vericred_client 0.0.9 → 0.0.11

data/lib/vericred_client/api/drugs_api.rb

@@ -6,13 +6,20 @@ accepts.
 
 ## Getting Started
 
-Visit our [Developer Portal](https://vericred.3scale.net) to
+Visit our [Developer Portal](https://developers.vericred.com) to
 create an account.
 
 Once you have created an account, you can create one Application for
 Production and another for our Sandbox (select the appropriate Plan when
 you create the Application).
 
+## SDKs
+
+Our API follows standard REST conventions, so you can use any HTTP client
+to integrate with us. You will likely find it easier to use one of our
+[autogenerated SDKs](https://github.com/vericred/?query=vericred-),
+which we make available for several common programming languages.
+
 ## Authentication
 
 To authenticate, pass the API Key you created in the Developer Portal as
@@ -108,6 +115,86 @@ The response would be
 }
 ```
 
+## Benefits summary format
+Benefit cost-share strings are formatted to capture:
+ * Network tiers
+ * Compound or conditional cost-share
+ * Limits on the cost-share
+ * Benefit-specific maximum out-of-pocket costs
+
+**Example #1**
+As an example, we would represent [this Summary of Benefits & Coverage](https://s3.amazonaws.com/vericred-data/SBC/2017/33602TX0780032.pdf) as:
+
+* **Hospital stay facility fees**:
+  - Network Provider: `$400 copay/admit plus 20% coinsurance`
+  - Out-of-Network Provider: `$1,500 copay/admit plus 50% coinsurance`
+  - 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`
+
+* **Rehabilitation services:**
+  - Network Provider: `20% coinsurance`
+  - Out-of-Network Provider: `50% coinsurance`
+  - Limitations & Exceptions: `35 visit maximum per benefit period combined with Chiropractic care.`
+  - Vericred's format for this benefit: `In-Network: 20% after deductible / Out-of-Network: 50% after deductible | limit: 35 visit(s) per Benefit Period`
+
+**Example #2**
+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.
+* **Specialty drugs:**
+  - Network Provider: `40% coinsurance up to a $500 maximum for up to a 30 day supply`
+  - Out-of-Network Provider `Not covered`
+  - Vericred's format for this benefit: `In-Network: 40% after deductible, up to $500 per script / Out-of-Network: 100%`
+
+**BNF**
+
+Here's a description of the benefits summary string, represented as a context-free grammar:
+
+```
+root                      ::= coverage
+
+coverage                  ::= (simple_coverage | tiered_coverage) (space pipe space coverage_limitation)?
+tiered_coverage           ::= tier (space slash space tier)*
+tier                      ::= tier_name colon space (tier_coverage | not_applicable)
+tier_coverage             ::= simple_coverage (space (then | or | and) space simple_coverage)* tier_limitation?
+simple_coverage           ::= (pre_coverage_limitation space)? coverage_amount (space post_coverage_limitation)? (comma? space coverage_condition)?
+coverage_limitation       ::= "limit" colon space (((simple_coverage | simple_limitation) (semicolon space see_carrier_documentation)?) | see_carrier_documentation | waived_if_admitted)
+waived_if_admitted        ::= ("copay" space)? "waived if admitted"
+simple_limitation         ::= pre_coverage_limitation space "copay applies"
+tier_name                 ::= "In-Network-Tier-2" | "Out-of-Network" | "In-Network"
+tier_limitation           ::= comma space "up to" space (currency | (integer space time_unit plural?)) (space post_coverage_limitation)?
+coverage_amount           ::= currency | unlimited | included | unknown | percentage | (digits space (treatment_unit | time_unit) plural?)
+pre_coverage_limitation   ::= first space digits space time_unit plural?
+post_coverage_limitation  ::= (((then space currency) | "per condition") space)? "per" space (treatment_unit | (integer space time_unit) | time_unit) plural?
+coverage_condition        ::= ("before deductible" | "after deductible" | "penalty" | allowance | "in-state" | "out-of-state") (space allowance)?
+allowance                 ::= upto_allowance | after_allowance
+upto_allowance            ::= "up to" space (currency space)? "allowance"
+after_allowance           ::= "after" space (currency space)? "allowance"
+see_carrier_documentation ::= "see carrier documentation for more information"
+unknown                   ::= "unknown"
+unlimited                 ::= /[uU]nlimited/
+included                  ::= /[iI]ncluded in [mM]edical/
+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/)
+treatment_unit            ::= /[pP]erson/ | /[gG]roup/ | /[cC]ondition/ | /[sS]cript/ | /[vV]isit/ | /[eE]xam/ | /[iI]tem/ | /[sS]tay/ | /[tT]reatment/ | /[aA]dmission/ | /[eE]pisode/
+comma                     ::= ","
+colon                     ::= ":"
+semicolon                 ::= ";"
+pipe                      ::= "|"
+slash                     ::= "/"
+plural                    ::= "(s)" | "s"
+then                      ::= "then" | ("," space) | space
+or                        ::= "or"
+and                       ::= "and"
+not_applicable            ::= "Not Applicable" | "N/A" | "NA"
+first                     ::= "first"
+currency                  ::= "$" number
+percentage                ::= number "%"
+number                    ::= float | integer
+float                     ::= digits "." digits
+integer                   ::= /[0-9]/+ (comma_int | under_int)*
+comma_int                 ::= ("," /[0-9]/*3) !"_"
+under_int                 ::= ("_" /[0-9]/*3) !","
+digits                    ::= /[0-9]/+ ("_" /[0-9]/+)*
+space                     ::= /[ \t]/+
+```
+
 
 
 OpenAPI spec version: 1.0.0
@@ -138,73 +225,6 @@ module VericredClient
       @api_client = api_client
     end
 
-    # Search for DrugCoverages
-    # Drug Coverages are the specific tier level, quantity limit, prior authorization and step therapy for a given Drug/Plan combination. This endpoint returns all DrugCoverages for a given Drug
-    # @param ndc_package_code NDC package code
-    # @param audience Two-character state code
-    # @param state_code Two-character state code
-    # @param [Hash] opts the optional parameters
-    # @return [DrugCoverageResponse]
-    def get_drug_coverages(ndc_package_code, audience, state_code, opts = {})
-      data, _status_code, _headers = get_drug_coverages_with_http_info(ndc_package_code, audience, state_code, opts)
-      return data
-    end
-
-    # Search for DrugCoverages
-    # Drug Coverages are the specific tier level, quantity limit, prior authorization and step therapy for a given Drug/Plan combination. This endpoint returns all DrugCoverages for a given Drug
-    # @param ndc_package_code NDC package code
-    # @param audience Two-character state code
-    # @param state_code Two-character state code
-    # @param [Hash] opts the optional parameters
-    # @return [Array<(DrugCoverageResponse, Fixnum, Hash)>] DrugCoverageResponse data, response status code and response headers
-    def get_drug_coverages_with_http_info(ndc_package_code, audience, state_code, opts = {})
-      if @api_client.config.debugging
-        @api_client.config.logger.debug "Calling API: DrugsApi.get_drug_coverages ..."
-      end
-      # verify the required parameter 'ndc_package_code' is set
-      fail ArgumentError, "Missing the required parameter 'ndc_package_code' when calling DrugsApi.get_drug_coverages" if ndc_package_code.nil?
-      # verify the required parameter 'audience' is set
-      fail ArgumentError, "Missing the required parameter 'audience' when calling DrugsApi.get_drug_coverages" if audience.nil?
-      # verify the required parameter 'state_code' is set
-      fail ArgumentError, "Missing the required parameter 'state_code' when calling DrugsApi.get_drug_coverages" if state_code.nil?
-      # resource path
-      local_var_path = "/drug_packages/{ndc_package_code}/coverages".sub('{format}','json').sub('{' + 'ndc_package_code' + '}', ndc_package_code.to_s)
-
-      # query parameters
-      query_params = {}
-      query_params[:'audience'] = audience
-      query_params[:'state_code'] = state_code
-
-      # header parameters
-      header_params = {}
-
-      # HTTP header 'Accept' (if needed)
-      local_header_accept = []
-      local_header_accept_result = @api_client.select_header_accept(local_header_accept) and header_params['Accept'] = local_header_accept_result
-
-      # HTTP header 'Content-Type'
-      local_header_content_type = []
-      header_params['Content-Type'] = @api_client.select_header_content_type(local_header_content_type)
-
-      # form parameters
-      form_params = {}
-
-      # http body (model)
-      post_body = nil
-      auth_names = ['Vericred-Api-Key']
-      data, status_code, headers = @api_client.call_api(:GET, local_var_path,
-        :header_params => header_params,
-        :query_params => query_params,
-        :form_params => form_params,
-        :body => post_body,
-        :auth_names => auth_names,
-        :return_type => 'DrugCoverageResponse')
-      if @api_client.config.debugging
-        @api_client.config.logger.debug "API called: DrugsApi#get_drug_coverages\nData: #{data.inspect}\nStatus code: #{status_code}\nHeaders: #{headers}"
-      end
-      return data, status_code, headers
-    end
-
     # Drug Search
     # Search for drugs by proprietary name
     # @param search_term Full or partial proprietary name of drug

data/lib/vericred_client/api/network_sizes_api.rb

@@ -0,0 +1,348 @@
+=begin
+#Vericred API
+
+#Vericred's API allows you to search for Health Plans that a specific doctor
+accepts.
+
+## Getting Started
+
+Visit our [Developer Portal](https://developers.vericred.com) to
+create an account.
+
+Once you have created an account, you can create one Application for
+Production and another for our Sandbox (select the appropriate Plan when
+you create the Application).
+
+## SDKs
+
+Our API follows standard REST conventions, so you can use any HTTP client
+to integrate with us. You will likely find it easier to use one of our
+[autogenerated SDKs](https://github.com/vericred/?query=vericred-),
+which we make available for several common programming languages.
+
+## Authentication
+
+To authenticate, pass the API Key you created in the Developer Portal as
+a `Vericred-Api-Key` header.
+
+`curl -H 'Vericred-Api-Key: YOUR_KEY' "https://api.vericred.com/providers?search_term=Foo&zip_code=11215"`
+
+## Versioning
+
+Vericred's API default to the latest version.  However, if you need a specific
+version, you can request it with an `Accept-Version` header.
+
+The current version is `v3`.  Previous versions are `v1` and `v2`.
+
+`curl -H 'Vericred-Api-Key: YOUR_KEY' -H 'Accept-Version: v2' "https://api.vericred.com/providers?search_term=Foo&zip_code=11215"`
+
+## Pagination
+
+Endpoints that accept `page` and `per_page` parameters are paginated. They expose
+four additional fields that contain data about your position in the response,
+namely `Total`, `Per-Page`, `Link`, and `Page` as described in [RFC-5988](https://tools.ietf.org/html/rfc5988).
+
+For example, to display 5 results per page and view the second page of a
+`GET` to `/networks`, your final request would be `GET /networks?....page=2&per_page=5`.
+
+## Sideloading
+
+When we return multiple levels of an object graph (e.g. `Provider`s and their `State`s
+we sideload the associated data.  In this example, we would provide an Array of
+`State`s and a `state_id` for each provider.  This is done primarily to reduce the
+payload size since many of the `Provider`s will share a `State`
+
+```
+{
+  providers: [{ id: 1, state_id: 1}, { id: 2, state_id: 1 }],
+  states: [{ id: 1, code: 'NY' }]
+}
+```
+
+If you need the second level of the object graph, you can just match the
+corresponding id.
+
+## Selecting specific data
+
+All endpoints allow you to specify which fields you would like to return.
+This allows you to limit the response to contain only the data you need.
+
+For example, let's take a request that returns the following JSON by default
+
+```
+{
+  provider: {
+    id: 1,
+    name: 'John',
+    phone: '1234567890',
+    field_we_dont_care_about: 'value_we_dont_care_about'
+  },
+  states: [{
+    id: 1,
+    name: 'New York',
+    code: 'NY',
+    field_we_dont_care_about: 'value_we_dont_care_about'
+  }]
+}
+```
+
+To limit our results to only return the fields we care about, we specify the
+`select` query string parameter for the corresponding fields in the JSON
+document.
+
+In this case, we want to select `name` and `phone` from the `provider` key,
+so we would add the parameters `select=provider.name,provider.phone`.
+We also want the `name` and `code` from the `states` key, so we would
+add the parameters `select=states.name,staes.code`.  The id field of
+each document is always returned whether or not it is requested.
+
+Our final request would be `GET /providers/12345?select=provider.name,provider.phone,states.name,states.code`
+
+The response would be
+
+```
+{
+  provider: {
+    id: 1,
+    name: 'John',
+    phone: '1234567890'
+  },
+  states: [{
+    id: 1,
+    name: 'New York',
+    code: 'NY'
+  }]
+}
+```
+
+## Benefits summary format
+Benefit cost-share strings are formatted to capture:
+ * Network tiers
+ * Compound or conditional cost-share
+ * Limits on the cost-share
+ * Benefit-specific maximum out-of-pocket costs
+
+**Example #1**
+As an example, we would represent [this Summary of Benefits & Coverage](https://s3.amazonaws.com/vericred-data/SBC/2017/33602TX0780032.pdf) as:
+
+* **Hospital stay facility fees**:
+  - Network Provider: `$400 copay/admit plus 20% coinsurance`
+  - Out-of-Network Provider: `$1,500 copay/admit plus 50% coinsurance`
+  - 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`
+
+* **Rehabilitation services:**
+  - Network Provider: `20% coinsurance`
+  - Out-of-Network Provider: `50% coinsurance`
+  - Limitations & Exceptions: `35 visit maximum per benefit period combined with Chiropractic care.`
+  - Vericred's format for this benefit: `In-Network: 20% after deductible / Out-of-Network: 50% after deductible | limit: 35 visit(s) per Benefit Period`
+
+**Example #2**
+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.
+* **Specialty drugs:**
+  - Network Provider: `40% coinsurance up to a $500 maximum for up to a 30 day supply`
+  - Out-of-Network Provider `Not covered`
+  - Vericred's format for this benefit: `In-Network: 40% after deductible, up to $500 per script / Out-of-Network: 100%`
+
+**BNF**
+
+Here's a description of the benefits summary string, represented as a context-free grammar:
+
+```
+root                      ::= coverage
+
+coverage                  ::= (simple_coverage | tiered_coverage) (space pipe space coverage_limitation)?
+tiered_coverage           ::= tier (space slash space tier)*
+tier                      ::= tier_name colon space (tier_coverage | not_applicable)
+tier_coverage             ::= simple_coverage (space (then | or | and) space simple_coverage)* tier_limitation?
+simple_coverage           ::= (pre_coverage_limitation space)? coverage_amount (space post_coverage_limitation)? (comma? space coverage_condition)?
+coverage_limitation       ::= "limit" colon space (((simple_coverage | simple_limitation) (semicolon space see_carrier_documentation)?) | see_carrier_documentation | waived_if_admitted)
+waived_if_admitted        ::= ("copay" space)? "waived if admitted"
+simple_limitation         ::= pre_coverage_limitation space "copay applies"
+tier_name                 ::= "In-Network-Tier-2" | "Out-of-Network" | "In-Network"
+tier_limitation           ::= comma space "up to" space (currency | (integer space time_unit plural?)) (space post_coverage_limitation)?
+coverage_amount           ::= currency | unlimited | included | unknown | percentage | (digits space (treatment_unit | time_unit) plural?)
+pre_coverage_limitation   ::= first space digits space time_unit plural?
+post_coverage_limitation  ::= (((then space currency) | "per condition") space)? "per" space (treatment_unit | (integer space time_unit) | time_unit) plural?
+coverage_condition        ::= ("before deductible" | "after deductible" | "penalty" | allowance | "in-state" | "out-of-state") (space allowance)?
+allowance                 ::= upto_allowance | after_allowance
+upto_allowance            ::= "up to" space (currency space)? "allowance"
+after_allowance           ::= "after" space (currency space)? "allowance"
+see_carrier_documentation ::= "see carrier documentation for more information"
+unknown                   ::= "unknown"
+unlimited                 ::= /[uU]nlimited/
+included                  ::= /[iI]ncluded in [mM]edical/
+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/)
+treatment_unit            ::= /[pP]erson/ | /[gG]roup/ | /[cC]ondition/ | /[sS]cript/ | /[vV]isit/ | /[eE]xam/ | /[iI]tem/ | /[sS]tay/ | /[tT]reatment/ | /[aA]dmission/ | /[eE]pisode/
+comma                     ::= ","
+colon                     ::= ":"
+semicolon                 ::= ";"
+pipe                      ::= "|"
+slash                     ::= "/"
+plural                    ::= "(s)" | "s"
+then                      ::= "then" | ("," space) | space
+or                        ::= "or"
+and                       ::= "and"
+not_applicable            ::= "Not Applicable" | "N/A" | "NA"
+first                     ::= "first"
+currency                  ::= "$" number
+percentage                ::= number "%"
+number                    ::= float | integer
+float                     ::= digits "." digits
+integer                   ::= /[0-9]/+ (comma_int | under_int)*
+comma_int                 ::= ("," /[0-9]/*3) !"_"
+under_int                 ::= ("_" /[0-9]/*3) !","
+digits                    ::= /[0-9]/+ ("_" /[0-9]/+)*
+space                     ::= /[ \t]/+
+```
+
+
+
+OpenAPI spec version: 1.0.0
+
+Generated by: https://github.com/swagger-api/swagger-codegen.git
+
+Licensed under the Apache License, Version 2.0 (the "License");
+you may not use this file except in compliance with the License.
+You may obtain a copy of the License at
+
+http://www.apache.org/licenses/LICENSE-2.0
+
+Unless required by applicable law or agreed to in writing, software
+distributed under the License is distributed on an "AS IS" BASIS,
+WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+See the License for the specific language governing permissions and
+limitations under the License.
+
+=end
+
+require "uri"
+
+module VericredClient
+  class NetworkSizesApi
+    attr_accessor :api_client
+
+    def initialize(api_client = ApiClient.default)
+      @api_client = api_client
+    end
+
+    # State Network Sizes
+    # The number of in-network Providers for each network in a given state. This data is recalculated nightly.  The endpoint is paginated.
+    # @param state_id State code
+    # @param [Hash] opts the optional parameters
+    # @option opts [Integer] :page Page of paginated response
+    # @option opts [Integer] :per_page Responses per page
+    # @return [StateNetworkSizeResponse]
+    def list_state_network_sizes(state_id, opts = {})
+      data, _status_code, _headers = list_state_network_sizes_with_http_info(state_id, opts)
+      return data
+    end
+
+    # State Network Sizes
+    # The number of in-network Providers for each network in a given state. This data is recalculated nightly.  The endpoint is paginated.
+    # @param state_id State code
+    # @param [Hash] opts the optional parameters
+    # @option opts [Integer] :page Page of paginated response
+    # @option opts [Integer] :per_page Responses per page
+    # @return [Array<(StateNetworkSizeResponse, Fixnum, Hash)>] StateNetworkSizeResponse data, response status code and response headers
+    def list_state_network_sizes_with_http_info(state_id, opts = {})
+      if @api_client.config.debugging
+        @api_client.config.logger.debug "Calling API: NetworkSizesApi.list_state_network_sizes ..."
+      end
+      # verify the required parameter 'state_id' is set
+      fail ArgumentError, "Missing the required parameter 'state_id' when calling NetworkSizesApi.list_state_network_sizes" if state_id.nil?
+      # resource path
+      local_var_path = "/states/{state_id}/network_sizes".sub('{format}','json').sub('{' + 'state_id' + '}', state_id.to_s)
+
+      # query parameters
+      query_params = {}
+      query_params[:'page'] = opts[:'page'] if !opts[:'page'].nil?
+      query_params[:'per_page'] = opts[:'per_page'] if !opts[:'per_page'].nil?
+
+      # header parameters
+      header_params = {}
+
+      # HTTP header 'Accept' (if needed)
+      local_header_accept = ['application/json']
+      local_header_accept_result = @api_client.select_header_accept(local_header_accept) and header_params['Accept'] = local_header_accept_result
+
+      # HTTP header 'Content-Type'
+      local_header_content_type = ['application/json']
+      header_params['Content-Type'] = @api_client.select_header_content_type(local_header_content_type)
+
+      # form parameters
+      form_params = {}
+
+      # http body (model)
+      post_body = nil
+      auth_names = ['Vericred-Api-Key']
+      data, status_code, headers = @api_client.call_api(:GET, local_var_path,
+        :header_params => header_params,
+        :query_params => query_params,
+        :form_params => form_params,
+        :body => post_body,
+        :auth_names => auth_names,
+        :return_type => 'StateNetworkSizeResponse')
+      if @api_client.config.debugging
+        @api_client.config.logger.debug "API called: NetworkSizesApi#list_state_network_sizes\nData: #{data.inspect}\nStatus code: #{status_code}\nHeaders: #{headers}"
+      end
+      return data, status_code, headers
+    end
+
+    # Network Sizes
+    # The number of in-network Providers for each network/state combination provided. This data is recalculated nightly.
+    # @param body 
+    # @param [Hash] opts the optional parameters
+    # @return [StateNetworkSizeResponse]
+    def search_network_sizes(body, opts = {})
+      data, _status_code, _headers = search_network_sizes_with_http_info(body, opts)
+      return data
+    end
+
+    # Network Sizes
+    # The number of in-network Providers for each network/state combination provided. This data is recalculated nightly.
+    # @param body 
+    # @param [Hash] opts the optional parameters
+    # @return [Array<(StateNetworkSizeResponse, Fixnum, Hash)>] StateNetworkSizeResponse data, response status code and response headers
+    def search_network_sizes_with_http_info(body, opts = {})
+      if @api_client.config.debugging
+        @api_client.config.logger.debug "Calling API: NetworkSizesApi.search_network_sizes ..."
+      end
+      # verify the required parameter 'body' is set
+      fail ArgumentError, "Missing the required parameter 'body' when calling NetworkSizesApi.search_network_sizes" if body.nil?
+      # resource path
+      local_var_path = "/network_sizes/search".sub('{format}','json')
+
+      # query parameters
+      query_params = {}
+
+      # header parameters
+      header_params = {}
+
+      # HTTP header 'Accept' (if needed)
+      local_header_accept = ['application/json']
+      local_header_accept_result = @api_client.select_header_accept(local_header_accept) and header_params['Accept'] = local_header_accept_result
+
+      # HTTP header 'Content-Type'
+      local_header_content_type = ['application/json']
+      header_params['Content-Type'] = @api_client.select_header_content_type(local_header_content_type)
+
+      # form parameters
+      form_params = {}
+
+      # http body (model)
+      post_body = @api_client.object_to_http_body(body)
+      auth_names = ['Vericred-Api-Key']
+      data, status_code, headers = @api_client.call_api(:POST, local_var_path,
+        :header_params => header_params,
+        :query_params => query_params,
+        :form_params => form_params,
+        :body => post_body,
+        :auth_names => auth_names,
+        :return_type => 'StateNetworkSizeResponse')
+      if @api_client.config.debugging
+        @api_client.config.logger.debug "API called: NetworkSizesApi#search_network_sizes\nData: #{data.inspect}\nStatus code: #{status_code}\nHeaders: #{headers}"
+      end
+      return data, status_code, headers
+    end
+  end
+end