eligible 2.3 → 2.4.1

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Files changed (24) hide show
  1. checksums.yaml +4 -4
  2. data/CONTRIBUTORS +5 -1
  3. data/README.md +265 -69
  4. data/eligible.gemspec +6 -7
  5. data/lib/eligible.rb +53 -59
  6. data/lib/eligible/api_resource.rb +3 -1
  7. data/lib/eligible/claim.rb +17 -11
  8. data/lib/eligible/coverage.rb +13 -18
  9. data/lib/eligible/demographic.rb +9 -39
  10. data/lib/eligible/eligible_object.rb +1 -1
  11. data/lib/eligible/enrollment.rb +12 -17
  12. data/lib/eligible/json.rb +5 -15
  13. data/lib/eligible/medicare.rb +19 -0
  14. data/lib/eligible/payment.rb +11 -8
  15. data/lib/eligible/ticket.rb +40 -0
  16. data/lib/eligible/util.rb +32 -60
  17. data/lib/eligible/version.rb +1 -1
  18. data/lib/eligible/x12.rb +3 -12
  19. data/test/test_eligible.rb +13 -179
  20. data/test/test_helper.rb +30 -20
  21. metadata +18 -21
  22. data/lib/eligible/plan.rb +0 -42
  23. data/lib/eligible/service.rb +0 -59
  24. data/lib/eligible/webhook.rb +0 -16
data/test/test_helper.rb CHANGED
@@ -12,9 +12,12 @@ module Eligible
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  get_params = (opts[:headers] || {})[:params]
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  post_params = opts[:payload]
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  case opts[:method]
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- when :get then @mock_rest_client.get opts[:url], get_params, post_params
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- when :post then @mock_rest_client.post opts[:url], get_params, post_params
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- when :delete then @mock_rest_client.delete opts[:url], get_params, post_params
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+ when :get then
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+ @mock_rest_client.get opts[:url], get_params, post_params
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+ when :post then
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+ @mock_rest_client.post opts[:url], get_params, post_params
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+ when :delete then
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+ @mock_rest_client.delete opts[:url], get_params, post_params
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  end
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  end
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  end
@@ -25,63 +28,70 @@ def test_response(body, code=200)
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  body = MultiJson.dump(body) if !(body.kind_of? String)
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  m = mock
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  m.instance_variable_set('@eligible_values', { :body => body, :code => code })
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- def m.body; @eligible_values[:body]; end
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- def m.code; @eligible_values[:code]; end
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+
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+ def m.body
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+ @eligible_values[:body]
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+ end
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+
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+ def m.code
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+ @eligible_values[:code]
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+ end
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+
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  m
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- end
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+ end
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  def test_invalid_api_key_error
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- { "error" => [ { "message" => "Could not authenticate you. Please re-try with a valid API key.", "code" => 1 }] }
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+ { "error" => [{ "message" => "Could not authenticate you. Please re-try with a valid API key.", "code" => 1 }] }
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  end
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  def test_plan_missing_params
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- {"timestamp"=>"2013-02-01T13:25:58", "eligible_id"=>"A4F4E1D6-7DC3-4B20-87CE-B59F48811290", "mapping_version"=>"plan/all$Revision:6$$Date:13-01-110:18$", "error"=>{"response_code"=>"Y", "response_description"=>"Yes", "agency_qualifier_code"=>"", "agency_qualifier_description"=>"", "reject_reason_code"=>"41", "reject_reason_description"=>"Authorization/AccessRestrictions", "follow-up_action_code"=>"C", "follow-up_action_description"=>"PleaseCorrectandResubmit"}}
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+ { "timestamp" => "2013-02-01T13:25:58", "eligible_id" => "A4F4E1D6-7DC3-4B20-87CE-B59F48811290", "mapping_version" => "plan/all$Revision:6$$Date:13-01-110:18$", "error" => { "response_code" => "Y", "response_description" => "Yes", "agency_qualifier_code" => "", "agency_qualifier_description" => "", "reject_reason_code" => "41", "reject_reason_description" => "Authorization/AccessRestrictions", "follow-up_action_code" => "C", "follow-up_action_description" => "PleaseCorrectandResubmit" } }
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  end
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41
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  def test_plan
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- {"timestamp"=>"2013-01-14T20:39:57", "eligible_id"=>"B97BC91A-3E84-40A9-AA5C-D416CAE5CDB1", "mapping_version"=>"plan/all$Revision:6$$Date:13-01-110:18$", "primary_insurance"=>{"name"=>"Aetna", "id"=>"00002", "group_name"=>"TOWERGROUPCOMPANIES", "plan_begins"=>"2010-01-01", "plan_ends"=>"", "comments"=>["AetnaChoicePOSII"]}, "type"=>"30", "coverage_status"=>"1", "precertification_needed"=>"", "exclusions"=>"", "deductible_in_network"=>{"individual"=>{"base_period"=>"500", "remaining"=>"500", "comments"=>["MedDent", "MedDent"]}, "family"=>{"base_period"=>"1000", "remaining"=>"1000", "comments"=>["MedDent", "MedDent"]}}, "deductible_out_network"=>{"individual"=>{"base_period"=>"1250", "remaining"=>"1250", "comments"=>["MedDent", "MedDent"]}, "family"=>{"base_period"=>"3750", "remaining"=>"3750", "comments"=>["MedDent", "MedDent"]}}, "stop_loss_in_network"=>{"individual"=>{"base_period"=>"", "remaining"=>"2000", "comments"=>[]}, "family"=>{"base_period"=>"", "remaining"=>"4000", "comments"=>[]}}, "stop_loss_out_network"=>{"individual"=>{"base_period"=>"", "remaining"=>"3000", "comments"=>[]}, "family"=>{"base_period"=>"", "remaining"=>"6000", "comments"=>[]}}, "balance"=>"", "comments"=>[], "additional_insurance"=>{"comments"=>[]}}
52
+ { "timestamp" => "2013-01-14T20:39:57", "eligible_id" => "B97BC91A-3E84-40A9-AA5C-D416CAE5CDB1", "mapping_version" => "plan/all$Revision:6$$Date:13-01-110:18$", "primary_insurance" => { "name" => "Aetna", "id" => "00002", "group_name" => "TOWERGROUPCOMPANIES", "plan_begins" => "2010-01-01", "plan_ends" => "", "comments" => ["AetnaChoicePOSII"] }, "type" => "30", "coverage_status" => "1", "precertification_needed" => "", "exclusions" => "", "deductible_in_network" => { "individual" => { "base_period" => "500", "remaining" => "500", "comments" => ["MedDent", "MedDent"] }, "family" => { "base_period" => "1000", "remaining" => "1000", "comments" => ["MedDent", "MedDent"] } }, "deductible_out_network" => { "individual" => { "base_period" => "1250", "remaining" => "1250", "comments" => ["MedDent", "MedDent"] }, "family" => { "base_period" => "3750", "remaining" => "3750", "comments" => ["MedDent", "MedDent"] } }, "stop_loss_in_network" => { "individual" => { "base_period" => "", "remaining" => "2000", "comments" => [] }, "family" => { "base_period" => "", "remaining" => "4000", "comments" => [] } }, "stop_loss_out_network" => { "individual" => { "base_period" => "", "remaining" => "3000", "comments" => [] }, "family" => { "base_period" => "", "remaining" => "6000", "comments" => [] } }, "balance" => "", "comments" => [], "additional_insurance" => { "comments" => [] } }
43
53
  end
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45
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  def test_service_missing_params
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- {"timestamp"=>"2013-02-04T17:23:12", "eligible_id"=>"7EEA40A7-58C5-4EBC-A450-10C37CA2D252", "mapping_version"=>"service/all$Revision:4$$Date:12-12-280:13$", "error"=>{"response_code"=>"Y", "response_description"=>"Yes", "agency_qualifier_code"=>"", "agency_qualifier_description"=>"", "reject_reason_code"=>"41", "reject_reason_description"=>"Authorization/AccessRestrictions", "follow-up_action_code"=>"C", "follow-up_action_description"=>"PleaseCorrectandResubmit"}}
56
+ { "timestamp" => "2013-02-04T17:23:12", "eligible_id" => "7EEA40A7-58C5-4EBC-A450-10C37CA2D252", "mapping_version" => "service/all$Revision:4$$Date:12-12-280:13$", "error" => { "response_code" => "Y", "response_description" => "Yes", "agency_qualifier_code" => "", "agency_qualifier_description" => "", "reject_reason_code" => "41", "reject_reason_description" => "Authorization/AccessRestrictions", "follow-up_action_code" => "C", "follow-up_action_description" => "PleaseCorrectandResubmit" } }
47
57
  end
48
58
 
49
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  def test_service
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- {"timestamp"=>"2013-02-01T15:28:16", "eligible_id"=>"FD8994B1-F977-459A-81AC-D182EA8FE66D", "mapping_version"=>"service/all$Revision:4$$Date:12-12-280:13$", "type"=>"33", "coverage_status"=>"1", "service_begins"=>"", "service_ends"=>"", "not_covered"=>[], "comments"=>["AetnaChoicePOSII"], "precertification_needed"=>"", "visits_in_network"=>{"individual"=>{"total"=>"", "remaining"=>"", "comments"=>[]}, "family"=>{"total"=>"", "remaining"=>"", "comments"=>[]}}, "visits_out_network"=>{"individual"=>{"total"=>"", "remaining"=>"", "comments"=>[]}, "family"=>{"total"=>"", "remaining"=>"", "comments"=>[]}}, "copayment_in_network"=>{"individual"=>{"amount"=>"", "comments"=>[]}, "family"=>{"amount"=>"35", "comments"=>["OFFCHIROVISI", "COPAYNOTINCLUDEDINOOP", "MANPULATNCHRO"]}}, "copayment_out_network"=>{"individual"=>{"amount"=>"", "comments"=>[]}, "family"=>{"amount"=>"0", "comments"=>["MANPULATNCHRO"]}}, "coinsurance_in_network"=>{"individual"=>{"percent"=>"", "comments"=>[]}, "family"=>{"percent"=>"0", "comments"=>["OFFCHIROVISI", "MANPULATNCHRO"]}}, "coinsurance_out_network"=>{"individual"=>{"percent"=>"", "comments"=>[]}, "family"=>{"percent"=>"30", "comments"=>["CHIROVSTEVAL", "COINSAPPLIESTOOUTOFPOCKET", "MANPULATNCHRO"]}}, "deductible_in_network"=>{"individual"=>{"base_period"=>"", "remaining"=>"", "comments"=>[]}, "family"=>{"base_period"=>"", "remaining"=>"", "comments"=>[]}}, "deductible_out_network"=>{"individual"=>{"base_period"=>"", "remaining"=>"", "comments"=>[]}, "family"=>{"base_period"=>"", "remaining"=>"", "comments"=>[]}}, "additional_insurance"=>{"comments"=>[]}}
60
+ { "timestamp" => "2013-02-01T15:28:16", "eligible_id" => "FD8994B1-F977-459A-81AC-D182EA8FE66D", "mapping_version" => "service/all$Revision:4$$Date:12-12-280:13$", "type" => "33", "coverage_status" => "1", "service_begins" => "", "service_ends" => "", "not_covered" => [], "comments" => ["AetnaChoicePOSII"], "precertification_needed" => "", "visits_in_network" => { "individual" => { "total" => "", "remaining" => "", "comments" => [] }, "family" => { "total" => "", "remaining" => "", "comments" => [] } }, "visits_out_network" => { "individual" => { "total" => "", "remaining" => "", "comments" => [] }, "family" => { "total" => "", "remaining" => "", "comments" => [] } }, "copayment_in_network" => { "individual" => { "amount" => "", "comments" => [] }, "family" => { "amount" => "35", "comments" => ["OFFCHIROVISI", "COPAYNOTINCLUDEDINOOP", "MANPULATNCHRO"] } }, "copayment_out_network" => { "individual" => { "amount" => "", "comments" => [] }, "family" => { "amount" => "0", "comments" => ["MANPULATNCHRO"] } }, "coinsurance_in_network" => { "individual" => { "percent" => "", "comments" => [] }, "family" => { "percent" => "0", "comments" => ["OFFCHIROVISI", "MANPULATNCHRO"] } }, "coinsurance_out_network" => { "individual" => { "percent" => "", "comments" => [] }, "family" => { "percent" => "30", "comments" => ["CHIROVSTEVAL", "COINSAPPLIESTOOUTOFPOCKET", "MANPULATNCHRO"] } }, "deductible_in_network" => { "individual" => { "base_period" => "", "remaining" => "", "comments" => [] }, "family" => { "base_period" => "", "remaining" => "", "comments" => [] } }, "deductible_out_network" => { "individual" => { "base_period" => "", "remaining" => "", "comments" => [] }, "family" => { "base_period" => "", "remaining" => "", "comments" => [] } }, "additional_insurance" => { "comments" => [] } }
51
61
  end
52
62
 
53
63
  def test_demographic_missing_params
54
- {"timestamp"=>"2013-02-05T13:21:38", "eligible_id"=>"AE9F5EB3-B4BF-4B2E-92C5-6307CE91DB81", "mapping_version"=>"demographic/dob$Revision:1$$Date:12-12-2619:01$", "error"=>{"response_code"=>"Y", "response_description"=>"Yes", "agency_qualifier_code"=>"", "agency_qualifier_description"=>"", "reject_reason_code"=>"41", "reject_reason_description"=>"Authorization/AccessRestrictions", "follow-up_action_code"=>"C", "follow-up_action_description"=>"PleaseCorrectandResubmit"}}
64
+ { "timestamp" => "2013-02-05T13:21:38", "eligible_id" => "AE9F5EB3-B4BF-4B2E-92C5-6307CE91DB81", "mapping_version" => "demographic/dob$Revision:1$$Date:12-12-2619:01$", "error" => { "response_code" => "Y", "response_description" => "Yes", "agency_qualifier_code" => "", "agency_qualifier_description" => "", "reject_reason_code" => "41", "reject_reason_description" => "Authorization/AccessRestrictions", "follow-up_action_code" => "C", "follow-up_action_description" => "PleaseCorrectandResubmit" } }
55
65
  end
56
66
 
57
67
  def test_demographic
58
- {"timestamp"=>"2013-02-05T13:14:36", "eligible_id"=>"DCE2FFB3-179A-4825-ADA6-B8108FB5FB90", "mapping_version"=>"demographic/all$Revision:4$$Date:12-12-2622:25$", "last_name"=>"AUSTEN", "first_name"=>"JANE", "member_id"=>"R112114321", "group_id"=>"060801203300001", "group_name"=>"TOWERGROUPCOMPANIES", "dob"=>"1955-12-14", "gender"=>"M", "address"=>{"street_line_1"=>"123SOUTH7THSTREET", "street_line_2"=>"", "city"=>"CHICAGO", "state"=>"CA", "zip"=>"89701"}}
68
+ { "timestamp" => "2013-02-05T13:14:36", "eligible_id" => "DCE2FFB3-179A-4825-ADA6-B8108FB5FB90", "mapping_version" => "demographic/all$Revision:4$$Date:12-12-2622:25$", "last_name" => "AUSTEN", "first_name" => "JANE", "member_id" => "R112114321", "group_id" => "060801203300001", "group_name" => "TOWERGROUPCOMPANIES", "dob" => "1955-12-14", "gender" => "M", "address" => { "street_line_1" => "123SOUTH7THSTREET", "street_line_2" => "", "city" => "CHICAGO", "state" => "CA", "zip" => "89701" } }
59
69
  end
60
70
 
61
71
  def test_claim_missing_params
62
- {"success"=>"false", "created_at"=>"2013-06-03T23:53:39Z", "error"=>{"type"=>"scrub", "message"=>"you forgot to include gender"}}
72
+ { "success" => "false", "created_at" => "2013-06-03T23:53:39Z", "error" => { "type" => "scrub", "message" => "you forgot to include gender" } }
63
73
  end
64
74
 
65
75
  def test_post_claim
66
- {"timestamp"=>"2012-12-30T22:41:10", "eligible_id"=>"DCE2FFB3-179A-4825-ADA6-B8108FB5FB90", "mapping_version"=>"claim/status$Revision:1$$Date:12-12-3022:10$", "referenced_transaction_trace_number"=>"970779644", "claim_status_category_code"=>"F0", "claim_status_category_description"=>"Finalized-Theclaim/encounterhascompletedtheadjudicationcycleandnomoreactionwillbetaken.", "claim_status_code"=>"1", "claim_status_description"=>"Formoredetailedinformation,seeremittanceadvice.", "status_information_effective_date"=>"2007-03-13", "total_claim_charge_amount"=>"172", "claim_payment_amount"=>"126.9", "adjudication_finalized_date"=>"2007-03-18", "remittance_date"=>"2007-03-19", "remittance_trace_number"=>"458787", "payer_claim_control_number"=>"4121476181852", "claim_service_begin_date"=>"2007-02-23", "claim_service_end_date"=>"2007-02-28"}
76
+ { "timestamp" => "2012-12-30T22:41:10", "eligible_id" => "DCE2FFB3-179A-4825-ADA6-B8108FB5FB90", "mapping_version" => "claim/status$Revision:1$$Date:12-12-3022:10$", "referenced_transaction_trace_number" => "970779644", "claim_status_category_code" => "F0", "claim_status_category_description" => "Finalized-Theclaim/encounterhascompletedtheadjudicationcycleandnomoreactionwillbetaken.", "claim_status_code" => "1", "claim_status_description" => "Formoredetailedinformation,seeremittanceadvice.", "status_information_effective_date" => "2007-03-13", "total_claim_charge_amount" => "172", "claim_payment_amount" => "126.9", "adjudication_finalized_date" => "2007-03-18", "remittance_date" => "2007-03-19", "remittance_trace_number" => "458787", "payer_claim_control_number" => "4121476181852", "claim_service_begin_date" => "2007-02-23", "claim_service_end_date" => "2007-02-28" }
67
77
  end
68
78
 
69
79
  def test_coverage_missing_params
70
- {"created_at"=>"2013-06-11T12:21:47Z", "eligible_id"=>"57c320d8-2e14-68ed-73d0-41c3b23c0f43", "error"=>{"response_code"=>"Y", "response_description"=>"Yes", "agency_qualifier_code"=>"", "agency_qualifier_description"=>"", "reject_reason_code"=>"41", "reject_reason_description"=>"Authorization/Access Restrictions", "follow-up_action_code"=>"C", "follow-up_action_description"=>"Please Correct and Resubmit", "details"=>""}}
80
+ { "created_at" => "2013-06-11T12:21:47Z", "eligible_id" => "57c320d8-2e14-68ed-73d0-41c3b23c0f43", "error" => { "response_code" => "Y", "response_description" => "Yes", "agency_qualifier_code" => "", "agency_qualifier_description" => "", "reject_reason_code" => "41", "reject_reason_description" => "Authorization/Access Restrictions", "follow-up_action_code" => "C", "follow-up_action_description" => "Please Correct and Resubmit", "details" => "" } }
71
81
  end
72
82
 
73
83
  def test_coverage
74
- {"created_at"=>"2013-05-09T22:42:40Z", "eligible_id"=>"3233a9a1-a286-2896-ba3d-9f171303428b", "demographics"=>{"subscriber"=>{"last_name"=>"FRANKLIN", "first_name"=>"BENJAMIN", "member_id"=>"TYA445554301", "group_id"=>"3207524", "group_name"=>"FOUNDING FATHERS", "dob"=>"1701-10-17", "gender"=>"M", "address"=>{"street_line_1"=>"2 FRANKLIN STREET", "street_line_2"=>"", "city"=>"SAN FRANCISCO", "state"=>"CA", "zip"=>"94102"}}, "dependent"=>{"last_name"=>"FRANKLIN", "first_name"=>"IDA", "member_id"=>"ZZZ445554301", "group_id"=>"3207524", "group_name"=>"FOUNDING FATHERS", "dob"=>"1701-12-12", "gender"=>"F", "address"=>{"street_line_1"=>"2 FRANKLIN STREET", "street_line_2"=>"", "city"=>"SAN FRANCISCO", "state"=>"CA", "zip"=>"94102"}}}, "primary_insurance"=>{"name"=>"CIGNA", "id"=>"00001", "contacts"=>[{"contact_type"=>"url", "contact_value"=>"cignaforhcp.cigna.com"}], "service_providers"=>{"physicians"=>[{"insurance_type"=>"HN", "insurance_type_label"=>"Health Maintenance Organization (HMO)", "primary_care"=>"true", "restricted"=>"TRUE", "contact_details"=>[{"last_name"=>"JEFFERSON", "first_name"=>"THOMAS", "indentification_type"=>"Centers for Medicare and Medicaid Services National Provider Identifier", "identification_code"=>"2222222222", "contacts"=>[], "address"=>{"street_line_1"=>"PO BOX 2222222", "street_line_2"=>"", "city"=>"SAN FRANCISCO", "state"=>"CA", "zip"=>"94105"}}], "dates"=>[{"date_type"=>"eligibility", "date_value"=>"2010-01-01"}], "comments"=>["HRA BALANCE"]}]}}, "plan"=>{"type"=>"30", "coverage_status"=>"1", "coverage_status_label"=>"ACTIVE COVERAGE", "coverage_basis"=>[], "plan_number"=>"43", "plan_name"=>"TRADITIONAL BLUE PPO 813 $15/ $15 COPAY", "group_name"=>"FOUNDING FATHERS", "dates"=>[{"date_type"=>"plan_begin", "date_value"=>"2010-01-01"}, {"date_type"=>"service", "date_value"=>"2013-05-24"}, {"date_type"=>"eligibility_begin", "date_value"=>"2007-02-01"}], "exclusions"=>{"noncovered"=>[{"type"=>"BZ", "type_label"=>"Physician Visit - Well", "time_period"=>"32", "time_period_label"=>"lifetime", "level"=>"INDIVIDUAL", "network"=>"OUT", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "dates"=>[], "contact_details"=>[], "comments"=>[]}], "pre_exisiting_condition"=>{"waiting_period"=>[]}}, "financials"=>{"deductible"=>{"remainings"=>{"in_network"=>[{"amount"=>"0", "level"=>"FAMILY", "insurance_type"=>"", "insurance_type_label"=>"", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}, {"amount"=>"0", "level"=>"INDIVIDUAL", "insurance_type"=>"", "insurance_type_label"=>"", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}], "out_network"=>[]}, "totals"=>{"in_network"=>[{"amount"=>"0", "time_period"=>"24", "time_period_label"=>"year_to_date", "level"=>"INDIVIDUAL", "insurance_type"=>"", "insurance_type_label"=>"", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}, {"amount"=>"0", "time_period"=>"23", "time_period_label"=>"calendar_year", "level"=>"INDIVIDUAL", "insurance_type"=>"", "insurance_type_label"=>"", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}, {"amount"=>"0", "time_period"=>"24", "time_period_label"=>"year_to_date", "level"=>"FAMILY", "insurance_type"=>"", "insurance_type_label"=>"", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}, {"amount"=>"0", "time_period"=>"23", "time_period_label"=>"calendar_year", "level"=>"FAMILY", "insurance_type"=>"", "insurance_type_label"=>"", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}], "out_network"=>[]}}, "stop_loss"=>{"remainings"=>{"in_network"=>[{"amount"=>"6490", "level"=>"INDIVIDUAL", "insurance_type"=>"HN", "insurance_type_label"=>"Health Maintenance Organization (HMO) - Medicare Risk", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}, {"amount"=>"0", "level"=>"FAMILY", "insurance_type"=>"HN", "insurance_type_label"=>"Health Maintenance Organization (HMO) - Medicare Risk", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}], "out_network"=>[]}, "totals"=>{"in_network"=>[{"amount"=>"210", "time_period"=>"24", "time_period_label"=>"year_to_date", "level"=>"INDIVIDUAL", "insurance_type"=>"HN", "insurance_type_label"=>"Health Maintenance Organization (HMO) - Medicare Risk", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}, {"amount"=>"210", "time_period"=>"24", "time_period_label"=>"year_to_date", "level"=>"FAMILY", "insurance_type"=>"HN", "insurance_type_label"=>"Health Maintenance Organization (HMO) - Medicare Risk", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}, {"amount"=>"0", "time_period"=>"23", "time_period_label"=>"calendar_year", "level"=>"FAMILY", "insurance_type"=>"HN", "insurance_type_label"=>"Health Maintenance Organization (HMO) - Medicare Risk", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}, {"amount"=>"6700", "time_period"=>"23", "time_period_label"=>"calendar_year", "level"=>"INDIVIDUAL", "insurance_type"=>"HN", "insurance_type_label"=>"Health Maintenance Organization (HMO) - Medicare Risk", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[], "comments"=>[]}], "out_network"=>[]}}, "spending_account"=>{"remaining"=>[]}, "coinsurance"=>{"percents"=>{"in_network"=>[], "out_network"=>[]}}, "copayment"=>{"amounts"=>{"in_network"=>[{"amount"=>"20", "time_period"=>"", "time_period_label"=>"", "level"=>"INDIVIDUAL", "insurance_type"=>"", "insurance_type_label"=>"", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "dates"=>[], "contact_details"=>[], "comments"=>[]}], "out_network"=>[{"amount"=>"40", "time_period"=>"", "time_period_label"=>"", "level"=>"INDIVIDUAL", "insurance_type"=>"", "insurance_type_label"=>"", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "dates"=>[], "contact_details"=>[], "comments"=>[]}]}}, "cost_containment"=>{"remainings"=>{"in_network"=>[], "out_network"=>[]}, "totals"=>{"in_network"=>[], "out_network"=>[]}}, "spend_down"=>{"remainings"=>{"in_network"=>[], "out_network"=>[]}, "totals"=>{"in_network"=>[], "out_network"=>[]}}, "limitations"=>{"amounts"=>[]}, "disclaimer"=>[], "other_sources"=>{"amounts"=>[]}}, "benefit_details"=>{"benefit_type_label"=>{"amounts"=>[]}, "managed_care"=>{"amounts"=>[]}, "unlimited"=>{"amounts"=>[]}}, "additional_insurance_policies"=>[{"insurance_type"=>"47", "insurance_type_label"=>"Medicare Secondary, Other Liability Insurance is Primary", "coverage_description"=>"", "reference"=>[{"reference_code"=>"IG", "reference_label"=>"Insurance Policy Number", "reference_number"=>"1232004008"}], "contact_details"=>[{"last_name"=>"CLAIMS MANAGEMENT INC", "first_name"=>"", "indentification_type"=>"", "identification_code"=>"", "contacts"=>[], "address"=>{"street_line_1"=>"PO BOX 2210", "street_line_2"=>"ATTN JANE AUSTEN", "city"=>"SAN FRANCISCO", "state"=>"CA", "zip"=>"941052312"}}], "dates"=>[{"date_type"=>"coordination_of_benefits", "date_value"=>"2005-02-12"}], "comments"=>[]}]}, "services"=>[{"type"=>"96", "type_label"=>"Physician Professional", "coverage_status"=>"11", "coverage_status_label"=>"generic inquiry provided no information for this service type. Retry by including service_type_code=96 for an explicit inquiry for this service type."}, {"type"=>"98", "type_label"=>"Professional Physician Visit - Office", "coverage_status"=>"1", "coverage_status_label"=>"active coverage", "authorization_required"=>"", "noncovered"=>[], "facility"=>{"amounts"=>[{"amount"=>"", "time_period"=>"26", "time_period_label"=>"EPISODE", "level"=>"INDIVIDUAL", "network"=>"Y", "insurance_type"=>"MA", "insurance_type_label"=>"MEDICARE PART A", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "contact_details"=>[], "dates"=>[{"date_type"=>"benefit_begin", "date_value"=>"2013-05-20"}], "comments"=>["Revocation Code - 0"]}]}, "benefit_details"=>{"benefit_type_label"=>{"amounts"=>[]}, "managed_care"=>{"amounts"=>[]}, "unlimited"=>{"amounts"=>[]}}, "financials"=>{"deductible"=>{}, "stop_loss"=>{}, "spending_account"=>{}, "coinsurance"=>{}, "copayment"=>{}, "cost_containment"=>{}, "spend_down"=>{}, "limitations"=>{}, "other_sources"=>{}}, "visits"=>{"amounts"=>{"in_network"=>[{"amount"=>"20", "time_period"=>"", "time_period_label"=>"", "level"=>"INDIVIDUAL", "insurance_type"=>"", "insurance_type_label"=>"", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "dates"=>[], "contact_details"=>[], "comments"=>[]}], "out_network"=>[{"amount"=>"40", "time_period"=>"", "time_period_label"=>"", "level"=>"INDIVIDUAL", "insurance_type"=>"", "insurance_type_label"=>"", "pos"=>"", "pos_label"=>"", "authorization_required"=>"", "dates"=>[], "contact_details"=>[], "comments"=>[]}]}}, "additional_insurance_policies"=>[{"insurance_type"=>"47", "insurance_type_label"=>"Medicare Secondary, Other Liability Insurance is Primary", "coverage_description"=>"", "reference"=>[{"reference_code"=>"IG", "reference_label"=>"Insurance Policy Number", "reference_number"=>"1232004008"}], "contact_details"=>[{"last_name"=>"CLAIMS MANAGEMENT INC", "first_name"=>"", "indentification_type"=>"", "identification_code"=>"", "contacts"=>[], "address"=>{"street_line_1"=>"PO BOX 2210", "street_line_2"=>"ATTN JANE AUSTEN", "city"=>"SAN FRANCISCO", "state"=>"CA", "zip"=>"941052312"}}], "dates"=>[{"date_type"=>"coordination_of_benefits", "date_value"=>"2005-02-12"}], "comments"=>[]}]}]}
84
+ { "created_at" => "2013-05-09T22:42:40Z", "eligible_id" => "3233a9a1-a286-2896-ba3d-9f171303428b", "demographics" => { "subscriber" => { "last_name" => "FRANKLIN", "first_name" => "BENJAMIN", "member_id" => "TYA445554301", "group_id" => "3207524", "group_name" => "FOUNDING FATHERS", "dob" => "1701-10-17", "gender" => "M", "address" => { "street_line_1" => "2 FRANKLIN STREET", "street_line_2" => "", "city" => "SAN FRANCISCO", "state" => "CA", "zip" => "94102" } }, "dependent" => { "last_name" => "FRANKLIN", "first_name" => "IDA", "member_id" => "ZZZ445554301", "group_id" => "3207524", "group_name" => "FOUNDING FATHERS", "dob" => "1701-12-12", "gender" => "F", "address" => { "street_line_1" => "2 FRANKLIN STREET", "street_line_2" => "", "city" => "SAN FRANCISCO", "state" => "CA", "zip" => "94102" } } }, "primary_insurance" => { "name" => "CIGNA", "id" => "00001", "contacts" => [{ "contact_type" => "url", "contact_value" => "cignaforhcp.cigna.com" }], "service_providers" => { "physicians" => [{ "insurance_type" => "HN", "insurance_type_label" => "Health Maintenance Organization (HMO)", "primary_care" => "true", "restricted" => "TRUE", "contact_details" => [{ "last_name" => "JEFFERSON", "first_name" => "THOMAS", "indentification_type" => "Centers for Medicare and Medicaid Services National Provider Identifier", "identification_code" => "2222222222", "contacts" => [], "address" => { "street_line_1" => "PO BOX 2222222", "street_line_2" => "", "city" => "SAN FRANCISCO", "state" => "CA", "zip" => "94105" } }], "dates" => [{ "date_type" => "eligibility", "date_value" => "2010-01-01" }], "comments" => ["HRA BALANCE"] }] } }, "plan" => { "type" => "30", "coverage_status" => "1", "coverage_status_label" => "ACTIVE COVERAGE", "coverage_basis" => [], "plan_number" => "43", "plan_name" => "TRADITIONAL BLUE PPO 813 $15/ $15 COPAY", "group_name" => "FOUNDING FATHERS", "dates" => [{ "date_type" => "plan_begin", "date_value" => "2010-01-01" }, { "date_type" => "service", "date_value" => "2013-05-24" }, { "date_type" => "eligibility_begin", "date_value" => "2007-02-01" }], "exclusions" => { "noncovered" => [{ "type" => "BZ", "type_label" => "Physician Visit - Well", "time_period" => "32", "time_period_label" => "lifetime", "level" => "INDIVIDUAL", "network" => "OUT", "pos" => "", "pos_label" => "", "authorization_required" => "", "dates" => [], "contact_details" => [], "comments" => [] }], "pre_exisiting_condition" => { "waiting_period" => [] } }, "financials" => { "deductible" => { "remainings" => { "in_network" => [{ "amount" => "0", "level" => "FAMILY", "insurance_type" => "", "insurance_type_label" => "", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }, { "amount" => "0", "level" => "INDIVIDUAL", "insurance_type" => "", "insurance_type_label" => "", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }], "out_network" => [] }, "totals" => { "in_network" => [{ "amount" => "0", "time_period" => "24", "time_period_label" => "year_to_date", "level" => "INDIVIDUAL", "insurance_type" => "", "insurance_type_label" => "", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }, { "amount" => "0", "time_period" => "23", "time_period_label" => "calendar_year", "level" => "INDIVIDUAL", "insurance_type" => "", "insurance_type_label" => "", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }, { "amount" => "0", "time_period" => "24", "time_period_label" => "year_to_date", "level" => "FAMILY", "insurance_type" => "", "insurance_type_label" => "", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }, { "amount" => "0", "time_period" => "23", "time_period_label" => "calendar_year", "level" => "FAMILY", "insurance_type" => "", "insurance_type_label" => "", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }], "out_network" => [] } }, "stop_loss" => { "remainings" => { "in_network" => [{ "amount" => "6490", "level" => "INDIVIDUAL", "insurance_type" => "HN", "insurance_type_label" => "Health Maintenance Organization (HMO) - Medicare Risk", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }, { "amount" => "0", "level" => "FAMILY", "insurance_type" => "HN", "insurance_type_label" => "Health Maintenance Organization (HMO) - Medicare Risk", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }], "out_network" => [] }, "totals" => { "in_network" => [{ "amount" => "210", "time_period" => "24", "time_period_label" => "year_to_date", "level" => "INDIVIDUAL", "insurance_type" => "HN", "insurance_type_label" => "Health Maintenance Organization (HMO) - Medicare Risk", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }, { "amount" => "210", "time_period" => "24", "time_period_label" => "year_to_date", "level" => "FAMILY", "insurance_type" => "HN", "insurance_type_label" => "Health Maintenance Organization (HMO) - Medicare Risk", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }, { "amount" => "0", "time_period" => "23", "time_period_label" => "calendar_year", "level" => "FAMILY", "insurance_type" => "HN", "insurance_type_label" => "Health Maintenance Organization (HMO) - Medicare Risk", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }, { "amount" => "6700", "time_period" => "23", "time_period_label" => "calendar_year", "level" => "INDIVIDUAL", "insurance_type" => "HN", "insurance_type_label" => "Health Maintenance Organization (HMO) - Medicare Risk", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [], "comments" => [] }], "out_network" => [] } }, "spending_account" => { "remaining" => [] }, "coinsurance" => { "percents" => { "in_network" => [], "out_network" => [] } }, "copayment" => { "amounts" => { "in_network" => [{ "amount" => "20", "time_period" => "", "time_period_label" => "", "level" => "INDIVIDUAL", "insurance_type" => "", "insurance_type_label" => "", "pos" => "", "pos_label" => "", "authorization_required" => "", "dates" => [], "contact_details" => [], "comments" => [] }], "out_network" => [{ "amount" => "40", "time_period" => "", "time_period_label" => "", "level" => "INDIVIDUAL", "insurance_type" => "", "insurance_type_label" => "", "pos" => "", "pos_label" => "", "authorization_required" => "", "dates" => [], "contact_details" => [], "comments" => [] }] } }, "cost_containment" => { "remainings" => { "in_network" => [], "out_network" => [] }, "totals" => { "in_network" => [], "out_network" => [] } }, "spend_down" => { "remainings" => { "in_network" => [], "out_network" => [] }, "totals" => { "in_network" => [], "out_network" => [] } }, "limitations" => { "amounts" => [] }, "disclaimer" => [], "other_sources" => { "amounts" => [] } }, "benefit_details" => { "benefit_type_label" => { "amounts" => [] }, "managed_care" => { "amounts" => [] }, "unlimited" => { "amounts" => [] } }, "additional_insurance_policies" => [{ "insurance_type" => "47", "insurance_type_label" => "Medicare Secondary, Other Liability Insurance is Primary", "coverage_description" => "", "reference" => [{ "reference_code" => "IG", "reference_label" => "Insurance Policy Number", "reference_number" => "1232004008" }], "contact_details" => [{ "last_name" => "CLAIMS MANAGEMENT INC", "first_name" => "", "indentification_type" => "", "identification_code" => "", "contacts" => [], "address" => { "street_line_1" => "PO BOX 2210", "street_line_2" => "ATTN JANE AUSTEN", "city" => "SAN FRANCISCO", "state" => "CA", "zip" => "941052312" } }], "dates" => [{ "date_type" => "coordination_of_benefits", "date_value" => "2005-02-12" }], "comments" => [] }] }, "services" => [{ "type" => "96", "type_label" => "Physician Professional", "coverage_status" => "11", "coverage_status_label" => "generic inquiry provided no information for this service type. Retry by including service_type_code=96 for an explicit inquiry for this service type." }, { "type" => "98", "type_label" => "Professional Physician Visit - Office", "coverage_status" => "1", "coverage_status_label" => "active coverage", "authorization_required" => "", "noncovered" => [], "facility" => { "amounts" => [{ "amount" => "", "time_period" => "26", "time_period_label" => "EPISODE", "level" => "INDIVIDUAL", "network" => "Y", "insurance_type" => "MA", "insurance_type_label" => "MEDICARE PART A", "pos" => "", "pos_label" => "", "authorization_required" => "", "contact_details" => [], "dates" => [{ "date_type" => "benefit_begin", "date_value" => "2013-05-20" }], "comments" => ["Revocation Code - 0"] }] }, "benefit_details" => { "benefit_type_label" => { "amounts" => [] }, "managed_care" => { "amounts" => [] }, "unlimited" => { "amounts" => [] } }, "financials" => { "deductible" => {}, "stop_loss" => {}, "spending_account" => {}, "coinsurance" => {}, "copayment" => {}, "cost_containment" => {}, "spend_down" => {}, "limitations" => {}, "other_sources" => {} }, "visits" => { "amounts" => { "in_network" => [{ "amount" => "20", "time_period" => "", "time_period_label" => "", "level" => "INDIVIDUAL", "insurance_type" => "", "insurance_type_label" => "", "pos" => "", "pos_label" => "", "authorization_required" => "", "dates" => [], "contact_details" => [], "comments" => [] }], "out_network" => [{ "amount" => "40", "time_period" => "", "time_period_label" => "", "level" => "INDIVIDUAL", "insurance_type" => "", "insurance_type_label" => "", "pos" => "", "pos_label" => "", "authorization_required" => "", "dates" => [], "contact_details" => [], "comments" => [] }] } }, "additional_insurance_policies" => [{ "insurance_type" => "47", "insurance_type_label" => "Medicare Secondary, Other Liability Insurance is Primary", "coverage_description" => "", "reference" => [{ "reference_code" => "IG", "reference_label" => "Insurance Policy Number", "reference_number" => "1232004008" }], "contact_details" => [{ "last_name" => "CLAIMS MANAGEMENT INC", "first_name" => "", "indentification_type" => "", "identification_code" => "", "contacts" => [], "address" => { "street_line_1" => "PO BOX 2210", "street_line_2" => "ATTN JANE AUSTEN", "city" => "SAN FRANCISCO", "state" => "CA", "zip" => "941052312" } }], "dates" => [{ "date_type" => "coordination_of_benefits", "date_value" => "2005-02-12" }], "comments" => [] }] }] }
75
85
  end
76
86
 
77
87
  def test_enrollment_missing_params
78
- {"error" =>"Expeting enrollment_request_id or npis"}
88
+ { "error" => "Expeting enrollment_request_id or npis" }
79
89
  end
80
90
 
81
91
  def test_get_enrollment
82
- [{"enrollment_npi"=>{"address"=>"985 Snow Shoe Road", "city"=>"Sacramento", "created_at"=>"2013-04-24T21:47:31+00:00", "facility_name"=>"Quality", "npi"=>"987654321", "provider_name"=>"Jack Austen", "ptan"=>"54321", "state"=>"CA", "status"=>"rejected", "tax_id"=>"12345678", "updated_at"=>"2013-04-28T17:10:00+00:00", "zip"=>"94107", "enrollment_insurance_company"=>{"name"=>"Medicare", "payer_id"=>"00431"}}}, {"enrollment_npi"=>{"address"=>"985 Snow Shoe Road", "city"=>"Sacramento", "created_at"=>"2013-04-24T21:47:31+00:00", "facility_name"=>"Quality", "npi"=>"987654321", "provider_name"=>"Jack Austen", "ptan"=>"54321", "state"=>"CA", "status"=>"accepted", "tax_id"=>"12345678", "updated_at"=>"2013-04-28T22:51:43+00:00", "zip"=>"94107", "enrollment_insurance_company"=>{"name"=>"Kaiser North", "payer_id"=>"00282"}}}]
92
+ [{ "enrollment_npi" => { "address" => "985 Snow Shoe Road", "city" => "Sacramento", "created_at" => "2013-04-24T21:47:31+00:00", "facility_name" => "Quality", "npi" => "987654321", "provider_name" => "Jack Austen", "ptan" => "54321", "state" => "CA", "status" => "rejected", "tax_id" => "12345678", "updated_at" => "2013-04-28T17:10:00+00:00", "zip" => "94107", "enrollment_insurance_company" => { "name" => "Medicare", "payer_id" => "00431" } } }, { "enrollment_npi" => { "address" => "985 Snow Shoe Road", "city" => "Sacramento", "created_at" => "2013-04-24T21:47:31+00:00", "facility_name" => "Quality", "npi" => "987654321", "provider_name" => "Jack Austen", "ptan" => "54321", "state" => "CA", "status" => "accepted", "tax_id" => "12345678", "updated_at" => "2013-04-28T22:51:43+00:00", "zip" => "94107", "enrollment_insurance_company" => { "name" => "Kaiser North", "payer_id" => "00282" } } }]
83
93
  end
84
94
 
85
95
  def test_post_enrollment
86
- {"enrollment_request"=>{"created_at"=>"2013-04-14T07:29:09-07:00", "id"=>5, "status"=>"pending", "updated_at"=>"2013-04-14T07:29:09-07:00", "enrollment_npis"=>[{"address"=>"125 Snow Shoe Road", "city"=>"Sacramento", "created_at"=>"2013-04-14T07:29:09-07:00", "facility_name"=>"Quality", "npi"=>"987654321", "provider_name"=>"Jane Austen", "ptan"=>"54321", "state"=>"CA", "status"=>"submitted", "tax_id"=>"12345678", "updated_at"=>"2013-04-14T07:29:09-07:00", "zip"=>"94107", "enrollment_insurance_company"=>{"name"=>"Medicare", "payer_id"=>"00431"}}, {"address"=>"125 Snow Shoe Road", "city"=>"Sacramento", "created_at"=>"2013-04-14T07:29:09-07:00", "facility_name"=>"Quality", "npi"=>"987654321", "provider_name"=>"Jane Austen", "ptan"=>"54321", "state"=>"CA", "status"=>"submitted", "tax_id"=>"12345678", "updated_at"=>"2013-04-14T07:29:09-07:00", "zip"=>"94107", "enrollment_insurance_company"=>{"name"=>"Medicare", "payer_id"=>"00431"}}, {"address"=>"125 Snow Shoe Road", "city"=>"Sacramento", "created_at"=>"2013-04-14T07:29:09-07:00", "facility_name"=>"Quality", "npi"=>"987654321", "provider_name"=>"Jane Austen", "ptan"=>"54321", "state"=>"CA", "status"=>"submitted", "tax_id"=>"12345678", "updated_at"=>"2013-04-14T07:29:09-07:00", "zip"=>"94107", "enrollment_insurance_company"=>{"name"=>"Kaiser Nort", "payer_id"=>"00282"}}, {"address"=>"125 Snow Shoe Road", "city"=>"Sacramento", "created_at"=>"2013-04-14T07:29:09-07:00", "facility_name"=>"Quality", "npi"=>"987654321", "provider_name"=>"Jane Austen", "ptan"=>"54321", "state"=>"CA", "status"=>"submitted", "tax_id"=>"12345678", "updated_at"=>"2013-04-14T07:29:09-07:00", "zip"=>"94107", "enrollment_insurance_company"=>{"name"=>"Kaiser Nort", "payer_id"=>"00282"}}]}}
96
+ { "enrollment_request" => { "created_at" => "2013-04-14T07:29:09-07:00", "id" => 5, "status" => "pending", "updated_at" => "2013-04-14T07:29:09-07:00", "enrollment_npis" => [{ "address" => "125 Snow Shoe Road", "city" => "Sacramento", "created_at" => "2013-04-14T07:29:09-07:00", "facility_name" => "Quality", "npi" => "987654321", "provider_name" => "Jane Austen", "ptan" => "54321", "state" => "CA", "status" => "submitted", "tax_id" => "12345678", "updated_at" => "2013-04-14T07:29:09-07:00", "zip" => "94107", "enrollment_insurance_company" => { "name" => "Medicare", "payer_id" => "00431" } }, { "address" => "125 Snow Shoe Road", "city" => "Sacramento", "created_at" => "2013-04-14T07:29:09-07:00", "facility_name" => "Quality", "npi" => "987654321", "provider_name" => "Jane Austen", "ptan" => "54321", "state" => "CA", "status" => "submitted", "tax_id" => "12345678", "updated_at" => "2013-04-14T07:29:09-07:00", "zip" => "94107", "enrollment_insurance_company" => { "name" => "Medicare", "payer_id" => "00431" } }, { "address" => "125 Snow Shoe Road", "city" => "Sacramento", "created_at" => "2013-04-14T07:29:09-07:00", "facility_name" => "Quality", "npi" => "987654321", "provider_name" => "Jane Austen", "ptan" => "54321", "state" => "CA", "status" => "submitted", "tax_id" => "12345678", "updated_at" => "2013-04-14T07:29:09-07:00", "zip" => "94107", "enrollment_insurance_company" => { "name" => "Kaiser Nort", "payer_id" => "00282" } }, { "address" => "125 Snow Shoe Road", "city" => "Sacramento", "created_at" => "2013-04-14T07:29:09-07:00", "facility_name" => "Quality", "npi" => "987654321", "provider_name" => "Jane Austen", "ptan" => "54321", "state" => "CA", "status" => "submitted", "tax_id" => "12345678", "updated_at" => "2013-04-14T07:29:09-07:00", "zip" => "94107", "enrollment_insurance_company" => { "name" => "Kaiser Nort", "payer_id" => "00282" } }] } }
87
97
  end
metadata CHANGED
@@ -1,14 +1,16 @@
1
1
  --- !ruby/object:Gem::Specification
2
2
  name: eligible
3
3
  version: !ruby/object:Gem::Version
4
- version: '2.3'
4
+ version: 2.4.1
5
5
  platform: ruby
6
6
  authors:
7
- - Andy Brett
7
+ - Katelyn Gleaon
8
+ - Rodrigo Dominguez
9
+ - Andry Brett
8
10
  autorequire:
9
11
  bindir: bin
10
12
  cert_chain: []
11
- date: 2013-08-18 00:00:00.000000000 Z
13
+ date: 2013-08-28 00:00:00.000000000 Z
12
14
  dependencies:
13
15
  - !ruby/object:Gem::Dependency
14
16
  name: mocha
@@ -72,37 +74,33 @@ dependencies:
72
74
  requirements:
73
75
  - - ~>
74
76
  - !ruby/object:Gem::Version
75
- version: '1.4'
77
+ version: 1.6.7
76
78
  type: :runtime
77
79
  prerelease: false
78
80
  version_requirements: !ruby/object:Gem::Requirement
79
81
  requirements:
80
82
  - - ~>
81
83
  - !ruby/object:Gem::Version
82
- version: '1.4'
84
+ version: 1.6.7
83
85
  - !ruby/object:Gem::Dependency
84
86
  name: multi_json
85
87
  requirement: !ruby/object:Gem::Requirement
86
88
  requirements:
87
- - - '>='
88
- - !ruby/object:Gem::Version
89
- version: 1.0.4
90
- - - <
89
+ - - ~>
91
90
  - !ruby/object:Gem::Version
92
- version: '2'
91
+ version: 1.7.9
93
92
  type: :runtime
94
93
  prerelease: false
95
94
  version_requirements: !ruby/object:Gem::Requirement
96
95
  requirements:
97
- - - '>='
98
- - !ruby/object:Gem::Version
99
- version: 1.0.4
100
- - - <
96
+ - - ~>
101
97
  - !ruby/object:Gem::Version
102
- version: '2'
98
+ version: 1.7.9
103
99
  description: Eligible is a developer-friendly way to process health care eligibility
104
- checks. Learn more at https://eligibleapi.com
100
+ checks. Learn more at https://www.eligibleapi.com
105
101
  email:
102
+ - k@eligibleapi.com
103
+ - rod@eligibleapi.com
106
104
  - andy@andybrett.com
107
105
  executables: []
108
106
  extensions: []
@@ -128,16 +126,15 @@ files:
128
126
  - lib/eligible/errors/eligible_error.rb
129
127
  - lib/eligible/errors/invalid_request_error.rb
130
128
  - lib/eligible/json.rb
129
+ - lib/eligible/medicare.rb
131
130
  - lib/eligible/payment.rb
132
- - lib/eligible/plan.rb
133
- - lib/eligible/service.rb
131
+ - lib/eligible/ticket.rb
134
132
  - lib/eligible/util.rb
135
133
  - lib/eligible/version.rb
136
- - lib/eligible/webhook.rb
137
134
  - lib/eligible/x12.rb
138
135
  - test/test_eligible.rb
139
136
  - test/test_helper.rb
140
- homepage: https://eligibleapi.com/
137
+ homepage: https://www.eligibleapi.com/
141
138
  licenses:
142
139
  - MIT
143
140
  metadata: {}
@@ -157,7 +154,7 @@ required_rubygems_version: !ruby/object:Gem::Requirement
157
154
  version: '0'
158
155
  requirements: []
159
156
  rubyforge_project:
160
- rubygems_version: 2.0.3
157
+ rubygems_version: 2.0.6
161
158
  signing_key:
162
159
  specification_version: 4
163
160
  summary: Ruby wrapper for the Eligible API
data/lib/eligible/plan.rb DELETED
@@ -1,42 +0,0 @@
1
- module Eligible
2
- COMMON_ATTRIBUTES = [:timestamp, :eligible_id, :mapping_version, :primary_insurance, :additional_insurance]
3
- STATUS_ATTRIBUTES = [:type, :coverage_status]
4
- BALANCE_ATTRIBUTES = [:balance, :comments]
5
- STOP_LOSS_ATTRIBUTES = [:stop_loss_in_network, :stop_loss_out_network]
6
-
7
- class Plan < APIResource
8
- def self.get(params, api_key=nil)
9
- response, api_key = Eligible.request(:get, url, api_key, params)
10
- Util.convert_to_eligible_object(response, api_key)
11
- end
12
-
13
- def all
14
- error ? nil : to_hash
15
- end
16
-
17
- def status
18
- keys = COMMON_ATTRIBUTES + STATUS_ATTRIBUTES
19
- error ? nil : to_hash.select { |k, v| keys.include?(k) }
20
- end
21
-
22
- def deductible
23
- keys = COMMON_ATTRIBUTES + STATUS_ATTRIBUTES + [:deductible_in_network, :deductible_out_network]
24
- error ? nil : to_hash.select { |k, v| keys.include?(k) }
25
- end
26
-
27
- def dates
28
- keys = COMMON_ATTRIBUTES
29
- error ? nil : to_hash.select { |k, v| keys.include?(k) }
30
- end
31
-
32
- def balance
33
- keys = COMMON_ATTRIBUTES + BALANCE_ATTRIBUTES
34
- error ? nil : to_hash.select { |k, v| keys.include?(k) }
35
- end
36
-
37
- def stop_loss
38
- keys = COMMON_ATTRIBUTES + STOP_LOSS_ATTRIBUTES
39
- error ? nil : to_hash.select { |k, v| keys.include?(k) }
40
- end
41
- end
42
- end
data/lib/eligible/service.rb DELETED
@@ -1,59 +0,0 @@
1
- module Eligible
2
- class Service < APIResource
3
- COMMON_ATTRIBUTES = [:timestamp, :eligible_id, :mapping_version, :additional_insurance]
4
- STATUS_ATTRIBUTES = [:type, :coverage_status]
5
- VISITS_ATTRIBUTES = [:not_covered, :comments, :precertification_needed, :visits_in_network, :visits_out_network]
6
- COPAYMENT_ATTRIBUTES = [:copayment_in_network, :copayment_out_network]
7
- COINSURANCE_ATTRIBUTES = [:coinsurance_in_network, :coinsurance_out_network]
8
- DEDUCTIBLE_ATTRIBUTES = [:deductible_in_network, :deductible_out_network]
9
-
10
- def self.get(params, api_key=nil)
11
- response, api_key = Eligible.request(:get, url, api_key, params)
12
- Util.convert_to_eligible_object(response, api_key)
13
- end
14
-
15
- def all
16
- error ? nil : to_hash
17
- end
18
-
19
- def visits
20
- keys = COMMON_ATTRIBUTES + STATUS_ATTRIBUTES + VISITS_ATTRIBUTES
21
- k_to_hash(keys)
22
- end
23
-
24
- def copayment
25
- keys = COMMON_ATTRIBUTES + STATUS_ATTRIBUTES + COPAYMENT_ATTRIBUTES
26
- k_to_hash(keys)
27
- end
28
-
29
- def coinsurance
30
- keys = COMMON_ATTRIBUTES + STATUS_ATTRIBUTES + COINSURANCE_ATTRIBUTES
31
- k_to_hash(keys)
32
- end
33
-
34
- def deductible
35
- keys = COMMON_ATTRIBUTES + STATUS_ATTRIBUTES + DEDUCTIBLE_ATTRIBUTES
36
- k_to_hash(keys)
37
- end
38
-
39
- def self.general(params, api_key=nil)
40
- response, api_key = Eligible.request(:get, "/service/general.json", api_key, params)
41
- response = Util.convert_to_eligible_object(response, api_key)
42
- response = response.to_hash if response.is_a? Hash
43
- response
44
- end
45
-
46
- def self.list(params, api_key=nil)
47
- response, api_key = Eligible.request(:get, "/service/list.json", api_key, params)
48
- response = Util.convert_to_eligible_object(response, api_key)
49
- response = response.to_hash if response.is_a? Hash
50
- response
51
- end
52
-
53
- private
54
-
55
- def k_to_hash(keys)
56
- error ? nil : to_hash.select { |k, v| keys.include?(k) }
57
- end
58
- end
59
- end
data/lib/eligible/webhook.rb DELETED
@@ -1,16 +0,0 @@
1
- module Eligible
2
- class Webhook < APIResource
3
-
4
- def self.all(api_key=nil)
5
- response, api_key = Eligible.request(:get, url, api_key, params)
6
- Util.convert_to_eligible_object(response, api_key)
7
- end
8
-
9
- def self.post(params, api_key=nil)
10
- response, api_key = Eligible.request(:get, url, api_key, params)
11
- Util.convert_to_eligible_object(response, api_key)
12
- end
13
-
14
- end
15
-
16
- end