edi.inc

<?php
/*
 * Inc file for the 270 / 271 creation and uploading
 *
 * This program creates the segments for the x12 270 eligibility file
 * It also allows the reading and storing of the x12 271 file
 *
 * Copyright (C) 2016 Terry Hill <terry@lillysystems.com>
 * Copyright (C) 2010 MMF Systems, Inc
 *
 * LICENSE: This program is free software; you can redistribute it and/or
 * modify it under the terms of the GNU General Public License
 * as published by the Free Software Foundation; either version 3
 * of the License, or (at your option) any later version.
 * This program is distributed in the hope that it will be useful,
 * but WITHOUT ANY WARRANTY; without even the implied warranty of
 * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
 * GNU General Public License for more details.
 * You should have received a copy of the GNU General Public License
 * along with this program. If not, see http:https://opensource.org/licenses/gpl-license.php.
 *
 * @package OpenEMR
 * @author Terry Hill <terry@lilysystems.com>
 * @link http:https://www.open-emr.org
 */

// SEGMENT FUNCTION START

// ISA Segment  - EDI-270 format

function create_ISA($row, $X12info, $segTer, $compEleSep)
{

    $ISA     =  array();

    $ISA[0] = "ISA";                            // Interchange Control Header Segment ID

    $ISA[1] = "00";                                 // Author Info Qualifier

    $ISA[2] = str_pad("0000000", 10, " ");        // Author Information

    $ISA[3] = "00";                                 //   Security Information Qualifier
                                                //   MEDI-CAL NOTE: For Leased-Line & Dial-Up use '01',
                                                //   for BATCH use '00'.
                                                //   '00' No Security Information Present
                                                //   (No Meaningful Information in I04)

    $ISA[4] = str_pad("0000000000", 10, " ");         // Security Information

    $ISA[5] = str_pad("ZZ", 2, " ");              // Interchange ID Qualifier

    $ISA[6] = str_pad($X12info[2], 15, " ");      // INTERCHANGE SENDER ID

    $ISA[7] = str_pad("ZZ", 2, " ");              // Interchange ID Qualifier

    $ISA[8] = str_pad($X12info[3], 15, " ");      // INTERCHANGE RECEIVER ID

    $ISA[9] = str_pad(date('ymd'), 6, " ");       // Interchange Date (YYMMDD)

    $ISA[10] = str_pad(date('Hi'), 4, " ");       // Interchange Time (HHMM)

    $ISA[11] = "^";                                 // Interchange Control Standards Identifier

    $ISA[12] = str_pad("00501", 5, " ");          // Interchange Control Version Number

    $ISA[13] = str_pad("000000001", 9, " ");      // INTERCHANGE CONTROL NUMBER

    $ISA[14] = str_pad("1", 1, " ");              // Acknowledgment Request [0= not requested, 1= requested]

    $ISA[15] =  str_pad("P", 1, " ");                 // Usage Indicator [ P = Production Data, T = Test Data ]

    $ISA['Created'] = implode('*', $ISA);       // Data Element Separator

    $ISA['Created'] = $ISA['Created'] ."*";

    $ISA['Created'] = $ISA ['Created'] . $compEleSep . $segTer;

    return trim($ISA['Created']);
}

// GS Segment  - EDI-270 format

function create_GS($row, $X12info, $segTer, $compEleSep)
{

    $GS    = array();

    $GS[0] = "GS";                      // Functional Group Header Segment ID

    $GS[1] = "HS";                      // Functional ID Code [ HS = Eligibility, Coverage or Benefit Inquiry (270) ]

    $GS[2] =  $X12info[2];              // Application Sender's ID

    $GS[3] =  $X12info[3];              // Application Receiver's ID

    $GS[4] = date('Ymd');               // Date [CCYYMMDD]

    $GS[5] = date('His');               // Time [HHMM] Group Creation Time

    $GS[6] = "2";                       // Group Control Number No zeros for 5010

    $GS[7] = "X";                   // Responsible Agency Code Accredited Standards Committee X12 ]

    $GS[8] = "005010X279A1";            // Version Release / Industry[ Identifier Code Query 005010X279A1

    $GS['Created'] = implode('*', $GS);         // Data Element Separator

    $GS['Created'] = $GS ['Created'] . $segTer;  // change the information in the tag or change the tag

    return trim($GS['Created']);
}

// ST Segment  - EDI-270 format

function create_ST($row, $X12info, $segTer, $compEleSep)
{

    $ST    =    array();

    $ST[0] = "ST";                              // Transaction Set Header Segment ID

    $ST[1] = "270";                                 // Transaction Set Identifier Code (Inquiry Request)

    $ST[2] = "000000003";                       // Transaction Set Control Number - Must match SE's

    $ST[3] = "005010X279A1";                    // Standard 005010X279A1 in $ST[3]

    $ST['Created'] = implode('*', $ST);             // Data Element Separator

    $ST['Created'] = $ST ['Created'] . $segTer;

    return trim($ST['Created']);
}

// BHT Segment  - EDI-270 format

function create_BHT($row, $X12info, $segTer, $compEleSep)
{

    $BHT    =   array();

    $BHT[0] = "BHT";                        // Beginning of Hierarchical Transaction Segment ID

    $BHT[1] = "0022";                       // Subscriber Structure Code

    $BHT[2] = "13";                             // Purpose Code - This is a Request

    $BHT[3] = "PROVTest600";                //  Submitter Transaction Identifier
                                            //This information is required by the information Receiver
                                            //when using Real Time transactions.
                                            //For BATCH this can be used for optional information.

    $BHT[4] = str_pad(date('Ymd'), 8, " ");           // Date Transaction Set Created

    $BHT[5] = str_pad(date('Hi'), 4, " ");            // Time Transaction Set Created no space after and 1300 is plenty

    $BHT['Created'] = implode('*', $BHT);           // Data Element Separator

    $BHT['Created'] = $BHT ['Created'] . $segTer;

    return trim($BHT['Created']);
}

// HL Segment  - EDI-270 format

function create_HL($row, $nHlCounter, $X12info, $segTer, $compEleSep)
{

    $HL         = array();

    $HL[0]      = "HL";             // Hierarchical Level Segment ID
    $HL_LEN[0]  =  2;

    $HL[1] = $nHlCounter;       // Hierarchical ID No.

    if ($nHlCounter == 1) {
        $HL[2] = "";
        $HL[3] = 20;            // Description: Identifies the payor, maintainer, or source of the information.
        $HL[4] = 1;                 // 1 Additional Subordinate HL Data Segment in This Hierarchical Structure.
    } else if ($nHlCounter == 2) {
        $HL[2] = 1;                 // Hierarchical Parent ID Number
        $HL[3] = 21;            // Hierarchical Level Code. '21' Information Receiver
        $HL[4] = 1;                 // 1 Additional Subordinate HL Data Segment in This Hierarchical Structure.
    } else {
        $HL[2] = 2;
        $HL[3] = 22;            // Hierarchical Level Code.'22' Subscriber
        $HL[4] = 0;                 // 0 no Additional Subordinate in the Hierarchical Structure.
    }

    $HL['Created'] = implode('*', $HL);         // Data Element Separator

    $HL['Created'] = $HL ['Created'] . $segTer;

    return trim($HL['Created']);
}

// NM1 Segment  - EDI-270 format

function create_NM1($row, $nm1Cast, $X12info, $segTer, $compEleSep)
{

    $NM1        = array();

    $NM1[0]         = "NM1";                    // Subscriber Name Segment ID

    if ($nm1Cast == 'PR') {
        $NM1[1] = "PR";                         // Entity ID Code - Payer [PR Payer]
        $NM1[2] = "2";                      // Entity Type - Non-Person
        $NM1[3] = $row["payer_name"];       // Organizational Name
        $NM1[4] = "";                       // Data Element not required.
        $NM1[5] = "";                       // Data Element not required.
        $NM1[6] = "";                       // Data Element not required.
        $NM1[7] = "";                       // Data Element not required.
        $NM1[8] = "46";                         // 46 - Electronic Transmitter Identification Number (ETIN)
        $NM1[9] = $X12info[3];              // Application Sender's ID
    } else if ($nm1Cast == 'FA') {
        $NM1[1] = "FA";                         // Entity ID Code - Facility [FA Facility]
        $NM1[2] = "2";                      // Entity Type - Non-Person
        $NM1[3] = $row['facility_name'];            // Organizational Name
        $NM1[4] = "";           // Data Element not required.
        $NM1[5] = "";           // Data Element not required.
        $NM1[6] = "";                       // Data Element not required.
        $NM1[7] = "";                       // Data Element not required.
        $NM1[8] = "FI";
        $NM1[9] = $row['facility_npi'];
    } else if ($nm1Cast == 'IL') {
        $NM1[1] = "IL";                         // Insured or Subscriber
        $NM1[2] = "1";                      // Entity Type - Person
        $NM1[3] = $row['lname'];                // last Name
        $NM1[4] = $row['fname'];                // first Name
        $NM1[5] = $row['mname'];                // middle Name
        $NM1[6] = "";                       // data element
        $NM1[7] = "";                       // data element
        $NM1[8] = "MI";                         // Identification Code Qualifier
        $NM1[9] = $row['policy_number'];            // Identification Code
    }

    $NM1['Created'] = implode('*', $NM1);               // Data Element Separator

    $NM1['Created'] = $NM1['Created'] . $segTer;

    return trim($NM1['Created']);
}

// REF Segment  - EDI-270 format

function create_REF($row, $ref, $X12info, $segTer, $compEleSep)
{

    $REF    =   array();

    $REF[0] = "REF";                        // Subscriber Additional Identification    does not want this for anything

    if ($ref == '1P') {
        $REF[1] = "4A";                         // Reference Identification Qualifier
        $REF[2] = $row['provider_pin'];                 // Provider Pin.
    } else {
        $REF[1] = "EJ";                         // 'EJ' for Patient Account Number     does not want this for patient
        $REF[2] = $row['pid'];                  // Patient Account No.
    }

    $REF['Created'] = implode('*', $REF);               // Data Element Separator

    $REF['Created'] = $REF['Created'] . $segTer;

    return trim($REF['Created']);
}

// TRN Segment - EDI-270 format

function create_TRN($row, $tracno, $refiden, $X12info, $segTer, $compEleSep)
{

    $TRN    =   array();

    $TRN[0] = "TRN";                        // Subscriber Trace Number Segment ID

    $TRN[1] = "1";                          // Trace Type Code � Current Transaction Trace Numbers

    $TRN[2] = $tracno;                      // Trace Number

    $TRN[3] = "9000000000";                         // Originating Company ID � must be 10 positions in length

    $TRN[4] = $refiden;                         // Additional Entity Identifier (i.e. Subdivision)

    $TRN['Created'] = implode('*', $TRN);               // Data Element Separator

    $TRN['Created'] = $TRN['Created'] . $segTer;

    return trim($TRN['Created']);
}

// DMG Segment - EDI-270 format

function create_DMG($row, $X12info, $segTer, $compEleSep)
{

    $DMG    =   array();

    $DMG[0] = "DMG";                            // Date or Time or Period Segment ID

    $DMG[1] = "D8";                                 // Date Format Qualifier - (D8 means CCYYMMDD)

    $DMG[2] = $row['dob'];                      // Subscriber's Birth date

    $DMG['Created'] = implode('*', $DMG);       // Data Element Separator

    $DMG['Created'] = $DMG['Created'] .  $segTer;

    return trim($DMG['Created']);
}

// DTP Segment - EDI-270 format

function create_DTP($row, $qual, $X12info, $segTer, $compEleSep)
{

    $DTP    =   array();

    $DTP[0] = "DTP";                        // Date or Time or Period Segment ID

    $DTP[1] = $qual;                        // Qualifier - Date of Service

    $DTP[2] = "D8";                             // Date Format Qualifier - (D8 means CCYYMMDD)

    if ($qual == '102') {
        $DTP[3] = $row['date'];                 // Date
    } else {
        $DTP[3] = $row['pc_eventDate'];         // Date of Service
    }

    $DTP['Created'] = implode('*', $DTP);   // Data Element Separator

    $DTP['Created'] = $DTP['Created'] .  $segTer;

    return trim($DTP['Created']);
}

// EQ Segment - EDI-270 format

function create_EQ($row, $X12info, $segTer, $compEleSep)
{

    $EQ         =   array();

    $EQ[0]  = "EQ";                                     // Subscriber Eligibility or Benefit Inquiry Information

    $EQ[1]  = "30";                                     // Service Type Code

    $EQ['Created'] = implode('*', $EQ);                 // Data Element Separator

    $EQ['Created'] = $EQ['Created'] . $segTer;

    return trim($EQ['Created']);
}

// SE Segment - EDI-270 format

function create_SE($row, $segmentcount, $X12info, $segTer, $compEleSep)
{

    $SE     =   array();

    $SE[0] = "SE";                              // Transaction Set Trailer Segment ID

    $SE[1] = $segmentcount;                         // Segment Count

    $SE[2] = "000000003";                       // Transaction Set Control Number - Must match ST's

    $SE['Created'] = implode('*', $SE);             // Data Element Separator

    $SE['Created'] = $SE['Created'] . $segTer;

    return trim($SE['Created']);
}

// GE Segment - EDI-270 format

function create_GE($row, $X12info, $segTer, $compEleSep)
{

    $GE     =   array();

    $GE[0]  = "GE";                             // Functional Group Trailer Segment ID

    $GE[1]  = "1";                          // Number of included Transaction Sets

    $GE[2]  = "2";                          // Group Control Number

    $GE['Created'] = implode('*', $GE);                 // Data Element Separator

    $GE['Created'] = $GE['Created'] . $segTer;

    return trim($GE['Created']);
}

// IEA Segment - EDI-270 format

function create_IEA($row, $X12info, $segTer, $compEleSep)
{

    $IEA    =   array();

    $IEA[0] = "IEA";                        // Interchange Control Trailer Segment ID

    $IEA[1] = "1";                          // Number of included Functional Groups

    $IEA[2] = "000000001";                      // Interchange Control Number

    $IEA['Created'] = implode('*', $IEA);

    $IEA['Created'] = $IEA['Created'] .  $segTer;

    return trim($IEA['Created']);
}

function translate_relationship($relationship)
{
    switch ($relationship) {
        case "spouse":
            return "01";
            break;
        case "child":
            return "19";
            break;
        case "self":
        default:
            return "S";
    }
}

// EDI-270 Batch file Generation

function print_elig($res, $X12info, $segTer, $compEleSep)
{

    $i=1;

    $PATEDI    = "";

    // For Header Segment

    $nHlCounter = 1;
    $rowCount   = 0;
    $trcNo      = 1234501;
    $refiden    = 5432101;

    while ($row = sqlFetchArray($res)) {
        if ($nHlCounter == 1) {
            // create ISA
            $PATEDI    = create_ISA($row, $X12info, $segTer, $compEleSep);

            // create GS
            $PATEDI   .= create_GS($row, $X12info, $segTer, $compEleSep);

            // create ST
            $PATEDI   .= create_ST($row, $X12info, $segTer, $compEleSep);

            // create BHT
            $PATEDI   .= create_BHT($row, $X12info, $segTer, $compEleSep);

            // For Payer Segment

            $PATEDI  .= create_HL($row, 1, $X12info, $segTer, $compEleSep);
            $PATEDI  .= create_NM1($row, 'PR', $X12info, $segTer, $compEleSep);

            // For Provider Segment

            $PATEDI  .= create_HL($row, 2, $X12info, $segTer, $compEleSep);
            $PATEDI  .= create_NM1($row, 'FA', $X12info, $segTer, $compEleSep);

            $nHlCounter = $nHlCounter + 2;
            $segmentcount = 7; // segement counts - start from ST
        }

        // For Subscriber Segment

        $PATEDI  .= create_HL($row, $nHlCounter, $X12info, $segTer, $compEleSep);
        $PATEDI  .= create_NM1($row, 'IL', $X12info, $segTer, $compEleSep);
        $PATEDI  .= create_DMG($row, $X12info, $segTer, $compEleSep);

        $PATEDI  .= create_DTP($row, '291', $X12info, $segTer, $compEleSep);
        $PATEDI  .= create_EQ($row, $X12info, $segTer, $compEleSep);

        $segmentcount   = $segmentcount + 7;
        $nHlCounter     = $nHlCounter + 1;
        $rowCount   = $rowCount + 1;
        $trcNo      = $trcNo + 1;
        $refiden    = $refiden + 1;


        if ($rowCount == sqlNumRows($res)) {
            $segmentcount = $segmentcount + 1;
            $PATEDI   .= create_SE($row, $segmentcount, $X12info, $segTer, $compEleSep);
            $PATEDI   .= create_GE($row, $X12info, $segTer, $compEleSep);
            $PATEDI   .= create_IEA($row, $X12info, $segTer, $compEleSep);
        }
    }

    echo $PATEDI;
}

// Report Generation

function show_elig($res, $X12info, $segTer, $compEleSep)
{

    $i=0;
    echo "	<div id='report_results'>
			<table>
				<thead>

					<th style='width:12%;'>	". htmlspecialchars(xl('Facility Name'), ENT_NOQUOTES) ."</th>
					<th style='width:9%;' >	". htmlspecialchars(xl('Facility NPI'), ENT_NOQUOTES) ."</th>
					<th style='width:15%;'>	". htmlspecialchars(xl('Insurance Comp'), ENT_NOQUOTES) ."</th>
					<th style='width:8%;' >	". htmlspecialchars(xl('Policy No'), ENT_NOQUOTES) ."</th>
					<th style='width:16%;'>	". htmlspecialchars(xl('Patient Name'), ENT_NOQUOTES) ."</th>
					<th style='width:7%;' >	". htmlspecialchars(xl('DOB'), ENT_NOQUOTES) ."</th>
					<th style='width:6%;' >	". htmlspecialchars(xl('Gender'), ENT_NOQUOTES) ."</th>
					<th style='width:9%;' >	". htmlspecialchars(xl('SSN'), ENT_NOQUOTES) ."</th>
					<th style='width:2%;' >	&nbsp;			  </th>
				</thead>

				<tbody>

		";

    while ($row = sqlFetchArray($res)) {
        $i= $i+1;

        if ($i%2 == 0) {
            $background = '#FFF';
        } else {
            $background = '#FFF';
        }

        $elig     = array();
        $elig[0]  = $row['facility_name'];              // Inquiring Provider Name  calendadr
        $elig[1]  = $row['facility_npi'];               // Inquiring Provider NPI
        $elig[2]  = $row['payer_name'];                     // Payer Name  our insurance co name
        $elig[3]  = $row['policy_number'];              // Subscriber ID
        $elig[4]  = $row['subscriber_lname'];               // Subscriber Last Name
        $elig[5]  = $row['subscriber_fname'];               // Subscriber First Name
        $elig[6]  = $row['subscriber_mname'];               // Subscriber Middle Initial
        $elig[7]  = $row['subscriber_dob'];                 // Subscriber Date of Birth
        $elig[8]  = substr($row['subscriber_sex'], 0, 1);       // Subscriber Sex
        $elig[9]  = $row['subscriber_ss'];              // Subscriber SSN
        $elig[10] = translate_relationship($row['subscriber_relationship']);    // Pt Relationship to insured
        $elig[11] = $row['lname'];                  // Dependent Last Name
        $elig[12] = $row['fname'];                  // Dependent First Name
        $elig[13] = $row['mname'];                  // Dependent Middle Initial
        $elig[14] = $row['dob'];                    // Dependent Date of Birth
        $elig[15] = substr($row['sex'], 0, 1);              // Dependent Sex
        $elig[16] = $row['pc_eventDate'];               // Date of service
        $elig[17] = "30";                       // Service Type
        $elig[18] = $row['pubpid'];                     // Patient Account Number pubpid

        echo "	<tr id='PR".$i."_". htmlspecialchars($row['policy_number'], ENT_QUOTES)."'>
				<td class ='detail' style='width:12%;'>". htmlspecialchars($row['facility_name'], ENT_NOQUOTES) ."</td>
				<td class ='detail' style='width:9%;'>".  htmlspecialchars($row['facility_npi'], ENT_NOQUOTES) ."</td>
				<td class ='detail' style='width:15%;'>". htmlspecialchars($row['payer_name'], ENT_NOQUOTES) ."</td>
				<td class ='detail' style='width:8%;'>".  htmlspecialchars($row['policy_number'], ENT_NOQUOTES) ."</td>
				<td class ='detail' style='width:16%;'>". htmlspecialchars($row['subscriber_lname']." ".$row['subscriber_fname'], ENT_NOQUOTES) ."</td>
				<td class ='detail' style='width:7%;'>".  htmlspecialchars($row['subscriber_dob'], ENT_NOQUOTES) ."</td>
				<td class ='detail' style='width:6%;'>".  htmlspecialchars($row['subscriber_sex'], ENT_NOQUOTES) ."</td>
				<td class ='detail' style='width:9%;'>".  htmlspecialchars($row['subscriber_ss'], ENT_NOQUOTES) ."</td>
				<td class ='detail' style='width:2%;'>
					<img src='../../images/deleteBtn.png' title=' .htmlspecialchars( xl('Delete Row'), ENT_QUOTES) . ' style='cursor:pointer;cursor:hand;' onclick='deletetherow(\"" . $i."_". htmlspecialchars($row['policy_number'], ENT_QUOTES) . "\")'>
				</td>
			</tr>
		";


        unset($elig);
    }

    if ($i==0) {
        echo "	<tr>
				<td class='norecord' colspan=9>
					<div style='padding:5px;font-family:arial;font-size:13px;text-align:center;'>". htmlspecialchars(xl('No records found'), ENT_NOQUOTES) . "</div>
				</td>
			</tr>	";
    }

        echo "	</tbody>
			</table>";
}

// To Show Eligibility Verification data

function show_eligibility_information($pid)
{

    $query = "	SELECT 		eligr.response_description as ResponseMessage,
					DATE_FORMAT(eligv.eligibility_check_date, '%d %M %Y') as VerificationDate,
					eligv.copay, eligv.deductible, eligv.deductiblemet,
					if(eligr.response_status = 'A','Active','Inactive') as Status,
					insd.pid, insc.name
			FROM 		eligibility_verification eligv
			INNER JOIN	eligibility_response eligr on eligr.response_id = eligv.response_id
			INNER JOIN	insurance_data insd on insd.id = eligv.insurance_id
			INNER JOIN 	insurance_companies insc on insc.id = insd.provider
			WHERE 		insd.pid = ?
			AND			eligr.response_status = 'A'
			AND	 		eligv.eligibility_check_date = (SELECT max(eligibility_check_date)
										FROM eligibility_verification
										WHERE	insurance_id = eligv.insurance_id)";
    $result         = sqlStatement($query, array($pid));

    $row = sqlFetchArray($result);

        $showString="";
    $showString .=  "<br><div class='text'>" .
        "<b>" .
        xlt('Insurance Provider') . ":</b> " .
        (!empty($row['name']) ? text($row['name']) : xlt('n/a')) .
        "<br>\n" .
        "<b>" .
        xlt('Status') . ":</b> " .
        (!empty($row['ResponseMessage']) ? text($row['ResponseMessage']) : xlt('n/a')) .
        "<br>\n" .
        "<b>" .
        xlt('Last Verified On') . ":</b> " .
        (!empty($row['VerificationDate']) ? text($row['VerificationDate']) : xlt('n/a')) .
        "<br>" .
        "<b>" . xlt('Copay') . ":</b> " .
        (!empty($row['copay']) ? text($row['copay']) : xlt('n/a')) .
        "<br><b>" . xlt('Deductible') . ":</b> " .
        (!empty($row['deductible']) ? text($row['deductible']) : xlt('n/a')) .
        "<br><b>" . xlt('Deductible Met') . ":</b> " .
        (!empty($row['deductiblemet']) ? ($row['deductiblemet'] == 'Y' ? xlt('Yes') : xlt('No')) : xlt('n/a')) .
        "</div>";

    echo $showString;
}

// For EDI 271


// Function to save the values in eligibility_response table

function eligibility_response_save($segmentVal, $vendorID)
{

    $resCount = 0;

    $query = "  SELECT   count(*) as RecordsCount
				FROM	 eligibility_response
				WHERE	 response_description = ? and
					 response_vendor_id	  = ?";

    $resCount = sqlStatement($query, array($segmentVal, $vendorID));


    if (isset($resCount)) {
        $row        = sqlFetchArray($resCount);

        $resCount   = $row['RecordsCount'];
    }

    if ($resCount == 0) {
        $query = "INSERT into eligibility_response SET	response_description =?,
								response_vendor_id	 = ?,
								response_create_date = now(),
								response_modify_date = now()";
        $res    = sqlStatement($query, array($segmentVal, $vendorID));
    }
}

// Function to save the values in eligibility_verification table

function eligibility_verification_save($segmentVal, $x12PartnerId, $patientId)
{

    $resCount = 0;

    // For fetching the response Id

    $query = "  SELECT	 response_id
				FROM	 eligibility_response
				WHERE	 response_description = ? and
						 response_vendor_id	  = ?";

    $resId  = sqlStatement($query, array($segmentVal, $x12PartnerId));

    // For fetching the insuarace data Id

    $query = "  SELECT	 id,copay
				FROM	 insurance_data
				WHERE	 type = 'primary' and
						 pid = ?";

    $insId  = sqlStatement($query, array($patientId));

    if (isset($resId)) {
        $row        = sqlFetchArray($resId);

        $responseId     = $row['response_id'];
    }

    if (isset($insId)) {
        $row        = sqlFetchArray($insId);

        $insuranceId    = $row['id'];
        $copay      = $row['copay'];
    }

    if ($resCount == 0) {
        if (isset($insuranceId) && !empty($insuranceId)) {
            //Set up the sql variable binding array (this prevents sql-injection attacks)
            $sqlBindArray = array();
            $query = "INSERT into eligibility_verification SET	response_id	= ? ,
										insurance_id	= ?,";
            array_push($sqlBindArray, $responseId, $insuranceId);

            if (!empty($copay)) {
                $query .= "copay = ?,";
                array_push($sqlBindArray, $copay);
            }

            $query .= "eligibility_check_date	= now(),
				   create_date			= now()";
            $res    = sqlStatement($query, $sqlBindArray);
        }
    }
}

// Function to fetch the Patient information - eligibility

function eligibility_information($insuranceId)
{
    $insuranceId = 1;

    $query = "	SELECT		*
			FROM		eligibility_verification
			WHERE	    insuranceid = ?";

    $result         = sqlStatement($query, array($insuranceId));
    $row        = sqlFetchArray($result);
    return $row;
}
// return array of X12 partners

function getX12Partner()
{
    $rez = sqlStatement("select * from x12_partners");
    for ($iter=0; $row=sqlFetchArray($rez); $iter++) {
        $returnval[$iter]=$row;
    }

    return $returnval;
}

// return array of provider usernames
function getUsernames()
{
    $rez = sqlStatement("select distinct username, lname, fname,id from users " .
        "where authorized = 1 and username != ''");
    for ($iter=0; $row=sqlFetchArray($rez); $iter++) {
        $returnval[$iter]=$row;
    }

    return $returnval;
}

// return formated array

function arrFormated(&$item, $key)
{
    $item = strstr($item, '_');
    $item = substr($item, 1, strlen($item)-1);
    $item = "'".$item;
}