hippo_eyeDoc 0.0.1

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

@@ -0,0 +1,36 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2410 < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2410'    #Drug Identification
+
+      #Drug Identification
+      segment Hippo_eyeDoc::Segments::LIN,
+                :name           => 'Drug Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4940,
+                :identified_by => {
+                  'LIN02' => ["EN", "EO", "HI", "N4", "ON", "UK", "UP"]
+                }
+
+      #Drug Quantity
+      segment Hippo_eyeDoc::Segments::CTP,
+                :name           => 'Drug Quantity',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 4950
+
+      #Prescription or Compound Drug Association Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Prescription or Compound Drug Association Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 4960,
+                :identified_by => {
+                  'REF01' => ["VY", "XZ"]
+                }
+
+    end
+  end
+end

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

@@ -0,0 +1,41 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2420A < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2420A'    #Rendering Provider Name
+
+      #Rendering Provider Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Rendering Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000,
+                :identified_by => {
+                  'NM101' => '82',
+                  'NM102' => ["1", "2"]
+                }
+
+      #Rendering Provider Specialty Information
+      segment Hippo_eyeDoc::Segments::PRV,
+                :name           => 'Rendering Provider Specialty Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5050,
+                :identified_by => {
+                  'PRV01' => 'PE',
+                  'PRV02' => 'PXC'
+                }
+
+      #Rendering Provider Secondary Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Rendering Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 20,
+                :position       => 5250,
+                :identified_by => {
+                  'REF01' => ["0B", "1G", "G2", "LU"]
+                }
+
+    end
+  end
+end

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

@@ -0,0 +1,30 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2420B < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2420B'    #Purchased Service Provider Name
+
+      #Purchased Service Provider Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Purchased Service Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000,
+                :identified_by => {
+                  'NM101' => 'QB',
+                  'NM102' => ["1", "2"]
+                }
+
+      #Purchased Service Provider Secondary Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Purchased Service Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 20,
+                :position       => 5250,
+                :identified_by => {
+                  'REF01' => ["0B", "1G", "G2"]
+                }
+
+    end
+  end
+end

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

@@ -0,0 +1,44 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2420C < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2420C'    #Service Facility Location Name
+
+      #Service Facility Location Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Service Facility Location Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000,
+                :identified_by => {
+                  'NM101' => '77',
+                  'NM102' => '2'
+                }
+
+      #Service Facility Location Address
+      segment Hippo_eyeDoc::Segments::N3,
+                :name           => 'Service Facility Location Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 5140
+
+      #Service Facility Location City, State, ZIP Code
+      segment Hippo_eyeDoc::Segments::N4,
+                :name           => 'Service Facility Location City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 5200
+
+      #Service Facility Location Secondary Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Service Facility Location Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 3,
+                :position       => 5250,
+                :identified_by => {
+                  'REF01' => ["G2", "LU"]
+                }
+
+    end
+  end
+end

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

@@ -0,0 +1,30 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2420D < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2420D'    #Supervising Provider Name
+
+      #Supervising Provider Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Supervising Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000,
+                :identified_by => {
+                  'NM101' => 'DQ',
+                  'NM102' => '1'
+                }
+
+      #Supervising Provider Secondary Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Supervising Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 20,
+                :position       => 5250,
+                :identified_by => {
+                  'REF01' => ["0B", "1G", "G2", "LU"]
+                }
+
+    end
+  end
+end

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

@@ -0,0 +1,55 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2420E < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2420E'    #Ordering Provider Name
+
+      #Ordering Provider Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Ordering Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000,
+                :identified_by => {
+                  'NM101' => 'DK',
+                  'NM102' => '1'
+                }
+
+      #Ordering Provider Address
+      segment Hippo_eyeDoc::Segments::N3,
+                :name           => 'Ordering Provider Address',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5140
+
+      #Ordering Provider City, State, ZIP Code
+      segment Hippo_eyeDoc::Segments::N4,
+                :name           => 'Ordering Provider City, State, ZIP Code',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5200
+
+      #Ordering Provider Secondary Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Ordering Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 20,
+                :position       => 5250,
+                :identified_by => {
+                  'REF01' => ["0B", "1G", "G2"]
+                }
+
+      #Ordering Provider Contact Information
+      segment Hippo_eyeDoc::Segments::PER,
+                :name           => 'Ordering Provider Contact Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5300,
+                :identified_by => {
+                  'PER01' => 'IC',
+                  'PER03' => ["EM", "FX", "TE"]
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_837/L2420F.rb

@@ -0,0 +1,30 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2420F < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2420F'    #Referring Provider Name
+
+      #Referring Provider Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Referring Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5000,
+                :identified_by => {
+                  'NM101' => ["DN", "P3"],
+                  'NM102' => '1'
+                }
+
+      #Referring Provider Secondary Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Referring Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 20,
+                :position       => 5250,
+                :identified_by => {
+                  'REF01' => ["0B", "1G", "G2"]
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_837/L2420G.rb

@@ -0,0 +1,34 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2420G < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2420G'    #Ambulance Pick-up Location
+
+      #Ambulance Pick-up Location
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Ambulance Pick-up Location',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5310,
+                :identified_by => {
+                  'NM101' => 'PW',
+                  'NM102' => '2'
+                }
+
+      #Ambulance Pick-up Location Address
+      segment Hippo_eyeDoc::Segments::N3,
+                :name           => 'Ambulance Pick-up Location Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 5340
+
+      #Ambulance Pick-up Location City, State, ZIP Code
+      segment Hippo_eyeDoc::Segments::N4,
+                :name           => 'Ambulance Pick-up Location City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 5350
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_837/L2420H.rb

@@ -0,0 +1,34 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2420H < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2420H'    #Ambulance Drop-off Location
+
+      #Ambulance Drop-off Location
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Ambulance Drop-off Location',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5380,
+                :identified_by => {
+                  'NM101' => '45',
+                  'NM102' => '2'
+                }
+
+      #Ambulance Drop-off Location Address
+      segment Hippo_eyeDoc::Segments::N3,
+                :name           => 'Ambulance Drop-off Location Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 5410
+
+      #Ambulance Drop-off Location City, State, ZIP Code
+      segment Hippo_eyeDoc::Segments::N4,
+                :name           => 'Ambulance Drop-off Location City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 5420
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_837/L2430.rb

@@ -0,0 +1,47 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2430 < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2430'    #Line Adjudication Information
+
+      #Line Adjudication Information
+      segment Hippo_eyeDoc::Segments::SVD,
+                :name           => 'Line Adjudication Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5400
+
+      #Line Adjustment
+      segment Hippo_eyeDoc::Segments::CAS,
+                :name           => 'Line Adjustment',
+                :minimum        => 0,
+                :maximum        => 5,
+                :position       => 5450,
+                :identified_by => {
+                  'CAS01' => ["CO", "CR", "OA", "PI", "PR"]
+                }
+
+      #Line Check or Remittance Date
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Line Check or Remittance Date',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 5500,
+                :identified_by => {
+                  'DTP01' => '573',
+                  'DTP02' => 'D8'
+                }
+
+      #Remaining Patient Liability
+      segment Hippo_eyeDoc::Segments::AMT,
+                :name           => 'Remaining Patient Liability',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5505,
+                :identified_by => {
+                  'AMT01' => 'EAF'
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_837/L2440.rb

@@ -0,0 +1,26 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2440 < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2440'    #Form Identification Code
+
+      #Form Identification Code
+      segment Hippo_eyeDoc::Segments::LQ,
+                :name           => 'Form Identification Code',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 5510,
+                :identified_by => {
+                  'LQ01' => ["AS", "UT"]
+                }
+
+      #Supporting Documentation
+      segment Hippo_eyeDoc::Segments::FRM,
+                :name           => 'Supporting Documentation',
+                :minimum        => 1,
+                :maximum        => 99,
+                :position       => 5520
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_837/base.rb

@@ -0,0 +1,71 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class Base < Hippo_eyeDoc::TransactionSets::Base
+      #Transaction Set Header
+      segment Hippo_eyeDoc::Segments::ST,
+                :name           => 'Transaction Set Header',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 50,
+                :identified_by => {
+                  'ST01' => '837'
+                }
+
+      #Beginning of Hierarchical Transaction
+      segment Hippo_eyeDoc::Segments::BHT,
+                :name           => 'Beginning of Hierarchical Transaction',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100,
+                :identified_by => {
+                  'BHT01' => '0019',
+                  'BHT02' => ["00", "18"],
+                  'BHT06' => ["31", "CH", "RP"]
+                }
+
+      #Submitter Name
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_837::L1000A,
+                :name           => 'Submitter Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 200,
+                :identified_by => {
+                  'NM1.NM101' => '41',
+                  'NM1.NM102' => ["1", "2"],
+                  'NM1.NM108' => '46'
+                }
+
+      #Receiver Name
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_837::L1000B,
+                :name           => 'Receiver Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 500,
+                :identified_by => {
+                  'NM1.NM101' => '40',
+                  'NM1.NM102' => '2',
+                  'NM1.NM108' => '46'
+                }
+
+      #Billing Provider Hierarchical Level
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_837::L2000A,
+                :name           => 'Billing Provider Hierarchical Level',
+                :minimum        => 1,
+                :maximum        => 99999,
+                :position       => 10,
+                :identified_by => {
+                  'HL.HL03' => '20',
+                  'HL.HL04' => '1'
+                }
+
+      #Transaction Set Trailer
+      segment Hippo_eyeDoc::Segments::SE,
+                :name           => 'Transaction Set Trailer',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 5550
+
+    end
+  end
+end