private void gridMain_CellDoubleClick(object sender, ODGridClickEventArgs e)
{
Etrans etrans = list[e.Row];
if (etrans.Etype == EtransType.Eligibility_CA)
{
FormEtransEdit formETE = new FormEtransEdit();
formETE.EtransCur = etrans;
formETE.ShowDialog();
}
else
{
string settingErrors271 = X271.ValidateSettings();
if (settingErrors271 != "")
{
MessageBox.Show(settingErrors271);
return;
}
bool isDependent = (etrans.PatNum != 0 && _subPatNum != etrans.PatNum);//Old rows will be 0, but when 0 then request was for subscriber.
Carrier carrierCur = Carriers.GetCarrier(_carrierNum);
FormEtrans270Edit formE = new FormEtrans270Edit(PatPlanNum, PlanNum, SubNum, isDependent, _subPatNum, carrierCur.IsCoinsuranceInverted);
formE.EtransCur = etrans;
formE.benList = BenList;
formE.ShowDialog();
}
FillGrid();
}
///<summary>Attempts to request benefits. If successful the 270 request is returned.
///Otherwise null is returned and the out error string will contain more information. Mimics FormInsPlan.butGetElectronic_Click().</summary>
public static Etrans TryInsVerifyRequest(InsVerify insVerify, InsPlan insPlan, Carrier carrier, InsSub insSub, out string error)
{
error = "";
Etrans etrans270Request = null;
Clearinghouse clearinghouseHq = Clearinghouses.GetDefaultEligibility();
if (clearinghouseHq == null)
{
error = "No clearinghouse is set as default.";
return(null);
}
if (!clearinghouseHq.CommBridge.In(EclaimsCommBridge.ClaimConnect, EclaimsCommBridge.EDS, EclaimsCommBridge.WebMD))
{
error = "So far, eligibility checks only work with ClaimConnect, EDS, WebMD (Emdeon Dental), and CDAnet.";
return(null);
}
error = X271.ValidateSettings();
if (error.IsNullOrEmpty())
{
Clearinghouse clearinghouse = Clearinghouses.OverrideFields(clearinghouseHq, insVerify.ClinicNum); //ClinicNum pulled from appointment.
try {
//Can return null, can throw exceptions
etrans270Request = x270Controller.RequestBenefits(clearinghouse, insPlan, insVerify.PatNum, carrier, insSub, out error);
}
catch (Exception ex) {
error = ex.Message;
}
}
return(etrans270Request);
}
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();
}
}
public static void SetupClass(TestContext testContext)
{
//Add anything here that you want to run once before the tests in this class run.
ProcedureCodeT.AddIfNotPresent("D0120");
ProcedureCodeT.AddIfNotPresent("D1110");
ProcedureCodeT.AddIfNotPresent("D0602");
ProcedureCodeT.AddIfNotPresent("D1206");
ProcedureCodes.RefreshCache(); //Refresh cache if the codes above were added
_x271 = new X271(Properties.Resources.x271Test);
}
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;
}
}
///<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();
}
///<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);
}
