protected string SetSubmitterName(DataRow x, string strDefaultSep, string strEOS)
{
MNBilling oNM1 = new MNBilling();
NM1_SubmitterName_1000A Q = new NM1_SubmitterName_1000A();
try
{
Q.NM101__EntityIdentifierCode = NM1_SubmitterName_1000ANM101__EntityIdentifierCode.Item41;
Q.NM102__EntityTypeQualifier = NM1_SubmitterName_1000ANM102__EntityTypeQualifier.Item2;
Q.NM103__SubmitterLastOrOrganizationName = x["Biller"].ToString();
Q.NM104__SubmitterFirstName = "";
Q.NM105__SubmitterMiddleNameOrInitial = "";
Q.NM106 = "";
Q.NM107 = "";
Q.NM108__IdentificationCodeQualifier = NM1_SubmitterName_1000ANM108__IdentificationCodeQualifier.Item46;
Q.NM109__SubmitterIdentifier = x["NPI"].ToString();
return("NM1" + strDefaultSep + "41" + strDefaultSep + "2" + strDefaultSep + Q.NM103__SubmitterLastOrOrganizationName +
strDefaultSep + Q.NM104__SubmitterFirstName + strDefaultSep + Q.NM105__SubmitterMiddleNameOrInitial + strDefaultSep +
Q.NM106 + strDefaultSep + Q.NM107 + strDefaultSep + "46" + strDefaultSep + Q.NM109__SubmitterIdentifier + strEOS);
}
catch (Exception ex)
{
throw ex;
}
}
protected string SetReceiverName(DataRow x, string strDefaultSep, string strEOS)
{
MNBilling oNM1 = new MNBilling();
NM1_ReceiverName_1000B Q = new NM1_ReceiverName_1000B();
try
{
Q.NM101__EntityIdentifierCode = NM1_ReceiverName_1000BNM101__EntityIdentifierCode.Item40;
Q.NM102__EntityTypeQualifier = NM1_ReceiverName_1000BNM102__EntityTypeQualifier.Item2;
Q.NM103__ReceiverName = x["Payer"].ToString();
Q.NM104 = "";
Q.NM105 = "";
Q.NM106 = "";
Q.NM107 = "";
Q.NM108__IdentificationCodeQualifier = NM1_ReceiverName_1000BNM108__IdentificationCodeQualifier.Item46;
Q.NM109__ReceiverPrimaryIdentifier = x["PayerID"].ToString();
return("NM1" + strDefaultSep + "40" + strDefaultSep + "2" + strDefaultSep + Q.NM103__ReceiverName +
strDefaultSep + Q.NM104 + strDefaultSep + Q.NM105 + strDefaultSep +
Q.NM106 + strDefaultSep + Q.NM107 + strDefaultSep + "46" + strDefaultSep + Q.NM109__ReceiverPrimaryIdentifier + strEOS);
}
catch (Exception ex)
{
throw ex;
}
}
protected string SetBillingProviderName(DataRow x, string strDefaultSep, string strEOS)
{
MNBilling oNM1 = new MNBilling();
NM1_BillingProviderName_2010AA Q = new NM1_BillingProviderName_2010AA();
try
{
Q.NM101__EntityIdentifierCode = NM1_BillingProviderName_2010AANM101__EntityIdentifierCode.Item85;
Q.NM102__EntityTypeQualifier = NM1_BillingProviderName_2010AANM102__EntityTypeQualifier.Item2;
Q.NM103__BillingProviderLastOrOrganizationalName = x["Biller"].ToString();
Q.NM104__BillingProviderFirstName = "";
Q.NM105__BillingProviderMiddleNameOrInitial = "";
Q.NM106 = "";
Q.NM107__BillingProviderNameSuffix = "";
Q.NM108__IdentificationCodeQualifier = NM1_BillingProviderName_2010AANM108__IdentificationCodeQualifier.XX;
Q.NM109__BillingProviderIdentifier = x["NPI"].ToString();
return("NM1" + strDefaultSep + "85" + strDefaultSep + "2" + strDefaultSep + Q.NM103__BillingProviderLastOrOrganizationalName +
strDefaultSep + Q.NM104__BillingProviderFirstName + strDefaultSep + Q.NM105__BillingProviderMiddleNameOrInitial + strDefaultSep +
Q.NM106 + strDefaultSep + Q.NM107__BillingProviderNameSuffix + strDefaultSep + "XX" + strDefaultSep + Q.NM109__BillingProviderIdentifier + strEOS);
}
catch (Exception ex)
{
throw ex;
}
}
protected string SetST(string strControlNo, string strDefaultSep, string strEOS)
{
MNBilling oST = new MNBilling();
try
{
oST.ST_TransactionSetHeader = new ST_TransactionSetHeader();
oST.ST_TransactionSetHeader.ST02__TransactionSetControlNumber = strControlNo;
oST.ST_TransactionSetHeader.ST01__TransactionSetIdentifierCode = ST_TransactionSetHeaderST01__TransactionSetIdentifierCode.Item837;
oST.ST_TransactionSetHeader.ST03__ImplementationGuideVersionName = "005010X222A1";
return("ST" + strDefaultSep + "837" + strDefaultSep + oST.ST_TransactionSetHeader.ST02__TransactionSetControlNumber + strDefaultSep + oST.ST_TransactionSetHeader.ST03__ImplementationGuideVersionName + strEOS);
}
catch (Exception ex)
{
throw ex;
}
}
protected string SetBillingProviderLevel(int intHID, string strDefaultSep, string strEOS)
{
MNBilling oHL = new MNBilling();
HL_BillingProviderHierarchicalLevel_2000A Y = new HL_BillingProviderHierarchicalLevel_2000A();
try
{
Y.HL01__HierarchicalIDNumber = "1";
Y.HL02 = "";
Y.HL03__HierarchicalLevelCode = HL_BillingProviderHierarchicalLevel_2000AHL03__HierarchicalLevelCode.Item20;
Y.HL04__HierarchicalChildCode = HL_BillingProviderHierarchicalLevel_2000AHL04__HierarchicalChildCode.Item1;
return("HL" + strDefaultSep + Y.HL01__HierarchicalIDNumber + strDefaultSep + Y.HL02 + strDefaultSep + "20" + strDefaultSep + "1" + strEOS);
}
catch (Exception ex)
{
throw ex;
}
}
protected string SetBHT(string strControlNo, string strDefaultSep, string strEOS)
{
MNBilling oBHT = new MNBilling();
BHT_BeginningOfHierarchicalTransaction P = new BHT_BeginningOfHierarchicalTransaction();
try
{
P.BHT01__HierarchicalStructureCode = BHT_BeginningOfHierarchicalTransactionBHT01__HierarchicalStructureCode.Item0019;
P.BHT02__TransactionSetPurposeCode = BHT_BeginningOfHierarchicalTransactionBHT02__TransactionSetPurposeCode.Item00;
P.BHT03__OriginatorApplicationTransactionIdentifier = System.DateTime.Now.ToString("yyyyMMddHHmmss");
P.BHT04__TransactionSetCreationDate = System.DateTime.Now.ToString("yyyyMMdd");
P.BHT05__TransactionSetCreationTime = System.DateTime.Now.ToString("HHmm");
P.BHT06__ClaimOrEncounterIdentifier = BHT_BeginningOfHierarchicalTransactionBHT06__ClaimOrEncounterIdentifier.CH;
return("BHT" + strDefaultSep + "0019" + strDefaultSep + "00" + strDefaultSep + P.BHT03__OriginatorApplicationTransactionIdentifier +
strDefaultSep + P.BHT04__TransactionSetCreationDate + strDefaultSep + P.BHT05__TransactionSetCreationTime + strDefaultSep + "CH" + strEOS);
}
catch (Exception ex)
{
throw ex;
}
}
public string Build837P(DataSet dsRawData)
{
try
{
string strWellFormed837P = "";
ArrayList o837P = new ArrayList();
HIPAAComponents.MNBilling oBills = new MNBilling();
MNBilling.GE_FunctionalGroupTrailer oGE = new MNBilling.GE_FunctionalGroupTrailer();
MNBilling.IEA_InterchangeControlTrailer oIEA = new MNBilling.IEA_InterchangeControlTrailer();
int intSegmentCount;
int intSVCLineCount;
int intParent;
int intHLLevel;
string strBatchFilter;
string strClaimsAndBatchFilter;
//This section is used to set the header information required for all claims in all batches to be processed.
intInterchangeID = int.Parse(dsRawData.Tables[intEDIHeader].Rows[0]["intInterchangeID"].ToString());
strSenderIDQual = dsRawData.Tables[intEDIHeader].Rows[0]["strSenderIDQual"].ToString();
strSenderID = dsRawData.Tables[intEDIHeader].Rows[0]["strSenderID"].ToString();
strReceiverID = dsRawData.Tables[intEDIHeader].Rows[0]["strReceiverID"].ToString();
strReceiverIDQual = dsRawData.Tables[intEDIHeader].Rows[0]["strReceiverIDQual"].ToString();
blnAcknowledgement = bool.Parse(dsRawData.Tables[intEDIHeader].Rows[0]["blnAcknowledgement"].ToString());
strRepetitionSeparator = dsRawData.Tables[intEDIHeader].Rows[0]["strRepetitionSeparator"].ToString();
strElementSeparator = dsRawData.Tables[intEDIHeader].Rows[0]["strElementSeparator"].ToString();
strUsage = dsRawData.Tables[intEDIHeader].Rows[0]["strUsage"].ToString();
intSubmitterEDIContactID = int.Parse(dsRawData.Tables[intEDIHeader].Rows[0]["intSubmitterEDIContactID"].ToString());
strContactFunctionCode = dsRawData.Tables[intEDIHeader].Rows[0]["strContactFunctionCode"].ToString();
strContactName = dsRawData.Tables[intEDIHeader].Rows[0]["strContactName"].ToString();
strCommunicationNumberID = dsRawData.Tables[intEDIHeader].Rows[0]["strCommunicationNumberID"].ToString();
strCommunicationNumber = dsRawData.Tables[intEDIHeader].Rows[0]["strCommunicationNumber"].ToString();
strCommunicationNumberID2 = dsRawData.Tables[intEDIHeader].Rows[0]["strCommunicationNumberID2"].ToString();
strcommunicationNumber2 = dsRawData.Tables[intEDIHeader].Rows[0]["strcommunicationNumber2"].ToString();
strCommunicationNumberID3 = dsRawData.Tables[intEDIHeader].Rows[0]["strCommunicationNumberID3"].ToString();
strcommunicationNumber3 = dsRawData.Tables[intEDIHeader].Rows[0]["strCommunicationNumber3"].ToString();
//************************************************************************************************************
oBills.DefaultSep = "*";
oBills.EndOfSegment = "~";
oBills.AckRequested = blnAcknowledgement;
//This section starts the building of an 837P. The process starts
//with collecting all of the batches to be processes. This is normally
//1 but it is possible to include more that 1 per file if the payer
//will accept it that way.
foreach (DataRow b in dsRawData.Tables[intBatches].Rows)
{
intSegmentCount = 10;
intSVCLineCount = 1;
intParent = 1;
intHLLevel = 2;
o837P.Add(SetISA(b["BatchNumber"].ToString(), oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetGS(b["BatchNumber"].ToString(), oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetST(b["BatchNumber"].ToString(), oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetBHT(b["BatchNumber"].ToString(), oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetSubmitterName(b, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetEDIContact(oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetReceiverName(b, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetBillingProviderLevel(1, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetBillingProviderName(b, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetBillingProviderAddress(b, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetCityStateZip(b, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetTaxID(b, oBills.DefaultSep, oBills.EndOfSegment));
strBatchFilter = "BatchNumber=" + b["BatchNumber"].ToString();
//****************************************************************************************************************
//This section start iterating through each claim in a batch.
foreach (DataRow c in dsRawData.Tables[intClaimsinBatch].Select(strBatchFilter))
{
o837P.Add(SetSubscriberLevel(intHLLevel, intParent, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetSBRSegment(b, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetSubscriberName(c, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetBillingSubscriberAddress(c, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetSubscriberCityStateZip(c, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetSubscriberDemographics(c, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetPayerName(c, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetClaimSegment(c, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetPriorAuthorization(c, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetHISegment(c, oBills.DefaultSep, oBills.EndOfSegment));
strClaimsAndBatchFilter = "BatchNumber=" + b["BatchNumber"].ToString() + " And SubscriberID=" + c["ClaimsBatchID"].ToString();
//***************************************************************************************************************
foreach (DataRow s in dsRawData.Tables[intSVCLines4Claim].Select(strClaimsAndBatchFilter))
{
o837P.Add(SetLXSegment(intSVCLineCount, oBills.DefaultSep, oBills.EndOfSegment));
intSVCLineCount += 1;
o837P.Add(SetSV1Segment(s, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetServiceDate(s, oBills.DefaultSep, oBills.EndOfSegment));
intSegmentCount = intSegmentCount + 3;
}
intSegmentCount = intSegmentCount + 10;
intHLLevel += 1;
intSVCLineCount = 1;
}
intSegmentCount = intSegmentCount + 1;
o837P.Add(SetSESegment(intSegmentCount, b["BatchNumber"].ToString(), oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetGESegment(oBills.DefaultSep, oBills.EndOfSegment, b["BatchNumber"].ToString()));
o837P.Add(SetIEASegment(oBills.DefaultSep, oBills.EndOfSegment, b["BatchNumber"].ToString()));
}
foreach (string strResult in o837P)
{
strWellFormed837P = strWellFormed837P + strResult;
}
return(strWellFormed837P);
}
catch (Exception ex)
{
throw ex;
}
}
/// <summary>
/// Build Well-Formed 837P
/// </summary>
protected void build837Batches()
{
HIPAAComponents.MNBilling oBills = new MNBilling();
MNBilling.GE_FunctionalGroupTrailer oGE = new MNBilling.GE_FunctionalGroupTrailer();
MNBilling.IEA_InterchangeControlTrailer oIEA = new MNBilling.IEA_InterchangeControlTrailer();
SqlClientDataOperations oSalient = new SqlClientDataOperations();
DataSet oBatchDS = new DataSet();
DataSet oClaimsDS = new DataSet();
DataSet oLinesDS = new DataSet();
//string[] o837P;
ArrayList o837P = new ArrayList();
int intSegmentCount;
int intSVCLineCount;
int intParent;
int intHLLevel;
try
{
oSalient.ConnectionString = ConfigurationManager.ConnectionStrings["HIPAAComponents"].ConnectionString;
oSalient.LoadDataSetFromStoredProc("usp_GetBatches2Process").Fill(oBatchDS);
oBills.DefaultSep = "*";
oBills.EndOfSegment = "~";
oBills.AckRequested = blnAcknowledgement;
foreach (DataRow x in oBatchDS.Tables[0].Rows)
{
intSegmentCount = 10;
intSVCLineCount = 1;
intParent = 1;
intHLLevel = 2;
o837P.Add(SetISA(x["BatchNumber"].ToString(), oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetGS(x["BatchNumber"].ToString(), oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetST(x["BatchNumber"].ToString(), oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetBHT(x["BatchNumber"].ToString(), oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetSubmitterName(x, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetEDIContact(oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetReceiverName(x, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetBillingProviderLevel(1, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetBillingProviderName(x, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetBillingProviderAddress(x, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetCityStateZip(x, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetTaxID(x, oBills.DefaultSep, oBills.EndOfSegment));
ArrayList oParams = new ArrayList();
oParams.Add(new System.Data.SqlClient.SqlParameter("@BatchNumber", x["BatchNumber"].ToString()));
oSalient.LoadDataSet(oParams, "usp_GetClaimsByBatchNumber").Fill(oClaimsDS);
foreach (DataRow y in oClaimsDS.Tables[0].Rows)
{
o837P.Add(SetSubscriberLevel(intHLLevel, intParent, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetSBRSegment(x, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetSubscriberName(y, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetBillingSubscriberAddress(y, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetSubscriberCityStateZip(y, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetSubscriberDemographics(y, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetPayerName(y, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetClaimSegment(y, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetPriorAuthorization(y, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetHISegment(y, oBills.DefaultSep, oBills.EndOfSegment));
ArrayList oSVCParams = new ArrayList();
oSVCParams.Add(new System.Data.SqlClient.SqlParameter("@BatchNumber", x["BatchNumber"].ToString()));
oSVCParams.Add(new System.Data.SqlClient.SqlParameter("@SubscriberID", y["ClaimsBatchID"].ToString()));
oSalient.LoadDataSet(oSVCParams, "usp_GetSVCLinesByBatchAndClaim").Fill(oLinesDS);
foreach (DataRow q in oLinesDS.Tables[0].Rows)
{
o837P.Add(SetLXSegment(intSVCLineCount, oBills.DefaultSep, oBills.EndOfSegment));
intSVCLineCount += 1;
o837P.Add(SetSV1Segment(q, oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetServiceDate(q, oBills.DefaultSep, oBills.EndOfSegment));
intSegmentCount = intSegmentCount + 3;
}
intSegmentCount = intSegmentCount + 10;
intHLLevel += 1;
oLinesDS.Clear();
intSVCLineCount = 1;
}
intSegmentCount = intSegmentCount + 1;
o837P.Add(SetSESegment(intSegmentCount, x["BatchNumber"].ToString(), oBills.DefaultSep, oBills.EndOfSegment));
o837P.Add(SetGESegment(oBills.DefaultSep, oBills.EndOfSegment, x["BatchNumber"].ToString()));
o837P.Add(SetIEASegment(oBills.DefaultSep, oBills.EndOfSegment, x["BatchNumber"].ToString()));
int intBuffer = o837P[0].ToString().Length *(intSegmentCount + 6);
StreamWriter oFS = new StreamWriter(ConfigurationManager.AppSettings["ResultsPath"].ToString() + x["NPI"].ToString() + "_837P_" + System.DateTime.Now.ToString("yyyyMMdd") + ".dat");
foreach (string z in o837P)
{
oFS.Write(z);
oFS.Flush();
ArrayList oInsertParam = new ArrayList();
oInsertParam.Add(new System.Data.SqlClient.SqlParameter("@ControlNumber", x["BatchNumber"].ToString()));
oInsertParam.Add(new System.Data.SqlClient.SqlParameter("@LineSegment", z.ToString()));
//oSalient.ExecuteNonQuery(oInsertParam, "usp_InsertClaimLine");
}
}
}
catch (Exception ex)
{
throw ex;
}
}