support for the Availity clearinghouse and grouping claims into a sin…

…gle ISA/GS/ST segment per batch

edi/README.txt

@@ -0,0 +1,3 @@
+This directory is for saving transmitted electronic batches for various kinds
+of problem solving, and should be writable by the web server.
+

interface/billing/billing_process.php

@@ -1,6 +1,5 @@
 <?php
 include_once("../globals.php");
-
 include_once("$srcdir/patient.inc");
 include_once("$srcdir/billrep.inc");
 include_once(dirname(__FILE__) . "/../../library/classes/WSClaim.class.php");
@@ -11,16 +10,42 @@
  $BILLING_EXPORT = true;
 }
 
+// This is a kludge to enter some parameters that are not in the X12
+// Partners table, but should be:
+$ISA07 = 'ZZ'; // ZZ = mutually defined, 01 = Duns, etc.
+$ISA14 = '0'; // 1 = Acknowledgment requested, else 0
+$ISA15 = 'T'; // T = testing, P = production
+$GS02 = ''; // Empty to use the sender ID from the ISA segment
+$PER06 = ''; // The submitter's EDI Access Number, if any
+/**** For Availity:
+$ISA07 = '01'; // ZZ = mutually defined, 01 = Duns, etc.
+$ISA14 = '1'; // 1 = Acknowledgment requested, else 0
+$ISA15 = 'T'; // T = testing, P = production
+$GS02 = 'AV01101957';
+$PER06 = 'xxxxxx'; // The submitter's EDI Access Number
+****/
+
 $fconfig = $GLOBALS['oer_config']['freeb'];
 $bill_info = array();
 
 if (isset($_POST['bn_electronic_file']) && !empty($_POST['claims'])) {
 
  if (empty($_POST['claims'])) {
  $bill_info[] = xl("No claims were selected for inclusion.");
-
  }
- $efile = array();
+ // $efile = array();
+
+ $bat_type = ''; // will be edi or hcfa
+ $bat_sendid = '';
+ $bat_recvid = '';
+ $bat_content = '';
+ $bat_segcount = 2;
+ $bat_time = time();
+ $bat_hhmm = date('Hi' , $bat_time);
+ $bat_yymmdd = date('ymd', $bat_time);
+ $bat_yyyymmdd = date('Ymd', $bat_time);
+ // Minutes since 1/1/1970 00:00:00 GMT will be our interchange control number:
+ $bat_icn = sprintf('%09.0f', $bat_time/60);
 
  foreach ($_POST['claims'] as $claim) {
  if (isset($claim['bill'])) {
@@ -30,18 +55,68 @@
  else {
  $fname = $claim['file'];
  }
+
+ $tmp = substr($fname, strrpos($fname, '.') + 1);
+ if (!$bat_type) {
+ $bat_type = $tmp;
+ } else if ($bat_type != $tmp) {
+ die("You cannot mix '$bat_type' and '$tmp' formats in the same batch!");
+ }
+
  $fname = preg_replace("[/]","",$fname);
  $fname = preg_replace("[\.\.]","",$fname);
  $fname = preg_replace("[\\\\]","",$fname);
  $fname = $fconfig['claim_file_dir'] . $fname;
+
  if (file_exists($fname)) {
  //less than 500 is almost definitely an error
  if (filesize($fname) > 500) {
  $bill_info[] = xl("Added: ") . $fname . "\n";
- $ta = array();
- $ta["data"] = file_get_contents($fname);
- $ta["size"] = filesize($fname);
- $efile[] = $ta;
+
+ // $ta = array();
+ // $ta["data"] = file_get_contents($fname);
+ // $ta["size"] = filesize($fname);
+ // $efile[] = $ta;
+
+ if ($bat_type != 'edi') {
+ $bat_content .= file_get_contents($fname);
+ continue;
+ }
+
+ // If we get here, we are sending X12 837p data. Strip off the ISA,
+ // GS, ST, SE, GE, and IEA segments from the individual files and
+ // send just one set of these for the whole batch. We think this is
+ // what the partners are happiest with, and Availity for one requires
+ // (as of this writing) exactly one ISA/IEA pair per batch.
+ $segs = explode('~', file_get_contents($fname));
+ foreach ($segs as $seg) {
+ if (!$seg) continue;
+ $elems = explode('*', $seg);
+ if ($elems[0] == 'ISA') {
+ if (!$bat_content) {
+ $bat_sendid = trim($elems[6]);
+ $bat_recvid = trim($elems[8]);
+ $bat_sender = $GS02 ? $GS02 : $bat_sendid;
+ $bat_content = substr($seg, 0, 51) .
+ $ISA07 . substr($seg, 53, 17) .
+ "$bat_yymmdd*$bat_hhmm*U*00401*$bat_icn*$ISA14*$ISA15*:~" .
+ "GS*HC*$bat_sender*$bat_recvid*$bat_yyyymmdd*$bat_hhmm*1*X*004010X098A1~" .
+ "ST*837*0001~";
+ }
+ continue;
+ } else if (!$bat_content) {
+ die("Error in $fname:<br>\nInput must begin with 'ISA'; " .
+ "found '" . htmlentities($elems[0]) . "' instead");
+ }
+ if ($elems[0] == 'GS' || $elems[0] == 'ST') continue;
+ if ($elems[0] == 'SE' || $elems[0] == 'GE' || $elems[0] == 'IEA') continue;
+ if ($elems[0] == 'PER' && $PER06 && !$elems[5]) {
+ $seg .= "*ED*$PER06";
+ }
+ $bat_content .= $seg . '~';
+ $bat_segcount += 1;
+ }
+
  }
  else {
  $bill_info[] = xl("May have an error: ") . $fname . "\n";
@@ -53,7 +128,13 @@
  }
 
  }
- if (!empty($efile)) {
+
+ if ($bat_type == 'edi' && $bat_content) {
+ $bat_content .= "SE*$bat_segcount*0001~GE*1*1~IEA*1*$bat_icn~";
+ }
+
+ // if (!empty($efile)) {
+ if ($bat_content) {
  $db = $GLOBALS['adodb']['db'];
  $error = false;
  foreach ($_POST['claims'] as $claimid => $claim) {
@@ -78,23 +159,35 @@
  }
  }
  if (!$error) {
+ $fname = date("Y-m-d", $bat_time) . "-billing_batch.txt";
+
+ // If a writable edi directory exists, log the batch to it.
+ // I guarantee you'll be glad we did this. :-)
+ $fh = @fopen("$webserver_root/edi/$fname", 'a');
+ if ($fh) {
+ fwrite($fh, $bat_content);
+ fclose($fh);
+ }
+
  header("Pragma: public");
  header("Expires: 0");
  header("Cache-Control: must-revalidate, post-check=0, pre-check=0");
  header("Content-Type: application/force-download");
- header("Content-Disposition: attachment; filename=". date("Y-m-d") . "-billing_batch.txt");
+ header("Content-Disposition: attachment; filename=$fname");
  header("Content-Description: File Transfer");
 
- $data = "";
- $size = 0;
+ // $data = "";
+ // $size = 0;
+ // foreach ($efile as $file) {
+ // $data .= $file['data'];
+ // $size += $file['size'];
+ // }
+ // header("Content-Length: " . $size);
+ // echo $data;
 
- foreach ($efile as $file) {
- $data .= $file['data'];
- $size += $file['size'];
- }
+ header("Content-Length: " . strlen($bat_content));
+ echo $bat_content;
 
- header("Content-Length: " . $size);
- echo $data;
  exit;
  }
  }
@@ -104,7 +197,6 @@
  process_form($_POST);
 }
 
-
 function process_form($ar) {
  global $bill_info;
 
@@ -194,13 +286,10 @@ function process_form($ar) {
  $be->close();
  }
 }
-
-
 ?>
 <html>
 <head>
 
-
 <link rel=stylesheet href="<?echo $css_header;?>" type="text/css">
 
 </head>