Eligibility rework (openemr#2268)

* Enhance Insurance Eligibility - Add real time - Fix 271 x12 parse - add back some partner configs * log download buffer over run fix * eligibility rework - add Office Ally real time interface (MIME) - rewrite 271 parse - rework demographics eligibility tab - bug fixes * - bug fix a sql query escape breaks delete query - batch patient fetch now groups by patient ie unique patients in list - deleted eligibility_response table in database - fix various escaping * - add enable Enable Office Ally Insurance Eligibility in globals
DiscoverAndChange · Mar 9, 2019 · c120fdb · c120fdb
1 parent ed406bc
commit c120fdb
Show file tree

Hide file tree

Showing 6 changed files with 923 additions and 616 deletions.
diff --git a/interface/reports/edi_270.php b/interface/reports/edi_270.php
@@ -9,9 +9,11 @@
  * @link https://www.open-emr.org
  * @author Terry Hill <[email protected]>
  * @author Brady Miller <[email protected]>
+ * @author Jerry Padgett <[email protected]>
  * @copyright Copyright (c) 2010 MMF Systems, Inc
  * @copyright Copyright (c) 2016 Terry Hill <[email protected]>
  * @copyright Copyright (c) 2017 Brady Miller <[email protected]>
+ * @copyright Copyright (c) 2019 Jerry Padgett <[email protected]>
  * @license https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
  */
 
@@ -24,6 +26,7 @@
 require_once("$srcdir/edi.inc");
 
 use OpenEMR\Core\Header;
+use OpenEMR\Common\Http\oeHttp;
 
 if (!empty($_POST)) {
  if (!verifyCsrfToken($_POST["csrf_token_form"])) {
@@ -47,7 +50,8 @@
 $form_facility = $_POST['form_facility'] ? $_POST['form_facility'] : '';
 $form_provider = $_POST['form_users'] ? $_POST['form_users'] : '';
 $exclude_policy = $_POST['removedrows'] ? $_POST['removedrows'] : '';
-$X12info = $_POST['form_x12'] ? explode("|", $_POST['form_x12']) : '';
+$x12_partner = $_POST['form_x12'] ? $_POST['form_x12'] : '';
+$X12info = getX12Partner($x12_partner);
 
 //Set up the sql variable binding array (this prevents sql-injection attacks)
 $sqlBindArray = array();
@@ -74,59 +78,54 @@
 
 if ($exclude_policy != "") {
  $arrayExplode = explode(",", $exclude_policy);
- array_walk($arrayExplode, 'arrFormated');
- $exclude_policy = implode(",", $arrayExplode);
- $where .= " AND i.policy_number not in (".add_escape_custom($exclude_policy).")";
+ array_walk($arrayExplode, 'arrFormated');
+ $exclude_policy = implode(",", $arrayExplode);
+ $exclude_policy = add_escape_custom($exclude_policy);
+ $where .= " AND i.policy_number NOT IN ('$exclude_policy')";
 }
 
- $where .= " AND (i.policy_number is not null and i.policy_number != '')";
-
- $query = sprintf(" SELECT DATE_FORMAT(e.pc_eventDate, '%%Y%%m%%d') as pc_eventDate,
- e.pc_facility,
- p.lname,
- p.fname,
- p.mname,
- DATE_FORMAT(p.dob, '%%Y%%m%%d') as dob,
- p.ss,
- p.sex,
- p.pid,
- p.pubpid,
- i.subscriber_ss,
- i.policy_number,
- i.provider as payer_id,
- i.subscriber_relationship,
- i.subscriber_lname,
- i.subscriber_fname,
- i.subscriber_mname,
- DATE_FORMAT(i.subscriber_dob, '%%m/%%d/%%Y') as subscriber_dob,
- i.policy_number,
- i.subscriber_sex,
- DATE_FORMAT(i.date,'%%Y%%m%%d') as date,
- d.lname as provider_lname,
- d.fname as provider_fname,
- d.npi as provider_npi,
- d.upin as provider_pin,
- f.federal_ein as federal_ein,
- f.facility_npi as facility_npi,
- f.name as facility_name,
- c.name as payer_name
- FROM openemr_postcalendar_events AS e
- LEFT JOIN users AS d on (e.pc_aid is not null and e.pc_aid = d.id)
- LEFT JOIN facility AS f on (f.id = e.pc_facility)
- LEFT JOIN patient_data AS p ON p.pid = e.pc_pid
- LEFT JOIN insurance_data AS i ON (i.id =(
- SELECT id
- FROM insurance_data AS i
- WHERE pid = p.pid AND type = 'primary'
- ORDER BY date DESC
- LIMIT 1
- )
- )
- LEFT JOIN insurance_companies as c ON (c.id = i.provider)
- WHERE %s ", $where);
+ $where .= " AND (i.policy_number is NOT NULL AND i.policy_number != '')";
+ $where .= " GROUP BY p.pid ORDER BY c.name";
+ $query = sprintf("SELECT DATE_FORMAT(e.pc_eventDate, '%%Y%%m%%d') as pc_eventDate,
+ e.pc_facility,
+ p.lname,
+ p.fname,
+ p.mname,
+ DATE_FORMAT(p.dob, '%%Y%%m%%d') as dob,
+ p.ss,
+ p.sex,
+ p.pid,
+ p.pubpid,
+ i.subscriber_ss,
+ i.policy_number,
+ i.provider as payer_id,
+ i.subscriber_relationship,
+ i.subscriber_lname,
+ i.subscriber_fname,
+ i.subscriber_mname,
+ DATE_FORMAT(i.subscriber_dob, '%%m/%%d/%%Y') as subscriber_dob,
+ i.policy_number,
+ i.subscriber_sex,
+ DATE_FORMAT(i.date,'%%Y%%m%%d') as date,
+ d.lname as provider_lname,
+ d.fname as provider_fname,
+ d.npi as provider_npi,
+ d.upin as provider_pin,
+ f.federal_ein as federal_ein,
+ f.facility_npi as facility_npi,
+ f.name as facility_name,
+ c.cms_id as cms_id,
+ c.name as payer_name 
+ FROM openemr_postcalendar_events AS e
+ LEFT JOIN users AS d on (e.pc_aid is not null and e.pc_aid = d.id)
+ LEFT JOIN facility AS f on (f.id = e.pc_facility)
+ LEFT JOIN patient_data AS p ON p.pid = e.pc_pid
+ LEFT JOIN insurance_data AS i ON (i.id =(SELECT id FROM insurance_data AS i WHERE pid = p.pid AND type = 'primary' ORDER BY date DESC LIMIT 1))
+ LEFT JOIN insurance_companies as c ON (c.id = i.provider)
+ WHERE %s ", $where);
 
  // Run the query
- $res  = sqlStatement($query, $sqlBindArray);
+ $res = sqlStatement($query, $sqlBindArray);
 
  // Get the facilities information
  $facilities = getUserFacilities($_SESSION['authId']);
@@ -137,6 +136,26 @@
  //Get the x12 partners information
  $clearinghouses = getX12Partner();
 
+ if (isset($_POST['form_xmit']) && !empty($_POST['form_xmit']) && $res) {
+ $eFlag = !$GLOBALS['disable_eligibility_log'];
+ $log = requestRealTimeEligible($res, $X12info, $segTer, $compEleSep, $eFlag);
+ if ($eFlag) {
+ $fn = sprintf(
+ 'elig-log_%s_%s.txt',
+ strtolower(str_replace(' ', '', $X12info['name'])),
+ date("Y-m-d:H:i:s")
+ );
+ $log = str_replace('~', "~\r", $log);
+ while (@ob_end_flush()) {
+ }
+ header('Content-Type: text/plain');
+ header("Content-Length: " . strlen($log));
+ header('Content-Disposition: attachment; filename="' . $fn . '"');
+ ob_start();
+ echo $log;
+ exit();
+ }
+ }
 
  if (isset($_POST['form_savefile']) && !empty($_POST['form_savefile']) && $res) {
  header('Content-Type: text/plain');
@@ -212,21 +231,20 @@ function deletetherow(id){
  }
 
  // To validate the batch file generation - for the required field [clearing house/x12 partner]
- function validate_batch()
- {
- if(document.getElementById('form_x12').value=='')
- {
+ function validate_batch(eFlag) {
+ if (document.getElementById('form_x12').value == '') {
  alert(stringBatch);
  return false;
  }
- else
- {
- document.getElementById('form_savefile').value = "true";
- document.theform.submit();
+ else {
+ if (eFlag === true) {
+ document.getElementById('form_xmit').value = "true";
+ } else {
+ document.getElementById('form_savefile').value = "true";
+ }
 
+ document.theform.submit();
  }
-
-
  }
 
  // To Clear the hidden input field
@@ -235,13 +253,14 @@ function validate_policy()
  {
  document.getElementById('removedrows').value = "";
  document.getElementById('form_savefile').value = "";
+ document.getElementById('form_xmit').value = "";
  return true;
  }
 
  // To toggle the clearing house empty validation message
  function toggleMessage(id,x12){
 
- var spanstyle = new String();
+ var spanstyle = String();
 
  spanstyle = document.getElementById(id).style.visibility;
  selectoption = document.getElementById(x12).value;
@@ -337,20 +356,19 @@ function toggleMessage(id,x12){
  <?php echo xlt('X12 Partner'); ?>:
  </td>
  <td colspan='5'>
- <select name='form_x12' id='form_x12' class='form-control' onchange='return toggleMessage("emptyVald","form_x12");' >
- <option value=''>--<?php echo xlt('select'); ?>--</option>
- <?php
- if (isset($clearinghouses) && !empty($clearinghouses)) {
- foreach ($clearinghouses as $clearinghouse) { ?>
- <option value='<?php echo attr($clearinghouse['id']."|".$clearinghouse['id_number']."|".$clearinghouse['x12_sender_id']."|".$clearinghouse['x12_receiver_id']."|".$clearinghouse['x12_version']."|".$clearinghouse['processing_format']); ?>'
- <?php echo $clearinghouse['id'] == $X12info[0] ? " selected " : null; ?>
- ><?php echo text($clearinghouse['name']); ?></option>
- <?php
- }
- }
- ?>
- </select>
- <span id='emptyVald' style='color:red;font-size:12px;'> * <?php echo xlt('Clearing house info required for EDI 270 batch creation.'); ?></span>
+ <select name='form_x12' id='form_x12' class='form-control' onchange='return toggleMessage("emptyVald","form_x12");'>
+ <option value=''>--<?php echo xlt('select'); ?>--</option>
+ <?php
+ if (isset($clearinghouses) && !empty($clearinghouses)) {
+ foreach ($clearinghouses as $clearinghouse) {
+ echo "<option value='" . attr($clearinghouse['id']) . "'" .
+ ($clearinghouse['id'] == $X12info['id'] ? " selected " : '') . ">" . text($clearinghouse['name']) . "</option>";
+ }
+ }
+ ?>
+ </select>
+ <span id='emptyVald' style='color:red;font-size:12px;visibility: <?php echo $X12info['id'] ? "hidden" : ""; ?>'> *
+ <?php echo xlt('Clearing house info required for EDI 270 batch creation.'); ?></span>
  </td>
  </tr>
  </table>
@@ -365,9 +383,15 @@ function toggleMessage(id,x12){
  <a href='#' class='btn btn-default btn-refresh' onclick='validate_policy(); $("#theform").submit();'>
  <?php echo xlt('Refresh'); ?>
  </a>
- <a href='#' class='btn btn-default btn-transmit' onclick='return validate_batch();'>
+ <a href='#' class='btn btn-default btn-transmit' onclick='return validate_batch(false);'>
  <?php echo xlt('Create batch'); ?>
  <input type='hidden' name='form_savefile' id='form_savefile' value=''></input>
+
+ <?php if ($GLOBALS['enable_oa']) {
+ echo "<a href='#' class='btn btn-default btn-transmit' onclick='return validate_batch(true);'>" . xlt('Request Eligibility') . "</a>\n";
+}
+ ?>
+ <input type='hidden' name='form_xmit' id='form_xmit' value=''></input>
  </a>
  </div>
  </div>
@@ -378,7 +402,6 @@ function toggleMessage(id,x12){
  </tr>
  </table>
  </div>
-
  <div class='text'>
  <?php echo xlt('Please choose date range criteria above, and click Refresh to view results.'); ?>
  </div>