change_health 0.0.1 → 0.0.2

checksums.yaml

@@ -1,7 +1,7 @@
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data/CHANGELOG.md

@@ -4,6 +4,15 @@ 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).
 
+## [0.2.0] - [UNRELEASED]
+### Added
+- EligibilityData
+- EligibilityBenefit
+- EligibilityBenefits
+
+### Changed
+- Eligibility.query returns EligibilityData object
+
 ## [0.1.0] - 2020-03-04
 ### Added
 - Provider
@@ -13,4 +22,5 @@ and this project adheres to [Semantic Versioning](http://semver.org/spec/v2.0.0.
 - Authentication
 - Configuration
 
+[0.2.0]: https://github.com/WeInfuse/change_health/compare/v0.1.0...HEAD
 [0.1.0]: https://github.com/WeInfuse/change_health/compare/v0.1.0

data/README.md

@@ -32,20 +32,40 @@ encounter  = ChangeHealth::Models::Encounter.new(date_of_service: Date.current,
 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')
 
-ChangeHealth::Models::Eligibility.new(tradingPartnerServiceId: '000050', provider: provider, subscriber: subscriber, encounter: encounter).query.parsed_response
+edata = ChangeHealth::Models::Eligibility.new(tradingPartnerServiceId: '000050', provider: provider, subscriber: subscriber, encounter: encounter).query
+```
+
+### Benefit(s) objects
+```
+edata.benefits # Returns Benefits querying object (extends Array)
+
+edata.benefits.individual # Only benefits matching the 'IND' identifier
+
+edata.benefits.individual.in_network # 'IND' and in-plan-network = 'Y'
+
+edata.benefits.individual(name: 'Co-Payment') # Manually finding "name" == "Co-Payment" in JSON
+edata.benefits.individual(customParam: 'hi') # Filter on any params in the API combined with 'IND' type
+
+edata.benefits.where(name: 'Co-Payment', code: 'B', benefitAmount: '30) # Generic 'where' api returns a Benefits querying object for chaining
+edata.benefits.find_by(name: 'Co-Payment', code: 'B', benefitAmount: '30) # Generic 'find_by' api returns first object found
 ```
 
 ### Response
 
-Response is HTTParty Response object
+Response is EligibilityData object
 
 ```ruby
-response
+edata.response
 #<HTTParty::Response:0x7fa354c1fbe8>
 
-response.ok?
+edata.response.ok?
+true
+
+edata.individual_oop_remaining(service_code: '30')
+1344.88
+
+edata.raw == edata.response.parsed_response
 true
-```
 ```
 
 ### Configuration

data/lib/change_health.rb

@@ -5,6 +5,8 @@ require 'change_health/change_health_exception'
 require 'change_health/connection'
 require 'change_health/authentication'
 require 'change_health/models/eligibility'
+require 'change_health/models/eligibility_data'
+require 'change_health/models/eligibility_benefit'
 require 'change_health/models/encounter'
 require 'change_health/models/provider'
 require 'change_health/models/subscriber'

data/lib/change_health/models/eligibility.rb

@@ -25,7 +25,7 @@ module ChangeHealth
       end
 
       def query
-        ChangeHealth::Connection.new.request(endpoint: ENDPOINT, body: self.to_h)
+        ChangeHealth::Models::EligibilityData.new(response: ChangeHealth::Connection.new.request(endpoint: ENDPOINT, body: self.to_h))
       end
 
       def self.health_check

data/lib/change_health/models/eligibility_benefit.rb

@@ -0,0 +1,137 @@
+module ChangeHealth
+  module Models
+    class EligibilityBenefits < Array
+      def initialize(benefits)
+        super(benefits.map {|benefit| ChangeHealth::Models::EligibilityBenefit.new(benefit) })
+      end
+
+      def where(**kwargs)
+        EligibilityBenefits.new(self.select {|benefit| kwargs.all? {|k,v| benefit_matches?(benefit, k, v) } })
+      end
+
+      def find_by(**kwargs)
+        self.find {|benefit| kwargs.all? {|k,v| benefit[k].is_a?(Array) ? benefit[k].include?(v) : v == benefit[k] } }
+      end
+
+      def individual
+        self.where(coverageLevelCode: ChangeHealth::Models::EligibilityBenefit::INDIVIDUAL)
+      end
+
+      def in_network
+        self.where(inPlanNetworkIndicatorCode: 'Y')
+      end
+
+      %w(visit year remaining).each do |method|
+        define_method("#{method}s") do
+          self.where(timeQualifierCode: Object.const_get("ChangeHealth::Models::EligibilityBenefit::#{method.upcase}"))
+        end
+      end
+
+      %w(out_of_pocket copayment coinsurance).each do |method|
+        define_method("#{method}s") do
+          self.where(code: Object.const_get("ChangeHealth::Models::EligibilityBenefit::#{method.upcase}"))
+        end
+      end
+
+      def individual_coinsurance_visit(**kwargs)
+        self.individual.coinsurances.visits.where(kwargs).first
+      end
+
+      def individual_copayment_visit(**kwargs)
+        self.individual.copayments.visits.where(kwargs).first
+      end
+
+      def individual_out_of_pocket_remaining(**kwargs)
+        self.individual.out_of_pockets.remainings.where(kwargs).first
+      end
+
+      def individual_out_of_pocket_total(**kwargs)
+        self.individual.out_of_pockets.years.where(kwargs).first
+      end
+
+      alias_method :oops, :out_of_pockets
+      alias_method :copays, :copayments
+      alias_method :individual_copay_visit, :individual_copayment_visit
+      alias_method :individual_oop_remaining, :individual_out_of_pocket_remaining
+      alias_method :individual_oop_total, :individual_out_of_pocket_total
+
+      private
+      def benefit_matches?(benefit, k, v)
+        if benefit[k].is_a?(Array)
+          if v.is_a?(Array)
+            return v.any? {|possible_v| benefit[k].include?(possible_v) }
+          else
+            return benefit[k].include?(v)
+          end
+        else
+          if v.is_a?(Array)
+            return v.include?(benefit[k])
+          else
+            return v == benefit[k]
+          end
+        end
+      end
+    end
+
+    class EligibilityBenefit < Hash
+      include Hashie::Extensions::MergeInitializer
+      include Hashie::Extensions::IndifferentAccess
+
+      OUT_OF_POCKET = 'G'
+      COPAYMENT     = 'B'
+      COINSURANCE   = 'A'
+      NON_COVERED   = 'I'
+
+      INDIVIDUAL    = 'IND'
+      CHILD         = 'CHD'
+
+      VISIT         = '27'
+      YEAR          = '23'
+      REMAINING     = '29'
+
+      %w(individual child).each do |coverage_level|
+        define_method("#{coverage_level}?") do
+          Object.const_get("ChangeHealth::Models::EligibilityBenefit::#{coverage_level.upcase}") == self['coverageLevelCode']
+        end
+      end
+
+      %w(visit year remaining).each do |time_qualifier|
+        define_method("#{time_qualifier}?") do
+          Object.const_get("ChangeHealth::Models::EligibilityBenefit::#{time_qualifier.upcase}") == self['timeQualifier']
+        end
+      end
+
+      %w(out_of_pocket copayment coinsurance non_covered).each do |type|
+        define_method("#{type}?") do
+          Object.const_get("ChangeHealth::Models::EligibilityBenefit::#{type.upcase}") == self['code']
+        end
+      end
+
+      %w(benefitAmount benefitPercent).each do |amount_method|
+        define_method("#{amount_method}") do
+          format_amount(amount_method)
+        end
+      end
+
+      def in_plan_network?
+        return 'Y' == self[:inPlanNetworkIndicatorCode]
+      end
+      alias_method :in_plan?, :in_plan_network?
+      alias_method :in_network?, :in_plan_network?
+
+      def amount
+        self.coinsurance? ? self.benefitPercent : self.benefitAmount
+      end
+
+      def services 
+        self['serviceTypeCodes']&.each_with_index&.map {|stc, i| [stc, self['serviceTypes']&.at(i)]} || []
+      end
+
+      private
+      def format_amount(key)
+        amt = self[key]
+        amt = amt.to_f unless amt.nil?
+      end
+    end
+  end
+end

data/lib/change_health/models/eligibility_data.rb

@@ -0,0 +1,41 @@
+module ChangeHealth
+  module Models
+    class EligibilityData
+      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 active?(service_code: '30')
+        return '1' == plan_status(service_code: service_code).dig('statusCode')
+      end
+
+      %w(planStatus benefitsInformation controlNumber).each do |v|
+        define_method(v) do
+          @raw.dig(v)
+        end
+      end
+
+      def plan_status(service_code: )
+        self.planStatus&.find {|plan| plan.dig('serviceTypeCodes').include?(service_code) } || {}
+      end
+
+      def benefits
+        ChangeHealth::Models::EligibilityBenefits.new(self.benefitsInformation || [])
+      end
+
+      alias_method :control_number, :controlNumber
+      alias_method :benefits_information, :benefitsInformation
+      alias_method :plan_statuses, :planStatus
+    end
+  end
+end

data/lib/change_health/version.rb

@@ -1,3 +1,3 @@
 module ChangeHealth
-  VERSION = '0.0.1'.freeze
+  VERSION = '0.0.2'.freeze
 end

metadata

@@ -1,14 +1,14 @@
 --- !ruby/object:Gem::Specification
 name: change_health
 version: !ruby/object:Gem::Version
-  version: 0.0.1
+  version: 0.0.2
 platform: ruby
 authors:
 - Mike Crockett
 autorequire: 
 bindir: exe
 cert_chain: []
-date: 2020-03-04 00:00:00.000000000 Z
+date: 2020-03-09 00:00:00.000000000 Z
 dependencies:
 - !ruby/object:Gem::Dependency
   name: httparty
@@ -147,6 +147,8 @@ files:
 - lib/change_health/change_health_exception.rb
 - lib/change_health/connection.rb
 - lib/change_health/models/eligibility.rb
+- lib/change_health/models/eligibility_benefit.rb
+- lib/change_health/models/eligibility_data.rb
 - lib/change_health/models/encounter.rb
 - lib/change_health/models/provider.rb
 - lib/change_health/models/subscriber.rb