hippo 0.0.4

data/lib/hippo/transaction_sets/HIPAA_837/L2000B.rb

@@ -0,0 +1,49 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2000B < Hippo::TransactionSets::Base
+      loop_name 'L2000B'    #Subscriber Hierarchical Level
+
+      #Subscriber Hierarchical Level
+      segment Hippo::Segments::HL,
+                :name           => 'Subscriber Hierarchical Level',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 10,
+                :defaults => {
+                  'HL03' => '22'
+                }
+
+      #Subscriber Information
+      segment Hippo::Segments::SBR,
+                :name           => 'Subscriber Information',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 50
+
+      #Patient Information
+      segment Hippo::Segments::PAT,
+                :name           => 'Patient Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 70
+
+      #Subscriber Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2010BA,
+                :name           => 'Subscriber Name',
+                :identified_by  => {'NM1.NM101' => 'IL'},
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 150
+
+      #Payer Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2010BB,
+                :name           => 'Payer Name',
+                :identified_by  => {'NM1.NM101' => 'PR'},
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 150
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2000C.rb

@@ -0,0 +1,42 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2000C < Hippo::TransactionSets::Base
+      loop_name 'L2000C'    #Patient Hierarchical Level
+
+      #Patient Hierarchical Level
+      segment Hippo::Segments::HL,
+                :name           => 'Patient Hierarchical Level',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 10,
+                :defaults => {
+                  'HL03' => '23',
+                  'HL04' => '0'
+                }
+
+      #Patient Information
+      segment Hippo::Segments::PAT,
+                :name           => 'Patient Information',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 70
+
+      #Patient Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2010CA,
+                :name           => 'Patient Name',
+                :identified_by  => {'NM1.NM101' => 'QC'},
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 150
+
+      #Claim Information
+      loop    Hippo::TransactionSets::HIPAA_837::L2300,
+                :name           => 'Claim Information',
+                :minimum        => 1,
+                :maximum        => 100,
+                :position       => 1300
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2010AA.rb

@@ -0,0 +1,57 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2010AA < Hippo::TransactionSets::Base
+      loop_name 'L2010AA'    #Billing Provider Name
+
+      #Billing Provider Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Billing Provider Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 150,
+                :defaults => {
+                  'NM101' => '85'
+                }
+
+      #Billing Provider Address
+      segment Hippo::Segments::N3,
+                :name           => 'Billing Provider Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 250
+
+      #Billing Provider City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Billing Provider City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 300
+
+      #Billing Provider Tax Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Billing Provider Tax Identification',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 350
+
+      #Billing Provider UPIN/License Information
+      segment Hippo::Segments::REF,
+                :name           => 'Billing Provider UPIN/License Information',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 360
+
+      #Billing Provider Contact Information
+      segment Hippo::Segments::PER,
+                :name           => 'Billing Provider Contact Information',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 400,
+                :defaults => {
+                  'PER01' => 'IC'
+                }
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2010AB.rb

@@ -0,0 +1,33 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2010AB < Hippo::TransactionSets::Base
+      loop_name 'L2010AB'    #Pay-to Address Name
+
+      #Pay-to Address Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Pay-to Address Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 150,
+                :defaults => {
+                  'NM101' => '87'
+                }
+
+      #Pay-to Address - ADDRESS
+      segment Hippo::Segments::N3,
+                :name           => 'Pay-to Address - ADDRESS',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 250
+
+      #Pay-To Address City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Pay-To Address City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 300
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2010AC.rb

@@ -0,0 +1,51 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2010AC < Hippo::TransactionSets::Base
+      loop_name 'L2010AC'    #Pay-To Plan Name
+
+      #Pay-To Plan Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Pay-To Plan Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 450,
+                :defaults => {
+                  'NM101' => 'PE',
+                  'NM102' => '2'
+                }
+
+      #Pay-to Plan Address
+      segment Hippo::Segments::N3,
+                :name           => 'Pay-to Plan Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 550
+
+      #Pay-To Plan City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Pay-To Plan City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 600
+
+      #Pay-to Plan Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Pay-to Plan Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 650
+
+      #Pay-To Plan Tax Identification Number
+      segment Hippo::Segments::REF,
+                :name           => 'Pay-To Plan Tax Identification Number',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 655,
+                :defaults => {
+                  'REF01' => 'EI'
+                }
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2010BA.rb

@@ -0,0 +1,74 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2010BA < Hippo::TransactionSets::Base
+      loop_name 'L2010BA'    #Subscriber Name
+
+      #Subscriber Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Subscriber Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 150,
+                :defaults => {
+                  'NM101' => 'IL'
+                }
+
+      #Subscriber Address
+      segment Hippo::Segments::N3,
+                :name           => 'Subscriber Address',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 250
+
+      #Subscriber City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Subscriber City, State, ZIP Code',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 300
+
+      #Subscriber Demographic Information
+      segment Hippo::Segments::DMG,
+                :name           => 'Subscriber Demographic Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 320,
+                :defaults => {
+                  'DMG01' => 'D8'
+                }
+
+      #Subscriber Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Subscriber Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 350,
+                :defaults => {
+                  'REF01' => 'SY'
+                }
+
+      #Property and Casualty Claim Number
+      segment Hippo::Segments::REF,
+                :name           => 'Property and Casualty Claim Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 360,
+                :defaults => {
+                  'REF01' => 'Y4'
+                }
+
+      #Property and Casualty Subscriber Contact Information
+      segment Hippo::Segments::PER,
+                :name           => 'Property and Casualty Subscriber Contact Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 400,
+                :defaults => {
+                  'PER01' => 'IC',
+                  'PER03' => 'TE'
+                }
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2010BB.rb

@@ -0,0 +1,48 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2010BB < Hippo::TransactionSets::Base
+      loop_name 'L2010BB'    #Payer Name
+
+      #Payer Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Payer Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 150,
+                :defaults => {
+                  'NM101' => 'PR',
+                  'NM102' => '2'
+                }
+
+      #Payer Address
+      segment Hippo::Segments::N3,
+                :name           => 'Payer Address',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 250
+
+      #Payer City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Payer City, State, ZIP Code',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 300
+
+      #Payer Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Payer Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 3,
+                :position       => 350
+
+      #Billing Provider Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Billing Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 370
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2010CA.rb

@@ -0,0 +1,72 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2010CA < Hippo::TransactionSets::Base
+      loop_name 'L2010CA'    #Patient Name
+
+      #Patient Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Patient Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 150,
+                :defaults => {
+                  'NM101' => 'QC',
+                  'NM102' => '1'
+                }
+
+      #Patient Address
+      segment Hippo::Segments::N3,
+                :name           => 'Patient Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 250
+
+      #Patient City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Patient City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 300
+
+      #Patient Demographic Information
+      segment Hippo::Segments::DMG,
+                :name           => 'Patient Demographic Information',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 320,
+                :defaults => {
+                  'DMG01' => 'D8'
+                }
+
+      #Property and Casualty Claim Number
+      segment Hippo::Segments::REF,
+                :name           => 'Property and Casualty Claim Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 360,
+                :defaults => {
+                  'REF01' => 'Y4'
+                }
+
+      #Property and Casualty Patient Identifier
+      segment Hippo::Segments::REF,
+                :name           => 'Property and Casualty Patient Identifier',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 362
+
+      #Property and Casualty Patient Contact Information
+      segment Hippo::Segments::PER,
+                :name           => 'Property and Casualty Patient Contact Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 400,
+                :defaults => {
+                  'PER01' => 'IC',
+                  'PER03' => 'TE'
+                }
+
+    end
+  end
+end