hippo_eyeDoc 0.0.1

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_271/base.rb

@@ -0,0 +1,47 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_271
+
+    class Base < Hippo_eyeDoc::TransactionSets::Base
+
+      #Transaction Set Header
+      segment Hippo_eyeDoc::Segments::ST,
+                :name           => 'Transaction Set Header',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100,
+                :identified_by => {
+                  'ST01' => '271'
+                }
+
+      #Beginning of Hierarchical Transaction
+      segment Hippo_eyeDoc::Segments::BHT,
+                :name           => 'Beginning of Hierarchical Transaction',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 200,
+                :identified_by => {
+                  'BHT01' => '0022',
+                  'BHT02' => ["06", "11"]
+                }
+
+      #Information Source Level
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_271::L2000A,
+                :name           => 'Information Source Level',
+                :minimum        => 1,
+                :maximum        => 99999,
+                :position       => 100,
+                :identified_by => {
+                  'HL.HL03' => '20',
+                  'HL.HL04' => ["0", "1"]
+                }
+
+      #Transaction Set Trailer
+      segment Hippo_eyeDoc::Segments::SE,
+                :name           => 'Transaction Set Trailer',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 2300
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276.rb

@@ -0,0 +1,19 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+    autoload_relative :Base,      'HIPAA_276/base'
+    autoload_relative :L2000A,    'HIPAA_276/L2000A'
+    autoload_relative :L2000B,    'HIPAA_276/L2000B'
+    autoload_relative :L2000C,    'HIPAA_276/L2000C'
+    autoload_relative :L2000D,    'HIPAA_276/L2000D'
+    autoload_relative :L2000E,    'HIPAA_276/L2000E'
+    autoload_relative :L2100A,    'HIPAA_276/L2100A'
+    autoload_relative :L2100B,    'HIPAA_276/L2100B'
+    autoload_relative :L2100C,    'HIPAA_276/L2100C'
+    autoload_relative :L2100D,    'HIPAA_276/L2100D'
+    autoload_relative :L2100E,    'HIPAA_276/L2100E'
+    autoload_relative :L2200D,    'HIPAA_276/L2200D'
+    autoload_relative :L2200E,    'HIPAA_276/L2200E'
+    autoload_relative :L2210D,    'HIPAA_276/L2210D'
+    autoload_relative :L2210E,    'HIPAA_276/L2210E'
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276/L2000A.rb

@@ -0,0 +1,32 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+
+    class L2000A < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2000A'    #Information Source Level
+
+      #Information Source Level
+      segment Hippo_eyeDoc::Segments::HL,
+                :name           => 'Information Source Level',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100,
+                :identified_by => {
+                  'HL03' => '20',
+                  'HL04' => '1'
+                }
+
+      #Payer Name
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_276::L2100A,
+                :name           => 'Payer Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 500,
+                :identified_by => {
+                  'NM1.NM101' => 'PR',
+                  'NM1.NM102' => '2',
+                  'NM1.NM108' => ["PI", "XV"]
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276/L2000B.rb

@@ -0,0 +1,32 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+
+    class L2000B < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2000B'    #Information Receiver Level
+
+      #Information Receiver Level
+      segment Hippo_eyeDoc::Segments::HL,
+                :name           => 'Information Receiver Level',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100,
+                :identified_by => {
+                  'HL03' => '21',
+                  'HL04' => '1'
+                }
+
+      #Information Receiver Name
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_276::L2100B,
+                :name           => 'Information Receiver Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 500,
+                :identified_by => {
+                  'NM1.NM101' => '41',
+                  'NM1.NM102' => ["1", "2"],
+                  'NM1.NM108' => '46'
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276/L2000C.rb

@@ -0,0 +1,32 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+
+    class L2000C < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2000C'    #Service Provider Level
+
+      #Service Provider Level
+      segment Hippo_eyeDoc::Segments::HL,
+                :name           => 'Service Provider Level',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100,
+                :identified_by => {
+                  'HL03' => '19',
+                  'HL04' => '1'
+                }
+
+      #Provider Name
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_276::L2100C,
+                :name           => 'Provider Name',
+                :minimum        => 1,
+                :maximum        => 2,
+                :position       => 500,
+                :identified_by => {
+                  'NM1.NM101' => '1P',
+                  'NM1.NM102' => ["1", "2"],
+                  'NM1.NM108' => ["FI", "SV", "XX"]
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276/L2000D.rb

@@ -0,0 +1,52 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+
+    class L2000D < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2000D'    #Subscriber Level
+
+      #Subscriber Level
+      segment Hippo_eyeDoc::Segments::HL,
+                :name           => 'Subscriber Level',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100,
+                :identified_by => {
+                  'HL03' => '22',
+                  'HL04' => ["0", "1"]
+                }
+
+      #Subscriber Demographic Information
+      segment Hippo_eyeDoc::Segments::DMG,
+                :name           => 'Subscriber Demographic Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 400,
+                :identified_by => {
+                  'DMG01' => 'D8'
+                }
+
+      #Subscriber Name
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_276::L2100D,
+                :name           => 'Subscriber Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 500,
+                :identified_by => {
+                  'NM1.NM101' => 'IL',
+                  'NM1.NM102' => ["1", "2"],
+                  'NM1.NM108' => ["24", "II", "MI"]
+                }
+
+      #Claim Status Tracking Number
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_276::L2200D,
+                :name           => 'Claim Status Tracking Number',
+                :minimum        => 0,
+                :maximum        => 99999,
+                :position       => 900,
+                :identified_by => {
+                  'TRN.TRN01' => '1'
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276/L2000E.rb

@@ -0,0 +1,50 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+
+    class L2000E < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2000E'    #Dependent Level
+
+      #Dependent Level
+      segment Hippo_eyeDoc::Segments::HL,
+                :name           => 'Dependent Level',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 100,
+                :identified_by => {
+                  'HL03' => '23'
+                }
+
+      #Dependent Demographic Information
+      segment Hippo_eyeDoc::Segments::DMG,
+                :name           => 'Dependent Demographic Information',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 400,
+                :identified_by => {
+                  'DMG01' => 'D8'
+                }
+
+      #Dependent Name
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_276::L2100E,
+                :name           => 'Dependent Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 500,
+                :identified_by => {
+                  'NM1.NM101' => 'QC',
+                  'NM1.NM102' => '1'
+                }
+
+      #Claim Status Tracking Number
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_276::L2200E,
+                :name           => 'Claim Status Tracking Number',
+                :minimum        => 1,
+                :maximum        => 99999,
+                :position       => 900,
+                :identified_by => {
+                  'TRN.TRN01' => '1'
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276/L2100A.rb

@@ -0,0 +1,21 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+
+    class L2100A < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2100A'    #Payer Name
+
+      #Payer Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Payer Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 500,
+                :identified_by => {
+                  'NM101' => 'PR',
+                  'NM102' => '2',
+                  'NM108' => ["PI", "XV"]
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276/L2100B.rb

@@ -0,0 +1,21 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+
+    class L2100B < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2100B'    #Information Receiver Name
+
+      #Information Receiver Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Information Receiver Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 500,
+                :identified_by => {
+                  'NM101' => '41',
+                  'NM102' => ["1", "2"],
+                  'NM108' => '46'
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276/L2100C.rb

@@ -0,0 +1,21 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+
+    class L2100C < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2100C'    #Provider Name
+
+      #Provider Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Provider Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 500,
+                :identified_by => {
+                  'NM101' => '1P',
+                  'NM102' => ["1", "2"],
+                  'NM108' => ["FI", "SV", "XX"]
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276/L2100D.rb

@@ -0,0 +1,21 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+
+    class L2100D < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2100D'    #Subscriber Name
+
+      #Subscriber Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Subscriber Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 500,
+                :identified_by => {
+                  'NM101' => 'IL',
+                  'NM102' => ["1", "2"],
+                  'NM108' => ["24", "II", "MI"]
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276/L2100E.rb

@@ -0,0 +1,20 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+
+    class L2100E < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2100E'    #Dependent Name
+
+      #Dependent Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Dependent Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 500,
+                :identified_by => {
+                  'NM101' => 'QC',
+                  'NM102' => '1'
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_276/L2200D.rb

@@ -0,0 +1,117 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_276
+
+    class L2200D < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2200D'    #Claim Status Tracking Number
+
+      #Claim Status Tracking Number
+      segment Hippo_eyeDoc::Segments::TRN,
+                :name           => 'Claim Status Tracking Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 900,
+                :identified_by => {
+                  'TRN01' => '1'
+                }
+
+      #Payer Claim Control Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Payer Claim Control Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1000,
+                :identified_by => {
+                  'REF01' => '1K'
+                }
+
+      #Institutional Bill Type Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Institutional Bill Type Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1010,
+                :identified_by => {
+                  'REF01' => 'BLT'
+                }
+
+      #Application or Location System Identifier
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Application or Location System Identifier',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1030,
+                :identified_by => {
+                  'REF01' => 'LU'
+                }
+
+      #Group Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Group Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1035,
+                :identified_by => {
+                  'REF01' => '6P'
+                }
+
+      #Patient Control Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Patient Control Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1040,
+                :identified_by => {
+                  'REF01' => 'EJ'
+                }
+
+      #Pharmacy Prescription Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Pharmacy Prescription Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1045,
+                :identified_by => {
+                  'REF01' => 'XZ'
+                }
+
+      #Claim Identification Number For Clearinghouses and Other Transmission Intermediaries
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Claim Identification Number For Clearinghouses and Other Transmission Intermediaries',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1050,
+                :identified_by => {
+                  'REF01' => 'D9'
+                }
+
+      #Claim Submitted Charges
+      segment Hippo_eyeDoc::Segments::AMT,
+                :name           => 'Claim Submitted Charges',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1100,
+                :identified_by => {
+                  'AMT01' => 'T3'
+                }
+
+      #Claim Service Date
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Claim Service Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1200,
+                :identified_by => {
+                  'DTP01' => '472',
+                  'DTP02' => ["D8", "RD8"]
+                }
+
+      #Service Line Information
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_276::L2210D,
+                :name           => 'Service Line Information',
+                :minimum        => 0,
+                :maximum        => 99999,
+                :position       => 1300
+
+    end
+  end
+end