hippo_eyeDoc 0.0.1

data/samples/sample835.html

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+<fieldset class="hippo-transaction-set"><legend>HIPAA_835::Base</legend><span class="hippo-segment-name">Transaction Set Header</span><span class="hippo-segment-data">ST*835*1234~</span><br/><span class="hippo-segment-name">Financial Information</span><span class="hippo-segment-data">BPR*C*150000*C*ACH*CTX*01*999999992*DA*123456*1512345678**01*999988880*DA*98765*20020913~</span><br/><span class="hippo-segment-name">Reassociation Trace Number</span><span class="hippo-segment-data">TRN*1*12345*1512345678~</span><br/><span class="hippo-segment-name">Production Date</span><span class="hippo-segment-data">DTM*405*20020916~</span><br/><fieldset class="hippo-component"><legend>HIPAA_835::L1000A - Payer Identification</legend><span class="hippo-segment-name">Payer Identification</span><span class="hippo-segment-data">N1*PR*INSURANCE COMPANY OF TIMBUCKTU~</span><br/><span class="hippo-segment-name">Payer Address</span><span class="hippo-segment-data">N3*1 MAIN STREET~</span><br/><span class="hippo-segment-name">Payer City, State, ZIP Code</span><span class="hippo-segment-data">N4*TIMBUCKTU*AK*89111~</span><br/><span class="hippo-segment-name">Additional Payer Identification</span><span class="hippo-segment-data">REF*2U*999~</span><br/></fieldset><fieldset class="hippo-component"><legend>HIPAA_835::L1000B - Payee Identification</legend><span class="hippo-segment-name">Payee Identification</span><span class="hippo-segment-data">N1*PE*REGIONAL HOPE HOSPITAL*XX*6543210903~</span><br/></fieldset><fieldset class="hippo-component"><legend>HIPAA_835::L2000 - Header Number</legend><span class="hippo-segment-name">Header Number</span><span class="hippo-segment-data">LX*110212~</span><br/><span class="hippo-segment-name">Provider Summary Information</span><span class="hippo-segment-data">TS3*6543210903*11*20021231*1*211366.97****138018.4**73348.57~</span><br/><span class="hippo-segment-name">Provider Supplemental Summary Information</span><span class="hippo-segment-data">TS2*2178.45*1919.71**56.82*197.69*4.23~</span><br/><fieldset class="hippo-component"><legend>HIPAA_835::L2100 - Claim Payment Information</legend><span class="hippo-segment-name">Claim Payment Information</span><span class="hippo-segment-data">CLP*666123*1*211366.97*138018.4**MA*1999999444444*11*1~</span><br/><span class="hippo-segment-name">Claim Adjustment</span><span class="hippo-segment-data">CAS*CO*45*73348.57~</span><br/><span class="hippo-segment-name">Patient Name</span><span class="hippo-segment-data">NM1*QC*1*JONES*SAM*O***HN*666666666A~</span><br/><span class="hippo-segment-name">Inpatient Adjudication Information</span><span class="hippo-segment-data">MIA*0***138018.4~</span><br/><span class="hippo-segment-name">Statement From or To Date</span><span class="hippo-segment-data">DTM*232*20020816~DTM*233*20020824~</span><br/><span class="hippo-segment-name">Claim Supplemental Information Quantity</span><span class="hippo-segment-data">QTY*CA*8~</span><br/></fieldset><span class="hippo-segment-name">Header Number</span><span class="hippo-segment-data">LX*130212~</span><br/><span class="hippo-segment-name">Provider Summary Information</span><span class="hippo-segment-data">TS3*6543210909*13*19961231*1*15000****11980.33**3019.67~</span><br/><fieldset class="hippo-component"><legend>HIPAA_835::L2100 - Claim Payment Information</legend><span class="hippo-segment-name">Claim Payment Information</span><span class="hippo-segment-data">CLP*777777*1*15000*11980.33**MB*1999999444445*13*1~</span><br/><span class="hippo-segment-name">Claim Adjustment</span><span class="hippo-segment-data">CAS*CO*45*3019.67~</span><br/><span class="hippo-segment-name">Patient Name</span><span class="hippo-segment-data">NM1*QC*1*BORDER*LIZ*E***HN*996669999B~</span><br/><span class="hippo-segment-name">Outpatient Adjudication Information</span><span class="hippo-segment-data">MOA***MA02~</span><br/><span class="hippo-segment-name">Statement From or To Date</span><span class="hippo-segment-data">DTM*232*20020512~</span><br/></fieldset></fieldset><span class="hippo-segment-name">Provider Adjustment</span><span class="hippo-segment-data">PLB*6543210903*20021231*CV:CP*-1.27~</span><br/><span class="hippo-segment-name">Transaction Set Trailer</span><span class="hippo-segment-data">SE*28*1234~</span><br/></fieldset>

data/samples/sample835.pretty_string

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+ST*835*1234~
+  BPR*C*150000*C*ACH*CTX*01*999999992*DA*123456*1512345678**01*999988880*DA*98765*20020913~
+  TRN*1*12345*1512345678~
+  DTM*405*20020916~
+  N1*PR*INSURANCE COMPANY OF TIMBUCKTU~
+    N3*1 MAIN STREET~
+    N4*TIMBUCKTU*AK*89111~
+    REF*2U*999~
+  N1*PE*REGIONAL HOPE HOSPITAL*XX*6543210903~
+  LX*110212~
+    TS3*6543210903*11*20021231*1*211366.97****138018.4**73348.57~
+    TS2*2178.45*1919.71**56.82*197.69*4.23~
+    CLP*666123*1*211366.97*138018.4**MA*1999999444444*11*1~
+      CAS*CO*45*73348.57~
+      NM1*QC*1*JONES*SAM*O***HN*666666666A~
+      MIA*0***138018.4~
+      DTM*232*20020816~
+      DTM*233*20020824~
+      QTY*CA*8~
+  LX*130212~
+    TS3*6543210909*13*19961231*1*15000****11980.33**3019.67~
+    CLP*777777*1*15000*11980.33**MB*1999999444445*13*1~
+      CAS*CO*45*3019.67~
+      NM1*QC*1*BORDER*LIZ*E***HN*996669999B~
+      MOA***MA02~
+      DTM*232*20020512~
+  PLB*6543210903*20021231*CV:CP*-1.27~
+  SE*28*1234~

data/samples/sample837.html

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+<fieldset class="hippo-transaction-set"><legend>HIPAA_835::Base</legend><span class="hippo-segment-name">Transaction Set Header</span><span class="hippo-segment-data">ST*835*1234~</span><br/><span class="hippo-segment-name">Financial Information</span><span class="hippo-segment-data">BPR*C*150000*C*ACH*CTX*01*999999992*DA*123456*1512345678**01*999988880*DA*98765*20020913~</span><br/><span class="hippo-segment-name">Reassociation Trace Number</span><span class="hippo-segment-data">TRN*1*12345*1512345678~</span><br/><span class="hippo-segment-name">Production Date</span><span class="hippo-segment-data">DTM*405*20020916~</span><br/><fieldset class="hippo-component"><legend>HIPAA_835::L1000A - Payer Identification</legend><span class="hippo-segment-name">Payer Identification</span><span class="hippo-segment-data">N1*PR*INSURANCE COMPANY OF TIMBUCKTU~</span><br/><span class="hippo-segment-name">Payer Address</span><span class="hippo-segment-data">N3*1 MAIN STREET~</span><br/><span class="hippo-segment-name">Payer City, State, ZIP Code</span><span class="hippo-segment-data">N4*TIMBUCKTU*AK*89111~</span><br/><span class="hippo-segment-name">Additional Payer Identification</span><span class="hippo-segment-data">REF*2U*999~</span><br/></fieldset><fieldset class="hippo-component"><legend>HIPAA_835::L1000B - Payee Identification</legend><span class="hippo-segment-name">Payee Identification</span><span class="hippo-segment-data">N1*PE*REGIONAL HOPE HOSPITAL*XX*6543210903~</span><br/></fieldset><fieldset class="hippo-component"><legend>HIPAA_835::L2000 - Header Number</legend><span class="hippo-segment-name">Header Number</span><span class="hippo-segment-data">LX*110212~</span><br/><span class="hippo-segment-name">Provider Summary Information</span><span class="hippo-segment-data">TS3*6543210903*11*20021231*1*211366.97****138018.4**73348.57~</span><br/><span class="hippo-segment-name">Provider Supplemental Summary Information</span><span class="hippo-segment-data">TS2*2178.45*1919.71**56.82*197.69*4.23~</span><br/><fieldset class="hippo-component"><legend>HIPAA_835::L2100 - Claim Payment Information</legend><span class="hippo-segment-name">Claim Payment Information</span><span class="hippo-segment-data">CLP*666123*1*211366.97*138018.4**MA*1999999444444*11*1~</span><br/><span class="hippo-segment-name">Claim Adjustment</span><span class="hippo-segment-data">CAS*CO*45*73348.57~</span><br/><span class="hippo-segment-name">Patient Name</span><span class="hippo-segment-data">NM1*QC*1*JONES*SAM*O***HN*666666666A~</span><br/><span class="hippo-segment-name">Inpatient Adjudication Information</span><span class="hippo-segment-data">MIA*0***138018.4~</span><br/><span class="hippo-segment-name">Statement From or To Date</span><span class="hippo-segment-data">DTM*232*20020816~DTM*233*20020824~</span><br/><span class="hippo-segment-name">Claim Supplemental Information Quantity</span><span class="hippo-segment-data">QTY*CA*8~</span><br/></fieldset><span class="hippo-segment-name">Header Number</span><span class="hippo-segment-data">LX*130212~</span><br/><span class="hippo-segment-name">Provider Summary Information</span><span class="hippo-segment-data">TS3*6543210909*13*19961231*1*15000****11980.33**3019.67~</span><br/><fieldset class="hippo-component"><legend>HIPAA_835::L2100 - Claim Payment Information</legend><span class="hippo-segment-name">Claim Payment Information</span><span class="hippo-segment-data">CLP*777777*1*15000*11980.33**MB*1999999444445*13*1~</span><br/><span class="hippo-segment-name">Claim Adjustment</span><span class="hippo-segment-data">CAS*CO*45*3019.67~</span><br/><span class="hippo-segment-name">Patient Name</span><span class="hippo-segment-data">NM1*QC*1*BORDER*LIZ*E***HN*996669999B~</span><br/><span class="hippo-segment-name">Outpatient Adjudication Information</span><span class="hippo-segment-data">MOA***MA02~</span><br/><span class="hippo-segment-name">Statement From or To Date</span><span class="hippo-segment-data">DTM*232*20020512~</span><br/></fieldset></fieldset><span class="hippo-segment-name">Provider Adjustment</span><span class="hippo-segment-data">PLB*6543210903*20021231*CV:CP*-1.27~</span><br/><span class="hippo-segment-name">Transaction Set Trailer</span><span class="hippo-segment-data">SE*28*1234~</span><br/></fieldset>

data/test/test_helper.rb

@@ -0,0 +1,155 @@
+require 'rubygems'
+gem 'minitest'
+require 'minitest/autorun'
+require 'pp'
+require 'pry'
+
+require File.expand_path(File.join('..','lib','hippo_eyeDoc'), File.dirname(__FILE__))
+
+module Hippo_eyeDoc::Segments
+  class TSS < Hippo_eyeDoc::Segments::Base
+    segment_identifier 'TSS'
+
+    field :name => 'Field1'
+    field :name => 'Field2'
+    field :name => 'Field3'
+    field :name => 'Field4'
+    field :name => 'CommonName'
+    field :name => 'CommonName'
+    field :name => 'DateField', :datatype => :date
+    field :name => 'TimeField', :datatype => :time
+    field :name => 'IntegerField', :datatype => :integer
+    field :name => 'DecimalField', :datatype => :decimal
+  end
+
+  class TCS < Hippo_eyeDoc::Segments::Base
+    segment_identifier 'TCS'
+
+    composite_field 'CompositeField' do
+      field :name => 'Field1'
+      field :name => 'Field2'
+      field :name => 'Field3'
+      field :name => 'CompositeCommonName'
+    end
+
+    composite_field 'CompositeField' do
+      field :name => 'Field4'
+      field :name => 'Field5'
+      field :name => 'Field6'
+      field :name => 'CompositeCommonName'
+    end
+
+    field :name => 'Field7'
+  end
+end
+
+module Hippo_eyeDoc::TransactionSets
+  module Test
+    class L0001 < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L0001'
+
+      segment Hippo_eyeDoc::Segments::TSS,
+                :name           => 'Test Simple Segment #1',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 50
+    end
+
+    class L0002 < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L0002'
+
+      segment Hippo_eyeDoc::Segments::TCS,
+                :name           => 'Test Compound Segment #4',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100,
+                :identified_by => {
+                  'Field7' => ['Preset Field 7', 'Foo2']
+                }
+
+      segment Hippo_eyeDoc::Segments::TSS,
+                :name           => 'Test Simple Segment #5',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 50,
+                :identified_by => {
+                  'TSS01' => 'Last Segment'
+                }
+    end
+
+    class L0004 < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L0004'
+
+      segment Hippo_eyeDoc::Segments::TSS,
+                :name => 'Indicator of Child Location',
+                :identified_by => {'TSS01' => ['HAS CHILD LOOP','HAS NO CHILD LOOP']}
+
+      loop Hippo_eyeDoc::TransactionSets::Test::L0001,
+                :name           => 'Test Sub-Loop L0001',
+                :identified_by  => {
+                  'TSS.TSS01'   => 'Multiple Parents',
+                },
+                :parent_context_conditions => {
+                  'TSS.TSS01' => 'HAS NO CHILD LOOP'
+                }
+
+      segment Hippo_eyeDoc::Segments::TSS,
+                :name => 'Indicator of Child Location',
+                :identified_by => {'TSS01' => 'Multiple Parents'}
+
+    end
+
+    class Base < Hippo_eyeDoc::TransactionSets::Base
+
+      segment Hippo_eyeDoc::Segments::ST,
+        :identified_by => {
+        'ST01' => 'Test'
+      }
+
+      segment Hippo_eyeDoc::Segments::TSS,
+                :name           => 'Test Simple Segment #1',
+                :minimum        => 1,
+                :maximum        => 5,
+                :position       => 50,
+                :identified_by => {
+                  'TSS01' => 'Blah'
+                }
+
+      segment Hippo_eyeDoc::Segments::TCS,
+                :name           => 'Test Compound Segment #2',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 100,
+                :identified_by => {
+                  'Field7' => 'Preset Field 7'
+                }
+
+      segment Hippo_eyeDoc::Segments::TSS,
+                :name           => 'Test Simple Segment #3',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 50,
+                :identified_by => {
+                  'TSS01' => 'Last Standalone Segment'
+                }
+
+      loop Hippo_eyeDoc::TransactionSets::Test::L0001,
+                :name           => 'Test Sub-Loop',
+                :identified_by  => {
+                  'TSS.TSS01'   => 'Foo'
+                }
+
+      loop Hippo_eyeDoc::TransactionSets::Test::L0002,
+                :name           => 'Test Sub-Loop',
+                :maximum        => 5,
+                :identified_by  => {
+                  'TCS.Field7'   => 'Foo2'
+                }
+
+      segment Hippo_eyeDoc::Segments::SE,
+        :identified_by => {
+          'SE02' => 'Test'
+      }
+    end
+  end
+end

data/test/test_hipaa_835.rb

@@ -0,0 +1,229 @@
+require File.expand_path('test_helper', File.dirname(__FILE__))
+
+class TestHIPAA835 < MiniTest::Unit::TestCase
+
+  def test_business_scenario_1
+=begin
+
+Dollars and data are being sent together through the banking system to pay
+Medicare Part A institutional claims.
+
+This scenario depicts the use of the ANSI ASC X12 835 in a governmental
+institutional environment. The electronic transmission of funds request
+and the remittance detail are contained within this single 835. In this
+scenario, one or more Depository Financial Institutions is involved in 
+transferring information from the sender to the receiver.
+
+The following assumptions pertain to scenario one:
+• The dollars move using the ACH network from the Bank of Payorea, 
+  ABA# 999999992, account number 123456 to the Bank of No Return,
+  ABA# 999988880, checking account number 98765. The money moves on
+  September 13, 2002.
+• The Insurance Company of Timbucktu, Federal tax ID # 512345678 and
+  Medicare Intermediary ID# 999, is paying Regional Hope Hospital, National
+  Provider Number 6543210903. This is for one inpatient and one outpatient claim.
+• For the inpatient claim, the patient’s name is Sam O. Jones. The Health
+  Insurance Claim Number is 666-66-6666A. The Claim Submitter’s Identifier is
+  666123. The date of the hospitalization was August 16, 2002 to August 24, 2002.
+  Total charges reported are $211,366.97. Paid amount is $138,018.40. There is
+  no patient responsibility. Contractual adjustment is $73,348.57. No service
+  line detail is provided.
+• For the outpatient claim, the patient’s name is Liz E. Border, Health
+  Insurance Claim Number 996-66-9999B. The Claim Submitter’s Identifier is
+  777777. The date of service is May 12, 2002. Total charges reported are 
+  $15,000. Paid amount is $11,980.33. Contractual adjustment is $3,019.67.
+  There is no service line information.
+• There is a Capital Pass Through Amount (CV) payment to the provider for $1.27.
+
+=end
+
+    ts = Hippo_eyeDoc::TransactionSets::HIPAA_835::Base.new
+
+    ts.ST do |st|
+      st.TransactionSetControlNumber        = '1234'
+    end
+
+    ts.BPR do |bpr|
+      bpr.TransactionHandlingCode           = 'C'
+      bpr.MonetaryAmount                    = '150000'
+      bpr.CreditDebitFlagCode               = 'C'
+      bpr.PaymentMethodCode                 = 'ACH'
+      bpr.PaymentFormatCode                 = 'CTX'
+      bpr.DfiIdNumberQualifier              = '01'
+      bpr.DfiIdentificationNumber           = '999999992'
+      bpr.AccountNumberQualifier            = 'DA'
+      bpr.AccountNumber                     = '123456'
+      bpr.OriginatingCompanyIdentifier      = '1512345678'
+      bpr.DfiIdNumberQualifier_02           = '01'
+      bpr.DfiIdentificationNumber_02        = '999988880'
+      bpr.AccountNumberQualifier_02         = 'DA'
+      bpr.AccountNumber_02                  = '98765'
+      bpr.Date                              = '20020913'
+    end
+
+    ts.TRN do |trn|
+      trn.ReferenceIdentification           = '12345'
+      trn.OriginatingCompanyIdentifier      = '1512345678'
+    end
+
+    ts.DTM.Date = '20020916'
+
+    ts.L1000A do |l1000a|
+      l1000a.N1.Name                = 'INSURANCE COMPANY OF TIMBUCKTU'
+      l1000a.N3.AddressInformation  = '1 MAIN STREET'
+
+      l1000a.N4 do |n4|
+        n4.CityName                 = 'TIMBUCKTU'
+        n4.StateOrProvinceCode      = 'AK'
+        n4.PostalCode               = '89111'
+      end
+
+      l1000a.REF do |ref|
+        ref.ReferenceIdentificationQualifier  = '2U'
+        ref.ReferenceIdentification           = '999'
+      end
+    end
+
+    ts.L1000B do |l1000b|
+      l1000b.N1 do |n1|
+        n1.Name                         = 'REGIONAL HOPE HOSPITAL'
+        n1.IdentificationCodeQualifier  = 'XX'
+        n1.IdentificationCode           = '6543210903'
+      end
+    end
+
+    ts.L2000.build do |l2000|
+      l2000.LX.LX01 = '110212'
+
+      l2000.TS3 do |ts3|
+        ts3.ReferenceIdentification     = '6543210903'
+        ts3.FacilityCodeValue           = '11'
+        ts3.Date                        = '20021231'
+        ts3.Quantity                    = '1'
+        ts3.MonetaryAmount_01           = '211366.97'
+        ts3.MonetaryAmount_05           = '138018.4'
+        ts3.MonetaryAmount_07           = '73348.57'
+      end
+
+      l2000.TS2 do |ts2|
+        ts2.MonetaryAmount_01           = '2178.45'
+        ts2.MonetaryAmount_02           = '1919.71'
+        ts2.MonetaryAmount_04           = '56.82'
+        ts2.MonetaryAmount_05           = '197.69'
+        ts2.MonetaryAmount_06           = '4.23'
+      end
+
+      l2000.L2100.build do |l2100|
+        l2100.CLP do |clp|
+          clp.ClaimSubmitterSIdentifier = '666123'
+          clp.ClaimStatusCode           = '1'
+          clp.MonetaryAmount_01         = '211366.97'
+          clp.MonetaryAmount_02         = '138018.4'
+          clp.ClaimFilingIndicatorCode  = 'MA'
+          clp.ReferenceIdentification   = '1999999444444'
+          clp.FacilityCodeValue         = '11'
+          clp.ClaimFrequencyTypeCode    = '1'
+        end
+
+        l2100.CAS.build do |cas|
+          cas.ClaimAdjustmentGroupCode  = 'CO'
+          cas.ClaimAdjustmentReasonCode = '45'
+          cas.MonetaryAmount            = '73348.57'
+        end
+
+        l2100.NM1 do |nm1|
+          nm1.NameLastOrOrganizationName  = 'JONES'
+          nm1.NameFirst                   = 'SAM'
+          nm1.NameMiddle                  = 'O'
+          nm1.IdentificationCodeQualifier = 'HN'
+          nm1.IdentificationCode          = '666666666A'
+        end
+
+        l2100.MIA do |mia|
+          mia.Quantity                    = '0'
+          mia.MonetaryAmount_02           = '138018.4'
+        end
+
+        l2100.DTM_01.build do |dtm|
+          dtm.DateTimeQualifier           = '232'
+          dtm.Date                        = '20020816'
+        end
+
+        l2100.DTM_01.build do |dtm|
+          dtm.DateTimeQualifier           = '233'
+          dtm.Date                        = '20020824'
+        end
+
+        l2100.QTY do |qty|
+          qty.QuantityQualifier           = 'CA'
+          qty.Quantity                    = '8'
+        end
+      end
+    end
+
+    ts.L2000.build do |l2000|
+      l2000.LX.LX01 = '130212'
+
+      l2000.TS3 do |ts3|
+        ts3.ReferenceIdentification     = '6543210909'
+        ts3.FacilityCodeValue           = '13'
+        ts3.Date                        = '19961231'
+        ts3.Quantity                    = '1'
+        ts3.MonetaryAmount_01           = '15000'
+        ts3.MonetaryAmount_05           = '11980.33'
+        ts3.MonetaryAmount_07           = '3019.67'
+      end
+
+      l2000.L2100.build do |l2100|
+        l2100.CLP do |clp|
+          clp.ClaimSubmitterSIdentifier = '777777'
+          clp.ClaimStatusCode           = '1'
+          clp.MonetaryAmount_01         = '15000'
+          clp.MonetaryAmount_02         = '11980.33'
+          clp.ClaimFilingIndicatorCode  = 'MB'
+          clp.ReferenceIdentification   = '1999999444445'
+          clp.FacilityCodeValue         = '13'
+          clp.ClaimFrequencyTypeCode    = '1'
+        end
+
+        l2100.CAS.build do |cas|
+          cas.ClaimAdjustmentGroupCode  = 'CO'
+          cas.ClaimAdjustmentReasonCode = '45'
+          cas.MonetaryAmount            = '3019.67'
+        end
+
+        l2100.NM1 do |nm1|
+          nm1.NameLastOrOrganizationName  = 'BORDER'
+          nm1.NameFirst                   = 'LIZ'
+          nm1.NameMiddle                  = 'E'
+          nm1.IdentificationCodeQualifier = 'HN'
+          nm1.IdentificationCode          = '996669999B'
+        end
+
+        l2100.MOA do |moa|
+          moa.ReferenceIdentification     = 'MA02'
+        end
+
+        l2100.DTM_01.build do |dtm|
+          dtm.DateTimeQualifier           = '232'
+          dtm.Date                        = '20020512'
+        end
+      end
+    end
+
+    ts.PLB do |plb|
+      plb.ReferenceIdentification_01  = '6543210903'
+      plb.Date                        = '20021231'
+      plb.AdjustmentReasonCode        = 'CV'
+      plb.ReferenceIdentification_02  = 'CP'
+      plb.MonetaryAmount              = '-1.27'
+    end
+
+    ts.SE.TransactionSetControlNumber = ts.ST.TransactionSetControlNumber
+    ts.SE.NumberOfIncludedSegments    = ts.segment_count
+
+    provided_answer = File.read('samples/005010X221A1_business_scenario_1.edi')
+
+    assert_equal provided_answer.chomp, ts.to_s
+  end
+end

data/test/test_hipaa_837.rb

@@ -0,0 +1,596 @@
+require File.expand_path('test_helper', File.dirname(__FILE__))
+
+class TestHIPAA837 < MiniTest::Unit::TestCase
+
+  def test_commercial_health_insurance
+=begin
+This example file is based on the Commercial Health Insurance example (3.1.1) published in the 5010X222A1 TR3.
+
+Patient is a different person than the Subscriber. Payer is commercial health insurance company.
+
+SUBSCRIBER: Jane Smith
+PATIENT ADDRESS:236 N. Main St., Miami, Fl, 33413
+TELEPHONE NUMBER: 305-555-1111
+SEX: F
+DOB: 05/01/43
+EMPLOYER: ACME Inc.
+GROUP #: 2222-SJ
+KEY INSURANCE COMPANY ID #: JS00111223333
+
+PATIENT: Ted Smith
+PATIENT ADDRESS:236 N. Main St., Miami, Fl, 33413
+TELEPHONE NUMBER: 305-555-1111
+SEX: M
+DOB: 05/01/73
+KEY INSURANCE COMPANY ID #: JS01111223333
+
+DESTINATION PAYER: Key Insurance Company
+PAYER ADDRESS: 3333 Ocean St. South Miami, FL 33000
+PAYER ID: 999996666
+
+SUBMITTER: Premier Billing Service
+EDI#: TGJ23
+CONTACT PERSON AND PHONE NUMBER: JERRY, 305-555-2222 ext. 231
+
+RECEIVER: Key Insurance Company
+EDI #:66783JJT
+
+BILLING PROVIDER: Dr. Ben Kildare,
+ADDRESS: 234 Seaway St, Miami, FL, 33111
+NPI: 9876543210
+TIN: 587654321
+KEY INSURANCE COMPANY PROVIDER ID #: KA6663
+Taxonomy Code: 203BF0100Y
+
+PAY-TO PROVIDER: Kildare Associates,
+PROVIDER ADDRESS: 2345 Ocean Blvd, Miami, Fl 33111
+RENDERING PROVIDER: Dr. Ben Kildare 
+
+PATIENT ACCOUNT NUMBER: 2-646-3774
+CASE: Patient has sore throat.
+
+INITIAL VISIT: DOS=10/03/06. POS=Office
+SERVICES: Office visit, intermediate service, established patient, throat culture.
+CHARGES: Office first visit = $40.00, Lab test for strep = $15.00
+
+FOLLOW-UP VISIT: DOS=10/10/06 POS=Office
+Antibiotics didn’t work (pain continues).
+SERVICES: Office visit, intermediate service, established patient, mono screening.
+CHARGES: Follow-up visit = $35.00, lab test for mono = $10.00.
+
+TOTAL CHARGES: $100.00.
+ELECTRONIC ROUTE: Billing provider (sender), to VAN to Key Insurance Company (receiver).
+VAN claim identification number = 17312345600006351.
+
+=end
+
+    ts = Hippo_eyeDoc::TransactionSets::HIPAA_837::Base.new
+
+    ts.ST do |st|
+      st.TransactionSetControlNumber        = '0021'
+      st.ImplementationConventionReference  = '005010X222A1'
+    end
+
+    ts.BHT do |bht|
+      bht.TransactionSetPurposeCode = '00'
+      bht.ReferenceIdentification   = '244579'
+      bht.Date                      = '20061015'
+      bht.Time                      = '1023'
+      bht.TransactionTypeCode       = 'CH'
+    end
+
+    ts.L1000A do |l1000a|
+      l1000a.NM1 do |nm1|
+        nm1.EntityTypeQualifier        = '2'
+        nm1.NameLastOrOrganizationName = 'PREMIER BILLING SERVICE'
+        nm1.IdentificationCode         = 'TGJ23'
+      end
+
+      l1000a.PER do |per|
+        per.Name                            = 'JERRY'
+        per.CommunicationNumberQualifier_01 = 'TE'
+        per.CommunicationNumber_01          = '3055552222'
+        per.CommunicationNumberQualifier_02 = 'EX'
+        per.CommunicationNumber_02          = '231'
+      end
+    end
+
+    ts.L1000B do |l1000b|
+      l1000b.NM1 do |nm1|
+        nm1.EntityTypeQualifier        = '2'
+        nm1.NameLastOrOrganizationName = 'KEY INSURANCE COMPANY'
+        nm1.IdentificationCode         = '66783JJT'
+      end
+    end
+
+    ts.L2000A do |l2000a|
+      l2000a.HL do |hl|
+        hl.HL01 = ts.increment('HL')
+        hl.HL04 = 1
+      end
+
+      l2000a.PRV do |prv|
+        prv.ReferenceIdentification    = '203BF0100Y'
+      end
+
+      l2000a.L2010AA do |l2010aa|
+
+        l2010aa.NM1 do |nm1|
+          nm1.EntityTypeQualifier           = '2'
+          nm1.NameLastOrOrganizationName    = 'BEN KILDARE SERVICE'
+          nm1.IdentificationCodeQualifier   = 'XX'
+          nm1.IdentificationCode            = '9876543210'
+        end
+
+        l2010aa.N3 do |n3|
+          n3.AddressInformation             = '234 SEAWAY ST'
+        end
+
+        l2010aa.N4 do |n4|
+          n4.CityName                       = 'MIAMI'
+          n4.StateOrProvinceCode            = 'FL'
+          n4.PostalCode                     = '33111'
+        end
+
+        l2010aa.REF do |ref|
+          ref.ReferenceIdentificationQualifier = 'EI'
+          ref.ReferenceIdentification          = '587654321'
+        end
+      end
+
+      l2000a.L2010AB do |l2010ab|
+        l2010ab.NM1 do |nm1|
+          nm1.EntityTypeQualifier         = '2'
+        end
+
+        l2010ab.N3 do |n3|
+          n3.AddressInformation             = '2345 OCEAN BLVD'
+        end
+
+        l2010ab.N4 do |n4|
+          n4.CityName                       = 'MIAMI'
+          n4.StateOrProvinceCode            = 'FL'
+          n4.PostalCode                     = '33111'
+        end
+      end
+
+      l2000a.L2000B do |l2000b|
+        l2000b.HL do |hl|
+          hl.HL01 = ts.increment('HL')
+          hl.HL02 = l2000a.HL.HL01
+          hl.HL04 = 1
+        end
+
+        l2000b.SBR do |sbr|
+          sbr.PayerResponsibilitySequenceNumberCode = 'P'
+          sbr.ReferenceIdentification               = '2222-SJ'
+          sbr.ClaimFilingIndicatorCode              = 'CI'
+        end
+
+        l2000b.L2010BA do |l2010ba|
+          l2010ba.NM1 do |nm1|
+            nm1.EntityTypeQualifier         = '1'
+            nm1.NameLastOrOrganizationName  = 'SMITH'
+            nm1.NameFirst                   = 'JANE'
+            nm1.IdentificationCodeQualifier = 'MI'
+            nm1.IdentificationCode          = 'JS00111223333'
+          end
+
+          l2010ba.DMG do |dmg|
+            dmg.DateTimePeriod              = '19430501'
+            dmg.GenderCode                  = 'F'
+          end
+        end
+
+        l2000b.L2010BB do |l2010bb|
+          l2010bb.NM1 do |nm1|
+            nm1.EntityTypeQualifier           = '2'
+            nm1.NameLastOrOrganizationName    = 'KEY INSURANCE COMPANY'
+            nm1.IdentificationCodeQualifier   = 'PI'
+            nm1.IdentificationCode            = '999996666'
+          end
+
+          # second ref segment in L2010BB
+          l2010bb.REF_02 do |ref|
+            ref.ReferenceIdentificationQualifier = 'G2'
+            ref.ReferenceIdentification          = 'KA6663'
+          end
+        end
+
+        l2000b.L2000C do |l2000c|
+          l2000c.HL do |hl|
+            hl.HL01 = ts.increment('HL')
+            hl.HL02 = l2000b.HL.HL01
+            hl.HL04 = 0
+          end
+
+          l2000c.PAT do |pat|
+            pat.IndividualRelationshipCode = '19'
+          end
+
+          l2000c.L2010CA do |l2010ca|
+            l2010ca.NM1 do |nm1|
+              nm1.NameLastOrOrganizationName  = 'SMITH'
+              nm1.NameFirst                   = 'TED'
+            end
+
+            l2010ca.N3 do |n3|
+              n3.AddressInformation             = '236 N MAIN ST'
+            end
+
+            l2010ca.N4 do |n4|
+              n4.CityName                       = 'MIAMI'
+              n4.StateOrProvinceCode            = 'FL'
+              n4.PostalCode                     = '33413'
+            end
+
+            l2010ca.DMG do |dmg|
+              dmg.DateTimePeriod  = '19730501'
+              dmg.GenderCode      = 'M'
+            end
+          end
+
+          l2000c.L2300 do |l2300|
+            l2300.CLM do |clm|
+              clm.ClaimSubmitterSIdentifier         = '26463774'
+              clm.MonetaryAmount                    = '100'
+              clm.FacilityCodeValue                 = '11'
+              clm.FacilityCodeQualifier             = 'B'
+              clm.ClaimFrequencyTypeCode            = '1'
+              clm.YesNoConditionOrResponseCode      = 'Y'
+              clm.ProviderAcceptAssignmentCode      = 'A'
+              clm.YesNoConditionOrResponseCode_02   = 'Y'
+              clm.ReleaseOfInformationCode          = 'I'
+            end
+
+            l2300.REF_11 do |ref| #('Claim Identifier For Transmission Intermediaries') do |ref|
+              ref.ReferenceIdentification = '17312345600006351'
+            end
+
+            l2300.HI do |hi|
+              hi.CodeListQualifierCode_01 = 'BK'
+              hi.IndustryCode_01          = '0340'
+
+              hi.CodeListQualifierCode_02 = 'BF'
+              hi.IndustryCode_03          = 'V7389'
+            end
+
+            l2300.L2400.build do |l2400|
+              l2400.LX.LX01 = l2300.increment('LX')
+
+              l2400.SV1 do |sv1|
+                sv1.ProductServiceIdQualifier     = 'HC'
+                sv1.ProductServiceId              = '99213'
+                sv1.MonetaryAmount                = '40'
+                sv1.UnitOrBasisForMeasurementCode = 'UN'
+                sv1.Quantity                      = '1'
+                sv1.DiagnosisCodePointer          = 1
+              end
+
+              l2400.DTP('Date - Service Date') do |dtp|
+                dtp.DateTimePeriodFormatQualifier = 'D8'
+                dtp.DateTimePeriod                = '20061003'
+              end
+            end
+
+            l2300.L2400.build do |l2400|
+              l2400.LX.LX01 = l2300.increment('LX')
+
+              l2400.SV1 do |sv1|
+                sv1.ProductServiceIdQualifier     = 'HC'
+                sv1.ProductServiceId              = '87070'
+                sv1.MonetaryAmount                = '15'
+                sv1.UnitOrBasisForMeasurementCode = 'UN'
+                sv1.Quantity                      = '1'
+                sv1.DiagnosisCodePointer          = 1
+              end
+
+              l2400.DTP('Date - Service Date') do |dtp|
+                dtp.DateTimePeriodFormatQualifier = 'D8'
+                dtp.DateTimePeriod                = '20061003'
+              end
+            end
+
+            l2300.L2400.build do |l2400|
+              l2400.LX.LX01 = l2300.increment('LX')
+
+              l2400.SV1 do |sv1|
+                sv1.ProductServiceIdQualifier     = 'HC'
+                sv1.ProductServiceId              = '99214'
+                sv1.MonetaryAmount                = '35'
+                sv1.UnitOrBasisForMeasurementCode = 'UN'
+                sv1.Quantity                      = '1'
+                sv1.DiagnosisCodePointer          = 2
+              end
+
+              l2400.DTP('Date - Service Date') do |dtp|
+                dtp.DateTimePeriodFormatQualifier = 'D8'
+                dtp.DateTimePeriod                = '20061010'
+              end
+            end
+
+            l2300.L2400.build do |l2400|
+              l2400.LX.LX01 = l2300.increment('LX')
+
+              l2400.SV1 do |sv1|
+                sv1.ProductServiceIdQualifier     = 'HC'
+                sv1.ProductServiceId              = '86663'
+                sv1.MonetaryAmount                = '10'
+                sv1.UnitOrBasisForMeasurementCode = 'UN'
+                sv1.Quantity                      = '1'
+                sv1.DiagnosisCodePointer          = 2
+              end
+
+              l2400.DTP('Date - Service Date') do |dtp|
+                dtp.DateTimePeriodFormatQualifier = 'D8'
+                dtp.DateTimePeriod                = '20061010'
+              end
+            end
+          end
+        end
+      end
+    end
+
+
+    ts.SE do |se|
+      se.TransactionSetControlNumber = ts.ST.TransactionSetControlNumber
+    end
+
+    ts.SE.NumberOfIncludedSegments    = ts.segment_count
+
+    published_answer = File.read('samples/005010X222A1_commercial_health_insurance.edi')
+    assert_equal published_answer.chomp, ts.to_s
+  end
+
+  def test_anesthesia
+=begin
+Patient is the same as the subscriber. Payer is Medicare. 
+Encounter is billed directly to Medicare.
+
+SUBSCRIBER/PATIENT: Margaret Jones
+ADDRESS: 123 Rainbow Road, Nashville, TN 37232
+TELEPHONE: 615-555-1212
+SEX: F
+DOB: 03/03/1974
+EMPLOYER: ACME Inc.
+SUBSCRIBER #: 123456789A
+
+SECONDARY COVERAGE
+
+DESTINATION PAYER: ABC Payer
+PAYER ADDRESS: P.O. Box 1465, Nashville, TN, 37232
+PAYER ORGANIZATION ID: 05440
+
+RECEIVER: ABC Payer
+EDI #: 05440
+
+BILLING PROVIDER/SENDER: Provider Medical Group
+ADDRESS: 1234 West End Ave, Nashville, TN, 37232
+NPI#: 2366554859
+TIN: 756473826
+EDI #: N305
+CONTACT PERSON AND PHONE NUMBER: Nina, 615-555-1212 ext.911
+
+RENDERING PROVIDER: Dr. Jacob E. Townsend/Anesthesiologist
+NPI: 5678912345
+MEDICARE PROVIDER ID#: 9741234
+PLACE OF SERVICE: Provider OP Hospital
+PLACE OF SERVICE ADDRESS: 345 Main Drive, Nashville, TN,37232
+PLACE OF SERVICE ID#: 43294867
+
+PATIENT ACCOUNT NUMBER: 543211230
+CASE: Laser Eye Surgery.
+
+VISIT: DOS=1/12/2005 POS=Outpatient Hospital
+SERVICES: Anesthesia for the Laser Eye Surgery
+CHARGES: Anesthesia, 61 minutes = $827.00
+CONCURRENCY: 2 cases
+PHYSICAL STATUS: Normal
+PATIENT CONTROL #: 153829140
+MEDICAL RECORD ID #: 006653794
+
+TOTAL CHARGES: $827.00
+
+ELECTRONIC ROUTE: Billing Provider (sender) to ABC PAYER direct
+=end
+
+    ts = Hippo_eyeDoc::TransactionSets::HIPAA_837::Base.new
+
+    ts.ST.TransactionSetControlNumber        = '0001'
+    ts.ST.ImplementationConventionReference  = '005010X222A1'
+
+    ts.BHT do |bht|
+      bht.TransactionSetPurposeCode = '00'
+      bht.ReferenceIdentification   = '0123'
+      bht.Date                      = '20050117'
+      bht.Time                      = '1023'
+      bht.TransactionTypeCode       = 'CH'
+    end
+
+    ts.L1000A do |l1000a|
+      l1000a.NM1 do |nm1|
+        nm1.EntityTypeQualifier        = '2'
+        nm1.NameLastOrOrganizationName = 'PROVIDER MEDICAL GROUP'
+        nm1.IdentificationCode         = 'N305'
+      end
+
+      l1000a.PER do |per|
+        per.Name                            = 'NINA'
+        per.CommunicationNumberQualifier_01 = 'TE'
+        per.CommunicationNumber_01          = '6155551212'
+        per.CommunicationNumberQualifier_02 = 'EX'
+        per.CommunicationNumber_02          = '911'
+      end
+    end
+
+    ts.L1000B do |l1000b|
+      l1000b.NM1 do |nm1|
+        nm1.EntityTypeQualifier        = '2'
+        nm1.NameLastOrOrganizationName = 'ABC PAYER'
+        nm1.IdentificationCode         = '05440'
+      end
+    end
+
+    ts.L2000A.build do |l2000a|
+      l2000a.HL do |hl|
+        hl.HL01 = ts.increment('HL')
+        hl.HL04 = 1
+      end
+
+      l2000a.L2010AA do |l2010aa|
+
+        l2010aa.NM1 do |nm1|
+          nm1.EntityTypeQualifier           = '2'
+          nm1.NameLastOrOrganizationName    = 'PROVIDER MEDICAL GROUP'
+          nm1.IdentificationCodeQualifier   = 'XX'
+          nm1.IdentificationCode            = '2366554859'
+        end
+
+        l2010aa.N3 do |n3|
+          n3.AddressInformation             = '1234 WEST END AVE'
+        end
+
+        l2010aa.N4 do |n4|
+          n4.CityName                       = 'NASHVILLE'
+          n4.StateOrProvinceCode            = 'TN'
+          n4.PostalCode                     = '37232'
+        end
+
+        l2010aa.REF do |ref|
+          ref.ReferenceIdentificationQualifier = 'EI'
+          ref.ReferenceIdentification          = '756473826'
+        end
+      end
+
+      l2000a.L2000B.build do |l2000b|
+        l2000b.HL do |hl|
+          hl.HL01 = ts.increment('HL')
+          hl.HL02 = l2000a.HL.HL01
+          hl.HL04 = 0
+        end
+
+        l2000b.SBR do |sbr|
+          sbr.PayerResponsibilitySequenceNumberCode = 'P'
+          sbr.IndividualRelationshipCode            = '18'
+          sbr.ClaimFilingIndicatorCode              = 'MB'
+        end
+
+        l2000b.L2010BA do |l2010ba|
+          l2010ba.NM1 do |nm1|
+            nm1.EntityTypeQualifier         = '1'
+            nm1.NameLastOrOrganizationName  = 'JONES'
+            nm1.NameFirst                   = 'MARGARET'
+            nm1.IdentificationCodeQualifier = 'MI'
+            nm1.IdentificationCode          = '123456789A'
+          end
+
+          l2010ba.N3.AddressInformation     = '123 RAINBOW ROAD'
+
+          l2010ba.N4 do |n4|
+            n4.CityName                     = 'NASHVILLE'
+            n4.StateOrProvinceCode          = 'TN'
+            n4.PostalCode                   = '37232'
+          end
+
+          l2010ba.DMG do |dmg|
+            dmg.DateTimePeriod              = '19740303'
+            dmg.GenderCode                  = 'F'
+          end
+        end
+
+        l2000b.L2010BB do |l2010bb|
+          l2010bb.NM1 do |nm1|
+            nm1.EntityTypeQualifier           = '2'
+            nm1.NameLastOrOrganizationName    = 'ABC PAYER'
+            nm1.IdentificationCodeQualifier   = 'PI'
+            nm1.IdentificationCode            = '05440'
+          end
+        end
+
+        l2000b.L2300.build do |l2300|
+          l2300.CLM do |clm|
+            clm.ClaimSubmitterSIdentifier         = '153829140'
+            clm.MonetaryAmount                    = '827'
+            clm.FacilityCodeValue                 = '22'
+            clm.FacilityCodeQualifier             = 'B'
+            clm.ClaimFrequencyTypeCode            = '1'
+            clm.YesNoConditionOrResponseCode      = 'Y'
+            clm.ProviderAcceptAssignmentCode      = 'A'
+            clm.YesNoConditionOrResponseCode_02   = 'Y'
+            clm.ReleaseOfInformationCode          = 'Y'
+          end
+
+          l2300.HI do |hi|
+            hi.CodeListQualifierCode_01 = 'BK'
+            hi.IndustryCode_01          = '36616'
+          end
+
+          l2300.L2310B do |l2310b|
+            l2310b.NM1 do |nm1|
+              nm1.EntityTypeQualifier           = '1'
+              nm1.NameLastOrOrganizationName    = 'TOWNSEND'
+              nm1.NameFirst                     = 'JACOB'
+              nm1.NameMiddle                    = 'E'
+              nm1.IdentificationCodeQualifier   = 'XX'
+              nm1.IdentificationCode            = '5678912345'
+            end
+
+            l2310b.PRV do |prv|
+              prv.ReferenceIdentificationQualifier  = 'ZZ'
+              prv.ReferenceIdentification           = '207L00000X'
+            end
+          end
+
+          l2300.L2310C do |l2310c|
+            l2310c.NM1 do |nm1|
+              nm1.EntityTypeQualifier           = '2'
+              nm1.NameLastOrOrganizationName    = 'PROVIDER OP HOSP'
+              nm1.IdentificationCodeQualifier   = 'XX'
+              nm1.IdentificationCode            = '432198765'
+            end
+
+            l2310c.N3.AddressInformation     = '345 MAIN DRIVE'
+
+            l2310c.N4 do |n4|
+              n4.CityName                     = 'NASHVILLE'
+              n4.StateOrProvinceCode          = 'TN'
+              n4.PostalCode                   = '37232'
+            end
+          end
+
+          l2300.L2400.build do |l2400|
+            l2400.LX.LX01 = l2300.increment('LX')
+
+            l2400.SV1 do |sv1|
+              sv1.ProductServiceIdQualifier     = 'HC'
+              sv1.ProductServiceId              = '00142'
+              sv1.ProcedureModifier_01          = 'QK'
+              sv1.ProcedureModifier_02          = 'QS'
+              sv1.ProcedureModifier_03          = 'P1'
+              sv1.MonetaryAmount                = '827'
+              sv1.UnitOrBasisForMeasurementCode = 'MJ'
+              sv1.Quantity                      = '61'
+              sv1.DiagnosisCodePointer          = 1
+            end
+
+            l2400.DTP('Date - Service Date') do |dtp|
+              dtp.DateTimePeriodFormatQualifier = 'D8'
+              dtp.DateTimePeriod                = '20050112'
+            end
+          end
+        end
+      end
+    end
+
+
+    ts.SE do |se|
+      se.TransactionSetControlNumber = ts.ST.TransactionSetControlNumber
+    end
+
+    ts.SE.NumberOfIncludedSegments    = ts.segment_count
+
+    published_answer = File.read('samples/005010X222A1_anesthesia.edi')
+    assert_equal published_answer.chomp, ts.to_s
+
+  end
+end