public static string RunFour(bool showForms)
{
string retVal = "";
long provNum = ProviderC.ListShort[1].ProvNum; //dentist #2
Patient pat = Patients.GetPat(PatientTC.PatNum6); //patient#6
if (pat.PriProv != provNum)
{
Patient oldPat = pat.Copy();
pat.PriProv = provNum; //this script uses the primary provider for the patient
Patients.Update(pat, oldPat);
}
PatPlan patplan = PatPlans.GetPatPlan(pat.PatNum, 1);
InsSub sub = InsSubs.GetOne(patplan.InsSubNum);
InsPlan plan = InsPlans.GetPlan(sub.PlanNum, new List <InsPlan>());
long etransNum = CanadianOutput.SendElegibility(pat.PatNum, plan, new DateTime(1999, 1, 1), patplan.Relationship, patplan.PatID, showForms, sub);
Etrans etrans = Etranss.GetEtrans(etransNum);
string message = EtransMessageTexts.GetMessageText(etrans.EtransMessageTextNum);
CCDFieldInputter formData = new CCDFieldInputter(message);
string responseStatus = formData.GetValue("G05");
if (responseStatus != "M")
{
throw new Exception("Should be M");
}
retVal += "Eligibility #4 successful.\r\n";
return(retVal);
}
public static string RunOne(bool showForms)
{
string retVal = "";
long provNum = ProviderC.ListShort[0].ProvNum; //dentist #1
Patient pat = Patients.GetPat(PatientTC.PatNum1); //patient#1
if (pat.PriProv != provNum)
{
Patient oldPat = pat.Copy();
pat.PriProv = provNum; //this script uses the primary provider for the patient
Patients.Update(pat, oldPat);
}
PatPlan patplan = PatPlans.GetPatPlan(pat.PatNum, 1);
InsSub sub = InsSubs.GetOne(patplan.InsSubNum);
InsPlan plan = InsPlans.GetPlan(sub.PlanNum, new List <InsPlan>());
//the UI would block this due to carrier not supporting this transaction type.
Clearinghouse clearinghouseHq = Clearinghouses.GetDefaultDental();
Clearinghouse clearinghouseClin = Clearinghouses.OverrideFields(clearinghouseHq, Clinics.ClinicNum);
long etransNum = CanadianOutput.SendElegibility(clearinghouseClin, pat.PatNum, plan, new DateTime(1999, 1, 1), patplan.Relationship, patplan.PatID, showForms, sub);
Etrans etrans = Etranss.GetEtrans(etransNum);
string message = EtransMessageTexts.GetMessageText(etrans.EtransMessageTextNum);
CCDFieldInputter formData = new CCDFieldInputter(message);
string responseStatus = formData.GetValue("G05");
if (responseStatus != "R")
{
throw new Exception("Should be R");
}
retVal += "Eligibility #1 successful.\r\n";
return(retVal);
}
private void FormEtrans277Edit_Load(object sender, EventArgs e)
{
MessageText = EtransMessageTexts.GetMessageText(EtransCur.EtransMessageTextNum);
x277 = new X277(MessageText);
FillHeader();
FillGrid();
}
private void FormEtrans270Edit_Load(object sender, EventArgs e)
{
MessageText = EtransMessageTexts.GetMessageText(EtransCur.EtransMessageTextNum);
MessageTextAck = "";
//textMessageText.Text=MessageText;
textNote.Text = EtransCur.Note;
EtransAck271 = Etranss.GetEtrans(EtransCur.AckEtransNum);
x271 = null;
if (EtransAck271 != null)
{
MessageTextAck = EtransMessageTexts.GetMessageText(EtransAck271.EtransMessageTextNum); //.Replace("~","~\r\n");
if (EtransAck271.Etype == EtransType.BenefitResponse271)
{
x271 = new X271(MessageTextAck);
}
}
listDTP = new List <DTP271>();
if (x271 != null)
{
listDTP = x271.GetListDtpSubscriber();
}
radioBenefitSendsPat.Checked = (!_isConinsuranceInverted);
radioBenefitSendsIns.Checked = (_isConinsuranceInverted);
FillGridDates();
CreateListOfBenefits();
FillGrid();
FillGridBen();
if (IsInitialResponse)
{
SelectForImport();
}
long patNum = (EtransCur.PatNum == 0?_subPatNum:EtransCur.PatNum); //Older 270/217s were always for the subscriber and have etrans.PatNum of 0.
this.Text += ": " + Patients.GetNameLF(patNum);
}
private void FormEtrans270Edit_Load(object sender, EventArgs e)
{
MessageText = EtransMessageTexts.GetMessageText(EtransCur.EtransMessageTextNum);
MessageTextAck = "";
//textMessageText.Text=MessageText;
textNote.Text = EtransCur.Note;
EtransAck271 = Etranss.GetEtrans(EtransCur.AckEtransNum);
x271 = null;
if (EtransAck271 != null)
{
MessageTextAck = EtransMessageTexts.GetMessageText(EtransAck271.EtransMessageTextNum); //.Replace("~","~\r\n");
if (EtransAck271.Etype == EtransType.BenefitResponse271)
{
x271 = new X271(MessageTextAck);
}
}
listDTP = new List <DTP271>();
if (x271 != null)
{
listDTP = x271.GetListDtpSubscriber();
}
FillGridDates();
CreateListOfBenefits();
FillGrid();
FillGridBen();
if (IsInitialResponse)
{
SelectForImport();
}
}
private void FormEtrans277Edit_Load(object sender, EventArgs e)
{
MessageText = EtransMessageTexts.GetMessageText(EtransCur.EtransMessageTextNum);
try {
x277 = new X277(MessageText);
}
catch (Exception ex) {
MessageBox.Show(Lan.g(this, "Claim Status Response not valid. An error occurred while loading: ") + "\r\n" + ex.Message);
DialogResult = DialogResult.Cancel;
return;
}
FillHeader();
FillGrid();
}
/*
* private void butShowResponseDeciph_Click(object sender,EventArgs e) {
* if(!X12object.IsX12(MessageTextAck)) {
* MessageBox.Show("Only works with 997's");
* return;
* }
* X12object x12obj=new X12object(MessageTextAck);
* if(!x12obj.Is997()) {
* MessageBox.Show("Only works with 997's");
* return;
* }
* X997 x997=new X997(MessageTextAck);
* string display=x997.GetHumanReadable();
* MsgBoxCopyPaste msgbox=new MsgBoxCopyPaste(display);
* msgbox.ShowDialog();
* }*/
private void butDelete_Click(object sender, EventArgs e)
{
//This button is not visible if IsNew
if (!MsgBox.Show(this, MsgBoxButtons.OKCancel, "Delete entire request and response?"))
{
return;
}
if (EtransAck271 != null)
{
EtransMessageTexts.Delete(EtransAck271.EtransMessageTextNum);
Etranss.Delete(EtransAck271.EtransNum);
}
EtransMessageTexts.Delete(EtransCur.EtransMessageTextNum);
Etranss.Delete(EtransCur.EtransNum);
DialogResult = DialogResult.OK;
}
private void FormEtransEdit_Load(object sender, EventArgs e)
{
MessageText = EtransMessageTexts.GetMessageText(EtransCur.EtransMessageTextNum);
textMessageText.Text = MessageText;
textDateTimeTrans.Text = EtransCur.DateTimeTrans.ToString();
textClaimNum.Text = EtransCur.ClaimNum.ToString();
textBatchNumber.Text = EtransCur.BatchNumber.ToString();
textTransSetNum.Text = EtransCur.TransSetNum.ToString();
textAckCode.Text = EtransCur.AckCode;
textNote.Text = EtransCur.Note;
if (EtransCur.Etype == EtransType.ClaimSent)
{
if (X12object.IsX12(MessageText))
{
X12object x12obj = new X12object(MessageText);
if (x12obj.IsFormat4010())
{
X837_4010 x837 = new X837_4010(MessageText);
checkAttachments.Checked = x837.AttachmentsWereSent(EtransCur.ClaimNum); //This function does not currently work, so the corresponding checkbox is hidden on the form as well.
}
else if (x12obj.IsFormat5010())
{
X837_5010 x837 = new X837_5010(MessageText);
checkAttachments.Checked = x837.AttachmentsWereSent(EtransCur.ClaimNum); //This function does not currently work, so the corresponding checkbox is hidden on the form as well.
}
}
}
if (EtransCur.AckEtransNum > 0)
{
AckCur = Etranss.GetEtrans(EtransCur.AckEtransNum);
if (AckCur != null)
{
textAckMessage.Text = EtransMessageTexts.GetMessageText(AckCur.EtransMessageTextNum);
textAckDateTime.Text = AckCur.DateTimeTrans.ToString();
textAckNote.Text = AckCur.Note;
}
}
else
{
AckCur = null;
groupAck.Visible = false;
}
if (!CultureInfo.CurrentCulture.Name.EndsWith("CA")) //Not Canadian.
{
butPrintAck.Visible = false;
}
}
private void FormEtrans270Edit_Load(object sender, EventArgs e)
{
MessageText = EtransMessageTexts.GetMessageText(EtransCur.EtransMessageTextNum);
MessageTextAck = "";
//textMessageText.Text=MessageText;
textNote.Text = EtransCur.Note;
EtransAck271 = Etranss.GetEtrans(EtransCur.AckEtransNum);
x271 = null;
if (EtransAck271 != null)
{
MessageTextAck = EtransMessageTexts.GetMessageText(EtransAck271.EtransMessageTextNum); //.Replace("~","~\r\n");
if (EtransAck271.Etype == EtransType.BenefitResponse271)
{
x271 = new X271(MessageTextAck);
}
}
listDTP = new List <DTP271>();
if (x271 != null)
{
listDTP = x271.GetListDtpSubscriber();
textResponseGroupNum.Text = x271.GetGroupNum();
}
if (textCurrentGroupNum.Text != textResponseGroupNum.Text)
{
errorProviderGroupNum.SetError(textCurrentGroupNum, Lan.g(this, "Mismatched group number."));
}
radioBenefitSendsPat.Checked = (!_isConinsuranceInverted);
radioBenefitSendsIns.Checked = (_isConinsuranceInverted);
FillGridDates();
CreateListOfBenefits();
FillGrid();
FillGridBen();
if (IsInitialResponse)
{
SelectForImport();
}
long patNum = (EtransCur.PatNum == 0?_subPatNum:EtransCur.PatNum); //Older 270/217s were always for the subscriber and have etrans.PatNum of 0.
this.Text += ": " + Patients.GetNameLF(patNum);
if (Clearinghouses.GetFirstOrDefault(x => x.ClearinghouseNum == EtransCur.ClearingHouseNum)?.CommBridge == EclaimsCommBridge.EDS &&
EtransAck271 != null && EtransAck271.AckEtransNum != 0)
{
_htmlResponse = EtransMessageTexts.GetMessageText(Etranss.GetEtrans(EtransAck271.AckEtransNum).EtransMessageTextNum);
butPrint.Visible = true;
}
}
public static string Run(int scriptNum, string responseExpected, Claim claim)
{
string retVal = "";
InsPlan insPlan = InsPlans.GetPlan(claim.PlanNum, null);
InsSub insSub = InsSubs.GetOne(claim.InsSubNum);
long etransNum = CanadianOutput.SendClaimReversal(claim, insPlan, insSub);
Etrans etrans = Etranss.GetEtrans(etransNum);
string message = EtransMessageTexts.GetMessageText(etrans.EtransMessageTextNum);
CCDFieldInputter formData = new CCDFieldInputter(message);
string responseStatus = formData.GetValue("G05");
if (responseStatus != responseExpected)
{
return("G05 should be " + responseExpected + "\r\n");
}
retVal += "Reversal #" + scriptNum.ToString() + " successful.\r\n";
return(retVal);
}
public static string Run(int scriptNum, string responseExpected, string responseTypeExpected, Claim claim, bool showForms, int pageNumber, int lastPageNumber, double firstExamFee, double diagnosticPhaseFee)
{
string retVal = "";
ClaimSendQueueItem queueItem = Claims.GetQueueList(claim.ClaimNum, claim.ClinicNum, 0)[0];
Clearinghouse clearinghouseHq = ClearinghouseL.GetClearinghouseHq(queueItem.ClearinghouseNum);
Clearinghouse clearinghouseClin = Clearinghouses.OverrideFields(clearinghouseHq, Clinics.ClinicNum);
Eclaims.GetMissingData(clearinghouseClin, queueItem); //,out warnings);
if (queueItem.MissingData != "")
{
return("Cannot send predetermination until missing data is fixed:\r\n" + queueItem.MissingData + "\r\n");
}
#if DEBUG
Canadian.testNumber = scriptNum;
claim.PreAuthString = "" + pageNumber + "," + lastPageNumber + "," + firstExamFee + "," + diagnosticPhaseFee;
#endif
long etransNum = Canadian.SendClaim(clearinghouseClin, queueItem, showForms);
Etrans etrans = Etranss.GetEtrans(etransNum);
string message = EtransMessageTexts.GetMessageText(etrans.EtransMessageTextNum);
CCDFieldInputter formData = new CCDFieldInputter(message);
string responseType = formData.GetValue("A04");
if (responseType != responseTypeExpected)
{
return("Form type is '" + responseType + "' but should be '" + responseTypeExpected + "'\r\n");
}
string responseStatus = formData.GetValue("G05");
if (responseStatus != responseExpected)
{
return("G05 is '" + responseStatus + "' but should be '" + responseExpected + "'\r\n");
}
if (responseExpected == "R" && responseTypeExpected == "11")
{
//so far, only for #6. We need some other way to test if successful transaction
string errorMsgCount = formData.GetValue("G06");
if (errorMsgCount == "00")
{
return("Wrong message count.\r\n");
}
}
retVal += "Predetermination #" + scriptNum + " page " + pageNumber + " of " + lastPageNumber + " successful.\r\n";
return(retVal);
}
public static string Run(int scriptNum, string responseExpected, string responseTypeExpected, Claim claim, bool showForms)
{
string retVal = "";
ClaimSendQueueItem queueItem = Claims.GetQueueList(claim.ClaimNum, claim.ClinicNum, 0)[0];
Clearinghouse clearinghouseHq = ClearinghouseL.GetClearinghouseHq(queueItem.ClearinghouseNum);
Clearinghouse clearinghouseClin = Clearinghouses.OverrideFields(clearinghouseHq, Clinics.ClinicNum);
Eclaims.GetMissingData(clearinghouseClin, queueItem); //,out warnings);
if (queueItem.MissingData != "")
{
return("Cannot send claim until missing data is fixed:\r\n" + queueItem.MissingData + "\r\n");
}
#if DEBUG
Canadian.testNumber = scriptNum;
#endif
long etransNum = Canadian.SendClaim(clearinghouseClin, queueItem, showForms);
Etrans etrans = Etranss.GetEtrans(etransNum);
string message = EtransMessageTexts.GetMessageText(etrans.EtransMessageTextNum);
CCDFieldInputter formData = new CCDFieldInputter(message);
string responseType = formData.GetValue("A04");
if (responseType != responseTypeExpected)
{
return("Form type should be " + responseTypeExpected + "\r\n");
}
string responseStatus = formData.GetValue("G05");
if (responseStatus != responseExpected)
{
return("G05 should be " + responseExpected + "\r\n");
}
if (responseExpected == "R" && responseTypeExpected == "11")
{
//so far, only for #6. We need some other way to test if successful transaction
string errorMsgCount = formData.GetValue("G06");
if (errorMsgCount == "00")
{
return("Wrong message count.\r\n");
}
}
retVal += "Claim #" + scriptNum.ToString() + " successful.\r\n";
return(retVal);
}
private void FormEtransEdit_Load(object sender, EventArgs e)
{
MessageText = EtransMessageTexts.GetMessageText(EtransCur.EtransMessageTextNum);
textMessageText.Text = MessageText;
textDateTimeTrans.Text = EtransCur.DateTimeTrans.ToString();
textClaimNum.Text = EtransCur.ClaimNum.ToString();
textBatchNumber.Text = EtransCur.BatchNumber.ToString();
textTransSetNum.Text = EtransCur.TransSetNum.ToString();
textAckCode.Text = EtransCur.AckCode;
textNote.Text = EtransCur.Note;
if (EtransCur.Etype == EtransType.ClaimSent)
{
if (X12object.IsX12(MessageText))
{
//TODO: we need to do something different here for 5010s.
X837_4010 x837 = new X837_4010(MessageText);
checkAttachments.Checked = x837.AttachmentsWereSent(EtransCur.ClaimNum);
}
}
if (EtransCur.AckEtransNum > 0)
{
AckCur = Etranss.GetEtrans(EtransCur.AckEtransNum);
if (AckCur != null)
{
textAckMessage.Text = EtransMessageTexts.GetMessageText(AckCur.EtransMessageTextNum);
textAckDateTime.Text = AckCur.DateTimeTrans.ToString();
}
groupAck.Text = Lan.g(this, "Acknowledgement");
}
else
{
AckCur = null;
groupAck.Visible = false;
}
if (!CultureInfo.CurrentCulture.Name.EndsWith("CA")) //Not Canadian.
{
butPrintAck.Visible = false;
}
}
public static string Run(int scriptNum, string responseExpected, Claim claim)
{
string retVal = "";
InsPlan insPlan = InsPlans.GetPlan(claim.PlanNum, null);
InsSub insSub = InsSubs.GetOne(claim.InsSubNum);
Carrier carrier = Carriers.GetCarrier(insPlan.CarrierNum);
Clearinghouse clearinghouseHq =
Clearinghouses.GetClearinghouse(Clearinghouses.AutomateClearinghouseHqSelection(carrier.ElectID, claim.MedType));
Clearinghouse clearinghouseClin = Clearinghouses.OverrideFields(clearinghouseHq, Clinics.ClinicNum);
long etransNum = CanadianOutput.SendClaimReversal(clearinghouseClin, claim, insPlan, insSub);
Etrans etrans = Etranss.GetEtrans(etransNum);
string message = EtransMessageTexts.GetMessageText(etrans.EtransMessageTextNum);
CCDFieldInputter formData = new CCDFieldInputter(message);
string responseStatus = formData.GetValue("G05");
if (responseStatus != responseExpected)
{
return("G05 should be " + responseExpected + "\r\n");
}
retVal += "Reversal #" + scriptNum.ToString() + " successful.\r\n";
return(retVal);
}
///<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;
}
///<summary>Called from Eclaims and includes multiple claims.</summary>
public static string SendBatch(Clearinghouse clearinghouseClin, List <ClaimSendQueueItem> queueItems, int batchNum)
{
//STEP 1 - Build XML output.
List <DP_RACINDP> listDps = new List <DP_RACINDP>();
List <ProcedureCode> listProcCodes = ProcedureCodes.GetAllCodes();
List <Etrans> listEtrans = new List <Etrans>();
foreach (ClaimSendQueueItem queueItem in queueItems)
{
Etrans etrans = Etranss.SetClaimSentOrPrinted(queueItem.ClaimNum, queueItem.PatNum, clearinghouseClin.HqClearinghouseNum, EtransType.Claim_Ramq, batchNum, Security.CurUser.UserNum);
listEtrans.Add(etrans);
//Now we need to update our cache of claims to reflect the change that took place in the database above in Etranss.SetClaimSentOrPrinted()
queueItem.ClaimStatus = "S";
Claim claim = Claims.GetClaim(queueItem.ClaimNum);
Provider provClaimTreat = Providers.GetProv(claim.ProvTreat);
DP_RACINDP dp = new DP_RACINDP();
#region Header
dp.CHN = DP_RACINDPCHN.Item06;
dp.CHNSpecified = true;
dp.ENRG = DP_RACINDPENRG.Item1;
dp.ENRGSpecified = true;
//We hijack the TaxID number for the TRNSM field. The TRNSM is a office identifying number. Test range for developers is 18000 to 18999.
dp.TRNSM = clearinghouseClin.SenderTIN;
dp.DISP = provClaimTreat.NationalProvID;
//dp.CPTE_ADMN=;//Administrative account number. Not currently used.
JulianCalendar calendar = new JulianCalendar();
dp.ATTES = (DateTime.Now.Year % 10).ToString() //One digit for year
+ calendar.GetDayOfYear(DateTime.Now).ToString().PadLeft(3, '0') //3 digits for Julian day of year.
+ (etrans.CarrierTransCounter % 1000).ToString().PadLeft(3, '0'); //3 digits for sequence number.
dp.NCE = (etrans.CarrierTransCounter % 10000).ToString().PadLeft(4, '0');
dp.DISP_REFNT = claim.CanadianReferralProviderNum.Trim();
//dp.DIAGN=;//Diagnostic code. Not currently used.
dp.ETAB = provClaimTreat.CanadianOfficeNum; //Usually empty.
//dp.ADMIS=;//Date of patient admission. Not currently used. This would be the same as the date of service for dental claims anyway.
//dp.SORTI=;//Date patient discharged. Not currently used. This would be the same as the date of service for dental claims anyway.
dp.TOT_DEM = claim.ClaimFee.ToString().Replace(".", "").PadLeft(6, '0');
dp.COMPL = TidyStr(claim.ClaimNote, 200);
//dp.CS=;//Not sure what this is. Not currently used.
//dp.AUTOR=claim.PreAuthString;//Authorization number when invoicing acrylic prostheses. Required if DAT_AUTOR is present. Not currently used.
//dp.DAT_AUTOR=claim.CanadianDateInitialLower;//Date of authorization when invoicing acrylic prostheses. Format YYMMDD. Not currently used.
dp.SERV = claim.DateService.ToString("yyMMdd");
#endregion Header
#region Insurance
//Most fields in the insuranace section are optional.
InsSub insSub = InsSubs.GetOne(claim.InsSubNum);
dp.PERS_ASSU = new DP_RACINDPPERS_ASSU();
dp.PERS_ASSU.NAM = insSub.SubscriberID;
Patient pat = Patients.GetPat(claim.PatNum);
dp.PERS_ASSU.PRE = TidyStr(pat.FName, 20);
dp.PERS_ASSU.NOM = TidyStr(pat.LName, 30);
if (pat.Birthdate.Year > 1880)
{
dp.PERS_ASSU.NAISS = pat.Birthdate.ToString("yyyyMMdd");
}
if (pat.Gender == PatientGender.Male)
{
dp.PERS_ASSU.SEXE = DP_RACINDPPERS_ASSUSEXE.M;
}
else if (pat.Gender == PatientGender.Female)
{
dp.PERS_ASSU.SEXE = DP_RACINDPPERS_ASSUSEXE.F;
}
else
{
//There is no value for UNKNOWN. This field is optional if the subscriber ID is present anyway.
}
List <PatPlan> listPatPlans = PatPlans.Refresh(claim.PatNum);
PatPlan patPlan = PatPlans.GetByInsSubNum(listPatPlans, insSub.InsSubNum);
dp.PERS_ASSU.CAM = patPlan.PatID;
if (insSub.DateTerm.Year > 1880)
{
dp.PERS_ASSU.EXPIR_CAM = insSub.DateTerm.ToString("yyMM");
}
InsPlan insPlan = InsPlans.RefreshOne(claim.PlanNum);
InsPlan insPlan2 = InsPlans.RefreshOne(claim.PlanNum2);
Carrier carrier = null;
if (claim.ClaimType == "S")
{
carrier = Carriers.GetCarrier(insPlan2.CarrierNum);
}
else
{
carrier = Carriers.GetCarrier(insPlan.CarrierNum);
}
if (carrier.Address.Trim() != "")
{
dp.PERS_ASSU.ADR_1 = carrier.Address;
dp.PERS_ASSU.ADR_2 = carrier.Address2;
dp.PERS_ASSU.CP = carrier.Zip;
}
#endregion Insurance
#region Procedures
List <ClaimProc> listClaimProcsForPat = ClaimProcs.Refresh(claim.PatNum);
List <ClaimProc> listClaimProcsForClaim = ClaimProcs.GetForSendClaim(listClaimProcsForPat, claim.ClaimNum); //Excludes labs.
List <Procedure> listProcsForPat = Procedures.Refresh(claim.PatNum);
List <DP_RACINDPACTE> listProcs = new List <DP_RACINDPACTE>();
foreach (ClaimProc claimProc in listClaimProcsForClaim)
{
Procedure proc = Procedures.GetProcFromList(listProcsForPat, claimProc.ProcNum);
if (proc.ProcFee == 0)
{
continue;
}
ProcedureCode procCode = ProcedureCodes.GetProcCode(proc.CodeNum, listProcCodes);
if (procCode.NoBillIns)
{
continue;
}
DP_RACINDPACTE acteProc = new DP_RACINDPACTE();
acteProc.ACTE = procCode.ProcCode;
if (procCode.ProcCode.Length > 5)
{
acteProc.ACTE = procCode.ProcCode.Substring(0, 5);
}
acteProc.ROLE = "1"; //1 for principal role and 2 for assistant role.
//acte.MODIF=;//Optional. Not sure what to put here, so leaving blank for now.
acteProc.UNIT = proc.UnitQty.ToString().PadLeft(3, '0');
acteProc.MNT = proc.ProcFee.ToString("F").Replace(".", "").PadLeft(6, '0');
acteProc.DENT = proc.ToothNum.ToString().PadLeft(2, '0');
acteProc.SURF = proc.Surf.ToString().PadLeft(2, '0');
listProcs.Add(acteProc);
List <Procedure> listLabProcs = Procedures.GetCanadianLabFees(proc.ProcNum, listProcsForPat);
foreach (Procedure labProc in listLabProcs)
{
if (labProc.ProcFee == 0)
{
continue;
}
ProcedureCode labProcCode = ProcedureCodes.GetProcCode(labProc.CodeNum, listProcCodes);
DP_RACINDPACTE acteLab = new DP_RACINDPACTE();
acteLab.ACTE = labProcCode.ProcCode;
if (labProcCode.ProcCode.Length > 5)
{
acteLab.ACTE = labProcCode.ProcCode.Substring(0, 5);
}
acteLab.ROLE = "1"; //1 for principal role and 2 for assistant role.
acteLab.MNT = labProc.ProcFee.ToString("F").Replace(".", "").PadLeft(6, '0');
listProcs.Add(acteLab);
}
}
dp.ACTE = listProcs.ToArray();
#endregion Procedures
listDps.Add(dp);
}
DP_RACIN batch = new DP_RACIN();
batch.DP = listDps.ToArray();
StringWriter sw = new StringWriter();
XmlSerializer serializer = new XmlSerializer(typeof(DP_RACIN));
serializer.Serialize(sw, batch);
string xml = sw.ToString();
//Save a copy of the batch xml to each etrans entry (one per claim).
EtransMessageText etransMsgText = new EtransMessageText();
etransMsgText.MessageText = xml;
EtransMessageTexts.Insert(etransMsgText);
foreach (Etrans etrans in listEtrans)
{
etrans.EtransMessageTextNum = etransMsgText.EtransMessageTextNum;
Etranss.Update(etrans);
}
//Step 2 - ZIP XML and save to report path. The zip file name and file name within the zip file do not matter.
string zipFilePath = CodeBase.ODFileUtils.CreateRandomFile(clearinghouseClin.ExportPath, ".zip", "claims");
ZipFile zip = null;
try {
zip = new ZipFile();
zip.UseZip64WhenSaving = Zip64Option.Always;
zip.AddEntry("claims" + DateTime.Now.ToString("yyyyMMddHHmmss") + ".xml", xml);
zip.Save(zipFilePath);
zip.Dispose();
}
catch (Exception ex) {
ex.ToString();
if (zip != null)
{
zip.Dispose();
}
if (File.Exists(zipFilePath))
{
try {
File.Delete(zipFilePath);
}
catch (Exception ex2) {
ex2.ToString();
}
}
}
return(xml);
}
///<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>The insplan that's passed in need not be properly updated to the database first.</summary>
public static void RequestBenefits(Clearinghouse clearhouse, InsPlan plan, long patNum, Carrier carrier, List <Benefit> benList, long patPlanNum, InsSub insSub)
{
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(clearhouse, carrier, billProv, clinic, plan, subsc, insSub);
if (validationResult != "")
{
throw new Exception(Lan.g("FormInsPlan", "Please fix the following errors first:") + "\r\n" + validationResult);
}
//create a 270 message---------------------------------------------------------------
string x12message = X270.GenerateMessageText(clearhouse, carrier, billProv, clinic, plan, subsc, insSub);
EtransMessageText etransMessageText = new EtransMessageText();
etransMessageText.MessageText = x12message;
EtransMessageTexts.Insert(etransMessageText);
//attach it to an etrans-------------------------------------------------------------
Etrans etrans = new Etrans();
etrans.DateTimeTrans = DateTime.Now;
etrans.ClearingHouseNum = clearhouse.ClearinghouseNum;
etrans.Etype = EtransType.BenefitInquiry270;
etrans.PlanNum = plan.PlanNum;
etrans.InsSubNum = insSub.InsSubNum;
etrans.EtransMessageTextNum = etransMessageText.EtransMessageTextNum;
Etranss.Insert(etrans);
//send the 270----------------------------------------------------------------------
string x12response = "";
//a connection error here needs to bubble up
try {
if (clearhouse.CommBridge == EclaimsCommBridge.ClaimConnect)
{
x12response = ClaimConnect.Benefits270(clearhouse, x12message);
}
}
catch (Exception ex) {
EtransMessageTexts.Delete(etrans.EtransMessageTextNum);
Etranss.Delete(etrans.EtransNum);
throw new ApplicationException(Lan.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 //neither a 997 nor a 271
{
EtransMessageTexts.Delete(etrans.EtransMessageTextNum);
Etranss.Delete(etrans.EtransNum);
throw new ApplicationException(Lan.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.DateTimeTrans = DateTime.Now;
etrans271.ClearingHouseNum = clearhouse.ClearinghouseNum;
etrans271.Etype = EtransType.TextReport;
if (X12object.IsX12(x12response)) //this shouldn't need to be tested because it was tested above.
{
if (x271 == null)
{
etrans271.Etype = EtransType.Acknowledge_997;
}
else
{
etrans271.Etype = EtransType.BenefitResponse271;
}
}
etrans271.PlanNum = plan.PlanNum;
etrans271.InsSubNum = insSub.InsSubNum;
etrans271.EtransMessageTextNum = etransMessageText.EtransMessageTextNum;
Etranss.Insert(etrans271);
etrans.AckEtransNum = etrans271.EtransNum;
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);
MessageBox.Show(etrans.Note);
//CodeBase.MsgBoxCopyPaste msgbox=new CodeBase.MsgBoxCopyPaste(etrans.Note);
//msgbox.ShowDialog();
//don't show the 270 interface.
return;
}
else
{
string processingerror = x271.GetProcessingError();
if (processingerror != "")
{
etrans.Note = processingerror;
Etranss.Update(etrans);
MessageBox.Show(etrans.Note);
//CodeBase.MsgBoxCopyPaste msgbox=new CodeBase.MsgBoxCopyPaste(etrans.Note);
//msgbox.ShowDialog();
//don't show the 270 interface.
return;
}
else
{
etrans.Note = "Normal 271 response."; //change this later to be explanatory of content.
}
}
Etranss.Update(etrans);
//show the user a list of benefits to pick from for import--------------------------
FormEtrans270Edit formE = new FormEtrans270Edit(patPlanNum, plan.PlanNum, insSub.InsSubNum);
formE.EtransCur = etrans;
formE.IsInitialResponse = true;
formE.benList = benList;
formE.ShowDialog();
}
private void FormEtrans835Edit_Load(object sender, EventArgs e)
{
MessageText = EtransMessageTexts.GetMessageText(EtransCur.EtransMessageTextNum);
x835 = new X835(MessageText);
FillAll();
}
///<summary>Supply a list of ClaimSendQueueItems. Called from FormClaimSend. Can only send to one clearinghouse at a time.
///The queueItems must contain at least one item. Each item in queueItems must have the same ClinicNum. Cannot include Canadian.</summary>
public static void SendBatch(Clearinghouse clearinghouseClin, List <ClaimSendQueueItem> queueItems, EnumClaimMedType medType,
IFormClaimFormItemEdit formClaimFormItemEdit, Renaissance.FillRenaissanceDelegate fillRenaissance, ITerminalConnector terminalConnector)
{
string messageText = "";
if (clearinghouseClin.Eformat == ElectronicClaimFormat.Canadian)
{
MessageBox.Show(Lans.g("Eclaims", "Cannot send Canadian claims as part of Eclaims.SendBatch."));
return;
}
//get next batch number for this clearinghouse
int batchNum = Clearinghouses.GetNextBatchNumber(clearinghouseClin);
//---------------------------------------------------------------------------------------
//Create the claim file for this clearinghouse
if (clearinghouseClin.Eformat == ElectronicClaimFormat.x837D_4010 ||
clearinghouseClin.Eformat == ElectronicClaimFormat.x837D_5010_dental ||
clearinghouseClin.Eformat == ElectronicClaimFormat.x837_5010_med_inst)
{
messageText = x837Controller.SendBatch(clearinghouseClin, queueItems, batchNum, medType, false);
}
else if (clearinghouseClin.Eformat == ElectronicClaimFormat.Renaissance)
{
messageText = Renaissance.SendBatch(clearinghouseClin, queueItems, batchNum, formClaimFormItemEdit, fillRenaissance);
}
else if (clearinghouseClin.Eformat == ElectronicClaimFormat.Dutch)
{
messageText = Dutch.SendBatch(clearinghouseClin, queueItems, batchNum);
}
else if (clearinghouseClin.Eformat == ElectronicClaimFormat.Ramq)
{
messageText = Ramq.SendBatch(clearinghouseClin, queueItems, batchNum);
}
else
{
messageText = ""; //(ElectronicClaimFormat.None does not get sent)
}
if (messageText == "") //if failed to create claim file properly,
{
return; //don't launch program or change claim status
}
//----------------------------------------------------------------------------------------
//Launch Client Program for this clearinghouse if applicable
if (clearinghouseClin.CommBridge == EclaimsCommBridge.None)
{
AttemptLaunch(clearinghouseClin, batchNum);
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.WebMD)
{
if (!WebMD.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + WebMD.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.BCBSGA)
{
if (!BCBSGA.Launch(clearinghouseClin, batchNum, terminalConnector))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + BCBSGA.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.Renaissance)
{
AttemptLaunch(clearinghouseClin, batchNum);
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.ClaimConnect)
{
if (ClaimConnect.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show("Upload successful.");
}
else
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + ClaimConnect.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.RECS)
{
if (!RECS.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Claim file created, but could not launch RECS client.") + "\r\n" + RECS.ErrorMessage);
//continue;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.Inmediata)
{
if (!Inmediata.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Claim file created, but could not launch Inmediata client.") + "\r\n" + Inmediata.ErrorMessage);
//continue;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.AOS) // added by SPK 7/13/05
{
if (!AOS.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Claim file created, but could not launch AOS Communicator.") + "\r\n" + AOS.ErrorMessage);
//continue;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.PostnTrack)
{
AttemptLaunch(clearinghouseClin, batchNum);
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.MercuryDE)
{
if (!MercuryDE.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + MercuryDE.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.ClaimX)
{
if (!ClaimX.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Claim file created, but encountered an error while launching ClaimX Client.") + ":\r\n" + ClaimX.ErrorMessage);
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.EmdeonMedical)
{
if (!EmdeonMedical.Launch(clearinghouseClin, batchNum, medType))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + EmdeonMedical.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.DentiCal)
{
if (!DentiCal.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + DentiCal.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.NHS)
{
if (!NHS.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + NHS.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.EDS)
{
if (!EDS.Launch(clearinghouseClin, messageText))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + EDS.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.Ramq)
{
if (!Ramq.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + Ramq.ErrorMessage);
return;
}
}
//----------------------------------------------------------------------------------------
//finally, mark the claims sent. (only if not Canadian)
EtransType etype = EtransType.ClaimSent;
if (clearinghouseClin.Eformat == ElectronicClaimFormat.Renaissance)
{
etype = EtransType.Claim_Ren;
}
//Canadians cannot send in batches (see above). RAMQ is performing a similar algorithm but the steps are in a different order in Ramq.cs.
if (clearinghouseClin.Eformat != ElectronicClaimFormat.Canadian && clearinghouseClin.Eformat != ElectronicClaimFormat.Ramq)
{
//Create the etransmessagetext that all claims in the batch will point to.
EtransMessageText etransMsgText = new EtransMessageText();
etransMsgText.MessageText = messageText;
EtransMessageTexts.Insert(etransMsgText);
for (int j = 0; j < queueItems.Count; j++)
{
Etrans etrans = Etranss.SetClaimSentOrPrinted(queueItems[j].ClaimNum, queueItems[j].PatNum,
clearinghouseClin.HqClearinghouseNum, etype, batchNum, Security.CurUser.UserNum);
etrans.EtransMessageTextNum = etransMsgText.EtransMessageTextNum;
Etranss.Update(etrans);
//Now we need to update our cache of claims to reflect the change that took place in the database above in Etranss.SetClaimSentOrPrinted()
queueItems[j].ClaimStatus = "S";
}
}
}
///<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);
}
