change_health 0.10.0 → 0.15.0

checksums.yaml

@@ -1,7 +1,7 @@
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data/CHANGELOG.md

@@ -4,6 +4,43 @@ All notable changes to this project will be documented in this file.
 The format is based on [Keep a Changelog](http://keepachangelog.com/en/1.0.0/)
 and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.html).
 
+## [0.15.0] - [2020-06-12]
+### Added
+- Extensions - InNetworkMissing for plans that don't provide in network indicators.
+
+### Fixed
+- Bug where active codes with no service codes cause exception.
+
+## [0.14.0] - [2020-05-07]
+### Added
+- Extensions - mixins for common overrides
+
+## [0.13.0] - [2020-05-05]
+### Changed
+- Removed `alias_method` for `where` helpers so you can override a single method
+- Added type Year to Date type 24
+- Added type Day type 7
+
+## [0.12.0] - [2020-04-30]
+### Added
+- EligibilityData#errors
+- EligibilityData#errors?
+
+## [0.11.0] - [2020-04-24]
+### Added
+- EligibilityData#medicare?
+- EligibilityData#plan\_id
+- EligibilityData#plan?
+- EligibilityBenefits#where\_not
+- EligibilityBenefits#+
+- EligibilityBenefit#additional\_info
+- EligibilityBenefit#descriptions
+
+### Changed
+- EligibilityData initialize now checks for sub-classes of EligibilityBenefits with trading partner
+- EligibilityData initialize now checks for sub-classes of EligibilityBenefits with trading partner responds to `factory` to choose sub-class
+- EligibilityBenefits initializes `self.class` type in case it's a subclass
+
 ## [0.10.0] - [2020-04-09]
 ### Added
 - Add Trading Partner API querying capability
@@ -74,6 +111,11 @@ and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.
 - Authentication
 - Configuration
 
+[0.15.0]: https://github.com/WeInfuse/change_health/compare/v0.14.0...v0.15.0
+[0.14.0]: https://github.com/WeInfuse/change_health/compare/v0.13.0...v0.14.0
+[0.13.0]: https://github.com/WeInfuse/change_health/compare/v0.12.0...v0.13.0
+[0.12.0]: https://github.com/WeInfuse/change_health/compare/v0.11.0...v0.12.0
+[0.11.0]: https://github.com/WeInfuse/change_health/compare/v0.10.0...v0.11.0
 [0.10.0]: https://github.com/WeInfuse/change_health/compare/v0.9.0...v0.10.0
 [0.9.0]: https://github.com/WeInfuse/change_health/compare/v0.8.0...v0.9.0
 [0.8.0]: https://github.com/WeInfuse/change_health/compare/v0.7.0...v0.8.0

data/lib/change_health.rb

@@ -4,6 +4,7 @@ require 'change_health/version'
 require 'change_health/change_health_exception'
 require 'change_health/connection'
 require 'change_health/authentication'
+require 'change_health/extensions'
 require 'change_health/models/model'
 require 'change_health/models/eligibility'
 require 'change_health/models/eligibility_data'

data/lib/change_health/extensions.rb

@@ -0,0 +1,39 @@
+module ChangeHealth
+  module Extensions
+    module InNetworkW
+      def in_network
+        self.where(inPlanNetworkIndicatorCode: 'Y') + self.where(inPlanNetworkIndicatorCode: 'W')
+      end
+    end
+
+    module InNetworkMissing
+      def in_network
+        self.where_not(inPlanNetworkIndicatorCode: 'N')
+      end
+    end
+
+    module DeductiblesIgnoreSpecialistZero
+      def deductibles
+        super.where_not(serviceTypeCodes: '98', benefitAmount: '0')
+      end
+    end
+
+    module CopaymentsIgnoreSpecialistZero
+      def copayments
+        super.where_not(serviceTypeCodes: '98', benefitAmount: '0')
+      end
+    end
+
+    module CoinsurancesIgnoreSpecialistZero
+      def coinsurances
+        super.where_not(serviceTypeCodes: '98', benefitPercent: '0')
+      end
+    end
+
+    module IndividualsAllNonFamily
+      def individuals
+        self.where_not(coverageLevelCode: 'FAM')
+      end
+    end
+  end
+end

data/lib/change_health/models/eligibility_benefit.rb

@@ -14,10 +14,14 @@ module ChangeHealth
       CHILD         = 'CHD'
       EMPLOYEE      = 'EMP'
       FAMILY        = 'FAM'
-      EMPLOYEE_AND_CHILD = 'ECH'
+      EMPLOYEE_AND_CHILD  = 'ECH'
+      EMPLOYEE_AND_SPOUSE = 'ESP'
 
       VISIT         = '27'
+      SERVICE_YEAR  = '22'
       YEAR          = '23'
+      YTD           = '24'
+      DAY           =  '7'
       REMAINING     = '29'
 
       CODES = {
@@ -32,7 +36,8 @@ module ChangeHealth
         child: CHILD,
         employee: EMPLOYEE,
         family: FAMILY,
-        employee_and_child: EMPLOYEE_AND_CHILD
+        employee_and_child: EMPLOYEE_AND_CHILD,
+        employee_and_spouse: EMPLOYEE_AND_SPOUSE
       }
       TIMEFRAMES = {
         visit: VISIT,
@@ -68,7 +73,7 @@ module ChangeHealth
         end
       end
 
-      %w(insuranceType insuranceTypeCode benefitsDateInformation).each do |method|
+      %w(insuranceType insuranceTypeCode benefitsDateInformation additionalInformation).each do |method|
         define_method("#{method}") do
           self[method]
         end
@@ -76,6 +81,13 @@ module ChangeHealth
       alias_method :date_info, :benefitsDateInformation
       alias_method :insurance_type, :insuranceType
       alias_method :insurance_type_code, :insuranceTypeCode
+      alias_method :additional_info, :additionalInformation
+
+      def descriptions
+        data = self.additionalInformation || []
+
+        data.map {|info| info['description'] }.compact
+      end
 
       def in_plan_network?
         return 'Y' == self[:inPlanNetworkIndicatorCode] || self[:inPlanNetworkIndicatorCode].nil? && self.medicare?

data/lib/change_health/models/eligibility_benefits.rb

@@ -6,7 +6,15 @@ module ChangeHealth
       end
 
       def where(**kwargs)
-        EligibilityBenefits.new(self.select {|benefit| kwargs.all? {|k,v| benefit_matches?(benefit, k, v) } })
+        self.class.new(self.select {|benefit| kwargs.all? {|k,v| benefit_matches?(benefit, k, v) } })
+      end
+
+      def where_not(**kwargs)
+        self.class.new(self.reject {|benefit| kwargs.all? {|k,v| benefit_matches?(benefit, k, v) } })
+      end
+
+      def +(other_obj)
+        self.class.new(self.to_a + other_obj.to_a)
       end
 
       def find_by(**kwargs)
@@ -25,27 +33,49 @@ module ChangeHealth
         end
       end
 
-      def individual_coinsurance_visit(**kwargs)
-        self.individual.coinsurances.visits.where(kwargs).first
-      end
-
       %w(family individual employee child employee_and_child).each do |method|
-        alias_method method, "#{method}s"
+        define_method(method) do
+          self.send("#{method}s")
+        end
+
+        %w(copayment coinsurance).each do |type_mod|
+          method_name = "#{method}_#{type_mod}"
 
-        %w(copayment deductible out_of_pocket).each do |type_mod|
-          %w(year remaining visit).each do |time_mod|
+          define_method(method_name) do |**kwargs|
+            self.send(method).send("#{type_mod}s").where(kwargs).first
+          end
+
+          if ('copayment' == type_mod)
+            define_method(method_name.gsub('copayment', 'copay')) do |**kwargs|
+              self.send(method_name, kwargs)
+            end
+          end
+        end
+
+        %w(deductible out_of_pocket).each do |type_mod|
+          %w(year remaining).each do |time_mod|
             method_name = "#{method}_#{type_mod}_#{time_mod}"
-            alias_name  = method_name.gsub('copayment', 'copay').gsub('out_of_pocket', 'oop')
 
             define_method(method_name) do |**kwargs|
               self.send(method).send("#{type_mod}s").send("#{time_mod}s").where(kwargs).first || self.send(method).send("#{type_mod}s").where(kwargs).first
             end
 
-            alias_method alias_name, method_name if alias_name != method_name
+            if ('out_of_pocket' == type_mod)
+              define_method(method_name.gsub('out_of_pocket', 'oop')) do |**kwargs|
+                self.send(method_name, kwargs)
+              end
+
+              if ('year' == time_mod)
+                define_method(method_name.gsub('out_of_pocket', 'oop').gsub('year', 'total')) do |**kwargs|
+                  self.send(method_name, kwargs)
+                end
+              end
+            end
 
-            if method_name.include?('year')
-              alias_method method_name.gsub('year', 'total'), method_name
-              alias_method alias_name.gsub('year', 'total'), method_name
+            if ('year' == time_mod)
+              define_method(method_name.gsub('year', 'total')) do |**kwargs|
+                self.send(method_name, kwargs)
+              end
             end
           end
         end

data/lib/change_health/models/eligibility_data.rb

@@ -28,7 +28,15 @@ module ChangeHealth
         return '1' == plan_status(service_code: service_code).dig('statusCode')
       end
 
-      %w(planStatus benefitsInformation controlNumber planDateInformation).each do |v|
+      def errors?
+        self.errors.is_a?(Array) && false == self.errors.empty?
+      end
+
+      def dependents?
+        true == self.dependents&.any?
+      end
+
+      %w(planStatus benefitsInformation controlNumber planDateInformation dependents errors).each do |v|
         define_method(v) do
           @raw.dig(v)
         end
@@ -56,17 +64,40 @@ module ChangeHealth
         ChangeHealth::Models::EligibilityData::PARSE_DATE.call(self.plan_date_range[1])
       end
 
-
       def plan_status(service_code: )
-        self.planStatus&.find {|plan| plan.dig('serviceTypeCodes').include?(service_code) } || {}
+        self.planStatus&.find {|plan| plan.dig('serviceTypeCodes')&.include?(service_code) } || {}
       end
 
       def benefits
-        ChangeHealth::Models::EligibilityBenefits.new(self.benefitsInformation || [])
+        kname   = "ChangeHealth::Models::EligibilityBenefits#{self.trading_partner_id&.upcase}"
+        klazz   = Object.const_get(kname) if Module.const_defined?(kname)
+        klazz ||= ChangeHealth::Models::EligibilityBenefits
+
+        if klazz.respond_to?(:factory)
+          klazz = klazz.factory(self)
+        end
+
+        klazz.new(self.benefitsInformation || [])
+      end
+
+      def medicare?(**kwargs)
+        false == benefits.empty? && benefits.where(kwargs).all? {|b| b.medicare? }
+      end
+
+      def plan?(name)
+        self.plan_names.any? {|pname| name == pname }
+      end
+
+      def plan_names
+        self.planStatus&.map {|plan_status| plan_status['planDetails'] }&.compact || []
+      end
+
+      def trading_partner?(name)
+        self.trading_partner_id == name
       end
 
-      def medicare?
-        false == benefits.empty? && benefits.all? {|b| b.medicare? }
+      def trading_partner_id
+        @raw['tradingPartnerServiceId']
       end
 
       alias_method :control_number, :controlNumber

data/lib/change_health/version.rb

@@ -1,3 +1,3 @@
 module ChangeHealth
-  VERSION = '0.10.0'.freeze
+  VERSION = '0.15.0'.freeze
 end

metadata

@@ -1,14 +1,14 @@
 --- !ruby/object:Gem::Specification
 name: change_health
 version: !ruby/object:Gem::Version
-  version: 0.10.0
+  version: 0.15.0
 platform: ruby
 authors:
 - Mike Crockett
 autorequire: 
 bindir: exe
 cert_chain: []
-date: 2020-04-09 00:00:00.000000000 Z
+date: 2020-06-12 00:00:00.000000000 Z
 dependencies:
 - !ruby/object:Gem::Dependency
   name: httparty
@@ -146,6 +146,7 @@ files:
 - lib/change_health/authentication.rb
 - lib/change_health/change_health_exception.rb
 - lib/change_health/connection.rb
+- lib/change_health/extensions.rb
 - lib/change_health/models/eligibility.rb
 - lib/change_health/models/eligibility_benefit.rb
 - lib/change_health/models/eligibility_benefits.rb