eligible 1.0

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data/.gitignore ADDED
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+ *.gem
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+ *.rbc
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+ .bundle
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+ .config
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+ .yardoc
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+ Gemfile.lock
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+ InstalledFiles
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+ _yardoc
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+ coverage
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+ doc/
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+ lib/bundler/man
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+ pkg
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+ rdoc
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+ spec/reports
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+ test/tmp
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+ test/version_tmp
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+ tmp
data/CONTRIBUTORS ADDED
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+ Andy Brett <andy@andybrett.com>
data/Gemfile ADDED
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+ source 'https://rubygems.org'
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+
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+ # Specify your gem's dependencies in eligible.gemspec
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+ gemspec
data/LICENSE ADDED
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+ Copyright (c) 2013 Eligible
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+
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+ MIT License
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+
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+ Permission is hereby granted, free of charge, to any person obtaining
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+ a copy of this software and associated documentation files (the
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+ "Software"), to deal in the Software without restriction, including
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+ without limitation the rights to use, copy, modify, merge, publish,
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+ distribute, sublicense, and/or sell copies of the Software, and to
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+ permit persons to whom the Software is furnished to do so, subject to
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+ the following conditions:
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+
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+ The above copyright notice and this permission notice shall be
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+ included in all copies or substantial portions of the Software.
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+
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+ THE SOFTWARE IS PROVIDED "AS IS", WITHOUT WARRANTY OF ANY KIND,
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+ EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF
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+ MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND
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+ NONINFRINGEMENT. IN NO EVENT SHALL THE AUTHORS OR COPYRIGHT HOLDERS BE
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+ LIABLE FOR ANY CLAIM, DAMAGES OR OTHER LIABILITY, WHETHER IN AN ACTION
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+ OF CONTRACT, TORT OR OTHERWISE, ARISING FROM, OUT OF OR IN CONNECTION
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+ WITH THE SOFTWARE OR THE USE OR OTHER DEALINGS IN THE SOFTWARE.
data/README.md ADDED
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+ # Eligible
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+
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+ Ruby bindings for the [Eligible API](https://eligibleapi.com/rest-api-v1)
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+
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+ ## Installation
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+
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+ Add this line to your application's Gemfile:
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+
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+ gem 'eligible'
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+
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+ And then execute:
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+
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+ $ bundle
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+
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+ Or install it yourself with:
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+
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+ $ gem install eligible
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+
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+ ## Usage
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+
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+ ### Setup
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+ require eligible
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+ Eligible.api_key = YOUR_KEY
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+
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+ ### Retrieve Plan object and query it
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+ params = {
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+ :payer_name => "Aetna",
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+ :payer_id => "000001",
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+ :service_provider_last_name => "Last",
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+ :service_provider_first_name => "First",
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+ :service_provider_NPI => "1928384219",
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+ :subscriber_id => "W120923801",
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+ :subscriber_last_name => "Austen",
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+ :subscriber_first_name => "Jane",
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+ :subscriber_dob => "1955-12-14"
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+ }
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+
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+ plan = Eligible::Plan.get(params)
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+ plan.all # returns all fields on the plan, per the plan/all endpoint
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+ plan.status # returns status fields on the plan, per the plan/status endpoint
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+ ## Etc.: plan.deductible, plan.dates, plan.balance, plan.stop_loss
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+
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+ ### Retrieve Service object and query it
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+ params = {
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+ :payer_name => "Aetna",
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+ :payer_id => "000001",
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+ :service_provider_last_name => "Last",
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+ :service_provider_first_name => "First",
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+ :service_provider_NPI => "1928384219",
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+ :subscriber_id => "W120923801",
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+ :subscriber_last_name => "Austen",
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+ :subscriber_first_name => "Jane",
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+ :subscriber_dob => "1955-12-14"
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+ }
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+
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+ service = Eligible::Service.get(params)
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+ service.all # returns all fields for the service, per service/all
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+ service.visits # returns the visits for the service, per service/visits
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+ ## Etc.: service.copayment, service.coinsurance, service.deductible
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+
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+ ### Retrieve Demographic object and query it
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+ params = {
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+ :payer_name => "Aetna",
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+ :payer_id => "000001",
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+ :service_provider_last_name => "Last",
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+ :service_provider_first_name => "First",
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+ :service_provider_NPI => "1928384219",
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+ :subscriber_id => "W120923801",
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+ :subscriber_last_name => "Austen",
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+ :subscriber_first_name => "Jane",
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+ :subscriber_dob => "1955-12-14"
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+ }
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+
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+ demographic = Eligible::Demographic.get(params)
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+ demographic.all # returns all fields for the demographic, per demographic/all
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+ demographic.zip # returns the patient's zip code, per demographic/zip
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+ ## Etc.: demographic.employer, demographic.address, demographic.dob
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+
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+ ### Retrieve Claim object
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+
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+ params = {
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+ :payer_name => "Aetna",
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+ :payer_id => "000001",
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+ :information_receiver_organization_name => "Organization",
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+ :information_receiver_last_name => "Last",
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+ :information_receiver_first_name => "First",
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+ :information_receiver_etin => "1386332",
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+ :service_provider_organization_name => "Marshall Group",
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+ :service_provider_last_name => "Last",
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+ :service_provider_first_name => "First",
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+ :service_provider_npi => "1928384219",
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+ :service_provider_tax_id => "1386332",
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+ :subscriber_id => "W120923801",
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+ :subscriber_last_name => "Last",
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+ :subscriber_first_name => "First",
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+ :subscriber_dob => "1955-12-14",
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+ :dependent_last_name => "Last",
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+ :dependent_first_name => "First",
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+ :dependent_dob => "1975-12-14",
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+ :dependent_gender => "M",
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+ :trace_number => "12345",
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+ :claim_control_number => "67890",
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+ :claim_charge_amount => "45.00",
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+ :claim_start_date => "2013-01-05",
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+ :claim_end_date => "2013-01-05"
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+ }
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+
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+ claim = Eligible::Claim.get(params)
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+ claim.status # Returns in real time the status (paid, not paid, rejected, denied, etc) of claim specified.
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+
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+ ## Tests
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+
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+ You can run tests with
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+
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+ rake test
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+
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+ If you do send a pull request, please add passing tests for the new feature/fix.
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+
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+ ## Contributing
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+
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+ 1. Fork it
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+ 2. Create your feature branch (`git checkout -b my-new-feature`)
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+ 3. Commit your changes (`git commit -am 'Add some feature'`)
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+ 4. Run tests (see above)
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+ 5. Push to the branch (`git push origin my-new-feature`)
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+ 6. Create new Pull Request
data/Rakefile ADDED
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+ require "bundler/gem_tasks"
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+ require 'rake/testtask'
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+
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+ Rake::TestTask.new(:test)
data/eligible.gemspec ADDED
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+ # -*- encoding: utf-8 -*-
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+ lib = File.expand_path('../lib', __FILE__)
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+ $LOAD_PATH.unshift(lib) unless $LOAD_PATH.include?(lib)
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+ require 'eligible/version'
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+
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+ Gem::Specification.new do |gem|
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+ gem.name = "eligible"
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+ gem.version = Eligible::VERSION
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+ gem.authors = ["Andy Brett"]
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+ gem.email = ["andy@andybrett.com"]
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+ gem.description = 'Eligible is a developer-friendly way to process health care eligibility checks. Learn more at https://eligibleapi.com'
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+ gem.summary = 'Ruby wrapper for the Eligible API'
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+ gem.homepage = "https://eligibleapi.com/"
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+ gem.license = "MIT"
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+
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+ gem.files = `git ls-files`.split($/)
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+ # gem.executables = `git ls-files -- bin/*`.split("\n").map{ |f| File.basename(f) }
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+ gem.test_files = `git ls-files -- test/*`.split("\n")
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+ gem.require_paths = ["lib"]
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+
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+ gem.add_development_dependency('mocha')
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+ gem.add_development_dependency('shoulda')
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+ gem.add_development_dependency('test-unit')
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+ gem.add_development_dependency('rake')
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+
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+ gem.add_dependency('rest-client', '~> 1.4')
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+ gem.add_dependency('multi_json', '>= 1.0.4', '< 2')
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+ end
data/lib/eligible.rb ADDED
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+ require 'cgi'
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+ require 'set'
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+ require 'rubygems'
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+ require 'openssl'
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+
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+ gem 'rest-client', '~> 1.4'
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+ require 'rest_client'
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+ require 'multi_json'
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+
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+ require 'eligible/version'
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+ require 'eligible/util'
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+ require 'eligible/json'
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+ require 'eligible/eligible_object'
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+ require 'eligible/api_resource'
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+ require 'eligible/plan'
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+ require 'eligible/service'
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+ require 'eligible/demographic'
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+ require 'eligible/claim'
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+
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+ # Errors
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+ require 'eligible/errors/eligible_error'
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+ require 'eligible/errors/api_connection_error'
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+ require 'eligible/errors/authentication_error'
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+ require 'eligible/errors/api_error'
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+
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+ module Eligible
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+ @@api_key = nil
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+ @@api_base = "https://v1.eligibleapi.net"
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+ @@api_version = 1
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+
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+ def self.api_url(url='')
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+ @@api_base + url
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+ end
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+
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+ def self.api_key
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+ @@api_key
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+ end
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+
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+ def self.api_key=(api_key)
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+ @@api_key = api_key
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+ end
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+
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+ def self.api_version=(version)
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+ @@api_version = version
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+ end
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+
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+ def self.api_version
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+ @@api_version
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+ end
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+
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+ def self.request(method, url, api_key, params={}, headers={})
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+ api_key ||= @@api_key
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+ raise AuthenticationError.new('No API key provided. (HINT: set your API key using "Eligible.api_key = <API-KEY>".') unless api_key
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+
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+ # if !verify_ssl_certs
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+ # unless @no_verify
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+ # $stderr.puts "WARNING: Running without SSL cert verification. Execute 'Eligible.verify_ssl_certs = true' to enable verification."
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+ # @no_verify = true
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+ # end
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+ # ssl_opts = { :verify_ssl => false }
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+ # elsif !Util.file_readable(@@ssl_bundle_path)
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+ # unless @no_bundle
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+ # $stderr.puts "WARNING: Running without SSL cert verification because #{@@ssl_bundle_path} isn't readable"
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+ # @no_bundle = true
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+ # end
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+ # ssl_opts = { :verify_ssl => false }
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+ # else
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+ # ssl_opts = {
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+ # :verify_ssl => OpenSSL::SSL::VERIFY_PEER,
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+ # :ssl_ca_file => @@ssl_bundle_path
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+ # }
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+ # end
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+ uname = (@@uname ||= RUBY_PLATFORM =~ /linux|darwin/i ? `uname -a 2>/dev/null`.strip : nil)
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+ lang_version = "#{RUBY_VERSION} p#{RUBY_PATCHLEVEL} (#{RUBY_RELEASE_DATE})"
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+ ua = {
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+ :bindings_version => Eligible::VERSION,
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+ :lang => 'ruby',
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+ :lang_version => lang_version,
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+ :platform => RUBY_PLATFORM,
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+ :publisher => 'eligible',
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+ :uname => uname
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+ }
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+
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+ # params = Util.objects_to_ids(params)
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+ url = self.api_url(url)
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+ case method.to_s.downcase.to_sym
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+ when :get, :head, :delete
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+ # Make params into GET parameters
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+ url += "?api_key=#{api_key}"
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+ if params && params.count > 0
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+ query_string = Util.flatten_params(params).collect{|key, value| "#{key}=#{Util.url_encode(value)}"}.join('&')
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+ url += "&#{query_string}"
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+ end
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+ payload = nil
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+ else
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+ payload = Util.flatten_params(params).collect{|(key, value)| "#{key}=#{Util.url_encode(value)}"}.join('&')
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+ end
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+
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+ begin
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+ headers = { :x_eligible_client_user_agent => Eligible::JSON.dump(ua) }.merge(headers)
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+ rescue => e
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+ headers = {
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+ :x_eligible_client_raw_user_agent => ua.inspect,
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+ :error => "#{e} (#{e.class})"
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+ }.merge(headers)
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+ end
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+
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+ headers = {
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+ :user_agent => "Eligible/v1 RubyBindings/#{Eligible::VERSION}",
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+ :authorization => "Bearer #{api_key}",
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+ :content_type => 'application/x-www-form-urlencoded'
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+ }.merge(headers)
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+
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+ if self.api_version
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+ headers[:eligible_version] = self.api_version
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+ end
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+
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+ opts = {
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+ :method => method,
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+ :url => url,
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+ :headers => headers,
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+ :open_timeout => 30,
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+ :payload => payload,
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+ :timeout => 80
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+ }#.merge(ssl_opts)
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+
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+ begin
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+ response = execute_request(opts)
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+ rescue SocketError => e
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+ self.handle_restclient_error(e)
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+ rescue NoMethodError => e
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+ # Work around RestClient bug
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+ if e.message =~ /\WRequestFailed\W/
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+ e = APIConnectionError.new('Unexpected HTTP response code')
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+ self.handle_restclient_error(e)
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+ else
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+ raise
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+ end
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+ rescue RestClient::ExceptionWithResponse => e
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+ if rcode = e.http_code and rbody = e.http_body
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+ self.handle_api_error(rcode, rbody)
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+ else
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+ self.handle_restclient_error(e)
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+ end
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+ rescue RestClient::Exception, Errno::ECONNREFUSED => e
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+ self.handle_restclient_error(e)
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+ end
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+
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+ rbody = response.body
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+ rcode = response.code
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+ begin
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+ # Would use :symbolize_names => true, but apparently there is
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+ # some library out there that makes symbolize_names not work.
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+ resp = Eligible::JSON.load(rbody)
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+ rescue MultiJson::DecodeError
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+ raise APIError.new("Invalid response object from API: #{rbody.inspect} (HTTP response code was #{rcode})", rcode, rbody)
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+ end
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+
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+ resp = Util.symbolize_names(resp)
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+ [resp, api_key]
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+ end
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+
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+ private
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+
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+ def self.execute_request(opts)
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+ RestClient::Request.execute(opts)
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+ end
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+
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+ def self.handle_api_error(rcode, rbody)
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+ begin
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+ error_obj = Eligible::JSON.load(rbody)
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+ error_obj = Util.symbolize_names(error_obj)
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+ error = error_obj[:error] or raise EligibleError.new # escape from parsing
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+ rescue MultiJson::DecodeError, EligibleError
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+ raise APIError.new("Invalid response object from API: #{rbody.inspect} (HTTP response code was #{rcode})", rcode, rbody)
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+ end
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+
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+ case rcode
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+ when 400, 404 then
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+ raise invalid_request_error(error, rcode, rbody, error_obj)
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+ when 401
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+ raise authentication_error(error, rcode, rbody, error_obj)
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+ else
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+ raise api_error(error, rcode, rbody, error_obj)
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+ end
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+ end
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+
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+ def self.invalid_request_error(error, rcode, rbody, error_obj)
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+ InvalidRequestError.new(error[0][:message], error[:param], rcode, rbody, error_obj)
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+ end
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+
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+ def self.authentication_error(error, rcode, rbody, error_obj)
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+ AuthenticationError.new(error[0][:message], rcode, rbody, error_obj)
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+ end
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+
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+ def self.api_error(error, rcode, rbody, error_obj)
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+ APIError.new(error[0][:message], rcode, rbody, error_obj)
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+ end
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+
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+ def self.handle_restclient_error(e)
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+ case e
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+ when RestClient::ServerBrokeConnection, RestClient::RequestTimeout
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+ message = "Could not connect to Eligible (#{@@api_base}). Please check your internet connection and try again."
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+ when RestClient::SSLCertificateNotVerified
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+ message = "Could not verify Eligible's SSL certificate."
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+ when SocketError
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+ message = "Unexpected error communicating when trying to connect to Eligible."
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+ else
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+ message = "Unexpected error communicating with Eligible. If this problem persists, let us know at support@eligible.com."
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+ end
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+ message += "\n\n(Network error: #{e.message})"
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+ raise APIConnectionError.new(message)
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+ end
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+
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+ end
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+ module Eligible
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+ class APIResource < EligibleObject
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+ def self.class_name
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+ self.name.split('::')[-1]
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+ end
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+
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+ def self.url()
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+ if self == APIResource
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+ raise NotImplementedError.new('APIResource is an abstract class. You should perform actions on its subclasses (Plan, Service, etc.)')
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+ end
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+ "/#{CGI.escape(class_name.downcase)}/all.json"
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+ end
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+ end
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+ end
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+ module Eligible
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+ class Claim < APIResource
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+ def self.get(params, api_key=nil)
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+ response, api_key = Eligible.request(:get, url, api_key, params)
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+ Util.convert_to_eligible_object(response, api_key)
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+ end
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+
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+ def status
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+ error ? nil : to_hash
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+ end
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+ end
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+ end