Fixes

resources/views/app/patient/primary-coverage-manual-determination-commercial-modal.blade.php

@@ -9,10 +9,10 @@
 				<div class="form-group col-md-12">
 					<p class="mb-1">How did you manually check coverage?</p>
 					<div class="form-check form-check-inline">
-						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="REVIEWED_ELECTRONIC">Reviewed Electronically</label>
+						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="REVIEWED_ELECTRONIC" required>Reviewed Electronically</label>
 					</div>
 					<div class="form-check form-check-inline">
-						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="CALLED_PAYER">Called Payer</label>
+						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="CALLED_PAYER" required>Called Payer</label>
 					</div>
 				</div>
 			</div>
@@ -30,35 +30,77 @@
 							<td>Record Found?</td>
 							<td>{{$cpc->auto_commercial_is_match_found ? 'YES' : 'NO'}}</td>
 							<td>
-								<div class="form-group mb-0">
-									<label for="" class="control-label">Manual Determination Category</label>
-									<select name="manualDeterminationCategory" class="form-control input-sm" @change="onInputChange">
-										<option value="">--select--</option>
-										<option value="COVERED">Covered</option>
-										<option value="NOT_COVERED">Not Covered</option>
-										<option value="INVALID" :selected="cpc.auto_commercial_is_match_found == 'NO'">Invalid</option>
-										<option value="UNKNOWN">Unknown</option>
-									</select>
+								<div class="form-group">
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualCommercialIsMatched" value="YES" @change="onInputChange">Yes</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualCommercialIsMatched" value="NO" @change="onInputChange">No</label>
+									</div>
 								</div>
 							</td>
 						</tr>
+						<tr>
+							<td>Coverage Status?</td>
+							<td>UNKNOWN</td>
+							<td>
+								<select name="manualDeterminationCategory" class="form-control input-sm" @change="onInputChange">
+									<option value="">--select--</option>
+									<option value="COVERED" :selected="uiState.manualCommercialIsMatched == 'YES'">Covered</option>
+									<option value="NOT_COVERED">Not Covered</option>
+									<option value="INVALID" :selected="uiState.manualCommercialIsMatched == 'NO'">Invalid</option>
+									<option value="UNKNOWN">Unknown</option>
+								</select>
+							</td>
+						</tr>
+					</tbody>
+				</table>
+
+				@if($cpc->mcd_number)
+				<h5 class="mt-2 font-weight-bold">Medicaid Information Provided:</h5>
+				<table class="table table-bordered table-striped">
+					<tbody>
 						<tr>
 							<td>Medicaid Number</td>
-							<td colspan="2">{{$cpc->mcd_number ?? '-'}}</td>
+							<td>{{$cpc->mcd_number ?? '-'}}</td>
 						</tr>
 						<tr>
 							<td>Medicaid State</td>
-							<td colspan="2">{{$cpc->mcd_payer_name ?? '-'}}</td>
+							<td>{{$cpc->mcd_payer_name ?? '-'}}</td>
 						</tr>
 						<tr>
 							<td>Was Medicaid Record Found?</td>
-							<td colspan="2">{{$cpc->auto_medicaid_is_match_found ? 'Yes' : 'No'}}</td>
+							<td>{{$cpc->auto_medicaid_is_match_found ? 'Yes' : 'No'}}</td>
 						</tr>
+					</tbody>
+				</table>
+				@endif
+
+				@if($cpc->mcr_number)
+				<h5 class="mt-2 font-weight-bold">Medicare Information Provided:</h5>
+				<table class="table table-bordered table-striped">
+					<thead>
 						<tr>
-							<td>Medicare Number</td>
-							<td colspan="2">{{$cpc->mcr_number ?? '-'}}</td>
+							<th></th>
+							<th>Automatic</th>
+							<th>Override</th>
+						</tr>
+					</thead>
+					<tbody>
+						<tr>
+							<td>Record Found?</td>
+							<td>{{$cpc->auto_medicare_is_match_found ? 'YES' : 'NO'}}</td>
+							<td>
+								<div class="form-group mb-0">
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsMatched" value="YES" @click="onInputChange">Yes</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsMatched" value="NO" @click="onInputChange">No</label>
+									</div>
+								</div>
+							</td>
 						</tr>
-
 						<tr>
 							<td>Part B Active?</td>
 							<td>{{$cpc->auto_medicare_is_partbactive}}</td>
@@ -174,6 +216,9 @@
 						</tr>
 					</tbody>
 				</table>
+				@endif
+
+
 			</div>
 			<div class="row">
 				<div class="form-group col-md-12">
@@ -196,106 +241,132 @@
 </div>
 <script>
 	(function() {
-		function init() {
-			new Vue({
-				el: '#manual-determination-form-{{$patient->uid}}',
-				delimiters: ['@{{', '}}'],
-				data: {
-					url: '/api/clientPrimaryCoverage/manualDeterminationForCommercial',
-					uiState: {
-						manualDeterminationCategory: null,
-						manualMedicareIsPartBActive: null,
-						manualMedicareIsPartBPrimary: null,
-						manualMedicareIsPartCActive: null,
-						manualMedicareIsInpatient: null,
-						manualMedicareIsHospice: null,
-						manualMedicareIsHomeHealth: null,
-						manualMedicareIsMsp: null,
+			function init() {
+				new Vue({
+						el: '#manual-determination-form-{{$patient->uid}}',
+						delimiters: ['@{{', '}}'],
+						data: {
+							url: '/api/clientPrimaryCoverage/manualDeterminationForCommercial',
+							uiState: {
+								manualCommercialIsMatched: null,
+								manualDeterminationCategory: null,
+								manualMedicareIsPartBActive: null,
+								manualMedicareIsPartBPrimary: null,
+								manualMedicareIsPartCActive: null,
+								manualMedicareIsInpatient: null,
+								manualMedicareIsHospice: null,
+								manualMedicareIsHomeHealth: null,
+								manualMedicareIsMsp: null,
 
-					},
-					cpc: <?= json_encode($cpc); ?>,
-					processing: false,
-					response: null,
-					disabled: false
-				},
-				methods: {
-					onInputChange: function(evt){
-						var input = evt.target;
-						var name = input.name;
-						var value = input.value;
-						this.uiState[name] = value;
-						console.log({name, value});
-						if(name === 'manualMedicareIsPartBPrimary'){
-							if(value === 'YES') this.uiState.manualMedicareIsPartBActive = 'YES';
-						}
-						if(name === 'manualMedicareIsPartCActive'){
-							if(value === 'YES') this.uiState.manualMedicareIsPartBActive = 'NO';
-						}
-						if(name === 'manualDeterminationCategory'){
-							if(value === 'INVALID' || value === 'UNKNOWN'){
-								this.setUiStateDefaultValue('NO');
-								return;
-							}
-						}
-						this.refreshUi();
-					},
-					setUiStateDefaultValue: function(value){
-						var self = this;
-						for(var fieldName in self.uiState){
-							self.uiState[fieldName] = value;	
-						}
-						self.refreshUi();
-					},
-					submitForm: function(evt) {
-						var self = this;
-						if (self.processing) return;
-						var form = evt.target;
-						var data = $(form).serializeArray();
-						var url = self.url;
-						if (!url) {
-							self.response = {
-								success: false,
-								message: 'Invalid url'
-							};
-							return;
-						}
+								manualMedicareIsMatched: null,
+
+							},
+							cpc: <?= json_encode($cpc); ?>,
+							processing: false,
+							response: null,
+							disabled: false
+						},
+						methods: {
+							onInputChange: function(evt) {
+								var input = evt.target;
+								var name = input.name;
+								var nameLowerCase = name.toLowerCase();
+								var value = input.value;
+								this.uiState[name] = value;
+
+								if(/medicare/gi.test(nameLowerCase)){
+									if(value === 'YES') this.uiState.manualMedicareIsMatched = 'YES';
+								}								
+
+								if (name === 'manualMedicareIsPartBPrimary') {
+									if (value === 'YES') this.uiState.manualMedicareIsPartBActive = 'YES';
+								}
+								if (name === 'manualMedicareIsPartCActive') {
+									if (value === 'YES') this.uiState.manualMedicareIsPartBActive = 'NO';
+								}
+								if (name === 'manualDeterminationCategory') {
+									if (value === 'INVALID' || value === 'UNKNOWN') {
+										this.setUiStateDefaultValue('NO');
+										return;
+									}
+								}
+
+								if (this.uiState.manualMedicareIsMatched === 'NO') {
+									this.setUiStateDefaultValue('NO', 'medicare');
+									return;
+								}
+
+								this.refreshUi();
+							},
+							setUiStateDefaultValue: function(value, type) {
+								var self = this;
+								for (var fieldName in self.uiState) {
+									if (type) {
+										var fieldNameLowerCase = fieldName.toLowerCase();
+										var typeRegex = RegExp(type, 'g');
+										var isMatchFound = typeRegex.test(fieldNameLowerCase);
+										if(isMatchFound){
+											self.uiState[fieldName] = value;
+										}
+										}
+										else {
+											self.uiState[fieldName] = value;
+										}
+									}
+									self.refreshUi();
+								},
+								submitForm: function(evt) {
+										var self = this;
+										if (self.processing) return;
+										var form = evt.target;
+										var data = $(form).serializeArray();
+										var url = self.url;
+										if (!url) {
+											self.response = {
+												success: false,
+												message: 'Invalid url'
+											};
+											return;
+										}
 
-						self.processing = true;
-						$.post(url, data, function(response) {
-							self.processing = false;
-							if (response.success) {
-								closeStagPopup();
-								fastReload();
-							} else {
-								self.response = response;
+										self.processing = true;
+										$.post(url, data, function(response) {
+											self.processing = false;
+											if (response.success) {
+												closeStagPopup();
+												fastReload();
+											} else {
+												self.response = response;
+											}
+										}, 'json');
+									},
+									refreshUi: function() {
+										var self = this;
+										$("input[type=radio]").prop('checked', false);
+										for (var fieldName in self.uiState) {
+											var value = self.uiState[fieldName];
+											if (value) {
+												$("input[name=" + fieldName + "][type=radio][value=" + value + "]").prop('checked', true);
+											}
+										}
+										self.disabled = (self.cpc.auto_medicare_is_partcactive == 'YES' && self.cpc.auto_medicare_is_partbprimary == 'YES') || (self.uiState.manualMedicareIsPartBPrimary == 'YES' && self.uiState.manualMedicareIsPartCActive == 'YES');
+									},
+							},
+							mounted: function() {
+								if (this.cpc.auto_medicare_is_partbprimary == 'YES') {
+									this.uiState.manualMedicareIsPartBPrimary = 'YES';
+									this.uiState.manualMedicareIsPartCActive = 'NO';
+									this.uiState.manualMedicareIsPartBActive = 'YES';
+								};
+								this.uiState.manualMedicareIsMatched = this.cpc.auto_medicare_is_partbactive;
+								this.uiState.manualCommercialIsMatched = this.cpc.auto_commercial_is_match_found ? 'YES' : 'NO';
+								if (this.cpc.auto_commercial_is_match_found === 'NO') {
+									this.uiState.manualDeterminationCategory = 'INVALID';
+								}
+								this.refreshUi();
 							}
-						}, 'json');
-					},
-					refreshUi: function(){
-						var self = this;
-						$("input[type=radio]").prop('checked', false);
-						for(var fieldName in self.uiState){
-							var value = self.uiState[fieldName];
-							if(value){					
-								$("input[name="+ fieldName +"][type=radio][value=" + value + "]").prop('checked', true);
-							}							
-						}
-						self.disabled = (self.cpc.auto_medicare_is_partcactive == 'YES' && self.cpc.auto_medicare_is_partbprimary == 'YES') || (self.uiState.manualMedicareIsPartBPrimary == 'YES' && self.uiState.manualMedicareIsPartCActive == 'YES');
-					},
-				},
-				mounted: function() {
-					if (this.cpc.auto_medicare_is_partbprimary == 'YES') {
-						this.uiState.manualMedicareIsPartBPrimary = 'YES';
-						this.uiState.manualMedicareIsPartCActive = 'NO';
-						this.uiState.manualMedicareIsPartBActive = 'YES';
-					};
-					if(this.cpc.auto_commercial_is_match_found === 'NO'){
-						this.uiState.manualDeterminationCategory = 'INVALID';
-					}					
-					this.refreshUi();
+						});
 				}
-			});
-		}
-		addMCInitializer('manual-determination-form-{{$patient->uid}}', init, '#manual-determination-form-{{$patient->uid}}')
-	}).call(window);
-</script>
+				addMCInitializer('manual-determination-form-{{$patient->uid}}', init, '#manual-determination-form-{{$patient->uid}}')
+			}).call(window);
+</script>

resources/views/app/patient/primary-coverage-manual-determination-commercial-modal_.blade.php

@@ -0,0 +1,292 @@
+<div id="manual-determination-form-{{$patient->uid}}">
+	@php
+	$cpc = $patient->latestClientPrimaryCoverage;
+	@endphp
+	<div class="p-3">
+		<form @submit.prevent="submitForm" method="post" class="mcp-theme-1">
+			<input type="hidden" name="clientPrimaryCoverageUid" value="{{$cpc->uid}}" class="form-control input-sm" />
+			<div class="row">
+				<div class="form-group col-md-12">
+					<p class="mb-1">How did you manually check coverage?</p>
+					<div class="form-check form-check-inline">
+						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="REVIEWED_ELECTRONIC" required>Reviewed Electronically</label>
+					</div>
+					<div class="form-check form-check-inline">
+						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="CALLED_PAYER" required>Called Payer</label>
+					</div>
+				</div>
+			</div>
+			<div class="table-responsive">
+				<table class="table table-sm table-bordered table-striped">
+					<thead>
+						<tr>
+							<th></th>
+							<th>Automatic</th>
+							<th>Override</th>
+						</tr>
+					</thead>
+					<tbody>
+						<tr>
+							<td>Record Found?</td>
+							<td>{{$cpc->auto_commercial_is_match_found ? 'YES' : 'NO'}}</td>
+							<td>
+
+							</td>
+						</tr>
+						<tr>
+							<td>Medicaid Number</td>
+							<td colspan="2">{{$cpc->mcd_number ?? '-'}}</td>
+						</tr>
+						<tr>
+							<td>Medicaid State</td>
+							<td colspan="2">{{$cpc->mcd_payer_name ?? '-'}}</td>
+						</tr>
+						<tr>
+							<td>Was Medicaid Record Found?</td>
+							<td colspan="2">{{$cpc->auto_medicaid_is_match_found ? 'Yes' : 'No'}}</td>
+						</tr>
+						<tr>
+							<td>Medicare Number</td>
+							<td colspan="2">{{$cpc->mcr_number ?? '-'}}</td>
+						</tr>
+
+						<tr>
+							<td>Part B Active?</td>
+							<td>{{$cpc->auto_medicare_is_partbactive}}</td>
+							<td>
+								<div class="form-group mb-0">
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsPartBActive" @click="onInputChange" value="YES">Yes</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsPartBActive" @click="onInputChange" value="NO">No</label>
+									</div>
+								</div>
+							</td>
+						</tr>
+						<tr>
+							<td>Is Part B Primary?</td>
+							<td>{{$cpc->auto_medicare_is_partbprimary}}</td>
+							<td>
+								<div class="form-group mb-0">
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsPartBPrimary" @click="onInputChange" value="YES">Yes</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsPartBPrimary" @click="onInputChange" value="NO">No</label>
+									</div>
+								</div>
+							</td>
+						</tr>
+						<tr>
+							<td>Is Part C Active?</td>
+							<td>{{$cpc->auto_medicare_is_partcactive}}</td>
+							<td>
+								<div class="alert alert-danger" v-if="(cpc.auto_medicare_is_partcactive == 'YES' && cpc.auto_medicare_is_partbprimary == 'YES') || (uiState.manualMedicareIsPartBPrimary == 'YES' && uiState.manualMedicareIsPartCActive == 'YES')">
+									Oops! Patient Medicare Part B Primary is set to <b>Yes</b>.
+								</div>
+								<div class="form-group mb-0">
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsPartCActive" @click="onInputChange" value="YES">Yes</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsPartCActive" @click="onInputChange" value="NO">No</label>
+									</div>
+								</div>
+							</td>
+						</tr>
+						<tr>
+							<td>Inpatient?</td>
+							<td>{{$cpc->auto_medicare_is_inpatient}}</td>
+							<td>
+								<div class="form-group mb-0">
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsInpatient" @click="onInputChange" value="YES">Yes</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsInpatient" @click="onInputChange" value="NO">No</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsInpatient" @click="onInputChange" value="UNKNOWN">Unknown</label>
+									</div>
+								</div>
+							</td>
+						</tr>
+						<tr>
+							<td>Hospice?</td>
+							<td>UNKNOWN</td>
+							<td>
+								<div class="form-group mb-0">
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsHospice" @click="onInputChange" value="YES">Yes</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsHospice" @click="onInputChange" value="NO">No</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsHospice" @click="onInputChange" value="UNKNOWN">Unknown</label>
+									</div>
+								</div>
+							</td>
+						</tr>
+						<tr>
+							<td>Home Health?</td>
+							<td>UNKNOWN</td>
+							<td>
+								<div class="form-group mb-0">
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsHomeHealth" @click="onInputChange" value="YES">Yes</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsHomeHealth" @click="onInputChange" value="NO">No</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsHomeHealth" @click="onInputChange" value="UNKNOWN">Unknown</label>
+									</div>
+								</div>
+							</td>
+						</tr>
+						<tr>
+							<td>MSP?</td>
+							<td>{{$cpc->auto_medicare_is_msp}}</td>
+							<td>
+								<div class="form-group mb-0">
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsMsp" @click="onInputChange" value="YES">Yes</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsMsp" @click="onInputChange" value="NO">No</label>
+									</div>
+									<div class="form-check form-check-inline">
+										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsMsp" @click="onInputChange" value="UNKNOWN">Unknown</label>
+									</div>
+								</div>
+							</td>
+						</tr>
+					</tbody>
+				</table>
+			</div>
+			<div class="row">
+				<div class="form-group col-md-12">
+					<label for="" class="control-label">Memo</label>
+					<textarea name="manualMedicareMemo" class="form-control"></textarea>
+				</div>
+			</div>
+
+
+			<div v-if="response" :class="response.success ? 'alert success' : 'alert alert-danger'">
+				@{{ response.message }}
+			</div>
+
+			<div class="form-group text-nowrap mb-0">
+				<button v-if="!processing" class="btn btn-sm btn-primary" type="submit" :disabled="url == '' || disabled === true">Submt</button>
+				<button v-else class="btn btn-sm btn-primary" type="button"><i class="fas fa-circle-notch fa-spin"></i> Processing...</button>
+			</div>
+		</form>
+	</div>
+</div>
+<script>
+	(function() {
+		function init() {
+			new Vue({
+				el: '#manual-determination-form-{{$patient->uid}}',
+				delimiters: ['@{{', '}}'],
+				data: {
+					url: '/api/clientPrimaryCoverage/manualDeterminationForCommercial',
+					uiState: {
+						manualDeterminationCategory: null,
+						manualMedicareIsPartBActive: null,
+						manualMedicareIsPartBPrimary: null,
+						manualMedicareIsPartCActive: null,
+						manualMedicareIsInpatient: null,
+						manualMedicareIsHospice: null,
+						manualMedicareIsHomeHealth: null,
+						manualMedicareIsMsp: null,
+
+					},
+					cpc: <?= json_encode($cpc); ?>,
+					processing: false,
+					response: null,
+					disabled: false
+				},
+				methods: {
+					onInputChange: function(evt){
+						var input = evt.target;
+						var name = input.name;
+						var value = input.value;
+						this.uiState[name] = value;
+						console.log({name, value});
+						if(name === 'manualMedicareIsPartBPrimary'){
+							if(value === 'YES') this.uiState.manualMedicareIsPartBActive = 'YES';
+						}
+						if(name === 'manualMedicareIsPartCActive'){
+							if(value === 'YES') this.uiState.manualMedicareIsPartBActive = 'NO';
+						}
+						if(name === 'manualDeterminationCategory'){
+							if(value === 'INVALID' || value === 'UNKNOWN'){
+								this.setUiStateDefaultValue('NO');
+								return;
+							}
+						}
+						this.refreshUi();
+					},
+					setUiStateDefaultValue: function(value){
+						var self = this;
+						for(var fieldName in self.uiState){
+							self.uiState[fieldName] = value;	
+						}
+						self.refreshUi();
+					},
+					submitForm: function(evt) {
+						var self = this;
+						if (self.processing) return;
+						var form = evt.target;
+						var data = $(form).serializeArray();
+						var url = self.url;
+						if (!url) {
+							self.response = {
+								success: false,
+								message: 'Invalid url'
+							};
+							return;
+						}
+
+						self.processing = true;
+						$.post(url, data, function(response) {
+							self.processing = false;
+							if (response.success) {
+								closeStagPopup();
+								fastReload();
+							} else {
+								self.response = response;
+							}
+						}, 'json');
+					},
+					refreshUi: function(){
+						var self = this;
+						$("input[type=radio]").prop('checked', false);
+						for(var fieldName in self.uiState){
+							var value = self.uiState[fieldName];
+							if(value){					
+								$("input[name="+ fieldName +"][type=radio][value=" + value + "]").prop('checked', true);
+							}							
+						}
+						self.disabled = (self.cpc.auto_medicare_is_partcactive == 'YES' && self.cpc.auto_medicare_is_partbprimary == 'YES') || (self.uiState.manualMedicareIsPartBPrimary == 'YES' && self.uiState.manualMedicareIsPartCActive == 'YES');
+					},
+				},
+				mounted: function() {
+					if (this.cpc.auto_medicare_is_partbprimary == 'YES') {
+						this.uiState.manualMedicareIsPartBPrimary = 'YES';
+						this.uiState.manualMedicareIsPartCActive = 'NO';
+						this.uiState.manualMedicareIsPartBActive = 'YES';
+					};
+					if(this.cpc.auto_commercial_is_match_found === 'NO'){
+						this.uiState.manualDeterminationCategory = 'INVALID';
+					}					
+					this.refreshUi();
+				}
+			});
+		}
+		addMCInitializer('manual-determination-form-{{$patient->uid}}', init, '#manual-determination-form-{{$patient->uid}}')
+	}).call(window);
+</script>

resources/views/app/patient/primary-coverage-manual-determination-medicaid-modal.blade.php

@@ -9,10 +9,10 @@
 				<div class="form-group col-md-12">
 					<p class="mb-1">How did you manually check coverage?</p>
 					<div class="form-check form-check-inline">
-						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="REVIEWED_ELECTRONIC">Reviewed Electronically</label>
+						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="REVIEWED_ELECTRONIC" required>Reviewed Electronically</label>
 					</div>
 					<div class="form-check form-check-inline">
-						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="CALLED_PAYER">Called Payer</label>
+						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="CALLED_PAYER" required>Called Payer</label>
 					</div>
 				</div>
 			</div>

resources/views/app/patient/primary-coverage-manual-determination-medicare-modal.blade.php

@@ -9,10 +9,10 @@
 				<div class="form-group col-md-12">
 					<p class="mb-1">How did you manually check coverage?</p>
 					<div class="form-check form-check-inline">
-						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="REVIEWED_ELECTRONIC">Reviewed Electronically</label>
+						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="REVIEWED_ELECTRONIC" required>Reviewed Electronically</label>
 					</div>
 					<div class="form-check form-check-inline">
-						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="CALLED_PAYER">Called Payer</label>
+						<label class="form-check-label"><input class="form-check-input" type="radio" v-model="uiState.manualDeterminationStrategy" name="manualDeterminationStrategy" value="CALLED_PAYER" required>Called Payer</label>
 					</div>
 				</div>
 			</div>
@@ -64,11 +64,8 @@
 							<td>Is Part B Primary?</td>
 							<td>{{$cpc->auto_medicare_is_partbprimary}}</td>
 							<td>
-								<input type="hidden" name="manualDeterminationCategory" :value="
-							!cpc.auto_medicare_is_match_found ? 'INVALID' :
-							cpc.auto_medicare_is_partbprimary == 'YES' ? 'COVERED' :
-							cpc.auto_medicare_is_partbprimary == 'NO' ? 'NOT_COVERED' : 'UNKNOWN'
-							">
+							<input type="hidden" name="manualDeterminationCategory" :value="!cpc.auto_medicare_is_match_found ? 'INVALID' : (cpc.auto_medicare_is_partbprimary == 'YES' ? 'COVERED' : (cpc.auto_medicare_is_partbprimary == 'NO' ? 'NOT_COVERED' : 'UNKNOWN'))">
+
 								<div class="form-group mb-0">
 									<div class="form-check form-check-inline">
 										<label class="form-check-label"><input class="form-check-input" type="radio" name="manualMedicareIsPartBPrimary" @click="onInputChange" value="YES">Yes</label>