mphapi 0.4.2__tar.gz → 0.4.3__tar.gz

{mphapi-0.4.2 → mphapi-0.4.3}/PKG-INFO

@@ -1,6 +1,6 @@
 Metadata-Version: 2.1
 Name: mphapi
-Version: 0.4.2
+Version: 0.4.3
 Summary: A Python interface to the MyPriceHealth API
 Author: David Archibald
 Author-email: davidarchibald@myprice.health

{mphapi-0.4.2 → mphapi-0.4.3}/mphapi/claim.py

@@ -1,7 +1,9 @@
+import decimal
 from enum import Enum, IntEnum
-from typing import Annotated, Optional
+from typing import Annotated, Any, Optional
 
-from pydantic import BaseModel, Field
+from pydantic import BaseModel, Field, GetCoreSchemaHandler
+from pydantic_core import CoreSchema, core_schema
 
 from .date import Date
 from .fields import camel_case_model_config, field_name
@@ -100,17 +102,69 @@ class Provider(BaseModel):
     provider_state: Optional[str] = None
     """Address line 2 of the provider (from N302, optional)"""
 
-    provider_zip: Annotated[str, field_name("providerZIP")]
+    provider_zip: Annotated[Optional[str], field_name("providerZIP")] = None
     """ZIP code of the provider (from N403, required)"""
 
 
+class Decimal:
+    """
+    An arbitrary precision number.
+    When deserializing it allows to deserialize from a float, str, or int.
+    When serialized it always serializes to a str to prevent loss of precision.
+    """
+
+    # Python has an arbitrary precision number built in that this type is just a thin wrapper around.
+    value: decimal.Decimal
+
+    def __init__(self, value: decimal.Decimal):
+        self.value = value
+
+    def __str__(self) -> str:
+        return str(self.value)
+
+    # Based off of this: https://docs.pydantic.dev/2.1/usage/types/custom/#handling-third-party-types
+    @classmethod
+    def __get_pydantic_core_schema__(
+        cls, source_type: Any, handler: GetCoreSchemaHandler
+    ) -> CoreSchema:
+        def to_decimal(value: float | int | str | decimal.Decimal) -> Decimal:
+            return Decimal(decimal.Decimal(value))
+
+        from_value = core_schema.chain_schema(
+            [
+                core_schema.union_schema(
+                    [
+                        core_schema.str_schema(),
+                        core_schema.is_instance_schema(decimal.Decimal),
+                        core_schema.float_schema(),
+                        core_schema.int_schema(),
+                    ]
+                ),
+                core_schema.no_info_plain_validator_function(to_decimal),
+            ]
+        )
+
+        return core_schema.json_or_python_schema(
+            json_schema=from_value,
+            python_schema=core_schema.union_schema(
+                [
+                    core_schema.is_instance_schema(Decimal),
+                    from_value,
+                ]
+            ),
+            serialization=core_schema.plain_serializer_function_ser_schema(
+                lambda decimal: str(decimal)
+            ),
+        )
+
+
 class ValueCode(BaseModel):
     model_config = camel_case_model_config
 
     code: str
     """Code indicating the type of value provided (from HIxx_02)"""
 
-    amount: float
+    amount: Decimal
     """Amount associated with the value code (from HIxx_05)"""
 
 
@@ -173,9 +227,6 @@ class Service(BaseModel):
     place_of_service: Optional[str] = None
     """Place of service code (from SV105)"""
 
-    diagnosis_pointers: Optional[list[int]] = None
-    """Diagnosis pointers (from SV107)"""
-
     ambulance_pickup_zip: Annotated[Optional[str], field_name("ambulancePickupZIP")] = (
         None
     )

{mphapi-0.4.2 → mphapi-0.4.3}/mphapi/client.py

@@ -14,6 +14,9 @@ Header = Mapping[str, str | bytes | None]
 class PriceConfig(BaseModel):
     """PriceConfig is used to configure the behavior of the pricing API"""
 
+    price_zero_billed: StrictBool
+    """set to true to price claims with zero billed amounts (default is false)"""
+
     is_commercial: StrictBool
     """set to true to use commercial code crosswalks"""
 
@@ -35,6 +38,15 @@ class PriceConfig(BaseModel):
     include_edits: StrictBool
     """set to true to include edit details in the response"""
 
+    continue_on_edit_fail: StrictBool
+    """set to true to continue to price the claim even if there are edit failures"""
+
+    continue_on_provider_match_fail: StrictBool
+    """set to true to continue with a average provider for the geographic area if the provider cannot be matched"""
+
+    disable_machine_learning_estimates: StrictBool
+    """set to true to disable machine learning estimates (applies to estimates only)"""
+
 
 class Client:
     url: str
@@ -191,6 +203,9 @@ class Client:
 
     def _get_price_headers(self, config: PriceConfig) -> Header:
         headers: Header = {}
+        if config.price_zero_billed:
+            headers["price-zero-billed"] = "true"
+
         if config.is_commercial:
             headers["is-commercial"] = "true"
 
@@ -212,4 +227,13 @@ class Client:
         if config.use_best_drg_price:
             headers["use-best-drg-price"] = "true"
 
+        if config.continue_on_edit_fail:
+            headers["continue-on-edit-fail"] = "true"
+
+        if config.continue_on_provider_match_fail:
+            headers["continue-on-provider-match-fail"] = "true"
+
+        if config.disable_machine_learning_estimates:
+            headers["disable-machine-learning-estimates"] = "true"
+
         return headers

{mphapi-0.4.2 → mphapi-0.4.3}/mphapi/pricing.py

@@ -52,6 +52,28 @@ class RuralIndicator(str, Enum):
     URBAN = ""
 
 
+class MedicareSource(str, Enum):
+    Ambulance = "AmbulanceFS"
+    Anesthesia = "AnesthesiaFS"
+    CriticalAccessHospital = "CAH pricer"
+    Drugs = "DrugsFS"
+    EditError = "Claim editor"
+    EstimateByCodeOnly = "CodeOnly"
+    EstimateByLocalityCode = "LocalityCode"
+    EstimateByLocalityOnly = "LocalityOnly"
+    EstimateByNational = "National"
+    EstimateByStateCode = "StateCode"
+    EstimateByStateOnly = "StateOnly"
+    EstimateByUnknown = "Unknown"
+    Inpatient = "IPPS"
+    Labs = "LabsFS"
+    MPFS = "MPFS"
+    Outpatient = "Outpatient pricer"
+    ManualPricing = "Manual Pricing"
+    SNF = "SNF PPS"
+    Synthetic = "Synthetic Medicare"
+
+
 class InpatientPriceDetail(BaseModel):
     """InpatientPriceDetail contains pricing details for an inpatient claim"""
 
@@ -93,28 +115,28 @@ class OutpatientPriceDetail(BaseModel):
 
     model_config = camel_case_model_config
 
-    outlier_amount: float
+    outlier_amount: Optional[float] = None
     """Additional amount paid for high cost cases"""
 
-    first_passthrough_drug_offset_amount: float
+    first_passthrough_drug_offset_amount: Optional[float] = None
     """Amount built into the APC payment for certain drugs"""
 
-    second_passthrough_drug_offset_amount: float
+    second_passthrough_drug_offset_amount: Optional[float] = None
     """Amount built into the APC payment for certain drugs"""
 
-    third_passthrough_drug_offset_amount: float
+    third_passthrough_drug_offset_amount: Optional[float] = None
     """Amount built into the APC payment for certain drugs"""
 
-    first_device_offset_amount: float
+    first_device_offset_amount: Optional[float] = None
     """Amount built into the APC payment for certain devices"""
 
-    second_device_offset_amount: float
+    second_device_offset_amount: Optional[float] = None
     """Amount built into the APC payment for certain devices"""
 
-    full_or_partial_device_credit_offset_amount: float
+    full_or_partial_device_credit_offset_amount: Optional[float] = None
     """Credit for devices that are supplied for free or at a reduced cost"""
 
-    terminated_device_procedure_offset_amount: float
+    terminated_device_procedure_offset_amount: Optional[float] = None
     """Credit for devices that are not used due to a terminated procedure"""
 
     wage_index: Optional[float] = None
@@ -154,19 +176,47 @@ class ClaimEdits(BaseModel):
 
     model_config = camel_case_model_config
 
+    hcp_deny_code: Optional[str] = None
+    """The deny code that will be placed into the HCP13 data element for EDI 837 claims"""
+
     claim_overall_disposition: Optional[str] = None
+    """Overall explanation of why the claim edit failed"""
+
     claim_rejection_disposition: Optional[str] = None
+    """Explanation of why the claim was rejected"""
+
     claim_denial_disposition: Optional[str] = None
+    """Explanation of why the claim was denied"""
+
     claim_return_to_provider_disposition: Optional[str] = None
+    """Explanation of why the claim should be returned to provider"""
+
     claim_suspension_disposition: Optional[str] = None
+    """Explanation of why the claim was suspended"""
+
     line_item_rejection_disposition: Optional[str] = None
+    """Explanation of why the line item was rejected"""
+
     line_item_denial_disposition: Optional[str] = None
+    """Explanation of why the line item was denied"""
+
     claim_rejection_reasons: Optional[list[str]] = None
+    """Detailed reason(s) describing why the claim was rejected"""
+
     claim_denial_reasons: Optional[list[str]] = None
+    """Detailed reason(s) describing why the claim was denied"""
+
     claim_return_to_provider_reasons: Optional[list[str]] = None
+    """Detailed reason(s) describing why the claim should be returned to provider"""
+
     claim_suspension_reasons: Optional[list[str]] = None
+    """Detailed reason(s) describing why the claim was suspended"""
+
     line_item_rejection_reasons: Optional[list[str]] = None
+    """Detailed reason(s) describing why the line item was rejected"""
+
     line_item_denial_reasons: Optional[list[str]] = None
+    """Detailed reason(s) describing why the line item was denied"""
 
 
 class LineEdits(BaseModel):
@@ -174,16 +224,35 @@ class LineEdits(BaseModel):
 
     model_config = camel_case_model_config
 
-    denial_or_rejection_text: str
-    procedure_edits: list[str]
-    modifier1_edits: list[str]
-    modifier2_edits: list[str]
-    modifier3_edits: list[str]
-    modifier4_edits: list[str]
-    modifier5_edits: list[str]
-    data_edits: list[str]
-    revenue_edits: list[str]
-    professional_edits: list[str]
+    denial_or_rejection_text: Optional[str] = None
+    """The overall explanation for why this line item was denied or rejected by the claim editor"""
+
+    procedure_edits: Optional[list[str]] = None
+    """Detailed description of each procedure code edit error (from outpatient editor)"""
+
+    modifier1_edits: Optional[list[str]] = None
+    """Detailed description of each edit error for the first procedure code modifier (from outpatient editor)"""
+
+    modifier2_edits: Optional[list[str]] = None
+    """Detailed description of each edit error for the second procedure code modifier (from outpatient editor)"""
+
+    modifier3_edits: Optional[list[str]] = None
+    """Detailed description of each edit error for the third procedure code modifier (from outpatient editor)"""
+
+    modifier4_edits: Optional[list[str]] = None
+    """Detailed description of each edit error for the fourth procedure code modifier (from outpatient editor)"""
+
+    modifier5_edits: Optional[list[str]] = None
+    """Detailed description of each edit error for the fifth procedure code modifier (from outpatient editor)"""
+
+    data_edits: Optional[list[str]] = None
+    """Detailed description of each data edit error (from outpatient editor)"""
+
+    revenue_edits: Optional[list[str]] = None
+    """Detailed description of each revenue code edit error (from outpatient editor)"""
+
+    professional_edits: Optional[list[str]] = None
+    """Detailed description of each professional claim edit error"""
 
 
 class PricedService(BaseModel):
@@ -224,7 +293,7 @@ class PricedService(BaseModel):
     medicare_std_dev: Optional[float] = None
     """Standard deviation of the estimated Medicare amount (estimates service only)"""
 
-    medicare_source: Optional[str] = None
+    medicare_source: Optional[MedicareSource] = None
     """Source of the Medicare amount (e.g. physician fee schedule, OPPS, etc.)"""
 
     pricer_result: Optional[str] = None
@@ -272,7 +341,7 @@ class Pricing(BaseModel):
     medicare_std_dev: Optional[float] = None
     """The standard deviation of the estimated Medicare amount (estimates service only)"""
 
-    medicare_source: Optional[str] = None
+    medicare_source: Optional[MedicareSource] = None
     """Source of the Medicare amount (e.g. physician fee schedule, OPPS, etc.)"""
 
     inpatient_price_detail: Optional[InpatientPriceDetail] = None

{mphapi-0.4.2 → mphapi-0.4.3}/pyproject.toml

@@ -1,6 +1,6 @@
 [tool.poetry]
 name = "mphapi"
-version = "0.4.2"
+version = "0.4.3"
 description = "A Python interface to the MyPriceHealth API"
 authors = ["David Archibald <davidarchibald@myprice.health>"]