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

Developer
Oct 3, 2012 at 11:57 AM

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 12:05 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 2:34 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 2:03 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 10:51 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 10:53 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 15, 2012 at 11:20 PM

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 1:47 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.