///<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);
}
///<summary>Supply a list of ClaimSendQueueItems. Called from FormClaimSend. Can only send to one clearinghouse at a time.
///The queueItems must contain at least one item. Each item in queueItems must have the same ClinicNum. Cannot include Canadian.</summary>
public static void SendBatch(Clearinghouse clearinghouseClin, List <ClaimSendQueueItem> queueItems, EnumClaimMedType medType,
IFormClaimFormItemEdit formClaimFormItemEdit, Renaissance.FillRenaissanceDelegate fillRenaissance, ITerminalConnector terminalConnector)
{
string messageText = "";
if (clearinghouseClin.Eformat == ElectronicClaimFormat.Canadian)
{
MessageBox.Show(Lans.g("Eclaims", "Cannot send Canadian claims as part of Eclaims.SendBatch."));
return;
}
//get next batch number for this clearinghouse
int batchNum = Clearinghouses.GetNextBatchNumber(clearinghouseClin);
//---------------------------------------------------------------------------------------
//Create the claim file for this clearinghouse
if (clearinghouseClin.Eformat == ElectronicClaimFormat.x837D_4010 ||
clearinghouseClin.Eformat == ElectronicClaimFormat.x837D_5010_dental ||
clearinghouseClin.Eformat == ElectronicClaimFormat.x837_5010_med_inst)
{
messageText = x837Controller.SendBatch(clearinghouseClin, queueItems, batchNum, medType, false);
}
else if (clearinghouseClin.Eformat == ElectronicClaimFormat.Renaissance)
{
messageText = Renaissance.SendBatch(clearinghouseClin, queueItems, batchNum, formClaimFormItemEdit, fillRenaissance);
}
else if (clearinghouseClin.Eformat == ElectronicClaimFormat.Dutch)
{
messageText = Dutch.SendBatch(clearinghouseClin, queueItems, batchNum);
}
else if (clearinghouseClin.Eformat == ElectronicClaimFormat.Ramq)
{
messageText = Ramq.SendBatch(clearinghouseClin, queueItems, batchNum);
}
else
{
messageText = ""; //(ElectronicClaimFormat.None does not get sent)
}
if (messageText == "") //if failed to create claim file properly,
{
return; //don't launch program or change claim status
}
//----------------------------------------------------------------------------------------
//Launch Client Program for this clearinghouse if applicable
if (clearinghouseClin.CommBridge == EclaimsCommBridge.None)
{
AttemptLaunch(clearinghouseClin, batchNum);
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.WebMD)
{
if (!WebMD.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + WebMD.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.BCBSGA)
{
if (!BCBSGA.Launch(clearinghouseClin, batchNum, terminalConnector))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + BCBSGA.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.Renaissance)
{
AttemptLaunch(clearinghouseClin, batchNum);
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.ClaimConnect)
{
if (ClaimConnect.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show("Upload successful.");
}
else
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + ClaimConnect.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.RECS)
{
if (!RECS.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Claim file created, but could not launch RECS client.") + "\r\n" + RECS.ErrorMessage);
//continue;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.Inmediata)
{
if (!Inmediata.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Claim file created, but could not launch Inmediata client.") + "\r\n" + Inmediata.ErrorMessage);
//continue;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.AOS) // added by SPK 7/13/05
{
if (!AOS.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Claim file created, but could not launch AOS Communicator.") + "\r\n" + AOS.ErrorMessage);
//continue;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.PostnTrack)
{
AttemptLaunch(clearinghouseClin, batchNum);
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.MercuryDE)
{
if (!MercuryDE.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + MercuryDE.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.ClaimX)
{
if (!ClaimX.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Claim file created, but encountered an error while launching ClaimX Client.") + ":\r\n" + ClaimX.ErrorMessage);
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.EmdeonMedical)
{
if (!EmdeonMedical.Launch(clearinghouseClin, batchNum, medType))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + EmdeonMedical.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.DentiCal)
{
if (!DentiCal.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + DentiCal.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.NHS)
{
if (!NHS.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + NHS.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.EDS)
{
if (!EDS.Launch(clearinghouseClin, messageText))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + "\r\n" + EDS.ErrorMessage);
return;
}
}
else if (clearinghouseClin.CommBridge == EclaimsCommBridge.Ramq)
{
if (!Ramq.Launch(clearinghouseClin, batchNum))
{
MessageBox.Show(Lans.g("Eclaims", "Error sending.") + Ramq.ErrorMessage);
return;
}
}
//----------------------------------------------------------------------------------------
//finally, mark the claims sent. (only if not Canadian)
EtransType etype = EtransType.ClaimSent;
if (clearinghouseClin.Eformat == ElectronicClaimFormat.Renaissance)
{
etype = EtransType.Claim_Ren;
}
//Canadians cannot send in batches (see above). RAMQ is performing a similar algorithm but the steps are in a different order in Ramq.cs.
if (clearinghouseClin.Eformat != ElectronicClaimFormat.Canadian && clearinghouseClin.Eformat != ElectronicClaimFormat.Ramq)
{
//Create the etransmessagetext that all claims in the batch will point to.
EtransMessageText etransMsgText = new EtransMessageText();
etransMsgText.MessageText = messageText;
EtransMessageTexts.Insert(etransMsgText);
for (int j = 0; j < queueItems.Count; j++)
{
Etrans etrans = Etranss.SetClaimSentOrPrinted(queueItems[j].ClaimNum, queueItems[j].PatNum,
clearinghouseClin.HqClearinghouseNum, etype, batchNum, Security.CurUser.UserNum);
etrans.EtransMessageTextNum = etransMsgText.EtransMessageTextNum;
Etranss.Update(etrans);
//Now we need to update our cache of claims to reflect the change that took place in the database above in Etranss.SetClaimSentOrPrinted()
queueItems[j].ClaimStatus = "S";
}
}
}
