Claim object's Payer property not picking up of Payer Indentification

Developer
Oct 3, 2012 at 12:57 PM

For example, one of the claims I am working with has the following details in the interchange

<NM103>AETNA USHEALTHCARE</NM103>
<NM104 />
<NM105 />
<NM106 />
<NM107 />             
<!--Identification Code Qualifier-->             
<NM108>PI<!--Payor Identification--></NM108>
<!--Identification Code-->
<NM109>6400</NM109>
</NM1> 

But Payer member of Claim object has just as the name (AETNA USHEALTHCARE) but no indentification information (i.e it is null)

Please look into this.

 

Developer
Oct 3, 2012 at 1:05 PM

Better details of the loop

 

   <Loop LoopId="2010BB" Name="PAYER NAME">
            <NM1>
              <!--Entity Identifier Code-->
              <NM101>PR<!--Payer--></NM101>
              <!--Entity Type Qualifier-->
              <NM102>2<!--Non-Person Entity--></NM102>
              <!--Name Last or Organization Name-->
              <NM103>CIGNA MEDICARE ACCESS PLUS</NM103>
              <NM104 />
              <NM105 />
              <NM106 />
              <NM107 />
              <!--Identification Code Qualifier-->
              <NM108>PI<!--Payor Identification--></NM108>
              <!--Identification Code-->
              <NM109>5436</NM109>
            </NM1>
          </Loop>

Coordinator
Oct 8, 2012 at 3:34 PM

There are two places where identification can show up.  The following is an example from the UnitTests:

          <Loop LoopId="2010BB" Name="PAYER NAME">
            <NM1>
              <!--Entity Identifier Code-->
              <NM101>PR</NM101>
              <!--Entity Type Qualifier-->
              <NM102>2<!--Non-Person Entity--></NM102>
              <!--Name Last or Organization Name-->
              <NM103>MEDICARE B</NM103>
              <NM104 />
              <NM105 />
              <NM106 />
              <NM107 />
              <!--Identification Code Qualifier-->
              <NM108>PI<!--Payor Identification--></NM108>
              <!--Identification Code-->
              <NM109>00435</NM109>
            </NM1>
            <REF>
              <!--Reference Identification Qualifier-->
              <REF01>G2</REF01>
              <!--Reference Identification-->
              <REF02>330127</REF02>
            </REF>
          </Loop>

 The following assertions should pass:

Assert.AreEqual("PI", claim.Payer.Name.Identification.Qualifier);
Assert.AreEqual("00435", claim.Payer.Name.Identification.Id);
Assert.AreEqual("G2", claim.Payer.Identifications.First().Qualifier);
Assert.AreEqual("330127", claim.Payer.Identifications.First().Id);

If you look at the transformed xml it will look like this:
  <Payer>
    <Name LastName="MEDICARE B">
      <Type Identifier="PR" Qualifier="NonPerson">Payer</Type>
      <Identification Qualifier="PI" Id="00435">Payor Identification</Identification>
    </Name>
    <Identification Qualifier="G2" Id="330127" />
  </Payer>

You can always serialize the claim or document object to see where things you are expecting got mapped to.
See the TransformToInstitutionalClaim5010_PayerObjectTestunit test here: http://x12parser.codeplex.com/SourceControl/changeset/view/20394#154135
Let me know if this resolves your problem.
Developer
Oct 10, 2012 at 3:03 PM

Thank you.

BTW: I am putting together a rough object model the ERA (835) just like you have done for claim (837). I will upload that information asap.

 

Developer
Oct 15, 2012 at 11:51 PM

I have the Remittance (835) object model (v1) ready in visio file format. How I can send this to you? There is no option to upload any files here?

Please let me know.

Meanwhile, I am working on code to populate that object model.

 

Coordinator
Oct 15, 2012 at 11:53 PM
There should be, I can add you as a developer if you want to add your changes directly.
I will probably just make sure we have plenty of unit tests before the next release.

On Mon, Oct 15, 2012 at 5:51 PM, shanthuk <notifications@codeplex.com> wrote:

From: shanthuk

I have the Remittance (835) object model (v1) ready in visio file format. How I can send this to you? There is no option to upload any files here?

Please let me know.

Meanwhile, I am working on code to populate that object model.

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Developer
Oct 16, 2012 at 12:20 AM

I do not want to break anything. My code is not integrated into your solution yet. I have made those changes (populating ERA object model) in my system (which uses your code).

My preferred option is to send that code to you out of band. I hope you do not mind. Also, I would like to send the visio model.

 

Developer
Oct 23, 2012 at 2:47 AM

I have uploaded the source code which implementation of the logic of creating ERA object model. Created a seperate console project which is self containted.