change_health 3.0.0 → 3.1.0
Sign up to get free protection for your applications and to get access to all the features.
- checksums.yaml +4 -4
- data/CHANGELOG.md +10 -0
- data/README.md +30 -29
- data/lib/change_health/models/claim/submission/address.rb +13 -0
- data/lib/change_health/models/claim/submission/drug_identification.rb +12 -0
- data/lib/change_health/models/claim/submission/service_line.rb +2 -2
- data/lib/change_health/models/claim/submission/subscriber.rb +1 -0
- data/lib/change_health/models/model.rb +44 -16
- data/lib/change_health/request/submission.rb +11 -10
- data/lib/change_health/version.rb +1 -1
- data/lib/change_health.rb +2 -0
- metadata +4 -2
checksums.yaml
CHANGED
@@ -1,7 +1,7 @@
|
|
1
1
|
---
|
2
2
|
SHA256:
|
3
|
-
metadata.gz:
|
4
|
-
data.tar.gz:
|
3
|
+
metadata.gz: eef3b2530820969a781c893ec5079573073cf31124243bf781d3415186a45cb1
|
4
|
+
data.tar.gz: a48072bc0dd1437314eef45596569b6be7e56200c578164b4d8ff0cd98646df8
|
5
5
|
SHA512:
|
6
|
-
metadata.gz:
|
7
|
-
data.tar.gz:
|
6
|
+
metadata.gz: 2f67e82f2eb5660f767a297aa000cd4028606aab717b0db035b85b3933ad033276cb34bcb5373a5b716cd1bf611fd3b72d26fb3baae80a9d2783b2190a386179
|
7
|
+
data.tar.gz: f8e33bf4dece3c99287b0474bdaadf9d3b8ac1d39dccbfb35fc43c979cbb706973c93ae07adaa9202be5e20adb2ba74766b78fa615191fa29caf548526692597
|
data/CHANGELOG.md
CHANGED
@@ -4,6 +4,15 @@ All notable changes to this project will be documented in this file.
|
|
4
4
|
The format is based on [Keep a Changelog](http://keepachangelog.com/en/1.0.0/)
|
5
5
|
and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.html).
|
6
6
|
|
7
|
+
## [3.1.0] - 2021-12-21
|
8
|
+
### Added
|
9
|
+
#### Claim Submission
|
10
|
+
* ServiceLine - drugIdentification & renderingProvider
|
11
|
+
* Subscriber - groupNumber
|
12
|
+
* Address model w/ postalCode that is formatted to remove dashes, '-'
|
13
|
+
* Note: Using a plain hash for address still works
|
14
|
+
* Auto formatting of postal code fields
|
15
|
+
|
7
16
|
## [3.0.0] - 2021-12-08
|
8
17
|
### Added
|
9
18
|
* Report277Claim - specific to claims from 277 reports
|
@@ -216,6 +225,7 @@ Added the ability to hit professional claim submission API. For more details, se
|
|
216
225
|
- Authentication
|
217
226
|
- Configuration
|
218
227
|
|
228
|
+
[3.1.0]: https://github.com/WeInfuse/change_health/compare/v3.0.0...v3.1.0
|
219
229
|
[3.0.0]: https://github.com/WeInfuse/change_health/compare/v2.3.0...v3.0.0
|
220
230
|
[2.3.0]: https://github.com/WeInfuse/change_health/compare/v2.2.1...v2.3.0
|
221
231
|
[2.2.1]: https://github.com/WeInfuse/change_health/compare/v2.2.0...v2.2.1
|
data/README.md
CHANGED
@@ -109,12 +109,13 @@ claim_submitter = ChangeHealth::Models::Claim::Submitter.new(
|
|
109
109
|
)
|
110
110
|
|
111
111
|
receiver = { organizationName: "EXTRA HEALTHY INSURANCE"}
|
112
|
-
address =
|
113
|
-
|
114
|
-
|
115
|
-
|
116
|
-
|
117
|
-
|
112
|
+
address = ChangeHealth::Models::Claim::Address.new(
|
113
|
+
address1: "123 address1",
|
114
|
+
city: "city1",
|
115
|
+
state: "wa",
|
116
|
+
postalCode: "98101-0000"
|
117
|
+
)
|
118
|
+
|
118
119
|
subscriber = ChangeHealth::Models::Claim::Subscriber.new(
|
119
120
|
member_id: "0000000001",
|
120
121
|
payment_responsibility_level_code: "P",
|
@@ -126,45 +127,45 @@ subscriber = ChangeHealth::Models::Claim::Subscriber.new(
|
|
126
127
|
)
|
127
128
|
provider = ChangeHealth::Models::Claim::Provider.new(
|
128
129
|
address: address,
|
129
|
-
|
130
|
-
|
131
|
-
|
132
|
-
|
133
|
-
|
130
|
+
employer_id: "000000000",
|
131
|
+
first_name: "johnone",
|
132
|
+
last_name: "doetwo",
|
133
|
+
npi: "1760854442",
|
134
|
+
provider_type: "BillingProvider"
|
134
135
|
)
|
135
136
|
|
136
137
|
health_care_code_information1 = {
|
137
|
-
|
138
|
-
|
138
|
+
diagnosisTypeCode: "ABK",
|
139
|
+
diagnosisCode: "S93401A"
|
139
140
|
}
|
140
141
|
health_care_code_information2 = {
|
141
|
-
|
142
|
-
|
142
|
+
diagnosisTypeCode: "ABF",
|
143
|
+
diagnosisCode: "S72044G"
|
143
144
|
|
144
145
|
}
|
145
146
|
service_line1 = ChangeHealth::Models::Claim::ServiceLine.new(
|
146
147
|
service_date: "2018-05-14",
|
147
148
|
professional_service: {
|
148
|
-
|
149
|
-
|
150
|
-
|
151
|
-
|
152
|
-
|
153
|
-
|
154
|
-
|
149
|
+
procedureIdentifier: "HC",
|
150
|
+
lineItemChargeAmount: "25",
|
151
|
+
procedureCode: "E0570",
|
152
|
+
measurementUnit: "UN",
|
153
|
+
serviceUnitCount: "1",
|
154
|
+
compositeDiagnosisCodePointers: {
|
155
|
+
diagnosisCodePointers: ["1","2"]
|
155
156
|
}
|
156
157
|
}
|
157
158
|
)
|
158
159
|
service_line2 = ChangeHealth::Models::Claim::ServiceLine.new(
|
159
160
|
service_date: "20180514",
|
160
161
|
professional_service: {
|
161
|
-
|
162
|
-
|
163
|
-
|
164
|
-
|
165
|
-
|
166
|
-
|
167
|
-
|
162
|
+
procedureIdentifier: "HC",
|
163
|
+
lineItemChargeAmount: "3.75",
|
164
|
+
procedureCode: "A7003",
|
165
|
+
measurementUnit: "UN",
|
166
|
+
serviceUnitCount: "1",
|
167
|
+
compositeDiagnosisCodePointers: {
|
168
|
+
diagnosisCodePointers: ["1"]
|
168
169
|
}
|
169
170
|
}
|
170
171
|
)
|
@@ -0,0 +1,13 @@
|
|
1
|
+
module ChangeHealth
|
2
|
+
module Models
|
3
|
+
module Claim
|
4
|
+
class Address < Model
|
5
|
+
property :address1, required: false
|
6
|
+
property :address2, required: false
|
7
|
+
property :city, required: false
|
8
|
+
property :postalCode, from: :postal_code, required: false
|
9
|
+
property :state, required: false
|
10
|
+
end
|
11
|
+
end
|
12
|
+
end
|
13
|
+
end
|
@@ -0,0 +1,12 @@
|
|
1
|
+
module ChangeHealth
|
2
|
+
module Models
|
3
|
+
module Claim
|
4
|
+
class DrugIdentification < Model
|
5
|
+
property :measurementUnitCode, from: :measurement_unit_code, required: false
|
6
|
+
property :nationalDrugCode, from: :national_drug_code, required: false
|
7
|
+
property :nationalDrugUnitCount, from: :national_drug_unit_count, required: false
|
8
|
+
property :serviceIdQualifier, from: :service_id_qualifier, required: false
|
9
|
+
end
|
10
|
+
end
|
11
|
+
end
|
12
|
+
end
|
@@ -2,10 +2,10 @@ module ChangeHealth
|
|
2
2
|
module Models
|
3
3
|
module Claim
|
4
4
|
class ServiceLine < Model
|
5
|
-
|
5
|
+
property :drugIdentification, from: :drug_identification, required: false
|
6
6
|
property :serviceDate, from: :service_date, required: false
|
7
7
|
property :professionalService, from: :professional_service, required: false
|
8
|
-
|
8
|
+
property :renderingProvider, from: :rendering_provider, required: false
|
9
9
|
end
|
10
10
|
end
|
11
11
|
end
|
@@ -6,6 +6,7 @@ module ChangeHealth
|
|
6
6
|
property :dateOfBirth, from: :date_of_birth, required: false
|
7
7
|
property :firstName, from: :first_name, required: false
|
8
8
|
property :gender, required: false
|
9
|
+
property :groupNumber, from: :group_number, required: false
|
9
10
|
property :lastName, from: :last_name, required: false
|
10
11
|
property :memberId, from: :member_id, required: false
|
11
12
|
property :paymentResponsibilityLevelCode, from: :payment_responsibility_level_code, required: false
|
@@ -1,7 +1,7 @@
|
|
1
1
|
module ChangeHealth
|
2
2
|
module Models
|
3
3
|
DATE_FORMAT = '%Y%m%d'
|
4
|
-
DATE_FORMATTER =
|
4
|
+
DATE_FORMATTER = lambda { |d|
|
5
5
|
begin
|
6
6
|
d = Date.parse(d) if d.is_a?(String)
|
7
7
|
rescue ArgumentError
|
@@ -12,37 +12,65 @@ module ChangeHealth
|
|
12
12
|
d
|
13
13
|
}
|
14
14
|
|
15
|
-
PARSE_DATE =
|
15
|
+
PARSE_DATE = lambda { |d|
|
16
16
|
begin
|
17
17
|
d = Date.strptime(d, ChangeHealth::Models::DATE_FORMAT)
|
18
|
-
rescue
|
18
|
+
rescue StandardError
|
19
19
|
end
|
20
20
|
|
21
21
|
d
|
22
22
|
}
|
23
23
|
|
24
|
-
|
24
|
+
POSTAL_CODE_FORMATTER = lambda { |postal_code|
|
25
|
+
begin
|
26
|
+
formatted_postal_code = postal_code&.to_s&.tr('-', '')
|
27
|
+
rescue StandardError
|
28
|
+
end
|
29
|
+
formatted_postal_code || postal_code
|
30
|
+
}
|
31
|
+
|
32
|
+
CONTROL_NUMBER = -> { '%09d' % rand(1_000_000_000) }
|
25
33
|
|
26
34
|
class Model < Hashie::Trash
|
27
35
|
def to_h
|
28
|
-
|
36
|
+
self.class.hashify(self)
|
37
|
+
end
|
38
|
+
|
39
|
+
def self.hashify(model)
|
40
|
+
model.map do |key, value|
|
41
|
+
formatted_value = case value
|
42
|
+
when Hash
|
43
|
+
hashify(model[key])
|
44
|
+
when Array
|
45
|
+
value.map do |element|
|
46
|
+
if element.is_a?(Hash)
|
47
|
+
hashify(element)
|
48
|
+
else # if it's an array of arrays, can't handle it
|
49
|
+
format_value(key, element)
|
50
|
+
end
|
51
|
+
end
|
52
|
+
else
|
53
|
+
format_value(key, value)
|
54
|
+
end
|
55
|
+
[key, formatted_value]
|
56
|
+
end.to_h
|
57
|
+
end
|
58
|
+
|
59
|
+
def self.format_value(key, value)
|
60
|
+
return nil if value == ''
|
29
61
|
|
30
|
-
|
31
|
-
|
32
|
-
result[key] = ChangeHealth::Models::DATE_FORMATTER.call(result[key])
|
33
|
-
end
|
34
|
-
result[key] = nil if value == ""
|
35
|
-
end
|
62
|
+
return ChangeHealth::Models::DATE_FORMATTER.call(value) if key.to_s.downcase.include?('date')
|
63
|
+
return ChangeHealth::Models::POSTAL_CODE_FORMATTER.call(value) if key.to_s.downcase.include?('postalcode')
|
36
64
|
|
37
|
-
|
65
|
+
value
|
38
66
|
end
|
39
67
|
|
40
|
-
def as_json(
|
41
|
-
|
68
|
+
def as_json(_args = {})
|
69
|
+
to_h
|
42
70
|
end
|
43
71
|
|
44
|
-
def to_json
|
45
|
-
|
72
|
+
def to_json(*_args)
|
73
|
+
to_h.to_json
|
46
74
|
end
|
47
75
|
end
|
48
76
|
end
|
@@ -2,7 +2,6 @@ module ChangeHealth
|
|
2
2
|
module Request
|
3
3
|
module Claim
|
4
4
|
class Submission < Hashie::Trash
|
5
|
-
|
6
5
|
ENDPOINT = '/medicalnetwork/professionalclaims/v3'.freeze
|
7
6
|
HEALTH_CHECK_ENDPOINT = ENDPOINT + '/healthcheck'.freeze
|
8
7
|
SUBMISSION_ENDPOINT = ENDPOINT + '/submission'.freeze
|
@@ -25,11 +24,15 @@ module ChangeHealth
|
|
25
24
|
end
|
26
25
|
|
27
26
|
def submission
|
28
|
-
ChangeHealth::Response::Claim::SubmissionData.new(response: ChangeHealth::Connection.new.request(
|
27
|
+
ChangeHealth::Response::Claim::SubmissionData.new(response: ChangeHealth::Connection.new.request(
|
28
|
+
endpoint: SUBMISSION_ENDPOINT, body: to_h, headers: professional_headers
|
29
|
+
))
|
29
30
|
end
|
30
31
|
|
31
32
|
def validation
|
32
|
-
ChangeHealth::Response::Claim::SubmissionData.new(response: ChangeHealth::Connection.new.request(
|
33
|
+
ChangeHealth::Response::Claim::SubmissionData.new(response: ChangeHealth::Connection.new.request(
|
34
|
+
endpoint: VALIDATION_ENDPOINT, body: to_h, headers: professional_headers
|
35
|
+
))
|
33
36
|
end
|
34
37
|
|
35
38
|
def self.health_check
|
@@ -37,19 +40,17 @@ module ChangeHealth
|
|
37
40
|
end
|
38
41
|
|
39
42
|
def self.ping
|
40
|
-
|
43
|
+
health_check
|
41
44
|
end
|
42
45
|
|
43
46
|
def professional_headers
|
44
47
|
if self[:headers]
|
45
48
|
extra_headers = {}
|
46
|
-
extra_headers[
|
47
|
-
extra_headers[
|
48
|
-
extra_headers[
|
49
|
-
extra_headers[
|
49
|
+
extra_headers['X-CHC-ClaimSubmission-SubmitterId'] = self[:headers][:submitter_id]
|
50
|
+
extra_headers['X-CHC-ClaimSubmission-BillerId'] = self[:headers][:biller_id]
|
51
|
+
extra_headers['X-CHC-ClaimSubmission-Username'] = self[:headers][:username]
|
52
|
+
extra_headers['X-CHC-ClaimSubmission-Pwd'] = self[:headers][:password]
|
50
53
|
extra_headers
|
51
|
-
else
|
52
|
-
nil
|
53
54
|
end
|
54
55
|
end
|
55
56
|
end
|
data/lib/change_health.rb
CHANGED
@@ -6,7 +6,9 @@ require 'change_health/change_health_exception'
|
|
6
6
|
require 'change_health/connection'
|
7
7
|
require 'change_health/extensions'
|
8
8
|
require 'change_health/models/model'
|
9
|
+
require 'change_health/models/claim/submission/address'
|
9
10
|
require 'change_health/models/claim/submission/claim_information'
|
11
|
+
require 'change_health/models/claim/submission/drug_identification'
|
10
12
|
require 'change_health/models/claim/submission/provider'
|
11
13
|
require 'change_health/models/claim/submission/service_line'
|
12
14
|
require 'change_health/models/claim/submission/submitter'
|
metadata
CHANGED
@@ -1,14 +1,14 @@
|
|
1
1
|
--- !ruby/object:Gem::Specification
|
2
2
|
name: change_health
|
3
3
|
version: !ruby/object:Gem::Version
|
4
|
-
version: 3.
|
4
|
+
version: 3.1.0
|
5
5
|
platform: ruby
|
6
6
|
authors:
|
7
7
|
- Mike Crockett
|
8
8
|
autorequire:
|
9
9
|
bindir: exe
|
10
10
|
cert_chain: []
|
11
|
-
date: 2021-12-
|
11
|
+
date: 2021-12-21 00:00:00.000000000 Z
|
12
12
|
dependencies:
|
13
13
|
- !ruby/object:Gem::Dependency
|
14
14
|
name: httparty
|
@@ -147,7 +147,9 @@ files:
|
|
147
147
|
- lib/change_health/change_health_exception.rb
|
148
148
|
- lib/change_health/connection.rb
|
149
149
|
- lib/change_health/extensions.rb
|
150
|
+
- lib/change_health/models/claim/submission/address.rb
|
150
151
|
- lib/change_health/models/claim/submission/claim_information.rb
|
152
|
+
- lib/change_health/models/claim/submission/drug_identification.rb
|
151
153
|
- lib/change_health/models/claim/submission/provider.rb
|
152
154
|
- lib/change_health/models/claim/submission/service_line.rb
|
153
155
|
- lib/change_health/models/claim/submission/submitter.rb
|