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openemr/interface/patient_file/front_payment.php

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<?php
/**
* Front payment gui.
*
* @package OpenEMR
* @link http://www.open-emr.org
* @author Rod Roark <rod@sunsetsystems.com>
* @author Brady Miller <brady.g.miller@gmail.com>
* @copyright Copyright (c) 2006-2020 Rod Roark <rod@sunsetsystems.com>
* @copyright Copyright (c) 2017-2018 Brady Miller <brady.g.miller@gmail.com>
* @license https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
*/
require_once("../globals.php");
require_once("$srcdir/patient.inc");
require_once("$srcdir/payment.inc.php");
require_once("$srcdir/forms.inc");
require_once("../../custom/code_types.inc.php");
require_once("$srcdir/options.inc.php");
require_once("$srcdir/encounter_events.inc.php");
use OpenEMR\Billing\BillingUtilities;
use OpenEMR\Common\Acl\AclMain;
use OpenEMR\Common\Csrf\CsrfUtils;
use OpenEMR\Common\Twig\TwigContainer;
use OpenEMR\Core\Header;
use OpenEMR\OeUI\OemrUI;
use OpenEMR\PaymentProcessing\Sphere\SpherePayment;
use OpenEMR\Services\FacilityService;
if (!empty($_REQUEST['receipt']) && empty($_POST['form_save'])) {
if (!AclMain::aclCheckCore('acct', 'bill') && !AclMain::aclCheckCore('acct', 'rep_a') && !AclMain::aclCheckCore('patients', 'rx')) {
echo (new TwigContainer(null, $GLOBALS['kernel']))->getTwig()->render('core/unauthorized.html.twig', ['pageTitle' => xl("Receipt for Payment")]);
exit;
}
} else {
if (!AclMain::aclCheckCore('acct', 'bill', '', 'write')) {
if (!empty($_POST['form_save'])) {
$pageTitle = xl("Receipt for Payment");
} else {
$pageTitle = xl("Record Payment");
}
echo (new TwigContainer(null, $GLOBALS['kernel']))->getTwig()->render('core/unauthorized.html.twig', ['pageTitle' => $pageTitle]);
exit;
}
}
$pid = (!empty($_REQUEST['hidden_patient_code']) && ($_REQUEST['hidden_patient_code'] > 0)) ? $_REQUEST['hidden_patient_code'] : $pid;
$facilityService = new FacilityService();
?>
<!DOCTYPE html>
<html>
<head>
<?php Header::setupHeader(['opener']);?>
<?php if ($GLOBALS['payment_gateway'] == 'Stripe') { ?>
<script src="https://js.stripe.com/v3/"></script>
<?php } ?>
<?php if ($GLOBALS['payment_gateway'] == 'AuthorizeNet') {
// Must be loaded from their server
$script = "https://jstest.authorize.net/v1/Accept.js"; // test script
if ($GLOBALS['gateway_mode_production']) {
$script = "https://js.authorize.net/v1/Accept.js"; // Production script
} ?>
<script src=<?php echo $script; ?> charset="utf-8"></script>
<?php } ?>
<?php
// Format dollars for display.
function bucks($amount)
{
if ($amount) {
$amount = oeFormatMoney($amount);
return $amount;
}
return '';
}
function rawbucks($amount)
{
if ($amount) {
$amount = sprintf("%.2f", $amount);
return $amount;
}
return '';
}
// Display a row of data for an encounter.
//
$var_index = 0;
function echoLine($iname, $date, $charges, $ptpaid, $inspaid, $duept, $encounter = 0, $copay = 0, $patcopay = 0)
{
global $var_index;
$var_index++;
$balance = bucks($charges - $ptpaid - $inspaid);
$balance = (round($duept, 2) != 0) ? 0 : $balance;//if balance is due from patient, then insurance balance is displayed as zero
$encounter = $encounter ? $encounter : '';
echo " <tr id='tr_" . attr($var_index) . "' >\n";
echo " <td>" . text(oeFormatShortDate($date)) . "</td>\n";
echo " <td class='text-center' id='" . attr($date) . "'>" . text($encounter) . "</td>\n";
echo " <td class='text-center' id='td_charges_$var_index' >" . text(bucks($charges)) . "</td>\n";
echo " <td class='text-center' id='td_inspaid_$var_index' >" . text(bucks($inspaid * -1)) . "</td>\n";
echo " <td class='text-center' id='td_ptpaid_$var_index' >" . text(bucks($ptpaid * -1)) . "</td>\n";
echo " <td class='text-center' id='td_patient_copay_$var_index' >" . text(bucks($patcopay)) . "</td>\n";
echo " <td class='text-center' id='td_copay_$var_index' >" . text(bucks($copay)) . "</td>\n";
echo " <td class='text-center' id='balance_$var_index'>" . text(bucks($balance)) . "</td>\n";
echo " <td class='text-center' id='duept_$var_index'>" . text(bucks(round($duept, 2) * 1)) . "</td>\n";
echo " <td class='text-right'><input type='text' class='form-control' name='" . attr($iname) . "' id='paying_" . attr($var_index) . "' " .
" value='' onchange='coloring();calctotal()' autocomplete='off' " .
"onkeyup='calctotal()'/></td>\n";
echo " </tr>\n";
}
// We use this to put dashes, colons, etc. back into a timestamp.
//
function decorateString($fmt, $str)
{
$res = '';
while ($fmt) {
$fc = substr($fmt, 0, 1);
$fmt = substr($fmt, 1);
if ($fc == '.') {
$res .= substr($str, 0, 1);
$str = substr($str, 1);
} else {
$res .= $fc;
}
}
return $res;
}
// Compute taxes from a tax rate string and a possibly taxable amount.
//
function calcTaxes($row, $amount)
{
$total = 0;
if (empty($row['taxrates'])) {
return $total;
}
$arates = explode(':', $row['taxrates']);
if (empty($arates)) {
return $total;
}
foreach ($arates as $value) {
if (empty($value)) {
continue;
}
$trow = sqlQuery("SELECT option_value FROM list_options WHERE " .
"list_id = 'taxrate' AND option_id = ? AND activity = 1 LIMIT 1", array($value));
if (empty($trow['option_value'])) {
echo "<!-- Missing tax rate '" . text($value) . "'! -->\n";
continue;
}
$tax = sprintf("%01.2f", $amount * $trow['option_value']);
// echo "<!-- Rate = '$value', amount = '$amount', tax = '$tax' -->\n";
$total += $tax;
}
return $total;
}
$now = time();
$today = date('Y-m-d', $now);
$timestamp = date('Y-m-d H:i:s', $now);
$patdata = sqlQuery("SELECT " .
"p.fname, p.mname, p.lname, p.pubpid,p.pid, i.copay " .
"FROM patient_data AS p " .
"LEFT OUTER JOIN insurance_data AS i ON " .
"i.pid = p.pid AND i.type = 'primary' " .
"WHERE p.pid = ? ORDER BY i.date DESC LIMIT 1", array($pid));
$alertmsg = ''; // anything here pops up in an alert box
// If the Save button was clicked...
if (!empty($_POST['form_save'])) {
if (!CsrfUtils::verifyCsrfToken($_POST["csrf_token_form"])) {
CsrfUtils::csrfNotVerified();
}
$form_pid = $_POST['form_pid'];
$form_method = trim($_POST['form_method']);
$form_source = trim($_POST['form_source']);
$patdata = getPatientData($form_pid, 'fname,mname,lname,pubpid');
$NameNew = $patdata['fname'] . " " . $patdata['lname'] . " " . $patdata['mname'];
if ($_REQUEST['radio_type_of_payment'] == 'pre_payment') {
$payment_id = sqlInsert(
"insert into ar_session set " .
"payer_id = ?" .
", patient_id = ?" .
", user_id = ?" .
", closed = ?" .
", reference = ?" .
", check_date = now() , deposit_date = now() " .
", pay_total = ?" .
", payment_type = 'patient'" .
", description = ?" .
", adjustment_code = 'pre_payment'" .
", post_to_date = now() " .
", payment_method = ?",
array(0, $form_pid, $_SESSION['authUserID'], 0, $form_source, $_REQUEST['form_prepayment'], $NameNew, $form_method)
);
frontPayment($form_pid, 0, $form_method, $form_source, $_REQUEST['form_prepayment'], 0, $timestamp);//insertion to 'payments' table.
}
if ($_POST['form_upay'] && $_REQUEST['radio_type_of_payment'] != 'pre_payment') {
foreach ($_POST['form_upay'] as $enc => $payment) {
$payment = floatval($payment);
if ($amount = $payment) {
$zero_enc = $enc;
if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance') {
if (!$enc) {
$enc = calendar_arrived($form_pid);
}
} else {
if (!$enc) {
$enc = calendar_arrived($form_pid);
}
}
//----------------------------------------------------------------------------------------------------
//Fetching the existing code and modifier
$ResultSearchNew = sqlStatement(
"SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key " .
"WHERE code_types.ct_fee=1 AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier",
array($form_pid, $enc)
);
if ($RowSearch = sqlFetchArray($ResultSearchNew)) {
$Codetype = $RowSearch['code_type'];
$Code = $RowSearch['code'];
$Modifier = $RowSearch['modifier'];
} else {
$Codetype = '';
$Code = '';
$Modifier = '';
}
//----------------------------------------------------------------------------------------------------
if ($_REQUEST['radio_type_of_payment'] == 'copay') {//copay saving to ar_session and ar_activity tables
$session_id = sqlInsert(
"INSERT INTO ar_session (payer_id,user_id,reference,check_date,deposit_date,pay_total," .
" global_amount,payment_type,description,patient_id,payment_method,adjustment_code,post_to_date) " .
" VALUES ('0',?,?,now(),now(),?,'','patient','COPAY',?,?,'patient_payment',now())",
array($_SESSION['authUserID'], $form_source, $amount, $form_pid, $form_method)
);
sqlBeginTrans();
$sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment FROM ar_activity WHERE pid = ? AND encounter = ?", array($form_pid, $enc));
$insrt_id = sqlInsert(
"INSERT INTO ar_activity (pid,encounter,sequence_no,code_type,code,modifier,payer_type,post_time,post_user,session_id,pay_amount,account_code)" .
" VALUES (?,?,?,?,?,?,0,now(),?,?,?,'PCP')",
array($form_pid, $enc, $sequence_no['increment'], $Codetype, $Code, $Modifier, $_SESSION['authUserID'], $session_id, $amount)
);
sqlCommitTrans();
frontPayment($form_pid, $enc, $form_method, $form_source, $amount, 0, $timestamp);//insertion to 'payments' table.
}
if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance' || $_REQUEST['radio_type_of_payment'] == 'cash') { //Payment by patient after insurance paid, cash patients similar to do not bill insurance in feesheet.
if ($_REQUEST['radio_type_of_payment'] == 'cash') {
sqlStatement(
"update form_encounter set last_level_closed=? where encounter=? and pid=? ",
array(4, $enc, $form_pid)
);
sqlStatement(
"update billing set billed=? where encounter=? and pid=?",
array(1, $enc, $form_pid)
);
}
$adjustment_code = 'patient_payment';
$payment_id = sqlInsert(
"insert into ar_session set " .
"payer_id = ?" .
", patient_id = ?" .
", user_id = ?" .
", closed = ?" .
", reference = ?" .
", check_date = now() , deposit_date = now() " .
", pay_total = ?" .
", payment_type = 'patient'" .
", description = ?" .
", adjustment_code = ?" .
", post_to_date = now() " .
", payment_method = ?",
array(0, $form_pid, $_SESSION['authUserID'], 0, $form_source, $amount, $NameNew, $adjustment_code, $form_method)
);
//--------------------------------------------------------------------------------------------------------------------
frontPayment($form_pid, $enc, $form_method, $form_source, 0, $amount, $timestamp);//insertion to 'payments' table.
//--------------------------------------------------------------------------------------------------------------------
$resMoneyGot = sqlStatement(
"SELECT sum(pay_amount) as PatientPay FROM ar_activity where pid =? and " .
"encounter = ? and payer_type = 0 and account_code = 'PCP' AND deleted IS NULL",
array($form_pid, $enc)
);//new fees screen copay gives account_code='PCP'
$rowMoneyGot = sqlFetchArray($resMoneyGot);
$Copay = $rowMoneyGot['PatientPay'];
//--------------------------------------------------------------------------------------------------------------------
//Looping the existing code and modifier
$ResultSearchNew = sqlStatement(
"SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key WHERE code_types.ct_fee=1 " .
"AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier",
array($form_pid, $enc)
);
while ($RowSearch = sqlFetchArray($ResultSearchNew)) {
$Codetype = $RowSearch['code_type'];
$Code = $RowSearch['code'];
$Modifier = $RowSearch['modifier'];
$Fee = $RowSearch['fee'];
$resMoneyGot = sqlStatement(
"SELECT sum(pay_amount) as MoneyGot FROM ar_activity where pid = ? AND deleted IS NULL " .
"and code_type=? and code=? and modifier=? and encounter =? and !(payer_type=0 and account_code='PCP')",
array($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 != $encounter) {
echo "&nbsp;<input type='button' class='btn btn-primary' " .
"value='" . xla('Open Today`s Visit') . "' " .
"onclick='toencounter(" . attr_js($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="" />&nbsp;&nbsp;
</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'); ?>:&nbsp;
<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'); ?>:&nbsp;<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>