Requirement Constraints

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Saturday, 20 April 2013

EDI 270–5010 Documentation - ISA – Interchange Control Header

Posted on 21:06 by Unknown

ISA – Interchange Control Header


ISA – Interchange Control Header 

The ISA is a fixed record length segment and all positions within each of the data elements must be filled. The first element separator defines the  element separator to be used through the entire interchange. The segment terminator used after the ISA defines the segment terminator to be used throughout the entire interchange.This results in the segment terminator always being in position 106.


Loop

Seg ID

Segment Name

Format

Length

Ref#

Req

Value

Header

ISA

Interchange Control Header


3


R

ISA



Element Separator

AN

1



*


ISA01

Authorization information qualifier

ID

2/2

101

R

See below for valid Values



Element Separator

AN

1



*


ISA02

Authorization information

AN

10/10

102

R

Not used. Fill with 10 empty spaces.



Element Separator

AN

1



*


ISA03

Security Information qualifier

ID

2/2

103

R

See below for valid Values



Element Separator

AN

1



*


ISA04

Security Information

AN

10/10

104

R

Not used. Fill with 10 empty spaces.



Element Separator

AN

1



*


ISA05

Interchange ID Qualifier

ID

2/2

105

R

See below for valid Values



Element Separator

AN

1



*


ISA06

Interchange Sender ID

AN

2/15

106

R

See below for more information



Element Separator

AN

1



*


ISA07

Interchange ID Qualifier

ID

2/2

105

R

See below for valid Values



Element Separator

AN

1



*


ISA08

Interchange Receiver ID

AN

15/15

107

R

See below for more information



Element Separator

AN

1



*


ISA09

Interchange Date

DT

6/6

108

R

Current date in YYMMDD Format



Element Separator

AN

1



*


ISA10

Interchange Time

TM

4/4

109

R

Current Time in HHMM Format



Element Separator

AN

1



*


ISA11

Repetition Separator

ID

1/1

110

R

^



Element Separator

AN

1



*


ISA12

Interchange Control Version Number

ID

5/5

111

R

00501



Element Separator

AN

1



*


ISA13

Interchange Control Number

No

9/9

112

R

000000001 (See below for more info)



Element Separator

AN

1



*


ISA14

Acknowledgment Required

ID

1/1

113

R

0 (See below for more information)



Element Separator

AN

1



*


ISA15

Usage Indicator

ID

1/1

114

R

P (See below for more information)



Element Separator

AN

1



*


ISA16

Component Element Separator


1/1

115

R

: (semi colon).
this value must be different than the data element separator and the segment terminator



Segment Terminator





~

Sample: 

ISA*00*          *00*          *ZZ*8431           *ZZ*ZIRMED         *130215*1234*^*00501*000000001*1*P*:~


Important Note on the above sample:
ISA02
Since ISA is fixed length segment, even though if no values are present, we need to fill up empty spaces. Here ISA02 is filled with 10 empty spaces.

ISA04
Since ISA is fixed length segment, even though if no values are present, we need to fill up empty spaces. Here ISA04 is filled with 10 empty spaces.

ISA06
Since ISA is fixed length segment, if the value is not 15 characters length, then we need to append empty space to make 15 characters string.

ISA08
Since ISA is fixed length segment, if the value is not 15 characters length, then we need to append empty space to make 15 characters string.


Segment Structure 

image



Sample 2
ISA*03*id27032743*01*XYXY2233  *ZZ*XX09211223     *01*030240928      *130829*1102*^*00501*290811021*0*T*:~

User Name and Password
In some clearing house, they might ask to send the user name and password along with each EDI file. That's what Authorization information Information refer ISA01, ISA02,ISA03 and ISA04.  After you sign up with the clearing house, ask your user name and password to send along the EDI File if they need.  In such case, ISA01 will have the value"03" , ISA02 will have the user id, ISA03 will have the value "01" and ISA04 will have the actual password. Very important, since ISA is fixed length segment, and ISA02 is 10 character, so if your user id is less than 10 characters, then you need to append empty spaces to make it as 10 character word.
 
Sample with the User id and Password.


Segment Structure 
image

ISA01 - Authorization Information Qualifier
Code to identify the type of information in the Authorization Information

Code Definition
00

No Authorization Information Present (No Meaningful information in 102). Advised unless security requirements Mandate use of Additional identification information.

03

Additional data Identification.


ISA03 - Security Information Qualifier
Code to identify the type of information in the Security information qualifier

Code

Definition

00

No Security Information Present (No Meaningful information in 104). Advised unless security requirements Mandate use of password data.

01

Password

ISA05, ISA07- Interchange ID Qualifier
Code to identify the type of information in the Security information qualifier

Code Definition

01

Duns(Dun & BradStreet)

14

Duns Plus Suffix

20

Health Industry Number (HIN)

27

Carrier Identification Number

28

Fiscal Intermediary Identification Number.

29

Medicare Provider and Supplier Identification Number.

30

U.S Federal Tax Identification Number.

33

National Association of Insurance Commissioners Company Code (NAIC).

ZZ

Mutually Defined.


ISA06 – Interchange Sender ID
During the sign up process with clearing house, they will assign a unique ID to the software vendor. So in the practice information setup, software should have a option to enter this value. This is mandatory for all the EDI Files, without this ID, clearing house will not be able to process the file.

ISA08 – Interchange Receiver ID
During the sign up process with clearing house, they will provide this value. Usually, this will be clearing house name. So in the practice information setup, software should have a option to enter this value. This is mandatory for all the EDI Files, without this ID, clearing house will not be able to process the file.

ISA13 – Interchange Control Number
Control Number assigned by the Sender for tracking purpose. This number must be identical to the Interchange Trailer IEA02. Ever time
when creating the EDI File, software can generate a unique number to identify the batch for later case to track. 

ISA14 - Acknowledgment Requested.


Code Definition
0 No Acknowledgment Requested
1 Interchange Acknowledgement Requested

Default to 0. In some cases, if the software vendor integrated to clearing house via web services. then we can ask the clearing house to send the acknowledgment for each EDI File batches.

ISA15 – Usage Indicator.

Code Definition
P Production Data
T Test Data

After the  sign up process with clearing house, they will ask the software vendor to send sample files with different use cases. In such cases, all the files should be send as Test Data. So in the practice information setup, software should have this option to select. Once test files are approved, then software admin can change this value to Production.

 

        





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Friday, 19 April 2013

EDI 270 - 5010 Health Care Eligibility/Benefit Inquiry

Posted on 20:14 by Unknown


If you are new to Medical Billing, then please read this article first.
If you are new to EDI, then  read the following articles

1. What is an EDI ?
2. EDI Transactions 

3. Understanding EDI Structure
4. EDI Instruction

Introduction

For the health care industry to achieve the potential administrative cost savings with Electronic Data Interchange (EDI), standards have been developed and need to be implemented consistently by all organizations. To facilitate a smooth transition into the EDI environment, uniform implementation is critical.

Providers of medical services must currently submit health care eligibility and benefit inquiries in a variety of methods, either on paper, via phone, or electronically. The information requirements vary depending upon:

  • type of insurance plan
  • type of service performed
  • where the service is performed
  • where the inquiry is initiated
  • where the inquiry is sent

The Health Care Coverage, Eligibility, and Benefit transactions are designed so that inquiry submitters (information receivers) can determine (a) whether an information source organization (e.g., payer, employer, HMO) has a particular subscriber or dependent on file, and (b) the health care eligibility and/or benefit information about that subscriber and/or dependent(s). The data available through these transaction sets is used to verify an individual’s eligibility and benefits, but cannot provide a history of benefit use.

The purpose of this implementation guide is to explain the developers’ intent when the Health Care Eligibility, Coverage, or Benefit Inquiry (270) and Health Care Eligibility, Coverage, or Benefit Information (271) transaction sets were designed and to give guidance on how they should be implemented in the health care industry. Specifically, this guide defines where data is put and when it is included for the ANSI ASC X12.281 and X12.282 transaction sets for the purpose of conveying health care eligibility and benefit information.

This paired transaction set is comprised of two transactions: the 270, which is used to request (inquire) information, and the 271, which is used to respond with coverage, eligibility, and benefit information. The official names for these transactions are:

ANSI ASC X12.281 - Eligibility, Coverage, or Benefit Inquiry (270)
ANSI ASC X12.282 - Eligibility, Coverage, or Benefit Information (271)

The 270 document typically includes the following:

  • Details of the sender of the inquiry (name and contact information of the information receiver)
  • Name of the recipient of the inquiry (the information source)
  • Details of the plan subscriber about to the inquiry is referring
  • Description of eligibility or benefit information requested

The ASC X12N Specification  - 5010 Version

 1. EDI 270–5010 Documentation - ISA – Interchange Control Header
 2. EDI 270–5010 Documentation – GS – Functional Group Header
 3. EDI 270–5010 Documentation – ST – Transaction Set Header
 4. EDI 270–5010 Documentation – BHT – Beginning Of Hierarchical Transaction
 5 EDI 270–5010 Documentation – HL – Hierarchical Level
 6. EDI 270–5010 Documentation–2100A Information Source Name
 7. EDI 270–5010 Documentation–2000B Information Receiver Level
 8. EDI 270–5010 Documentation–2000B Information Receiver Name
 9. EDI 270 – 5010 Documentation-2000C Hierarchical Level
10. EDI 270 – 5010 Documentation – Subscriber Trace Number 
11. EDI 270 – 5010 Documentation –  2100C SUBSCRIBER Name

EDI   Examples

Please note ; all these examples are tested against WPC First Pass software.

You can download trial version here.

Also, you can download the following trial version software to view/validate EDI File.

1. EDI Notepad
2. HIPPA Document Viewer 2
3. On Line Validator American Coders
4. On Line Validator EDIVance

The following open source converts X12 EDI File to XML and 1500.
OopFactory X12 Parser

The following URL discuss about other open source in EDI Software.
Comparing Open Source EDI Software


Sample EDI 270 5010. For clear understanding, line separator are used between loops

ISA*03*id27032743*01*XYXY2233  *ZZ*XX09211223     *01*030240928      *130829*1102*^*00501*290811021*0*T*:~
GS*HS*XX09211223*030240928*20130829*1102*1*X*005010X279A1~
ST*270*0001*005010X279A1~
BHT*0022*13*0001*20130829*1102~
HL*1**20*1~
NM1*PR*2*FLORIDA BLUE*****PI*BCBSF~
HL*2*1*21*1~
NM1*1P*2*Bella Vista Health Center*****XX*1306849724~
HL*3*2*22*0~
TRN*1*290811021*3030240928~
NM1*IL*1*MULLIN*DANIEL****MI*XJBH12345678~
DMG*D8*19571112~
DTP*291*D8*20130829~
EQ*30~
SE*13*0001~
GE*1*1~
IEA*1*290811021~

Questions or feedback are always welcome. You can email me at vbsenthilinnet@gmail.com. You can hire me as consultant for EMR/PMS Domain and Web development on EMR/PMS Product!


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ZK MVVM Form Binding CRUD with Spring and Hibernate

Posted on 02:56 by Unknown

In this series of articles, we will see examples for various concept of ZK Framework.

About the application
This is a small application to store the users information such as first name, last name, email, login id , password, etc. We will have the listing screen which will display all the users in the database. And from this listing screen, we will be able to add new users and edit the existing users in the database.

MySQL table structure.

CREATE TABLE `userprofile` (
`id` bigint(20) NOT NULL auto_increment,
`firstname` varchar(50) NOT NULL,
`lastname` varchar(50) NOT NULL,
`middlename` varchar(2) default NULL,
`userAccountNumber` varchar(50) NOT NULL,
`DOB` date default NULL,
`SSN` varchar(50) default NULL,
`address1` varchar(200) NOT NULL,
`address2` varchar(200) default NULL,
`city` varchar(100) NOT NULL,
`state` varchar(2) NOT NULL,
`zipcode` varchar(12) NOT NULL,
`email` varchar(100) NOT NULL,
`userloginid` varchar(20) NOT NULL,
`password` varchar(50) NOT NULL,
PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=latin1

Insert some records in the database for the above table

Technologies Used
    1. ZK 6.5.2 CE Version
    3. Hibernate Core Version 4.1.10 Final
    4. Spring ORM Version 3.2.0
    5. MySQL version 5
    6. Maven 3

First let us setup the development environment. Download this document and follow the step by step instruction to install the necessary software’s.

Part 1: This post explain how to create ZK Maven project in eclipse IDE as step by step.
Part 2: This post talks about creating Domain, DAO and Service Layer.
Part 3: Spring Integration with Hibernate
Part 4: Presentation Layer
Part 5: Change the look and feel.
Part 6: Spring security 3 integration with hibernate 4
Part 7: More features such as Data filter, etc..
Part 8: ZK Theme customization for each user
Part 9: Bug Fixing Cycle :)
Part 10: jQuery integration with ZK Framework
Part 11: Store image in the database.
Part 12 : Validation using Hibernate Validator
Part 13 : More Validation using Hibernate Validator


You can download the source here


For online demo, click here.

Use the following user id and password to check out different theme for each user
a) For blue theme, user id : lee and password : lee.
b) For brown theme, user id : wing and password : wing
c) for Green theme, user id : dennis and password : dennis
d) For purple theme, user id : senthil and password : senthil
e) For red theme, user id : zkoss and password : zkoss



Screen shots

image



image



image

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Sunday, 14 April 2013

ZK MVVM Form Binding CRUD with Spring and Hibernate - Part 11

Posted on 03:52 by Unknown

Storing Image in the Database

        


Left hugMy Sincere thanks to Joshi who helped me in this article

In the last article, we have successfully integrated jQuery plugin with ZK. Now we will see how to upload a image file and store in the database and display back to the UI.

Step 1:
First we will add one more column in the mysql table userprofile. The column name will be “userPhoto” and type will be longblob. Here is the structure.
image
Step 2:
Next we need to modify our bean UserProfile. Here is the modified file UserProfile.java in which we have added the new column.

package zkexample.domain;

import java.io.Serializable;
import java.util.Date;

import javax.persistence.Column;
import javax.persistence.Entity;
import javax.persistence.GeneratedValue;
import javax.persistence.GenerationType;
import javax.persistence.Id;
import javax.persistence.Lob;
import javax.persistence.Table;
import javax.persistence.Temporal;
import javax.persistence.TemporalType;

import org.hibernate.annotations.NamedQuery;

@Entity
@Table(name = "userprofile")
@NamedQuery(name = "UserProfile.findUserByUserID", query = "SELECT usr FROM UserProfile as usr WHERE usr.userLoginID = ?")
public class UserProfile implements Serializable {

/**
*
*/
private static final long serialVersionUID = 1L;

@Id
@GeneratedValue(strategy = GenerationType.IDENTITY)
private long id;

private String firstName;
private String lastName;
private String middleName;
private String userAccountNumber;
private String SSN;
private String address1;
private String address2;
private String city;
private String State;
private String zipCode;
private String email;
private String userLoginID;
private String password;
private Integer system;
private String theme;

@Column(name = "userPhoto")
@Lob
private byte[] userPhoto;

@Temporal(TemporalType.DATE)
private Date DOB;

public long getId() {
return id;
}

public void setId(long id) {
this.id = id;
}

public String getFirstName() {
return firstName;
}

public void setFirstName(String firstName) {
this.firstName = firstName;
}

public String getLastName() {
return lastName;
}

public void setLastName(String lastName) {
this.lastName = lastName;
}

public String getMiddleName() {
return middleName;
}

public void setMiddleName(String middleName) {
this.middleName = middleName;
}

public String getUserAccountNumber() {
return userAccountNumber;
}

public void setUserAccountNumber(String userAccountNumber) {
this.userAccountNumber = userAccountNumber;
}

public Date getDOB() {
return DOB;
}

public void setDOB(Date dOB) {
DOB = dOB;
}

public String getSSN() {
return SSN;
}

public void setSSN(String sSN) {
SSN = sSN;
}

public String getAddress1() {
return address1;
}

public void setAddress1(String address1) {
this.address1 = address1;
}

public String getAddress2() {
return address2;
}

public void setAddress2(String address2) {
this.address2 = address2;
}

public String getCity() {
return city;
}

public void setCity(String city) {
this.city = city;
}

public String getState() {
return State;
}

public void setState(String state) {
State = state;
}

public String getZipCode() {
return zipCode;
}

public void setZipCode(String zipCode) {
this.zipCode = zipCode;
}

public String getEmail() {
return email;
}

public void setEmail(String email) {
this.email = email;
}

public String getUserLoginID() {
return userLoginID;
}

public void setUserLoginID(String userLoginID) {
this.userLoginID = userLoginID;
}

public String getPassword() {
return password;
}

public void setPassword(String password) {
this.password = password;
}

public Integer getSystem() {
return system;
}

public void setSystem(Integer system) {
this.system = system;
}

public String getTheme() {
return theme;
}

public void setTheme(String theme) {
this.theme = theme;
}

public byte[] getUserPhoto() {
return userPhoto;
}

public void setUserPhoto(byte[] userPhoto) {
this.userPhoto = userPhoto;
}

}



Step 3:
Next we will modify our zul file such as it will have one image file and two buttons(one button is to add image and other button is to remove the image if need). In the UserCRUD.zul file, next heading “Personel Information” , add the following lines.
You can also get the complete source at the bottom link provided.


	<div>
<image content="@bind(vm.myImage)" width="150px"
style="overflow:auto;z-index:999;position:absolute;right:30px;top:56px;width:150px;height:140px;background-color:#ff99cc;" />
<button Label="Add" sclass="mybutton button theme small"
width="40px" upload="true,maxsize=300"
visible="@load(not vm.makeAsReadOnly)"
style="position:absolute;right:115px;top:200px;"
onUpload="@command('upload', upEvent=event)" mold="trendy" />
<button Label="Del" sclass="mybutton button theme small"
visible="@load(not vm.makeAsReadOnly)" width="40px"
style="position:absolute;right:30px;top:200px;"
onClick="@command('removeImage')" mold="trendy" />
</div>



Step 3:
Next in the images folder, add image male.png. You can download the source at the bottom and use that image.

image
Step 4:
Next we need to modify the VM. Open the UserCRUDVM.java and do the changes
Change : 1



Add the following two new methods.


@Command
@NotifyChange("myImage")
public void removeImage() {

myImage = null;
}

@Command
@NotifyChange("myImage")
public void upload(@ContextParam(ContextType.BIND_CONTEXT) BindContext ctx) {

UploadEvent upEvent = null;
Object objUploadEvent = ctx.getTriggerEvent();
if (objUploadEvent != null && (objUploadEvent instanceof UploadEvent)) {
upEvent = (UploadEvent) objUploadEvent;
}
if (upEvent != null) {
Media media = upEvent.getMedia();
int lengthofImage = media.getByteData().length;
if (media instanceof Image) {
if (lengthofImage > 500 * 1024) {
Messagebox
.show("Please Select a Image of size less than 500Kb.");
return;
} else {
myImage = (AImage) media;// Initialize the bind object to
// show image in zul page and
// Notify it also
}
} else {
Messagebox.show("The selected File is not an image.");
}
}
}


Change 2:
Change the Method initSetup as follows


@AfterCompose
@NotifyChange("myImage")
public void initSetup(@ContextParam(ContextType.VIEW) Component view,
@ExecutionArgParam("selectedRecord") UserProfile userProfile,
@ExecutionArgParam("recordMode") String recordMode,
@ExecutionArgParam("centerArea") Center centerArea)
throws IOException {

Selectors.wireComponents(view, this, false);
setRecordMode(recordMode);
CRUDService = (CRUDService) SpringUtil.getBean("CRUDService");
this.centerArea = centerArea;

Themes.register("bluetheme", ThemeOrigin.FOLDER);
Themes.register("greentheme", ThemeOrigin.FOLDER);
Themes.register("browntheme", ThemeOrigin.FOLDER);
Themes.register("purpletheme", ThemeOrigin.FOLDER);
Themes.register("redtheme", ThemeOrigin.FOLDER);



String[] themes = Themes.getThemes();
themes = Arrays.copyOf(themes, themes.length + 1);

// Attempting to switch to a theme that is not registered
// will switch to the default theme (i.e. breeze)
themes[themes.length - 1] = "unknown";
_themes = new ListModelList<String>(themes);

currentTheme = Themes.getCurrentTheme();
myImage = new AImage(Executions.getCurrent().getDesktop().getWebApp().getRealPath("/images") +"/male.png" );
if (recordMode.equals("NEW")) {
this.selectedRecord = new UserProfile();
this.selectedRecord.setSystem(0);
}

if (recordMode.equals("EDIT")) {
this.selectedRecord = userProfile;
if (this.selectedRecord.getUserPhoto() != null)
myImage = new AImage("userPhoto",
this.selectedRecord.getUserPhoto());
}

if (recordMode == "READ") {
setMakeAsReadOnly(true);
this.selectedRecord = userProfile;
if (this.selectedRecord.getUserPhoto() != null)
myImage = new AImage("userPhoto",
this.selectedRecord.getUserPhoto());
}
}


Change 3:
Change the Savethis Method as follows


	@Command
public void saveThis(@BindingParam("action") Integer action) {
if (myImage != null) {
byte[] bFile = myImage.getByteData();
this.selectedRecord.setUserPhoto(bFile);
} else
this.selectedRecord.setUserPhoto(null);
CRUDService.Save(this.selectedRecord);
if (action == 0) {
final HashMap<String, Object> map = new HashMap<String, Object>();
map.put("centerArea", centerArea);
centerArea.getChildren().clear();
Executions.createComponents("userList.zul", centerArea, map);
}
if (action == 1) {
this.selectedRecord = new UserProfile();
BindUtils.postNotifyChange(null, null, UserCRUDVM.this,
"selectedRecord");

}
}

Step 5:
Now you can run the application, login and Click Add new and you can see the following output.
image

Step 6:
Finally, we will one more option such after each DB operation such as New/Edit/Delete, we will show the confirmation message. In the MyLib.java file, add the below function



	public static void showSuccessmessage() {
Clients.showNotification("Operation Completed Successfully",
Clients.NOTIFICATION_TYPE_INFO, null, "top_center", 4100);
}

Now call this Function in the UserListVM.Java after delete as follows":


@Override
public void onConfirmClick(String code, int button) {
if (code.equals("deleteFirstConfirm") && button == Messagebox.YES) {
MyLib.confirm(
"deleteSecondConfirm",
"The Selected user \""
+ selectedItem.getUserLoginID()
+ "\" will be permanently deleted and the action cannot be undone..?",
"Confirmation", this);
}
if (code.equals("deleteSecondConfirm") && button == Messagebox.YES) {

CRUDService.delete(selectedItem);

allReordsInDB.remove(allReordsInDB.indexOf(selectedItem));
BindUtils.postNotifyChange(null, null, UserListVM.this, "dataSet");
MyLib.showSuccessmessage();

}
}

Similarly, call this in SaveThis in UserCRUDVM.Java as follows


@Command
public void saveThis(@BindingParam("action") Integer action) {
if (myImage != null) {
byte[] bFile = myImage.getByteData();
this.selectedRecord.setUserPhoto(bFile);
} else
this.selectedRecord.setUserPhoto(null);
CRUDService.Save(this.selectedRecord);
MyLib.showSuccessmessage();
if (action == 0) {
final HashMap<String, Object> map = new HashMap<String, Object>();
map.put("centerArea", centerArea);
centerArea.getChildren().clear();
Executions.createComponents("userList.zul", centerArea, map);
}
if (action == 1) {
this.selectedRecord = new UserProfile();
BindUtils.postNotifyChange(null, null, UserCRUDVM.this,
"selectedRecord");

}
}


You can control the look and feel of the notification message. Add the below lines in Style.css


/* ----------------------------------------------------------------------------------------------------------------------- */
/* Start: Auto Close Notification message box
/* ----------------------------------------------------------------------------------------------------------------------- */
.z-notification .z-notification-cl,.z-notification .z-notification-cnt {
height: 30px;
width: 250px;
}

.z-notification-info .z-notification-cl {
background-color: #ADD8E6;
}

.z-notification .z-notification-cl {
color: white;
}

.z-notification .z-notification-cnt {
background: none repeat scroll 0 center transparent;
font-size: 14px;
font-weight: normal;
margin: 0 !important;
overflow: hidden;
}

In Next Part 12, we will see how to validate user inputs using hibernate validator


You can download the source from here.

You can see the demo here :  user id wing and password is wing



        

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