private static void TransformBillingProviderLoopTo837(XmlNode billingProviderLoop, Claim claim, TransformBillingProviderHLoopTo837State state)
{
var nameTypeNode = billingProviderLoop.SelectSingleNode("NM1/NM101");
if (nameTypeNode != null)
{
switch (nameTypeNode.InnerText)
{
case "87":if (state.FirstType87 == null) state.FirstType87 = billingProviderLoop;break;
case "85": if (state.FirstType85 == null) state.FirstType85 = billingProviderLoop; break;
}
}
}
public void SerializationTest1()
{
var document = new ClaimDocument();
var claim = new Claim
{
Type = ClaimTypeEnum.Institutional,
PatientControlNumber = "756048Q",
TotalClaimChargeAmount = 89.93M
};
document.Claims.Add(claim);
string xml = document.Serialize();
Trace.Write(xml);
}
private static void TransformBillingProviderHLoopTo837(XmlNodeList xmlNodeList, Claim claim)
{
TransformBillingProviderHLoopTo837State state = new TransformBillingProviderHLoopTo837State();
foreach (XmlNode item in xmlNodeList)
{
TransformBillingProviderHLoopTo837(item, claim, state);
}
if (claim.PayToProvider != null )
{
if (state.FirstType87 != null)
{
TransformPayToProvider(state.FirstType87, claim);
}
else if (state.FirstType85 != null)
{
TransformPayToProvider(state.FirstType85, claim);
}
}
}
//reverse engineer from https://raw.githubusercontent.com/mmooney/MMDB.DataService/master/ThirdParty/x12parser/trunk/src/OopFactory.X12.Hipaa/Claims/Services/Xsl/X12-837-To-ClaimDocument.xslt
private static XmlDocument TransformClaimDocumentTo837(Interchange interchange, Claim claim)
{
XmlDocument document = new XmlDocument() { PreserveWhitespace = true } ;
document.LoadXml(interchange.Serialize());
var claimLoop2300 = document.SelectNodes("//Loop");
for (int i = 0; i < claimLoop2300.Count; i++)
{
TransformLoopTo837(claimLoop2300[i],claim);
}
return document;
}
private static void TransformBillingProviderHLoopTo837(XmlNode xmlNode, Claim claim, TransformBillingProviderHLoopTo837State state)
{
var billingProviderLoop= xmlNode.SelectSingleNode("Loop");
TransformBillingProviderLoopTo837(billingProviderLoop, claim,state);
}
private static void TransformAMTTo837(XmlNodeList xmlNodeList, Claim claim)
{
}
private static void TransformSubscriberHLoopTo837(XmlNode hloop, Claim claim)
{
TransformSBRTo837(hloop.SelectSingleNode("SBR"), claim.SubscriberInformation);
}
private static void TransformSubscriberHLoopTo837(XmlNodeList xmlNodeList, Claim claim)
{
foreach (XmlNode item in xmlNodeList)
{
TransformSubscriberHLoopTo837(item,claim);
}
}
private static void TransformPayToProvider(XmlNode billingProvider, Claim claim)
{
XmlNode name = billingProvider.SelectSingleNode("REF");
XmlNode taxId = null;
if (name != null)
{
XmlNode nameId = name.SelectSingleNode("REF02");
XmlNode nameQualifier = name.SelectSingleNode("REF01");
if (nameId != null && nameQualifier != null)
{
switch (nameQualifier.InnerText)
{
case "FI": taxId =nameId; break;
case "24": taxId = nameId; ; break;
}
}
}
if (taxId != null)
taxId.InnerText = claim.PayToProvider.TaxId;
else
{
taxId = GetReferenceId(billingProvider, "EI");
if (taxId == null)
taxId = GetReferenceId(billingProvider, "TJ");
}
if (taxId != null)
taxId.InnerText = claim.PayToProvider.TaxId;
}
private static void TransformPatientHLoopTo837(XmlNodeList xmlNodeList, Claim claim)
{
}
private static void TransformLoopTo837(XmlNode loop, Claim claim)
{
var loopId = ((XmlElement)loop).GetAttribute("LoopId");
switch (loopId)
{
case "2300":
TransformLoop2300To837(loop, claim);break;
case "2010BA":
TransformLoop2010BATo837(loop, claim.Subscriber);break;
}
}
private static void TransformLoop2300To837(XmlNode loop2300, Claim claim)
{
var parentLoopId = loop2300.SelectSingleNode("../@LoopId");
var parentLoopIdValue= (parentLoopId ==null)?string.Empty:parentLoopId.Value;
XmlNode transactionCode;
if (parentLoopIdValue == "2000B")
{
transactionCode = loop2300.SelectSingleNode("../../../ST/ST02");
}
else
transactionCode = loop2300.SelectSingleNode("../../../../ST/ST02");
transactionCode.InnerText= claim.TransactionCode;
var claimNumber = loop2300.SelectSingleNode("REF[REF01 = 'D9'] / REF02");
claimNumber.InnerText = claim.ClaimNumber;
var patientControlNumber= loop2300.SelectSingleNode("CLM/CLM01");
patientControlNumber.InnerText = claim.PatientControlNumber;
var totalClaimChargeAmount= loop2300.SelectSingleNode("CLM/CLM02");
totalClaimChargeAmount.InnerText = claim.TotalClaimChargeAmount.ToString();
if (!string.IsNullOrWhiteSpace(claim.ProviderSignatureOnFile))
{
var providerSignatureOnFile = loop2300.SelectSingleNode("CLM/CLM06");
providerSignatureOnFile.InnerText = claim.ProviderSignatureOnFile;
}
if (!string.IsNullOrWhiteSpace(claim.MedicalRecordNumber))
{
var medicalRecordNumber = loop2300.SelectSingleNode("REF[REF01 = 'EA'] / REF02");
medicalRecordNumber.InnerText = claim.MedicalRecordNumber;
}
if(!string.IsNullOrWhiteSpace(claim.PriorAuthorizationNumber))
{
var priorAuthorizationNumber = loop2300.SelectSingleNode("REF[REF01 = 'G1'] / REF02");
priorAuthorizationNumber.Value = claim.PriorAuthorizationNumber;
}
if (parentLoopIdValue == "2000B")
{
TransformBillingProviderHLoopTo837(loop2300.SelectNodes("../../."), claim);
TransformSubscriberHLoopTo837(loop2300.SelectNodes("../."), claim);
}
else if (parentLoopIdValue == "2000C")
{
TransformBillingProviderHLoopTo837(loop2300.SelectNodes("../../../."), claim);
TransformSubscriberHLoopTo837(loop2300.SelectNodes("../../."), claim);
TransformPatientHLoopTo837(loop2300.SelectNodes("../."), claim);
}
TransformPWKTo837(loop2300.SelectNodes("PWK"), claim);
TransformDTPTo837(loop2300.SelectNodes("DTP"), claim);
TransformAMTTo837(loop2300.SelectNodes("AMT"), claim);
TransformREFTo837(loop2300.SelectNodes("REF"), claim);
TransformNTETo837(loop2300.SelectNodes("NTE"), claim);
TransformHITo837(loop2300.SelectNodes("HI"), claim);
TransformLoopTo837(loop2300.SelectNodes("Loop"), claim);
}
