trizetto-api 0.1.1

checksums.yaml

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+SHA1:
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+  data.tar.gz: f88c0595014114ef36f32ea4557bfc69914e9463
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data/.gitignore

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+/.bundle/
+/.yardoc
+/_yardoc/
+/coverage/
+/doc/
+/pkg/
+/spec/reports/
+/tmp/
+
+# rspec failure tracking
+.rspec_status

data/.rspec

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+--format documentation
+--color
+--require spec_helper

data/.travis.yml

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+sudo: false
+language: ruby
+rvm:
+  - 2.3.1
+before_install: gem install bundler -v 1.16.0

data/CHANGELOG.md

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+## 0.1.1 (January 11, 2018) ##
+
+* Initial implementation of 5 Trizetto API endpoints: Eligibility check with
+  CORE II, Eligibility check via web service, ping the service, download the
+  payer list, and get a document link to an enrollment form.
+* Current implementation is just a thin wrapper - you will have to parse the result
+* No X12 serialization/deserization yet - you must craft and decode X12 messages
+  to use the eligibility API
+* The payer list endpoint seems to either timeout or error on the Trizetto Server
+

data/CODE_OF_CONDUCT.md

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+# Contributor Covenant Code of Conduct
+
+## Our Pledge
+
+In the interest of fostering an open and welcoming environment, we as
+contributors and maintainers pledge to making participation in our project and
+our community a harassment-free experience for everyone, regardless of age, body
+size, disability, ethnicity, gender identity and expression, level of experience,
+nationality, personal appearance, race, religion, or sexual identity and
+orientation.
+
+## Our Standards
+
+Examples of behavior that contributes to creating a positive environment
+include:
+
+* Using welcoming and inclusive language
+* Being respectful of differing viewpoints and experiences
+* Gracefully accepting constructive criticism
+* Focusing on what is best for the community
+* Showing empathy towards other community members
+
+Examples of unacceptable behavior by participants include:
+
+* The use of sexualized language or imagery and unwelcome sexual attention or
+advances
+* Trolling, insulting/derogatory comments, and personal or political attacks
+* Public or private harassment
+* Publishing others' private information, such as a physical or electronic
+  address, without explicit permission
+* Other conduct which could reasonably be considered inappropriate in a
+  professional setting
+
+## Our Responsibilities
+
+Project maintainers are responsible for clarifying the standards of acceptable
+behavior and are expected to take appropriate and fair corrective action in
+response to any instances of unacceptable behavior.
+
+Project maintainers have the right and responsibility to remove, edit, or
+reject comments, commits, code, wiki edits, issues, and other contributions
+that are not aligned to this Code of Conduct, or to ban temporarily or
+permanently any contributor for other behaviors that they deem inappropriate,
+threatening, offensive, or harmful.
+
+## Scope
+
+This Code of Conduct applies both within project spaces and in public spaces
+when an individual is representing the project or its community. Examples of
+representing a project or community include using an official project e-mail
+address, posting via an official social media account, or acting as an appointed
+representative at an online or offline event. Representation of a project may be
+further defined and clarified by project maintainers.
+
+## Enforcement
+
+Instances of abusive, harassing, or otherwise unacceptable behavior may be
+reported by contacting the project team at john.naegle@goodmeasures.com. All
+complaints will be reviewed and investigated and will result in a response that
+is deemed necessary and appropriate to the circumstances. The project team is
+obligated to maintain confidentiality with regard to the reporter of an incident.
+Further details of specific enforcement policies may be posted separately.
+
+Project maintainers who do not follow or enforce the Code of Conduct in good
+faith may face temporary or permanent repercussions as determined by other
+members of the project's leadership.
+
+## Attribution
+
+This Code of Conduct is adapted from the [Contributor Covenant][homepage], version 1.4,
+available at [http://contributor-covenant.org/version/1/4][version]
+
+[homepage]: http://contributor-covenant.org
+[version]: http://contributor-covenant.org/version/1/4/

data/Gemfile

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+source "https://rubygems.org"
+
+git_source(:github) {|repo_name| "https://github.com/#{repo_name}" }
+
+# Specify your gem's dependencies in trizetto-api.gemspec
+gemspec

data/Gemfile.lock

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+PATH
+  remote: .
+  specs:
+    trizetto-api (0.1.1)
+      savon (~> 2.0)
+      savon-multipart (~> 2.0)
+
+GEM
+  remote: https://rubygems.org/
+  specs:
+    akami (1.3.1)
+      gyoku (>= 0.4.0)
+      nokogiri
+    builder (3.2.3)
+    diff-lcs (1.3)
+    gyoku (1.3.1)
+      builder (>= 2.1.2)
+    httpi (2.4.2)
+      rack
+      socksify
+    mail (2.5.5)
+      mime-types (~> 1.16)
+      treetop (~> 1.4.8)
+    mime-types (1.25.1)
+    mini_portile2 (2.3.0)
+    nokogiri (1.8.1)
+      mini_portile2 (~> 2.3.0)
+    nori (2.6.0)
+    polyglot (0.3.5)
+    rack (2.0.3)
+    rake (10.5.0)
+    rspec (3.7.0)
+      rspec-core (~> 3.7.0)
+      rspec-expectations (~> 3.7.0)
+      rspec-mocks (~> 3.7.0)
+    rspec-core (3.7.1)
+      rspec-support (~> 3.7.0)
+    rspec-expectations (3.7.0)
+      diff-lcs (>= 1.2.0, < 2.0)
+      rspec-support (~> 3.7.0)
+    rspec-mocks (3.7.0)
+      diff-lcs (>= 1.2.0, < 2.0)
+      rspec-support (~> 3.7.0)
+    rspec-support (3.7.0)
+    savon (2.11.2)
+      akami (~> 1.2)
+      builder (>= 2.1.2)
+      gyoku (~> 1.2)
+      httpi (~> 2.3)
+      nokogiri (>= 1.4.0)
+      nori (~> 2.4)
+      wasabi (~> 3.4)
+    savon-multipart (2.1.1)
+      mail (~> 2.5.4)
+      savon (~> 2)
+    socksify (1.7.1)
+    treetop (1.4.15)
+      polyglot
+      polyglot (>= 0.3.1)
+    wasabi (3.5.0)
+      httpi (~> 2.0)
+      nokogiri (>= 1.4.2)
+
+PLATFORMS
+  ruby
+
+DEPENDENCIES
+  bundler (~> 1.16)
+  rake (~> 10.0)
+  rspec (~> 3.0)
+  trizetto-api!
+
+BUNDLED WITH
+   1.16.0

data/LICENSE.txt

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+The MIT License (MIT)
+
+Copyright (c) 2018 John Naegle
+
+Permission is hereby granted, free of charge, to any person obtaining a copy
+of this software and associated documentation files (the "Software"), to deal
+in the Software without restriction, including without limitation the rights
+to use, copy, modify, merge, publish, distribute, sublicense, and/or sell
+copies of the Software, and to permit persons to whom the Software is
+furnished to do so, subject to the following conditions:
+
+The above copyright notice and this permission notice shall be included in
+all copies or substantial portions of the Software.
+
+THE SOFTWARE IS PROVIDED "AS IS", WITHOUT WARRANTY OF ANY KIND, EXPRESS OR
+IMPLIED, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF MERCHANTABILITY,
+FITNESS FOR A PARTICULAR PURPOSE AND NONINFRINGEMENT. IN NO EVENT SHALL THE
+AUTHORS OR COPYRIGHT HOLDERS BE LIABLE FOR ANY CLAIM, DAMAGES OR OTHER
+LIABILITY, WHETHER IN AN ACTION OF CONTRACT, TORT OR OTHERWISE, ARISING FROM,
+OUT OF OR IN CONNECTION WITH THE SOFTWARE OR THE USE OR OTHER DEALINGS IN
+THE SOFTWARE.

data/README.md

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+# Trizetto::Api
+
+Ruby wrapper for Trizetto APIs
+
+## Installation
+
+Add this line to your application's Gemfile:
+
+```ruby
+gem 'trizetto-api'
+```
+
+And then execute:
+
+    $ bundle
+
+Or install it yourself as:
+
+    $ gem install trizetto-api
+
+## Usage
+
+### Use the CORE2 API with an X12 payload to check eligibility in realtime
+
+```ruby
+
+require 'trizetto/api'
+
+Trizetto::Api.configure do |config|
+  config.username = 'Not the real username'
+  config.password = 'Super Top Secret'
+end
+
+
+client = Trizetto::Api::Eligibility::Core2.new
+client.check_eligibility(payload: x12_message)
+```
+
+### Use the Eligibility Web Service with an XML payload to check eligibility in realtime
+
+```ruby
+require 'trizetto/api'
+
+Trizetto::Api.configure do |config|
+  config.username = 'Not the real username'
+  config.password = 'Super Top Secret'
+end
+
+
+client = Trizetto::Api::Eligibility::WebService.new({
+  pretty_print_xml: true,
+  log: true,
+  log_level: :debug,
+})
+response = client.do_inquiry({
+  'ProviderLastName': 'BLUE CROSS BLUE SHIELD OF MASSACHUSETTS',
+  'NPI':              'YOUR NPI HERE',
+  'InsuredFirstName': 'Mickey',
+  'InsuredLastName':  'Mouse',
+  'InsuredDob':       '19281118',
+  'GediPayerId':      'N4222',
+})
+```
+
+
+### Ping the Payer List endpoint to see if it is up
+
+```ruby
+require 'trizetto/api'
+
+Trizetto::Api.configure do |config|
+  config.username = 'Not the real username'
+  config.password = 'Super Top Secret'
+end
+
+client = Trizetto::Api::PayerList::WebService.new({
+  pretty_print_xml: true,
+  log: true,
+  log_level: :debug,
+})
+
+response = client.ping
+```
+
+### Fetch the Payer List
+
+```ruby
+require 'trizetto/api'
+
+Trizetto::Api.configure do |config|
+  config.username = 'Not the real username'
+  config.password = 'Super Top Secret'
+end
+
+client = Trizetto::Api::PayerList::WebService.new({
+  pretty_print_xml: true,
+  log: true,
+  log_level: :debug,
+  read_timeout: 60*5 # 5 minutes
+})
+
+response = client.payer_list
+
+```
+
+## Development
+
+After checking out the repo, run `bin/setup` to install dependencies. Then, run `rake spec` to run the tests. You can also run `bin/console` for an interactive prompt that will allow you to experiment.
+
+To install this gem onto your local machine, run `bundle exec rake install`. To release a new version, update the version number in `version.rb`, and then run `bundle exec rake release`, which will create a git tag for the version, push git commits and tags, and push the `.gem` file to [rubygems.org](https://rubygems.org).
+
+## Contributing
+
+Bug reports and pull requests are welcome on GitHub at https://github.com/GoodMeasuresLLC/trizetto-api. This project is intended to be a safe, welcoming space for collaboration, and contributors are expected to adhere to the [Contributor Covenant](http://contributor-covenant.org) code of conduct.
+
+## License
+
+The gem is available as open source under the terms of the [MIT License](https://opensource.org/licenses/MIT).
+
+## Code of Conduct
+
+Everyone interacting in the Trizetto::Api project’s codebases, issue trackers, chat rooms and mailing lists is expected to follow the [code of conduct](https://github.com/GoodMeasuresLLC/trizetto-api/blob/master/CODE_OF_CONDUCT.md).

data/Rakefile

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+require "bundler/gem_tasks"
+require "rspec/core/rake_task"
+
+RSpec::Core::RakeTask.new(:spec)
+
+task :default => :spec

data/bin/console

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+#!/usr/bin/env ruby
+
+require "bundler/setup"
+require "trizetto/api"
+
+# You can add fixtures and/or initialization code here to make experimenting
+# with your gem easier. You can also use a different console, if you like.
+
+# (If you use this, don't forget to add pry to your Gemfile!)
+# require "pry"
+# Pry.start
+
+require "irb"
+IRB.start(__FILE__)

data/bin/setup

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+#!/usr/bin/env bash
+set -euo pipefail
+IFS=$'\n\t'
+set -vx
+
+bundle install
+
+# Do any other automated setup that you need to do here

data/lib/trizetto/api.rb

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+require "trizetto/api/version"
+require "trizetto/api/configuration"
+require "trizetto/api/web_service"
+
+require "trizetto/api/eligibility"
+require "trizetto/api/payer_list/web_service"

data/lib/trizetto/api/configuration.rb

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+module Trizetto
+  module Api
+    class << self
+      attr_accessor :configuration
+    end
+
+    def self.configure
+      self.configuration ||= Configuration.new
+      yield(configuration)
+    end
+
+    class Configuration
+      attr_accessor :username
+      attr_accessor :password
+      attr_accessor :eligibility_core2_endpoint
+      attr_accessor :eligibiltiy_webservice_endpoint
+      attr_accessor :payer_list_webservice_endpoint
+      def initialize
+        @eligibility_core2_endpoint      = "https://api.gatewayedi.com/v2/CORE_CAQH/soap"
+        @eligibiltiy_webservice_endpoint = "https://services.gatewayedi.com/eligibility/service.asmx"
+        @payer_list_webservice_endpoint  = "https://services.gatewayedi.com/PayerList/PayerList.asmx"
+      end
+    end
+  end
+end

data/lib/trizetto/api/eligibility.rb

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+require "trizetto/api/eligibility/core2"
+require "trizetto/api/eligibility/web_service"
+

data/lib/trizetto/api/eligibility/core2.rb

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+require 'savon-multipart'
+
+module Trizetto
+  module Api
+    module Eligibility
+
+      # Ruby Wrapper for the CORE II Eligibility API
+      #
+      # Performs a real-time eligibility check using the CORE II SOAP API.  This
+      # API provides an X12/270 request and receives an X12/271 response.
+      #
+      # As of right now, you have to generate the correct X12/271 payload.
+      #
+      # See Also
+      #
+      # - Eligibility 270/271 Companion Guide: https://mytools.gatewayedi.com/webcontent/Eligibility_Companion_Guide.pdf
+      #
+      class Core2
+        def initialize(options={})
+          @client = Savon.client({
+            # We use a local WSDL for 1) speed and 2) the remote wsdl had a target
+            # namespace that Savon consumed (SOAP UI did not).  I changed
+            # targetNamespace in the WSDL to "http://www.caqh.org/SOAP/WSDL/CORERule2.2.0.xsd"
+            # from "http://www.caqh.org/SOAP/WSDL/".  With that one simple change,
+            # Savon is able to generate a SOAP requests that Trizetto accepts.
+            # without that, you get back a 500 error and no information giving
+            # insite into the error.
+            wsdl:        File.join( File.dirname(__FILE__), 'core2.wsdl' ),
+
+            endpoint:    Trizetto::Api.configuration.eligibility_core2_endpoint,
+
+            # Digest authentication is not supported :(
+            wsse_auth:   [Trizetto::Api.configuration.username, Trizetto::Api.configuration.password],
+
+            # SOAP Version 1 sends the wrong content type header and you get back a 415 response
+            soap_version: 2,
+
+            # API maybe case sensitive - im not sure
+            convert_request_keys_to: :camelcase,
+
+            # This removes the namespace prefix in the request body nodes
+            #   <CORE-XSD:PayloadType>X12_270_Request_005010X279A1</CORE-XSD:PayloadType>
+            #   becomes:
+            #   <PayloadType>X12_270_Request_005010X279A1</PayloadType>
+            # Without this option, you get back erros like: Payload Type Required
+            element_form_default: :unqualified,
+
+            # Lots of PHI, so lets not log anything
+            log: false,
+
+            # We get back multipart responses.  You have to tell Savon that its
+            # multipart, it doesn't just figure it out
+            multipart: true,
+
+          }.merge(options))
+        end
+
+
+        # TODO: Understand the X12 format and allow options to be passed in, then generate the X12 message
+        #
+        # Required Field:
+        #   +ProviderLastName+   - Provider Last Name/Organization Name
+        #   +NPI+                - National Provider Identifier
+        #
+        # Situational Fields:
+        #
+        #   +ProviderFirstName+  - Provider First Name
+        #   +InsuredFirstName+   - Subscriber First Name
+        #   +InsuredLastName+    - Subscriber Last Name
+        #   +InsuranceNum+       - Subscriber Id
+        #   +InsuredDob+         - Subscriber DOB
+        #   +InsuredGender+      - Subscriber Gender
+        #   +DependentFirstName+ - Dependent First Name
+        #   +DependentLastName+  - Dependent Last Name
+        #   +DependentDob+       - Dependent DOB
+        #   +DependentGender+    - Dependent Gender
+        #
+        # Note: Some payers require additional information than those listed above. Please refer to the
+        # companion guide for the additional parameters required by few payers. A valid inquiry submitted
+        # to those payers must also account for the additional payer specific parameters. “InsuranceNum,” in
+        # particular, is not a required field for all transactions, but is required by almost all payers.
+        #
+        def check_eligibility(options = {})
+        @client.call(:real_time_transaction, message: {
+          'PayloadType': 'X12_270_Request_005010X279A1',
+          'ProcessingMode': 'RealTime',
+          'PayloadID': SecureRandom.uuid,
+          'TimeStamp': Time.now.utc.xmlschema,
+          'SenderID': Trizetto::Api.configuration.username,
+          'ReceiverID': 'GATEWAY EDI',
+          'CORERuleVersion': '2.2.0',
+          'Payload': options[:payload]
+        });
+        end
+      end
+    end
+  end
+end