hippo 0.0.4

data/lib/hippo/transaction_sets/HIPAA_835/L1000A.rb

@@ -0,0 +1,71 @@
+module Hippo::TransactionSets
+  module HIPAA_835
+
+    class L1000A < Hippo::TransactionSets::Base
+      loop_name 'L1000A'    #Payer Identification
+
+      #Payer Identification
+      segment Hippo::Segments::N1,
+                :name           => 'Payer Identification',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 800,
+                :defaults => {
+                  'N101' => 'PR'
+                }
+
+      #Payer Address
+      segment Hippo::Segments::N3,
+                :name           => 'Payer Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 1000
+
+      #Payer City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Payer City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 1100
+
+      #Additional Payer Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Additional Payer Identification',
+                :minimum        => 0,
+                :maximum        => 4,
+                :position       => 1200
+
+      #Payer Business Contact Information
+      segment Hippo::Segments::PER,
+                :name           => 'Payer Business Contact Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1300,
+                :defaults => {
+                  'PER01' => 'CX'
+                }
+
+      #Payer Technical Contact Information
+      segment Hippo::Segments::PER,
+                :name           => 'Payer Technical Contact Information',
+                :minimum        => 1,
+                :maximum        => nil,
+                :position       => 1303,
+                :defaults => {
+                  'PER01' => 'BL'
+                }
+
+      #Payer WEB Site
+      segment Hippo::Segments::PER,
+                :name           => 'Payer WEB Site',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1305,
+                :defaults => {
+                  'PER01' => 'IC',
+                  'PER03' => 'UR'
+                }
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_835/L1000B.rb

@@ -0,0 +1,47 @@
+module Hippo::TransactionSets
+  module HIPAA_835
+
+    class L1000B < Hippo::TransactionSets::Base
+      loop_name 'L1000B'    #Payee Identification
+
+      #Payee Identification
+      segment Hippo::Segments::N1,
+                :name           => 'Payee Identification',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 1400,
+                :defaults => {
+                  'N101' => 'PE'
+                }
+
+      #Payee Address
+      segment Hippo::Segments::N3,
+                :name           => 'Payee Address',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1600
+
+      #Payee City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Payee City, State, ZIP Code',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1700
+
+      #Payee Additional Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Payee Additional Identification',
+                :minimum        => 0,
+                :maximum        => nil,
+                :position       => 1800
+
+      #Remittance Delivery Method
+      segment Hippo::Segments::RDM,
+                :name           => 'Remittance Delivery Method',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2000
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_835/L2000.rb

@@ -0,0 +1,37 @@
+module Hippo::TransactionSets
+  module HIPAA_835
+
+    class L2000 < Hippo::TransactionSets::Base
+      loop_name 'L2000'    #Header Number
+
+      #Header Number
+      segment Hippo::Segments::LX,
+                :name           => 'Header Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 30
+
+      #Provider Summary Information
+      segment Hippo::Segments::TS3,
+                :name           => 'Provider Summary Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 50
+
+      #Provider Supplemental Summary Information
+      segment Hippo::Segments::TS2,
+                :name           => 'Provider Supplemental Summary Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 70
+
+      #Claim Payment Information
+      loop    Hippo::TransactionSets::HIPAA_835::L2100,
+                :name           => 'Claim Payment Information',
+                :minimum        => 1,
+                :maximum        => nil,
+                :position       => 100
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_835/L2100.rb

@@ -0,0 +1,182 @@
+module Hippo::TransactionSets
+  module HIPAA_835
+
+    class L2100 < Hippo::TransactionSets::Base
+      loop_name 'L2100'    #Claim Payment Information
+
+      #Claim Payment Information
+      segment Hippo::Segments::CLP,
+                :name           => 'Claim Payment Information',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100
+
+      #Claim Adjustment
+      segment Hippo::Segments::CAS,
+                :name           => 'Claim Adjustment',
+                :minimum        => 0,
+                :maximum        => 99,
+                :position       => 200
+
+      #Patient Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Patient Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 290,
+                :defaults => {
+                  'NM101' => 'QC',
+                  'NM102' => '1'
+                }
+
+      #Insured Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Insured Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 300,
+                :defaults => {
+                  'NM101' => 'IL'
+                }
+
+      #Corrected Patient/Insured Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Corrected Patient/Insured Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 310,
+                :defaults => {
+                  'NM101' => '74'
+                }
+
+      #Service Provider Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Service Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 320,
+                :defaults => {
+                  'NM101' => '82'
+                }
+
+      #Crossover Carrier Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Crossover Carrier Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 330,
+                :defaults => {
+                  'NM101' => 'TT',
+                  'NM102' => '2'
+                }
+
+      #Corrected Priority Payer Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Corrected Priority Payer Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 340,
+                :defaults => {
+                  'NM101' => 'PR',
+                  'NM102' => '2'
+                }
+
+      #Other Subscriber Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Other Subscriber Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 350,
+                :defaults => {
+                  'NM101' => 'GB'
+                }
+
+      #Inpatient Adjudication Information
+      segment Hippo::Segments::MIA,
+                :name           => 'Inpatient Adjudication Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 370
+
+      #Outpatient Adjudication Information
+      segment Hippo::Segments::MOA,
+                :name           => 'Outpatient Adjudication Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 380
+
+      #Other Claim Related Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Other Claim Related Identification',
+                :minimum        => 0,
+                :maximum        => 5,
+                :position       => 400
+
+      #Rendering Provider Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Rendering Provider Identification',
+                :minimum        => 0,
+                :maximum        => 10,
+                :position       => 450
+
+      #Statement From or To Date
+      segment Hippo::Segments::DTM,
+                :name           => 'Statement From or To Date',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 500
+
+      #Coverage Expiration Date
+      segment Hippo::Segments::DTM,
+                :name           => 'Coverage Expiration Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 505,
+                :defaults => {
+                  'DTM01' => '036'
+                }
+
+      #Claim Received Date
+      segment Hippo::Segments::DTM,
+                :name           => 'Claim Received Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 510,
+                :defaults => {
+                  'DTM01' => '050'
+                }
+
+      #Claim Contact Information
+      segment Hippo::Segments::PER,
+                :name           => 'Claim Contact Information',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 600,
+                :defaults => {
+                  'PER01' => 'CX'
+                }
+
+      #Claim Supplemental Information
+      segment Hippo::Segments::AMT,
+                :name           => 'Claim Supplemental Information',
+                :minimum        => 0,
+                :maximum        => 13,
+                :position       => 620
+
+      #Claim Supplemental Information Quantity
+      segment Hippo::Segments::QTY,
+                :name           => 'Claim Supplemental Information Quantity',
+                :minimum        => 0,
+                :maximum        => 14,
+                :position       => 640
+
+      #Service Payment Information
+      loop    Hippo::TransactionSets::HIPAA_835::L2110,
+                :name           => 'Service Payment Information',
+                :minimum        => 0,
+                :maximum        => 999,
+                :position       => 700
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_835/L2110.rb

@@ -0,0 +1,85 @@
+module Hippo::TransactionSets
+  module HIPAA_835
+
+    class L2110 < Hippo::TransactionSets::Base
+      loop_name 'L2110'    #Service Payment Information
+
+      #Service Payment Information
+      segment Hippo::Segments::SVC,
+                :name           => 'Service Payment Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 700
+
+      #Service Date
+      segment Hippo::Segments::DTM,
+                :name           => 'Service Date',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 800
+
+      #Service Adjustment
+      segment Hippo::Segments::CAS,
+                :name           => 'Service Adjustment',
+                :minimum        => 0,
+                :maximum        => 99,
+                :position       => 900
+
+      #Service Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Service Identification',
+                :minimum        => 0,
+                :maximum        => 8,
+                :position       => 1000
+
+      #Line Item Control Number
+      segment Hippo::Segments::REF,
+                :name           => 'Line Item Control Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1010,
+                :defaults => {
+                  'REF01' => '6R'
+                }
+
+      #Rendering Provider Information
+      segment Hippo::Segments::REF,
+                :name           => 'Rendering Provider Information',
+                :minimum        => 0,
+                :maximum        => 10,
+                :position       => 1050
+
+      #HealthCare Policy Identification
+      segment Hippo::Segments::REF,
+                :name           => 'HealthCare Policy Identification',
+                :minimum        => 0,
+                :maximum        => 5,
+                :position       => 1060,
+                :defaults => {
+                  'REF01' => '0K'
+                }
+
+      #Service Supplemental Amount
+      segment Hippo::Segments::AMT,
+                :name           => 'Service Supplemental Amount',
+                :minimum        => 0,
+                :maximum        => 9,
+                :position       => 1100
+
+      #Service Supplemental Quantity
+      segment Hippo::Segments::QTY,
+                :name           => 'Service Supplemental Quantity',
+                :minimum        => 0,
+                :maximum        => 6,
+                :position       => 1200
+
+      #Health Care Remark Codes
+      segment Hippo::Segments::LQ,
+                :name           => 'Health Care Remark Codes',
+                :minimum        => 0,
+                :maximum        => 99,
+                :position       => 1300
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_835/base.rb

@@ -0,0 +1,112 @@
+module Hippo::TransactionSets
+  module HIPAA_835
+
+    class Base < Hippo::TransactionSets::Base
+
+      #Transaction Set Header
+      segment Hippo::Segments::ST,
+                :name           => 'Transaction Set Header',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100,
+                :defaults => {
+                  'ST01' => '835'
+                }
+
+      #Financial Information
+      segment Hippo::Segments::BPR,
+                :name           => 'Financial Information',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 200
+
+      #Reassociation Trace Number
+      segment Hippo::Segments::TRN,
+                :name           => 'Reassociation Trace Number',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 400,
+                :defaults => {
+                  'TRN01' => '1'
+                }
+
+      #Foreign Currency Information
+      segment Hippo::Segments::CUR,
+                :name           => 'Foreign Currency Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 500,
+                :defaults => {
+                  'CUR01' => 'PR'
+                }
+
+      #Receiver Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Receiver Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 590,
+                :defaults => {
+                  'REF01' => 'EV'
+                }
+
+      #Version Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Version Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 600,
+                :defaults => {
+                  'REF01' => 'F2'
+                }
+
+      #Production Date
+      segment Hippo::Segments::DTM,
+                :name           => 'Production Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 700,
+                :defaults => {
+                  'DTM01' => '405'
+                }
+
+      #Payer Identification
+      loop    Hippo::TransactionSets::HIPAA_835::L1000A,
+                :name           => 'Payer Identification',
+                :identified_by  => {'N1.N101' => 'PR'},
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 800
+
+      #Payee Identification
+      loop    Hippo::TransactionSets::HIPAA_835::L1000B,
+                :name           => 'Payee Identification',
+                :identified_by  => {'N1.N101' => 'PE'},
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 1400
+
+      #Header Number
+      loop    Hippo::TransactionSets::HIPAA_835::L2000,
+                :name           => 'Header Number',
+                :minimum        => 0,
+                :maximum        => nil,
+                :position       => 30
+
+      #Provider Adjustment
+      segment Hippo::Segments::PLB,
+                :name           => 'Provider Adjustment',
+                :minimum        => 0,
+                :maximum        => nil,
+                :position       => 100
+
+      #Transaction Set Trailer
+      segment Hippo::Segments::SE,
+                :name           => 'Transaction Set Trailer',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 200
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_835.rb

@@ -0,0 +1,12 @@
+module Hippo::TransactionSets
+  module HIPAA_835
+
+    autoload :Base,      'hippo/transaction_sets/HIPAA_835/base'
+    autoload :L1000A,    'hippo/transaction_sets/HIPAA_835/L1000A'
+    autoload :L1000B,    'hippo/transaction_sets/HIPAA_835/L1000B'
+    autoload :L2000,     'hippo/transaction_sets/HIPAA_835/L2000'
+    autoload :L2100,     'hippo/transaction_sets/HIPAA_835/L2100'
+    autoload :L2110,     'hippo/transaction_sets/HIPAA_835/L2110'
+
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L1000A.rb

@@ -0,0 +1,30 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L1000A < Hippo::TransactionSets::Base
+      loop_name 'L1000A'    #Submitter Name
+
+      #Submitter Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Submitter Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 200,
+                :defaults => {
+                  'NM101' => '41',
+                  'NM108' => '46'
+                }
+
+      #Submitter EDI Contact Information
+      segment Hippo::Segments::PER,
+                :name           => 'Submitter EDI Contact Information',
+                :minimum        => 1,
+                :maximum        => 2,
+                :position       => 450,
+                :defaults => {
+                  'PER01' => 'IC'
+                }
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L1000B.rb

@@ -0,0 +1,21 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L1000B < Hippo::TransactionSets::Base
+      loop_name 'L1000B'    #Receiver Name
+
+      #Receiver Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Receiver Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 500,
+                :defaults => {
+                  'NM101' => '40',
+                  'NM102' => '2',
+                  'NM108' => '46'
+                }
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2000A.rb

@@ -0,0 +1,65 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2000A < Hippo::TransactionSets::Base
+      loop_name 'L2000A'    #Billing Provider Hierarchical Level
+
+      #Billing Provider Hierarchical Level
+      segment Hippo::Segments::HL,
+                :name           => 'Billing Provider Hierarchical Level',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 10,
+                :defaults => {
+                  'HL03' => '20',
+                  'HL04' => '1'
+                }
+
+      #Billing Provider Specialty Information
+      segment Hippo::Segments::PRV,
+                :name           => 'Billing Provider Specialty Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 30,
+                :defaults => {
+                  'PRV01' => 'BI',
+                  'PRV02' => 'PXC'
+                }
+
+      #Foreign Currency Information
+      segment Hippo::Segments::CUR,
+                :name           => 'Foreign Currency Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 100,
+                :defaults => {
+                  'CUR01' => '85'
+                }
+
+      #Billing Provider Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2010AA,
+                :name           => 'Billing Provider Name',
+                :identified_by  => {'NM1.NM101' => '85'},
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 150
+
+      #Pay-to Address Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2010AB,
+                :name           => 'Pay-to Address Name',
+                :identified_by  => {'NM1.NM101' => '87'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 150
+
+      #Pay-To Plan Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2010AC,
+                :name           => 'Pay-To Plan Name',
+                :identified_by  => {'NM1.NM101' => 'PE'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 450
+
+    end
+  end
+end