{"id":5920,"date":"2019-08-27T00:26:18","date_gmt":"2019-08-27T00:26:18","guid":{"rendered":"http:\/\/mportal.jipanetwork.com\/?page_id=5920"},"modified":"2020-01-07T22:16:47","modified_gmt":"2020-01-07T22:16:47","slug":"claims-history","status":"publish","type":"page","link":"https:\/\/mportal.jipanetwork.com\/?page_id=5920","title":{"rendered":"Claims History"},"content":{"rendered":"\n<script>\nfunction getClaimStatus(memberid) {\n    \/\/ Create an instance of the XML HTTP Request object\n    var oXMLHTTP;\n    if (window.XMLHttpRequest) { \/\/ Mozilla, Safari, ...\n        oXMLHTTP = new XMLHttpRequest();\n    }\n    else if (window.ActiveXObject) { \/\/ IE\n        oXMLHTTP = new ActiveXObject( \"microsoft.XMLHTTP\" );\n    }\n\n    \/\/ Prepare the XMLHTTP object for a HTTP POST to our validation ASP page\n    var sURL = \"https:\/\/online271.ehdl.com\/srvc1?CLMINQCL8\"\n    oXMLHTTP.open( \"POST\", sURL, false );\n    oXMLHTTP.setRequestHeader(\"Content-type\", \"application\/x-www-form-urlencoded\");\n    oXMLHTTP.send(\"subno=\"+memberid+\"&dos_1=\"+document.getElementById(\"dos_1\").value+\"&dos_2=\"+document.getElementById(\"dos_2\").value);\n\n    if (oXMLHTTP.responseText == \"\") {\n    }\n    else {    \n        document.getElementById('clmsts_results').innerHTML = oXMLHTTP.responseText;\n    }\n}\n\nfunction getinfo(claimqry) {                                                           \n    var memberid;                                                                                                                   \n    \/\/ Create an instance of the XML HTTP Request object\n    var oXMLHTTP;\n    if (window.XMLHttpRequest) { \/\/ Mozilla, Safari, ...\n        oXMLHTTP = new XMLHttpRequest();\n    }\n    else if (window.ActiveXObject) { \/\/ IE\n        oXMLHTTP = new ActiveXObject( \"microsoft.XMLHTTP\" );\n    }\n\n    \/\/ Prepare the XMLHTTP object for a HTTP POST to our validation ASP page\n    var sURL = \"https:\/\/mportal.jipanetwork.com\/?page_id=603\"\n    oXMLHTTP.open( \"GET\", sURL, false );\n\n    \/\/ Execute the request\n    oXMLHTTP.send();\n\n    if (oXMLHTTP.responseText == \"\") {\n    }\n    else {\n        fragDOM= document.createRange().createContextualFragment(oXMLHTTP.response);\n        memberid = fragDOM.querySelectorAll(\".um-field-value\")[0].textContent;\n        getClaimStatus(memberid);\n    }\n}\n\nfunction clearPage() {\n    document.getElementById('clmsts_results').innerHTML = \"\";\n    document.getElementById('dos_1').value=\"\";\n    document.getElementById('dos_2').value=\"\";\n}\n<\/script>\n\n<style>\n.qry {border:none}\n<\/style>\n\n<FORM method=\"post\" name=\"clmsts_form\" ONSUBMIT=\"getinfo(this);return false\">\n<TABLE class=\"qry\">\n<tr class=\"qry\">\n  <TD class=\"qry\">\n  <INPUT TYPE=\"hidden\" name=\"subno\" size=\"12\" MAXLENGTH=20\" \/>\n  <\/TD>\n  <TD class=\"qry\">\n    <INPUT TYPE=\"hidden\" name=\"perno\" size=\"3\" MAXLENGTH=3 value=\"\">\n  <\/TD>\n<\/tr>\n<TR class=\"qry\">\n  <TD class=\"qry\">\n    <INPUT TYPE=\"hidden\" name=\"provider\"  size=\"10\">\n  <\/TD>\n<\/TR>\n<TR class=\"qry\">\n  <TD class=\"qry\" style=\"text-align:right\" width=\"50%\">\n    <FONT SIZE=2 COLOR=blue FACE=\"verdana\"><B>Date of Service:<\/B<\/FONT>\n  <\/TD>\n  <TD  class=\"qry\" width=\"50%\" style=\"text-align:left\">\n    <INPUT type=\"text\" id=\"dos_1\" name=\"dos_1\" size=\"8\" maxlength=\"12\"\/>\n    <FONT size=2 FACE=\"Times New Roman\" color=black>to<\/font>\n    <INPUT type=\"text\" id=\"dos_2\" name=\"dos_2\" size=\"8\" maxlength=\"12\" \/>\n    <font size=2 FACE=\"Times New Roman\" color=black><i>(mmddyyyy)<\/i<\/font><\/td>\n<\/TR>\n<TR class=\"qry\">\n  <TD class=\"qry\">\n    <INPUT TYPE=\"hidden\" name=\"user\"  size=\"10\">\n  <\/TD>\n<\/TR>\n<TR class=\"qry\">\n  <TD class=\"qry\">\n    <INPUT TYPE=\"hidden\" name=\"curtomerid\"  size=\"12\"><\/TD>\n  <TD class=\"qry\">\n    <INPUT TYPE=\"hidden\" name=\"ins#\"  size=\"5\" value=\"\"><\/TD>\n<\/TR>\n<tr class=\"qry\"><td class=\"qry\" colspan=2>&nbsp;<\/td><\/tr>\n<TR class=\"qry\">\n  <td class=\"qry\" COLSPAN=\"2\" align=center>\n    <button TYPE=\"submit\" VALUE=\"Submit\">Submit<\/button>\n    <button  TYPE=\"reset\" VALUE=\"Reset\" onclick=\"clearPage()\">Reset<\/button>\n  <\/td>\n<\/TR>\n<\/table>\n<\/FORM>\n<p>\n\n<div id=\"clmsts_results\">\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":128,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/mportal.jipanetwork.com\/index.php?rest_route=\/wp\/v2\/pages\/5920"}],"collection":[{"href":"https:\/\/mportal.jipanetwork.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mportal.jipanetwork.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mportal.jipanetwork.com\/index.php?rest_route=\/wp\/v2\/users\/128"}],"replies":[{"embeddable":true,"href":"https:\/\/mportal.jipanetwork.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5920"}],"version-history":[{"count":75,"href":"https:\/\/mportal.jipanetwork.com\/index.php?rest_route=\/wp\/v2\/pages\/5920\/revisions"}],"predecessor-version":[{"id":5995,"href":"https:\/\/mportal.jipanetwork.com\/index.php?rest_route=\/wp\/v2\/pages\/5920\/revisions\/5995"}],"wp:attachment":[{"href":"https:\/\/mportal.jipanetwork.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5920"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}