trizetto-api 0.1.1 → 0.1.2
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/CHANGELOG.md +5 -0
- data/README.md +29 -16
- data/lib/trizetto/api/eligibility/core2.rb +0 -22
- data/lib/trizetto/api/eligibility/web_service.rb +26 -1
- data/lib/trizetto/api/payer_list/web_service.rb +14 -0
- data/lib/trizetto/api/version.rb +1 -1
- metadata +2 -2
checksums.yaml
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---
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SHA1:
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metadata.gz:
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data.tar.gz:
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metadata.gz: e4fbff1ea29b8ff7be9a59a73684fbf34b4c4418
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data.tar.gz: 6697e7baa4a73b991efb4462f880466ae5fbc858
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SHA512:
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metadata.gz:
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metadata.gz: eedcb3a711f90fdf8a1be47b85de37f4df7c4adcc55aba3ac3a387a362262f48da504bd7ad8144226789c8ed63afe155fff8cbd77af575a75ef953bb8e76807b
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data.tar.gz: e9a45666b41c6cfd81f5b673f2aec1504021273a14db19b0e18cb3d682526c9899f18efe895b9062a2492b11d73bb08b2abd018fb98a89cf5a2c51a06a32682a
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data/CHANGELOG.md
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## 0.1.2 (January 12, 2018) ##
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* Have the non-COR II Eligiblity check return an XML document. YAY! We can
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parse and understand XML without having to understand X12.
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## 0.1.1 (January 11, 2018) ##
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* Initial implementation of 5 Trizetto API endpoints: Eligibility check with
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data/README.md
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## Usage
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### Use the CORE2 API with an X12 payload to check eligibility in realtime
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```ruby
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require 'trizetto/api'
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Trizetto::Api.configure do |config|
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config.username = 'Not the real username'
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config.password = 'Super Top Secret'
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end
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client = Trizetto::Api::Eligibility::Core2.new
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client.check_eligibility(payload: x12_message)
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```
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### Use the Eligibility Web Service with an XML payload to check eligibility in realtime
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This uses name/value pairs in a request and returns an XML docunment as a response.
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You can force this API to return an X12 document if you like pain.
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```ruby
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require 'trizetto/api'
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'InsuredDob': '19281118',
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'GediPayerId': 'N4222',
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})
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puts response.to_hash[:do_inquiry_response][:do_inquiry_result][:success_code]
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source = response.to_hash[:do_inquiry_response][:do_inquiry_result][:response_as_xml]
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puts Nokogiri::XML(source).to_xml
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```
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### Use the CORE2 API with an X12 payload to check eligibility in realtime
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This returns an X12/271 response. You will need to understand how to build
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X12/270 requests and parse X12/271 responses.
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```ruby
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require 'trizetto/api'
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Trizetto::Api.configure do |config|
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config.username = 'Not the real username'
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config.password = 'Super Top Secret'
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end
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client = Trizetto::Api::Eligibility::Core2.new
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client.check_eligibility(payload: x12_message)
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```
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### Ping the Payer List endpoint to see if it is up
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```ruby
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### Fetch the Payer List
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This API times out or errors out on the Trizetto server. But you may get it to work.
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```ruby
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require 'trizetto/api'
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# TODO: Understand the X12 format and allow options to be passed in, then generate the X12 message
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#
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# Required Field:
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# +ProviderLastName+ - Provider Last Name/Organization Name
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# +NPI+ - National Provider Identifier
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#
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# Situational Fields:
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#
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# +ProviderFirstName+ - Provider First Name
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# +InsuredFirstName+ - Subscriber First Name
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# +InsuredLastName+ - Subscriber Last Name
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# +InsuranceNum+ - Subscriber Id
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# +InsuredDob+ - Subscriber DOB
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# +InsuredGender+ - Subscriber Gender
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# +DependentFirstName+ - Dependent First Name
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# +DependentLastName+ - Dependent Last Name
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# +DependentDob+ - Dependent DOB
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# +DependentGender+ - Dependent Gender
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#
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# Note: Some payers require additional information than those listed above. Please refer to the
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# companion guide for the additional parameters required by few payers. A valid inquiry submitted
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# to those payers must also account for the additional payer specific parameters. “InsuranceNum,” in
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# particular, is not a required field for all transactions, but is required by almost all payers.
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#
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def check_eligibility(options = {})
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@client.call(:real_time_transaction, message: {
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'PayloadType': 'X12_270_Request_005010X279A1',
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}))
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end
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# Required Field:
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# +GediPayerId+ - The Gateway EDI specific payer identifier
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# +ProviderLastName+ - Provider Last Name/Organization Name
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# +NPI+ - National Provider Identifier
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#
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# Situational Fields:
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#
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# +ProviderFirstName+ - Provider First Name
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# +InsuredFirstName+ - Subscriber First Name
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# +InsuredLastName+ - Subscriber Last Name
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# +InsuranceNum+ - Subscriber Id
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# +InsuredDob+ - Subscriber DOB
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# +InsuredGender+ - Subscriber Gender
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# +DependentFirstName+ - Dependent First Name
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# +DependentLastName+ - Dependent Last Name
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# +DependentDob+ - Dependent DOB
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# +DependentGender+ - Dependent Gender
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#
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# Note: Some payers require additional information than those listed above. Please refer to the
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# companion guide for the additional parameters required by few payers. A valid inquiry submitted
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# to those payers must also account for the additional payer specific parameters. “InsuranceNum,” in
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# particular, is not a required field for all transactions, but is required by almost all payers.
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#
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# See Also:
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#
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# - Service Description: https://services.gatewayedi.com/eligibility/service.asmx?op=DoInquiry
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def do_inquiry(parameters={})
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@client.call(:do_inquiry, message: { 'Inquiry': {
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@client.call(:do_inquiry, message: { 'Inquiry': {
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'ResponseDataType': 'Xml',
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'Parameters': {
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'MyNameValue': parameters.map do |name, value|
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{'Name': name, 'Value': value}
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end
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# Retrieves all Gateway EDI recognized payers along with their supported transaction types and
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# servicing states and links to their enrollment documentation, if it exists.
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#
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# The service provides the following information for each payer
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# Type – HCFA or UB.
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# - Payer ID – The Gateway EDI payer identification number.
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# - Payer Name – The payer name.
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# - Nation Wide – Yes or No.
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# - Servicing States – List of supported states.
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# - Supported Transactions – List of supported transactions.
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# -- Description – A description of the available transactions. Transaction include Claims, Real-time Claim Status, Remittance Advice, Real-time Eligibility, and Electronic COB.
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# -- Enrollment Required – Yes or No.
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# -- Enrollment Agreement – A http link to the enrollment documentation.
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# -- Authorization Required – Yes or No.
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# - Provider ID Required – Yes or No.
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# - NPI Enabled – Yes or No.
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# - Last Date Modified – Last date that payer information was modified.
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# Note: You probably need to set a long timeout to make this call
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def payer_list
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@client.call(:get_xml_payer_list, message: {})
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data/lib/trizetto/api/version.rb
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metadata
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--- !ruby/object:Gem::Specification
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name: trizetto-api
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version: !ruby/object:Gem::Version
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version: 0.1.
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version: 0.1.2
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platform: ruby
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authors:
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- John Naegle
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autorequire:
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bindir: exe
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cert_chain: []
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date: 2018-01-
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date: 2018-01-12 00:00:00.000000000 Z
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dependencies:
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- !ruby/object:Gem::Dependency
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name: bundler
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