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339 lines
11 KiB
339 lines
11 KiB
2 years ago
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<?php
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/**
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* This module is used to find and add insurance companies.
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* It is opened as a popup window. The opener may have a
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* JavaScript function named set_insurance(id, name), in which
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* case selecting or adding an insurance company will cause the
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* function to be called passing the ID and name of that company.
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*
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* When used for searching, this module will in turn open another
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* popup window ins_list.php, which lists the matched results and
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* permits selection of one of them via the same set_insurance()
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* function.
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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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* @author Tyler Wrenn <tyler@tylerwrenn.com>
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* @copyright Copyright (c) 2005 Rod Roark <rod@sunsetsystems.com>
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* @copyright Copyright (c) 2018 Brady Miller <brady.g.miller@gmail.com>
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* @copyright Copyright (c) 2020 Tyler Wrenn <tyler@tylerwrenn.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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use OpenEMR\Common\Csrf\CsrfUtils;
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use OpenEMR\Core\Header;
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use OpenEMR\Services\InsuranceCompanyService;
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// Putting a message here will cause a popup window to display it.
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$info_msg = "";
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// Grab insurance type codes from service
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$insuranceCompany = new InsuranceCompanyService();
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$ins_type_code_array = $insuranceCompany->getInsuranceTypes();
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?>
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<html>
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<head>
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<title><?php echo xlt('Insurance Company Search/Add');?></title>
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<?php Header::setupHeader(['opener','topdialog']); ?>
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<style>
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td {
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font-size: 0.8125rem;
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}
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#form_entry {
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display: block;
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}
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#form_list {
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display: none;
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}
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</style>
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<script>
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<?php require($GLOBALS['srcdir'] . "/restoreSession.php"); ?>
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// This is invoked when our Search button is clicked.
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function dosearch() {
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$("#form_entry").hide();
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var f = document.forms[0];
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var search_list = 'ins_list.php' +
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'?form_name=' + encodeURIComponent(f.form_name.value ) +
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'&form_attn=' + encodeURIComponent(f.form_attn.value ) +
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'&form_addr1=' + encodeURIComponent(f.form_addr1.value ) +
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'&form_addr2=' + encodeURIComponent(f.form_addr2.value ) +
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'&form_city=' + encodeURIComponent(f.form_city.value ) +
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'&form_state=' + encodeURIComponent(f.form_state.value ) +
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'&form_zip=' + encodeURIComponent(f.form_zip.value ) +
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'&form_phone=' + encodeURIComponent(f.form_phone.value ) +
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'&form_cms_id=' + encodeURIComponent(f.form_cms_id.value) +
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'&csrf_token_form=' + <?php echo js_url(CsrfUtils::collectCsrfToken()); ?>;
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top.restoreSession();
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$("#form_list").load( search_list ).show();
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return false;
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}
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// The ins_list.php window calls this to set the selected insurance.
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function set_insurance(ins_id, ins_name) {
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if (opener.closed || ! opener.set_insurance)
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alert('The target form was closed; I cannot apply your selection.');
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else
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opener.set_insurance(ins_id, ins_name);
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dlgclose('InsSaveClose',false);
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}
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// This is set to true on a mousedown of the Save button. The
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// reason is so we can distinguish between clicking on the Save
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// button vs. hitting the Enter key, as we prefer the "default"
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// action to be search and not save.
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var save_clicked = false;
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// Onsubmit handler.
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function validate(f) {
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// If save was not clicked then default to searching.
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if (! save_clicked) return dosearch();
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save_clicked = false;
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msg = '';
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if (! f.form_name.value.length ) msg += 'Company name is missing. ';
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if (! f.form_addr1.value.length) msg += 'Address is missing. ';
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if (! f.form_city.value.length ) msg += 'City is missing. ';
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if (! f.form_state.value.length) msg += 'State is missing. ';
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if (! f.form_zip.value.length ) msg += 'Zip is missing.';
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if (msg) {
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alert(msg);
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return false;
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}
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top.restoreSession();
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return true;
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}
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</script>
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</head>
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<body class="body_top">
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<?php
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// If we are saving, then save and close the window.
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//
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if ($_POST['form_save'] ?? '') {
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if (!CsrfUtils::verifyCsrfToken($_POST["csrf_token_form"])) {
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CsrfUtils::csrfNotVerified();
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}
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$ins_id = '';
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$ins_name = $_POST['form_name'];
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if ($ins_id) {
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// sql for updating could go here if this script is enhanced to support
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// editing of existing insurance companies.
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} else {
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$ins_id = $insuranceCompany->insert(
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array(
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'name' => $ins_name,
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'attn' => $_POST['form_attn'],
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'cms_id' => $_POST['form_cms_id'],
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'ins_type_code' => $_POST['form_ins_type_code'],
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'x12_receiver_id' => $_POST['form_partner'],
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'x12_default_parter_id' => $_POST['form_partner'],
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'alt_cms_id' => null,
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'line1' => $_POST['form_addr1'],
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'line2' => $_POST['form_addr2'],
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'city' => $_POST['form_city'],
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'state' => $_POST['form_state'],
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'zip' => $_POST['form_zip'],
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'country' => $_POST['form_country'],
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'foreign_id' => $ins_id,
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'cqm_sop' => $_POST['form_cqm_sop']
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)
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);
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$phone_parts = array();
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preg_match(
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"/(\d\d\d)\D*(\d\d\d)\D*(\d\d\d\d)/",
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$_POST['form_phone'],
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$phone_parts
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);
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if (!empty($phone_parts)) {
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sqlStatement("INSERT INTO phone_numbers ( " .
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"id, country_code, area_code, prefix, number, type, foreign_id " .
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") VALUES ( " .
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"'" . add_escape_custom(generate_id()) . "', " .
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"'+1'" . ", " .
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"'" . add_escape_custom($phone_parts[1] ?? '') . "', " .
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"'" . add_escape_custom($phone_parts[2] ?? '') . "', " .
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"'" . add_escape_custom($phone_parts[3] ?? '') . "', " .
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"'2'" . ", " .
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"'" . add_escape_custom($ins_id) . "' " .
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")");
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}
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}
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// Close this window and tell our opener to select the new company.
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//
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echo "<script>\n";
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if ($info_msg) {
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echo " alert(" . js_escape($info_msg) . ");\n";
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}
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echo " top.restoreSession();\n";
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echo " if (opener.set_insurance) opener.set_insurance(" . js_escape($ins_id) . "," . js_escape($ins_name) . ");\n";
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echo " dlgclose();\n";
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echo "</script></body></html>\n";
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exit();
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}
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// Query x12_partners.
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$xres = sqlStatement(
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"SELECT id, name FROM x12_partners ORDER BY name"
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);
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?>
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<div id="form_entry">
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<form method='post' name='theform' action='ins_search.php' onsubmit='return validate(this)'>
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<input type="hidden" name="csrf_token_form" value="<?php echo attr(CsrfUtils::collectCsrfToken()); ?>" />
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<center>
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<p>
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<table class="w-100 border-0">
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<tr>
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<td class="font-weight-bold" width='1%' nowrap><?php echo xlt('Name'); ?>:</td>
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<td>
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<input type='text' size='20' name='form_name' maxlength='35' class='form-control form-control-sm' title='<?php echo xla('Name of insurance company'); ?>' />
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</td>
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</tr>
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<tr>
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<td class="font-weight-bold" nowrap><?php echo xlt('Attention');?>:</td>
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<td>
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<input type='text' size='20' name='form_attn' maxlength='35' class='form-control form-control-sm' title='<?php echo xla('Contact name'); ?>' />
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</td>
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</tr>
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<tr>
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<td class="font-weight-bold" nowrap><?php echo xlt('Address1'); ?>:</td>
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<td>
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<input type='text' size='20' name='form_addr1' maxlength='35' class='form-control form-control-sm' title='First address line' />
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</td>
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</tr>
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<tr>
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<td class="font-weight-bold" nowrap><?php echo xlt('Address2'); ?>:</td>
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<td>
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<input type='text' size='20' name='form_addr2' maxlength='35' class='form-control form-control-sm' title='Second address line, if any' />
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</td>
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</tr>
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<tr>
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<td class="font-weight-bold" nowrap><?php echo xlt('City/State'); ?>:</td>
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<td class="form-row">
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<div class="col">
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<input type='text' size='20' name='form_city' maxlength='25' class='form-control form-control-sm' title='City name' />
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</div>
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<div class="col">
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<input type='text' size='3' name='form_state' maxlength='35' class='form-control form-control-sm' title='State or locality' />
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</div>
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</td>
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</tr>
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<tr>
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<td class="font-weight-bold" nowrap><?php echo xlt('Zip/Country:'); ?></td>
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<td class="form-row">
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<div class="col">
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<input type='text' size='20' name='form_zip' maxlength='10' class='form-control form-control-sm' title='Postal code' />
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</div>
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<div class="col">
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<input type='text' size='20' class="form-control form-control-sm" name='form_country' value='USA' maxlength='35' title='Country name' />
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</div>
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</td>
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</tr>
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<tr>
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<td class="font-weight-bold" nowrap><?php echo xlt('Phone'); ?>:</td>
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<td>
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<input type='text' size='20' name='form_phone' maxlength='20' class='form-control form-control-sm' title='Telephone number' />
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</td>
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</tr>
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<tr>
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<td class="font-weight-bold" nowrap><?php echo xlt('Payer ID'); ?>:</td>
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<td>
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<input type='text' size='20' name='form_cms_id' maxlength='15' class='form-control form-control-sm' title='Identifier assigned by CMS' />
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</td>
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</tr>
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<tr>
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<td class="font-weight-bold" nowrap><?php echo xlt('Payer Type'); ?>:</td>
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<td>
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<select name='form_ins_type_code' class="form-control form-control-sm">
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<?php
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for ($i = 1; $i < count($ins_type_code_array); ++$i) {
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echo " <option value='" . attr($i) . "'";
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echo ">" . text($ins_type_code_array[$i]) . "\n";
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}
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?>
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</select>
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</td>
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</tr>
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<tr>
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<td class="font-weight-bold" nowrap><?php echo xlt('X12 Partner'); ?>:</td>
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<td>
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<select name='form_partner' title='Default X12 Partner' class="form-control form-control-sm">
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<option value=""><?php echo '-- ' . xlt('None{{Partner}}') . ' --'; ?></option>
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<?php
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while ($xrow = sqlFetchArray($xres)) {
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echo " <option value='" . attr($xrow['id']) . "'";
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echo ">" . text($xrow['name']) . "</option>\n";
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}
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?>
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</select>
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</td>
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</tr>
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<tr>
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<td class="font-weight-bold" nowrap><?php echo xlt('CQM Source of Payment'); ?>:</td>
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<td>
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<select name='form_cqm_sop' title='CQM Source of Payment' class="form-control form-control-sm">
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<option value=""><?php echo '-- ' . xlt('None{{CQM SOP}}') . ' --'; ?></option>
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<?php
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$cqm_sop_array = $insuranceCompany->getInsuranceCqmSop();
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foreach ($cqm_sop_array as $key => $value) {
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echo " <option value='" . attr($key) . "'";
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echo ">" . text($value) . "</option>\n";
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}
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?>
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</select>
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</td>
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</tr>
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</table>
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<input type='button' value='<?php echo xla('Search'); ?>' class='btn btn-primary' onclick='dosearch()' />
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<input type='submit' value='<?php echo xla('Save as New'); ?>' class='btn btn-primary' name='form_save' onmousedown='save_clicked=true' />
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<input type='button' value='<?php echo xla('Cancel'); ?>' class='btn btn-primary' onclick='window.close();'/>
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</center>
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</form>
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</div>
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<div id="form_list">
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</div>
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</body>
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</html>
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