require 'open-uri' # Era835Parser::Parser.new(file_path: "../era_835_parser/spec/test_era.txt").parse module Era835Parser class Parser attr_reader :file_path def initialize(file_path:) @file_path = file_path end def parse # hash initialization era = Hash.new checks = Hash.new line_items = Hash.new adjustment_groups = Hash.new adjustments = Hash.new individual_era = Hash.new individual_line_item = Hash.new check_number = '' era_text = "--------------------------------------------------------------------------------------------------------------------------------------------------------\n" # counters adjustment_counter = 0 # trigger variables adjustments_start = false checks_start = false eras_start = false next_line_check_number = false next_line_address = false next_line_city = false next_line_tax_id = false next_line_payer_claim_control = false next_line_claim_statement_period = false next_line_line_item = false next_line_adjustment_group = false open(file_path).readlines.each do |line| era_text += line if eras_start && line !~ /-{10,}/i if line.include?("Dear:") era[:addressed_to] = line.gsub("Dear:", "").strip end if line !~ /={10,}/i && adjustments_start == true adjustment = Hash.new adjustment[:adjustment_date] = /\d+\/\d+\/\d+/.match(line)[0].strip if !/\d+\/\d+\/\d+/.match(line).nil? adjustment[:provider_id] = /\d+\/\d+\/\d+\s+\d+\s+[^\s]+/.match(line)[0].split(" ")[1].strip if !/\d+\/\d+\/\d+\s+\d+\s+[^\s]+/.match(line).nil? adjustment[:reference_id] = /\d+\/\d+\/\d+\s+\d+\s+[^\s]+/.match(line)[0].split(" ")[2].strip if !/\d+\/\d+\/\d+\s+\d+\s+[^\s]+/.match(line).nil? adjustment[:adjustment_amount] = (/\d+\/\d+\/\d+\s+\d+\s+[^\s]+\s+[\-\d\.]+/.match(line)[0].split(" ")[3].strip.to_f * 100).to_i if !/\d+\/\d+\/\d+\s+\d+\s+[^\s]+\s+[\-\d\.]+/.match(line).nil? adjustment[:reason] = line.gsub(/\d+\/\d+\/\d+\s+\d+\s+[^\s]+\s+[\-\d\.]+/, "").strip adjustments[adjustment_counter] = adjustment adjustment_counter += 1 end if line !~ /={10,}/i && checks_start == true && line !~ /^\s+$/ && line !~ /-{10,}/i check = Hash.new check[:check_number] = /^[^\s]+(?=\s)/.match(line)[0] if !/^[^\s]+(?=\s)/.match(line).nil? check[:amount] = (/^[^\s]+\s+\d+\.\d+(?=\s)/.match(line)[0].split(" ")[1].strip.to_f * 100).to_i if !/^[^\s]+\s+\d+\.\d+(?=\s)/.match(line).nil? check[:number_of_claims] = /^[^\s]+\s+\d+\.\d+\s+\d+(?=\s)/.match(line)[0].split(" ")[2].strip.to_i if !/^[^\s]+\s+\d+\.\d+\s+\d+(?=\s)/.match(line).nil? check[:npi_tax_id] = /^[^\s]+\s+\d+\.\d+\s+\d+\s+[^\s]+/.match(line)[0].split(" ")[3].strip if !/^[^\s]+\s+\d+\.\d+\s+\d+\s+[^\s]+/.match(line).nil? check[:date] = /\d+\/\d+\/\d+/.match(line)[0] if !/\d+\/\d+\/\d+/.match(line).nil? check[:payee] = line.gsub(check[:check_number].to_s, "").gsub(check[:npi_tax_id].to_s, "").gsub(check[:amount].to_s, "").gsub(/\d/, "").gsub(/\./, "").gsub(/\//, "").strip checks[check[:check_number]] = check end if next_line_line_item individual_line_item = Hash.new adjustment_groups = Hash.new end if line.include?("Line Item:") || line =~ /-{10,}/i || line =~ /^\s+$/ next_line_adjustment_group = false end if next_line_adjustment_group && individual_adjustment_group_item = Hash.new individual_adjustment_group_item[:adjustment_group] = /.+\s+\-?\d+\.\d+/.match(line)[0].strip.split(/\s+\-?\d+/)[0].strip if !/.+\s+\-?\d+\.\d+/.match(line).nil? individual_adjustment_group_item[:adjustment_amount] = (/\-?\d+\.\d+/.match(line)[0].strip.to_f * 100).to_i if !/\-?\d+\.\d+/.match(line).nil? individual_adjustment_group_item[:translated_reason_code] = /\-?\d+\.\d+\s+.+/.match(line)[0].strip.split(/(?:\d)\s/)[1].strip if !/\-?\d+\.\d+\s+.+/.match(line).nil? if adjustment_groups.nil? adjustment_groups[0] = individual_adjustment_group_item else adjustment_groups[adjustment_groups.count] = individual_adjustment_group_item end individual_line_item[:adjustment_groups] = adjustment_groups end if line.include?("Adjustment Group") next_line_adjustment_group = true end if next_line_line_item individual_line_item[:service_date] = /\d+\/\d+\/\d+/.match(line)[0].strip if !/\d+\/\d+\/\d+/.match(line).nil? individual_line_item[:cpt_code] = /\d+\/\d+\/\d+\s\d+/.match(line)[0].strip.split(" ")[1] if !/\d+\/\d+\/\d+\s\d+/.match(line).nil? individual_line_item[:charge_amount] = (/\d+\/\d+\/\d+\s\d+\s+\-?\d+\.\d+/.match(line)[0].strip.split(" ")[2].to_f * 100).to_i if !/\d+\/\d+\/\d+\s\d+\s+\-?\d+\.\d+/.match(line).nil? individual_line_item[:payment_amount] = (/\d+\/\d+\/\d+\s\d+\s+\-?\d+\.\d+\s+\-?\d+\.\d+/.match(line)[0].strip.split(" ")[3].to_f * 100).to_i if !/\d+\/\d+\/\d+\s\d+\s+\-?\d+\.\d+\s+\-?\d+\.\d+/.match(line).nil? individual_line_item[:total_adjustment_amount] = (/\d+\/\d+\/\d+\s\d+\s+\-?\d+\.\d+\s+\-?\d+\.\d+\s+\-?\d+\.\d+/.match(line)[0].strip.split(" ")[4].to_f * 100).to_i if !/\d+\/\d+\/\d+\s\d+\s+\-?\d+\.\d+\s+\-?\d+\.\d+\s+\-?\d+\.\d+/.match(line).nil? individual_line_item[:remarks] = line.gsub(/\d+\/\d+\/\d+\s\d+\s+\-?\d+\.\d+\s+\-?\d+\.\d+\s+\-?\d+\.\d+/, "").strip if !/\d+\/\d+\/\d+\s\d+\s+\-?\d+\.\d+\s+\-?\d+\.\d+\s+\-?\d+\.\d+/.match(line).nil? if line_items.nil? line_items[0] = individual_line_item else line_items[line_items.count] = individual_line_item end next_line_line_item = false end if line.include?("Line Item:") next_line_line_item = true end if next_line_claim_statement_period && line.include?("Claim Statement Period") individual_era[:claim_statement_period_start] = line.gsub("Claim Statement Period:", "").strip.split("-")[0].strip individual_era[:claim_statement_period_end] = line.gsub("Claim Statement Period:", "").strip.split("-")[1].strip next_line_claim_statement_period = false elsif next_line_claim_statement_period next_line_claim_statement_period = false end if next_line_payer_claim_control && line.include?("Payer Claim Control Number") individual_era[:payer_claim_control_number] = line.gsub("Payer Claim Control Number:", "").strip next_line_payer_claim_control = false next_line_claim_statement_period = true elsif next_line_payer_claim_control next_line_payer_claim_control = false next_line_claim_statement_period = true end if next_line_tax_id && line.include?("Tax ID") individual_era[:payer_tax_id] = line.gsub("Tax ID:", "").strip next_line_tax_id = false next_line_payer_claim_control = true elsif next_line_tax_id next_line_tax_id = false next_line_payer_claim_control = true end if next_line_city individual_era[:payer_city] = line.strip.split(",")[0].strip individual_era[:payer_state] = line.strip.split(",")[1].split(" ")[0].strip individual_era[:payer_zip_code] = line.strip.split(",")[1].split(" ")[1].strip next_line_city = false next_line_tax_id = true end if next_line_address individual_era[:payer_address] = line.strip next_line_address = false next_line_city = true end if next_line_check_number check_number = /^[^\s]+(?=\s)/.match(line)[0].strip if !/^[^\s]+(?=\s)/.match(line).nil? next_line_check_number = false individual_era[:patient_id] = /^[^\s]+(?=\s)\s+[^\s]+/.match(line)[0].strip.split(" ")[1] if !/^[^\s]+(?=\s)\s+[^\s]+/.match(line).nil? individual_era[:patient_name] = /\s\D*,\D*\s/.match(line)[0].strip if !/\s\D*,\D*\s/.match(line).nil? individual_era[:patient_last_name] = individual_era[:patient_name].split(",")[0].downcase.split(" ").map { |word| word.capitalize }.join(" ") individual_era[:patient_first_name] = individual_era[:patient_name].split(",")[1].downcase.split(" ").map { |word| word.capitalize }.join(" ") individual_era[:charge_amount] = (/,\D+\d+\.\d+\s/.match(line)[0].gsub(/[a-zA-Z,]/, "").strip.to_f * 100).to_i if !/,\D+\d+\.\d+\s/.match(line).nil? individual_era[:payment_amount] = (/\.\d+\s+\-?\d+\.\d+\s/.match(line)[0].strip.split(" ")[1].strip.to_f * 100).to_i if !/\.\d+\s+\-?\d+\.\d+\s/.match(line).nil? individual_era[:account_number] = /\.\d+\s+\-?\d+\.\d+\s+[A-Z\d]+\s/.match(line)[0].strip.split(" ")[2] if !/\.\d+\s+\-?\d+\.\d+\s+[A-Z\d]+\s/.match(line).nil? if !/PROCESSED AS PRIMARY\s+.+$/.match(line).nil? && !/^[^\s]+(?=\s)/.match(line).nil? individual_era[:status] = "PROCESSED AS PRIMARY" individual_era[:payer_name] = /PROCESSED AS PRIMARY\s+.+$/.match(line)[0].gsub("PROCESSED AS PRIMARY", "").strip elsif !/PROCESSED AS PRIMARY,\sFWDED\s+.+$/.match(line).nil? && !/^[^\s]+(?=\s)/.match(line).nil? individual_era[:status] = "PROCESSED AS PRIMARY, FWDED" individual_era[:payer_name] = /PROCESSED AS PRIMARY,\sFWDED\s+.+$/.match(line)[0].gsub("PROCESSED AS PRIMARY, FWDED", "").strip elsif !/PROCESSED AS SECONDARY\s+.+$/.match(line).nil? && !/^[^\s]+(?=\s)/.match(line).nil? individual_era[:status] = "PROCESSED AS SECONDARY" individual_era[:payer_name] = /PROCESSED AS SECONDARY\s+.+$/.match(line)[0].gsub("PROCESSED AS SECONDARY", "").strip elsif !/DENIED\s+.+$/.match(line).nil? && !/^[^\s]+(?=\s)/.match(line).nil? individual_era[:status] = "DENIED" individual_era[:payer_name] = /DENIED\s+.+$/.match(line)[0].gsub("DENIED", "").strip elsif !/OTHER\s+.+$/.match(line).nil? && !/^[^\s]+(?=\s)/.match(line).nil? individual_era[:status] = "OTHER" individual_era[:payer_name] = /OTHER\s+.+$/.match(line)[0].gsub("OTHER", "").strip end next_line_address = true end if line.include?("Check#") && line.include?("Patient ID") next_line_check_number = true individual_era = Hash.new line_items = Hash.new end if eras_start == true && !line.include?("Check#") if line =~ /-{10,}/i if era[:checks][check_number][:eras].nil? era_counter = 0 eras = Hash.new individual_era[:line_items] = line_items individual_era[:era_text] = era_text.strip.gsub(/\r/, "") eras[era_counter] = individual_era era[:checks][check_number][:eras] = eras else era_counter = era[:checks][check_number][:eras].count eras = Hash.new individual_era[:line_items] = line_items individual_era[:era_text] = era_text.strip.gsub(/\r/, "") eras[era_counter] = individual_era era[:checks][check_number][:eras] = era[:checks][check_number][:eras].merge(eras) end era_text = "--------------------------------------------------------------------------------------------------------------------------------------------------------\n" end end if line.include?("Adjustment Date") adjustments_start = true end if line.include?("Check#") && line.include?("# Claims") checks_start = true end if line =~ /={10,}/i && adjustments_start == true && adjustments != {} adjustments_start = false end if line =~ /-{10,}/i && checks_start == true && checks != {} checks_start = false era[:adjustments] = adjustments era[:checks] = checks eras_start = true end end if era[:checks][check_number][:eras].nil? era_counter = 0 eras = Hash.new individual_era[:line_items] = line_items individual_era[:era_text] = era_text.strip.gsub(/\r/, "") eras[era_counter] = individual_era era[:checks][check_number][:eras] = eras else era_counter = era[:checks][check_number][:eras].count eras = Hash.new individual_era[:line_items] = line_items individual_era[:era_text] = era_text.strip.gsub(/\r/, "") eras[era_counter] = individual_era era[:checks][check_number][:eras] = era[:checks][check_number][:eras].merge(eras) end return era end end end