era_835_parser 0.1.12 → 0.2.1
This diff represents the content of publicly available package versions that have been released to one of the supported registries. The information contained in this diff is provided for informational purposes only and reflects changes between package versions as they appear in their respective public registries.
- checksums.yaml +4 -4
- data/README.md +23 -6
- data/lib/era_835_parser/parser.rb +77 -35
- data/lib/era_835_parser/version.rb +1 -1
- data/spec/era_835_parser_spec.rb +868 -22
- data/spec/example_5.835 +34 -0
- data/spec/example_6.835 +66 -0
- metadata +6 -2
data/spec/era_835_parser_spec.rb
CHANGED
|
@@ -35,6 +35,15 @@ RSpec.describe Era835Parser::Parser do
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35
35
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it 'returns the check number' do
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36
36
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expect(@era[:checks]['70408535'][:check_number]).to eq('70408535')
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37
37
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end
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38
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+
it 'returns the transaction handling code' do
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39
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expect(@era[:checks]['70408535'][:transaction_handling_code]).to eq('I')
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40
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end
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41
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it 'returns the credit debit flag' do
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42
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expect(@era[:checks]['70408535'][:credit_debit_flag]).to eq('C')
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43
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end
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44
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it 'returns the payment method code' do
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45
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expect(@era[:checks]['70408535'][:payment_method_code]).to eq('CHK')
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46
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end
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38
47
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it 'returns the amount' do
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expect(@era[:checks]['70408535'][:amount]).to eq(1509646)
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40
49
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end
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@@ -78,10 +87,10 @@ RSpec.describe Era835Parser::Parser do
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87
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it 'returns the Patient name' do
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79
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expect(@era[:checks]['70408535'][:eras][0][:patient_name]).to eq('RABBIT,ROGER')
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80
89
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end
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81
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-
it 'returns the Patient last name (
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90
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+
it 'returns the Patient last name (titleized)' do
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82
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expect(@era[:checks]['70408535'][:eras][0][:patient_last_name]).to eq('Rabbit')
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83
92
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end
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84
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-
it 'returns the Patient first name (
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93
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+
it 'returns the Patient first name (titleized)' do
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85
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expect(@era[:checks]['70408535'][:eras][0][:patient_first_name]).to eq('Roger')
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86
95
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end
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87
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it 'returns the Total charge amount (integer)' do
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@@ -93,7 +102,7 @@ RSpec.describe Era835Parser::Parser do
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it 'returns the Account number' do
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expect(@era[:checks]['70408535'][:eras][0][:account_number]).to eq('474623UB001CW0321')
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end
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96
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-
it 'returns the
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105
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it 'returns the Claim status code' do
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expect(@era[:checks]['70408535'][:eras][0][:claim_status_code]).to eq('1')
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98
107
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end
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99
108
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it 'returns the Claim status code description' do
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@@ -192,6 +201,15 @@ RSpec.describe Era835Parser::Parser do
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it 'returns the check number' do
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193
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expect(@era[:checks]['02790758'][:check_number]).to eq('02790758')
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194
203
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end
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204
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+
it 'returns the transaction handling code' do
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expect(@era[:checks]['02790758'][:transaction_handling_code]).to eq('I')
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206
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end
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207
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it 'returns the credit debit flag' do
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expect(@era[:checks]['02790758'][:credit_debit_flag]).to eq('C')
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end
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it 'returns the payment method code' do
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expect(@era[:checks]['02790758'][:payment_method_code]).to eq('CHK')
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212
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end
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it 'returns the amount' do
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expect(@era[:checks]['02790758'][:amount]).to eq(192286)
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197
215
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end
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@@ -235,10 +253,10 @@ RSpec.describe Era835Parser::Parser do
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235
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it 'returns the Patient name' do
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expect(@era[:checks]['02790758'][:eras][0][:patient_name]).to eq('DOUGH,MARY')
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237
255
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end
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238
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-
it 'returns the Patient last name (
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256
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+
it 'returns the Patient last name (titleized)' do
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239
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expect(@era[:checks]['02790758'][:eras][0][:patient_last_name]).to eq('Dough')
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240
258
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end
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241
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-
it 'returns the Patient first name (
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259
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+
it 'returns the Patient first name (titleized)' do
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242
260
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expect(@era[:checks]['02790758'][:eras][0][:patient_first_name]).to eq('Mary')
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243
261
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end
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244
262
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it 'returns the Total charge amount (integer)' do
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@@ -250,7 +268,7 @@ RSpec.describe Era835Parser::Parser do
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250
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it 'returns the Account number' do
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251
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expect(@era[:checks]['02790758'][:eras][0][:account_number]).to eq('200200964A52')
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252
270
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end
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253
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-
it 'returns the
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271
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+
it 'returns the Claim status code' do
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254
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expect(@era[:checks]['02790758'][:eras][0][:claim_status_code]).to eq('1')
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255
273
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end
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256
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it 'returns the Claim status code description' do
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@@ -435,6 +453,15 @@ RSpec.describe Era835Parser::Parser do
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435
453
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it 'returns the check number' do
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436
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expect(@era[:checks]['02790758'][:check_number]).to eq('02790758')
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437
455
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end
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456
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+
it 'returns the transaction handling code' do
|
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457
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+
expect(@era[:checks]['02790758'][:transaction_handling_code]).to eq('I')
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458
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+
end
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459
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+
it 'returns the credit debit flag' do
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460
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expect(@era[:checks]['02790758'][:credit_debit_flag]).to eq('C')
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461
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+
end
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462
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+
it 'returns the payment method code' do
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463
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expect(@era[:checks]['02790758'][:payment_method_code]).to eq('CHK')
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464
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+
end
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438
465
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it 'returns the amount' do
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439
466
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expect(@era[:checks]['02790758'][:amount]).to eq(192286)
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440
467
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end
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@@ -478,10 +505,10 @@ RSpec.describe Era835Parser::Parser do
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478
505
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it 'returns the Patient name' do
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479
506
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expect(@era[:checks]['02790758'][:eras][0][:patient_name]).to eq('DOUGH,MARY')
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480
507
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end
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481
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-
it 'returns the Patient last name (
|
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508
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+
it 'returns the Patient last name (titleized)' do
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482
509
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expect(@era[:checks]['02790758'][:eras][0][:patient_last_name]).to eq('Dough')
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483
510
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end
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484
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-
it 'returns the Patient first name (
|
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511
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+
it 'returns the Patient first name (titleized)' do
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485
512
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expect(@era[:checks]['02790758'][:eras][0][:patient_first_name]).to eq('Mary')
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486
513
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end
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487
514
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it 'returns the Total charge amount (integer)' do
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@@ -493,7 +520,7 @@ RSpec.describe Era835Parser::Parser do
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493
520
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it 'returns the Account number' do
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494
521
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expect(@era[:checks]['02790758'][:eras][0][:account_number]).to eq('200200964A52')
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495
522
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end
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496
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-
it 'returns the
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523
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+
it 'returns the Claim status code' do
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497
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expect(@era[:checks]['02790758'][:eras][0][:claim_status_code]).to eq('1')
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498
525
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end
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499
526
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it 'returns the Claim status code description' do
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@@ -678,6 +705,15 @@ RSpec.describe Era835Parser::Parser do
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678
705
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it 'returns the check number' do
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679
706
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expect(@era[:checks]['0123456789012345678901234567890123456789'][:check_number]).to eq('0123456789012345678901234567890123456789')
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680
707
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end
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708
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+
it 'returns the transaction handling code' do
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709
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expect(@era[:checks]['0123456789012345678901234567890123456789'][:transaction_handling_code]).to eq('I')
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710
|
+
end
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711
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+
it 'returns the credit debit flag' do
|
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712
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expect(@era[:checks]['0123456789012345678901234567890123456789'][:credit_debit_flag]).to eq('C')
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713
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+
end
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714
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+
it 'returns the payment method code' do
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715
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expect(@era[:checks]['0123456789012345678901234567890123456789'][:payment_method_code]).to eq('CHK')
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716
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+
end
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681
717
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it 'returns the amount' do
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682
718
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expect(@era[:checks]['0123456789012345678901234567890123456789'][:amount]).to eq(192286)
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683
719
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end
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@@ -721,10 +757,10 @@ RSpec.describe Era835Parser::Parser do
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721
757
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it 'returns the Patient name' do
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722
758
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expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:patient_name]).to eq('DOUGH,MARY')
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723
759
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end
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724
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-
it 'returns the Patient last name (
|
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760
|
+
it 'returns the Patient last name (titleized)' do
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725
761
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expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:patient_last_name]).to eq('Dough')
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726
762
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end
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727
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-
it 'returns the Patient first name (
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763
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+
it 'returns the Patient first name (titleized)' do
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728
764
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expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:patient_first_name]).to eq('Mary')
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729
765
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end
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730
766
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it 'returns the Total charge amount (integer)' do
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@@ -736,7 +772,7 @@ RSpec.describe Era835Parser::Parser do
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736
772
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it 'returns the Account number' do
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737
773
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expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:account_number]).to eq('200200964A52')
|
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738
774
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end
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739
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-
it 'returns the
|
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775
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+
it 'returns the Claim status code' do
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740
776
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expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:claim_status_code]).to eq('1')
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741
777
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end
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742
778
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it 'returns the Claim status code description' do
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@@ -884,6 +920,816 @@ RSpec.describe Era835Parser::Parser do
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884
920
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end
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885
921
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end
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886
922
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end
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923
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+
|
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924
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+
context 'example_5.835' do
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925
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+
before :all do
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926
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@era = Era835Parser::Parser.new(file_path: "../era_835_parser/spec/example_5.835").parse
|
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927
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+
end
|
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928
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+
|
|
929
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+
context 'Aggregate totals' do
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930
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+
it 'returns the addressed to' do
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931
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+
expect(@era[:addressed_to]).to eq(nil)
|
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932
|
+
end
|
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933
|
+
it 'returns the correct number of checks' do
|
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934
|
+
expect(@era[:checks].count).to eq(1)
|
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935
|
+
end
|
|
936
|
+
it 'returns the correct number of adjustments' do
|
|
937
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expect(@era[:adjustments]).to eq(nil)
|
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938
|
+
end
|
|
939
|
+
it 'returns the correct number of eras' do
|
|
940
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras].count).to eq(1)
|
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941
|
+
end
|
|
942
|
+
it 'returns the correct number of line items' do
|
|
943
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items].count).to eq(3)
|
|
944
|
+
end
|
|
945
|
+
it 'returns the correct number of adjustment groups' do
|
|
946
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:adjustment_groups].count).to eq(2)
|
|
947
|
+
end
|
|
948
|
+
it 'returns the correct number of adjustment groups' do
|
|
949
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:adjustment_groups].count).to eq(1)
|
|
950
|
+
end
|
|
951
|
+
it 'returns the correct number of adjustment groups' do
|
|
952
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][2][:adjustment_groups]).to eq(nil)
|
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953
|
+
end
|
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954
|
+
end
|
|
955
|
+
|
|
956
|
+
context 'Check #70408535' do
|
|
957
|
+
it 'returns the check number' do
|
|
958
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:check_number]).to eq('0123456789012345678901234567890123456789')
|
|
959
|
+
end
|
|
960
|
+
it 'returns the transaction handling code' do
|
|
961
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:transaction_handling_code]).to eq('I')
|
|
962
|
+
end
|
|
963
|
+
it 'returns the credit debit flag' do
|
|
964
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:credit_debit_flag]).to eq('C')
|
|
965
|
+
end
|
|
966
|
+
it 'returns the payment method code' do
|
|
967
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:payment_method_code]).to eq('CHK')
|
|
968
|
+
end
|
|
969
|
+
it 'returns the amount' do
|
|
970
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:amount]).to eq(192286)
|
|
971
|
+
end
|
|
972
|
+
it 'returns the number of claims' do
|
|
973
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:number_of_claims]).to eq(1)
|
|
974
|
+
end
|
|
975
|
+
it 'returns the NPI or Tax ID of payee' do
|
|
976
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:npi_tax_id]).to eq('0987654321')
|
|
977
|
+
end
|
|
978
|
+
it 'returns the Check payee' do
|
|
979
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:payee]).to eq('XYZ HEALTHCARE CORPORATION')
|
|
980
|
+
end
|
|
981
|
+
it 'returns the Payer name' do
|
|
982
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:payer_name]).to eq('BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA')
|
|
983
|
+
end
|
|
984
|
+
it 'returns the Payer address' do
|
|
985
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:payer_address]).to eq('P O BOX 2291')
|
|
986
|
+
end
|
|
987
|
+
it 'returns the Payer city' do
|
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988
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:payer_city]).to eq('DURHAM')
|
|
989
|
+
end
|
|
990
|
+
it 'returns the Payer state' do
|
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991
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:payer_state]).to eq('NC')
|
|
992
|
+
end
|
|
993
|
+
it 'returns the Payer zip code' do
|
|
994
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:payer_zip_code]).to eq('27702')
|
|
995
|
+
end
|
|
996
|
+
it 'returns the Payer tax id' do
|
|
997
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:payer_tax_id]).to eq('60-894904')
|
|
998
|
+
end
|
|
999
|
+
it 'returns the Payer EDI id' do
|
|
1000
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:payer_edi_id]).to eq(nil)
|
|
1001
|
+
end
|
|
1002
|
+
it 'returns the Check date (string mm/dd/yyyy)' do
|
|
1003
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:date]).to eq('01/08/2011')
|
|
1004
|
+
end
|
|
1005
|
+
context 'ERA #0' do
|
|
1006
|
+
it 'returns the Patient ID' do
|
|
1007
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:patient_id]).to eq(nil)
|
|
1008
|
+
end
|
|
1009
|
+
it 'returns the Patient name' do
|
|
1010
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:patient_name]).to eq('DOUGH,MARY')
|
|
1011
|
+
end
|
|
1012
|
+
it 'returns the Patient last name (titleized)' do
|
|
1013
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:patient_last_name]).to eq('Dough')
|
|
1014
|
+
end
|
|
1015
|
+
it 'returns the Patient first name (titleized)' do
|
|
1016
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:patient_first_name]).to eq('Mary')
|
|
1017
|
+
end
|
|
1018
|
+
it 'returns the Subscriber last name (titleized)' do
|
|
1019
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:subscriber_first_name]).to eq('Marty')
|
|
1020
|
+
end
|
|
1021
|
+
it 'returns the Subscriber last name (titleized)' do
|
|
1022
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:subscriber_last_name]).to eq('Dough')
|
|
1023
|
+
end
|
|
1024
|
+
it 'returns the Subscriber name (titleized)' do
|
|
1025
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:subscriber_name]).to eq('DOUGH,MARTY')
|
|
1026
|
+
end
|
|
1027
|
+
it 'returns the Subscriber middle initial' do
|
|
1028
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:subscriber_middle_initial]).to eq('L')
|
|
1029
|
+
end
|
|
1030
|
+
it 'returns the Subscriber suffix' do
|
|
1031
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:subscriber_suffix]).to eq('Sr.')
|
|
1032
|
+
end
|
|
1033
|
+
it 'returns the Subscriber ID' do
|
|
1034
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:subscriber_id]).to eq('YPB123456789009')
|
|
1035
|
+
end
|
|
1036
|
+
it 'returns the rendering provider last_name (titleized)' do
|
|
1037
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:rendering_provider_last_name]).to eq('Jones')
|
|
1038
|
+
end
|
|
1039
|
+
it 'returns the rendering provider first name (titleized)' do
|
|
1040
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:rendering_provider_first_name]).to eq('Alice')
|
|
1041
|
+
end
|
|
1042
|
+
it 'returns the rendering provider NPI' do
|
|
1043
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:rendering_provider_npi]).to eq('1116359906')
|
|
1044
|
+
end
|
|
1045
|
+
it 'returns the Total charge amount (integer)' do
|
|
1046
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:charge_amount]).to eq(210000)
|
|
1047
|
+
end
|
|
1048
|
+
it 'returns the Total payment amount (integer)' do
|
|
1049
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:payment_amount]).to eq(192286)
|
|
1050
|
+
end
|
|
1051
|
+
it 'returns the Account number' do
|
|
1052
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:account_number]).to eq('200200964A52')
|
|
1053
|
+
end
|
|
1054
|
+
it 'returns the Claim status code' do
|
|
1055
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:claim_status_code]).to eq('1')
|
|
1056
|
+
end
|
|
1057
|
+
it 'returns the Claim status code description' do
|
|
1058
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:status]).to eq("PROCESSED AS PRIMARY")
|
|
1059
|
+
end
|
|
1060
|
+
it 'returns the Payer claim control number' do
|
|
1061
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:payer_claim_control_number]).to eq('94151100100')
|
|
1062
|
+
end
|
|
1063
|
+
it 'returns the Claim statement period start' do
|
|
1064
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:claim_statement_period_start]).to eq(nil)
|
|
1065
|
+
end
|
|
1066
|
+
it 'returns the Claim statement period end' do
|
|
1067
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:claim_statement_period_end]).to eq(nil)
|
|
1068
|
+
end
|
|
1069
|
+
|
|
1070
|
+
context 'Line item #0' do
|
|
1071
|
+
it 'returns the Date of service (string mm/dd/yyyy)' do
|
|
1072
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:service_date]).to eq("12/31/2010")
|
|
1073
|
+
end
|
|
1074
|
+
it 'returns the CPT code' do
|
|
1075
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:cpt_code]).to eq("59430")
|
|
1076
|
+
end
|
|
1077
|
+
it 'returns the Charge amount (integer)' do
|
|
1078
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:charge_amount]).to eq(121000)
|
|
1079
|
+
end
|
|
1080
|
+
it 'returns the Payment amount (integer)' do
|
|
1081
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:payment_amount]).to eq(105786)
|
|
1082
|
+
end
|
|
1083
|
+
it 'returns the Total adjustment amount (integer)' do
|
|
1084
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:total_adjustment_amount]).to eq(15214)
|
|
1085
|
+
end
|
|
1086
|
+
it 'returns the Remark code' do
|
|
1087
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:remark_code]).to eq(nil)
|
|
1088
|
+
end
|
|
1089
|
+
it 'returns the Remarks' do
|
|
1090
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:remarks]).to eq(nil)
|
|
1091
|
+
end
|
|
1092
|
+
it 'returns the Reference number' do
|
|
1093
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:reference_number]).to eq('0001')
|
|
1094
|
+
end
|
|
1095
|
+
context 'Adjustment group #0' do
|
|
1096
|
+
it 'returns the Adjustment group' do
|
|
1097
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:adjustment_groups][0][:adjustment_group]).to eq("Contractual Obligation")
|
|
1098
|
+
end
|
|
1099
|
+
it 'returns the Adjustment group code' do
|
|
1100
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:adjustment_groups][0][:adjustment_group_code]).to eq("CO")
|
|
1101
|
+
end
|
|
1102
|
+
it 'returns the Adjustment amount (integer)' do
|
|
1103
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:adjustment_groups][0][:adjustment_amount]).to eq(3460)
|
|
1104
|
+
end
|
|
1105
|
+
it 'returns the Reason code' do
|
|
1106
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:adjustment_groups][0][:reason_code]).to eq('42')
|
|
1107
|
+
end
|
|
1108
|
+
it 'returns the Translated reason code' do
|
|
1109
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:adjustment_groups][0][:translated_reason_code]).to eq("Charges exceed our fee schedule or maximum allowable amount. (Use CARC 45)")
|
|
1110
|
+
end
|
|
1111
|
+
end
|
|
1112
|
+
context 'Adjustment group #1' do
|
|
1113
|
+
it 'returns the Adjustment group' do
|
|
1114
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:adjustment_groups][1][:adjustment_group]).to eq("Patient Responsibility")
|
|
1115
|
+
end
|
|
1116
|
+
it 'returns the Adjustment group code' do
|
|
1117
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:adjustment_groups][1][:adjustment_group_code]).to eq("PR")
|
|
1118
|
+
end
|
|
1119
|
+
it 'returns the Adjustment amount (integer)' do
|
|
1120
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:adjustment_groups][1][:adjustment_amount]).to eq(11754)
|
|
1121
|
+
end
|
|
1122
|
+
it 'returns the Reason code' do
|
|
1123
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:adjustment_groups][1][:reason_code]).to eq('2')
|
|
1124
|
+
end
|
|
1125
|
+
it 'returns the Translated reason code' do
|
|
1126
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][0][:adjustment_groups][1][:translated_reason_code]).to eq("Coinsurance Amount")
|
|
1127
|
+
end
|
|
1128
|
+
end
|
|
1129
|
+
end
|
|
1130
|
+
context 'Line item #1' do
|
|
1131
|
+
it 'returns the Date of service (string mm/dd/yyyy)' do
|
|
1132
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:service_date]).to eq("12/31/2010")
|
|
1133
|
+
end
|
|
1134
|
+
it 'returns the CPT code' do
|
|
1135
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:cpt_code]).to eq("59440")
|
|
1136
|
+
end
|
|
1137
|
+
it 'returns the Charge amount (integer)' do
|
|
1138
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:charge_amount]).to eq(89000)
|
|
1139
|
+
end
|
|
1140
|
+
it 'returns the Payment amount (integer)' do
|
|
1141
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:payment_amount]).to eq(86500)
|
|
1142
|
+
end
|
|
1143
|
+
it 'returns the Total adjustment amount (integer)' do
|
|
1144
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:total_adjustment_amount]).to eq(2500)
|
|
1145
|
+
end
|
|
1146
|
+
it 'returns the Remark code' do
|
|
1147
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:remark_code]).to eq(nil)
|
|
1148
|
+
end
|
|
1149
|
+
it 'returns the Remarks' do
|
|
1150
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:remarks]).to eq(nil)
|
|
1151
|
+
end
|
|
1152
|
+
it 'returns the Reference number' do
|
|
1153
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:reference_number]).to eq('0002')
|
|
1154
|
+
end
|
|
1155
|
+
context 'Adjustment group #0' do
|
|
1156
|
+
it 'returns the Adjustment group' do
|
|
1157
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:adjustment_groups][0][:adjustment_group]).to eq("Patient Responsibility")
|
|
1158
|
+
end
|
|
1159
|
+
it 'returns the Adjustment group code' do
|
|
1160
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:adjustment_groups][0][:adjustment_group_code]).to eq("PR")
|
|
1161
|
+
end
|
|
1162
|
+
it 'returns the Adjustment amount (integer)' do
|
|
1163
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:adjustment_groups][0][:adjustment_amount]).to eq(2500)
|
|
1164
|
+
end
|
|
1165
|
+
it 'returns the Reason code' do
|
|
1166
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:adjustment_groups][0][:reason_code]).to eq('3')
|
|
1167
|
+
end
|
|
1168
|
+
it 'returns the Translated reason code' do
|
|
1169
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][1][:adjustment_groups][0][:translated_reason_code]).to eq("Co-payment Amount")
|
|
1170
|
+
end
|
|
1171
|
+
end
|
|
1172
|
+
end
|
|
1173
|
+
context 'Line item #2' do
|
|
1174
|
+
it 'returns the Date of service (string mm/dd/yyyy)' do
|
|
1175
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][2][:service_date]).to eq("12/31/2010")
|
|
1176
|
+
end
|
|
1177
|
+
it 'returns the CPT code' do
|
|
1178
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][2][:cpt_code]).to eq("59426")
|
|
1179
|
+
end
|
|
1180
|
+
it 'returns the Charge amount (integer)' do
|
|
1181
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][2][:charge_amount]).to eq(74200)
|
|
1182
|
+
end
|
|
1183
|
+
it 'returns the Payment amount (integer)' do
|
|
1184
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][2][:payment_amount]).to eq(74200)
|
|
1185
|
+
end
|
|
1186
|
+
it 'returns the Total adjustment amount (integer)' do
|
|
1187
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][2][:total_adjustment_amount]).to eq(nil)
|
|
1188
|
+
end
|
|
1189
|
+
it 'returns the Remark code' do
|
|
1190
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][2][:remark_code]).to eq(nil)
|
|
1191
|
+
end
|
|
1192
|
+
it 'returns the Remarks' do
|
|
1193
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][2][:remarks]).to eq(nil)
|
|
1194
|
+
end
|
|
1195
|
+
it 'returns the Reference number' do
|
|
1196
|
+
expect(@era[:checks]['0123456789012345678901234567890123456789'][:eras][0][:line_items][2][:reference_number]).to eq('0003')
|
|
1197
|
+
end
|
|
1198
|
+
end
|
|
1199
|
+
end
|
|
1200
|
+
end
|
|
1201
|
+
end
|
|
1202
|
+
context 'example_6.835' do
|
|
1203
|
+
before :all do
|
|
1204
|
+
@era = Era835Parser::Parser.new(file_path: "../era_835_parser/spec/example_6.835").parse
|
|
1205
|
+
@check_5003 = @era[:checks]['5003']
|
|
1206
|
+
@check_5010 = @era[:checks]['5010']
|
|
1207
|
+
end
|
|
1208
|
+
|
|
1209
|
+
context 'Aggregate totals' do
|
|
1210
|
+
it 'returns the addressed to' do
|
|
1211
|
+
expect(@era[:addressed_to]).to eq(nil)
|
|
1212
|
+
end
|
|
1213
|
+
it 'returns the correct number of checks' do
|
|
1214
|
+
expect(@era[:checks].count).to eq(2)
|
|
1215
|
+
end
|
|
1216
|
+
it 'returns the correct number of adjustments' do
|
|
1217
|
+
expect(@era[:adjustments]).to eq(nil)
|
|
1218
|
+
end
|
|
1219
|
+
it 'returns the correct number of eras' do
|
|
1220
|
+
total = @check_5003[:eras].count + @check_5010[:eras].count
|
|
1221
|
+
expect(total).to eq(2)
|
|
1222
|
+
end
|
|
1223
|
+
it 'returns the correct number of line items' do
|
|
1224
|
+
total = @check_5003[:eras][0][:line_items].count + @check_5010[:eras][0][:line_items].count
|
|
1225
|
+
expect(total).to eq(6)
|
|
1226
|
+
end
|
|
1227
|
+
it 'returns the correct number of adjustment groups' do
|
|
1228
|
+
total = @check_5003[:eras][0][:line_items][0][:adjustment_groups].count + @check_5010[:eras][0][:line_items][0][:adjustment_groups].count
|
|
1229
|
+
expect(total).to eq(4)
|
|
1230
|
+
end
|
|
1231
|
+
it 'returns the correct number of adjustment groups' do
|
|
1232
|
+
total = @check_5003[:eras][0][:line_items][1][:adjustment_groups].count + @check_5010[:eras][0][:line_items][1][:adjustment_groups].count
|
|
1233
|
+
expect(total).to eq(2)
|
|
1234
|
+
end
|
|
1235
|
+
it 'returns the correct number of adjustment groups' do
|
|
1236
|
+
total = @check_5003[:eras][0][:line_items][2][:adjustment_groups].count + @check_5010[:eras][0][:line_items][2][:adjustment_groups].count
|
|
1237
|
+
expect(total).to eq(2)
|
|
1238
|
+
end
|
|
1239
|
+
end
|
|
1240
|
+
|
|
1241
|
+
context 'Check #5003' do
|
|
1242
|
+
it 'returns the check number' do
|
|
1243
|
+
expect(@check_5003[:check_number]).to eq('5003')
|
|
1244
|
+
end
|
|
1245
|
+
it 'returns the transaction handling code' do
|
|
1246
|
+
expect(@check_5003[:transaction_handling_code]).to eq('H')
|
|
1247
|
+
end
|
|
1248
|
+
it 'returns the credit debit flag' do
|
|
1249
|
+
expect(@check_5003[:credit_debit_flag]).to eq('C')
|
|
1250
|
+
end
|
|
1251
|
+
it 'returns the payment method code' do
|
|
1252
|
+
expect(@check_5003[:payment_method_code]).to eq('NON')
|
|
1253
|
+
end
|
|
1254
|
+
it 'returns the amount' do
|
|
1255
|
+
expect(@check_5003[:amount]).to eq(0)
|
|
1256
|
+
end
|
|
1257
|
+
it 'returns the number of claims' do
|
|
1258
|
+
expect(@check_5003[:number_of_claims]).to eq(1)
|
|
1259
|
+
end
|
|
1260
|
+
it 'returns the NPI or Tax ID of payee' do
|
|
1261
|
+
expect(@check_5003[:npi_tax_id]).to eq('0987654321')
|
|
1262
|
+
end
|
|
1263
|
+
it 'returns the Check payee' do
|
|
1264
|
+
expect(@check_5003[:payee]).to eq('XYZ HEALTHCARE CORPORATION')
|
|
1265
|
+
end
|
|
1266
|
+
it 'returns the Payer name' do
|
|
1267
|
+
expect(@check_5003[:payer_name]).to eq('BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA')
|
|
1268
|
+
end
|
|
1269
|
+
it 'returns the Payer address' do
|
|
1270
|
+
expect(@check_5003[:payer_address]).to eq('P O BOX 2291')
|
|
1271
|
+
end
|
|
1272
|
+
it 'returns the Payer city' do
|
|
1273
|
+
expect(@check_5003[:payer_city]).to eq('DURHAM')
|
|
1274
|
+
end
|
|
1275
|
+
it 'returns the Payer state' do
|
|
1276
|
+
expect(@check_5003[:payer_state]).to eq('NC')
|
|
1277
|
+
end
|
|
1278
|
+
it 'returns the Payer zip code' do
|
|
1279
|
+
expect(@check_5003[:payer_zip_code]).to eq('27702')
|
|
1280
|
+
end
|
|
1281
|
+
it 'returns the Payer tax id' do
|
|
1282
|
+
expect(@check_5003[:payer_tax_id]).to eq('60-894904')
|
|
1283
|
+
end
|
|
1284
|
+
it 'returns the Payer EDI id' do
|
|
1285
|
+
expect(@check_5003[:payer_edi_id]).to eq(nil)
|
|
1286
|
+
end
|
|
1287
|
+
it 'returns the Check date (string mm/dd/yyyy)' do
|
|
1288
|
+
expect(@check_5003[:date]).to eq('01/08/2026')
|
|
1289
|
+
end
|
|
1290
|
+
context 'ERA #0' do
|
|
1291
|
+
it 'returns the Patient ID' do
|
|
1292
|
+
expect(@check_5003[:eras][0][:patient_id]).to eq(nil)
|
|
1293
|
+
end
|
|
1294
|
+
it 'returns the Patient name' do
|
|
1295
|
+
expect(@check_5003[:eras][0][:patient_name]).to eq('DOUGH,MARY')
|
|
1296
|
+
end
|
|
1297
|
+
it 'returns the Patient last name (titleized)' do
|
|
1298
|
+
expect(@check_5003[:eras][0][:patient_last_name]).to eq('Dough')
|
|
1299
|
+
end
|
|
1300
|
+
it 'returns the Patient first name (titleized)' do
|
|
1301
|
+
expect(@check_5003[:eras][0][:patient_first_name]).to eq('Mary')
|
|
1302
|
+
end
|
|
1303
|
+
it 'returns the Subscriber last name (titleized)' do
|
|
1304
|
+
expect(@check_5003[:eras][0][:subscriber_first_name]).to eq('Marty')
|
|
1305
|
+
end
|
|
1306
|
+
it 'returns the Subscriber last name (titleized)' do
|
|
1307
|
+
expect(@check_5003[:eras][0][:subscriber_last_name]).to eq('Dough')
|
|
1308
|
+
end
|
|
1309
|
+
it 'returns the Subscriber name (titleized)' do
|
|
1310
|
+
expect(@check_5003[:eras][0][:subscriber_name]).to eq('DOUGH,MARTY')
|
|
1311
|
+
end
|
|
1312
|
+
it 'returns the Subscriber middle initial' do
|
|
1313
|
+
expect(@check_5003[:eras][0][:subscriber_middle_initial]).to eq('L')
|
|
1314
|
+
end
|
|
1315
|
+
it 'returns the Subscriber suffix' do
|
|
1316
|
+
expect(@check_5003[:eras][0][:subscriber_suffix]).to eq('Sr.')
|
|
1317
|
+
end
|
|
1318
|
+
it 'returns the Subscriber ID' do
|
|
1319
|
+
expect(@check_5003[:eras][0][:subscriber_id]).to eq('YPB123456789009')
|
|
1320
|
+
end
|
|
1321
|
+
it 'returns the rendering provider last_name (titleized)' do
|
|
1322
|
+
expect(@check_5003[:eras][0][:rendering_provider_last_name]).to eq('Jones')
|
|
1323
|
+
end
|
|
1324
|
+
it 'returns the rendering provider first name (titleized)' do
|
|
1325
|
+
expect(@check_5003[:eras][0][:rendering_provider_first_name]).to eq('Alice')
|
|
1326
|
+
end
|
|
1327
|
+
it 'returns the rendering provider NPI' do
|
|
1328
|
+
expect(@check_5003[:eras][0][:rendering_provider_npi]).to eq('1116359906')
|
|
1329
|
+
end
|
|
1330
|
+
it 'returns the Total charge amount (integer)' do
|
|
1331
|
+
expect(@check_5003[:eras][0][:charge_amount]).to eq(30000)
|
|
1332
|
+
end
|
|
1333
|
+
it 'returns the Total payment amount (integer)' do
|
|
1334
|
+
expect(@check_5003[:eras][0][:payment_amount]).to eq(15000)
|
|
1335
|
+
end
|
|
1336
|
+
it 'returns the Account number' do
|
|
1337
|
+
expect(@check_5003[:eras][0][:account_number]).to eq('200200964A52')
|
|
1338
|
+
end
|
|
1339
|
+
it 'returns the Claim status code' do
|
|
1340
|
+
expect(@check_5003[:eras][0][:claim_status_code]).to eq('1')
|
|
1341
|
+
end
|
|
1342
|
+
it 'returns the Claim status code description' do
|
|
1343
|
+
expect(@check_5003[:eras][0][:status]).to eq("PROCESSED AS PRIMARY")
|
|
1344
|
+
end
|
|
1345
|
+
it 'returns the Payer claim control number' do
|
|
1346
|
+
expect(@check_5003[:eras][0][:payer_claim_control_number]).to eq('94151100100')
|
|
1347
|
+
end
|
|
1348
|
+
it 'returns the Claim statement period start' do
|
|
1349
|
+
expect(@check_5003[:eras][0][:claim_statement_period_start]).to eq(nil)
|
|
1350
|
+
end
|
|
1351
|
+
it 'returns the Claim statement period end' do
|
|
1352
|
+
expect(@check_5003[:eras][0][:claim_statement_period_end]).to eq(nil)
|
|
1353
|
+
end
|
|
1354
|
+
|
|
1355
|
+
context 'Line item #0' do
|
|
1356
|
+
it 'returns the Date of service (string mm/dd/yyyy)' do
|
|
1357
|
+
expect(@check_5003[:eras][0][:line_items][0][:service_date]).to eq("12/31/2010")
|
|
1358
|
+
end
|
|
1359
|
+
it 'returns the CPT code' do
|
|
1360
|
+
expect(@check_5003[:eras][0][:line_items][0][:cpt_code]).to eq("59430")
|
|
1361
|
+
end
|
|
1362
|
+
it 'returns the Charge amount (integer)' do
|
|
1363
|
+
expect(@check_5003[:eras][0][:line_items][0][:charge_amount]).to eq(10100)
|
|
1364
|
+
end
|
|
1365
|
+
it 'returns the Payment amount (integer)' do
|
|
1366
|
+
expect(@check_5003[:eras][0][:line_items][0][:payment_amount]).to eq(5050)
|
|
1367
|
+
end
|
|
1368
|
+
it 'returns the Total adjustment amount (integer)' do
|
|
1369
|
+
expect(@check_5003[:eras][0][:line_items][0][:total_adjustment_amount]).to eq(5050)
|
|
1370
|
+
end
|
|
1371
|
+
it 'returns the Remark code' do
|
|
1372
|
+
expect(@check_5003[:eras][0][:line_items][0][:remark_code]).to eq(nil)
|
|
1373
|
+
end
|
|
1374
|
+
it 'returns the Remarks' do
|
|
1375
|
+
expect(@check_5003[:eras][0][:line_items][0][:remarks]).to eq(nil)
|
|
1376
|
+
end
|
|
1377
|
+
it 'returns the Reference number' do
|
|
1378
|
+
expect(@check_5003[:eras][0][:line_items][0][:reference_number]).to eq('0001')
|
|
1379
|
+
end
|
|
1380
|
+
context 'Adjustment group #0' do
|
|
1381
|
+
it 'returns the Adjustment group' do
|
|
1382
|
+
expect(@check_5003[:eras][0][:line_items][0][:adjustment_groups][0][:adjustment_group]).to eq("Contractual Obligation")
|
|
1383
|
+
end
|
|
1384
|
+
it 'returns the Adjustment group code' do
|
|
1385
|
+
expect(@check_5003[:eras][0][:line_items][0][:adjustment_groups][0][:adjustment_group_code]).to eq("CO")
|
|
1386
|
+
end
|
|
1387
|
+
it 'returns the Adjustment amount (integer)' do
|
|
1388
|
+
expect(@check_5003[:eras][0][:line_items][0][:adjustment_groups][0][:adjustment_amount]).to eq(2550)
|
|
1389
|
+
end
|
|
1390
|
+
it 'returns the Reason code' do
|
|
1391
|
+
expect(@check_5003[:eras][0][:line_items][0][:adjustment_groups][0][:reason_code]).to eq('42')
|
|
1392
|
+
end
|
|
1393
|
+
it 'returns the Translated reason code' do
|
|
1394
|
+
expect(@check_5003[:eras][0][:line_items][0][:adjustment_groups][0][:translated_reason_code]).to eq("Charges exceed our fee schedule or maximum allowable amount. (Use CARC 45)")
|
|
1395
|
+
end
|
|
1396
|
+
end
|
|
1397
|
+
context 'Adjustment group #1' do
|
|
1398
|
+
it 'returns the Adjustment group' do
|
|
1399
|
+
expect(@check_5003[:eras][0][:line_items][0][:adjustment_groups][1][:adjustment_group]).to eq("Patient Responsibility")
|
|
1400
|
+
end
|
|
1401
|
+
it 'returns the Adjustment group code' do
|
|
1402
|
+
expect(@check_5003[:eras][0][:line_items][0][:adjustment_groups][1][:adjustment_group_code]).to eq("PR")
|
|
1403
|
+
end
|
|
1404
|
+
it 'returns the Adjustment amount (integer)' do
|
|
1405
|
+
expect(@check_5003[:eras][0][:line_items][0][:adjustment_groups][1][:adjustment_amount]).to eq(2500)
|
|
1406
|
+
end
|
|
1407
|
+
it 'returns the Reason code' do
|
|
1408
|
+
expect(@check_5003[:eras][0][:line_items][0][:adjustment_groups][1][:reason_code]).to eq('2')
|
|
1409
|
+
end
|
|
1410
|
+
it 'returns the Translated reason code' do
|
|
1411
|
+
expect(@check_5003[:eras][0][:line_items][0][:adjustment_groups][1][:translated_reason_code]).to eq("Coinsurance Amount")
|
|
1412
|
+
end
|
|
1413
|
+
end
|
|
1414
|
+
end
|
|
1415
|
+
context 'Line item #1' do
|
|
1416
|
+
it 'returns the Date of service (string mm/dd/yyyy)' do
|
|
1417
|
+
expect(@check_5003[:eras][0][:line_items][1][:service_date]).to eq("12/31/2010")
|
|
1418
|
+
end
|
|
1419
|
+
it 'returns the CPT code' do
|
|
1420
|
+
expect(@check_5003[:eras][0][:line_items][1][:cpt_code]).to eq("59440")
|
|
1421
|
+
end
|
|
1422
|
+
it 'returns the Charge amount (integer)' do
|
|
1423
|
+
expect(@check_5003[:eras][0][:line_items][1][:charge_amount]).to eq(10000)
|
|
1424
|
+
end
|
|
1425
|
+
it 'returns the Payment amount (integer)' do
|
|
1426
|
+
expect(@check_5003[:eras][0][:line_items][1][:payment_amount]).to eq(5000)
|
|
1427
|
+
end
|
|
1428
|
+
it 'returns the Total adjustment amount (integer)' do
|
|
1429
|
+
expect(@check_5003[:eras][0][:line_items][1][:total_adjustment_amount]).to eq(5000)
|
|
1430
|
+
end
|
|
1431
|
+
it 'returns the Remark code' do
|
|
1432
|
+
expect(@check_5003[:eras][0][:line_items][1][:remark_code]).to eq(nil)
|
|
1433
|
+
end
|
|
1434
|
+
it 'returns the Remarks' do
|
|
1435
|
+
expect(@check_5003[:eras][0][:line_items][1][:remarks]).to eq(nil)
|
|
1436
|
+
end
|
|
1437
|
+
it 'returns the Reference number' do
|
|
1438
|
+
expect(@check_5003[:eras][0][:line_items][1][:reference_number]).to eq('0002')
|
|
1439
|
+
end
|
|
1440
|
+
context 'Adjustment group #0' do
|
|
1441
|
+
it 'returns the Adjustment group' do
|
|
1442
|
+
expect(@check_5003[:eras][0][:line_items][1][:adjustment_groups][0][:adjustment_group]).to eq("Patient Responsibility")
|
|
1443
|
+
end
|
|
1444
|
+
it 'returns the Adjustment group code' do
|
|
1445
|
+
expect(@check_5003[:eras][0][:line_items][1][:adjustment_groups][0][:adjustment_group_code]).to eq("PR")
|
|
1446
|
+
end
|
|
1447
|
+
it 'returns the Adjustment amount (integer)' do
|
|
1448
|
+
expect(@check_5003[:eras][0][:line_items][1][:adjustment_groups][0][:adjustment_amount]).to eq(5000)
|
|
1449
|
+
end
|
|
1450
|
+
it 'returns the Reason code' do
|
|
1451
|
+
expect(@check_5003[:eras][0][:line_items][1][:adjustment_groups][0][:reason_code]).to eq('3')
|
|
1452
|
+
end
|
|
1453
|
+
it 'returns the Translated reason code' do
|
|
1454
|
+
expect(@check_5003[:eras][0][:line_items][1][:adjustment_groups][0][:translated_reason_code]).to eq("Co-payment Amount")
|
|
1455
|
+
end
|
|
1456
|
+
end
|
|
1457
|
+
end
|
|
1458
|
+
context 'Line item #2' do
|
|
1459
|
+
it 'returns the Date of service (string mm/dd/yyyy)' do
|
|
1460
|
+
expect(@check_5003[:eras][0][:line_items][2][:service_date]).to eq("12/31/2010")
|
|
1461
|
+
end
|
|
1462
|
+
it 'returns the CPT code' do
|
|
1463
|
+
expect(@check_5003[:eras][0][:line_items][2][:cpt_code]).to eq("59426")
|
|
1464
|
+
end
|
|
1465
|
+
it 'returns the Charge amount (integer)' do
|
|
1466
|
+
expect(@check_5003[:eras][0][:line_items][2][:charge_amount]).to eq(9900)
|
|
1467
|
+
end
|
|
1468
|
+
it 'returns the Payment amount (integer)' do
|
|
1469
|
+
expect(@check_5003[:eras][0][:line_items][2][:payment_amount]).to eq(4950)
|
|
1470
|
+
end
|
|
1471
|
+
it 'returns the Total adjustment amount (integer)' do
|
|
1472
|
+
expect(@check_5003[:eras][0][:line_items][2][:total_adjustment_amount]).to eq(4950)
|
|
1473
|
+
end
|
|
1474
|
+
it 'returns the Remark code' do
|
|
1475
|
+
expect(@check_5003[:eras][0][:line_items][2][:remark_code]).to eq(nil)
|
|
1476
|
+
end
|
|
1477
|
+
it 'returns the Remarks' do
|
|
1478
|
+
expect(@check_5003[:eras][0][:line_items][2][:remarks]).to eq(nil)
|
|
1479
|
+
end
|
|
1480
|
+
it 'returns the Reference number' do
|
|
1481
|
+
expect(@check_5003[:eras][0][:line_items][2][:reference_number]).to eq('0003')
|
|
1482
|
+
end
|
|
1483
|
+
end
|
|
1484
|
+
end
|
|
1485
|
+
end
|
|
1486
|
+
|
|
1487
|
+
context 'Check #5010' do
|
|
1488
|
+
it 'returns the check number' do
|
|
1489
|
+
expect(@check_5010[:check_number]).to eq('5010')
|
|
1490
|
+
end
|
|
1491
|
+
it 'returns the transaction handling code' do
|
|
1492
|
+
expect(@check_5010[:transaction_handling_code]).to eq('I')
|
|
1493
|
+
end
|
|
1494
|
+
it 'returns the credit debit flag' do
|
|
1495
|
+
expect(@check_5010[:credit_debit_flag]).to eq('C')
|
|
1496
|
+
end
|
|
1497
|
+
it 'returns the payment method code' do
|
|
1498
|
+
expect(@check_5010[:payment_method_code]).to eq('ACH')
|
|
1499
|
+
end
|
|
1500
|
+
it 'returns the amount' do
|
|
1501
|
+
expect(@check_5010[:amount]).to eq(30000)
|
|
1502
|
+
end
|
|
1503
|
+
it 'returns the number of claims' do
|
|
1504
|
+
expect(@check_5010[:number_of_claims]).to eq(1)
|
|
1505
|
+
end
|
|
1506
|
+
it 'returns the NPI or Tax ID of payee' do
|
|
1507
|
+
expect(@check_5010[:npi_tax_id]).to eq('0987654321')
|
|
1508
|
+
end
|
|
1509
|
+
it 'returns the Check payee' do
|
|
1510
|
+
expect(@check_5010[:payee]).to eq('XYZ HEALTHCARE CORPORATION')
|
|
1511
|
+
end
|
|
1512
|
+
it 'returns the Payer name' do
|
|
1513
|
+
expect(@check_5010[:payer_name]).to eq('BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA')
|
|
1514
|
+
end
|
|
1515
|
+
it 'returns the Payer address' do
|
|
1516
|
+
expect(@check_5010[:payer_address]).to eq('P O BOX 2291')
|
|
1517
|
+
end
|
|
1518
|
+
it 'returns the Payer city' do
|
|
1519
|
+
expect(@check_5010[:payer_city]).to eq('DURHAM')
|
|
1520
|
+
end
|
|
1521
|
+
it 'returns the Payer state' do
|
|
1522
|
+
expect(@check_5010[:payer_state]).to eq('NC')
|
|
1523
|
+
end
|
|
1524
|
+
it 'returns the Payer zip code' do
|
|
1525
|
+
expect(@check_5010[:payer_zip_code]).to eq('27702')
|
|
1526
|
+
end
|
|
1527
|
+
it 'returns the Payer tax id' do
|
|
1528
|
+
expect(@check_5010[:payer_tax_id]).to eq('60-894904')
|
|
1529
|
+
end
|
|
1530
|
+
it 'returns the Payer EDI id' do
|
|
1531
|
+
expect(@check_5010[:payer_edi_id]).to eq(nil)
|
|
1532
|
+
end
|
|
1533
|
+
it 'returns the Check date (string mm/dd/yyyy)' do
|
|
1534
|
+
expect(@check_5010[:date]).to eq('01/09/2026')
|
|
1535
|
+
end
|
|
1536
|
+
context 'ERA #0' do
|
|
1537
|
+
it 'returns the Patient ID' do
|
|
1538
|
+
expect(@check_5010[:eras][0][:patient_id]).to eq(nil)
|
|
1539
|
+
end
|
|
1540
|
+
it 'returns the Patient name' do
|
|
1541
|
+
expect(@check_5010[:eras][0][:patient_name]).to eq('DOUGH,MARY')
|
|
1542
|
+
end
|
|
1543
|
+
it 'returns the Patient last name (titleized)' do
|
|
1544
|
+
expect(@check_5010[:eras][0][:patient_last_name]).to eq('Dough')
|
|
1545
|
+
end
|
|
1546
|
+
it 'returns the Patient first name (titleized)' do
|
|
1547
|
+
expect(@check_5010[:eras][0][:patient_first_name]).to eq('Mary')
|
|
1548
|
+
end
|
|
1549
|
+
it 'returns the Subscriber last name (titleized)' do
|
|
1550
|
+
expect(@check_5010[:eras][0][:subscriber_first_name]).to eq('Marty')
|
|
1551
|
+
end
|
|
1552
|
+
it 'returns the Subscriber last name (titleized)' do
|
|
1553
|
+
expect(@check_5010[:eras][0][:subscriber_last_name]).to eq('Dough')
|
|
1554
|
+
end
|
|
1555
|
+
it 'returns the Subscriber name (titleized)' do
|
|
1556
|
+
expect(@check_5010[:eras][0][:subscriber_name]).to eq('DOUGH,MARTY')
|
|
1557
|
+
end
|
|
1558
|
+
it 'returns the Subscriber middle initial' do
|
|
1559
|
+
expect(@check_5010[:eras][0][:subscriber_middle_initial]).to eq('L')
|
|
1560
|
+
end
|
|
1561
|
+
it 'returns the Subscriber suffix' do
|
|
1562
|
+
expect(@check_5010[:eras][0][:subscriber_suffix]).to eq('Sr.')
|
|
1563
|
+
end
|
|
1564
|
+
it 'returns the Subscriber ID' do
|
|
1565
|
+
expect(@check_5010[:eras][0][:subscriber_id]).to eq('YPB123456789009')
|
|
1566
|
+
end
|
|
1567
|
+
it 'returns the rendering provider last_name (titleized)' do
|
|
1568
|
+
expect(@check_5010[:eras][0][:rendering_provider_last_name]).to eq('Jones')
|
|
1569
|
+
end
|
|
1570
|
+
it 'returns the rendering provider first name (titleized)' do
|
|
1571
|
+
expect(@check_5010[:eras][0][:rendering_provider_first_name]).to eq('Alice')
|
|
1572
|
+
end
|
|
1573
|
+
it 'returns the rendering provider NPI' do
|
|
1574
|
+
expect(@check_5010[:eras][0][:rendering_provider_npi]).to eq('1116359906')
|
|
1575
|
+
end
|
|
1576
|
+
it 'returns the Total charge amount (integer)' do
|
|
1577
|
+
expect(@check_5010[:eras][0][:charge_amount]).to eq(30000)
|
|
1578
|
+
end
|
|
1579
|
+
it 'returns the Total payment amount (integer)' do
|
|
1580
|
+
expect(@check_5010[:eras][0][:payment_amount]).to eq(15000)
|
|
1581
|
+
end
|
|
1582
|
+
it 'returns the Account number' do
|
|
1583
|
+
expect(@check_5010[:eras][0][:account_number]).to eq('200200964A52')
|
|
1584
|
+
end
|
|
1585
|
+
it 'returns the Claim status code' do
|
|
1586
|
+
expect(@check_5010[:eras][0][:claim_status_code]).to eq('1')
|
|
1587
|
+
end
|
|
1588
|
+
it 'returns the Claim status code description' do
|
|
1589
|
+
expect(@check_5010[:eras][0][:status]).to eq("PROCESSED AS PRIMARY")
|
|
1590
|
+
end
|
|
1591
|
+
it 'returns the Payer claim control number' do
|
|
1592
|
+
expect(@check_5010[:eras][0][:payer_claim_control_number]).to eq('94151100100')
|
|
1593
|
+
end
|
|
1594
|
+
it 'returns the Claim statement period start' do
|
|
1595
|
+
expect(@check_5010[:eras][0][:claim_statement_period_start]).to eq(nil)
|
|
1596
|
+
end
|
|
1597
|
+
it 'returns the Claim statement period end' do
|
|
1598
|
+
expect(@check_5010[:eras][0][:claim_statement_period_end]).to eq(nil)
|
|
1599
|
+
end
|
|
1600
|
+
|
|
1601
|
+
context 'Line item #0' do
|
|
1602
|
+
it 'returns the Date of service (string mm/dd/yyyy)' do
|
|
1603
|
+
expect(@check_5010[:eras][0][:line_items][0][:service_date]).to eq("12/31/2010")
|
|
1604
|
+
end
|
|
1605
|
+
it 'returns the CPT code' do
|
|
1606
|
+
expect(@check_5010[:eras][0][:line_items][0][:cpt_code]).to eq("59430")
|
|
1607
|
+
end
|
|
1608
|
+
it 'returns the Charge amount (integer)' do
|
|
1609
|
+
expect(@check_5010[:eras][0][:line_items][0][:charge_amount]).to eq(10100)
|
|
1610
|
+
end
|
|
1611
|
+
it 'returns the Payment amount (integer)' do
|
|
1612
|
+
expect(@check_5010[:eras][0][:line_items][0][:payment_amount]).to eq(5050)
|
|
1613
|
+
end
|
|
1614
|
+
it 'returns the Total adjustment amount (integer)' do
|
|
1615
|
+
expect(@check_5010[:eras][0][:line_items][0][:total_adjustment_amount]).to eq(5050)
|
|
1616
|
+
end
|
|
1617
|
+
it 'returns the Remark code' do
|
|
1618
|
+
expect(@check_5010[:eras][0][:line_items][0][:remark_code]).to eq(nil)
|
|
1619
|
+
end
|
|
1620
|
+
it 'returns the Remarks' do
|
|
1621
|
+
expect(@check_5010[:eras][0][:line_items][0][:remarks]).to eq(nil)
|
|
1622
|
+
end
|
|
1623
|
+
it 'returns the Reference number' do
|
|
1624
|
+
expect(@check_5010[:eras][0][:line_items][0][:reference_number]).to eq('0001')
|
|
1625
|
+
end
|
|
1626
|
+
context 'Adjustment group #0' do
|
|
1627
|
+
it 'returns the Adjustment group' do
|
|
1628
|
+
expect(@check_5010[:eras][0][:line_items][0][:adjustment_groups][0][:adjustment_group]).to eq("Contractual Obligation")
|
|
1629
|
+
end
|
|
1630
|
+
it 'returns the Adjustment group code' do
|
|
1631
|
+
expect(@check_5010[:eras][0][:line_items][0][:adjustment_groups][0][:adjustment_group_code]).to eq("CO")
|
|
1632
|
+
end
|
|
1633
|
+
it 'returns the Adjustment amount (integer)' do
|
|
1634
|
+
expect(@check_5010[:eras][0][:line_items][0][:adjustment_groups][0][:adjustment_amount]).to eq(2550)
|
|
1635
|
+
end
|
|
1636
|
+
it 'returns the Reason code' do
|
|
1637
|
+
expect(@check_5010[:eras][0][:line_items][0][:adjustment_groups][0][:reason_code]).to eq('42')
|
|
1638
|
+
end
|
|
1639
|
+
it 'returns the Translated reason code' do
|
|
1640
|
+
expect(@check_5010[:eras][0][:line_items][0][:adjustment_groups][0][:translated_reason_code]).to eq("Charges exceed our fee schedule or maximum allowable amount. (Use CARC 45)")
|
|
1641
|
+
end
|
|
1642
|
+
end
|
|
1643
|
+
context 'Adjustment group #1' do
|
|
1644
|
+
it 'returns the Adjustment group' do
|
|
1645
|
+
expect(@check_5010[:eras][0][:line_items][0][:adjustment_groups][1][:adjustment_group]).to eq("Patient Responsibility")
|
|
1646
|
+
end
|
|
1647
|
+
it 'returns the Adjustment group code' do
|
|
1648
|
+
expect(@check_5010[:eras][0][:line_items][0][:adjustment_groups][1][:adjustment_group_code]).to eq("PR")
|
|
1649
|
+
end
|
|
1650
|
+
it 'returns the Adjustment amount (integer)' do
|
|
1651
|
+
expect(@check_5010[:eras][0][:line_items][0][:adjustment_groups][1][:adjustment_amount]).to eq(2500)
|
|
1652
|
+
end
|
|
1653
|
+
it 'returns the Reason code' do
|
|
1654
|
+
expect(@check_5010[:eras][0][:line_items][0][:adjustment_groups][1][:reason_code]).to eq('2')
|
|
1655
|
+
end
|
|
1656
|
+
it 'returns the Translated reason code' do
|
|
1657
|
+
expect(@check_5010[:eras][0][:line_items][0][:adjustment_groups][1][:translated_reason_code]).to eq("Coinsurance Amount")
|
|
1658
|
+
end
|
|
1659
|
+
end
|
|
1660
|
+
end
|
|
1661
|
+
context 'Line item #1' do
|
|
1662
|
+
it 'returns the Date of service (string mm/dd/yyyy)' do
|
|
1663
|
+
expect(@check_5010[:eras][0][:line_items][1][:service_date]).to eq("12/31/2010")
|
|
1664
|
+
end
|
|
1665
|
+
it 'returns the CPT code' do
|
|
1666
|
+
expect(@check_5010[:eras][0][:line_items][1][:cpt_code]).to eq("59440")
|
|
1667
|
+
end
|
|
1668
|
+
it 'returns the Charge amount (integer)' do
|
|
1669
|
+
expect(@check_5010[:eras][0][:line_items][1][:charge_amount]).to eq(10000)
|
|
1670
|
+
end
|
|
1671
|
+
it 'returns the Payment amount (integer)' do
|
|
1672
|
+
expect(@check_5010[:eras][0][:line_items][1][:payment_amount]).to eq(5000)
|
|
1673
|
+
end
|
|
1674
|
+
it 'returns the Total adjustment amount (integer)' do
|
|
1675
|
+
expect(@check_5010[:eras][0][:line_items][1][:total_adjustment_amount]).to eq(5000)
|
|
1676
|
+
end
|
|
1677
|
+
it 'returns the Remark code' do
|
|
1678
|
+
expect(@check_5010[:eras][0][:line_items][1][:remark_code]).to eq(nil)
|
|
1679
|
+
end
|
|
1680
|
+
it 'returns the Remarks' do
|
|
1681
|
+
expect(@check_5010[:eras][0][:line_items][1][:remarks]).to eq(nil)
|
|
1682
|
+
end
|
|
1683
|
+
it 'returns the Reference number' do
|
|
1684
|
+
expect(@check_5010[:eras][0][:line_items][1][:reference_number]).to eq('0002')
|
|
1685
|
+
end
|
|
1686
|
+
context 'Adjustment group #0' do
|
|
1687
|
+
it 'returns the Adjustment group' do
|
|
1688
|
+
expect(@check_5010[:eras][0][:line_items][1][:adjustment_groups][0][:adjustment_group]).to eq("Patient Responsibility")
|
|
1689
|
+
end
|
|
1690
|
+
it 'returns the Adjustment group code' do
|
|
1691
|
+
expect(@check_5010[:eras][0][:line_items][1][:adjustment_groups][0][:adjustment_group_code]).to eq("PR")
|
|
1692
|
+
end
|
|
1693
|
+
it 'returns the Adjustment amount (integer)' do
|
|
1694
|
+
expect(@check_5010[:eras][0][:line_items][1][:adjustment_groups][0][:adjustment_amount]).to eq(5000)
|
|
1695
|
+
end
|
|
1696
|
+
it 'returns the Reason code' do
|
|
1697
|
+
expect(@check_5010[:eras][0][:line_items][1][:adjustment_groups][0][:reason_code]).to eq('3')
|
|
1698
|
+
end
|
|
1699
|
+
it 'returns the Translated reason code' do
|
|
1700
|
+
expect(@check_5010[:eras][0][:line_items][1][:adjustment_groups][0][:translated_reason_code]).to eq("Co-payment Amount")
|
|
1701
|
+
end
|
|
1702
|
+
end
|
|
1703
|
+
end
|
|
1704
|
+
context 'Line item #2' do
|
|
1705
|
+
it 'returns the Date of service (string mm/dd/yyyy)' do
|
|
1706
|
+
expect(@check_5010[:eras][0][:line_items][2][:service_date]).to eq("12/31/2010")
|
|
1707
|
+
end
|
|
1708
|
+
it 'returns the CPT code' do
|
|
1709
|
+
expect(@check_5010[:eras][0][:line_items][2][:cpt_code]).to eq("59426")
|
|
1710
|
+
end
|
|
1711
|
+
it 'returns the Charge amount (integer)' do
|
|
1712
|
+
expect(@check_5010[:eras][0][:line_items][2][:charge_amount]).to eq(9900)
|
|
1713
|
+
end
|
|
1714
|
+
it 'returns the Payment amount (integer)' do
|
|
1715
|
+
expect(@check_5010[:eras][0][:line_items][2][:payment_amount]).to eq(4950)
|
|
1716
|
+
end
|
|
1717
|
+
it 'returns the Total adjustment amount (integer)' do
|
|
1718
|
+
expect(@check_5010[:eras][0][:line_items][2][:total_adjustment_amount]).to eq(4950)
|
|
1719
|
+
end
|
|
1720
|
+
it 'returns the Remark code' do
|
|
1721
|
+
expect(@check_5010[:eras][0][:line_items][2][:remark_code]).to eq(nil)
|
|
1722
|
+
end
|
|
1723
|
+
it 'returns the Remarks' do
|
|
1724
|
+
expect(@check_5010[:eras][0][:line_items][2][:remarks]).to eq(nil)
|
|
1725
|
+
end
|
|
1726
|
+
it 'returns the Reference number' do
|
|
1727
|
+
expect(@check_5010[:eras][0][:line_items][2][:reference_number]).to eq('0003')
|
|
1728
|
+
end
|
|
1729
|
+
end
|
|
1730
|
+
end
|
|
1731
|
+
end
|
|
1732
|
+
end
|
|
887
1733
|
end
|
|
888
1734
|
|
|
889
1735
|
context 'Human readable' do
|
|
@@ -1002,10 +1848,10 @@ Check# Patient ID Last,First Charge Amt
|
|
|
1002
1848
|
it 'returns the Patient name' do
|
|
1003
1849
|
expect(@era[:checks]['201812215555555555'][:eras][0][:patient_name]).to eq('DOE JR,DAVIS')
|
|
1004
1850
|
end
|
|
1005
|
-
it 'returns the Patient last name (
|
|
1851
|
+
it 'returns the Patient last name (titleized)' do
|
|
1006
1852
|
expect(@era[:checks]['201812215555555555'][:eras][0][:patient_last_name]).to eq('Doe Jr')
|
|
1007
1853
|
end
|
|
1008
|
-
it 'returns the Patient first name (
|
|
1854
|
+
it 'returns the Patient first name (titleized)' do
|
|
1009
1855
|
expect(@era[:checks]['201812215555555555'][:eras][0][:patient_first_name]).to eq('Davis')
|
|
1010
1856
|
end
|
|
1011
1857
|
it 'returns the Total charge amount (integer)' do
|
|
@@ -1133,10 +1979,10 @@ Check# Patient ID Last,First Charge Amt
|
|
|
1133
1979
|
it 'returns the Patient name' do
|
|
1134
1980
|
expect(@era[:checks]['201812215555555556'][:eras][0][:patient_name]).to eq('DOE,JANE')
|
|
1135
1981
|
end
|
|
1136
|
-
it 'returns the Patient last name (
|
|
1982
|
+
it 'returns the Patient last name (titleized)' do
|
|
1137
1983
|
expect(@era[:checks]['201812215555555556'][:eras][0][:patient_last_name]).to eq('Doe')
|
|
1138
1984
|
end
|
|
1139
|
-
it 'returns the Patient first name (
|
|
1985
|
+
it 'returns the Patient first name (titleized)' do
|
|
1140
1986
|
expect(@era[:checks]['201812215555555556'][:eras][0][:patient_first_name]).to eq('Jane')
|
|
1141
1987
|
end
|
|
1142
1988
|
it 'returns the Total charge amount (integer)' do
|
|
@@ -1248,10 +2094,10 @@ Check# Patient ID Last,First Charge Amt
|
|
|
1248
2094
|
it 'returns the Patient name' do
|
|
1249
2095
|
expect(@era[:checks]['201812215555555556'][:eras][1][:patient_name]).to eq('SMITH,JOSEPH')
|
|
1250
2096
|
end
|
|
1251
|
-
it 'returns the Patient last name (
|
|
2097
|
+
it 'returns the Patient last name (titleized)' do
|
|
1252
2098
|
expect(@era[:checks]['201812215555555556'][:eras][1][:patient_last_name]).to eq('Smith')
|
|
1253
2099
|
end
|
|
1254
|
-
it 'returns the Patient first name (
|
|
2100
|
+
it 'returns the Patient first name (titleized)' do
|
|
1255
2101
|
expect(@era[:checks]['201812215555555556'][:eras][1][:patient_first_name]).to eq('Joseph')
|
|
1256
2102
|
end
|
|
1257
2103
|
it 'returns the Total charge amount (integer)' do
|
|
@@ -1363,10 +2209,10 @@ Check# Patient ID Last,First Charge Amt
|
|
|
1363
2209
|
it 'returns the Patient name' do
|
|
1364
2210
|
expect(@era[:checks]['201812215555555557'][:eras][0][:patient_name]).to eq('LASTNAME,')
|
|
1365
2211
|
end
|
|
1366
|
-
it 'returns the Patient last name (
|
|
2212
|
+
it 'returns the Patient last name (titleized)' do
|
|
1367
2213
|
expect(@era[:checks]['201812215555555557'][:eras][0][:patient_last_name]).to eq('Lastname')
|
|
1368
2214
|
end
|
|
1369
|
-
it 'returns the Patient first name (
|
|
2215
|
+
it 'returns the Patient first name (titleized)' do
|
|
1370
2216
|
expect(@era[:checks]['201812215555555557'][:eras][0][:patient_first_name]).to eq(nil)
|
|
1371
2217
|
end
|
|
1372
2218
|
it 'returns the Total charge amount (integer)' do
|
|
@@ -1450,10 +2296,10 @@ Check# Patient ID Last,First Charge Amt
|
|
|
1450
2296
|
it 'returns the Patient name' do
|
|
1451
2297
|
expect(@era[:checks]['201812215555555557'][:eras][1][:patient_name]).to eq('WORLD,HELLO')
|
|
1452
2298
|
end
|
|
1453
|
-
it 'returns the Patient last name (
|
|
2299
|
+
it 'returns the Patient last name (titleized)' do
|
|
1454
2300
|
expect(@era[:checks]['201812215555555557'][:eras][1][:patient_last_name]).to eq('World')
|
|
1455
2301
|
end
|
|
1456
|
-
it 'returns the Patient first name (
|
|
2302
|
+
it 'returns the Patient first name (titleized)' do
|
|
1457
2303
|
expect(@era[:checks]['201812215555555557'][:eras][1][:patient_first_name]).to eq('Hello')
|
|
1458
2304
|
end
|
|
1459
2305
|
it 'returns the Total charge amount (integer)' do
|