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openemr/interface/billing/edit_payment.php

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<?php
/*
* Payments can be edited here whch includes deletion of an allocation, modifying the
* same or adding a new allocation. Log is kept for the deleted ones.
* The functions of this class support the billing process like the script billing_process.php.
*
* @package OpenEMR
* @link http://www.open-emr.org
* @author Eldho Chacko <eldho@zhservices.com>
* @author Paul Simon K <paul@zhservices.com>
* @author Stephen Waite <stephen.waite@cmsvt.com>
* @author Brady Miller <brady.g.miller@gmail.com>
* @author Rod Roark <rod@sunsetsystems.com>
* @copyright Copyright (c) 2010 Z&H Consultancy Services Private Limited <sam@zhservices.com>
* @copyright Copyright (C) 2018-2020 Stephen Waite <stephen.waite@cmsvt.com>
* @copyright Copyright (c) 2019-2020 Brady Miller <brady.g.miller@gmail.com>
* @copyright Copyright (c) 2020 Rod Roark <rod@sunsetsystems.com>
* @license https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
*/
require_once("../globals.php");
require_once("$srcdir/auth.inc");
require_once("../../custom/code_types.inc.php");
require_once("$srcdir/patient.inc");
require_once("$srcdir/options.inc.php");
require_once("$srcdir/payment.inc.php");
use OpenEMR\Common\Acl\AclMain;
use OpenEMR\Common\Twig\TwigContainer;
use OpenEMR\Core\Header;
if (!AclMain::aclCheckCore('acct', 'bill', '', 'write') && !AclMain::aclCheckCore('acct', 'eob', '', 'write')) {
echo (new TwigContainer(null, $GLOBALS['kernel']))->getTwig()->render('core/unauthorized.html.twig', ['pageTitle' => xl("Confirm Payment")]);
exit;
}
$screen = 'edit_payment';
// Deletion of payment distribution code
if (isset($_POST["mode"])) {
if ($_POST["mode"] == "DeletePaymentDistribution") {
$DeletePaymentDistributionId = (isset($_POST['DeletePaymentDistributionId']) ? trim($_POST['DeletePaymentDistributionId']) : '');
$DeletePaymentDistributionIdArray = explode('_', $DeletePaymentDistributionId);
$payment_id = $DeletePaymentDistributionIdArray[0];
$PId = $DeletePaymentDistributionIdArray[1];
$Encounter = $DeletePaymentDistributionIdArray[2];
$Code = $DeletePaymentDistributionIdArray[3];
$Modifier = $DeletePaymentDistributionIdArray[4];
$Codetype = $DeletePaymentDistributionIdArray[5];
//delete and log that action
row_modify(
"ar_activity",
"deleted = NOW()",
"session_id = '" . add_escape_custom($payment_id) . "' AND " .
"pid = '" . add_escape_custom($PId) . "' AND " .
"deleted IS NULL AND " .
"encounter = '" . add_escape_custom($Encounter) . "' AND " .
"code_type = '" . add_escape_custom($Codetype) . "' AND " .
"code = '" . add_escape_custom($Code) . "' AND " .
"modifier='" . add_escape_custom($Modifier) . "'"
);
$Message = 'Delete';
//------------------
$_POST["mode"] = "searchdatabase";
}
}
//===============================================================================
//Modify Payment Code.
//===============================================================================
if (isset($_POST["mode"])) {
if ($_POST["mode"] == "ModifyPayments" || $_POST["mode"] == "FinishPayments") {
$payment_id = $_REQUEST['payment_id'];
//ar_session Code
//===============================================================================
if (trim($_POST['type_name']) == 'insurance') {
$QueryPart = "payer_id = '" . trim(formData('hidden_type_code')) .
"', patient_id = '" . 0;
} elseif (trim($_POST['type_name']) == 'patient') {
$QueryPart = "payer_id = '" . 0 .
"', patient_id = '" . trim(formData('hidden_type_code'));
}
$user_id = $_SESSION['authUserID'];
$closed = 0;
$modified_time = date('Y-m-d H:i:s');
$check_date = DateToYYYYMMDD(formData('check_date'));
$deposit_date = DateToYYYYMMDD(formData('deposit_date'));
$post_to_date = DateToYYYYMMDD(formData('post_to_date'));
if ($post_to_date == '') {
$post_to_date = date('Y-m-d');
}
if ($_POST['deposit_date'] == '') {
$deposit_date = $post_to_date;
}
$global_account = "";
if (formData('global_reset') == '-0.00') {
$global_account = "', global_amount = '" . trim(formData('global_reset'));
}
sqlStatement("update ar_session set " .
$QueryPart .
"', user_id = '" . trim(add_escape_custom($user_id)) .
"', closed = '" . trim(add_escape_custom($closed)) .
"', reference = '" . trim(formData('check_number')) .
"', check_date = '" . trim(add_escape_custom($check_date)) .
"', deposit_date = '" . trim(add_escape_custom($deposit_date)) .
"', pay_total = '" . trim(formData('payment_amount')) .
"', modified_time = '" . trim(add_escape_custom($modified_time)) .
$global_account .
"', payment_type = '" . trim(formData('type_name')) .
"', description = '" . trim(formData('description')) .
"', adjustment_code = '" . trim(formData('adjustment_code')) .
"', post_to_date = '" . trim(add_escape_custom($post_to_date)) .
"', payment_method = '" . trim(formData('payment_method')) .
"' where session_id='" . add_escape_custom($payment_id) . "'");
//===============================================================================
$CountIndexAbove = $_REQUEST['CountIndexAbove'];
$CountIndexBelow = $_REQUEST['CountIndexBelow'];
$hidden_patient_code = $_REQUEST['hidden_patient_code'];
$user_id = $_SESSION['authUserID'];
$created_time = date('Y-m-d H:i:s');
//==================================================================
//UPDATION
//It is done with out deleting any old entries.
//==================================================================
for ($CountRow = 1; $CountRow <= $CountIndexAbove; $CountRow++) {
if (isset($_POST["HiddenEncounter$CountRow"])) {
$where1 = "WHERE deleted IS NULL AND session_id = '" . add_escape_custom($payment_id) .
"' AND pid ='" . trim(formData("HiddenPId$CountRow")) .
"' AND encounter = '" . trim(formData("HiddenEncounter$CountRow")) .
"' AND code_type = '" . trim(formData("HiddenCodetype$CountRow")) .
"' AND code = '" . trim(formData("HiddenCode$CountRow")) .
"' AND modifier = '" . trim(formData("HiddenModifier$CountRow")) .
"'";
$where = "$where1 AND pay_amount > 0";
if (isset($_POST["Payment$CountRow"]) && $_POST["Payment$CountRow"] * 1 > 0) {
if (trim($_POST['type_name']) == 'insurance') {
if (trim($_POST["HiddenIns$CountRow"]) == 1) {
$AccountCode = "IPP";
}
if (trim($_POST["HiddenIns$CountRow"]) == 2) {
$AccountCode = "ISP";
}
if (trim($_POST["HiddenIns$CountRow"]) == 3) {
$AccountCode = "ITP";
}
} elseif (trim($_POST['type_name']) == 'patient') {
$AccountCode = "PP";
}
$resPayment = sqlStatement("SELECT * from ar_activity $where");
if (sqlNumRows($resPayment) > 0) {
sqlStatement("UPDATE ar_activity SET deleted = NOW() $where");
}
sqlBeginTrans();
$sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment " .
"FROM ar_activity WHERE pid = '" . trim(formData("HiddenPId$CountRow")) .
"' AND encounter = '" . trim(formData("HiddenEncounter$CountRow")) . "'");
sqlStatement("insert into ar_activity set " .
"pid = '" . trim(formData("HiddenPId$CountRow")) .
"', encounter = '" . trim(formData("HiddenEncounter$CountRow")) .
"', sequence_no = '" . add_escape_custom($sequence_no['increment']) .
"', code_type = '" . trim(formData("HiddenCodetype$CountRow")) .
"', code = '" . trim(formData("HiddenCode$CountRow")) .
"', modifier = '" . trim(formData("HiddenModifier$CountRow")) .
"', payer_type = '" . trim(formData("HiddenIns$CountRow")) .
"', reason_code = '" . trim(formData("ReasonCode$CountRow")) .
"', post_time = '" . trim(add_escape_custom($created_time)) .
"', post_user = '" . trim(add_escape_custom($user_id)) .
"', session_id = '" . trim(formData('payment_id')) .
"', modified_time = '" . trim(add_escape_custom($created_time)) .
"', pay_amount = '" . trim(formData("Payment$CountRow")) .
"', adj_amount = '" . 0 .
"', account_code = '" . add_escape_custom($AccountCode) .
"'");
sqlCommitTrans();
} else {
sqlStatement("UPDATE ar_activity SET deleted = NOW() $where");
}
//==============================================================================================================================
$where = "$where1 AND adj_amount != 0";
if (isset($_POST["AdjAmount$CountRow"]) && $_POST["AdjAmount$CountRow"] * 1 !== 0) {
if (trim($_POST['type_name']) == 'insurance') {
$AdjustString = "Ins adjust Ins" . trim($_POST["HiddenIns$CountRow"]);
$AccountCode = "IA";
} elseif (trim($_POST['type_name']) == 'patient') {
$AdjustString = "Pt adjust";
$AccountCode = "PA";
}
$resPayment = sqlStatement("SELECT * from ar_activity $where");
if (sqlNumRows($resPayment) > 0) {
sqlStatement("update ar_activity set deleted = NOW() $where");
}
sqlBeginTrans();
$sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment FROM ar_activity WHERE pid = '" . trim(formData("HiddenPId$CountRow")) . "' AND encounter = '" . trim(formData("HiddenEncounter$CountRow")) . "'");
sqlStatement("insert into ar_activity set " .
"pid = '" . trim(formData("HiddenPId$CountRow")) .
"', encounter = '" . trim(formData("HiddenEncounter$CountRow")) .
"', sequence_no = '" . add_escape_custom($sequence_no['increment']) .
"', code_type = '" . trim(formData("HiddenCodetype$CountRow")) .
"', code = '" . trim(formData("HiddenCode$CountRow")) .
"', modifier = '" . trim(formData("HiddenModifier$CountRow")) .
"', payer_type = '" . trim(formData("HiddenIns$CountRow")) .
"', post_time = '" . trim(add_escape_custom($created_time)) .
"', post_user = '" . trim(add_escape_custom($user_id)) .
"', session_id = '" . trim(formData('payment_id')) .
"', modified_time = '" . trim(add_escape_custom($created_time)) .
"', pay_amount = '" . 0 .
"', adj_amount = '" . trim(formData("AdjAmount$CountRow")) .
"', memo = '" . add_escape_custom($AdjustString) .
"', account_code = '" . add_escape_custom($AccountCode) .
"'");
sqlCommitTrans();
} else {
sqlStatement("update ar_activity set deleted = NOW() $where");
}
//==============================================================================================================================
$where = "$where1 AND (memo LIKE 'Deductable%' OR memo LIKE 'Deductible%')";
if (isset($_POST["Deductible$CountRow"]) && $_POST["Deductible$CountRow"] * 1 > 0) {
$resPayment = sqlStatement("SELECT * from ar_activity $where");
if (sqlNumRows($resPayment) > 0) {
sqlStatement("update ar_activity set deleted = NOW() $where");
}
sqlBeginTrans();
$sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment FROM ar_activity WHERE pid = '" . trim(formData("HiddenPId$CountRow")) . "' AND encounter = '" . trim(formData("HiddenEncounter$CountRow")) . "'");
sqlStatement("insert into ar_activity set " .
"pid = '" . trim(formData("HiddenPId$CountRow")) .
"', encounter = '" . trim(formData("HiddenEncounter$CountRow")) .
"', sequence_no = '" . add_escape_custom($sequence_no['increment']) .
"', code_type = '" . trim(formData("HiddenCodetype$CountRow")) .
"', code = '" . trim(formData("HiddenCode$CountRow")) .
"', modifier = '" . trim(formData("HiddenModifier$CountRow")) .
"', payer_type = '" . trim(formData("HiddenIns$CountRow")) .
"', post_time = '" . trim(add_escape_custom($created_time)) .
"', post_user = '" . trim(add_escape_custom($user_id)) .
"', session_id = '" . trim(formData('payment_id')) .
"', modified_time = '" . trim(add_escape_custom($created_time)) .
"', pay_amount = '" . 0 .
"', adj_amount = '" . 0 .
"', memo = '" . "Deductible $" . trim(formData("Deductible$CountRow")) .
"', account_code = '" . "Deduct" .
"'");
sqlCommitTrans();
} else {
sqlStatement("delete from ar_activity $where");
}
//==============================================================================================================================
$where = "$where1 AND pay_amount < 0";
if (isset($_POST["Takeback$CountRow"]) && $_POST["Takeback$CountRow"] * 1 > 0) {
$resPayment = sqlStatement("SELECT * from ar_activity $where");
if (sqlNumRows($resPayment) > 0) {
sqlStatement("update ar_activity set deleted = NOW() $where");
}
sqlBeginTrans();
$sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment FROM ar_activity WHERE pid = '" . trim(formData("HiddenPId$CountRow")) . "' AND encounter = '" . trim(formData("HiddenEncounter$CountRow")) . "'");
sqlStatement("insert into ar_activity set " .
"pid = '" . trim(formData("HiddenPId$CountRow")) .
"', encounter = '" . trim(formData("HiddenEncounter$CountRow")) .
"', sequence_no = '" . add_escape_custom($sequence_no['increment']) .
"', code_type = '" . trim(formData("HiddenCodetype$CountRow")) .
"', code = '" . trim(formData("HiddenCode$CountRow")) .
"', modifier = '" . trim(formData("HiddenModifier$CountRow")) .
"', payer_type = '" . trim(formData("HiddenIns$CountRow")) .
"', post_time = '" . trim(add_escape_custom($created_time)) .
"', post_user = '" . trim(add_escape_custom($user_id)) .
"', session_id = '" . trim(formData('payment_id')) .
"', modified_time = '" . trim(add_escape_custom($created_time)) .
"', pay_amount = '" . trim(formData("Takeback$CountRow")) * -1 .
"', adj_amount = '" . 0 .
"', account_code = '" . "Takeback" .
"'");
sqlCommitTrans();
} else {
sqlStatement("delete from ar_activity $where");
}
//==============================================================================================================================
$where = "$where1 AND follow_up = 'y'";
if (isset($_POST["FollowUp$CountRow"]) && $_POST["FollowUp$CountRow"] == 'y') {
$resPayment = sqlStatement("SELECT * from ar_activity $where");
if (sqlNumRows($resPayment) > 0) {
sqlStatement("update ar_activity set deleted = NOW() $where");
}
sqlBeginTrans();
$sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment FROM ar_activity WHERE pid = '" . trim(formData("HiddenPId$CountRow")) . "' AND encounter = '" . trim(formData("HiddenEncounter$CountRow")) . "'");
sqlStatement("insert into ar_activity set " .
"pid = '" . trim(formData("HiddenPId$CountRow")) .
"', encounter = '" . trim(formData("HiddenEncounter$CountRow")) .
"', sequence_no = '" . add_escape_custom($sequence_no['increment']) .
"', code_type = '" . trim(formData("HiddenCodetype$CountRow")) .
"', code = '" . trim(formData("HiddenCode$CountRow")) .
"', modifier = '" . trim(formData("HiddenModifier$CountRow")) .
"', payer_type = '" . trim(formData("HiddenIns$CountRow")) .
"', post_time = '" . trim(add_escape_custom($created_time)) .
"', post_user = '" . trim(add_escape_custom($user_id)) .
"', session_id = '" . trim(formData('payment_id')) .
"', modified_time = '" . trim(add_escape_custom($created_time)) .
"', pay_amount = '" . 0 .
"', adj_amount = '" . 0 .
"', follow_up = '" . "y" .
"', follow_up_note = '" . trim(formData("FollowUpReason$CountRow")) .
"'");
sqlCommitTrans();
} else {
sqlStatement("delete from ar_activity $where");
}
//==============================================================================================================================
} else {
break;
}
}
//=========
//INSERTION of new entries,continuation of modification.
//=========
for ($CountRow = $CountIndexAbove + 1; $CountRow <= $CountIndexAbove + $CountIndexBelow; $CountRow++) {
if (isset($_POST["HiddenEncounter$CountRow"])) {
DistributionInsert($CountRow, $created_time, $user_id);
} else {
break;
}
}
if ($_REQUEST['global_amount'] == 'yes') {
sqlStatement("update ar_session set global_amount=? where session_id =?", [(isset($_POST["HidUnappliedAmount"]) ? trim($_POST["HidUnappliedAmount"]) * 1 : ''), $payment_id]);
} elseif ($_REQUEST['global_reset'] == '-0.00') {
sqlStatement("update ar_session set global_amount=? where session_id =?", [0, $payment_id]);
}
if ($_POST["mode"] == "FinishPayments") {
$Message = 'Finish';
}
$_POST["mode"] = "searchdatabase";
$Message = 'Modify';
}
}
//==============================================================================
//Search Code
//===============================================================================
$payment_id = ($payment_id ?? null) * 1 > 0 ? $payment_id : $_REQUEST['payment_id'];
$ResultSearchSub = sqlStatement(
"SELECT DISTINCT encounter, code_type, code, modifier, pid " .
"FROM ar_activity WHERE deleted IS NULL AND session_id = ? " .
"ORDER BY pid, encounter, code, modifier",
[$payment_id]
);
//==============================================================================
//==============================================================================
//===============================================================================
?>
<!DOCTYPE html>
<html>
<head>
<title><?php echo xlt('Confirm Payment'); ?></title>
<?php Header::setupHeader(['datetime-picker', 'common']); ?>
<script>
const mypcc = '1';
</script>
<?php include_once("{$GLOBALS['srcdir']}/payment_jav.inc.php"); ?>
<?php include_once("{$GLOBALS['srcdir']}/ajax/payment_ajax_jav.inc.php"); ?>
<script>
function ModifyPayments() {//Used while modifying the allocation
if (!FormValidations())//FormValidations contains the form checks
{
return false;
}
if (CompletlyBlankAbove())//The distribution rows already in the database are checked.
{
alert(<?php echo xlj('None of the Top Distribution Row Can be Completly Blank.'); ?> +"\n" + <?php echo xlj('Use Delete Option to Remove.'); ?>);
return false;
}
if (!CheckPayingEntityAndDistributionPostFor()) {
//Ensures that Insurance payment is distributed under Ins1,Ins2,Ins3 and Patient paymentat under Pat.
return false;
}
if (CompletlyBlankBelow()) {
//The newly added distribution rows are checked.
alert(<?php echo xlj('Fill any of the Below Row.'); ?>);
return false;
}
let PostValue = CheckUnappliedAmount();//Decides TdUnappliedAmount >0, or <0 or =0
if (PostValue == 1) {
alert(<?php echo xlj('Cannot Modify Payments.Undistributed is Negative.'); ?>);
return false;
}
dialog.confirm(<?php echo xlj('Would you like to Modify Payments?'); ?>).then(returned => {
if (returned === true) {
document.getElementById('mode').value = 'ModifyPayments';
top.restoreSession();
document.forms[0].submit();
} else {
dialog.close();
return false;
}
});
}
function FinishPayments() {
if (!FormValidations())//FormValidations contains the form checks
{
return false;
}
if (CompletlyBlankAbove())//The distribution rows already in the database are checked.
{
alert(<?php echo xlj('None of the Top Distribution Row Can be Completly Blank.'); ?> +"\n" + <?php echo xlj('Use Delete Option to Remove.'); ?>);
return false;
}
if (!CheckPayingEntityAndDistributionPostFor())//Ensures that Insurance payment is distributed under Ins1,Ins2,Ins3 and Patient paymentat under Pat.
{
return false;
}
if (CompletlyBlankBelow())//The newly added distribution rows are checked.
{
alert(<?php echo xlj('Fill any of the Below Row.'); ?>);
return false;
}
let PostValue = CheckUnappliedAmount();//Decides TdUnappliedAmount >0, or <0 or =0
if (PostValue == 1) {
alert(<?php echo xlj('Cannot Modify Payments.Undistributed is Negative.'); ?>);
return false;
}
if (PostValue == 2) {
if (confirm(<?php echo xlj('Would you like to Modify and Finish Payments?'); ?>)) {
UnappliedAmount = document.getElementById('TdUnappliedAmount').innerHTML * 1;
if (confirm(<?php echo xlj('Undistributed is'); ?> +' ' + UnappliedAmount + '.' + '\n' + <?php echo xlj('Would you like the balance amount to apply to Global Account?'); ?>)) {
document.getElementById('mode').value = 'FinishPayments';
document.getElementById('global_amount').value = 'yes';
top.restoreSession();
document.forms[0].submit();
} else {
document.getElementById('mode').value = 'FinishPayments';
top.restoreSession();
document.forms[0].submit();
}
} else
return false;
} else {
if (confirm(<?php echo xlj('Would you like to Modify and Finish Payments?'); ?>)) {
document.getElementById('mode').value = 'FinishPayments';
top.restoreSession();
document.forms[0].submit();
} else
return false;
}
}
function CompletlyBlankAbove() {//The distribution rows already in the database are checked.
//It is not allowed to be made completly empty.If needed delete option need to be used.
let CountIndexAbove = document.getElementById('CountIndexAbove').value * 1;
for (RowCount = 1; RowCount <= CountIndexAbove; RowCount++) {
if (document.getElementById('Allowed' + RowCount).value == '' && document.getElementById('Payment' + RowCount).value == '' && document.getElementById('AdjAmount' + RowCount).value == '' && document.getElementById('Deductible' + RowCount).value == '' && document.getElementById('Takeback' + RowCount).value == '' && document.getElementById('FollowUp' + RowCount).checked == false) {
return true;
}
}
return false;
}
function CompletlyBlankBelow() {//The newly added distribution rows are checked.
//It is not allowed to be made completly empty.
let CountIndexAbove = document.getElementById('CountIndexAbove').value * 1;
let CountIndexBelow = document.getElementById('CountIndexBelow').value * 1;
if (CountIndexBelow == 0)
return false;
for (RowCount = CountIndexAbove + 1; RowCount <= CountIndexAbove + CountIndexBelow; RowCount++) {
if (document.getElementById('Allowed' + RowCount).value == '' && document.getElementById('Payment' + RowCount).value == '' && document.getElementById('AdjAmount' + RowCount).value == '' && document.getElementById('Deductible' + RowCount).value == '' && document.getElementById('Takeback' + RowCount).value == '' && document.getElementById('FollowUp' + RowCount).checked == false) {
} else
return false;
}
return true;
}
function OnloadAction() {//Displays message while loading after some action.
let after_value = document.getElementById('ActionStatus').value;
if (after_value == 'Delete') {
alert(<?php echo xlj('Successfully Deleted'); ?>);
return true;
}
if (after_value == 'Modify' || after_value == 'Finish') {
alert(<?php echo xlj('Successfully Modified'); ?>);
return true;
}
after_value = document.getElementById('after_value').value;
let payment_id = document.getElementById('payment_id').value;
if (after_value == 'distribute') {
} else if (after_value == 'new_payment') {
if (document.getElementById('TablePatientPortion')) {
document.getElementById('TablePatientPortion').style.display = 'none';
}
if (confirm(<?php echo xlj('Successfully Saved.Would you like to Distribute?'); ?>)) {
if (document.getElementById('TablePatientPortion')) {
document.getElementById('TablePatientPortion').style.display = '';
}
}
}
}
function DeletePaymentDistribution(DeleteId) {//Confirms deletion of payment distribution.
if (confirm(<?php echo xlj('Would you like to Delete Payment Distribution?'); ?>)) {
document.getElementById('mode').value = 'DeletePaymentDistribution';
document.getElementById('DeletePaymentDistributionId').value = DeleteId;
top.restoreSession();
document.forms[0].submit();
} else
return false;
}
//========================================================================================
$(function () {
$('.datepicker').datetimepicker({
<?php $datetimepicker_timepicker = false; ?>
<?php $datetimepicker_showseconds = false; ?>
<?php $datetimepicker_formatInput = true; ?>
<?php require($GLOBALS['srcdir'] . '/js/xl/jquery-datetimepicker-2-5-4.js.php'); ?>
<?php // can add any additional javascript settings to datetimepicker here; need to prepend first setting with a comma ?>
});
});
document.onclick = HideTheAjaxDivs;
</script>
<style>
.amt_input {
max-width: 75px;
}
.bottom {
border-bottom: 1px solid var(--black);
}
.top {
border-top: 1px solid var(--black);
}
.left {
border-left: 1px solid var(--black);
}
.right {
border-right: 1px solid var(--black);
}
.form-group {
margin-bottom: 5px;
}
legend {
border-bottom: 2px solid #E5E5E5;
background: #E5E5E5;
padding-left: 10px;
}
.form-horizontal .control-label {
padding-top: 2px;
}
fieldset {
border-color: #68171A !important;
background-color: #f2f2f2;
margin-bottom: 10px;
padding-bottom: 15px;
}
@media only screen and (max-width: 768px) {
[class*="col-"] {
width: 100%;
text-align: left !important;
}
}
</style>
<?php Header::setupHeader(['datetime-picker', 'common']); ?>
</head>
<body class="body_top" onload="OnloadAction()">
<div class="container-fluid">
<?php
if ($_REQUEST['ParentPage'] ?? '' == 'new_payment') {
?>
<div class="row">
<div class="col-12">
<h2><?php echo xlt('Payments'); ?></h2>
</div>
</div>
<div class="row">
<div class="col-sm-12">
<nav class="navbar navbar-nav navbar-expand-md navbar-light text-body bg-light static-top">
<button class="navbar-toggler icon-bar" data-target="#myNavbar" data-toggle="collapse" type="button"><span class="navbar-toggler-icon"></span></button>
<div class="collapse navbar-collapse" id="myNavbar">
<ul class="navbar-nav mr-auto">
<li class="nav-item active">
<a class="nav-link font-weight-bold" href='new_payment.php'><?php echo xlt('New Payment'); ?></a>
</li>
<li class="nav-item">
<a class="nav-link font-weight-bold" href='search_payments.php'><?php echo xlt('Search Payment'); ?></a>
</li>
<li class="nav-item">
<a class="nav-link font-weight-bold" href='era_payments.php'><?php echo xlt('ERA Posting'); ?></a>
</li>
</ul>
</div>
</nav>
</div>
</div>
<?php
}
?>
<?php
if ($payment_id * 1 == 0) {
$onclick = "top.restoreSession();return SavePayment();";
} else {
$onclick = "return false;";
}
?>
<form class="form" name='new_payment' method='post' action="edit_payment.php" onsubmit='<?php echo $onclick; ?>'>
<?php
if ($payment_id * 1 > 0) { ?>
<fieldset>
<?php
require_once("payment_master.inc.php"); //Check/cash details are entered here.
?>
<?php }//End of if($payment_id*1>0) ?>
<?php
if ($payment_id * 1 > 0) {//Distribution rows already in the database are displayed.
?>
<?php //
$resCount = sqlStatement(
"SELECT DISTINCT encounter, code_type, code, modifier FROM ar_activity " .
"WHERE deleted IS NULL AND session_id = ?",
[$payment_id]
);
$TotalRows = sqlNumRows($resCount);
$CountPatient = 0;
$CountIndex = 0;
$CountIndexAbove = 0;
$paymenttot = 0;
$adjamttot = 0;
$deductibletot = 0;
$takebacktot = 0;
$allowedtot = 0;
if ($RowSearchSub = sqlFetchArray($ResultSearchSub)) {
do {
$CountPatient++;
$PId = $RowSearchSub['pid'];
$EncounterMaster = $RowSearchSub['encounter'];
// Only use the code_type in the queries below if it is specified in the ar_activity table.
// If it is not specified in the ar_activity table, also note it is not requested from the
// billing table in below query, thus making it blank in all queries below in this script.
$CodetypeMaster = $RowSearchSub['code_type'];
$sql_select_part_codetype = "";
$sql_where_part_codetype = "";
if (!empty($CodetypeMaster)) {
$sql_select_part_codetype = "billing.code_type,";
$sql_where_part_codetype = "and billing.code_type ='" . add_escape_custom($CodetypeMaster) . "'";
}
$CodeMaster = $RowSearchSub['code'];
$ModifierMaster = $RowSearchSub['modifier'];
$res = sqlStatement("SELECT fname,lname,mname FROM patient_data where pid =?", [$PId]);
$row = sqlFetchArray($res);
$fname = $row['fname'];
$lname = $row['lname'];
$mname = $row['mname'];
$NameDB = $lname . ' ' . $fname . ' ' . $mname;
$ResultSearch = sqlStatement("SELECT billing.id,last_level_closed,billing.encounter,form_encounter.`date`,$sql_select_part_codetype billing.code,billing.modifier,fee
FROM billing ,form_encounter
where billing.encounter=form_encounter.encounter and billing.pid=form_encounter.pid and
code_type !='ICD9' and code_type !='COPAY' and billing.activity !=0 and
form_encounter.pid ='" . add_escape_custom($PId) . "' and billing.pid ='" . add_escape_custom($PId) . "' and billing.encounter ='" . add_escape_custom($EncounterMaster) . "'
$sql_where_part_codetype
and billing.code ='" . add_escape_custom($CodeMaster) . "'
and billing.modifier ='" . add_escape_custom($ModifierMaster) . "'
ORDER BY form_encounter.`date`,form_encounter.encounter,billing.code,billing.modifier");
if (sqlNumRows($ResultSearch) > 0) {
if ($CountPatient === 1) {
$Table = 'yes';
?>
<br /><br />
<div class="row" id="tableRow">
<legend><?php echo xlt("Distributed Edits") ?></legend>
<div class="table-responsive-lg">
<table class="table table-sm table-bordered table-light" id="TableDistributedEdit" >
<thead class="bg-dark text-light">
<tr>
<th>&nbsp;</th>
<th><?php echo xlt('Patient Name'); ?></th>
<th><?php echo xlt('Post For'); ?></th>
<th><?php echo xlt('Service Date'); ?></th>
<th><?php echo xlt('Enc#'); ?></th>
<th><?php echo xlt('Code'); ?></th>
<th><?php echo xlt('Charge'); ?></th>
<th><?php echo xlt('Copay'); ?></th>
<th><?php echo xlt('Bal-Due'); ?></th>
<th><?php echo xlt('Allowed(c)'); ?></th><!-- (c) means it is calculated.Not stored one. -->
<th><?php echo xlt('Payment'); ?></th>
<th><?php echo xlt('Adj Amount'); ?></th>
<th><?php echo xlt('Deductible'); ?></th>
<th><?php echo xlt('Takeback'); ?></th>
<th><?php echo xlt('MSP'); ?></th>
<th><?php echo xlt('Resn'); ?></th>
<th><?php echo xlt('Follow Up Reason'); ?></th>
</tr>
</thead>
<?php }
while ($RowSearch = sqlFetchArray($ResultSearch)) {
$CountIndex++;
$CountIndexAbove++;
$ServiceDateArray = explode(' ', $RowSearch['date']);
$ServiceDate = oeFormatShortDate($ServiceDateArray[0]);
$Codetype = $RowSearch['code_type'];
$Code = $RowSearch['code'];
$Modifier = $RowSearch['modifier'];
if ($Modifier != '') {
$ModifierString = ", $Modifier";
} else {
$ModifierString = "";
}
$Fee = $RowSearch['fee'];
$Encounter = $RowSearch['encounter'];
$resPayer = sqlStatement(
"SELECT payer_type FROM ar_activity WHERE " .
"deleted IS NULL AND session_id = ? AND pid = ? AND encounter = ? " .
"AND code_type = ? AND code = ? AND modifier = ?",
[$payment_id, $PId, $Encounter, $Codetype, $Code, $Modifier]
);
$rowPayer = sqlFetchArray($resPayer);
$Ins = $rowPayer['payer_type'];
//Always associating the copay to a particular charge.
$BillingId = $RowSearch['id'];
$resId = sqlStatement("SELECT id FROM billing where code_type != 'ICD9' and code_type != 'COPAY' and
pid =? and encounter =? and billing.activity!=0 order by id", [$PId, $Encounter]);
$rowId = sqlFetchArray($resId);
$Id = $rowId['id'];
if ($BillingId != $Id) {//multiple cpt in single encounter
$Copay = 0.00;
} else {
$resCopay = sqlStatement("SELECT sum(fee) as copay FROM billing where
code_type='COPAY' and pid =? and encounter =? and billing.activity!=0", [$PId, $Encounter]);
$rowCopay = sqlFetchArray($resCopay);
$Copay = $rowCopay['copay'] * -1;
$resMoneyGot = sqlStatement(
"SELECT sum(pay_amount) AS PatientPay FROM ar_activity WHERE " .
"deleted IS NULL AND pid = ? and encounter = ? AND " .
"payer_type = 0 AND account_code = 'PCP'",
[$PId, $Encounter]
); //new fees screen copay gives account_code='PCP'
$rowMoneyGot = sqlFetchArray($resMoneyGot);
$PatientPay = $rowMoneyGot['PatientPay'];
$Copay = $Copay + $PatientPay;
}
//For calculating Remainder
if ($Ins == 0) {//Fetch all values
$resMoneyGot = sqlStatement(
"SELECT sum(pay_amount) as MoneyGot FROM ar_activity WHERE " .
"deleted IS NULL AND pid = ? and code_type = ? AND code = ? AND " .
"modifier = ? AND encounter = ? AND " .
"!(payer_type = 0 AND account_code = 'PCP')",
[$PId, $Codetype, $Code, $Modifier, $Encounter]
);
//new fees screen copay gives account_code='PCP'
$rowMoneyGot = sqlFetchArray($resMoneyGot);
$MoneyGot = $rowMoneyGot['MoneyGot'];
$resMoneyAdjusted = sqlStatement(
"SELECT sum(adj_amount) AS MoneyAdjusted FROM ar_activity WHERE " .
"deleted IS NULL AND pid = ? and code_type = ? and code = ? AND " .
"modifier = ? AND encounter = ?",
[$PId, $Codetype, $Code, $Modifier, $Encounter]
);
$rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
$MoneyAdjusted = $rowMoneyAdjusted['MoneyAdjusted'];
} else {
//Fetch till that much got
//Fetch the HIGHEST sequence_no till this session.
//Used maily in the case if primary/others pays once more.
$resSequence = sqlStatement("SELECT sequence_no from ar_activity where session_id=? and
pid=? and encounter=? order by sequence_no desc ", [$payment_id, $PId, $Encounter]);
$rowSequence = sqlFetchArray($resSequence);
$Sequence = $rowSequence['sequence_no'];
$resMoneyGot = sqlStatement(
"SELECT sum(pay_amount) as MoneyGot FROM ar_activity WHERE " .
"deleted IS NULL AND pid = ? and code_type = ? AND code = ? AND " .
"modifier = ? and encounter = ? AND " .
"payer_type > 0 and payer_type <= ? and sequence_no <= ?",
[$PId, $Codetype, $Code, $Modifier, $Encounter, $Ins, $Sequence]
);
$rowMoneyGot = sqlFetchArray($resMoneyGot);
$MoneyGot = $rowMoneyGot['MoneyGot'];
$resMoneyAdjusted = sqlStatement(
"SELECT sum(adj_amount) AS MoneyAdjusted FROM ar_activity WHERE " .
"deleted IS NULL AND pid = ? and code_type = ? and code = ? AND " .
"modifier = ? AND encounter = ? AND payer_type > 0 AND " .
"payer_type <= ? and sequence_no <= ?",
[$PId, $Codetype, $Code, $Modifier, $Encounter, $Ins, $Sequence]
);
$rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
$MoneyAdjusted = $rowMoneyAdjusted['MoneyAdjusted'];
}
$Remainder = $Fee - $Copay - $MoneyGot - $MoneyAdjusted;
//For calculating RemainderJS.Used while restoring back the values.
if ($Ins == 0) {//Got just before Patient
$resMoneyGot = sqlStatement(
"SELECT sum(pay_amount) AS MoneyGot FROM ar_activity WHERE " .
"deleted IS NULL AND pid = ? AND code_type = ? AND code = ? AND " .
"modifier = ? AND encounter = ? and payer_type != 0",
[$PId, $Codetype, $Code, $Modifier, $Encounter]
);
$rowMoneyGot = sqlFetchArray($resMoneyGot);
$MoneyGot = $rowMoneyGot['MoneyGot'];
$resMoneyAdjusted = sqlStatement(
"SELECT sum(adj_amount) AS MoneyAdjusted FROM ar_activity WHERE " .
"deleted IS NULL AND pid = ? AND code_type = ? AND code = ? AND " .
"modifier = ? and encounter = ? and payer_type != 0",
[$PId, $Codetype, $Code, $Modifier, $Encounter]
);
$rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
$MoneyAdjusted = $rowMoneyAdjusted['MoneyAdjusted'];
} else {
//Got just before the previous
//Fetch the LOWEST sequence_no till this session.
//Used maily in the case if primary/others pays once more.
$resSequence = sqlStatement(
"SELECT sequence_no FROM ar_activity WHERE " .
"session_id = ? AND deleted IS NULL AND pid = ? AND encounter = ? " .
"order by sequence_no",
[$payment_id, $PId, $Encounter]
);
$rowSequence = sqlFetchArray($resSequence);
$Sequence = $rowSequence['sequence_no'];
$resMoneyGot = sqlStatement(
"SELECT sum(pay_amount) as MoneyGot FROM ar_activity WHERE " .
"deleted IS NULL AND pid = ? AND code_type = ? AND code = ? " .
"AND modifier = ? AND encounter = ? AND payer_type > 0 AND " .
"payer_type <= ? AND sequence_no < ?",
[$PId, $Codetype, $Code, $Modifier, $Encounter, $Ins, $Sequence]
);
$rowMoneyGot = sqlFetchArray($resMoneyGot);
$MoneyGot = $rowMoneyGot['MoneyGot'];
$resMoneyAdjusted = sqlStatement(
"SELECT sum(adj_amount) as MoneyAdjusted FROM ar_activity WHERE " .
"deleted IS NULL AND pid = ? and code_type = ? and code = ? AND " .
"modifier = ? AND encounter = ? AND payer_type <= ? AND sequence_no < ?",
[$PId, $Codetype, $Code, $Modifier, $Encounter, $Ins, $Sequence]
);
$rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
$MoneyAdjusted = $rowMoneyAdjusted['MoneyAdjusted'];
}
//Stored in hidden so that can be used while restoring back the values.
$RemainderJS = $Fee - $Copay - $MoneyGot - $MoneyAdjusted;
$resPayment = sqlStatement(
"SELECT pay_amount FROM ar_activity WHERE " .
"deleted IS NULL AND session_id=? AND pid = ? AND encounter = ? AND " .
"code_type = ? AND code = ? AND modifier = ? AND pay_amount > 0",
[$payment_id, $PId, $Encounter, $Codetype, $Code, $Modifier]
);
$rowPayment = sqlFetchArray($resPayment);
$PaymentDB = $rowPayment['pay_amount'] ?? null * 1;
$PaymentDB = $PaymentDB == 0 ? '' : $PaymentDB;
$resPayment = sqlStatement(
"SELECT pay_amount FROM ar_activity WHERE " .
"deleted IS NULL AND session_id = ? AND pid = ? AND encounter = ? AND " .
"code_type = ? AND code = ? AND modifier = ? AND pay_amount < 0",
[$payment_id, $PId, $Encounter, $Codetype, $Code, $Modifier]
);
$rowPayment = sqlFetchArray($resPayment);
$TakebackDB = ($rowPayment['pay_amount'] ?? null) * -1;
$TakebackDB = $TakebackDB == 0 ? '' : $TakebackDB;
$resPayment = sqlStatement(
"SELECT adj_amount FROM ar_activity WHERE " .
"deleted IS NULL AND session_id = ? AND pid = ? AND encounter = ? AND " .
"code_type = ? AND code = ? AND modifier = ? AND adj_amount != 0",
[$payment_id, $PId, $Encounter, $Codetype, $Code, $Modifier]
);
$rowPayment = sqlFetchArray($resPayment);
$AdjAmountDB = $rowPayment['adj_amount'] * 1;
$AdjAmountDB = $AdjAmountDB == 0 ? '' : $AdjAmountDB;
$resPayment = sqlStatement(
"SELECT memo FROM ar_activity WHERE " .
"deleted IS NULL AND session_id = ? AND pid = ? AND encounter = ? AND " .
"code_type = ? AND code = ? AND modifier = ? AND " .
"(memo LIKE 'Deductable%' OR memo LIKE 'Deductible%')",
[$payment_id, $PId, $Encounter, $Codetype, $Code, $Modifier]
);
$rowPayment = sqlFetchArray($resPayment);
$DeductibleDB = $rowPayment['memo'] ?? '';
$DeductibleDB = str_replace('Deductable $', '', $DeductibleDB);
$DeductibleDB = str_replace('Deductible $', '', $DeductibleDB);
$resPayment = sqlStatement(
"SELECT follow_up, follow_up_note FROM ar_activity WHERE " .
"deleted IS NULL AND session_id = ? AND pid = ? AND encounter = ? AND " .
"code_type = ? AND code = ? AND modifier = ? AND follow_up = 'y'",
[$payment_id, $PId, $Encounter, $Codetype, $Code, $Modifier]
);
$rowPayment = sqlFetchArray($resPayment);
$FollowUpDB = $rowPayment['follow_up'] ?? '';
$FollowUpReasonDB = $rowPayment['follow_up_note'] ?? '';
$resPayment = sqlStatement(
"SELECT reason_code FROM ar_activity WHERE " .
"deleted IS NULL AND session_id = ? AND pid = ? AND encounter = ? AND " .
"code_type = ? AND code = ? AND modifier = ?",
[$payment_id, $PId, $Encounter, $Codetype, $Code, $Modifier]
);
$rowPayment = sqlFetchArray($resPayment);
$ReasonCodeDB = $rowPayment['reason_code'];
if ($Ins == 1) {
$AllowedDB = number_format($Fee - $AdjAmountDB, 2);
} else {
$AllowedDB = 0;
}
$AllowedDB = $AllowedDB === 0 ? '' : $AllowedDB;
if ($Ins == 1) {
$bgcolor = '#ddddff';
} elseif ($Ins == 2) {
$bgcolor = '#ffdddd';
} elseif ($Ins == 3) {
$bgcolor = '#F2F1BC';
} elseif ($Ins == 0) {
$bgcolor = '#AAFFFF';
}
$paymenttot = $paymenttot + floatval($PaymentDB);
$adjamttot = $adjamttot + floatval($AdjAmountDB);
$deductibletot = $deductibletot + floatval($DeductibleDB);
$takebacktot = $takebacktot + floatval($TakebackDB);
$allowedtot = $allowedtot + floatval($AllowedDB);
?>
<tr class="border-dark" bgcolor='<?php echo attr($bgcolor); ?>' class="text" id="trCharges<?php echo attr($CountIndex); ?>">
<td align="left">
<a href="#" onclick="javascript:return DeletePaymentDistribution(<?php echo attr_js($payment_id . '_' . $PId . '_' . $Encounter . '_' . $Code . '_' . $Modifier . '_' . $Codetype); ?>);"><img border="0" src="../pic/Delete.gif"></a>
</td>
<td align="left">
<?php echo text($NameDB); ?><input name="HiddenPId<?php echo attr($CountIndex); ?>" type="hidden" value="<?php echo attr($PId); ?>" />
</td>
<td align="left">
<input id="HiddenIns<?php echo attr($CountIndex); ?>" name="HiddenIns<?php echo attr($CountIndex); ?>" type="hidden" value="<?php echo attr($Ins); ?>" /><?php echo generate_select_list("payment_ins$CountIndex", "payment_ins", "$Ins", "Insurance/Patient", '', 'w-100', 'ActionOnInsPat("' . $CountIndex . '")'); ?>
</td>
<td>
<?php echo text($ServiceDate); ?>
</td>
<td align="right">
<input name="HiddenEncounter<?php echo attr($CountIndex); ?>" type="hidden" value="<?php echo attr($Encounter); ?>" /><?php echo text($Encounter); ?>
</td>
<td>
<input name="HiddenCodetype<?php echo attr($CountIndex); ?>" type="hidden" value="<?php echo attr($Codetype); ?>" />
<input name="HiddenCode<?php echo attr($CountIndex); ?>" type="hidden" value="<?php echo attr($Code); ?>" /><?php echo text($Codetype . "-" . $Code . $ModifierString); ?>
<input name="HiddenModifier<?php echo attr($CountIndex); ?>" type="hidden" value="<?php echo attr($Modifier); ?>" />
</td>
<td align="right">
<input id="HiddenChargeAmount<?php echo attr($CountIndex); ?>" name="HiddenChargeAmount<?php echo attr($CountIndex); ?>" type="hidden" value="<?php echo attr($Fee); ?>" /><?php echo text($Fee); ?>
</td>
<td align="right">
<input id="HiddenCopayAmount<?php echo attr($CountIndex); ?>" name="HiddenCopayAmount<?php echo attr($CountIndex); ?>" type="hidden" value="<?php echo attr($Copay); ?>"><?php echo text(number_format($Copay, 2)); ?>
</td>
<td align="right" id="RemainderTd<?php echo attr($CountIndex); ?>"> <?php echo text(round($Remainder, 2)); ?> </td>
<input name="HiddenRemainderTd<?php echo attr($CountIndex); ?>" id="HiddenRemainderTd<?php echo attr($CountIndex); ?>" value="<?php echo attr(round($Remainder, 2)); ?>" type="hidden" />
<td>
<input autocomplete="off" id="Allowed<?php echo attr($CountIndex); ?>" name="Allowed<?php echo attr($CountIndex); ?>" onchange="ValidateNumeric(this);ScreenAdjustment(this,<?php echo attr_js($CountIndex); ?>);UpdateTotalValues(1,<?php echo attr_js($TotalRows); ?>,'Allowed','allowtotal');UpdateTotalValues(1,<?php echo attr_js($TotalRows); ?>,'Payment','paymenttotal');UpdateTotalValues(1,<?php echo attr_js($TotalRows); ?>,'AdjAmount','AdjAmounttotal');RestoreValues(<?php echo attr_js($CountIndex); ?>)" onkeydown="PreventIt(event)" class="text-right input-sm w-100" type="text" value="<?php echo attr($AllowedDB); ?>" />
</td>
<td>
<input autocomplete="off" id="Payment<?php echo attr($CountIndex); ?>" name="Payment<?php echo attr($CountIndex); ?>" onchange="ValidateNumeric(this);ScreenAdjustment(this,<?php echo attr_js($CountIndex); ?>);UpdateTotalValues(1,<?php echo attr_js($TotalRows); ?>,'Payment','paymenttotal');RestoreValues(<?php echo attr_js($CountIndex); ?>)" onkeydown="PreventIt(event)" class="text-right input-sm w-100" type="text" value="<?php echo attr($PaymentDB); ?>" />
</td>
<td>
<input autocomplete="off" id="AdjAmount<?php echo attr($CountIndex); ?>" name="AdjAmount<?php echo attr($CountIndex); ?>" onchange="ValidateNumeric(this);ScreenAdjustment(this,<?php echo attr_js($CountIndex); ?>);UpdateTotalValues(1,<?php echo attr_js($TotalRows); ?>,'AdjAmount','AdjAmounttotal');RestoreValues(<?php echo attr_js($CountIndex); ?>)" onkeydown="PreventIt(event)" class="text-right input-sm w-100" type="text" value="<?php echo attr($AdjAmountDB); ?>" />
</td>
<td>
<input autocomplete="off" id="Deductible<?php echo attr($CountIndex); ?>" name="Deductible<?php echo attr($CountIndex); ?>" onchange="ValidateNumeric(this);UpdateTotalValues(1,<?php echo attr_js($TotalRows); ?>,'Deductible','deductibletotal');" onkeydown="PreventIt(event)" class="text-right input-sm w-100" type="text" value="<?php echo attr($DeductibleDB); ?>" />
</td>
<td>
<input autocomplete="off" id="Takeback<?php echo attr($CountIndex); ?>" name="Takeback<?php echo attr($CountIndex); ?>" onchange="ValidateNumeric(this);ScreenAdjustment(this,<?php echo attr_js($CountIndex); ?>);UpdateTotalValues(1,<?php echo attr_js($TotalRows); ?>,'Takeback','takebacktotal');RestoreValues(<?php echo attr_js($CountIndex); ?>)" onkeydown="PreventIt(event)" class="text-right input-sm w-100" type="text" value="<?php echo attr($TakebackDB); ?>" />
</td>
<td align="left">
<input id="HiddenReasonCode<?php echo attr($CountIndex); ?>" name="HiddenReasonCode<?php echo attr($CountIndex); ?>" type="hidden" value="<?php echo attr($ReasonCodeDB); ?>" /><?php echo generate_select_list("ReasonCode$CountIndex", "msp_remit_codes", "$ReasonCodeDB", "MSP", '', 'w-100'); ?>
</td>
<td align="center">
<input id="FollowUp<?php echo attr($CountIndex); ?>" name="FollowUp<?php echo attr($CountIndex); ?>" onclick="ActionFollowUp(<?php echo attr_js($CountIndex); ?>)" type="checkbox" value="y" />
</td>
<td>
<input id="FollowUpReason<?php echo attr($CountIndex); ?>" name="FollowUpReason<?php echo attr($CountIndex); ?>" onkeydown="PreventIt(event)" class=" input-sm w-100" type="text" value="<?php echo attr($FollowUpReasonDB); ?>" readonly>
</td>
</tr><?php
}//End of while ($RowSearch = sqlFetchArray($ResultSearch))
?>
<?php
}//End of if(sqlNumRows($ResultSearch)>0)
} while ($RowSearchSub = sqlFetchArray($ResultSearchSub));
if ($Table == 'yes') { ?>
<tr>
<td class="text-right text-dark" align="left" colspan="9"><b><?php echo (xlt("Totals") . ": ") ?></b></td>
<td class="bg-dark text-secondary" align="center" id="allowtotal"><?php echo text(number_format($allowedtot, 2)); ?></td>
<td class="bg-dark text-secondary" align="center" id="paymenttotal"><?php echo text(number_format($paymenttot, 2)); ?></td>
<td class="bg-dark text-secondary" align="center" id="AdjAmounttotal"><?php echo text(number_format($adjamttot, 2)); ?></td>
<td class="bg-dark text-secondary" align="center" id="deductibletotal"><?php echo text(number_format($deductibletot, 2)); ?></td>
<td class="bg-dark text-secondary" align="center" id="takebacktotal"><?php echo text(number_format($takebacktot, 2)); ?></td>
<td align="center" colspan="2">&nbsp;</td>
<td align="right">
<button type="button" class="btn btn-sm btn-secondary btn-refresh pull-right"
onclick="updateAllFormTotals(<?php echo attr_js($TotalRows); ?>);"><?php echo xlt("Recalculate"); ?></button>
</td>
</tr>
</table>
<?php
}
?>
<?php
echo '<br/>';
}//End of if($RowSearchSub = sqlFetchArray($ResultSearchSub))
?>
</div>
</div>
<div>
<?php
require_once("payment_pat_sel.inc.php"); //Patient ajax section and listing of charges.
?>
</div>
<?php
}//End of if($payment_id*1>0)
?>
<?php //can change position of buttons by creating a class 'position-override' and adding rule text-align:center or right as the case may be in individual stylesheets ?>
<div class="form-group clearfix">
<div class="col-sm-12 text-left position-override">
<div class="btn-group" role="group">
<a class="btn btn-secondary btn-save" href="#" onclick="return ModifyPayments();"><span><?php echo xlt('Modify Payments'); ?></span></a>
<a class="btn btn-secondary btn-save" href="#" onclick="return FinishPayments();"><span><?php echo xlt('Finish Payments'); ?></span></a>
</div>
</div>
</div>
<div class="row">
<input type="hidden" name="hidden_patient_code" id="hidden_patient_code" value="<?php echo attr($hidden_patient_code ?? ''); ?>" />
<input type='hidden' name='mode' id='mode' value='' />
<input type='hidden' name='ajax_mode' id='ajax_mode' value='' />
<input type="hidden" name="after_value" id="after_value" value="<?php echo attr($_POST["mode"] ?? ''); ?>" />
<input type="hidden" name="payment_id" id="payment_id" value="<?php echo attr($payment_id); ?>" />
<input type="hidden" name="hidden_type_code" id="hidden_type_code" value="<?php echo attr($TypeCode); ?>" />
<input type='hidden' name='global_amount' id='global_amount' value='' />
<input type='hidden' name='DeletePaymentDistributionId' id='DeletePaymentDistributionId' value='' />
<input type="hidden" name="ActionStatus" id="ActionStatus" value="<?php echo attr($Message ?? ''); ?>" />
<input type='hidden' name='CountIndexAbove' id='CountIndexAbove' value='<?php echo attr($CountIndexAbove * 1); ?>' />
<input type='hidden' name='CountIndexBelow' id='CountIndexBelow' value='<?php echo attr($CountIndexBelow * 1); ?>' />
<input type="hidden" name="ParentPage" id="ParentPage" value="<?php echo attr($_REQUEST['ParentPage'] ?? ''); ?>" />
</div>
</form>
</div><!-- End of container div-->
<script>
function ResetForm() {//Resets form used in the 'Cancel Changes' button in the master screen.
document.forms[0].reset();
document.getElementById('TdUnappliedAmount').innerHTML = '0.00';
document.getElementById('div_insurance_or_patient').innerHTML = '&nbsp;';
CheckVisible('yes');//Payment Method is made 'Check Payment' and the Check box is made visible.
PayingEntityAction();//Paying Entity is made 'insurance' and Payment Category is 'Insurance Payment'
}
$(function () {
if (document.getElementById("TableDistributePortion")) {
$("html").animate({scrollTop: $("#TableDistributePortion").offset().top}, 800);
} else if (document.getElementById("TableDistributedEdit")) {
$("html").animate({scrollTop: $("#TableDistributedEdit").offset().top}, 800);
}
});
</script>
</body>
</html>