trizetto-api 0.1.1 → 0.1.2
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- 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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@@ -20,24 +20,11 @@ Or install it yourself as:
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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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-
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require 'trizetto/api'
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-
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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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@@ -60,9 +47,33 @@ response = client.do_inquiry({
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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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@@ -84,6 +95,8 @@ response = client.ping
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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
CHANGED
metadata
CHANGED
@@ -1,14 +1,14 @@
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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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