candidhealth 0.43.1 → 0.45.0
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.
- checksums.yaml +4 -4
- data/lib/candidhealth/charge_capture/v_1/client.rb +483 -479
- data/lib/candidhealth/charge_capture/v_1/types/charge_capture_data.rb +184 -174
- data/lib/candidhealth/commons/types/street_address_optional_base.rb +99 -0
- data/lib/candidhealth/commons/types/street_address_short_zip_optional.rb +107 -0
- data/lib/candidhealth/encounter_providers/v_2/types/billing_provider_update_with_optional_address.rb +160 -0
- data/lib/candidhealth/encounter_providers/v_2/types/initial_referring_provider_update_with_optional_address.rb +134 -0
- data/lib/candidhealth/encounter_providers/v_2/types/referring_provider_update_with_optional_address.rb +125 -0
- data/lib/candidhealth/encounter_providers/v_2/types/rendering_provider_update_with_optional_address.rb +125 -0
- data/lib/candidhealth/encounter_providers/v_2/types/supervising_provider_update_with_optional_address.rb +125 -0
- data/lib/candidhealth/encounters/v_4/client.rb +243 -213
- data/lib/candidhealth/encounters/v_4/types/encounter.rb +11 -1
- data/lib/candidhealth/encounters/v_4/types/encounter_optional.rb +12 -170
- data/lib/candidhealth/individual/types/patient_update_with_optional_address.rb +179 -0
- data/lib/candidhealth/service_facility/types/encounter_service_facility_update_with_optional_address.rb +113 -0
- data/lib/requests.rb +2 -2
- data/lib/types_export.rb +9 -1
- metadata +11 -3
- data/lib/candidhealth/billing_notes/v_2/types/billing_note_optional.rb +0 -112
@@ -37,15 +37,15 @@ require_relative "../../custom_schemas/v_1/types/schema_instance"
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require_relative "types/epsdt_referral"
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require_relative "types/claim_supplemental_information"
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require_relative "types/encounter_create_from_pre_encounter"
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require_relative "../../individual/types/patient_update"
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require_relative "types/vitals_update"
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require_relative "../../guarantor/v_1/types/guarantor_update"
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require_relative "../../encounter_providers/v_2/types/initial_referring_provider_update"
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require_relative "../../encounter_providers/v_2/types/referring_provider_update"
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require_relative "../../individual/types/patient_update"
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require_relative "../../encounter_providers/v_2/types/rendering_provider_update"
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require_relative "../../service_facility/types/encounter_service_facility_update"
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require_relative "../../guarantor/v_1/types/guarantor_update"
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require_relative "../../encounter_providers/v_2/types/billing_provider_update"
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require_relative "../../encounter_providers/v_2/types/supervising_provider_update"
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require_relative "../../encounter_providers/v_2/types/
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require_relative "../../encounter_providers/v_2/types/initial_referring_provider_update"
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require_relative "../../encounter_providers/v_2/types/billing_provider_update"
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require "async"
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module CandidApiClient
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@@ -576,6 +576,8 @@ module CandidApiClient
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# * :attachment_report_type_code (CandidApiClient::Encounters::V4::Types::ReportTypeCode)
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# * :attachment_transmission_code (CandidApiClient::Encounters::V4::Types::ReportTransmissionCode)
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# * :attachment_control_number (String)
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# @param secondary_payer_carrier_code [String] When Medicaid is billed as the secondary payer the Carrier Code is used to
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# identify the primary payer. This is required for certain states.
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# @param request_options [CandidApiClient::RequestOptions]
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# @return [CandidApiClient::Encounters::V4::Types::Encounter]
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# @example
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@@ -605,10 +607,11 @@ 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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# referral_number: "string",
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# epsdt_referral: { condition_indicator_1: AV, condition_indicator_2: AV, condition_indicator_3: AV },
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# claim_supplemental_information: [{ attachment_report_type_code: C_03, attachment_transmission_code: CBM }]
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# claim_supplemental_information: [{ attachment_report_type_code: C_03, attachment_transmission_code: CBM }],
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# secondary_payer_carrier_code: "string"
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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:, patient:, billing_provider:, rendering_provider:, responsible_party:, diagnoses:, place_of_service_code:, date_of_service: nil, end_date_of_service: nil, appointment_type: 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, subscriber_tertiary: nil, prior_authorization_number: 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, referral_number: nil, epsdt_referral: nil, claim_supplemental_information: nil, request_options: nil)
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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, appointment_type: 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, subscriber_tertiary: nil, prior_authorization_number: 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, referral_number: nil, epsdt_referral: nil, claim_supplemental_information: nil, secondary_payer_carrier_code: 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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@@ -665,7 +668,8 @@ module CandidApiClient
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schema_instances: schema_instances,
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referral_number: referral_number,
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epsdt_referral: epsdt_referral,
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claim_supplemental_information: claim_supplemental_information
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claim_supplemental_information: claim_supplemental_information,
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secondary_payer_carrier_code: secondary_payer_carrier_code
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}.compact
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req.url "#{@request_client.get_url(environment: CandidApi,
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request_options: request_options)}/api/encounters/v4"
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@@ -850,13 +854,6 @@ module CandidApiClient
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# patient encounters.Request of type Array<CandidApiClient::Encounters::V4::Types::ClinicalNoteCategoryCreate>, as a Hash
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# * :category (CandidApiClient::Encounters::V4::Types::NoteCategory)
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# * :notes (Array<CandidApiClient::Encounters::V4::Types::ClinicalNote>)
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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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# * :address_2 (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 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 if the Encounter
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# has not occurred yet or if there is no intention of ever billing the
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@@ -991,26 +988,6 @@ module CandidApiClient
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# related to the patient's pregnancy.de
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# @param delay_reason_code [CandidApiClient::Commons::Types::DelayReasonCode] 837i Loop2300, CLM-1300 Box 20
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# Code indicating the reason why a request was delayed
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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::PatientUpdate, as a Hash
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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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# * :external_id (String)
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# * :date_of_birth (Date)
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# * :address (Hash)
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# * :zip_plus_four_code (String)
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# * :address_1 (String)
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# * :address_2 (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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# * :phone_numbers (Array<CandidApiClient::Commons::Types::PhoneNumber>)
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# * :phone_consent (Boolean)
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# * :email (String)
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# * :email_consent (Boolean)
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# * :non_insurance_payers (Array<String>)
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# * :non_insurance_payers_info (Array<CandidApiClient::Individual::Types::PatientNonInsurancePayerInfoCreate>)
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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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@@ -1042,11 +1019,54 @@ module CandidApiClient
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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
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#
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# @param guarantor [Hash] Personal and contact info for the guarantor of the patient responsibility.Request of type CandidApiClient::Guarantor::V1::Types::GuarantorUpdate, as a Hash
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# * :first_name (String)
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# * :last_name (String)
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# * :external_id (String)
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# * :date_of_birth (Date)
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# * :address (Hash)
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# * :zip_plus_four_code (String)
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# * :address_1 (String)
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# * :address_2 (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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# * :phone_numbers (Array<CandidApiClient::Commons::Types::PhoneNumber>)
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# * :phone_consent (Boolean)
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# * :email (String)
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# * :email_consent (Boolean)
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# @param referral_number [String] Refers to REF\*9F on the 837p. Value cannot be greater than 50 characters.
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# @param epsdt_referral [Hash] Refers Box 24H on the CMS1500 form and Loop 2300 CRC - EPSDT Referral on the
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# 837P formRequest of type CandidApiClient::Encounters::V4::Types::EpsdtReferral, as a Hash
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# * :condition_indicator_1 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
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# * :condition_indicator_2 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
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# * :condition_indicator_3 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
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# @param claim_supplemental_information [Array<Hash>] Refers to Loop 2300 - Segment PWK on the 837P form. No more than 10 entries are
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# permitted.Request of type Array<CandidApiClient::Encounters::V4::Types::ClaimSupplementalInformation>, as a Hash
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# * :attachment_report_type_code (CandidApiClient::Encounters::V4::Types::ReportTypeCode)
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# * :attachment_transmission_code (CandidApiClient::Encounters::V4::Types::ReportTransmissionCode)
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# * :attachment_control_number (String)
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# @param secondary_payer_carrier_code [String] When Medicaid is billed as the secondary payer the Carrier Code is used to
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# identify the primary payer. This is required for certain states.
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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 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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# * :address_2 (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 diagnosis_ids [Array<String>] 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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# be
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# submitted to the payor.
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# @param initial_referring_provider [Hash] The second iteration of Loop ID-2310. Use code "P3 - Primary Care Provider" in
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# this loop to
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# indicate the initial referral from the primary care provider or whatever
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# provider wrote the initial referral for this patient's episode of care being
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# billed/reported in this transaction.Request of type CandidApiClient::EncounterProviders::V2::Types::InitialReferringProviderUpdate, as a Hash
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# * :npi (String)
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# * :taxonomy_code (String)
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# * :address (Hash)
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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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# * :qualifier (CandidApiClient::Commons::Types::QualifierCode)
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# * :first_name (String)
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# * :last_name (String)
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# * :organization_name (String)
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# @param
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# (e.g., home), or the location where an in-person visit would have taken place,
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# whichever is easier to identify. If the provider is in-network, service facility
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# may be defined in payer contracts. Box 32 on the CMS-1500 claim form. Note that
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# for an in-network claim to be successfully adjudicated, the service facility
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# address listed on claims must match what was provided to the payer during the
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# credentialing process.Request of type CandidApiClient::ServiceFacility::Types::EncounterServiceFacilityUpdate, as a Hash
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# * :organization_name (String)
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# @param referring_provider [Hash] The final provider who referred the services that were rendered.
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# All physicians who order services or refer Medicare beneficiaries must
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# report this data.Request of type CandidApiClient::EncounterProviders::V2::Types::ReferringProviderUpdate, as a Hash
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# * :npi (String)
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# * :taxonomy_code (String)
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# * :address (Hash)
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# * :zip_plus_four_code (String)
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# * :address_1 (String)
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# * :zip_code (String)
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# * :secondary_identification (String)
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# @param guarantor [Hash] Personal and contact info for the guarantor of the patient responsibility.Request of type CandidApiClient::Guarantor::V1::Types::GuarantorUpdate, as a Hash
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# * :first_name (String)
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# * :last_name (String)
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# * :organization_name (String)
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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::PatientUpdate, as a Hash
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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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# * :external_id (String)
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# * :date_of_birth (Date)
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# * :address (Hash)
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# * :phone_consent (Boolean)
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# * :email (String)
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#
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# * :non_insurance_payers (Array<String>)
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# * :non_insurance_payers_info (Array<CandidApiClient::Individual::Types::PatientNonInsurancePayerInfoCreate>)
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# @param rendering_provider [Hash] The rendering provider is the practitioner -- physician, nurse practitioner,
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# etc. -- performing the service.
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# For telehealth services, the rendering provider performs the visit, asynchronous
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# communication, or other service. The rendering provider address should generally
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# be the same as the service facility address.Request of type CandidApiClient::EncounterProviders::V2::Types::RenderingProviderUpdate, as a Hash
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# * :npi (String)
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# * :taxonomy_code (String)
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# * :address (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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# * :tax_id (String)
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# * :npi (String)
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# * :taxonomy_code (String)
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# * :provider_commercial_license_type (CandidApiClient::Commons::Types::BillingProviderCommercialLicenseType)
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# * :first_name (String)
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# * :last_name (String)
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# * :organization_name (String)
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# @param
|
1121
|
-
#
|
1135
|
+
# @param service_facility [Hash] Encounter Service facility is typically the location a medical service was
|
1136
|
+
# rendered, such as a provider office or hospital. For telehealth, service
|
1137
|
+
# facility can represent the provider's location when the service was delivered
|
1138
|
+
# (e.g., home), or the location where an in-person visit would have taken place,
|
1139
|
+
# whichever is easier to identify. If the provider is in-network, service facility
|
1140
|
+
# may be defined in payer contracts. Box 32 on the CMS-1500 claim form. Note that
|
1141
|
+
# for an in-network claim to be successfully adjudicated, the service facility
|
1142
|
+
# address listed on claims must match what was provided to the payer during the
|
1143
|
+
# credentialing process.Request of type CandidApiClient::ServiceFacility::Types::EncounterServiceFacilityUpdate, as a Hash
|
1144
|
+
# * :organization_name (String)
|
1122
1145
|
# * :npi (String)
|
1123
|
-
# * :taxonomy_code (String)
|
1124
1146
|
# * :address (Hash)
|
1125
1147
|
# * :zip_plus_four_code (String)
|
1126
1148
|
# * :address_1 (String)
|
@@ -1128,12 +1150,9 @@ module CandidApiClient
|
|
1128
1150
|
# * :city (String)
|
1129
1151
|
# * :state (CandidApiClient::Commons::Types::State)
|
1130
1152
|
# * :zip_code (String)
|
1131
|
-
# * :
|
1132
|
-
#
|
1133
|
-
#
|
1134
|
-
# @param referring_provider [Hash] The final provider who referred the services that were rendered.
|
1135
|
-
# All physicians who order services or refer Medicare beneficiaries must
|
1136
|
-
# report this data.Request of type CandidApiClient::EncounterProviders::V2::Types::ReferringProviderUpdate, as a Hash
|
1153
|
+
# * :secondary_identification (String)
|
1154
|
+
# @param supervising_provider [Hash] Required when the rendering provider is supervised by a physician. If not
|
1155
|
+
# required by this implementation guide, do not send.Request of type CandidApiClient::EncounterProviders::V2::Types::SupervisingProviderUpdate, as a Hash
|
1137
1156
|
# * :npi (String)
|
1138
1157
|
# * :taxonomy_code (String)
|
1139
1158
|
# * :address (Hash)
|
@@ -1146,13 +1165,15 @@ module CandidApiClient
|
|
1146
1165
|
# * :first_name (String)
|
1147
1166
|
# * :last_name (String)
|
1148
1167
|
# * :organization_name (String)
|
1149
|
-
# @param
|
1150
|
-
#
|
1151
|
-
#
|
1152
|
-
#
|
1153
|
-
#
|
1154
|
-
#
|
1155
|
-
#
|
1168
|
+
# @param billing_provider [Hash] The billing provider is the provider or business entity submitting the claim.
|
1169
|
+
# Billing provider may be, but is not necessarily, the same person/NPI as the
|
1170
|
+
# rendering provider. From a payer's perspective, this represents the person or
|
1171
|
+
# entity being reimbursed. When a contract exists with the target payer, the
|
1172
|
+
# billing provider should be the entity contracted with the payer. In some
|
1173
|
+
# circumstances, this will be an individual provider. In that case, submit that
|
1174
|
+
# provider's NPI and the tax ID (TIN) that the provider gave to the payer during
|
1175
|
+
# contracting. In other cases, the billing entity will be a medical group. If so,
|
1176
|
+
# 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::BillingProviderUpdate, as a Hash
|
1156
1177
|
# * :address (Hash)
|
1157
1178
|
# * :zip_plus_four_code (String)
|
1158
1179
|
# * :address_1 (String)
|
@@ -1160,28 +1181,13 @@ module CandidApiClient
|
|
1160
1181
|
# * :city (String)
|
1161
1182
|
# * :state (CandidApiClient::Commons::Types::State)
|
1162
1183
|
# * :zip_code (String)
|
1163
|
-
# * :
|
1184
|
+
# * :tax_id (String)
|
1185
|
+
# * :npi (String)
|
1186
|
+
# * :taxonomy_code (String)
|
1187
|
+
# * :provider_commercial_license_type (CandidApiClient::Commons::Types::BillingProviderCommercialLicenseType)
|
1164
1188
|
# * :first_name (String)
|
1165
1189
|
# * :last_name (String)
|
1166
1190
|
# * :organization_name (String)
|
1167
|
-
# @param referral_number [String] Refers to REF\*9F on the 837p. Value cannot be greater than 50 characters.
|
1168
|
-
# @param epsdt_referral [Hash] Refers Box 24H on the CMS1500 form and Loop 2300 CRC - EPSDT Referral on the
|
1169
|
-
# 837P formRequest of type CandidApiClient::Encounters::V4::Types::EpsdtReferral, as a Hash
|
1170
|
-
# * :condition_indicator_1 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
|
1171
|
-
# * :condition_indicator_2 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
|
1172
|
-
# * :condition_indicator_3 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
|
1173
|
-
# @param claim_supplemental_information [Array<Hash>] Refers to Loop 2300 - Segment PWK on the 837P form. No more than 10 entries are
|
1174
|
-
# permitted.Request of type Array<CandidApiClient::Encounters::V4::Types::ClaimSupplementalInformation>, as a Hash
|
1175
|
-
# * :attachment_report_type_code (CandidApiClient::Encounters::V4::Types::ReportTypeCode)
|
1176
|
-
# * :attachment_transmission_code (CandidApiClient::Encounters::V4::Types::ReportTransmissionCode)
|
1177
|
-
# * :attachment_control_number (String)
|
1178
|
-
# @param additional_properties [OpenStruct] Additional properties unmapped to the current class definition
|
1179
|
-
# @param _field_set [Object]
|
1180
|
-
# @param diagnosis_ids [Array<String>] Ideally, this field should contain no more than 12 diagnoses. However, more
|
1181
|
-
# diagnoses
|
1182
|
-
# may be submitted at this time, and coders will later prioritize the 12 that will
|
1183
|
-
# be
|
1184
|
-
# submitted to the payor.
|
1185
1191
|
# @param place_of_service_code_as_submitted [CandidApiClient::Commons::Types::FacilityTypeCode] Box 24B on the CMS-1500 claim form. 837p Loop2300, CLM-05-1. 02 for
|
1186
1192
|
# telemedicine, 11 for in-person. Full list
|
1187
1193
|
# //www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
|
@@ -1191,11 +1197,19 @@ module CandidApiClient
|
|
1191
1197
|
# api = CandidApiClient::Client.new(base_url: "https://api.example.com", environment: CandidApiClient::Environment::PRODUCTION)
|
1192
1198
|
# api.encounters.v_4.update(
|
1193
1199
|
# encounter_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
|
1200
|
+
# 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" },
|
1194
1201
|
# diagnosis_ids: ["d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32"],
|
1202
|
+
# 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" },
|
1203
|
+
# 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" },
|
1204
|
+
# patient: { first_name: "string", last_name: "string", gender: MALE, 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" }, phone_numbers: [{ number: "1234567890", type: HOME }], phone_consent: true, email: "johndoe@joincandidhealth.com", email_consent: true, non_insurance_payers: ["d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32"], non_insurance_payers_info: [{ non_insurance_payer_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32", member_id: "string", clinical_trial_info: [{ clinical_trial_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32" }] }] },
|
1205
|
+
# rendering_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" },
|
1206
|
+
# service_facility: { organization_name: "Test Organization", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" } },
|
1207
|
+
# 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" },
|
1208
|
+
# 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", provider_commercial_license_type: LICENSED_CLINICAL_SOCIAL_WORKER, first_name: "string", last_name: "string", organization_name: "string" },
|
1195
1209
|
# place_of_service_code_as_submitted: PHARMACY
|
1196
1210
|
# )
|
1197
1211
|
def update(encounter_id:, benefits_assigned_to_provider: nil, prior_authorization_number: nil,
|
1198
|
-
external_id: nil, date_of_service: nil, tag_ids: nil, clinical_notes: nil,
|
1212
|
+
external_id: nil, date_of_service: nil, tag_ids: nil, clinical_notes: nil, billable_status: nil, responsible_party: nil, provider_accepts_assignment: nil, synchronicity: nil, place_of_service_code: nil, appointment_type: nil, end_date_of_service: nil, subscriber_primary: nil, subscriber_secondary: nil, subscriber_tertiary: 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, existing_medications: nil, guarantor: nil, referral_number: nil, epsdt_referral: nil, claim_supplemental_information: nil, secondary_payer_carrier_code: nil, additional_properties: nil, _field_set: nil, pay_to_address: nil, diagnosis_ids: nil, initial_referring_provider: nil, referring_provider: nil, patient: nil, rendering_provider: nil, service_facility: nil, supervising_provider: nil, billing_provider: nil, place_of_service_code_as_submitted: nil, request_options: nil)
|
1199
1213
|
response = @request_client.conn.patch do |req|
|
1200
1214
|
req.options.timeout = request_options.timeout_in_seconds unless request_options&.timeout_in_seconds.nil?
|
1201
1215
|
req.headers["Authorization"] = request_options.token unless request_options&.token.nil?
|
@@ -1212,7 +1226,6 @@ module CandidApiClient
|
|
1212
1226
|
date_of_service: date_of_service,
|
1213
1227
|
tag_ids: tag_ids,
|
1214
1228
|
clinical_notes: clinical_notes,
|
1215
|
-
pay_to_address: pay_to_address,
|
1216
1229
|
billable_status: billable_status,
|
1217
1230
|
responsible_party: responsible_party,
|
1218
1231
|
provider_accepts_assignment: provider_accepts_assignment,
|
@@ -1230,24 +1243,26 @@ module CandidApiClient
|
|
1230
1243
|
onset_of_current_illness_or_symptom_date: onset_of_current_illness_or_symptom_date,
|
1231
1244
|
last_menstrual_period_date: last_menstrual_period_date,
|
1232
1245
|
delay_reason_code: delay_reason_code,
|
1233
|
-
patient: patient,
|
1234
1246
|
patient_authorized_release: patient_authorized_release,
|
1235
1247
|
schema_instances: schema_instances,
|
1236
1248
|
vitals: vitals,
|
1237
1249
|
existing_medications: existing_medications,
|
1238
|
-
rendering_provider: rendering_provider,
|
1239
|
-
service_facility: service_facility,
|
1240
1250
|
guarantor: guarantor,
|
1241
|
-
billing_provider: billing_provider,
|
1242
|
-
supervising_provider: supervising_provider,
|
1243
|
-
referring_provider: referring_provider,
|
1244
|
-
initial_referring_provider: initial_referring_provider,
|
1245
1251
|
referral_number: referral_number,
|
1246
1252
|
epsdt_referral: epsdt_referral,
|
1247
1253
|
claim_supplemental_information: claim_supplemental_information,
|
1254
|
+
secondary_payer_carrier_code: secondary_payer_carrier_code,
|
1248
1255
|
additional_properties: additional_properties,
|
1249
1256
|
_field_set: _field_set,
|
1257
|
+
pay_to_address: pay_to_address,
|
1250
1258
|
diagnosis_ids: diagnosis_ids,
|
1259
|
+
initial_referring_provider: initial_referring_provider,
|
1260
|
+
referring_provider: referring_provider,
|
1261
|
+
patient: patient,
|
1262
|
+
rendering_provider: rendering_provider,
|
1263
|
+
service_facility: service_facility,
|
1264
|
+
supervising_provider: supervising_provider,
|
1265
|
+
billing_provider: billing_provider,
|
1251
1266
|
place_of_service_code_as_submitted: place_of_service_code_as_submitted
|
1252
1267
|
}.compact
|
1253
1268
|
req.url "#{@request_client.get_url(environment: CandidApi,
|
@@ -1786,6 +1801,8 @@ module CandidApiClient
|
|
1786
1801
|
# * :attachment_report_type_code (CandidApiClient::Encounters::V4::Types::ReportTypeCode)
|
1787
1802
|
# * :attachment_transmission_code (CandidApiClient::Encounters::V4::Types::ReportTransmissionCode)
|
1788
1803
|
# * :attachment_control_number (String)
|
1804
|
+
# @param secondary_payer_carrier_code [String] When Medicaid is billed as the secondary payer the Carrier Code is used to
|
1805
|
+
# identify the primary payer. This is required for certain states.
|
1789
1806
|
# @param request_options [CandidApiClient::RequestOptions]
|
1790
1807
|
# @return [CandidApiClient::Encounters::V4::Types::Encounter]
|
1791
1808
|
# @example
|
@@ -1815,10 +1832,11 @@ module CandidApiClient
|
|
1815
1832
|
# schema_instances: [{ schema_id: "ec096b13-f80a-471d-aaeb-54b021c9d582", content: { "provider_category": "internist", "is_urgent_care": true, "bmi": 24.2, "age": 38 } }],
|
1816
1833
|
# referral_number: "string",
|
1817
1834
|
# epsdt_referral: { condition_indicator_1: AV, condition_indicator_2: AV, condition_indicator_3: AV },
|
1818
|
-
# claim_supplemental_information: [{ attachment_report_type_code: C_03, attachment_transmission_code: CBM }]
|
1835
|
+
# claim_supplemental_information: [{ attachment_report_type_code: C_03, attachment_transmission_code: CBM }],
|
1836
|
+
# secondary_payer_carrier_code: "string"
|
1819
1837
|
# )
|
1820
1838
|
def create(external_id:, patient_authorized_release:, benefits_assigned_to_provider:,
|
1821
|
-
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, appointment_type: 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, subscriber_tertiary: nil, prior_authorization_number: 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, referral_number: nil, epsdt_referral: nil, claim_supplemental_information: nil, request_options: nil)
|
1839
|
+
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, appointment_type: 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, subscriber_tertiary: nil, prior_authorization_number: 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, referral_number: nil, epsdt_referral: nil, claim_supplemental_information: nil, secondary_payer_carrier_code: nil, request_options: nil)
|
1822
1840
|
Async do
|
1823
1841
|
response = @request_client.conn.post do |req|
|
1824
1842
|
req.options.timeout = request_options.timeout_in_seconds unless request_options&.timeout_in_seconds.nil?
|
@@ -1876,7 +1894,8 @@ module CandidApiClient
|
|
1876
1894
|
schema_instances: schema_instances,
|
1877
1895
|
referral_number: referral_number,
|
1878
1896
|
epsdt_referral: epsdt_referral,
|
1879
|
-
claim_supplemental_information: claim_supplemental_information
|
1897
|
+
claim_supplemental_information: claim_supplemental_information,
|
1898
|
+
secondary_payer_carrier_code: secondary_payer_carrier_code
|
1880
1899
|
}.compact
|
1881
1900
|
req.url "#{@request_client.get_url(environment: CandidApi,
|
1882
1901
|
request_options: request_options)}/api/encounters/v4"
|
@@ -2064,13 +2083,6 @@ module CandidApiClient
|
|
2064
2083
|
# patient encounters.Request of type Array<CandidApiClient::Encounters::V4::Types::ClinicalNoteCategoryCreate>, as a Hash
|
2065
2084
|
# * :category (CandidApiClient::Encounters::V4::Types::NoteCategory)
|
2066
2085
|
# * :notes (Array<CandidApiClient::Encounters::V4::Types::ClinicalNote>)
|
2067
|
-
# @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
|
2068
|
-
# * :zip_plus_four_code (String)
|
2069
|
-
# * :address_1 (String)
|
2070
|
-
# * :address_2 (String)
|
2071
|
-
# * :city (String)
|
2072
|
-
# * :state (CandidApiClient::Commons::Types::State)
|
2073
|
-
# * :zip_code (String)
|
2074
2086
|
# @param billable_status [CandidApiClient::Encounters::V4::Types::BillableStatusType] Defines if the Encounter is to be billed by Candid to the responsible_party.
|
2075
2087
|
# Examples for when this should be set to NOT_BILLABLE include if the Encounter
|
2076
2088
|
# has not occurred yet or if there is no intention of ever billing the
|
@@ -2205,26 +2217,6 @@ module CandidApiClient
|
|
2205
2217
|
# related to the patient's pregnancy.de
|
2206
2218
|
# @param delay_reason_code [CandidApiClient::Commons::Types::DelayReasonCode] 837i Loop2300, CLM-1300 Box 20
|
2207
2219
|
# Code indicating the reason why a request was delayed
|
2208
|
-
# @param patient [Hash] Contains the identification information of the individual receiving medical
|
2209
|
-
# services.Request of type CandidApiClient::Individual::Types::PatientUpdate, as a Hash
|
2210
|
-
# * :first_name (String)
|
2211
|
-
# * :last_name (String)
|
2212
|
-
# * :gender (CandidApiClient::Individual::Types::Gender)
|
2213
|
-
# * :external_id (String)
|
2214
|
-
# * :date_of_birth (Date)
|
2215
|
-
# * :address (Hash)
|
2216
|
-
# * :zip_plus_four_code (String)
|
2217
|
-
# * :address_1 (String)
|
2218
|
-
# * :address_2 (String)
|
2219
|
-
# * :city (String)
|
2220
|
-
# * :state (CandidApiClient::Commons::Types::State)
|
2221
|
-
# * :zip_code (String)
|
2222
|
-
# * :phone_numbers (Array<CandidApiClient::Commons::Types::PhoneNumber>)
|
2223
|
-
# * :phone_consent (Boolean)
|
2224
|
-
# * :email (String)
|
2225
|
-
# * :email_consent (Boolean)
|
2226
|
-
# * :non_insurance_payers (Array<String>)
|
2227
|
-
# * :non_insurance_payers_info (Array<CandidApiClient::Individual::Types::PatientNonInsurancePayerInfoCreate>)
|
2228
2220
|
# @param patient_authorized_release [Boolean] Whether this patient has authorized the release of medical information
|
2229
2221
|
# for billing purpose.
|
2230
2222
|
# Box 12 on the CMS-1500 claim form.
|
@@ -2256,11 +2248,54 @@ module CandidApiClient
|
|
2256
2248
|
# * :dosage_form (String)
|
2257
2249
|
# * :frequency (String)
|
2258
2250
|
# * :as_needed (Boolean)
|
2259
|
-
# @param
|
2260
|
-
#
|
2261
|
-
#
|
2262
|
-
#
|
2263
|
-
#
|
2251
|
+
# @param guarantor [Hash] Personal and contact info for the guarantor of the patient responsibility.Request of type CandidApiClient::Guarantor::V1::Types::GuarantorUpdate, as a Hash
|
2252
|
+
# * :first_name (String)
|
2253
|
+
# * :last_name (String)
|
2254
|
+
# * :external_id (String)
|
2255
|
+
# * :date_of_birth (Date)
|
2256
|
+
# * :address (Hash)
|
2257
|
+
# * :zip_plus_four_code (String)
|
2258
|
+
# * :address_1 (String)
|
2259
|
+
# * :address_2 (String)
|
2260
|
+
# * :city (String)
|
2261
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
2262
|
+
# * :zip_code (String)
|
2263
|
+
# * :phone_numbers (Array<CandidApiClient::Commons::Types::PhoneNumber>)
|
2264
|
+
# * :phone_consent (Boolean)
|
2265
|
+
# * :email (String)
|
2266
|
+
# * :email_consent (Boolean)
|
2267
|
+
# @param referral_number [String] Refers to REF\*9F on the 837p. Value cannot be greater than 50 characters.
|
2268
|
+
# @param epsdt_referral [Hash] Refers Box 24H on the CMS1500 form and Loop 2300 CRC - EPSDT Referral on the
|
2269
|
+
# 837P formRequest of type CandidApiClient::Encounters::V4::Types::EpsdtReferral, as a Hash
|
2270
|
+
# * :condition_indicator_1 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
|
2271
|
+
# * :condition_indicator_2 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
|
2272
|
+
# * :condition_indicator_3 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
|
2273
|
+
# @param claim_supplemental_information [Array<Hash>] Refers to Loop 2300 - Segment PWK on the 837P form. No more than 10 entries are
|
2274
|
+
# permitted.Request of type Array<CandidApiClient::Encounters::V4::Types::ClaimSupplementalInformation>, as a Hash
|
2275
|
+
# * :attachment_report_type_code (CandidApiClient::Encounters::V4::Types::ReportTypeCode)
|
2276
|
+
# * :attachment_transmission_code (CandidApiClient::Encounters::V4::Types::ReportTransmissionCode)
|
2277
|
+
# * :attachment_control_number (String)
|
2278
|
+
# @param secondary_payer_carrier_code [String] When Medicaid is billed as the secondary payer the Carrier Code is used to
|
2279
|
+
# identify the primary payer. This is required for certain states.
|
2280
|
+
# @param additional_properties [OpenStruct] Additional properties unmapped to the current class definition
|
2281
|
+
# @param _field_set [Object]
|
2282
|
+
# @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
|
2283
|
+
# * :zip_plus_four_code (String)
|
2284
|
+
# * :address_1 (String)
|
2285
|
+
# * :address_2 (String)
|
2286
|
+
# * :city (String)
|
2287
|
+
# * :state (CandidApiClient::Commons::Types::State)
|
2288
|
+
# * :zip_code (String)
|
2289
|
+
# @param diagnosis_ids [Array<String>] Ideally, this field should contain no more than 12 diagnoses. However, more
|
2290
|
+
# diagnoses
|
2291
|
+
# may be submitted at this time, and coders will later prioritize the 12 that will
|
2292
|
+
# be
|
2293
|
+
# submitted to the payor.
|
2294
|
+
# @param initial_referring_provider [Hash] The second iteration of Loop ID-2310. Use code "P3 - Primary Care Provider" in
|
2295
|
+
# this loop to
|
2296
|
+
# indicate the initial referral from the primary care provider or whatever
|
2297
|
+
# provider wrote the initial referral for this patient's episode of care being
|
2298
|
+
# billed/reported in this transaction.Request of type CandidApiClient::EncounterProviders::V2::Types::InitialReferringProviderUpdate, as a Hash
|
2264
2299
|
# * :npi (String)
|
2265
2300
|
# * :taxonomy_code (String)
|
2266
2301
|
# * :address (Hash)
|
@@ -2270,20 +2305,15 @@ module CandidApiClient
|
|
2270
2305
|
# * :city (String)
|
2271
2306
|
# * :state (CandidApiClient::Commons::Types::State)
|
2272
2307
|
# * :zip_code (String)
|
2308
|
+
# * :qualifier (CandidApiClient::Commons::Types::QualifierCode)
|
2273
2309
|
# * :first_name (String)
|
2274
2310
|
# * :last_name (String)
|
2275
2311
|
# * :organization_name (String)
|
2276
|
-
# @param
|
2277
|
-
#
|
2278
|
-
#
|
2279
|
-
# (e.g., home), or the location where an in-person visit would have taken place,
|
2280
|
-
# whichever is easier to identify. If the provider is in-network, service facility
|
2281
|
-
# may be defined in payer contracts. Box 32 on the CMS-1500 claim form. Note that
|
2282
|
-
# for an in-network claim to be successfully adjudicated, the service facility
|
2283
|
-
# address listed on claims must match what was provided to the payer during the
|
2284
|
-
# credentialing process.Request of type CandidApiClient::ServiceFacility::Types::EncounterServiceFacilityUpdate, as a Hash
|
2285
|
-
# * :organization_name (String)
|
2312
|
+
# @param referring_provider [Hash] The final provider who referred the services that were rendered.
|
2313
|
+
# All physicians who order services or refer Medicare beneficiaries must
|
2314
|
+
# report this data.Request of type CandidApiClient::EncounterProviders::V2::Types::ReferringProviderUpdate, as a Hash
|
2286
2315
|
# * :npi (String)
|
2316
|
+
# * :taxonomy_code (String)
|
2287
2317
|
# * :address (Hash)
|
2288
2318
|
# * :zip_plus_four_code (String)
|
2289
2319
|
# * :address_1 (String)
|
@@ -2291,10 +2321,14 @@ module CandidApiClient
|
|
2291
2321
|
# * :city (String)
|
2292
2322
|
# * :state (CandidApiClient::Commons::Types::State)
|
2293
2323
|
# * :zip_code (String)
|
2294
|
-
# * :secondary_identification (String)
|
2295
|
-
# @param guarantor [Hash] Personal and contact info for the guarantor of the patient responsibility.Request of type CandidApiClient::Guarantor::V1::Types::GuarantorUpdate, as a Hash
|
2296
2324
|
# * :first_name (String)
|
2297
2325
|
# * :last_name (String)
|
2326
|
+
# * :organization_name (String)
|
2327
|
+
# @param patient [Hash] Contains the identification information of the individual receiving medical
|
2328
|
+
# services.Request of type CandidApiClient::Individual::Types::PatientUpdate, as a Hash
|
2329
|
+
# * :first_name (String)
|
2330
|
+
# * :last_name (String)
|
2331
|
+
# * :gender (CandidApiClient::Individual::Types::Gender)
|
2298
2332
|
# * :external_id (String)
|
2299
2333
|
# * :date_of_birth (Date)
|
2300
2334
|
# * :address (Hash)
|
@@ -2308,15 +2342,15 @@ module CandidApiClient
|
|
2308
2342
|
# * :phone_consent (Boolean)
|
2309
2343
|
# * :email (String)
|
2310
2344
|
# * :email_consent (Boolean)
|
2311
|
-
#
|
2312
|
-
#
|
2313
|
-
#
|
2314
|
-
#
|
2315
|
-
#
|
2316
|
-
#
|
2317
|
-
#
|
2318
|
-
#
|
2319
|
-
#
|
2345
|
+
# * :non_insurance_payers (Array<String>)
|
2346
|
+
# * :non_insurance_payers_info (Array<CandidApiClient::Individual::Types::PatientNonInsurancePayerInfoCreate>)
|
2347
|
+
# @param rendering_provider [Hash] The rendering provider is the practitioner -- physician, nurse practitioner,
|
2348
|
+
# etc. -- performing the service.
|
2349
|
+
# For telehealth services, the rendering provider performs the visit, asynchronous
|
2350
|
+
# communication, or other service. The rendering provider address should generally
|
2351
|
+
# be the same as the service facility address.Request of type CandidApiClient::EncounterProviders::V2::Types::RenderingProviderUpdate, as a Hash
|
2352
|
+
# * :npi (String)
|
2353
|
+
# * :taxonomy_code (String)
|
2320
2354
|
# * :address (Hash)
|
2321
2355
|
# * :zip_plus_four_code (String)
|
2322
2356
|
# * :address_1 (String)
|
@@ -2324,17 +2358,20 @@ module CandidApiClient
|
|
2324
2358
|
# * :city (String)
|
2325
2359
|
# * :state (CandidApiClient::Commons::Types::State)
|
2326
2360
|
# * :zip_code (String)
|
2327
|
-
# * :tax_id (String)
|
2328
|
-
# * :npi (String)
|
2329
|
-
# * :taxonomy_code (String)
|
2330
|
-
# * :provider_commercial_license_type (CandidApiClient::Commons::Types::BillingProviderCommercialLicenseType)
|
2331
2361
|
# * :first_name (String)
|
2332
2362
|
# * :last_name (String)
|
2333
2363
|
# * :organization_name (String)
|
2334
|
-
# @param
|
2335
|
-
#
|
2364
|
+
# @param service_facility [Hash] Encounter Service facility is typically the location a medical service was
|
2365
|
+
# rendered, such as a provider office or hospital. For telehealth, service
|
2366
|
+
# facility can represent the provider's location when the service was delivered
|
2367
|
+
# (e.g., home), or the location where an in-person visit would have taken place,
|
2368
|
+
# whichever is easier to identify. If the provider is in-network, service facility
|
2369
|
+
# may be defined in payer contracts. Box 32 on the CMS-1500 claim form. Note that
|
2370
|
+
# for an in-network claim to be successfully adjudicated, the service facility
|
2371
|
+
# address listed on claims must match what was provided to the payer during the
|
2372
|
+
# credentialing process.Request of type CandidApiClient::ServiceFacility::Types::EncounterServiceFacilityUpdate, as a Hash
|
2373
|
+
# * :organization_name (String)
|
2336
2374
|
# * :npi (String)
|
2337
|
-
# * :taxonomy_code (String)
|
2338
2375
|
# * :address (Hash)
|
2339
2376
|
# * :zip_plus_four_code (String)
|
2340
2377
|
# * :address_1 (String)
|
@@ -2342,12 +2379,9 @@ module CandidApiClient
|
|
2342
2379
|
# * :city (String)
|
2343
2380
|
# * :state (CandidApiClient::Commons::Types::State)
|
2344
2381
|
# * :zip_code (String)
|
2345
|
-
# * :
|
2346
|
-
#
|
2347
|
-
#
|
2348
|
-
# @param referring_provider [Hash] The final provider who referred the services that were rendered.
|
2349
|
-
# All physicians who order services or refer Medicare beneficiaries must
|
2350
|
-
# report this data.Request of type CandidApiClient::EncounterProviders::V2::Types::ReferringProviderUpdate, as a Hash
|
2382
|
+
# * :secondary_identification (String)
|
2383
|
+
# @param supervising_provider [Hash] Required when the rendering provider is supervised by a physician. If not
|
2384
|
+
# required by this implementation guide, do not send.Request of type CandidApiClient::EncounterProviders::V2::Types::SupervisingProviderUpdate, as a Hash
|
2351
2385
|
# * :npi (String)
|
2352
2386
|
# * :taxonomy_code (String)
|
2353
2387
|
# * :address (Hash)
|
@@ -2360,13 +2394,15 @@ module CandidApiClient
|
|
2360
2394
|
# * :first_name (String)
|
2361
2395
|
# * :last_name (String)
|
2362
2396
|
# * :organization_name (String)
|
2363
|
-
# @param
|
2364
|
-
#
|
2365
|
-
#
|
2366
|
-
#
|
2367
|
-
#
|
2368
|
-
#
|
2369
|
-
#
|
2397
|
+
# @param billing_provider [Hash] The billing provider is the provider or business entity submitting the claim.
|
2398
|
+
# Billing provider may be, but is not necessarily, the same person/NPI as the
|
2399
|
+
# rendering provider. From a payer's perspective, this represents the person or
|
2400
|
+
# entity being reimbursed. When a contract exists with the target payer, the
|
2401
|
+
# billing provider should be the entity contracted with the payer. In some
|
2402
|
+
# circumstances, this will be an individual provider. In that case, submit that
|
2403
|
+
# provider's NPI and the tax ID (TIN) that the provider gave to the payer during
|
2404
|
+
# contracting. In other cases, the billing entity will be a medical group. If so,
|
2405
|
+
# 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::BillingProviderUpdate, as a Hash
|
2370
2406
|
# * :address (Hash)
|
2371
2407
|
# * :zip_plus_four_code (String)
|
2372
2408
|
# * :address_1 (String)
|
@@ -2374,28 +2410,13 @@ module CandidApiClient
|
|
2374
2410
|
# * :city (String)
|
2375
2411
|
# * :state (CandidApiClient::Commons::Types::State)
|
2376
2412
|
# * :zip_code (String)
|
2377
|
-
# * :
|
2413
|
+
# * :tax_id (String)
|
2414
|
+
# * :npi (String)
|
2415
|
+
# * :taxonomy_code (String)
|
2416
|
+
# * :provider_commercial_license_type (CandidApiClient::Commons::Types::BillingProviderCommercialLicenseType)
|
2378
2417
|
# * :first_name (String)
|
2379
2418
|
# * :last_name (String)
|
2380
2419
|
# * :organization_name (String)
|
2381
|
-
# @param referral_number [String] Refers to REF\*9F on the 837p. Value cannot be greater than 50 characters.
|
2382
|
-
# @param epsdt_referral [Hash] Refers Box 24H on the CMS1500 form and Loop 2300 CRC - EPSDT Referral on the
|
2383
|
-
# 837P formRequest of type CandidApiClient::Encounters::V4::Types::EpsdtReferral, as a Hash
|
2384
|
-
# * :condition_indicator_1 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
|
2385
|
-
# * :condition_indicator_2 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
|
2386
|
-
# * :condition_indicator_3 (CandidApiClient::Commons::Types::EpsdtReferralConditionIndicatorCode)
|
2387
|
-
# @param claim_supplemental_information [Array<Hash>] Refers to Loop 2300 - Segment PWK on the 837P form. No more than 10 entries are
|
2388
|
-
# permitted.Request of type Array<CandidApiClient::Encounters::V4::Types::ClaimSupplementalInformation>, as a Hash
|
2389
|
-
# * :attachment_report_type_code (CandidApiClient::Encounters::V4::Types::ReportTypeCode)
|
2390
|
-
# * :attachment_transmission_code (CandidApiClient::Encounters::V4::Types::ReportTransmissionCode)
|
2391
|
-
# * :attachment_control_number (String)
|
2392
|
-
# @param additional_properties [OpenStruct] Additional properties unmapped to the current class definition
|
2393
|
-
# @param _field_set [Object]
|
2394
|
-
# @param diagnosis_ids [Array<String>] Ideally, this field should contain no more than 12 diagnoses. However, more
|
2395
|
-
# diagnoses
|
2396
|
-
# may be submitted at this time, and coders will later prioritize the 12 that will
|
2397
|
-
# be
|
2398
|
-
# submitted to the payor.
|
2399
2420
|
# @param place_of_service_code_as_submitted [CandidApiClient::Commons::Types::FacilityTypeCode] Box 24B on the CMS-1500 claim form. 837p Loop2300, CLM-05-1. 02 for
|
2400
2421
|
# telemedicine, 11 for in-person. Full list
|
2401
2422
|
# //www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
|
@@ -2405,11 +2426,19 @@ module CandidApiClient
|
|
2405
2426
|
# api = CandidApiClient::Client.new(base_url: "https://api.example.com", environment: CandidApiClient::Environment::PRODUCTION)
|
2406
2427
|
# api.encounters.v_4.update(
|
2407
2428
|
# encounter_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32",
|
2429
|
+
# 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" },
|
2408
2430
|
# diagnosis_ids: ["d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32"],
|
2431
|
+
# 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" },
|
2432
|
+
# 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" },
|
2433
|
+
# patient: { first_name: "string", last_name: "string", gender: MALE, 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" }, phone_numbers: [{ number: "1234567890", type: HOME }], phone_consent: true, email: "johndoe@joincandidhealth.com", email_consent: true, non_insurance_payers: ["d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32"], non_insurance_payers_info: [{ non_insurance_payer_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32", member_id: "string", clinical_trial_info: [{ clinical_trial_id: "d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32" }] }] },
|
2434
|
+
# rendering_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" },
|
2435
|
+
# service_facility: { organization_name: "Test Organization", address: { address_1: "123 Main St", address_2: "Apt 1", city: "New York", state: NY, zip_code: "10001", zip_plus_four_code: "1234" } },
|
2436
|
+
# 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" },
|
2437
|
+
# 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", provider_commercial_license_type: LICENSED_CLINICAL_SOCIAL_WORKER, first_name: "string", last_name: "string", organization_name: "string" },
|
2409
2438
|
# place_of_service_code_as_submitted: PHARMACY
|
2410
2439
|
# )
|
2411
2440
|
def update(encounter_id:, benefits_assigned_to_provider: nil, prior_authorization_number: nil,
|
2412
|
-
external_id: nil, date_of_service: nil, tag_ids: nil, clinical_notes: nil,
|
2441
|
+
external_id: nil, date_of_service: nil, tag_ids: nil, clinical_notes: nil, billable_status: nil, responsible_party: nil, provider_accepts_assignment: nil, synchronicity: nil, place_of_service_code: nil, appointment_type: nil, end_date_of_service: nil, subscriber_primary: nil, subscriber_secondary: nil, subscriber_tertiary: 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, existing_medications: nil, guarantor: nil, referral_number: nil, epsdt_referral: nil, claim_supplemental_information: nil, secondary_payer_carrier_code: nil, additional_properties: nil, _field_set: nil, pay_to_address: nil, diagnosis_ids: nil, initial_referring_provider: nil, referring_provider: nil, patient: nil, rendering_provider: nil, service_facility: nil, supervising_provider: nil, billing_provider: nil, place_of_service_code_as_submitted: nil, request_options: nil)
|
2413
2442
|
Async do
|
2414
2443
|
response = @request_client.conn.patch do |req|
|
2415
2444
|
req.options.timeout = request_options.timeout_in_seconds unless request_options&.timeout_in_seconds.nil?
|
@@ -2427,7 +2456,6 @@ module CandidApiClient
|
|
2427
2456
|
date_of_service: date_of_service,
|
2428
2457
|
tag_ids: tag_ids,
|
2429
2458
|
clinical_notes: clinical_notes,
|
2430
|
-
pay_to_address: pay_to_address,
|
2431
2459
|
billable_status: billable_status,
|
2432
2460
|
responsible_party: responsible_party,
|
2433
2461
|
provider_accepts_assignment: provider_accepts_assignment,
|
@@ -2445,24 +2473,26 @@ module CandidApiClient
|
|
2445
2473
|
onset_of_current_illness_or_symptom_date: onset_of_current_illness_or_symptom_date,
|
2446
2474
|
last_menstrual_period_date: last_menstrual_period_date,
|
2447
2475
|
delay_reason_code: delay_reason_code,
|
2448
|
-
patient: patient,
|
2449
2476
|
patient_authorized_release: patient_authorized_release,
|
2450
2477
|
schema_instances: schema_instances,
|
2451
2478
|
vitals: vitals,
|
2452
2479
|
existing_medications: existing_medications,
|
2453
|
-
rendering_provider: rendering_provider,
|
2454
|
-
service_facility: service_facility,
|
2455
2480
|
guarantor: guarantor,
|
2456
|
-
billing_provider: billing_provider,
|
2457
|
-
supervising_provider: supervising_provider,
|
2458
|
-
referring_provider: referring_provider,
|
2459
|
-
initial_referring_provider: initial_referring_provider,
|
2460
2481
|
referral_number: referral_number,
|
2461
2482
|
epsdt_referral: epsdt_referral,
|
2462
2483
|
claim_supplemental_information: claim_supplemental_information,
|
2484
|
+
secondary_payer_carrier_code: secondary_payer_carrier_code,
|
2463
2485
|
additional_properties: additional_properties,
|
2464
2486
|
_field_set: _field_set,
|
2487
|
+
pay_to_address: pay_to_address,
|
2465
2488
|
diagnosis_ids: diagnosis_ids,
|
2489
|
+
initial_referring_provider: initial_referring_provider,
|
2490
|
+
referring_provider: referring_provider,
|
2491
|
+
patient: patient,
|
2492
|
+
rendering_provider: rendering_provider,
|
2493
|
+
service_facility: service_facility,
|
2494
|
+
supervising_provider: supervising_provider,
|
2495
|
+
billing_provider: billing_provider,
|
2466
2496
|
place_of_service_code_as_submitted: place_of_service_code_as_submitted
|
2467
2497
|
}.compact
|
2468
2498
|
req.url "#{@request_client.get_url(environment: CandidApi,
|