CPC carrier_free_text & memo support

resources/views/app/patient/create-patient/insurance-coverage-form.blade.php

@@ -23,6 +23,17 @@
 				<input name="commercialPayerUidSuggest" class="form-control input-sm" value="" autocomplete="off" stag-suggest stag-suggest-ep="/search-payer/json" />
 				<input type="hidden" name="commercialPayerUid" />
 			</div>
+			<div class="col-md-12">
+				<p class="mb-2 font-weight-bold">If payer not found above, please key in carrier name (and memo if any):</p>
+			</div>
+			<div class="form-group col-md-6">
+				<label class="control-label">Carrier Name</label>
+				<input type="text" name="carrierFreeText" class="form-control input-sm">
+			</div>
+			<div class="form-group col-md-6">
+				<label class="control-label">Carrier Memo</label>
+				<input type="text" name="carrierFreeTextMemo" class="form-control input-sm">
+			</div>
 			<div class="form-group col-md-6">
 				<label class="control-label">Patient Member Identifier</label>
 				<input type="text" name="commercialMemberIdentifier" class="form-control input-sm">
@@ -31,6 +42,10 @@
 				<label class="control-label">Patient Group Number</label>
 				<input type="text" name="commercialGroupNumber" class="form-control input-sm">
 			</div>
+			<div class="form-group col-md-6">
+				<label class="control-label">Phone Number For Hcps</label>
+				<input type="text" name="primaryInsurancePhoneNumberForHcps" class="form-control input-sm">
+			</div>
 		</div>
 		<div class="row">
 			<div class="form-group col-md-12" v-if="planType == 'MEDICAID' || planType == 'COMMERCIAL'">

resources/views/app/patient/primary-coverage-form.blade.php

@@ -27,13 +27,28 @@
 						<input name="commercialPayerUidSuggest" class="form-control input-sm" value="" stag-suggest stag-suggest-ep="/search-payer/json" />
 						<input type="hidden" name="commercialPayerUid" />
 					</div>
+					<div class="col-md-12">
+						<p class="mb-2 font-weight-bold">If payer not found above, please key in carrier name (and memo if any):</p>
+					</div>
+					<div class="form-group col-md-6">
+						<label class="control-label">Carrier Name</label>
+						<input type="text" name="carrierFreeText" class="form-control input-sm">
+					</div>
+					<div class="form-group col-md-6">
+						<label class="control-label">Carrier Memo</label>
+						<input type="text" name="carrierFreeTextMemo" class="form-control input-sm">
+					</div>
 					<div class="form-group col-md-6">
 						<label class="control-label">Patient Member Identifier</label>
-						<input type="text" name="commercialMemberIdentifier"  class="form-control input-sm">
+						<input type="text" name="commercialMemberIdentifier" class="form-control input-sm">
 					</div>
 					<div class="form-group col-md-6">
 						<label class="control-label">Patient Group Number</label>
-						<input type="text" name="commercialGroupNumber"  class="form-control input-sm">
+						<input type="text" name="commercialGroupNumber" class="form-control input-sm">
+					</div>
+					<div class="form-group col-md-6">
+						<label class="control-label">Phone Number For Hcps</label>
+						<input type="text" name="primaryInsurancePhoneNumberForHcps" class="form-control input-sm">
 					</div>
 				</div>
 

resources/views/app/patient/primary-coverage-view.blade.php

@@ -46,6 +46,14 @@
 								<td>Commercial Payer</td>
 								<td>{{$cpc->commercial_payer_id ? $cpc->payer->name : '-'}}</td>
 							</tr>
+							<tr v-if="cpc.plan_type == 'COMMERCIAL'">
+								<td>Carrier Free Text</td>
+								<td>{{$cpc->carrier_free_text}}</td>
+							</tr>
+							<tr v-if="cpc.plan_type == 'COMMERCIAL'">
+								<td>Carrier Free Text Memo</td>
+								<td>{{$cpc->carrier_free_text_memo}}</td>
+							</tr>
 							<tr v-if="cpc.plan_type == 'COMMERCIAL'">
 								<td>Patient Member Identifier</td>
 								<td>