eligible 2.4.3 → 2.5.0

data/CONTRIBUTORS

@@ -1,5 +0,0 @@
-Andy Brett <andy@andybrett.com>
-Ivan Müller <mulleivan@gmail.com>
-Janet Chang <janetlaichang@gmail.com>
-Katelyn Gleason <k@eligibleapi.com>
-Rodrigo Dominguez <rod@eligibleapi.com>

data/test/test_eligible.rb

@@ -1,178 +0,0 @@
-require File.expand_path('../test_helper', __FILE__)
-require 'test/unit'
-require 'shoulda'
-require 'mocha'
-require 'rest-client'
-
-class TestEligible < Test::Unit::TestCase
-  include Mocha
-
-  context 'Version' do
-    should 'have a version number' do
-      assert_not_nil Eligible::VERSION
-    end
-  end
-
-  context '"General API"' do
-    setup do
-      Eligible.mock_rest_client = @mock = mock
-    end
-
-    teardown do
-      Eligible.mock_rest_client = Eligible.api_key = nil
-    end
-
-    should 'not specifying api credentials should raise an exception' do
-      Eligible.api_key = nil
-      assert_raises Eligible::AuthenticationError do
-        Eligible::Coverage.get({})
-      end
-    end
-
-    should 'specifying invalid api credentials should raise an exception' do
-      Eligible.api_key = 'invalid'
-      response = test_response(test_invalid_api_key_error, 401)
-      assert_raises Eligible::AuthenticationError do
-        @mock.expects(:get).once.raises(RestClient::ExceptionWithResponse.new(response, 401))
-        Eligible::Coverage.get({})
-      end
-    end
-  end
-
-  context 'Demographic' do
-    setup do
-      Eligible.api_key = 'TEST'
-      @mock = mock
-      Eligible.mock_rest_client = @mock
-    end
-
-    teardown do
-      Eligible.mock_rest_client = nil
-      Eligible.api_key = nil
-    end
-
-    should 'return an error if no params are supplied' do
-      params = {}
-      response = test_response(test_demographic_missing_params)
-      @mock.expects(:get).returns(response)
-      demographic = Eligible::Demographic.get(params)
-      assert_not_nil demographic.error
-    end
-
-    should 'return demographic information if valid params are supplied' do
-      params = {
-        :payer_name => "Aetna",
-        :payer_id => "000001",
-        :provider_last_name => "Last",
-        :provider_first_name => "First",
-        :provider_npi => "1028384219",
-        :member_id => "W120923801",
-        :member_last_name => "Austen",
-        :member_first_name => "Jane",
-        :member_dob => "1955-12-14"
-      }
-      response = test_response(test_demographic)
-      @mock.expects(:get).returns(response)
-      demographic = Eligible::Demographic.get(params)
-      assert_nil demographic.error
-      assert_not_nil demographic.to_hash
-    end
-  end
-
-  context 'Claim' do
-    setup do
-      Eligible.api_key = 'TEST'
-      @mock = mock
-      Eligible.mock_rest_client = @mock
-    end
-
-    teardown do
-      Eligible.mock_rest_client = nil
-      Eligible.api_key = nil
-    end
-
-    should 'return an error if no params are supplied' do
-      params = {}
-      response = test_response(test_claim_missing_params)
-      @mock.expects(:get).returns(response)
-      claim = Eligible::Claim.get(params)
-      assert claim["success"] == "false"
-    end
-
-    should 'post a claim' do
-      params = { "api_key" => "asdfsdfsd21132ddsfsdfd", "billing_provider" => { "taxonomy_code" => "332B00000X", "practice_name" => "Jane Austen Practice", "npi" => "1922222222", "address" => { "street_line_1" => "419 Fulton", "street_line_2" => "", "city" => "San Francisco", "state" => "CA", "zip" => "94102" }, "tin" => "43291023", "insurance_provider_id" => "129873210" }, "pay_to_provider" => { "address" => { "street_line_1" => "", "street_line_2" => "", "city" => "", "state" => "", "zip" => "" } }, "subscriber" => { "last_name" => "Franklin", "first_name" => "Benjamin", "member_id" => "W2832032427", "group_id" => "455716", "group_name" => "none", "dob" => "1734-05-04", "gender" => "M", "address" => { "street_line_1" => "435 Sugar Lane", "street_line_2" => "", "city" => "Sweet", "state" => "OH", "zip" => "436233127" } }, "payer" => { "name" => "AETNA", "id" => "60054", "address" => { "street_line_1" => "Po Box 981106", "street_line_2" => "", "city" => "El Paso", "state" => "TX", "zip" => "799981222" } }, "dependent" => { "relationship" => "", "last_name" => "", "first_name" => "", "dob" => "", "gender" => "", "address" => { "street_line_1" => "", "street_line_2" => "", "city" => "", "state" => "", "zip" => "" } }, "claim" => { "total_charge_amount" => "275", "claim_frequency" => "1", "patient_signature_on_file" => "Y", "provider_plan_participation" => "A", "direct_payment_authorized" => "Y", "release_of_information" => "I", "service_lines" => [{ "line_number" => "1", "service_start" => "2013-03-07", "service_end" => "2013-03-07", "authorization_code" => "", "place_of_service" => "11", "charge_amount" => "275", "product_service" => "99213", "qualifier" => "HC", "description" => "", "modifier_1" => "", "diagnosis_1" => "32723" }] } }
-      response = test_response(test_post_claim)
-    end
-  end
-
-  context 'Coverage' do
-    setup do
-      Eligible.api_key = 'TEST'
-      @mock = mock
-      Eligible.mock_rest_client = @mock
-    end
-
-    teardown do
-      Eligible.mock_rest_client = nil
-      Eligible.api_key = nil
-    end
-
-    should 'return an error if no params are supplied' do
-      params = {}
-      response = test_response(test_coverage_missing_params)
-      @mock.expects(:get).returns(response)
-      coverage = Eligible::Coverage.get(params)
-      assert_not_nil coverage.error
-    end
-
-    should 'return coverage information if valid params are supplied' do
-      params = {
-        :payer_name => "Aetna",
-        :payer_id => "000001",
-        :provider_last_name => "Last",
-        :provider_first_name => "First",
-        :provider_npi => "1028384219",
-        :member_id => "W120923801",
-        :member_last_name => "Austen",
-        :member_first_name => "Jane",
-        :member_dob => "1955-12-14"
-      }
-      response = test_response(test_coverage)
-      @mock.expects(:get).returns(response)
-      coverage = Eligible::Coverage.get(params)
-
-      assert_not_nil coverage.to_hash[:eligible_id]
-    end
-  end
-
-  context 'Enrollment' do
-    setup do
-      Eligible.api_key = 'TEST'
-      @mock = mock
-      Eligible.mock_rest_client = @mock
-    end
-
-    teardown do
-      Eligible.mock_rest_client = nil
-      Eligible.api_key = nil
-    end
-
-    should 'post an enrollment request' do
-      params = { "service_provider_list" => [{ "facility_name" => "Quality", "provider_name" => "Jane Austen", "tax_id" => "12345678", "address" => "125 Snow Shoe Road", "city" => "Sacramento", "state" => "CA", "zip" => "94107", "ptan" => "54321", "npi" => "987654321" }, { "facility_name" => "Aetna", "provider_name" => "Jack Austen", "tax_id" => "12345678", "address" => "985 Snow Shoe Road", "city" => "Menlo Park", "state" => "CA", "zip" => "94107", "ptan" => "54321", "npi" => "987654321" }], "payer_ids" => ["00431", "00282"] }
-      response = test_response(test_post_enrollment)
-
-      @mock.expects(:post).returns(response)
-      enrollment = Eligible::Enrollment.post(params)
-
-      assert_not_nil enrollment.to_hash[:enrollment_request]
-    end
-
-    should 'get the status of an enrollment request' do
-      params = { "NPI" => "1028384219" }
-      response = test_response(test_get_enrollment)
-      @mock.expects(:get).returns(response)
-      enrollment = Eligible::Enrollment.get(params)
-      assert_not_nil enrollment.to_hash[:enrollments]
-    end
-  end
-end

data/test/test_helper.rb

@@ -1,97 +0,0 @@
-$LOAD_PATH.unshift File.expand_path('../../lib', __FILE__)
-require 'eligible'
-
-module Eligible
-  @mock_rest_client = nil
-
-  def self.mock_rest_client=(mock_client)
-    @mock_rest_client = mock_client
-  end
-
-  def self.execute_request(opts)
-    get_params = (opts[:headers] || {})[:params]
-    post_params = opts[:payload]
-    case opts[:method]
-      when :get then
-        @mock_rest_client.get opts[:url], get_params, post_params
-      when :post then
-        @mock_rest_client.post opts[:url], get_params, post_params
-      when :delete then
-        @mock_rest_client.delete opts[:url], get_params, post_params
-    end
-  end
-end
-
-def test_response(body, code=200)
-  # When an exception is raised, restclient clobbers method_missing.  Hence we
-  # can't just use the stubs interface.
-  body = MultiJson.dump(body) if !(body.kind_of? String)
-  m = mock
-  m.instance_variable_set('@eligible_values', { :body => body, :code => code })
-
-  def m.body
-    @eligible_values[:body]
-  end
-
-  def m.code
-    @eligible_values[:code]
-  end
-
-  m
-end
-
-def test_invalid_api_key_error
-  { "error" => [{ "message" => "Could not authenticate you. Please re-try with a valid API key.", "code" => 1 }] }
-end
-
-def test_plan_missing_params
-  { "timestamp" => "2013-02-01T13:25:58", "eligible_id" => "A4F4E1D6-7DC3-4B20-87CE-B59F48811290", "mapping_version" => "plan/all$Revision:6$$Date:13-01-110:18$", "error" => { "response_code" => "Y", "response_description" => "Yes", "agency_qualifier_code" => "", "agency_qualifier_description" => "", "reject_reason_code" => "41", "reject_reason_description" => "Authorization/AccessRestrictions", "follow-up_action_code" => "C", "follow-up_action_description" => "PleaseCorrectandResubmit" } }
-end
-
-def test_plan
-  { "timestamp" => "2013-01-14T20:39:57", "eligible_id" => "B97BC91A-3E84-40A9-AA5C-D416CAE5CDB1", "mapping_version" => "plan/all$Revision:6$$Date:13-01-110:18$", "primary_insurance" => { "name" => "Aetna", "id" => "00002", "group_name" => "TOWERGROUPCOMPANIES", "plan_begins" => "2010-01-01", "plan_ends" => "", "comments" => ["AetnaChoicePOSII"] }, "type" => "30", "coverage_status" => "1", "precertification_needed" => "", "exclusions" => "", "deductible_in_network" => { "individual" => { "base_period" => "500", "remaining" => "500", "comments" => ["MedDent", "MedDent"] }, "family" => { "base_period" => "1000", "remaining" => "1000", "comments" => ["MedDent", "MedDent"] } }, "deductible_out_network" => { "individual" => { "base_period" => "1250", "remaining" => "1250", "comments" => ["MedDent", "MedDent"] }, "family" => { "base_period" => "3750", "remaining" => "3750", "comments" => ["MedDent", "MedDent"] } }, "stop_loss_in_network" => { "individual" => { "base_period" => "", "remaining" => "2000", "comments" => [] }, "family" => { "base_period" => "", "remaining" => "4000", "comments" => [] } }, "stop_loss_out_network" => { "individual" => { "base_period" => "", "remaining" => "3000", "comments" => [] }, "family" => { "base_period" => "", "remaining" => "6000", "comments" => [] } }, "balance" => "", "comments" => [], "additional_insurance" => { "comments" => [] } }
-end
-
-def test_service_missing_params
-  { "timestamp" => "2013-02-04T17:23:12", "eligible_id" => "7EEA40A7-58C5-4EBC-A450-10C37CA2D252", "mapping_version" => "service/all$Revision:4$$Date:12-12-280:13$", "error" => { "response_code" => "Y", "response_description" => "Yes", "agency_qualifier_code" => "", "agency_qualifier_description" => "", "reject_reason_code" => "41", "reject_reason_description" => "Authorization/AccessRestrictions", "follow-up_action_code" => "C", "follow-up_action_description" => "PleaseCorrectandResubmit" } }
-end
-
-def test_service
-  { "timestamp" => "2013-02-01T15:28:16", "eligible_id" => "FD8994B1-F977-459A-81AC-D182EA8FE66D", "mapping_version" => "service/all$Revision:4$$Date:12-12-280:13$", "type" => "33", "coverage_status" => "1", "service_begins" => "", "service_ends" => "", "not_covered" => [], "comments" => ["AetnaChoicePOSII"], "precertification_needed" => "", "visits_in_network" => { "individual" => { "total" => "", "remaining" => "", "comments" => [] }, "family" => { "total" => "", "remaining" => "", "comments" => [] } }, "visits_out_network" => { "individual" => { "total" => "", "remaining" => "", "comments" => [] }, "family" => { "total" => "", "remaining" => "", "comments" => [] } }, "copayment_in_network" => { "individual" => { "amount" => "", "comments" => [] }, "family" => { "amount" => "35", "comments" => ["OFFCHIROVISI", "COPAYNOTINCLUDEDINOOP", "MANPULATNCHRO"] } }, "copayment_out_network" => { "individual" => { "amount" => "", "comments" => [] }, "family" => { "amount" => "0", "comments" => ["MANPULATNCHRO"] } }, "coinsurance_in_network" => { "individual" => { "percent" => "", "comments" => [] }, "family" => { "percent" => "0", "comments" => ["OFFCHIROVISI", "MANPULATNCHRO"] } }, "coinsurance_out_network" => { "individual" => { "percent" => "", "comments" => [] }, "family" => { "percent" => "30", "comments" => ["CHIROVSTEVAL", "COINSAPPLIESTOOUTOFPOCKET", "MANPULATNCHRO"] } }, "deductible_in_network" => { "individual" => { "base_period" => "", "remaining" => "", "comments" => [] }, "family" => { "base_period" => "", "remaining" => "", "comments" => [] } }, "deductible_out_network" => { "individual" => { "base_period" => "", "remaining" => "", "comments" => [] }, "family" => { "base_period" => "", "remaining" => "", "comments" => [] } }, "additional_insurance" => { "comments" => [] } }
-end
-
-def test_demographic_missing_params
-  { "timestamp" => "2013-02-05T13:21:38", "eligible_id" => "AE9F5EB3-B4BF-4B2E-92C5-6307CE91DB81", "mapping_version" => "demographic/dob$Revision:1$$Date:12-12-2619:01$", "error" => { "response_code" => "Y", "response_description" => "Yes", "agency_qualifier_code" => "", "agency_qualifier_description" => "", "reject_reason_code" => "41", "reject_reason_description" => "Authorization/AccessRestrictions", "follow-up_action_code" => "C", "follow-up_action_description" => "PleaseCorrectandResubmit" } }
-end
-
-def test_demographic
-  { "timestamp" => "2013-02-05T13:14:36", "eligible_id" => "DCE2FFB3-179A-4825-ADA6-B8108FB5FB90", "mapping_version" => "demographic/all$Revision:4$$Date:12-12-2622:25$", "last_name" => "AUSTEN", "first_name" => "JANE", "member_id" => "R112114321", "group_id" => "060801203300001", "group_name" => "TOWERGROUPCOMPANIES", "dob" => "1955-12-14", "gender" => "M", "address" => { "street_line_1" => "123SOUTH7THSTREET", "street_line_2" => "", "city" => "CHICAGO", "state" => "CA", "zip" => "89701" } }
-end
-
-def test_claim_missing_params
-  { "success" => "false", "created_at" => "2013-06-03T23:53:39Z", "error" => { "type" => "scrub", "message" => "you forgot to include gender" } }
-end
-
-def test_post_claim
-  { "timestamp" => "2012-12-30T22:41:10", "eligible_id" => "DCE2FFB3-179A-4825-ADA6-B8108FB5FB90", "mapping_version" => "claim/status$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" }
-end
-
-def test_coverage_missing_params
-  { "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" => "" } }
-end
-
-def test_coverage
-  { "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" => [] }] }] }
-end
-
-def test_enrollment_missing_params
-  { "error" => "Expeting enrollment_request_id or npis" }
-end
-
-def test_get_enrollment
-  [{ "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" } } }]
-end
-
-def test_post_enrollment
-  { "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" } }] } }
-end