vericred_client 0.0.21 → 0.0.23
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- checksums.yaml +4 -4
- data/LICENSE +201 -0
- data/README.md +204 -8
- data/docs/CarrierGroupsApi.md +3 -3
- data/docs/CarrierVerificationPlansApi.md +1 -1
- data/docs/CarriersApi.md +3 -3
- data/docs/DentalPlansApi.md +4 -4
- data/docs/DrugCoveragesApi.md +4 -4
- data/docs/DrugPackagesApi.md +2 -2
- data/docs/DrugsApi.md +2 -2
- data/docs/EmbargoesApi.md +3 -3
- data/docs/FormulariesApi.md +3 -3
- data/docs/IssuersApi.md +3 -3
- data/docs/MedicalPlansApi.md +3 -3
- data/docs/NetworkSizesApi.md +2 -2
- data/docs/NetworksApi.md +1 -1
- data/docs/PlansApi.md +3 -3
- data/docs/ProviderNotificationSubscriptionsApi.md +2 -2
- data/docs/ProvidersApi.md +1 -1
- data/docs/RatesApi.md +3 -3
- data/docs/VisionPlansApi.md +4 -4
- data/docs/ZipCountiesApi.md +2 -2
- data/lib/vericred_client/api/carrier_groups_api.rb +226 -17
- data/lib/vericred_client/api/carrier_verification_plans_api.rb +217 -8
- data/lib/vericred_client/api/carriers_api.rb +226 -17
- data/lib/vericred_client/api/dental_plans_api.rb +234 -23
- data/lib/vericred_client/api/drug_coverages_api.rb +221 -12
- data/lib/vericred_client/api/drug_packages_api.rb +218 -11
- data/lib/vericred_client/api/drugs_api.rb +217 -8
- data/lib/vericred_client/api/embargoes_api.rb +226 -17
- data/lib/vericred_client/api/formularies_api.rb +216 -5
- data/lib/vericred_client/api/issuers_api.rb +226 -17
- data/lib/vericred_client/api/medical_plans_api.rb +236 -21
- data/lib/vericred_client/api/network_sizes_api.rb +225 -14
- data/lib/vericred_client/api/networks_api.rb +234 -23
- data/lib/vericred_client/api/plans_api.rb +244 -27
- data/lib/vericred_client/api/provider_notification_subscriptions_api.rb +233 -12
- data/lib/vericred_client/api/providers_api.rb +246 -25
- data/lib/vericred_client/api/rates_api.rb +226 -17
- data/lib/vericred_client/api/vision_plans_api.rb +234 -23
- data/lib/vericred_client/api/zip_counties_api.rb +229 -10
- data/lib/vericred_client/api_client.rb +257 -69
- data/lib/vericred_client/api_error.rb +214 -9
- data/lib/vericred_client/configuration.rb +209 -8
- data/lib/vericred_client/models/aca_plan.rb +211 -4
- data/lib/vericred_client/models/aca_plan2018.rb +211 -4
- data/lib/vericred_client/models/aca_plan2018_search_response.rb +211 -4
- data/lib/vericred_client/models/aca_plan2018_search_result.rb +211 -4
- data/lib/vericred_client/models/aca_plan2018_show_response.rb +211 -4
- data/lib/vericred_client/models/aca_plan_pre2018.rb +211 -4
- data/lib/vericred_client/models/aca_plan_pre2018_search_response.rb +211 -4
- data/lib/vericred_client/models/aca_plan_pre2018_search_result.rb +211 -4
- data/lib/vericred_client/models/aca_plan_pre2018_show_response.rb +211 -4
- data/lib/vericred_client/models/base.rb +211 -4
- data/lib/vericred_client/models/base_plan_search_response.rb +211 -4
- data/lib/vericred_client/models/carrier.rb +211 -4
- data/lib/vericred_client/models/carrier_group_request.rb +211 -4
- data/lib/vericred_client/models/carrier_request.rb +211 -4
- data/lib/vericred_client/models/carrier_subsidiary.rb +211 -4
- data/lib/vericred_client/models/county.rb +211 -4
- data/lib/vericred_client/models/county_bulk.rb +211 -4
- data/lib/vericred_client/models/dental_plan.rb +211 -4
- data/lib/vericred_client/models/dental_plan_benefits.rb +211 -4
- data/lib/vericred_client/models/dental_plan_search_applicant.rb +211 -4
- data/lib/vericred_client/models/dental_plan_search_request.rb +211 -4
- data/lib/vericred_client/models/dental_plan_search_response.rb +211 -4
- data/lib/vericred_client/models/dental_plan_show_response.rb +211 -4
- data/lib/vericred_client/models/dental_plan_update.rb +211 -4
- data/lib/vericred_client/models/dental_plan_update_request.rb +211 -4
- data/lib/vericred_client/models/drug.rb +211 -4
- data/lib/vericred_client/models/drug_coverage.rb +211 -4
- data/lib/vericred_client/models/drug_coverage_response.rb +211 -4
- data/lib/vericred_client/models/drug_package.rb +211 -4
- data/lib/vericred_client/models/drug_search_response.rb +211 -4
- data/lib/vericred_client/models/embargo_request.rb +211 -4
- data/lib/vericred_client/models/formulary.rb +211 -4
- data/lib/vericred_client/models/formulary_drug_package_response.rb +211 -4
- data/lib/vericred_client/models/formulary_response.rb +211 -4
- data/lib/vericred_client/models/issuer_request.rb +211 -4
- data/lib/vericred_client/models/medical_plan_benefits.rb +211 -4
- data/lib/vericred_client/models/medical_plan_update.rb +211 -4
- data/lib/vericred_client/models/medical_plan_update_request.rb +211 -4
- data/lib/vericred_client/models/meta.rb +211 -4
- data/lib/vericred_client/models/meta_plan_search_response.rb +211 -4
- data/lib/vericred_client/models/network.rb +211 -4
- data/lib/vericred_client/models/network_comparison.rb +211 -4
- data/lib/vericred_client/models/network_comparison_request.rb +211 -4
- data/lib/vericred_client/models/network_comparison_response.rb +211 -4
- data/lib/vericred_client/models/network_details.rb +211 -4
- data/lib/vericred_client/models/network_details_response.rb +211 -4
- data/lib/vericred_client/models/network_search_response.rb +211 -4
- data/lib/vericred_client/models/network_size.rb +211 -4
- data/lib/vericred_client/models/notification_subscription.rb +211 -4
- data/lib/vericred_client/models/notification_subscription_response.rb +211 -4
- data/lib/vericred_client/models/plan.rb +211 -4
- data/lib/vericred_client/models/plan_county.rb +211 -4
- data/lib/vericred_client/models/plan_county_bulk.rb +211 -4
- data/lib/vericred_client/models/plan_deleted.rb +211 -4
- data/lib/vericred_client/models/plan_identifier.rb +211 -4
- data/lib/vericred_client/models/plan_medicare.rb +211 -4
- data/lib/vericred_client/models/plan_medicare_bulk.rb +211 -4
- data/lib/vericred_client/models/plan_pricing_medicare.rb +211 -4
- data/lib/vericred_client/models/plan_search_response.rb +211 -4
- data/lib/vericred_client/models/plan_show_response.rb +211 -4
- data/lib/vericred_client/models/provider.rb +211 -4
- data/lib/vericred_client/models/provider_details.rb +211 -4
- data/lib/vericred_client/models/provider_geocode.rb +211 -4
- data/lib/vericred_client/models/provider_network_event_notification.rb +211 -4
- data/lib/vericred_client/models/provider_show_response.rb +211 -4
- data/lib/vericred_client/models/providers_geocode_response.rb +211 -4
- data/lib/vericred_client/models/providers_search_response.rb +211 -4
- data/lib/vericred_client/models/rate_request.rb +211 -4
- data/lib/vericred_client/models/rate_search.rb +211 -4
- data/lib/vericred_client/models/rating_area.rb +211 -4
- data/lib/vericred_client/models/request_plan_find.rb +211 -4
- data/lib/vericred_client/models/request_plan_find_applicant.rb +211 -4
- data/lib/vericred_client/models/request_plan_find_carrier_verification.rb +211 -4
- data/lib/vericred_client/models/request_plan_find_drug_package.rb +211 -4
- data/lib/vericred_client/models/request_plan_find_provider.rb +211 -4
- data/lib/vericred_client/models/request_provider_notification_subscription.rb +211 -4
- data/lib/vericred_client/models/request_providers_search.rb +211 -4
- data/lib/vericred_client/models/request_rates_search.rb +211 -4
- data/lib/vericred_client/models/response_rates_search.rb +211 -4
- data/lib/vericred_client/models/rx_cui_identifier.rb +211 -4
- data/lib/vericred_client/models/rx_cui_identifier_search_response.rb +211 -4
- data/lib/vericred_client/models/service_area.rb +211 -4
- data/lib/vericred_client/models/service_area_zip_county.rb +211 -4
- data/lib/vericred_client/models/state.rb +211 -4
- data/lib/vericred_client/models/state_network_size_request.rb +211 -4
- data/lib/vericred_client/models/state_network_size_response.rb +211 -4
- data/lib/vericred_client/models/vision_plan.rb +211 -4
- data/lib/vericred_client/models/vision_plan_benefits.rb +211 -4
- data/lib/vericred_client/models/vision_plan_search_applicant.rb +211 -4
- data/lib/vericred_client/models/vision_plan_search_request.rb +211 -4
- data/lib/vericred_client/models/vision_plan_search_response.rb +211 -4
- data/lib/vericred_client/models/vision_plan_show_response.rb +211 -4
- data/lib/vericred_client/models/vision_plan_update.rb +211 -4
- data/lib/vericred_client/models/vision_plan_update_request.rb +211 -4
- data/lib/vericred_client/models/zip_code.rb +211 -4
- data/lib/vericred_client/models/zip_counties_response.rb +211 -4
- data/lib/vericred_client/models/zip_county.rb +211 -4
- data/lib/vericred_client/models/zip_county_bulk.rb +211 -4
- data/lib/vericred_client/models/zip_county_response.rb +211 -4
- data/lib/vericred_client/version.rb +210 -3
- data/lib/vericred_client.rb +209 -2
- data/spec/api/carrier_groups_api_spec.rb +210 -3
- data/spec/api/carrier_verification_plans_api_spec.rb +210 -3
- data/spec/api/carriers_api_spec.rb +210 -3
- data/spec/api/dental_plans_api_spec.rb +210 -3
- data/spec/api/drug_coverages_api_spec.rb +210 -3
- data/spec/api/drug_packages_api_spec.rb +210 -3
- data/spec/api/drugs_api_spec.rb +210 -3
- data/spec/api/embargoes_api_spec.rb +210 -3
- data/spec/api/formularies_api_spec.rb +210 -3
- data/spec/api/issuers_api_spec.rb +210 -3
- data/spec/api/medical_plans_api_spec.rb +210 -3
- data/spec/api/network_sizes_api_spec.rb +210 -3
- data/spec/api/networks_api_spec.rb +210 -3
- data/spec/api/plans_api_spec.rb +210 -3
- data/spec/api/provider_notification_subscriptions_api_spec.rb +210 -3
- data/spec/api/providers_api_spec.rb +210 -3
- data/spec/api/rates_api_spec.rb +210 -3
- data/spec/api/vision_plans_api_spec.rb +210 -3
- data/spec/api/zip_counties_api_spec.rb +210 -3
- data/spec/api_client_spec.rb +212 -26
- data/spec/configuration_spec.rb +212 -5
- data/spec/models/aca_plan2018_search_response_spec.rb +210 -3
- data/spec/models/aca_plan2018_search_result_spec.rb +210 -3
- data/spec/models/aca_plan2018_show_response_spec.rb +210 -3
- data/spec/models/aca_plan2018_spec.rb +210 -3
- data/spec/models/aca_plan_pre2018_search_response_spec.rb +210 -3
- data/spec/models/aca_plan_pre2018_search_result_spec.rb +210 -3
- data/spec/models/aca_plan_pre2018_show_response_spec.rb +210 -3
- data/spec/models/aca_plan_pre2018_spec.rb +210 -3
- data/spec/models/aca_plan_spec.rb +210 -3
- data/spec/models/base_plan_search_response_spec.rb +210 -3
- data/spec/models/base_spec.rb +210 -3
- data/spec/models/carrier_group_request_spec.rb +210 -3
- data/spec/models/carrier_request_spec.rb +210 -3
- data/spec/models/carrier_spec.rb +210 -3
- data/spec/models/carrier_subsidiary_spec.rb +210 -3
- data/spec/models/county_bulk_spec.rb +210 -3
- data/spec/models/county_spec.rb +210 -3
- data/spec/models/dental_plan_benefits_spec.rb +210 -3
- data/spec/models/dental_plan_search_applicant_spec.rb +210 -3
- data/spec/models/dental_plan_search_request_spec.rb +210 -3
- data/spec/models/dental_plan_search_response_spec.rb +210 -3
- data/spec/models/dental_plan_show_response_spec.rb +210 -3
- data/spec/models/dental_plan_spec.rb +210 -3
- data/spec/models/dental_plan_update_request_spec.rb +210 -3
- data/spec/models/dental_plan_update_spec.rb +210 -3
- data/spec/models/drug_coverage_response_spec.rb +210 -3
- data/spec/models/drug_coverage_spec.rb +210 -3
- data/spec/models/drug_package_spec.rb +210 -3
- data/spec/models/drug_search_response_spec.rb +210 -3
- data/spec/models/drug_spec.rb +210 -3
- data/spec/models/embargo_request_spec.rb +210 -3
- data/spec/models/formulary_drug_package_response_spec.rb +210 -3
- data/spec/models/formulary_response_spec.rb +210 -3
- data/spec/models/formulary_spec.rb +210 -3
- data/spec/models/issuer_request_spec.rb +210 -3
- data/spec/models/medical_plan_benefits_spec.rb +210 -3
- data/spec/models/medical_plan_update_request_spec.rb +210 -3
- data/spec/models/medical_plan_update_spec.rb +210 -3
- data/spec/models/meta_plan_search_response_spec.rb +210 -3
- data/spec/models/meta_spec.rb +210 -3
- data/spec/models/network_comparison_request_spec.rb +210 -3
- data/spec/models/network_comparison_response_spec.rb +210 -3
- data/spec/models/network_comparison_spec.rb +210 -3
- data/spec/models/network_details_response_spec.rb +210 -3
- data/spec/models/network_details_spec.rb +210 -3
- data/spec/models/network_search_response_spec.rb +210 -3
- data/spec/models/network_size_spec.rb +210 -3
- data/spec/models/network_spec.rb +210 -3
- data/spec/models/notification_subscription_response_spec.rb +210 -3
- data/spec/models/notification_subscription_spec.rb +210 -3
- data/spec/models/plan_county_bulk_spec.rb +210 -3
- data/spec/models/plan_county_spec.rb +210 -3
- data/spec/models/plan_deleted_spec.rb +210 -3
- data/spec/models/plan_identifier_spec.rb +210 -3
- data/spec/models/plan_medicare_bulk_spec.rb +210 -3
- data/spec/models/plan_medicare_spec.rb +210 -3
- data/spec/models/plan_pricing_medicare_spec.rb +210 -3
- data/spec/models/plan_search_response_spec.rb +210 -3
- data/spec/models/plan_show_response_spec.rb +210 -3
- data/spec/models/plan_spec.rb +210 -3
- data/spec/models/provider_details_spec.rb +210 -3
- data/spec/models/provider_geocode_spec.rb +210 -3
- data/spec/models/provider_network_event_notification_spec.rb +210 -3
- data/spec/models/provider_show_response_spec.rb +210 -3
- data/spec/models/provider_spec.rb +210 -3
- data/spec/models/providers_geocode_response_spec.rb +210 -3
- data/spec/models/providers_search_response_spec.rb +210 -3
- data/spec/models/rate_request_spec.rb +210 -3
- data/spec/models/rate_search_spec.rb +210 -3
- data/spec/models/rating_area_spec.rb +210 -3
- data/spec/models/request_plan_find_applicant_spec.rb +210 -3
- data/spec/models/request_plan_find_carrier_verification_spec.rb +210 -3
- data/spec/models/request_plan_find_drug_package_spec.rb +210 -3
- data/spec/models/request_plan_find_provider_spec.rb +210 -3
- data/spec/models/request_plan_find_spec.rb +210 -3
- data/spec/models/request_provider_notification_subscription_spec.rb +210 -3
- data/spec/models/request_providers_search_spec.rb +210 -3
- data/spec/models/request_rates_search_spec.rb +210 -3
- data/spec/models/response_rates_search_spec.rb +210 -3
- data/spec/models/rx_cui_identifier_search_response_spec.rb +210 -3
- data/spec/models/rx_cui_identifier_spec.rb +210 -3
- data/spec/models/service_area_spec.rb +210 -3
- data/spec/models/service_area_zip_county_spec.rb +210 -3
- data/spec/models/state_network_size_request_spec.rb +210 -3
- data/spec/models/state_network_size_response_spec.rb +210 -3
- data/spec/models/state_spec.rb +210 -3
- data/spec/models/vision_plan_benefits_spec.rb +210 -3
- data/spec/models/vision_plan_search_applicant_spec.rb +210 -3
- data/spec/models/vision_plan_search_request_spec.rb +210 -3
- data/spec/models/vision_plan_search_response_spec.rb +210 -3
- data/spec/models/vision_plan_show_response_spec.rb +210 -3
- data/spec/models/vision_plan_spec.rb +210 -3
- data/spec/models/vision_plan_update_request_spec.rb +210 -3
- data/spec/models/vision_plan_update_spec.rb +210 -3
- data/spec/models/zip_code_spec.rb +210 -3
- data/spec/models/zip_counties_response_spec.rb +210 -3
- data/spec/models/zip_county_bulk_spec.rb +210 -3
- data/spec/models/zip_county_response_spec.rb +210 -3
- data/spec/models/zip_county_spec.rb +210 -3
- data/spec/spec_helper.rb +209 -2
- data/vericred_client.gemspec +213 -6
- metadata +16 -23
- data/Gemfile +0 -7
- data/Rakefile +0 -8
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=begin
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#Vericred API
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#Vericred's API allows you to search for Health Plans that a specific doctor
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#Vericred's API allows you to search for Health Plans that a specific doctor
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accepts.
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## Getting Started
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Visit our [Developer Portal](https://developers.vericred.com) to
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create an account.
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Once you have created an account, you can create one Application for
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Production and another for our Sandbox (select the appropriate Plan when
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you create the Application).
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## SDKs
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Our API follows standard REST conventions, so you can use any HTTP client
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to integrate with us. You will likely find it easier to use one of our
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[autogenerated SDKs](https://github.com/vericred/?query=vericred-),
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which we make available for several common programming languages.
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## Authentication
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To authenticate, pass the API Key you created in the Developer Portal as
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a `Vericred-Api-Key` header.
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`curl -H 'Vericred-Api-Key: YOUR_KEY' "https://api.vericred.com/providers?search_term=Foo&zip_code=11215"`
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## Versioning
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Vericred's API default to the latest version. However, if you need a specific
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version, you can request it with an `Accept-Version` header.
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The current version is `v3`. Previous versions are `v1` and `v2`.
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`curl -H 'Vericred-Api-Key: YOUR_KEY' -H 'Accept-Version: v2' "https://api.vericred.com/providers?search_term=Foo&zip_code=11215"`
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## Pagination
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Endpoints that accept `page` and `per_page` parameters are paginated. They expose
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four additional fields that contain data about your position in the response,
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namely `Total`, `Per-Page`, `Link`, and `Page` as described in [RFC-5988](https://tools.ietf.org/html/rfc5988).
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For example, to display 5 results per page and view the second page of a
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`GET` to `/networks`, your final request would be `GET /networks?....page=2&per_page=5`.
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## Sideloading
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When we return multiple levels of an object graph (e.g. `Provider`s and their `State`s
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we sideload the associated data. In this example, we would provide an Array of
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`State`s and a `state_id` for each provider. This is done primarily to reduce the
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payload size since many of the `Provider`s will share a `State`
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```
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{
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providers: [{ id: 1, state_id: 1}, { id: 2, state_id: 1 }],
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states: [{ id: 1, code: 'NY' }]
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}
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```
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If you need the second level of the object graph, you can just match the
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corresponding id.
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## Selecting specific data
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All endpoints allow you to specify which fields you would like to return.
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This allows you to limit the response to contain only the data you need.
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For example, let's take a request that returns the following JSON by default
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```
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{
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provider: {
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id: 1,
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name: 'John',
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phone: '1234567890',
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field_we_dont_care_about: 'value_we_dont_care_about'
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},
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states: [{
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+
id: 1,
|
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+
name: 'New York',
|
83
|
+
code: 'NY',
|
84
|
+
field_we_dont_care_about: 'value_we_dont_care_about'
|
85
|
+
}]
|
86
|
+
}
|
87
|
+
```
|
88
|
+
|
89
|
+
To limit our results to only return the fields we care about, we specify the
|
90
|
+
`select` query string parameter for the corresponding fields in the JSON
|
91
|
+
document.
|
92
|
+
|
93
|
+
In this case, we want to select `name` and `phone` from the `provider` key,
|
94
|
+
so we would add the parameters `select=provider.name,provider.phone`.
|
95
|
+
We also want the `name` and `code` from the `states` key, so we would
|
96
|
+
add the parameters `select=states.name,states.code`. The id field of
|
97
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+
each document is always returned whether or not it is requested.
|
98
|
+
|
99
|
+
Our final request would be `GET /providers/12345?select=provider.name,provider.phone,states.name,states.code`
|
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+
|
101
|
+
The response would be
|
102
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+
|
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|
+
```
|
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+
{
|
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+
provider: {
|
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+
id: 1,
|
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+
name: 'John',
|
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+
phone: '1234567890'
|
109
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+
},
|
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+
states: [{
|
111
|
+
id: 1,
|
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|
+
name: 'New York',
|
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+
code: 'NY'
|
114
|
+
}]
|
115
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+
}
|
116
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+
```
|
117
|
+
|
118
|
+
## Benefits summary format
|
119
|
+
Benefit cost-share strings are formatted to capture:
|
120
|
+
* Network tiers
|
121
|
+
* Compound or conditional cost-share
|
122
|
+
* Limits on the cost-share
|
123
|
+
* Benefit-specific maximum out-of-pocket costs
|
124
|
+
|
125
|
+
**Example #1**
|
126
|
+
As an example, we would represent [this Summary of Benefits & Coverage](https://s3.amazonaws.com/vericred-data/SBC/2017/33602TX0780032.pdf) as:
|
127
|
+
|
128
|
+
* **Hospital stay facility fees**:
|
129
|
+
- Network Provider: `$400 copay/admit plus 20% coinsurance`
|
130
|
+
- Out-of-Network Provider: `$1,500 copay/admit plus 50% coinsurance`
|
131
|
+
- Vericred's format for this benefit: `In-Network: $400 before deductible then 20% after deductible / Out-of-Network: $1,500 before deductible then 50% after deductible`
|
132
|
+
|
133
|
+
* **Rehabilitation services:**
|
134
|
+
- Network Provider: `20% coinsurance`
|
135
|
+
- Out-of-Network Provider: `50% coinsurance`
|
136
|
+
- Limitations & Exceptions: `35 visit maximum per benefit period combined with Chiropractic care.`
|
137
|
+
- Vericred's format for this benefit: `In-Network: 20% after deductible / Out-of-Network: 50% after deductible | limit: 35 visit(s) per Benefit Period`
|
138
|
+
|
139
|
+
**Example #2**
|
140
|
+
In [this other Summary of Benefits & Coverage](https://s3.amazonaws.com/vericred-data/SBC/2017/40733CA0110568.pdf), the **specialty_drugs** cost-share has a maximum out-of-pocket for in-network pharmacies.
|
141
|
+
* **Specialty drugs:**
|
142
|
+
- Network Provider: `40% coinsurance up to a $500 maximum for up to a 30 day supply`
|
143
|
+
- Out-of-Network Provider `Not covered`
|
144
|
+
- Vericred's format for this benefit: `In-Network: 40% after deductible, up to $500 per script / Out-of-Network: 100%`
|
145
|
+
|
146
|
+
**BNF**
|
147
|
+
|
148
|
+
Here's a description of the benefits summary string, represented as a context-free grammar:
|
149
|
+
|
150
|
+
```
|
151
|
+
root ::= coverage
|
152
|
+
|
153
|
+
coverage ::= (simple_coverage | tiered_coverage) (space pipe space coverage_modifier)?
|
154
|
+
tiered_coverage ::= tier (space slash space tier)*
|
155
|
+
tier ::= tier_name colon space (tier_coverage | not_applicable)
|
156
|
+
tier_coverage ::= simple_coverage (space (then | or | and) space simple_coverage)* tier_limitation?
|
157
|
+
simple_coverage ::= (pre_coverage_limitation space)? coverage_amount (space post_coverage_limitation)? (comma? space coverage_condition)?
|
158
|
+
coverage_modifier ::= limit_condition colon space (((simple_coverage | simple_limitation) (semicolon space see_carrier_documentation)?) | see_carrier_documentation | waived_if_admitted | shared_across_tiers)
|
159
|
+
waived_if_admitted ::= ("copay" space)? "waived if admitted"
|
160
|
+
simple_limitation ::= pre_coverage_limitation space "copay applies"
|
161
|
+
tier_name ::= "In-Network-Tier-2" | "Out-of-Network" | "In-Network"
|
162
|
+
limit_condition ::= "limit" | "condition"
|
163
|
+
tier_limitation ::= comma space "up to" space (currency | (integer space time_unit plural?)) (space post_coverage_limitation)?
|
164
|
+
coverage_amount ::= currency | unlimited | included | unknown | percentage | (digits space (treatment_unit | time_unit) plural?)
|
165
|
+
pre_coverage_limitation ::= first space digits space time_unit plural?
|
166
|
+
post_coverage_limitation ::= (((then space currency) | "per condition") space)? "per" space (treatment_unit | (integer space time_unit) | time_unit) plural?
|
167
|
+
coverage_condition ::= ("before deductible" | "after deductible" | "penalty" | allowance | "in-state" | "out-of-state") (space allowance)?
|
168
|
+
allowance ::= upto_allowance | after_allowance
|
169
|
+
upto_allowance ::= "up to" space (currency space)? "allowance"
|
170
|
+
after_allowance ::= "after" space (currency space)? "allowance"
|
171
|
+
see_carrier_documentation ::= "see carrier documentation for more information"
|
172
|
+
shared_across_tiers ::= "shared across all tiers"
|
173
|
+
unknown ::= "unknown"
|
174
|
+
unlimited ::= /[uU]nlimited/
|
175
|
+
included ::= /[iI]ncluded in [mM]edical/
|
176
|
+
time_unit ::= /[hH]our/ | (((/[cC]alendar/ | /[cC]ontract/) space)? /[yY]ear/) | /[mM]onth/ | /[dD]ay/ | /[wW]eek/ | /[vV]isit/ | /[lL]ifetime/ | ((((/[bB]enefit/ plural?) | /[eE]ligibility/) space)? /[pP]eriod/)
|
177
|
+
treatment_unit ::= /[pP]erson/ | /[gG]roup/ | /[cC]ondition/ | /[sS]cript/ | /[vV]isit/ | /[eE]xam/ | /[iI]tem/ | /[sS]tay/ | /[tT]reatment/ | /[aA]dmission/ | /[eE]pisode/
|
178
|
+
comma ::= ","
|
179
|
+
colon ::= ":"
|
180
|
+
semicolon ::= ";"
|
181
|
+
pipe ::= "|"
|
182
|
+
slash ::= "/"
|
183
|
+
plural ::= "(s)" | "s"
|
184
|
+
then ::= "then" | ("," space) | space
|
185
|
+
or ::= "or"
|
186
|
+
and ::= "and"
|
187
|
+
not_applicable ::= "Not Applicable" | "N/A" | "NA"
|
188
|
+
first ::= "first"
|
189
|
+
currency ::= "$" number
|
190
|
+
percentage ::= number "%"
|
191
|
+
number ::= float | integer
|
192
|
+
float ::= digits "." digits
|
193
|
+
integer ::= /[0-9]/+ (comma_int | under_int)*
|
194
|
+
comma_int ::= ("," /[0-9]/*3) !"_"
|
195
|
+
under_int ::= ("_" /[0-9]/*3) !","
|
196
|
+
digits ::= /[0-9]/+ ("_" /[0-9]/+)*
|
197
|
+
space ::= /[ \t]/+
|
198
|
+
```
|
199
|
+
|
200
|
+
|
5
201
|
|
6
202
|
OpenAPI spec version: 1.0.0
|
7
203
|
|
8
204
|
Generated by: https://github.com/swagger-api/swagger-codegen.git
|
9
|
-
|
205
|
+
|
206
|
+
Licensed under the Apache License, Version 2.0 (the "License");
|
207
|
+
you may not use this file except in compliance with the License.
|
208
|
+
You may obtain a copy of the License at
|
209
|
+
|
210
|
+
http://www.apache.org/licenses/LICENSE-2.0
|
211
|
+
|
212
|
+
Unless required by applicable law or agreed to in writing, software
|
213
|
+
distributed under the License is distributed on an "AS IS" BASIS,
|
214
|
+
WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
|
215
|
+
See the License for the specific language governing permissions and
|
216
|
+
limitations under the License.
|
10
217
|
|
11
218
|
=end
|
12
219
|
|
@@ -28,7 +235,7 @@ describe 'ProviderNetworkEventNotification' do
|
|
28
235
|
end
|
29
236
|
|
30
237
|
describe 'test an instance of ProviderNetworkEventNotification' do
|
31
|
-
it 'should create an
|
238
|
+
it 'should create an instact of ProviderNetworkEventNotification' do
|
32
239
|
expect(@instance).to be_instance_of(VericredClient::ProviderNetworkEventNotification)
|
33
240
|
end
|
34
241
|
end
|
@@ -1,12 +1,219 @@
|
|
1
1
|
=begin
|
2
2
|
#Vericred API
|
3
3
|
|
4
|
-
#Vericred's API allows you to search for Health Plans that a specific doctor
|
4
|
+
#Vericred's API allows you to search for Health Plans that a specific doctor
|
5
|
+
accepts.
|
6
|
+
|
7
|
+
## Getting Started
|
8
|
+
|
9
|
+
Visit our [Developer Portal](https://developers.vericred.com) to
|
10
|
+
create an account.
|
11
|
+
|
12
|
+
Once you have created an account, you can create one Application for
|
13
|
+
Production and another for our Sandbox (select the appropriate Plan when
|
14
|
+
you create the Application).
|
15
|
+
|
16
|
+
## SDKs
|
17
|
+
|
18
|
+
Our API follows standard REST conventions, so you can use any HTTP client
|
19
|
+
to integrate with us. You will likely find it easier to use one of our
|
20
|
+
[autogenerated SDKs](https://github.com/vericred/?query=vericred-),
|
21
|
+
which we make available for several common programming languages.
|
22
|
+
|
23
|
+
## Authentication
|
24
|
+
|
25
|
+
To authenticate, pass the API Key you created in the Developer Portal as
|
26
|
+
a `Vericred-Api-Key` header.
|
27
|
+
|
28
|
+
`curl -H 'Vericred-Api-Key: YOUR_KEY' "https://api.vericred.com/providers?search_term=Foo&zip_code=11215"`
|
29
|
+
|
30
|
+
## Versioning
|
31
|
+
|
32
|
+
Vericred's API default to the latest version. However, if you need a specific
|
33
|
+
version, you can request it with an `Accept-Version` header.
|
34
|
+
|
35
|
+
The current version is `v3`. Previous versions are `v1` and `v2`.
|
36
|
+
|
37
|
+
`curl -H 'Vericred-Api-Key: YOUR_KEY' -H 'Accept-Version: v2' "https://api.vericred.com/providers?search_term=Foo&zip_code=11215"`
|
38
|
+
|
39
|
+
## Pagination
|
40
|
+
|
41
|
+
Endpoints that accept `page` and `per_page` parameters are paginated. They expose
|
42
|
+
four additional fields that contain data about your position in the response,
|
43
|
+
namely `Total`, `Per-Page`, `Link`, and `Page` as described in [RFC-5988](https://tools.ietf.org/html/rfc5988).
|
44
|
+
|
45
|
+
For example, to display 5 results per page and view the second page of a
|
46
|
+
`GET` to `/networks`, your final request would be `GET /networks?....page=2&per_page=5`.
|
47
|
+
|
48
|
+
## Sideloading
|
49
|
+
|
50
|
+
When we return multiple levels of an object graph (e.g. `Provider`s and their `State`s
|
51
|
+
we sideload the associated data. In this example, we would provide an Array of
|
52
|
+
`State`s and a `state_id` for each provider. This is done primarily to reduce the
|
53
|
+
payload size since many of the `Provider`s will share a `State`
|
54
|
+
|
55
|
+
```
|
56
|
+
{
|
57
|
+
providers: [{ id: 1, state_id: 1}, { id: 2, state_id: 1 }],
|
58
|
+
states: [{ id: 1, code: 'NY' }]
|
59
|
+
}
|
60
|
+
```
|
61
|
+
|
62
|
+
If you need the second level of the object graph, you can just match the
|
63
|
+
corresponding id.
|
64
|
+
|
65
|
+
## Selecting specific data
|
66
|
+
|
67
|
+
All endpoints allow you to specify which fields you would like to return.
|
68
|
+
This allows you to limit the response to contain only the data you need.
|
69
|
+
|
70
|
+
For example, let's take a request that returns the following JSON by default
|
71
|
+
|
72
|
+
```
|
73
|
+
{
|
74
|
+
provider: {
|
75
|
+
id: 1,
|
76
|
+
name: 'John',
|
77
|
+
phone: '1234567890',
|
78
|
+
field_we_dont_care_about: 'value_we_dont_care_about'
|
79
|
+
},
|
80
|
+
states: [{
|
81
|
+
id: 1,
|
82
|
+
name: 'New York',
|
83
|
+
code: 'NY',
|
84
|
+
field_we_dont_care_about: 'value_we_dont_care_about'
|
85
|
+
}]
|
86
|
+
}
|
87
|
+
```
|
88
|
+
|
89
|
+
To limit our results to only return the fields we care about, we specify the
|
90
|
+
`select` query string parameter for the corresponding fields in the JSON
|
91
|
+
document.
|
92
|
+
|
93
|
+
In this case, we want to select `name` and `phone` from the `provider` key,
|
94
|
+
so we would add the parameters `select=provider.name,provider.phone`.
|
95
|
+
We also want the `name` and `code` from the `states` key, so we would
|
96
|
+
add the parameters `select=states.name,states.code`. The id field of
|
97
|
+
each document is always returned whether or not it is requested.
|
98
|
+
|
99
|
+
Our final request would be `GET /providers/12345?select=provider.name,provider.phone,states.name,states.code`
|
100
|
+
|
101
|
+
The response would be
|
102
|
+
|
103
|
+
```
|
104
|
+
{
|
105
|
+
provider: {
|
106
|
+
id: 1,
|
107
|
+
name: 'John',
|
108
|
+
phone: '1234567890'
|
109
|
+
},
|
110
|
+
states: [{
|
111
|
+
id: 1,
|
112
|
+
name: 'New York',
|
113
|
+
code: 'NY'
|
114
|
+
}]
|
115
|
+
}
|
116
|
+
```
|
117
|
+
|
118
|
+
## Benefits summary format
|
119
|
+
Benefit cost-share strings are formatted to capture:
|
120
|
+
* Network tiers
|
121
|
+
* Compound or conditional cost-share
|
122
|
+
* Limits on the cost-share
|
123
|
+
* Benefit-specific maximum out-of-pocket costs
|
124
|
+
|
125
|
+
**Example #1**
|
126
|
+
As an example, we would represent [this Summary of Benefits & Coverage](https://s3.amazonaws.com/vericred-data/SBC/2017/33602TX0780032.pdf) as:
|
127
|
+
|
128
|
+
* **Hospital stay facility fees**:
|
129
|
+
- Network Provider: `$400 copay/admit plus 20% coinsurance`
|
130
|
+
- Out-of-Network Provider: `$1,500 copay/admit plus 50% coinsurance`
|
131
|
+
- Vericred's format for this benefit: `In-Network: $400 before deductible then 20% after deductible / Out-of-Network: $1,500 before deductible then 50% after deductible`
|
132
|
+
|
133
|
+
* **Rehabilitation services:**
|
134
|
+
- Network Provider: `20% coinsurance`
|
135
|
+
- Out-of-Network Provider: `50% coinsurance`
|
136
|
+
- Limitations & Exceptions: `35 visit maximum per benefit period combined with Chiropractic care.`
|
137
|
+
- Vericred's format for this benefit: `In-Network: 20% after deductible / Out-of-Network: 50% after deductible | limit: 35 visit(s) per Benefit Period`
|
138
|
+
|
139
|
+
**Example #2**
|
140
|
+
In [this other Summary of Benefits & Coverage](https://s3.amazonaws.com/vericred-data/SBC/2017/40733CA0110568.pdf), the **specialty_drugs** cost-share has a maximum out-of-pocket for in-network pharmacies.
|
141
|
+
* **Specialty drugs:**
|
142
|
+
- Network Provider: `40% coinsurance up to a $500 maximum for up to a 30 day supply`
|
143
|
+
- Out-of-Network Provider `Not covered`
|
144
|
+
- Vericred's format for this benefit: `In-Network: 40% after deductible, up to $500 per script / Out-of-Network: 100%`
|
145
|
+
|
146
|
+
**BNF**
|
147
|
+
|
148
|
+
Here's a description of the benefits summary string, represented as a context-free grammar:
|
149
|
+
|
150
|
+
```
|
151
|
+
root ::= coverage
|
152
|
+
|
153
|
+
coverage ::= (simple_coverage | tiered_coverage) (space pipe space coverage_modifier)?
|
154
|
+
tiered_coverage ::= tier (space slash space tier)*
|
155
|
+
tier ::= tier_name colon space (tier_coverage | not_applicable)
|
156
|
+
tier_coverage ::= simple_coverage (space (then | or | and) space simple_coverage)* tier_limitation?
|
157
|
+
simple_coverage ::= (pre_coverage_limitation space)? coverage_amount (space post_coverage_limitation)? (comma? space coverage_condition)?
|
158
|
+
coverage_modifier ::= limit_condition colon space (((simple_coverage | simple_limitation) (semicolon space see_carrier_documentation)?) | see_carrier_documentation | waived_if_admitted | shared_across_tiers)
|
159
|
+
waived_if_admitted ::= ("copay" space)? "waived if admitted"
|
160
|
+
simple_limitation ::= pre_coverage_limitation space "copay applies"
|
161
|
+
tier_name ::= "In-Network-Tier-2" | "Out-of-Network" | "In-Network"
|
162
|
+
limit_condition ::= "limit" | "condition"
|
163
|
+
tier_limitation ::= comma space "up to" space (currency | (integer space time_unit plural?)) (space post_coverage_limitation)?
|
164
|
+
coverage_amount ::= currency | unlimited | included | unknown | percentage | (digits space (treatment_unit | time_unit) plural?)
|
165
|
+
pre_coverage_limitation ::= first space digits space time_unit plural?
|
166
|
+
post_coverage_limitation ::= (((then space currency) | "per condition") space)? "per" space (treatment_unit | (integer space time_unit) | time_unit) plural?
|
167
|
+
coverage_condition ::= ("before deductible" | "after deductible" | "penalty" | allowance | "in-state" | "out-of-state") (space allowance)?
|
168
|
+
allowance ::= upto_allowance | after_allowance
|
169
|
+
upto_allowance ::= "up to" space (currency space)? "allowance"
|
170
|
+
after_allowance ::= "after" space (currency space)? "allowance"
|
171
|
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see_carrier_documentation ::= "see carrier documentation for more information"
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shared_across_tiers ::= "shared across all tiers"
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unknown ::= "unknown"
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unlimited ::= /[uU]nlimited/
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included ::= /[iI]ncluded in [mM]edical/
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time_unit ::= /[hH]our/ | (((/[cC]alendar/ | /[cC]ontract/) space)? /[yY]ear/) | /[mM]onth/ | /[dD]ay/ | /[wW]eek/ | /[vV]isit/ | /[lL]ifetime/ | ((((/[bB]enefit/ plural?) | /[eE]ligibility/) space)? /[pP]eriod/)
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treatment_unit ::= /[pP]erson/ | /[gG]roup/ | /[cC]ondition/ | /[sS]cript/ | /[vV]isit/ | /[eE]xam/ | /[iI]tem/ | /[sS]tay/ | /[tT]reatment/ | /[aA]dmission/ | /[eE]pisode/
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comma ::= ","
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colon ::= ":"
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+
semicolon ::= ";"
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pipe ::= "|"
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+
slash ::= "/"
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+
plural ::= "(s)" | "s"
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then ::= "then" | ("," space) | space
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+
or ::= "or"
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+
and ::= "and"
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+
not_applicable ::= "Not Applicable" | "N/A" | "NA"
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+
first ::= "first"
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+
currency ::= "$" number
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+
percentage ::= number "%"
|
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+
number ::= float | integer
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+
float ::= digits "." digits
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+
integer ::= /[0-9]/+ (comma_int | under_int)*
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+
comma_int ::= ("," /[0-9]/*3) !"_"
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+
under_int ::= ("_" /[0-9]/*3) !","
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+
digits ::= /[0-9]/+ ("_" /[0-9]/+)*
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+
space ::= /[ \t]/+
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+
```
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OpenAPI spec version: 1.0.0
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Generated by: https://github.com/swagger-api/swagger-codegen.git
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-
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+
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Licensed under the Apache License, Version 2.0 (the "License");
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+
you may not use this file except in compliance with the License.
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+
You may obtain a copy of the License at
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+
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http://www.apache.org/licenses/LICENSE-2.0
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+
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Unless required by applicable law or agreed to in writing, software
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+
distributed under the License is distributed on an "AS IS" BASIS,
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+
WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
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+
See the License for the specific language governing permissions and
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+
limitations under the License.
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=end
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|
@@ -28,7 +235,7 @@ describe 'ProviderShowResponse' do
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end
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describe 'test an instance of ProviderShowResponse' do
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-
it 'should create an
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+
it 'should create an instact of ProviderShowResponse' do
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expect(@instance).to be_instance_of(VericredClient::ProviderShowResponse)
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end
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end
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