add eligibility to insurance setup (openemr#2287)

* add eligibility to insurance setup

* escaping

* test dates minor fix

* Don't want effective date darn it. it needs to be dos.

controllers/C_InsuranceCompany.class.php

@@ -16,6 +16,7 @@ function __construct($template_mod = "general")
  $this->assign("CURRENT_ACTION", $GLOBALS['webroot']."/controller.php?" . "practice_settings&insurance_company&");
  $this->assign("STYLE", $GLOBALS['style']);
  $this->assign("SUPPORT_ENCOUNTER_CLAIMS", $GLOBALS['support_encounter_claims']);
+ $this->assign("SUPPORT_ELIGIBILITY_REQUESTS", $GLOBALS['enable_oa']);
  $this->InsuranceCompany = new InsuranceCompany();
  }
 

interface/reports/edi_270.php

@@ -113,7 +113,7 @@
  f.facility_npi as facility_npi,
  f.name as facility_name,
  c.cms_id as cms_id,
- c.alt_cms_id as alt_cms_id,
+ c.eligibility_id as eligibility_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)

library/classes/InsuranceCompany.class.php

@@ -49,10 +49,11 @@ class InsuranceCompany extends ORDataObject
  var $attn;
  var $cms_id;
  var $alt_cms_id;
+ var $eligibility_id;
  //this is now deprecated use new x12 partners instead
  var $x12_receiver_id;
  var $x12_default_partner_id;
-
+ var $x12_default_eligibility_id;
  /*
  * OpenEMR used this value to determine special formatting for the specified type of payer.
  * This value is a mutually exclusive choice answering the FB.Payer.isX API calls
@@ -232,6 +233,14 @@ function get_alt_cms_id()
  {
  return $this->alt_cms_id;
  }
+ function set_eligibility_id($id)
+ {
+ $this->eligibility_id = $id;
+ }
+ function get_eligibility_id()
+ {
+ return $this->eligibility_id;
+ }
  function set_ins_type_code($type)
  {
  $this->ins_type_code = $type;
@@ -311,6 +320,22 @@ function get_x12_default_partner_name()
  return $xa[$this->get_x12_default_partner_id()];
  }
 
+ function set_x12_default_eligibility_id($id)
+ {
+ $this->x12_default_eligibility_id = $id;
+ }
+
+ function get_x12_default_eligibility_id()
+ {
+ return $this->x12_default_eligibility_id;
+ }
+
+ function get_x12_default_eligibility_name()
+ {
+ $xa = $this->_utility_array($this->X12Partner->x12_partner_factory());
+ return $xa[$this->get_x12_default_eligibility_id()];
+ }
+
  function populate()
  {
  parent::populate();

library/edi.inc

@@ -141,7 +141,7 @@ function create_NM1($row, $nm1Cast, $X12info, $segTer, $compEleSep)
  $NM1[7] = ""; // Data Element not required.
  $NM1[8] = $X12info['id_number'] ? $X12info['id_number'] : "46"; // 46 - Electronic Transmitter Identification Number (ETIN)
  if ($GLOBALS['enable_oa']) {
- $payerId = $row['alt_cms_id'];
+ $payerId = $row['eligibility_id'];
  } else {
  $payerId = $row['cms_id'];
  }
@@ -232,7 +232,7 @@ function create_DTP($row, $qual, $X12info, $segTer, $compEleSep)
  if ($qual == '102') {
  $DTP[3] = $row['date']; // Date
  } else {
- $DTP[3] = $DTP[3] ? $row['pc_eventDate'] : $row['date']; // Date of Service
+ $DTP[3] = !empty($row['pc_eventDate']) && $row['pc_eventDate'] > '20010101' ? $row['pc_eventDate'] : date("Ymd"); // Date of Service
  }
  $DTP['Created'] = implode('*', $DTP); // Data Element Separator
  $DTP['Created'] = $DTP['Created'] . $segTer;
@@ -381,9 +381,9 @@ function requestEligibleTransaction($pid = 0, $eFlag = false)
  f.facility_npi as facility_npi,
  f.name as facility_name,
  c.cms_id as cms_id,
- c.alt_cms_id as alt_cms_id,
- c.x12_default_partner_id as partner,
- c.name as payer_name 
+ c.eligibility_id as eligibility_id,
+ c.x12_default_eligibility_id as partner,
+ c.name as payer_name
  FROM patient_data AS p 
  LEFT JOIN users AS d on (p.providerID = d.id)
  LEFT JOIN facility AS f on (f.id = d.facility_id)
@@ -418,7 +418,7 @@ function requestRealTimeEligible($res, $X12info, $segTer, $compEleSep, $eFlag =
  if ($row['providerID'] === 0 || !$row['provider_npi']) {
  $error_accum .= xlt("Error") . ": " . xlt("Provider Missing Add one in Choices") . "\n";
  }
- if (!$row['alt_cms_id']) {
+ if (!$row['eligibility_id']) {
  $error_accum .= xlt("Error") . ": " . xlt("Missing Insurance Payer Id") . "\n";
  }
  if (!$row['policy_number'] || !$row['subscriber_dob']) {
@@ -630,7 +630,6 @@ function show_eligibility_information($pid, $flag = false)
  if ($title === 1) {
  $showString = "<br><span><b>" . xlt("Nothing To Report") . "</b></span><br>";
  }
-
  $showString .= "</div>\n";
  echo $showString;
 }

sql/5_0_1-to-5_0_2_upgrade.sql

@@ -747,7 +747,7 @@ ALTER TABLE `issue_encounter`
 
 #IfNotColumnType onsite_documents pid bigint(20)
 ALTER TABLE `onsite_documents`
- MODIFY `pid` bigint(20) UNSIGNED DEFAULT NULL;
+ MODIFY `pid` bigint(20) UNSIGNED default NULL;
 #EndIf
 
 #IfNotColumnType patient_access_onsite pid bigint(20)
@@ -848,3 +848,15 @@ CREATE TABLE `benefit_eligibility` (
 #IfTable eligibility_response
 DROP TABLE `eligibility_response`;
 #Endif
+
+#IfTable x12_partners
+ALTER TABLE `x12_partners` CHANGE `processing_format` `processing_format` ENUM('standard','medi-cal','cms','proxymed','oa-eligibility','avality-eligibility') DEFAULT NULL;
+#Endif
+
+#IfMissingColumn eligibility_id insurance_companies
+ALTER TABLE `insurance_companies` ADD `eligibility_id` VARCHAR(32) DEFAULT NULL;
+#Endif
+
+#IfMissingColumn x12_default_eligibility_id insurance_companies
+ALTER TABLE `insurance_companies` ADD `x12_default_eligibility_id` INT(11) DEFAULT NULL;
+#Endif

sql/database.sql

@@ -2899,6 +2899,8 @@ CREATE TABLE `insurance_companies` (
  `x12_default_partner_id` int(11) default NULL,
  `alt_cms_id` varchar(15) NOT NULL DEFAULT '',
  `inactive` int(1) NOT NULL DEFAULT '0',
+ `eligibility_id` VARCHAR(32) default NULL,
+ `x12_default_eligibility_id` INT(11) default NULL,
  PRIMARY KEY (`id`)
 ) ENGINE=InnoDB;
 
@@ -7235,7 +7237,7 @@ CREATE TABLE `x12_partners` (
  `id_number` varchar(255) default NULL,
  `x12_sender_id` varchar(255) default NULL,
  `x12_receiver_id` varchar(255) default NULL,
- `processing_format` enum('standard','medi-cal','cms','proxymed') default NULL,
+ `processing_format` enum('standard','medi-cal','cms','proxymed','oa_eligibility','availity_eligibility') default NULL,
  `x12_isa01` VARCHAR( 2 ) NOT NULL DEFAULT '00' COMMENT 'User logon Required Indicator',
  `x12_isa02` VARCHAR( 10 ) NOT NULL DEFAULT ' ' COMMENT 'User Logon',
  `x12_isa03` VARCHAR( 2 ) NOT NULL DEFAULT '00' COMMENT 'User password required Indicator',

templates/insurance_companies/general_edit.html

@@ -90,6 +90,14 @@
  </div>
  </div>
  {/if}
+ {if $SUPPORT_ELIGIBILITY_REQUESTS}
+ <div class="form-group">
+ <label for="eligibility_id" class="control-label col-sm-2">{xlt t='Payer Id For Eligibility'}</label>
+ <div class="col-sm-8">
+ <input type="text" id="eligibility_id" name="eligibility_id" class="form-control" value="{$insurancecompany->get_eligibility_id()|attr}" onKeyDown="PreventIt(event)">
+ </div>
+ </div>
+ {/if}
  <div class="form-group">
  <label for="ins_type_code" class="control-label col-sm-2">{xlt t='Payer Type'}</label>
  <div class="col-sm-8">
@@ -106,6 +114,16 @@
  </select>
  </div>
  </div>
+ {if $SUPPORT_ELIGIBILITY_REQUESTS}
+ <div class="form-group">
+ <label for="x12_default_eligibility_id" class="control-label col-sm-2">{xlt t='Default Eligibility X12 Partner'}</label>
+ <div class="col-sm-8">
+ <select id="x12_default_eligibility_id" name="x12_default_eligibility_id" class="form-control">
+ {html_options options=$x12_partners selected=$insurancecompany->get_x12_default_eligibility_id()}
+ </select>
+ </div>
+ </div>
+ {/if}
  <div class="btn-group col-sm-offset-2">
  <a href="javascript:submit_insurancecompany();" class="btn btn-default btn-save" onclick="top.restoreSession()">
  {xlt t='Save'}
@@ -139,4 +157,4 @@
  } while ((endTime - startTime) < delay);
  }
 </script>
-{/literal}
+{/literal}