/// <summary>
/// Inserts a string as a new LineServiceValue
/// </summary>
/// <param name="newValue"></param>
public void InsertLineService(LineHelper newValue)
{
baseXML = baseXML.Replace(LINEIDENTIFIER, LINEIDENTIFIER + newValue.ToXML());
}
public static List <string> ConvertBatchToXML(NHDG.NHDGCommon.Claims.ClaimBatch toConvert, string targetFolder)
{
List <string> fileData = new List <string>();
XMLClaimData xh;
foreach (NHDG.NHDGCommon.Claims.Claim aClaim in toConvert.Claims)
{
xh = new XMLClaimData();
claim localClaim = new claim();
localClaim.LoadWithDentrixIDs(aClaim.Identity.ClaimID.ToString(), aClaim.Identity.ClaimDB.ToString());
string claimtype;
if (localClaim.claim_type == claim.ClaimTypes.Predeterm || localClaim.claim_type == claim.ClaimTypes.SecondaryPredeterm)
{
claimtype = "P";
}
else
{
claimtype = "C";
}
xh.CLAIM_TYPE = claimtype;
// BILLING_PROVIDER
xh.BILLING_LASTNAME = "NEW HAVEN DENTAL GROUP";
xh.BILLING_FIRSTNAME = "";
xh.BILLING_ADDRESS1 = "123 York St";
xh.BILLING_ADDRESS2 = "4L";
xh.BILLING_CITY = "New Haven";
xh.BILLING_STATE = "CT";
xh.BILLING_ZIP = "06511";
xh.BILLING_NPIN = "1609916089";
xh.BILLING_STATE_LICENCE = "03419";
xh.BILLING_TIN_SSN = "061025204";
xh.BILLING_PHONE = "203-781-8051";
xh.BILLING_ADDITIONAL_ID = "";
// PAYTO_PROVIDER
xh.PAYTO_LASTNAME = CleanData(localClaim.doctor_last_name);
xh.PAYTO_FIRSTNAME = CleanData(localClaim.doctor_first_name);
xh.PAYTO_ADDRESS1 = CleanData(localClaim.doctor_address);
xh.PAYTO_ADDRESS2 = CleanData(localClaim.doctor_address2);
xh.PAYTO_CITY = CleanData(localClaim.doctor_city);
xh.PAYTO_STATE = CleanData(localClaim.doctor_state);
xh.PAYTO_ZIP = CleanData(localClaim.doctor_zip);
xh.PAYTO_NPIN = CleanData(aClaim.BillingDentist.NPINumber);
xh.PAYTO_STATE_LICENCE = ""; // ***
xh.PAYTO_TIN = CleanData(aClaim.BillingDentist.TIN);
xh.PAYTO_SSN = ""; // *** Do we need this?
xh.PAYTO_PHONE = CleanData(localClaim.doctor_phone_number_object.FormattedPhone);
xh.PAYTO_ADDITIONAL_ID = ""; // *** additional ID
// RENDERING_PROVIDER
xh.RENDERING_PROVIDER_LASTNAME = CleanData(localClaim.doctor_last_name);
xh.RENDERING_PROVIDER_FIRSTNAME = CleanData(localClaim.doctor_first_name);
xh.RENDERING_PROVIDER_SIGNATURE_DATE = ""; // *** Signature date
xh.RENDERING_PROVIDER_ADDRESS1 = CleanData(localClaim.doctor_address);
xh.RENDERING_PROVIDER_ADDRESS2 = CleanData(localClaim.doctor_address2);
xh.RENDERING_PROVIDER_CITY = CleanData(localClaim.doctor_city);
xh.RENDERING_PROVIDER_STATE = CleanData(localClaim.doctor_state);
xh.RENDERING_PROVIDER_ZIP = CleanData(localClaim.doctor_zip);
xh.RENDERING_PROVIDER_NPIN = CleanData(aClaim.BillingDentist.NPINumber);
xh.RENDERING_PROVIDER_LICENSE_NUMBER = CleanData(aClaim.BillingDentist.License);
if (localClaim.doctor_first_name.Contains("Eva")) // *** Hard-coded for the periodontist right now
{
xh.RENDERING_PROVIDER_SPECIALTY = "1223P0300X"; // Periodontics
}
else
{
xh.RENDERING_PROVIDER_SPECIALTY = "122300000X";
}
xh.RENDERING_PROVIDER_PHONE = CleanData(localClaim.doctor_phone_number_object.FormattedPhone);
xh.RENDERING_PROVIDER_ADDITIONAL_ID = ""; // *** additional ID
// SUBSCRIBER
xh.SUBSCRIBER_LASTNAME = CleanData(localClaim.subscriber_last_name);
xh.SUBSCRIBER_FIRSTNAME = CleanData(localClaim.subscriber_first_name);
xh.SUBSCRIBER_MIDDLENAME = CleanData(localClaim.subscriber_middle_initial);
xh.SUBSCRIBER_SUFFIX = "";
xh.SUBSCRIBER_ADDRESS1 = CleanData(localClaim.subscriber_address);
xh.SUBSCRIBER_ADDRESS2 = CleanData(localClaim.subscriber_address2);
xh.SUBSCRIBER_CITY = CleanData(localClaim.subscriber_city);
xh.SUBSCRIBER_STATE = CleanData(localClaim.subscriber_state);
xh.SUBSCRIBER_ZIP = CleanData(localClaim.subscriber_zip);
xh.SUBSCRIBER_DOB = ConvertDateTime(localClaim.subscriber_dob);
xh.SUBSCRIBER_GENDER = ConvertGender(aClaim.Subscriber.Sex);
xh.SUBSCRIBER_ID = CleanData(aClaim.Subscriber.ID);
xh.SUBSCRIBER_GROUP_PLAN_NAME = CleanData(localClaim.subscriber_group_name);
xh.SUBSCRIBER_GROUP_PLAN_NUMBER = CleanData(localClaim.subscriber_group_number);
xh.SUBSCRIBER_EMPLOYER_NAME = CleanData(aClaim.Subscriber.Employer.Name);
xh.SUBSCRIBER_INSURANCE_SEQUENCE = "P"; // *** Not sure how this should be used
xh.SUBSCRIBER_SIGNATURE = "Yes";
xh.SUBSCRIBER_SIGNATURE_DATE = ""; // *** Another signature date field, not sure
// PATIENT
xh.PATIENT_RELATION = ConvertRelationship(aClaim.Patient.SubscriberRelationship); // *** Excel document lists this as subscriber_relation, do all relationships work the same way?
xh.PATIENT_STUDENTSTATUS = CleanData(aClaim.Patient.StudentStatus); // We're ignoring this currently
xh.PATIENT_LASTNAME = CleanData(localClaim.patient_last_name);
xh.PATIENT_FIRSTNAME = CleanData(localClaim.patient_first_name);
xh.PATIENT_MIDDLENAME = CleanData(localClaim.patient_middle_initial);
xh.PATIENT_SUFFIX = "";
xh.PATIENT_ADDRESS1 = CleanData(localClaim.patient_address);
xh.PATIENT_ADDRESS2 = CleanData(localClaim.patient_address2);
xh.PATIENT_CITY = CleanData(localClaim.patient_city);
xh.PATIENT_STATE = CleanData(localClaim.patient_state);
xh.PATIENT_ZIP = CleanData(localClaim.patient_zip);
xh.PATIENT_DOB = ConvertDateTime(localClaim.patient_dob);
xh.PATIENT_GENDER = ConvertGender(aClaim.Patient.Sex);
xh.PATIENT_ID = CleanData(aClaim.Patient.ID);
xh.PATIENT_SIGNATURE = "Yes";
xh.PATIENT_SIGNATURE_DATE = ""; // *** Signature date
// PRIMARY_PAYER // *** Primary payer section, not sure what this is
xh.PRIMARY_PAYER_NAME = CleanData(localClaim.payer_name);
xh.PRIMARY_PAYER_ID = CleanData(localClaim.payer_id); // This should be the electronic ID used in eclaims
xh.PRIMARY_PAYER_ADDRESS1 = CleanData(aClaim.GeneralInformation.Carrier.Address.Street1);
xh.PRIMARY_PAYER_ADDRESS2 = CleanData(aClaim.GeneralInformation.Carrier.Address.Street2);
xh.PRIMARY_PAYER_CITY = CleanData(aClaim.GeneralInformation.Carrier.Address.City);
xh.PRIMARY_PAYER_STATE = CleanData(aClaim.GeneralInformation.Carrier.Address.State);
xh.PRIMARY_PAYER_ZIP = CleanData(aClaim.GeneralInformation.Carrier.Address.Zip);
// OTHER_COVERAGE
if (aClaim.OtherPolicy == null)
{
xh.OTHERPAYER_FLAG = "N";
}
else
{
xh.OTHERPAYER_FLAG = "Y";
CommonFunctions.FormattedName subscriberName = CommonFunctions.GetFormattedName(aClaim.OtherPolicy.SubscriberName);
xh.OTHER_SUBSCRIBER_LASTNAME = subscriberName.LastName;
xh.OTHER_SUBSCRIBER_FIRSTNAME = subscriberName.FirstName;
xh.OTHER_SUBSCRIBER_MIDDLENAME = subscriberName.MiddleInitial;
xh.OTHER_SUBSCRIBER_SUFFIX = "";
xh.OTHER_SUBSCRIBER_DOB = ConvertToMercuryDateTime(aClaim.OtherPolicy.SubscriberBirthDate);
xh.OTHER_SUBSCRIBER_GENDER = ConvertGender(aClaim.OtherPolicy.SubscriberSex);
xh.OTHER_SUBSCRIBER_ID = CleanData(aClaim.OtherPolicy.SubscriberID);
xh.OTHER_SUBSCRIBER_GROUP_PLAN_NAME = CleanData(aClaim.OtherPolicy.PlanName);
xh.OTHER_SUBSCRIBER_GROUP_PLAN_NUMBER = CleanData(aClaim.OtherPolicy.PolicyNumber);
xh.OTHER_SUBSCRIBER_RELATION = ConvertRelationshipString(aClaim.OtherPolicy.PatientRelationship);
xh.OTHER_SUBSCRIBER_ADDRESS1 = CleanData(aClaim.OtherPolicy.SubscriberAddress.Street1);
xh.OTHER_SUBSCRIBER_ADDRESS2 = CleanData(aClaim.OtherPolicy.SubscriberAddress.Street2);
xh.OTHER_SUBSCRIBER_CITY = CleanData(aClaim.OtherPolicy.SubscriberAddress.City);
xh.OTHER_SUBSCRIBER_STATE = CleanData(aClaim.OtherPolicy.SubscriberAddress.State);
xh.OTHER_SUBSCRIBER_ZIP = CleanData(aClaim.OtherPolicy.SubscriberAddress.Zip);
xh.OTHER_SUBSCRIBER_INSURANCE_SEQUENCE = "S"; // May need to look into this more
xh.OTHER_SUBSCRIBER_COB_PAYER_PAID_AMT = ""; // Same as above - leaving this blank for now
xh.OTHER_SUBSCRIBER_COB_PATIENT_RESP_AMT = ""; // Same as above - leaving this blank for now
// *********************** Not sure what to fill in for this entire Other Payer section
Dictionary <string, string> payerInfo = GetOtherPayerID(aClaim.OtherPolicy.PlanName);
if (payerInfo != null)
{
xh.OTHERPAYER_NAME = payerInfo["name"];
xh.OTHERPAYER_ID = payerInfo["id"];
}
else
{
xh.OTHERPAYER_NAME = CleanData(aClaim.OtherPolicy.PlanName);
xh.OTHERPAYER_ID = CleanData(aClaim.OtherPolicy.SubscriberID);
}
xh.OTHERPAYER_ADDRESS1 = CleanData(aClaim.OtherPolicy.InsuranceAddress.Street1);
xh.OTHERPAYER_ADDRESS2 = CleanData(aClaim.OtherPolicy.InsuranceAddress.Street2);
xh.OTHERPAYER_CITY = CleanData(aClaim.OtherPolicy.InsuranceAddress.City);
xh.OTHERPAYER_STATE = CleanData(aClaim.OtherPolicy.InsuranceAddress.State);
xh.OTHERPAYER_ZIP = CleanData(aClaim.OtherPolicy.InsuranceAddress.Zip);
xh.OTHERPAYER_CONTACT_NAME = "";
xh.OTHERPAYER_CONTACT_EMAIL = "";
xh.OTHERPAYER_CONTACT_TELEPHONE = "";
xh.OTHERPAYER_CONTACT_FAX = "";
xh.OTHERPAYER_CLAIM_PAID_DATE = "";
// ********************************************************************************************
}
// CLAIM
xh.CLAIM_NUMBER = localClaim.id.ToString();
xh.SERVICE_DATE = ConvertDateTime(localClaim.date_of_service);
xh.PREDIDENTIFICATION = ""; // *** PRED Identification?
xh.OTHERFEE = ""; // Ignore
xh.TOTAL_AMOUNT = localClaim.amount_of_claim.ToString();
// ***** COME BACK TO THIS - Missing teeth
// MISSING_TOOTHS
// xh.MISSING_TOOTH = "";
// *** Diagnosis qualifier and diagnosis codes don't appear to be available
xh.DIAG_QUALIFIER = ""; // For now, ignore
// DIAGNOSIS_CODES
xh.DIAGNOSIS_CODES_A = "";
xh.DIAGNOSIS_CODES_D = "";
xh.DIAGNOSIS_CODES_D = "";
xh.DIAGNOSIS_CODES_D = "";
xh.CLAIM_NOTES = "";
xh.PLACE_SERVICE = "OFF";
// Enclosures
xh.ENCLOSURES_RADIOGRAPH = CleanData(aClaim.AncillaryData.NumRadiographsEnclosed.ToString());
xh.ENCLOSURES_ORAL_IMAGES = ""; // Ignore
xh.ENCLOSURES_MODELS = ""; // Ignore
xh.ORTHOCLAIM = CommonFunctions.ToYesNo(aClaim.AncillaryData.Orthodontics.TreatmentForOrthodontics)[0].ToString();
xh.APPLIANCE_PLACEMENT_DATE = ConvertToMercuryDateTime(aClaim.AncillaryData.Orthodontics.DateAppliancePlaced);
if (ConvertEmptyToN(aClaim.AncillaryData.Prosthesis.InitialReplacement) == "N")
{
xh.PLACEMENT_TYPE = "Initial";
}
else
{
xh.PLACEMENT_TYPE = "Replacement";
}
xh.MONTHS_TREATMENT_REMAININT = CleanData(aClaim.AncillaryData.Orthodontics.RemainingMonths.ToString());
xh.REPLACEMENT_PROSTHESIS = ConvertEmptyToN(aClaim.AncillaryData.Prosthesis.InitialReplacement);
xh.PROIR_PLACEMENT_DATE = ConvertToMercuryDateTime(aClaim.AncillaryData.Prosthesis.PriorPlacement);
xh.OCCUPATIONAL_ILLNESS = "N"; // Ignore this, we track auto or other
if (aClaim.BillingDentist.Accident.Type == NHDG.NHDGCommon.Claims.AccidentType.Automobile)
{
xh.AUTO_ACCIDENT = "Y";
xh.OTHER_ACCIDENT = "N";
}
else if (aClaim.BillingDentist.Accident.Type == NHDG.NHDGCommon.Claims.AccidentType.Other)
{
xh.OTHER_ACCIDENT = "Y";
xh.AUTO_ACCIDENT = "N";
}
else
{
xh.AUTO_ACCIDENT = "N";
xh.OTHER_ACCIDENT = "N";
}
xh.ACCIDENT_DATE = aClaim.AncillaryData.DateOfAccident;
xh.ACCIDENT_STATE = aClaim.AncillaryData.AccidentState;
xh.ADMISSION_DATE = ""; // Ignore
xh.TOT_TREATMENT_PERIOD = ""; // Ignore
// We just won't have any attachments for now, can ask if this is important though
// ATTACHMENTS
xh.ATTACHMENT_ID = "";
// LINE_SERVICE
foreach (NHDG.NHDGCommon.Claims.Treatment t in aClaim.TreatmentInformation.Treatments)
{
LineHelper lh = new LineHelper();
lh.SERVICE_DATE = ConvertToMercuryDateTime(t.ProcedureDate);
lh.CAVITY_DESIGNATION = ""; // Ignore
lh.TOOTH_SYSTEM = ""; // Ignore
lh.PROCEDURE_CODE = t.ProcedureCode;
lh.DIAGNOSIS_POINTER = ""; // *** Ignore for now, we're not using on ADA form
lh.QUANTITY = t.Quantity;
lh.PROCEDURE_DESCRIPTION = CleanData(t.Description);
lh.FEE = t.Fee;
lh.LINE_NOTES = "";
try
{
// teeth
foreach (string aTooth in ConvertToothsToList(t.Tooth, t.ToothEnd))
{
lh.InsertTooth(aTooth);
}
}
catch (Exception ex)
{
C_DentalClaimTracker.LoggingHelper.Log(ex, false);
// Send it anyway, but log an error here
}
// surfaces
if (t.Surface != "")
{
foreach (char aChar in t.Surface.ToCharArray())
{
lh.InsertSurface(aChar.ToString());
}
}
xh.InsertLineService(lh);
}
fileData.Add(xh.MainDocAsString);
}
return(fileData);
}
