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.
6
6
 
7
7
  ## Getting Started
8
8
 
9
- Visit our [Developer Portal](https://vericred.3scale.net) to
9
+ Visit our [Developer Portal](https://developers.vericred.com) to
10
10
  create an account.
11
11
 
12
12
  Once you have created an account, you can create one Application for
13
13
  Production and another for our Sandbox (select the appropriate Plan when
14
14
  you create the Application).
15
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
+
16
23
  ## Authentication
17
24
 
18
25
  To authenticate, pass the API Key you created in the Developer Portal as
@@ -108,6 +115,86 @@ The response would be
108
115
  }
109
116
  ```
110
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
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+
153
+ 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"
162
+ 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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+
111
198
 
112
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113
200
  OpenAPI spec version: 1.0.0
@@ -6,13 +6,20 @@ accepts.
6
6
 
7
7
  ## Getting Started
8
8
 
9
- Visit our [Developer Portal](https://vericred.3scale.net) to
9
+ Visit our [Developer Portal](https://developers.vericred.com) to
10
10
  create an account.
11
11
 
12
12
  Once you have created an account, you can create one Application for
13
13
  Production and another for our Sandbox (select the appropriate Plan when
14
14
  you create the Application).
15
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
+
16
23
  ## Authentication
17
24
 
18
25
  To authenticate, pass the API Key you created in the Developer Portal as
@@ -108,6 +115,86 @@ The response would be
108
115
  }
109
116
  ```
110
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
+
111
198
 
112
199
 
113
200
  OpenAPI spec version: 1.0.0
@@ -8,13 +8,20 @@ accepts.
8
8
 
9
9
  ## Getting Started
10
10
 
11
- Visit our [Developer Portal](https://vericred.3scale.net) to
11
+ Visit our [Developer Portal](https://developers.vericred.com) to
12
12
  create an account.
13
13
 
14
14
  Once you have created an account, you can create one Application for
15
15
  Production and another for our Sandbox (select the appropriate Plan when
16
16
  you create the Application).
17
17
 
18
+ ## SDKs
19
+
20
+ Our API follows standard REST conventions, so you can use any HTTP client
21
+ to integrate with us. You will likely find it easier to use one of our
22
+ [autogenerated SDKs](https://github.com/vericred/?query=vericred-),
23
+ which we make available for several common programming languages.
24
+
18
25
  ## Authentication
19
26
 
20
27
  To authenticate, pass the API Key you created in the Developer Portal as
@@ -110,6 +117,86 @@ The response would be
110
117
  }
111
118
  ```
112
119
 
120
+ ## Benefits summary format
121
+ Benefit cost-share strings are formatted to capture:
122
+ * Network tiers
123
+ * Compound or conditional cost-share
124
+ * Limits on the cost-share
125
+ * Benefit-specific maximum out-of-pocket costs
126
+
127
+ **Example #1**
128
+ As an example, we would represent [this Summary of Benefits & Coverage](https://s3.amazonaws.com/vericred-data/SBC/2017/33602TX0780032.pdf) as:
129
+
130
+ * **Hospital stay facility fees**:
131
+ - Network Provider: `$400 copay/admit plus 20% coinsurance`
132
+ - Out-of-Network Provider: `$1,500 copay/admit plus 50% coinsurance`
133
+ - 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`
134
+
135
+ * **Rehabilitation services:**
136
+ - Network Provider: `20% coinsurance`
137
+ - Out-of-Network Provider: `50% coinsurance`
138
+ - Limitations & Exceptions: `35 visit maximum per benefit period combined with Chiropractic care.`
139
+ - Vericred's format for this benefit: `In-Network: 20% after deductible / Out-of-Network: 50% after deductible | limit: 35 visit(s) per Benefit Period`
140
+
141
+ **Example #2**
142
+ 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.
143
+ * **Specialty drugs:**
144
+ - Network Provider: `40% coinsurance up to a $500 maximum for up to a 30 day supply`
145
+ - Out-of-Network Provider `Not covered`
146
+ - Vericred's format for this benefit: `In-Network: 40% after deductible, up to $500 per script / Out-of-Network: 100%`
147
+
148
+ **BNF**
149
+
150
+ Here's a description of the benefits summary string, represented as a context-free grammar:
151
+
152
+ ```
153
+ root ::= coverage
154
+
155
+ coverage ::= (simple_coverage | tiered_coverage) (space pipe space coverage_limitation)?
156
+ tiered_coverage ::= tier (space slash space tier)*
157
+ tier ::= tier_name colon space (tier_coverage | not_applicable)
158
+ tier_coverage ::= simple_coverage (space (then | or | and) space simple_coverage)* tier_limitation?
159
+ simple_coverage ::= (pre_coverage_limitation space)? coverage_amount (space post_coverage_limitation)? (comma? space coverage_condition)?
160
+ coverage_limitation ::= "limit" colon space (((simple_coverage | simple_limitation) (semicolon space see_carrier_documentation)?) | see_carrier_documentation | waived_if_admitted)
161
+ waived_if_admitted ::= ("copay" space)? "waived if admitted"
162
+ simple_limitation ::= pre_coverage_limitation space "copay applies"
163
+ tier_name ::= "In-Network-Tier-2" | "Out-of-Network" | "In-Network"
164
+ tier_limitation ::= comma space "up to" space (currency | (integer space time_unit plural?)) (space post_coverage_limitation)?
165
+ coverage_amount ::= currency | unlimited | included | unknown | percentage | (digits space (treatment_unit | time_unit) plural?)
166
+ pre_coverage_limitation ::= first space digits space time_unit plural?
167
+ post_coverage_limitation ::= (((then space currency) | "per condition") space)? "per" space (treatment_unit | (integer space time_unit) | time_unit) plural?
168
+ coverage_condition ::= ("before deductible" | "after deductible" | "penalty" | allowance | "in-state" | "out-of-state") (space allowance)?
169
+ allowance ::= upto_allowance | after_allowance
170
+ upto_allowance ::= "up to" space (currency space)? "allowance"
171
+ after_allowance ::= "after" space (currency space)? "allowance"
172
+ see_carrier_documentation ::= "see carrier documentation for more information"
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
+
113
200
 
114
201
 
115
202
  OpenAPI spec version: 1.0.0
@@ -143,8 +230,9 @@ Gem::Specification.new do |s|
143
230
  s.summary = "Vericred API Ruby Gem"
144
231
  s.description = "Autogenerated Ruby client for the Vericred API"
145
232
  s.license = "MIT"
233
+ s.required_ruby_version = ">= 1.9"
146
234
 
147
- s.add_runtime_dependency 'typhoeus', '~> 1.0', '>= 1.0.1'
235
+ s.add_runtime_dependency 'httpclient', '~> 2.0'
148
236
  s.add_runtime_dependency 'json', '~> 1.8', '>= 1.8.3'
149
237
 
150
238
  s.add_development_dependency 'rspec', '~> 3.4', '>= 3.4.0'
metadata CHANGED
@@ -1,35 +1,29 @@
1
1
  --- !ruby/object:Gem::Specification
2
2
  name: vericred_client
3
3
  version: !ruby/object:Gem::Version
4
- version: 0.0.9
4
+ version: 0.0.11
5
5
  platform: ruby
6
6
  authors:
7
7
  - Vericred Inc.
8
8
  autorequire:
9
9
  bindir: bin
10
10
  cert_chain: []
11
- date: 2016-08-24 00:00:00.000000000 Z
11
+ date: 2017-04-04 00:00:00.000000000 Z
12
12
  dependencies:
13
13
  - !ruby/object:Gem::Dependency
14
- name: typhoeus
14
+ name: httpclient
15
15
  requirement: !ruby/object:Gem::Requirement
16
16
  requirements:
17
17
  - - "~>"
18
18
  - !ruby/object:Gem::Version
19
- version: '1.0'
20
- - - ">="
21
- - !ruby/object:Gem::Version
22
- version: 1.0.1
19
+ version: '2.0'
23
20
  type: :runtime
24
21
  prerelease: false
25
22
  version_requirements: !ruby/object:Gem::Requirement
26
23
  requirements:
27
24
  - - "~>"
28
25
  - !ruby/object:Gem::Version
29
- version: '1.0'
30
- - - ">="
31
- - !ruby/object:Gem::Version
32
- version: 1.0.1
26
+ version: '2.0'
33
27
  - !ruby/object:Gem::Dependency
34
28
  name: json
35
29
  requirement: !ruby/object:Gem::Requirement
@@ -208,24 +202,36 @@ files:
208
202
  - docs/Drug.md
209
203
  - docs/DrugCoverage.md
210
204
  - docs/DrugCoverageResponse.md
205
+ - docs/DrugCoveragesApi.md
211
206
  - docs/DrugPackage.md
207
+ - docs/DrugPackagesApi.md
212
208
  - docs/DrugSearchResponse.md
213
209
  - docs/DrugsApi.md
210
+ - docs/Formulary.md
211
+ - docs/FormularyDrugPackageResponse.md
212
+ - docs/FormularyResponse.md
214
213
  - docs/Meta.md
215
214
  - docs/Network.md
215
+ - docs/NetworkDetails.md
216
+ - docs/NetworkDetailsResponse.md
216
217
  - docs/NetworkSearchResponse.md
218
+ - docs/NetworkSize.md
219
+ - docs/NetworkSizesApi.md
217
220
  - docs/NetworksApi.md
218
221
  - docs/Plan.md
219
222
  - docs/PlanCounty.md
220
223
  - docs/PlanCountyBulk.md
221
224
  - docs/PlanSearchResponse.md
225
+ - docs/PlanSearchResponseMeta.md
222
226
  - docs/PlanSearchResult.md
223
227
  - docs/PlanShowResponse.md
224
228
  - docs/PlansApi.md
225
- - docs/Pricing.md
226
229
  - docs/Provider.md
230
+ - docs/ProviderDetails.md
231
+ - docs/ProviderGeocode.md
227
232
  - docs/ProviderShowResponse.md
228
233
  - docs/ProvidersApi.md
234
+ - docs/ProvidersGeocodeResponse.md
229
235
  - docs/ProvidersSearchResponse.md
230
236
  - docs/RatingArea.md
231
237
  - docs/RequestPlanFind.md
@@ -236,6 +242,8 @@ files:
236
242
  - docs/ServiceArea.md
237
243
  - docs/ServiceAreaZipCounty.md
238
244
  - docs/State.md
245
+ - docs/StateNetworkSizeRequest.md
246
+ - docs/StateNetworkSizeResponse.md
239
247
  - docs/ZipCode.md
240
248
  - docs/ZipCountiesApi.md
241
249
  - docs/ZipCountiesResponse.md
@@ -244,7 +252,10 @@ files:
244
252
  - docs/ZipCountyResponse.md
245
253
  - git_push.sh
246
254
  - lib/vericred_client.rb
255
+ - lib/vericred_client/api/drug_coverages_api.rb
256
+ - lib/vericred_client/api/drug_packages_api.rb
247
257
  - lib/vericred_client/api/drugs_api.rb
258
+ - lib/vericred_client/api/network_sizes_api.rb
248
259
  - lib/vericred_client/api/networks_api.rb
249
260
  - lib/vericred_client/api/plans_api.rb
250
261
  - lib/vericred_client/api/providers_api.rb
@@ -263,18 +274,27 @@ files:
263
274
  - lib/vericred_client/models/drug_coverage_response.rb
264
275
  - lib/vericred_client/models/drug_package.rb
265
276
  - lib/vericred_client/models/drug_search_response.rb
277
+ - lib/vericred_client/models/formulary.rb
278
+ - lib/vericred_client/models/formulary_drug_package_response.rb
279
+ - lib/vericred_client/models/formulary_response.rb
266
280
  - lib/vericred_client/models/meta.rb
267
281
  - lib/vericred_client/models/network.rb
282
+ - lib/vericred_client/models/network_details.rb
283
+ - lib/vericred_client/models/network_details_response.rb
268
284
  - lib/vericred_client/models/network_search_response.rb
285
+ - lib/vericred_client/models/network_size.rb
269
286
  - lib/vericred_client/models/plan.rb
270
287
  - lib/vericred_client/models/plan_county.rb
271
288
  - lib/vericred_client/models/plan_county_bulk.rb
272
289
  - lib/vericred_client/models/plan_search_response.rb
290
+ - lib/vericred_client/models/plan_search_response_meta.rb
273
291
  - lib/vericred_client/models/plan_search_result.rb
274
292
  - lib/vericred_client/models/plan_show_response.rb
275
- - lib/vericred_client/models/pricing.rb
276
293
  - lib/vericred_client/models/provider.rb
294
+ - lib/vericred_client/models/provider_details.rb
295
+ - lib/vericred_client/models/provider_geocode.rb
277
296
  - lib/vericred_client/models/provider_show_response.rb
297
+ - lib/vericred_client/models/providers_geocode_response.rb
278
298
  - lib/vericred_client/models/providers_search_response.rb
279
299
  - lib/vericred_client/models/rating_area.rb
280
300
  - lib/vericred_client/models/request_plan_find.rb
@@ -285,13 +305,18 @@ files:
285
305
  - lib/vericred_client/models/service_area.rb
286
306
  - lib/vericred_client/models/service_area_zip_county.rb
287
307
  - lib/vericred_client/models/state.rb
308
+ - lib/vericred_client/models/state_network_size_request.rb
309
+ - lib/vericred_client/models/state_network_size_response.rb
288
310
  - lib/vericred_client/models/zip_code.rb
289
311
  - lib/vericred_client/models/zip_counties_response.rb
290
312
  - lib/vericred_client/models/zip_county.rb
291
313
  - lib/vericred_client/models/zip_county_bulk.rb
292
314
  - lib/vericred_client/models/zip_county_response.rb
293
315
  - lib/vericred_client/version.rb
316
+ - spec/api/drug_coverages_api_spec.rb
317
+ - spec/api/drug_packages_api_spec.rb
294
318
  - spec/api/drugs_api_spec.rb
319
+ - spec/api/network_sizes_api_spec.rb
295
320
  - spec/api/networks_api_spec.rb
296
321
  - spec/api/plans_api_spec.rb
297
322
  - spec/api/providers_api_spec.rb
@@ -309,18 +334,27 @@ files:
309
334
  - spec/models/drug_package_spec.rb
310
335
  - spec/models/drug_search_response_spec.rb
311
336
  - spec/models/drug_spec.rb
337
+ - spec/models/formulary_drug_package_response_spec.rb
338
+ - spec/models/formulary_response_spec.rb
339
+ - spec/models/formulary_spec.rb
312
340
  - spec/models/meta_spec.rb
341
+ - spec/models/network_details_response_spec.rb
342
+ - spec/models/network_details_spec.rb
313
343
  - spec/models/network_search_response_spec.rb
344
+ - spec/models/network_size_spec.rb
314
345
  - spec/models/network_spec.rb
315
346
  - spec/models/plan_county_bulk_spec.rb
316
347
  - spec/models/plan_county_spec.rb
348
+ - spec/models/plan_search_response_meta_spec.rb
317
349
  - spec/models/plan_search_response_spec.rb
318
350
  - spec/models/plan_search_result_spec.rb
319
351
  - spec/models/plan_show_response_spec.rb
320
352
  - spec/models/plan_spec.rb
321
- - spec/models/pricing_spec.rb
353
+ - spec/models/provider_details_spec.rb
354
+ - spec/models/provider_geocode_spec.rb
322
355
  - spec/models/provider_show_response_spec.rb
323
356
  - spec/models/provider_spec.rb
357
+ - spec/models/providers_geocode_response_spec.rb
324
358
  - spec/models/providers_search_response_spec.rb
325
359
  - spec/models/rating_area_spec.rb
326
360
  - spec/models/request_plan_find_applicant_spec.rb
@@ -330,6 +364,8 @@ files:
330
364
  - spec/models/request_providers_search_spec.rb
331
365
  - spec/models/service_area_spec.rb
332
366
  - spec/models/service_area_zip_county_spec.rb
367
+ - spec/models/state_network_size_request_spec.rb
368
+ - spec/models/state_network_size_response_spec.rb
333
369
  - spec/models/state_spec.rb
334
370
  - spec/models/zip_code_spec.rb
335
371
  - spec/models/zip_counties_response_spec.rb
@@ -350,7 +386,7 @@ required_ruby_version: !ruby/object:Gem::Requirement
350
386
  requirements:
351
387
  - - ">="
352
388
  - !ruby/object:Gem::Version
353
- version: '0'
389
+ version: '1.9'
354
390
  required_rubygems_version: !ruby/object:Gem::Requirement
355
391
  requirements:
356
392
  - - ">="
@@ -363,7 +399,10 @@ signing_key:
363
399
  specification_version: 4
364
400
  summary: Vericred API Ruby Gem
365
401
  test_files:
402
+ - spec/api/drug_coverages_api_spec.rb
403
+ - spec/api/drug_packages_api_spec.rb
366
404
  - spec/api/drugs_api_spec.rb
405
+ - spec/api/network_sizes_api_spec.rb
367
406
  - spec/api/networks_api_spec.rb
368
407
  - spec/api/plans_api_spec.rb
369
408
  - spec/api/providers_api_spec.rb
@@ -381,18 +420,27 @@ test_files:
381
420
  - spec/models/drug_package_spec.rb
382
421
  - spec/models/drug_search_response_spec.rb
383
422
  - spec/models/drug_spec.rb
423
+ - spec/models/formulary_drug_package_response_spec.rb
424
+ - spec/models/formulary_response_spec.rb
425
+ - spec/models/formulary_spec.rb
384
426
  - spec/models/meta_spec.rb
427
+ - spec/models/network_details_response_spec.rb
428
+ - spec/models/network_details_spec.rb
385
429
  - spec/models/network_search_response_spec.rb
430
+ - spec/models/network_size_spec.rb
386
431
  - spec/models/network_spec.rb
387
432
  - spec/models/plan_county_bulk_spec.rb
388
433
  - spec/models/plan_county_spec.rb
434
+ - spec/models/plan_search_response_meta_spec.rb
389
435
  - spec/models/plan_search_response_spec.rb
390
436
  - spec/models/plan_search_result_spec.rb
391
437
  - spec/models/plan_show_response_spec.rb
392
438
  - spec/models/plan_spec.rb
393
- - spec/models/pricing_spec.rb
439
+ - spec/models/provider_details_spec.rb
440
+ - spec/models/provider_geocode_spec.rb
394
441
  - spec/models/provider_show_response_spec.rb
395
442
  - spec/models/provider_spec.rb
443
+ - spec/models/providers_geocode_response_spec.rb
396
444
  - spec/models/providers_search_response_spec.rb
397
445
  - spec/models/rating_area_spec.rb
398
446
  - spec/models/request_plan_find_applicant_spec.rb
@@ -402,6 +450,8 @@ test_files:
402
450
  - spec/models/request_providers_search_spec.rb
403
451
  - spec/models/service_area_spec.rb
404
452
  - spec/models/service_area_zip_county_spec.rb
453
+ - spec/models/state_network_size_request_spec.rb
454
+ - spec/models/state_network_size_response_spec.rb
405
455
  - spec/models/state_spec.rb
406
456
  - spec/models/zip_code_spec.rb
407
457
  - spec/models/zip_counties_response_spec.rb