change_health 3.3.0 → 3.5.1

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data/CHANGELOG.md

@@ -1,23 +1,47 @@
 # Changelog
+
 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).
 
+# [3.5.1] - 2022-04-12
+
+* Added properties of `lineAdjudicationInformation` and `otherSubscriberInformation` so they can serialize correctly into JSON
+
+# [3.5.0] - 2022-04-08
+
+### Added
+
+* Report835Claim - added payer_identifier property
+* Report835ServiceLine - Dynamically creates line_adjustments for remark codes and adjustments that are needed for secondary claims
+
+# [3.4.0] - 2022-03-23
+
+### Added
+* Report835Claim - check_or_eft_trace_number & check_issue_or_eft_effective_date
+
 # [3.3.0] - 2022-02-11
+
 ### Added
+
 * Report277Claim - 'message' from informationClaimStatuses, clearinghouse_trace_number, patient_account_number, referenced_transaction_trace_number, trading_partner_claim_number
 * Report835Claim - patient_control_number
 * ReportClaim - report_name, patient_member_id
 
 ## [3.2.0] - 2021-12-23
+
 ### Added
+
 * Report835HealthCareCheckRemarkCode
 * Report835Claim - added claim_payment_remark_codes
 
 ## [3.1.0] - 2021-12-21
+
 ### Added
+
 #### Claim Submission
+
 * ServiceLine - drugIdentification & renderingProvider
 * Subscriber - groupNumber
 * Address model w/ postalCode that is formatted to remove dashes, '-'
@@ -25,21 +49,26 @@ and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.
 * Auto formatting of postal code fields
 
 ## [3.0.0] - 2021-12-08
+
 ### Added
+
 * Report277Claim - specific to claims from 277 reports
 * Report835Claim - specific to claims from 835 reports
 * Report835ServiceAdjustment & Report835ServiceLine - helper classes for readability of claims from 835 reports
 
 ### Changed
+
 * ReportClaim - removed 277 report unique fields
 
 #### Namespace
+
 | Previous | Current |
 |-|-|
 | ChangeHealth::Models::Error | ChangeHealth::Response::Error |
 | ChangeHealth::Response::Claim::ReportInfoClaimStatus | ChangeHealth::Response::Claim::Report277InfoClaimStatus|
 
 #### Methods
+
 | Previous | Current |
 |-|-|
 | Report277Data#payer_org_name | Report277Data#payer_name |
@@ -51,38 +80,54 @@ and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.
 | ReportClaim#subscriber_last_name | ReportClaim#patient_last_name |
 | ReportClaim#transaction_set_creation_date | ReportClaim#report_creation_date |
 
-
 ## [2.3.0] - 2021-11-18
+
 ### Added
+
 * Report277Data & Report835Data - Specific classes for 277 & 835 reports
 * ReportClaim & ReportInfoClaimStatus - only works for json 277 reports
 
 ### Fixed
+
 * Headers can now be nil for requests
 
 ## [2.2.1] - 2021-11-15
+
 ### Added
+
 Custom Headers for Reports API and Professional Claims API
+
 * Report
 * Submission
 
 ## [2.2.0] - 2021-11-04
+
 ### 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
@@ -90,11 +135,15 @@ Added the ability to hit professional claim submission API. For more details, se
 * 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
+
+* 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 |
 |-|-|
@@ -105,137 +154,200 @@ Added the ability to hit professional claim submission API. For more details, se
 | ChangeHealth::Models::EligibilityBenefit | ChangeHealth::Response::EligibilityBenefit|
 | ChangeHealth::Models::EligibilityBenefits | ChangeHealth::Response::EligibilityBenefits|
 | ChangeHealth::Models::EligibilityData | ChangeHealth::Response::EligibilityData|
+
 ### Fixed
- * Eligibility#add_dependent actually works
+
+* 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
+
+* 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
+
+* EligibilityData#recommend_retry? - fix a bug in the search statement
 
 ## [1.0.1] - 2021-03-24
+
 ### Added
-- EligibilityData#plan_status - adds ability to select instead of find
-- EligibilityData#inactive? active? - use new plan_status select
+
+* EligibilityData#plan_status - adds ability to select instead of find
+
+* EligibilityData#inactive? active? - use new plan_status select
 
 ## [1.0.0] - 2021-03-17
+
 ### Added
-- Model::Error - help with error codes
-- EligibilityData#recommend_retry? - if it looks like you can retry the exact same request
-- EligibilityData#inactive? - looks for plan status 6
+
+* Model::Error - help with error codes
+
+* EligibilityData#recommend_retry? - if it looks like you can retry the exact same request
+* EligibilityData#inactive? - looks for plan status 6
 
 ## [0.15.0] - 2020-06-12
+
 ### Added
-- Extensions - InNetworkMissing for plans that don't provide in network indicators.
+
+* Extensions - InNetworkMissing for plans that don't provide in network indicators.
 
 ### Fixed
-- Bug where active codes with no service codes cause exception.
+
+* Bug where active codes with no service codes cause exception.
 
 ## [0.14.0] - 2020-05-07
+
 ### Added
-- Extensions - mixins for common overrides
+
+* 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
+
+* 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?
+
+* 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
+
+* 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
+
+* 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
-- Request::TradingPartner
-- Response::TradingPartnerData
-- Response::TradingPartnersData
-- Models::TradingPartner
+
+* Add Trading Partner API querying capability
+
+* Request::TradingPartner
+* Response::TradingPartnerData
+* Response::TradingPartnersData
+* Models::TradingPartner
 
 ## [0.9.0] - 2020-04-08
+
 ### Added
-- Added EligibilityBenefit#medicare?
-- Added EligibilityData#medicare?
+
+* Added EligibilityBenefit#medicare?
+
+* Added EligibilityData#medicare?
 
 ### Changed
-- EligibilityBenefit(s)#individual returns true for medicare in benefit and queries that look for 'IND'
-- EligibilityBenefit(s)#in\_network returns true for medicare in benefit and queries that look for 'Y'
+
+* EligibilityBenefit(s)#individual returns true for medicare in benefit and queries that look for 'IND'
+
+* EligibilityBenefit(s)#in\_network returns true for medicare in benefit and queries that look for 'Y'
 
 ## [0.8.0] - 2020-04-04
+
 ### Changed
-- Attempt to serialize all properties with 'date' in the name to ChangeHealth date format
+
+* Attempt to serialize all properties with 'date' in the name to ChangeHealth date format
 
 ## [0.7.0] - 2020-04-03
+
 ### Changed
-- Fixed bug in serializing date on subscriber and encounter
+
+* Fixed bug in serializing date on subscriber and encounter
 
 ## [0.6.0] - 2020-04-02
+
 ### Changed
-- Added Indifferent Access to hashes
-- Fixed bug with Authentication endpoint
+
+* Added Indifferent Access to hashes
+
+* Fixed bug with Authentication endpoint
 
 ## [0.5.0] - 2020-03-11
+
 ### Added
-- EligibilityBenefit Deductible information
-- EligibilityBenefit benefits date information
-- EligibilityBenefit(s) child
-- EligibilityBenefit(s) employee
-- EligibilityBenefit(s) family
-- EligibilityBenefit(s) employee and child
+
+* EligibilityBenefit Deductible information
+
+* EligibilityBenefit benefits date information
+* EligibilityBenefit(s) child
+* EligibilityBenefit(s) employee
+* EligibilityBenefit(s) family
+* EligibilityBenefit(s) employee and child
 
 ### Changed
-- Broke EligibilityBenefit and EligibilityBenefits into separate files
+
+* Broke EligibilityBenefit and EligibilityBenefits into separate files
 
 ## [0.4.0] - 2020-03-10
+
 ### Added
-- EligibilityBenefit(s) Employee information
-- EligibilityData plan date information
-- EligibilityData eligibility, plan and service date helpers on date info
+
+* EligibilityBenefit(s) Employee information
+
+* EligibilityData plan date information
+* EligibilityData eligibility, plan and service date helpers on date info
 
 ## [0.3.0] - 2020-03-09
+
 ### Added
-- Production endpoint
+
+* Production endpoint
 
 ## [0.0.2] - 2020-03-09
+
 ### Added
-- EligibilityData
-- EligibilityBenefit
-- EligibilityBenefits
+
+* EligibilityData
+
+* EligibilityBenefit
+* EligibilityBenefits
 
 ### Changed
-- Eligibility.query returns EligibilityData object
+
+* Eligibility.query returns EligibilityData object
 
 ## [0.0.1] - 2020-03-04
+
 ### Added
-- Provider
-- Subscriber
-- Encounter
-- Eligibility
-- Authentication
-- Configuration
 
+* Provider
+
+* Subscriber
+* Encounter
+* Eligibility
+* Authentication
+* Configuration
+
+[3.5.1]: https://github.com/WeInfuse/change_health/compare/v3.4.0...v3.5.1
+[3.5.0]: https://github.com/WeInfuse/change_health/compare/v3.4.0...v3.5.0
+[3.4.0]: https://github.com/WeInfuse/change_health/compare/v3.3.0...v3.4.0
 [3.3.0]: https://github.com/WeInfuse/change_health/compare/v3.2.0...v3.3.0
 [3.2.0]: https://github.com/WeInfuse/change_health/compare/v3.1.0...v3.2.0
 [3.1.0]: https://github.com/WeInfuse/change_health/compare/v3.0.0...v3.1.0

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

@@ -15,6 +15,7 @@ module ChangeHealth
         property :serviceFacilityLocation, from: :service_facility_location, required: false
         property :serviceLines, from: :service_lines, required: false
         property :signatureIndicator, from: :signature_indicator, required: false
+        property :otherSubscriberInformation, from: :other_subscriber_information, required: false
 
         def add_service_line(service_line)
           self[:serviceLines] ||= []

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

@@ -6,6 +6,7 @@ module ChangeHealth
         property :serviceDate, from: :service_date, required: false
         property :professionalService, from: :professional_service, required: false
         property :renderingProvider, from: :rendering_provider, required: false
+        property :lineAdjudicationInformation, from: :line_adjudication_information, required: false
       end
     end
   end

data/lib/change_health/response/claim/report/report_835_claim.rb

@@ -2,9 +2,12 @@ module ChangeHealth
   module Response
     module Claim
       class Report835Claim < ReportClaim
+        property :check_issue_or_eft_effective_date, required: false
+        property :check_or_eft_trace_number, required: false
         property :claim_payment_remark_codes, required: false
         property :patient_control_number, required: false
         property :payer_claim_control_number, required: false
+        property :payer_identifier, required: false
         property :payment_method_code, required: false
         property :service_lines, required: false
         property :total_actual_provider_payment_amount, required: false

data/lib/change_health/response/claim/report/report_835_data.rb

@@ -7,11 +7,27 @@ module ChangeHealth
           @raw['transactions']
         end
 
+        def check_or_eft_trace_number
+          transactions&.first&.dig('paymentAndRemitReassociationDetails', 'checkOrEFTTraceNumber')
+        end
+
+        def check_issue_or_eft_effective_date
+          ChangeHealth::Models::PARSE_DATE.call(transactions&.first&.dig('financialInformation', 'checkIssueOrEFTEffectiveDate'))
+        end
+
+        def payer_identification
+          transactions&.first&.dig('payer', 'payerIdentificationNumber')
+        end
+
         # Only one payer per report
         def payer_name
           transactions&.first&.dig('payer')&.dig('name')
         end
 
+        def payer_identifier
+          ChangeHealth::Models::PARSE_DATE.call(transactions&.first&.dig('financialInformation', 'payerIdentifier'))
+        end
+
         def payment_method_code
           transactions&.first&.dig('financialInformation', 'paymentMethodCode')
         end
@@ -28,13 +44,6 @@ module ChangeHealth
           report_claims = []
 
           transactions&.each do |transaction|
-            payment_method_code = transaction.dig('financialInformation', 'paymentMethodCode')
-            payer_name = transaction.dig('payer', 'name')
-            payer_identification = transaction.dig('payer', 'payerIdentificationNumber')
-            report_creation_date = ChangeHealth::Models::PARSE_DATE.call(transaction['productionDate'])
-            total_actual_provider_payment_amount = transaction.dig('financialInformation',
-                                                                   'totalActualProviderPaymentAmount')
-
             transaction['detailInfo']&.each do |detail_info|
               detail_info['paymentInfo']&.each do |payment_info|
                 patient_control_number = payment_info.dig('claimPaymentInfo', 'patientControlNumber')
@@ -56,8 +65,7 @@ module ChangeHealth
 
                 service_date_begin = nil
                 service_date_end = nil
-                service_lines = []
-                payment_info['serviceLines']&.each do |service_line|
+                service_lines = payment_info['serviceLines']&.map do |service_line|
                   service_line_date = ChangeHealth::Models::PARSE_DATE.call(service_line['serviceDate'])
                   if service_date_begin.nil? || service_line_date < service_date_begin
                     service_date_begin = service_line_date
@@ -70,8 +78,7 @@ module ChangeHealth
                   line_item_provider_payment_amount = service_line.dig('servicePaymentInformation',
                                                                        'lineItemProviderPaymentAmount')
 
-                  service_adjustments = []
-                  service_line['serviceAdjustments']&.each do |service_adjustment|
+                  service_adjustments = service_line['serviceAdjustments']&.map do |service_adjustment|
                     adjustments = {}
                     service_adjustment_index = 1
                     while service_adjustment["adjustmentReasonCode#{service_adjustment_index}"]
@@ -83,22 +90,21 @@ module ChangeHealth
 
                     claim_adjustment_group_code = service_adjustment['claimAdjustmentGroupCode']
 
-                    service_adjustments << Report835ServiceAdjustment.new(
+                    Report835ServiceAdjustment.new(
                       adjustments: adjustments,
                       claim_adjustment_group_code: claim_adjustment_group_code
                     )
                   end
 
-                  health_care_check_remark_codes = []
-                  service_line['healthCareCheckRemarkCodes']&.each do |health_care_check_remark_code|
-                    health_care_check_remark_codes << Report835HealthCareCheckRemarkCode.new(
+                  health_care_check_remark_codes = service_line['healthCareCheckRemarkCodes']&.map do |health_care_check_remark_code|
+                    Report835HealthCareCheckRemarkCode.new(
                       code_list_qualifier_code: health_care_check_remark_code['codeListQualifierCode'],
                       code_list_qualifier_code_value: health_care_check_remark_code['codeListQualifierCodeValue'],
                       remark_code: health_care_check_remark_code['remarkCode']
                     )
                   end
 
-                  service_lines << Report835ServiceLine.new(
+                  Report835ServiceLine.new(
                     adjudicated_procedure_code: adjudicated_procedure_code,
                     allowed_actual: allowed_actual,
                     line_item_charge_amount: line_item_charge_amount,
@@ -109,6 +115,8 @@ module ChangeHealth
                 end
 
                 report_claims << Report835Claim.new(
+                  check_issue_or_eft_effective_date: check_issue_or_eft_effective_date,
+                  check_or_eft_trace_number: check_or_eft_trace_number,
                   claim_payment_remark_codes: claim_payment_remark_codes,
                   patient_control_number: patient_control_number,
                   patient_first_name: patient_first_name,
@@ -116,6 +124,7 @@ module ChangeHealth
                   patient_member_id: patient_member_id,
                   payer_claim_control_number: payer_claim_control_number,
                   payer_identification: payer_identification,
+                  payer_identifier: payer_identifier,
                   payer_name: payer_name,
                   payment_method_code: payment_method_code,
                   report_creation_date: report_creation_date,

data/lib/change_health/response/claim/report/report_835_service_line.rb

@@ -8,6 +8,45 @@ module ChangeHealth
         property :line_item_charge_amount, required: false
         property :line_item_provider_payment_amount, required: false
         property :service_adjustments, required: false
+
+        def create_group_adjustments(service_adjustments)
+          adjustment_array = service_adjustments[:adjustments].map do |key, value|
+            {
+              adjustmentReasonCode: key,
+              adjustmentAmount: value
+            }
+          end
+          {
+            adjustmentDetails: adjustment_array,
+            adjustmentGroupCode: service_adjustments[:claim_adjustment_group_code]
+          }
+        end
+
+        def create_remark_code_adjustments(remark_codes_array)
+          adjustment_array = remark_codes_array.map do |_key, value|
+            {
+              adjustmentReasonCode: value,
+              adjustmentAmount: ""
+            }
+          end
+          {
+            adjustmentDetails: adjustment_array,
+            adjustmentGroupCode: ""
+          }
+        end
+
+        def create_adjustment_detail_array
+          all_service_adjustments = self.service_adjustments
+          adjustment_details = all_service_adjustments.map do |service_adjustments|
+            create_group_adjustments(service_adjustments)
+          end
+
+          health_care_check_remark_codes = self[:health_care_check_remark_codes]
+          health_care_check_remark_codes.each do |remark_codes|
+            adjustment_details << create_remark_code_adjustments(remark_codes)
+          end
+          adjustment_details
+        end
       end
     end
   end

data/lib/change_health/version.rb

@@ -1,3 +1,3 @@
 module ChangeHealth
-  VERSION = '3.3.0'.freeze
+  VERSION = '3.5.1'.freeze
 end

metadata

@@ -1,14 +1,14 @@
 --- !ruby/object:Gem::Specification
 name: change_health
 version: !ruby/object:Gem::Version
-  version: 3.3.0
+  version: 3.5.1
 platform: ruby
 authors:
 - Mike Crockett
 autorequire: 
 bindir: exe
 cert_chain: []
-date: 2022-02-11 00:00:00.000000000 Z
+date: 2022-04-12 00:00:00.000000000 Z
 dependencies:
 - !ruby/object:Gem::Dependency
   name: httparty