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
@@ -264,7 +351,7 @@ module VericredClient
264
351
  def build_from_hash(attributes)
265
352
  return nil unless attributes.is_a?(Hash)
266
353
  self.class.swagger_types.each_pair do |key, type|
267
- if type =~ /^Array<(.*)>/i
354
+ if type =~ /\AArray<(.*)>/i
268
355
  # check to ensure the input is an array given that the the attribute
269
356
  # is documented as an array but the input is not
270
357
  if attributes[self.class.attribute_map[key]].is_a?(Array)
@@ -295,7 +382,7 @@ module VericredClient
295
382
  when :Float
296
383
  value.to_f
297
384
  when :BOOLEAN
298
- if value.to_s =~ /^(true|t|yes|y|1)$/i
385
+ if value.to_s =~ /\A(true|t|yes|y|1)\z/i
299
386
  true
300
387
  else
301
388
  false
@@ -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 &amp; 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 &amp; 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
@@ -133,7 +220,7 @@ require 'date'
133
220
  module VericredClient
134
221
 
135
222
  class Base
136
- # Metadata for query
223
+ # Meta-data
137
224
  attr_accessor :meta
138
225
 
139
226
 
@@ -204,7 +291,7 @@ module VericredClient
204
291
  def build_from_hash(attributes)
205
292
  return nil unless attributes.is_a?(Hash)
206
293
  self.class.swagger_types.each_pair do |key, type|
207
- if type =~ /^Array<(.*)>/i
294
+ if type =~ /\AArray<(.*)>/i
208
295
  # check to ensure the input is an array given that the the attribute
209
296
  # is documented as an array but the input is not
210
297
  if attributes[self.class.attribute_map[key]].is_a?(Array)
@@ -235,7 +322,7 @@ module VericredClient
235
322
  when :Float
236
323
  value.to_f
237
324
  when :BOOLEAN
238
- if value.to_s =~ /^(true|t|yes|y|1)$/i
325
+ if value.to_s =~ /\A(true|t|yes|y|1)\z/i
239
326
  true
240
327
  else
241
328
  false
@@ -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 &amp; 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 &amp; 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
@@ -224,7 +311,7 @@ module VericredClient
224
311
  def build_from_hash(attributes)
225
312
  return nil unless attributes.is_a?(Hash)
226
313
  self.class.swagger_types.each_pair do |key, type|
227
- if type =~ /^Array<(.*)>/i
314
+ if type =~ /\AArray<(.*)>/i
228
315
  # check to ensure the input is an array given that the the attribute
229
316
  # is documented as an array but the input is not
230
317
  if attributes[self.class.attribute_map[key]].is_a?(Array)
@@ -255,7 +342,7 @@ module VericredClient
255
342
  when :Float
256
343
  value.to_f
257
344
  when :BOOLEAN
258
- if value.to_s =~ /^(true|t|yes|y|1)$/i
345
+ if value.to_s =~ /\A(true|t|yes|y|1)\z/i
259
346
  true
260
347
  else
261
348
  false