public static int Parse(Edi834DataAccess dbAccess,string content)
{
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;
// Int32 nWarningsCount;
string sPath = AppDomain.CurrentDomain.BaseDirectory;
string sSefFile = "834_005010X220A1.SemRef.SEF";
ediAcknowledgment oAck = null;
//string sValue;
//string sHlEntity = "";
//string sNm1Entity = "";
//string sQlfr;
//CREATES EDIDOC OBJECT
oEdiDoc = new ediDocument();
oEdiDoc.EventNotify += new EventNotifyDelegate(oEdiDoc_EventNotify);
//THIS MAKES CERTAIN THAT FREDI ONLY USES THE SEF FILE PROVIDED, AND THAT IT DOES
//NOT USE ITS BUILT-IN STANDARD REFERENCE TABLE TO TRANSLATE THE EDI FILE.
oSchemas = (ediSchemas)oEdiDoc.GetSchemas();
oSchemas.EnableStandardReference = false;
oAck = (ediAcknowledgment)oEdiDoc.GetAcknowledgment();
oAck.EnableInterchangeAcknowledgment = true;
//THIS OPTIONS STOPS FREDI FROM KEEPING ALL THE SEGMENTS IN MEMORY
oEdiDoc.CursorType = DocumentCursorTypeConstants.Cursor_ForwardOnly;
//LOADS THE SEF FILE
oEdiDoc.LoadSchema(sPath + sSefFile, SchemaTypeIDConstants.Schema_Standard_Exchange_Format);
//LOADS THE EDI FILE
oEdiDoc.LoadEdiString(content);
//GETS THE FIRST DATA SEGMENT
ediDataSegment.Set(ref oSegment, (ediDataSegment)oEdiDoc.FirstDataSegment);
MsgHeader msg_header=null;
MsgTrailer msg_trailer =null;
Int64 msg_HeaderID = 0;
Int64 msg_transID = 0;
TransactionHeader trans_Header = null;
TransactionTrailer trans_Trailer = null;
Member.HealthCoverage health_coverage=null;
Member.MemberReport member_report=null;
Member msg_Member = null;
while (oSegment != null)
{
sSegmentID = oSegment.ID;
sLoopSection = oSegment.LoopSection;
nArea = oSegment.Area;
// Debug.WriteLine("segment id ="+ sSegmentID+"\t section ="+sLoopSection+" \t nArea= "+nArea+"\r\t");
if (nArea == 0)
{
if (sLoopSection == "")
{
if (sSegmentID == "ISA")
{
if (msg_header == null)
msg_header = new MsgHeader();
msg_header.InterchangeControlHeader=oSegment.get_DataElementValue(1, 0);
msg_header.AuthorizationInformation = oSegment.get_DataElementValue(2, 0);
msg_header.SecurityInformationQualifier = oSegment.get_DataElementValue(3, 0);
msg_header.SecurityInformation = oSegment.get_DataElementValue(4, 0);
msg_header.InterchangeIDQualifier_1 = oSegment.get_DataElementValue(5, 0);
msg_header.InterchangeSenderID = oSegment.get_DataElementValue(6, 0);
msg_header.InterchangeIDQualifier_2 = oSegment.get_DataElementValue(7, 0);
msg_header.InterchangeReceiverID = oSegment.get_DataElementValue(8, 0);
msg_header.IntegerchangeDate = oSegment.get_DataElementValue(9, 0);
msg_header.IntegerchangeTime = oSegment.get_DataElementValue(10, 0);
msg_header.RepetitionSeperator = oSegment.get_DataElementValue(11, 0);
msg_header.InterchangeControlVersionNumber = oSegment.get_DataElementValue(12, 0);
msg_header.InterchangeControlNumber_header = oSegment.get_DataElementValue(13, 0);
msg_header.AcknowledgementRequest = oSegment.get_DataElementValue(14, 0);
msg_header.UsageIdentifier = oSegment.get_DataElementValue(15, 0);
msg_header.ComponentElementSeparator = oSegment.get_DataElementValue(16, 0);
}
else if (sSegmentID == "GS")
{
if (msg_header == null)
msg_header = new MsgHeader();
msg_header.FunctionalGroupHeader_header=oSegment.get_DataElementValue(1,0);
msg_header.ApplicationSendersCode=oSegment.get_DataElementValue(2,0);
msg_header.ApplicationReceiversCode=oSegment.get_DataElementValue(3,0);
msg_header.Date=oSegment.get_DataElementValue(4,0);
msg_header.Time=oSegment.get_DataElementValue(5,0);
msg_header.GroupControlNumber_header=oSegment.get_DataElementValue(6,0);
msg_header.ResponsibleAgencyCode=oSegment.get_DataElementValue(7,0);
msg_header.IndustryIndentifierCode=oSegment.get_DataElementValue(8,0);
dbAccess.InsertNewMessageHeader(msg_header); //insert it into the database;
msg_header = null;
msg_HeaderID = dbAccess.getHeaderID(); //get the header id;
}
else if (sSegmentID == "GE")
{
if (msg_trailer == null)
msg_trailer = new MsgTrailer();
msg_trailer.FunctionalGroupHeader_trailer = oSegment.get_DataElementValue(1, 0);
msg_trailer.GroupControlNumber_trailer = oSegment.get_DataElementValue(2, 0);
}
else if (sSegmentID == "IEA")
{
msg_trailer.InterchangeControlTrailer = oSegment.get_DataElementValue(1, 0);
msg_trailer.InterchangeControlNumber_trailer = oSegment.get_DataElementValue(2, 0);
dbAccess.insertNewMessageTrailer(msg_trailer,msg_HeaderID);
msg_trailer = null;
}
else
{
Debug.WriteLine("segment id ="+ sSegmentID+"\t section ="+sLoopSection+" \t nArea= "+nArea+" is not be recorded");
}
}
}
else if (nArea == 1)
{
if (trans_Header == null)
trans_Header = new TransactionHeader();
if (sLoopSection == "")
{
if (sSegmentID == "ST")
{
trans_Header.HeaderID = msg_HeaderID;
trans_Header.TransactionSetIdentifier = oSegment.get_DataElementValue(1, 0);
trans_Header.TranscationSetControlNumber = oSegment.get_DataElementValue(2, 0);
trans_Header.ImplementationConventionReference = oSegment.get_DataElementValue(3, 0);
}
else if (sSegmentID == "BGN")
{
if (trans_Header == null)
trans_Header = new TransactionHeader();
trans_Header.TransactionSetPurposeCode = oSegment.get_DataElementValue(1, 0);
trans_Header.ReferenceIdentification_BS = oSegment.get_DataElementValue(2, 0);
trans_Header.Date = oSegment.get_DataElementValue(3, 0);
trans_Header.Time = oSegment.get_DataElementValue(4, 0);
trans_Header.ActionCode = oSegment.get_DataElementValue(5, 0);
}
else if (sSegmentID == "REF")
{if (trans_Header == null)
trans_Header = new TransactionHeader();
trans_Header.ReferenceIdentificationQualifier = oSegment.get_DataElementValue(1, 0);
trans_Header.ReferenceIdentification = oSegment.get_DataElementValue(2, 0);
}
else if(sSegmentID=="DTP")
{
//LOOP
EDIModel.TransactionHeader.FileDate file_date;
file_date.Date_TimeQualifier=oSegment.get_DataElementValue(1,0);
file_date.DateTimePeriodFormatQualifier=oSegment.get_DataElementValue(2,0);
file_date.DateTimePeriod=oSegment.get_DataElementValue(3,0);
trans_Header.FileEffectiveDate.AddLast(file_date);
}
else if (sSegmentID == "QTY")
{
EDIModel.TransactionHeader.TransactionSets trans_set;
trans_set.QuantityQualifier = oSegment.get_DataElementValue(1, 0);
trans_set.Quantity = oSegment.get_DataElementValue(2, 0);
trans_Header.TransactionSetControlTotals.AddLast(trans_set);
}
}
else if (sLoopSection == "N1")
{
if (sSegmentID == "N1" )
{
string EntityIdentifier = oSegment.get_DataElementValue(1, 0);
if (EntityIdentifier == "P5")
{
trans_Header.EntityIdentifierCode_Sponsor = oSegment.get_DataElementValue(1, 0);
trans_Header.Name_Sponsor = oSegment.get_DataElementValue(2, 0);
trans_Header.IdentificationCodeQualifier_Sponsor = oSegment.get_DataElementValue(3, 0);
//optional
trans_Header.IdentificationCode_Sponsor = oSegment.get_DataElementValue(4, 0);
}
else if (EntityIdentifier =="IN")
{
trans_Header.EntityIdentifierCode_Payer= oSegment.get_DataElementValue(1, 0);
trans_Header.Name_Payer = oSegment.get_DataElementValue(2, 0);
trans_Header.IdentificationCodeQualifier_Payer = oSegment.get_DataElementValue(3, 0);
trans_Header.IdentificationCode_Payer = oSegment.get_DataElementValue(4, 0);
}
else
{
//LOOP
EDIModel.TransactionHeader.TPABroker tpa_broker;
tpa_broker.EntityIdentityCode = oSegment.get_DataElementValue(1, 0);
tpa_broker.Name_TPA_Broker = oSegment.get_DataElementValue(2, 0);
tpa_broker.IdentificationCodeQualifier_TPA_Broker = oSegment.get_DataElementValue(3, 0);
tpa_broker.IdentificationCode_TPA_Broker = oSegment.get_DataElementValue(4, 0);
trans_Header.TPABrokerAccount.AddLast(tpa_broker);
}
}
}
}
else if (nArea == 2)
{
if (trans_Header != null)
{
dbAccess.insertNewTransaction(trans_Header); //insert the header into database
msg_transID = dbAccess.getTransactionID();
dbAccess.insertNewTransaction_FileDate(trans_Header.FileEffectiveDate, msg_transID);
dbAccess.insertNewTransaction_Sets(trans_Header.TransactionSetControlTotals, msg_transID);
dbAccess.insertNewTransaction_TPABroker(trans_Header.TPABrokerAccount, msg_transID);
trans_Header = null;
}
if (sLoopSection == "INS")
{
if (sSegmentID == "INS")
{
//Start to import the memeber information;
msg_Member = null;
msg_Member = new Member();
msg_Member.Yes_No_Condition = oSegment.get_DataElementValue(1, 0);
msg_Member.IndividualRelationshipCode = oSegment.get_DataElementValue(2, 0);
msg_Member.MaintenanceTypeCode_MLD = oSegment.get_DataElementValue(3, 0);
//Optional
msg_Member.MaintenanceReasonCode = oSegment.get_DataElementValue(4, 0);
msg_Member.BenefitStatusCode = oSegment.get_DataElementValue(5, 0);
//Optional
msg_Member.EmploymentStatusCode = oSegment.get_DataElementValue(8, 0);
}
else if (sSegmentID == "REF")
{
string SubscriberNumber = oSegment.get_DataElementValue(1, 0);
if (SubscriberNumber == "0F")
{
msg_Member.SubscriberNumber = oSegment.get_DataElementValue(1, 0);
//Optional
msg_Member.ReferenceNumber = oSegment.get_DataElementValue(2, 0);
}
else if (SubscriberNumber == "1L")
{
msg_Member.MemberPolicyNumber = oSegment.get_DataElementValue(1, 0);
msg_Member.ReferenceIdentification_MPM = oSegment.get_DataElementValue(2, 0);
}
else
{
//LOOP
EDIModel.Member.MemberIdentification member_Identification;
member_Identification.MemberIdentificationNumber = oSegment.get_DataElementValue(1, 0);
member_Identification.ReferenceIdentification = oSegment.get_DataElementValue(2, 0);
msg_Member.MemberIdentificationNumber.AddLast(member_Identification);
}
}
else if (sSegmentID == "DTP")
{
EDIModel.Member.MemberDate member_level_date;
//optional
member_level_date.Date_Time_Qualifier = oSegment.get_DataElementValue(1, 0);
//optional
member_level_date.Date_Time_Format = oSegment.get_DataElementValue(2, 0);
//optional
member_level_date.Date_Time_Period = oSegment.get_DataElementValue(3, 0);
msg_Member.MemberLevelDate.AddLast(member_level_date);
}
else if (sSegmentID == "LS")
{
msg_Member.LoopIdentifierCode = oSegment.get_DataElementValue(1, 0);
}
else if (sSegmentID == "LE")
{
msg_Member.LoopIdentifierCode = oSegment.get_DataElementValue(1, 0);
}
}
else if (sLoopSection == "")
{
if (sSegmentID == "SE")
{
//Insert into database;
if (health_coverage != null)
{
msg_Member.HealthCoverages.AddLast(health_coverage);
health_coverage = null;
}
if (member_report != null)
{
msg_Member.MemberReportingCategories.AddLast(member_report);
member_report = null;
}
dbAccess.insertNewMember(msg_Member, msg_transID);// insert the member into the database
if (trans_Trailer == null)
trans_Trailer = new TransactionTrailer();
trans_Trailer.NumberOfIncludedSegments = oSegment.get_DataElementValue(1, 0);
trans_Trailer.TransactionSetControlNumber = oSegment.get_DataElementValue(2, 0);
dbAccess.insertNewTransactionTrailer(trans_Trailer, msg_transID);
trans_Trailer = null;
}
}
else if (sLoopSection == "INS;NM1")
{
if (sSegmentID == "NM1")
{
msg_Member.EntityIdentifierCode_Member = oSegment.get_DataElementValue(1, 0);
msg_Member.EntityTypeQualifier_Member = oSegment.get_DataElementValue(2, 0);
msg_Member.NameLast = oSegment.get_DataElementValue(3, 0);
msg_Member.NameFirst = oSegment.get_DataElementValue(4, 0);
//optional
msg_Member.NameMiddle = oSegment.get_DataElementValue(5, 0);
msg_Member.IdentificationCodeQualifier = oSegment.get_DataElementValue(8, 0);
//optional
msg_Member.IdentificationCode = oSegment.get_DataElementValue(9, 0);
}
else if (sSegmentID == "PER")
{
msg_Member.ContactFunctionCode = oSegment.get_DataElementValue(1, 0);
//keep empty if not given
msg_Member.CommunicationNumberQualifier_1 = oSegment.get_DataElementValue(3, 0);
msg_Member.CommunicationNumber_1 = oSegment.get_DataElementValue(4, 0);
msg_Member.CommunicationNumberQualifier_2 = oSegment.get_DataElementValue(5, 0);
msg_Member.CommunicationNumber_2 = oSegment.get_DataElementValue(6, 0);
msg_Member.CommunicationNumberQualifier_3 = oSegment.get_DataElementValue(7, 0);
msg_Member.CommunicationNumber_3 = oSegment.get_DataElementValue(8, 0);
}
else if (sSegmentID == "N3")
{
//Keep Empty if not Given
msg_Member.AddressLine_1 = oSegment.get_DataElementValue(1, 0);
//optional
msg_Member.AddressLine_2 = oSegment.get_DataElementValue(2, 0);
}
else if (sSegmentID == "N4")
{
msg_Member.City = oSegment.get_DataElementValue(1, 0);
msg_Member.State = oSegment.get_DataElementValue(2, 0);
msg_Member.PostalCode = oSegment.get_DataElementValue(3, 0);
//Optional
msg_Member.LocationQualifier = oSegment.get_DataElementValue(5, 0);
//optional
msg_Member.LocationIdentifier = oSegment.get_DataElementValue(6, 0);
}
else if (sSegmentID == "DMG")
{
msg_Member.Date_Time_FormatQualifier_MD = oSegment.get_DataElementValue(1, 0);
msg_Member.Date_Time_Period_MD = oSegment.get_DataElementValue(2, 0);
msg_Member.GenderCode = oSegment.get_DataElementValue(3, 0);
//optional
msg_Member.MaritalStatusCode = oSegment.get_DataElementValue(4, 0);
msg_Member.CompositeRaceOrEthnicityInformation = oSegment.get_DataElementValue(5, 0);
}
else if (sSegmentID == "HLH")
{
//optional
msg_Member.HealthRelatedCode = oSegment.get_DataElementValue(1, 0);
}
}
else if (sLoopSection == "INS;HD")
{
if (sSegmentID == "HD")
{
//LOOP Class
if (health_coverage == null)
health_coverage = new Member.HealthCoverage();
else
{
msg_Member.HealthCoverages.AddLast(health_coverage);
health_coverage = new Member.HealthCoverage();
}
health_coverage.MaintenanceTypeCode = oSegment.get_DataElementValue(1, 0);
health_coverage.InsuranceLineCode = oSegment.get_DataElementValue(3, 0);
//should set to be empty
health_coverage.PlanCoverageDescription = oSegment.get_DataElementValue(4, 0);
}
else if (sSegmentID == "DTP")
{
EDIModel.Member.HealthCoverage_Dates health_date;
health_date.Date_Time_Qualifier = oSegment.get_DataElementValue(1, 0);
health_date.Date_Time_FormatQualifier_HCD = oSegment.get_DataElementValue(2, 0);
health_date.Date_Time_Period_HCD = oSegment.get_DataElementValue(3, 0);
health_coverage.HealthCoverageDates.AddLast(health_date);
}
else if (sSegmentID == "REF")
{
EDIModel.Member.HealthPolicyNum policy_num;
policy_num.ReferenceIdentificationQualifier = oSegment.get_DataElementValue(1, 0);
policy_num.ReferenceIdentification = oSegment.get_DataElementValue(2, 0);
health_coverage.PolicyNumber.AddLast(policy_num);
}
}
else if (sLoopSection == "INS;LX")
{
if (sSegmentID == "LX")
{
if (member_report == null)
member_report = new Member.MemberReport();
else
{
msg_Member.MemberReportingCategories.AddLast(member_report);
member_report = new Member.MemberReport();
}
member_report.AssignedNumber = oSegment.get_DataElementValue(1, 0);
}
}
else if (sLoopSection == "INS;LX;N1")
{
if (sSegmentID == "N1")
{
member_report.EntityIdentifierCode = oSegment.get_DataElementValue(1, 0);
member_report.Name = oSegment.get_DataElementValue(2, 0);
}
else if (sSegmentID == "REF")
{
member_report.ReferenceIdentificationQualifier = oSegment.get_DataElementValue(1, 0);
member_report.ReferenceIdentification = oSegment.get_DataElementValue(2, 0);
}
}
}
ediDataSegment.Set(ref oSegment, (ediDataSegment)oSegment.Next());
}
//dbAccess.getHeaderTrailerID();
//Console.ReadKey();
string sFileName = "TA1_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";
oAck.Save(DIR_TA1_OUT+ sFileName);
oSchemas.Dispose();
oEdiDoc.Dispose();
return 0;
}
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
}
