vericred_client 0.0.9 → 0.0.11

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Files changed (164) hide show
  1. checksums.yaml +4 -4
  2. data/README.md +116 -13
  3. data/docs/Base.md +1 -1
  4. data/docs/Drug.md +1 -0
  5. data/docs/DrugCoverage.md +2 -1
  6. data/docs/DrugCoverageResponse.md +1 -1
  7. data/docs/DrugCoveragesApi.md +69 -0
  8. data/docs/DrugPackage.md +1 -0
  9. data/docs/DrugPackagesApi.md +66 -0
  10. data/docs/DrugSearchResponse.md +1 -1
  11. data/docs/DrugsApi.md +0 -61
  12. data/docs/Formulary.md +9 -0
  13. data/docs/FormularyDrugPackageResponse.md +10 -0
  14. data/docs/FormularyResponse.md +9 -0
  15. data/docs/Network.md +1 -1
  16. data/docs/NetworkDetails.md +10 -0
  17. data/docs/NetworkDetailsResponse.md +8 -0
  18. data/docs/NetworkSearchResponse.md +1 -1
  19. data/docs/NetworkSize.md +10 -0
  20. data/docs/NetworkSizesApi.md +124 -0
  21. data/docs/NetworksApi.md +55 -0
  22. data/docs/Plan.md +6 -4
  23. data/docs/PlanSearchResponse.md +2 -2
  24. data/docs/PlanSearchResponseMeta.md +9 -0
  25. data/docs/PlanSearchResult.md +6 -4
  26. data/docs/PlansApi.md +12 -10
  27. data/docs/Provider.md +1 -6
  28. data/docs/ProviderDetails.md +31 -0
  29. data/docs/ProviderGeocode.md +10 -0
  30. data/docs/ProvidersApi.md +61 -7
  31. data/docs/ProvidersGeocodeResponse.md +9 -0
  32. data/docs/ProvidersSearchResponse.md +1 -1
  33. data/docs/RequestPlanFindApplicant.md +2 -0
  34. data/docs/RequestPlanFindDrugPackage.md +1 -0
  35. data/docs/RequestProvidersSearch.md +5 -2
  36. data/docs/StateNetworkSizeRequest.md +9 -0
  37. data/docs/StateNetworkSizeResponse.md +9 -0
  38. data/docs/ZipCountiesApi.md +56 -1
  39. data/lib/vericred_client.rb +103 -2
  40. data/lib/vericred_client/api/drug_coverages_api.rb +295 -0
  41. data/lib/vericred_client/api/drug_packages_api.rb +289 -0
  42. data/lib/vericred_client/api/drugs_api.rb +88 -68
  43. data/lib/vericred_client/api/network_sizes_api.rb +348 -0
  44. data/lib/vericred_client/api/networks_api.rb +145 -1
  45. data/lib/vericred_client/api/plans_api.rb +108 -15
  46. data/lib/vericred_client/api/providers_api.rb +155 -9
  47. data/lib/vericred_client/api/zip_counties_api.rb +148 -4
  48. data/lib/vericred_client/api_client.rb +110 -21
  49. data/lib/vericred_client/api_error.rb +88 -1
  50. data/lib/vericred_client/configuration.rb +88 -1
  51. data/lib/vericred_client/models/applicant.rb +90 -3
  52. data/lib/vericred_client/models/base.rb +91 -4
  53. data/lib/vericred_client/models/carrier.rb +90 -3
  54. data/lib/vericred_client/models/carrier_subsidiary.rb +90 -3
  55. data/lib/vericred_client/models/county.rb +90 -3
  56. data/lib/vericred_client/models/county_bulk.rb +90 -3
  57. data/lib/vericred_client/models/drug.rb +101 -4
  58. data/lib/vericred_client/models/drug_coverage.rb +111 -14
  59. data/lib/vericred_client/models/drug_coverage_response.rb +91 -4
  60. data/lib/vericred_client/models/drug_package.rb +104 -7
  61. data/lib/vericred_client/models/drug_search_response.rb +91 -4
  62. data/lib/vericred_client/models/formulary.rb +404 -0
  63. data/lib/vericred_client/models/formulary_drug_package_response.rb +414 -0
  64. data/lib/vericred_client/models/formulary_response.rb +406 -0
  65. data/lib/vericred_client/models/meta.rb +90 -3
  66. data/lib/vericred_client/models/network.rb +91 -4
  67. data/lib/vericred_client/models/network_details.rb +416 -0
  68. data/lib/vericred_client/models/{pricing.rb → network_details_response.rb} +99 -112
  69. data/lib/vericred_client/models/network_search_response.rb +91 -4
  70. data/lib/vericred_client/models/network_size.rb +414 -0
  71. data/lib/vericred_client/models/plan.rb +115 -8
  72. data/lib/vericred_client/models/plan_county.rb +90 -3
  73. data/lib/vericred_client/models/plan_county_bulk.rb +90 -3
  74. data/lib/vericred_client/models/plan_search_response.rb +93 -6
  75. data/lib/vericred_client/models/plan_search_response_meta.rb +404 -0
  76. data/lib/vericred_client/models/plan_search_result.rb +115 -8
  77. data/lib/vericred_client/models/plan_show_response.rb +90 -3
  78. data/lib/vericred_client/models/provider.rb +101 -66
  79. data/lib/vericred_client/models/provider_details.rb +628 -0
  80. data/lib/vericred_client/models/provider_geocode.rb +414 -0
  81. data/lib/vericred_client/models/provider_show_response.rb +90 -3
  82. data/lib/vericred_client/models/providers_geocode_response.rb +406 -0
  83. data/lib/vericred_client/models/providers_search_response.rb +91 -4
  84. data/lib/vericred_client/models/rating_area.rb +90 -3
  85. data/lib/vericred_client/models/request_plan_find.rb +90 -3
  86. data/lib/vericred_client/models/request_plan_find_applicant.rb +114 -7
  87. data/lib/vericred_client/models/request_plan_find_drug_package.rb +104 -7
  88. data/lib/vericred_client/models/request_plan_find_provider.rb +90 -3
  89. data/lib/vericred_client/models/request_providers_search.rb +143 -26
  90. data/lib/vericred_client/models/service_area.rb +90 -3
  91. data/lib/vericred_client/models/service_area_zip_county.rb +90 -3
  92. data/lib/vericred_client/models/state.rb +90 -3
  93. data/lib/vericred_client/models/state_network_size_request.rb +408 -0
  94. data/lib/vericred_client/models/state_network_size_response.rb +406 -0
  95. data/lib/vericred_client/models/zip_code.rb +90 -3
  96. data/lib/vericred_client/models/zip_counties_response.rb +90 -3
  97. data/lib/vericred_client/models/zip_county.rb +90 -3
  98. data/lib/vericred_client/models/zip_county_bulk.rb +90 -3
  99. data/lib/vericred_client/models/zip_county_response.rb +90 -3
  100. data/lib/vericred_client/version.rb +89 -2
  101. data/spec/api/drug_coverages_api_spec.rb +254 -0
  102. data/spec/api/drug_packages_api_spec.rb +253 -0
  103. data/spec/api/drugs_api_spec.rb +88 -15
  104. data/spec/api/network_sizes_api_spec.rb +266 -0
  105. data/spec/api/networks_api_spec.rb +100 -1
  106. data/spec/api/plans_api_spec.rb +92 -4
  107. data/spec/api/providers_api_spec.rb +102 -3
  108. data/spec/api/zip_counties_api_spec.rb +101 -2
  109. data/spec/api_client_spec.rb +91 -25
  110. data/spec/configuration_spec.rb +88 -1
  111. data/spec/models/applicant_spec.rb +88 -1
  112. data/spec/models/base_spec.rb +88 -1
  113. data/spec/models/carrier_spec.rb +88 -1
  114. data/spec/models/carrier_subsidiary_spec.rb +88 -1
  115. data/spec/models/county_bulk_spec.rb +88 -1
  116. data/spec/models/county_spec.rb +88 -1
  117. data/spec/models/drug_coverage_response_spec.rb +88 -1
  118. data/spec/models/drug_coverage_spec.rb +95 -2
  119. data/spec/models/drug_package_spec.rb +94 -1
  120. data/spec/models/drug_search_response_spec.rb +88 -1
  121. data/spec/models/drug_spec.rb +94 -1
  122. data/spec/models/formulary_drug_package_response_spec.rb +259 -0
  123. data/spec/models/formulary_response_spec.rb +253 -0
  124. data/spec/models/formulary_spec.rb +253 -0
  125. data/spec/models/meta_spec.rb +88 -1
  126. data/spec/models/network_details_response_spec.rb +247 -0
  127. data/spec/models/network_details_spec.rb +259 -0
  128. data/spec/models/network_search_response_spec.rb +88 -1
  129. data/spec/models/network_size_spec.rb +259 -0
  130. data/spec/models/network_spec.rb +88 -1
  131. data/spec/models/plan_county_bulk_spec.rb +88 -1
  132. data/spec/models/plan_county_spec.rb +88 -1
  133. data/spec/models/plan_search_response_meta_spec.rb +253 -0
  134. data/spec/models/plan_search_response_spec.rb +88 -1
  135. data/spec/models/plan_search_result_spec.rb +100 -1
  136. data/spec/models/plan_show_response_spec.rb +88 -1
  137. data/spec/models/plan_spec.rb +100 -1
  138. data/spec/models/provider_details_spec.rb +385 -0
  139. data/spec/models/provider_geocode_spec.rb +259 -0
  140. data/spec/models/provider_show_response_spec.rb +88 -1
  141. data/spec/models/provider_spec.rb +94 -37
  142. data/spec/models/providers_geocode_response_spec.rb +253 -0
  143. data/spec/models/providers_search_response_spec.rb +88 -1
  144. data/spec/models/rating_area_spec.rb +88 -1
  145. data/spec/models/request_plan_find_applicant_spec.rb +100 -1
  146. data/spec/models/request_plan_find_drug_package_spec.rb +94 -1
  147. data/spec/models/request_plan_find_provider_spec.rb +88 -1
  148. data/spec/models/request_plan_find_spec.rb +88 -1
  149. data/spec/models/request_providers_search_spec.rb +109 -4
  150. data/spec/models/service_area_spec.rb +88 -1
  151. data/spec/models/service_area_zip_county_spec.rb +88 -1
  152. data/spec/models/state_network_size_request_spec.rb +253 -0
  153. data/spec/models/state_network_size_response_spec.rb +253 -0
  154. data/spec/models/state_spec.rb +88 -1
  155. data/spec/models/zip_code_spec.rb +88 -1
  156. data/spec/models/zip_counties_response_spec.rb +88 -1
  157. data/spec/models/zip_county_bulk_spec.rb +88 -1
  158. data/spec/models/zip_county_response_spec.rb +88 -1
  159. data/spec/models/zip_county_spec.rb +88 -1
  160. data/spec/spec_helper.rb +88 -1
  161. data/vericred_client.gemspec +90 -2
  162. metadata +66 -16
  163. data/docs/Pricing.md +0 -18
  164. data/spec/models/pricing_spec.rb +0 -220
@@ -6,13 +6,20 @@ accepts.
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  ## Getting Started
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8
 
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- Visit our [Developer Portal](https://vericred.3scale.net) to
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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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15
 
16
+ ## SDKs
17
+
18
+ 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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+
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  ## Authentication
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24
 
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  To authenticate, pass the API Key you created in the Developer Portal as
@@ -108,6 +115,86 @@ The response would be
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  }
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  ```
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+ ## Benefits summary format
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+ Benefit cost-share strings are formatted to capture:
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+ * Network tiers
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+ * Compound or conditional cost-share
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+ * Limits on the cost-share
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+ * Benefit-specific maximum out-of-pocket costs
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+
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+ **Example #1**
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+ As an example, we would represent [this Summary of Benefits & Coverage](https://s3.amazonaws.com/vericred-data/SBC/2017/33602TX0780032.pdf) as:
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+
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`
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+ - 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`
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+
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+ * **Rehabilitation services:**
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+ - Network Provider: `20% coinsurance`
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+ - Out-of-Network Provider: `50% coinsurance`
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+ - Limitations & Exceptions: `35 visit maximum per benefit period combined with Chiropractic care.`
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+ - Vericred's format for this benefit: `In-Network: 20% after deductible / Out-of-Network: 50% after deductible | limit: 35 visit(s) per Benefit Period`
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+
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+ **Example #2**
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+ 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.
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+ * **Specialty drugs:**
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+ - Network Provider: `40% coinsurance up to a $500 maximum for up to a 30 day supply`
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+ - Out-of-Network Provider `Not covered`
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+ - Vericred's format for this benefit: `In-Network: 40% after deductible, up to $500 per script / Out-of-Network: 100%`
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+
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+ **BNF**
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+
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+ Here's a description of the benefits summary string, represented as a context-free grammar:
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+
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+ ```
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+ root ::= coverage
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+
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+ coverage ::= (simple_coverage | tiered_coverage) (space pipe space coverage_limitation)?
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+ tiered_coverage ::= tier (space slash space tier)*
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+ tier ::= tier_name colon space (tier_coverage | not_applicable)
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+ tier_coverage ::= simple_coverage (space (then | or | and) space simple_coverage)* tier_limitation?
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+ simple_coverage ::= (pre_coverage_limitation space)? coverage_amount (space post_coverage_limitation)? (comma? space coverage_condition)?
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+ coverage_limitation ::= "limit" colon space (((simple_coverage | simple_limitation) (semicolon space see_carrier_documentation)?) | see_carrier_documentation | waived_if_admitted)
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+ waived_if_admitted ::= ("copay" space)? "waived if admitted"
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+ simple_limitation ::= pre_coverage_limitation space "copay applies"
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+ tier_name ::= "In-Network-Tier-2" | "Out-of-Network" | "In-Network"
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+ tier_limitation ::= comma space "up to" space (currency | (integer space time_unit plural?)) (space post_coverage_limitation)?
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+ coverage_amount ::= currency | unlimited | included | unknown | percentage | (digits space (treatment_unit | time_unit) plural?)
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+ pre_coverage_limitation ::= first space digits space time_unit plural?
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+ post_coverage_limitation ::= (((then space currency) | "per condition") space)? "per" space (treatment_unit | (integer space time_unit) | time_unit) plural?
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+ coverage_condition ::= ("before deductible" | "after deductible" | "penalty" | allowance | "in-state" | "out-of-state") (space allowance)?
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+ allowance ::= upto_allowance | after_allowance
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+ upto_allowance ::= "up to" space (currency space)? "allowance"
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+ after_allowance ::= "after" space (currency space)? "allowance"
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+ see_carrier_documentation ::= "see carrier documentation for more information"
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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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+
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  OpenAPI spec version: 1.0.0
@@ -0,0 +1,247 @@
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+ =begin
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+ #Vericred API
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+
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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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+
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+ ## Getting Started
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+
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+ Visit our [Developer Portal](https://developers.vericred.com) to
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+ create an account.
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+
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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
14
+ you create the Application).
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+
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.
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+
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+ ## Authentication
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+
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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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+
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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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+
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+ ## Versioning
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+
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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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+
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+ The current version is `v3`. Previous versions are `v1` and `v2`.
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+
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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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+
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+ ## Pagination
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+
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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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+
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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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+
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+ ## Sideloading
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+
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
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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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+
55
+ ```
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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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+
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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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+
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+ ## Selecting specific data
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+
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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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+
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+ For example, let's take a request that returns the following JSON by default
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+
72
+ ```
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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'
79
+ },
80
+ states: [{
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+ id: 1,
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+ name: 'New York',
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+ code: 'NY',
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+ field_we_dont_care_about: 'value_we_dont_care_about'
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+ }]
86
+ }
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+ ```
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+
89
+ To limit our results to only return the fields we care about, we specify the
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+ `select` query string parameter for the corresponding fields in the JSON
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+ document.
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+
93
+ In this case, we want to select `name` and `phone` from the `provider` key,
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+ so we would add the parameters `select=provider.name,provider.phone`.
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+ We also want the `name` and `code` from the `states` key, so we would
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+ add the parameters `select=states.name,staes.code`. The id field of
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+ each document is always returned whether or not it is requested.
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+
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
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+
103
+ ```
104
+ {
105
+ provider: {
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+ id: 1,
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+ name: 'John',
108
+ phone: '1234567890'
109
+ },
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+ states: [{
111
+ id: 1,
112
+ name: 'New York',
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+ 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_limitation)?
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_limitation ::= "limit" colon space (((simple_coverage | simple_limitation) (semicolon space see_carrier_documentation)?) | see_carrier_documentation | waived_if_admitted)
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
+ tier_limitation ::= comma space "up to" space (currency | (integer space time_unit plural?)) (space post_coverage_limitation)?
163
+ coverage_amount ::= currency | unlimited | included | unknown | percentage | (digits space (treatment_unit | time_unit) plural?)
164
+ pre_coverage_limitation ::= first space digits space time_unit plural?
165
+ post_coverage_limitation ::= (((then space currency) | "per condition") space)? "per" space (treatment_unit | (integer space time_unit) | time_unit) plural?
166
+ coverage_condition ::= ("before deductible" | "after deductible" | "penalty" | allowance | "in-state" | "out-of-state") (space allowance)?
167
+ allowance ::= upto_allowance | after_allowance
168
+ upto_allowance ::= "up to" space (currency space)? "allowance"
169
+ after_allowance ::= "after" space (currency space)? "allowance"
170
+ see_carrier_documentation ::= "see carrier documentation for more information"
171
+ unknown ::= "unknown"
172
+ unlimited ::= /[uU]nlimited/
173
+ included ::= /[iI]ncluded in [mM]edical/
174
+ 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/)
175
+ treatment_unit ::= /[pP]erson/ | /[gG]roup/ | /[cC]ondition/ | /[sS]cript/ | /[vV]isit/ | /[eE]xam/ | /[iI]tem/ | /[sS]tay/ | /[tT]reatment/ | /[aA]dmission/ | /[eE]pisode/
176
+ comma ::= ","
177
+ colon ::= ":"
178
+ semicolon ::= ";"
179
+ pipe ::= "|"
180
+ slash ::= "/"
181
+ plural ::= "(s)" | "s"
182
+ then ::= "then" | ("," space) | space
183
+ or ::= "or"
184
+ and ::= "and"
185
+ not_applicable ::= "Not Applicable" | "N/A" | "NA"
186
+ first ::= "first"
187
+ currency ::= "$" number
188
+ percentage ::= number "%"
189
+ number ::= float | integer
190
+ float ::= digits "." digits
191
+ integer ::= /[0-9]/+ (comma_int | under_int)*
192
+ comma_int ::= ("," /[0-9]/*3) !"_"
193
+ under_int ::= ("_" /[0-9]/*3) !","
194
+ digits ::= /[0-9]/+ ("_" /[0-9]/+)*
195
+ space ::= /[ \t]/+
196
+ ```
197
+
198
+
199
+
200
+ OpenAPI spec version: 1.0.0
201
+
202
+ Generated by: https://github.com/swagger-api/swagger-codegen.git
203
+
204
+ Licensed under the Apache License, Version 2.0 (the "License");
205
+ you may not use this file except in compliance with the License.
206
+ You may obtain a copy of the License at
207
+
208
+ http://www.apache.org/licenses/LICENSE-2.0
209
+
210
+ Unless required by applicable law or agreed to in writing, software
211
+ distributed under the License is distributed on an "AS IS" BASIS,
212
+ WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
213
+ See the License for the specific language governing permissions and
214
+ limitations under the License.
215
+
216
+ =end
217
+
218
+ require 'spec_helper'
219
+ require 'json'
220
+ require 'date'
221
+
222
+ # Unit tests for VericredClient::NetworkDetailsResponse
223
+ # Automatically generated by swagger-codegen (github.com/swagger-api/swagger-codegen)
224
+ # Please update as you see appropriate
225
+ describe 'NetworkDetailsResponse' do
226
+ before do
227
+ # run before each test
228
+ @instance = VericredClient::NetworkDetailsResponse.new
229
+ end
230
+
231
+ after do
232
+ # run after each test
233
+ end
234
+
235
+ describe 'test an instance of NetworkDetailsResponse' do
236
+ it 'should create an instact of NetworkDetailsResponse' do
237
+ expect(@instance).to be_instance_of(VericredClient::NetworkDetailsResponse)
238
+ end
239
+ end
240
+ describe 'test attribute "network"' do
241
+ it 'should work' do
242
+ # assertion here. ref: https://www.relishapp.com/rspec/rspec-expectations/docs/built-in-matchers
243
+ end
244
+ end
245
+
246
+ end
247
+
@@ -0,0 +1,259 @@
1
+ =begin
2
+ #Vericred API
3
+
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,staes.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_limitation)?
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_limitation ::= "limit" colon space (((simple_coverage | simple_limitation) (semicolon space see_carrier_documentation)?) | see_carrier_documentation | waived_if_admitted)
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
+ tier_limitation ::= comma space "up to" space (currency | (integer space time_unit plural?)) (space post_coverage_limitation)?
163
+ coverage_amount ::= currency | unlimited | included | unknown | percentage | (digits space (treatment_unit | time_unit) plural?)
164
+ pre_coverage_limitation ::= first space digits space time_unit plural?
165
+ post_coverage_limitation ::= (((then space currency) | "per condition") space)? "per" space (treatment_unit | (integer space time_unit) | time_unit) plural?
166
+ coverage_condition ::= ("before deductible" | "after deductible" | "penalty" | allowance | "in-state" | "out-of-state") (space allowance)?
167
+ allowance ::= upto_allowance | after_allowance
168
+ upto_allowance ::= "up to" space (currency space)? "allowance"
169
+ after_allowance ::= "after" space (currency space)? "allowance"
170
+ see_carrier_documentation ::= "see carrier documentation for more information"
171
+ unknown ::= "unknown"
172
+ unlimited ::= /[uU]nlimited/
173
+ included ::= /[iI]ncluded in [mM]edical/
174
+ 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/)
175
+ treatment_unit ::= /[pP]erson/ | /[gG]roup/ | /[cC]ondition/ | /[sS]cript/ | /[vV]isit/ | /[eE]xam/ | /[iI]tem/ | /[sS]tay/ | /[tT]reatment/ | /[aA]dmission/ | /[eE]pisode/
176
+ comma ::= ","
177
+ colon ::= ":"
178
+ semicolon ::= ";"
179
+ pipe ::= "|"
180
+ slash ::= "/"
181
+ plural ::= "(s)" | "s"
182
+ then ::= "then" | ("," space) | space
183
+ or ::= "or"
184
+ and ::= "and"
185
+ not_applicable ::= "Not Applicable" | "N/A" | "NA"
186
+ first ::= "first"
187
+ currency ::= "$" number
188
+ percentage ::= number "%"
189
+ number ::= float | integer
190
+ float ::= digits "." digits
191
+ integer ::= /[0-9]/+ (comma_int | under_int)*
192
+ comma_int ::= ("," /[0-9]/*3) !"_"
193
+ under_int ::= ("_" /[0-9]/*3) !","
194
+ digits ::= /[0-9]/+ ("_" /[0-9]/+)*
195
+ space ::= /[ \t]/+
196
+ ```
197
+
198
+
199
+
200
+ OpenAPI spec version: 1.0.0
201
+
202
+ Generated by: https://github.com/swagger-api/swagger-codegen.git
203
+
204
+ Licensed under the Apache License, Version 2.0 (the "License");
205
+ you may not use this file except in compliance with the License.
206
+ You may obtain a copy of the License at
207
+
208
+ http://www.apache.org/licenses/LICENSE-2.0
209
+
210
+ Unless required by applicable law or agreed to in writing, software
211
+ distributed under the License is distributed on an "AS IS" BASIS,
212
+ WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
213
+ See the License for the specific language governing permissions and
214
+ limitations under the License.
215
+
216
+ =end
217
+
218
+ require 'spec_helper'
219
+ require 'json'
220
+ require 'date'
221
+
222
+ # Unit tests for VericredClient::NetworkDetails
223
+ # Automatically generated by swagger-codegen (github.com/swagger-api/swagger-codegen)
224
+ # Please update as you see appropriate
225
+ describe 'NetworkDetails' do
226
+ before do
227
+ # run before each test
228
+ @instance = VericredClient::NetworkDetails.new
229
+ end
230
+
231
+ after do
232
+ # run after each test
233
+ end
234
+
235
+ describe 'test an instance of NetworkDetails' do
236
+ it 'should create an instact of NetworkDetails' do
237
+ expect(@instance).to be_instance_of(VericredClient::NetworkDetails)
238
+ end
239
+ end
240
+ describe 'test attribute "id"' do
241
+ it 'should work' do
242
+ # assertion here. ref: https://www.relishapp.com/rspec/rspec-expectations/docs/built-in-matchers
243
+ end
244
+ end
245
+
246
+ describe 'test attribute "name"' do
247
+ it 'should work' do
248
+ # assertion here. ref: https://www.relishapp.com/rspec/rspec-expectations/docs/built-in-matchers
249
+ end
250
+ end
251
+
252
+ describe 'test attribute "hios_issuer_ids"' do
253
+ it 'should work' do
254
+ # assertion here. ref: https://www.relishapp.com/rspec/rspec-expectations/docs/built-in-matchers
255
+ end
256
+ end
257
+
258
+ end
259
+