"1",
"ba0" => "2",
"ba1" => "3",
"ca0" => "4",
"cb0" => "5",
"da0" => "6",
"da1" => "7",
"da2" => "8",
"ea0" => "9",
"ea1" => "10",
"fa0" => "11",
"fb0" => "12",
"fb1" => "13",
"xa0" => "14",
"ya0" => "15",
"za0" => "16",
"gu0" => "17"
);
var $rendorform_variables = array(
"aa0",
"ba0",
"ba1",
"ca0",
"cb0",
"da0",
"da1",
"da2",
"ea0",
"ea1",
"fa0",
"fb0",
"fb1",
"gu0",
"ha0",
"xa0",
"ya0"
);
function NSF()
{
return;
}
function NSF_Setup($user,$pw,$formno,$insmod)
{
$this->userid = $user;
$this->password = $pw;
$this->formno = $formno;
$this->insmod = $insmod;
return;
}
function Insurer($procstack)
{
$row = $procstack[0];
// cov types should be the same for entire stack
$bill_request_type = $row[proccurcovtp];
if ($bill_request_type == PRIMARY)
$buffer = $this->PrimaryInfo($procstack);
else
$buffer = $this->SecondaryInfo($procstack);
return $buffer;
}
function SecondaryInfo($procstack)
{
reset ($GLOBALS);
while (list($k,$v)=each($GLOBALS)) global $$k;
global $da0,$da1,$da2;
$row = $procstack[0]; // all rows are the same
$billto = $row[proccurcovtp];
$cov = $row[proccov2];
$pat = $row[procpatient];
$da0[recid] = "DA0";
$da1[recid] = "XXX";
$da2[recid] = "XXX";
$coverage = CreateObject('FreeMED.Coverage', $cov);
if (!$coverage)
{
echo "Error Insurer no coverage covid".$row[proccov2]." procid ".$row[id]."
";
return;
}
$insco = $coverage->covinsco;
if (!$insco)
{
echo "Error Insurer no insurance
";
return;
}
$patient = CreateObject('FreeMED.Patient', $pat);
if (!$patient)
{
echo "Error Insurer no patient
";
return;
}
$da0[recid] = "DA0";
$da0[seqno] = "02";
$da0[patcntl] = $ca0[patcntl];
$da0[payerid] = $this->CleanNumber($insco->local_record[inscoid]); // NAIC #
$da0[payername] = $this->CleanChar($insco->insconame);
$da0[patgrpno] = $this->CleanNumber($coverage->covpatgrpno);
if ($billto == SECONDARY)
$da0[clmfileind] = "P"; // request pay from secondary
else
$da0[clmfileind] = "I"; // secondary is info only
$clmsource = $this->GetClaimSource($insco);
//echo "clmsource $clmsource
";
if (empty($clmsource))
echo "ERROR - No Claim Source in SecondaryInfo
";
else
$da0[clmsource] = $clmsource;
if ($coverage->local_record[covbenasgn] == 1)
$da0[assign] = "Y";
else
$da0[assign] = "N";
$da0[patrel] = $this->GetRelationShip($coverage->covreldep,"NSF");
$da0[patidno] = $this->CleanNumber($coverage->covpatinsno);
if ($coverage->covdep == 0) // patient is the insured
{
$da0[insrdlname] = $this->CleanChar($patient->ptlname);
$da0[insrdfname] = $this->CleanChar($patient->ptfname);
$da0[insrdmi] = $this->CleanChar($patient->ptmname);
$da0[insrdsex] = $this->CleanChar($patient->ptsex);
$da0[insrddob] = $this->CleanNumber($patient->ptdob);
$addr1 = $this->CleanChar($patient->local_record[ptaddr1]);
$city = $this->CleanChar($patient->local_record[ptcity]);
$state = $this->CleanChar($patient->local_record[ptstate]);
$zip = $this->CleanNumber($patient->local_record[ptzip]);
}
else
{
$guarantor = CreateObject('FreeMED.Guarantor', $coverage->covdep);
if (!$guarantor)
{
echo "Error Insurer guarantor failed
";
return;
}
$da0[insrdlname] = $this->CleanChar($guarantor->guarlname);
$da0[insrdfname] = $this->CleanChar($guarantor->guarfname);
$da0[insrdmi] = $this->CleanChar($guarantor->guarmname);
$da0[insrdsex] = $this->CleanChar($guarantor->guarsex);
$da0[insrddob] = $this->CleanNumber($guarantor->guardob);
if ($guarantor->guarsame) // guar addr same as patient?
{
$addr1 = $this->CleanChar($patient->local_record[ptaddr1]);
$city = $this->CleanChar($patient->local_record[ptcity]);
$state = $this->CleanChar($patient->local_record[ptstate]);
$zip = $this->CleanNumber($patient->local_record[ptzip]);
}
else
{
$addr1 = $this->CleanChar($guarantor->guaraddr1);
$city = $this->CleanChar($guarantor->guarcity);
$state = $this->CleanChar($guarantor->guarstate);
$zip = $this->CleanNumber($guarantor->guarzip);
}
}
$auth_num = $this->VerifyAuth($procstack);
if ($auth_num != "0")
$da0[authno] = $this->CleanNumber($auth_num);
$da1[recid] = "DA1";
$da1[seqno] = "02";
$da1[patcntl] = $ca0[patcntl];
$da1[payeraddr1] = $this->CleanChar($insco->local_record[inscoaddr1]);
$da1[payeraddr2] = $this->CleanChar($insco->local_record[inscoaddr2]);
$da1[payercity] = $this->CleanChar($insco->local_record[inscocity]);
$da1[payerstate] = $this->CleanChar($insco->local_record[inscostate]);
$da1[payerzip] = $this->CleanNumber($insco->local_record[inscozip]);
$da2[recid] = "DA2";
$da2[seqno] = "02";
$da2[patcntl] = $ca0[patcntl];
$da2[insrdaddr1] = $addr1;
$da2[insrdcity] = $city;
$da2[insrdstate] = $state;
$da2[insrdzip] = $zip;
return;
} // end SecondaryInfo
function PrimaryInfo($procstack)
{
reset ($GLOBALS);
while (list($k,$v)=each($GLOBALS)) global $$k;
//unset($GLOBALS[da0]);
//unset($GLOBALS[da1]);
//unset($GLOBALS[da2]);
global $da1,$da0,$da2;
$row = $procstack[0]; // all rows are the same
$billto = $row[proccurcovtp];
$cov = $row[proccov1];
$pat = $row[procpatient];
$da0[recid] = "DA0";
$coverage = CreateObject('FreeMED.Coverage', $cov);
if (!$coverage)
{
echo "Error Insurer no coverage
";
return;
}
$insco = $coverage->covinsco;
if (!$insco)
{
echo "Error Insurer no insurance
";
return;
}
$patient = CreateObject('FreeMED.Patient', $pat);
if (!$patient)
{
echo "Error Insurer no patient
";
return;
}
$da0[seqno] = "01";
$da0[patcntl] = $ca0[patcntl];
if ($billto == PRIMARY)
$da0[clmfileind] = "P"; // request pay from primary
else
$da0[clmfileind] = "I"; // primary is info only
$clmsource = $this->GetClaimSource($insco);
//echo "clmsource $clmsource
";
if (empty($clmsource))
echo "ERROR - No Claim Source in PrimaryInfo
";
else
$da0[clmsource] = $clmsource;
$da0[payerid] = $this->CleanNumber($insco->local_record[inscoid]); // NAIC #
$da0[payername] = $this->CleanChar($insco->insconame);
$da0[patgrpno] = $this->CleanNumber($coverage->covpatgrpno);
if ($coverage->local_record[covbenasgn] == 1)
$da0[assign] = "Y";
else
$da0[assign] = "N";
$da0[patsigsrc] = "C"; // signed HCFA 1500 on file.
$da0[patrel] = $this->GetRelationShip($coverage->covreldep,"NSF");
$da0[patidno] = $this->CleanNumber($coverage->covpatinsno);
if ($coverage->covdep == 0) // patient is the insured
{
$da0[insrdlname] = $this->CleanChar($patient->ptlname);
$da0[insrdfname] = $this->CleanChar($patient->ptfname);
$da0[insrdmi] = $this->CleanChar($patient->ptmname);
$da0[insrdsex] = $this->CleanChar($patient->ptsex);
$da0[insrddob] = $this->CleanNumber($patient->ptdob);
$addr1 = $this->CleanChar($patient->local_record[ptaddr1]);
$city = $this->CleanChar($patient->local_record[ptcity]);
$state = $this->CleanChar($patient->local_record[ptstate]);
$zip = $this->CleanNumber($patient->local_record[ptzip]);
}
else
{
$guarantor = CreateObject('FreeMED.Guarantor', $coverage->covdep);
if (!$guarantor)
{
echo "Error Insurer guarantor failed
";
return;
}
$da0[insrdlname] = $this->CleanChar($guarantor->guarlname);
$da0[insrdfname] = $this->CleanChar($guarantor->guarfname);
$da0[insrdmi] = $this->CleanChar($guarantor->guarmname);
$da0[insrdsex] = $this->CleanChar($guarantor->guarsex);
$da0[insrddob] = $this->CleanNumber($guarantor->guardob);
if ($guarantor->guarsame) // guar addr same as patient?
{
$addr1 = $this->CleanChar($patient->local_record[ptaddr1]);
$city = $this->CleanChar($patient->local_record[ptcity]);
$state = $this->CleanChar($patient->local_record[ptstate]);
$zip = $this->CleanNumber($patient->local_record[ptzip]);
}
else
{
$addr1 = $this->CleanChar($guarantor->guaraddr1);
$city = $this->CleanChar($guarantor->guarcity);
$state = $this->CleanChar($guarantor->guarstate);
$zip = $this->CleanNumber($guarantor->guarzip);
}
}
$auth_num = $this->VerifyAuth($procstack);
if ($auth_num != "0")
{
if ($da0[payerid] == "MHN") // Managed Health Network are IDIOTS!
$da0[mcaidid] = $this->CleanNumber($auth_num);
else
$da0[authno] = $this->CleanNumber($auth_num);
}
$da1[recid] = "DA1";
$da1[seqno] = "01";
$da1[patcntl] = $ca0[patcntl];
$da1[payeraddr1] = $this->CleanChar($insco->local_record[inscoaddr1]);
$da1[payeraddr2] = $this->CleanChar($insco->local_record[inscoaddr2]);
$da1[payercity] = $this->CleanChar($insco->local_record[inscocity]);
$da1[payerstate] = $this->CleanChar($insco->local_record[inscostate]);
$da1[payerzip] = $this->CleanNumber($insco->local_record[inscozip]);
if ($billto != PRIMARY) // if not billing the primary
{
// show amounts paid by primary
$this->PrimaryPaidAmounts($procstack);
}
$da2[recid] = "DA2";
$da2[seqno] = "01";
$da2[patcntl] = $ca0[patcntl];
//echo "da2 addr city state zip $addr1 $city $state $zip
";
$da2[insrdaddr1] = $addr1;
$da2[insrdcity] = $city;
$da2[insrdstate] = $state;
$da2[insrdzip] = $zip;
if ($da0[payerid] == "MHN")
$da0[payerid] == "PAPER"; // They dont do edi either!!
return;
} // end PrimaryInfo
function ClaimHeader($procstack)
{
reset ($GLOBALS);
while (list($k,$v)=each($GLOBALS)) global $$k;
global $ca0, $cb0;
$row = $procstack[0]; // all rows are the same
$cov = $row[proccurcovid];
$pat = $row[procpatient];
$doc = $row[procphysician];
$ca0[recid] = "CA0";
$coverage = CreateObject('FreeMED.Coverage', $cov);
if (!$coverage)
{
echo "Error in claimheader no coverage
";
return;
}
$physician = CreateObject('FreeMED.Physician', $doc);
if (!$physician)
{
echo "Error in claimheader no physician
";
return;
}
$patient = CreateObject('FreeMED.Patient', $pat);
if (!$patient)
{
echo "Error in claimheader no patient
";
return;
}
if (empty($patient->local_record[ptid]))
$ca0[patcntl] = $patient->local_record[id];
else
$ca0[patcntl] = $this->CleanChar($patient->local_record[ptid]);
$ca0[deathind] = "N";
if ($patient->local_record[ptdead] > 0)
{
$ca0[deathind] = "Y";
$ca0[patdtdead] = $this->CleanNumber($patient->local_record[ptdeaddt]);
}
$ca0[patlname] = $this->CleanChar($patient->local_record[ptlname]);
$ca0[patfname] = $this->CleanChar($patient->local_record[ptfname]);
$ca0[patdob] = $this->CleanNumber($patient->local_record[ptdob]);
$ca0[patsex] = $this->CleanChar($patient->local_record[ptsex]);
$ca0[pataddr1] = $this->CleanChar($patient->local_record[ptaddr1]);
$ca0[pataddr2] = $this->CleanChar($patient->local_record[ptaddr2]);
$ca0[patcity] = $this->CleanChar($patient->local_record[ptcity]);
$ca0[patstate] = $this->CleanChar($patient->local_record[ptstate]);
$ca0[patzip] = $this->CleanNumber($patient->local_record[ptzip]);
$ca0[patphone] = $this->CleanNumber($patient->local_record[pthphone]);
// marital status
if ($patient->ptmarital == "single")
$ca0[patmarital] = "S";
if ($patient->ptmarital == "divorced")
$ca0[patmarital] = "D";
if ($patient->ptmarital == "seperated")
$ca0[patmarital] = "S";
if ($patient->ptmarital == "married")
$ca0[patmarital] = "M";
if ($patient->ptmarital == "widowed")
$ca0[patmarital] = "W";
if ($patient->local_record[ptempl] == "y")
$ca0[patempl] = "1"; //full time
if ($patient->local_record[ptempl] == "p")
$ca0[patempl] = "2"; // part time
if ($patient->local_record[ptempl] == "n")
$ca0[patempl] = "3"; // not employed
if ($patient->local_record[ptempl] == "s")
$ca0[patempl] = "4"; // self employed
if ($patient->local_record[ptempl] == "r")
$ca0[patempl] = "5"; // retired
if ($patient->local_record[ptempl] == "m")
$ca0[patempl] = "6"; // active military
if ($patient->local_record[ptempl] == "u")
$ca0[patempl] = "9"; // unknown
$covtype = $coverage->local_record[covtype];
$othrins = 3; // no other coverage
if ( ($covtype == PRIMARY) AND ($row[proccov.(SECONDARY)] != 0) )
$othrins = "1"; // has other coverage in this bill
if ( ($covtype == SECONDARY) AND ($row[proccov.(PRIMARY)] != 0) )
$othrins = "1"; // has other coverage in this bill
// NSF does not handle tertiary!
$ca0[patothrins] = $othrins;
//$buffer = "";
//$buffer = render_fixedRecord ($this->formno,$this->record_types["ca0"]);
//if ($cb0[recid] == "CB0") // only required for champus
//$buffer .= render_fixedRecord ($this->formno,$this->record_types["cb0"]);
//return $buffer;
return;
} // end claimheader
function FileHeader()
{
//unset($GLOBALS[aa0]);
global $aa0,$cur_date;
$aa0[recid] = "AA0";
$aa0[submtrid] = $this->CleanChar($this->userid);
$aa0[subtype] = "U";
$this->subno++;
// this should be saved in the ch table. gotton when started.
// incremented as used then saved when done.
$aa0[subno] = $this->subno; // once in 7 months!!!
$aa0[createdt] = $this->CleanNumber($cur_date);
$aa0[recvrid] = "MIXED"; // file contains claims for multiple payers
$aa0[nsfverno] = "00301";
$aa0[testprod] = "PROD";
$aa0[password] = $this->CleanChar($this->password);
$aa0[vendorid] = "FREMED";
//$buffer = render_fixedRecord ($this->formno,$this->record_types["aa0"]);
//return $buffer;
return;
} // end fileheader
function ProviderHeader($procstack)
{
foreach ($GLOBALS AS $k => $v) { global ${$k}; }
//unset($GLOBALS[ba0]);
//unset($GLOBALS[ba1]);
global $ba0, $ba1;
$row = $procstack[0]; // all rows are the same
$doc = $row[procphysician];
$cov = $row[proccurcovid];
$ba0[recid] = "BA0";
$ba1[recid] = "BA1";
$physician = CreateObject('FreeMED.Physician', $doc);
if (!$physician)
{
echo "Error no physician
";
return;
}
$coverage = CreateObject('FreeMED.Coverage', $cov);
if (!$coverage)
{
echo "Error no coverage
";
return;
}
$insco = $coverage->covinsco;
if (!$insco)
{
echo "Error no insco
";
return;
}
$ba0[batchtype] = "100";
$this->batchno++;
$ba0[batchnum] = $this->batchno; // needs incrementer
$this->batchid++;
// this should be saved in the ch table. gotton when started.
// incremented as used then saved when done.
$ba0[batchid] = $this->batchid; // only used once for 30 days!!!
$ba0[taxid] = "";
if ($_SESSION['default_facility'] != 0)
{
$fac = 0;
$fac = freemed::get_link_rec(
$_SESSION['default_facility'],
"facility"
);
if (!$fac)
echo "ERROR - Failed getting default facility
";
$ba0[posname] = $this->CleanChar($fac[psrname]);
$ba0[taxid] = $this->CleanNumber($fac[psrein]);
$ba0[idtype] = "E";
}
if (empty($ba0[taxid]))
{
echo "Warning - No EIN using Providers SSN
";
$ba0[posname] = $this->CleanChar($physician->local_record[phypracname]);
$ba0[taxid] = $this->CleanNumber($physician->local_record[physsn]);
$ba0[idtype] = "S";
}
// other id's are dependant on the ins NAIC no
$ba0[prlname] = $this->CleanChar($physician->local_record[phylname]);
$fname = $physician->local_record[phyfname];
$insid = $this->CleanChar($insco->local_record[inscoid]);
if ($insid=="PAPER") // paper claim require credentials
$fname = $fname." ".$physician->local_record[phytitle];
$ba0[prfname] = $this->CleanChar($fname);
$prspec = $physician->local_record[physpe1];
$specrow = freemed::get_link_rec($prspec,"specialties");
$ba0[prspec] = $this->CleanChar($specrow[specname]);
//$provider_id = "0";
//$grp = $insco->local_record[inscogroup];
//if (!$grp)
//{
// $name = $insco->local_record[insconame];
// echo "Failed getting inscogroup for $name
";
//}
//$providerids = explode(":",$physician->local_record[phyidmap]);
//$provider_id = $providerids[$grp];
//$upin = $physician->local_record[phyupin];
//$ba0[upin] = $this->CleanNumber($upin);
//$ba0[ciid] = $this->CleanNumber($provider_id); // commercial provider id
$ba1[batchtype] = $ba0[batchtype];
$ba1[batchid] = $ba0[batchid];
$ba1[batchnum] = $ba0[batchnum];
$ba1[praddr1] = $this->CleanChar($physician->local_record[phyaddr1a]);
$ba1[praddr2] = $this->CleanChar($physician->local_record[phyaddr2a]);
$ba1[prcity] = $this->CleanChar($physician->local_record[phycitya]);
$ba1[prstate] = $this->CleanChar($physician->local_record[phystatea]);
$ba1[przip] = $this->CleanNumber($physician->local_record[phyzipa]);
$ba1[prphone] = $this->CleanNumber($physician->local_record[phyphonea]);
$ba1[prpayaddr1] = $this->CleanChar($physician->local_record[phyaddr1a]);
$ba1[prpayaddr2] = $this->CleanChar($physician->local_record[phyaddr2a]);
$ba1[prpaycity] = $this->CleanChar($physician->local_record[phycitya]);
$ba1[prpaystate] = $this->CleanChar($physician->local_record[phystatea]);
$ba1[prpayzip] = $this->CleanNumber($physician->local_record[phyzipa]);
$ba1[prpayphone] = $this->CleanNumber($physician->local_record[phyphonea]);
//$buffer = "";
//$buffer = render_fixedRecord ($this->formno,$this->record_types["ba0"]);
//$buffer .= render_fixedRecord ($this->formno,$this->record_types["ba1"]);
//return $buffer;
return;
} // end provider
function ClaimData($procstack)
{
reset ($GLOBALS);
while (list($k,$v)=each($GLOBALS)) global $$k;
global $ea0,$ea1,$ca0;
$row = $procstack[0];
$cov = $row[proccurcovid];
$coverage = CreateObject('FreeMED.Coverage', $cov);
if (!$coverage)
{
echo "Error no coverage ClaimData
";
return;
}
$insco = $coverage->covinsco;
if (!$insco)
{
echo "Error ClaimData no insurance
";
return;
}
$ea0[recid] = "EA0";
$ea1[recid] = "XXX";
$ea0[patcntl] = $ca0[patcntl];
$ea0[relemp] = "N";
$ea0[accident] = "N";
$ea0[symptomind] = "0";
$ea0[accsympdt] = " ";
if ($coverage->local_record[covrelinfo] == 0)
$ea0[relinfoind] = "N";
if ($coverage->local_record[covrelinfo] == 1)
$ea0[relinfoind] = "Y";
if ($coverage->local_record[covrelinfo] == 2)
$ea0[relinfoind] = "M";
$ea0[relinfodt] = $this->CleanNumber($coverage->local_record[covrelinfodt]);
if ($coverage->local_record[covprovasgn] == 0)
$ea0[provassign] = "N"; // provider accepts assigmnent
if ($coverage->local_record[covprovasgn] == 1)
$ea0[provassign] = "A"; // provider accepts assigmnent
//echo "referer $row[procrefdoc]
";
if ($row[procrefdoc] != 0)
{
$refdoc = CreateObject('FreeMED.Physician', $row[procrefdoc]);
if (!$refdoc)
echo "Error getting referring physician
";
$ea0[refprovupin] = $this->CleanChar($refdoc->local_record[phyupin]);
$ea0[reflname] = $this->CleanChar($refdoc->local_record[phylname]);
$ea0[reffname] = $this->CleanChar($refdoc->local_record[phyfname]);
}
if ($row[proceoc] != 0)
$eoc_row = freemed::get_link_rec($row[proceoc], "eoc");
else
echo "Warning - No EOC for this procedure $row[procdt]
";
if ($eoc_row)
{
$eoc_row = freemed::get_link_rec($row[proceoc], "eoc");
if (!$eoc_row)
echo "Failed reading eoc record
";
if ($eoc_row[eocrelauto] == "yes")
{
$ea0[accident] = "A";
$ea0[symptomind] = "0";
$accident_date = $eoc_row[eocstartdate];
}
if ($eoc_row[eocrelemp] == "yes")
{
$ea0[relemp] = "Y";
$accident_date = $eoc_row[eocstartdate];
}
if ($eoc_row[eocrelother] == "yes") // other Accident!
{
$ea0[accident] = "O";
$ea0[symptomind] = "0";
$accident_date = $eoc_row[eocstartdate];
}
if ($eoc_row[eocrelpreg] == "yes") // preg?
{
$ea0[symptomind] = "2";
$accident_date = $eoc_row[eocpreglastper];
}
if ($ea0[accident] == "A" OR
$ea0[accident] == "O" OR
$ea0[symtomind] == "1" OR
$ea0[symtomind] == "2")
$ea0[accsympdt] = $this->CleanNumber($accident_date);
if ($eoc_row[eochospital] > 0)
{
$ea0[admitdt] = $this->CleanNumber($eoc_row[eochosadmdt]);
$ea0[dischargdt] = $this->CleanNumber($eoc_row[eochosdischrgdt]);
}
if ($eoc_row[eocdistype] != 0)
$ea0[distype] = $eoc_row[eocdistype];
echo "distype ".$eoc_row[eocdistype]." nsf ".$eoc_row[eocdistype]."
";
if ( ($eoc_row[eocdistype] == "1") OR ($eoc_row[eocdistype] == "2") )
{
$ea0[disfromdt] = $this->CleanNumber($eoc_row[eocdisfromdt]);
$ea0[distodt] = $this->CleanNumber($eoc_row[eocdistodt]);
}
if ($eoc_row[eocsimsympind] > 0)
{
$ea0[samesympind] = "Y";
$ea0[samesympdt] = $this->CleanNumber($eoc_row[eocdtlastsimilar]);
}
} // end got eoc rec
$count = count($procstack);
if ($count == 0)
{
echo "Error in GenClaimSegment Stack count 0
";
return;
}
$diagset = CreateObject('FreeMED.diagnosis_set');
for ($i=0;$i<$count;$i++)
{
$prow = $procstack[$i];
// this should never overflow if the control break is working.
$diagset->testAddSet($prow[procdiag1],
$prow[procdiag2],
$prow[procdiag3],
$prow[procdiag4]);
}
$diagstack = $diagset->getStack();
$diagcnt = count($diagstack);
//echo "stack count $diagcnt
";
if ($diagcnt == 0)
{
echo "Procedures do not have Diagnosis codes
";
return;
}
for ($i=0;$i<$diagcnt;$i++)
{
$varno = $i+1;
$var = "diag".$varno;
$ea0[$var] = $this->CleanNumber($diagstack[$varno]);
//$this->edi_buffer .= $icd9code;
}
// see if procpos is not home or office
$pos = 0;
$fac_row=0;
$fac_row = freemed::get_link_rec($row[procpos], "facility");
if ($fac_row)
{
// use code from facility
if ($fac_row[psrpos] == 0)
{
echo "Facility does not have a pos code
";
}
$cur_pos = freemed::get_link_rec($fac_row[psrpos], "pos");
if (!$cur_pos)
echo "Failed reading pos table";
$pos = $cur_pos[posname];
}
if ($pos==0)
$pos="11"; // office default
// 11 = office 12 = home
if ($pos > 12)
{
$ea0[faclabname] = $this->CleanChar($fac_row[psrname]);
$ea1[recid] = "EA1";
$ea1[patcntl] = $ca0[patcntl];
// for these facilites the ien doubles as the facility id.
$ea1[faclabid] = $this->CleanChar($fac_row[psrein]);
$ea1[faclabaddr1] = $this->CleanChar($fac_row[psraddr1]);
$ea1[faclabaddr2] = $this->CleanChar($fac_row[psraddr2]);
$ea1[faclabcity] = $this->CleanChar($fac_row[psrcity]);
$ea1[faclabstate] = $this->CleanChar($fac_row[psrstate]);
}
if ($ba0[prspec] == "31") // podiatry?
{
if (substr($row[procrefdt],0,1) != "0")
$ea0[dtlastseen] = $this->CleanNumber($row[procrefdt]);
else
echo "Warning - Date last seen is zero for Podiatry bill
";
}
if ($row[procatnddoc] > 0) // attending doc?
{
$ea1[recid] = "EA1";
$ea1[patcntl] = $ca0[patcntl];
$atnddoc = CreateObject('FreeMED.Physician', $row[procatnddoc]);
if (!$atnddoc)
echo "Error getting attending physician
";
$ea1[supvprovupin] = $this->CleanChar($atnddoc->local_record[phyupin]);
$ea1[supvprovlnam] = $this->CleanChar($atnddoc->local_record[phylname]);
$ea1[supvprovfnam] = $this->CleanChar($atnddoc->local_record[phyfname]);
}
return;
} // end claimdata
function ServiceDetail($proc)
{
reset ($GLOBALS);
while (list($k,$v)=each($GLOBALS)) global $$k;
unset ($GLOBALS[fa0]);
unset ($GLOBALS[fb1]);
global $fa0,$fb1,$ca0,$ba0;
$row = $proc;
$doc = $row[procphysician];
$cov = $row[proccurcovid];
$coverage = CreateObject('FreeMED.Coverage', $cov);
if (!$coverage)
{
echo "Error ServiceDetail no coverage
";
return;
}
$insco = $coverage->covinsco;
if (!$insco)
{
echo "Error ServiceDetail no insurance
";
return;
}
$physician = CreateObject('FreeMED.Physician', $doc);
if (!$physician)
{
echo "Error in ServiceDetail no physician
";
}
$grp = $insco->local_record[inscogroup];
if (!$grp)
{
$name = $insco->local_record[insconame];
echo "ERROR - Failed getting Insurance Group in ServiceDetail!
";
}
$provider_id = $this->GetProviderGroupID($physician->local_record[phygrpprac],$grp);
if ($provider_id != "0")
{
// if group practice then get the rendering providerid
$provider_id = $this->GetProviderID($physician->local_record[phyidmap],$grp);
if ($provider_id=="0")
echo "ERROR - No Rendering Provider ID in ServiceDetail!
";
}
$payerid = $this->CleanNumber($insco->local_record[inscoid]);
$diagset = CreateObject('FreeMED.diagnosis_set');
$fa0[recid] = "FA0";
$fa0[patcntl] = $ca0[patcntl];
$fa0[startdt] = $this->CleanNumber($row[procdt]);
$fa0[enddt] = $this->CleanNumber($row[procdt]);
if ($provider_id != "0")
$fa0[rendprid] = $this->CleanNumber($provider_id);
if ($row[proccptmod] != 0)
{
$itemcptmod = freemed::get_link_field ($row[proccptmod], "cptmod", "cptmod");
if (!$itemcptmod)
echo "ERROR - Failed reading cptmod table
";
$fa0[cptmod1] = $itemcptmod;
}
if ($row[proccptmod2] != 0)
{
$itemcptmod = freemed::get_link_field ($row[proccptmod2], "cptmod", "cptmod");
if (!$itemcptmod)
echo "ERROR - Failed reading cptmod table
";
$fa0[cptmod2] = $itemcptmod;
}
$cur_cpt = freemed::get_link_rec ($row[proccpt], "cpt");
if (!$cur_cpt)
echo "ERROR - Failed reading cpt table
";
$cur_insco = $insco->local_record[id];
//echo "insco $cur_insco
";
$tos_stack = fm_split_into_array ($cur_cpt[cpttos]);
$tosid = ( ($tos_stack[$cur_insco] < 1) ?
$cur_cpt[cptdeftos] :
$tos_stack[$cur_insco] );
// tos prefix used by champus
//echo "cpt prefix $cur_cpt[cpttosprfx]";
$tosprfx_stack = fm_split_into_array ($cur_cpt[cpttosprfx]);
$tosprfxid = ( ($tosprfx_stack[$cur_insco] < 1) ?
"0" :
$tosprfx_stack[$cur_insco] );
if ($tosid == 0)
{
echo "ERROR - No default type of service for this proc $row[procdt]
";
$tos = "XX";
}
else
{
$cur_tos = freemed::get_link_rec($tosid, "tos");
if (!$cur_tos)
echo "ERROR - Failed reading TOS table
";
$tos = $cur_tos[tosname];
}
if ($payerid=="REG06") // champus REG06 wanst wird tos codes
{
if ($tosprfxid == 0)
{
echo "ERROR - No REG06 TOS Prefix for this proc $row[procdt]
";
$tos = "XX";
}
else
{
//echo "prfxid $tosprfxid
";
$cur_tos = freemed::get_link_rec($tosprfxid, "tos");
if (!$cur_tos)
echo "ERROR - Failed REG06 reading prefix tos table
";
$tosprfx = $cur_tos[tosname];
}
// make champus tos
$tos = $tosprfx.$tos;
if (strlen($tos) > 3)
{
echo "ERROR - Invalid REG06 TOS proc $row[procdt]
";
$tos = "XX";
}
}
if ( (strlen($tos) < 2) AND ($tos > 0) AND ($tos < 10) )
$tos = "0".$tos;
$fa0[tos] = $tos;
$cur_cpt = freemed::get_link_rec ($row[proccpt], "cpt");
if (!$cur_cpt)
echo "Failed reading cpt table
";
$diagset->testAddSet($row[procdiag1],
$row[procdiag2],
$row[procdiag3],
$row[procdiag4]);
$diag_xref = $diagset->xrefList($row[procdiag1],
$row[procdiag2],
$row[procdiag3],
$row[procdiag4]);
$fa0[cpt] = $cur_cpt[cptcode];
$data = $this->MakeDecimal($row[procbalorig],2);
$fa0[charges] = $data;
$diag_xref = explode(",",$diag_xref);
for ($x=0;$x";
$xoff = $x+1;
$var = "diag".$xoff;
$fa0[$var] = $diag_xref[$x];
}
$data = $this->MakeDecimal($row[procunits],1);
$fa0[units] = $data;
return;
} // end servicedetail
function ClaimTrailer($procstack,$buffer)
{
reset ($GLOBALS);
while (list($k,$v)=each($GLOBALS)) global $$k;
//unset($GLOBALS[xa0]);
global $xa0;
$buff = explode("\n",$buffer);
$buffcount = count($buff);
$cxx = $dxx = $exx = $fxx = $gxx = $hxx = "00";
for ($i=0;$i<$buffcount;$i++)
{
if (substr($buff[$i],0,1) == "C")
$cxx++;
if (substr($buff[$i],0,1) == "D")
$dxx++;
if (substr($buff[$i],0,1) == "E")
$exx++;
if (substr($buff[$i],0,1) == "F")
$fxx++;
if (substr($buff[$i],0,1) == "G")
$gxx++;
if (substr($buff[$i],0,1) == "H")
$hxx++;
}
$xa0[recid] = "XA0";
$xa0[patcntl] = $ca0[patcntl];
$xa0[cxxcount] = $cxx;
$xa0[dxxcount] = $dxx;
$xa0[exxcount] = $exx;
$xa0[fxxcount] = $fxx;
$xa0[gxxcount] = $gxx;
$xa0[hxxcount] = $hxx;
$xa0[clmreccount] = $cxx+$dxx+$exx+$fxx+$gxx+$hxx;
$count = count($procstack);
if ($count == 0)
{
echo "Error no procedures in ClaimTrailerquery($query) or DIE("Query failed for patient payments");
while ($pay_row = $sql->fetch_array($pay_result))
{
$total_paid_bypatient += $pay_row[payrecamt];
}
*/
}
$data = $this->MakeDecimal($total,2);
$xa0[totalcharge] = $data;
//$data = $this->MakeDecimal($total_paid_bypatient,2);
$data = $this->GetPatientPaid($procstack);
$xa0[patamtpd] = $data;
//$buffer = render_fixedRecord ($this->formno,$this->record_types["xa0"]);
//return $buffer;
return;
} // end claimtrailer
function ProviderTrailer($procstack, $buffer)
{
reset ($GLOBALS);
while (list($k,$v)=each($GLOBALS)) global $$k;
reset ($this->rendorform_variables);
while (list($k,$v)=each($this->rendorform_variables)) global $$v;
//unset($GLOBALS[ya0]);
//unset($GLOBALS[za0]);
global $ya0;
global $za0;
$ya0[recid] = "YA0";
$ya0[emcprvid] = $ba0[emcprvid];
$ya0[batchtype] = $ba0[batchtype];
$ya0[batchno] = $ba0[batchnum];
$ya0[batchid] = $ba0[batchid];
$ya0[prvtaxid] = $ba0[taxid];
$buff = explode("\n",$buffer);
$buffcount = count($buff);
$tot = $cxx = $fxx = 0;
for ($i=0;$i<$buffcount;$i++)
{
//if (substr($buff[$i],0,1) == "")
// continue;
//if (substr($buff[$i],0,1) == " ")
// continue;
$tot++;
if (substr($buff[$i],0,3) == "CA0")
$cxx++;
if (substr($buff[$i],0,3) == "FA0")
$fxx++;
}
//$tot++; // account for this ya0 record
//echo "count $tot
";
$ya0[batchreccnt] = $tot;
$ya0[svclinecnt] = $fxx;
$ya0[batchclmcnt] = $cxx;
$ya0[batchtotchg] = $xa0[totalcharge]; // only one batch per control break
$this->batchcnt++;
$this->batchreccnt += $tot;
$this->svclinecnt += $fxx;
$this->batchclmcnt += $cxx;
$this->batchtotchg += $xa0[totalcharge];
//$buffer = render_fixedRecord ($this->formno,$this->record_types["ya0"]);
//return $buffer;
return;
} // end provider trailer
function FileTrailer($buffer)
{
reset ($GLOBALS);
while (list($k,$v)=each($GLOBALS)) global $$k;
reset ($this->rendorform_variables);
while (list($k,$v)=each($this->rendorform_variables)) global $$v;
//unset($GLOBALS[za0]);
global $za0;
$za0[recid] = "ZA0";
$za0[subid] = $aa0[submtrid];
$za0[recvrid] = $aa0[recvrid];
$za0[filesvclinecnt] = $this->svclinecnt;
$za0[filereccnt] = $this->batchreccnt;
$za0[fileclmcnt] = $this->batchclmcnt;
$za0[batchcnt] = $this->batchcnt;
$za0[filetotchg] = $this->batchtotchg;
$this->svclinecnt=0;
$this->batchreccnt=0;
$this->batchclmcnt=0;
$this->batchcnt=0;
$this->batchtotchg=0;
$zabuffer = render_fixedRecord ($this->formno,$this->record_types["za0"]);
$new_buffer = $buffer.$zabuffer;
return $new_buffer;
} // end file trailer
// convert int to float
// then strip out the "."
function MakeDecimal($data,$places)
{
$data = bcadd($data,0,$places);
$data = $this->CleanNumber($data);
return $data;
}
// all reporting data must stipped of junk
// and all upper cased
function CleanChar($data)
{
$data = stripslashes($data);
$data = str_replace("/"," ",$data);
$data = str_replace("'"," ",$data);
$data = str_replace("-"," ",$data);
$data = str_replace(";"," ",$data);
$data = str_replace("(","",$data);
$data = str_replace(")","",$data);
$data = str_replace(":"," ",$data);
$data = str_replace("."," ",$data);
$data = str_replace(","," ",$data);
$data = trim($data);
$data = strtoupper($data);
return $data;
} // end cleanchar
// all reporting data must stipped of junk
// and all upper cased then for number all blanks
// removed
function CleanNumber($data)
{
$data = $this->CleanChar($data);
$data = str_replace(" ","",$data);
$data = trim($data);
return $data;
} // end cleannumber
function GetRelationShip($rel,$type="NSF")
{
if ($type=="NSF")
{
if ($rel == "S")
$patrel = "01";
if ($rel == "LR") // medicare legal rep
$patrel = "01";
if ($rel == "H" OR $rel == "W")
$patrel = "02";
if ($rel == "C")
$patrel = "03";
if ($rel == "D") // Natural Child insured not financially resp.
$patrel = "04";
if ($rel == "SC") // Step child
$patrel = "05";
if ($rel == "FC") // Foster child
$patrel = "06";
if ($rel == "WC") // Ward of Court
$patrel = "07";
if ($rel == "HD") // Handicapped Dependent
$patrel = "10";
if ($rel == "SD") // Sponsered Dependent
$patrel = "16";
return $patrel;
}
} // end getrelationship
// allow derived classes to use us for rendering records
// the child does not need render_forms inc.
function RenderFixedRecord($whichform,$rectype)
{
return render_fixedRecord ($whichform,$rectype);
} // end RenderFixedRecord
function PrimaryPaidAmounts($procstack)
{
global $sql,$da1;
$count = count($procstack);
$payerpaid = 0;
$patpaid = 0;
$total = 0;
for ($i=0;$i<$count;$i++)
{
$row = $procstack[$i];
$total += $row[procbalorig];
$query = "SELECT * FROM payrec WHERE payrecproc='".$row[id]."' AND
payrecsource='".PRIMARY."' AND
payreclink='".$row[proccov1]."' AND
payreccat='".PAYMENT."'";
$pay_result = $sql->query($query) or DIE("Query failed for primary payments");
while ($pay_row = $sql->fetch_array($pay_result))
{
$payerpaid += $pay_row[payrecamt];
}
$query = "SELECT * FROM payrec WHERE payrecproc='".$row[id]."' AND
payrecsource='".PATIENT."' AND
payreccat='".PAYMENT."'";
$pay_result = $sql->query($query) or DIE("Query failed for patient payments");
while ($pay_row = $sql->fetch_array($pay_result))
{
$patpaid += $pay_row[payrecamt];
}
}
$da1[payeramtpd] = $this->MakeDecimal($payerpaid,2);
$baldue = $total - $patpaid;
$da1[baldue] = $this->MakeDecimal($baldue,2);
if ($payerpaid == 0)
$da1[zeropayind] = "Z";
else
$da1[zeropayind] = "N";
return;
} // end PrimaryPaidAmounts
function VerifyAuth($procstack)
{
$row = $procstack[0];
$auth_num="0";
if ($row[procauth] != 0)
{
$auth_row = freemed::get_link_rec($row[procauth],"authorizations");
if (!$auth_row)
echo "Failed to read procauth";
$auth_num = $auth_row[authnum];
if ( (empty($auth_num)) )
{
echo "ERROR - Authorization number Invalid
";
return "0";
}
$authdtbegin = $auth_row[authdtbegin];
$authdtend = $auth_row[authdtend];
$numprocs = count($procstack);
for ($i=0;$i<$numprocs;$i++)
{
$procrow = $procstack[$i];
$procdt = $procrow[procdt];
if (!date_in_range($procdt,$authdtbegin,$authdtend))
{
echo "Warning: Authorization $auth_num has expired for procedure $procdt
";
}
if ($auth_row[authvisitsremain] == 0)
{
echo "Warning: No Remaining visits for Authorization $auth_num procedure $procdt
";
}
}
}
else
{
echo "Warning - No Authorization for this procedure
";
}
return $auth_num;
} // end VerifyAuth
function GetClaimSource($insco)
{
$insmodrec=0;
$insmodrec = freemed::get_link_rec($insco->modifiers[0],"insmod");
if (!$insmodrec)
DIE("Failed getting insurance modifier");
$insmod = $insmodrec[insmod];
//echo "insmod $insmod inscomodifier ".$insco->modifiers[0]."
";
$clmsource="";
if ($insmod == "WC")
$clmsource = "B";
if ($insmod == "CI")
$clmsource = "F";
if ($insmod == "BL")
$clmsource = "G";
if ($insmod == "HM")
$clmsource = "I";
if ($insmod == "FI")
$clmsource = "J";
if ($insmod == "CH")
$clmsource = "H";
if ($insmod == "MB")
$clmsource = "C";
//echo "clmsource $clmsource
";
return $clmsource;
}
function GetProviderID($phymap,$insgrp)
{
$provider_id="0";
// assume it's not a group bill
$providerids = explode(":",$phymap);
$prid = $providerids[$insgrp];
if (!empty($prid))
$provider_id = $prid;
return $provider_id;
}
function GetProviderGroupID($phygrp,$insgrp)
{
$provider_id="0";
if ($phygrp > 0)
{
// we can have a group but necessarily an ID for this insurance
// So. if we have a group defined (phygrpprac) AND a groupid exists for this group
// then use this groupid for the bill. FA0-23 will use the *rendering* provider id
$phygroup_rec = freemed::get_link_rec($phygrp,"phygroup");
if (!$phygroup_rec)
echo "ERROR - Failed getting group rec in GetProviderGroupID
";
$provider_group_ids = explode(":",$phygroup_rec[phygroupidmap]);
$provider_group_id = $provider_group_ids[$insgrp];
if (!empty($provider_group_id))
$provider_id = $provider_group_id;
}
return $provider_id;
}
function GetPatientPaid($procstack)
{
global $sql;
$total_paid_bypatient = 00.00;
$count = count($procstack);
for ($i=0;$i<$count;$i++)
{
$row = $procstack[$i];
$query = "SELECT * FROM payrec WHERE payrecproc='$row[id]' AND
payrecsource='0' AND
payreccat='".PAYMENT."'";
$pay_result = $sql->query($query) or DIE("Query failed for patient payments");
while ($pay_row = $sql->fetch_array($pay_result))
{
$total_paid_bypatient += $pay_row[payrecamt];
}
}
$data = $this->MakeDecimal($total_paid_bypatient,2);
return $data;
}
} // end NSF class
} // End define NSF_PHP
?>