154 lines
7.9 KiB
PHP
Executable File
154 lines
7.9 KiB
PHP
Executable File
<?php $this->titre = "INTER SANTE - Consulter une entente préalable";
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$codeActe = $this->nettoyer($ententeprealable['codeActe']);
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$libelleActe = $this->nettoyer($ententeprealable['libelleActe']);
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$numeroBonExamen = $this->nettoyer($ententeprealable['numeroBonExamen']);
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$fraisReelExamen = $this->nettoyer($ententeprealable['fraisReelExamen']);
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$numeroFeuilleMaladie = $this->nettoyer($ententeprealable['numeroFeuilleMaladie']);
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$codeGarantie = $this->nettoyer($ententeprealable['codeGarantie']);
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$numeroBon = $this->nettoyer($ententeprealable['numeroBon']);
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$codeTypePrestation = $this->nettoyer($ententeprealable['codeTypePrestation']);
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if($codeTypePrestation=="EXAM"){
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if (est_anglophone()){
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$libelleActe = "DISPLAY THE LIST OF EXAMS";
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}else{
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$libelleActe = "AFFICHER LA LISTE DES EXAMENS";
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}
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}
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$idProlongation = $this->nettoyer($ententeprealable['idProlongation']);
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if(($idProlongation > "0") && ($ententeprealable['codeActe'] == "HHM" || $ententeprealable['codeActe'] == "HHC")){
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$libelleActe = $libelleActe." - "."PROROGATION";
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}
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?>
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<INPUT class="sr-only" TYPE="text" id="retour" NAME="retour" value="<?= $retour ?>" readonly>
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<form >
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<input class="sr-only" type="text" id="nomForm" name="nomForm" value="consulterEntentePrealable">
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<INPUT class="sr-only" TYPE="text" id="idDemandeententeprealable" name="idDemandeententeprealable" value="<?= $this->nettoyer($ententeprealable['idDemandeententeprealable']) ?>">
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<INPUT class="sr-only" TYPE="text" id="prestataire" name="prestataire" value="<?= $this->nettoyer($ententeprealable['prestataire']) ?>">
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<INPUT class="sr-only" TYPE="text" id="beneficiaire" name="beneficiaire" value="<?= $this->nettoyer($ententeprealable['beneficiaire']) ?>">
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<INPUT class="sr-only" TYPE="text" id="numeroBeneficiaire" name="numeroBeneficiaire" value="<?= $this->nettoyer($ententeprealable['numeroBeneficiaire']) ?>">
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<INPUT class="sr-only" TYPE="text" id="libelleActe" name="libelleActe" value="<?= $this->nettoyer($ententeprealable['libelleActe']) ?>">
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<legend> <?= _("Consulter une entente préalable") ?> </legend>
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<table class="table table-responsive table-condensed" style='font-size:10pt;'>
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<tbody>
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<tr>
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<td width="10%" > <?= _("No") ?> </td>
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<td width="20%"> <INPUT id="numeroEntentePrealable" name="numeroEntentePrealable" class="form-control" TYPE="text" style='font-size:10pt;' value="<?= $this->nettoyer($ententeprealable['numeroEntentePrealable']) ?>" readonly> </td>
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<td width="10%" align="center"> <?= _("Acte") ?> </td>
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<td colspan="3">
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<?php if($codeTypePrestation=='EXAM'): ?>
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<a title='<?= _("Afficher les examens prescrits") ?>' href="javascript:afficherListeActesPrescrits('<?= $numeroFeuilleMaladie ?>', '<?= $codeTypePrestation ?>', '<?= $codeGarantie ?>');">
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<span style="color:blue; background-color:#eeeeee; border:1px solid #000; border-radius:3px; padding-left:5px; padding-right:5px;">
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<?= $libelleActe ?>
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</span>
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</a>
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<?php elseif($codeTypePrestation=='ACT'): ?>
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<a title='<?= _("Afficher les actes médicaux prescrits") ?>' href="javascript:afficherListeActesPrescrits('<?= $numeroFeuilleMaladie ?>', '<?= $codeTypePrestation ?>', '<?= $codeGarantie ?>');">
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<span style="color:blue; background-color:#eeeeee; border:1px solid #000; border-radius:3px; padding-left:5px; padding-right:5px;">
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<?= $libelleActe ?>
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</span>
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</a>
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<?php else: ?>
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<INPUT class="form-control" TYPE="text" style='font-size:10pt;' value="<?= $libelleActe ?>" readonly>
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<?php endif; ?>
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</td>
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</tr>
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<tr>
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<td> Date </td>
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<td> <INPUT class="form-control" TYPE="text" style='font-size:10pt;' value="<?= dateheureLang($this->nettoyer($ententeprealable['dateSysteme'])) ?>" readonly> </td>
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<td align="center"> <?= _("Prestataire") ?> </td>
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<td colspan="3"> <INPUT class="form-control" TYPE="text" style='font-size:10pt;' value="<?= $this->nettoyer($ententeprealable['prestataire']).' / Bon No: '.$numeroBon ?>" readonly> </td>
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</tr>
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<tr>
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<td> <?= _("Motif Clinique") ?> </td>
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<td colspan="5"><INPUT class="form-control" TYPE="text" id="motifPrestataire" NAME="motifPrestataire" style='font-size:10pt;' value="<?= $this->nettoyer($ententeprealable['motifPrestataire']); ?>" readonly></td>
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</tr>
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<tr>
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<td> <?= _("Bénéficiaire") ?> </td>
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<td colspan="5"><INPUT class="form-control" TYPE="text" style='font-size:10pt;' value="<?= $this->nettoyer($ententeprealable['beneficiaire']) ?>" readonly> </td>
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</tr>
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<tr>
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<td> <?= _("Répondu le") ?> </td>
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<td> <INPUT class="form-control" TYPE="text" style='font-size:10pt;' value="<?= dateheureLang($this->nettoyer($ententeprealable['dateReponse'])) ?>" readonly> </td>
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<td align="center"> <?= _("Réponse") ?> </td>
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<td> <INPUT class="form-control" TYPE="text" style='font-size:10pt;' value="<?= $this->nettoyer($ententeprealable['reponsentEnteprealable']) ?>" readonly> </td>
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<td align="center"> <?= _("Par") ?> </td>
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<td> <INPUT class="form-control" TYPE="text" style='font-size:10pt;' value="<?= $this->nettoyer($ententeprealable['responsableAccord']) ?>" readonly> </td>
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</tr>
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<tr>
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<td> <?= _("observation") ?> </td>
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<td colspan="5"><INPUT class="form-control" TYPE="text" style='font-size:10pt;' value="<?= $this->nettoyer($ententeprealable['motifReel']) ?>" readonly> </td>
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</tr>
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<tr>
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<td> <?= _("Motif Refus") ?> </td>
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<td colspan="5"><INPUT class="form-control" TYPE="text" style='font-size:10pt;' value="<?= $this->nettoyer($ententeprealable['motifRefusAssure']) ?>" readonly> </td>
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</tr>
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</tbody>
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</table>
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</form>
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<div id="div_info">
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<?php if($codeActe=='EXAM'): ?>
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<p style='font-size:13pt;'>
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<span style="display: block; color:red; background-color:#eeeeee; border-radius:3px;">
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<?= _("NB: Le montant total des actes était ou est supérieur au montant indicatif.") ?>
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</span>
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</p>
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<?php endif; ?>
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</div>
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<table class="table table-responsive table-condensed">
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<tbody>
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<tr>
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<td width="10%"> <?= _("Plafond Bénéf.") ?> </td>
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<td><INPUT style='text-align:center; background-color:#027BE3 !important;color:white; font-size:10pt;' class="form-control" TYPE="text" value="<?= format_N($this->nettoyer($college['plafond'])) ?>" readonly ></td>
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<td align="center"> <?= _("Conso. Bénéf.") ?> </td>
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<td><INPUT style='text-align:center; background-color:rgba(255, 0, 127) !important;color:white; font-size:10pt;' class="form-control" TYPE="text" value="<?= format_N($this->nettoyer($college['consommation'])) ?>" readonly ></td>
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<td align="center"> <?= _("Solde Bénéf.") ?> </td>
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<td> <INPUT style='text-align:center; background-color:green !important; color:white; font-size:10pt;' class="form-control" TYPE="text" value="<?= format_N($this->nettoyer($college['soldeConsommation'])) ?>" readonly ></td>
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</tr>
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<tr>
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<td width="10%"> <?= _("Plafond Famille") ?> </td>
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<td><INPUT style='text-align:center; background-color:#027BE3 !important;color:white; font-size:10pt;' class="form-control" TYPE="text" value="<?= format_N($this->nettoyer($police['plafond'])) ?>" readonly ></td>
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<td align="center"> <?= _("Conso. Famille") ?> </td>
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<td><INPUT style='text-align:center; background-color:rgba(255, 0, 127) !important;color:white; font-size:10pt;' class="form-control" TYPE="text" value="<?= format_N($this->nettoyer($police['consommation'])) ?>" readonly ></td>
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<td align="center"> <?= _("Solde Famille") ?> </td>
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<td> <INPUT style='text-align:center; background-color:green !important;color:white; font-size:10pt;' class="form-control" TYPE="text" value="<?= format_N($this->nettoyer($police['soldeConsommation'])) ?>" readonly ></td>
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</tr>
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</tbody>
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</table>
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<div id="div_examens_prescrits" class="modal fade" role="dialog" data-backdrop="static" data-keyboard="false">
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</div>
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