change_health 3.4.0 → 3.5.0

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data/CHANGELOG.md CHANGED
@@ -1,27 +1,43 @@
1
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  # Changelog
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+
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  All notable changes to this project will be documented in this file.
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4
 
4
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  The format is based on [Keep a Changelog](http://keepachangelog.com/en/1.0.0/)
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  and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.html).
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7
 
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+ # [3.5.0] - 2022-04-08
9
+
10
+ ### Added
11
+
12
+ * Report835Claim - added payer_identifier property
13
+ * Report835ServiceLine - Dynamically creates line_adjustments for remark codes and adjustments that are needed for secondary claims
14
+
7
15
  # [3.4.0] - 2022-03-23
16
+
8
17
  ### Added
9
18
  * Report835Claim - check_or_eft_trace_number & check_issue_or_eft_effective_date
10
19
 
11
20
  # [3.3.0] - 2022-02-11
21
+
12
22
  ### Added
23
+
13
24
  * Report277Claim - 'message' from informationClaimStatuses, clearinghouse_trace_number, patient_account_number, referenced_transaction_trace_number, trading_partner_claim_number
14
25
  * Report835Claim - patient_control_number
15
26
  * ReportClaim - report_name, patient_member_id
16
27
 
17
28
  ## [3.2.0] - 2021-12-23
29
+
18
30
  ### Added
31
+
19
32
  * Report835HealthCareCheckRemarkCode
20
33
  * Report835Claim - added claim_payment_remark_codes
21
34
 
22
35
  ## [3.1.0] - 2021-12-21
36
+
23
37
  ### Added
38
+
24
39
  #### Claim Submission
40
+
25
41
  * ServiceLine - drugIdentification & renderingProvider
26
42
  * Subscriber - groupNumber
27
43
  * Address model w/ postalCode that is formatted to remove dashes, '-'
@@ -29,21 +45,26 @@ and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.
29
45
  * Auto formatting of postal code fields
30
46
 
31
47
  ## [3.0.0] - 2021-12-08
48
+
32
49
  ### Added
50
+
33
51
  * Report277Claim - specific to claims from 277 reports
34
52
  * Report835Claim - specific to claims from 835 reports
35
53
  * Report835ServiceAdjustment & Report835ServiceLine - helper classes for readability of claims from 835 reports
36
54
 
37
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  ### Changed
56
+
38
57
  * ReportClaim - removed 277 report unique fields
39
58
 
40
59
  #### Namespace
60
+
41
61
  | Previous | Current |
42
62
  |-|-|
43
63
  | ChangeHealth::Models::Error | ChangeHealth::Response::Error |
44
64
  | ChangeHealth::Response::Claim::ReportInfoClaimStatus | ChangeHealth::Response::Claim::Report277InfoClaimStatus|
45
65
 
46
66
  #### Methods
67
+
47
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  | Previous | Current |
48
69
  |-|-|
49
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  | Report277Data#payer_org_name | Report277Data#payer_name |
@@ -55,38 +76,54 @@ and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.
55
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  | ReportClaim#subscriber_last_name | ReportClaim#patient_last_name |
56
77
  | ReportClaim#transaction_set_creation_date | ReportClaim#report_creation_date |
57
78
 
58
-
59
79
  ## [2.3.0] - 2021-11-18
80
+
60
81
  ### Added
82
+
61
83
  * Report277Data & Report835Data - Specific classes for 277 & 835 reports
62
84
  * ReportClaim & ReportInfoClaimStatus - only works for json 277 reports
63
85
 
64
86
  ### Fixed
87
+
65
88
  * Headers can now be nil for requests
66
89
 
67
90
  ## [2.2.1] - 2021-11-15
91
+
68
92
  ### Added
93
+
69
94
  Custom Headers for Reports API and Professional Claims API
95
+
70
96
  * Report
71
97
  * Submission
72
98
 
73
99
  ## [2.2.0] - 2021-11-04
100
+
74
101
  ### Added
102
+
75
103
  Ability to hit [Claim Responses and Reports](https://developers.changehealthcare.com/eligibilityandclaims/docs/claims-responses-and-reports-getting-started)
104
+
76
105
  * Report
77
106
  * ReportListData
78
107
  * ReportData
79
108
 
80
109
  ## [2.1.0] - 2021-10-12
110
+
81
111
  ### Changed
112
+
82
113
  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.
83
114
 
84
115
  ## [2.0.0] - 2021-10-08
116
+
85
117
  ### Added
118
+
86
119
  #### Models
120
+
87
121
  * ResponseData - for responses from calling change healthcare api used by EligibilityData and SubmissionData
122
+
88
123
  #### Claim Submission
124
+
89
125
  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)
126
+
90
127
  * ClaimInformation
91
128
  * Provider
92
129
  * ServiceLine
@@ -94,11 +131,15 @@ Added the ability to hit professional claim submission API. For more details, se
94
131
  * SubmissionData
95
132
  * Submitter
96
133
  * Subscriber
134
+
97
135
  ### Changed
98
- * 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)
99
- * PARSE_DATE moved from ChangeHealth::Models::EligibilityData to ChangeHealth::Models
100
- * Moved Error class into its own file
136
+
137
+ * 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)
138
+ * PARSE_DATE moved from ChangeHealth::Models::EligibilityData to ChangeHealth::Models
139
+ * Moved Error class into its own file
140
+
101
141
  #### Namespace
142
+
102
143
  Many classes moved namespaces to be more consistent across the many endpoints in Change Healthcare
103
144
  | Previous | Current |
104
145
  |-|-|
@@ -109,136 +150,196 @@ Added the ability to hit professional claim submission API. For more details, se
109
150
  | ChangeHealth::Models::EligibilityBenefit | ChangeHealth::Response::EligibilityBenefit|
110
151
  | ChangeHealth::Models::EligibilityBenefits | ChangeHealth::Response::EligibilityBenefits|
111
152
  | ChangeHealth::Models::EligibilityData | ChangeHealth::Response::EligibilityData|
153
+
112
154
  ### Fixed
113
- * Eligibility#add_dependent actually works
155
+
156
+ * Eligibility#add_dependent actually works
114
157
 
115
158
  ## [1.0.3] - 2021-04-26
159
+
116
160
  ### Added
117
- - Model::Error#represents_down? - adds ability to distinguish error representing down state
118
- - Model::Error#retryable? - retryable when down
119
- - EligibilityData#recommend_retry? - recommend retry when down
161
+
162
+ * Model::Error#represents_down? - adds ability to distinguish error representing down state
163
+
164
+ * Model::Error#retryable? - retryable when down
165
+ * EligibilityData#recommend_retry? - recommend retry when down
120
166
 
121
167
  ## [1.0.2] - 2021-04-06
168
+
122
169
  ### Added
123
- - EligibilityData#recommend_retry? - fix a bug in the search statement
170
+
171
+ * EligibilityData#recommend_retry? - fix a bug in the search statement
124
172
 
125
173
  ## [1.0.1] - 2021-03-24
174
+
126
175
  ### Added
127
- - EligibilityData#plan_status - adds ability to select instead of find
128
- - EligibilityData#inactive? active? - use new plan_status select
176
+
177
+ * EligibilityData#plan_status - adds ability to select instead of find
178
+
179
+ * EligibilityData#inactive? active? - use new plan_status select
129
180
 
130
181
  ## [1.0.0] - 2021-03-17
182
+
131
183
  ### Added
132
- - Model::Error - help with error codes
133
- - EligibilityData#recommend_retry? - if it looks like you can retry the exact same request
134
- - EligibilityData#inactive? - looks for plan status 6
184
+
185
+ * Model::Error - help with error codes
186
+
187
+ * EligibilityData#recommend_retry? - if it looks like you can retry the exact same request
188
+ * EligibilityData#inactive? - looks for plan status 6
135
189
 
136
190
  ## [0.15.0] - 2020-06-12
191
+
137
192
  ### Added
138
- - Extensions - InNetworkMissing for plans that don't provide in network indicators.
193
+
194
+ * Extensions - InNetworkMissing for plans that don't provide in network indicators.
139
195
 
140
196
  ### Fixed
141
- - Bug where active codes with no service codes cause exception.
197
+
198
+ * Bug where active codes with no service codes cause exception.
142
199
 
143
200
  ## [0.14.0] - 2020-05-07
201
+
144
202
  ### Added
145
- - Extensions - mixins for common overrides
203
+
204
+ * Extensions - mixins for common overrides
146
205
 
147
206
  ## [0.13.0] - 2020-05-05
207
+
148
208
  ### Changed
149
- - Removed `alias_method` for `where` helpers so you can override a single method
150
- - Added type Year to Date type 24
151
- - Added type Day type 7
209
+
210
+ * Removed `alias_method` for `where` helpers so you can override a single method
211
+
212
+ * Added type Year to Date type 24
213
+ * Added type Day type 7
152
214
 
153
215
  ## [0.12.0] - 2020-04-30
216
+
154
217
  ### Added
155
- - EligibilityData#errors
156
- - EligibilityData#errors?
218
+
219
+ * EligibilityData#errors
220
+
221
+ * EligibilityData#errors?
157
222
 
158
223
  ## [0.11.0] - 2020-04-24
224
+
159
225
  ### Added
160
- - EligibilityData#medicare?
161
- - EligibilityData#plan\_id
162
- - EligibilityData#plan?
163
- - EligibilityBenefits#where\_not
164
- - EligibilityBenefits#+
165
- - EligibilityBenefit#additional\_info
166
- - EligibilityBenefit#descriptions
226
+
227
+ * EligibilityData#medicare?
228
+
229
+ * EligibilityData#plan\_id
230
+ * EligibilityData#plan?
231
+ * EligibilityBenefits#where\_not
232
+ * EligibilityBenefits#+
233
+ * EligibilityBenefit#additional\_info
234
+ * EligibilityBenefit#descriptions
167
235
 
168
236
  ### Changed
169
- - EligibilityData initialize now checks for sub-classes of EligibilityBenefits with trading partner
170
- - EligibilityData initialize now checks for sub-classes of EligibilityBenefits with trading partner responds to `factory` to choose sub-class
171
- - EligibilityBenefits initializes `self.class` type in case it's a subclass
237
+
238
+ * EligibilityData initialize now checks for sub-classes of EligibilityBenefits with trading partner
239
+
240
+ * EligibilityData initialize now checks for sub-classes of EligibilityBenefits with trading partner responds to `factory` to choose sub-class
241
+ * EligibilityBenefits initializes `self.class` type in case it's a subclass
172
242
 
173
243
  ## [0.10.0] - 2020-04-09
244
+
174
245
  ### Added
175
- - Add Trading Partner API querying capability
176
- - Request::TradingPartner
177
- - Response::TradingPartnerData
178
- - Response::TradingPartnersData
179
- - Models::TradingPartner
246
+
247
+ * Add Trading Partner API querying capability
248
+
249
+ * Request::TradingPartner
250
+ * Response::TradingPartnerData
251
+ * Response::TradingPartnersData
252
+ * Models::TradingPartner
180
253
 
181
254
  ## [0.9.0] - 2020-04-08
255
+
182
256
  ### Added
183
- - Added EligibilityBenefit#medicare?
184
- - Added EligibilityData#medicare?
257
+
258
+ * Added EligibilityBenefit#medicare?
259
+
260
+ * Added EligibilityData#medicare?
185
261
 
186
262
  ### Changed
187
- - EligibilityBenefit(s)#individual returns true for medicare in benefit and queries that look for 'IND'
188
- - EligibilityBenefit(s)#in\_network returns true for medicare in benefit and queries that look for 'Y'
263
+
264
+ * EligibilityBenefit(s)#individual returns true for medicare in benefit and queries that look for 'IND'
265
+
266
+ * EligibilityBenefit(s)#in\_network returns true for medicare in benefit and queries that look for 'Y'
189
267
 
190
268
  ## [0.8.0] - 2020-04-04
269
+
191
270
  ### Changed
192
- - Attempt to serialize all properties with 'date' in the name to ChangeHealth date format
271
+
272
+ * Attempt to serialize all properties with 'date' in the name to ChangeHealth date format
193
273
 
194
274
  ## [0.7.0] - 2020-04-03
275
+
195
276
  ### Changed
196
- - Fixed bug in serializing date on subscriber and encounter
277
+
278
+ * Fixed bug in serializing date on subscriber and encounter
197
279
 
198
280
  ## [0.6.0] - 2020-04-02
281
+
199
282
  ### Changed
200
- - Added Indifferent Access to hashes
201
- - Fixed bug with Authentication endpoint
283
+
284
+ * Added Indifferent Access to hashes
285
+
286
+ * Fixed bug with Authentication endpoint
202
287
 
203
288
  ## [0.5.0] - 2020-03-11
289
+
204
290
  ### Added
205
- - EligibilityBenefit Deductible information
206
- - EligibilityBenefit benefits date information
207
- - EligibilityBenefit(s) child
208
- - EligibilityBenefit(s) employee
209
- - EligibilityBenefit(s) family
210
- - EligibilityBenefit(s) employee and child
291
+
292
+ * EligibilityBenefit Deductible information
293
+
294
+ * EligibilityBenefit benefits date information
295
+ * EligibilityBenefit(s) child
296
+ * EligibilityBenefit(s) employee
297
+ * EligibilityBenefit(s) family
298
+ * EligibilityBenefit(s) employee and child
211
299
 
212
300
  ### Changed
213
- - Broke EligibilityBenefit and EligibilityBenefits into separate files
301
+
302
+ * Broke EligibilityBenefit and EligibilityBenefits into separate files
214
303
 
215
304
  ## [0.4.0] - 2020-03-10
305
+
216
306
  ### Added
217
- - EligibilityBenefit(s) Employee information
218
- - EligibilityData plan date information
219
- - EligibilityData eligibility, plan and service date helpers on date info
307
+
308
+ * EligibilityBenefit(s) Employee information
309
+
310
+ * EligibilityData plan date information
311
+ * EligibilityData eligibility, plan and service date helpers on date info
220
312
 
221
313
  ## [0.3.0] - 2020-03-09
314
+
222
315
  ### Added
223
- - Production endpoint
316
+
317
+ * Production endpoint
224
318
 
225
319
  ## [0.0.2] - 2020-03-09
320
+
226
321
  ### Added
227
- - EligibilityData
228
- - EligibilityBenefit
229
- - EligibilityBenefits
322
+
323
+ * EligibilityData
324
+
325
+ * EligibilityBenefit
326
+ * EligibilityBenefits
230
327
 
231
328
  ### Changed
232
- - Eligibility.query returns EligibilityData object
329
+
330
+ * Eligibility.query returns EligibilityData object
233
331
 
234
332
  ## [0.0.1] - 2020-03-04
333
+
235
334
  ### Added
236
- - Provider
237
- - Subscriber
238
- - Encounter
239
- - Eligibility
240
- - Authentication
241
- - Configuration
335
+
336
+ * Provider
337
+
338
+ * Subscriber
339
+ * Encounter
340
+ * Eligibility
341
+ * Authentication
342
+ * Configuration
242
343
 
243
344
  [3.4.0]: https://github.com/WeInfuse/change_health/compare/v3.3.0...v3.4.0
244
345
  [3.3.0]: https://github.com/WeInfuse/change_health/compare/v3.2.0...v3.3.0
@@ -7,6 +7,7 @@ module ChangeHealth
7
7
  property :claim_payment_remark_codes, required: false
8
8
  property :patient_control_number, required: false
9
9
  property :payer_claim_control_number, required: false
10
+ property :payer_identifier, required: false
10
11
  property :payment_method_code, required: false
11
12
  property :service_lines, required: false
12
13
  property :total_actual_provider_payment_amount, required: false
@@ -24,6 +24,10 @@ module ChangeHealth
24
24
  transactions&.first&.dig('payer')&.dig('name')
25
25
  end
26
26
 
27
+ def payer_identifier
28
+ ChangeHealth::Models::PARSE_DATE.call(transactions&.first&.dig('financialInformation', 'payerIdentifier'))
29
+ end
30
+
27
31
  def payment_method_code
28
32
  transactions&.first&.dig('financialInformation', 'paymentMethodCode')
29
33
  end
@@ -120,6 +124,7 @@ module ChangeHealth
120
124
  patient_member_id: patient_member_id,
121
125
  payer_claim_control_number: payer_claim_control_number,
122
126
  payer_identification: payer_identification,
127
+ payer_identifier: payer_identifier,
123
128
  payer_name: payer_name,
124
129
  payment_method_code: payment_method_code,
125
130
  report_creation_date: report_creation_date,
@@ -8,6 +8,45 @@ module ChangeHealth
8
8
  property :line_item_charge_amount, required: false
9
9
  property :line_item_provider_payment_amount, required: false
10
10
  property :service_adjustments, required: false
11
+
12
+ def create_group_adjustments(service_adjustments)
13
+ adjustment_array = service_adjustments[:adjustments].map do |key, value|
14
+ {
15
+ adjustmentReasonCode: key,
16
+ adjustmentAmount: value
17
+ }
18
+ end
19
+ {
20
+ adjustmentDetails: adjustment_array,
21
+ adjustmentGroupCode: service_adjustments[:claim_adjustment_group_code]
22
+ }
23
+ end
24
+
25
+ def create_remark_code_adjustments(remark_codes_array)
26
+ adjustment_array = remark_codes_array.map do |_key, value|
27
+ {
28
+ adjustmentReasonCode: value,
29
+ adjustmentAmount: ""
30
+ }
31
+ end
32
+ {
33
+ adjustmentDetails: adjustment_array,
34
+ adjustmentGroupCode: ""
35
+ }
36
+ end
37
+
38
+ def create_adjustment_detail_array
39
+ all_service_adjustments = self.service_adjustments
40
+ adjustment_details = all_service_adjustments.map do |service_adjustments|
41
+ create_group_adjustments(service_adjustments)
42
+ end
43
+
44
+ health_care_check_remark_codes = self[:health_care_check_remark_codes]
45
+ health_care_check_remark_codes.each do |remark_codes|
46
+ adjustment_details << create_remark_code_adjustments(remark_codes)
47
+ end
48
+ adjustment_details
49
+ end
11
50
  end
12
51
  end
13
52
  end
@@ -1,3 +1,3 @@
1
1
  module ChangeHealth
2
- VERSION = '3.4.0'.freeze
2
+ VERSION = '3.5.0'.freeze
3
3
  end
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: 3.4.0
4
+ version: 3.5.0
5
5
  platform: ruby
6
6
  authors:
7
7
  - Mike Crockett
8
8
  autorequire:
9
9
  bindir: exe
10
10
  cert_chain: []
11
- date: 2022-03-23 00:00:00.000000000 Z
11
+ date: 2022-04-08 00:00:00.000000000 Z
12
12
  dependencies:
13
13
  - !ruby/object:Gem::Dependency
14
14
  name: httparty