///<summary>Set x835 to view all x835.ListClaims info. Otherwise set claimPaid to a specific Hx835_Claim to view.</summary>
public FormEtrans835Print(X835 x835, Hx835_Claim claimPaid = null)
{
InitializeComponent();
Lan.F(this);
_x835 = x835;
_claimPaid = claimPaid;
}
private void FormEtrans835Edit_Load(object sender, EventArgs e)
{
if (_form835 != null && !_form835.IsDisposed)
{
if (!MsgBox.Show(this, true, "Opening another ERA will close the current ERA you already have open. Continue?"))
{
//Form already exists and user wants to keep current instance.
TranSetId835 = _form835.TranSetId835;
EtransCur = _form835.EtransCur;
MessageText835 = _form835.MessageText835;
}
_form835.Close(); //Always close old form and open new form, so the new copy will come to front, since BringToFront() does not always work.
}
_form835 = this; //Set the static variable to this form because we're always going to show this form even if they're viewing old information.
List <Etrans835Attach> listAttached = Etrans835Attaches.GetForEtrans(EtransCur.EtransNum);
_x835 = new X835(EtransCur, MessageText835, TranSetId835, listAttached);
RefreshFromDb();
FillAll();
Menu.MenuItemCollection menuItemCollection = new Menu.MenuItemCollection(gridClaimDetailsMenu);
List <MenuItem> listMenuItems = new List <MenuItem>();
listMenuItems.Add(new MenuItem(Lan.g(this, "Go to Account"), new EventHandler(gridClaimDetails_RightClickHelper)));
listMenuItems.Add(new MenuItem(Lan.g(this, "Add Tracking Status"), new EventHandler(gridClaimDetails_RightClickHelper))); //Enabled by default
menuItemCollection.AddRange(listMenuItems.ToArray());
gridClaimDetails.ContextMenu = gridClaimDetailsMenu;
gridClaimDetails.AllowSortingByColumn = true;
}
///<summary>Returns if given claim is already recieved. Currently ERA test do not consider supplemental.</summary>
public static void TryEnterPayment(X835 x835, Hx835_Claim claimPaid, Claim claim, bool isAutomatic)
{
if (claim.ClaimStatus == "R") //Currently we do not have test for supplemental payments.
{
return;
}
EtransL.ImportEraClaimData(x835, claimPaid, claim, isAutomatic);
}
public void SetupTest()
{
#region Create Patient and claim: Justin Smith
Patient patJustinSmith = PatientT.CreatePatient(lName: "Smith", fName: "Justin");
List <EraTestProcCodeData> listProcData = new List <EraTestProcCodeData>();
listProcData.Add(new EraTestProcCodeData("D0120", ProcStat.TP, 43, new DateTime(2017, 09, 26)));
listProcData.Add(new EraTestProcCodeData("D1110", ProcStat.TP, 110, new DateTime(2017, 09, 26)));
listProcData.Add(new EraTestProcCodeData("D0602", ProcStat.TP, 5, new DateTime(2017, 09, 26)));
_claimPrimaryJustinSmith = EtransT.SetupEraClaim(patJustinSmith, listProcData, "P", "217308827", out List <InsuranceInfo> _listJustinSmithInsuranceInfo);
#endregion
#region Create Patient and claim: Jacob Jones
Patient patJacobJones = PatientT.CreatePatient(lName: "Jones", fName: "Jacob");
listProcData.Clear();
listProcData.Add(new EraTestProcCodeData("D0120", ProcStat.TP, 43, new DateTime(2017, 09, 26)));
listProcData.Add(new EraTestProcCodeData("D1110", ProcStat.TP, 110, new DateTime(2017, 09, 26)));
listProcData.Add(new EraTestProcCodeData("D1206", ProcStat.TP, 68, new DateTime(2017, 09, 26)));
_claimPrimaryJacobJones = EtransT.SetupEraClaim(patJacobJones, listProcData, "P", "217180995", out List <InsuranceInfo> _listJacobJonesInsuranceInfo);
#endregion
#region Create Patient and claim: Stephanie Mayer
Patient patStephanieMayer = PatientT.CreatePatient(lName: "Mayer", fName: "Stephanie");
listProcData.Clear();
listProcData.Add(new EraTestProcCodeData("D0120", ProcStat.TP, 43, new DateTime(2017, 09, 26)));
listProcData.Add(new EraTestProcCodeData("D1110", ProcStat.TP, 110, new DateTime(2017, 09, 26)));
listProcData.Add(new EraTestProcCodeData("D0602", ProcStat.TP, 5, new DateTime(2017, 09, 26)));
listProcData.Add(new EraTestProcCodeData("D1206", ProcStat.TP, 68, new DateTime(2017, 09, 26)));
_claimPrimaryStephanieMayer = EtransT.SetupEraClaim(patStephanieMayer, listProcData, "P", "217439125", out List <InsuranceInfo> _listStephanieMayerInsuranceInfo);
#endregion
//Create and insert etrans entry
Etrans etrans835 = EtransT.Insert835Etrans(Properties.Resources.JustinSmithERA, new DateTime(2017, 09, 30)); //Spoof etrans imported 4 days after claim sent.
List <ODTuple <Patient, long> > listPats = new List <ODTuple <Patient, long> >()
{
new ODTuple <Patient, long>(patJustinSmith, _claimPrimaryJustinSmith.ClaimNum),
new ODTuple <Patient, long>(patJacobJones, _claimPrimaryJacobJones.ClaimNum),
new ODTuple <Patient, long>(patStephanieMayer, _claimPrimaryStephanieMayer.ClaimNum)
};
_x835 = EtransT.Construct835(etrans835, Properties.Resources.JustinSmithERA, listPats, out _listEtrans835Attaches);
foreach (Hx835_Claim eraClaim in _x835.ListClaimsPaid)
{
switch (eraClaim.PatientName.Fname.ToLower())
{
case "justin":
_eraJustinSmithClaim = eraClaim;
break;
case "jacob":
_eraJacobJonesClaim = eraClaim;
break;
case "stephanie":
_eraStephanieMayerClaim = eraClaim;
break;
}
}
}
private void butPrint_Click(object sender, EventArgs e)
{
Sheet sheet = SheetUtil.CreateSheet(SheetDefs.GetInternalOrCustom(SheetInternalType.ERA));
X835 x835 = _x835.Copy();
x835.ListClaimsPaid = new List <Hx835_Claim>()
{
_claimPaid
}; //Only print the current claim.
SheetParameter.GetParamByName(sheet.Parameters, "ERA").ParamValue = x835; //Required param
SheetParameter.GetParamByName(sheet.Parameters, "IsSingleClaimPaid").ParamValue = true; //Value is null if not set
SheetFiller.FillFields(sheet);
SheetPrinting.Print(sheet, isPreviewMode: true);
}
///<summary>Builds the X835 for given etrans835 and etransMessageText.
///Also attempts to create attaches for patients in listPatients using their first/last name and the claim num in their tuple entry.</summary>
public static X835 Construct835(Etrans etrans835, string etransMessageText, List <ODTuple <Patient, long> > listPatients, out List <Etrans835Attach> listEtrans835Attaches)
{
listEtrans835Attaches = new List <Etrans835Attach>();
//Construct the inital X835 so that we can find the ERA claim we are testing against, needed for attach information.
X835 x835 = new X835(etrans835, etransMessageText, etrans835.TranSetId835);
foreach (ODTuple <Patient, long> data in listPatients)
{
Patient pat = data.Item1;
long claimNum = data.Item2;
//Then using that ERA claim we will spoof the Etrans835Attach logic that would run when associating an OD claim to the ERA claim.
Hx835_Claim eraClaim = x835.ListClaimsPaid.First(x => x.PatientName.Fname.ToLower() == pat.FName.ToLower() && x.PatientName.Lname.ToLower() == pat.LName.ToLower());
//Spoof ERA claim attachement.
Etrans835Attach attach = Insert835Attach(etrans835.EtransNum, claimNum, eraClaim.ClpSegmentIndex, etrans835.DateTimeTrans);
listEtrans835Attaches.Add(attach);
}
//Finally we must reconstruct the X835 with the new spoofed attach.
return(new X835(etrans835, etransMessageText, etrans835.TranSetId835, listEtrans835Attaches));
}
///<summary>Fills grid based on values in _listEtrans.
///Set isRefreshNeeded to true when we need to reinitialize local dictionarys after in memory list is also updated. Required true for first time running.
///Also allows you to passed in predetermined filter options.</summary>
private void FillGrid(bool isRefreshNeeded, List <string> listSelectedStatuses, List <long> listSelectedClinicNums,
string carrierName, string checkTraceNum, string amountMin, string amountMax, string controlId)
{
Cursor = Cursors.WaitCursor;
labelControlId.Visible = PrefC.GetBool(PrefName.EraShowControlIdFilter);
textControlId.Visible = PrefC.GetBool(PrefName.EraShowControlIdFilter);
Action actionCloseProgress = null;
if (isRefreshNeeded)
{
actionCloseProgress = ODProgress.Show(ODEventType.Etrans, typeof(EtransEvent), Lan.g(this, "Gathering data") + "...");
_dictEtrans835s.Clear();
_dictEtransClaims.Clear();
List <Etrans835Attach> listAttached = Etrans835Attaches.GetForEtrans(_listAllEtrans.Select(x => x.EtransNum).ToArray());
Dictionary <long, string> dictEtransMessages = new Dictionary <long, string>();
List <X12ClaimMatch> list835ClaimMatches = new List <X12ClaimMatch>();
Dictionary <long, int> dictClaimMatchCount = new Dictionary <long, int>(); //1:1 with _listEtranss. Stores how many claim matches each 835 has.
int batchQueryInterval = 500; //Every 500 rows we get the next 500 message texts to save memory.
int rowCur = 0;
foreach (Etrans etrans in _listAllEtrans)
{
if (rowCur % batchQueryInterval == 0)
{
int range = Math.Min(batchQueryInterval, _listAllEtrans.Count - rowCur); //Either the full batchQueryInterval amount or the remaining amount of etrans.
dictEtransMessages = EtransMessageTexts.GetMessageTexts(_listAllEtrans.GetRange(rowCur, range).Select(x => x.EtransMessageTextNum).ToList(), false);
}
rowCur++;
EtransEvent.Fire(ODEventType.Etrans, Lan.g(this, "Processing 835: ") + ": " + rowCur + " out of " + _listAllEtrans.Count);
List <Etrans835Attach> listAttachedTo835 = listAttached.FindAll(x => x.EtransNum == etrans.EtransNum);
X835 x835 = new X835(etrans, dictEtransMessages[etrans.EtransMessageTextNum], etrans.TranSetId835, listAttachedTo835, true);
_dictEtrans835s.Add(etrans.EtransNum, x835);
List <X12ClaimMatch> listClaimMatches = x835.GetClaimMatches();
dictClaimMatchCount.Add(etrans.EtransNum, listClaimMatches.Count);
list835ClaimMatches.AddRange(listClaimMatches);
}
#region Set 835 unattached in batch and build _dictEtransClaims and _dictClaimPayCheckNums.
EtransEvent.Fire(ODEventType.Etrans, Lan.g(this, "Gathering internal claim matches."));
List <long> listClaimNums = Claims.GetClaimFromX12(list835ClaimMatches); //Can return null.
EtransEvent.Fire(ODEventType.Etrans, Lan.g(this, "Building data sets."));
int claimIndexCur = 0;
List <long> listMatchedClaimNums = new List <long>();
foreach (Etrans etrans in _listAllEtrans)
{
X835 x835 = _dictEtrans835s[etrans.EtransNum];
if (listClaimNums != null)
{
x835.SetClaimNumsForUnattached(listClaimNums.GetRange(claimIndexCur, dictClaimMatchCount[etrans.EtransNum]));
}
claimIndexCur += dictClaimMatchCount[etrans.EtransNum];
listMatchedClaimNums.AddRange(x835.ListClaimsPaid.FindAll(x => x.ClaimNum != 0).Select(x => x.ClaimNum).ToList());
}
List <Claim> listClaims = Claims.GetClaimsFromClaimNums(listMatchedClaimNums.Distinct().ToList());
//The following line includes manually detached and split attaches.
_listAllAttaches = Etrans835Attaches.GetForEtransNumOrClaimNums(false, _listAllEtrans.Select(x => x.EtransNum).ToList(), listMatchedClaimNums.ToArray());
_listAllClaimProcs = ClaimProcs.RefreshForClaims(listMatchedClaimNums);
foreach (Etrans etrans in _listAllEtrans)
{
X835 x835 = _dictEtrans835s[etrans.EtransNum];
#region _dictEtransClaims, _dictClaimPayCheckNums
_dictEtransClaims.Add(etrans.EtransNum, new List <Claim>());
List <long> listSubClaimNums = x835.ListClaimsPaid.FindAll(x => x.ClaimNum != 0).Select(y => y.ClaimNum).ToList();
List <Claim> listClaimsFor835 = listClaims.FindAll(x => listSubClaimNums.Contains(x.ClaimNum));
foreach (Hx835_Claim claim in x835.ListClaimsPaid)
{
Claim claimCur = listClaimsFor835.FirstOrDefault(x => x.ClaimNum == claim.ClaimNum); //Can be null.
_dictEtransClaims[etrans.EtransNum].Add(claimCur);
}
#endregion
}
EtransEvent.Fire(ODEventType.Etrans, Lan.g(this, "Filling Grid."));
#endregion
}
gridMain.BeginUpdate();
#region Initilize columns
gridMain.ListGridColumns.Clear();
gridMain.ListGridColumns.Add(new GridColumn(Lan.g("TableEtrans835s", "Patient Name"), 250));
gridMain.ListGridColumns.Add(new GridColumn(Lan.g("TableEtrans835s", "Carrier Name"), 190));
gridMain.ListGridColumns.Add(new GridColumn(Lan.g("TableEtrans835s", "Status"), 80));
gridMain.ListGridColumns.Add(new GridColumn(Lan.g("TableEtrans835s", "Date"), 80, GridSortingStrategy.DateParse));
gridMain.ListGridColumns.Add(new GridColumn(Lan.g("TableEtrans835s", "Amount"), 80, GridSortingStrategy.AmountParse));
if (PrefC.HasClinicsEnabled)
{
gridMain.ListGridColumns.Add(new GridColumn(Lan.g("TableEtrans835s", "Clinic"), 70));
}
gridMain.ListGridColumns.Add(new GridColumn(Lan.g("TableEtrans835s", "Code"), 37, HorizontalAlignment.Center));
if (PrefC.GetBool(PrefName.EraShowControlIdFilter))
{
gridMain.ListGridColumns.Add(new GridColumn(Lan.g("TableEtrans835s", "ControlID"), -1));
}
gridMain.ListGridColumns.Add(new GridColumn(Lan.g("TableEtrans835s", "Note"), -2));
#endregion
gridMain.ListGridRows.Clear();
foreach (Etrans etrans in _listAllEtrans)
{
X835 x835 = _dictEtrans835s[etrans.EtransNum];
#region Filter: Carrier Name
if (carrierName != "" && !x835.PayerName.ToLower().Contains(carrierName.ToLower().Trim()))
{
continue;
}
#endregion
string status = GetStringStatus(etrans.EtransNum);
#region Filter: Status
if (!listSelectedStatuses.Contains(status.Replace("*", ""))) //The filter will ignore finalized with detached claims.
{
continue;
}
#endregion
//List of ClinicNums for the current etrans.ListClaimsPaid from the DB.
List <long> listClinicNums = _dictEtransClaims[etrans.EtransNum].Select(x => x == null? 0 :x.ClinicNum).Distinct().ToList();
#region Filter: Clinics
if (PrefC.HasClinicsEnabled && !listClinicNums.Exists(x => listSelectedClinicNums.Contains(x)))
{
continue; //The ClinicNums associated to the 835 do not match any of the selected ClinicNums, so nothing to show in this 835.
}
#endregion
#region Filter: Check and Trace Value
if (checkTraceNum != "" && !x835.TransRefNum.ToLower().Contains(checkTraceNum.ToLower().Trim())) //Trace Number does not match
{
continue;
}
#endregion
#region Filter: Insurance Check Range Min and Max
if (amountMin != "" && x835.InsPaid < PIn.Decimal(amountMin) || amountMax != "" && x835.InsPaid > PIn.Decimal(amountMax))
{
continue; //Either the InsPaid is below or above our range.
}
#endregion
#region Filter: ControlID
if (controlId != "" && !x835.ControlId.ToLower().Contains(controlId.ToLower()))
{
continue;
}
#endregion
GridRow row = new GridRow();
#region Column: Patient Name
List <string> listPatNames = x835.ListClaimsPaid.Select(x => x.PatientName.ToString()).Distinct().ToList();
string patName = (listPatNames.Count > 0 ? listPatNames[0] : "");
if (listPatNames.Count > 1)
{
patName = "(" + POut.Long(listPatNames.Count) + ")";
}
row.Cells.Add(patName);
#endregion
row.Cells.Add(x835.PayerName);
row.Cells.Add(status); //See GetStringStatus(...) for possible values.
row.Cells.Add(POut.Date(etrans.DateTimeTrans));
row.Cells.Add(POut.Decimal(x835.InsPaid));
#region Column: Clinic
if (PrefC.HasClinicsEnabled)
{
string clinicAbbr = "";
if (listClinicNums.Count == 1)
{
if (listClinicNums[0] == 0)
{
clinicAbbr = Lan.g(this, "Unassigned");
}
else
{
clinicAbbr = Clinics.GetAbbr(listClinicNums[0]);
}
}
else if (listClinicNums.Count > 1)
{
clinicAbbr = "(" + Lan.g(this, "Multiple") + ")";
}
row.Cells.Add(clinicAbbr);
}
#endregion
row.Cells.Add(x835._paymentMethodCode);
if (PrefC.GetBool(PrefName.EraShowControlIdFilter))
{
row.Cells.Add(x835.ControlId);
}
row.Cells.Add(etrans.Note);
row.Tag = etrans;
gridMain.ListGridRows.Add(row);
}
gridMain.EndUpdate();
actionCloseProgress?.Invoke(); //When this function executes quickly this can fail rarely, fail silently because of WaitCursor.
Cursor = Cursors.Default;
}
private void FormEtrans835Edit_Load(object sender, EventArgs e)
{
MessageText = EtransMessageTexts.GetMessageText(EtransCur.EtransMessageTextNum);
x835 = new X835(MessageText);
FillAll();
}
///<summary>Throws exceptions. The insplan that's passed in need not be properly updated to the database first.</summary>
///<returns>The Etrans created from the request. Will be null if the request failed in any way.</returns>
public static Etrans RequestBenefits(Clearinghouse clearinghouseClin, InsPlan plan, long patNum, Carrier carrier, InsSub insSub, out string error)
{
error = "";
Patient pat = Patients.GetPat(patNum);
Patient subsc = Patients.GetPat(insSub.Subscriber);
Clinic clinic = Clinics.GetClinic(pat.ClinicNum);
Provider billProv = Providers.GetProv(Providers.GetBillingProvNum(pat.PriProv, pat.ClinicNum));
//validation. Throw exception if missing info----------------------------------------
string validationResult = X270.Validate(clearinghouseClin, carrier, billProv, clinic, plan, subsc, insSub, pat);
if (validationResult != "")
{
throw new Exception(Lans.g("FormInsPlan", "Please fix the following errors first:") + "\r\n" + validationResult);
}
//create a 270 message---------------------------------------------------------------
string x12message = X270.GenerateMessageText(clearinghouseClin, carrier, billProv, clinic, plan, subsc, insSub, pat);
EtransMessageText etransMessageText = new EtransMessageText();
etransMessageText.MessageText = x12message;
EtransMessageTexts.Insert(etransMessageText);
//attach it to an etrans-------------------------------------------------------------
Etrans etrans = new Etrans();
etrans.PatNum = patNum;
etrans.DateTimeTrans = DateTime.Now;
etrans.ClearingHouseNum = clearinghouseClin.HqClearinghouseNum;
etrans.Etype = EtransType.BenefitInquiry270;
etrans.PlanNum = plan.PlanNum;
etrans.InsSubNum = insSub.InsSubNum;
etrans.EtransMessageTextNum = etransMessageText.EtransMessageTextNum;
Etranss.Insert(etrans);
//send the 270----------------------------------------------------------------------
string x12response = "";
Etrans etransHtml = null;
//a connection error here needs to bubble up
try {
if (!String.IsNullOrWhiteSpace(FakeResponseOverride271))
{
x12response = FakeResponseOverride271;
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.ClaimConnect)
{
x12response = ClaimConnect.Benefits270(clearinghouseClin, x12message);
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.EDS)
{
x12response = EDS.Benefits270(clearinghouseClin, x12message, out etransHtml);
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.WebMD)
{
x12response = WebMD.Benefits270(clearinghouseClin, x12message);
}
}
catch (Exception ex) {
EtransMessageTexts.Delete(etrans.EtransMessageTextNum);
Etranss.Delete(etrans.EtransNum);
throw new ApplicationException(Lans.g("FormInsPlan", "Connection Error:") + "\r\n" + ex.GetType().Name + "\r\n" + ex.Message);
}
//start to process the 271----------------------------------------------------------
X271 x271 = null;
if (X12object.IsX12(x12response))
{
X12object x12obj = new X12object(x12response);
if (x12obj.Is271())
{
x271 = new X271(x12response);
}
}
else //not a 997, 999, 277 or 271
{
EtransMessageTexts.Delete(etrans.EtransMessageTextNum);
Etranss.Delete(etrans.EtransNum);
throw new ApplicationException(Lans.g("FormInsPlan", "Error:") + "\r\n" + x12response);
}
/*
* //In realtime mode, X12 limits the request to one patient.
* //We will always use the subscriber.
* //So all EB segments are for the subscriber.
* List<EB271> listEB=new List<EB271>();
* EB271 eb;
* if(x271 != null) {
* for(int i=0;i<x271.Segments.Count;i++) {
* if(x271.Segments[i].SegmentID != "EB") {
* continue;
* }
* eb=new EB271(x271.Segments[i]);
* listEB.Add(eb);
* }
* }*/
//create an etrans for the 271------------------------------------------------------
etransMessageText = new EtransMessageText();
etransMessageText.MessageText = x12response;
EtransMessageTexts.Insert(etransMessageText);
Etrans etrans271 = new Etrans();
etrans271.PatNum = patNum;
etrans271.DateTimeTrans = DateTime.Now;
etrans271.ClearingHouseNum = clearinghouseClin.HqClearinghouseNum;
etrans271.Etype = EtransType.TextReport;
if (X12object.IsX12(x12response)) //this shouldn't need to be tested because it was tested above.
{
if (x271 == null)
{
X12object Xobj = new X12object(x12response);
if (Xobj.Is997())
{
etrans271.Etype = EtransType.Acknowledge_997;
}
else if (Xobj.Is999())
{
etrans271.Etype = EtransType.Acknowledge_999;
}
else if (X277.Is277(Xobj))
{
etrans271.Etype = EtransType.StatusNotify_277;
}
else if (X835.Is835(Xobj))
{
etrans271.Etype = EtransType.ERA_835;
}
else if (Xobj.IsAckInterchange())
{
etrans271.Etype = EtransType.Ack_Interchange;
}
}
else
{
etrans271.Etype = EtransType.BenefitResponse271;
}
}
etrans271.PlanNum = plan.PlanNum;
etrans271.InsSubNum = insSub.InsSubNum;
etrans271.EtransMessageTextNum = etransMessageText.EtransMessageTextNum;
etrans271.MessageText = etransMessageText.MessageText; //Not a DB column, used to save queries for some calling methods (OpenDentalService).
if (etransHtml != null)
{
etrans271.AckEtransNum = etransHtml.EtransNum;
}
Etranss.Insert(etrans271);
etrans.AckEtransNum = etrans271.EtransNum;
etrans.AckEtrans = etrans271; //Not a DB column, used to save queries for some calling methods (OpenDentalService).
if (etrans271.Etype == EtransType.Acknowledge_997)
{
X997 x997 = new X997(x12response);
string error997 = x997.GetHumanReadable();
etrans.Note = "Error: " + error997; //"Malformed document sent. 997 error returned.";
Etranss.Update(etrans);
error = etrans.Note;
return(null);
}
else if (etrans271.Etype == EtransType.Acknowledge_999)
{
X999 x999 = new X999(x12response);
string error999 = x999.GetHumanReadable();
etrans.Note = "Error: " + error999; //"Malformed document sent. 999 error returned.";
Etranss.Update(etrans);
error = etrans.Note;
return(null);
}
else if (etrans271.Etype == EtransType.StatusNotify_277)
{
X277 x277 = new X277(x12response);
string error277 = x277.GetHumanReadable();
etrans.Note = "Error: " + error277; //"Malformed document sent. 277 error returned.";
Etranss.Update(etrans);
error = etrans.Note;
return(null);
}
else if (etrans271.Etype == EtransType.ERA_835)
{
X835 x835 = new X835(etrans271, x12response, "");
string error835 = x835.GetHumanReadable();
etrans.Note = "Error: " + error835; //"Malformed document sent. 835 error returned.";
Etranss.Update(etrans);
error = etrans.Note;
return(null);
}
else if (etrans271.Etype == EtransType.BenefitResponse271) //271
{
string processingerror = x271.GetProcessingError();
if (processingerror != "")
{
etrans.Note = processingerror;
Etranss.Update(etrans);
error = etrans.Note;
return(null);
}
else
{
etrans.Note = "Normal 271 response."; //change this later to be explanatory of content.
}
}
else if (etrans271.Etype == EtransType.Ack_Interchange) //See document "X092 Elig 270-271.pdf" pages 388 and 401.
{
X12object xobj = new X12object(x12response);
X12Segment segTa1 = xobj.GetNextSegmentById(0, "TA1");
if (segTa1.Get(4) == "A")
{
etrans.Note = "The request was accepted, but the response is empty.";
}
else
{
if (segTa1.Get(4) == "E")
{
etrans.Note = "The request was accepted with errors: ";
}
else if (segTa1.Get(4) == "R")
{
etrans.Note = "The request was rejected with errors: ";
}
switch (segTa1.Get(5))
{
case "000": etrans.Note += "No error"; break;
case "001": etrans.Note += "The Interchange Control Number in the Header and Trailer Do Not Match. "
+ "The Value From the Header is Used in the Acknowledgment."; break;
case "002": etrans.Note += "This Standard as Noted in the Control Standards Identifier is Not Supported."; break;
case "003": etrans.Note += "This Version of the Controls is Not Supported"; break;
case "004": etrans.Note += "The Segment Terminator is Invalid"; break;
case "005": etrans.Note += "Invalid Interchange ID Qualifier for Sender"; break;
case "006": etrans.Note += "Invalid Interchange Sender ID"; break;
case "007": etrans.Note += "Invalid Interchange ID Qualifier for Receiver"; break;
case "008": etrans.Note += "Invalid Interchange Receiver ID"; break;
case "009": etrans.Note += "Unknown Interchange Receiver ID"; break;
case "010": etrans.Note += "Invalid Authorization Information Qualifier Value"; break;
case "011": etrans.Note += "Invalid Authorization Information Value"; break;
case "012": etrans.Note += "Invalid Security Information Qualifier Value"; break;
case "013": etrans.Note += "Invalid Security Information Value"; break;
case "014": etrans.Note += "Invalid Interchange Date Value"; break;
case "015": etrans.Note += "Invalid Interchange Time Value"; break;
case "016": etrans.Note += "Invalid Interchange Standards Identifier Value"; break;
case "017": etrans.Note += "Invalid Interchange Version ID Value"; break;
case "018": etrans.Note += "Invalid Interchange Control Number Value"; break;
case "019": etrans.Note += "Invalid Acknowledgment Requested Value"; break;
case "020": etrans.Note += "Invalid Test Indicator Value"; break;
case "021": etrans.Note += "Invalid Number of Included Groups Value"; break;
case "022": etrans.Note += "Invalid Control Structure"; break;
case "023": etrans.Note += "Improper (Premature) End-of-File (Transmission)"; break;
case "024": etrans.Note += "Invalid Interchange Content (e.g., Invalid GS Segment)"; break;
case "025": etrans.Note += "Duplicate Interchange Control Number"; break;
case "026": etrans.Note += "Invalid Data Element Separator"; break;
case "027": etrans.Note += "Invalid Component Element Separator"; break;
case "028": etrans.Note += "Invalid Delivery Date in Deferred Delivery Request"; break;
case "029": etrans.Note += "Invalid Delivery Time in Deferred Delivery Request"; break;
case "030": etrans.Note += "Invalid Delivery Time Code in Deferred Delivery Request"; break;
case "031": etrans.Note += "Invalid Grade of Service Code"; break;
}
}
}
else
{
throw new Exception("Unknown response");
}
Etranss.Update(etrans);
return(etrans);
}
///<summary>Fills grid based on values in _listEtrans.
///Set isRefreshNeeded to true when we need to reinitialize local dictionarys after in memory list is also updated. Required true for first time running.
///Also allows you to passed in predetermined filter options.</summary>
private void FillGrid(bool isRefreshNeeded, List <string> listSelectedStatuses, List <long> listSelectedClinicNums,
string carrierName, string checkTraceNum, string amountMin, string amountMax)
{
Action actionCloseProgress = null;
if (isRefreshNeeded)
{
actionCloseProgress = ODProgressOld.ShowProgressStatus("Etrans835", this, Lan.g(this, "Gathering data") + "...", false);
_dictEtrans835s.Clear();
_dictEtransClaims.Clear();
_dictClaimPayExists.Clear();
List <Etrans835Attach> listAttached = Etrans835Attaches.GetForEtrans(_listEtranss.Select(x => x.EtransNum).ToArray());
Dictionary <long, string> dictEtransMessages = new Dictionary <long, string>();
List <X12ClaimMatch> list835ClaimMatches = new List <X12ClaimMatch>();
Dictionary <long, int> dictClaimMatchCount = new Dictionary <long, int>(); //1:1 with _listEtranss. Stores how many claim matches each 835 has.
int batchQueryInterval = 500; //Every 500 rows we get the next 500 message texts to save memory.
int rowCur = 0;
foreach (Etrans etrans in _listEtranss)
{
if (rowCur % batchQueryInterval == 0)
{
int range = Math.Min(batchQueryInterval, _listEtranss.Count - rowCur); //Either the full batchQueryInterval amount or the remaining amount of etrans.
dictEtransMessages = EtransMessageTexts.GetMessageTexts(_listEtranss.GetRange(rowCur, range).Select(x => x.EtransMessageTextNum).ToList(), false);
}
rowCur++;
ODEvent.Fire(new ODEventArgs("Etrans835", Lan.g(this, "Processing 835: ") + ": " + rowCur + " out of " + _listEtranss.Count));
List <Etrans835Attach> listAttachedTo835 = listAttached.FindAll(x => x.EtransNum == etrans.EtransNum);
X835 x835 = new X835(etrans, dictEtransMessages[etrans.EtransMessageTextNum], etrans.TranSetId835, listAttachedTo835, true);
_dictEtrans835s.Add(etrans.EtransNum, x835);
List <X12ClaimMatch> listClaimMatches = x835.GetClaimMatches();
dictClaimMatchCount.Add(etrans.EtransNum, listClaimMatches.Count);
list835ClaimMatches.AddRange(listClaimMatches);
}
#region Set 835 unattached in batch and build _dictEtransClaims and _dictClaimPayCheckNums.
ODEvent.Fire(new ODEventArgs("Etrans835", Lan.g(this, "Gathering internal claim matches.")));
List <long> listClaimNums = Claims.GetClaimFromX12(list835ClaimMatches); //Can return null.
ODEvent.Fire(new ODEventArgs("Etrans835", Lan.g(this, "Building data sets.")));
int claimIndexCur = 0;
List <long> listMatchedClaimNums = new List <long>();
foreach (Etrans etrans in _listEtranss)
{
X835 x835 = _dictEtrans835s[etrans.EtransNum];
if (listClaimNums != null)
{
x835.SetClaimNumsForUnattached(listClaimNums.GetRange(claimIndexCur, dictClaimMatchCount[etrans.EtransNum]));
}
claimIndexCur += dictClaimMatchCount[etrans.EtransNum];
listMatchedClaimNums.AddRange(x835.ListClaimsPaid.FindAll(x => x.ClaimNum != 0).Select(x => x.ClaimNum).ToList());
}
List <Claim> listClaims = Claims.GetClaimsFromClaimNums(listMatchedClaimNums.Distinct().ToList());
_dictClaimPayExists = ClaimPayments.HasClaimPayment(listMatchedClaimNums); //Every claim num is associated to a bool. True when there is an existing claimPayment.
foreach (Etrans etrans in _listEtranss)
{
X835 x835 = _dictEtrans835s[etrans.EtransNum];
#region _dictEtransClaims, _dictClaimPayCheckNums
_dictEtransClaims.Add(etrans.EtransNum, new List <Claim>());
List <long> listSubClaimNums = x835.ListClaimsPaid.FindAll(x => x.ClaimNum != 0).Select(y => y.ClaimNum).ToList();
List <Claim> listClaimsFor835 = listClaims.FindAll(x => listSubClaimNums.Contains(x.ClaimNum));
foreach (Hx835_Claim claim in x835.ListClaimsPaid)
{
Claim claimCur = listClaimsFor835.FirstOrDefault(x => x.ClaimNum == claim.ClaimNum); //Can be null.
if (claimCur == null && claim.IsAttachedToClaim && claim.ClaimNum == 0)
{
claimCur = new Claim(); //Create empty claim since user detached claim manually, will not be considered in GetStringStatus(...).
}
if (claimCur != null && claim.IsPreauth) //User attached preauth to internal claim, no payment needed to be considered 'Finalized' in GetStringStatus(...).
{
_dictClaimPayExists[claim.ClaimNum] = true;
}
_dictEtransClaims[etrans.EtransNum].Add(claimCur);
}
#endregion
}
ODEvent.Fire(new ODEventArgs("Etrans835", Lan.g(this, "Filling Grid.")));
#endregion
}
gridMain.BeginUpdate();
#region Initilize columns only once
if (gridMain.Columns.Count == 0)
{
ODGridColumn col;
col = new ODGridColumn(Lan.g("TableEtrans835s", "Patient Name"), 250);
gridMain.Columns.Add(col);
col = new ODGridColumn(Lan.g("TableEtrans835s", "Carrier Name"), 190);
gridMain.Columns.Add(col);
col = new ODGridColumn(Lan.g("TableEtrans835s", "Status"), 80);
gridMain.Columns.Add(col);
col = new ODGridColumn(Lan.g("TableEtrans835s", "Date"), 80);
gridMain.Columns.Add(col);
col = new ODGridColumn(Lan.g("TableEtrans835s", "Amount"), 80);
gridMain.Columns.Add(col);
if (PrefC.HasClinicsEnabled)
{
col = new ODGridColumn(Lan.g("TableEtrans835s", "Clinic"), 70);
gridMain.Columns.Add(col);
}
col = new ODGridColumn(Lan.g("TableEtrans835s", "Code"), 37, HorizontalAlignment.Center);
gridMain.Columns.Add(col);
col = new ODGridColumn(Lan.g("TableEtrans835s", "Note"), 0);
gridMain.Columns.Add(col);
}
#endregion
gridMain.Rows.Clear();
foreach (Etrans etrans in _listEtranss)
{
X835 x835 = _dictEtrans835s[etrans.EtransNum];
#region Filter: Carrier Name
if (carrierName != "" && !x835.PayerName.ToLower().Contains(carrierName.ToLower()))
{
continue;
}
#endregion
string status = GetStringStatus(etrans.EtransNum);
#region Filter: Status
if (!listSelectedStatuses.Contains(status.Replace("*", ""))) //The filter will ignore finalized with detached claims.
{
continue;
}
#endregion
//List of ClinicNums for the current etrans.ListClaimsPaid from the DB.
List <long> listClinicNums = _dictEtransClaims[etrans.EtransNum].Select(x => x == null? 0 :x.ClinicNum).Distinct().ToList();
#region Filter: Clinics
if (PrefC.HasClinicsEnabled && !listClinicNums.Exists(x => listSelectedClinicNums.Contains(x)))
{
continue; //The ClinicNums associated to the 835 do not match any of the selected ClinicNums, so nothing to show in this 835.
}
#endregion
#region Filter: Check and Trace Value
if (checkTraceNum != "" && !x835.TransRefNum.Contains(checkTraceNum)) //Trace Number does not match
{
continue;
}
#endregion
#region Filter: Insurance Check Range Min and Max
if (amountMin != "" && x835.InsPaid < PIn.Decimal(amountMin) || amountMax != "" && x835.InsPaid > PIn.Decimal(amountMax))
{
continue; //Either the InsPaid is below or above our range.
}
#endregion
ODGridRow row = new ODGridRow();
#region Column: Patient Name
List <string> listPatNames = x835.ListClaimsPaid.Select(x => x.PatientName.ToString()).Distinct().ToList();
string patName = (listPatNames.Count > 0 ? listPatNames[0] : "");
if (listPatNames.Count > 1)
{
patName = "(" + POut.Long(listPatNames.Count) + ")";
}
row.Cells.Add(patName);
#endregion
row.Cells.Add(x835.PayerName);
row.Cells.Add(status); //See GetStringStatus(...) for possible values.
row.Cells.Add(POut.Date(etrans.DateTimeTrans));
row.Cells.Add(POut.Decimal(x835.InsPaid));
#region Column: Clinic
if (PrefC.HasClinicsEnabled)
{
string clinicAbbr = "";
if (listClinicNums.Count == 1)
{
if (listClinicNums[0] == 0)
{
clinicAbbr = Lan.g(this, "Unassigned");
}
else
{
clinicAbbr = Clinics.GetAbbr(listClinicNums[0]);
}
}
else if (listClinicNums.Count > 1)
{
clinicAbbr = "(" + Lan.g(this, "Multiple") + ")";
}
row.Cells.Add(clinicAbbr);
}
#endregion
row.Cells.Add(x835._paymentMethodCode);
row.Cells.Add(etrans.Note);
row.Tag = etrans;
gridMain.Rows.Add(row);
}
gridMain.EndUpdate();
actionCloseProgress?.Invoke();
}
///<summary>Etrans type will be figured out by this class. Either TextReport, Acknowledge_997, Acknowledge_999, or StatusNotify_277.</summary>
public static void ProcessIncomingReport(DateTime dateTimeTrans,long hqClearinghouseNum,string messageText,long userNum) {
if(RemotingClient.RemotingRole==RemotingRole.ClientWeb) {
Meth.GetVoid(MethodBase.GetCurrentMethod(),dateTimeTrans,hqClearinghouseNum,messageText,userNum);
return;
}
Etrans etrans=CreateEtrans(dateTimeTrans,hqClearinghouseNum,messageText,userNum);
string command;
X12object Xobj=X12object.ToX12object(messageText);
if(Xobj!=null) {//Is a correctly formatted X12 message.
if(Xobj.IsAckInterchange()) {
etrans.Etype=EtransType.Ack_Interchange;
Etranss.Insert(etrans);
//At some point in the future, we should use TA101 to match to batch number and TA104 to get the ack code,
//then update historic etrans entries like we do for 997s, 999s and 277s.
}
else if(Xobj.Is997()) {
X997 x997=new X997(messageText);
etrans.Etype=EtransType.Acknowledge_997;
etrans.BatchNumber=x997.GetBatchNumber();
Etranss.Insert(etrans);
string batchack=x997.GetBatchAckCode();
if(batchack=="A"||batchack=="R") {//accepted or rejected
command="UPDATE etrans SET AckCode='"+batchack+"', "
+"AckEtransNum="+POut.Long(etrans.EtransNum)
+" WHERE BatchNumber="+POut.Long(etrans.BatchNumber)
+" AND ClearinghouseNum="+POut.Long(hqClearinghouseNum)
+" AND DateTimeTrans > "+POut.DateT(dateTimeTrans.AddDays(-14))
+" AND DateTimeTrans < "+POut.DateT(dateTimeTrans.AddDays(1))
+" AND AckEtransNum=0";
Db.NonQ(command);
}
else {//partially accepted
List<int> transNums=x997.GetTransNums();
string ack;
for(int i=0;i<transNums.Count;i++) {
ack=x997.GetAckForTrans(transNums[i]);
if(ack=="A"||ack=="R") {//accepted or rejected
command="UPDATE etrans SET AckCode='"+ack+"', "
+"AckEtransNum="+POut.Long(etrans.EtransNum)
+" WHERE BatchNumber="+POut.Long(etrans.BatchNumber)
+" AND TransSetNum="+POut.Long(transNums[i])
+" AND ClearinghouseNum="+POut.Long(hqClearinghouseNum)
+" AND DateTimeTrans > "+POut.DateT(dateTimeTrans.AddDays(-14))
+" AND DateTimeTrans < "+POut.DateT(dateTimeTrans.AddDays(1))
+" AND AckEtransNum=0";
Db.NonQ(command);
}
}
}
//none of the other fields make sense, because this ack could refer to many claims.
}
else if(Xobj.Is999()) {
X999 x999=new X999(messageText);
etrans.Etype=EtransType.Acknowledge_999;
etrans.BatchNumber=x999.GetBatchNumber();
Etranss.Insert(etrans);
string batchack=x999.GetBatchAckCode();
if(batchack=="A"||batchack=="R") {//accepted or rejected
command="UPDATE etrans SET AckCode='"+batchack+"', "
+"AckEtransNum="+POut.Long(etrans.EtransNum)
+" WHERE BatchNumber="+POut.Long(etrans.BatchNumber)
+" AND ClearinghouseNum="+POut.Long(hqClearinghouseNum)
+" AND DateTimeTrans > "+POut.DateT(dateTimeTrans.AddDays(-14))
+" AND DateTimeTrans < "+POut.DateT(dateTimeTrans.AddDays(1))
+" AND AckEtransNum=0";
Db.NonQ(command);
}
else {//partially accepted
List<int> transNums=x999.GetTransNums();
string ack;
for(int i=0;i<transNums.Count;i++) {
ack=x999.GetAckForTrans(transNums[i]);
if(ack=="A"||ack=="R") {//accepted or rejected
command="UPDATE etrans SET AckCode='"+ack+"', "
+"AckEtransNum="+POut.Long(etrans.EtransNum)
+" WHERE BatchNumber="+POut.Long(etrans.BatchNumber)
+" AND TransSetNum="+POut.Long(transNums[i])
+" AND ClearinghouseNum="+POut.Long(hqClearinghouseNum)
+" AND DateTimeTrans > "+POut.DateT(dateTimeTrans.AddDays(-14))
+" AND DateTimeTrans < "+POut.DateT(dateTimeTrans.AddDays(1))
+" AND AckEtransNum=0";
Db.NonQ(command);
}
}
}
//none of the other fields make sense, because this ack could refer to many claims.
}
else if(X277.Is277(Xobj)) {
X277 x277=new X277(messageText);
etrans.Etype=EtransType.StatusNotify_277;
Etranss.Insert(etrans);
List<string> listClaimIdentifiers=x277.GetClaimTrackingNumbers();
//Dictionary to run one update command per ack code for many claims.
Dictionary <string,List<X12ClaimMatch>> dictClaimMatchesByAck=new Dictionary<string,List<X12ClaimMatch>>();
for(int i=0;i<listClaimIdentifiers.Count;i++) {
X12ClaimMatch claimMatch=new X12ClaimMatch();
claimMatch.ClaimIdentifier=listClaimIdentifiers[i];
string[] arrayClaimInfo=x277.GetClaimInfo(claimMatch.ClaimIdentifier);
claimMatch.PatFname=PIn.String(arrayClaimInfo[0]);
claimMatch.PatLname=PIn.String(arrayClaimInfo[1]);
claimMatch.DateServiceStart=PIn.DateT(arrayClaimInfo[6]);
claimMatch.DateServiceEnd=PIn.DateT(arrayClaimInfo[7]);
claimMatch.ClaimFee=PIn.Double(arrayClaimInfo[9]);
claimMatch.SubscriberId=PIn.String(arrayClaimInfo[10]);
claimMatch.EtransNum=etrans.EtransNum;
string ack=arrayClaimInfo[3];
if(!dictClaimMatchesByAck.ContainsKey(ack)) {
dictClaimMatchesByAck.Add(ack,new List<X12ClaimMatch>());
}
dictClaimMatchesByAck[ack].Add(claimMatch);
}
foreach(string ack in dictClaimMatchesByAck.Keys) {
List <long> listClaimNums=Claims.GetClaimFromX12(dictClaimMatchesByAck[ack]);
if(listClaimNums!=null) {
listClaimNums=listClaimNums.Where(x => x!=0).ToList();
if(listClaimNums.Count > 0) {
//Locate the latest etrans entries for the claims based on DateTimeTrans with EType of ClaimSent or Claim_Ren and update the AckCode and AckEtransNum.
//We overwrite existing acks from 997s, 999s and older 277s.
command="UPDATE etrans SET AckCode='"+ack+"', "
+"AckEtransNum="+POut.Long(etrans.EtransNum)
+" WHERE EType IN ("+POut.Int((int)EtransType.ClaimSent)+","+POut.Int((int)EtransType.Claim_Ren)+") "
+" AND ClaimNum IN("+String.Join(",",listClaimNums.Select(x => POut.Long(x)))+")"
+" AND ClearinghouseNum="+POut.Long(hqClearinghouseNum)
+" AND DateTimeTrans > "+POut.DateT(dateTimeTrans.AddDays(-14))
+" AND DateTimeTrans < "+POut.DateT(dateTimeTrans.AddDays(1));
Db.NonQ(command);
}
}
//none of the other fields make sense, because this ack could refer to many claims.
}
}
else if(X835.Is835(Xobj)) {
etrans.Etype=EtransType.ERA_835;
List <string> listTranSetIds=Xobj.GetTranSetIds();
List <Etrans> listEtrans=new List<Etrans>();
List <X835> list835s=new List<X835>();
//We pull in the 835 data in two loops so that we can ensure the 835 is fully parsed before we create any etrans entries.
for(int i=0;i<listTranSetIds.Count;i++) {
etrans.TranSetId835=listTranSetIds[i];
if(i>0) {
etrans.EtransNum=0;//To get a new record to insert.
}
X835 x835=new X835(etrans,messageText,etrans.TranSetId835);//parse. If parsing fails, then no etrans entries will be inserted.
etrans.CarrierNameRaw=x835.PayerName;
List<string> listUniquePatientNames=new List<string>();
for(int j=0;j<x835.ListClaimsPaid.Count;j++) {
string patName=x835.ListClaimsPaid[j].PatientName.ToString(false);
if(!listUniquePatientNames.Contains(patName)) {
listUniquePatientNames.Add(patName);
}
}
if(listUniquePatientNames.Count==1) {
etrans.PatientNameRaw=listUniquePatientNames[0];
}
else {
etrans.PatientNameRaw="("+listUniquePatientNames.Count+" "+Lans.g("Etranss","patients")+")";
}
listEtrans.Add(etrans.Copy());
list835s.Add(x835);
}
//The 835 was completely parsed. Create etrans entries.
for(int i=0;i<listEtrans.Count;i++) {
etrans=listEtrans[i];
X835 x835=list835s[i];
Etranss.Insert(etrans);//insert
List<long> listClaimNums=x835.ListClaimsPaid.Select(x => x.ClaimNum).Where(x => x!=0).ToList();
if(listClaimNums.Count > 0) {
//Locate the latest etrans entries for the claim based on DateTimeTrans with EType of ClaimSent or Claim_Ren and update the AckCode and AckEtransNum.
//We overwrite existing acks from 997s, 999s, and 277s.
command="UPDATE etrans SET AckCode='A', "
+"AckEtransNum="+POut.Long(etrans.EtransNum)
+" WHERE EType IN (0,3) "//ClaimSent and Claim_Ren
+" AND ClaimNum IN("+String.Join(",",listClaimNums.Select(x => POut.Long(x)))+")"
+" AND ClearinghouseNum="+POut.Long(hqClearinghouseNum)
+" AND DateTimeTrans > "+POut.DateT(dateTimeTrans.AddDays(-14))
+" AND DateTimeTrans < "+POut.DateT(dateTimeTrans.AddDays(1));
Db.NonQ(command);
}
//none of the other fields make sense, because this ack could refer to many claims.
}
}
else {//unknown type of X12 report.
etrans.Etype=EtransType.TextReport;
Etranss.Insert(etrans);
}
}
else {//not X12
etrans.Etype=EtransType.TextReport;
Etranss.Insert(etrans);
}
}