public void Create810_4010Version()
{
var message = new Interchange(Convert.ToDateTime("1/4/99 15:32"), 35, false, '~', '*', '>')
{
SecurityInfoQualifier = "00",
InterchangeSenderIdQualifier = "30",
InterchangeSenderId = "943274043",
InterchangeReceiverIdQualifier = "16",
InterchangeReceiverId = "0069088189999"
};
var fg = message.AddFunctionGroup("IN", Convert.ToDateTime("1/4/1999 15:32"), 1);
fg.ApplicationSendersCode = "943274043TO";
fg.ApplicationReceiversCode = "0069088189999";
fg.ResponsibleAgencyCode = "X";
fg.VersionIdentifierCode = "004010";
var trans = fg.AddTransaction("810", "0001");
var big = trans.AddSegment(new TypedSegmentBIG());
big.BIG01_InvoiceDate = Convert.ToDateTime("10/14/1998");
big.BIG02_InvoiceNumber = "3662";
big.BIG07_TransactionTypeCode = "N6";
var billTo = trans.AddLoop(new TypedLoopN1());
billTo.N101_EntityIdentifierCodeEnum = EntityIdentifierCode.BillToParty;
billTo.N102_Name = "The Scheduling Coordinator, Inc";
var billToAddress = billTo.AddSegment(new TypedSegmentN3());
billToAddress.N301_AddressInformation = "53241 Hamilton Dr";
var billToLocale = billTo.AddSegment(new TypedSegmentN4());
billToLocale.N401_CityName = "Palo Alto";
billToLocale.N402_StateOrProvinceCode = "CA";
billToLocale.N403_PostalCode = "95622";
billToLocale.N404_CountryCode = "US";
var remitTo = trans.AddLoop(new TypedLoopN1());
remitTo.N101_EntityIdentifierCodeEnum = EntityIdentifierCode.PartyToReceiveCommercialInvoiceRemittance;
remitTo.N102_Name = "Bank of America- (Mkt and GMC)";
var remitToAddress = remitTo.AddSegment(new TypedSegmentN3());
remitToAddress.N301_AddressInformation = "1850 Gateway Boulevard";
var remitToLocale = remitTo.AddSegment(new TypedSegmentN4());
remitToLocale.N401_CityName = "Concord";
remitToLocale.N402_StateOrProvinceCode = "CA";
remitToLocale.N403_PostalCode = "94520";
remitToLocale.N404_CountryCode = "US";
var remitToRef1 = remitTo.AddSegment(new TypedSegmentREF());
remitToRef1.REF01_ReferenceIdQualifier = "11";
remitToRef1.REF02_ReferenceId = "1233626208";
var remitToRef2 = remitTo.AddSegment(new TypedSegmentREF());
remitToRef2.REF01_ReferenceIdQualifier = "01";
remitToRef2.REF02_ReferenceId = "026009593";
var itd = trans.AddSegment(new TypedSegmentITD());
itd.ITD01_TermsTypeCode = "03";
itd.ITD06_TermsNetDueDate = Convert.ToDateTime("10/20/1998");
var it1 = trans.AddLoop(new TypedLoopIT1());
it1.IT101_AssignedIdentification = "1";
it1.IT102_QuantityInvoiced = 1;
it1.IT103_UnitOrBasisForMeasurementCode = UnitOrBasisOfMeasurementCode.Each;
it1.IT104_UnitPrice = 2896035.3m;
var pid = it1.AddLoop(new TypedLoopPID());
pid.PID01_ItemDescriptionType = "X";
pid.PID05_Description = "RMR Scheduling Coordinator - Estimated RMR";
var tds = trans.AddSegment(new TypedSegmentTDS());
tds.TDS01_AmountN2 = 289603530;
var ctt = trans.AddSegment(new TypedSegmentCTT());
ctt.CTT01_NumberOfLineItems = 1;
var x12 = message.SerializeToX12(false);
Console.WriteLine(x12);
}
static void Main(string[] args)
{
string inputFilename = args[0];
string outputFilename = args[1];
string isaControlNumber = args.Length > 2 ? args[2] : "999";
string gsControlNumber = args.Length > 3 ? args[3] : "99";
var service = new X12AcknowledgmentService();
using (FileStream fs = new FileStream(inputFilename, FileMode.Open, FileAccess.Read))
{
using (X12StreamReader reader = new X12StreamReader(fs, Encoding.UTF8))
{
var firstTrans = reader.ReadNextTransaction();
if (reader.LastTransactionCode == "837")
{
if (reader.TransactionContainsSegment(firstTrans.Transactions[0], "SV2"))
service = new InstitutionalClaimAcknowledgmentService();
if (reader.TransactionContainsSegment(firstTrans.Transactions[0], "SV1"))
service = new X12AcknowledgmentService(new ProfessionalClaimSpecificationFinder());
}
}
}
using (FileStream fs = new FileStream(inputFilename, FileMode.Open, FileAccess.Read))
{
// Create aknowledgements and identify errors
var responses = service.AcknowledgeTransactions(fs);
// Change any acknowledgment codes here to reject transactions with errors
// CUSTOM BUSINESS LOGIC HERE
// Transform to outbound interchange for serialization
var interchange = new Interchange(DateTime.Now, int.Parse(isaControlNumber), true);
interchange.AuthorInfoQualifier = ConfigurationManager.AppSettings["AuthorInfoQualifier"];
interchange.AuthorInfo = ConfigurationManager.AppSettings["AuthorInfo"];
interchange.SecurityInfoQualifier = ConfigurationManager.AppSettings["SecurityInfoQualifier"];
interchange.SecurityInfo = ConfigurationManager.AppSettings["SecurityInfo"];
interchange.InterchangeSenderIdQualifier = ConfigurationManager.AppSettings["InterchangeSenderIdQualifier"];
interchange.InterchangeSenderId = ConfigurationManager.AppSettings["InterchangeSenderId"];
interchange.InterchangeReceiverIdQualifier = responses.First().SenderIdQualifier;
interchange.InterchangeReceiverId = responses.First().SenderId;
interchange.SetElement(12, "00501");
var group = interchange.AddFunctionGroup("FA", DateTime.Now, int.Parse(gsControlNumber));
group.ApplicationSendersCode = ConfigurationManager.AppSettings["InterchangeSenderId"];
group.VersionIdentifierCode = "005010X231A1";
group.Add999Transaction(responses);
// This is a demonstration example only, change true to false to create continous x12 without line feeds.
File.WriteAllText(outputFilename, interchange.SerializeToX12(true));
}
}
public void Acknowledge837ITest()
{
var service = new InstitutionalClaimAcknowledgmentService();
var responses = service.AcknowledgeTransactions(GetEdi("837I_4010_Batch1.txt"));
Assert.AreEqual(1, responses.Count);
var response = responses.First();
Assert.AreEqual("612200041", response.GroupControlNumber);
Assert.AreEqual(54, response.TransactionSetResponses.Count);
var interchange = new Interchange(DateTime.Now, 1, true);
var group = interchange.AddFunctionGroup("FA", DateTime.Now, 1);
group.VersionIdentifierCode = "005010X231A1";
group.Add999Transaction(responses);
Trace.WriteLine(interchange.SerializeToX12(true));
}
public void CreatePurchaseOrder850()
{
DateTime purcaseOrderDate = new DateTime(2010, 8, 17, 08, 50, 0);
Interchange interchange = new Interchange(purcaseOrderDate, 245, true)
{
InterchangeSenderIdQualifier = "01",
InterchangeSenderId = "828513080",
InterchangeReceiverIdQualifier = "01",
InterchangeReceiverId = "001903202U",
InterchangeDate = purcaseOrderDate,
};
interchange.SetElement(14, "0"); //No Aknowlegement is 0
FunctionGroup group = interchange.AddFunctionGroup("PO", purcaseOrderDate, 1, "005010X222");
group.ApplicationSendersCode = "828513080";
group.ApplicationReceiversCode = "001903202U";
group.Date = purcaseOrderDate;
group.ControlNumber = 245;
Transaction transaction = group.AddTransaction("850", "0001");
Segment bhtSegment = transaction.AddSegment("BEG");
bhtSegment.SetElement(1, "05");
bhtSegment.SetElement(2, "SA");
bhtSegment.SetElement(3, "S41000439");
bhtSegment.SetElement(5, "20100810");
bhtSegment = transaction.AddSegment("CUR");
bhtSegment.SetElement(1, "BY");
bhtSegment.SetElement(2, "USD");
bhtSegment = transaction.AddSegment("PER");
bhtSegment.SetElement(1, "IC");
bhtSegment.SetElement(2, "Doe,Jane");
bhtSegment.SetElement(8, "Doe,Jane");
var x12 = interchange.SerializeToX12(true);
System.Diagnostics.Trace.Write(x12);
}
public void Create837_5010Version()
{
var message = new Interchange(Convert.ToDateTime("01/01/03"), 000905, false)
{
InterchangeSenderIdQualifier = "ZZ",
InterchangeSenderId = "SUBMITTERS.ID",
InterchangeReceiverIdQualifier = "ZZ",
InterchangeReceiverId = "RECEIVERS.ID",
SecurityInfo = "SECRET",
SecurityInfoQualifier = "01",
};
message.SetElement(12, "00501");
message.SetElement(10, "1253");
message.SetElement(11, "^");
var group = message.AddFunctionGroup("HC", DateTime.Now, 1, "005010X222");
group.ApplicationSendersCode = "SENDER CODE";
group.ApplicationReceiversCode = "RECEIVER CODE";
group.Date = Convert.ToDateTime("12/31/1999");
group.ControlNumber = 1;
group.SetElement(5, "0802");
var transaction = group.AddTransaction("837", "0021");
transaction.SetElement(2, "0021");
transaction.SetElement(3, "005010X222");
var bhtSegment = transaction.AddSegment("BHT");
bhtSegment.SetElement(1, "0019");
bhtSegment.SetElement(2, "00");
bhtSegment.SetElement(3, "244579");
bhtSegment.SetElement(4, "20061015");
bhtSegment.SetElement(5, "1023");
bhtSegment.SetElement(6, "CH");
var submitterLoop = transaction.AddLoop(new TypedLoopNM1("41")); //submitter identifier code
submitterLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
submitterLoop.NM103_NameLastOrOrganizationName = "PREMIER BILLING SERVICE";
submitterLoop.NM104_NameFirst = "";
submitterLoop.NM109_IdCode = "TGJ23";
submitterLoop.NM108_IdCodeQualifier = "46";
var perSegment = submitterLoop.AddSegment(new TypedSegmentPER());
perSegment.PER01_ContactFunctionCode = "IC"; //information contact function code
perSegment.PER02_Name = "JERRY";
perSegment.PER03_CommunicationNumberQualifier = CommunicationNumberQualifer.Telephone;
perSegment.PER04_CommunicationNumber = "3055552222";
perSegment.PER05_CommunicationNumberQualifier = CommunicationNumberQualifer.TelephoneExtension;
perSegment.PER06_CommunicationNumber = "231";
var submitterLoop2 = transaction.AddLoop(new TypedLoopNM1("40"));
submitterLoop2.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
submitterLoop2.NM103_NameLastOrOrganizationName = "KEY INSURANCE COMPANY";
submitterLoop2.NM104_NameFirst = "";
submitterLoop2.NM109_IdCode = "66783JJT";
submitterLoop2.NM108_IdCodeQualifier = "46";
var provider2000AHLoop = transaction.AddHLoop("1", "20", true); //*********HL 1 ******
var prvSegment = provider2000AHLoop.AddSegment(new TypedSegmentPRV()); //Specialty Segment
prvSegment.PRV01_ProviderCode = "BI";
prvSegment.PRV02_ReferenceIdQualifier = "PXC";
prvSegment.PRV03_ProviderTaxonomyCode = "203BF0100Y";
var provider2010ACLoop = provider2000AHLoop.AddLoop(new TypedLoopNM1("85"));
provider2010ACLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
provider2010ACLoop.NM103_NameLastOrOrganizationName = "BEN KILDARE SERVICE";
provider2010ACLoop.NM109_IdCode = "9876543210";
provider2010ACLoop.NM108_IdCodeQualifier = "XX";
var provider2010AC_N3Segment = provider2010ACLoop.AddSegment(new TypedSegmentN3());
provider2010AC_N3Segment.N301_AddressInformation = "234 SEAWAY ST";
var provider2010AC_N4Segment = provider2010ACLoop.AddSegment(new TypedSegmentN4());
provider2010AC_N4Segment.N401_CityName = "MIAMI";
provider2010AC_N4Segment.N402_StateOrProvinceCode = "FL";
provider2010AC_N4Segment.N403_PostalCode = "33111";
var provider2010AC_REFSegment = provider2010ACLoop.AddSegment(new TypedSegmentREF());
provider2010AC_REFSegment.REF01_ReferenceIdQualifier = "EI";
provider2010AC_REFSegment.REF02_ReferenceId = "587654321";
var provider2010ACLoop2 = provider2000AHLoop.AddLoop(new TypedLoopNM1("87"));
provider2010ACLoop2.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
var provider2010AC_N3Segment2 = provider2010ACLoop2.AddSegment(new TypedSegmentN3());
provider2010AC_N3Segment2.N301_AddressInformation = "2345 OCEAN BLVD";
var provider2010AC_N4Segment2 = provider2010ACLoop2.AddSegment(new TypedSegmentN4());
provider2010AC_N4Segment2.N401_CityName = "MAIMI"; // MISSPELLED IN COMPARETO DOC
provider2010AC_N4Segment2.N402_StateOrProvinceCode = "FL";
provider2010AC_N4Segment2.N403_PostalCode = "33111";
var subscriber2000BHLoop = provider2000AHLoop.AddHLoop("2", "22", true); // **** HL 2 ******
var segmentSBR = subscriber2000BHLoop.AddSegment(new TypedSegmentSBR());
segmentSBR.SBR01_PayerResponsibilitySequenceNumberCode = "P";
segmentSBR.SBR03_PolicyOrGroupNumber = "2222-SJ";
segmentSBR.SBR09_ClaimFilingIndicatorCode = "CI";
var subscriberName2010BALoop = subscriber2000BHLoop.AddLoop(new TypedLoopNM1("IL"));
subscriberName2010BALoop.NM102_EntityTypeQualifier = EntityTypeQualifier.Person;
subscriberName2010BALoop.NM104_NameFirst = "JANE";
subscriberName2010BALoop.NM103_NameLastOrOrganizationName = "SMITH";
subscriberName2010BALoop.NM109_IdCode = "JS00111223333";
subscriberName2010BALoop.NM108_IdCodeQualifier = "MI";
var subscriber_DMGSegment = subscriberName2010BALoop.AddSegment(new TypedSegmentDMG());
subscriber_DMGSegment.DMG01_DateTimePeriodFormatQualifier = "D8";
subscriber_DMGSegment.DMG02_DateOfBirth = DateTime.Parse("5/1/1943");
subscriber_DMGSegment.DMG03_Gender = Gender.Female;
var subscriberName2010BALoop2 = subscriber2000BHLoop.AddLoop(new TypedLoopNM1("PR"));
subscriberName2010BALoop2.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
subscriberName2010BALoop2.NM103_NameLastOrOrganizationName = "KEY INSURANCE COMPANY";
subscriberName2010BALoop2.NM108_IdCodeQualifier = "PI";
subscriberName2010BALoop2.NM109_IdCode = "999996666";
var refSegment2 = subscriberName2010BALoop2.AddSegment(new TypedSegmentREF());
refSegment2.REF01_ReferenceIdQualifier = "G2";
refSegment2.REF02_ReferenceId = "KA6663";
var HL3Loop = subscriber2000BHLoop.AddHLoop("3", "23", false); // **** HL 3 ******
var HL3PATSegment = HL3Loop.AddSegment(new TypedSegmentPAT());
HL3PATSegment.PAT01_IndividualRelationshipCode = "19";
var HL3NM1Segment = HL3Loop.AddLoop(new TypedLoopNM1("QC"));
HL3NM1Segment.NM102_EntityTypeQualifier = EntityTypeQualifier.Person;
HL3NM1Segment.NM104_NameFirst = "TED";
HL3NM1Segment.NM103_NameLastOrOrganizationName = "SMITH";
// add N3 and N4 segments under the above NM1 loop
var HL3NM1_N3_Segment = HL3NM1Segment.AddSegment(new TypedSegmentN3());
HL3NM1_N3_Segment.N301_AddressInformation = "236 N MAIN ST";
var HL3NM1_N4_Segment = HL3NM1Segment.AddSegment(new TypedSegmentN4());
HL3NM1_N4_Segment.N401_CityName = "MIAMI";
HL3NM1_N4_Segment.N402_StateOrProvinceCode = "FL";
HL3NM1_N4_Segment.N403_PostalCode = "33413";
var HL3NM1_DMG_Segment = HL3NM1Segment.AddSegment(new TypedSegmentDMG());
HL3NM1_DMG_Segment.DMG01_DateTimePeriodFormatQualifier = "D8";
HL3NM1_DMG_Segment.DMG02_DateOfBirth = Convert.ToDateTime("5/1/1973");
HL3NM1_DMG_Segment.DMG03_Gender = Gender.Male;
var claim2300Loop = HL3Loop.AddLoop(new TypedLoopCLM());
claim2300Loop.CLM01_PatientControlNumber = "26463774";
claim2300Loop.CLM02_TotalClaimChargeAmount = Convert.ToDecimal(100);
claim2300Loop.CLM05._1_FacilityCodeValue = "11";
claim2300Loop.CLM05._2_FacilityCodeQualifier = "B";
claim2300Loop.CLM05._3_ClaimFrequencyTypeCode = "1";
claim2300Loop.CLM06_ProviderOrSupplierSignatureIndicator = true;
claim2300Loop.CLM07_ProviderAcceptAssignmentCode = "A";
claim2300Loop.CLM08_BenefitsAssignmentCerficationIndicator = "Y";
claim2300Loop.CLM09_ReleaseOfInformationCode = "I";
var refSegment = claim2300Loop.AddSegment(new TypedSegmentREF());
refSegment.REF01_ReferenceIdQualifier = "D9";
refSegment.REF02_ReferenceId = "17312345600006351";
var hiSegment = claim2300Loop.AddSegment(new TypedSegmentHI());
hiSegment.HI01_HealthCareCodeInformation = "BK:0340";
hiSegment.HI02_HealthCareCodeInformation = "BF:V7389";
var lxLoop = claim2300Loop.AddLoop(new TypedLoopLX("LX"));
lxLoop.LX01_AssignedNumber = "1";
var sv1Segment = lxLoop.AddSegment(new TypedSegmentSV1());
sv1Segment.SV101_CompositeMedicalProcedure = "HC:99213";
sv1Segment.SV102_MonetaryAmount = "40";
sv1Segment.SV103_UnitBasisMeasCode = "UN";
sv1Segment.SV104_Quantity = "1";
sv1Segment.SV107_CompDiagCodePoint = "1";
var dtpSegment = lxLoop.AddSegment(new TypedSegmentDTP());
dtpSegment.DTP01_DateTimeQualifier = DTPQualifier.Service;
dtpSegment.DTP02_DateTimePeriodFormatQualifier = DTPFormatQualifier.CCYYMMDD;
DateTime theDate = DateTime.ParseExact("20061003", "yyyyMMdd", null);
dtpSegment.DTP03_Date = new DateTimePeriod(theDate);
var lxLoop2 = claim2300Loop.AddLoop(new TypedLoopLX("LX"));
lxLoop2.LX01_AssignedNumber = "2";
var sv1Segment2 = lxLoop2.AddSegment(new TypedSegmentSV1());
sv1Segment2.SV101_CompositeMedicalProcedure = "HC:87070";
sv1Segment2.SV102_MonetaryAmount = "15";
sv1Segment2.SV103_UnitBasisMeasCode = "UN";
sv1Segment2.SV104_Quantity = "1";
sv1Segment2.SV107_CompDiagCodePoint = "1";
var dtpSegment2 = lxLoop2.AddSegment(new TypedSegmentDTP());
dtpSegment2.DTP01_DateTimeQualifier = DTPQualifier.Service;
dtpSegment2.DTP02_DateTimePeriodFormatQualifier = DTPFormatQualifier.CCYYMMDD;
DateTime theDate2 = DateTime.ParseExact("20061003", "yyyyMMdd", null);
dtpSegment2.DTP03_Date = new DateTimePeriod(theDate2);
var lxLoop3 = claim2300Loop.AddLoop(new TypedLoopLX("LX"));
lxLoop3.LX01_AssignedNumber = "3";
var sv1Segment3 = lxLoop3.AddSegment(new TypedSegmentSV1());
sv1Segment3.SV101_CompositeMedicalProcedure = "HC:99214";
sv1Segment3.SV102_MonetaryAmount = "35";
sv1Segment3.SV103_UnitBasisMeasCode = "UN";
sv1Segment3.SV104_Quantity = "1";
sv1Segment3.SV107_CompDiagCodePoint = "2";
var dtpSegment3 = lxLoop3.AddSegment(new TypedSegmentDTP());
dtpSegment3.DTP01_DateTimeQualifier = DTPQualifier.Service;
dtpSegment3.DTP02_DateTimePeriodFormatQualifier = DTPFormatQualifier.CCYYMMDD;
DateTime theDate3 = DateTime.ParseExact("20061010", "yyyyMMdd", null);
dtpSegment3.DTP03_Date = new DateTimePeriod(theDate3);
var lxLoop4 = claim2300Loop.AddLoop(new TypedLoopLX("LX"));
lxLoop4.LX01_AssignedNumber = "4";
var sv1Segment4 = lxLoop4.AddSegment(new TypedSegmentSV1());
sv1Segment4.SV101_CompositeMedicalProcedure = "HC:86663";
sv1Segment4.SV102_MonetaryAmount = "10";
sv1Segment4.SV103_UnitBasisMeasCode = "UN";
sv1Segment4.SV104_Quantity = "1";
sv1Segment4.SV107_CompDiagCodePoint = "2";
var dtpSegment4 = lxLoop4.AddSegment(new TypedSegmentDTP());
dtpSegment4.DTP01_DateTimeQualifier = DTPQualifier.Service;
dtpSegment4.DTP02_DateTimePeriodFormatQualifier = DTPFormatQualifier.CCYYMMDD_CCYYMMDD;
DateTime theDate4 = DateTime.ParseExact("20061010", "yyyyMMdd", null);
dtpSegment4.DTP03_Date = new DateTimePeriod(theDate4, DateTime.ParseExact("20061025", "yyyyMMdd", null));
var x12 = message.SerializeToX12(true);
Assert.AreEqual(new StreamReader(Extensions.GetEdi("INS._837P._5010.Example1_HealthInsurance.txt")).ReadToEnd(), message.SerializeToX12(true));
//Trace.Write(new StreamReader(Extensions.GetEdi("INS._837P._5010.Example1_HealthInsurance.txt")).ReadToEnd());
//Trace.Write(x12);
}
/// <summary>
/// Generates the health care claim837 professional.
/// </summary>
/// <returns>A _healthCareClaim837Professional message.</returns>
public virtual HealthCareClaim837Professional GenerateHealthCareClaim837Professional( )
{
var healthCareClaim837ProfessionalFactory = IoC.CurrentContainer.Resolve<IHealthCareClaim837ProfessionalFactory> ();
var currenDateTime = DateTime.Now;
var autoIncrementedHierarchicalIDNumber = 1; // NOTE: The first HL01 within each ST-SE envelope must begin with "1".
var interchangeCopntrolNumber = GetInterchangeControlNumber ( Key );
// Interchange.
var message = new Interchange (
currenDateTime,
interchangeCopntrolNumber,
false, // TODO: Use web.config to set InterchangeUsageIndicator.
PayorType.HealthCareClaim837Setup.X12Delimiters.SegmentDelimiter,
PayorType.HealthCareClaim837Setup.X12Delimiters.ElementDelimiter,
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter )
{
InterchangeSenderIdQualifier = InterchangeIDQualifier.MutuallyDefined,
InterchangeSenderId = PayorType.HealthCareClaim837Setup.InterchangeSenderNumber,
InterchangeReceiverIdQualifier = InterchangeIDQualifier.MutuallyDefined,
InterchangeReceiverId = PayorType.HealthCareClaim837Setup.InterchangeReceiverNumber,
};
message.SetElement ( 11, PayorType.HealthCareClaim837Setup.X12Delimiters.RepetitionDelimiter.ToString ( CultureInfo.InvariantCulture ) );
message.SetElement ( 12, InterchangeVersionControlNumber.ApprovedForPublicationByASCX12ProceduresReviewBoardThroughOctober2003 );
message.SetElement ( 14, AcknowledgmentRequested.InterchangeAcknowledgmentRequested );
// Functional group.
var group = message.AddFunctionGroup ( FunctionalIdentifierCode.HealthCareClaim, currenDateTime, interchangeCopntrolNumber, ImplementationConventionReference.Version5010);
group.ApplicationSendersCode = PayorType.HealthCareClaim837Setup.InterchangeSenderNumber;
group.ApplicationReceiversCode = PayorType.HealthCareClaim837Setup.InterchangeReceiverNumber;
group.ResponsibleAgencyCode = ResponsibleAgencyCode.AccreditedStandardsCommitteeX12;
var interchangeControlNumberString = interchangeCopntrolNumber.ToString ( CultureInfo.InvariantCulture );
var transactionControlIdentifier = interchangeControlNumberString.Length < 4
? interchangeControlNumberString.PadLeft ( 4, '0' )
: interchangeControlNumberString;
// Transaction set.
var transaction = group.AddTransaction ( TransactionSetIdentifierCode.HealthCareClaim, transactionControlIdentifier );
transaction.SetElement ( 3, ImplementationConventionReference.Version5010 );
// Beginning of hierarchical transaction.
var bhtSegment = transaction.AddSegment ( BeginningOfHierarchicalTransaction );
bhtSegment.SetElement ( 1, HierarchicalStructureCode.InformationSourceOrSubscriberOrDependent );
bhtSegment.SetElement ( 2, TransactionSetPurposeCode.Original );
bhtSegment.SetElement ( 3, BatchControlNumber.ToString ( CultureInfo.InvariantCulture ) );
bhtSegment.SetElement ( 4, currenDateTime.Date.ToString ( "yyyyMMdd" ) );
bhtSegment.SetElement ( 5, currenDateTime.ToString ( "HHmm" ) );
bhtSegment.SetElement ( 6, TransactionTypeCode.Chargeable );
// Submitter name.
var submitterLoop = transaction.AddLoop ( new TypedLoopNM1 ( EntityIdentifierCode.Submitter ) );
submitterLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
submitterLoop.NM103_NameLastOrOrganizationName = PayorType.BillingOffice.Agency.AgencyProfile.AgencyName.LegalName;
submitterLoop.NM108_IdCodeQualifier = IdentificationCodeQualifier.ElectronicTransmitterIdentificationNumber;
submitterLoop.NM109_IdCode = PayorType.BillingOffice.ElectronicTransmitterIdentificationNumber;
// Submitter EDI contact information.
var perSegment = submitterLoop.AddSegment ( new TypedSegmentPER () );
perSegment.PER01_ContactFunctionCode = ContactFunctionCode.InfromationContact;
// NOTE: PER02_Name is situational. But, as we have provided a nonperson entity for submitter, this field is required.
perSegment.PER02_Name = PayorType.BillingOffice.AdministratorStaff.StaffProfile.StaffName.Complete;
perSegment.PER03_CommunicationNumberQualifier = CommunicationNumberQualifer.Telephone;
var staffPhone =
PayorType.BillingOffice.AdministratorStaff.PhoneNumbers.FirstOrDefault (
phoneNumber => phoneNumber.StaffPhoneType.WellKnownName == StaffPhoneType.Work );
if ( staffPhone == null || staffPhone.Phone == null )
{
throw new ArgumentException (
string.Format (
"Unable to find '{0}' staff work phone number",
PayorType.BillingOffice.AdministratorStaff.StaffProfile.StaffName.Complete ) );
}
perSegment.PER04_CommunicationNumber = staffPhone.Phone.PhoneNumber.RemoveNonAlphanumericChar();
if ( !string.IsNullOrEmpty ( staffPhone.Phone.PhoneExtensionNumber ) )
{
perSegment.PER05_CommunicationNumberQualifier = CommunicationNumberQualifer.TelephoneExtension;
perSegment.PER06_CommunicationNumber = staffPhone.Phone.PhoneExtensionNumber;
}
// Receiver name.
var receiverLoop = transaction.AddLoop ( new TypedLoopNM1 ( EntityIdentifierCode.Receiver ) );
receiverLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
receiverLoop.NM103_NameLastOrOrganizationName = PayorType.Name;
receiverLoop.NM108_IdCodeQualifier = IdentificationCodeQualifier.ElectronicTransmitterIdentificationNumber;
receiverLoop.NM109_IdCode = PayorType.SubmitterIdentifier;
// Billing provider hierarchical level. ***** HL1 *****
var provider2000AHierachicalLoop = transaction.AddHLoop (
autoIncrementedHierarchicalIDNumber.ToString ( CultureInfo.InvariantCulture ),
HierarchicalLevelCode.InformationSource,
HierarchicalChildCode.AdditionalSubordinateHLDataSegmentInThisHierarchicalStructure );
// Billing provide specialty information.
var prvSegment = provider2000AHierachicalLoop.AddSegment ( new TypedSegmentPRV () );
prvSegment.PRV01_ProviderCode = ProviderCode.Billing;
prvSegment.PRV02_ReferenceIdQualifier = ReferenceIdentificationQualifier.HealthCareProviderTaxonomyCode;
prvSegment.PRV03_ProviderTaxonomyCode = ProviderTaxonomyCode;
// Billing provider Name
var provider2010AaLoop = provider2000AHierachicalLoop.AddLoop ( new TypedLoopNM1 ( EntityIdentifierCode.BillingProvider ) );
provider2010AaLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
provider2010AaLoop.NM103_NameLastOrOrganizationName = PayorType.BillingOffice.Agency.AgencyProfile.AgencyName.LegalName;
provider2010AaLoop.NM108_IdCodeQualifier = IdentificationCodeQualifier.CentersForMedicareAndMedicaidServicesNationalProviderIdentifier;
var agencyNpi =
PayorType.BillingOffice.Agency.AgencyIdentifiers.FirstOrDefault (
identifier => identifier.AgencyIdentifierType.WellKnownName == AgencyIdentifierType.Npi );
if ( agencyNpi == null || agencyNpi.IdentifierNumber == null )
{
throw new ArgumentException (
string.Format (
"Unable to find '{0}' agency NPI identifier number", PayorType.BillingOffice.Agency.AgencyProfile.AgencyName.LegalName ) );
}
provider2010AaLoop.NM109_IdCode = agencyNpi.IdentifierNumber;
var agencyBillingAddressAndPhone =
PayorType.BillingOffice.Agency.AddressesAndPhones.FirstOrDefault (
address => address.AgencyAddress.AgencyAddressType.WellKnownName == AgencyAddressType.Billing );
if ( agencyBillingAddressAndPhone == null || agencyBillingAddressAndPhone.AgencyAddress == null )
{
throw new ArgumentException (
string.Format (
"Unable to find '{0}' agency Billing address", PayorType.BillingOffice.Agency.AgencyProfile.AgencyName.LegalName ) );
}
// Billing provider address.
var provider2010AaN3Segment = provider2010AaLoop.AddSegment ( new TypedSegmentN3 () );
provider2010AaN3Segment.N301_AddressInformation = agencyBillingAddressAndPhone.AgencyAddress.Address.FirstStreetAddress
+
( string.IsNullOrWhiteSpace (
agencyBillingAddressAndPhone.AgencyAddress.Address.SecondStreetAddress )
? string.Empty
: " "
+ agencyBillingAddressAndPhone.AgencyAddress.Address.SecondStreetAddress );
// Billing provider City,State,Zip code
var provider2010AaN4Segment = provider2010AaLoop.AddSegment ( new TypedSegmentN4 () );
provider2010AaN4Segment.N401_CityName = agencyBillingAddressAndPhone.AgencyAddress.Address.CityName;
provider2010AaN4Segment.N402_StateOrProvinceCode = agencyBillingAddressAndPhone.AgencyAddress.Address.StateProvince.ShortName;
provider2010AaN4Segment.N403_PostalCode = agencyBillingAddressAndPhone.AgencyAddress.Address.PostalCode.Code;
var agencyFederalTaxID =
PayorType.BillingOffice.Agency.AgencyIdentifiers.FirstOrDefault (
identifier => identifier.AgencyIdentifierType.WellKnownName == AgencyIdentifierType.FederalTaxId );
if ( agencyFederalTaxID == null || agencyFederalTaxID.IdentifierNumber == null )
{
throw new ArgumentException (
string.Format (
"Unable to find '{0}' agency Federal Tax ID", PayorType.BillingOffice.Agency.AgencyProfile.AgencyName.LegalName ) );
}
// Billing provider - tax identification
var provider2010AaRefSegment = provider2010AaLoop.AddSegment ( new TypedSegmentREF () );
provider2010AaRefSegment.REF01_ReferenceIdQualifier = ReferenceIdentificationQualifier.EmployersIdentificationNumber;
provider2010AaRefSegment.REF02_ReferenceId = agencyFederalTaxID.IdentifierNumber;
//If it is the same as Billing provider, no need.
/*
var provider2010ABLoop = provider2000AHierachicalLoop.AddLoop ( new TypedLoopNM1 ( EntityIdentifierCode.PayToProvider ) );
provider2010ABLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
// NOTE: Pay-To address is same as Billing provider address ie., same N3 and N4 segments.
provider2010ABLoop.AddSegment ( provider2010AAN3Segment );
provider2010ABLoop.AddSegment ( provider2010AAN4Segment );
*/
var claimDictionary = GroupClaimsByPrimaryPayorCoverage ( Claims );
//TODO: needs confirm if this loop pulling the correct data *** need bill every insurance or just the primary???
foreach (var keyValuePair in claimDictionary)
{
var payorCoverage = keyValuePair.Key;
var claimList = keyValuePair.Value;
var isPatientTheSubscriber =
payorCoverage.PayorSubscriber.PayorSubscriberRelationshipType.WellKnownName.Equals ( PayorSubscriberRelationshipType.Self );
autoIncrementedHierarchicalIDNumber++;
// Subscriber hierarchical level. **** HL 2 ******
var subscriber2000BHierarchicalLoop =
provider2000AHierachicalLoop.AddHLoop (
autoIncrementedHierarchicalIDNumber.ToString ( CultureInfo.InvariantCulture ),
HierarchicalLevelCode.Subscriber,
isPatientTheSubscriber
? HierarchicalChildCode.NoSubordinateHLSegmentInThisHierarchicalStructure
: HierarchicalChildCode.AdditionalSubordinateHLDataSegmentInThisHierarchicalStructure );
// Subscriber information.
var sbrSegment = subscriber2000BHierarchicalLoop.AddSegment ( new TypedSegmentSBR () );
sbrSegment.SBR01_PayerResponsibilitySequenceNumberCode = payorCoverage.PayorCoverageType.ShortName;
if ( isPatientTheSubscriber )
{
sbrSegment.SBR02_IndividualRelationshipCode = payorCoverage.PayorSubscriber.PayorSubscriberRelationshipType.ShortName;
}
// Subscriber Name
var subscriberName2010BaLoop =
subscriber2000BHierarchicalLoop.AddLoop ( new TypedLoopNM1 ( EntityIdentifierCode.InsuredOrSubscriber ) );
subscriberName2010BaLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.Person;
subscriberName2010BaLoop.NM104_NameFirst = payorCoverage.PayorSubscriber.Name.First;
subscriberName2010BaLoop.NM103_NameLastOrOrganizationName = payorCoverage.PayorSubscriber.Name.Last;
subscriberName2010BaLoop.NM108_IdCodeQualifier = IdentificationCodeQualifier.MemberIdentificationNumber;
subscriberName2010BaLoop.NM109_IdCode = payorCoverage.MemberNumber;
if ( isPatientTheSubscriber )
{
// Subscriber address
var provider2010BaN3Segment = subscriberName2010BaLoop.AddSegment ( new TypedSegmentN3 () );
provider2010BaN3Segment.N301_AddressInformation = payorCoverage.PayorSubscriber.Address.FirstStreetAddress +
( string.IsNullOrWhiteSpace (
payorCoverage.PayorSubscriber.Address.SecondStreetAddress )
? string.Empty
: " "
+ payorCoverage.PayorSubscriber.Address.SecondStreetAddress );
// Subscriber city,state,postal code.
var provider2010BaN4Segment = subscriberName2010BaLoop.AddSegment ( new TypedSegmentN4 () );
provider2010BaN4Segment.N401_CityName = payorCoverage.PayorSubscriber.Address.CityName;
provider2010BaN4Segment.N402_StateOrProvinceCode = payorCoverage.PayorSubscriber.Address.StateProvince.ShortName;
provider2010BaN4Segment.N403_PostalCode = payorCoverage.PayorSubscriber.Address.PostalCode.Code;
// Demographic information
var subscriberDmgSegment = subscriberName2010BaLoop.AddSegment ( new TypedSegmentDMG () );
subscriberDmgSegment.DMG01_DateTimePeriodFormatQualifier = DateTimePeriodFormatQualifier.DateExpressedAsCCYYMMDD;
subscriberDmgSegment.DMG02_DateOfBirth = payorCoverage.PayorSubscriber.BirthDate;
subscriberDmgSegment.DMG03_Gender =
ConvertToGenderCodeFromAdministrativeGender ( payorCoverage.PayorSubscriber.AdministrativeGender );
}
// Loop 2010BB - Payer Name.
var subscriberName2010BbLoop = subscriber2000BHierarchicalLoop.AddLoop ( new TypedLoopNM1 ( EntityIdentifierCode.Payer ) );
subscriberName2010BbLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
subscriberName2010BbLoop.NM103_NameLastOrOrganizationName = payorCoverage.Payor.Name;
subscriberName2010BbLoop.NM108_IdCodeQualifier = IdentificationCodeQualifier.PayorIdentification;
subscriberName2010BbLoop.NM109_IdCode = payorCoverage.Payor.ElectronicTransmitterIdentificationNumber;
// TODO: Kate needs to get back on this.
HierarchicalLoop parentHierarchicalLoop = subscriber2000BHierarchicalLoop;
if ( !isPatientTheSubscriber )
{
autoIncrementedHierarchicalIDNumber++;
// PATIENT HIERARCHICAL LEVEL Loop Repeat: >1 **** HL 3 ******
var patientDetailLoop2000CLoop =
subscriber2000BHierarchicalLoop.AddHLoop (
autoIncrementedHierarchicalIDNumber.ToString ( CultureInfo.InvariantCulture ),
HierarchicalLevelCode.Dependent,
HierarchicalChildCode.NoSubordinateHLSegmentInThisHierarchicalStructure );
parentHierarchicalLoop = patientDetailLoop2000CLoop;
var hl3PatSegment = patientDetailLoop2000CLoop.AddSegment ( new TypedSegmentPAT () );
hl3PatSegment.PAT01_IndividualRelationshipCode =
payorCoverage.PayorSubscriber.PayorSubscriberRelationshipType.ShortName;
var hl3Nm1Segment = patientDetailLoop2000CLoop.AddLoop ( new TypedLoopNM1 ( EntityIdentifierCode.Patient ) );
hl3Nm1Segment.NM102_EntityTypeQualifier = EntityTypeQualifier.Person;
hl3Nm1Segment.NM104_NameFirst = payorCoverage.PatientAccount.Name.First; //TODO: confirm it comes from primaryPayorCoverage.PatientAccount, not from Claim.PatientAccount, the later make more sense
hl3Nm1Segment.NM103_NameLastOrOrganizationName = payorCoverage.PatientAccount.Name.Last;
var hl3Nm1N3Segment = hl3Nm1Segment.AddSegment ( new TypedSegmentN3 () );
hl3Nm1N3Segment.N301_AddressInformation = payorCoverage.PatientAccount.HomeAddress.FirstStreetAddress
+
( string.IsNullOrWhiteSpace (
payorCoverage.PatientAccount.HomeAddress.SecondStreetAddress )
? string.Empty
: " " + payorCoverage.PatientAccount.HomeAddress.SecondStreetAddress );
var hl3Nm1N4Segment = hl3Nm1Segment.AddSegment ( new TypedSegmentN4 () );
hl3Nm1N4Segment.N401_CityName = payorCoverage.PatientAccount.HomeAddress.CityName;
hl3Nm1N4Segment.N402_StateOrProvinceCode = payorCoverage.PatientAccount.HomeAddress.StateProvince.ShortName;
hl3Nm1N4Segment.N403_PostalCode = payorCoverage.PatientAccount.HomeAddress.PostalCode.Code;
var hl3Nm1DmgSegment = hl3Nm1Segment.AddSegment ( new TypedSegmentDMG () );
hl3Nm1DmgSegment.DMG01_DateTimePeriodFormatQualifier = DateTimePeriodFormatQualifier.DateExpressedAsCCYYMMDD;
hl3Nm1DmgSegment.DMG02_DateOfBirth = payorCoverage.PatientAccount.BirthDate;
hl3Nm1DmgSegment.DMG03_Gender =
ConvertToGenderCodeFromAdministrativeGender ( payorCoverage.PatientAccount.AdministrativeGender );
}
// 2300 Claim Information loop repeat 100
// LX loop repeat 50 => total 5000 claims in a HCC837 message or a Subscriber HL? ( seems the later make more sense)
// TODO: confirm it with Kate and how to handle it if exceed the max loop repeat
foreach ( var claim in claimList )
{
var claim2300Loop = parentHierarchicalLoop.AddLoop ( new TypedLoopCLM () ); // Claim 2300 loop: repeat 100
claim2300Loop.CLM01_PatientControlNumber = claim.Key.ToString ( CultureInfo.InvariantCulture );
claim2300Loop.CLM02_TotalClaimChargeAmount = decimal.Parse ( X12Utility.ConvertToDecimalString ( claim.ChargeAmount.Amount ) );
claim2300Loop.CLM05._1_FacilityCodeValue = PlaceOfServiceCode.Office;
claim2300Loop.CLM05._2_FacilityCodeQualifier = FacilityCodeQualifier.PlaceOfServiceCodesForProfessionalOrDentalService;
claim2300Loop.CLM05._3_ClaimFrequencyTypeCode = ClaimFrequencyTypeCode.Original;
claim2300Loop.CLM06_ProviderOrSupplierSignatureIndicator = YesOrNoConditionResponseCode.YesIndicator;
claim2300Loop.CLM07_ProviderAcceptAssignmentCode = ProviderAcceptAssignementCode.Assigned;
claim2300Loop.CLM08_BenefitsAssignmentCerficationIndicator = YesOrNoConditionResponseCode.Yes;
claim2300Loop.CLM09_ReleaseOfInformationCode = ReleaseOfInformationCode.Yes;
// TODO: diagnosis code -- Diagnosis is associated with Claim Line Item
// List the principal Dx with BK and others with BF, like HI✽BK:8901✽BF:87200✽BF:5559~, up to 12 diagnosis
// assume the 1st Dx is the principal Dx
var hiSegment = claim2300Loop.AddSegment ( new TypedSegmentHI () );
var index = 0;
foreach (var claimLineItem in claim.ClaimLineItems)
{
index++;
if (index == 1)
{
hiSegment.HI01_HealthCareCodeInformation =
X12Utility.BuildCompositeElement (
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMPrincipleDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode );
}
else if (index == 2)
{
hiSegment.HI02_HealthCareCodeInformation =
X12Utility.BuildCompositeElement(
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode);
}
else if (index == 3)
{
hiSegment.HI03_HealthCareCodeInformation =
X12Utility.BuildCompositeElement(
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode);
}
else if (index == 4)
{
hiSegment.HI04_HealthCareCodeInformation =
X12Utility.BuildCompositeElement(
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode);
}
else if (index == 5)
{
hiSegment.HI05_HealthCareCodeInformation =
X12Utility.BuildCompositeElement(
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode);
}
else if (index == 6)
{
hiSegment.HI06_HealthCareCodeInformation =
X12Utility.BuildCompositeElement(
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode);
}
else if (index == 7)
{
hiSegment.HI07_HealthCareCodeInformation =
X12Utility.BuildCompositeElement(
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode);
}
else if (index == 8)
{
hiSegment.HI08_HealthCareCodeInformation =
X12Utility.BuildCompositeElement(
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode);
}
else if (index == 9)
{
hiSegment.HI09_HealthCareCodeInformation =
X12Utility.BuildCompositeElement(
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode);
}
else if (index == 10)
{
hiSegment.HI10_HealthCareCodeInformation =
X12Utility.BuildCompositeElement(
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode);
}
else if (index == 11)
{
hiSegment.HI11_HealthCareCodeInformation =
X12Utility.BuildCompositeElement(
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode);
}
else if (index == 12)
{
hiSegment.HI12_HealthCareCodeInformation =
X12Utility.BuildCompositeElement(
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
CodeListQualifierCode.ICD9CMDiagnostics,
claimLineItem.Diagnosis.CodedConceptCode);
}
}
var autoIncrementedServiceLineNumber = 0;
foreach ( var claimLineItem in claim.ClaimLineItems )
{
autoIncrementedServiceLineNumber++;
var lxLoop = claim2300Loop.AddLoop ( new TypedLoopLX ( string.Empty ) ); // LX loop repeat: 50
lxLoop.LX01_AssignedNumber = autoIncrementedServiceLineNumber.ToString ( CultureInfo.InvariantCulture );
var sv1Segment = lxLoop.AddSegment ( new TypedSegmentSV1 () );
sv1Segment.SV101_CompositeMedicalProcedure =
X12Utility.BuildCompositeElement (
PayorType.HealthCareClaim837Setup.X12Delimiters.CompositeDelimiter,
ProductOrServiceIDQualifier.HCPCS, //TODO: Confirm with Kate if we can use HCPCS for all procedures.
claimLineItem.Procedure.CodedConceptCode );
sv1Segment.SV102_MonetaryAmount = X12Utility.ConvertToDecimalString ( claimLineItem.ChargeAmount.Amount );
sv1Segment.SV103_UnitBasisMeasCode = UnitsOrBasisOfMeasurementCode.Unit;
sv1Segment.SV104_Quantity = claimLineItem.BillingUnitCount.Count.ToString ( CultureInfo.InvariantCulture );
sv1Segment.SV107_CompDiagCodePoint = DiagnosisCodePointer;
var dtpSegment = lxLoop.AddSegment ( new TypedSegmentDTP () );
dtpSegment.DTP01_DateTimeQualifier = DateTimeQualifier.Service;
dtpSegment.DTP02_DateTimePeriodFormatQualifier = DateTimePeriodFormatQualifier.DateExpressedAsCCYYMMDD;
dtpSegment.DTP03_Date = claim.ServiceDate;
}
}
}
var healthCareClaim837ProfessionalX12Message = message.SerializeToX12 ( true ); //TODO: Configure the whitespace option.
var healthCareClaim837Professional = healthCareClaim837ProfessionalFactory.CreateHealthCareClaim837Professional ( this, Encoding.ASCII.GetBytes ( healthCareClaim837ProfessionalX12Message ) );
var lookupValueRepository = IoC.CurrentContainer.Resolve<ILookupValueRepository>();
ReviseClaimBatchStatus ( lookupValueRepository.GetLookupByWellKnownName<ClaimBatchStatus>(WellKnownNames.ClaimModule.ClaimBatchStatus.Hcc837PGenerated) );
return healthCareClaim837Professional;
}
public void CreatePurchaseOrderChangeNotice860()
{
DateTime purcaseOrderDate = new DateTime(2010, 8, 17, 08, 50, 0);
DateTime changeOrderDate = DateTime.Now;
DateTime requestedShipDate = DateTime.Now.AddDays(2d);
Interchange interchange = new Interchange(changeOrderDate , 245, true)
{
InterchangeSenderIdQualifier = "01",
InterchangeSenderId = "828513080",
InterchangeReceiverIdQualifier = "01",
InterchangeReceiverId = "001903202U",
InterchangeDate = changeOrderDate,
};
interchange.SetElement(14, "0"); //No Aknowlegement is 0
FunctionGroup group = interchange.AddFunctionGroup("PO", changeOrderDate, 1, "005010X222");
group.ApplicationSendersCode = "828513080";
group.ApplicationReceiversCode = "001903202U";
group.Date = changeOrderDate;
group.ControlNumber = 245;
Transaction transaction = group.AddTransaction("860", "0001");
//BCH - Beginning Segment for Purchase Order Change
//Mandatory / Max Use=1 time
Segment bhtSegment = transaction.AddSegment("BCH");
bhtSegment.SetElement((int)BeginningSegmentPurchaseOrderChangeIndex.TransactionSetPurpose , "01"); //01 is cancelllation 04 is change
bhtSegment.SetElement((int)BeginningSegmentPurchaseOrderChangeIndex.TransactionSetTypeCode, "SA");
bhtSegment.SetElement((int)BeginningSegmentPurchaseOrderChangeIndex.PurchaseOrderDate, purcaseOrderDate.ToString("yyyyMMdd"));
bhtSegment.SetElement((int)BeginningSegmentPurchaseOrderChangeIndex.ChangeRequestDate, changeOrderDate.ToString("yyyyMMdd"));
//REF- Reference Identification
//Optional / Max Use=1 time
bhtSegment = transaction.AddSegment("REF");
bhtSegment.SetElement((int)ReferenceIdentificationIndex.ReferenceIdentificationQualifier , "IA");
bhtSegment.SetElement((int)ReferenceIdentificationIndex.ReferenceNumber, "1to30chars");
//DTM – Date/Time Reference
//Optional/ Max Use=1 time
bhtSegment = transaction.AddSegment("DTM");
bhtSegment.SetElement((int)DateTimeReferenceIndex.TermsTypeCode, "010");
bhtSegment.SetElement((int)DateTimeReferenceIndex.RequestedShipDate, requestedShipDate.ToString("yyyyMMdd"));
//Add to test
//N1 – Name
//Optional / Max Use=1
//N3 – Address Information
//Conditional – use if N1 used/ Max Use=2
//N4 – Geographic Location
//Conditional – use if N3 used / Max Use=1 time
//POC – Line Item Change
//Mandatory / Max Use=1 times per loop / Max Loop=99 times
//DTM – Date/Time Reference
//Mandatory / Max Use=1 times per loop
//CTT – Transaction Totals
//Mandatory / Max Use=1 time
var x12 = interchange.SerializeToX12(true);
System.Diagnostics.Trace.Write(x12);
}
public void PatientIsSelfInsuredTest()
{
var creationDateTime = new DateTime ( 2011, 02, 13, 12, 53, 00 ); //DateTime.Now.
int autoIncrementedControlNumber = 1; //Must be persisted, so that it will be unique per interchange.
int autoIncrementedHierarchicalIDNumber = 1; //The first HL01 within each ST-SE envelope must begin with “1”.
int autoIncrementedServiceLineNumber = 1;
var message = new Interchange ( creationDateTime, autoIncrementedControlNumber, IS_PRODUCTION )
{
//When Authorization information is not provided, it chooses 00 as qualifier with empty value. Refer 'Authorization Information Qualifier' code table.
//SecurityInfoQualifier = SECURITY_INFORMATION_CODE_PASSWORD, //Refer 'Security Information Qualifier'. What does WITS do ?
//SecurityInfo = "THEPASSWORD", //What does WITS do ?
InterchangeSenderIdQualifier = INTERCHANGE_IDENTIFIER_CODE_MUTUALLY_DEFINED,
//Need to a code table for 'Interchange ID Qualifier'. Pg: 638. ZZ - 'Mutually Defined'.
InterchangeSenderId = "SUBMITTERS.ID",
//HealthCareClaim837Setup.InterchangeSenderNumber
InterchangeReceiverIdQualifier = INTERCHANGE_IDENTIFIER_CODE_MUTUALLY_DEFINED,
//Refer 'Interchange ID Qualifier'. Can we reuse the same code table ?
InterchangeReceiverId = "RECEIVERS.ID" //HealthCareClaim837Setup.InterchangeRecieverNumber
};
message.SetElement ( 12, INTERCHANGE_CONTROL_VERSION_NUMBER );
//Refer 'Interchange Control Version Number' code table. It has only 1 value.
//message.SetElement(10, "1253"); //Interchange time, can be part of 'interchangeDateTime' variable declared above.
message.SetElement ( 11, REPITITION_SEPARATOR ); //Repetition separator.
message.SetElement(14, "1");
var group = message.AddFunctionGroup (
FUNCTIONAL_IDENTIFIER_CODE, creationDateTime, autoIncrementedControlNumber, IMPLEMENTATION_GUIDE_VERSION_NAME );
group.ApplicationSendersCode = "SENDER CODE"; //HealthCareClaim837Setup.InterchangeSenderNumber
group.ApplicationReceiversCode = "RECEIVER CODE"; //HealthCareClaim837Setup.InterchangeRecieverNumber
group.ResponsibleAgencyCode = "X";
//group.Date = Convert.ToDateTime("12/31/1999"); //Overwriting given DateTime.Now value. Functional Group Creation Date.
//group.ControlNumber = 1; //Control number overwritten. Same as 'autoIncrementedFunctionalGroupControlNumber' variable.
//group.SetElement(5, "0802"); //Overwriting given DateTime.Now value. Functional Group Creation Time. hh:mm
string interchangeControlNumber = autoIncrementedControlNumber.ToString ( CultureInfo.InvariantCulture );
interchangeControlNumber = interchangeControlNumber.Length < 4 ? interchangeControlNumber.PadLeft ( 4, '0' ) : interchangeControlNumber;
var transaction = group.AddTransaction ( TRANSACTIONSET_IDENTIFIER_CODE, interchangeControlNumber ); //Pg: 70.
//transaction.SetElement(2, transactionSetControlNumber);
transaction.SetElement ( 3, IMPLEMENTATION_GUIDE_VERSION_NAME );
//It is the Implementation Guide Version Name. Refer 'Version / Release / Industry Identifier' Code table
var bhtSegment = transaction.AddSegment ( BEGINING_OF_HIERARCHICAL_TRANSACTION );
bhtSegment.SetElement ( 1, HIERARCHICAL_STRUCTURE_CODE_INFORMATIONSOURCE_SUBSCRIBER_DEPENDENT );
//Refer 'Hierarchical Structure' Code table.
bhtSegment.SetElement ( 2, TRANSACTIONSET_PURPOSE_CODE_ORIGINAL ); //Refer 'Transaction Set Purpose' code table.
bhtSegment.SetElement(3, REFERENCE_IDENTIFICATION_BATCH_CONTROL_NUMBER); //Acts as batch control number. 30 chars.
bhtSegment.SetElement(4, "20061015"); //date that the original submitter created the claim file from their business application system.
bhtSegment.SetElement(5, "1023"); //- time that the original submitter created the claim file from their business application system.
bhtSegment.SetElement(6, "CH"); // - indicates that the transaction contains only fee for service claims or claims with at least one chargeable line item. Refer code table 'Transaction Type'.
//Submitter Name
var submitterLoop = transaction.AddLoop ( new TypedLoopNM1 ( EntityIdentifierCodes.SUBMITTER ) );
//submitter identifier code. See 'Entity Identifier' code table
submitterLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity; //See 'Entity Type Qualifier' code table.
submitterLoop.NM103_NameLastOrOrganizationName = "SAFE HARBOR"; //BillingOffice.Agency.LegalName
//submitterLoop.NM104_NameFirst = ""; //Always empty when EntityTypeQualifier is Non-Person entity.
submitterLoop.NM108_IdCodeQualifier = IdentificationCodes.ELECTRONIC_TRANSMITTER_IDENTIFICATION_NUMBER;
//See code table 'Identification Code Qualifier' - Electronic Transmitter Identification Number - established by trading partner agreement.
submitterLoop.NM109_IdCode = "SAFEHARBOR_ETIN"; //BillingOffice.ElectronicTransmitterIdentificationNumber.
//SUBMITTER EDI CONTACT INFORMATION.
var perSegment = submitterLoop.AddSegment ( new TypedSegmentPER () );
perSegment.PER01_ContactFunctionCode = INFORMATION_CONTACT; //information contact function code
perSegment.PER02_Name = "JERRY";
//BillingOffice.Administrator - Situational - required when the person to contact is different from the subscriber. As we provided a nonperson entity we need to provide the person name.
perSegment.PER03_CommunicationNumberQualifier = CommunicationNumberQualifer.Telephone; //See code table 'Communication Number Qualifier'.
perSegment.PER04_CommunicationNumber = "3055552222"; //telephone. //BillingOffice.Administrator.TelephoneNumber
//if(There is telephone extension)
perSegment.PER05_CommunicationNumberQualifier = CommunicationNumberQualifer.TelephoneExtension;
//See code table 'Communication Number Qualifier'.
perSegment.PER06_CommunicationNumber = "231"; //telephone extension //BillingOffice.Administrator.TelephoneNumberExtension
//RECEIVER NAME
var receiverLoop = transaction.AddLoop ( new TypedLoopNM1 ( EntityIdentifierCodes.RECEIVER ) );
//receiver identifier code. See 'Entity Identifier' code table
receiverLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity; //See 'Entity Type Qualifier' code table.
receiverLoop.NM103_NameLastOrOrganizationName = "KEY INSURANCE COMPANY"; //Payor.Name
//receiverLoop.NM104_NameFirst = ""; //Always empty when EntityTypeQualifier is Non-Person entity.
receiverLoop.NM108_IdCodeQualifier = IdentificationCodes.ELECTRONIC_TRANSMITTER_IDENTIFICATION_NUMBER;
//See code table 'Identification Code Qualifier' - Electronic Transmitter Identification Number - established by trading partner agreement.
receiverLoop.NM109_IdCode = "KEY_INSURANCE_ETIN"; //Payor.ElectronicTransmitterIdentificationNumber.
//Billing Provider Hierarchical Level.
var provider2000AHierachicalLoop = transaction.AddHLoop (
autoIncrementedHierarchicalIDNumber.ToString ( CultureInfo.InvariantCulture ),
HierarchicalLevelCodes.INFORMATIONSOURCE,
BILLING_PROVIDER_HIERARCHICAL_LOOP_CAN_HOLD_CHILD_HIERARCHICAL_LOOPS ); //*********HL 1 ******.
var prvSegment = provider2000AHierachicalLoop.AddSegment ( new TypedSegmentPRV () );
//Specialty Segment. PRV - BILLING PROVIDER SPECIALTY INFORMATION.
prvSegment.PRV01_ProviderCode = PROVIDER_CODE_BILLING; //Refer 'Provider Code' code table.
prvSegment.PRV02_ReferenceIdQualifier = ReferenceIdentificationCodes.HEALTHCARE_PROVIDER_TAXONOMY;
//Refer 'Reference Identification Qualifier' code table
prvSegment.PRV03_ProviderTaxonomyCode = HEALTHCARE_PROVIDER_TAXONOMY_VALUE;
//Billing provider Name
var provider2010AALoop = provider2000AHierachicalLoop.AddLoop ( new TypedLoopNM1 ( BILLING_PROVIDER ) );
provider2010AALoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
provider2010AALoop.NM103_NameLastOrOrganizationName = "Safe Harbor"; //BillingOffice.Agency.LegalName
provider2010AALoop.NM108_IdCodeQualifier = IdentificationCodes.CENTERS_FOR_MEDICARE_AND_MEDICAID_SERVICES_NATIONAL_PROVIDER_IDENTIFIER;
provider2010AALoop.NM109_IdCode = "9876543210"; //BillingOffice.Agency.Identifiers.NPINumber
//Billing provider address
var provider2010AA_N3Segment = provider2010AALoop.AddSegment ( new TypedSegmentN3 () );
provider2010AA_N3Segment.N301_AddressInformation = "234 SEAWAY ST";
//BillingOffice.Agency.Address.FirstStreetAddress & SecondStreetAddress
//Billing provider City,State,Zipcode
var provider2010AA_N4Segment = provider2010AALoop.AddSegment ( new TypedSegmentN4 () );
provider2010AA_N4Segment.N401_CityName = "MIAMI"; //BillingOffice.Agency.Address.CityName
provider2010AA_N4Segment.N402_StateOrProvinceCode = "FL"; //BillingOffice.Agency.Address.StateProvince
provider2010AA_N4Segment.N403_PostalCode = "33111"; //BillingOffice.Agency.Address.PostalCode
//Billing provider - tax identification
var provider2010AA_REFSegment = provider2010AALoop.AddSegment ( new TypedSegmentREF () );
provider2010AA_REFSegment.REF01_ReferenceIdQualifier = ReferenceIdentificationCodes.EMPLOYERS_IDENTIFICATION_NUMBER;
provider2010AA_REFSegment.REF02_ReferenceId = "587654321"; //BillingOffice.Agency.Identifiers.FederalTaxID
var provider2010ABLoop = provider2000AHierachicalLoop.AddLoop ( new TypedLoopNM1 ( EntityIdentifierCodes.PAY_TO_PROVIDER ) );
provider2010ABLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
var provider2010AB_N3Segment = provider2010ABLoop.AddSegment ( new TypedSegmentN3 () );
provider2010AB_N3Segment.N301_AddressInformation = "234 SEAWAY ST";
//BillingOffice.Agency.Address.FirstStreetAddress & SecondStreetAddress
var provider2010AB_N4Segment = provider2010ABLoop.AddSegment ( new TypedSegmentN4 () );
provider2010AB_N4Segment.N401_CityName = "MIAMI"; //BillingOffice.Agency.Address.CityName
provider2010AB_N4Segment.N402_StateOrProvinceCode = "FL"; //BillingOffice.Agency.Address.StateProvince
provider2010AB_N4Segment.N403_PostalCode = "33111"; //BillingOffice.Agency.Address.PostalCode
autoIncrementedHierarchicalIDNumber++;
var subscriber2000BHierarchicalLoop =
provider2000AHierachicalLoop.AddHLoop (
autoIncrementedHierarchicalIDNumber.ToString ( CultureInfo.InvariantCulture ),
HierarchicalLevelCodes.SUBSCRIBER,
false /*SUBSCRIBER_HIERARCHICAL_LOOP_CAN_HOLD_CHILD_HIERARCHICAL_LOOPS*/ ); // **** HL 2 ****** No Child HL
//Subscriber information
var segmentSBR = subscriber2000BHierarchicalLoop.AddSegment ( new TypedSegmentSBR () );
segmentSBR.SBR01_PayerResponsibilitySequenceNumberCode = PayerResponsibilitySequenceCodes.PRIMARY;
segmentSBR.SBR02_IndividualRelationshipCode = IndividualRelationshipCodes.SELF;
//segmentSBR.SBR03_PolicyOrGroupNumber = "2222-SJ"; //Required when the subscriber’s identification card for the destination payer (Loop ID-2010BB) shows a group number.
//segmentSBR.SBR09_ClaimFilingIndicatorCode = "CI"; //Not in practical use.
//Patient information - Required when the patient is the subscriber.
//var segmentPAT = subscriber2000BHierarchicalLoop.AddSegment ( new TypedSegmentPAT () );
//segmentPAT.PAT09_PregnancyIndicator = false;
//Loop 2010BA - Subscriber Name
var subscriberName2010BALoop = subscriber2000BHierarchicalLoop.AddLoop (
new TypedLoopNM1 ( EntityIdentifierCodes.INSURED_OR_SUBSCRIBER ) );
subscriberName2010BALoop.NM102_EntityTypeQualifier = EntityTypeQualifier.Person;
subscriberName2010BALoop.NM104_NameFirst = "JANE"; //PayorSubscriber.LastName
subscriberName2010BALoop.NM103_NameLastOrOrganizationName = "SMITH"; //PayorSubscriber.FirstName
subscriberName2010BALoop.NM109_IdCode = "JS00111223333"; //PayorSubscriber.PayorCoverage.MemberNumber
subscriberName2010BALoop.NM108_IdCodeQualifier = IdentificationCodes.MEMBER_IDENTIFICATION_NUMBER;
//Loop 2010BA - Subscriber address
var provider2010BA_N3Segment = subscriberName2010BALoop.AddSegment ( new TypedSegmentN3 () );
provider2010BA_N3Segment.N301_AddressInformation = "234 SEAWAY ST"; //PayorSubscriber.Address.FirstStreetAddress & SecondStreetAddress
//Loop 2010BA - Subscriber city,state,postal code.
var provider2010BA_N4Segment = subscriberName2010BALoop.AddSegment ( new TypedSegmentN4 () );
provider2010BA_N4Segment.N401_CityName = "MIAMI"; //PayorSubscriber.Address.CityName
provider2010BA_N4Segment.N402_StateOrProvinceCode = "FL"; //PayorSubscriber.Address.StateProvince
provider2010BA_N4Segment.N403_PostalCode = "33413"; //PayorSubscriber.Address.PostalCode
//Loop 2010BA - Demographic information
var subscriber_DMGSegment = subscriberName2010BALoop.AddSegment ( new TypedSegmentDMG () );
subscriber_DMGSegment.DMG01_DateTimePeriodFormatQualifier = DATE_TIME_PERIOD_FORMAT_QUALIFIER_DATE_EXPRESSED_IN_FORMAT_CCYYMMDD;
subscriber_DMGSegment.DMG02_DateOfBirth = DateTime.Parse ( "5/1/1943" ); //PayorSubscriber.BirthDate
subscriber_DMGSegment.DMG03_Gender = Gender.Female; //PayorSubscriber.AdministrativeGender
//Loop 2010BB - Payer Name.
var subscriberName2010BBLoop = subscriber2000BHierarchicalLoop.AddLoop ( new TypedLoopNM1 ( EntityIdentifierCodes.PAYER ) );
subscriberName2010BBLoop.NM102_EntityTypeQualifier = EntityTypeQualifier.NonPersonEntity;
subscriberName2010BBLoop.NM103_NameLastOrOrganizationName = "KEY INSURANCE COMPANY"; //Payor.Name
subscriberName2010BBLoop.NM108_IdCodeQualifier = IdentificationCodes.PAYOR_IDENTIFICATION;
subscriberName2010BBLoop.NM109_IdCode = "999996666"; //NPI? Kate needs time to check.
//optional.
//var refSegment2 = subscriberName2010BBLoop.AddSegment(new TypedSegmentREF());
//refSegment2.REF01_ReferenceIdQualifier = ReferenceIdentificationCodes.PROVIDER_COMMERCIAL_NUMBER;
//refSegment2.REF02_ReferenceId = "KA6663";
//autoIncrementedHierarchicalIDNumber++;
//PATIENT HIERARCHICAL LEVEL Loop Repeat: >1
//var patientDetailLoop2000CLoop = subscriber2000BHierarchicalLoop.AddHLoop(autoIncrementedHierarchicalIDNumber.ToString(CultureInfo.InvariantCulture), HierarchicalLevelCodes.DEPENDENT, PATIENT_HIERARCHICAL_LOOP_CAN_HOLD_CHILD_HIERARCHICAL_LOOPS); // **** HL 3 ******
//var HL3PATSegment = subscriber2000BHierarchicalLoop.AddSegment(new TypedSegmentPAT());
//HL3PATSegment.PAT01_IndividualRelationshipCode = IndividualRelationshipCodes.CHILD;
//How does the billing side access patient information on the clinical side.
//var HL3NM1Segment = subscriber2000BHierarchicalLoop.AddLoop(new TypedLoopNM1(EntityIdentifierCodes.PATIENT));
//HL3NM1Segment.NM102_EntityTypeQualifier = EntityTypeQualifier.Person;
//HL3NM1Segment.NM104_NameFirst = "TED"; //Patinet.FirstName
//HL3NM1Segment.NM103_NameLastOrOrganizationName = "SMITH"; //Patinet.LastName
//// add N3 and N4 segments under the above NM1 loop
//var HL3NM1_N3_Segment = HL3NM1Segment.AddSegment(new TypedSegmentN3());
//HL3NM1_N3_Segment.N301_AddressInformation = "236 N MAIN ST"; //Patient.Address.FirstStreetAddress & SecondStreetAddress
//var HL3NM1_N4_Segment = HL3NM1Segment.AddSegment(new TypedSegmentN4());
//HL3NM1_N4_Segment.N401_CityName = "MIAMI"; //Patient.Address.CityName
//HL3NM1_N4_Segment.N402_StateOrProvinceCode = "FL"; //Patient.Address.StateProvince
//HL3NM1_N4_Segment.N403_PostalCode = "33413"; //Patient.Address.PostalCode
//var HL3NM1_DMG_Segment = HL3NM1Segment.AddSegment(new TypedSegmentDMG());
//HL3NM1_DMG_Segment.DMG01_DateTimePeriodFormatQualifier = DATE_TIME_PERIOD_FORMAT_QUALIFIER_DATE_EXPRESSED_IN_FORMAT_CCYYMMDD;
//HL3NM1_DMG_Segment.DMG02_DateOfBirth = Convert.ToDateTime("5/1/1973"); //Patinet.BirthDate
//HL3NM1_DMG_Segment.DMG03_Gender = Gender.Male; //Patinet.AdministrativeGender
var claim2300Loop = subscriber2000BHierarchicalLoop.AddLoop ( new TypedLoopCLM () );
claim2300Loop.CLM01_PatientControlNumber = "26463774"; //BillingOffice.PlaceOfService.Claims[0].Key
claim2300Loop.CLM02_TotalClaimChargeAmount = Convert.ToDecimal ( 100 ); //BillingOffice.PlaceOfService.Claims[0].ChargeAmount
claim2300Loop.CLM05._1_FacilityCodeValue = PLACE_OF_SERVICE_CODE_OFFICE;
claim2300Loop.CLM05._2_FacilityCodeQualifier = PLACE_OF_SERVICE_CODES_FOR_PROFESSIONAL_OR_DENTAL_SERVICES;
claim2300Loop.CLM05._3_ClaimFrequencyTypeCode = CLAIM_FREQUENCY_TYPE_CODE_ORIGINAL;
claim2300Loop.CLM06_ProviderOrSupplierSignatureIndicator = PROVIDER_OR_SUPPLIER_SIGNATURE_INDICATOR_CODE_YES;
claim2300Loop.CLM07_ProviderAcceptAssignmentCode = PROVIDER_ACCEPTANCE_ASSIGNMENT_CODE_ASSIGNED;
claim2300Loop.CLM08_BenefitsAssignmentCerficationIndicator = BENIFITS_ASSIGNMENT_CERTIFICATION_INDICATOR_CODE_YES;
claim2300Loop.CLM09_ReleaseOfInformationCode = RELEASE_OF_INFORMATION_CODE_YES; //Kate says 'I don't think it matters too much'
//Claim Identifier for Transmission Intermediaries is the new name for the Claim Identification Number for Clearinghouses
//and Other Transmission Intermediaries segment. The qualifier (REF01 = D9) did not change. ??? Do we use the intermediaries ? Kate says 'Not Yet'.
//var refSegment = claim2300Loop.AddSegment(new TypedSegmentREF());
//refSegment.REF01_ReferenceIdQualifier = "D9";
//refSegment.REF02_ReferenceId = "17312345600006351";
var hiSegment = claim2300Loop.AddSegment ( new TypedSegmentHI () );
//Which value to use ?
hiSegment.HI01_HealthCareCodeInformation =
X12Utility.BuildCompositeElement ( x12Delimiters.CompositeDelimiter, INTERNATIONAL_CLASSIFICATION_OF_DISEASES_CLINICAL_MODIFICATION_ICD9CM_PRINCIPLE_DIAGNOSTICS, "0340" );
//hiSegment.HI02_HealthCareCodeInformation = hiSegment.X12Utility.BuildCompositeElement("BF", "V7389"); - optional
var lxLoop = claim2300Loop.AddLoop ( new TypedLoopLX ( "LX" ) );
lxLoop.LX01_AssignedNumber = autoIncrementedServiceLineNumber.ToString ( CultureInfo.InvariantCulture );
var sv1Segment = lxLoop.AddSegment ( new TypedSegmentSV1 () );
sv1Segment.SV101_CompositeMedicalProcedure = X12Utility.BuildCompositeElement ( x12Delimiters.CompositeDelimiter, SERVICE_ID_QUALIFIER_CODE_HCPCS, "99213" );
//HC for HCPCS - constant for now. BillingOffice.PlaceOfService.Claims[0].ClaimLineItem[0].Procedure.
sv1Segment.SV102_MonetaryAmount = "40"; //BillingOffice.PlaceOfService.Claims[0].ClaimLineItem[0].ChargeAmount
sv1Segment.SV103_UnitBasisMeasCode = UNIT_OR_BASIS_FOR_MEASUREMENT_CODE_UNIT; //Constant.
sv1Segment.SV104_Quantity = "1"; //BillingOffice.PlaceOfService.Claims[0].ClaimLineItem[0].BillingUnitCount
sv1Segment.SV107_CompDiagCodePoint = "1"; //No functionality in REM. Default to 1.
var dtpSegment = lxLoop.AddSegment ( new TypedSegmentDTP () );
dtpSegment.DTP01_DateTimeQualifier = DATE_TIME_QUALIFIER_CODE_SERVICE;
dtpSegment.DTP02_DateTimePeriodFormatQualifier = DATE_TIME_PERIOD_FORMAT_QUALIFIER_DATE_EXPRESSED_IN_FORMAT_CCYYMMDD;
DateTime theDate = DateTime.ParseExact ( "20061003", "yyyyMMdd", null ); //BillingOffice.PlaceOfService.Claims[0].ServiceDate
dtpSegment.DTP03_Date = theDate;
autoIncrementedServiceLineNumber++;
var lxLoop2 = claim2300Loop.AddLoop ( new TypedLoopLX ( "LX" ) );
lxLoop2.LX01_AssignedNumber = autoIncrementedServiceLineNumber.ToString ( CultureInfo.InvariantCulture );
var sv1Segment2 = lxLoop2.AddSegment ( new TypedSegmentSV1 () );
sv1Segment2.SV101_CompositeMedicalProcedure = X12Utility.BuildCompositeElement ( x12Delimiters.CompositeDelimiter, SERVICE_ID_QUALIFIER_CODE_HCPCS, "87070" );
//HC for HCPCS - constant for now. BillingOffice.PlaceOfService.Claims[0].ClaimLineItem[0].Procedure.
sv1Segment2.SV102_MonetaryAmount = "15"; //BillingOffice.PlaceOfService.Claims[0].ClaimLineItem[0].ChargeAmount
sv1Segment2.SV103_UnitBasisMeasCode = UNIT_OR_BASIS_FOR_MEASUREMENT_CODE_UNIT; //
sv1Segment2.SV104_Quantity = "1"; //BillingOffice.PlaceOfService.Claims[0].ClaimLineItem[0].BillingUnitCount
sv1Segment2.SV107_CompDiagCodePoint = "1"; //No functionality in REM. Default to 1.
var dtpSegment2 = lxLoop2.AddSegment ( new TypedSegmentDTP () );
dtpSegment2.DTP01_DateTimeQualifier = DATE_TIME_QUALIFIER_CODE_SERVICE;
dtpSegment2.DTP02_DateTimePeriodFormatQualifier = DATE_TIME_PERIOD_FORMAT_QUALIFIER_DATE_EXPRESSED_IN_FORMAT_CCYYMMDD;
DateTime theDate2 = DateTime.ParseExact ( "20061003", "yyyyMMdd", null ); //BillingOffice.PlaceOfService.Claims[0].ServiceDate
dtpSegment2.DTP03_Date = theDate2;
autoIncrementedServiceLineNumber++;
var lxLoop3 = claim2300Loop.AddLoop ( new TypedLoopLX ( "LX" ) );
lxLoop3.LX01_AssignedNumber = autoIncrementedServiceLineNumber.ToString ( CultureInfo.InvariantCulture );
var sv1Segment3 = lxLoop3.AddSegment ( new TypedSegmentSV1 () );
sv1Segment3.SV101_CompositeMedicalProcedure = X12Utility.BuildCompositeElement ( x12Delimiters.CompositeDelimiter, SERVICE_ID_QUALIFIER_CODE_HCPCS, "99214" );
//HC for HCPCS - constant for now. BillingOffice.PlaceOfService.Claims[0].ClaimLineItem[0].Procedure.
sv1Segment3.SV102_MonetaryAmount = "35";
sv1Segment3.SV103_UnitBasisMeasCode = UNIT_OR_BASIS_FOR_MEASUREMENT_CODE_UNIT;
sv1Segment3.SV104_Quantity = "1"; //BillingOffice.PlaceOfService.Claims[0].ClaimLineItem[0].BillingUnitCount
sv1Segment3.SV107_CompDiagCodePoint = "1"; //No functionality in REM. Default to 1.
var dtpSegment3 = lxLoop3.AddSegment ( new TypedSegmentDTP () );
dtpSegment3.DTP01_DateTimeQualifier = DATE_TIME_QUALIFIER_CODE_SERVICE;
dtpSegment3.DTP02_DateTimePeriodFormatQualifier = DATE_TIME_PERIOD_FORMAT_QUALIFIER_DATE_EXPRESSED_IN_FORMAT_CCYYMMDD;
DateTime theDate3 = DateTime.ParseExact ( "20061010", "yyyyMMdd", null ); //BillingOffice.PlaceOfService.Claims[0].ServiceDate
dtpSegment3.DTP03_Date = theDate3;
autoIncrementedServiceLineNumber++;
var lxLoop4 = claim2300Loop.AddLoop ( new TypedLoopLX ( "LX" ) );
lxLoop4.LX01_AssignedNumber = autoIncrementedServiceLineNumber.ToString ( CultureInfo.InvariantCulture );
var sv1Segment4 = lxLoop4.AddSegment ( new TypedSegmentSV1 () );
sv1Segment4.SV101_CompositeMedicalProcedure = X12Utility.BuildCompositeElement ( x12Delimiters.CompositeDelimiter, SERVICE_ID_QUALIFIER_CODE_HCPCS, "86663" );
//HC for HCPCS - constant for now. BillingOffice.PlaceOfService.Claims[0].ClaimLineItem[0].Procedure.
sv1Segment4.SV102_MonetaryAmount = "10";
sv1Segment4.SV103_UnitBasisMeasCode = UNIT_OR_BASIS_FOR_MEASUREMENT_CODE_UNIT;
sv1Segment4.SV104_Quantity = "1"; //BillingOffice.PlaceOfService.Claims[0].ClaimLineItem[0].BillingUnitCount
sv1Segment4.SV107_CompDiagCodePoint = "1"; //No functionality in REM. Default to 1.
var dtpSegment4 = lxLoop4.AddSegment ( new TypedSegmentDTP () );
dtpSegment4.DTP01_DateTimeQualifier = DATE_TIME_QUALIFIER_CODE_SERVICE;
dtpSegment4.DTP02_DateTimePeriodFormatQualifier = DATE_TIME_PERIOD_FORMAT_QUALIFIER_DATE_EXPRESSED_IN_FORMAT_CCYYMMDD;
DateTime theDate4 = DateTime.ParseExact ( "20061010", "yyyyMMdd", null ); //BillingOffice.PlaceOfService.Claims[0].ServiceDate
dtpSegment4.DTP03_Date = theDate4;
var x12 = message.SerializeToX12 ( true );
var ediString = Pillar.Common.Utility.EmbeddedResourceUtil.GetEmbeddedResourceValue("Rem.Domain.Billing.Tests.TestData._837p.Example2_SelfInsured.txt", Assembly.GetExecutingAssembly());
Assert.AreEqual(ediString, x12);
}
private String InterchangeSenderId = "828513080"; // need a mutually agreed up ID
#endregion Fields
#region Methods
public void CreatePurchaseOrder850(PurchaseOrder purchaseOrder,string fileName)
{
DateTime purcaseOrderDate = DateTime.Now;
Interchange interchange = new Interchange(purcaseOrderDate, Convert.ToInt32(purchaseOrder.Number), true)
{
InterchangeSenderIdQualifier = "ZZ",
InterchangeSenderId = InterchangeSenderId,
InterchangeReceiverIdQualifier = "ZZ",
InterchangeReceiverId = InterchangeReceiverId,
InterchangeDate = purcaseOrderDate,
};
interchange.SetElement(14, "0"); //No Aknowlegement is 0
FunctionGroup group = interchange.AddFunctionGroup("PO", purcaseOrderDate, Convert.ToInt32(purchaseOrder.Number), "004010");
group.ApplicationSendersCode = InterchangeSenderId;
group.ApplicationReceiversCode = InterchangeReceiverId;
// group.Date = purcaseOrderDate;
// group.ControlNumber = Convert.ToInt32(purchaseOrder.Number);
Transaction transaction = group.AddTransaction("850", "0001");
Segment bhtSegment = transaction.AddSegment("BEG");
bhtSegment.SetElement(1, "00");
bhtSegment.SetElement(2, "SA");
bhtSegment.SetElement(3, purchaseOrder.Number);
bhtSegment.SetElement(5, purcaseOrderDate.ToString("yyyyMMdd"));
//bhtSegment = transaction.AddSegment("CUR");
//bhtSegment.SetElement(1, "BY");
//bhtSegment.SetElement(2, "USD");
//bhtSegment = transaction.AddSegment("PER");
//bhtSegment.SetElement(1, "IC");
//bhtSegment.SetElement(2, "Doe,Jane");
//bhtSegment.SetElement(8, "Doe,Jane");
//bill to section
Loop loop = transaction.AddLoop("N1");
loop.SetElement(1, "BT");
loop.SetElement(2, purchaseOrder.Customer.BillingName);
loop.SetElement(3,92);
loop.SetElement(4,purchaseOrder.Customer.BillingAddress.Id);
Segment segment = loop.AddSegment("N3");
segment.SetElement(1, purchaseOrder.Customer.BillingAddress.Street);
segment.SetElement(2, purchaseOrder.Customer.BillingAddress.City + " " + purchaseOrder.Customer.BillingAddress.State + " " + purchaseOrder.Customer.BillingAddress.PostalCode + " " + purchaseOrder.Customer.BillingAddress.Country);
segment = loop.AddSegment("N4");
segment.SetElement(1, purchaseOrder.Customer.BillingAddress.City);
segment.SetElement(2, purchaseOrder.Customer.BillingAddress.ShortState); // short state
segment.SetElement(3, purchaseOrder.Customer.BillingAddress.PostalCode);
segment.SetElement(4, purchaseOrder.Customer.BillingAddress.ShortCountry); //short country
//ship to to section
loop = transaction.AddLoop("N1");
loop.SetElement(1, "ST");
loop.SetElement(2, purchaseOrder.Customer.ShippingName);
loop.SetElement(3, 92);
loop.SetElement(4, purchaseOrder.Customer.ShippingAddress.Id);
segment = loop.AddSegment("N3");
segment.SetElement(1, purchaseOrder.Customer.ShippingAddress.Street);
segment.SetElement(2, purchaseOrder.Customer.ShippingAddress.City + " " + purchaseOrder.Customer.ShippingAddress.State + " " + purchaseOrder.Customer.ShippingAddress.PostalCode + " " + purchaseOrder.Customer.ShippingAddress.Country);
segment = loop.AddSegment("N4");
segment.SetElement(1, purchaseOrder.Customer.ShippingAddress.City);
segment.SetElement(2, purchaseOrder.Customer.BillingAddress.ShortState); // short state
segment.SetElement(3, purchaseOrder.Customer.BillingAddress.PostalCode);
segment.SetElement(4, purchaseOrder.Customer.BillingAddress.ShortCountry); //short country
int count = 1;
foreach(LineItem lineItem in purchaseOrder.Items)
{
loop = transaction.AddLoop("PO1");
loop.SetElement(1, count++);
loop.SetElement(2, lineItem.Quantity);
loop.SetElement(3, "EA");
loop.SetElement(4, lineItem.Price);
loop.SetElement(6, "CGT");
loop.SetElement(7, lineItem.SupplierItemNumber);
}
loop = transaction.AddLoop("CTT");
loop.SetElement(1, --count);
var x12 = interchange.SerializeToX12(true);
Console.WriteLine(x12);
// Write the string to a file.
fileName += purchaseOrder.Number + ".850";
System.IO.StreamWriter file = new System.IO.StreamWriter(fileName);
file.WriteLine(x12);
file.Close();
}
public void CreatePurchaseOrder850()
{
DateTime purcaseOrderDate = DateTime.Now;
Interchange interchange = new Interchange(purcaseOrderDate, 245, true)
{
InterchangeSenderIdQualifier = "01",
InterchangeSenderId = "828513080",
InterchangeReceiverIdQualifier = "01",
InterchangeReceiverId = "001903202U",
InterchangeDate = purcaseOrderDate,
};
interchange.SetElement(14, "0"); //No Aknowlegement is 0
FunctionGroup group = interchange.AddFunctionGroup("PO", purcaseOrderDate, 1, "005010X222");
group.ApplicationSendersCode = "828513080";
group.ApplicationReceiversCode = "001903202U";
group.Date = purcaseOrderDate;
group.ControlNumber = 245;
Transaction transaction = group.AddTransaction("850", "0001");
Segment bhtSegment = transaction.AddSegment("BEG");
bhtSegment.SetElement(1, "00");
bhtSegment.SetElement(2, "SA");
bhtSegment.SetElement(3, "S41000439");
bhtSegment.SetElement(5, "20100810");
bhtSegment = transaction.AddSegment("CUR");
bhtSegment.SetElement(1, "BY");
bhtSegment.SetElement(2, "USD");
bhtSegment = transaction.AddSegment("PER");
bhtSegment.SetElement(1, "IC");
bhtSegment.SetElement(2, "Doe,Jane");
bhtSegment.SetElement(8, "Doe,Jane");
// Bill to address
Loop loop= transaction.AddLoop("N1");
loop.SetElement(1, "BT");
loop.SetElement(2,"Doe Jane");
loop.SetElement(3, 92);
loop.SetElement(4, 10001);
Segment segment=loop.AddSegment("N3");
segment.SetElement(1, "Street");
segment.SetElement(2, "City State Pin Country");
segment = loop.AddSegment("N4");
segment.SetElement(1,"City");
segment.SetElement(2,"SS");
segment.SetElement(3,"PIN");
segment.SetElement(4,"SC");
// ship to address
loop = transaction.AddLoop("N1");
loop.SetElement(1, "ST");
loop.SetElement(2, "Doe Jane");
loop.SetElement(3, 92);
loop.SetElement(4, 10001);
segment = loop.AddSegment("N3");
segment.SetElement(1, "Street");
segment.SetElement(2, "City State Pin Country");
segment = loop.AddSegment("N4");
segment.SetElement(1, "City");
segment.SetElement(2, "SS");
segment.SetElement(3, "PIN");
segment.SetElement(4, "SC");
// add products ordered
loop = transaction.AddLoop("PO1");
loop.SetElement(1,"1");
loop.SetElement(2, 10);
loop.SetElement(3, "EA");
loop.SetElement(4, "10.2");
loop.SetElement(6, "IB");
loop.SetElement(7,"100001");
var x12 = interchange.SerializeToX12(true);
Console.WriteLine(x12);
}