change_health 4.3.0 → 4.6.0

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data/CHANGELOG.md

@@ -5,6 +5,24 @@ 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).
 
+# [4.6.0] - 2022-09-01
+
+### Added
+
+* Report835Data - extract claimStatusCode for Report835Claim
+
+# [4.5.0] - 2022-08-29
+
+### Added
+
+* Report835Data - pull out provider adjustments
+
+# [4.4.0] - 2022-08-29
+
+### Added
+
+* Claim Submission - add payToAddress field
+
 # [4.3.0] - 2022-08-08
 
 ### Added
@@ -412,6 +430,9 @@ Added the ability to hit professional claim submission API. For more details, se
 * Authentication
 * Configuration
 
+[4.6.0]: https://github.com/WeInfuse/change_health/compare/v4.5.0...v4.6.0
+[4.5.0]: https://github.com/WeInfuse/change_health/compare/v4.4.0...v4.5.0
+[4.4.0]: https://github.com/WeInfuse/change_health/compare/v4.3.0...v4.4.0
 [4.3.0]: https://github.com/WeInfuse/change_health/compare/v4.2.5...v4.3.0
 [4.2.5]: https://github.com/WeInfuse/change_health/compare/v4.2.4...v4.2.5
 [4.2.4]: https://github.com/WeInfuse/change_health/compare/v4.2.3...v4.2.4

data/README.md

@@ -205,6 +205,7 @@ claim_submission = ChangeHealth::Request::Claim::Submission.new(
   claim_information: claim_information,
   dependent: dependent,
   headers: professional_headers,
+  pay_to_address: address,
   providers: [provider],
   receiver: receiver,
   submitter: claim_submitter,
@@ -318,6 +319,9 @@ claim835.procedure_codes
 
 claim835.service_lines.map(&:line_item_charge_amount)
 # ["3600", "1890", "1836", "1680"]
+
+claim835.claim_status_code
+# "19"
 ```
 
 ## Configuration

data/lib/change_health/request/submission.rb

@@ -10,6 +10,7 @@ module ChangeHealth
         property :claimInformation, from: :claim_information, required: false
         property :controlNumber, from: :control_number, required: true, default: ChangeHealth::Models::CONTROL_NUMBER
         property :dependent, required: false
+        property :payToAddress, from: :pay_to_address, required: false
         property :providers, required: false
         property :receiver, required: false
         property :submitter, required: false

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

@@ -3,6 +3,7 @@ module ChangeHealth
     module Claim
       class Report835Claim < ReportClaim
         property :claim_payment_remark_codes, required: false
+        property :claim_status_code, required: false
         property :patient_control_number, required: false
         property :payer_claim_control_number, required: false
         property :service_lines, required: false

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

@@ -35,11 +35,27 @@ module ChangeHealth
               )
             payer_identifier = transaction.dig('financialInformation', 'payerIdentifier')
             payment_method_code = transaction.dig('financialInformation', 'paymentMethodCode')
-            report_creation_date = ChangeHealth::Models::PARSE_DATE.call(transaction.dig('productionDate'))
+            provider_adjustments = transaction['providerAdjustments']&.map do |provider_adjustment|
+              adjustments = provider_adjustment['adjustments']&.map do |adjustment|
+                {
+                  amount: adjustment['providerAdjustmentAmount'],
+                  identifier: adjustment['providerAdjustmentIdentifier'],
+                  reason_code: adjustment['adjustmentReasonCode']
+                }
+              end
+              Report835ProviderAdjustment.new(
+                adjustments: adjustments,
+                fiscal_period_date: ChangeHealth::Models::PARSE_DATE.call(provider_adjustment['fiscalPeriodDate']),
+                provider_identifier: provider_adjustment['providerIdentifier']
+              )
+            end
+
+            report_creation_date = ChangeHealth::Models::PARSE_DATE.call(transaction['productionDate'])
             total_actual_provider_payment_amount =
               transaction.dig('financialInformation', 'totalActualProviderPaymentAmount')
             claims = transaction['detailInfo']&.flat_map do |detail_info|
               detail_info['paymentInfo']&.map do |payment_info|
+                claim_status_code = payment_info.dig('claimPaymentInfo', 'claimStatusCode')
                 patient_control_number = payment_info.dig('claimPaymentInfo', 'patientControlNumber')
                 patient_first_name = payment_info.dig('patientName', 'firstName')
                 patient_last_name = payment_info.dig('patientName', 'lastName')
@@ -124,6 +140,7 @@ module ChangeHealth
 
                 Report835Claim.new(
                   claim_payment_remark_codes: claim_payment_remark_codes,
+                  claim_status_code: claim_status_code,
                   patient_control_number: patient_control_number,
                   patient_first_name: patient_first_name,
                   patient_last_name: patient_last_name,
@@ -148,6 +165,7 @@ module ChangeHealth
               payer_identifier: payer_identifier,
               payer_name: payer_name,
               payment_method_code: payment_method_code,
+              provider_adjustments: provider_adjustments,
               report_creation_date: report_creation_date,
               report_name: report_name,
               total_actual_provider_payment_amount: total_actual_provider_payment_amount

data/lib/change_health/response/claim/report/report_835_payment.rb

@@ -8,6 +8,7 @@ module ChangeHealth
         property :payer_identifier, required: false
         property :payer_name, required: false
         property :payment_method_code, required: false
+        property :provider_adjustments, required: false
         property :report_creation_date, required: false
         property :report_name, required: false
         property :total_actual_provider_payment_amount, required: false

data/lib/change_health/response/claim/report/report_835_provider_adjustment.rb

@@ -0,0 +1,16 @@
+module ChangeHealth
+  module Response
+    module Claim
+      class Report835ProviderAdjustment < Hashie::Trash
+        property :adjustments
+        property :fiscal_period_date, required: false
+        property :provider_identifier, required: false
+
+        def add_adjustment(adjustment)
+          self[:adjustments] ||= []
+          self[:adjustments] << adjustment
+        end
+      end
+    end
+  end
+end

data/lib/change_health/version.rb

@@ -1,3 +1,3 @@
 module ChangeHealth
-  VERSION = '4.3.0'.freeze
+  VERSION = '4.6.0'.freeze
 end

data/lib/change_health.rb

@@ -35,6 +35,7 @@ require 'change_health/response/claim/report/report_277_info_claim_status'
 require 'change_health/response/claim/report/report_835_claim'
 require 'change_health/response/claim/report/report_835_health_care_check_remark_code'
 require 'change_health/response/claim/report/report_835_payment'
+require 'change_health/response/claim/report/report_835_provider_adjustment'
 require 'change_health/response/claim/report/report_835_service_adjustment'
 require 'change_health/response/claim/report/report_835_service_line'
 require 'change_health/response/eligibility/eligibility_benefit'

metadata

@@ -1,14 +1,14 @@
 --- !ruby/object:Gem::Specification
 name: change_health
 version: !ruby/object:Gem::Version
-  version: 4.3.0
+  version: 4.6.0
 platform: ruby
 authors:
 - Mike Crockett
 autorequire: 
 bindir: exe
 cert_chain: []
-date: 2022-08-08 00:00:00.000000000 Z
+date: 2022-09-02 00:00:00.000000000 Z
 dependencies:
 - !ruby/object:Gem::Dependency
   name: httparty
@@ -171,6 +171,7 @@ files:
 - lib/change_health/response/claim/report/report_835_data.rb
 - lib/change_health/response/claim/report/report_835_health_care_check_remark_code.rb
 - lib/change_health/response/claim/report/report_835_payment.rb
+- lib/change_health/response/claim/report/report_835_provider_adjustment.rb
 - lib/change_health/response/claim/report/report_835_service_adjustment.rb
 - lib/change_health/response/claim/report/report_835_service_line.rb
 - lib/change_health/response/claim/report/report_claim.rb