public J400Claim TransformClaimToJ400(Claim claim)
{
var j400 = new J400Claim();
j400.Field12_SubscriberInformation.Line1 = claim.Subscriber.Name.Formatted();
if (claim.Subscriber.Address != null)
{
j400.Field12_SubscriberInformation.Line2 = claim.Subscriber.Address.Line1;
if (!string.IsNullOrEmpty(claim.Subscriber.Address.Line2))
{
j400.Field12_SubscriberInformation.Line3 = claim.Subscriber.Address.Line2;
j400.Field12_SubscriberInformation.Line4 = claim.Subscriber.Address.Locale;
}
else
j400.Field12_SubscriberInformation.Line3 = claim.Subscriber.Address.Locale;
}
j400.Field13_SubscriberDateOfBirth = claim.Subscriber.DateOfBirth;
j400.Field14_SubscriberGender_Female = claim.Subscriber.Gender == GenderEnum.Female;
j400.Field14_SubscriberGender_Male = claim.Subscriber.Gender == GenderEnum.Male;
j400.Field15_SubscriberId = claim.Subscriber.Name.Identification.Id;
j400.Field16_SubscriberGroupNumber = claim.SubscriberInformation.ReferenceIdentification;
if (claim.Patient == null)
{
j400.Field18_PatientRelationshipToSubscriber_Self = true;
}
else
{
switch (claim.Patient.Relationship.Code)
{
case "18":
j400.Field18_PatientRelationshipToSubscriber_Self = true;
break;
case "01":
j400.Field18_PatientRelationshipToSubscriber_Spouse = true;
break;
case "19":
j400.Field18_PatientRelationshipToSubscriber_Dependent = true;
break;
default:
j400.Field18_PatientRelationshipToSubscriber_Other = true;
break;
}
}
var patient = claim.Patient ?? claim.Subscriber;
j400.Field20_PatientInformation.Line1 = patient.Name.Formatted();
if (patient.Address != null)
{
j400.Field20_PatientInformation.Line2 = patient.Address.Line1;
if (!string.IsNullOrEmpty(patient.Address.Line2))
{
j400.Field20_PatientInformation.Line3 = patient.Address.Line2;
j400.Field20_PatientInformation.Line4 = patient.Address.Locale;
}
else
j400.Field20_PatientInformation.Line3 = patient.Address.Locale;
}
j400.Field21_PatientDateOfBirth = patient.DateOfBirth;
j400.Field22_PatientGender_Female = patient.Gender == GenderEnum.Female;
j400.Field22_PatientGender_Male = patient.Gender == GenderEnum.Male;
j400.Field23_PatientAccountNumber = claim.PatientControlNumber;
foreach (var line in claim.ServiceLines)
{
var j400Line = new J400ServiceLine
{
Field24_ProcedureDate = line.ServiceDateFrom,
Field25_AreaOfOralCavity = string.Join(",", line.OralCavityDesignations.Select(ocd => ocd.Code)),
Field27_ToothNumberOrLetter = string.Join(",", line.ToothInformations.Select(ti => ti.ToothCode)),
Field28_ToothSurface = string.Join("", line.ToothInformations.Select(t => string.Join("", t.ToothSurfaces.Select(ts => ts.Code)))),
Field29_ProcedureCode = line.Procedure != null ? line.Procedure.ProcedureCode : "",
Field31_Fee = line.ChargeAmount
};
j400.ServiceLines.Add(j400Line);
}
return j400;
}
public List<FormPage> TransformJ400ToFormPages(J400Claim j400)
{
List<FormPage> pages = new List<FormPage>();
int pageCount = 1 + ((j400.ServiceLines.Count - 1) / 10);
FormPage page = null;
for (int i = 0; i < j400.ServiceLines.Count; i++)
{
if (i % 10 == 0)
{
page = new FormPage();
pages.Add(page);
page.MasterReference = "j400";
page.ImagePath = _formImagePath;
AddBlock(page, 43, 8, 38, j400.Field12_SubscriberInformation.Line1);
AddBlock(page, 43, 9, 38, j400.Field12_SubscriberInformation.Line2);
AddBlock(page, 43, 10, 38, j400.Field12_SubscriberInformation.Line3);
AddBlock(page, 43, 11, 38, j400.Field12_SubscriberInformation.Line4);
AddBlock(page, 43, 13, 10, string.Format("{0:MM/dd/yyyy}", j400.Field13_SubscriberDateOfBirth));
AddBlock(page, 57, 13, 1, j400.Field14_SubscriberGender_Female ? "X" : "");
AddBlock(page, 60, 13, 1, j400.Field14_SubscriberGender_Male ? "X" : "");
AddBlock(page, 65, 13, 15, j400.Field15_SubscriberId);
AddBlock(page, 43, 15, 11, j400.Field16_SubscriberGroupNumber);
AddBlock(page, 56, 15, 24, 'X'.Repeat(24));
AddBlock(page, 43, 18, 1, j400.Field18_PatientRelationshipToSubscriber_Self ? "X": "");
AddBlock(page, 48, 18, 1, j400.Field18_PatientRelationshipToSubscriber_Spouse ? "X" : "");
AddBlock(page, 54, 18, 1, j400.Field18_PatientRelationshipToSubscriber_Dependent ? "X" : "");
AddBlock(page, 63, 18, 1, j400.Field04_OtherDentalOrMedicalCoverage ? "X" : "");
AddBlock(page, 43, 20, 38, j400.Field20_PatientInformation.Line1);
AddBlock(page, 43, 21, 38, j400.Field20_PatientInformation.Line2);
AddBlock(page, 43, 22, 38, j400.Field20_PatientInformation.Line3);
AddBlock(page, 43, 23, 38, j400.Field20_PatientInformation.Line4);
AddBlock(page, 43, 25, 10, string.Format("{0:MM/dd/yyyy}", j400.Field21_PatientDateOfBirth));
AddBlock(page, 57, 25, 1, j400.Field22_PatientGender_Female ? "X" : "");
AddBlock(page, 60, 25, 1, j400.Field22_PatientGender_Male ? "X" : "");
AddBlock(page, 64, 25, 17, j400.Field23_PatientAccountNumber);
}
decimal y = 29 + (i % 10);
var line = j400.ServiceLines[i];
AddBlock(page, 2, y, 10, string.Format("{0:MM/dd/yyyy}", line.Field24_ProcedureDate));
AddBlock(page, 13, y, 2, line.Field25_AreaOfOralCavity);
AddBlock(page, 16, y, 2, line.Field26_ToothSystem);
AddBlock(page, 19, y, 11, line.Field27_ToothNumberOrLetter);
AddBlock(page, 31, y, 5, line.Field28_ToothSurface);
AddBlock(page, 37, y, 5, line.Field29_ProcedureCode);
AddBlock(page, 43, y, 31, 'D'.Repeat(31)); // line.Field30_Description);
string amount = string.Format("{0:0.00}", line.Field31_Fee).Replace(".","");
AddBlock(page, 81 - amount.Length, y, amount.Length, amount);
if (i % 10 == 9 || i == j400.ServiceLines.Count - 1) // Footer
{
}
}
return pages;
}
