hippo 0.0.4

data/lib/hippo/transaction_sets/HIPAA_837/L2400.rb

@@ -0,0 +1,475 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2400 < Hippo::TransactionSets::Base
+      loop_name 'L2400'    #Service Line Number
+
+      #Service Line Number
+      segment Hippo::Segments::LX,
+                :name           => 'Service Line Number',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 3650
+
+      #Professional Service
+      segment Hippo::Segments::SV1,
+                :name           => 'Professional Service',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 3700
+
+      #Durable Medical Equipment Service
+      segment Hippo::Segments::SV5,
+                :name           => 'Durable Medical Equipment Service',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4000,
+                :defaults => {
+                  'SV502' => 'DA'
+                }
+
+      #Line Supplemental Information
+      segment Hippo::Segments::PWK,
+                :name           => 'Line Supplemental Information',
+                :minimum        => 0,
+                :maximum        => 10,
+                :position       => 4200
+
+      #Durable Medical Equipment Certificate of Medical Necessity Indicator
+      segment Hippo::Segments::PWK,
+                :name           => 'Durable Medical Equipment Certificate of Medical Necessity Indicator',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4220,
+                :defaults => {
+                  'PWK01' => 'CT'
+                }
+
+      #Ambulance Transport Information
+      segment Hippo::Segments::CR1,
+                :name           => 'Ambulance Transport Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4250,
+                :defaults => {
+                  'CR105' => 'DH'
+                }
+
+      #Durable Medical Equipment Certification
+      segment Hippo::Segments::CR3,
+                :name           => 'Durable Medical Equipment Certification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4350,
+                :defaults => {
+                  'CR302' => 'MO'
+                }
+
+      #Ambulance Certification
+      segment Hippo::Segments::CRC,
+                :name           => 'Ambulance Certification',
+                :minimum        => 0,
+                :maximum        => 3,
+                :position       => 4500,
+                :defaults => {
+                  'CRC01' => '07'
+                }
+
+      #Hospice Employee Indicator
+      segment Hippo::Segments::CRC,
+                :name           => 'Hospice Employee Indicator',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4520,
+                :defaults => {
+                  'CRC01' => '70',
+                  'CRC03' => '65'
+                }
+
+      #Condition Indicator/Durable Medical Equipment
+      segment Hippo::Segments::CRC,
+                :name           => 'Condition Indicator/Durable Medical Equipment',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4530,
+                :defaults => {
+                  'CRC01' => '09'
+                }
+
+      #Date - Service Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Service Date',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 4550,
+                :defaults => {
+                  'DTP01' => '472'
+                }
+
+      #Date - Prescription Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Prescription Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4555,
+                :defaults => {
+                  'DTP01' => '471',
+                  'DTP02' => 'D8'
+                }
+
+      #DATE - Certification Revision/Recertification Date
+      segment Hippo::Segments::DTP,
+                :name           => 'DATE - Certification Revision/Recertification Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4560,
+                :defaults => {
+                  'DTP01' => '607',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Begin Therapy Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Begin Therapy Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4580,
+                :defaults => {
+                  'DTP01' => '463',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Last Certification Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Last Certification Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4590,
+                :defaults => {
+                  'DTP01' => '461',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Last Seen Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Last Seen Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 45,
+                :defaults => {
+                  'DTP01' => '304',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Test Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Test Date',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 45,
+                :defaults => {
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Shipped Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Shipped Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 45,
+                :defaults => {
+                  'DTP01' => '011',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Last X-ray Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Last X-ray Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 45,
+                :defaults => {
+                  'DTP01' => '455',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Initial Treatment Date
+      segment Hippo::Segments::DTP,
+                :name           => 'Date - Initial Treatment Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 45,
+                :defaults => {
+                  'DTP01' => '454',
+                  'DTP02' => 'D8'
+                }
+
+      #Ambulance Patient Count
+      segment Hippo::Segments::QTY,
+                :name           => 'Ambulance Patient Count',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4600,
+                :defaults => {
+                  'QTY01' => 'PT'
+                }
+
+      #Obstetric Anesthesia Additional Units
+      segment Hippo::Segments::QTY,
+                :name           => 'Obstetric Anesthesia Additional Units',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4610,
+                :defaults => {
+                  'QTY01' => 'FL'
+                }
+
+      #Test Result
+      segment Hippo::Segments::MEA,
+                :name           => 'Test Result',
+                :minimum        => 0,
+                :maximum        => 5,
+                :position       => 4620
+
+      #Contract Information
+      segment Hippo::Segments::CN1,
+                :name           => 'Contract Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4650
+
+      #Repriced Line Item Reference Number
+      segment Hippo::Segments::REF,
+                :name           => 'Repriced Line Item Reference Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4700,
+                :defaults => {
+                  'REF01' => '9B'
+                }
+
+      #Adjusted Repriced Line Item Reference Number
+      segment Hippo::Segments::REF,
+                :name           => 'Adjusted Repriced Line Item Reference Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4710,
+                :defaults => {
+                  'REF01' => '9D'
+                }
+
+      #Prior Authorization
+      segment Hippo::Segments::REF,
+                :name           => 'Prior Authorization',
+                :minimum        => 0,
+                :maximum        => 5,
+                :position       => 4730,
+                :defaults => {
+                  'REF01' => 'G1'
+                }
+
+      #Line Item Control Number
+      segment Hippo::Segments::REF,
+                :name           => 'Line Item Control Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 47,
+                :defaults => {
+                  'REF01' => '6R'
+                }
+
+      #Mammography Certification Number
+      segment Hippo::Segments::REF,
+                :name           => 'Mammography Certification Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 47,
+                :defaults => {
+                  'REF01' => 'EW'
+                }
+
+      #Clinical Laboratory Improvement Amendment (CLIA) Number
+      segment Hippo::Segments::REF,
+                :name           => 'Clinical Laboratory Improvement Amendment (CLIA) Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 47,
+                :defaults => {
+                  'REF01' => 'X4'
+                }
+
+      #Referring Clinical Laboratory Improvement Amendment (CLIA) Facility Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Referring Clinical Laboratory Improvement Amendment (CLIA) Facility Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 47,
+                :defaults => {
+                  'REF01' => 'F4'
+                }
+
+      #Immunization Batch Number
+      segment Hippo::Segments::REF,
+                :name           => 'Immunization Batch Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 47,
+                :defaults => {
+                  'REF01' => 'BT'
+                }
+
+      #Referral Number
+      segment Hippo::Segments::REF,
+                :name           => 'Referral Number',
+                :minimum        => 0,
+                :maximum        => 5,
+                :position       => 47,
+                :defaults => {
+                  'REF01' => '9F'
+                }
+
+      #Sales Tax Amount
+      segment Hippo::Segments::AMT,
+                :name           => 'Sales Tax Amount',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4810,
+                :defaults => {
+                  'AMT01' => 'T'
+                }
+
+      #Postage Claimed Amount
+      segment Hippo::Segments::AMT,
+                :name           => 'Postage Claimed Amount',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4830,
+                :defaults => {
+                  'AMT01' => 'F4'
+                }
+
+      #File Information
+      segment Hippo::Segments::K3,
+                :name           => 'File Information',
+                :minimum        => 0,
+                :maximum        => 10,
+                :position       => 4850
+
+      #Line Note
+      segment Hippo::Segments::NTE,
+                :name           => 'Line Note',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4860
+
+      #Third Party Organization Notes
+      segment Hippo::Segments::NTE,
+                :name           => 'Third Party Organization Notes',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4865,
+                :defaults => {
+                  'NTE01' => 'TPO'
+                }
+
+      #Purchased Service Information
+      segment Hippo::Segments::PS1,
+                :name           => 'Purchased Service Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4880
+
+      #Line Pricing/Repricing Information
+      segment Hippo::Segments::HCP,
+                :name           => 'Line Pricing/Repricing Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4920
+
+      #Drug Identification
+      loop    Hippo::TransactionSets::HIPAA_837::L2410,
+                :name           => 'Drug Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4940
+
+      #Rendering Provider Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2420A,
+                :name           => 'Rendering Provider Name',
+                :identified_by  => {'NM1.NM101' => '82'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000
+
+      #Purchased Service Provider Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2420B,
+                :name           => 'Purchased Service Provider Name',
+                :identified_by  => {'NM1.NM101' => 'QB'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000
+
+      #Service Facility Location Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2420C,
+                :name           => 'Service Facility Location Name',
+                :identified_by  => {'NM1.NM101' => '77'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000
+
+      #Supervising Provider Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2420D,
+                :name           => 'Supervising Provider Name',
+                :identified_by  => {'NM1.NM101' => 'DQ'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000
+
+      #Ordering Provider Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2420E,
+                :name           => 'Ordering Provider Name',
+                :identified_by  => {'NM1.NM101' => 'DK'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000
+
+      #Referring Provider Name
+      loop    Hippo::TransactionSets::HIPAA_837::L2420F,
+                :name           => 'Referring Provider Name',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 5000
+
+      #Ambulance Pick-up Location
+      loop    Hippo::TransactionSets::HIPAA_837::L2420G,
+                :name           => 'Ambulance Pick-up Location',
+                :identified_by  => {'NM1.NM101' => 'PW'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5310
+
+      #Ambulance Drop-off Location
+      loop    Hippo::TransactionSets::HIPAA_837::L2420H,
+                :name           => 'Ambulance Drop-off Location',
+                :identified_by  => {'NM1.NM101' => '45'},
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5380
+
+      #Line Adjudication Information
+      loop    Hippo::TransactionSets::HIPAA_837::L2430,
+                :name           => 'Line Adjudication Information',
+                :minimum        => 0,
+                :maximum        => 15,
+                :position       => 5400
+
+      #Form Identification Code
+      loop    Hippo::TransactionSets::HIPAA_837::L2440,
+                :name           => 'Form Identification Code',
+                :minimum        => 0,
+                :maximum        => nil,
+                :position       => 5510
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2410.rb

@@ -0,0 +1,30 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2410 < Hippo::TransactionSets::Base
+      loop_name 'L2410'    #Drug Identification
+
+      #Drug Identification
+      segment Hippo::Segments::LIN,
+                :name           => 'Drug Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4940
+
+      #Drug Quantity
+      segment Hippo::Segments::CTP,
+                :name           => 'Drug Quantity',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 4950
+
+      #Prescription or Compound Drug Association Number
+      segment Hippo::Segments::REF,
+                :name           => 'Prescription or Compound Drug Association Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4960
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2420A.rb

@@ -0,0 +1,37 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2420A < Hippo::TransactionSets::Base
+      loop_name 'L2420A'    #Rendering Provider Name
+
+      #Rendering Provider Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Rendering Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000,
+                :defaults => {
+                  'NM101' => '82'
+                }
+
+      #Rendering Provider Specialty Information
+      segment Hippo::Segments::PRV,
+                :name           => 'Rendering Provider Specialty Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5050,
+                :defaults => {
+                  'PRV01' => 'PE',
+                  'PRV02' => 'PXC'
+                }
+
+      #Rendering Provider Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Rendering Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 20,
+                :position       => 5250
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2420B.rb

@@ -0,0 +1,26 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2420B < Hippo::TransactionSets::Base
+      loop_name 'L2420B'    #Purchased Service Provider Name
+
+      #Purchased Service Provider Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Purchased Service Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000,
+                :defaults => {
+                  'NM101' => 'QB'
+                }
+
+      #Purchased Service Provider Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Purchased Service Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 20,
+                :position       => 5250
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2420C.rb

@@ -0,0 +1,41 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2420C < Hippo::TransactionSets::Base
+      loop_name 'L2420C'    #Service Facility Location Name
+
+      #Service Facility Location Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Service Facility Location Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000,
+                :defaults => {
+                  'NM101' => '77',
+                  'NM102' => '2'
+                }
+
+      #Service Facility Location Address
+      segment Hippo::Segments::N3,
+                :name           => 'Service Facility Location Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 5140
+
+      #Service Facility Location City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Service Facility Location City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 5200
+
+      #Service Facility Location Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Service Facility Location Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 3,
+                :position       => 5250
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2420D.rb

@@ -0,0 +1,27 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2420D < Hippo::TransactionSets::Base
+      loop_name 'L2420D'    #Supervising Provider Name
+
+      #Supervising Provider Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Supervising Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000,
+                :defaults => {
+                  'NM101' => 'DQ',
+                  'NM102' => '1'
+                }
+
+      #Supervising Provider Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Supervising Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 20,
+                :position       => 5250
+
+    end
+  end
+end

data/lib/hippo/transaction_sets/HIPAA_837/L2420E.rb

@@ -0,0 +1,51 @@
+module Hippo::TransactionSets
+  module HIPAA_837
+
+    class L2420E < Hippo::TransactionSets::Base
+      loop_name 'L2420E'    #Ordering Provider Name
+
+      #Ordering Provider Name
+      segment Hippo::Segments::NM1,
+                :name           => 'Ordering Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000,
+                :defaults => {
+                  'NM101' => 'DK',
+                  'NM102' => '1'
+                }
+
+      #Ordering Provider Address
+      segment Hippo::Segments::N3,
+                :name           => 'Ordering Provider Address',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5140
+
+      #Ordering Provider City, State, ZIP Code
+      segment Hippo::Segments::N4,
+                :name           => 'Ordering Provider City, State, ZIP Code',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5200
+
+      #Ordering Provider Secondary Identification
+      segment Hippo::Segments::REF,
+                :name           => 'Ordering Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 20,
+                :position       => 5250
+
+      #Ordering Provider Contact Information
+      segment Hippo::Segments::PER,
+                :name           => 'Ordering Provider Contact Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5300,
+                :defaults => {
+                  'PER01' => 'IC'
+                }
+
+    end
+  end
+end