hippo_eyeDoc 0.0.1

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_277/L2200E.rb

@@ -0,0 +1,104 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_277
+
+    class L2200E < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2200E'    #Claim Status Tracking Number
+
+      #Claim Status Tracking Number
+      segment Hippo_eyeDoc::Segments::TRN,
+                :name           => 'Claim Status Tracking Number',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 900,
+                :identified_by => {
+                  'TRN01' => '2'
+                }
+
+      #Claim Level Status Information
+      segment Hippo_eyeDoc::Segments::STC,
+                :name           => 'Claim Level Status Information',
+                :minimum        => 1,
+                :maximum        => 99999,
+                :position       => 1000
+
+      #Payer Claim Control Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Payer Claim Control Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1100,
+                :identified_by => {
+                  'REF01' => '1K'
+                }
+
+      #Institutional Bill Type Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Institutional Bill Type Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1120,
+                :identified_by => {
+                  'REF01' => 'BLT'
+                }
+
+      #Patient Control Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Patient Control Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1145,
+                :identified_by => {
+                  'REF01' => 'EJ'
+                }
+
+      #Pharmacy Prescription Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Pharmacy Prescription Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1150,
+                :identified_by => {
+                  'REF01' => 'XZ'
+                }
+
+      #Voucher Identifier
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Voucher Identifier',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1155,
+                :identified_by => {
+                  'REF01' => 'VV'
+                }
+
+      #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       => 1160,
+                :identified_by => {
+                  'REF01' => 'D9'
+                }
+
+      #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_277::L2220E,
+                :name           => 'Service Line Information',
+                :minimum        => 0,
+                :maximum        => 99999,
+                :position       => 1800
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_277/L2220D.rb

@@ -0,0 +1,57 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_277
+
+    class L2220D < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2220D'    #Service Line Information
+
+      #Service Line Information
+      segment Hippo_eyeDoc::Segments::SVC,
+                :name           => 'Service Line Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1800
+
+      #Service Line Level Status Information
+      segment Hippo_eyeDoc::Segments::STC,
+                :name           => 'Service Line Level Status Information',
+                :minimum        => 1,
+                :maximum        => 99999,
+                :position       => 1900,
+                :identified_by => {
+                  'STC03' => 'U'
+                }
+
+      #Service Line Item Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Service Line Item Identification',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 2000,
+                :identified_by => {
+                  'REF01' => 'FJ'
+                }
+
+      #Pharmacy Prescription Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Pharmacy Prescription Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2010,
+                :identified_by => {
+                  'REF01' => 'XZ'
+                }
+
+      #Service Line Date
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Service Line Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2100,
+                :identified_by => {
+                  'DTP01' => '472',
+                  'DTP02' => ["D8", "RD8"]
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_277/L2220E.rb

@@ -0,0 +1,44 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_277
+
+    class L2220E < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2220E'    #Service Line Information
+
+      #Service Line Information
+      segment Hippo_eyeDoc::Segments::SVC,
+                :name           => 'Service Line Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1800
+
+      #Service Line Status Information
+      segment Hippo_eyeDoc::Segments::STC,
+                :name           => 'Service Line Status Information',
+                :minimum        => 1,
+                :maximum        => 99999,
+                :position       => 1900
+
+      #Service Line Item Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Service Line Item Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2000,
+                :identified_by => {
+                  'REF01' => 'FJ'
+                }
+
+      #Service Line Date
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Service Line Date',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 2100,
+                :identified_by => {
+                  'DTP01' => '472',
+                  'DTP02' => ["D8", "RD8"]
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_277/base.rb

@@ -0,0 +1,70 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_277
+
+    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' => '277'
+                }
+
+      #Beginning of Hierarchical Transaction
+      segment Hippo_eyeDoc::Segments::BHT,
+                :name           => 'Beginning of Hierarchical Transaction',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 200,
+                :identified_by => {
+                  'BHT01' => '0085',
+                  'BHT02' => '08',
+                  'BHT06' => 'TH'
+                }
+
+      #Information Source Level
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_277::L2000A,
+                :name           => 'Information Source Level',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100,
+                :identified_by => {
+                  'HL.HL03' => '20',
+                  'HL.HL04' => '1'
+                }
+
+      #Information Receiver Level
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_277::L2000B,
+                :name           => 'Information Receiver Level',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100,
+                :identified_by => {
+                  'HL.HL03' => '21',
+                  'HL.HL04' => ["0", "1"]
+                }
+
+      #Billing Provider of Service Level
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_277::L2000C,
+                :name           => 'Billing Provider of Service Level',
+                :minimum        => 0,
+                :maximum        => 99999,
+                :position       => 100,
+                :identified_by => {
+                  'HL.HL03' => '19',
+                  'HL.HL04' => ["0", "1"]
+                }
+
+      #Transaction Set Trailer
+      segment Hippo_eyeDoc::Segments::SE,
+                :name           => 'Transaction Set Trailer',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 2700
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_835.rb

@@ -0,0 +1,10 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_835
+    autoload_relative :Base,      'HIPAA_835/base'
+    autoload_relative :L1000A,    'HIPAA_835/L1000A'
+    autoload_relative :L1000B,    'HIPAA_835/L1000B'
+    autoload_relative :L2000,     'HIPAA_835/L2000'
+    autoload_relative :L2100,     'HIPAA_835/L2100'
+    autoload_relative :L2110,     'HIPAA_835/L2110'
+  end
+end

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

@@ -0,0 +1,74 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_835
+
+    class L1000A < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L1000A'    #Payer Identification
+
+      #Payer Identification
+      segment Hippo_eyeDoc::Segments::N1,
+                :name           => 'Payer Identification',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 800,
+                :identified_by => {
+                  'N101' => 'PR'
+                }
+
+      #Payer Address
+      segment Hippo_eyeDoc::Segments::N3,
+                :name           => 'Payer Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 1000
+
+      #Payer City, State, ZIP Code
+      segment Hippo_eyeDoc::Segments::N4,
+                :name           => 'Payer City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 1100
+
+      #Additional Payer Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Additional Payer Identification',
+                :minimum        => 0,
+                :maximum        => 4,
+                :position       => 1200,
+                :identified_by => {
+                  'REF01' => ["2U", "EO", "HI", "NF"]
+                }
+
+      #Payer Business Contact Information
+      segment Hippo_eyeDoc::Segments::PER,
+                :name           => 'Payer Business Contact Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1300,
+                :identified_by => {
+                  'PER01' => 'CX'
+                }
+
+      #Payer Technical Contact Information
+      segment Hippo_eyeDoc::Segments::PER,
+                :name           => 'Payer Technical Contact Information',
+                :minimum        => 1,
+                :maximum        => 99999,
+                :position       => 1303,
+                :identified_by => {
+                  'PER01' => 'BL'
+                }
+
+      #Payer WEB Site
+      segment Hippo_eyeDoc::Segments::PER,
+                :name           => 'Payer WEB Site',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1305,
+                :identified_by => {
+                  'PER01' => 'IC',
+                  'PER03' => 'UR'
+                }
+
+    end
+  end
+end

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

@@ -0,0 +1,54 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_835
+
+    class L1000B < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L1000B'    #Payee Identification
+
+      #Payee Identification
+      segment Hippo_eyeDoc::Segments::N1,
+                :name           => 'Payee Identification',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 1400,
+                :identified_by => {
+                  'N101' => 'PE',
+                  'N103' => ["FI", "XV", "XX"]
+                }
+
+      #Payee Address
+      segment Hippo_eyeDoc::Segments::N3,
+                :name           => 'Payee Address',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1600
+
+      #Payee City, State, ZIP Code
+      segment Hippo_eyeDoc::Segments::N4,
+                :name           => 'Payee City, State, ZIP Code',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1700
+
+      #Payee Additional Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Payee Additional Identification',
+                :minimum        => 0,
+                :maximum        => 99999,
+                :position       => 1800,
+                :identified_by => {
+                  'REF01' => ["0B", "D3", "PQ", "TJ"]
+                }
+
+      #Remittance Delivery Method
+      segment Hippo_eyeDoc::Segments::RDM,
+                :name           => 'Remittance Delivery Method',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2000,
+                :identified_by => {
+                  'RDM01' => ["BM", "EM", "FT", "OL"]
+                }
+
+    end
+  end
+end

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

@@ -0,0 +1,41 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_835
+
+    class L2000 < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2000'    #Header Number
+
+      #Header Number
+      segment Hippo_eyeDoc::Segments::LX,
+                :name           => 'Header Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 30
+
+      #Provider Summary Information
+      segment Hippo_eyeDoc::Segments::TS3,
+                :name           => 'Provider Summary Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 50
+
+      #Provider Supplemental Summary Information
+      segment Hippo_eyeDoc::Segments::TS2,
+                :name           => 'Provider Supplemental Summary Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 70
+
+      #Claim Payment Information
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_835::L2100,
+                :name           => 'Claim Payment Information',
+                :minimum        => 1,
+                :maximum        => 99999,
+                :position       => 100,
+                :identified_by => {
+                  'CLP.CLP02' => ["1", "2", "3", "4", "19", "20", "21", "22", "23", "25"],
+                  'CLP.CLP06' => ["12", "13", "14", "15", "16", "17", "AM", "CH", "DS", "HM", "LM", "MA", "MB", "MC", "OF", "TV", "VA", "WC", "ZZ"]
+                }
+
+    end
+  end
+end