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Client Bill Type Transfer
Client: | Invoice Number: | Lab Code: |
Bill Type: Patient | Patient Name: | Specimen#: |
Collection Date: |
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If you need assistance, please contact the billing customer service department.
' }); }); $.unblockUI(); // keep this line below to fix a bug. $(".blockUI").fadeOut("slow");}); // end new phys stuff. function clearRespPartyPatientCheckBox() {document.getElementById('doClientBtt_respPartyCheckBox').checked = false; } function RespPartySameAsPatient() {if (document.getElementById('doClientBtt_respPartyCheckBox').checked) { document.getElementById('doClientBtt_respPartyFirstName').value = ''; document.getElementById('doClientBtt_respPartyLastName').value = ''; document.getElementById('doClientBtt_respPartyMidInit').value = ''; document.getElementById('doClientBtt_respPartyAddress1').value = document.getElementById('doClientBtt_patientAddress1').value; document.getElementById('doClientBtt_respPartyAddress2').value = document.getElementById('doClientBtt_patientAddress2').value; document.getElementById('doClientBtt_respPartyCity').value = document.getElementById('doClientBtt_patientCity').value; document.getElementById('doClientBtt_respPartyState').selectedIndex = document.getElementById('doClientBtt_patientState').selectedIndex; document.getElementById('doClientBtt_respPartyZip').value = document.getElementById('doClientBtt_patientZip').value; document.getElementById('doClientBtt_respPartyCheckBox').checked = true;} else { document.getElementById('doClientBtt_respPartyFirstName').value = ''; document.getElementById('doClientBtt_respPartyLastName').value = ''; document.getElementById('doClientBtt_respPartyMidInit').value = ''; document.getElementById('doClientBtt_respPartyAddress1').value = ''; document.getElementById('doClientBtt_respPartyAddress2').value = ''; document.getElementById('doClientBtt_respPartyCity').value = ''; document.getElementById('doClientBtt_respPartyState').selectedIndex = 0; document.getElementById('doClientBtt_respPartyZip').value = ''; document.getElementById('doClientBtt_respPartyCheckBox').checked = false;}$.uniform.update(); } function ToggleRows(rowName, displayState) { // '' visible, 'none' hiddenvar rows = document.getElementsByName(rowName);if (rows != null) { for (var i = 0; i < rows.length; i++) {rows[i].style.display = displayState; }} } function processDialogOpen(qbsWSPayorType) {var message = '';switch (qbsWSPayorType) { case '-1': // Ajax error message = 'An unexpected error has occurred. Please try your request again.
'; break; case '3': // Medicare message = 'Your account is not allowed to change to:
' + 'Medicare'; break; case '4': // Medicaid message = 'Your account is not allowed to change to:
' + 'Medicaid'; break; default: message = 'Your account is not allowed to change to:
' + 'Commercial Insurance'; break;}document.getElementById('dialogBttFormMessage').innerHTML = '
' + message + '
';$('#dialogBttForm').dialog('open'); } function processDialogClose() {document.getElementById("doClientBtt_insCarrierString").selectedIndex = -1;document.getElementById('insuranceMessage').innerHTML = 'Please select a carrier from the list on the left side of the screen.';$('#dialogBttForm').dialog('close'); } window.onload = function() {$("#uniform-doClientBtt_patientDobMonth").addClass("dobmonth");$("#uniform-doClientBtt_patientDobDay").addClass("dobday");$("#uniform-doClientBtt_dateOfInjuryMonth").addClass("dobmonth");$("#uniform-doClientBtt_dateOfInjuryDay").addClass("dobday");$("#uniform-doClientBtt_dateOfInjuryYear").addClass("dobyeardd"); }function toggleExcludeElements(display) {if (display) {$("#EXPLANATORY_MESSAGE").show();$("#INSTRUCTIONAL_MESSAGE").show();$("#EXCLUDES_CHECK").show();} else {$("#EXPLANATORY_MESSAGE").hide();$("#INSTRUCTIONAL_MESSAGE").hide();$("#EXCLUDES_CHECK").hide();$("#FAX_INFO").hide();$("#COVER_LETTER").hide();}} $(function() { if ('' == "I") { $("#doClientBtt_byPassAddDx").val(false);if ('false' === 'true') {$("#deleteEnabled").val(true);$("#FAX_INFO").show();$("#COVER_LETTER").show();$("#doClientBtt_byPassAddDx").val(true);} if ('0' <= 0) {$("#DiagTable").hide();}toggleExcludeElements('false' === "true" ? true : false);if ($("#doClientBtt_excludeError").val() === "true" && ('' == "005" || '' == "006" || '' == "004")) {diagnosisInquiry();} else if ('false' === 'true') {diagnosisInquiry();$("#DiagTable").css('display', true);} } }); function deleteDX(dxCode, obj, excludeException) {var dinfosrc = $('#doClientBtt_insCarrierString').val().split('^')[0];if(dxCode == null) {let objArray = new Array();dxCode = "";$("input[name=deleteDiganosis]:checked").each(function (index, obj) {dxCode = dxCode + $(this).prop("value") + ","; objArray[index] = $(this).closest("tr");});}$.blockUI({message: ' Processing
"; var exclude = data['ajaxResponse']['EXCLUDES_CHECK'].split("\|"); var checked = ""; $("#FAX_INFO").html(data['ajaxResponse']['FAX_INFO']); for (let i = 0; i < exclude.length; i++) { if (data['ajaxResponse']['checkEnabled'] === "true") { $("#deleteEnabled").val(true); checked = "checked='checked'"; $("#FAX_INFO").show();$("#COVER_LETTER").show();$("#doClientBtt_byPassAddDx").val(true); } html = html + "" html = html + " " + exclude[i].split("::")[1] + " ";} $("#EXCLUDES_CHECK").append(html+"
");break;case "004":case "499":toggleExcludeElements(false); $("#doClientBtt_excludeError").val(false); $("#dxInqError").show(); $("#dxInqError").empty(); $("#dxInqError").append(data['ajaxResponse']['status']); break; case "000": $("#doClientBtt_excludeError").val(false); toggleExcludeElements(false); break; default : break; } $("#diagCodes").empty(); html = "";var i=0;$.each(data['diagCodeOnFile'], function(key, item) {html = html + '
';i++; }); if(i > 0) { $("#DiagTable").show(); $("#diagCodes").append(html); $diagInFile = $("input[name=deleteDiganosis]").each(function (index, obj) {diagCodeInFile[$(this).prop("value")] = this;}); } else { $diagInFile = {}; $("#DiagTable").hide(); } }$("#deleteICD").click(function() {var insOk = ('' == "I") ? (Number($('#doClientBtt_insCarrierString option:selected').index()) >= 0) : false;if ($("#doClientBtt_excludeError").val() && !($("input[name=excludeOne]").val()) && !insOk ) { $('#insCarrierStringError').text('Insurance carrier is required').show(); return ;}let objArray = new Array();var dxCode = "";$("input[name=deleteDiganosis]:checked").each(function (index, obj) {dxCode = dxCode + $(this).prop("value") + ","; objArray[index] = $(this).closest("tr");});if (dxCode != "") {deleteDX(dxCode, objArray, null);}});//-->