BillingExport.csv.php

<?php

// Copyright (C) 2005 Rod Roark <rod@sunsetsystems.com>
//
// 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 2
// of the License, or (at your option) any later version.

// This class exports billing information to an external billing
// system.  In this case we are writing a custom CSV format, but
// it would be easy and more generally useful to write X12 (837p)
// format and then have some separate utilities for converting to
// HCFA 1500, UB-92, etc.
//
// To implement this feature, rename this file to BillingExport.php.


class BillingExport
{
  // You should customize these paths.  They must share the same
  // physical disk partition so that the final rename will be an
  // atomic operation.
    var $TMP_DIR    = "/home/billing/tmp";
    var $TARGET_DIR = "/home/billing/ftp";

    var $tmpname; // output filename including path
    var $tmpfh;   // output file handle

    function fixString($string)
    {
        return addslashes(trim($string));
    }

    function fixMI($string)
    {
        return addslashes(substr(trim($string), 0, 1));
    }

    function fixSex($sex)
    {
        $sex = substr(strtoupper(trim($sex)), 0, 1);
        if ($sex == 'M') {
            return 'Male';
        }

        if ($sex == 'F') {
            return 'Female';
        }

        return '';
    }

    function fixPhone($phone)
    {
        $tmparr = array();
        if (preg_match("/(\d\d\d)\D*(\d\d\d)\D*(\d\d\d\d)/", $phone, $tmparr)) {
            return $tmparr[1] . '-' . $tmparr[2] . '-' . $tmparr[3];
        }

        return '';
    }

    function fixSSN($ssn)
    {
        $tmparr = array();
        if (preg_match("/(\d\d\d)\D*(\d\d)\D*(\d\d\d\d)/", $ssn, $tmparr)) {
            return $tmparr[1] . '-' . $tmparr[2] . '-' . $tmparr[3];
        }

        return '';
    }

    function fixMStatus($status)
    {
        return ucfirst(trim($status));
    }

    function fixEStatus($employer)
    {
        $status = strtoupper(trim($employer));
        if (! $status) {
            return '';
        }

        if ($status == 'STUDENT') {
            return 'Student';
        }

        if ($status == 'RETIRED') {
            return 'Retired';
        }

        return 'Full-time';
    }

    function fixRelation($rel)
    {
        return ucfirst(trim($rel));
    }

    function fixCPT($code, $mod)
    {
        $code = trim($code);
        $mod = trim($mod);
        if ($mod) {
            $code .= '-' . $mod;
        }

        return addslashes($code);
    }

    function fixJust($str)
    {
        return addslashes(trim(str_replace(':', ' ', $str)));
    }

    function fixDate($date)
    {
        return substr($date, 0, 10);
    }

  // Creating a BillingExport object opens the output file.
  // Filename format is "transYYYYMMDDHHMMSS.txt".
  //
    function __construct()
    {
        $this->tmpname = $this->TMP_DIR . '/trans' . date("YmdHis") . '.txt';
        $this->tmpfh = fopen($this->tmpname, 'w');
    }

  // Call this once for each claim to be processed.
  //
    function addClaim($patient_id, $encounter)
    {

        // Patient information:

        $query = "SELECT p.pubpid, p.ss, p.lname, p.fname, p.mname, p.DOB, " .
        "p.street, p.city, p.state, p.postal_code, p.phone_home, p.phone_biz, " .
        "p.status, p.sex, e.name " .
        "FROM patient_data AS p " .
        "LEFT OUTER JOIN employer_data AS e ON e.pid = ? " .
        "WHERE p.pid = ? " .
        "LIMIT 1";
        $prow = sqlQuery($query, array($patient_id, $patient_id));

        // Patient line.
        fwrite($this->tmpfh, 'PT' .
        ',"' . $this->fixString($prow['pubpid'])      . '"' .
        ',"' . $this->fixString($prow['lname'])       . '"' .
        ',"' . $this->fixString($prow['fname'])       . '"' .
        ',"' . $this->fixMI($prow['mname'])           . '"' .
        ',"' . $this->fixString($prow['street'])      . '"' .
        ',""'                                  .
        ',"' . $this->fixString($prow['city'])        . '"' .
        ',"' . $this->fixString($prow['state'])       . '"' .
        ',"' . $this->fixString($prow['postal_code']) . '"' .
        ',"' . $this->fixPhone($prow['phone_home'])   . '"' .
        ',"' . $this->fixPhone($prow['phone_biz'])    . '"' .
        ',"' . $this->fixSex($prow['sex'])            . '"' .
        ',"' . $prow['DOB']                    . '"' .
        ',"' . $this->fixSSN($prow['ss'])             . '"' .
        ',"' . $this->fixEStatus($prow['name'])       . '"' .
        ',"' . $this->fixString($prow['name'])        . '"' .
        "\n");

        // Encounter information:

        $query = "SELECT e.date, e.facility, " .
          "u.id, u.lname, u.fname, u.mname, u.upin, " .
          "f.street, f.city, f.state, f.postal_code, f.pos_code, " .
          "f.domain_identifier AS clia_code " .
          "FROM form_encounter AS e " .
          "LEFT OUTER JOIN forms ON forms.formdir = 'newpatient' AND " .
          "forms.form_id = e.id AND forms.pid = ? " .
          "LEFT OUTER JOIN users AS u ON u.username = forms.user " .
          "LEFT OUTER JOIN facility AS f ON f.name = e.facility " .
          "WHERE e.pid = ? AND e.encounter = ? " .
          "LIMIT 1";
        $erow = sqlQuery($query, array($patient_id, $patient_id, $encounter));

        // Performing Provider line.
        fwrite($this->tmpfh, 'PP' .
          ',"' . $this->fixString($erow['lname'])       . '"' .
          ',"' . $this->fixString($erow['fname'])       . '"' .
          ',"' . $this->fixMI($erow['mname'])           . '"' .
          ',"' . $this->fixString($erow['upin'])        . '"' .
        "\n");

        // TBD: Referring Provider line when we have such a thing.

        // Insurance information, up to 3 lines:

        $query = "SELECT " .
          "d.type, d.policy_number, d.group_number, " .
          "d.subscriber_lname, d.subscriber_fname, d.subscriber_mname, " .
          "d.subscriber_street, d.subscriber_city, d.subscriber_state, " .
          "d.subscriber_postal_code, d.subscriber_DOB, d.subscriber_sex, " .
          "d.subscriber_relationship, " .
          "c.name, " .
          "a.line1, a.line2, a.city, a.state, a.zip, " .
          "p.area_code, p.prefix, p.number, " .
          "n.provider_number " .
          "FROM insurance_data AS d " .
          "LEFT OUTER JOIN insurance_companies AS c ON c.id = d.provider " .
          "LEFT OUTER JOIN addresses AS a ON a.foreign_id = c.id " .
          "LEFT OUTER JOIN phone_numbers AS p ON p.foreign_id = c.id AND p.type = 2 " .
          "LEFT OUTER JOIN insurance_numbers AS n ON n.provider_id = ? " .
          "AND n.insurance_company_id = c.id " .
          "WHERE d.pid = ? AND d.provider != '' " .
          "ORDER BY d.type ASC, d.date DESC";
        $ires = sqlStatement($query, array($erow['id'], $patient_id));

        $prev_type = '?';
        while ($irow = sqlFetchArray($ires)) {
            if (strcmp($irow['type'], $prev_type) == 0) {
                continue;
            }

              $prev_type = $irow['type'];

              fwrite($this->tmpfh, 'IN' .
              ',"' . $this->fixString($irow['subscriber_lname'])          . '"' .
              ',"' . $this->fixString($irow['subscriber_fname'])          . '"' .
              ',"' . $this->fixMI($irow['subscriber_mname'])              . '"' .
              ',"' . $this->fixString($irow['subscriber_street'])         . '"' .
              ',"' . $this->fixString($irow['subscriber_city'])           . '"' .
              ',"' . $this->fixString($irow['subscriber_state'])          . '"' .
              ',"' . $this->fixString($irow['subscriber_postal_code'])    . '"' .
              ',"' . $irow['subscriber_DOB']                       . '"' .
              ',"' . $this->fixRelation($irow['subscriber_relationship']) . '"' .
              ',"' . $this->fixString($irow['policy_number'])             . '"' .
              ',"' . $this->fixString($irow['group_number'])              . '"' .
              ',"' . $this->fixString($irow['name'])                      . '"' .
              ',"' . $this->fixString($irow['line1'])                     . '"' .
              ',"' . $this->fixString($irow['line2'])                     . '"' .
              ',"' . $this->fixString($irow['city'])                      . '"' .
              ',"' . $this->fixString($irow['state'])                     . '"' .
              ',"' . $this->fixString($irow['zip'])                       . '"' .
              ',"' . $this->fixPhone($irow['area_code'] . $irow['prefix'] . $irow['number']) . '"' .
              ',"' . $this->fixString($irow['provider_number'])           . '"' .
              ',"' . $this->fixString($irow['provider_number'])           . '"' . // TBD: referring provider
              "\n");
        }

        // Procedure information:

        $query = "SELECT id, code, modifier, justify " .
        "FROM billing " .
        "WHERE pid = ? AND encounter = ? " .
        "AND activity = 1 AND code_type = 'CPT4' " .
        "ORDER BY id";
        $bres = sqlStatement($query, array($patient_id, $encounter));

        while ($brow = sqlFetchArray($bres)) {
              fwrite($this->tmpfh, 'PR' .
                ',"' . $this->fixCPT($brow['code'], $brow['modifier']) . '"' .
                ',"' . $this->fixJust($brow['justify'])                . '"' .
                ',"' . $this->fixDate($erow['date'])                   . '"' .
                ',"' . $this->fixString($erow['pos_code'])             . '"' .
                ',"' . $this->fixString($erow['clia_code'])            . '"' .
                ',"' . $this->fixString($erow['facility'])             . '"' .
                ',"' . $this->fixString($erow['street'])               . '"' .
                ',""'                                           .
                ',"' . $this->fixString($erow['city'])                 . '"' .
                ',"' . $this->fixString($erow['state'])                . '"' .
                ',"' . $this->fixString($erow['postal_code'])          . '"' .
              "\n");
        }
    }

  // Close the output file and move it to the ftp download area.
  //
    function close()
    {
        fclose($this->tmpfh);
        chmod($this->tmpname, 0666);
        rename($this->tmpname, $this->TARGET_DIR . '/' . basename($this->tmpname));
    }
}