public static int Run()
{
dbAccess = new Edi834DataAccess();
Extras.Logging log = new Extras.Logging();
string sEdiFile = ""; ;
ediDocument oEdiDoc = null;
ediSchema oSchema = null;
ediSchemas oSchemas = null;
ediInterchange oInterchange = null;
ediGroup oGroup = null;
ediTransactionSet oTransactionset = null;
ediDataSegment oSegment = null;
// ediAcknowledgment oAck = null;
// ediWarning oWarning = null;
// ediWarnings oWarnings = null;
string sPath = AppDomain.CurrentDomain.BaseDirectory;
string sSefFile = "834_005010X220A1.SemRef.SEF";
string InterchangeControlNumber = "0000000000"; //For temp testing purpose
DataTable dt = dbAccess.GetEnrollmentData();
string sDate = DateTime.Now.ToString("yyyyMMdd");
string sTime = DateTime.Now.ToString("HHmm");
try
{
string fileLastName = ""; // Used to ensure that no more than 1 edi message is generated a second when batching (which we never seem to do; but this prepares us)
// This ensures that the batch file names are unique by making sure that only one file name is generated per second
// However, the performance hit on ImportSchemas seems to limit it as well
while (fileLastName == (sEdiFile = "834_X220A1_" +
System.DateTime.Now.Year.ToString() +
System.DateTime.Now.Month.ToString().PadLeft(2, '0') +
System.DateTime.Now.Day.ToString().PadLeft(2, '0') +
System.DateTime.Now.Hour.ToString().PadLeft(2, '0') +
System.DateTime.Now.Minute.ToString().PadLeft(2, '0') +
System.DateTime.Now.Second.ToString().PadLeft(2, '0') + ".txt"))
{
System.Threading.Thread.Sleep(100);
}
fileLastName = sEdiFile;
// Create the new EDI_SndMsg Record
//InterchangeControlNumber = dbAccess.AddMsg(oFacility.FacilityID, "", sEdiFile, 0);
#region Create Edi document
oEdiDoc = new ediDocument();
// Change the cursor type from dynamic to forward to improve speed performance
oEdiDoc.CursorType = DocumentCursorTypeConstants.Cursor_ForwardWrite;
// Disable the internal standard reference library to be memory effecient
oSchemas = oEdiDoc.GetSchemas();
oSchemas.EnableStandardReference = false;
// Load the SEF file
oSchema = oEdiDoc.ImportSchema(sPath + sSefFile, 0);
// Set termintors
oEdiDoc.SegmentTerminator = "~";
oEdiDoc.ElementTerminator = "*";
oEdiDoc.CompositeTerminator = ":";
#endregion Create Edi document
#region Create File Header
// ISA Interchange Control Header Segment
ediInterchange.Set(ref oInterchange, (ediInterchange)oEdiDoc.CreateInterchange("X", "005010")); // 5010 Change
ediDataSegment.Set(ref oSegment, (ediDataSegment)oInterchange.GetDataSegmentHeader());
oSegment.set_DataElementValue(1, 0, Valence.ISASegment.InfoQualifier); //Authorization Information Qualifier
oSegment.set_DataElementValue(2, 0, " "); //Authorization Information
oSegment.set_DataElementValue(3, 0, Valence.ISASegment.InfoQualifier); //Security Information Qualifier
oSegment.set_DataElementValue(4, 0, " "); //Security Information
oSegment.set_DataElementValue(5, 0, Valence.ISASegment.InterchangeIDQualifier); //Interchange ID Qualifier
oSegment.set_DataElementValue(6, 0, "582335921".PadRight(15, ' ')); //Interchange Sender ID
oSegment.set_DataElementValue(7, 0, Valence.ISASegment.InterchangeIDQualifier); //Interchange ID Qualifier
oSegment.set_DataElementValue(8, 0, "582335921".PadRight(15, ' ')); //Interchange Receiver ID
oSegment.set_DataElementValue(9, 0, sDate.Substring(2)); //Interchange Date
oSegment.set_DataElementValue(10, 0, sTime); //Interchange Time
oSegment.set_DataElementValue(11, 0, "^"); //Interchange Control Standards Identifier
oSegment.set_DataElementValue(12, 0, "00501"); //Interchange Control Version Number // 5010 Change
oSegment.set_DataElementValue(13, 0, InterchangeControlNumber); //Interchange Control Number
oSegment.set_DataElementValue(14, 0, "1"); //Acknowledgment Requested
//oSegment.set_DataElementValue(15, 0, InstaMed.ISASegment.Environment.Testing); //Usage Indicator
//oSegment.set_DataElementValue(15, 0, InstaMed.ISASegment.Environment.Production); //Usage Indicator
oSegment.set_DataElementValue(15, 0, ConfigurationManager.AppSettings["Environment"]); //Usage Indicator
oSegment.set_DataElementValue(16, 0, ":"); //Component Element Separator
// GS Functional Group Header Segment
ediGroup.Set(ref oGroup, (ediGroup)oInterchange.CreateGroup("005010X220A1"));// 5010 Change
ediDataSegment.Set(ref oSegment, (ediDataSegment)oGroup.GetDataSegmentHeader());
oSegment.set_DataElementValue(1, 0, Valence.GSSegment.FunctionalIdentifierCode); //Functional Identifier Code
oSegment.set_DataElementValue(2, 0, "582335921"); //Application Sender's Code
oSegment.set_DataElementValue(3, 0, "582335921"); //Application Receiver's Code
oSegment.set_DataElementValue(4, 0, sDate); //Date
oSegment.set_DataElementValue(5, 0, sTime); //Time
oSegment.set_DataElementValue(6, 0, Valence.GSSegment.GroupControlNumber); //Group Control Number
oSegment.set_DataElementValue(7, 0, "X"); //Responsible Agency Code
oSegment.set_DataElementValue(8, 0, "005010X220A1"); //Version / Release / Industry Identifier Code // 5010 Change
#endregion Create File Header
int count=0;
foreach (DataRow dr in dt.Rows)
{
if (!validateData(dr))
continue;
#region LOOP ID - 2000 Member Level Detail
Member oMember = setupMember(dr);
if (oMember == null) // Status = General error/invaid claim
{
//dbAccess.UpdateClaimStatus(Convert.ToInt32(dsClaims.Tables[0].Rows[iClaim]["EDIClaimID"].ToString()), cCLAIMSTATUS_ERRORGENERAL, InterchangeControlNumber);
log.writeToAppLog("INVALID CLAIM", "Updating status to errored. Enrollment is missing required fields.\t\n" + dr["PolicyID"] + "\t" + dr["LastName"] + "\t" + dr["FirstName"] + "\t" + dr["MiddleName"] + "\t" + dr["SSN"] + "\t" + dr["Phone"] + "\t" + dr["Address"] + "\t" + dr["City"] + "\t" + dr["State"] + "\t" + dr["Zip"] + "\t" + dr[" DOB"] + "\t" + dr["Gender"] + "\t" + dr["PlanName"] + "\t" + dr["StartDate"] + "\r\n", "", "");
continue;
}
ediTransactionSet.Set(ref oTransactionset, (ediTransactionSet)oGroup.CreateTransactionSet("834"));
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.GetDataSegmentHeader());
oSegment.set_DataElementValue(1, 0, "834"); //Transaction Set Identifier Code
count++;
oSegment.set_DataElementValue(2, 0,count+"" ); //Transaction Set Control Number
oSegment.set_DataElementValue(3, 0, "005010X220A1");
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("BGN"));
oSegment.set_DataElementValue(1, 0, "00"); //"00"-Original
oSegment.set_DataElementValue(2, 0, "12345"); //An ID for this transaction set, need to be generated
oSegment.set_DataElementValue(3, 0, sDate);
oSegment.set_DataElementValue(4, 0, sTime);
oSegment.set_DataElementValue(5, 0, "CT");//Time Zone
oSegment.set_DataElementValue(8, 0, ConfigurationManager.AppSettings["ActionCode"]); //2-Change, 4-Verify, RX-Replace
//ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("REF"));
//oSegment.set_DataElementValue(1, 0, "38");
//oSegment.set_DataElementValue(2, 0, "ALL");
#region LOOP ID - 1000A Sponsor Name
//N1 Plan Sponsor
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("N1\\N1"));
oSegment.set_DataElementValue(1, 0, "P5"); //P5-Plan Sponsor
oSegment.set_DataElementValue(2, 0, "Alliant Health Plans");//Free-form Name
oSegment.set_DataElementValue(3, 0, "FI"); //Frderal Tax ID
oSegment.set_DataElementValue(4, 0, "582335921");
#endregion
#region LOOP ID - 1000B Payer Name
//N1 Plan Sponsor
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("N1\\N1"));
oSegment.set_DataElementValue(1, 0, "IN"); //IN-Insurer
oSegment.set_DataElementValue(2, 0, "PHR");
oSegment.set_DataElementValue(3, 0, "FI");//Frderal Tax ID
oSegment.set_DataElementValue(4, 0, "582335921");
#endregion
#region LOOP ID - 1000C Broker Name
//ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("N1\\N1"));
//oSegment.set_DataElementValue(1, 0, "BO"); //BO-Broker
//oSegment.set_DataElementValue(2, 0, ""); //Broker Name
//oSegment.set_DataElementValue(1, 0, "94"); //94-National Producer Number (NPN)
//oSegment.set_DataElementValue(2, 0, ""); //Broker NPN
#endregion
//// HL Counters for loops
//int nHlCounter = 1;
//int nHlSubscriberParent = 1;
//int nHlDependentParent = 0;
//Subscriber
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("INS\\INS"));
oSegment.set_DataElementValue(1, 0, oMember.Yes_No_Condition);
oSegment.set_DataElementValue(2, 0, oMember.IndividualRelationshipCode); //18-Self
oSegment.set_DataElementValue(3, 0, oMember.MaintenanceTypeCode_MLD);//021-Addition
/*INS03 Maintainance Type
001 = Change (change existing record)
021 = Addition (used to add subscriber or dependent)
024 = Cancellation or Termination
025 = Reinstatement
030 = Audit or Compare (BGN08 = 4 or RX)*/
oSegment.set_DataElementValue(4, 0,oMember.MaintenanceReasonCode); //Maintainance Reason, leave blank
oSegment.set_DataElementValue(5, 0, oMember.BenefitStatusCode);
/*INS05 Benefit Status Code
A = Active
C = Cobra
S = Surviving Insured
T = Tax Equity and Fiscal Responsibility Act (TEFRA)
*/
oSegment.set_DataElementValue(8, 0, oMember.EmploymentStatusCode); //FT- Full-time
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("INS\\REF"));
oSegment.set_DataElementValue(1, 0, oMember.SubscriberNumber); //OF-Subscriber Number
oSegment.set_DataElementValue(2, 0, oMember.ReferenceNumber);
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("INS\\REF"));
oSegment.set_DataElementValue(1, 0, oMember.MemberPolicyNumber); //1L-Group
oSegment.set_DataElementValue(2, 0, oMember.ReferenceIdentification_MPM);
foreach(EDIModel.Member.MemberIdentification identification in oMember.MemberIdentificationNumber)
{
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("INS\\REF"));
oSegment.set_DataElementValue(1, 0, identification.MemberIdentificationNumber); //23-Person Code
oSegment.set_DataElementValue(2, 0, identification.ReferenceIdentification); //Reference Identification
}
#region LOOP ID - 2100A Member Name
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("INS\\NM1\\NM1"));
oSegment.set_DataElementValue(1, 0, oMember.EntityIdentifierCode_Member); //IL-Insured or Subscriber
oSegment.set_DataElementValue(2, 0,oMember.EntityTypeQualifier_Member); //1 -Person
oSegment.set_DataElementValue(3, 0, oMember.NameLast); //indiviual last name
oSegment.set_DataElementValue(4, 0, oMember.NameFirst);
oSegment.set_DataElementValue(5, 0, oMember.NameMiddle);
oSegment.set_DataElementValue(8, 0, oMember.IdentificationCodeQualifier); //34-Social Security Number
oSegment.set_DataElementValue(9, 0, oMember.IdentificationCode);
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("INS\\NM1\\PER"));
oSegment.set_DataElementValue(1, 0, oMember.ContactFunctionCode); //IP -Insured Party
oSegment.set_DataElementValue(3, 0, oMember.CommunicationNumberQualifier_1); //Telephone
oSegment.set_DataElementValue(4, 0, oMember.CommunicationNumber_1);
oSegment.set_DataElementValue(5, 0, oMember.CommunicationNumberQualifier_2);
oSegment.set_DataElementValue(6, 0, oMember.CommunicationNumber_2);
//oSegment.set_DataElementValue(5, 0, "TE"); //Communication Number Qualifier TE - Telephone
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("INS\\NM1\\N3"));
oSegment.set_DataElementValue(1, 0, oMember.AddressLine_1);
oSegment.set_DataElementValue(2, 0, oMember.AddressLine_2);
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("INS\\NM1\\N4"));
oSegment.set_DataElementValue(1, 0, oMember.City);
oSegment.set_DataElementValue(2, 0, oMember.State);
oSegment.set_DataElementValue(3, 0, oMember.PostalCode);
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("INS\\NM1\\DMG"));
oSegment.set_DataElementValue(1, 0, oMember.Date_Time_FormatQualifier_MD); //D8 - Date Expressed in Format CCYYMMDD
oSegment.set_DataElementValue(2, 0, oMember.Date_Time_Period_MD);
oSegment.set_DataElementValue(3, 0, oMember.GenderCode);
#endregion LOOP 2100a
#region LOOP ID - 2300 Health Coverage
foreach (Member.HealthCoverage hc in oMember.HealthCoverages )
{
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("INS\\HD\\HD"));
oSegment.set_DataElementValue(1, 0,hc.MaintenanceTypeCode ); //021- Addition
oSegment.set_DataElementValue(3, 0, hc.InsuranceLineCode); //HLT -Health
oSegment.set_DataElementValue(4, 0, hc.PlanCoverageDescription);
// oSegment.set_DataElementValue(5, 0, "IND"); //IND- Individual
foreach(Member.HealthCoverage_Dates date in hc.HealthCoverageDates)
{
ediDataSegment.Set(ref oSegment, (ediDataSegment)oTransactionset.CreateDataSegment("INS\\HD\\DTP"));
oSegment.set_DataElementValue(1, 0, date.Date_Time_Qualifier); //348-Benefit Begin
oSegment.set_DataElementValue(2, 0, date.Date_Time_FormatQualifier_HCD);
oSegment.set_DataElementValue(3, 0, date.Date_Time_Period_HCD);
}
}
#endregion LOOP 2300
#endregion LOOP 2000
}
oEdiDoc.Save(DIR_Valence_Out + sEdiFile);
oEdiDoc.Dispose();
}//try
catch (Exception ex)
{
log.writeToAppLog("ERROR", ex.ToString() + "r\n", "", "");
throw new Exception(ex.ToString());
}
return 0; // return Total Number of Claims
}
