|
@@ -1,33 +1,32 @@
|
|
<div id="new-coverage-form-{{$patient->uid}}">
|
|
<div id="new-coverage-form-{{$patient->uid}}">
|
|
<div class="p-3">
|
|
<div class="p-3">
|
|
- <form :url="url" class="mcp-theme-1">
|
|
|
|
- <input type="hidden" name="clientUid" value="{{$patient->uid}}" class="form-control input-sm" />
|
|
|
|
- <div class="row">
|
|
|
|
- <div class="form-group col-md-12">
|
|
|
|
- <p class="mb-1">Type of insurance card:</p>
|
|
|
|
- <div class="form-check form-check-inline">
|
|
|
|
- <label class="form-check-label"><input class="form-check-input" type="radio" v-model="insuranceCardType" @change="updateUrl" name="insuranceCardType" value="medicare">Medicare Part B (Primary)</label>
|
|
|
|
- </div>
|
|
|
|
- <div class="form-check form-check-inline">
|
|
|
|
- <label class="form-check-label"><input class="form-check-input" type="radio" v-model="insuranceCardType" @change="updateUrl" name="insuranceCardType" value="medicaid">Medicaid (Primary)</label>
|
|
|
|
- </div>
|
|
|
|
- <div class="form-check form-check-inline">
|
|
|
|
- <label class="form-check-label"><input class="form-check-input" type="radio" v-model="insuranceCardType" @change="updateUrl" name="insuranceCardType" value="commercial">Commercial / Third Party (Primary)</label>
|
|
|
|
|
|
+ <form :url="url" class="mcp-theme-1" @submit.prevent="submitForm">
|
|
|
|
+ <input type="hidden" name="clientUid" value="{{$patient->uid}}" class="form-control input-sm" />
|
|
|
|
+ <div class="row">
|
|
|
|
+ <div class="form-group col-md-12">
|
|
|
|
+ <p class="mb-1">Type of insurance card:</p>
|
|
|
|
+ <div class="form-check form-check-inline">
|
|
|
|
+ <label class="form-check-label"><input class="form-check-input" type="radio" v-model="insuranceCardType" @change="updateUrl" name="insuranceCardType" value="medicare">Medicare Part B (Primary)</label>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-check form-check-inline">
|
|
|
|
+ <label class="form-check-label"><input class="form-check-input" type="radio" v-model="insuranceCardType" @change="updateUrl" name="insuranceCardType" value="medicaid">Medicaid (Primary)</label>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-check form-check-inline">
|
|
|
|
+ <label class="form-check-label"><input class="form-check-input" type="radio" v-model="insuranceCardType" @change="updateUrl" name="insuranceCardType" value="commercial">Commercial / Third Party (Primary)</label>
|
|
|
|
+ </div>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
- </div>
|
|
|
|
|
|
|
|
- <div class="row" v-if="insuranceCardType == 'commercial'">
|
|
|
|
- <div class="form-group col-md-12">
|
|
|
|
- <label for="" class="control-label">Commercial Payer</label>
|
|
|
|
- <select name="commercialPayerUid" data-url="{{ route('searchPayer') }}" data-text-prop="name" data-id-prop="uid" placeholder="Search" select2-search class="form-control input-sm">
|
|
|
|
- <option value="">--</option>
|
|
|
|
- </select>
|
|
|
|
|
|
+ <div class="row" v-show="insuranceCardType == 'commercial'">
|
|
|
|
+ <div class="form-group col-md-12">
|
|
|
|
+ <label for="" class="control-label">Commercial Payer</label>
|
|
|
|
+ <input name="commercialPayerUidSuggest" class="form-control input-sm" value="" stag-suggest stag-suggest-ep="/search-payer/json" />
|
|
|
|
+ <input type="hidden" name="commercialPayerUid" />
|
|
|
|
+ </div>
|
|
</div>
|
|
</div>
|
|
- </div>
|
|
|
|
|
|
|
|
|
|
|
|
- <div class="row" v-if="insuranceCardType">
|
|
|
|
|
|
+ <div class="row" v-if="insuranceCardType">
|
|
<div class="col-md-12 bg-light p-3 mb-2">
|
|
<div class="col-md-12 bg-light p-3 mb-2">
|
|
<h5 class="m-0 font-weight-bold">Patient Name / Demographics:</h5>
|
|
<h5 class="m-0 font-weight-bold">Patient Name / Demographics:</h5>
|
|
</div>
|
|
</div>
|
|
@@ -49,7 +48,7 @@
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-md-4">
|
|
<div class="form-group col-md-4">
|
|
<label class="control-label">Patient Sex</label>
|
|
<label class="control-label">Patient Sex</label>
|
|
- <select class="form-control input-sm" name="patientSex">
|
|
|
|
|
|
+ <select class="form-control input-sm" name="patientSex" select2>
|
|
<option value="">--</option>
|
|
<option value="">--</option>
|
|
<option value="M">Male</option>
|
|
<option value="M">Male</option>
|
|
<option value="F">Female</option>
|
|
<option value="F">Female</option>
|
|
@@ -64,23 +63,23 @@
|
|
<label class="control-label">Date Of Service</label>
|
|
<label class="control-label">Date Of Service</label>
|
|
<input type="date" name="dateOfService" value="{{date('Y-m-d')}}" class="form-control input-sm">
|
|
<input type="date" name="dateOfService" value="{{date('Y-m-d')}}" class="form-control input-sm">
|
|
</div>
|
|
</div>
|
|
- </div>
|
|
|
|
- <div class="row">
|
|
|
|
- <div class="form-group col-md-12" v-if="insuranceCardType == 'medicaid' || insuranceCardType == 'commercial'">
|
|
|
|
- <p class="mb-1">Is Patient The Subscriber?</p>
|
|
|
|
- <div class="form-check form-check-inline">
|
|
|
|
- <label class="form-check-label"><input class="form-check-input" type="radio" name="isPatientSubscriber" v-model="isPatientSubscriber" value="1">Yes</label>
|
|
|
|
- </div>
|
|
|
|
- <div class="form-check form-check-inline">
|
|
|
|
- <label class="form-check-label"><input class="form-check-input" type="radio" name="isPatientSubscriber" v-model="isPatientSubscriber" value="0">No</label>
|
|
|
|
|
|
+ </div>
|
|
|
|
+ <div class="row">
|
|
|
|
+ <div class="form-group col-md-12" v-if="insuranceCardType == 'medicaid' || insuranceCardType == 'commercial'">
|
|
|
|
+ <p class="mb-1">Is Patient The Subscriber?</p>
|
|
|
|
+ <div class="form-check form-check-inline">
|
|
|
|
+ <label class="form-check-label"><input class="form-check-input" type="radio" name="isPatientSubscriber" v-model="isPatientSubscriber" value="1">Yes</label>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-check form-check-inline">
|
|
|
|
+ <label class="form-check-label"><input class="form-check-input" type="radio" name="isPatientSubscriber" v-model="isPatientSubscriber" value="0">No</label>
|
|
|
|
+ </div>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
- </div>
|
|
|
|
|
|
|
|
- <div v-if="isPatientSubscriber == 0 && (insuranceCardType == 'medicaid' || insuranceCardType == 'commercial')" class="row">
|
|
|
|
- <div class="col-md-12 bg-light p-3 mb-2">
|
|
|
|
- <h5 class="m-0 font-weight-bold">Subscriber Details:</h5>
|
|
|
|
- </div>
|
|
|
|
|
|
+ <div v-if="isPatientSubscriber == 0 && (insuranceCardType == 'medicaid' || insuranceCardType == 'commercial')" class="row">
|
|
|
|
+ <div class="col-md-12 bg-light p-3 mb-2">
|
|
|
|
+ <h5 class="m-0 font-weight-bold">Subscriber Details:</h5>
|
|
|
|
+ </div>
|
|
<div class="form-group col-md-4">
|
|
<div class="form-group col-md-4">
|
|
<label class="control-label">Subscriber First Name</label>
|
|
<label class="control-label">Subscriber First Name</label>
|
|
<input type="text" name="subscriberNameFirst" value="{{$patient->name_first}}" class="form-control input-sm">
|
|
<input type="text" name="subscriberNameFirst" value="{{$patient->name_first}}" class="form-control input-sm">
|
|
@@ -124,127 +123,175 @@
|
|
<option value="UNKNOWN">Unknown</option>
|
|
<option value="UNKNOWN">Unknown</option>
|
|
</select>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
- </div>
|
|
|
|
- <div class="mb-1" v-if="insuranceCardType == 'commercial'">
|
|
|
|
- <p>Does the patient also have either a Medicare or Medicaid #? (optional)</p>
|
|
|
|
- </div>
|
|
|
|
- <div class="row" v-if="insuranceCardType == 'medicaid' || insuranceCardType == 'commercial'">
|
|
|
|
- <div class="col-md-12 bg-light p-3 mb-2">
|
|
|
|
- <h5 class="m-0 font-weight-bold">Medicaid Information:</h5>
|
|
|
|
</div>
|
|
</div>
|
|
- <div class="form-group col-md-6">
|
|
|
|
- <label for="" class="control-label">Medicaid State</label>
|
|
|
|
- <select name="mcdPayerUid" id="" class="form-control input-sm">
|
|
|
|
- <option value="">--</option>
|
|
|
|
- <option>MEDICAID ALABAMA</option>
|
|
|
|
- <option>MEDICAID ALASKA</option>
|
|
|
|
- <option>MEDICAID ARIZONA</option>
|
|
|
|
- <option>MEDICAID ARKANSAS</option>
|
|
|
|
- <option>MEDICAID CALIFORNIA MEDI-CAL</option>
|
|
|
|
- <option>MEDICAID COLORADO</option>
|
|
|
|
- <option>MEDICAID CONNECTICUT</option>
|
|
|
|
- <option>MEDICAID DELAWARE</option>
|
|
|
|
- <option>MEDICAID DISTRICT OF COLUMBIA</option>
|
|
|
|
- <option>MEDICAID FLORIDA</option>
|
|
|
|
- <option>MEDICAID GEORGIA</option>
|
|
|
|
- <option>MEDICAID HAWAII</option>
|
|
|
|
- <option>MEDICAID IDAHO</option>
|
|
|
|
- <option>MEDICAID ILLINOIS</option>
|
|
|
|
- <option>MEDICAID INDIANA</option>
|
|
|
|
- <option>MEDICAID IOWA</option>
|
|
|
|
- <option>MEDICAID KANSAS</option>
|
|
|
|
- <option>MEDICAID KENTUCKY</option>
|
|
|
|
- <option>MEDICAID LOUISIANA</option>
|
|
|
|
- <option>MEDICAID MAINE</option>
|
|
|
|
- <option>MEDICAID MARYLAND</option>
|
|
|
|
- <option>MEDICAID MARYLAND DHMH</option>
|
|
|
|
- <option>MEDICAID MASSACHUSETTS</option>
|
|
|
|
- <option>MEDICAID MICHIGAN</option>
|
|
|
|
- <option>MEDICAID MINNESOTA</option>
|
|
|
|
- <option>MEDICAID MISSISSIPPI</option>
|
|
|
|
- <option>MEDICAID MISSISSIPPI</option>
|
|
|
|
- <option>MEDICAID MISSOURI</option>
|
|
|
|
- <option>MEDICAID MONTANA</option>
|
|
|
|
- <option>MEDICAID NEBRASKA</option>
|
|
|
|
- <option>MEDICAID NEVADA</option>
|
|
|
|
- <option>MEDICAID NEW HAMPSHIRE</option>
|
|
|
|
- <option>MEDICAID NEW JERSEY</option>
|
|
|
|
- <option>MEDICAID NEW MEXICO</option>
|
|
|
|
- <option>MEDICAID NEW YORK</option>
|
|
|
|
- <option>MEDICAID NEW YORK</option>
|
|
|
|
- <option>MEDICAID NORTH CAROLINA</option>
|
|
|
|
- <option>MEDICAID NORTH DAKOTA</option>
|
|
|
|
- <option>MEDICAID OHIO</option>
|
|
|
|
- <option>MEDICAID OKLAHOMA</option>
|
|
|
|
- <option>MEDICAID OREGON</option>
|
|
|
|
- <option>MEDICAID OREGON (DHS OMAP)</option>
|
|
|
|
- <option>MEDICAID PENNSYLVANIA</option>
|
|
|
|
- <option>MEDICAID RHODE ISLAND</option>
|
|
|
|
- <option>MEDICAID SOUTH CAROLINA</option>
|
|
|
|
- <option>MEDICAID SOUTH DAKOTA</option>
|
|
|
|
- <option>MEDICAID TENNESSEE</option>
|
|
|
|
- <option>MEDICAID TEXAS</option>
|
|
|
|
- <option>MEDICAID TEXAS AND TEXAS HEALTH STEPS</option>
|
|
|
|
- <option>MEDICAID UTAH</option>
|
|
|
|
- <option>MEDICAID VERMONT</option>
|
|
|
|
- <option>MEDICAID VIRGINIA</option>
|
|
|
|
- <option>MEDICAID WASHINGTON (PROVIDER ONE)</option>
|
|
|
|
- <option>MEDICAID WEST VIRGINIA</option>
|
|
|
|
- <option>MEDICAID WISCONSIN</option>
|
|
|
|
- <option>MEDICAID WYOMING</option>
|
|
|
|
- </select>
|
|
|
|
|
|
+ <div class="mb-1" v-if="insuranceCardType == 'commercial'">
|
|
|
|
+ <p>Does the patient also have either a Medicare or Medicaid #? (optional)</p>
|
|
</div>
|
|
</div>
|
|
|
|
+ <div class="row" v-if="insuranceCardType == 'medicaid' || insuranceCardType == 'commercial'">
|
|
|
|
+ <div class="col-md-12 bg-light p-3 mb-2">
|
|
|
|
+ <h5 class="m-0 font-weight-bold">Medicaid Information:</h5>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-group col-md-6">
|
|
|
|
+ <label for="" class="control-label">Medicaid State</label>
|
|
|
|
+ <input class="form-control input-sm" list="mcdPayer" name="mcdPayerUid" id="mcdPayerUid">
|
|
|
|
+ <datalist id="mcdPayer">
|
|
|
|
+ <option value="">--</option>
|
|
|
|
+ <option>MEDICAID ALABAMA</option>
|
|
|
|
+ <option>MEDICAID ALASKA</option>
|
|
|
|
+ <option>MEDICAID ARIZONA</option>
|
|
|
|
+ <option>MEDICAID ARKANSAS</option>
|
|
|
|
+ <option>MEDICAID CALIFORNIA MEDI-CAL</option>
|
|
|
|
+ <option>MEDICAID COLORADO</option>
|
|
|
|
+ <option>MEDICAID CONNECTICUT</option>
|
|
|
|
+ <option>MEDICAID DELAWARE</option>
|
|
|
|
+ <option>MEDICAID DISTRICT OF COLUMBIA</option>
|
|
|
|
+ <option>MEDICAID FLORIDA</option>
|
|
|
|
+ <option>MEDICAID GEORGIA</option>
|
|
|
|
+ <option>MEDICAID HAWAII</option>
|
|
|
|
+ <option>MEDICAID IDAHO</option>
|
|
|
|
+ <option>MEDICAID ILLINOIS</option>
|
|
|
|
+ <option>MEDICAID INDIANA</option>
|
|
|
|
+ <option>MEDICAID IOWA</option>
|
|
|
|
+ <option>MEDICAID KANSAS</option>
|
|
|
|
+ <option>MEDICAID KENTUCKY</option>
|
|
|
|
+ <option>MEDICAID LOUISIANA</option>
|
|
|
|
+ <option>MEDICAID MAINE</option>
|
|
|
|
+ <option>MEDICAID MARYLAND</option>
|
|
|
|
+ <option>MEDICAID MARYLAND DHMH</option>
|
|
|
|
+ <option>MEDICAID MASSACHUSETTS</option>
|
|
|
|
+ <option>MEDICAID MICHIGAN</option>
|
|
|
|
+ <option>MEDICAID MINNESOTA</option>
|
|
|
|
+ <option>MEDICAID MISSISSIPPI</option>
|
|
|
|
+ <option>MEDICAID MISSISSIPPI</option>
|
|
|
|
+ <option>MEDICAID MISSOURI</option>
|
|
|
|
+ <option>MEDICAID MONTANA</option>
|
|
|
|
+ <option>MEDICAID NEBRASKA</option>
|
|
|
|
+ <option>MEDICAID NEVADA</option>
|
|
|
|
+ <option>MEDICAID NEW HAMPSHIRE</option>
|
|
|
|
+ <option>MEDICAID NEW JERSEY</option>
|
|
|
|
+ <option>MEDICAID NEW MEXICO</option>
|
|
|
|
+ <option>MEDICAID NEW YORK</option>
|
|
|
|
+ <option>MEDICAID NEW YORK</option>
|
|
|
|
+ <option>MEDICAID NORTH CAROLINA</option>
|
|
|
|
+ <option>MEDICAID NORTH DAKOTA</option>
|
|
|
|
+ <option>MEDICAID OHIO</option>
|
|
|
|
+ <option>MEDICAID OKLAHOMA</option>
|
|
|
|
+ <option>MEDICAID OREGON</option>
|
|
|
|
+ <option>MEDICAID OREGON (DHS OMAP)</option>
|
|
|
|
+ <option>MEDICAID PENNSYLVANIA</option>
|
|
|
|
+ <option>MEDICAID RHODE ISLAND</option>
|
|
|
|
+ <option>MEDICAID SOUTH CAROLINA</option>
|
|
|
|
+ <option>MEDICAID SOUTH DAKOTA</option>
|
|
|
|
+ <option>MEDICAID TENNESSEE</option>
|
|
|
|
+ <option>MEDICAID TEXAS</option>
|
|
|
|
+ <option>MEDICAID TEXAS AND TEXAS HEALTH STEPS</option>
|
|
|
|
+ <option>MEDICAID UTAH</option>
|
|
|
|
+ <option>MEDICAID VERMONT</option>
|
|
|
|
+ <option>MEDICAID VIRGINIA</option>
|
|
|
|
+ <option>MEDICAID WASHINGTON (PROVIDER ONE)</option>
|
|
|
|
+ <option>MEDICAID WEST VIRGINIA</option>
|
|
|
|
+ <option>MEDICAID WISCONSIN</option>
|
|
|
|
+ <option>MEDICAID WYOMING</option>
|
|
|
|
+ </datalist>
|
|
|
|
+ </div>
|
|
|
|
|
|
- <div class="form-group col-md-6">
|
|
|
|
- <label class="control-label">Medicaid Number</label>
|
|
|
|
- <input type="text" name="mcdNumber" class="form-control input-sm">
|
|
|
|
|
|
+ <div class="form-group col-md-6">
|
|
|
|
+ <label class="control-label">Medicaid Number</label>
|
|
|
|
+ <input type="text" name="mcdNumber" class="form-control input-sm">
|
|
|
|
+ </div>
|
|
</div>
|
|
</div>
|
|
- </div>
|
|
|
|
|
|
|
|
- <div class="row" v-if="insuranceCardType == 'medicare' || insuranceCardType == 'commercial'">
|
|
|
|
- <div class="col-md-12 bg-light p-3 mb-2">
|
|
|
|
- <h5 class="m-0 font-weight-bold">Medicare Information:</h5>
|
|
|
|
- </div>
|
|
|
|
- <div class="form-group col-md-6" >
|
|
|
|
- <label class="control-label">Medicare Number</label>
|
|
|
|
- <input type="text" name="mcrNumber" class="form-control input-sm">
|
|
|
|
|
|
+ <div class="row" v-if="insuranceCardType == 'medicare' || insuranceCardType == 'commercial'">
|
|
|
|
+ <div class="col-md-12 bg-light p-3 mb-2">
|
|
|
|
+ <h5 class="m-0 font-weight-bold">Medicare Information:</h5>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-group col-md-6">
|
|
|
|
+ <label class="control-label">Medicare Number</label>
|
|
|
|
+ <input type="text" name="mcrNumber" class="form-control input-sm">
|
|
|
|
+ </div>
|
|
|
|
+
|
|
</div>
|
|
</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 class="btn btn-sm btn-primary" type="submit" :disabled="url == ''">Submt</button>
|
|
|
|
- </div>
|
|
|
|
- </form>
|
|
|
|
|
|
+ <div class="form-group text-nowrap mb-0">
|
|
|
|
+ <button v-if="!processing" class="btn btn-sm btn-primary" type="submit" :disabled="url == ''">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>
|
|
</div>
|
|
-</div>
|
|
|
|
-<script>
|
|
|
|
- (function() {
|
|
|
|
- function init() {
|
|
|
|
- STAG.initSelect2RemoteSearch()
|
|
|
|
- new Vue({
|
|
|
|
- el: '#new-coverage-form-{{$patient->uid}}',
|
|
|
|
- delimiters:['@{{','}}'],
|
|
|
|
- data: {
|
|
|
|
- url: '',
|
|
|
|
- insuranceCardType: '',
|
|
|
|
- isPatientSubscriber: 1
|
|
|
|
- },
|
|
|
|
- methods: {
|
|
|
|
- updateUrl: function() {
|
|
|
|
- if (this.insuranceCardType == 'medicare') {
|
|
|
|
- this.url = '/api/clientPrimaryCoverage/createNewCoverageForMedicare';
|
|
|
|
- }
|
|
|
|
- if (this.insuranceCardType == 'medicaid') {
|
|
|
|
- this.url = '/api/clientPrimaryCoverage/createNewCoverageForMedicaid';
|
|
|
|
- }
|
|
|
|
- if (this.insuranceCardType == 'commercial') {
|
|
|
|
- this.url = '/api/clientPrimaryCoverage/createNewCoverageForCommercial';
|
|
|
|
- }
|
|
|
|
- }
|
|
|
|
|
|
+ <script>
|
|
|
|
+ (function() {
|
|
|
|
+ function init() {
|
|
|
|
+ new Vue({
|
|
|
|
+ el: '#new-coverage-form-{{$patient->uid}}',
|
|
|
|
+ delimiters: ['@{{', '}}'],
|
|
|
|
+ data: {
|
|
|
|
+ url: '',
|
|
|
|
+ insuranceCardType: '',
|
|
|
|
+ isPatientSubscriber: 1,
|
|
|
|
+ processing: false,
|
|
|
|
+ response: null
|
|
|
|
+ },
|
|
|
|
+ methods: {
|
|
|
|
+ updateUrl: function() {
|
|
|
|
+ if (this.insuranceCardType == 'medicare') {
|
|
|
|
+ this.url = '/api/clientPrimaryCoverage/createNewCoverageForMedicare';
|
|
|
|
+ }
|
|
|
|
+ if (this.insuranceCardType == 'medicaid') {
|
|
|
|
+ this.url = '/api/clientPrimaryCoverage/createNewCoverageForMedicaid';
|
|
|
|
+ }
|
|
|
|
+ if (this.insuranceCardType == 'commercial') {
|
|
|
|
+ this.url = '/api/clientPrimaryCoverage/createNewCoverageForCommercial';
|
|
|
|
+ }
|
|
|
|
+ },
|
|
|
|
+ onCommercialPayerChange: function() {
|
|
|
|
+ var input = $('input[name=commercialPayerUidSuggest]');
|
|
|
|
+ var hiddenInput = $('input[name=commercialPayerUid]');
|
|
|
|
+ input
|
|
|
|
+ .off('stag-suggest-selected')
|
|
|
|
+ .on('stag-suggest-selected', (e, input, _data) => {
|
|
|
|
+ hiddenInput.val(_data.uid);
|
|
|
|
+ });
|
|
|
|
+
|
|
|
|
+ },
|
|
|
|
+ submitForm: function(evt) {
|
|
|
|
+ var self = this;
|
|
|
|
+ var form = evt.target;
|
|
|
|
+ var data = $(form).serializeArray();
|
|
|
|
+ var url = $(form).attr('url');
|
|
|
|
+ if (!url) {
|
|
|
|
+ self.response = {
|
|
|
|
+ success: false,
|
|
|
|
+ message: 'Invalid url'
|
|
|
|
+ };
|
|
|
|
+ return;
|
|
|
|
+ }
|
|
|
|
+
|
|
|
|
+ self.processing = true;
|
|
|
|
+ $.post(url, data, function(response) {
|
|
|
|
+ self.processing = false;
|
|
|
|
+ if (response.success) {
|
|
|
|
+ closeStagPopup();
|
|
|
|
+ fastReload();
|
|
|
|
+ } else {
|
|
|
|
+ self.response = response;
|
|
}
|
|
}
|
|
- });
|
|
|
|
- }
|
|
|
|
- addMCInitializer('new-coverage-form-{{$patient->uid}}', init, '#new-coverage-form-{{$patient->uid}}')
|
|
|
|
- }).call(window);
|
|
|
|
-</script>
|
|
|
|
|
|
+ }, 'json');
|
|
|
|
+ },
|
|
|
|
+ init: function() {
|
|
|
|
+ initStagSuggest();
|
|
|
|
+ this.onCommercialPayerChange();
|
|
|
|
+ }
|
|
|
|
+ },
|
|
|
|
+ mounted: function() {
|
|
|
|
+ this.init();
|
|
|
|
+ }
|
|
|
|
+ });
|
|
|
|
+ }
|
|
|
|
+ addMCInitializer('new-coverage-form-{{$patient->uid}}', init, '#new-coverage-form-{{$patient->uid}}')
|
|
|
|
+ }).call(window);
|
|
|
|
+ </script>
|