Examples with Beneficiary gov.cms.bfd.model.rif.Beneficiary used on opensource projects

Example 96 with Beneficiary

use of gov.cms.bfd.model.rif.Beneficiary in project beneficiary-fhir-data by CMSgov.

the class RifLoaderIT method failOnUpdateBeneficiaryBeforeInsert.

/**
 * Runs {@link RifLoader} against the {@link StaticRifResourceGroup#SAMPLE_A} data for an <code>
 * UPDATE</code> {@link Beneficiary} record that there hasn't been a previous <code>INSERT</code>
 * on, to verify that this fails as expected.
 */
@Test
public void failOnUpdateBeneficiaryBeforeInsert() {
    // Tweak the SAMPLE_A beneficiary to be an UPDATE.
    Stream<RifFile> samplesStream = filterSamples(r -> r.getFileType() == RifFileType.BENEFICIARY, StaticRifResourceGroup.SAMPLE_A.getResources());
    Function<RifRecordEvent<?>, List<List<String>>> recordEditor = rifRecordEvent -> {
        CSVRecord beneCsvRow = rifRecordEvent.getRawCsvRecords().get(0);
        List<String> beneCsvValues = StreamSupport.stream(beneCsvRow.spliterator(), false).collect(Collectors.toList());
        beneCsvValues.set(0, "UPDATE");
        return List.of(beneCsvValues);
    };
    Function<RifFile, RifFile> fileEditor = sample -> editSampleRecords(sample, recordEditor);
    Stream<RifFile> editedSample = editSamples(samplesStream, fileEditor);
    // Load the edited sample to verify that it fails, as expected.
    AssertionFailedError thrown = assertThrows(AssertionFailedError.class, () -> {
        loadSample("SAMPLE_A, bene only, UPDATE", CcwRifLoadTestUtils.getLoadOptions(), editedSample);
    });
    assertTrue(thrown.getMessage().contains("Load errors encountered"));
}

Example 97 with Beneficiary

use of gov.cms.bfd.model.rif.Beneficiary in project beneficiary-fhir-data by CMSgov.

the class RifLoaderIT method loadInitialEnrollmentShouldCount20SinceThereIsAUpdateOf8Months.

/*
   * This test checks that all enrollment data for 2 years has been loaded into the beneficiary
   * monthly table and than does an update of 8 years without the 4 other months for the year
   */
@Test
public void loadInitialEnrollmentShouldCount20SinceThereIsAUpdateOf8Months() {
    // Loads first year of data
    loadSample(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    // Loads second year of data
    loadSample(Arrays.asList(StaticRifResourceGroup.SAMPLE_U.getResources()));
    // Loads  second year of data with only 8 months
    loadSample(Arrays.asList(StaticRifResourceGroup.SAMPLE_U_BENES_CHANGED_WITH_8_MONTHS.getResources()));
    EntityManagerFactory entityManagerFactory = PipelineTestUtils.get().getPipelineApplicationState().getEntityManagerFactory();
    EntityManager entityManager = null;
    try {
        entityManager = entityManagerFactory.createEntityManager();
        Beneficiary beneficiaryFromDb = entityManager.find(Beneficiary.class, "567834");
        // Checks to make sure we only have 20 months of data
        assertEquals(20, beneficiaryFromDb.getBeneficiaryMonthlys().size());
    } finally {
        if (entityManager != null)
            entityManager.close();
    }
}

Example 98 with Beneficiary

use of gov.cms.bfd.model.rif.Beneficiary in project beneficiary-fhir-data by CMSgov.

the class RifLoaderTest method isBeneficiaryHistoryEqual.

/**
 * Runs a couple of fake HICNs through {@link RifLoader#computeHicnHash(LoadAppOptions,
 * SecretKeyFactory, String)} to verify that the expected result is produced.
 */
@Test
public void isBeneficiaryHistoryEqual() {
    Beneficiary newBene = new Beneficiary();
    LocalDate birthDate = LocalDate.of(1960, 1, 8);
    String hicn = "2332j3l2";
    Optional<String> hicnUnhased = Optional.of("323232");
    char sex = 'M';
    Optional<String> medicareBeneficiaryId = Optional.of("beneficiaryId");
    Optional<String> mbiHash = Optional.of("mbiHash");
    Optional<LocalDate> mbiEffectiveDate = Optional.of(LocalDate.of(2020, 1, 1));
    Optional<LocalDate> mbiObsoleteDate = Optional.of(LocalDate.of(2020, 1, 8));
    newBene.setBirthDate(birthDate);
    newBene.setHicn(hicn);
    newBene.setHicnUnhashed(hicnUnhased);
    newBene.setSex(sex);
    newBene.setMedicareBeneficiaryId(medicareBeneficiaryId);
    newBene.setMbiHash(mbiHash);
    newBene.setMbiEffectiveDate(mbiEffectiveDate);
    newBene.setMbiObsoleteDate(mbiObsoleteDate);
    Beneficiary oldBene = new Beneficiary();
    oldBene.setBirthDate(birthDate);
    oldBene.setHicn(hicn);
    oldBene.setHicnUnhashed(hicnUnhased);
    oldBene.setSex(sex);
    oldBene.setMedicareBeneficiaryId(medicareBeneficiaryId);
    oldBene.setMbiHash(mbiHash);
    oldBene.setMbiEffectiveDate(mbiEffectiveDate);
    oldBene.setMbiObsoleteDate(mbiObsoleteDate);
    // Both old and new beneficiary have the same values return true
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary birth date is not the same as old should assert false
    newBene.setBirthDate(LocalDate.of(1950, 1, 8));
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Undo New beneficiary birth date and set it back to old should assert true
    newBene.setBirthDate(birthDate);
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary hicn is not the same as old should assert false
    newBene.setHicn("difHicn");
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Undo New beneficiary hicn and set it back to old should assert true
    newBene.setHicn(hicn);
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary hicnunHashed is not the same as old should assert false
    newBene.setHicnUnhashed(Optional.of("difHicn"));
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Undo New beneficiary hicnUnhased and set it back to old should assert true
    newBene.setHicnUnhashed(hicnUnhased);
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary sex is not the same as old should assert false
    newBene.setSex('F');
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Undo New beneficiary sex and set it back to old should assert true
    newBene.setSex(sex);
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary mediciarybeneficiaryid is not the same as old should assert false
    newBene.setMedicareBeneficiaryId(Optional.of("diff"));
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Undo New beneficiary mediciarybeneficiaryid and set it back to old should assert true
    newBene.setMedicareBeneficiaryId(medicareBeneficiaryId);
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary mbihash is not the same as old should assert false
    newBene.setMbiHash(Optional.of("mbihashdiff"));
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Undo New beneficiary mbihash and set it back to old should assert true
    newBene.setMbiHash(mbiHash);
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary mbiEffectiveDate is not the same as old should assert false
    newBene.setMbiEffectiveDate(Optional.of(LocalDate.of(2020, 1, 8)));
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Undo New beneficiary mbiEffectiveDate and set it back to old should assert true
    newBene.setMbiEffectiveDate(mbiEffectiveDate);
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary mbiObsoleteDate is not the same as old should assert true
    // becasue mbiObsoleteDate is no longer part of the equality check.
    newBene.setMbiObsoleteDate(Optional.of(LocalDate.of(2020, 1, 2)));
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Undo New beneficiary mbiObsoleteDate and set it back to old should assert true
    newBene.setMbiObsoleteDate(mbiObsoleteDate);
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Check for nulls on fields
    // New beneficiary hicnUnhashed is null and the return result should assert false
    newBene.setHicnUnhashed(Optional.empty());
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Undo New beneficiary hicnUnhashed and set it back to old should assert true
    newBene.setHicnUnhashed(hicnUnhased);
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary sex is null and the return result should assert false
    newBene.setSex(Character.MIN_VALUE);
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Undo New beneficiary sex and set it back to old should assert true
    newBene.setSex(sex);
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary mediciarybeneficiaryid is null and the return result should assert false
    newBene.setMedicareBeneficiaryId(Optional.empty());
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // Undo beneficiary mediciarybeneficiaryid and set it back to old should assert true
    newBene.setMedicareBeneficiaryId(medicareBeneficiaryId);
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary mbiEffectiveDate is null and the return result should assert false
    newBene.setMbiEffectiveDate(Optional.empty());
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // old beneficiary mbiEffectiveDate was empty and new beneficiary has mbiEffectiveDate
    newBene.setMbiEffectiveDate(mbiEffectiveDate);
    oldBene.setMbiEffectiveDate(Optional.empty());
    assertFalse(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
    // New beneficiary mbiObsoleteDate is null and the return result should assert true
    // since the test will ignore empty setMbiObsoleteDate.
    oldBene.setMbiEffectiveDate(mbiEffectiveDate);
    newBene.setMbiObsoleteDate(Optional.empty());
    assertTrue(RifLoader.isBeneficiaryHistoryEqual(newBene, oldBene));
}

Example 99 with Beneficiary

use of gov.cms.bfd.model.rif.Beneficiary in project beneficiary-fhir-data by CMSgov.

the class R4ExplanationOfBenefitResourceProvider method findClaimTypeByPatient.

/**
 * @param claimType the {@link ClaimTypeV2} to find
 * @param patientId the {@link Beneficiary#getBeneficiaryId()} to filter by
 * @param lastUpdated the update time to filter by
 * @return the matching claim/event entities
 */
@SuppressWarnings({ "rawtypes", "unchecked" })
@Trace
private <T> List<T> findClaimTypeByPatient(ClaimTypeV2 claimType, String patientId, DateRangeParam lastUpdated, DateRangeParam serviceDate) {
    CriteriaBuilder builder = entityManager.getCriteriaBuilder();
    CriteriaQuery criteria = builder.createQuery((Class) claimType.getEntityClass());
    Root root = criteria.from(claimType.getEntityClass());
    claimType.getEntityLazyAttributes().stream().forEach(a -> root.fetch(a));
    criteria.select(root).distinct(true);
    // Search for a beneficiary's records. Use lastUpdated if present
    Predicate wherePredicate = builder.equal(root.get(claimType.getEntityBeneficiaryIdAttribute()), patientId);
    if (lastUpdated != null && !lastUpdated.isEmpty()) {
        Predicate predicate = QueryUtils.createLastUpdatedPredicate(builder, root, lastUpdated);
        wherePredicate = builder.and(wherePredicate, predicate);
    }
    criteria.where(wherePredicate);
    List<T> claimEntities = null;
    Long eobsByBeneIdQueryNanoSeconds = null;
    Timer.Context timerEobQuery = metricRegistry.timer(MetricRegistry.name(metricRegistry.getClass().getSimpleName(), "query", "eobs_by_bene_id", claimType.name().toLowerCase())).time();
    try {
        claimEntities = entityManager.createQuery(criteria).getResultList();
    } finally {
        eobsByBeneIdQueryNanoSeconds = timerEobQuery.stop();
        TransformerUtilsV2.recordQueryInMdc(String.format("eobs_by_bene_id.%s", claimType.name().toLowerCase()), eobsByBeneIdQueryNanoSeconds, claimEntities == null ? 0 : claimEntities.size());
    }
    if (claimEntities != null && serviceDate != null && !serviceDate.isEmpty()) {
        final Instant lowerBound = serviceDate.getLowerBoundAsInstant() != null ? serviceDate.getLowerBoundAsInstant().toInstant() : null;
        final Instant upperBound = serviceDate.getUpperBoundAsInstant() != null ? serviceDate.getUpperBoundAsInstant().toInstant() : null;
        final java.util.function.Predicate<LocalDate> lowerBoundCheck = lowerBound == null ? (date) -> true : (date) -> compareLocalDate(date, lowerBound.atZone(ZoneId.systemDefault()).toLocalDate(), serviceDate.getLowerBound().getPrefix());
        final java.util.function.Predicate<LocalDate> upperBoundCheck = upperBound == null ? (date) -> true : (date) -> compareLocalDate(date, upperBound.atZone(ZoneId.systemDefault()).toLocalDate(), serviceDate.getUpperBound().getPrefix());
        return claimEntities.stream().filter(entity -> lowerBoundCheck.test(claimType.getServiceEndAttributeFunction().apply(entity)) && upperBoundCheck.test(claimType.getServiceEndAttributeFunction().apply(entity))).collect(Collectors.toList());
    }
    return claimEntities;
}

Example 100 with Beneficiary

use of gov.cms.bfd.model.rif.Beneficiary in project beneficiary-fhir-data by CMSgov.

the class R4PatientResourceProvider method searchByCoverageContractAndYearMonth.

@Trace
private Bundle searchByCoverageContractAndYearMonth(// of relational search is more common.
TokenParam coverageId, LocalDate yearMonth, RequestDetails requestDetails) {
    checkCoverageId(coverageId);
    RequestHeaders requestHeader = RequestHeaders.getHeaderWrapper(requestDetails);
    // requested.
    if (!requestHeader.isMBIinIncludeIdentifiers() || requestHeader.isHICNinIncludeIdentifiers()) {
        throw new InvalidRequestException(String.format("This endpoint requires the '%s: mbi' header.", CommonHeaders.HEADER_NAME_INCLUDE_IDENTIFIERS));
    }
    PatientLinkBuilder paging = new PatientLinkBuilder(requestDetails.getCompleteUrl());
    Operation operation = new Operation(Operation.Endpoint.V2_PATIENT);
    operation.setOption("by", "coverageContractForYearMonth");
    requestHeader.getNVPairs().forEach((n, v) -> operation.setOption(n, v.toString()));
    operation.publishOperationName();
    List<Beneficiary> matchingBeneficiaries = fetchBeneficiariesByContractAndYearMonth(coverageId, yearMonth, paging);
    boolean hasAnotherPage = matchingBeneficiaries.size() > paging.getPageSize();
    if (hasAnotherPage) {
        matchingBeneficiaries = matchingBeneficiaries.subList(0, paging.getPageSize());
        paging = new PatientLinkBuilder(paging, hasAnotherPage);
    }
    List<IBaseResource> patients = matchingBeneficiaries.stream().map(b -> BeneficiaryTransformerV2.transform(metricRegistry, b, requestHeader)).collect(Collectors.toList());
    Bundle bundle = TransformerUtilsV2.createBundle(patients, paging, loadedFilterManager.getTransactionTime());
    TransformerUtilsV2.workAroundHAPIIssue1585(requestDetails);
    return bundle;
}