Summary Table
Categories |
Total Count |
PII |
0 |
URL |
0 |
DNS |
0 |
EKL |
0 |
IP |
0 |
PORT |
0 |
VsID |
0 |
CF |
0 |
AI |
0 |
VPD |
0 |
PL |
0 |
Other |
0 |
File Content
export class EwvSearchModel {
patientHeaderInfo: PatientHeaderInfo;
patientInfo: PatientInfo;
serviceLocationInfo: ServiceLocationInfo;
billingProviderInfo: BillingProviderInfo;
billingMiscellanous: BillingMiscellanous;
procedureCodesInfo: ProcedureCodesInfo;
px: string[] = [];
dx: string[] = [];
eCodes: string[] = [];
healthCareInfo: HealthCareInfo;
ServiceLinesInfo: ServiceLineInfo[] = [];
ohiInfo: OhiInfo;
claimLevelAmbulanceInfo: null;
}
export class PatientHeaderInfo {
format = '';
claimFormat = '';
claimType = '';
medicareCrossOver = '';
patientName = '';
billingNPI = '';
memberID = '';
tin = '';
pdi = '';
pcn = '';
pcnShort = '';
usePcnModalPanel = false;
}
export class PatientInfo {
patientName = '';
patientIdNumber = '';
dateOfBirth = '';
dateOfDeath_5010 = '';
gender = '';
addressLineOne = '';
addressLineTwo: string = null;
city = '';
state = '';
postalCode = '';
country = '';
firstName = '';
lastName = '';
}
export class ServiceLocationInfo {
name = '';
taxIdNumber = '';
npi = '';
entityId = '';
billingVendorTaxonomyCode = '';
addressLineOne = '';
addressLineTwo: string = null;
city = '';
state = '';
postalCode = '';
country = '';
}
export class BillingProviderInfo {
name = '';
taxIdNumber = '';
npi = '';
entityId = '';
billingVendorTaxonomyCode = '';
addressLineOne = '';
addressLineTwo = '';
city = '';
state = '';
postalCode = '';
country = '';
}
export class BillingMiscellanous {
patientAccountNumber = '';
totalClaimCharges = '';
typeOfBillOrFrequency = '';
statementFromTo = '';
statementFromToEWV2 = '';
previousPDIOrClaimNumber = '';
patientPaidAmount = '';
patientSignature = '';
patientStatus = '';
admissionType = '';
providerAcceptsAssignment = '';
admissionSource = '';
assignmentOfBenefits = '';
admissionDateOrHour = '';
medicareIcn = '';
renderingPrvdName = '';
renderingPrvdNpi = '';
renderingPrvdTaxonomyCode = '';
admissionDate = '';
admissionHour = '';
dischargeDateOrHour = '';
accidentDate = '';
accidentIndicator = '';
priorAuthorizationReferralLong = '';
priorAuthorizationReferralShort = '';
usePriorAuthorizationModalPanel = false;
frequency = '';
admittingDiagnosis = '';
reasonForVisit = '';
eeCode = '';
poaNotesShort = '';
poaNotesLong = '';
usePoaNotesModalPanel = false;
reasonForVisit2_5010 = '';
reasonForVisit3_5010 = '';
referralLong_5010 = '';
referralShort_5010 = '';
useReferralModalPanel_5010 = false;
allReasonsForVisit = '';
shouldMiscPanelRender: boolean = null;
}
export class ProcedureCodesInfo {
principalProcedure = '';
dateOfPrincipalProcedure = '';
procedureCodes: string[] = [];
}
export class HealthCareInfo {
healthCareValueInformationBeanList: string[] = [];
healthCareConditionInformationBeanList: string[] = [];
healthCareOccurranceSpanInformationBeanList: string[] = [];
healthCareOccurranceInformationBeanList: string[] = [];
healthCareDRGInformationBeanList: string[] = [];
}
// service line info starts
export class ServiceLineInfo {
beginDateOfService = '';
endDateOfService = '';
dateOfService = '';
revCode = '';
procedureCode = '';
ndcCode = '';
modifiers = '';
quantityOrType = '';
primaryPayerPaidAmount = '';
primaryOhiServiceLineAdjustments: ServiceLineOhiAdjustment[] = [];
secondaryPayerPaidAmount = '';
secondaryOhiServiceLineAdjustments: ServiceLineOhiAdjustment[] = [];
quantity = '';
type = '';
serviceTax = '';
facilityTax = '';
charge = '';
lineNumber = '';
listOfDrugLines: DrugLine[] = [];
listOfTeeth: ToothLine[] = [];
listOfEquipment: MedicalEquipmentLine[] = [];
listOfProviderInfo: Provider[] = [];
pos = '';
serviceLineLevelAmbulanceInfo: ServiceLineLevelAmbulanceInfo[] = [];
serviceLineLevelAmbulanceInfoShouldRender: boolean = null;
dxDtPointers = '';
salesTax = '';
}
export class ServiceLineOhiAdjustment {
descriptionLong = '';
descriptionShort = '';
reasonCode = '';
quantity = '';
coAmount = '';
crAmount = '';
oaAmount = '';
piAmount = '';
prAmount = '';
adjustmentType = '';
adjustmentCode = '';
adjustmentAmount = '';
}
export class DrugLine {
drugRx = '';
drugRxNdcCode = '';
drugRxQuantityPlusType = '';
drugRxCharge = '';
drugRxQuantity = '';
drugRxType = '';
drugCategory_5010 = '';
}
export class ToothLine {
toothNumber = '';
surface1 = '';
surface2 = '';
surface3 = '';
surface4 = '';
surface5 = '';
}
export class MedicalEquipmentLine {
lengthOfMedicalNecessity = '';
frequency = '';
rentalAmt = '';
purchaseAmt = '';
}
export class Provider {
type = '';
providerId = '';
providerNpi_5010 = '';
name = '';
postalCode_5010 = '';
taxonomyCode = '';
}
export class ServiceLineLevelAmbulanceInfo {
pickupAddressLine1 = '';
pickupAddressLine2 = '';
pickupCity = '';
pickupState = '';
pickupZip = '';
dropoffAddressLine1 = '';
dropoffAddressLine2 = '';
dropoffCity = '';
dropoffState = '';
dropoffZip = '';
transportReasonCode = '';
transportDistance = '';
roundTripPurpose = '';
roundTripPurposeShort = '';
useRoundTripPurposeModalPanel: boolean = null;
stretcherPurpose = '';
stretcherPurposeShort = '';
useStretcherPurposeModalPanel: boolean = null;
certs: AmbulanceCert[] = [];
}
export class AmbulanceCert {
certIndicator = '';
conditionCodes = '';
}
// service line info ends
// claimOhi
export class ClaimOhi {
claimOhiHeaderBean: ClaimOhiHeaderBean;
claimOhiAdjustmentsBean: ClaimOhiAdjustmentsBean;
cobAmountsBean: CobAmountsBean;
medicareInPatientAdjudicationBean: MedicareInPatientAdjudicationBean;
medicareOutPatientAdjudicationBean: MedicareOutPatientAdudicationBean;
shouldRenderClaimOhiAmountsSection: boolean = null;
}
export class ClaimOhiHeaderBean {
paymentSequenceIndicator = '';
ohiGroupName = '';
filingIndicator = '';
benefitsAssignmentIndicator = '';
insuranceType = '';
claimAdjustmentDate = '';
ohiPayerID = '';
otherPayerName = '';
subscriberPayerId: string;
}
export class ClaimOhiAdjustmentsBean {
ohiPayerId = '';
allClaimAdjustments: Adjustment[] = [];
}
export class Adjustment {
reasonCode: '';
descriptionLong: '';
descriptionShort: '';
quantity: '';
coAmount: '';
crAmount: '';
oaAmount: '';
piAmount: '';
prAmount: '';
adjustmentType: '';
adjustmentCode: '';
adjustmentAmount: '';
}
export class CobAmountsBean {
ohiPayerId = '';
cobPatientResponsibility = '';
cobSubmittedCharges = '';
cobTotalAllowedAmount = '';
cobApprovedAmount = '';
cobTotalNonCoveredAmount = '';
cobPayerPaidAmount = '';
cobTotalDeniedAmount = '';
cobPatientPaidAmount = '';
cobTotalMedicarePaidAmount = '';
medicarePaidOneHundredPercentAmount = '';
medicarePaidEightyPercentAmount = '';
medicarePaidAmt = '';
cobMedicareATrustFund = '';
cobMedicareBTrustFund = '';
}
export class MedicareInPatientAdjudicationBean {
ohiPayerId = '';
lifetimeReserveDays = '';
coveredDays = '';
lifetimePsychiatricDays = '';
nonPayableProfessionalComponent = '';
claimDisproportionateShare = '';
costReportDayCount = '';
remittanceRemarkCodes: RemittanceRemarkCode[] = [];
ppsOperatingFederalSpecDrugAmount = '';
ppsCapitalOutlierAmount = '';
claimIndirectTeachingAmount = '';
claimDrugAmount = '';
ppsCapitalExceptionAmount = '';
mspPassThruAmount = '';
claimPpsCapitalAmount = '';
ppsCapitalFspDrugAmount = '';
ppsCapitalHspDrugAmount = '';
ppsCapitalDshDrugAmount = '';
oldCapitalAmount = '';
ppsCapitalImeAmount = '';
ppsOperHospitalSpecicalDrugAmount = '';
}
export class MedicareOutPatientAdudicationBean {
ohiPayerId = '';
remittanceRemarkCodes: RemittanceRemarkCode[] = [];
reimbursementRate = '';
claimHcpcsPayableAmount = '';
esrdPaidAmount = '';
nonPayableProfessionalComponentAmount = '';
}
export class RemittanceRemarkCode {
code = '';
remarkLong = '';
remarkShort = '';
}
export class QuickViewServiceLineOhiOutputRow {
lineNumber = '';
beginDateOfService = '';
charge = '';
primaryPayerProcedureCode = '';
primaryPayerPaidAmount = '';
primaryServiceLineAdjustment: ServiceLineOhiAdjustment;
secondaryPayerProcedureCode = '';
secondaryPayerPaidAmount = '';
ServiceLineOhiAdjustment: ServiceLineOhiAdjustment;
ohiModifiers = '';
}
export class DetailServiceLineOhiOutputRow {
lineNumber = '';
payerId = '';
paymentSequenceIndicator = '';
beginDateOfService = '';
adjudicationDate = '';
bundledUnbundledLineNumber = '';
revenueCode = '';
procedureCode = '';
modifiers = '';
lineCharge = '';
payerPaidAmount = '';
quantity = '';
adjustment: Adjustment;
}
export class OhiModel {
otherPayerShortName = '';
otherPayerName = '';
useOtherPayerModalPanel: boolean = null;
ohiGroupName = '';
ohiPayerId = '';
ohiPayerShortId = '';
payerPaidAmount = '';
claimOhiAdjustments: Adjustment[] = [];
remittanceRemarkCodes: RemittanceRemarkCode[] = [];
}
export class OhiInfo {
claimOhiList: ClaimOhi[] = [];
quickviewServiceLineOhiOutputRows: QuickViewServiceLineOhiOutputRow[] = [];
detailServiceLineOhiOutputRows: DetailServiceLineOhiOutputRow[] = [];
primaryOhi: OhiModel;
secondaryOhi: OhiModel;
tertiaryOhi: OhiModel;
isTertiaryOhi = '';
pdi = '';
hasMultiplePrimaryPayers: boolean = null;
hasMultipleSecondaryPayers: boolean = null;
hasMultiplePayersWithSamePayerId: boolean = null;
hasPayerIdProblem: boolean = null;
hasMultipleAdjudicationsFromSamePayer: boolean = null;
shouldRenderRemittanceRemarks: boolean = null;
payerProblemExplanation = '';
shouldRenderClaimOhis: boolean = null;
shouldRenderServiceLineOhis: boolean = null;
shouldRenderQuickview: boolean = null;
shouldRenderClaimOhisDetail: boolean = null;
}
// export class AttachmentResponseModel {
// attachmentId = '';
// attachmentPath: string[];
// reportCode = '';
// reportDefinition = '';
// }
export class FileUploadRequestModel {
pdfReferencesList: FilesModel[] = [];
}
export class ArchiveRequestModel {
archivedPdfReferences: FilesModel[] = [];
}
export class FilesModel {
// file: any;
guid: number;
alt = '';
archive = false;
href = '';
editedFlag = false;
}