candidhealth 0.33.1 → 0.34.0
This diff represents the content of publicly available package versions that have been released to one of the supported registries. The information contained in this diff is provided for informational purposes only and reflects changes between package versions as they appear in their respective public registries.
@@ -150,7 +150,22 @@ module CandidApiClient
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# @param external_id [String] A client-specified unique ID to associate with this encounter;
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# for example, your internal encounter ID or a Dr. Chrono encounter ID.
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# This field should not contain PHI.
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# @param
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# @param date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-24.
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# This date must be the local date in the timezone where the service occurred.
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# Box 24a on the CMS-1500 claim form.
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# If service occurred over a range of dates, this should be the start date.
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# date_of_service must be defined on either the encounter or the service lines but
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# not both.
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# If there are greater than zero service lines, it is recommended to specify
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# date_of_service on the service_line instead of on the encounter to prepare for
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# future API versions.
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# @param end_date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-25.
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# This date must be the local date in the timezone where the service occurred.
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# If omitted, the Encounter is assumed to be for a single day.
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# Must not be temporally before the date_of_service field.
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# If there are greater than zero service lines, it is recommended to specify
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# end_date_of_service on the service_line instead of on the encounter to prepare
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# for future API versions.
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# @param patient_authorized_release [Boolean] Whether this patient has authorized the release of medical information
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# for billing purpose.
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# Box 12 on the CMS-1500 claim form.
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@@ -160,8 +175,6 @@ module CandidApiClient
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# @param provider_accepts_assignment [Boolean] Whether you have accepted the patient's authorization for insurance payments
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# to be made to you, not them.
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# Box 27 on the CMS-1500 claim form.
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# @param appointment_type [String] Human-readable description of the appointment type (ex: "Acupuncture -
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# Headaches").
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# @param existing_medications [Array<Hash>] Request of type Array<CandidApiClient::Encounters::V4::Types::Medication>, as a Hash
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# * :name (String)
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# * :rx_cui (String)
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@@ -207,7 +220,6 @@ module CandidApiClient
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# Examples for when this should be set to NOT_BILLABLE include
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# if the Encounter has not occurred yet or if there is no intention of ever
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# billing the responsible_party.
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# @param responsible_party [CandidApiClient::Encounters::V4::Types::ResponsiblePartyType] Defines the party to be billed with the initial balance owed on the claim.
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# @param additional_information [String] Defines additional information on the claim needed by the payer.
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# Box 19 on the CMS-1500 claim form.
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# @param service_authorization_exception_code [CandidApiClient::Encounters::V4::Types::ServiceAuthorizationExceptionCode] 837p Loop2300 REF\*4N
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@@ -237,22 +249,6 @@ module CandidApiClient
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# Code indicating the reason why a request was delayed
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# @param additional_properties [OpenStruct] Additional properties unmapped to the current class definition
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# @param _field_set [Object]
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# @param date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-24.
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# This date must be the local date in the timezone where the service occurred.
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# Box 24a on the CMS-1500 claim form.
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# If service occurred over a range of dates, this should be the start date.
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# date_of_service must be defined on either the encounter or the service lines but
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# not both.
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# If there are greater than zero service lines, it is recommended to specify
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# date_of_service on the service_line instead of on the encounter to prepare for
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# future API versions.
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# @param end_date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-25.
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# This date must be the local date in the timezone where the service occurred.
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# If omitted, the Encounter is assumed to be for a single day.
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# Must not be temporally before the date_of_service field.
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# If there are greater than zero service lines, it is recommended to specify
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# end_date_of_service on the service_line instead of on the encounter to prepare
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# for future API versions.
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# @param patient [Hash] Contains the identification information of the individual receiving medical
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# services.Request of type CandidApiClient::Individual::Types::PatientCreate, as a Hash
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# * :phone_numbers (Array<CandidApiClient::Commons::Types::PhoneNumber>)
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@@ -435,6 +431,10 @@ module CandidApiClient
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# * :first_name (String)
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# * :last_name (String)
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# * :gender (CandidApiClient::Individual::Types::Gender)
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# @param prior_authorization_number [String] Box 23 on the CMS-1500 claim form.
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# @param appointment_type [String] Human-readable description of the appointment type (ex: "Acupuncture -
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# Headaches").
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# @param responsible_party [CandidApiClient::Encounters::V4::Types::ResponsiblePartyType] Defines the party to be billed with the initial balance owed on the claim.
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# @param diagnoses [Array<Hash>] Ideally, this field should contain no more than 12 diagnoses. However, more
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# diagnoses
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# may be submitted at this time, and coders will later prioritize the 12 that will
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@@ -524,8 +524,6 @@ module CandidApiClient
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# @example
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# api = CandidApiClient::Client.new(base_url: "https://api.example.com", environment: CandidApiClient::Environment::PRODUCTION)
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# api.encounters.v_4.create(
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# date_of_service: DateTime.parse(2023-01-15),
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# end_date_of_service: DateTime.parse(2023-01-15),
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# patient: { phone_numbers: [{ number: "1234567890", type: HOME }], phone_consent: true, email: "johndoe@joincandidhealth.com", non_insurance_payers: ["d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32"], email_consent: true, external_id: "string", date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", gender: MALE },
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# billing_provider: { address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, tax_id: "string", npi: "string", taxonomy_code: "string", first_name: "string", last_name: "string", organization_name: "string" },
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# rendering_provider: { address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, npi: "string", taxonomy_code: "string", first_name: "string", last_name: "string", organization_name: "string" },
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@@ -535,6 +533,9 @@ module CandidApiClient
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# service_facility: { organization_name: "string", npi: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" } },
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# subscriber_primary: { insurance_card: { member_id: "string", payer_name: "string", payer_id: "string", rx_bin: "string", rx_pcn: "string", image_url_front: "string", image_url_back: "string", emr_payer_crosswalk: HEALTHIE, group_number: "string", plan_name: "string", plan_type: SELF_PAY, insurance_type: C_01 }, patient_relationship_to_subscriber_code: SPOUSE, date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", gender: MALE },
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# subscriber_secondary: { insurance_card: { member_id: "string", payer_name: "string", payer_id: "string", rx_bin: "string", rx_pcn: "string", image_url_front: "string", image_url_back: "string", emr_payer_crosswalk: HEALTHIE, group_number: "string", plan_name: "string", plan_type: SELF_PAY, insurance_type: C_01 }, patient_relationship_to_subscriber_code: SPOUSE, date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", gender: MALE },
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# prior_authorization_number: "string",
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# appointment_type: "string",
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# responsible_party: INSURANCE_PAY,
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# diagnoses: [{ name: "string", code_type: ABF, code: "string" }],
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# clinical_notes: [{ category: CLINICAL, notes: [{ text: "string", author_name: "string", author_npi: "string", timestamp: DateTime.parse(2024-01-15T09:30:00.000Z) }] }],
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# billing_notes: [{ text: "string" }],
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@@ -547,7 +548,7 @@ module CandidApiClient
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# schema_instances: [{ schema_id: "ec096b13-f80a-471d-aaeb-54b021c9d582", content: { "provider_category": "internist", "is_urgent_care": true, "bmi": 24.2, "age": 38 } }]
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# )
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def create(external_id:, patient_authorized_release:, benefits_assigned_to_provider:,
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provider_accepts_assignment:, billable_status:,
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provider_accepts_assignment:, billable_status:, patient:, billing_provider:, rendering_provider:, responsible_party:, diagnoses:, place_of_service_code:, date_of_service: nil, end_date_of_service: nil, existing_medications: nil, vitals: nil, interventions: nil, pay_to_address: nil, synchronicity: nil, additional_information: nil, service_authorization_exception_code: nil, admission_date: nil, discharge_date: nil, onset_of_current_illness_or_symptom_date: nil, last_menstrual_period_date: nil, delay_reason_code: nil, additional_properties: nil, _field_set: nil, referring_provider: nil, initial_referring_provider: nil, supervising_provider: nil, service_facility: nil, subscriber_primary: nil, subscriber_secondary: nil, prior_authorization_number: nil, appointment_type: nil, clinical_notes: nil, billing_notes: nil, patient_histories: nil, service_lines: nil, guarantor: nil, external_claim_submission: nil, tag_ids: nil, schema_instances: nil, request_options: nil)
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response = @request_client.conn.post do |req|
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req.options.timeout = request_options.timeout_in_seconds unless request_options&.timeout_in_seconds.nil?
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req.headers["Authorization"] = request_options.token unless request_options&.token.nil?
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@@ -559,18 +560,17 @@ module CandidApiClient
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req.body = {
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**(request_options&.additional_body_parameters || {}),
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external_id: external_id,
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date_of_service: date_of_service,
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end_date_of_service: end_date_of_service,
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patient_authorized_release: patient_authorized_release,
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benefits_assigned_to_provider: benefits_assigned_to_provider,
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provider_accepts_assignment: provider_accepts_assignment,
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appointment_type: appointment_type,
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existing_medications: existing_medications,
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vitals: vitals,
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interventions: interventions,
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pay_to_address: pay_to_address,
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synchronicity: synchronicity,
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billable_status: billable_status,
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responsible_party: responsible_party,
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additional_information: additional_information,
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service_authorization_exception_code: service_authorization_exception_code,
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admission_date: admission_date,
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delay_reason_code: delay_reason_code,
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additional_properties: additional_properties,
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_field_set: _field_set,
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date_of_service: date_of_service,
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end_date_of_service: end_date_of_service,
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patient: patient,
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billing_provider: billing_provider,
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rendering_provider: rendering_provider,
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service_facility: service_facility,
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subscriber_primary: subscriber_primary,
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subscriber_secondary: subscriber_secondary,
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prior_authorization_number: prior_authorization_number,
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appointment_type: appointment_type,
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responsible_party: responsible_party,
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diagnoses: diagnoses,
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clinical_notes: clinical_notes,
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billing_notes: billing_notes,
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@@ -608,8 +609,27 @@ module CandidApiClient
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CandidApiClient::Encounters::V4::Types::Encounter.from_json(json_object: response.body)
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end
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#
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#
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# Create an encounter from a pre-encounter patient and appointment. This endpoint
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# is intended to be used by consumers who are managing
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# patients and appointments in the pre-encounter service and is currently under
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# development. Consumers who are not taking advantage
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# of the pre-encounter service should use the standard create endpoint.
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# The endpoint will create an encounter from the provided fields, pulling
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# information from the provided patient and appointment objects
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# where applicable. In particular, the following fields are populated from the
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# patient and appointment objects:
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# - Patient
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# - Referring Provider
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# - Subscriber Primary
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# - Subscriber Secondary
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# - Prior Authorization Number
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# - Appointment Type
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# - Responsible Party
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# - Guarantor
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# Utilizing this endpoint opts you into automatic updating of the encounter when
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# the patient or appointment is updated, assuming the
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# encounter has not already been submitted or adjudicated.
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#
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# @param external_id [String] A client-specified unique ID to associate with this encounter;
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# for example, your internal encounter ID or a Dr. Chrono encounter ID.
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# This field should not contain PHI.
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# This date must be the local date in the timezone where the service occurred.
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# Box 24a on the CMS-1500 claim form.
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# If service occurred over a range of dates, this should be the start date.
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# date_of_service
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# be
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# date_of_service must be defined on either the encounter or the service lines but
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# not both.
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# If there are greater than zero service lines, it is recommended to specify
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# date_of_service on the service_line instead of on the encounter to prepare for
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# future API versions.
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# @param end_date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-25.
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# This date must be the local date in the timezone where the service occurred.
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# If omitted, the Encounter is assumed to be for a single day.
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# Must not be temporally before the date_of_service field.
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# If there are greater than zero service lines, it is recommended to specify
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# end_date_of_service on the service_line instead of on the encounter to prepare
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# for future API versions.
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# @param patient_authorized_release [Boolean] Whether this patient has authorized the release of medical information
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# for billing purpose.
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# Box 12 on the CMS-1500 claim form.
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# @param benefits_assigned_to_provider [Boolean] Whether this patient has authorized insurance payments to be made to you,
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# not them. If false, patient may receive reimbursement.
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# Box 13 on the CMS-1500 claim form.
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# @param provider_accepts_assignment [Boolean] Whether you have accepted the patient's authorization for insurance payments
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# to be made to you, not them.
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# Box 27 on the CMS-1500 claim form.
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# @param existing_medications [Array<Hash>] Request of type Array<CandidApiClient::Encounters::V4::Types::Medication>, as a Hash
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# * :name (String)
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# * :rx_cui (String)
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# * :dosage (String)
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# * :dosage_form (String)
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# * :frequency (String)
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# * :as_needed (Boolean)
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# @param vitals [Hash] Request of type CandidApiClient::Encounters::V4::Types::Vitals, as a Hash
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# * :height_in (Integer)
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# * :weight_lbs (Integer)
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# * :blood_pressure_systolic_mmhg (Integer)
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# * :blood_pressure_diastolic_mmhg (Integer)
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# * :body_temperature_f (Float)
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# * :hemoglobin_gdl (Float)
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# * :hematocrit_pct (Float)
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# @param interventions [Array<Hash>] Request of type Array<CandidApiClient::Encounters::V4::Types::Intervention>, as a Hash
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# * :name (String)
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# * :category (CandidApiClient::Encounters::V4::Types::InterventionCategory)
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# * :description (String)
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# * :medication (Hash)
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# * :name (String)
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# * :rx_cui (String)
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# * :dosage (String)
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# * :dosage_form (String)
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# * :frequency (String)
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# * :as_needed (Boolean)
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# * :labs (Array<CandidApiClient::Encounters::V4::Types::Lab>)
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# @param pay_to_address [Hash] Specifies the address to which payments for the claim should be sent.Request of type CandidApiClient::Commons::Types::StreetAddressLongZip, as a Hash
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# * :zip_plus_four_code (String)
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# * :address_1 (String)
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# * :city (String)
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# * :state (CandidApiClient::Commons::Types::State)
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# * :zip_code (String)
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# @param synchronicity [CandidApiClient::Encounters::V4::Types::SynchronicityType] Whether or not this was a synchronous or asynchronous encounter.
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# Asynchronous encounters occur when providers and patients communicate online
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# using
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# forms, instant messaging, or other pre-recorded digital mediums.
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# Synchronous encounters occur in live, real-time settings where the patient
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# interacts
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# directly with the provider, such as over video or a phone call.
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# @param billable_status [CandidApiClient::Encounters::V4::Types::BillableStatusType] Defines if the Encounter is to be billed by Candid to the responsible_party.
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# Examples for when this should be set to NOT_BILLABLE include
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# has not occurred yet or if there is no intention of ever
|
645
|
-
# responsible_party.
|
646
|
-
# @param responsible_party [CandidApiClient::Encounters::V4::Types::ResponsiblePartyType] Defines the party to be billed with the initial balance owed on the claim. Use
|
647
|
-
# SELF_PAY if you intend to bill self pay/cash pay.
|
648
|
-
# @param provider_accepts_assignment [Boolean] Whether you have accepted the patient's authorization for insurance payments to
|
649
|
-
# be made to you, not them. Box 27 on the CMS-1500 claim form.
|
650
|
-
# @param benefits_assigned_to_provider [Boolean] Whether this patient has authorized insurance payments to be made to you, not
|
651
|
-
# them. If false, patient may receive reimbursement. Box 13 on the CMS-1500 claim
|
652
|
-
# form.
|
653
|
-
# @param synchronicity [CandidApiClient::Encounters::V4::Types::SynchronicityType] Whether or not this was a synchronous or asynchronous encounter. Asynchronous
|
654
|
-
# encounters occur when providers and patients communicate online using forms,
|
655
|
-
# instant messaging, or other pre-recorded digital mediums. Synchronous encounters
|
656
|
-
# occur in live, real-time settings where the patient interacts directly with the
|
657
|
-
# provider, such as over video or a phone call.
|
658
|
-
# @param place_of_service_code [CandidApiClient::Commons::Types::FacilityTypeCode] Box 24B on the CMS-1500 claim form. Line-level place of service is not currently
|
659
|
-
# supported. 02 for telemedicine, 11 for in-person. Full list
|
660
|
-
# //www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
|
661
|
-
# @param place_of_service_code_as_submitted [CandidApiClient::Commons::Types::FacilityTypeCode] Box 24B on the CMS-1500 claim form. Line-level place of service is not currently
|
662
|
-
# supported. 02 for telemedicine, 11 for in-person. Full list
|
663
|
-
# //www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
|
664
|
-
# @param appointment_type [String] Human-readable description of the appointment type (ex: "Acupuncture -
|
665
|
-
# Headaches").
|
666
|
-
# @param end_date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-25.
|
667
|
-
# This date must be the local date in the timezone where the service occurred.
|
668
|
-
# If omitted, the Encounter is assumed to be for a single day.
|
669
|
-
# Must not be temporally before the date_of_service field.
|
670
|
-
# If service lines have distinct end_date_of_service values, updating the
|
671
|
-
# encounter's end_date_of_service will fail. If all service line
|
672
|
-
# end_date_of_service values are the same, updating the encounter's
|
673
|
-
# end_date_of_service will update all service line date_of_service values.
|
674
|
-
# @param subscriber_primary [Hash] Contains details of the primary insurance subscriber.Request of type CandidApiClient::Individual::Types::SubscriberCreate, as a Hash
|
675
|
-
# * :insurance_card (Hash)
|
676
|
-
# * :member_id (String)
|
677
|
-
# * :payer_name (String)
|
678
|
-
# * :payer_id (String)
|
679
|
-
# * :rx_bin (String)
|
680
|
-
# * :rx_pcn (String)
|
681
|
-
# * :image_url_front (String)
|
682
|
-
# * :image_url_back (String)
|
683
|
-
# * :emr_payer_crosswalk (CandidApiClient::Commons::Types::EmrPayerCrosswalk)
|
684
|
-
# * :group_number (String)
|
685
|
-
# * :plan_name (String)
|
686
|
-
# * :plan_type (CandidApiClient::Commons::Types::SourceOfPaymentCode)
|
687
|
-
# * :insurance_type (CandidApiClient::Commons::Types::InsuranceTypeCode)
|
688
|
-
# * :patient_relationship_to_subscriber_code (CandidApiClient::Commons::Types::PatientRelationshipToInsuredCodeAll)
|
689
|
-
# * :date_of_birth (Date)
|
690
|
-
# * :address (Hash)
|
691
|
-
# * :zip_plus_four_code (String)
|
692
|
-
# * :address_1 (String)
|
693
|
-
# * :address_2 (String)
|
694
|
-
# * :city (String)
|
695
|
-
# * :state (CandidApiClient::Commons::Types::State)
|
696
|
-
# * :zip_code (String)
|
697
|
-
# * :first_name (String)
|
698
|
-
# * :last_name (String)
|
699
|
-
# * :gender (CandidApiClient::Individual::Types::Gender)
|
700
|
-
# @param subscriber_secondary [Hash] Contains details of the secondary insurance subscriber.Request of type CandidApiClient::Individual::Types::SubscriberCreate, as a Hash
|
701
|
-
# * :insurance_card (Hash)
|
702
|
-
# * :member_id (String)
|
703
|
-
# * :payer_name (String)
|
704
|
-
# * :payer_id (String)
|
705
|
-
# * :rx_bin (String)
|
706
|
-
# * :rx_pcn (String)
|
707
|
-
# * :image_url_front (String)
|
708
|
-
# * :image_url_back (String)
|
709
|
-
# * :emr_payer_crosswalk (CandidApiClient::Commons::Types::EmrPayerCrosswalk)
|
710
|
-
# * :group_number (String)
|
711
|
-
# * :plan_name (String)
|
712
|
-
# * :plan_type (CandidApiClient::Commons::Types::SourceOfPaymentCode)
|
713
|
-
# * :insurance_type (CandidApiClient::Commons::Types::InsuranceTypeCode)
|
714
|
-
# * :patient_relationship_to_subscriber_code (CandidApiClient::Commons::Types::PatientRelationshipToInsuredCodeAll)
|
715
|
-
# * :date_of_birth (Date)
|
716
|
-
# * :address (Hash)
|
717
|
-
# * :zip_plus_four_code (String)
|
718
|
-
# * :address_1 (String)
|
719
|
-
# * :address_2 (String)
|
720
|
-
# * :city (String)
|
721
|
-
# * :state (CandidApiClient::Commons::Types::State)
|
722
|
-
# * :zip_code (String)
|
723
|
-
# * :first_name (String)
|
724
|
-
# * :last_name (String)
|
725
|
-
# * :gender (CandidApiClient::Individual::Types::Gender)
|
703
|
+
# Examples for when this should be set to NOT_BILLABLE include
|
704
|
+
# if the Encounter has not occurred yet or if there is no intention of ever
|
705
|
+
# billing the responsible_party.
|
726
706
|
# @param additional_information [String] Defines additional information on the claim needed by the payer.
|
727
707
|
# Box 19 on the CMS-1500 claim form.
|
728
|
-
# @param service_authorization_exception_code [CandidApiClient::Encounters::V4::Types::ServiceAuthorizationExceptionCode] 837p Loop2300 REF
|
708
|
+
# @param service_authorization_exception_code [CandidApiClient::Encounters::V4::Types::ServiceAuthorizationExceptionCode] 837p Loop2300 REF\*4N
|
729
709
|
# Required when mandated by government law or regulation to obtain authorization
|
730
710
|
# for specific service(s) but, for the
|
731
711
|
# reasons listed in one of the enum values of ServiceAuthorizationExceptionCode,
|
732
712
|
# the service was performed without
|
733
713
|
# obtaining the authorization.
|
734
|
-
# @param admission_date [Date] 837p Loop2300 DTP
|
714
|
+
# @param admission_date [Date] 837p Loop2300 DTP\*435, CMS-1500 Box 18
|
735
715
|
# Required on all ambulance claims when the patient was known to be admitted to
|
736
716
|
# the hospital.
|
737
717
|
# OR
|
738
718
|
# Required on all claims involving inpatient medical visits.
|
739
|
-
# @param discharge_date [Date] 837p Loop2300 DTP
|
719
|
+
# @param discharge_date [Date] 837p Loop2300 DTP\*096, CMS-1500 Box 18
|
740
720
|
# Required for inpatient claims when the patient was discharged from the facility
|
741
721
|
# and the discharge date is known.
|
742
|
-
# @param onset_of_current_illness_or_symptom_date [Date] 837p Loop2300 DTP
|
722
|
+
# @param onset_of_current_illness_or_symptom_date [Date] 837p Loop2300 DTP\*431, CMS-1500 Box 14
|
743
723
|
# Required for the initial medical service or visit performed in response to a
|
744
724
|
# medical emergency when the date is available and is different than the date of
|
745
725
|
# service.
|
746
726
|
# OR
|
747
727
|
# This date is the onset of acute symptoms for the current illness or condition.
|
748
|
-
# @param last_menstrual_period_date [Date] 837p Loop2300 DTP
|
728
|
+
# @param last_menstrual_period_date [Date] 837p Loop2300 DTP\*484, CMS-1500 Box 14
|
749
729
|
# Required when, in the judgment of the provider, the services on this claim are
|
750
730
|
# related to the patient's pregnancy.
|
751
731
|
# @param delay_reason_code [CandidApiClient::Commons::Types::DelayReasonCode] 837i Loop2300, CLM-1300 Box 20
|
752
732
|
# Code indicating the reason why a request was delayed
|
753
|
-
# @param
|
754
|
-
#
|
755
|
-
#
|
756
|
-
# @param
|
757
|
-
#
|
758
|
-
#
|
759
|
-
#
|
760
|
-
#
|
761
|
-
#
|
762
|
-
#
|
763
|
-
#
|
764
|
-
#
|
765
|
-
#
|
766
|
-
#
|
767
|
-
#
|
768
|
-
#
|
769
|
-
#
|
770
|
-
#
|
771
|
-
#
|
772
|
-
#
|
773
|
-
# * :
|
774
|
-
# * :
|
775
|
-
#
|
776
|
-
#
|
777
|
-
#
|
778
|
-
#
|
779
|
-
#
|
780
|
-
#
|
781
|
-
#
|
782
|
-
#
|
783
|
-
#
|
784
|
-
#
|
785
|
-
#
|
733
|
+
# @param additional_properties [OpenStruct] Additional properties unmapped to the current class definition
|
734
|
+
# @param _field_set [Object]
|
735
|
+
# @param pre_encounter_patient_id [String]
|
736
|
+
# @param pre_encounter_appointment_id [String]
|
737
|
+
# @param billing_provider [Hash] The billing provider is the provider or business entity submitting the claim.
|
738
|
+
# Billing provider may be, but is not necessarily, the same person/NPI as the
|
739
|
+
# rendering provider. From a payer's perspective, this represents the person or
|
740
|
+
# entity being reimbursed. When a contract exists with the target payer, the
|
741
|
+
# billing provider should be the entity contracted with the payer. In some
|
742
|
+
# circumstances, this will be an individual provider. In that case, submit that
|
743
|
+
# provider's NPI and the tax ID (TIN) that the provider gave to the payer during
|
744
|
+
# contracting. In other cases, the billing entity will be a medical group. If so,
|
745
|
+
# submit the group NPI and the group's tax ID. Box 33 on the CMS-1500 claim form.Request of type CandidApiClient::EncounterProviders::V2::Types::BillingProvider, as a Hash
|
746
|
+
# * :address (Hash)
|
747
|
+
# * :zip_plus_four_code (String)
|
748
|
+
# * :address_1 (String)
|
749
|
+
# * :address_2 (String)
|
750
|
+
# * :city (String)
|
751
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
752
|
+
# * :zip_code (String)
|
753
|
+
# * :tax_id (String)
|
754
|
+
# * :npi (String)
|
755
|
+
# * :taxonomy_code (String)
|
756
|
+
# * :first_name (String)
|
757
|
+
# * :last_name (String)
|
758
|
+
# * :organization_name (String)
|
759
|
+
# @param rendering_provider [Hash] The rendering provider is the practitioner -- physician, nurse practitioner,
|
760
|
+
# etc. -- performing the service.
|
761
|
+
# For telehealth services, the rendering provider performs the visit, asynchronous
|
762
|
+
# communication, or other service. The rendering provider address should generally
|
763
|
+
# be the same as the service facility address.Request of type CandidApiClient::EncounterProviders::V2::Types::RenderingProvider, as a Hash
|
764
|
+
# * :address (Hash)
|
765
|
+
# * :zip_plus_four_code (String)
|
766
|
+
# * :address_1 (String)
|
767
|
+
# * :address_2 (String)
|
768
|
+
# * :city (String)
|
769
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
770
|
+
# * :zip_code (String)
|
771
|
+
# * :npi (String)
|
772
|
+
# * :taxonomy_code (String)
|
773
|
+
# * :first_name (String)
|
774
|
+
# * :last_name (String)
|
775
|
+
# * :organization_name (String)
|
776
|
+
# @param initial_referring_provider [Hash] The second iteration of Loop ID-2310. Use code "P3 - Primary Care Provider" in
|
777
|
+
# this loop to
|
778
|
+
# indicate the initial referral from the primary care provider or whatever
|
779
|
+
# provider wrote the initial referral for this patient's episode of care being
|
780
|
+
# billed/reported in this transaction.Request of type CandidApiClient::EncounterProviders::V2::Types::InitialReferringProvider, as a Hash
|
781
|
+
# * :npi (String)
|
782
|
+
# * :taxonomy_code (String)
|
783
|
+
# * :address (Hash)
|
784
|
+
# * :zip_plus_four_code (String)
|
785
|
+
# * :address_1 (String)
|
786
|
+
# * :address_2 (String)
|
787
|
+
# * :city (String)
|
788
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
789
|
+
# * :zip_code (String)
|
790
|
+
# * :qualifier (CandidApiClient::Commons::Types::QualifierCode)
|
791
|
+
# * :first_name (String)
|
792
|
+
# * :last_name (String)
|
793
|
+
# * :organization_name (String)
|
794
|
+
# @param supervising_provider [Hash] Required when the rendering provider is supervised by a physician. If not
|
795
|
+
# required by this implementation guide, do not send.Request of type CandidApiClient::EncounterProviders::V2::Types::SupervisingProvider, as a Hash
|
796
|
+
# * :npi (String)
|
797
|
+
# * :taxonomy_code (String)
|
798
|
+
# * :address (Hash)
|
799
|
+
# * :zip_plus_four_code (String)
|
800
|
+
# * :address_1 (String)
|
801
|
+
# * :address_2 (String)
|
802
|
+
# * :city (String)
|
803
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
804
|
+
# * :zip_code (String)
|
805
|
+
# * :first_name (String)
|
806
|
+
# * :last_name (String)
|
807
|
+
# * :organization_name (String)
|
808
|
+
# @param service_facility [Hash] Encounter Service facility is typically the location a medical service was
|
809
|
+
# rendered, such as a provider office or hospital. For telehealth, service
|
810
|
+
# facility can represent the provider's location when the service was delivered
|
811
|
+
# (e.g., home), or the location where an in-person visit would have taken place,
|
812
|
+
# whichever is easier to identify. If the provider is in-network, service facility
|
813
|
+
# may be defined in payer contracts. Box 32 on the CMS-1500 claim form. Note that
|
814
|
+
# for an in-network claim to be successfully adjudicated, the service facility
|
815
|
+
# address listed on claims must match what was provided to the payer during the
|
816
|
+
# credentialing process.Request of type CandidApiClient::ServiceFacility::Types::EncounterServiceFacilityBase, as a Hash
|
817
|
+
# * :organization_name (String)
|
818
|
+
# * :npi (String)
|
819
|
+
# * :address (Hash)
|
820
|
+
# * :zip_plus_four_code (String)
|
821
|
+
# * :address_1 (String)
|
822
|
+
# * :address_2 (String)
|
823
|
+
# * :city (String)
|
824
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
825
|
+
# * :zip_code (String)
|
826
|
+
# @param diagnoses [Array<Hash>] Ideally, this field should contain no more than 12 diagnoses. However, more
|
827
|
+
# diagnoses
|
828
|
+
# may be submitted at this time, and coders will later prioritize the 12 that will
|
829
|
+
# be
|
830
|
+
# submitted to the payor.Request of type Array<CandidApiClient::Diagnoses::Types::DiagnosisCreate>, as a Hash
|
831
|
+
# * :name (String)
|
832
|
+
# * :code_type (CandidApiClient::Diagnoses::Types::DiagnosisTypeCode)
|
833
|
+
# * :code (String)
|
834
|
+
# @param clinical_notes [Array<Hash>] Holds a collection of clinical observations made by healthcare providers during
|
835
|
+
# patient encounters.Request of type Array<CandidApiClient::Encounters::V4::Types::ClinicalNoteCategoryCreate>, as a Hash
|
836
|
+
# * :category (CandidApiClient::Encounters::V4::Types::NoteCategory)
|
837
|
+
# * :notes (Array<CandidApiClient::Encounters::V4::Types::ClinicalNote>)
|
838
|
+
# @param billing_notes [Array<Hash>] Spot to store misc, human-readable, notes about this encounter to be used
|
839
|
+
# in the billing process.Request of type Array<CandidApiClient::BillingNotes::V2::Types::BillingNoteBase>, as a Hash
|
840
|
+
# * :text (String)
|
841
|
+
# @param place_of_service_code [CandidApiClient::Commons::Types::FacilityTypeCode] Box 24B on the CMS-1500 claim form. Line-level place of service is not currently
|
842
|
+
# supported. 02 for telemedicine, 11 for in-person. Full list
|
843
|
+
# //www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
|
844
|
+
# @param patient_histories [Array<Hash>] Request of type Array<CandidApiClient::Encounters::V4::Types::PatientHistoryCategory>, as a Hash
|
845
|
+
# * :category (CandidApiClient::Encounters::V4::Types::PatientHistoryCategoryEnum)
|
846
|
+
# * :questions (Array<CandidApiClient::Encounters::V4::Types::IntakeQuestion>)
|
847
|
+
# @param service_lines [Array<Hash>] Each service line must be linked to a diagnosis. Concretely,
|
848
|
+
# `service_line.diagnosis_pointers`must contain at least one entry which should be
|
849
|
+
# in bounds of the diagnoses list field.Request of type Array<CandidApiClient::ServiceLines::V2::Types::ServiceLineCreate>, as a Hash
|
850
|
+
# * :modifiers (Array<CandidApiClient::Commons::Types::ProcedureModifier>)
|
851
|
+
# * :procedure_code (String)
|
852
|
+
# * :quantity (String)
|
853
|
+
# * :units (CandidApiClient::Commons::Types::ServiceLineUnits)
|
854
|
+
# * :charge_amount_cents (Integer)
|
855
|
+
# * :diagnosis_pointers (Array<Integer>)
|
856
|
+
# * :drug_identification (Hash)
|
857
|
+
# * :service_id_qualifier (CandidApiClient::ServiceLines::V2::Types::ServiceIdQualifier)
|
858
|
+
# * :national_drug_code (String)
|
859
|
+
# * :national_drug_unit_count (String)
|
860
|
+
# * :measurement_unit_code (CandidApiClient::ServiceLines::V2::Types::MeasurementUnitCode)
|
861
|
+
# * :link_sequence_number (String)
|
862
|
+
# * :pharmacy_prescription_number (String)
|
863
|
+
# * :conversion_formula (String)
|
864
|
+
# * :place_of_service_code (CandidApiClient::Commons::Types::FacilityTypeCode)
|
865
|
+
# * :description (String)
|
866
|
+
# * :date_of_service (Date)
|
867
|
+
# * :end_date_of_service (Date)
|
868
|
+
# * :ordering_provider (Hash)
|
869
|
+
# * :npi (String)
|
870
|
+
# * :taxonomy_code (String)
|
871
|
+
# * :address (Hash)
|
872
|
+
# * :zip_plus_four_code (String)
|
873
|
+
# * :address_1 (String)
|
874
|
+
# * :address_2 (String)
|
875
|
+
# * :city (String)
|
876
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
877
|
+
# * :zip_code (String)
|
878
|
+
# * :first_name (String)
|
879
|
+
# * :last_name (String)
|
880
|
+
# * :organization_name (String)
|
881
|
+
# @param external_claim_submission [Hash] ***This field is in beta.***
|
882
|
+
# To be included for claims that have been submitted outside of Candid.
|
883
|
+
# Candid supports posting remits and payments to these claims and working them
|
884
|
+
# in-platform (e.g. editing, resubmitting).Request of type CandidApiClient::ClaimSubmission::V1::Types::ExternalClaimSubmissionCreate, as a Hash
|
885
|
+
# * :claim_created_at (DateTime)
|
886
|
+
# * :patient_control_number (String)
|
887
|
+
# * :submission_records (Array<CandidApiClient::ClaimSubmission::V1::Types::ClaimSubmissionRecordCreate>)
|
888
|
+
# @param tag_ids [Array<String>] Names of tags that should be on the encounter.
|
889
|
+
# @param schema_instances [Array<Hash>] Key-value pairs that must adhere to a schema created via the Custom Schema API.
|
890
|
+
# Multiple schema
|
891
|
+
# instances cannot be created for the same schema on an encounter.Request of type Array<CandidApiClient::CustomSchemas::V1::Types::SchemaInstance>, as a Hash
|
892
|
+
# * :schema_id (String)
|
893
|
+
# * :content (Hash{String => Object})
|
894
|
+
# @param request_options [CandidApiClient::RequestOptions]
|
895
|
+
# @return [CandidApiClient::Encounters::V4::Types::Encounter]
|
896
|
+
# @example
|
897
|
+
# api = CandidApiClient::Client.new(base_url: "https://api.example.com", environment: CandidApiClient::Environment::PRODUCTION)
|
898
|
+
# api.encounters.v_4.create_from_pre_encounter_patient(
|
899
|
+
# pre_encounter_patient_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
|
900
|
+
# pre_encounter_appointment_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
|
901
|
+
# billing_provider: { address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, tax_id: "string", npi: "string", taxonomy_code: "string", first_name: "string", last_name: "string", organization_name: "string" },
|
902
|
+
# rendering_provider: { address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, npi: "string", taxonomy_code: "string", first_name: "string", last_name: "string", organization_name: "string" },
|
903
|
+
# initial_referring_provider: { npi: "string", taxonomy_code: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, qualifier: DQ, first_name: "string", last_name: "string", organization_name: "string" },
|
904
|
+
# supervising_provider: { npi: "string", taxonomy_code: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", organization_name: "string" },
|
905
|
+
# service_facility: { organization_name: "string", npi: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" } },
|
906
|
+
# diagnoses: [{ name: "string", code_type: ABF, code: "string" }],
|
786
907
|
# clinical_notes: [{ category: CLINICAL, notes: [{ text: "string", author_name: "string", author_npi: "string", timestamp: DateTime.parse(2024-01-15T09:30:00.000Z) }] }],
|
787
|
-
#
|
788
|
-
# billable_status: BILLABLE,
|
789
|
-
# responsible_party: INSURANCE_PAY,
|
790
|
-
# provider_accepts_assignment: true,
|
791
|
-
# benefits_assigned_to_provider: true,
|
792
|
-
# synchronicity: SYNCHRONOUS,
|
908
|
+
# billing_notes: [{ text: "string" }],
|
793
909
|
# place_of_service_code: PHARMACY,
|
794
|
-
#
|
795
|
-
#
|
796
|
-
#
|
797
|
-
#
|
798
|
-
#
|
799
|
-
# additional_information: "string",
|
800
|
-
# service_authorization_exception_code: C_1,
|
801
|
-
# admission_date: DateTime.parse(2023-01-15),
|
802
|
-
# discharge_date: DateTime.parse(2023-01-15),
|
803
|
-
# onset_of_current_illness_or_symptom_date: DateTime.parse(2023-01-15),
|
804
|
-
# last_menstrual_period_date: DateTime.parse(2023-01-15),
|
805
|
-
# delay_reason_code: C_1,
|
806
|
-
# patient_authorized_release: true,
|
807
|
-
# schema_instances: [{ schema_id: "ec096b13-f80a-471d-aaeb-54b021c9d582", content: { "provider_category": "internist", "is_urgent_care": true, "bmi": 24.2, "age": 38 } }],
|
808
|
-
# vitals: { height_in: 70, weight_lbs: 165, blood_pressure_systolic_mmhg: 115, blood_pressure_diastolic_mmhg: 85, body_temperature_f: 98, hemoglobin_gdl: 15.1, hematocrit_pct: 51.2 }
|
910
|
+
# patient_histories: [{ category: PRESENT_ILLNESS, questions: [{ id: "6E7FBCE4-A8EA-46D0-A8D8-FF83CA3BB176", text: "Do you have any allergies?", responses: [{ response: "No allergies", follow_ups: [{ id: "4F3D57F9-AC94-49D6-87E4-E804B709917A", text: "Do you have any allergies?", response: "No allergies" }] }] }] }],
|
911
|
+
# service_lines: [{ modifiers: [TWENTY_TWO], procedure_code: "string", quantity: "string", units: MJ, charge_amount_cents: 1, diagnosis_pointers: [1], drug_identification: { service_id_qualifier: EAN_UCC_13, national_drug_code: "string", national_drug_unit_count: "string", measurement_unit_code: MILLILITERS, link_sequence_number: "string", pharmacy_prescription_number: "string", conversion_formula: "string" }, place_of_service_code: PHARMACY, description: "string", date_of_service: DateTime.parse(2023-01-15), end_date_of_service: DateTime.parse(2023-01-15), ordering_provider: { npi: "string", taxonomy_code: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", organization_name: "string" } }],
|
912
|
+
# external_claim_submission: { claim_created_at: DateTime.parse(2023-01-01T12:00:00.000Z), patient_control_number: "PATIENT_CONTROL_NUMBER", submission_records: [{ submitted_at: DateTime.parse(2023-01-01T13:00:00.000Z), claim_frequency_code: ORIGINAL, payer_responsibility: PRIMARY, intended_submission_medium: ELECTRONIC }, { submitted_at: DateTime.parse(2023-01-04T12:00:00.000Z), claim_frequency_code: REPLACEMENT, payer_responsibility: PRIMARY, intended_submission_medium: PAPER }] },
|
913
|
+
# tag_ids: ["string"],
|
914
|
+
# schema_instances: [{ schema_id: "ec096b13-f80a-471d-aaeb-54b021c9d582", content: { "provider_category": "internist", "is_urgent_care": true, "bmi": 24.2, "age": 38 } }]
|
809
915
|
# )
|
810
|
-
def
|
811
|
-
|
812
|
-
response = @request_client.conn.
|
916
|
+
def create_from_pre_encounter_patient(external_id:, patient_authorized_release:,
|
917
|
+
benefits_assigned_to_provider:, provider_accepts_assignment:, billable_status:, pre_encounter_patient_id:, pre_encounter_appointment_id:, billing_provider:, rendering_provider:, diagnoses:, place_of_service_code:, date_of_service: nil, end_date_of_service: nil, existing_medications: nil, vitals: nil, interventions: nil, pay_to_address: nil, synchronicity: nil, additional_information: nil, service_authorization_exception_code: nil, admission_date: nil, discharge_date: nil, onset_of_current_illness_or_symptom_date: nil, last_menstrual_period_date: nil, delay_reason_code: nil, additional_properties: nil, _field_set: nil, initial_referring_provider: nil, supervising_provider: nil, service_facility: nil, clinical_notes: nil, billing_notes: nil, patient_histories: nil, service_lines: nil, external_claim_submission: nil, tag_ids: nil, schema_instances: nil, request_options: nil)
|
918
|
+
response = @request_client.conn.post do |req|
|
813
919
|
req.options.timeout = request_options.timeout_in_seconds unless request_options&.timeout_in_seconds.nil?
|
814
920
|
req.headers["Authorization"] = request_options.token unless request_options&.token.nil?
|
815
921
|
req.headers = {
|
@@ -819,24 +925,18 @@ module CandidApiClient
|
|
819
925
|
}.compact
|
820
926
|
req.body = {
|
821
927
|
**(request_options&.additional_body_parameters || {}),
|
822
|
-
prior_authorization_number: prior_authorization_number,
|
823
928
|
external_id: external_id,
|
824
929
|
date_of_service: date_of_service,
|
825
|
-
|
826
|
-
|
827
|
-
clinical_notes: clinical_notes,
|
828
|
-
pay_to_address: pay_to_address,
|
829
|
-
billable_status: billable_status,
|
830
|
-
responsible_party: responsible_party,
|
831
|
-
provider_accepts_assignment: provider_accepts_assignment,
|
930
|
+
end_date_of_service: end_date_of_service,
|
931
|
+
patient_authorized_release: patient_authorized_release,
|
832
932
|
benefits_assigned_to_provider: benefits_assigned_to_provider,
|
933
|
+
provider_accepts_assignment: provider_accepts_assignment,
|
934
|
+
existing_medications: existing_medications,
|
935
|
+
vitals: vitals,
|
936
|
+
interventions: interventions,
|
937
|
+
pay_to_address: pay_to_address,
|
833
938
|
synchronicity: synchronicity,
|
834
|
-
|
835
|
-
place_of_service_code_as_submitted: place_of_service_code_as_submitted,
|
836
|
-
appointment_type: appointment_type,
|
837
|
-
end_date_of_service: end_date_of_service,
|
838
|
-
subscriber_primary: subscriber_primary,
|
839
|
-
subscriber_secondary: subscriber_secondary,
|
939
|
+
billable_status: billable_status,
|
840
940
|
additional_information: additional_information,
|
841
941
|
service_authorization_exception_code: service_authorization_exception_code,
|
842
942
|
admission_date: admission_date,
|
@@ -844,114 +944,793 @@ module CandidApiClient
|
|
844
944
|
onset_of_current_illness_or_symptom_date: onset_of_current_illness_or_symptom_date,
|
845
945
|
last_menstrual_period_date: last_menstrual_period_date,
|
846
946
|
delay_reason_code: delay_reason_code,
|
847
|
-
|
848
|
-
|
849
|
-
|
947
|
+
additional_properties: additional_properties,
|
948
|
+
_field_set: _field_set,
|
949
|
+
pre_encounter_patient_id: pre_encounter_patient_id,
|
950
|
+
pre_encounter_appointment_id: pre_encounter_appointment_id,
|
951
|
+
billing_provider: billing_provider,
|
952
|
+
rendering_provider: rendering_provider,
|
953
|
+
initial_referring_provider: initial_referring_provider,
|
954
|
+
supervising_provider: supervising_provider,
|
955
|
+
service_facility: service_facility,
|
956
|
+
diagnoses: diagnoses,
|
957
|
+
clinical_notes: clinical_notes,
|
958
|
+
billing_notes: billing_notes,
|
959
|
+
place_of_service_code: place_of_service_code,
|
960
|
+
patient_histories: patient_histories,
|
961
|
+
service_lines: service_lines,
|
962
|
+
external_claim_submission: external_claim_submission,
|
963
|
+
tag_ids: tag_ids,
|
964
|
+
schema_instances: schema_instances
|
850
965
|
}.compact
|
851
966
|
req.url "#{@request_client.get_url(environment: CandidApi,
|
852
|
-
request_options: request_options)}/api/encounters/v4
|
967
|
+
request_options: request_options)}/api/encounters/v4/create-from-pre-encounter"
|
853
968
|
end
|
854
969
|
CandidApiClient::Encounters::V4::Types::Encounter.from_json(json_object: response.body)
|
855
970
|
end
|
856
|
-
end
|
857
|
-
|
858
|
-
class AsyncV4Client
|
859
|
-
# @return [CandidApiClient::AsyncRequestClient]
|
860
|
-
attr_reader :request_client
|
861
|
-
|
862
|
-
# @param request_client [CandidApiClient::AsyncRequestClient]
|
863
|
-
# @return [CandidApiClient::Encounters::V4::AsyncV4Client]
|
864
|
-
def initialize(request_client:)
|
865
|
-
@request_client = request_client
|
866
|
-
end
|
867
971
|
|
868
|
-
# @param
|
869
|
-
# @param
|
870
|
-
# @param
|
871
|
-
#
|
872
|
-
#
|
873
|
-
# @param
|
874
|
-
#
|
875
|
-
#
|
876
|
-
#
|
877
|
-
#
|
878
|
-
#
|
879
|
-
#
|
880
|
-
#
|
881
|
-
#
|
882
|
-
#
|
883
|
-
#
|
972
|
+
# @param encounter_id [String]
|
973
|
+
# @param prior_authorization_number [String] Box 23 on the CMS-1500 claim form.
|
974
|
+
# @param external_id [String] A client-specified unique ID to associate with this encounter;
|
975
|
+
# for example, your internal encounter ID or a Dr. Chrono encounter ID.
|
976
|
+
# This field should not contain PHI.
|
977
|
+
# @param date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-24.
|
978
|
+
# This date must be the local date in the timezone where the service occurred.
|
979
|
+
# Box 24a on the CMS-1500 claim form.
|
980
|
+
# If service occurred over a range of dates, this should be the start date.
|
981
|
+
# If service lines have distinct date_of_service values, updating the encounter's
|
982
|
+
# date_of_service will fail. If all service line date_of_service values are the
|
983
|
+
# same, updating the encounter's date_of_service will update all service line
|
984
|
+
# date_of_service values.
|
985
|
+
# @param diagnosis_ids [Array<String>] Ideally, this field should contain no more than 12 diagnoses. However, more
|
986
|
+
# diagnoses
|
987
|
+
# may be submitted at this time, and coders will later prioritize the 12 that will
|
988
|
+
# be
|
989
|
+
# submitted to the payor.
|
990
|
+
# @param tag_ids [Array<String>] Names of tags that should be on the encounter. Note all tags on encounter will
|
991
|
+
# be overriden with this list.
|
992
|
+
# @param clinical_notes [Array<Hash>] Holds a collection of clinical observations made by healthcare providers during
|
993
|
+
# patient encounters.Request of type Array<CandidApiClient::Encounters::V4::Types::ClinicalNoteCategoryCreate>, as a Hash
|
994
|
+
# * :category (CandidApiClient::Encounters::V4::Types::NoteCategory)
|
995
|
+
# * :notes (Array<CandidApiClient::Encounters::V4::Types::ClinicalNote>)
|
996
|
+
# @param pay_to_address [Hash] Specifies the address to which payments for the claim should be sent.Request of type CandidApiClient::Commons::Types::StreetAddressLongZip, as a Hash
|
997
|
+
# * :zip_plus_four_code (String)
|
998
|
+
# * :address_1 (String)
|
999
|
+
# * :address_2 (String)
|
1000
|
+
# * :city (String)
|
1001
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1002
|
+
# * :zip_code (String)
|
884
1003
|
# @param billable_status [CandidApiClient::Encounters::V4::Types::BillableStatusType] Defines if the Encounter is to be billed by Candid to the responsible_party.
|
885
1004
|
# Examples for when this should be set to NOT_BILLABLE include if the Encounter
|
886
1005
|
# has not occurred yet or if there is no intention of ever billing the
|
887
1006
|
# responsible_party.
|
888
1007
|
# @param responsible_party [CandidApiClient::Encounters::V4::Types::ResponsiblePartyType] Defines the party to be billed with the initial balance owed on the claim. Use
|
889
1008
|
# SELF_PAY if you intend to bill self pay/cash pay.
|
890
|
-
# @param
|
891
|
-
#
|
892
|
-
# @param
|
1009
|
+
# @param provider_accepts_assignment [Boolean] Whether you have accepted the patient's authorization for insurance payments to
|
1010
|
+
# be made to you, not them. Box 27 on the CMS-1500 claim form.
|
1011
|
+
# @param benefits_assigned_to_provider [Boolean] Whether this patient has authorized insurance payments to be made to you, not
|
1012
|
+
# them. If false, patient may receive reimbursement. Box 13 on the CMS-1500 claim
|
1013
|
+
# form.
|
1014
|
+
# @param synchronicity [CandidApiClient::Encounters::V4::Types::SynchronicityType] Whether or not this was a synchronous or asynchronous encounter. Asynchronous
|
1015
|
+
# encounters occur when providers and patients communicate online using forms,
|
1016
|
+
# instant messaging, or other pre-recorded digital mediums. Synchronous encounters
|
1017
|
+
# occur in live, real-time settings where the patient interacts directly with the
|
1018
|
+
# provider, such as over video or a phone call.
|
1019
|
+
# @param place_of_service_code [CandidApiClient::Commons::Types::FacilityTypeCode] Box 24B on the CMS-1500 claim form. Line-level place of service is not currently
|
1020
|
+
# supported. 02 for telemedicine, 11 for in-person. Full list
|
1021
|
+
# //www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
|
1022
|
+
# @param place_of_service_code_as_submitted [CandidApiClient::Commons::Types::FacilityTypeCode] Box 24B on the CMS-1500 claim form. Line-level place of service is not currently
|
1023
|
+
# supported. 02 for telemedicine, 11 for in-person. Full list
|
1024
|
+
# //www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
|
1025
|
+
# @param appointment_type [String] Human-readable description of the appointment type (ex: "Acupuncture -
|
1026
|
+
# Headaches").
|
1027
|
+
# @param end_date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-25.
|
1028
|
+
# This date must be the local date in the timezone where the service occurred.
|
1029
|
+
# If omitted, the Encounter is assumed to be for a single day.
|
1030
|
+
# Must not be temporally before the date_of_service field.
|
1031
|
+
# If service lines have distinct end_date_of_service values, updating the
|
1032
|
+
# encounter's end_date_of_service will fail. If all service line
|
1033
|
+
# end_date_of_service values are the same, updating the encounter's
|
1034
|
+
# end_date_of_service will update all service line date_of_service values.
|
1035
|
+
# @param subscriber_primary [Hash] Contains details of the primary insurance subscriber.Request of type CandidApiClient::Individual::Types::SubscriberCreate, as a Hash
|
1036
|
+
# * :insurance_card (Hash)
|
1037
|
+
# * :member_id (String)
|
1038
|
+
# * :payer_name (String)
|
1039
|
+
# * :payer_id (String)
|
1040
|
+
# * :rx_bin (String)
|
1041
|
+
# * :rx_pcn (String)
|
1042
|
+
# * :image_url_front (String)
|
1043
|
+
# * :image_url_back (String)
|
1044
|
+
# * :emr_payer_crosswalk (CandidApiClient::Commons::Types::EmrPayerCrosswalk)
|
1045
|
+
# * :group_number (String)
|
1046
|
+
# * :plan_name (String)
|
1047
|
+
# * :plan_type (CandidApiClient::Commons::Types::SourceOfPaymentCode)
|
1048
|
+
# * :insurance_type (CandidApiClient::Commons::Types::InsuranceTypeCode)
|
1049
|
+
# * :patient_relationship_to_subscriber_code (CandidApiClient::Commons::Types::PatientRelationshipToInsuredCodeAll)
|
1050
|
+
# * :date_of_birth (Date)
|
1051
|
+
# * :address (Hash)
|
1052
|
+
# * :zip_plus_four_code (String)
|
1053
|
+
# * :address_1 (String)
|
1054
|
+
# * :address_2 (String)
|
1055
|
+
# * :city (String)
|
1056
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1057
|
+
# * :zip_code (String)
|
1058
|
+
# * :first_name (String)
|
1059
|
+
# * :last_name (String)
|
1060
|
+
# * :gender (CandidApiClient::Individual::Types::Gender)
|
1061
|
+
# @param subscriber_secondary [Hash] Contains details of the secondary insurance subscriber.Request of type CandidApiClient::Individual::Types::SubscriberCreate, as a Hash
|
1062
|
+
# * :insurance_card (Hash)
|
1063
|
+
# * :member_id (String)
|
1064
|
+
# * :payer_name (String)
|
1065
|
+
# * :payer_id (String)
|
1066
|
+
# * :rx_bin (String)
|
1067
|
+
# * :rx_pcn (String)
|
1068
|
+
# * :image_url_front (String)
|
1069
|
+
# * :image_url_back (String)
|
1070
|
+
# * :emr_payer_crosswalk (CandidApiClient::Commons::Types::EmrPayerCrosswalk)
|
1071
|
+
# * :group_number (String)
|
1072
|
+
# * :plan_name (String)
|
1073
|
+
# * :plan_type (CandidApiClient::Commons::Types::SourceOfPaymentCode)
|
1074
|
+
# * :insurance_type (CandidApiClient::Commons::Types::InsuranceTypeCode)
|
1075
|
+
# * :patient_relationship_to_subscriber_code (CandidApiClient::Commons::Types::PatientRelationshipToInsuredCodeAll)
|
1076
|
+
# * :date_of_birth (Date)
|
1077
|
+
# * :address (Hash)
|
1078
|
+
# * :zip_plus_four_code (String)
|
1079
|
+
# * :address_1 (String)
|
1080
|
+
# * :address_2 (String)
|
1081
|
+
# * :city (String)
|
1082
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1083
|
+
# * :zip_code (String)
|
1084
|
+
# * :first_name (String)
|
1085
|
+
# * :last_name (String)
|
1086
|
+
# * :gender (CandidApiClient::Individual::Types::Gender)
|
1087
|
+
# @param additional_information [String] Defines additional information on the claim needed by the payer.
|
1088
|
+
# Box 19 on the CMS-1500 claim form.
|
1089
|
+
# @param service_authorization_exception_code [CandidApiClient::Encounters::V4::Types::ServiceAuthorizationExceptionCode] 837p Loop2300 REF*4N
|
1090
|
+
# Required when mandated by government law or regulation to obtain authorization
|
1091
|
+
# for specific service(s) but, for the
|
1092
|
+
# reasons listed in one of the enum values of ServiceAuthorizationExceptionCode,
|
1093
|
+
# the service was performed without
|
1094
|
+
# obtaining the authorization.
|
1095
|
+
# @param admission_date [Date] 837p Loop2300 DTP*435, CMS-1500 Box 18
|
1096
|
+
# Required on all ambulance claims when the patient was known to be admitted to
|
1097
|
+
# the hospital.
|
1098
|
+
# OR
|
1099
|
+
# Required on all claims involving inpatient medical visits.
|
1100
|
+
# @param discharge_date [Date] 837p Loop2300 DTP*096, CMS-1500 Box 18
|
1101
|
+
# Required for inpatient claims when the patient was discharged from the facility
|
1102
|
+
# and the discharge date is known.
|
1103
|
+
# @param onset_of_current_illness_or_symptom_date [Date] 837p Loop2300 DTP*431, CMS-1500 Box 14
|
1104
|
+
# Required for the initial medical service or visit performed in response to a
|
1105
|
+
# medical emergency when the date is available and is different than the date of
|
1106
|
+
# service.
|
1107
|
+
# OR
|
1108
|
+
# This date is the onset of acute symptoms for the current illness or condition.
|
1109
|
+
# @param last_menstrual_period_date [Date] 837p Loop2300 DTP*484, CMS-1500 Box 14
|
1110
|
+
# Required when, in the judgment of the provider, the services on this claim are
|
1111
|
+
# related to the patient's pregnancy.
|
1112
|
+
# @param delay_reason_code [CandidApiClient::Commons::Types::DelayReasonCode] 837i Loop2300, CLM-1300 Box 20
|
1113
|
+
# Code indicating the reason why a request was delayed
|
1114
|
+
# @param patient_authorized_release [Boolean] Whether this patient has authorized the release of medical information
|
1115
|
+
# for billing purpose.
|
1116
|
+
# Box 12 on the CMS-1500 claim form.
|
1117
|
+
# @param schema_instances [Array<Hash>] Key-value pairs that must adhere to a schema created via the Custom Schema API.
|
1118
|
+
# Multiple schema
|
1119
|
+
# instances cannot be created for the same schema on an encounter. Updating schema
|
1120
|
+
# instances utilizes PUT
|
1121
|
+
# semantics, so the schema instances on the encounter will be set to whatever
|
1122
|
+
# inputs are provided. If null
|
1123
|
+
# is provided as an input, then the encounter's schema instances will be cleared.Request of type Array<CandidApiClient::CustomSchemas::V1::Types::SchemaInstance>, as a Hash
|
1124
|
+
# * :schema_id (String)
|
1125
|
+
# * :content (Hash{String => Object})
|
1126
|
+
# @param vitals [Hash] If a vitals entity already exists for the encounter, then all values will be
|
1127
|
+
# updated to the provided values.
|
1128
|
+
# Otherwise, a new vitals object will be created for the encounter.Request of type CandidApiClient::Encounters::V4::Types::VitalsUpdate, as a Hash
|
1129
|
+
# * :height_in (Integer)
|
1130
|
+
# * :weight_lbs (Integer)
|
1131
|
+
# * :blood_pressure_systolic_mmhg (Integer)
|
1132
|
+
# * :blood_pressure_diastolic_mmhg (Integer)
|
1133
|
+
# * :body_temperature_f (Float)
|
1134
|
+
# * :hemoglobin_gdl (Float)
|
1135
|
+
# * :hematocrit_pct (Float)
|
893
1136
|
# @param request_options [CandidApiClient::RequestOptions]
|
894
|
-
# @return [CandidApiClient::Encounters::V4::Types::
|
1137
|
+
# @return [CandidApiClient::Encounters::V4::Types::Encounter]
|
895
1138
|
# @example
|
896
1139
|
# api = CandidApiClient::Client.new(base_url: "https://api.example.com", environment: CandidApiClient::Environment::PRODUCTION)
|
897
|
-
# api.encounters.v_4.
|
898
|
-
#
|
899
|
-
#
|
900
|
-
#
|
901
|
-
#
|
902
|
-
#
|
903
|
-
#
|
904
|
-
#
|
905
|
-
#
|
906
|
-
#
|
907
|
-
#
|
1140
|
+
# api.encounters.v_4.update(
|
1141
|
+
# encounter_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
|
1142
|
+
# prior_authorization_number: "string",
|
1143
|
+
# external_id: "string",
|
1144
|
+
# date_of_service: DateTime.parse(2023-01-15),
|
1145
|
+
# diagnosis_ids: ["d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32"],
|
1146
|
+
# tag_ids: ["string"],
|
1147
|
+
# clinical_notes: [{ category: CLINICAL, notes: [{ text: "string", author_name: "string", author_npi: "string", timestamp: DateTime.parse(2024-01-15T09:30:00.000Z) }] }],
|
1148
|
+
# pay_to_address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" },
|
1149
|
+
# billable_status: BILLABLE,
|
1150
|
+
# responsible_party: INSURANCE_PAY,
|
1151
|
+
# provider_accepts_assignment: true,
|
1152
|
+
# benefits_assigned_to_provider: true,
|
1153
|
+
# synchronicity: SYNCHRONOUS,
|
1154
|
+
# place_of_service_code: PHARMACY,
|
1155
|
+
# place_of_service_code_as_submitted: PHARMACY,
|
1156
|
+
# appointment_type: "string",
|
1157
|
+
# end_date_of_service: DateTime.parse(2023-01-15),
|
1158
|
+
# subscriber_primary: { insurance_card: { member_id: "string", payer_name: "string", payer_id: "string", rx_bin: "string", rx_pcn: "string", image_url_front: "string", image_url_back: "string", emr_payer_crosswalk: HEALTHIE, group_number: "string", plan_name: "string", plan_type: SELF_PAY, insurance_type: C_01 }, patient_relationship_to_subscriber_code: SPOUSE, date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", gender: MALE },
|
1159
|
+
# subscriber_secondary: { insurance_card: { member_id: "string", payer_name: "string", payer_id: "string", rx_bin: "string", rx_pcn: "string", image_url_front: "string", image_url_back: "string", emr_payer_crosswalk: HEALTHIE, group_number: "string", plan_name: "string", plan_type: SELF_PAY, insurance_type: C_01 }, patient_relationship_to_subscriber_code: SPOUSE, date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", gender: MALE },
|
1160
|
+
# additional_information: "string",
|
1161
|
+
# service_authorization_exception_code: C_1,
|
1162
|
+
# admission_date: DateTime.parse(2023-01-15),
|
1163
|
+
# discharge_date: DateTime.parse(2023-01-15),
|
1164
|
+
# onset_of_current_illness_or_symptom_date: DateTime.parse(2023-01-15),
|
1165
|
+
# last_menstrual_period_date: DateTime.parse(2023-01-15),
|
1166
|
+
# delay_reason_code: C_1,
|
1167
|
+
# patient_authorized_release: true,
|
1168
|
+
# schema_instances: [{ schema_id: "ec096b13-f80a-471d-aaeb-54b021c9d582", content: { "provider_category": "internist", "is_urgent_care": true, "bmi": 24.2, "age": 38 } }],
|
1169
|
+
# vitals: { height_in: 70, weight_lbs: 165, blood_pressure_systolic_mmhg: 115, blood_pressure_diastolic_mmhg: 85, body_temperature_f: 98, hemoglobin_gdl: 15.1, hematocrit_pct: 51.2 }
|
908
1170
|
# )
|
909
|
-
def
|
910
|
-
|
911
|
-
|
912
|
-
|
913
|
-
|
914
|
-
|
915
|
-
|
916
|
-
|
917
|
-
|
918
|
-
|
919
|
-
|
920
|
-
|
921
|
-
|
922
|
-
|
923
|
-
|
924
|
-
|
925
|
-
|
926
|
-
|
927
|
-
|
928
|
-
|
929
|
-
|
930
|
-
|
931
|
-
|
932
|
-
|
933
|
-
|
934
|
-
|
935
|
-
|
936
|
-
|
937
|
-
|
938
|
-
|
939
|
-
|
940
|
-
|
941
|
-
|
942
|
-
|
943
|
-
|
944
|
-
|
945
|
-
|
946
|
-
|
1171
|
+
def update(encounter_id:, prior_authorization_number: nil, external_id: nil, date_of_service: nil,
|
1172
|
+
diagnosis_ids: nil, tag_ids: nil, clinical_notes: nil, pay_to_address: nil, billable_status: nil, responsible_party: nil, provider_accepts_assignment: nil, benefits_assigned_to_provider: nil, synchronicity: nil, place_of_service_code: nil, place_of_service_code_as_submitted: nil, appointment_type: nil, end_date_of_service: nil, subscriber_primary: nil, subscriber_secondary: nil, additional_information: nil, service_authorization_exception_code: nil, admission_date: nil, discharge_date: nil, onset_of_current_illness_or_symptom_date: nil, last_menstrual_period_date: nil, delay_reason_code: nil, patient_authorized_release: nil, schema_instances: nil, vitals: nil, request_options: nil)
|
1173
|
+
response = @request_client.conn.patch do |req|
|
1174
|
+
req.options.timeout = request_options.timeout_in_seconds unless request_options&.timeout_in_seconds.nil?
|
1175
|
+
req.headers["Authorization"] = request_options.token unless request_options&.token.nil?
|
1176
|
+
req.headers = {
|
1177
|
+
**(req.headers || {}),
|
1178
|
+
**@request_client.get_headers,
|
1179
|
+
**(request_options&.additional_headers || {})
|
1180
|
+
}.compact
|
1181
|
+
req.body = {
|
1182
|
+
**(request_options&.additional_body_parameters || {}),
|
1183
|
+
prior_authorization_number: prior_authorization_number,
|
1184
|
+
external_id: external_id,
|
1185
|
+
date_of_service: date_of_service,
|
1186
|
+
diagnosis_ids: diagnosis_ids,
|
1187
|
+
tag_ids: tag_ids,
|
1188
|
+
clinical_notes: clinical_notes,
|
1189
|
+
pay_to_address: pay_to_address,
|
1190
|
+
billable_status: billable_status,
|
1191
|
+
responsible_party: responsible_party,
|
1192
|
+
provider_accepts_assignment: provider_accepts_assignment,
|
1193
|
+
benefits_assigned_to_provider: benefits_assigned_to_provider,
|
1194
|
+
synchronicity: synchronicity,
|
1195
|
+
place_of_service_code: place_of_service_code,
|
1196
|
+
place_of_service_code_as_submitted: place_of_service_code_as_submitted,
|
1197
|
+
appointment_type: appointment_type,
|
1198
|
+
end_date_of_service: end_date_of_service,
|
1199
|
+
subscriber_primary: subscriber_primary,
|
1200
|
+
subscriber_secondary: subscriber_secondary,
|
1201
|
+
additional_information: additional_information,
|
1202
|
+
service_authorization_exception_code: service_authorization_exception_code,
|
1203
|
+
admission_date: admission_date,
|
1204
|
+
discharge_date: discharge_date,
|
1205
|
+
onset_of_current_illness_or_symptom_date: onset_of_current_illness_or_symptom_date,
|
1206
|
+
last_menstrual_period_date: last_menstrual_period_date,
|
1207
|
+
delay_reason_code: delay_reason_code,
|
1208
|
+
patient_authorized_release: patient_authorized_release,
|
1209
|
+
schema_instances: schema_instances,
|
1210
|
+
vitals: vitals
|
1211
|
+
}.compact
|
1212
|
+
req.url "#{@request_client.get_url(environment: CandidApi,
|
1213
|
+
request_options: request_options)}/api/encounters/v4/#{encounter_id}"
|
1214
|
+
end
|
1215
|
+
CandidApiClient::Encounters::V4::Types::Encounter.from_json(json_object: response.body)
|
1216
|
+
end
|
1217
|
+
end
|
1218
|
+
|
1219
|
+
class AsyncV4Client
|
1220
|
+
# @return [CandidApiClient::AsyncRequestClient]
|
1221
|
+
attr_reader :request_client
|
1222
|
+
|
1223
|
+
# @param request_client [CandidApiClient::AsyncRequestClient]
|
1224
|
+
# @return [CandidApiClient::Encounters::V4::AsyncV4Client]
|
1225
|
+
def initialize(request_client:)
|
1226
|
+
@request_client = request_client
|
1227
|
+
end
|
1228
|
+
|
1229
|
+
# @param limit [Integer] Maximum number of entities per page, defaults to 100.
|
1230
|
+
# @param claim_status [CandidApiClient::Claims::Types::ClaimStatus] Indicates the current status of an insurance claim within the billing process.
|
1231
|
+
# @param sort [CandidApiClient::Encounters::V4::Types::EncounterSortOptions] Defaults to created_at:desc.
|
1232
|
+
# @param page_token [String]
|
1233
|
+
# @param date_of_service_min [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-25.
|
1234
|
+
# @param date_of_service_max [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-25.
|
1235
|
+
# @param primary_payer_names [String] Comma delimited string.
|
1236
|
+
# @param search_term [String] Filter by any of the following fields: encounter_id, claim_id, patient
|
1237
|
+
# external_id,
|
1238
|
+
# patient date of birth, patient first name, patient last name,
|
1239
|
+
# or encounter external id.
|
1240
|
+
# @param external_id [String] Filter to an exact match on encounter external_id, if one exists.
|
1241
|
+
# @param diagnoses_updated_since [DateTime] ISO 8601 timestamp; ideally in UTC (although not required):
|
1242
|
+
# 2019-08-24T14:15:22Z.
|
1243
|
+
# @param tag_ids [String] Filter by name of tags on encounters.
|
1244
|
+
# @param work_queue_id [String]
|
1245
|
+
# @param billable_status [CandidApiClient::Encounters::V4::Types::BillableStatusType] Defines if the Encounter is to be billed by Candid to the responsible_party.
|
1246
|
+
# Examples for when this should be set to NOT_BILLABLE include if the Encounter
|
1247
|
+
# has not occurred yet or if there is no intention of ever billing the
|
1248
|
+
# responsible_party.
|
1249
|
+
# @param responsible_party [CandidApiClient::Encounters::V4::Types::ResponsiblePartyType] Defines the party to be billed with the initial balance owed on the claim. Use
|
1250
|
+
# SELF_PAY if you intend to bill self pay/cash pay.
|
1251
|
+
# @param owner_of_next_action [CandidApiClient::Encounters::V4::Types::EncounterOwnerOfNextActionType] The party who is responsible for taking the next action on an Encounter, as
|
1252
|
+
# defined by ownership of open Tasks.
|
1253
|
+
# @param patient_external_id [String] The patient ID from the external EMR platform for the patient
|
1254
|
+
# @param request_options [CandidApiClient::RequestOptions]
|
1255
|
+
# @return [CandidApiClient::Encounters::V4::Types::EncounterPage]
|
1256
|
+
# @example
|
1257
|
+
# api = CandidApiClient::Client.new(base_url: "https://api.example.com", environment: CandidApiClient::Environment::PRODUCTION)
|
1258
|
+
# api.encounters.v_4.get_all(
|
1259
|
+
# limit: 100,
|
1260
|
+
# claim_status: BILLER_RECEIVED,
|
1261
|
+
# sort: CREATED_AT_ASC,
|
1262
|
+
# page_token: "eyJ0b2tlbiI6IjEiLCJwYWdlX3Rva2VuIjoiMiJ9",
|
1263
|
+
# date_of_service_min: DateTime.parse(2019-08-24),
|
1264
|
+
# date_of_service_max: DateTime.parse(2019-08-25),
|
1265
|
+
# primary_payer_names: "Medicare,Medicaid",
|
1266
|
+
# search_term: "doe",
|
1267
|
+
# external_id: "123456",
|
1268
|
+
# diagnoses_updated_since: DateTime.parse(2019-08-24T14:15:22.000Z)
|
1269
|
+
# )
|
1270
|
+
def get_all(limit: nil, claim_status: nil, sort: nil, page_token: nil, date_of_service_min: nil,
|
1271
|
+
date_of_service_max: nil, primary_payer_names: nil, search_term: nil, external_id: nil, diagnoses_updated_since: nil, tag_ids: nil, work_queue_id: nil, billable_status: nil, responsible_party: nil, owner_of_next_action: nil, patient_external_id: nil, request_options: nil)
|
1272
|
+
Async do
|
1273
|
+
response = @request_client.conn.get do |req|
|
1274
|
+
req.options.timeout = request_options.timeout_in_seconds unless request_options&.timeout_in_seconds.nil?
|
1275
|
+
req.headers["Authorization"] = request_options.token unless request_options&.token.nil?
|
1276
|
+
req.headers = {
|
1277
|
+
**(req.headers || {}),
|
1278
|
+
**@request_client.get_headers,
|
1279
|
+
**(request_options&.additional_headers || {})
|
1280
|
+
}.compact
|
1281
|
+
req.params = {
|
1282
|
+
**(request_options&.additional_query_parameters || {}),
|
1283
|
+
"limit": limit,
|
1284
|
+
"claim_status": claim_status,
|
1285
|
+
"sort": sort,
|
1286
|
+
"page_token": page_token,
|
1287
|
+
"date_of_service_min": date_of_service_min,
|
1288
|
+
"date_of_service_max": date_of_service_max,
|
1289
|
+
"primary_payer_names": primary_payer_names,
|
1290
|
+
"search_term": search_term,
|
1291
|
+
"external_id": external_id,
|
1292
|
+
"diagnoses_updated_since": diagnoses_updated_since,
|
1293
|
+
"tag_ids": tag_ids,
|
1294
|
+
"work_queue_id": work_queue_id,
|
1295
|
+
"billable_status": billable_status,
|
1296
|
+
"responsible_party": responsible_party,
|
1297
|
+
"owner_of_next_action": owner_of_next_action,
|
1298
|
+
"patient_external_id": patient_external_id
|
1299
|
+
}.compact
|
1300
|
+
req.url "#{@request_client.get_url(environment: CandidApi,
|
1301
|
+
request_options: request_options)}/api/encounters/v4"
|
1302
|
+
end
|
1303
|
+
CandidApiClient::Encounters::V4::Types::EncounterPage.from_json(json_object: response.body)
|
1304
|
+
end
|
1305
|
+
end
|
1306
|
+
|
1307
|
+
# @param encounter_id [String]
|
1308
|
+
# @param request_options [CandidApiClient::RequestOptions]
|
1309
|
+
# @return [CandidApiClient::Encounters::V4::Types::Encounter]
|
1310
|
+
# @example
|
1311
|
+
# api = CandidApiClient::Client.new(base_url: "https://api.example.com", environment: CandidApiClient::Environment::PRODUCTION)
|
1312
|
+
# api.encounters.v_4.get(encounter_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32")
|
1313
|
+
def get(encounter_id:, request_options: nil)
|
1314
|
+
Async do
|
1315
|
+
response = @request_client.conn.get do |req|
|
1316
|
+
req.options.timeout = request_options.timeout_in_seconds unless request_options&.timeout_in_seconds.nil?
|
1317
|
+
req.headers["Authorization"] = request_options.token unless request_options&.token.nil?
|
1318
|
+
req.headers = {
|
1319
|
+
**(req.headers || {}),
|
1320
|
+
**@request_client.get_headers,
|
1321
|
+
**(request_options&.additional_headers || {})
|
1322
|
+
}.compact
|
1323
|
+
req.url "#{@request_client.get_url(environment: CandidApi,
|
1324
|
+
request_options: request_options)}/api/encounters/v4/#{encounter_id}"
|
1325
|
+
end
|
1326
|
+
CandidApiClient::Encounters::V4::Types::Encounter.from_json(json_object: response.body)
|
1327
|
+
end
|
1328
|
+
end
|
1329
|
+
|
1330
|
+
# @param external_id [String] A client-specified unique ID to associate with this encounter;
|
1331
|
+
# for example, your internal encounter ID or a Dr. Chrono encounter ID.
|
1332
|
+
# This field should not contain PHI.
|
1333
|
+
# @param date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-24.
|
1334
|
+
# This date must be the local date in the timezone where the service occurred.
|
1335
|
+
# Box 24a on the CMS-1500 claim form.
|
1336
|
+
# If service occurred over a range of dates, this should be the start date.
|
1337
|
+
# date_of_service must be defined on either the encounter or the service lines but
|
1338
|
+
# not both.
|
1339
|
+
# If there are greater than zero service lines, it is recommended to specify
|
1340
|
+
# date_of_service on the service_line instead of on the encounter to prepare for
|
1341
|
+
# future API versions.
|
1342
|
+
# @param end_date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-25.
|
1343
|
+
# This date must be the local date in the timezone where the service occurred.
|
1344
|
+
# If omitted, the Encounter is assumed to be for a single day.
|
1345
|
+
# Must not be temporally before the date_of_service field.
|
1346
|
+
# If there are greater than zero service lines, it is recommended to specify
|
1347
|
+
# end_date_of_service on the service_line instead of on the encounter to prepare
|
1348
|
+
# for future API versions.
|
1349
|
+
# @param patient_authorized_release [Boolean] Whether this patient has authorized the release of medical information
|
1350
|
+
# for billing purpose.
|
1351
|
+
# Box 12 on the CMS-1500 claim form.
|
1352
|
+
# @param benefits_assigned_to_provider [Boolean] Whether this patient has authorized insurance payments to be made to you,
|
1353
|
+
# not them. If false, patient may receive reimbursement.
|
1354
|
+
# Box 13 on the CMS-1500 claim form.
|
1355
|
+
# @param provider_accepts_assignment [Boolean] Whether you have accepted the patient's authorization for insurance payments
|
1356
|
+
# to be made to you, not them.
|
1357
|
+
# Box 27 on the CMS-1500 claim form.
|
1358
|
+
# @param existing_medications [Array<Hash>] Request of type Array<CandidApiClient::Encounters::V4::Types::Medication>, as a Hash
|
1359
|
+
# * :name (String)
|
1360
|
+
# * :rx_cui (String)
|
1361
|
+
# * :dosage (String)
|
1362
|
+
# * :dosage_form (String)
|
1363
|
+
# * :frequency (String)
|
1364
|
+
# * :as_needed (Boolean)
|
1365
|
+
# @param vitals [Hash] Request of type CandidApiClient::Encounters::V4::Types::Vitals, as a Hash
|
1366
|
+
# * :height_in (Integer)
|
1367
|
+
# * :weight_lbs (Integer)
|
1368
|
+
# * :blood_pressure_systolic_mmhg (Integer)
|
1369
|
+
# * :blood_pressure_diastolic_mmhg (Integer)
|
1370
|
+
# * :body_temperature_f (Float)
|
1371
|
+
# * :hemoglobin_gdl (Float)
|
1372
|
+
# * :hematocrit_pct (Float)
|
1373
|
+
# @param interventions [Array<Hash>] Request of type Array<CandidApiClient::Encounters::V4::Types::Intervention>, as a Hash
|
1374
|
+
# * :name (String)
|
1375
|
+
# * :category (CandidApiClient::Encounters::V4::Types::InterventionCategory)
|
1376
|
+
# * :description (String)
|
1377
|
+
# * :medication (Hash)
|
1378
|
+
# * :name (String)
|
1379
|
+
# * :rx_cui (String)
|
1380
|
+
# * :dosage (String)
|
1381
|
+
# * :dosage_form (String)
|
1382
|
+
# * :frequency (String)
|
1383
|
+
# * :as_needed (Boolean)
|
1384
|
+
# * :labs (Array<CandidApiClient::Encounters::V4::Types::Lab>)
|
1385
|
+
# @param pay_to_address [Hash] Specifies the address to which payments for the claim should be sent.Request of type CandidApiClient::Commons::Types::StreetAddressLongZip, as a Hash
|
1386
|
+
# * :zip_plus_four_code (String)
|
1387
|
+
# * :address_1 (String)
|
1388
|
+
# * :address_2 (String)
|
1389
|
+
# * :city (String)
|
1390
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1391
|
+
# * :zip_code (String)
|
1392
|
+
# @param synchronicity [CandidApiClient::Encounters::V4::Types::SynchronicityType] Whether or not this was a synchronous or asynchronous encounter.
|
1393
|
+
# Asynchronous encounters occur when providers and patients communicate online
|
1394
|
+
# using
|
1395
|
+
# forms, instant messaging, or other pre-recorded digital mediums.
|
1396
|
+
# Synchronous encounters occur in live, real-time settings where the patient
|
1397
|
+
# interacts
|
1398
|
+
# directly with the provider, such as over video or a phone call.
|
1399
|
+
# @param billable_status [CandidApiClient::Encounters::V4::Types::BillableStatusType] Defines if the Encounter is to be billed by Candid to the responsible_party.
|
1400
|
+
# Examples for when this should be set to NOT_BILLABLE include
|
1401
|
+
# if the Encounter has not occurred yet or if there is no intention of ever
|
1402
|
+
# billing the responsible_party.
|
1403
|
+
# @param additional_information [String] Defines additional information on the claim needed by the payer.
|
1404
|
+
# Box 19 on the CMS-1500 claim form.
|
1405
|
+
# @param service_authorization_exception_code [CandidApiClient::Encounters::V4::Types::ServiceAuthorizationExceptionCode] 837p Loop2300 REF\*4N
|
1406
|
+
# Required when mandated by government law or regulation to obtain authorization
|
1407
|
+
# for specific service(s) but, for the
|
1408
|
+
# reasons listed in one of the enum values of ServiceAuthorizationExceptionCode,
|
1409
|
+
# the service was performed without
|
1410
|
+
# obtaining the authorization.
|
1411
|
+
# @param admission_date [Date] 837p Loop2300 DTP\*435, CMS-1500 Box 18
|
1412
|
+
# Required on all ambulance claims when the patient was known to be admitted to
|
1413
|
+
# the hospital.
|
1414
|
+
# OR
|
1415
|
+
# Required on all claims involving inpatient medical visits.
|
1416
|
+
# @param discharge_date [Date] 837p Loop2300 DTP\*096, CMS-1500 Box 18
|
1417
|
+
# Required for inpatient claims when the patient was discharged from the facility
|
1418
|
+
# and the discharge date is known.
|
1419
|
+
# @param onset_of_current_illness_or_symptom_date [Date] 837p Loop2300 DTP\*431, CMS-1500 Box 14
|
1420
|
+
# Required for the initial medical service or visit performed in response to a
|
1421
|
+
# medical emergency when the date is available and is different than the date of
|
1422
|
+
# service.
|
1423
|
+
# OR
|
1424
|
+
# This date is the onset of acute symptoms for the current illness or condition.
|
1425
|
+
# @param last_menstrual_period_date [Date] 837p Loop2300 DTP\*484, CMS-1500 Box 14
|
1426
|
+
# Required when, in the judgment of the provider, the services on this claim are
|
1427
|
+
# related to the patient's pregnancy.
|
1428
|
+
# @param delay_reason_code [CandidApiClient::Commons::Types::DelayReasonCode] 837i Loop2300, CLM-1300 Box 20
|
1429
|
+
# Code indicating the reason why a request was delayed
|
1430
|
+
# @param additional_properties [OpenStruct] Additional properties unmapped to the current class definition
|
1431
|
+
# @param _field_set [Object]
|
1432
|
+
# @param patient [Hash] Contains the identification information of the individual receiving medical
|
1433
|
+
# services.Request of type CandidApiClient::Individual::Types::PatientCreate, as a Hash
|
1434
|
+
# * :phone_numbers (Array<CandidApiClient::Commons::Types::PhoneNumber>)
|
1435
|
+
# * :phone_consent (Boolean)
|
1436
|
+
# * :email (String)
|
1437
|
+
# * :non_insurance_payers (Array<String>)
|
1438
|
+
# * :email_consent (Boolean)
|
1439
|
+
# * :external_id (String)
|
1440
|
+
# * :date_of_birth (Date)
|
1441
|
+
# * :address (Hash)
|
1442
|
+
# * :zip_plus_four_code (String)
|
1443
|
+
# * :address_1 (String)
|
1444
|
+
# * :address_2 (String)
|
1445
|
+
# * :city (String)
|
1446
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1447
|
+
# * :zip_code (String)
|
1448
|
+
# * :first_name (String)
|
1449
|
+
# * :last_name (String)
|
1450
|
+
# * :gender (CandidApiClient::Individual::Types::Gender)
|
1451
|
+
# @param billing_provider [Hash] The billing provider is the provider or business entity submitting the claim.
|
1452
|
+
# Billing provider may be, but is not necessarily, the same person/NPI as the
|
1453
|
+
# rendering provider. From a payer's perspective, this represents the person or
|
1454
|
+
# entity being reimbursed. When a contract exists with the target payer, the
|
1455
|
+
# billing provider should be the entity contracted with the payer. In some
|
1456
|
+
# circumstances, this will be an individual provider. In that case, submit that
|
1457
|
+
# provider's NPI and the tax ID (TIN) that the provider gave to the payer during
|
1458
|
+
# contracting. In other cases, the billing entity will be a medical group. If so,
|
1459
|
+
# submit the group NPI and the group's tax ID. Box 33 on the CMS-1500 claim form.Request of type CandidApiClient::EncounterProviders::V2::Types::BillingProvider, as a Hash
|
1460
|
+
# * :address (Hash)
|
1461
|
+
# * :zip_plus_four_code (String)
|
1462
|
+
# * :address_1 (String)
|
1463
|
+
# * :address_2 (String)
|
1464
|
+
# * :city (String)
|
1465
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1466
|
+
# * :zip_code (String)
|
1467
|
+
# * :tax_id (String)
|
1468
|
+
# * :npi (String)
|
1469
|
+
# * :taxonomy_code (String)
|
1470
|
+
# * :first_name (String)
|
1471
|
+
# * :last_name (String)
|
1472
|
+
# * :organization_name (String)
|
1473
|
+
# @param rendering_provider [Hash] The rendering provider is the practitioner -- physician, nurse practitioner,
|
1474
|
+
# etc. -- performing the service.
|
1475
|
+
# For telehealth services, the rendering provider performs the visit, asynchronous
|
1476
|
+
# communication, or other service. The rendering provider address should generally
|
1477
|
+
# be the same as the service facility address.Request of type CandidApiClient::EncounterProviders::V2::Types::RenderingProvider, as a Hash
|
1478
|
+
# * :address (Hash)
|
1479
|
+
# * :zip_plus_four_code (String)
|
1480
|
+
# * :address_1 (String)
|
1481
|
+
# * :address_2 (String)
|
1482
|
+
# * :city (String)
|
1483
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1484
|
+
# * :zip_code (String)
|
1485
|
+
# * :npi (String)
|
1486
|
+
# * :taxonomy_code (String)
|
1487
|
+
# * :first_name (String)
|
1488
|
+
# * :last_name (String)
|
1489
|
+
# * :organization_name (String)
|
1490
|
+
# @param referring_provider [Hash] The final provider who referred the services that were rendered.
|
1491
|
+
# All physicians who order services or refer Medicare beneficiaries must
|
1492
|
+
# report this data.Request of type CandidApiClient::EncounterProviders::V2::Types::ReferringProvider, as a Hash
|
1493
|
+
# * :npi (String)
|
1494
|
+
# * :taxonomy_code (String)
|
1495
|
+
# * :address (Hash)
|
1496
|
+
# * :zip_plus_four_code (String)
|
1497
|
+
# * :address_1 (String)
|
1498
|
+
# * :address_2 (String)
|
1499
|
+
# * :city (String)
|
1500
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1501
|
+
# * :zip_code (String)
|
1502
|
+
# * :first_name (String)
|
1503
|
+
# * :last_name (String)
|
1504
|
+
# * :organization_name (String)
|
1505
|
+
# @param initial_referring_provider [Hash] The second iteration of Loop ID-2310. Use code "P3 - Primary Care Provider" in
|
1506
|
+
# this loop to
|
1507
|
+
# indicate the initial referral from the primary care provider or whatever
|
1508
|
+
# provider wrote the initial referral for this patient's episode of care being
|
1509
|
+
# billed/reported in this transaction.Request of type CandidApiClient::EncounterProviders::V2::Types::InitialReferringProvider, as a Hash
|
1510
|
+
# * :npi (String)
|
1511
|
+
# * :taxonomy_code (String)
|
1512
|
+
# * :address (Hash)
|
1513
|
+
# * :zip_plus_four_code (String)
|
1514
|
+
# * :address_1 (String)
|
1515
|
+
# * :address_2 (String)
|
1516
|
+
# * :city (String)
|
1517
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1518
|
+
# * :zip_code (String)
|
1519
|
+
# * :qualifier (CandidApiClient::Commons::Types::QualifierCode)
|
1520
|
+
# * :first_name (String)
|
1521
|
+
# * :last_name (String)
|
1522
|
+
# * :organization_name (String)
|
1523
|
+
# @param supervising_provider [Hash] Required when the rendering provider is supervised by a physician. If not
|
1524
|
+
# required by this implementation guide, do not send.Request of type CandidApiClient::EncounterProviders::V2::Types::SupervisingProvider, as a Hash
|
1525
|
+
# * :npi (String)
|
1526
|
+
# * :taxonomy_code (String)
|
1527
|
+
# * :address (Hash)
|
1528
|
+
# * :zip_plus_four_code (String)
|
1529
|
+
# * :address_1 (String)
|
1530
|
+
# * :address_2 (String)
|
1531
|
+
# * :city (String)
|
1532
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1533
|
+
# * :zip_code (String)
|
1534
|
+
# * :first_name (String)
|
1535
|
+
# * :last_name (String)
|
1536
|
+
# * :organization_name (String)
|
1537
|
+
# @param service_facility [Hash] Encounter Service facility is typically the location a medical service was
|
1538
|
+
# rendered, such as a provider office or hospital. For telehealth, service
|
1539
|
+
# facility can represent the provider's location when the service was delivered
|
1540
|
+
# (e.g., home), or the location where an in-person visit would have taken place,
|
1541
|
+
# whichever is easier to identify. If the provider is in-network, service facility
|
1542
|
+
# may be defined in payer contracts. Box 32 on the CMS-1500 claim form. Note that
|
1543
|
+
# for an in-network claim to be successfully adjudicated, the service facility
|
1544
|
+
# address listed on claims must match what was provided to the payer during the
|
1545
|
+
# credentialing process.Request of type CandidApiClient::ServiceFacility::Types::EncounterServiceFacilityBase, as a Hash
|
1546
|
+
# * :organization_name (String)
|
1547
|
+
# * :npi (String)
|
1548
|
+
# * :address (Hash)
|
1549
|
+
# * :zip_plus_four_code (String)
|
1550
|
+
# * :address_1 (String)
|
1551
|
+
# * :address_2 (String)
|
1552
|
+
# * :city (String)
|
1553
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1554
|
+
# * :zip_code (String)
|
1555
|
+
# @param subscriber_primary [Hash] Subscriber_primary is required when responsible_party is INSURANCE_PAY (i.e.
|
1556
|
+
# when the claim should be billed to insurance).
|
1557
|
+
# These are not required fields when responsible_party is SELF_PAY (i.e. when the
|
1558
|
+
# claim should be billed to the patient).
|
1559
|
+
# However, if you collect this for patients, even self-pay, we recommend including
|
1560
|
+
# it when sending encounters to Candid.
|
1561
|
+
# Note: Cash Pay is no longer a valid payer_id in v4, please use responsible party
|
1562
|
+
# to define self-pay claims.Request of type CandidApiClient::Individual::Types::SubscriberCreate, as a Hash
|
1563
|
+
# * :insurance_card (Hash)
|
1564
|
+
# * :member_id (String)
|
1565
|
+
# * :payer_name (String)
|
1566
|
+
# * :payer_id (String)
|
1567
|
+
# * :rx_bin (String)
|
1568
|
+
# * :rx_pcn (String)
|
1569
|
+
# * :image_url_front (String)
|
1570
|
+
# * :image_url_back (String)
|
1571
|
+
# * :emr_payer_crosswalk (CandidApiClient::Commons::Types::EmrPayerCrosswalk)
|
1572
|
+
# * :group_number (String)
|
1573
|
+
# * :plan_name (String)
|
1574
|
+
# * :plan_type (CandidApiClient::Commons::Types::SourceOfPaymentCode)
|
1575
|
+
# * :insurance_type (CandidApiClient::Commons::Types::InsuranceTypeCode)
|
1576
|
+
# * :patient_relationship_to_subscriber_code (CandidApiClient::Commons::Types::PatientRelationshipToInsuredCodeAll)
|
1577
|
+
# * :date_of_birth (Date)
|
1578
|
+
# * :address (Hash)
|
1579
|
+
# * :zip_plus_four_code (String)
|
1580
|
+
# * :address_1 (String)
|
1581
|
+
# * :address_2 (String)
|
1582
|
+
# * :city (String)
|
1583
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1584
|
+
# * :zip_code (String)
|
1585
|
+
# * :first_name (String)
|
1586
|
+
# * :last_name (String)
|
1587
|
+
# * :gender (CandidApiClient::Individual::Types::Gender)
|
1588
|
+
# @param subscriber_secondary [Hash] Please always include this when you have it, even for self-pay claims.Request of type CandidApiClient::Individual::Types::SubscriberCreate, as a Hash
|
1589
|
+
# * :insurance_card (Hash)
|
1590
|
+
# * :member_id (String)
|
1591
|
+
# * :payer_name (String)
|
1592
|
+
# * :payer_id (String)
|
1593
|
+
# * :rx_bin (String)
|
1594
|
+
# * :rx_pcn (String)
|
1595
|
+
# * :image_url_front (String)
|
1596
|
+
# * :image_url_back (String)
|
1597
|
+
# * :emr_payer_crosswalk (CandidApiClient::Commons::Types::EmrPayerCrosswalk)
|
1598
|
+
# * :group_number (String)
|
1599
|
+
# * :plan_name (String)
|
1600
|
+
# * :plan_type (CandidApiClient::Commons::Types::SourceOfPaymentCode)
|
1601
|
+
# * :insurance_type (CandidApiClient::Commons::Types::InsuranceTypeCode)
|
1602
|
+
# * :patient_relationship_to_subscriber_code (CandidApiClient::Commons::Types::PatientRelationshipToInsuredCodeAll)
|
1603
|
+
# * :date_of_birth (Date)
|
1604
|
+
# * :address (Hash)
|
1605
|
+
# * :zip_plus_four_code (String)
|
1606
|
+
# * :address_1 (String)
|
1607
|
+
# * :address_2 (String)
|
1608
|
+
# * :city (String)
|
1609
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1610
|
+
# * :zip_code (String)
|
1611
|
+
# * :first_name (String)
|
1612
|
+
# * :last_name (String)
|
1613
|
+
# * :gender (CandidApiClient::Individual::Types::Gender)
|
1614
|
+
# @param prior_authorization_number [String] Box 23 on the CMS-1500 claim form.
|
1615
|
+
# @param appointment_type [String] Human-readable description of the appointment type (ex: "Acupuncture -
|
1616
|
+
# Headaches").
|
1617
|
+
# @param responsible_party [CandidApiClient::Encounters::V4::Types::ResponsiblePartyType] Defines the party to be billed with the initial balance owed on the claim.
|
1618
|
+
# @param diagnoses [Array<Hash>] Ideally, this field should contain no more than 12 diagnoses. However, more
|
1619
|
+
# diagnoses
|
1620
|
+
# may be submitted at this time, and coders will later prioritize the 12 that will
|
1621
|
+
# be
|
1622
|
+
# submitted to the payor.Request of type Array<CandidApiClient::Diagnoses::Types::DiagnosisCreate>, as a Hash
|
1623
|
+
# * :name (String)
|
1624
|
+
# * :code_type (CandidApiClient::Diagnoses::Types::DiagnosisTypeCode)
|
1625
|
+
# * :code (String)
|
1626
|
+
# @param clinical_notes [Array<Hash>] Holds a collection of clinical observations made by healthcare providers during
|
1627
|
+
# patient encounters.Request of type Array<CandidApiClient::Encounters::V4::Types::ClinicalNoteCategoryCreate>, as a Hash
|
1628
|
+
# * :category (CandidApiClient::Encounters::V4::Types::NoteCategory)
|
1629
|
+
# * :notes (Array<CandidApiClient::Encounters::V4::Types::ClinicalNote>)
|
1630
|
+
# @param billing_notes [Array<Hash>] Spot to store misc, human-readable, notes about this encounter to be used
|
1631
|
+
# in the billing process.Request of type Array<CandidApiClient::BillingNotes::V2::Types::BillingNoteBase>, as a Hash
|
1632
|
+
# * :text (String)
|
1633
|
+
# @param place_of_service_code [CandidApiClient::Commons::Types::FacilityTypeCode] Box 24B on the CMS-1500 claim form. Line-level place of service is not currently
|
1634
|
+
# supported. 02 for telemedicine, 11 for in-person. Full list
|
1635
|
+
# //www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
|
1636
|
+
# @param patient_histories [Array<Hash>] Request of type Array<CandidApiClient::Encounters::V4::Types::PatientHistoryCategory>, as a Hash
|
1637
|
+
# * :category (CandidApiClient::Encounters::V4::Types::PatientHistoryCategoryEnum)
|
1638
|
+
# * :questions (Array<CandidApiClient::Encounters::V4::Types::IntakeQuestion>)
|
1639
|
+
# @param service_lines [Array<Hash>] Each service line must be linked to a diagnosis. Concretely,
|
1640
|
+
# `service_line.diagnosis_pointers`must contain at least one entry which should be
|
1641
|
+
# in bounds of the diagnoses list field.Request of type Array<CandidApiClient::ServiceLines::V2::Types::ServiceLineCreate>, as a Hash
|
1642
|
+
# * :modifiers (Array<CandidApiClient::Commons::Types::ProcedureModifier>)
|
1643
|
+
# * :procedure_code (String)
|
1644
|
+
# * :quantity (String)
|
1645
|
+
# * :units (CandidApiClient::Commons::Types::ServiceLineUnits)
|
1646
|
+
# * :charge_amount_cents (Integer)
|
1647
|
+
# * :diagnosis_pointers (Array<Integer>)
|
1648
|
+
# * :drug_identification (Hash)
|
1649
|
+
# * :service_id_qualifier (CandidApiClient::ServiceLines::V2::Types::ServiceIdQualifier)
|
1650
|
+
# * :national_drug_code (String)
|
1651
|
+
# * :national_drug_unit_count (String)
|
1652
|
+
# * :measurement_unit_code (CandidApiClient::ServiceLines::V2::Types::MeasurementUnitCode)
|
1653
|
+
# * :link_sequence_number (String)
|
1654
|
+
# * :pharmacy_prescription_number (String)
|
1655
|
+
# * :conversion_formula (String)
|
1656
|
+
# * :place_of_service_code (CandidApiClient::Commons::Types::FacilityTypeCode)
|
1657
|
+
# * :description (String)
|
1658
|
+
# * :date_of_service (Date)
|
1659
|
+
# * :end_date_of_service (Date)
|
1660
|
+
# * :ordering_provider (Hash)
|
1661
|
+
# * :npi (String)
|
1662
|
+
# * :taxonomy_code (String)
|
1663
|
+
# * :address (Hash)
|
1664
|
+
# * :zip_plus_four_code (String)
|
1665
|
+
# * :address_1 (String)
|
1666
|
+
# * :address_2 (String)
|
1667
|
+
# * :city (String)
|
1668
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1669
|
+
# * :zip_code (String)
|
1670
|
+
# * :first_name (String)
|
1671
|
+
# * :last_name (String)
|
1672
|
+
# * :organization_name (String)
|
1673
|
+
# @param guarantor [Hash] Personal and contact info for the guarantor of the patient responsibility.Request of type CandidApiClient::Guarantor::V1::Types::GuarantorCreate, as a Hash
|
1674
|
+
# * :phone_numbers (Array<CandidApiClient::Commons::Types::PhoneNumber>)
|
1675
|
+
# * :phone_consent (Boolean)
|
1676
|
+
# * :email (String)
|
1677
|
+
# * :email_consent (Boolean)
|
1678
|
+
# * :first_name (String)
|
1679
|
+
# * :last_name (String)
|
1680
|
+
# * :external_id (String)
|
1681
|
+
# * :date_of_birth (Date)
|
1682
|
+
# * :address (Hash)
|
1683
|
+
# * :zip_plus_four_code (String)
|
1684
|
+
# * :address_1 (String)
|
1685
|
+
# * :address_2 (String)
|
1686
|
+
# * :city (String)
|
1687
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
1688
|
+
# * :zip_code (String)
|
1689
|
+
# @param external_claim_submission [Hash] ***This field is in beta.***
|
1690
|
+
# To be included for claims that have been submitted outside of Candid.
|
1691
|
+
# Candid supports posting remits and payments to these claims and working them
|
1692
|
+
# in-platform (e.g. editing, resubmitting).Request of type CandidApiClient::ClaimSubmission::V1::Types::ExternalClaimSubmissionCreate, as a Hash
|
1693
|
+
# * :claim_created_at (DateTime)
|
1694
|
+
# * :patient_control_number (String)
|
1695
|
+
# * :submission_records (Array<CandidApiClient::ClaimSubmission::V1::Types::ClaimSubmissionRecordCreate>)
|
1696
|
+
# @param tag_ids [Array<String>] Names of tags that should be on the encounter.
|
1697
|
+
# @param schema_instances [Array<Hash>] Key-value pairs that must adhere to a schema created via the Custom Schema API.
|
1698
|
+
# Multiple schema
|
1699
|
+
# instances cannot be created for the same schema on an encounter.Request of type Array<CandidApiClient::CustomSchemas::V1::Types::SchemaInstance>, as a Hash
|
1700
|
+
# * :schema_id (String)
|
1701
|
+
# * :content (Hash{String => Object})
|
947
1702
|
# @param request_options [CandidApiClient::RequestOptions]
|
948
1703
|
# @return [CandidApiClient::Encounters::V4::Types::Encounter]
|
949
1704
|
# @example
|
950
1705
|
# api = CandidApiClient::Client.new(base_url: "https://api.example.com", environment: CandidApiClient::Environment::PRODUCTION)
|
951
|
-
# api.encounters.v_4.
|
952
|
-
|
1706
|
+
# api.encounters.v_4.create(
|
1707
|
+
# patient: { phone_numbers: [{ number: "1234567890", type: HOME }], phone_consent: true, email: "johndoe@joincandidhealth.com", non_insurance_payers: ["d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32"], email_consent: true, external_id: "string", date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", gender: MALE },
|
1708
|
+
# billing_provider: { address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, tax_id: "string", npi: "string", taxonomy_code: "string", first_name: "string", last_name: "string", organization_name: "string" },
|
1709
|
+
# rendering_provider: { address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, npi: "string", taxonomy_code: "string", first_name: "string", last_name: "string", organization_name: "string" },
|
1710
|
+
# referring_provider: { npi: "string", taxonomy_code: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", organization_name: "string" },
|
1711
|
+
# initial_referring_provider: { npi: "string", taxonomy_code: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, qualifier: DQ, first_name: "string", last_name: "string", organization_name: "string" },
|
1712
|
+
# supervising_provider: { npi: "string", taxonomy_code: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", organization_name: "string" },
|
1713
|
+
# service_facility: { organization_name: "string", npi: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" } },
|
1714
|
+
# subscriber_primary: { insurance_card: { member_id: "string", payer_name: "string", payer_id: "string", rx_bin: "string", rx_pcn: "string", image_url_front: "string", image_url_back: "string", emr_payer_crosswalk: HEALTHIE, group_number: "string", plan_name: "string", plan_type: SELF_PAY, insurance_type: C_01 }, patient_relationship_to_subscriber_code: SPOUSE, date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", gender: MALE },
|
1715
|
+
# subscriber_secondary: { insurance_card: { member_id: "string", payer_name: "string", payer_id: "string", rx_bin: "string", rx_pcn: "string", image_url_front: "string", image_url_back: "string", emr_payer_crosswalk: HEALTHIE, group_number: "string", plan_name: "string", plan_type: SELF_PAY, insurance_type: C_01 }, patient_relationship_to_subscriber_code: SPOUSE, date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", gender: MALE },
|
1716
|
+
# prior_authorization_number: "string",
|
1717
|
+
# appointment_type: "string",
|
1718
|
+
# responsible_party: INSURANCE_PAY,
|
1719
|
+
# diagnoses: [{ name: "string", code_type: ABF, code: "string" }],
|
1720
|
+
# clinical_notes: [{ category: CLINICAL, notes: [{ text: "string", author_name: "string", author_npi: "string", timestamp: DateTime.parse(2024-01-15T09:30:00.000Z) }] }],
|
1721
|
+
# billing_notes: [{ text: "string" }],
|
1722
|
+
# place_of_service_code: PHARMACY,
|
1723
|
+
# patient_histories: [{ category: PRESENT_ILLNESS, questions: [{ id: "6E7FBCE4-A8EA-46D0-A8D8-FF83CA3BB176", text: "Do you have any allergies?", responses: [{ response: "No allergies", follow_ups: [{ id: "4F3D57F9-AC94-49D6-87E4-E804B709917A", text: "Do you have any allergies?", response: "No allergies" }] }] }] }],
|
1724
|
+
# service_lines: [{ modifiers: [TWENTY_TWO], procedure_code: "string", quantity: "string", units: MJ, charge_amount_cents: 1, diagnosis_pointers: [1], drug_identification: { service_id_qualifier: EAN_UCC_13, national_drug_code: "string", national_drug_unit_count: "string", measurement_unit_code: MILLILITERS, link_sequence_number: "string", pharmacy_prescription_number: "string", conversion_formula: "string" }, place_of_service_code: PHARMACY, description: "string", date_of_service: DateTime.parse(2023-01-15), end_date_of_service: DateTime.parse(2023-01-15), ordering_provider: { npi: "string", taxonomy_code: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", organization_name: "string" } }],
|
1725
|
+
# guarantor: { phone_numbers: [{ number: "1234567890", type: HOME }], phone_consent: true, email: "johndoe@joincandidhealth.com", email_consent: true, first_name: "string", last_name: "string", external_id: "string", date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" } },
|
1726
|
+
# external_claim_submission: { claim_created_at: DateTime.parse(2023-01-01T12:00:00.000Z), patient_control_number: "PATIENT_CONTROL_NUMBER", submission_records: [{ submitted_at: DateTime.parse(2023-01-01T13:00:00.000Z), claim_frequency_code: ORIGINAL, payer_responsibility: PRIMARY, intended_submission_medium: ELECTRONIC }, { submitted_at: DateTime.parse(2023-01-04T12:00:00.000Z), claim_frequency_code: REPLACEMENT, payer_responsibility: PRIMARY, intended_submission_medium: PAPER }] },
|
1727
|
+
# tag_ids: ["string"],
|
1728
|
+
# schema_instances: [{ schema_id: "ec096b13-f80a-471d-aaeb-54b021c9d582", content: { "provider_category": "internist", "is_urgent_care": true, "bmi": 24.2, "age": 38 } }]
|
1729
|
+
# )
|
1730
|
+
def create(external_id:, patient_authorized_release:, benefits_assigned_to_provider:,
|
1731
|
+
provider_accepts_assignment:, billable_status:, patient:, billing_provider:, rendering_provider:, responsible_party:, diagnoses:, place_of_service_code:, date_of_service: nil, end_date_of_service: nil, existing_medications: nil, vitals: nil, interventions: nil, pay_to_address: nil, synchronicity: nil, additional_information: nil, service_authorization_exception_code: nil, admission_date: nil, discharge_date: nil, onset_of_current_illness_or_symptom_date: nil, last_menstrual_period_date: nil, delay_reason_code: nil, additional_properties: nil, _field_set: nil, referring_provider: nil, initial_referring_provider: nil, supervising_provider: nil, service_facility: nil, subscriber_primary: nil, subscriber_secondary: nil, prior_authorization_number: nil, appointment_type: nil, clinical_notes: nil, billing_notes: nil, patient_histories: nil, service_lines: nil, guarantor: nil, external_claim_submission: nil, tag_ids: nil, schema_instances: nil, request_options: nil)
|
953
1732
|
Async do
|
954
|
-
response = @request_client.conn.
|
1733
|
+
response = @request_client.conn.post do |req|
|
955
1734
|
req.options.timeout = request_options.timeout_in_seconds unless request_options&.timeout_in_seconds.nil?
|
956
1735
|
req.headers["Authorization"] = request_options.token unless request_options&.token.nil?
|
957
1736
|
req.headers = {
|
@@ -959,17 +1738,99 @@ module CandidApiClient
|
|
959
1738
|
**@request_client.get_headers,
|
960
1739
|
**(request_options&.additional_headers || {})
|
961
1740
|
}.compact
|
1741
|
+
req.body = {
|
1742
|
+
**(request_options&.additional_body_parameters || {}),
|
1743
|
+
external_id: external_id,
|
1744
|
+
date_of_service: date_of_service,
|
1745
|
+
end_date_of_service: end_date_of_service,
|
1746
|
+
patient_authorized_release: patient_authorized_release,
|
1747
|
+
benefits_assigned_to_provider: benefits_assigned_to_provider,
|
1748
|
+
provider_accepts_assignment: provider_accepts_assignment,
|
1749
|
+
existing_medications: existing_medications,
|
1750
|
+
vitals: vitals,
|
1751
|
+
interventions: interventions,
|
1752
|
+
pay_to_address: pay_to_address,
|
1753
|
+
synchronicity: synchronicity,
|
1754
|
+
billable_status: billable_status,
|
1755
|
+
additional_information: additional_information,
|
1756
|
+
service_authorization_exception_code: service_authorization_exception_code,
|
1757
|
+
admission_date: admission_date,
|
1758
|
+
discharge_date: discharge_date,
|
1759
|
+
onset_of_current_illness_or_symptom_date: onset_of_current_illness_or_symptom_date,
|
1760
|
+
last_menstrual_period_date: last_menstrual_period_date,
|
1761
|
+
delay_reason_code: delay_reason_code,
|
1762
|
+
additional_properties: additional_properties,
|
1763
|
+
_field_set: _field_set,
|
1764
|
+
patient: patient,
|
1765
|
+
billing_provider: billing_provider,
|
1766
|
+
rendering_provider: rendering_provider,
|
1767
|
+
referring_provider: referring_provider,
|
1768
|
+
initial_referring_provider: initial_referring_provider,
|
1769
|
+
supervising_provider: supervising_provider,
|
1770
|
+
service_facility: service_facility,
|
1771
|
+
subscriber_primary: subscriber_primary,
|
1772
|
+
subscriber_secondary: subscriber_secondary,
|
1773
|
+
prior_authorization_number: prior_authorization_number,
|
1774
|
+
appointment_type: appointment_type,
|
1775
|
+
responsible_party: responsible_party,
|
1776
|
+
diagnoses: diagnoses,
|
1777
|
+
clinical_notes: clinical_notes,
|
1778
|
+
billing_notes: billing_notes,
|
1779
|
+
place_of_service_code: place_of_service_code,
|
1780
|
+
patient_histories: patient_histories,
|
1781
|
+
service_lines: service_lines,
|
1782
|
+
guarantor: guarantor,
|
1783
|
+
external_claim_submission: external_claim_submission,
|
1784
|
+
tag_ids: tag_ids,
|
1785
|
+
schema_instances: schema_instances
|
1786
|
+
}.compact
|
962
1787
|
req.url "#{@request_client.get_url(environment: CandidApi,
|
963
|
-
request_options: request_options)}/api/encounters/v4
|
1788
|
+
request_options: request_options)}/api/encounters/v4"
|
964
1789
|
end
|
965
1790
|
CandidApiClient::Encounters::V4::Types::Encounter.from_json(json_object: response.body)
|
966
1791
|
end
|
967
1792
|
end
|
968
1793
|
|
1794
|
+
# Create an encounter from a pre-encounter patient and appointment. This endpoint
|
1795
|
+
# is intended to be used by consumers who are managing
|
1796
|
+
# patients and appointments in the pre-encounter service and is currently under
|
1797
|
+
# development. Consumers who are not taking advantage
|
1798
|
+
# of the pre-encounter service should use the standard create endpoint.
|
1799
|
+
# The endpoint will create an encounter from the provided fields, pulling
|
1800
|
+
# information from the provided patient and appointment objects
|
1801
|
+
# where applicable. In particular, the following fields are populated from the
|
1802
|
+
# patient and appointment objects:
|
1803
|
+
# - Patient
|
1804
|
+
# - Referring Provider
|
1805
|
+
# - Subscriber Primary
|
1806
|
+
# - Subscriber Secondary
|
1807
|
+
# - Prior Authorization Number
|
1808
|
+
# - Appointment Type
|
1809
|
+
# - Responsible Party
|
1810
|
+
# - Guarantor
|
1811
|
+
# Utilizing this endpoint opts you into automatic updating of the encounter when
|
1812
|
+
# the patient or appointment is updated, assuming the
|
1813
|
+
# encounter has not already been submitted or adjudicated.
|
1814
|
+
#
|
969
1815
|
# @param external_id [String] A client-specified unique ID to associate with this encounter;
|
970
1816
|
# for example, your internal encounter ID or a Dr. Chrono encounter ID.
|
971
1817
|
# This field should not contain PHI.
|
972
|
-
# @param
|
1818
|
+
# @param date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-24.
|
1819
|
+
# This date must be the local date in the timezone where the service occurred.
|
1820
|
+
# Box 24a on the CMS-1500 claim form.
|
1821
|
+
# If service occurred over a range of dates, this should be the start date.
|
1822
|
+
# date_of_service must be defined on either the encounter or the service lines but
|
1823
|
+
# not both.
|
1824
|
+
# If there are greater than zero service lines, it is recommended to specify
|
1825
|
+
# date_of_service on the service_line instead of on the encounter to prepare for
|
1826
|
+
# future API versions.
|
1827
|
+
# @param end_date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-25.
|
1828
|
+
# This date must be the local date in the timezone where the service occurred.
|
1829
|
+
# If omitted, the Encounter is assumed to be for a single day.
|
1830
|
+
# Must not be temporally before the date_of_service field.
|
1831
|
+
# If there are greater than zero service lines, it is recommended to specify
|
1832
|
+
# end_date_of_service on the service_line instead of on the encounter to prepare
|
1833
|
+
# for future API versions.
|
973
1834
|
# @param patient_authorized_release [Boolean] Whether this patient has authorized the release of medical information
|
974
1835
|
# for billing purpose.
|
975
1836
|
# Box 12 on the CMS-1500 claim form.
|
@@ -979,8 +1840,6 @@ module CandidApiClient
|
|
979
1840
|
# @param provider_accepts_assignment [Boolean] Whether you have accepted the patient's authorization for insurance payments
|
980
1841
|
# to be made to you, not them.
|
981
1842
|
# Box 27 on the CMS-1500 claim form.
|
982
|
-
# @param appointment_type [String] Human-readable description of the appointment type (ex: "Acupuncture -
|
983
|
-
# Headaches").
|
984
1843
|
# @param existing_medications [Array<Hash>] Request of type Array<CandidApiClient::Encounters::V4::Types::Medication>, as a Hash
|
985
1844
|
# * :name (String)
|
986
1845
|
# * :rx_cui (String)
|
@@ -1026,7 +1885,6 @@ module CandidApiClient
|
|
1026
1885
|
# Examples for when this should be set to NOT_BILLABLE include
|
1027
1886
|
# if the Encounter has not occurred yet or if there is no intention of ever
|
1028
1887
|
# billing the responsible_party.
|
1029
|
-
# @param responsible_party [CandidApiClient::Encounters::V4::Types::ResponsiblePartyType] Defines the party to be billed with the initial balance owed on the claim.
|
1030
1888
|
# @param additional_information [String] Defines additional information on the claim needed by the payer.
|
1031
1889
|
# Box 19 on the CMS-1500 claim form.
|
1032
1890
|
# @param service_authorization_exception_code [CandidApiClient::Encounters::V4::Types::ServiceAuthorizationExceptionCode] 837p Loop2300 REF\*4N
|
@@ -1056,41 +1914,8 @@ module CandidApiClient
|
|
1056
1914
|
# Code indicating the reason why a request was delayed
|
1057
1915
|
# @param additional_properties [OpenStruct] Additional properties unmapped to the current class definition
|
1058
1916
|
# @param _field_set [Object]
|
1059
|
-
# @param
|
1060
|
-
#
|
1061
|
-
# Box 24a on the CMS-1500 claim form.
|
1062
|
-
# If service occurred over a range of dates, this should be the start date.
|
1063
|
-
# date_of_service must be defined on either the encounter or the service lines but
|
1064
|
-
# not both.
|
1065
|
-
# If there are greater than zero service lines, it is recommended to specify
|
1066
|
-
# date_of_service on the service_line instead of on the encounter to prepare for
|
1067
|
-
# future API versions.
|
1068
|
-
# @param end_date_of_service [Date] Date formatted as YYYY-MM-DD; eg: 2019-08-25.
|
1069
|
-
# This date must be the local date in the timezone where the service occurred.
|
1070
|
-
# If omitted, the Encounter is assumed to be for a single day.
|
1071
|
-
# Must not be temporally before the date_of_service field.
|
1072
|
-
# If there are greater than zero service lines, it is recommended to specify
|
1073
|
-
# end_date_of_service on the service_line instead of on the encounter to prepare
|
1074
|
-
# for future API versions.
|
1075
|
-
# @param patient [Hash] Contains the identification information of the individual receiving medical
|
1076
|
-
# services.Request of type CandidApiClient::Individual::Types::PatientCreate, as a Hash
|
1077
|
-
# * :phone_numbers (Array<CandidApiClient::Commons::Types::PhoneNumber>)
|
1078
|
-
# * :phone_consent (Boolean)
|
1079
|
-
# * :email (String)
|
1080
|
-
# * :non_insurance_payers (Array<String>)
|
1081
|
-
# * :email_consent (Boolean)
|
1082
|
-
# * :external_id (String)
|
1083
|
-
# * :date_of_birth (Date)
|
1084
|
-
# * :address (Hash)
|
1085
|
-
# * :zip_plus_four_code (String)
|
1086
|
-
# * :address_1 (String)
|
1087
|
-
# * :address_2 (String)
|
1088
|
-
# * :city (String)
|
1089
|
-
# * :state (CandidApiClient::Commons::Types::State)
|
1090
|
-
# * :zip_code (String)
|
1091
|
-
# * :first_name (String)
|
1092
|
-
# * :last_name (String)
|
1093
|
-
# * :gender (CandidApiClient::Individual::Types::Gender)
|
1917
|
+
# @param pre_encounter_patient_id [String]
|
1918
|
+
# @param pre_encounter_appointment_id [String]
|
1094
1919
|
# @param billing_provider [Hash] The billing provider is the provider or business entity submitting the claim.
|
1095
1920
|
# Billing provider may be, but is not necessarily, the same person/NPI as the
|
1096
1921
|
# rendering provider. From a payer's perspective, this represents the person or
|
@@ -1130,21 +1955,6 @@ module CandidApiClient
|
|
1130
1955
|
# * :first_name (String)
|
1131
1956
|
# * :last_name (String)
|
1132
1957
|
# * :organization_name (String)
|
1133
|
-
# @param referring_provider [Hash] The final provider who referred the services that were rendered.
|
1134
|
-
# All physicians who order services or refer Medicare beneficiaries must
|
1135
|
-
# report this data.Request of type CandidApiClient::EncounterProviders::V2::Types::ReferringProvider, as a Hash
|
1136
|
-
# * :npi (String)
|
1137
|
-
# * :taxonomy_code (String)
|
1138
|
-
# * :address (Hash)
|
1139
|
-
# * :zip_plus_four_code (String)
|
1140
|
-
# * :address_1 (String)
|
1141
|
-
# * :address_2 (String)
|
1142
|
-
# * :city (String)
|
1143
|
-
# * :state (CandidApiClient::Commons::Types::State)
|
1144
|
-
# * :zip_code (String)
|
1145
|
-
# * :first_name (String)
|
1146
|
-
# * :last_name (String)
|
1147
|
-
# * :organization_name (String)
|
1148
1958
|
# @param initial_referring_provider [Hash] The second iteration of Loop ID-2310. Use code "P3 - Primary Care Provider" in
|
1149
1959
|
# this loop to
|
1150
1960
|
# indicate the initial referral from the primary care provider or whatever
|
@@ -1195,65 +2005,6 @@ module CandidApiClient
|
|
1195
2005
|
# * :city (String)
|
1196
2006
|
# * :state (CandidApiClient::Commons::Types::State)
|
1197
2007
|
# * :zip_code (String)
|
1198
|
-
# @param subscriber_primary [Hash] Subscriber_primary is required when responsible_party is INSURANCE_PAY (i.e.
|
1199
|
-
# when the claim should be billed to insurance).
|
1200
|
-
# These are not required fields when responsible_party is SELF_PAY (i.e. when the
|
1201
|
-
# claim should be billed to the patient).
|
1202
|
-
# However, if you collect this for patients, even self-pay, we recommend including
|
1203
|
-
# it when sending encounters to Candid.
|
1204
|
-
# Note: Cash Pay is no longer a valid payer_id in v4, please use responsible party
|
1205
|
-
# to define self-pay claims.Request of type CandidApiClient::Individual::Types::SubscriberCreate, as a Hash
|
1206
|
-
# * :insurance_card (Hash)
|
1207
|
-
# * :member_id (String)
|
1208
|
-
# * :payer_name (String)
|
1209
|
-
# * :payer_id (String)
|
1210
|
-
# * :rx_bin (String)
|
1211
|
-
# * :rx_pcn (String)
|
1212
|
-
# * :image_url_front (String)
|
1213
|
-
# * :image_url_back (String)
|
1214
|
-
# * :emr_payer_crosswalk (CandidApiClient::Commons::Types::EmrPayerCrosswalk)
|
1215
|
-
# * :group_number (String)
|
1216
|
-
# * :plan_name (String)
|
1217
|
-
# * :plan_type (CandidApiClient::Commons::Types::SourceOfPaymentCode)
|
1218
|
-
# * :insurance_type (CandidApiClient::Commons::Types::InsuranceTypeCode)
|
1219
|
-
# * :patient_relationship_to_subscriber_code (CandidApiClient::Commons::Types::PatientRelationshipToInsuredCodeAll)
|
1220
|
-
# * :date_of_birth (Date)
|
1221
|
-
# * :address (Hash)
|
1222
|
-
# * :zip_plus_four_code (String)
|
1223
|
-
# * :address_1 (String)
|
1224
|
-
# * :address_2 (String)
|
1225
|
-
# * :city (String)
|
1226
|
-
# * :state (CandidApiClient::Commons::Types::State)
|
1227
|
-
# * :zip_code (String)
|
1228
|
-
# * :first_name (String)
|
1229
|
-
# * :last_name (String)
|
1230
|
-
# * :gender (CandidApiClient::Individual::Types::Gender)
|
1231
|
-
# @param subscriber_secondary [Hash] Please always include this when you have it, even for self-pay claims.Request of type CandidApiClient::Individual::Types::SubscriberCreate, as a Hash
|
1232
|
-
# * :insurance_card (Hash)
|
1233
|
-
# * :member_id (String)
|
1234
|
-
# * :payer_name (String)
|
1235
|
-
# * :payer_id (String)
|
1236
|
-
# * :rx_bin (String)
|
1237
|
-
# * :rx_pcn (String)
|
1238
|
-
# * :image_url_front (String)
|
1239
|
-
# * :image_url_back (String)
|
1240
|
-
# * :emr_payer_crosswalk (CandidApiClient::Commons::Types::EmrPayerCrosswalk)
|
1241
|
-
# * :group_number (String)
|
1242
|
-
# * :plan_name (String)
|
1243
|
-
# * :plan_type (CandidApiClient::Commons::Types::SourceOfPaymentCode)
|
1244
|
-
# * :insurance_type (CandidApiClient::Commons::Types::InsuranceTypeCode)
|
1245
|
-
# * :patient_relationship_to_subscriber_code (CandidApiClient::Commons::Types::PatientRelationshipToInsuredCodeAll)
|
1246
|
-
# * :date_of_birth (Date)
|
1247
|
-
# * :address (Hash)
|
1248
|
-
# * :zip_plus_four_code (String)
|
1249
|
-
# * :address_1 (String)
|
1250
|
-
# * :address_2 (String)
|
1251
|
-
# * :city (String)
|
1252
|
-
# * :state (CandidApiClient::Commons::Types::State)
|
1253
|
-
# * :zip_code (String)
|
1254
|
-
# * :first_name (String)
|
1255
|
-
# * :last_name (String)
|
1256
|
-
# * :gender (CandidApiClient::Individual::Types::Gender)
|
1257
2008
|
# @param diagnoses [Array<Hash>] Ideally, this field should contain no more than 12 diagnoses. However, more
|
1258
2009
|
# diagnoses
|
1259
2010
|
# may be submitted at this time, and coders will later prioritize the 12 that will
|
@@ -1309,22 +2060,6 @@ module CandidApiClient
|
|
1309
2060
|
# * :first_name (String)
|
1310
2061
|
# * :last_name (String)
|
1311
2062
|
# * :organization_name (String)
|
1312
|
-
# @param guarantor [Hash] Personal and contact info for the guarantor of the patient responsibility.Request of type CandidApiClient::Guarantor::V1::Types::GuarantorCreate, as a Hash
|
1313
|
-
# * :phone_numbers (Array<CandidApiClient::Commons::Types::PhoneNumber>)
|
1314
|
-
# * :phone_consent (Boolean)
|
1315
|
-
# * :email (String)
|
1316
|
-
# * :email_consent (Boolean)
|
1317
|
-
# * :first_name (String)
|
1318
|
-
# * :last_name (String)
|
1319
|
-
# * :external_id (String)
|
1320
|
-
# * :date_of_birth (Date)
|
1321
|
-
# * :address (Hash)
|
1322
|
-
# * :zip_plus_four_code (String)
|
1323
|
-
# * :address_1 (String)
|
1324
|
-
# * :address_2 (String)
|
1325
|
-
# * :city (String)
|
1326
|
-
# * :state (CandidApiClient::Commons::Types::State)
|
1327
|
-
# * :zip_code (String)
|
1328
2063
|
# @param external_claim_submission [Hash] ***This field is in beta.***
|
1329
2064
|
# To be included for claims that have been submitted outside of Candid.
|
1330
2065
|
# Candid supports posting remits and payments to these claims and working them
|
@@ -1342,31 +2077,26 @@ module CandidApiClient
|
|
1342
2077
|
# @return [CandidApiClient::Encounters::V4::Types::Encounter]
|
1343
2078
|
# @example
|
1344
2079
|
# api = CandidApiClient::Client.new(base_url: "https://api.example.com", environment: CandidApiClient::Environment::PRODUCTION)
|
1345
|
-
# api.encounters.v_4.
|
1346
|
-
#
|
1347
|
-
#
|
1348
|
-
# patient: { phone_numbers: [{ number: "1234567890", type: HOME }], phone_consent: true, email: "johndoe@joincandidhealth.com", non_insurance_payers: ["d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32"], email_consent: true, external_id: "string", date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", gender: MALE },
|
2080
|
+
# api.encounters.v_4.create_from_pre_encounter_patient(
|
2081
|
+
# pre_encounter_patient_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
|
2082
|
+
# pre_encounter_appointment_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
|
1349
2083
|
# billing_provider: { address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, tax_id: "string", npi: "string", taxonomy_code: "string", first_name: "string", last_name: "string", organization_name: "string" },
|
1350
2084
|
# rendering_provider: { address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, npi: "string", taxonomy_code: "string", first_name: "string", last_name: "string", organization_name: "string" },
|
1351
|
-
# referring_provider: { npi: "string", taxonomy_code: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", organization_name: "string" },
|
1352
2085
|
# initial_referring_provider: { npi: "string", taxonomy_code: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, qualifier: DQ, first_name: "string", last_name: "string", organization_name: "string" },
|
1353
2086
|
# supervising_provider: { npi: "string", taxonomy_code: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", organization_name: "string" },
|
1354
2087
|
# service_facility: { organization_name: "string", npi: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" } },
|
1355
|
-
# subscriber_primary: { insurance_card: { member_id: "string", payer_name: "string", payer_id: "string", rx_bin: "string", rx_pcn: "string", image_url_front: "string", image_url_back: "string", emr_payer_crosswalk: HEALTHIE, group_number: "string", plan_name: "string", plan_type: SELF_PAY, insurance_type: C_01 }, patient_relationship_to_subscriber_code: SPOUSE, date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", gender: MALE },
|
1356
|
-
# subscriber_secondary: { insurance_card: { member_id: "string", payer_name: "string", payer_id: "string", rx_bin: "string", rx_pcn: "string", image_url_front: "string", image_url_back: "string", emr_payer_crosswalk: HEALTHIE, group_number: "string", plan_name: "string", plan_type: SELF_PAY, insurance_type: C_01 }, patient_relationship_to_subscriber_code: SPOUSE, date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", gender: MALE },
|
1357
2088
|
# diagnoses: [{ name: "string", code_type: ABF, code: "string" }],
|
1358
2089
|
# clinical_notes: [{ category: CLINICAL, notes: [{ text: "string", author_name: "string", author_npi: "string", timestamp: DateTime.parse(2024-01-15T09:30:00.000Z) }] }],
|
1359
2090
|
# billing_notes: [{ text: "string" }],
|
1360
2091
|
# place_of_service_code: PHARMACY,
|
1361
2092
|
# patient_histories: [{ category: PRESENT_ILLNESS, questions: [{ id: "6E7FBCE4-A8EA-46D0-A8D8-FF83CA3BB176", text: "Do you have any allergies?", responses: [{ response: "No allergies", follow_ups: [{ id: "4F3D57F9-AC94-49D6-87E4-E804B709917A", text: "Do you have any allergies?", response: "No allergies" }] }] }] }],
|
1362
2093
|
# service_lines: [{ modifiers: [TWENTY_TWO], procedure_code: "string", quantity: "string", units: MJ, charge_amount_cents: 1, diagnosis_pointers: [1], drug_identification: { service_id_qualifier: EAN_UCC_13, national_drug_code: "string", national_drug_unit_count: "string", measurement_unit_code: MILLILITERS, link_sequence_number: "string", pharmacy_prescription_number: "string", conversion_formula: "string" }, place_of_service_code: PHARMACY, description: "string", date_of_service: DateTime.parse(2023-01-15), end_date_of_service: DateTime.parse(2023-01-15), ordering_provider: { npi: "string", taxonomy_code: "string", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" }, first_name: "string", last_name: "string", organization_name: "string" } }],
|
1363
|
-
# guarantor: { phone_numbers: [{ number: "1234567890", type: HOME }], phone_consent: true, email: "johndoe@joincandidhealth.com", email_consent: true, first_name: "string", last_name: "string", external_id: "string", date_of_birth: DateTime.parse(2023-01-15), address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" } },
|
1364
2094
|
# external_claim_submission: { claim_created_at: DateTime.parse(2023-01-01T12:00:00.000Z), patient_control_number: "PATIENT_CONTROL_NUMBER", submission_records: [{ submitted_at: DateTime.parse(2023-01-01T13:00:00.000Z), claim_frequency_code: ORIGINAL, payer_responsibility: PRIMARY, intended_submission_medium: ELECTRONIC }, { submitted_at: DateTime.parse(2023-01-04T12:00:00.000Z), claim_frequency_code: REPLACEMENT, payer_responsibility: PRIMARY, intended_submission_medium: PAPER }] },
|
1365
2095
|
# tag_ids: ["string"],
|
1366
2096
|
# schema_instances: [{ schema_id: "ec096b13-f80a-471d-aaeb-54b021c9d582", content: { "provider_category": "internist", "is_urgent_care": true, "bmi": 24.2, "age": 38 } }]
|
1367
2097
|
# )
|
1368
|
-
def
|
1369
|
-
|
2098
|
+
def create_from_pre_encounter_patient(external_id:, patient_authorized_release:,
|
2099
|
+
benefits_assigned_to_provider:, provider_accepts_assignment:, billable_status:, pre_encounter_patient_id:, pre_encounter_appointment_id:, billing_provider:, rendering_provider:, diagnoses:, place_of_service_code:, date_of_service: nil, end_date_of_service: nil, existing_medications: nil, vitals: nil, interventions: nil, pay_to_address: nil, synchronicity: nil, additional_information: nil, service_authorization_exception_code: nil, admission_date: nil, discharge_date: nil, onset_of_current_illness_or_symptom_date: nil, last_menstrual_period_date: nil, delay_reason_code: nil, additional_properties: nil, _field_set: nil, initial_referring_provider: nil, supervising_provider: nil, service_facility: nil, clinical_notes: nil, billing_notes: nil, patient_histories: nil, service_lines: nil, external_claim_submission: nil, tag_ids: nil, schema_instances: nil, request_options: nil)
|
1370
2100
|
Async do
|
1371
2101
|
response = @request_client.conn.post do |req|
|
1372
2102
|
req.options.timeout = request_options.timeout_in_seconds unless request_options&.timeout_in_seconds.nil?
|
@@ -1379,18 +2109,17 @@ module CandidApiClient
|
|
1379
2109
|
req.body = {
|
1380
2110
|
**(request_options&.additional_body_parameters || {}),
|
1381
2111
|
external_id: external_id,
|
1382
|
-
|
2112
|
+
date_of_service: date_of_service,
|
2113
|
+
end_date_of_service: end_date_of_service,
|
1383
2114
|
patient_authorized_release: patient_authorized_release,
|
1384
2115
|
benefits_assigned_to_provider: benefits_assigned_to_provider,
|
1385
2116
|
provider_accepts_assignment: provider_accepts_assignment,
|
1386
|
-
appointment_type: appointment_type,
|
1387
2117
|
existing_medications: existing_medications,
|
1388
2118
|
vitals: vitals,
|
1389
2119
|
interventions: interventions,
|
1390
2120
|
pay_to_address: pay_to_address,
|
1391
2121
|
synchronicity: synchronicity,
|
1392
2122
|
billable_status: billable_status,
|
1393
|
-
responsible_party: responsible_party,
|
1394
2123
|
additional_information: additional_information,
|
1395
2124
|
service_authorization_exception_code: service_authorization_exception_code,
|
1396
2125
|
admission_date: admission_date,
|
@@ -1400,30 +2129,25 @@ module CandidApiClient
|
|
1400
2129
|
delay_reason_code: delay_reason_code,
|
1401
2130
|
additional_properties: additional_properties,
|
1402
2131
|
_field_set: _field_set,
|
1403
|
-
|
1404
|
-
|
1405
|
-
patient: patient,
|
2132
|
+
pre_encounter_patient_id: pre_encounter_patient_id,
|
2133
|
+
pre_encounter_appointment_id: pre_encounter_appointment_id,
|
1406
2134
|
billing_provider: billing_provider,
|
1407
2135
|
rendering_provider: rendering_provider,
|
1408
|
-
referring_provider: referring_provider,
|
1409
2136
|
initial_referring_provider: initial_referring_provider,
|
1410
2137
|
supervising_provider: supervising_provider,
|
1411
2138
|
service_facility: service_facility,
|
1412
|
-
subscriber_primary: subscriber_primary,
|
1413
|
-
subscriber_secondary: subscriber_secondary,
|
1414
2139
|
diagnoses: diagnoses,
|
1415
2140
|
clinical_notes: clinical_notes,
|
1416
2141
|
billing_notes: billing_notes,
|
1417
2142
|
place_of_service_code: place_of_service_code,
|
1418
2143
|
patient_histories: patient_histories,
|
1419
2144
|
service_lines: service_lines,
|
1420
|
-
guarantor: guarantor,
|
1421
2145
|
external_claim_submission: external_claim_submission,
|
1422
2146
|
tag_ids: tag_ids,
|
1423
2147
|
schema_instances: schema_instances
|
1424
2148
|
}.compact
|
1425
2149
|
req.url "#{@request_client.get_url(environment: CandidApi,
|
1426
|
-
request_options: request_options)}/api/encounters/v4"
|
2150
|
+
request_options: request_options)}/api/encounters/v4/create-from-pre-encounter"
|
1427
2151
|
end
|
1428
2152
|
CandidApiClient::Encounters::V4::Types::Encounter.from_json(json_object: response.body)
|
1429
2153
|
end
|