eligible 1.1 → 2.0

data/README.md

@@ -32,13 +32,13 @@ Include `{ :format => "X12" }` in the params hash to get back the raw X12 respon
 params = {
   :payer_name => "Aetna",
   :payer_id   => "000001",
-  :service_provider_last_name => "Last",
-  :service_provider_first_name => "First",
-  :service_provider_NPI => "12345678",
-  :subscriber_id => "12345678",
-  :subscriber_last_name => "Austen",
-  :subscriber_first_name => "Jane",
-  :subscriber_dob => "1955-12-14"
+  :provider_last_name => "Last",
+  :provider_first_name => "First",
+  :provider_npi => "12345678",
+  :member_id => "12345678",
+  :member_last_name => "Austen",
+  :member_first_name => "Jane",
+  :member_dob => "1955-12-14"
 }
 
 plan = Eligible::Plan.get(params)
@@ -53,13 +53,13 @@ plan.status   # returns status fields on the plan, per the plan/status endpoint
 params = {
   :payer_name => "Aetna",
   :payer_id   => "000001",
-  :service_provider_last_name => "Last",
-  :service_provider_first_name => "First",
-  :service_provider_NPI => "12345678",
-  :subscriber_id => "12345678",
-  :subscriber_last_name => "Austen",
-  :subscriber_first_name => "Jane",
-  :subscriber_dob => "1955-12-14"
+  :provider_last_name => "Last",
+  :provider_first_name => "First",
+  :provider_npi => "12345678",
+  :member_id => "12345678",
+  :member_last_name => "Austen",
+  :member_first_name => "Jane",
+  :member_dob => "1955-12-14"
 }
 
 service = Eligible::Service.get(params)
@@ -78,13 +78,13 @@ json = Eligible::Service.list(params)
 params = {
   :payer_name => "Aetna",
   :payer_id   => "000001",
-  :service_provider_last_name => "Last",
-  :service_provider_first_name => "First",
-  :service_provider_NPI => "12345678",
-  :subscriber_id => "12345678",
-  :subscriber_last_name => "Austen",
-  :subscriber_first_name => "Jane",
-  :subscriber_dob => "1955-12-14"
+  :provider_last_name => "Last",
+  :provider_first_name => "First",
+  :provider_npi => "12345678",
+  :member_id => "12345678",
+  :member_last_name => "Austen",
+  :member_first_name => "Jane",
+  :member_dob => "1955-12-14"
 }
 
 demographic = Eligible::Demographic.get(params)
@@ -103,15 +103,15 @@ params = {
   :information_receiver_last_name => "Last",
   :information_receiver_first_name => "First",
   :information_receiver_etin => "12345678",
-  :service_provider_organization_name => "Marshall Group",
-  :service_provider_last_name => "Last",
-  :service_provider_first_name => "First",
-  :service_provider_npi => "12345678",
-  :service_provider_tax_id => "12345678",
-  :subscriber_id => "12345678",
-  :subscriber_last_name => "Last", 
-  :subscriber_first_name => "First",
-  :subscriber_dob => "1955-12-14",
+  :provider_organization_name => "Marshall Group",
+  :provider_last_name => "Last",
+  :provider_first_name => "First",
+  :provider_npi => "12345678",
+  :provider_tax_id => "12345678",
+  :member_id => "12345678",
+  :member_last_name => "Last", 
+  :member_first_name => "First",
+  :member_dob => "1955-12-14",
   :dependent_last_name => "Last",
   :dependent_first_name => "First",
   :dependent_dob => "1975-12-14",
@@ -127,6 +127,196 @@ claim = Eligible::Claim.get(params)
 claim.status # Returns in real time the status (paid, not paid, rejected, denied, etc) of claim specified.
 ```
 
+### Post Enrollment object
+
+```ruby
+params = {
+  "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"
+    ]
+}
+
+Eligible::Enrollment.post(params)
+```
+
+### Retrieve Enrollment object
+
+```ruby
+params = { "enrollment_request_id" => "123" }
+
+enrollment = Eligible::Enrollment.get(params)
+enrollment.status # returns the status of the request to enroll the provider(s)
+```
+
+### Retrieve Coverage object
+
+```ruby
+params = {
+  :service_type => "33",
+  :network => "OUT",
+  :payer_id   => "000001",
+  :provider_last_name => "Last",
+  :provider_first_name => "First",
+  :provider_npi => "12345678",
+  :member_id => "12345678",
+  :member_last_name => "Austen",
+  :member_first_name => "Jane",
+  :member_dob => "1955-12-14"
+}
+
+coverage = Eligible::Coverage.get(params)
+coverage.all # returns all coverage info for the request
+```
+
+### Post Claim object
+
+```ruby
+params = {
+    "api_key": "asdfsdfsd21132ddsfsdfd",
+    "receiver": {
+        "name": "AETNA",
+        "id": "60054"
+    },
+    "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": {
+        "claim_number": "412",
+        "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",
+                "place_of_service": "11",
+                "charge_amount": "275",
+                "product_service": "99213",
+                "qualifier": "HC",
+                "description": "",
+                "modifier_1": "",
+                "modifier_2": "",
+                "modifier_3": "",
+                "modifier_4": "",
+                "diagnosis_1": "32723",
+                "diagnosis_2": "",
+                "diagnosis_3": "",
+                "diagnosis_4": "",
+                "service_start": "2013-03-07",
+                "service_end": "2013-03-07",
+                "authorization_code": ""
+            }
+        ]
+    }
+}
+
+Eligible::Claim.post(params)
+```
+
+### Retrieve all Claim objects/acknowledgments
+
+```ruby
+claims = Eligible::Claim.all # returns status information for all claims that have been submitted with the API key
+```
+
+### Retrieve individual Claim object/acknowledgment
+
+```ruby
+params = { 
+  :response_id => "12345"
+}
+
+claim = Eligible::Claim.get(params) # returns status information on an individual claim
+```
+
 ## Tests
 
 You can run tests with 

data/lib/eligible.rb

@@ -2,6 +2,7 @@ require 'cgi'
 require 'set'
 require 'rubygems'
 require 'openssl'
+require 'json' 
 
 gem 'rest-client', '~> 1.4'
 require 'rest_client'
@@ -16,6 +17,8 @@ require 'eligible/plan'
 require 'eligible/service'
 require 'eligible/demographic'
 require 'eligible/claim'
+require 'eligible/enrollment'
+require 'eligible/coverage'
 
 # Errors
 require 'eligible/errors/eligible_error'
@@ -25,8 +28,8 @@ require 'eligible/errors/api_error'
 
 module Eligible
   @@api_key  = nil
-  @@api_base = "https://v1.eligibleapi.net"
-  @@api_version = 1
+  @@api_base = "https://gds.eligibleapi.com/v1.1"
+  @@api_version = 1.1
 
   def self.api_url(url='')
     @@api_base + url
@@ -93,7 +96,7 @@ module Eligible
       end
       payload = nil
     else
-      payload = Util.flatten_params(params).collect{|(key, value)| "#{key}=#{Util.url_encode(value)}"}.join('&')
+      payload = params.merge!({"api_key" => api_key }).to_json #Util.flatten_params(params).collect{|(key, value)| "#{key}=#{Util.url_encode(value)}"}.join('&')
     end
 
     begin

data/lib/eligible/claim.rb

@@ -1,7 +1,17 @@
 module Eligible
   class Claim < APIResource
     def self.get(params, api_key=nil)
-      response, api_key = Eligible.request(:get, url, api_key, params)
+      response, api_key = Eligible.request(:get, "/claims/acknowledgements/#{params[:reference_id]}.json", api_key, params)
+      Util.convert_to_eligible_object(response, api_key)
+    end
+
+    def self.post(params, api_key=nil)
+      response, api_key = Eligible.request(:get, "/claims.json", api_key, params)
+      Util.convert_to_eligible_object(response, api_key)
+    end
+
+    def self.all(api_key=nil)
+      response, api_key = Eligible.request(:get, "/claims/acknowledgements.json", api_key)
       Util.convert_to_eligible_object(response, api_key)
     end
 

data/lib/eligible/coverage.rb

@@ -0,0 +1,16 @@
+module Eligible
+
+  class Coverage < APIResource
+
+    def self.get(params, api_key=nil)
+      response, api_key = Eligible.request(:get, url, api_key, params)
+      Util.convert_to_eligible_object(response, api_key)      
+    end
+
+    def all
+      error ? nil : to_hash
+    end
+
+  end
+
+end

data/lib/eligible/enrollment.rb

@@ -0,0 +1,20 @@
+module Eligible
+
+  class Enrollment < APIResource
+
+    def self.get(params, api_key=nil)
+      response, api_key = Eligible.request(:get, "/enrollment.json", api_key, params)
+      Util.convert_to_eligible_object(response, api_key)
+    end
+
+    def self.post(params, api_key=nil)
+      response, api_key = Eligible.request(:post, "/enrollment.json", api_key, params)
+      Util.convert_to_eligible_object(response, api_key)
+    end
+
+    def all
+      error ? nil : to_hash
+    end
+  end
+
+end

data/lib/eligible/util.rb

@@ -20,15 +20,25 @@ module Eligible
         'plan' => Plan,
         'service' => Service,
         'demographic' => Demographic,
-        'claim' => Claim
+        'claim' => Claim,
+        'coverage' => Coverage,
+        'enrollment' => Enrollment
       }
       case resp
       when Array
-        resp.map { |i| convert_to_eligible_object(i, api_key) }
+        if resp[0] && resp[0][:enrollment_npi]
+          Enrollment.construct_from({ :enrollments => resp }, api_key)
+        else
+          resp.map { |i| convert_to_eligible_object(i, api_key) }
+        end
       when Hash
         # Try converting to a known object class.  If none available, fall back to generic APIResource
         if resp[:mapping_version] && klass_name = resp[:mapping_version].match(/^[^\/]*/)[0]
           klass = types[klass_name]
+        elsif resp[:enrollment_request]
+          klass = Enrollment
+        elsif resp[:demographics]
+          klass = Coverage
         end
         klass ||= EligibleObject
         klass.construct_from(resp, api_key)

data/lib/eligible/version.rb

@@ -1,3 +1,3 @@
 module Eligible
-    VERSION = "1.1"
+    VERSION = "2.0"
 end

data/lib/eligible/webhook.rb

@@ -0,0 +1,16 @@
+module Eligible
+  class Webhook < APIResource
+
+    def self.all(api_key=nil)
+      response, api_key = Eligible.request(:get, url, api_key, params)
+      Util.convert_to_eligible_object(response, api_key)
+    end
+
+    def self.post(params, api_key=nil)
+      response, api_key = Eligible.request(:get, url, api_key, params)
+      Util.convert_to_eligible_object(response, api_key)
+    end
+
+  end
+
+end

data/test/test_eligible.rb

@@ -66,13 +66,13 @@ class TestEligible < Test::Unit::TestCase
       params = {
         :payer_name => "Aetna",
         :payer_id   => "000001",
-        :service_provider_last_name => "Last",
-        :service_provider_first_name => "First",
-        :service_provider_NPI => "1928384219",
-        :subscriber_id => "W120923801",
-        :subscriber_last_name => "Austen",
-        :subscriber_first_name => "Jane",
-        :subscriber_dob => "1955-12-14"
+        :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_plan)
       @mock.expects(:get).returns(response)
@@ -85,13 +85,13 @@ class TestEligible < Test::Unit::TestCase
       params = {
         :payer_name => "Aetna",
         :payer_id   => "000001",
-        :service_provider_last_name => "Last",
-        :service_provider_first_name => "First",
-        :service_provider_NPI => "1928384219",
-        :subscriber_id => "W120923801",
-        :subscriber_last_name => "Austen",
-        :subscriber_first_name => "Jane",
-        :subscriber_dob => "1955-12-14"
+        :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_plan)
       @mock.expects(:get).returns(response)
@@ -135,13 +135,13 @@ class TestEligible < Test::Unit::TestCase
       params = {
         :payer_name => "Aetna",
         :payer_id   => "000001",
-        :service_provider_last_name => "Last",
-        :service_provider_first_name => "First",
-        :service_provider_NPI => "1928384219",
-        :subscriber_id => "W120923801",
-        :subscriber_last_name => "Austen",
-        :subscriber_first_name => "Jane",
-        :subscriber_dob => "1955-12-14"
+        :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_service)
       @mock.expects(:get).returns(response)
@@ -154,13 +154,13 @@ class TestEligible < Test::Unit::TestCase
       params = {
         :payer_name => "Aetna",
         :payer_id   => "000001",
-        :service_provider_last_name => "Last",
-        :service_provider_first_name => "First",
-        :service_provider_NPI => "1928384219",
-        :subscriber_id => "W120923801",
-        :subscriber_last_name => "Austen",
-        :subscriber_first_name => "Jane",
-        :subscriber_dob => "1955-12-14"
+        :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_service)
       @mock.expects(:get).returns(response)
@@ -202,13 +202,13 @@ class TestEligible < Test::Unit::TestCase
       params = {
         :payer_name => "Aetna",
         :payer_id   => "000001",
-        :service_provider_last_name => "Last",
-        :service_provider_first_name => "First",
-        :service_provider_NPI => "1928384219",
-        :subscriber_id => "W120923801",
-        :subscriber_last_name => "Austen",
-        :subscriber_first_name => "Jane",
-        :subscriber_dob => "1955-12-14"
+        :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)
@@ -221,13 +221,13 @@ class TestEligible < Test::Unit::TestCase
       params = {
         :payer_name => "Aetna",
         :payer_id   => "000001",
-        :service_provider_last_name => "Last",
-        :service_provider_first_name => "First",
-        :service_provider_NPI => "1928384219",
-        :subscriber_id => "W120923801",
-        :subscriber_last_name => "Austen",
-        :subscriber_first_name => "Jane",
-        :subscriber_dob => "1955-12-14"
+        :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)
@@ -262,18 +262,83 @@ class TestEligible < Test::Unit::TestCase
       response = test_response(test_claim_missing_params)
       @mock.expects(:get).returns(response)
       claim = Eligible::Claim.get(params)
-      assert_not_nil claim.error
+      assert claim["success"] == "false"
     end
 
-    should "return claim information if valid params are supplied" do
+    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 = {
-        :tbd => true
+        :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_claim)
+      response = test_response(test_coverage)
       @mock.expects(:get).returns(response)
-      claim = Eligible::Claim.get(params)
-      assert_nil claim.error
-      assert_not_nil claim.status
+      coverage = Eligible::Coverage.get(params)
+
+      assert_not_nil coverage.all[: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.all[: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.all[:enrollments]
     end
   end
 end

data/test/test_helper.rb

@@ -59,9 +59,29 @@ def test_demographic
 end
 
 def test_claim_missing_params
-  {"timestamp"=>"2013-02-05T13:21:38", "eligible_id"=>"AE9F5EB3-B4BF-4B2E-92C5-6307CE91DB81", "mapping_version"=>"claim/status$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"}}
+  {"success"=>"false", "created_at"=>"2013-06-03T23:53:39Z", "error"=>{"type"=>"scrub", "message"=>"you forgot to include gender"}} 
 end
 
-def test_claim
+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

metadata

@@ -1,7 +1,7 @@
 --- !ruby/object:Gem::Specification
 name: eligible
 version: !ruby/object:Gem::Version
-  version: '1.1'
+  version: '2.0'
   prerelease: 
 platform: ruby
 authors:
@@ -9,11 +9,11 @@ authors:
 autorequire: 
 bindir: bin
 cert_chain: []
-date: 2013-03-14 00:00:00.000000000 Z
+date: 2013-06-13 00:00:00.000000000 Z
 dependencies:
 - !ruby/object:Gem::Dependency
   name: mocha
-  requirement: &70151816374100 !ruby/object:Gem::Requirement
+  requirement: &70203756283980 !ruby/object:Gem::Requirement
     none: false
     requirements:
     - - ! '>='
@@ -21,10 +21,10 @@ dependencies:
         version: '0'
   type: :development
   prerelease: false
-  version_requirements: *70151816374100
+  version_requirements: *70203756283980
 - !ruby/object:Gem::Dependency
   name: shoulda
-  requirement: &70151816370940 !ruby/object:Gem::Requirement
+  requirement: &70203756283560 !ruby/object:Gem::Requirement
     none: false
     requirements:
     - - ! '>='
@@ -32,10 +32,10 @@ dependencies:
         version: '0'
   type: :development
   prerelease: false
-  version_requirements: *70151816370940
+  version_requirements: *70203756283560
 - !ruby/object:Gem::Dependency
   name: test-unit
-  requirement: &70151816383660 !ruby/object:Gem::Requirement
+  requirement: &70203756283140 !ruby/object:Gem::Requirement
     none: false
     requirements:
     - - ! '>='
@@ -43,10 +43,10 @@ dependencies:
         version: '0'
   type: :development
   prerelease: false
-  version_requirements: *70151816383660
+  version_requirements: *70203756283140
 - !ruby/object:Gem::Dependency
   name: rake
-  requirement: &70151816381080 !ruby/object:Gem::Requirement
+  requirement: &70203756282720 !ruby/object:Gem::Requirement
     none: false
     requirements:
     - - ! '>='
@@ -54,10 +54,10 @@ dependencies:
         version: '0'
   type: :development
   prerelease: false
-  version_requirements: *70151816381080
+  version_requirements: *70203756282720
 - !ruby/object:Gem::Dependency
   name: rest-client
-  requirement: &70151816394460 !ruby/object:Gem::Requirement
+  requirement: &70203756282220 !ruby/object:Gem::Requirement
     none: false
     requirements:
     - - ~>
@@ -65,10 +65,10 @@ dependencies:
         version: '1.4'
   type: :runtime
   prerelease: false
-  version_requirements: *70151816394460
+  version_requirements: *70203756282220
 - !ruby/object:Gem::Dependency
   name: multi_json
-  requirement: &70151816402500 !ruby/object:Gem::Requirement
+  requirement: &70203756281700 !ruby/object:Gem::Requirement
     none: false
     requirements:
     - - ! '>='
@@ -79,7 +79,7 @@ dependencies:
         version: '2'
   type: :runtime
   prerelease: false
-  version_requirements: *70151816402500
+  version_requirements: *70203756281700
 description: Eligible is a developer-friendly way to process health care eligibility
   checks. Learn more at https://eligibleapi.com
 email:
@@ -98,8 +98,10 @@ files:
 - lib/eligible.rb
 - lib/eligible/api_resource.rb
 - lib/eligible/claim.rb
+- lib/eligible/coverage.rb
 - lib/eligible/demographic.rb
 - lib/eligible/eligible_object.rb
+- lib/eligible/enrollment.rb
 - lib/eligible/errors/api_connection_error.rb
 - lib/eligible/errors/api_error.rb
 - lib/eligible/errors/authentication_error.rb
@@ -109,6 +111,7 @@ files:
 - lib/eligible/service.rb
 - lib/eligible/util.rb
 - lib/eligible/version.rb
+- lib/eligible/webhook.rb
 - test/test_eligible.rb
 - test/test_helper.rb
 homepage: https://eligibleapi.com/