
|
|
}//if ($_POST['form_save'])
|
||
|
|
|
||
|
|
if (!empty($_POST['form_save']) || !empty($_REQUEST['receipt'])) {
|
||
|
|
if (!empty($_REQUEST['receipt'])) {
|
||
|
|
$form_pid = $_GET['patient'];
|
||
|
|
$timestamp = decorateString('....-..-.. ..:..:..', $_GET['time']);
|
||
|
|
}
|
||
|
|
|
||
|
|
// Get details for what we guess is the primary facility.
|
||
|
|
$frow = $facilityService->getPrimaryBusinessEntity(array("useLegacyImplementation" => true));
|
||
|
|
|
||
|
|
// Get the patient's name and chart number.
|
||
|
|
$patdata = getPatientData($form_pid, 'fname,mname,lname,pubpid');
|
||
|
|
|
||
|
|
// Re-fetch payment info.
|
||
|
|
$payrow = sqlQuery("SELECT " .
|
||
|
|
"SUM(amount1) AS amount1, " .
|
||
|
|
"SUM(amount2) AS amount2, " .
|
||
|
|
"MAX(method) AS method, " .
|
||
|
|
"MAX(source) AS source, " .
|
||
|
|
"MAX(dtime) AS dtime, " .
|
||
|
|
// "MAX(user) AS user " .
|
||
|
|
"MAX(user) AS user, " .
|
||
|
|
"MAX(encounter) as encounter " .
|
||
|
|
"FROM payments WHERE " .
|
||
|
|
"pid = ? AND dtime = ?", array($form_pid, $timestamp));
|
||
|
|
|
||
|
|
// Create key for deleting, just in case.
|
||
|
|
$ref_id = ($_REQUEST['radio_type_of_payment'] == 'copay') ? $session_id : $payment_id;
|
||
|
|
$payment_key = $form_pid . '.' . preg_replace('/[^0-9]/', '', $timestamp) . '.' . $ref_id;
|
||
|
|
|
||
|
|
if ($_REQUEST['radio_type_of_payment'] != 'pre_payment') {
|
||
|
|
// get facility from encounter
|
||
|
|
$tmprow = sqlQuery("SELECT `facility_id` FROM `form_encounter` WHERE `encounter` = ?", array($payrow['encounter']));
|
||
|
|
$frow = $facilityService->getById($tmprow['facility_id']);
|
||
|
|
} else {
|
||
|
|
// if pre_payment, then no encounter yet, so get main office address
|
||
|
|
$frow = $facilityService->getPrimaryBillingLocation();
|
||
|
|
}
|
||
|
|
|
||
|
|
// Now proceed with printing the receipt.
|
||
|
|
?>
|
||
|
|
|
||
|
|
<title><?php echo xlt('Receipt for Payment'); ?></title>
|
||
|
|
<?php Header::setupHeader(); ?>
|
||
|
|
<script>
|
||
|
|
|
||
|
|
<?php require($GLOBALS['srcdir'] . "/restoreSession.php"); ?>
|
||
|
|
|
||
|
|
$(function () {
|
||
|
|
var win = top.printLogSetup ? top : opener.top;
|
||
|
|
win.printLogSetup(document.getElementById('printbutton'));
|
||
|
|
});
|
||
|
|
|
||
|
|
function closeHow(e) {
|
||
|
|
if (opener) {
|
||
|
|
dlgclose();
|
||
|
|
return;
|
||
|
|
}
|
||
|
|
top.activateTabByName('pat', true);
|
||
|
|
top.tabCloseByName(window.name);
|
||
|
|
}
|
||
|
|
|
||
|
|
// This is action to take before printing and is called from restoreSession.php.
|
||
|
|
function printlog_before_print() {
|
||
|
|
let divstyle = document.getElementById('hideonprint').style;
|
||
|
|
divstyle.display = 'none';
|
||
|
|
// currently exit is not hidden by default in case receipt print is not needed
|
||
|
|
// and left here for future option to force users to print via global etc..
|
||
|
|
// can still print later via reports.
|
||
|
|
divstyle = document.getElementById('showonprint').style;
|
||
|
|
divstyle.display = '';
|
||
|
|
}
|
||
|
|
|
||
|
|
// Process click on Delete button.
|
||
|
|
function deleteme() {
|
||
|
|
dlgopen('deleter.php?payment=' + <?php echo js_url($payment_key); ?> + '&csrf_token_form=' + <?php echo js_url(CsrfUtils::collectCsrfToken()); ?>, '_blank', 500, 450);
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
|
||
|
|
// Called by the deleteme.php window on a successful delete.
|
||
|
|
function imdeleted() {
|
||
|
|
if (opener) {
|
||
|
|
dlgclose(); // we're in reports/leftnav and callback reloads.
|
||
|
|
} else {
|
||
|
|
window.history.back(); // this is us full screen.
|
||
|
|
}
|
||
|
|
}
|
||
|
|
|
||
|
|
// Called to switch to the specified encounter having the specified DOS.
|
||
|
|
// This also closes the popup window.
|
||
|
|
function toencounter(enc, datestr, topframe) {
|
||
|
|
top.restoreSession();
|
||
|
|
top.goToEncounter(enc);
|
||
|
|
if (opener) dlgclose();
|
||
|
|
}
|
||
|
|
|
||
|
|
</script>
|
||
|
|
<style>
|
||
|
|
@media print {
|
||
|
|
#donebutton {
|
||
|
|
display: none;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
</style>
|
||
|
|
</head>
|
||
|
|
<body>
|
||
|
|
<div class="container mt-3">
|
||
|
|
<div class="row">
|
||
|
|
<div class="col-12 text-center">
|
||
|
|
<h2><?php echo xlt('Receipt for Payment'); ?></h2>
|
||
|
|
<p>
|
||
|
|
<?php echo text($frow['name']) ?>
|
||
|
|
<br />
|
||
|
|
<?php echo text($frow['street']) ?>
|
||
|
|
<br />
|
||
|
|
<?php echo text($frow['city'] . ', ' . $frow['state']) . ' ' . text($frow['postal_code']) ?>
|
||
|
|
<br />
|
||
|
|
<?php echo text($frow['phone']) ?>
|
||
|
|
</p>
|
||
|
|
|
||
|
|
<div class="table-responsive">
|
||
|
|
<table class="table table-borderless">
|
||
|
|
<tr>
|
||
|
|
<td><?php echo xlt('Date'); ?>:</td>
|
||
|
|
<td><?php echo text(oeFormatSDFT(strtotime($payrow['dtime']))) ?></td>
|
||
|
|
</tr>
|
||
|
|
<tr>
|
||
|
|
<td><?php echo xlt('Patient'); ?>:</td>
|
||
|
|
<td><?php echo text($patdata['fname']) . " " . text($patdata['mname']) . " " .
|
||
|
|
text($patdata['lname']) . " (" . text($patdata['pubpid']) . ")" ?></td>
|
||
|
|
</tr>
|
||
|
|
<tr>
|
||
|
|
<td><?php echo xlt('How Paid'); ?>:</td>
|
||
|
|
<td><?php echo generate_display_field(array('data_type' => '1', 'list_id' => 'payment_method'), $payrow['method']); ?></td>
|
||
|
|
</tr>
|
||
|
|
<tr>
|
||
|
|
<td><?php echo xlt('Check or Reference Number'); ?>:</td>
|
||
|
|
<td><?php echo text($payrow['source']) ?></td>
|
||
|
|
</tr>
|
||
|
|
<tr>
|
||
|
|
<td><?php echo xlt('Amount for This Visit'); ?>:</td>
|
||
|
|
<td><?php echo text(oeFormatMoney($payrow['amount1'])) ?></td>
|
||
|
|
</tr>
|
||
|
|
<tr>
|
||
|
|
<td>
|
||
|
|
<?php
|
||
|
|
if ($_REQUEST['radio_type_of_payment'] == 'pre_payment') {
|
||
|
|
echo xlt('Pre-payment Amount');
|
||
|
|
} else {
|
||
|
|
echo xlt('Amount for Past Balance');
|
||
|
|
}
|
||
|
|
?>
|
||
|
|
:</td>
|
||
|
|
<td><?php echo text(oeFormatMoney($payrow['amount2'])) ?></td>
|
||
|
|
</tr>
|
||
|
|
<tr>
|
||
|
|
<td><?php echo xlt('Received By'); ?>:</td>
|
||
|
|
<td><?php echo text($payrow['user']) ?></td>
|
||
|
|
</tr>
|
||
|
|
</table>
|
||
|
|
</div>
|
||
|
|
<div id='hideonprint'>
|
||
|
|
<button type="button" class="btn btn-primary btn-print" value='<?php echo xla('Print'); ?>' id='printbutton'>
|
||
|
|
<?php echo xlt('Print'); ?>
|
||
|
|
</button>
|
||
|
|
|
||
|
|
<?php
|
||
|
|
$todaysenc = todaysEncounterIf($pid);
|
||
|
|
if ($todaysenc && $todaysenc != $encounter) {
|
||
|
|
echo " <input type='button' class='btn btn-primary' " .
|
||
|
|
"value='" . xla('Open Today`s Visit') . "' " .
|
||
|
|
"onclick='toencounter(" . attr_js($todaysenc) . ", " . attr_js($today) . ", (opener ? opener.top : top))' />\n";
|
||
|
|
}
|
||
|
|
?>
|
||
|
|
|
||
|
|
<?php if (AclMain::aclCheckCore('admin', 'super') || AclMain::aclCheckCore('acct', 'bill')) {
|
||
|
|
// allowing biller to delete payments ?>
|
||
|
|
<button type="button" class="btn btn-danger btn-delete" value='<?php echo xla('Delete'); ?>' onclick="deleteme()">
|
||
|
|
<?php echo xlt('Delete'); ?>
|
||
|
|
</button>
|
||
|
|
<?php } ?>
|
||
|
|
</div>
|
||
|
|
<div class='mt-3' id='showonprint'>
|
||
|
|
<button type="button" class="btn btn-secondary btn-cancel" value='<?php echo xla('Exit'); ?>' id='donebutton' onclick="closeHow(event)">
|
||
|
|
<?php echo xlt('Exit'); ?>
|
||
|
|
</button>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</body>
|
||
|
|
|
||
|
|
<?php
|
||
|
|
//
|
||
|
|
// End of receipt printing logic.
|
||
|
|
//
|
||
|
|
} else {
|
||
|
|
//
|
||
|
|
// Here we display the form for data entry.
|
||
|
|
//
|
||
|
|
?>
|
||
|
|
<title><?php echo xlt('Record Payment'); ?></title>
|
||
|
|
|
||
|
|
<style>
|
||
|
|
#ajax_div_patient {
|
||
|
|
position: absolute;
|
||
|
|
z-index:10;
|
||
|
|
background-color: #FBFDD0;
|
||
|
|
border: 1px solid #ccc;
|
||
|
|
padding: 10px;
|
||
|
|
}
|
||
|
|
</style>
|
||
|
|
<!--Removed standard dependencies 12/29/17 as not needed any longer since moved to a tab/frame not popup.-->
|
||
|
|
|
||
|
|
<!-- supporting javascript code -->
|
||
|
|
<script>
|
||
|
|
var mypcc = '1';
|
||
|
|
</script>
|
||
|
|
<?php include_once("{$GLOBALS['srcdir']}/ajax/payment_ajax_jav.inc.php"); ?>
|
||
|
|
<script>
|
||
|
|
document.onclick=HideTheAjaxDivs;
|
||
|
|
</script>
|
||
|
|
|
||
|
|
<?php Header::setupAssets('topdialog'); ?>
|
||
|
|
|
||
|
|
<script src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-creditcardvalidator/jquery.creditCardValidator.js"></script>
|
||
|
|
|
||
|
|
<script>
|
||
|
|
var chargeMsg = <?php echo xlj('Payment was successfully authorized and charged. Thank You.'); ?>;
|
||
|
|
var publicKey = <?php echo json_encode($cryptoGen->decryptStandard($GLOBALS['gateway_public_key'])); ?>;
|
||
|
|
var apiKey = <?php echo json_encode($cryptoGen->decryptStandard($GLOBALS['gateway_api_key'])); ?>;
|
||
|
|
$(function() {
|
||
|
|
$('#openPayModal').on('show.bs.modal', function () {
|
||
|
|
let total = $("[name='form_paytotal']").val();
|
||
|
|
let prepay = $("#form_prepayment").val();
|
||
|
|
if (Number(total) < 1) {
|
||
|
|
if (Number(prepay) < 1) {
|
||
|
|
let error = <?php echo xlj("Please enter a payment amount"); ?>;
|
||
|
|
alert(error);
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
total = prepay;
|
||
|
|
}
|
||
|
|
$("#form_method").val('credit_card');
|
||
|
|
$("#payTotal").text(total);
|
||
|
|
$("#paymentAmount").val(total);
|
||
|
|
});
|
||
|
|
});
|
||
|
|
<?php require($GLOBALS['srcdir'] . "/restoreSession.php"); ?>
|
||
|
|
function closeHow(e) {
|
||
|
|
if (opener) {
|
||
|
|
dlgclose();
|
||
|
|
return;
|
||
|
|
}
|
||
|
|
top.activateTabByName('pat', true);
|
||
|
|
top.tabCloseByName(window.name);
|
||
|
|
}
|
||
|
|
function calctotal() {
|
||
|
|
var f = document.forms[0];
|
||
|
|
var total = 0;
|
||
|
|
for (var i = 0; i < f.elements.length; ++i) {
|
||
|
|
var elem = f.elements[i];
|
||
|
|
var ename = elem.name;
|
||
|
|
if (ename.indexOf('form_upay[') == 0 || ename.indexOf('form_bpay[') == 0) {
|
||
|
|
if (elem.value.length > 0) total += Number(elem.value);
|
||
|
|
}
|
||
|
|
}
|
||
|
|
f.form_paytotal.value = Number(total).toFixed(2);
|
||
|
|
return true;
|
||
|
|
}
|
||
|
|
|
||
|
|
function coloring() {
|
||
|
|
for (var i = 1; ; ++i) {
|
||
|
|
if (document.getElementById('paying_' + i)) {
|
||
|
|
paying = document.getElementById('paying_' + i).value * 1;
|
||
|
|
patient_balance = document.getElementById('duept_' + i).innerHTML * 1;
|
||
|
|
|
||
|
|
//balance=document.getElementById('balance_'+i).innerHTML*1;
|
||
|
|
if (patient_balance > 0 && paying > 0) {
|
||
|
|
if (paying > patient_balance) {
|
||
|
|
document.getElementById('paying_' + i).style.background = '#FF0000';
|
||
|
|
}
|
||
|
|
else if (paying < patient_balance) {
|
||
|
|
document.getElementById('paying_' + i).style.background = '#99CC00';
|
||
|
|
}
|
||
|
|
else if (paying == patient_balance) {
|
||
|
|
document.getElementById('paying_' + i).style.background = 'var(--white)';
|
||
|
|
}
|
||
|
|
} else {
|
||
|
|
document.getElementById('paying_' + i).style.background = 'var(--white)';
|
||
|
|
}
|
||
|
|
}
|
||
|
|
else {
|
||
|
|
break;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
}
|
||
|
|
|
||
|
|
function CheckVisible(MakeBlank) { //Displays and hides the check number text box.
|
||
|
|
if (document.getElementById('form_method').options[document.getElementById(
|
||
|
|
'form_method').selectedIndex].value == 'check_payment' || document.getElementById(
|
||
|
|
'form_method').options[document.getElementById('form_method').selectedIndex]
|
||
|
|
.value == 'bank_draft') {
|
||
|
|
document.getElementById('check_number').disabled = false;
|
||
|
|
} else {
|
||
|
|
document.getElementById('check_number').disabled = true;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
|
||
|
|
function validate(notSubmit = false) {
|
||
|
|
var f = document.forms[0];
|
||
|
|
let ok = -1;
|
||
|
|
top.restoreSession();
|
||
|
|
issue = 'no';
|
||
|
|
// prevent an empty form submission
|
||
|
|
let flgempty = true;
|
||
|
|
for (let i = 0; i < f.elements.length; ++i) {
|
||
|
|
let ename = f.elements[i].name;
|
||
|
|
if (f.elements[i].value == 'pre_payment' && f.elements[i].checked === true) {
|
||
|
|
if (Number(f.elements.namedItem("form_prepayment").value) !== 0) {
|
||
|
|
flgempty = false;
|
||
|
|
}
|
||
|
|
break;
|
||
|
|
}
|
||
|
|
if (ename.indexOf('form_upay[') === 0 || ename.indexOf('form_bpay[') === 0) {
|
||
|
|
if (Number(f.elements[i].value) !== 0) flgempty = false;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
if (flgempty) {
|
||
|
|
alert(<?php echo xlj('A Payment is Required!. Please input a payment line item entry.'); ?>);
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
// continue validation.
|
||
|
|
if (((document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value == 'check_payment' ||
|
||
|
|
document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value == 'bank_draft') &&
|
||
|
|
document.getElementById('check_number').value == '')) {
|
||
|
|
alert(<?php echo xlj('Please Fill the Check or Reference Number'); ?>);
|
||
|
|
document.getElementById('check_number').focus();
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
if (document.getElementById('radio_type_of_payment_self1').checked == false &&
|
||
|
|
document.getElementById('radio_type_of_payment1').checked == false &&
|
||
|
|
document.getElementById('radio_type_of_payment2').checked == false &&
|
||
|
|
document.getElementById('radio_type_of_payment4').checked == false) {
|
||
|
|
alert(<?php echo xlj('Please Select Type Of Payment.'); ?>);
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
if (document.getElementById('radio_type_of_payment_self1').checked == true ||
|
||
|
|
document.getElementById('radio_type_of_payment1').checked == true) {
|
||
|
|
for (var i = 0; i < f.elements.length; ++i) {
|
||
|
|
var elem = f.elements[i];
|
||
|
|
var ename = elem.name;
|
||
|
|
if (ename.indexOf('form_upay[0') == 0) //Today is this text box.
|
||
|
|
{
|
||
|
|
if (elem.value * 1 > 0) {//A warning message, if the amount is posted with out encounter.
|
||
|
|
if (confirm(<?php echo xlj('If patient has appointment click OK to create encounter otherwise, cancel this and then create an encounter for today visit.'); ?>)) {
|
||
|
|
ok = 2;
|
||
|
|
} else {
|
||
|
|
elem.focus();
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
break;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
}
|
||
|
|
|
||
|
|
if (document.getElementById('radio_type_of_payment1').checked == true){//CO-PAY
|
||
|
|
var total = 0;
|
||
|
|
for (var i = 0; i < f.elements.length; ++i) {
|
||
|
|
var elem = f.elements[i];
|
||
|
|
var ename = elem.name;
|
||
|
|
if (ename.indexOf('form_upay[0]') == 0) {//Today is this text box.
|
||
|
|
if (f.form_paytotal.value * 1 != elem.value * 1) {//Total CO-PAY is not posted against today
|
||
|
|
//A warning message, if the amount is posted against an old encounter.
|
||
|
|
if (confirm(<?php echo xlj('You are posting against an old encounter?'); ?>)) {
|
||
|
|
ok = 1;
|
||
|
|
} else {
|
||
|
|
elem.focus();
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
break;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
}//Co Pay
|
||
|
|
else if (document.getElementById('radio_type_of_payment2').checked == true) {//Invoice Balance
|
||
|
|
for (var i = 0; i < f.elements.length; ++i) {
|
||
|
|
var elem = f.elements[i];
|
||
|
|
var ename = elem.name;
|
||
|
|
if (ename.indexOf('form_upay[0') == 0) {
|
||
|
|
if (elem.value * 1 > 0) {
|
||
|
|
alert(<?php echo xlj('Invoice Balance cannot be posted. No Encounter is created.'); ?>);
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
break;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
}
|
||
|
|
if (notSubmit) {
|
||
|
|
return true;
|
||
|
|
}
|
||
|
|
if (ok === -1) {
|
||
|
|
if (confirm(<?php echo xlj('Would you like to save?'); ?>)) {
|
||
|
|
return true;
|
||
|
|
}
|
||
|
|
else {
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
return ok;
|
||
|
|
}
|
||
|
|
|
||
|
|
function cursor_pointer() { //Point the cursor to the latest encounter(Today)
|
||
|
|
var f = document.forms[0];
|
||
|
|
var total = 0;
|
||
|
|
for (var i = 0; i < f.elements.length; ++i) {
|
||
|
|
var elem = f.elements[i];
|
||
|
|
var ename = elem.name;
|
||
|
|
if (ename.indexOf('form_upay[') == 0) {
|
||
|
|
elem.focus();
|
||
|
|
break;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
}
|
||
|
|
//=====================================================
|
||
|
|
function make_it_hide_enc_pay() {
|
||
|
|
document.getElementById('td_head_insurance_payment').style.display = "none";
|
||
|
|
document.getElementById('td_head_patient_co_pay').style.display = "none";
|
||
|
|
document.getElementById('td_head_co_pay').style.display = "none";
|
||
|
|
document.getElementById('td_head_insurance_balance').style.display = "none";
|
||
|
|
for (var i = 1; ; ++i) {
|
||
|
|
var td_inspaid_elem = document.getElementById('td_inspaid_' + i)
|
||
|
|
var td_patient_copay_elem = document.getElementById('td_patient_copay_' + i)
|
||
|
|
var td_copay_elem = document.getElementById('td_copay_' + i)
|
||
|
|
var balance_elem = document.getElementById('balance_' + i)
|
||
|
|
if (td_inspaid_elem) {
|
||
|
|
td_inspaid_elem.style.display = "none";
|
||
|
|
td_patient_copay_elem.style.display = "none";
|
||
|
|
td_copay_elem.style.display = "none";
|
||
|
|
balance_elem.style.display = "none";
|
||
|
|
} else {
|
||
|
|
break;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
document.getElementById('td_total_4').style.display = "none";
|
||
|
|
document.getElementById('td_total_7').style.display = "none";
|
||
|
|
document.getElementById('td_total_8').style.display = "none";
|
||
|
|
document.getElementById('td_total_6').style.display = "none";
|
||
|
|
document.getElementById('table_display').width = "420px";
|
||
|
|
}
|
||
|
|
//=====================================================
|
||
|
|
function make_visible() {
|
||
|
|
document.getElementById('td_head_rep_doc').style.display = "";
|
||
|
|
document.getElementById('td_head_description').style.display = "";
|
||
|
|
document.getElementById('td_head_total_charge').style.display = "none";
|
||
|
|
document.getElementById('td_head_insurance_payment').style.display = "none";
|
||
|
|
document.getElementById('td_head_patient_payment').style.display = "none";
|
||
|
|
document.getElementById('td_head_patient_co_pay').style.display = "none";
|
||
|
|
document.getElementById('td_head_co_pay').style.display = "none";
|
||
|
|
document.getElementById('td_head_insurance_balance').style.display = "none";
|
||
|
|
document.getElementById('td_head_patient_balance').style.display = "none";
|
||
|
|
for (var i = 1; ; ++i) {
|
||
|
|
var td_charges_elem = document.getElementById('td_charges_' + i)
|
||
|
|
var td_inspaid_elem = document.getElementById('td_inspaid_' + i)
|
||
|
|
var td_ptpaid_elem = document.getElementById('td_ptpaid_' + i)
|
||
|
|
var td_patient_copay_elem = document.getElementById('td_patient_copay_' + i)
|
||
|
|
|
||
|
|
var td_copay_elem = document.getElementById('td_copay_' + i)
|
||
|
|
var balance_elem = document.getElementById('balance_' + i)
|
||
|
|
var duept_elem = document.getElementById('duept_' + i)
|
||
|
|
if (td_charges_elem) {
|
||
|
|
td_charges_elem.style.display = "none";
|
||
|
|
td_inspaid_elem.style.display = "none";
|
||
|
|
td_ptpaid_elem.style.display = "none";
|
||
|
|
td_patient_copay_elem.style.display = "none";
|
||
|
|
td_copay_elem.style.display = "none";
|
||
|
|
balance_elem.style.display = "none";
|
||
|
|
duept_elem.style.display = "none";
|
||
|
|
} else {
|
||
|
|
break;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
document.getElementById('td_total_7').style.display = "";
|
||
|
|
document.getElementById('td_total_8').style.display = "";
|
||
|
|
document.getElementById('td_total_1').style.display = "none";
|
||
|
|
document.getElementById('td_total_2').style.display = "none";
|
||
|
|
document.getElementById('td_total_3').style.display = "none";
|
||
|
|
document.getElementById('td_total_4').style.display = "none";
|
||
|
|
document.getElementById('td_total_5').style.display = "none";
|
||
|
|
document.getElementById('td_total_6').style.display = "none";
|
||
|
|
document.getElementById('table_display').width = "505px";
|
||
|
|
}
|
||
|
|
|
||
|
|
function make_it_hide() {
|
||
|
|
document.getElementById('td_head_rep_doc').style.display = "none";
|
||
|
|
document.getElementById('td_head_description').style.display = "none";
|
||
|
|
document.getElementById('td_head_total_charge').style.display = "";
|
||
|
|
document.getElementById('td_head_insurance_payment').style.display = "";
|
||
|
|
document.getElementById('td_head_patient_payment').style.display = "";
|
||
|
|
document.getElementById('td_head_patient_co_pay').style.display = "";
|
||
|
|
document.getElementById('td_head_co_pay').style.display = "";
|
||
|
|
document.getElementById('td_head_insurance_balance').style.display = "";
|
||
|
|
document.getElementById('td_head_patient_balance').style.display = "";
|
||
|
|
for (var i = 1; ; ++i) {
|
||
|
|
var td_charges_elem = document.getElementById('td_charges_' + i)
|
||
|
|
var td_inspaid_elem = document.getElementById('td_inspaid_' + i)
|
||
|
|
var td_ptpaid_elem = document.getElementById('td_ptpaid_' + i)
|
||
|
|
var td_patient_copay_elem = document.getElementById('td_patient_copay_' + i)
|
||
|
|
|
||
|
|
var td_copay_elem = document.getElementById('td_copay_' + i)
|
||
|
|
var balance_elem = document.getElementById('balance_' + i)
|
||
|
|
var duept_elem = document.getElementById('duept_' + i)
|
||
|
|
if (td_charges_elem) {
|
||
|
|
td_charges_elem.style.display = "";
|
||
|
|
td_inspaid_elem.style.display = "";
|
||
|
|
td_ptpaid_elem.style.display = "";
|
||
|
|
td_patient_copay_elem.style.display = "";
|
||
|
|
td_copay_elem.style.display = "";
|
||
|
|
balance_elem.style.display = "";
|
||
|
|
duept_elem.style.display = "";
|
||
|
|
} else {
|
||
|
|
break;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
document.getElementById('td_total_1').style.display = "";
|
||
|
|
document.getElementById('td_total_2').style.display = "";
|
||
|
|
document.getElementById('td_total_3').style.display = "";
|
||
|
|
document.getElementById('td_total_4').style.display = "";
|
||
|
|
document.getElementById('td_total_5').style.display = "";
|
||
|
|
document.getElementById('td_total_6').style.display = "";
|
||
|
|
document.getElementById('td_total_7').style.display = "";
|
||
|
|
document.getElementById('td_total_8').style.display = "";
|
||
|
|
document.getElementById('table_display').width = "635px";
|
||
|
|
}
|
||
|
|
|
||
|
|
function make_visible_radio() {
|
||
|
|
document.getElementById('tr_radio1').style.display = "";
|
||
|
|
document.getElementById('tr_radio2').style.display = "none";
|
||
|
|
}
|
||
|
|
|
||
|
|
function make_hide_radio() {
|
||
|
|
document.getElementById('tr_radio1').style.display = "none";
|
||
|
|
document.getElementById('tr_radio2').style.display = "";
|
||
|
|
}
|
||
|
|
|
||
|
|
function make_visible_row() {
|
||
|
|
document.getElementById('table_display').style.display = "";
|
||
|
|
document.getElementById('table_display_prepayment').style.display = "none";
|
||
|
|
}
|
||
|
|
|
||
|
|
function make_hide_row() {
|
||
|
|
document.getElementById('table_display').style.display = "none";
|
||
|
|
document.getElementById('table_display_prepayment').style.display = "";
|
||
|
|
}
|
||
|
|
|
||
|
|
function make_self() {
|
||
|
|
make_visible_row();
|
||
|
|
make_it_hide();
|
||
|
|
make_it_hide_enc_pay();
|
||
|
|
document.getElementById('radio_type_of_payment_self1').checked = true;
|
||
|
|
cursor_pointer();
|
||
|
|
}
|
||
|
|
|
||
|
|
function make_insurance() {
|
||
|
|
make_visible_row();
|
||
|
|
make_it_hide();
|
||
|
|
cursor_pointer();
|
||
|
|
document.getElementById('radio_type_of_payment1').checked = true;
|
||
|
|
}
|
||
|
|
</script>
|
||
|
|
|
||
|
|
<style>
|
||
|
|
@media (min-width: 992px) {
|
||
|
|
.modal-lg {
|
||
|
|
width: 1000px !Important;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
</style>
|
||
|
|
<title><?php echo xlt('Record Payment'); ?></title>
|
||
|
|
<?php $NameNew = $patdata['fname'] . " " . $patdata['lname'] . " " . $patdata['mname']; ?>
|
||
|
|
<?php
|
||
|
|
$arrOeUiSettings = array(
|
||
|
|
'heading_title' => xl('Accept Payment'),
|
||
|
|
'include_patient_name' => true,// use only in appropriate pages
|
||
|
|
'expandable' => false,
|
||
|
|
'expandable_files' => array(),//all file names need suffix _xpd
|
||
|
|
'action' => "",//conceal, reveal, search, reset, link or back
|
||
|
|
'action_title' => "",
|
||
|
|
'action_href' => "",//only for actions - reset, link or back
|
||
|
|
'show_help_icon' => false,
|
||
|
|
'help_file_name' => ""
|
||
|
|
);
|
||
|
|
$oemr_ui = new OemrUI($arrOeUiSettings);
|
||
|
|
?>
|
||
|
|
</head>
|
||
|
|
<body>
|
||
|
|
<div class="container mt-3"><!--begin container div for form-->
|
||
|
|
<div class="row">
|
||
|
|
<div class="col-sm-12">
|
||
|
|
<?php echo $oemr_ui->pageHeading() . "\r\n"; ?>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="row">
|
||
|
|
<div class="col-sm-12">
|
||
|
|
<form class="form form-vertical" method='post' action='front_payment.php<?php echo (!empty($payid)) ? "?payid=" . attr_url($payid) : ""; ?>' onsubmit='return validate();'>
|
||
|
|
<input type="hidden" name="csrf_token_form" value="<?php echo attr(CsrfUtils::collectCsrfToken()); ?>" />
|
||
|
|
<input name='form_pid' type='hidden' value='<?php echo attr($pid) ?>' />
|
||
|
|
<fieldset>
|
||
|
|
<legend><?php echo xlt('Payment'); ?></legend>
|
||
|
|
<div class="col-12 oe-custom-line">
|
||
|
|
<label class="control-label" for="form_method"><?php echo xlt('Payment Method'); ?>:</label>
|
||
|
|
<select class="form-control" id="form_method" name="form_method" onchange='CheckVisible("yes")'>
|
||
|
|
<?php
|
||
|
|
$query1112 = "SELECT * FROM list_options where activity=1 AND list_id=? ORDER BY seq, title ";
|
||
|
|
$bres1112 = sqlStatement($query1112, array('payment_method'));
|
||
|
|
while ($brow1112 = sqlFetchArray($bres1112)) {
|
||
|
|
if ($brow1112['option_id'] == 'electronic' || $brow1112['option_id'] == 'bank_draft') {
|
||
|
|
continue;
|
||
|
|
}
|
||
|
|
echo "<option value='" . attr($brow1112['option_id']) . "'>" . text(xl_list_label($brow1112['title'])) . "</option>";
|
||
|
|
}
|
||
|
|
?>
|
||
|
|
</select>
|
||
|
|
</div>
|
||
|
|
<div class="col-12 oe-custom-line">
|
||
|
|
<label class="control-label" for="check_number"><?php echo xlt('Check or Reference Number'); ?>:</label>
|
||
|
|
<div id="ajax_div_patient" style="display:none;"></div>
|
||
|
|
<input type='text' id="check_number" name='form_source' class='form-control' value='<?php echo attr($payrow['source'] ?? ''); ?>' />
|
||
|
|
</div>
|
||
|
|
<div class="col-12 oe-custom-line">
|
||
|
|
<label class="control-label" for="form_discount"><?php echo xla('Patient Coverage'); ?>:</label>
|
||
|
|
<div class="pl-3">
|
||
|
|
<label class="radio-inline">
|
||
|
|
<input id="radio_type_of_coverage1" name="radio_type_of_coverage" onclick="make_visible_radio();make_self();" type="radio" value="self"><?php echo xlt('Self'); ?>
|
||
|
|
</label>
|
||
|
|
<label class="radio-inline">
|
||
|
|
<input checked="checked" id="radio_type_of_coverag2" name="radio_type_of_coverage" onclick="make_hide_radio();make_insurance();" type="radio" value="insurance"><?php echo xlt('Insurance'); ?>
|
||
|
|
</label>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="col-12 oe-custom-line">
|
||
|
|
<label class="control-label" for=""><?php echo xlt('Payment against'); ?>:</label>
|
||
|
|
<div id="tr_radio1" style="padding-left:15px; display:none"><!-- For radio Insurance -->
|
||
|
|
<label class="radio-inline">
|
||
|
|
<input id="radio_type_of_payment_self1" name="radio_type_of_payment" onclick="make_visible_row();make_it_hide_enc_pay();cursor_pointer();" type="radio" value="cash"><?php echo xlt('Encounter Payment'); ?>
|
||
|
|
</label>
|
||
|
|
</div>
|
||
|
|
<div id="tr_radio2" style="padding-left:15px"><!-- For radio self -->
|
||
|
|
<label class="radio-inline">
|
||
|
|
<input checked="checked" id="radio_type_of_payment1" name="radio_type_of_payment" onclick="make_visible_row();cursor_pointer();" type="radio" value="copay"><?php echo xlt('Co Pay'); ?>
|
||
|
|
</label>
|
||
|
|
<label class="radio-inline">
|
||
|
|
<input id="radio_type_of_payment2" name="radio_type_of_payment" onclick="make_visible_row();" type="radio" value="invoice_balance"><?php echo xlt('Invoice Balance'); ?><br />
|
||
|
|
</label>
|
||
|
|
<label class="radio-inline">
|
||
|
|
<input id="radio_type_of_payment4" name="radio_type_of_payment" onclick="make_hide_row();" type="radio" value="pre_payment"><?php echo xlt('Pre Pay'); ?>
|
||
|
|
</label>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="col-12 oe-custom-line">
|
||
|
|
<div id="table_display_prepayment" style="display:none">
|
||
|
|
<label class="control-label" for="form_prepayment"><?php echo xlt('Pre Payment'); ?>:</label>
|
||
|
|
<input name='form_prepayment' id='form_prepayment'class='form-control' type='text' value ='' />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</fieldset>
|
||
|
|
<fieldset>
|
||
|
|
<legend><?php echo xlt('Collect For'); ?></legend>
|
||
|
|
<div class="table-responsive">
|
||
|
|
<table class="table" id="table_display">
|
||
|
|
<thead>
|
||
|
|
<tr class="table-active" id="tr_head">
|
||
|
|
<th class="font-weight-bold" width="70"><?php echo xlt('DOS'); ?></td>
|
||
|
|
<th class="font-weight-bold" width="65"><?php echo xlt('Encounter'); ?></td>
|
||
|
|
<th class="font-weight-bold text-center" id="td_head_total_charge" width="80"><?php echo xlt('Total Charge'); ?></td>
|
||
|
|
<th class="font-weight-bold text-center" id="td_head_rep_doc" style='display:none' width="70"><?php echo xlt('Report/ Form'); ?></td>
|
||
|
|
<th class="font-weight-bold text-center" id="td_head_description" style='display:none' width="200"><?php echo xlt('Description'); ?></td>
|
||
|
|
<th class="font-weight-bold text-center" id="td_head_insurance_payment" width="80"><?php echo xlt('Insurance Payment'); ?></td>
|
||
|
|
<th class="font-weight-bold text-center" id="td_head_patient_payment" width="80"><?php echo xlt('Patient Payment'); ?></td>
|
||
|
|
<th class="font-weight-bold text-center" id="td_head_patient_co_pay" width="55"><?php echo xlt('Co Pay Paid'); ?></td>
|
||
|
|
<th class="font-weight-bold text-center" id="td_head_co_pay" width="55"><?php echo xlt('Required Co Pay'); ?></td>
|
||
|
|
<th class="font-weight-bold text-center" id="td_head_insurance_balance" width="80"><?php echo xlt('Insurance Balance'); ?></td>
|
||
|
|
<th class="font-weight-bold text-center" id="td_head_patient_balance" width="80"><?php echo xlt('Patient Balance'); ?></td>
|
||
|
|
<th class="font-weight-bold text-center" width="50"><?php echo xlt('Paying'); ?></th>
|
||
|
|
</tr>
|
||
|
|
</thead>
|
||
|
|
<?php
|
||
|
|
$encs = array();
|
||
|
|
|
||
|
|
// Get the unbilled service charges and payments by encounter for this patient.
|
||
|
|
//
|
||
|
|
$query = "SELECT fe.encounter, b.code_type, b.code, b.modifier, b.fee, " .
|
||
|
|
"LEFT(fe.date, 10) AS encdate ,fe.last_level_closed " .
|
||
|
|
"FROM form_encounter AS fe left join billing AS b on " .
|
||
|
|
"b.pid = ? AND b.activity = 1 AND " . //AND b.billed = 0
|
||
|
|
"b.code_type != 'TAX' AND b.fee != 0 " .
|
||
|
|
"AND fe.pid = b.pid AND fe.encounter = b.encounter " .
|
||
|
|
"where fe.pid = ? " .
|
||
|
|
"ORDER BY b.encounter";
|
||
|
|
$bres = sqlStatement($query, array($pid, $pid));
|
||
|
|
//
|
||
|
|
while ($brow = sqlFetchArray($bres)) {
|
||
|
|
$key = 0 - $brow['encounter'];
|
||
|
|
if (empty($encs[$key])) {
|
||
|
|
$encs[$key] = array(
|
||
|
|
'encounter' => $brow['encounter'],
|
||
|
|
'date' => $brow['encdate'],
|
||
|
|
'last_level_closed' => $brow['last_level_closed'],
|
||
|
|
'charges' => 0,
|
||
|
|
'payments' => 0);
|
||
|
|
}
|
||
|
|
|
||
|
|
if ($brow['code_type'] === 'COPAY') {
|
||
|
|
//$encs[$key]['payments'] -= $brow['fee'];
|
||
|
|
} else {
|
||
|
|
$encs[$key]['charges'] += $brow['fee'];
|
||
|
|
// Add taxes.
|
||
|
|
$sql_array = array();
|
||
|
|
$query = "SELECT taxrates FROM codes WHERE " .
|
||
|
|
"code_type = ? AND " .
|
||
|
|
"code = ? AND ";
|
||
|
|
array_push($sql_array, ($code_types[$brow['code_type']]['id'] ?? null), $brow['code']);
|
||
|
|
if ($brow['modifier']) {
|
||
|
|
$query .= "modifier = ?";
|
||
|
|
array_push($sql_array, $brow['modifier']);
|
||
|
|
} else {
|
||
|
|
$query .= "(modifier IS NULL OR modifier = '')";
|
||
|
|
}
|
||
|
|
|
||
|
|
$query .= " LIMIT 1";
|
||
|
|
$trow = sqlQuery($query, $sql_array);
|
||
|
|
$encs[$key]['charges'] += calcTaxes($trow, $brow['fee']);
|
||
|
|
}
|
||
|
|
}
|
||
|
|
|
||
|
|
// Do the same for unbilled product sales.
|
||
|
|
//
|
||
|
|
$query = "SELECT fe.encounter, s.drug_id, s.fee, " .
|
||
|
|
"LEFT(fe.date, 10) AS encdate,fe.last_level_closed " .
|
||
|
|
"FROM form_encounter AS fe left join drug_sales AS s " .
|
||
|
|
"on s.pid = ? AND s.fee != 0 " . //AND s.billed = 0
|
||
|
|
"AND fe.pid = s.pid AND fe.encounter = s.encounter " .
|
||
|
|
"where fe.pid = ? " .
|
||
|
|
"ORDER BY s.encounter";
|
||
|
|
|
||
|
|
$dres = sqlStatement($query, array($pid, $pid));
|
||
|
|
//
|
||
|
|
while ($drow = sqlFetchArray($dres)) {
|
||
|
|
$key = 0 - $drow['encounter'];
|
||
|
|
if (empty($encs[$key])) {
|
||
|
|
$encs[$key] = array(
|
||
|
|
'encounter' => $drow['encounter'],
|
||
|
|
'date' => $drow['encdate'],
|
||
|
|
'last_level_closed' => $drow['last_level_closed'],
|
||
|
|
'charges' => 0,
|
||
|
|
'payments' => 0);
|
||
|
|
}
|
||
|
|
|
||
|
|
$encs[$key]['charges'] += $drow['fee'];
|
||
|
|
// Add taxes.
|
||
|
|
$trow = sqlQuery("SELECT taxrates FROM drug_templates WHERE drug_id = ? " .
|
||
|
|
"ORDER BY selector LIMIT 1", array($drow['drug_id']));
|
||
|
|
$encs[$key]['charges'] += calcTaxes($trow, $drow['fee']);
|
||
|
|
}
|
||
|
|
|
||
|
|
ksort($encs, SORT_NUMERIC);
|
||
|
|
$gottoday = false;
|
||
|
|
//Bringing on top the Today always
|
||
|
|
foreach ($encs as $key => $value) {
|
||
|
|
$dispdate = $value['date'];
|
||
|
|
if (strcmp($dispdate, $today) == 0 && !$gottoday) {
|
||
|
|
$gottoday = true;
|
||
|
|
break;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
|
||
|
|
// If no billing was entered yet for today, then generate a line for
|
||
|
|
// entering today's co-pay.
|
||
|
|
//
|
||
|
|
if (!$gottoday) {
|
||
|
|
echoLine("form_upay[0]", date("Y-m-d"), 0, 0, 0, 0 /*$duept*/);//No encounter yet defined.
|
||
|
|
}
|
||
|
|
|
||
|
|
$gottoday = false;
|
||
|
|
foreach ($encs as $key => $value) {
|
||
|
|
$enc = $value['encounter'];
|
||
|
|
$dispdate = $value['date'];
|
||
|
|
if (strcmp($dispdate, $today) == 0 && !$gottoday) {
|
||
|
|
$dispdate = date("Y-m-d");
|
||
|
|
$gottoday = true;
|
||
|
|
}
|
||
|
|
//------------------------------------------------------------------------------------
|
||
|
|
$inscopay = BillingUtilities::getCopay($pid, $dispdate);
|
||
|
|
$patcopay = BillingUtilities::getPatientCopay($pid, $enc);
|
||
|
|
//Insurance Payment
|
||
|
|
//-----------------
|
||
|
|
$drow = sqlQuery(
|
||
|
|
"SELECT SUM(pay_amount) AS payments, " .
|
||
|
|
"SUM(adj_amount) AS adjustments FROM ar_activity WHERE " .
|
||
|
|
"deleted IS NULL AND pid = ? and encounter = ? and " .
|
||
|
|
"payer_type != 0 and account_code!='PCP' ",
|
||
|
|
array($pid, $enc)
|
||
|
|
);
|
||
|
|
$dpayment = $drow['payments'];
|
||
|
|
$dadjustment = $drow['adjustments'];
|
||
|
|
//Patient Payment
|
||
|
|
//---------------
|
||
|
|
$drow = sqlQuery(
|
||
|
|
"SELECT SUM(pay_amount) AS payments, " .
|
||
|
|
"SUM(adj_amount) AS adjustments FROM ar_activity WHERE " .
|
||
|
|
"deleted IS NULL AND pid = ? and encounter = ? and " .
|
||
|
|
"payer_type = 0 and account_code!='PCP' ",
|
||
|
|
array($pid, $enc)
|
||
|
|
);
|
||
|
|
$dpayment_pat = $drow['payments'];
|
||
|
|
|
||
|
|
//------------------------------------------------------------------------------------
|
||
|
|
//NumberOfInsurance
|
||
|
|
$ResultNumberOfInsurance = sqlStatement("SELECT COUNT( DISTINCT TYPE ) NumberOfInsurance FROM insurance_data
|
||
|
|
where pid = ? and provider>0 ", array($pid));
|
||
|
|
$RowNumberOfInsurance = sqlFetchArray($ResultNumberOfInsurance);
|
||
|
|
$NumberOfInsurance = $RowNumberOfInsurance['NumberOfInsurance'] * 1;
|
||
|
|
//------------------------------------------------------------------------------------
|
||
|
|
$duept = 0;
|
||
|
|
if ((($NumberOfInsurance == 0 || $value['last_level_closed'] == 4 || $NumberOfInsurance == $value['last_level_closed']))) {//Patient balance
|
||
|
|
$brow = sqlQuery("SELECT SUM(fee) AS amount FROM billing WHERE " .
|
||
|
|
"pid = ? and encounter = ? AND activity = 1", array($pid, $enc));
|
||
|
|
$srow = sqlQuery("SELECT SUM(fee) AS amount FROM drug_sales WHERE " .
|
||
|
|
"pid = ? and encounter = ? ", array($pid, $enc));
|
||
|
|
$drow = sqlQuery("SELECT SUM(pay_amount) AS payments, " .
|
||
|
|
"SUM(adj_amount) AS adjustments FROM ar_activity WHERE " .
|
||
|
|
"deleted IS NULL AND pid = ? and encounter = ? ", array($pid, $enc));
|
||
|
|
$duept = $brow['amount'] + $srow['amount'] - $drow['payments'] - $drow['adjustments'];
|
||
|
|
}
|
||
|
|
|
||
|
|
echoLine(
|
||
|
|
"form_upay[$enc]",
|
||
|
|
$dispdate,
|
||
|
|
$value['charges'],
|
||
|
|
$dpayment_pat,
|
||
|
|
($dpayment + $dadjustment),
|
||
|
|
$duept,
|
||
|
|
$enc,
|
||
|
|
$inscopay,
|
||
|
|
$patcopay
|
||
|
|
);
|
||
|
|
}
|
||
|
|
// Continue with display of the data entry form.
|
||
|
|
?>
|
||
|
|
|
||
|
|
<tr class="table-active">
|
||
|
|
<td class="font-weight-bold" id='td_total_1'></td>
|
||
|
|
<td class="font-weight-bold" id='td_total_2'></td>
|
||
|
|
<td class="font-weight-bold" id='td_total_3'></td>
|
||
|
|
<td class="font-weight-bold" id='td_total_4'></td>
|
||
|
|
<td class="font-weight-bold" id='td_total_5'></td>
|
||
|
|
<td class="font-weight-bold" id='td_total_6'></td>
|
||
|
|
<td class="font-weight-bold" id='td_total_7'></td>
|
||
|
|
<td class="font-weight-bold" id='td_total_8'></td>
|
||
|
|
<td class="font-weight-bold text-right"><?php echo xlt('Total');?></td>
|
||
|
|
<td class="font-weight-bold text-right">
|
||
|
|
<input type='text' class='form-control text-success' name='form_paytotal' value='' readonly />
|
||
|
|
</td>
|
||
|
|
</tr>
|
||
|
|
</table>
|
||
|
|
</div>
|
||
|
|
</fieldset>
|
||
|
|
<div class="form-group">
|
||
|
|
<div class="col-sm-12 text-left position-override">
|
||
|
|
<div class="form-group" role="group">
|
||
|
|
<button type='submit' class="btn btn-primary btn-save" name='form_save' value='<?php echo xla('Generate Invoice');?>'><?php echo xlt('Generate Invoice');?></button>
|
||
|
|
<?php if (!empty($GLOBALS['cc_front_payments']) && $GLOBALS['payment_gateway'] != 'InHouse') {
|
||
|
|
if ($GLOBALS['payment_gateway'] == 'Sphere') {
|
||
|
|
echo SpherePayment::renderSphereHtml('clinic');
|
||
|
|
} else {
|
||
|
|
echo '<button type="button" class="btn btn-success btn-transmit mx-1" data-toggle="modal" data-target="#openPayModal">' . xlt("Credit Card Pay") . '</button>';
|
||
|
|
if (!empty($GLOBALS['cc_stripe_terminal'])) {
|
||
|
|
echo '<button type="button" class="btn btn-success btn-transmit mx-1" onclick="posDialog()">' . xlt("POS Payment") . '</button>';
|
||
|
|
}
|
||
|
|
}
|
||
|
|
} ?>
|
||
|
|
<button type='button' class="btn btn-secondary btn-cancel" value='<?php echo xla('Cancel'); ?>' onclick='closeHow(event)'><?php echo xlt('Cancel'); ?></button>
|
||
|
|
<input type="hidden" name="hidden_patient_code" id="hidden_patient_code" value="<?php echo attr($pid);?>"/>
|
||
|
|
<input type='hidden' name='ajax_mode' id='ajax_mode' value='' />
|
||
|
|
<input type='hidden' name='mode' id='mode' value='' />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</form>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<script>
|
||
|
|
calctotal();
|
||
|
|
</script>
|
||
|
|
<!-- credit payment modal -->
|
||
|
|
<div id="openPayModal" class="modal fade" role="dialog">
|
||
|
|
<div class="modal-dialog">
|
||
|
|
<div class="modal-content">
|
||
|
|
<div class="modal-header">
|
||
|
|
<h4><?php echo xlt('Submit Payment for Authorization'); ?></h4>
|
||
|
|
</div>
|
||
|
|
<div class="modal-body">
|
||
|
|
<?php if ($GLOBALS['payment_gateway'] == 'AuthorizeNet') { ?>
|
||
|
|
<form id='paymentForm' method='post' action='./front_payment_cc.php'>
|
||
|
|
<fieldset>
|
||
|
|
<div class="form-group">
|
||
|
|
<label
|
||
|
|
class="control-label"><?php echo xlt('Name on Card'); ?></label>
|
||
|
|
<div class="controls">
|
||
|
|
<input name="cardHolderName" id="cardHolderName" type="text" class="form-control"
|
||
|
|
pattern="\w+ \w+.*"
|
||
|
|
title="<?php echo xla('Fill your first and last name'); ?>"
|
||
|
|
value="<?php echo attr($patdata['fname']) . ' ' . attr($patdata['lname']) ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="form-group">
|
||
|
|
<div class="row">
|
||
|
|
<div class="col-sm-6">
|
||
|
|
<label class="control-label"><?php echo xlt('Card Number'); ?></label>
|
||
|
|
<input name="cardNumber" id="cardNumber" type="text"
|
||
|
|
class="form-control"
|
||
|
|
autocomplete="off" maxlength="19" pattern="\d"
|
||
|
|
onchange="validateCC()"
|
||
|
|
title="<?php echo xla('Card Number'); ?>" value="" />
|
||
|
|
</div>
|
||
|
|
<span class="col-sm-6">
|
||
|
|
<label class="control-label"><?php echo xlt('Entry Status'); ?></label>
|
||
|
|
<h5 name="cardtype" id="cardtype" style="color:#cc0000;"><?php echo xlt('Validating') ?></h5>
|
||
|
|
</span>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="form-group">
|
||
|
|
<label
|
||
|
|
class="control-label"><?php echo xlt('Card Expiry Date and Card Holders Zip'); ?></label>
|
||
|
|
<div class="row">
|
||
|
|
<div class="col-md-4">
|
||
|
|
<select name="month" id="expMonth" class="form-control">
|
||
|
|
<option value=""><?php echo xlt('Select Month'); ?></option>
|
||
|
|
<option value="01"><?php echo xlt('January'); ?></option>
|
||
|
|
<option value="02"><?php echo xlt('February'); ?></option>
|
||
|
|
<option value="03"><?php echo xlt('March'); ?></option>
|
||
|
|
<option value="04"><?php echo xlt('April'); ?></option>
|
||
|
|
<option value="05"><?php echo xlt('May'); ?></option>
|
||
|
|
<option value="06"><?php echo xlt('June'); ?></option>
|
||
|
|
<option value="07"><?php echo xlt('July'); ?></option>
|
||
|
|
<option value="08"><?php echo xlt('August'); ?></option>
|
||
|
|
<option value="09"><?php echo xlt('September'); ?></option>
|
||
|
|
<option value="10"><?php echo xlt('October'); ?></option>
|
||
|
|
<option value="11"><?php echo xlt('November'); ?></option>
|
||
|
|
<option value="12"><?php echo xlt('December'); ?></option>
|
||
|
|
</select>
|
||
|
|
</div>
|
||
|
|
<div class="col-md-4">
|
||
|
|
<select name="year" id="expYear" class="form-control">
|
||
|
|
<option value=""><?php echo xlt('Select Year'); ?></option>
|
||
|
|
<option value="2021">2021</option>
|
||
|
|
<option value="2022">2022</option>
|
||
|
|
<option value="2023">2023</option>
|
||
|
|
<option value="2024">2024</option>
|
||
|
|
<option value="2025">2025</option>
|
||
|
|
<option value="2026">2026</option>
|
||
|
|
<option value="2027">2027</option>
|
||
|
|
<option value="2028">2028</option>
|
||
|
|
<option value="2028">2029</option>
|
||
|
|
<option value="2028">2030</option>
|
||
|
|
</select>
|
||
|
|
</div>
|
||
|
|
<div class="col-md-4">
|
||
|
|
<input name="zip" id="cczip" type="text" class="form-control"
|
||
|
|
pattern="\d"
|
||
|
|
title="<?php echo xla('Enter Your Zip'); ?>"
|
||
|
|
placeholder="<?php echo xla('Card Holder Zip'); ?>"
|
||
|
|
value="<?php echo attr($patdata['postal_code']) ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="form-group">
|
||
|
|
<label class="control-label"><?php echo xlt('Card CVV'); ?></label>
|
||
|
|
<div class="row">
|
||
|
|
<div class="col-md-3">
|
||
|
|
<input name="cardCode" id="cardCode" type="text" class="form-control"
|
||
|
|
autocomplete="off" maxlength="4" onfocus="validateCC()"
|
||
|
|
title="<?php echo xla('Three or four digits at back of your card'); ?>"
|
||
|
|
value="" />
|
||
|
|
</div>
|
||
|
|
<div class="col-md-3">
|
||
|
|
<img src='./../../portal/images/img_cvc.png' style='height: 40px; width: auto'>
|
||
|
|
</div>
|
||
|
|
<div class="col-md-6">
|
||
|
|
<h4 style="display: inline-block;"><?php echo xlt('Payment Amount'); ?>:
|
||
|
|
<strong><span id="payTotal"></span></strong></h4>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<input type='hidden' name='pid' id='pid' value='<?php echo attr($pid) ?>' />
|
||
|
|
<input type='hidden' name='mode' id='mode' value='' />
|
||
|
|
<input type='hidden' name='cc_type' id='cc_type' value='' />
|
||
|
|
<input type='hidden' name='payment' id='paymentAmount' value='' />
|
||
|
|
<input type='hidden' name='invValues' id='invValues' value='' />
|
||
|
|
<input type="hidden" name="dataValue" id="dataValue" />
|
||
|
|
<input type="hidden" name="dataDescriptor" id="dataDescriptor" />
|
||
|
|
</fieldset>
|
||
|
|
</form>
|
||
|
|
<?php }
|
||
|
|
if ($GLOBALS['payment_gateway'] == 'Stripe') { ?>
|
||
|
|
<form class="form" method="post" name="payment-form" id="payment-form">
|
||
|
|
<fieldset>
|
||
|
|
<div class="form-group">
|
||
|
|
<label for="cardHolderName" class="control-label"><?php echo xlt('Name on Card'); ?></label>
|
||
|
|
<input name="cardHolderName" id="cardHolderName" type="text"
|
||
|
|
class="form-control"
|
||
|
|
pattern="\w+ \w+.*"
|
||
|
|
title="<?php echo xla('Fill your first and last name'); ?>"
|
||
|
|
value="<?php echo attr($patdata['fname']) . ' ' . attr($patdata['lname']) ?>" />
|
||
|
|
</div>
|
||
|
|
<div class="form-group">
|
||
|
|
<label for="card-element"><?php echo xlt('Credit or Debit Card') ?></label>
|
||
|
|
<div class="form-group" id="card-element"></div>
|
||
|
|
<div class="text-danger" id="card-errors" role="alert"></div>
|
||
|
|
</div>
|
||
|
|
<div class="form-row">
|
||
|
|
<?php echo xlt('Payment Amount'); ?>: <span id="payTotal"></span>
|
||
|
|
</div>
|
||
|
|
<input type='hidden' name='mode' id='mode' value='' />
|
||
|
|
<input type='hidden' name='cc_type' id='cc_type' value='' />
|
||
|
|
<input type='hidden' name='payment' id='paymentAmount' value='' />
|
||
|
|
<input type='hidden' name='invValues' id='invValues' value='' />
|
||
|
|
<input type='hidden' name='encs' id='encs' value='' />
|
||
|
|
</fieldset>
|
||
|
|
</form>
|
||
|
|
<?php } ?>
|
||
|
|
</div>
|
||
|
|
<!-- Body -->
|
||
|
|
<div class="modal-footer">
|
||
|
|
<div class="button-group">
|
||
|
|
<button type="button" class="btn btn-default" data-dismiss="modal"><?php echo xlt('Cancel'); ?></button>
|
||
|
|
<?php
|
||
|
|
if ($GLOBALS['payment_gateway'] == 'AuthorizeNet') { ?>
|
||
|
|
<button id="payAurhorizeNet" class="btn btn-primary"
|
||
|
|
onclick="sendPaymentDataToAnet(event)"><?php echo xlt('Pay Now'); ?></button>
|
||
|
|
<?php }
|
||
|
|
if ($GLOBALS['payment_gateway'] == 'Stripe') { ?>
|
||
|
|
<button id="stripeSubmit" class="btn btn-primary"><?php echo xlt('Pay Now'); ?></button>
|
||
|
|
<?php } ?>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
|
||
|
|
<?php if ($GLOBALS['payment_gateway'] == 'AuthorizeNet') {
|
||
|
|
// Include Authorize.Net dependency to tokenize card.
|
||
|
|
// Will return a token to use for payment request keeping
|
||
|
|
// credit info off the server.
|
||
|
|
?>
|
||
|
|
<script>
|
||
|
|
var ccerr = <?php echo xlj('Invalid Credit Card Number'); ?>
|
||
|
|
|
||
|
|
// In House CC number Validation
|
||
|
|
$('#cardNumber').validateCreditCard(function (result) {
|
||
|
|
var r = (result.card_type === null ? '' : result.card_type.name.toUpperCase())
|
||
|
|
var v = (result.valid === true ? ' Valid Number' : ' Validating')
|
||
|
|
if (result.valid === true) {
|
||
|
|
document.getElementById("cardtype").style.color = "#00aa00";
|
||
|
|
} else {
|
||
|
|
document.getElementById("cardtype").style.color = "#aa0000";
|
||
|
|
}
|
||
|
|
$('#cardtype').text(r + v);
|
||
|
|
});
|
||
|
|
|
||
|
|
// Authorize.net
|
||
|
|
function validateCC() {
|
||
|
|
var result = $('#cardNumber').validateCreditCard();
|
||
|
|
var r = (result.card_type == null ? '' : result.card_type.name.toUpperCase())
|
||
|
|
var v = (result.valid === true ? ' Valid Card Number' : ' Invalid Card Number')
|
||
|
|
if (result.valid === true) {
|
||
|
|
document.getElementById("cardtype").style.color = "#00aa00";
|
||
|
|
} else {
|
||
|
|
document.getElementById("cardtype").style.color = "#aa0000";
|
||
|
|
}
|
||
|
|
$('#cardtype').text(r + v);
|
||
|
|
$('#cc_type').val(r);
|
||
|
|
if (!result.valid) {
|
||
|
|
alert(ccerr);
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
else {
|
||
|
|
return true;
|
||
|
|
}
|
||
|
|
}
|
||
|
|
|
||
|
|
function sendPaymentDataToAnet(e) {
|
||
|
|
e.preventDefault();
|
||
|
|
const authData = {};
|
||
|
|
authData.clientKey = publicKey;
|
||
|
|
authData.apiLoginID = apiKey;
|
||
|
|
|
||
|
|
const cardData = {};
|
||
|
|
cardData.cardNumber = document.getElementById("cardNumber").value;
|
||
|
|
cardData.month = document.getElementById("expMonth").value;
|
||
|
|
cardData.year = document.getElementById("expYear").value;
|
||
|
|
cardData.cardCode = document.getElementById("cardCode").value;
|
||
|
|
cardData.fullName = document.getElementById("cardHolderName").value;
|
||
|
|
cardData.zip = document.getElementById("cczip").value;
|
||
|
|
|
||
|
|
const secureData = {};
|
||
|
|
secureData.authData = authData;
|
||
|
|
secureData.cardData = cardData;
|
||
|
|
|
||
|
|
Accept.dispatchData(secureData, acceptResponseHandler);
|
||
|
|
|
||
|
|
function acceptResponseHandler(response) {
|
||
|
|
if (response.messages.resultCode === "Error") {
|
||
|
|
let i = 0;
|
||
|
|
let errorMsg = '';
|
||
|
|
while (i < response.messages.message.length) {
|
||
|
|
errorMsg = errorMsg + response.messages.message[i].code + ": " +response.messages.message[i].text;
|
||
|
|
console.log(errorMsg);
|
||
|
|
i = i + 1;
|
||
|
|
}
|
||
|
|
alert(errorMsg);
|
||
|
|
} else {
|
||
|
|
paymentFormUpdate(response.opaqueData);
|
||
|
|
}
|
||
|
|
}
|
||
|
|
}
|
||
|
|
|
||
|
|
function paymentFormUpdate(opaqueData) {
|
||
|
|
// this is card tokenized
|
||
|
|
document.getElementById("dataDescriptor").value = opaqueData.dataDescriptor;
|
||
|
|
document.getElementById("dataValue").value = opaqueData.dataValue;
|
||
|
|
let oForm = document.forms['paymentForm'];
|
||
|
|
oForm.elements['mode'].value = "AuthorizeNet";
|
||
|
|
// empty out the fields before submitting to server.
|
||
|
|
document.getElementById("cardNumber").value = "";
|
||
|
|
document.getElementById("expMonth").value = "";
|
||
|
|
document.getElementById("expYear").value = "";
|
||
|
|
document.getElementById("cardCode").value = "";
|
||
|
|
|
||
|
|
// Submit payment to server
|
||
|
|
fetch('./front_payment_cc.php', {
|
||
|
|
method: 'POST',
|
||
|
|
body: new FormData(oForm)
|
||
|
|
}).then((response) => {
|
||
|
|
if (!response.ok) {
|
||
|
|
throw Error(response.statusText);
|
||
|
|
}
|
||
|
|
return response.json();
|
||
|
|
}).then(function(data) {
|
||
|
|
if(data.status !== 'ok') {
|
||
|
|
alert(data);
|
||
|
|
return;
|
||
|
|
}
|
||
|
|
document.getElementById("check_number").value = data.authCode;
|
||
|
|
alert(chargeMsg + "\n" + 'Auth: ' + data.authCode + ' TransId: ' + data.transId);
|
||
|
|
$("[name='form_save']").click();
|
||
|
|
}).catch(function(error) {
|
||
|
|
alert(error)
|
||
|
|
});
|
||
|
|
}
|
||
|
|
</script>
|
||
|
|
<?php } // end authorize.net ?>
|
||
|
|
|
||
|
|
<?php if ($GLOBALS['payment_gateway'] == 'Stripe') { // Begin Include Stripe ?>
|
||
|
|
<script>
|
||
|
|
// await validation function.
|
||
|
|
const waitValidate = async (state = false) => {
|
||
|
|
return await validate(state);
|
||
|
|
}
|
||
|
|
const stripe = Stripe(publicKey);
|
||
|
|
const elements = stripe.elements();
|
||
|
|
const style = {
|
||
|
|
base: {
|
||
|
|
color: '#32325d',
|
||
|
|
lineHeight: '1.2rem',
|
||
|
|
fontSmoothing: 'antialiased',
|
||
|
|
'::placeholder': {
|
||
|
|
color: '#ccc'
|
||
|
|
}
|
||
|
|
},
|
||
|
|
invalid: {
|
||
|
|
color: '#f42c03',
|
||
|
|
iconColor: '#ff0000'
|
||
|
|
}
|
||
|
|
|
||
|
|
};
|
||
|
|
// Create an instance of the card Element.
|
||
|
|
const card = elements.create('card', {style: style});
|
||
|
|
// Add an instance of the card Element into the `card-element` <div>.
|
||
|
|
card.mount('#card-element');
|
||
|
|
// Handle real-time validation errors from the card Element.
|
||
|
|
card.addEventListener('change', function (event) {
|
||
|
|
let displayError = document.getElementById('card-errors');
|
||
|
|
if (event.error) {
|
||
|
|
displayError.textContent = event.error.message;
|
||
|
|
} else {
|
||
|
|
displayError.textContent = '';
|
||
|
|
}
|
||
|
|
});
|
||
|
|
// Handle form submission.
|
||
|
|
let form = document.getElementById('stripeSubmit');
|
||
|
|
form.addEventListener('click', function (event) {
|
||
|
|
event.preventDefault();
|
||
|
|
stripe.createToken(card).then(function (result) {
|
||
|
|
if (result.error) {
|
||
|
|
// Inform the user if there was an error.
|
||
|
|
let errorElement = document.getElementById('card-errors');
|
||
|
|
errorElement.textContent = result.error.message;
|
||
|
|
} else {
|
||
|
|
// Send the token to server.
|
||
|
|
stripeTokenHandler(result.token);
|
||
|
|
}
|
||
|
|
});
|
||
|
|
});
|
||
|
|
|
||
|
|
// Submit the form with the token ID.
|
||
|
|
function stripeTokenHandler(token) {
|
||
|
|
// below for manual cc audit
|
||
|
|
const encDates = (() => {
|
||
|
|
let i = 0, c;
|
||
|
|
let invDates = '';
|
||
|
|
$('#table_display tbody tr').each(function () {
|
||
|
|
if (this.className == 'table-active') {
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
if(i > 4) {
|
||
|
|
return false; // breaks on max 5 encounters
|
||
|
|
}
|
||
|
|
invDates += 'item' + ++i + ': ';
|
||
|
|
c = 0;
|
||
|
|
$(this).find('td').each(function() {
|
||
|
|
if (++c < 3) {
|
||
|
|
invDates += this.innerText + ' ';
|
||
|
|
}
|
||
|
|
})
|
||
|
|
});
|
||
|
|
return invDates;
|
||
|
|
})();
|
||
|
|
// Insert the token ID into the form so it gets submitted to the server
|
||
|
|
let oForm = document.forms['payment-form'];
|
||
|
|
oForm.elements['mode'].value = "Stripe";
|
||
|
|
oForm.elements['encs'].value = encDates;
|
||
|
|
|
||
|
|
let hiddenInput = document.createElement('input');
|
||
|
|
hiddenInput.setAttribute('type', 'hidden');
|
||
|
|
hiddenInput.setAttribute('name', 'stripeToken');
|
||
|
|
hiddenInput.setAttribute('value', token.id);
|
||
|
|
oForm.appendChild(hiddenInput);
|
||
|
|
|
||
|
|
// Submit payment to server
|
||
|
|
fetch('./front_payment_cc.php', {
|
||
|
|
method: 'POST',
|
||
|
|
body: new FormData(oForm)
|
||
|
|
}).then((response) => {
|
||
|
|
if (!response.ok) {
|
||
|
|
throw Error(response.statusText);
|
||
|
|
}
|
||
|
|
return response.json();
|
||
|
|
}).then(function (data) {
|
||
|
|
if (data.status !== 'ok') {
|
||
|
|
alert(data);
|
||
|
|
return;
|
||
|
|
}
|
||
|
|
document.getElementById("check_number").value = data.transId;
|
||
|
|
alert(chargeMsg + "\n" + 'Auth: ' + data.authCode + ' TransId: ' + data.transId);
|
||
|
|
$("[name='form_save']").click();
|
||
|
|
}).catch(function (error) {
|
||
|
|
alert(error.message);
|
||
|
|
});
|
||
|
|
}
|
||
|
|
// terminal
|
||
|
|
<?php if (!empty($GLOBALS['cc_stripe_terminal'])) { ?>
|
||
|
|
// Dialog function for Stripe terminal payment.
|
||
|
|
// Will post on successful credit payment.
|
||
|
|
function posDialog() {
|
||
|
|
// to pass validation check and saving a user having to click.
|
||
|
|
$("#form_method").val('credit_card');
|
||
|
|
// let's validate prior to collect payment from terminal
|
||
|
|
// we'll use an await and validate promise to proceed.
|
||
|
|
waitValidate(true).then((validateOk) => {
|
||
|
|
// validation failed for some reason that user is aware
|
||
|
|
// by alerts or a quite fail we'll handle.
|
||
|
|
if (validateOk === false || typeof validateOk === 'undefined') {
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
// if 2 then need an encounter so credit is no no!
|
||
|
|
// 1 would be posting against old encounter. will allow.
|
||
|
|
if (validateOk === 2) {
|
||
|
|
alert(xl("Must have an encounter to take credit card payment."));
|
||
|
|
return true;
|
||
|
|
}
|
||
|
|
let total = $("[name='form_paytotal']").val();
|
||
|
|
let prepay = $("#form_prepayment").val();
|
||
|
|
// just to be sure. validate() should catch...
|
||
|
|
if (Number(total) < 1) {
|
||
|
|
if (Number(prepay) < 1) {
|
||
|
|
let error = xl("Please enter a payment amount");
|
||
|
|
alert(error);
|
||
|
|
return false;
|
||
|
|
}
|
||
|
|
total = prepay;
|
||
|
|
}
|
||
|
|
$("#payTotal").text(total);
|
||
|
|
$("#paymentAmount").val(total);
|
||
|
|
let title = xl("POS Payment");
|
||
|
|
let url = "./front_payment_terminal.php?total=" + encodeURIComponent(total);
|
||
|
|
dlgopen(url, 'terminal', 'modal-md', '550', '', title, {
|
||
|
|
buttons: [
|
||
|
|
{text: xl('Cancel'), close: false, id: "closeBtn", style: 'secondary btn-cancel'}
|
||
|
|
]
|
||
|
|
});
|
||
|
|
});
|
||
|
|
}
|
||
|
|
<?php } ?>
|
||
|
|
</script>
|
||
|
|
<?php } ?>
|
||
|
|
|
||
|
|
<?php
|
||
|
|
if ($GLOBALS['payment_gateway'] == 'Sphere') {
|
||
|
|
echo (new SpherePayment('clinic', $pid))->renderSphereJs();
|
||
|
|
}
|
||
|
|
?>
|
||
|
|
|
||
|
|
</div><!--end of container div of accept payment i.e the form-->
|
||
|
|
<?php
|
||
|
|
$oemr_ui->oeBelowContainerDiv();
|
||
|
|
} // forms else close
|
||
|
|
?>
|
||
|
|
</body>
|
||
|
|
</html>
|