hippo 0.0.4

data/lib/hippo/transaction_sets/HIPAA_837/L2300.rb

@@ -0,0 +1,510 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2300 < Hippo::TransactionSets::Base
+      loop_name 'L2300'    #Claim Information
+
+      #Claim Information
+      segment Hippo::Segments::CLM,
+                :name           => 'Claim Information',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 1300
+
+      #Date - Onset of Current Illness or Symptom
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Onset of Current Illness or Symptom',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1350,
+                :defaults => {
+                  'DTP01' => '431',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Initial Treatment Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Initial Treatment Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1370,
+                :defaults => {
+                  'DTP01' => '454',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Last Seen Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Last Seen Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1390,
+                :defaults => {
+                  'DTP01' => '304',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Acute Manifestation
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Acute Manifestation',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :defaults => {
+                  'DTP01' => '453',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Accident
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Accident',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :defaults => {
+                  'DTP01' => '439',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Last Menstrual Period
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Last Menstrual Period',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :defaults => {
+                  'DTP01' => '484',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Last X-ray Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Last X-ray Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :defaults => {
+                  'DTP01' => '455',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Hearing and Vision Prescription Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Hearing and Vision Prescription Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :defaults => {
+                  'DTP01' => '471',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Disability Dates
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Disability Dates',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13
+
+      #Date - Last Worked
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Last Worked',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :defaults => {
+                  'DTP01' => '297',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Authorized Return to Work
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Authorized Return to Work',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :defaults => {
+                  'DTP01' => '296',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Admission
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Admission',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :defaults => {
+                  'DTP01' => '435',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Discharge
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Discharge',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :defaults => {
+                  'DTP01' => '096',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Assumed and Relinquished Care Dates
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Assumed and Relinquished Care Dates',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 13,
+                :defaults => {
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Property and Casualty Date of First Contact
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Property and Casualty Date of First Contact',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :defaults => {
+                  'DTP01' => '444',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Repricer Received Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Repricer Received Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :defaults => {
+                  'DTP01' => '050',
+                  'DTP02' => 'D8'
+                }
+
+      #Claim Supplemental Information
+      segment Hippo::Segments::PWK,
+                :name           => 'Claim Supplemental Information',
+                :minimum        => 0,
+                :maximum        => 10,
+                :position       => 1550
+
+      #Contract Information
+      segment Hippo::Segments::CN1,
+                :name           => 'Contract Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1600
+
+      #Patient Amount Paid
+      segment Hippo::Segments::AMT,
+                :name           => 'Patient Amount Paid',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1760,
+                :defaults => {
+                  'AMT01' => 'F5'
+                }
+
+      #Service Authorization Exception Code
+      segment Hippo::Segments::REF,
+                :name           => 'Service Authorization Exception Code',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 17,
+                :defaults => {
+                  'REF01' => '4N'
+                }
+
+      #Mandatory Medicare (Section 4081) Crossover Indicator
+      segment Hippo::Segments::REF,
+                :name           => 'Mandatory Medicare (Section 4081) Crossover Indicator',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 17,
+                :defaults => {
+                  'REF01' => 'F5'
+                }
+
+      #Mammography Certification Number
+      segment Hippo::Segments::REF,
+                :name           => 'Mammography Certification Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 17,
+                :defaults => {
+                  'REF01' => 'EW'
+                }
+
+      #Referral Number
+      segment Hippo::Segments::REF,
+                :name           => 'Referral Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 17,
+                :defaults => {
+                  'REF01' => '9F'
+                }
+
+      #Prior Authorization
+      segment Hippo::Segments::REF,
+                :name           => 'Prior Authorization',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1800,
+                :defaults => {
+                  'REF01' => 'G1'
+                }
+
+      #Payer Claim Control Number
+      segment Hippo::Segments::REF,
+                :name           => 'Payer Claim Control Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1810,
+                :defaults => {
+                  'REF01' => 'F8'
+                }
+
+      #Clinical Laboratory Improvement Amendment (CLIA) Number
+      segment Hippo::Segments::REF,
+                :name           => 'Clinical Laboratory Improvement Amendment (CLIA) Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1820,
+                :defaults => {
+                  'REF01' => 'X4'
+                }
+
+      #Repriced Claim Number
+      segment Hippo::Segments::REF,
+                :name           => 'Repriced Claim Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1830,
+                :defaults => {
+                  'REF01' => '9A'
+                }
+
+      #Adjusted Repriced Claim Number
+      segment Hippo::Segments::REF,
+                :name           => 'Adjusted Repriced Claim Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1840,
+                :defaults => {
+                  'REF01' => '9C'
+                }
+
+      #Investigational Device Exemption Number
+      segment Hippo::Segments::REF,
+                :name           => 'Investigational Device Exemption Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1850,
+                :defaults => {
+                  'REF01' => 'LX'
+                }
+
+      #Claim Identifier For Transmission Intermediaries
+      segment Hippo::Segments::REF,
+                :name           => 'Claim Identifier For Transmission Intermediaries',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1860,
+                :defaults => {
+                  'REF01' => 'D9'
+                }
+
+      #Medical Record Number
+      segment Hippo::Segments::REF,
+                :name           => 'Medical Record Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1890,
+                :defaults => {
+                  'REF01' => 'EA'
+                }
+
+      #Demonstration Project Identifier
+      segment Hippo::Segments::REF,
+                :name           => 'Demonstration Project Identifier',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 18,
+                :defaults => {
+                  'REF01' => 'P4'
+                }
+
+      #Care Plan Oversight
+      segment Hippo::Segments::REF,
+                :name           => 'Care Plan Oversight',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 18,
+                :defaults => {
+                  'REF01' => '1J'
+                }
+
+      #File Information
+      segment Hippo::Segments::K3,
+                :name           => 'File Information',
+                :minimum        => 0,
+                :maximum        => 10,
+                :position       => 18
+
+      #Claim Note
+      segment Hippo::Segments::NTE,
+                :name           => 'Claim Note',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1900
+
+      #Ambulance Transport Information
+      segment Hippo::Segments::CR1,
+                :name           => 'Ambulance Transport Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1950,
+                :defaults => {
+                  'CR105' => 'DH'
+                }
+
+      #Spinal Manipulation Service Information
+      segment Hippo::Segments::CR2,
+                :name           => 'Spinal Manipulation Service Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2000
+
+      #Ambulance Certification
+      segment Hippo::Segments::CRC,
+                :name           => 'Ambulance Certification',
+                :minimum        => 0,
+                :maximum        => 3,
+                :position       => 2200,
+                :defaults => {
+                  'CRC01' => '07'
+                }
+
+      #Patient Condition Information: Vision
+      segment Hippo::Segments::CRC,
+                :name           => 'Patient Condition Information: Vision',
+                :minimum        => 0,
+                :maximum        => 3,
+                :position       => 2210
+
+      #Homebound Indicator
+      segment Hippo::Segments::CRC,
+                :name           => 'Homebound Indicator',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2220,
+                :defaults => {
+                  'CRC01' => '75',
+                  'CRC02' => 'Y',
+                  'CRC03' => 'IH'
+                }
+
+      #EPSDT Referral
+      segment Hippo::Segments::CRC,
+                :name           => 'EPSDT Referral',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2230,
+                :defaults => {
+                  'CRC01' => 'ZZ'
+                }
+
+      #Health Care Diagnosis Code
+      segment Hippo::Segments::HI,
+                :name           => 'Health Care Diagnosis Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 2310
+
+      #Anesthesia Related Procedure
+      segment Hippo::Segments::HI,
+                :name           => 'Anesthesia Related Procedure',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2313
+
+      #Condition Information
+      segment Hippo::Segments::HI,
+                :name           => 'Condition Information',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 2320
+
+      #Claim Pricing/Repricing Information
+      segment Hippo::Segments::HCP,
+                :name           => 'Claim Pricing/Repricing Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2410
+
+      #Referring Provider Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2310A,
+                :name           => 'Referring Provider Name',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 2500
+
+      #Rendering Provider Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2310B,
+                :name           => 'Rendering Provider Name',
+                :identified_by  => {'NM1.NM101' => '82'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500
+
+      #Service Facility Location Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2310C,
+                :name           => 'Service Facility Location Name',
+                :identified_by  => {'NM1.NM101' => '77'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500
+
+      #Supervising Provider Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2310D,
+                :name           => 'Supervising Provider Name',
+                :identified_by  => {'NM1.NM101' => 'DQ'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500
+
+      #Ambulance Pick-up Location
+      loop    Hippo::TransactionSets::HIPAA_837::L2310E,
+                :name           => 'Ambulance Pick-up Location',
+                :identified_by  => {'NM1.NM101' => 'PW'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500
+
+      #Ambulance Drop-off Location
+      loop    Hippo::TransactionSets::HIPAA_837::L2310F,
+                :name           => 'Ambulance Drop-off Location',
+                :identified_by  => {'NM1.NM101' => '45'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500
+
+      #Other Subscriber Information
+      loop    Hippo::TransactionSets::HIPAA_837::L2320,
+                :name           => 'Other Subscriber Information',
+                :minimum        => 0,
+                :maximum        => 10,
+                :position       => 2900
+
+      #Service Line Number
+      loop    Hippo::TransactionSets::HIPAA_837::L2400,
+                :name           => 'Service Line Number',
+                :minimum        => 1,
+                :maximum        => 50,
+                :position       => 3650
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2310A.rb

@@ -0,0 +1,26 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2310A < Hippo::TransactionSets::Base
+      loop_name 'L2310A'    #Referring Provider Name
+
+      #Referring Provider Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Referring Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500,
+                :defaults => {
+                  'NM102' => '1'
+                }
+
+      #Referring Provider Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Referring Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 3,
+                :position       => 2710
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2310B.rb

@@ -0,0 +1,37 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2310B < Hippo::TransactionSets::Base
+      loop_name 'L2310B'    #Rendering Provider Name
+
+      #Rendering Provider Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Rendering Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500,
+                :defaults => {
+                  'NM101' => '82'
+                }
+
+      #Rendering Provider Specialty Information
+      segment Hippo::Segments::PRV,
+                :name           => 'Rendering Provider Specialty Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2550,
+                :defaults => {
+                  'PRV01' => 'PE',
+                  'PRV02' => 'PXC'
+                }
+
+      #Rendering Provider Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Rendering Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 4,
+                :position       => 2710
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2310C.rb

@@ -0,0 +1,52 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2310C < Hippo::TransactionSets::Base
+      loop_name 'L2310C'    #Service Facility Location Name
+
+      #Service Facility Location Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Service Facility Location Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500,
+                :defaults => {
+                  'NM101' => '77',
+                  'NM102' => '2'
+                }
+
+      #Service Facility Location Address
+      segment Hippo::Segments::N3,
+                :name           => 'Service Facility Location Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 2650
+
+      #Service Facility Location City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Service Facility Location City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 2700
+
+      #Service Facility Location Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Service Facility Location Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 3,
+                :position       => 2710
+
+      #Service Facility Contact Information
+      segment Hippo::Segments::PER,
+                :name           => 'Service Facility Contact Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2750,
+                :defaults => {
+                  'PER01' => 'IC',
+                  'PER03' => 'TE'
+                }
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2310D.rb

@@ -0,0 +1,27 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2310D < Hippo::TransactionSets::Base
+      loop_name 'L2310D'    #Supervising Provider Name
+
+      #Supervising Provider Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Supervising Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500,
+                :defaults => {
+                  'NM101' => 'DQ',
+                  'NM102' => '1'
+                }
+
+      #Supervising Provider Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Supervising Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 4,
+                :position       => 2710
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2310E.rb

@@ -0,0 +1,34 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2310E < Hippo::TransactionSets::Base
+      loop_name 'L2310E'    #Ambulance Pick-up Location
+
+      #Ambulance Pick-up Location
+      segment Hippo::Segments::NM1,
+                :name           => 'Ambulance Pick-up Location',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500,
+                :defaults => {
+                  'NM101' => 'PW',
+                  'NM102' => '2'
+                }
+
+      #Ambulance Pick-up Location Address
+      segment Hippo::Segments::N3,
+                :name           => 'Ambulance Pick-up Location Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 2650
+
+      #Ambulance Pick-up Location City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Ambulance Pick-up Location City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 2700
+
+    end
+  end
+end