change_health 1.0.2 → 2.2.0

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data/CHANGELOG.md

@@ -4,6 +4,54 @@ 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).
 
+## [2.2.0] - [2021-11-04-21]
+### Added
+Ability to hit [Claim Responses and Reports](https://developers.changehealthcare.com/eligibilityandclaims/docs/claims-responses-and-reports-getting-started)
+* Report
+* ReportListData
+* ReportData
+
+## [2.1.0] - [2021-10-12]
+### Changed
+Model#to_h enhanced to change empty values AKA "" to nil. Reason: If a field is empty, Change Healthcare responds with an error - `Invalid value. Item must not be blank value.`. If the empty field is optional, Change Healthcare will accept the field as nil without error. If the empty field is required, Change Healthcare will return an error if the value is empty or nil.
+
+## [2.0.0] - [2021-10-08]
+### Added
+#### Models
+* ResponseData - for responses from calling change healthcare api used by EligibilityData and SubmissionData
+#### Claim Submission
+Added the ability to hit professional claim submission API. For more details, see [Change Healthcare documentation here](https://developers.changehealthcare.com/eligibilityandclaims/docs/professional-claims-v3-getting-started)
+* ClaimInformation
+* Provider
+* ServiceLine
+* Submission
+* SubmissionData
+* Submitter
+* Subscriber
+### Changed
+ * Using new Change Healthcare url. From apis to apigw. For more info see [change log here](https://developers.changehealthcare.com/eligibilityandclaims/docs/change-logrelease-notes-1)
+ * PARSE_DATE moved from ChangeHealth::Models::EligibilityData to ChangeHealth::Models
+ * Moved Error class into its own file
+#### Namespace
+ Many classes moved namespaces to be more consistent across the many endpoints in Change Healthcare
+| Previous | Current |
+|-|-|
+|ChangeHealth::Models::Eligibility | ChangeHealth::Request::Eligibility |
+| ChangeHealth::Models::Encounter | ChangeHealth::Models::Eligibility::Encounter|
+| ChangeHealth::Models::Provider | ChangeHealth::Models::Eligibility::Provider|
+| ChangeHealth::Models::Subscriber | ChangeHealth::Models::Eligibility::Subscriber|
+| ChangeHealth::Models::EligibilityBenefit | ChangeHealth::Response::EligibilityBenefit|
+| ChangeHealth::Models::EligibilityBenefits | ChangeHealth::Response::EligibilityBenefits|
+| ChangeHealth::Models::EligibilityData | ChangeHealth::Response::EligibilityData|
+### Fixed
+ * Eligibility#add_dependent actually works
+
+## [1.0.3] - [2021-04-26]
+### Added
+- Model::Error#represents_down? - adds ability to distinguish error representing down state
+- Model::Error#retryable? - retryable when down
+- EligibilityData#recommend_retry? - recommend retry when down
+
 ## [1.0.2] - [2021-04-06]
 ### Added
 - EligibilityData#recommend_retry? - fix a bug in the search statement
@@ -108,7 +156,7 @@ and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.
 ### Added
 - Production endpoint
 
-## [0.2.0] - [2020-03-09]
+## [0.0.2] - [2020-03-09]
 ### Added
 - EligibilityData
 - EligibilityBenefit
@@ -117,7 +165,7 @@ and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.
 ### Changed
 - Eligibility.query returns EligibilityData object
 
-## [0.1.0] - 2020-03-04
+## [0.0.1] - 2020-03-04
 ### Added
 - Provider
 - Subscriber
@@ -126,6 +174,10 @@ and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.
 - Authentication
 - Configuration
 
+[2.2.0]: https://github.com/WeInfuse/change_health/compare/v2.1.0...v2.2.0
+[2.1.0]: https://github.com/WeInfuse/change_health/compare/v2.0.0...v2.1.0
+[2.0.0]: https://github.com/WeInfuse/change_health/compare/v1.0.3...v2.0.0
+[1.0.3]: https://github.com/WeInfuse/change_health/compare/v1.0.2...v1.0.3
 [1.0.2]: https://github.com/WeInfuse/change_health/compare/v1.0.1...v1.0.2
 [1.0.1]: https://github.com/WeInfuse/change_health/compare/v1.0.0...v1.0.1
 [1.0.0]: https://github.com/WeInfuse/change_health/compare/v0.15.0...v1.0.0
@@ -141,6 +193,6 @@ and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.
 [0.6.0]: https://github.com/WeInfuse/change_health/compare/v0.5.0...v0.6.0
 [0.5.0]: https://github.com/WeInfuse/change_health/compare/v0.4.0...v0.5.0
 [0.4.0]: https://github.com/WeInfuse/change_health/compare/v0.3.0...v0.4.0
-[0.3.0]: https://github.com/WeInfuse/change_health/compare/v0.2.0...v0.3.0
-[0.2.0]: https://github.com/WeInfuse/change_health/compare/v0.1.0...v0.2.0
-[0.1.0]: https://github.com/WeInfuse/change_health/compare/v0.1.0
+[0.3.0]: https://github.com/WeInfuse/change_health/compare/v0.0.2...v0.3.0
+[0.0.2]: https://github.com/WeInfuse/change_health/compare/v0.0.1...v0.0.2
+[0.0.1]: https://github.com/WeInfuse/change_health/compare/520a8c54d07...v0.0.1

data/README.md

@@ -26,24 +26,25 @@ Or install it yourself as:
 Make sure you're [configured](#configuration)!
 
 ### Eligibility
+[Change Healthcare Eligibility Guide](https://developers.changehealthcare.com/eligibilityandclaims/docs)
 ```ruby
-ChangeHealth::Models::Eligibility.ping # Test your connection
+ChangeHealth::Request::Eligibility.ping # Test your connection
 
-encounter  = ChangeHealth::Models::Encounter.new(date_of_service: Date.current, service_type_codes: ['98'])
-provider   = ChangeHealth::Models::Provider.new(npi: '0123456789', last_name: 'Bobson', first_name: 'Bob')
-subscriber = ChangeHealth::Models::Subscriber.new(member_id: '0000000000', first_name: 'johnOne', last_name: 'doeOne', date_of_birth: '18800102')
+encounter  = ChangeHealth::Models::Eligibility::Encounter.new(date_of_service: Date.current, service_type_codes: ['98'])
+provider   = ChangeHealth::Models::Eligibility::Provider.new(npi: '0123456789', last_name: 'Bobson', first_name: 'Bob')
+subscriber = ChangeHealth::Models::Eligibility::Subscriber.new(member_id: '0000000000', first_name: 'johnOne', last_name: 'doeOne', date_of_birth: '18800102')
 
-edata = ChangeHealth::Models::Eligibility.new(tradingPartnerServiceId: '000050', provider: provider, subscriber: subscriber, encounter: encounter).query
+edata = ChangeHealth::Request::Eligibility.new(tradingPartnerServiceId: '000050', provider: provider, subscriber: subscriber, encounter: encounter).query
 
 edata.raw # Raw Hash of JSON response
 ```
 
-### Benefit(s) objects
+#### Benefit(s) objects
 Benefits extends Array and provides a query-like interface.
 
 Benefit extends Hash and provides helpers for single-benefit.
 
-```
+```ruby
 edata.benefits # Returns Benefits querying object (extends Array)
 
 edata.benefits.individual # Only benefits matching the 'IND' identifier
@@ -57,7 +58,7 @@ edata.benefits.where(name: 'Co-Payment', code: 'B', benefitAmount: '30) # Generi
 edata.benefits.find_by(name: 'Co-Payment', code: 'B', benefitAmount: '30) # Generic 'find_by' api returns first object found
 ```
 
-### Response
+#### Response
 
 Response is EligibilityData object
 
@@ -77,16 +78,138 @@ true
 
 ### Trading Partners
 ```ruby
-  # Query trading partners using a wildcard search
-  # Returns Array of ChangeHealth::Models::TradingPartner Objects
-  trading_partners = ChangeHealth::Request::TradingPartner.query("Aetna")
+# Query trading partners using a wildcard search
+# Returns Array of ChangeHealth::Models::TradingPartner Objects
+trading_partners = ChangeHealth::Request::TradingPartner.query("Aetna")
 
-  trading_partners.first.name
-  "Aetna"
+trading_partners.first.name
+# "Aetna"
+
+trading_partners.first.service_id
+# "ABC123"
+```
 
-  trading_partners.first.service_id
-  "ABC123"
+### Claim Submission
+[Change Healthcare Claim Submission Guide](https://developers.changehealthcare.com/eligibilityandclaims/docs/professional-claims-v3-getting-started)
+```ruby
+ChangeHealth::Request::Claim::Submission.ping # Test your connection
+
+contact_information = { name: "SUBMITTER CONTACT INFO", phoneNumber: "123456789"}
+claim_submitter = ChangeHealth::Models::Claim::Submitter.new(
+  organization_name: "REGIONAL PPO NETWORK",
+  contact_information: contact_information
+)
+
+receiver = { organizationName: "EXTRA HEALTHY INSURANCE"}
+address = {
+  "address1": "123 address1",
+  "city": "city1",
+  "state": "wa",
+  "postalCode": "981010000"
+}
+subscriber = ChangeHealth::Models::Claim::Subscriber.new(
+  member_id: "0000000001",
+  payment_responsibility_level_code: "P",
+  first_name: "johnone",
+  last_name: "doetwo",
+  gender: "M",
+  date_of_birth: "02/01/1980",
+  address: address
+)
+provider = ChangeHealth::Models::Claim::Provider.new(
+  address: address,
+ employer_id: "000000000",
+ first_name: "johnone",
+ last_name: "doetwo",
+ npi: "1760854442",
+ provider_type: "BillingProvider"
+)
+
+health_care_code_information1 = {
+  "diagnosisTypeCode": "ABK",
+  "diagnosisCode": "S93401A"
+}
+health_care_code_information2 = {
+  "diagnosisTypeCode": "ABF",
+  "diagnosisCode": "S72044G"
+
+}
+service_line1 = ChangeHealth::Models::Claim::ServiceLine.new(
+  service_date: "2018-05-14",
+  professional_service: {
+    "procedureIdentifier": "HC",
+    "lineItemChargeAmount": "25",
+    "procedureCode": "E0570",
+    "measurementUnit": "UN",
+    "serviceUnitCount": "1",
+    "compositeDiagnosisCodePointers": {
+      "diagnosisCodePointers": ["1","2"]
+    }
+  }
+)
+service_line2 = ChangeHealth::Models::Claim::ServiceLine.new(
+  service_date: "20180514",
+  professional_service: {
+    "procedureIdentifier": "HC",
+    "lineItemChargeAmount": "3.75",
+    "procedureCode": "A7003",
+    "measurementUnit": "UN",
+    "serviceUnitCount": "1",
+    "compositeDiagnosisCodePointers": {
+      "diagnosisCodePointers": ["1"]
+    }
+  }
+)
+claim_information = ChangeHealth::Models::Claim::ClaimInformation.new(
+  benefits_assignment_certification_indicator: "Y",
+  claim_charge_amount: "28.75",
+  claim_filing_code: "CI",
+  claim_frequency_code: "1",
+  patient_control_number: "12345",
+  place_of_service_code: "11",
+  plan_participation_code: "A",
+  release_information_code: "Y",
+  signature_indicator: "Y",
+  health_care_code_information: [health_care_code_information1, health_care_code_information2],
+  service_lines: [service_line1, service_line2]
+)
+
+
+claim_submission = ChangeHealth::Request::Claim::Submission.new(
+  trading_partner_service_id: "9496",
+  submitter: claim_submitter,
+  receiver: receiver,
+  subscriber: subscriber,
+  providers: [provider],
+  claim_information: claim_information
+)
+
+claim_submission_data = claim_submission.submission
 ```
+
+### Claim Reports
+[Change Healthcare Claim Responses and Reports Guide](https://developers.changehealthcare.com/eligibilityandclaims/docs/claims-responses-and-reports-getting-started)
+```ruby
+ChangeHealth::Request::Claim::Report.ping # Test your connection
+
+report_list = ChangeHealth::Request::Claim::Report.report_list
+
+report_list.report_names
+# ["X3000000.XX", "R5000000.XY", "R5000000.XX", "X3000000.AB", "X3000000.AC", "X3000000.ZZ", "R5000000.XZ", "R5000000.YZ", "R5000000.WA", "R5000000.WB", "R5000000.WC"]
+
+report1_edi = ChangeHealth::Request::Claim::Report.get_report(report_list.report_names.first, as_json_report: false)
+# Report in edi format
+
+report1_json = ChangeHealth::Request::Claim::Report.get_report(report_list.report_names.first, as_json_report: true)
+# Report in json format
+
+reports_json = report_list.report_names.map {|report_name| ChangeHealth::Request::Claim::Report.get_report(report_name)}
+# all reports in json format
+
+reports_edi = report_list.report_names.map {|report_name| ChangeHealth::Request::Claim::Report.get_report(report_name, as_json_report: false)}
+# all reports in edi format
+```
+
 ### Configuration
 
 ```ruby

data/lib/change_health/connection.rb

@@ -1,6 +1,6 @@
 module ChangeHealth
   class Connection
-    URI_BUILDER = ->(host) { "https://#{host}apis.changehealthcare.com/".freeze }
+    URI_BUILDER = ->(host) { "https://#{host}apigw.changehealthcare.com/".freeze }
 
     QA_ENDPOINT   = URI_BUILDER.call('sandbox.')
     PROD_ENDPOINT = URI_BUILDER.call('')

data/lib/change_health/models/claim/submission/claim_information.rb

@@ -0,0 +1,31 @@
+module ChangeHealth
+  module Models
+    module Claim
+      class ClaimInformation < Hashie::Trash
+        property :benefitsAssignmentCertificationIndicator, from: :benefits_assignment_certification_indicator, required: false
+        property :claimChargeAmount, from: :claim_charge_amount, required: false
+        property :claimFilingCode, from: :claim_filing_code, required: false
+        property :claimFrequencyCode, from: :claim_frequency_code, required: false
+        property :claimSupplementalInformation, from: :claim_supplemental_information, required: false
+        property :healthCareCodeInformation, from: :health_care_code_information, required: false
+        property :patientControlNumber, from: :patient_control_number, required: false
+        property :placeOfServiceCode, from: :place_of_service_code, required: false
+        property :planParticipationCode, from: :plan_participation_code, required: false
+        property :releaseInformationCode, from: :release_information_code, required: false
+        property :serviceFacilityLocation, from: :service_facility_location, required: false
+        property :serviceLines, from: :service_lines, required: false
+        property :signatureIndicator, from: :signature_indicator, required: false
+
+        def add_service_line(service_line)
+          self[:serviceLines] ||= []
+          self[:serviceLines] << service_line
+        end
+
+        def add_health_care_code_information(health_care_code_information)
+          self[:healthCareCodeInformation] ||= []
+          self[:healthCareCodeInformation] << health_care_code_information
+        end
+      end
+    end
+  end
+end

data/lib/change_health/models/claim/submission/provider.rb

@@ -0,0 +1,17 @@
+module ChangeHealth
+  module Models
+    module Claim
+      class Provider < Hashie::Trash
+        property :address, required: false
+        property :contactInformation, from: :contact_information, required: false
+        property :employerId, from: :employer_id, required: false # or ssn
+        property :firstName, from: :first_name, required: false
+        property :lastName, from: :last_name, required: false
+        property :organizationName, from: :organization_name, required: false
+        property :npi, required: false
+        property :providerType, from: :provider_type, required: false
+        property :ssn, required: false # or employer id
+      end
+    end
+  end
+end

data/lib/change_health/models/claim/submission/service_line.rb

@@ -0,0 +1,12 @@
+module ChangeHealth
+  module Models
+    module Claim
+      class ServiceLine < Model
+
+        property :serviceDate, from: :service_date, required: false
+        property :professionalService, from: :professional_service, required: false
+
+      end
+    end
+  end
+end

data/lib/change_health/models/claim/submission/submitter.rb

@@ -0,0 +1,11 @@
+module ChangeHealth
+  module Models
+    module Claim
+      class Submitter < Hashie::Trash
+        property :organizationName, from: :organization_name, required: false
+        # contact information has a name & phone number inside
+        property :contactInformation, from: :contact_information, required: false
+      end
+    end
+  end
+end

data/lib/change_health/models/claim/submission/subscriber.rb

@@ -0,0 +1,15 @@
+module ChangeHealth
+  module Models
+    module Claim
+      class Subscriber < Model
+        property :address, required: false
+        property :dateOfBirth, from: :date_of_birth, required: false
+        property :firstName, from: :first_name, required: false
+        property :gender, required: false
+        property :lastName, from: :last_name, required: false
+        property :memberId, from: :member_id, required: false
+        property :paymentResponsibilityLevelCode, from: :payment_responsibility_level_code, required: false
+      end
+    end
+  end
+end

data/lib/change_health/models/eligibility/encounter.rb

@@ -0,0 +1,22 @@
+module ChangeHealth
+  module Models
+    module Eligibility
+      class Encounter < Model
+        property :beginningDateOfService, from: :beginning_date_of_service, required: false
+        property :dateOfService, from: :date_of_service, required: false
+        property :dateRange, from: :date_range, required: false, default: false
+        property :endDateOfService, from: :end_date_of_service, required: false
+        property :serviceTypeCodes, from: :service_type_codes, required: false
+
+        alias_method :dateRange?, :dateRange
+        alias_method :date_range?, :dateRange
+        alias_method :service_type_codes, :serviceTypeCodes
+
+        def add_service_type_code(code)
+          self[:serviceTypeCodes] ||= []
+          self[:serviceTypeCodes] << code
+        end
+      end
+    end
+  end
+end

data/lib/change_health/models/eligibility/provider.rb

@@ -0,0 +1,23 @@
+module ChangeHealth
+  module Models
+    module Eligibility
+      class Provider < Hashie::Trash
+        property :firstName, from: :first_name, required: false
+        property :lastName, from: :last_name, required: false
+        property :name, default: true, required: false
+        property :npi, required: false
+        property :organizationName, from: :organization_name, required: false
+        property :payorId, from: :payer_id, required: false
+        property :person, default: true, required: false
+        property :providerCode, from: :provider_code, required: false
+        property :providerName, from: :provider_name, required: false
+        property :providerType, from: :provider_type, required: false
+        property :referenceIdentification, from: :reference_identification, required: false
+        property :serviceProviderNumber, from: :service_provider_number, required: false
+        property :taxId, from: :tax_id, required: false
+
+        alias_method :name?, :name
+      end
+    end
+  end
+end

data/lib/change_health/models/eligibility/subscriber.rb

@@ -0,0 +1,31 @@
+module ChangeHealth
+  module Models
+    module Eligibility
+      class Subscriber < Model
+        property :additionalIdentification, required: false
+        property :address, required: false
+        property :birthSequenceNumber, from: :birth_sequence_number, required: false
+        property :caseNumber, from: :case_number, required: false
+        property :dateOfBirth, from: :date_of_birth, required: false
+        property :firstName, from: :first_name, required: false
+        property :gender, required: false
+        property :groupNumber, from: :group_number, required: false
+        property :healthCareCodeInformation, from: :health_care_code_information, required: false
+        property :idCard, from: :id_card, required: false
+        property :idCardIssueDate, from: :id_card_issued_date, required: false
+        property :lastName, from: :last_name, required: false
+        property :medicaidRecipientIdentificationNumber, from: :medicaid_recipient_identification_number, required: false
+        property :memberId, from: :member_id, required: false
+        property :providerCode, from: :provider_code, required: false
+        property :providerIdentifier, from: :provider_identification, required: false
+        property :referenceIdentificationQualifier, from: :reference_identification_qualifier, required: false
+        property :ssn, required: false
+
+        def add_health_care_code_information(value)
+          self[:healthCareCodeInformation] ||= []
+          self[:healthCareCodeInformation] << value
+        end
+      end
+    end
+  end
+end

data/lib/change_health/models/error.rb

@@ -0,0 +1,57 @@
+module ChangeHealth
+  # TODO: This should be the response module/folder... next major release
+  module Models
+    class Error
+      attr_reader :data
+
+      SIMPLE_RETRY_CODES = %w[
+            42
+            80
+          ].freeze
+
+      NO_RESUBMIT_MESSAGES = [
+        'resubmission not allowed',
+        'do not resubmit'
+      ].freeze
+
+      DOWN_FIELD = 'Http Header'.freeze
+
+      DOWN_MESSAGE = 'Please review http headers for this API, please contact support if you are unsure how to resolve.'.freeze
+
+      def initialize(data)
+        @data = data
+      end
+
+      def message
+        field_message || code_message
+      end
+
+      def field_message
+        "#{field}: #{description}" if field?
+      end
+
+      def code_message
+        "#{code}: #{description}" if code?
+      end
+
+      def represents_down?
+        field == DOWN_FIELD && description == DOWN_MESSAGE
+      end
+
+      def retryable?
+        represents_down? ||
+          (code? && SIMPLE_RETRY_CODES.include?(code) && followupAction? && NO_RESUBMIT_MESSAGES.none? {|msg| followupAction.downcase.include?(msg) })
+      end
+
+      %w[field description code followupAction location].each do |method_name|
+        define_method("#{method_name}?") do
+          false == send(method_name).nil?
+        end
+
+        define_method("#{method_name}") do
+          @data[method_name]
+        end
+      end
+    end
+  end
+end

data/lib/change_health/models/model.rb

@@ -12,14 +12,26 @@ module ChangeHealth
       d
     }
 
+    PARSE_DATE = ->(d) {
+      begin
+        d = Date.strptime(d, ChangeHealth::Models::DATE_FORMAT)
+      rescue
+      end
+
+      d
+    }
+
+    CONTROL_NUMBER = ->() { '%09d' % rand(1_000_000_000) }
+
     class Model < Hashie::Trash
       def to_h
         result = super.to_h
 
-        self.class.properties.each do |key|
+        self.each_pair do |key, value|
           if key.to_s.downcase.include?('date')
             result[key] = ChangeHealth::Models::DATE_FORMATTER.call(result[key])
           end
+          result[key] = nil if value == ""
         end
 
         result

data/lib/change_health/{models → request}/eligibility.rb

@@ -1,10 +1,10 @@
 module ChangeHealth
-  module Models
+  module Request
     class Eligibility < Hashie::Trash
       ENDPOINT = '/medicalnetwork/eligibility/v3'.freeze
       HEALTH_CHECK_ENDPOINT = ENDPOINT + '/healthcheck'.freeze
 
-      property :controlNumber, from: :control_number, required: true, default: ->() { '%09d' % rand(1_000_000_000) }
+      property :controlNumber, from: :control_number, required: true, default: ChangeHealth::Models::CONTROL_NUMBER
       property :dependents, required: false
       property :encounter, required: false
       property :informationReceiverName, from: :information_receiver_name, required: false
@@ -20,12 +20,12 @@ module ChangeHealth
       alias_method :partner_id?, :partnerId
 
       def add_dependent(dependent)
-        self[:dependent] ||= []
-        self[:dependent] << dependent
+        self[:dependents] ||= []
+        self[:dependents] << dependent
       end
 
       def query
-        ChangeHealth::Models::EligibilityData.new(response: ChangeHealth::Connection.new.request(endpoint: ENDPOINT, body: self.to_h))
+        ChangeHealth::Response::EligibilityData.new(response: ChangeHealth::Connection.new.request(endpoint: ENDPOINT, body: self.to_h))
       end
 
       def self.health_check

data/lib/change_health/request/report.rb

@@ -0,0 +1,39 @@
+module ChangeHealth
+  module Request
+    module Claim
+      class Report
+        ENDPOINT = '/medicalnetwork/reports/v2'.freeze
+        HEALTH_CHECK_ENDPOINT = ENDPOINT + '/healthcheck'.freeze
+
+        def self.report_list
+          ChangeHealth::Response::Claim::ReportListData.new(response: ChangeHealth::Connection.new.request(endpoint: ENDPOINT, verb: :get))
+        end
+
+        def self.get_report(report_name, as_json_report: true)
+          return if report_name.nil? || report_name.empty?
+
+          individual_report_endpoint = ENDPOINT + '/' + report_name
+          if as_json_report
+            # https://developers.changehealthcare.com/eligibilityandclaims/docs/what-file-types-does-this-api-get-from-the-mailbox
+            report_type = ChangeHealth::Response::Claim::ReportData.report_type(report_name)
+            return if report_type.nil?
+
+            individual_report_endpoint += '/' + report_type
+          end
+
+          ChangeHealth::Response::Claim::ReportData.new(report_name,
+                                                        as_json_report,
+                                                        response: ChangeHealth::Connection.new.request(endpoint: individual_report_endpoint, verb: :get))
+        end
+
+        def self.health_check
+          ChangeHealth::Connection.new.request(endpoint: HEALTH_CHECK_ENDPOINT, verb: :get)
+        end
+
+        def self.ping
+          self.health_check
+        end
+      end
+    end
+  end
+end

data/lib/change_health/request/submission.rb

@@ -0,0 +1,38 @@
+module ChangeHealth
+  module Request
+    module Claim
+      class Submission < Hashie::Trash
+        ENDPOINT = '/medicalnetwork/professionalclaims/v3'.freeze
+        HEALTH_CHECK_ENDPOINT = ENDPOINT + '/healthcheck'.freeze
+        SUBMISSION_ENDPOINT = ENDPOINT + '/submission'.freeze
+
+        property :claimInformation, from: :claim_information, required: false
+        property :controlNumber, from: :control_number, required: true, default: ChangeHealth::Models::CONTROL_NUMBER
+        property :providers, required: false
+        property :receiver, required: false
+        property :submitter, required: false
+        property :subscriber, required: false
+        # Need one or the other, trading partner id or trading partner service id
+        property :tradingPartnerId, from: :trading_partner_id, required: false
+        property :tradingPartnerServiceId, from: :trading_partner_service_id, required: false
+
+        def add_provider(provider)
+          self[:providers] ||= []
+          self[:providers] << provider
+        end
+
+        def submission
+          ChangeHealth::Response::Claim::SubmissionData.new(response: ChangeHealth::Connection.new.request(endpoint: SUBMISSION_ENDPOINT, body: self.to_h))
+        end
+
+        def self.health_check
+          ChangeHealth::Connection.new.request(endpoint: HEALTH_CHECK_ENDPOINT, verb: :get)
+        end
+
+        def self.ping
+          self.health_check
+        end
+      end
+    end
+  end
+end

data/lib/change_health/response/claim/report/report_data.rb

@@ -0,0 +1,45 @@
+module ChangeHealth
+  module Response
+    module Claim
+      class ReportData < ChangeHealth::Response::ResponseData
+        attr_reader :report_name, :json
+        alias_method :json?, :json
+
+        def initialize(report_name, json, data: nil, response: nil)
+          super(data: data, response: response)
+          @report_name = report_name
+          @json = json
+        end
+
+        def edi?
+          !@json
+        end
+
+        def report_type
+          self.class.report_type(@report_name)
+        end
+
+        def self.report_type(report_name)
+          return '277' if is_277?(report_name)
+          return '835' if is_835?(report_name)
+        end
+
+        def is_277?
+          self.class.is_277?(@report_name)
+        end
+
+        def self.is_277?(report_name)
+          report_name.start_with?('X3')
+        end
+
+        def is_835?
+          self.class.is_835?(@report_name)
+        end
+
+        def self.is_835?(report_name)
+          report_name.start_with?('R5')
+        end
+      end
+    end
+  end
+end

data/lib/change_health/response/claim/report/report_list_data.rb

@@ -0,0 +1,13 @@
+module ChangeHealth
+  module Response
+    module Claim
+      class ReportListData < ChangeHealth::Response::ResponseData
+
+        def report_names
+          @raw.dig('reports')
+        end
+        
+      end
+    end
+  end
+end

data/lib/change_health/response/claim/submission/submission_data.rb

@@ -0,0 +1,23 @@
+module ChangeHealth
+  module Response
+    module Claim
+      class SubmissionData < ChangeHealth::Response::ResponseData
+
+        %w(controlNumber status tradingPartnerId tradingPartnerServiceId).each do |v|
+          define_method(v) do
+            @raw.dig(v)
+          end
+        end
+
+        alias_method :control_number, :controlNumber
+        alias_method :trading_partner_id, :tradingPartnerId
+        alias_method :trading_partner_service_id, :tradingPartnerServiceId
+
+        def trading_partner?(name)
+          self.trading_partner_id == name || trading_partner_service_id == name
+        end
+
+      end
+    end
+  end
+end

data/lib/change_health/{models → response/eligibility}/eligibility_benefit.rb

@@ -1,5 +1,5 @@
 module ChangeHealth
-  module Models
+  module Response
     class EligibilityBenefit < Hash
       include Hashie::Extensions::MergeInitializer
       include Hashie::Extensions::IndifferentAccess
@@ -54,7 +54,7 @@ module ChangeHealth
         coverageLevelCode: COVERAGES,
         code: CODES
       }
-        
+
       HELPERS.each do |key, types|
         types.each do |method, value|
           define_method("#{method}?") do
@@ -99,13 +99,13 @@ module ChangeHealth
         self.coinsurance? ? self.benefitPercent : self.benefitAmount
       end
 
-      def services 
+      def services
         self['serviceTypeCodes']&.each_with_index&.map {|stc, i| [stc, self['serviceTypes']&.at(i)]} || []
       end
 
       %w(eligibilityBegin eligibilityEnd planBegin planEnd service).each do |f|
         define_method(f) do
-          return ChangeHealth::Models::EligibilityData::PARSE_DATE.call(self.date_info&.dig(f))
+          return ChangeHealth::Models::PARSE_DATE.call(self.date_info&.dig(f))
         end
       end
       alias_method :eligibility_begin_date, :eligibilityBegin
@@ -120,11 +120,11 @@ module ChangeHealth
       end
 
       def plan_date_range_start
-        ChangeHealth::Models::EligibilityData::PARSE_DATE.call(self.plan_date_range[0])
+        ChangeHealth::Models::PARSE_DATE.call(self.plan_date_range[0])
       end
 
       def plan_date_range_end
-        ChangeHealth::Models::EligibilityData::PARSE_DATE.call(self.plan_date_range[1])
+        ChangeHealth::Models::PARSE_DATE.call(self.plan_date_range[1])
       end
 
       private

data/lib/change_health/{models → response/eligibility}/eligibility_benefits.rb

@@ -1,8 +1,8 @@
 module ChangeHealth
-  module Models
+  module Response
     class EligibilityBenefits < Array
       def initialize(benefits)
-        super(benefits.map {|benefit| ChangeHealth::Models::EligibilityBenefit.new(benefit) })
+        super(benefits.map {|benefit| ChangeHealth::Response::EligibilityBenefit.new(benefit) })
       end
 
       def where(**kwargs)
@@ -25,7 +25,7 @@ module ChangeHealth
         self.where(inPlanNetworkIndicatorCode: 'Y')
       end
 
-      ChangeHealth::Models::EligibilityBenefit::HELPERS.each do |key, types|
+      ChangeHealth::Response::EligibilityBenefit::HELPERS.each do |key, types|
         types.each do |method, value|
           define_method("#{method}s") do
             self.where(key => value)

data/lib/change_health/{models → response/eligibility}/eligibility_data.rb

@@ -1,76 +1,10 @@
 module ChangeHealth
-  module Models
-    class Error
-      attr_reader :data
-
-      SIMPLE_RETRY_CODES = %w[
-        42
-        80
-      ].freeze
-
-      NO_RESUBMIT_MESSAGES = [
-        'resubmission not allowed',
-        'do not resubmit'
-      ].freeze
-
-      def initialize(data)
-        @data = data
-      end
-
-      def message
-        field_message || code_message
-      end
-
-      def field_message
-        "#{field}: #{description}" if field?
-      end
-
-      def code_message
-        "#{code}: #{description}" if code?
-      end
-
-      def retryable?
-        code? && SIMPLE_RETRY_CODES.include?(code) && followupAction? && NO_RESUBMIT_MESSAGES.none? {|msg| followupAction.downcase.include?(msg) }
-      end
-
-      %w[field description code followupAction location].each do |method_name|
-        define_method("#{method_name}?") do
-          false == send(method_name).nil?
-        end
-
-        define_method("#{method_name}") do
-          @data[method_name]
-        end
-      end
-    end
-
-    class EligibilityData
-      attr_reader :response, :raw
+  module Response
+    class EligibilityData < ChangeHealth::Response::ResponseData
 
       ACTIVE = '1'
       INACTIVE = '6'
 
-      PARSE_DATE = ->(d) {
-        begin
-          d = Date.strptime(d, ChangeHealth::Models::DATE_FORMAT)
-        rescue
-        end
-
-        d
-      }
-
-      def initialize(data: nil, response: nil)
-        @response = response
-        @raw      = data
-
-        begin
-          @raw ||= response&.parsed_response
-        rescue JSON::ParserError
-        end
-
-        @raw ||= {}
-      end
-
       def active?(service_code: '30')
         plan_status(service_code: service_code, single: false).any? {|status| ACTIVE == status['statusCode'] }
       end
@@ -79,26 +13,6 @@ module ChangeHealth
         plan_status(service_code: service_code, single: false).any? {|status| INACTIVE == status['statusCode'] }
       end
 
-      def errors?
-        self.errors.is_a?(Array) && false == self.errors.empty?
-      end
-
-      def errors
-        errors = @raw.dig('errors') || []
-
-        errors.flatten.map {|error| ChangeHealth::Models::Error.new(error) }
-      end
-
-      def recommend_retry?
-        return false unless errors?
-
-        error_codes = errors.select(&:code?)
-
-        return false if error_codes.empty?
-
-        return error_codes.all?(&:retryable?)
-      end
-
       def dependents?
         true == self.dependents&.any?
       end
@@ -111,7 +25,7 @@ module ChangeHealth
 
       %w(eligibilityBegin planBegin service).each do |f|
         define_method(f) do
-          return PARSE_DATE.call(self.date_info&.dig(f))
+          return ChangeHealth::Models::PARSE_DATE.call(self.date_info&.dig(f))
         end
       end
       alias_method :eligibility_begin_date, :eligibilityBegin
@@ -124,11 +38,11 @@ module ChangeHealth
       end
 
       def plan_date_range_start
-        ChangeHealth::Models::EligibilityData::PARSE_DATE.call(self.plan_date_range[0])
+        ChangeHealth::Models::PARSE_DATE.call(self.plan_date_range[0])
       end
 
       def plan_date_range_end
-        ChangeHealth::Models::EligibilityData::PARSE_DATE.call(self.plan_date_range[1])
+        ChangeHealth::Models::PARSE_DATE.call(self.plan_date_range[1])
       end
 
       def plan_status(service_code: , single: true)
@@ -140,9 +54,9 @@ module ChangeHealth
       end
 
       def benefits
-        kname   = "ChangeHealth::Models::EligibilityBenefits#{self.trading_partner_id&.upcase}"
+        kname   = "ChangeHealth::Response::EligibilityBenefits#{self.trading_partner_id&.upcase}"
         klazz   = Object.const_get(kname) if Module.const_defined?(kname)
-        klazz ||= ChangeHealth::Models::EligibilityBenefits
+        klazz ||= ChangeHealth::Response::EligibilityBenefits
 
         if klazz.respond_to?(:factory)
           klazz = klazz.factory(self)

data/lib/change_health/response/response_data.rb

@@ -0,0 +1,41 @@
+module ChangeHealth
+  module Response
+    class ResponseData
+      attr_reader :response, :raw
+
+      def initialize(data: nil, response: nil)
+        @response = response
+        @raw      = data
+
+        begin
+          @raw ||= response&.parsed_response
+        rescue JSON::ParserError
+        end
+
+        @raw ||= {}
+      end
+
+      def errors?
+        self.errors.is_a?(Array) && false == self.errors.empty?
+      end
+
+      def errors
+        errors = @raw.dig('errors') || []
+
+        errors.flatten.map {|error| ChangeHealth::Models::Error.new(error) }
+      end
+
+      def recommend_retry?
+        return false unless errors?
+
+        return true if errors.any?(&:represents_down?)
+
+        error_codes = errors.select(&:code?)
+
+        return false if error_codes.empty?
+
+        return error_codes.all?(&:retryable?)
+      end
+    end
+  end
+end

data/lib/change_health/version.rb

@@ -1,3 +1,3 @@
 module ChangeHealth
-  VERSION = '1.0.2'.freeze
+  VERSION = '2.2.0'.freeze
 end

data/lib/change_health.rb

@@ -1,22 +1,34 @@
 require 'httparty'
 require 'hashie'
 require 'change_health/version'
+require 'change_health/authentication'
 require 'change_health/change_health_exception'
 require 'change_health/connection'
-require 'change_health/authentication'
 require 'change_health/extensions'
+require 'change_health/models/error'
 require 'change_health/models/model'
-require 'change_health/models/eligibility'
-require 'change_health/models/eligibility_data'
-require 'change_health/models/eligibility_benefit'
-require 'change_health/models/eligibility_benefits'
-require 'change_health/models/trading_partner'
+require 'change_health/models/claim/submission/claim_information'
+require 'change_health/models/claim/submission/provider'
+require 'change_health/models/claim/submission/service_line'
+require 'change_health/models/claim/submission/submitter'
+require 'change_health/models/claim/submission/subscriber'
+require 'change_health/models/eligibility/encounter'
+require 'change_health/models/eligibility/provider'
+require 'change_health/models/eligibility/subscriber'
+require 'change_health/models/trading_partner/trading_partner'
+require 'change_health/request/eligibility'
+require 'change_health/request/submission'
+require 'change_health/request/report'
 require 'change_health/request/trading_partner'
-require 'change_health/response/trading_partner_data'
-require 'change_health/response/trading_partners_data'
-require 'change_health/models/encounter'
-require 'change_health/models/provider'
-require 'change_health/models/subscriber'
+require 'change_health/response/response_data'
+require 'change_health/response/claim/submission/submission_data'
+require 'change_health/response/claim/report/report_list_data'
+require 'change_health/response/claim/report/report_data'
+require 'change_health/response/eligibility/eligibility_benefit'
+require 'change_health/response/eligibility/eligibility_benefits'
+require 'change_health/response/eligibility/eligibility_data'
+require 'change_health/response/trading_partner/trading_partner_data'
+require 'change_health/response/trading_partner/trading_partners_data'
 
 module ChangeHealth
   class Configuration

metadata

@@ -1,14 +1,14 @@
 --- !ruby/object:Gem::Specification
 name: change_health
 version: !ruby/object:Gem::Version
-  version: 1.0.2
+  version: 2.2.0
 platform: ruby
 authors:
 - Mike Crockett
-autorequire:
+autorequire: 
 bindir: exe
 cert_chain: []
-date: 2021-04-06 00:00:00.000000000 Z
+date: 2021-11-05 00:00:00.000000000 Z
 dependencies:
 - !ruby/object:Gem::Dependency
   name: httparty
@@ -128,7 +128,7 @@ dependencies:
     - - "~>"
       - !ruby/object:Gem::Version
         version: '0.9'
-description:
+description: 
 email:
 - mike.crockett@weinfuse.com
 executables: []
@@ -147,25 +147,37 @@ files:
 - 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
-- lib/change_health/models/eligibility_data.rb
-- lib/change_health/models/encounter.rb
+- lib/change_health/models/claim/submission/claim_information.rb
+- lib/change_health/models/claim/submission/provider.rb
+- lib/change_health/models/claim/submission/service_line.rb
+- lib/change_health/models/claim/submission/submitter.rb
+- lib/change_health/models/claim/submission/subscriber.rb
+- lib/change_health/models/eligibility/encounter.rb
+- lib/change_health/models/eligibility/provider.rb
+- lib/change_health/models/eligibility/subscriber.rb
+- lib/change_health/models/error.rb
 - lib/change_health/models/model.rb
-- lib/change_health/models/provider.rb
-- lib/change_health/models/subscriber.rb
-- lib/change_health/models/trading_partner.rb
+- lib/change_health/models/trading_partner/trading_partner.rb
+- lib/change_health/request/eligibility.rb
+- lib/change_health/request/report.rb
+- lib/change_health/request/submission.rb
 - lib/change_health/request/trading_partner.rb
-- lib/change_health/response/trading_partner_data.rb
-- lib/change_health/response/trading_partners_data.rb
+- lib/change_health/response/claim/report/report_data.rb
+- lib/change_health/response/claim/report/report_list_data.rb
+- lib/change_health/response/claim/submission/submission_data.rb
+- lib/change_health/response/eligibility/eligibility_benefit.rb
+- lib/change_health/response/eligibility/eligibility_benefits.rb
+- lib/change_health/response/eligibility/eligibility_data.rb
+- lib/change_health/response/response_data.rb
+- lib/change_health/response/trading_partner/trading_partner_data.rb
+- lib/change_health/response/trading_partner/trading_partners_data.rb
 - lib/change_health/version.rb
 homepage: https://github.com/WeInfuse/change_health
 licenses:
 - MIT
 metadata:
   allowed_push_host: https://rubygems.org
-post_install_message:
+post_install_message: 
 rdoc_options: []
 require_paths:
 - lib
@@ -180,8 +192,8 @@ required_rubygems_version: !ruby/object:Gem::Requirement
     - !ruby/object:Gem::Version
       version: '0'
 requirements: []
-rubygems_version: 3.2.15
-signing_key:
+rubygems_version: 3.1.6
+signing_key: 
 specification_version: 4
 summary: Ruby wrapper for the ChangeHealth API
 test_files: []

data/lib/change_health/models/encounter.rb

@@ -1,20 +0,0 @@
-module ChangeHealth
-  module Models
-    class Encounter < Model
-      property :beginningDateOfService, from: :beginning_date_of_service, required: false
-      property :dateOfService, from: :date_of_service, required: false
-      property :dateRange, from: :date_range, required: false, default: false
-      property :endDateOfService, from: :end_date_of_service, required: false
-      property :serviceTypeCodes, from: :service_type_codes, required: false
-
-      alias_method :dateRange?, :dateRange
-      alias_method :date_range?, :dateRange
-      alias_method :service_type_codes, :serviceTypeCodes
-
-      def add_service_type_code(code)
-        self[:serviceTypeCodes] ||= []
-        self[:serviceTypeCodes] << code
-      end
-    end
-  end
-end

data/lib/change_health/models/provider.rb

@@ -1,21 +0,0 @@
-module ChangeHealth
-  module Models
-    class Provider < Hashie::Trash
-      property :firstName, from: :first_name, required: false
-      property :lastName, from: :last_name, required: false
-      property :name, default: true, required: false
-      property :npi, required: false
-      property :organizationName, from: :organization_name, required: false
-      property :payorId, from: :payer_id, required: false
-      property :person, default: true, required: false
-      property :providerCode, from: :provider_code, required: false
-      property :providerName, from: :provider_name, required: false
-      property :providerType, from: :provider_type, required: false
-      property :referenceIdentification, from: :reference_identification, required: false
-      property :serviceProviderNumber, from: :service_provider_number, required: false
-      property :taxId, from: :tax_id, required: false
-
-      alias_method :name?, :name
-    end
-  end
-end

data/lib/change_health/models/subscriber.rb

@@ -1,29 +0,0 @@
-module ChangeHealth
-  module Models
-    class Subscriber < Model
-      property :additionalIdentification, required: false
-      property :address, required: false
-      property :birthSequenceNumber, from: :birth_sequence_number, required: false
-      property :caseNumber, from: :case_number, required: false
-      property :dateOfBirth, from: :date_of_birth, required: false
-      property :firstName, from: :first_name, required: false
-      property :gender, required: false
-      property :groupNumber, from: :group_number, required: false
-      property :healthCareCodeInformation, from: :health_care_code_information, required: false
-      property :idCard, from: :id_card, required: false
-      property :idCardIssueDate, from: :id_card_issued_date, required: false
-      property :lastName, from: :last_name, required: false
-      property :medicaidRecipientIdentificationNumber, from: :medicaid_recipient_identification_number, required: false
-      property :memberId, from: :member_id, required: false
-      property :providerCode, from: :provider_code, required: false
-      property :providerIdentifier, from: :provider_identification, required: false
-      property :referenceIdentificationQualifier, from: :reference_identification_qualifier, required: false
-      property :ssn, required: false
-
-      def add_health_care_code_information(value)
-        self[:healthCareCodeInformation] ||= []
-        self[:healthCareCodeInformation] << value
-      end
-    end
-  end
-end