trizetto-api 0.2.2 → 0.2.3

checksums.yaml

@@ -1,7 +1,7 @@
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data/CHANGELOG.md

@@ -1,3 +1,17 @@
+## 0.2.3 (Feb 02, 2018) ##
+
+* Add helpers for extracting the group number and plan number from either a
+  subscriber or dependent node in the response.  As a remdiner, the patient is
+  the dependent if present, or the subscriber.  Depending on the payer, the
+  group number might be in the subscriber or in the dependent, you can't rely
+  on it being in the subscriber 100%.  You need to check both, starting with the
+  dependent to get the group number. `dependent&.group_number || subscriber&.group_number`
+* Parse subscriber additional information (subscriberaddinfo) into the patient
+  note.  For some payers, they put subscriberaddinfo in the dependent, so its
+  present in both subscribers and dependents.
+* Turn the subscriberid node into an id.  This seems to be the member number for
+  the insurance so make it easy to get
+
 ## 0.2.2 (January 19, 2018) ##
 
 * The response from the DoInquiry eligiblity check now captures the raw XML and

data/Gemfile.lock

@@ -1,7 +1,7 @@
 PATH
   remote: .
   specs:
-    trizetto-api (0.2.1)
+    trizetto-api (0.2.3)
       savon (~> 2.0)
       savon-multipart (~> 2.0)
 

data/README.md

@@ -50,7 +50,7 @@ To simply check if the patient is covered by a health plan
 
 ```ruby
 response = client.do_inquiry({...})
-response.active_coverage_for?("30`")  #=> true | false
+response.active_coverage_for?("30")  #=> true | false
 ```
 
 ```ruby
@@ -92,14 +92,20 @@ response.trace_number               # => "88213481"
 response.payer_name                 # => "BLUE CROSS BLUE SHIELD OF MASSACHUSETTS"
 response.active_coverage_for?("30") # => true
 
+# Did the response have group number for the subscriber or dependent?
+response.subscriber&.group_number || response.dependent&.group_number  # =>999999999A6AG999
+
+# What is the subscriber's member number?
+response.subscriber.id  # => XXP123456789
+
 # Was the response rejected? We got back an eligibility response, but probably the patient wasn't found
 response.success?                           # => true
 response.success_code                       # => "Success"
 response.active_coverage_for?("30")         # => false
 response.rejected?                          # => true
-response.rejectsions.count                  # => 1
-response.rejectsions.first.reason           # => "Patient Birth Date Does Not Match That for the Patient on the Database"
-response.rejectsions.first.follow_up_action # => "Please Correct and Resubmit"
+response.rejections.count                  # => 1
+response.rejections.first.reason           # => "Patient Birth Date Does Not Match That for the Patient on the Database"
+response.rejections.first.follow_up_action # => "Please Correct and Resubmit"
 
 # What active insurance coverages of service_type_code=30 does this patient have?
 coverages = response.patient.benefits.select {|benefit| benefit.active_coverage? && benefit.service_type_codes.include?("30")}

data/lib/trizetto/api/eligibility/web_service/additional_info.rb

@@ -0,0 +1,16 @@
+module Trizetto
+  module Api
+    module Eligibility
+      module WebService
+        class AdditionalInfo < Node
+          KEY_CLEANUP = {
+            subsupplementalid: :id,
+            grouppolicynum:    :group_policy_number,
+            plansponsorname:   :plan_sponsor_name,
+          }
+        end
+      end
+    end
+  end
+end
+

data/lib/trizetto/api/eligibility/web_service/patient.rb

@@ -49,6 +49,37 @@ module Trizetto
                 traces[id.upcase] = trace_numbers[index]
               end
             end
+
+            if self.subscriberaddinfo.is_a?(Hash)
+              self.subscriberaddinfo = [self.subscriberaddinfo]
+            end
+
+            self.additional_info = self.subscriberaddinfo&.map do |additional_info_hash|
+              AdditionalInfo.new(additional_info_hash)
+            end || []
+          end
+
+          # Looks in the additional info returned with the patient for a group number
+          #
+          # The group number is the additinal infomation node with a id of 6P
+          # or Group Number.
+          #
+          # @see https://www.eedi.net/4010/278004010X094A1%5C29_278004010X094A1.htm
+          #
+          # @return [String]
+          def group_number
+            # it seems 6P is group number
+            self.additional_info.detect do |additional_info|
+              ["6P", "Group Number"].include?(additional_info.id)
+            end&.group_policy_number
+          end
+
+          # Looks in the additional info returned with the patient for a group number
+          # @return [String]
+          def plan_number
+            self.additional_info.detect do |additional_info|
+              additional_info.id == "Plan Number"
+            end&.group_policy_number
           end
 
           # Looks for a trace number by trace_id (who added the trace).

data/lib/trizetto/api/eligibility/web_service/subscriber.rb

@@ -22,6 +22,8 @@ module Trizetto
                 end
               end
             end
+
+            clean_hash[:id] = clean_hash.delete(:subscriberid) if clean_hash.has_key?(:subscriberid)
             super(clean_hash)
           end
         end

data/lib/trizetto/api/version.rb

@@ -1,5 +1,5 @@
 module Trizetto
   module Api
-    VERSION = "0.2.2"
+    VERSION = "0.2.3"
   end
 end

metadata

@@ -1,14 +1,14 @@
 --- !ruby/object:Gem::Specification
 name: trizetto-api
 version: !ruby/object:Gem::Version
-  version: 0.2.2
+  version: 0.2.3
 platform: ruby
 authors:
 - John Naegle
 autorequire: 
 bindir: exe
 cert_chain: []
-date: 2018-01-19 00:00:00.000000000 Z
+date: 2018-02-02 00:00:00.000000000 Z
 dependencies:
 - !ruby/object:Gem::Dependency
   name: bundler
@@ -121,6 +121,7 @@ files:
 - lib/trizetto/api/eligibility/core2.wsdl
 - lib/trizetto/api/eligibility/web_service.rb
 - lib/trizetto/api/eligibility/web_service.wsdl
+- lib/trizetto/api/eligibility/web_service/additional_info.rb
 - lib/trizetto/api/eligibility/web_service/benefit.rb
 - lib/trizetto/api/eligibility/web_service/benefit_entity.rb
 - lib/trizetto/api/eligibility/web_service/dependent.rb