<?php
/*
<LICENSE>
This file is part of AGENCY.
AGENCY is Copyright (c) 2003-2022 by Ken Tanzer and Downtown Emergency
Service Center (DESC).
All rights reserved.
For more information about AGENCY, see http://agency-software.org/
For more information about DESC, see http://www.desc.org/.
AGENCY is free software: you can redistribute it and/or modify
it under the terms of version 3 of the GNU General Public License
as published by the Free Software Foundation.
AGENCY is distributed in the hope that it will be useful,
but WITHOUT ANY WARRANTY; without even the implied warranty of
MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
GNU General Public License for more details.
You should have received a copy of the GNU General Public License
along with AGENCY. If not, see <http://www.gnu.org/licenses/>.
For additional information, see the README.copyright file that
should be included in this distribution.
</LICENSE>
*/
/*
*
* Utilities for creating or parsing EDI files
*
*/
class Make_EDI {
var $segment_count = 0;
var $hl_count = 0;
var $hl_par_count = 0;
var $transaction_type = '';
var $version_release_number = '';
var $transaction = ''; //837, 270, 271 etc
var $interchange_control_number; // used in ISA/IEA
var $group_control_number; // used in GS/GE
/* private static variables */
var $seg_sep = '*'; // the field separator
var $seg_end = '~'; // the end of string character
var $comp_sep = ':'; // the composite data element separator
var $comp_end = ''; // no end character now.
function Make_EDI($config,$interchange_control_number,$group_control_number,$batch_number)
{
$this->config = $config;
$this->interchange_control_number = $interchange_control_number;
$this->group_control_number = $group_control_number;
$this->batch_number = $batch_number;
}
function create_segment()
{
$this->segment_count ++;
$args = func_get_args();
$segment = implode( $this->seg_sep, $args);
$segment .= $this->seg_end;
return $segment;
}
function create_composite()
{
$args = func_get_args();
$composite=implode( $this->comp_sep, $args);
$composite .= $this->comp_end;
return $composite;
}
function escape_string($str)
{
return str_replace(array($this->comp_sep,$this->comp_end,$this->seg_sep,$this->seg_end),'',$str);
}
function process_header()
{
return $this->set_isa()
. $this->set_gs()
. $this->set_st();
}
function begin_hierarchical_transaction()
{
$o = $this->set_bht()
. $this->set_source()
. $this->set_receiver();
return $o;
}
function process_trailer()
{
return $this->set_se()
. $this->set_ge()
. $this->set_iea();
}
/* Interchange Control */
function set_isa()
{
/*
* INTERCHANGE CONTOL HEADER
*/
$isa = $this->create_segment('ISA',
// 01 - Authorization Information Qualifier
'00',
// 02 - Authorization Information
str_pad($this->config['isa_auth_info'],10),
// 03 - Security Information Qualifier
'00',
// 04 - Security Information
str_pad($this->config['isa_sec_info'],10),
// 05 - Interchange ID Qualifier
'ZZ',
// 06 - 15 length of element Interchange Sender ID
str_pad($this->config['sender_id'],15),
// 07 -Interchange ID Qualifier
'ZZ',
// 08 - 15 length of element Interchange Receiver ID
str_pad($this->config['int_receiver_id'],15),
// 09 - YYMMDD Interchange Date
dateof('now','NO_SEP_SHORT'),
// 10 - HHMM Interchange Time
timeof('now','NO_SEP_SHORT'),
// 11 - Interchange Control Standards Identifier
'U',
// 12 - Interchange Control Version Number
'00401',
// 13 - Interchange Control Number
lpad($this->interchange_control_number,9,'0'),
// 14 - Acknowledgement Requested
'0',
// 15 - T for TEST, P for PRODUCTION Usage Indicator
$this->config['usage_indicator'],
// 16 - Component Element Separator
':');
return $isa;
}
function set_iea()
{
/*
* Interchange Control Trailer
*/
$iea = $this->create_segment('IEA',
// 01 - Number of included functional groups
'1',
// 02 - Interchange Control Number
lpad($this->interchange_control_number,9,'0')
);
return $iea;
}
/* End Interchange Control */
/* Functional Group */
function set_gs()
{
/*
* Functional Group Header
*/
$gs = $this->create_segment(
'GS',
$this->transaction_type, // 01 - Functional Identifier Code
$this->config['sender_id'], // 02 - Application Sender's Code (DESC, for DSHS)
$this->config['receiver_id'], // 03 - Application Receiver's Code (DSHS)
dateof('now','NO_SEP'), // 04 - YYYYMMDD // Date
timeof('now','NO_SEP_SHORT'), // 05 - HHMM // Time
$this->group_control_number, // 06 - Group Control Number
'X', // 07 - Responsible Agency Code
$this->version_release_number // 08 - Version Release Number
);
return $gs;
}
function set_ge()
{
/*
* Functional Group Trailer
*/
$ge = $this->create_segment('GE',
'1', // Number of transaction sets included
$this->group_control_number); // Group Control Number
return $ge;
}
/* End Functional Group */
/* Transaction Set */
function set_st()
{
$st = $this->create_segment('ST',
$this->transaction,
$this->batch_number);
return $st;
}
function set_se()
{
$se = $this->create_segment('SE',
$this->segment_count - 2 + 1, /* we need to send segment count from ST through SE, we have a count
including ISA and GS and not including SE, so virtually we subtract two
and add 1 or more simply... */
$this->batch_number);
return $se;
}
/* End Transaction Set */
/* Hierarchical Transaction */
function set_bht()
{
/*
* Hierarchical Transaction Header
*/
$bht = $this->create_segment('BHT',
// 01 - Hierarchical Structure Code
$this->config['bht_struct_code'],
// 02 - Transaction Set Purpose Code
$this->config['bht_purp_code'],
// 03 - Reference Identification (? I think anything works ?)
$this->config['sender_id'].str_pad($this->batch_number,10,'0',STR_PAD_LEFT),
// 04 - YYYYMMDD Date
dateof('now','NO_SEP'),
// 05 - HHMM Time
timeof('now','NO_SEP_SHORT'));
return $bht;
}
function set_hierarchical_level($par,$level,$child)
{
$this->hl_count++;
return $this->create_segment('HL',
$this->hl_count, // 01 - Hierarchical Id Number
$par, // 02 - Parent ID
$level, // 03 - Hierarchical Level Code
$child); // 04 - Hierarchical Child Code
}
function set_nm1($ent,$orgn_name,$id_qual,$id,$person='2',$first='',$middle='',$suffix='')
{
return $this->create_segment('NM1',
// 01 - Entity Identifier Code
$ent, //gateway provider?
// 02 - Entity Type Qualifier
$person, // non-person = 2, person = 1
// 03 - Name Last (or organization)
trim($orgn_name),
trim($first), // 04 - Name First
trim($middle), // 05 - Name Middle
'', // 06 - Name Prefix - not used
trim($suffix), // 07 - Name Suffix
$id_qual, // 08 - ID Code Qualifier
$id // 09 - ID Code
);
}
/* Note: this is the end of the generalized workings - from here on out it is tailored to medicaid lookup/service data submission (fixme?)*/
function set_source() { }
function set_receiver() { }
function set_submitter() { }
} /* End class Make_EDI */
class Make_EDI_270 extends Make_EDI {
var $transaction = '270';
var $transaction_type = 'HS';
var $version_release_number = '004010X092A1';
function set_source()
{
/*
* Loop 2000A - Information Source Level
*/
$this->hl_par_count = '1';
$hl_seg = $this->set_hierarchical_level('','20','1');
/*
* Loop 2100A
*/
$nm1_seg = $this->set_nm1('2B','DSHS','PI',$this->config['receiver_id']);
return $hl_seg . $nm1_seg;
}
/*
* Information Source Loop 2000A
* Information Receiver Loop 2000B
* Subscriber Loop 2000C
* Dependent Loop 2000D
* Eligibility or Benefit Information
* Dependent Loop 2000D
* Eligibility or Benefit Information
* Subscriber Loop 2000C
* Eligibility or Benefit Information
* ...
*/
function set_receiver()
{
/*
* Loop 2000B
*/
$hl = $this->set_hierarchical_level($this->hl_par_count,'21','1');
$par = $this->hl_par_count = $this->hl_count;
/*
* Loop 2100B
*/
$nm1 = $this->set_nm1('1P','Downtown Emergency Service Center','SV',$this->config['sender_id']);
return $hl . $nm1;
}
function set_subscriber($person,$start,$end)
{
/*
* Loop 2000C - Subscriber loop
*/
$hl = $this->set_hierarchical_level($this->hl_par_count,'22','0');
$trn = $this->create_segment('TRN', // Trace
'1', //??
$person['trace_id'], '9'.str_pad($person['trace_id'],9,'0',STR_PAD_LEFT)
);
$nm1 = $this->set_nm1('IL',$person['name_last'],'MI',orr($person['pic'],'NA'),'1',
$person['name_first'],$person['name_middle'],$person['name_suffix']);
$ref = $this->create_segment('REF',
'SY',
str_replace('-','',$person['ssn']));
$dmg = $this->create_segment('DMG',
'D8',
dateof($person['dob'],'NO_SEP'));
$dtp = $this->create_segment('DTP',
'307',
'RD8',
dateof($start,'NO_SEP').'-'.dateof($end,'NO_SEP'));
$eq = $this->create_segment('EQ',
'30');
return $hl . $trn . $nm1 . $ref . $dmg . $dtp . $eq;
}
}
class Make_EDI_837 extends Make_EDI {
var $transaction = '837';
var $transaction_type = 'HC';
var $version_release_number = '004010X098A1';
var $service_count = 0;
/*
header[1]=set_isa()
header[2]=set_gs("HC") ;"HC" ;specifies 837 transactions
header[3]=set_837() ; start the 837 transaction
header[4]=set_submitter() ; loop 1000A
header[5]=set_receiver() ; loop 1000B
header[6]=set_provider() ; loop 2000A
header[7]=set_provider_name() ; loop 2010AA
*/
function begin_hierarchical_transaction()
{
$o = $this->set_bht()
. $this->create_segment('REF','87','004010X098A1')
. $this->set_submitter()
. $this->set_receiver()
. $this->set_provider();
return $o;
}
/* Hierarchical Transaction */
function set_bht()
{
/*
* Hierarchical Transaction Header
*/
$bht = $this->create_segment('BHT',
// 01 - Hierarchical Structure Code
$this->config['bht_struct_code'],
// 02 - Transaction Set Purpose Code
$this->config['bht_purp_code'],
// 03 - Reference Identification (? I think anything works ?)
$this->config['sender_id'].str_pad($this->batch_number,10,'0',STR_PAD_LEFT),
// 04 - YYYYMMDD Date
dateof('now','NO_SEP'),
// 05 - HHMM Time
timeof('now','NO_SEP_SHORT'),
// 06 - Transaction Type Code
'RP'
);
return $bht;
}
function set_submitter()
{
/*
* Loop 1000A
*/
$nm1_seg = $this->set_nm1('41',$this->config['sender_name'],'46',$this->config['sender_id']);
$per_seg = $this->create_segment('PER',
'IC',
'Data Systems Administrator',
'TE',
'2064641570');
return $nm1_seg . $per_seg;
}
function set_receiver()
{
/*
* Loop 1000B
*/
return $this->set_nm1('40',$this->config['receiver_name'],'46',$this->config['receiver_id']);
}
function set_provider()
{
/*
* Loop 2000A
*/
$this->hl_par_count = '1';
$hl_seg = $this->set_hierarchical_level('','20','1');
$prv_seg = $this->create_segment('PRV',
'PT',
'ZZ',
$this->config['sender_taxonomy_code']); //desc taxonomy code
/*
* Loop 2010A
*/
$nm1_seg = $this->set_nm1('85',
$this->config['sender_name'],
'XX',
$this->config['sender_npi']);
$n3_seg = $this->create_segment('N3',
$this->escape_string($this->config['sender_address']));
$n4_seg = $this->create_segment('N4',
$this->config['sender_city'],
$this->config['sender_state'],
$this->config['sender_zipcode']);
$ref_seg = $this->create_segment('REF',
'EI',
$this->config['sender_ein']);
return $hl_seg . $prv_seg . $nm1_seg . $n3_seg . $n4_seg . $ref_seg;
}
function set_subscriber($dal)
{
/*
* Loop 200B
*/
$hl_seg = $this->set_hierarchical_level($this->hl_par_count,'22','0');
$sbr_seg = $this->create_segment('SBR',
'P',
'18',
'',
'',
'',
'',
'',
'',
$dal['medicaid_status']
);
/*
* Loop 2010A
*/
$nm1_seg = $this->set_nm1('IL',$dal['name_last'],'MI',$dal['king_cty_id'],'1',$dal['name_first'],$dal['name_middle'],$dal['name_suffix']);
$n3_seg = $this->create_segment('N3',
$this->escape_string($dal['street_address']));
$n4_seg = $this->create_segment('N4',$dal['city'],$dal['state'],$dal['zipcode']);
$dmg_seg = $this->create_segment('DMG',
'D8',
dateof($dal['dob'],'NO_SEP'),
$dal['gender']);
return $hl_seg . $sbr_seg . $nm1_seg . $n3_seg . $n4_seg . $dmg_seg;
}
function set_payer($rec)
{
/*
* Loop 2010B
*/
$nm1_seg = $this->set_nm1('PR',$this->config['receiver_name'],'PI',$this->config['receiver_id']);
return $nm1_seg;
}
function set_claim($claim_number,$rec)
{
/*
* Loop 2300
*/
$clm_seg = $this->create_segment('CLM',
$claim_number,
'0',
'',
'',
// CLM06 - location info (action code 1=new, 8=delete
$this->create_composite($rec['location_cpt_code'],'',$rec['action_code']),
'Y',
'C', //provider accept assigment code
'Y', //benefits assignment certification
'N'); // whatever this is, if it's N, CLM11 is empty
$ref_seg = $this->create_segment('REF',
'G1',
$rec['kc_authorization_id']);
$hi_seg = $this->create_segment('HI',
$this->create_composite('BK',$rec['diagnosis']));
return $clm_seg . $ref_seg . $hi_seg;
}
function set_service_location($rec)
{
/*
* Loop 2310D
*/
$nm1_seg = $this->set_nm1('FA',
$rec['service_location_name'],
'XX', //NPI
$this->config['sender_npi']);
$n3_seg = $this->create_segment('N3',
$this->escape_string($rec['service_location_address']));
$n4_seg = $this->create_segment('N4',
$rec['service_location_city'],
$rec['service_location_state'],
$rec['service_location_zipcode']);
return $nm1_seg . $n3_seg . $n4_seg;
}
function set_service($rec)
{
/*
* Loop 2400
*/
$this->service_count ++;
$lx_seg = $this->create_segment('LX',
$this->service_count);
$sv1_seg = $this->create_segment('SV1',
(!be_null($rec['dal_modifiers'])
? $this->create_composite('HC',$rec['service_cpt_code'],$rec['dal_modifiers'])
: $this->create_composite('HC',$rec['service_cpt_code'])),
'0',
'MJ',
$rec['total_minutes'],
$rec['location_cpt_code'],
'',
'1');
$dtp_seg = $this->create_segment('DTP',
'472',
'D8',
dateof($rec['dal_date'],'NO_SEP'));
$ref_seg = $this->create_segment('REF',
'6R',
$rec['dal_id']);
return $lx_seg . $sv1_seg . $dtp_seg . $ref_seg;
}
function set_rendering_provider($rec)
{
/*
* Loop 2420A
*/
$nm1_seg = $this->set_nm1('82',
$this->config['sender_name'],
'XX', //XX - NPI, 24 - EIN
$this->config['sender_npi']);
$ref_seg = $this->create_segment('REF',
'N5',
$rec['kc_staff_id']);
$ref_seg2 = $this->create_segment('REF',
'EI',
$this->config['sender_ein']);
return $nm1_seg . $ref_seg . $ref_seg2;
}
}
?>
