wso2healthcare/health.x12.v006020x316

Package Overview

This package contains the Ballerina records generated from the X12 v006020X316 275 ("Additional Information to Support a Health Care Services Review") schema. These can be used to implement use cases that require processing data in this format, such as submitting supporting documentation for a prior authorization / health care services review.

How to read

X12 _ 006020 _ X316 _ 275
 │      │        │     │
 │      │        │     └── Transaction Set ID
 │      │        └──────── Implementation Guide Reference ID
 │      └───────────────── Version/Release
 └──────────────────────── Standards Body

Samples

An eligible X12 string can be used with the relevant X12 records library. Each library contains the following functions,

• fromEdiString - used to convert the EDI string of the relevant version to X12 ballerina records. The schema will be implicitly referred.
• fromEdiStringWithSchema - used to convert the EDI string of the relevant version to X12 ballerina records. The schema must be provided.
• toEdiString - used to convert the ballerina record of the relevant X12 version to EDI string. The schema will be implicitly referred.
• toEdiStringWithSchema - used to convert the ballerina record of the relevant X12 version to EDI string. The schema must be provided.
• getSchema() - retrieves the schema for the relevant version.

The following code snippet uses the wso2healthcare/health.x12.v006020x316.v275 library for this. The library defined in the v006020x316/modules directory is available to be used like this.

v275:X12_006020_275 'record = {}; // initializing the v275 record
edi:EdiSchema|error schema = v275:getSchema(); // retrieving the schema for v275

The EDI string used in the examples below is the published sample from the CMS esMD X12N 275 Companion Guide (ASC X12N/006020X316): Additional Information to Support Health Care Services Review (Version 3.0 Final, Section 4, Figure 2). The same sample is available at samples/Example_275_006020X316.edi.

1. Converting an EDI string to X12 ballerina record and fetch data from it.

Example:

import ballerina/io;
import ballerina/edi;

import wso2healthcare/health.x12.v006020x316.v275;

public function main() {

    string x12String = string `ISA*00*          *00*          *ZZ*TESTHIH        *ZZ*DBRRC          *180418*1156*+*00602*000104142*0*P*:~
                                        GS*PI*TESTHIH*DBRRC*20180418*115603*104142*X*006020X316~
                                        ST*275*104142*006020X316~
                                        BGN*02*1710101110473*20170320*111001~
                                        NM1*ACV*1*HIHPROVIDER*****XX*1111111112*67*1P~
                                        PER*IC*ESMD TESTING*FX*8034362416*TE*8034362416*EX*6788~
                                        NM1*40*2*COBIUS*****PI*50505*67*X3~
                                        NM1*IL*1*PARKER*CARROL*S***MI*215123556A~
                                        REF*EJ*1234567~
                                        REF*2I*RGK000000009500~
                                        LX*1~
                                        TRN*1*LANCEATYACHCTLNJSWL1ND0528~
                                        HI*ABK:R0600*ABJ:S06337A*ABJ:S29019A*ABJ:S238XXA*ABJ:S96919A~
                                        DTP*368*D8*20170320~
                                        CAT*AE*MB~
                                        OOI*1*47*ATTACHMENT~
                                        BDS*B64*28*cmVhbF9wYXlsb2FkXzFtYi50eHQ=~
                                        SE*16*104142~
                                        GE*1*104142~
                                        IEA*1*000104142~`;

    // Print the InformationSourceName from Loop_1000A
    edi:EdiSchema|error schema = v275:getSchema();
    if schema is edi:EdiSchema {
        v275:X12_006020_275|error fromEdiString = v275:fromEdiStringWithSchema(x12String, schema);
        if fromEdiString is v275:X12_006020_275 {
            io:println(fromEdiString?.X12_FunctionalGroup?.X12_006020_275?.Loop_1000A?.InformationSourceName?.NM103__InformationSourceLastOrOrganizationName);
        }
    }
}

2. Converting an X12 Ballerina record to the relevant EDI string.

The following code snippet uses the wso2healthcare/health.x12.v006020x316.v275 library for this.

Example:

import ballerina/io;

import wso2healthcare/health.x12.v006020x316.v275;

public function main() {

    v275:X12_006020_275 'record = {
        "InterchangeControlHeader": {
            "code": "ISA",
            "ISA01__AuthorizationInformationQualifier": "00",
            "ISA02__AuthorizationInformation": "          ",
            "ISA03__SecurityInformationQualifier": "00",
            "ISA04__SecurityInformation": "          ",
            "ISA05__InterchangeIDQualifier": "ZZ",
            "ISA06__InterchangeSenderID": "TESTHIH",
            "ISA07__InterchangeIDQualifier": "ZZ",
            "ISA08__InterchangeReceiverID": "DBRRC",
            "ISA09__InterchangeDate": "180418",
            "ISA10__InterchangeTime": "1156",
            "ISA11__RepetitionSeparator": "+",
            "ISA12__InterchangeControlVersionNumber": "00602",
            "ISA13__InterchangeControlNumber": 104142,
            "ISA14__AcknowledgmentRequested": "0",
            "ISA15__InterchangeUsageIndicator": "P",
            "ISA16__ComponentElementSeparator": ":"
        },
        "X12_FunctionalGroup": {
            "FunctionalGroupHeader": {
                "code": "GS",
                "GS01__FunctionalIdentifierCode": "PI",
                "GS02__ApplicationSendersCode": "TESTHIH",
                "GS03__ApplicationReceiversCode": "DBRRC",
                "GS04__Date": "20180418",
                "GS05__Time": "115603",
                "GS06__GroupControlNumber": 104142,
                "GS07__ResponsibleAgencyCode": "X",
                "GS08__VersionReleaseIndustryIdentifierCode": "006020X316"
            },
            "X12_006020_275": {
                "A_275TransactionSetHeader": {
                    "code": "ST",
                    "ST01__TransactionSetIdentifierCode": "275",
                    "ST02__TransactionSetControlNumber": "104142",
                    "ST03__ImplementationConventionReferenceIdentifier": "006020X316"
                },
                "BeginningSegment": {
                    "code": "BGN",
                    "BGN01__TransactionSetPurposeCode": "02",
                    "BGN02__TransactionSetReferenceNumber": "1710101110473",
                    "BGN03__TransactionSetCreationDate": "20170320",
                    "BGN04__TransactionSetCreationTime": "111001"
                },
                "Loop_1000A": {
                    "InformationSourceName": {
                        "code": "NM1",
                        "NM101__EntityIdentifierCode": "ACV",
                        "NM102__EntityTypeQualifier": "1",
                        "NM103__InformationSourceLastOrOrganizationName": "HIHPROVIDER",
                        "NM108__IdentificationCodeQualifier": "XX",
                        "NM109__InformationSourceIdentifier": "1111111112",
                        "NM110__EntityRelationshipCode": "67",
                        "NM111__EntityIdentifierCode": "1P"
                    }
                },
                "A_275TransactionSetTrailer": {
                    "code": "SE",
                    "SE01__TransactionSegmentCount": "16",
                    "SE02__TransactionSetControlNumber": "104142"
                }
            },
            "FunctionalGroupTrailer": {
                "code": "GE",
                "GE01__NumberofTransactionSetsIncluded": 1,
                "GE02__GroupControlNumber": 104142
            }
        },
        "InterchangeControlTrailer": {
            "code": "IEA",
            "IEA01__NumberofIncludedFunctionalGroups": 1,
            "IEA02__InterchangeControlNumber": 104142
        }
    };

    string|error ediString = v275:toEdiString('record);

    if ediString is string {
        io:print("The EDI string is : " + ediString);
    }
}