vericred_client 0.0.21 → 0.0.23
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/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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you create the Application).
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## SDKs
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to integrate with us. You will likely find it easier to use one of our
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which we make available for several common programming languages.
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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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version, you can request it with an `Accept-Version` header.
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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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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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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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## Selecting specific data
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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',
|
|
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|
+
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
|
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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'
|
|
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|
+
},
|
|
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|
+
states: [{
|
|
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|
+
id: 1,
|
|
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|
+
name: 'New York',
|
|
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|
+
code: 'NY'
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|
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|
+
}]
|
|
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|
+
}
|
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|
+
```
|
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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**:
|
|
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|
+
- Network Provider: `$400 copay/admit plus 20% coinsurance`
|
|
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|
+
- 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
|
|
|
@@ -182,7 +389,7 @@ module VericredClient
|
|
|
182
389
|
end
|
|
183
390
|
|
|
184
391
|
# Show invalid properties with the reasons. Usually used together with valid?
|
|
185
|
-
# @return Array for valid
|
|
392
|
+
# @return Array for valid properies with the reasons
|
|
186
393
|
def list_invalid_properties
|
|
187
394
|
invalid_properties = Array.new
|
|
188
395
|
return invalid_properties
|
|
@@ -276,7 +483,7 @@ module VericredClient
|
|
|
276
483
|
when /\AArray<(?<inner_type>.+)>\z/
|
|
277
484
|
inner_type = Regexp.last_match[:inner_type]
|
|
278
485
|
value.map { |v| _deserialize(inner_type, v) }
|
|
279
|
-
when /\AHash<(?<k_type
|
|
486
|
+
when /\AHash<(?<k_type>.+), (?<v_type>.+)>\z/
|
|
280
487
|
k_type = Regexp.last_match[:k_type]
|
|
281
488
|
v_type = Regexp.last_match[:v_type]
|
|
282
489
|
{}.tap do |hash|
|
|
@@ -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
|
+
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
|
|
|
@@ -66,7 +273,7 @@ module VericredClient
|
|
|
66
273
|
end
|
|
67
274
|
|
|
68
275
|
# Show invalid properties with the reasons. Usually used together with valid?
|
|
69
|
-
# @return Array for valid
|
|
276
|
+
# @return Array for valid properies with the reasons
|
|
70
277
|
def list_invalid_properties
|
|
71
278
|
invalid_properties = Array.new
|
|
72
279
|
return invalid_properties
|
|
@@ -148,7 +355,7 @@ module VericredClient
|
|
|
148
355
|
when /\AArray<(?<inner_type>.+)>\z/
|
|
149
356
|
inner_type = Regexp.last_match[:inner_type]
|
|
150
357
|
value.map { |v| _deserialize(inner_type, v) }
|
|
151
|
-
when /\AHash<(?<k_type
|
|
358
|
+
when /\AHash<(?<k_type>.+), (?<v_type>.+)>\z/
|
|
152
359
|
k_type = Regexp.last_match[:k_type]
|
|
153
360
|
v_type = Regexp.last_match[:v_type]
|
|
154
361
|
{}.tap do |hash|
|