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

Example 6 with HospiceClaim

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

the class ExplanationOfBenefitResourceProviderIT method searchForEobsByExistingPatientWithPageSizeZero.

/**
 * Verifies that {@link ExplanationOfBenefitResourceProvider#findByPatient} works as expected for
 * a {@link Patient} that does exist in the DB, with paging on a page size of 0.
 *
 * @throws FHIRException (indicates test failure)
 */
@Test
public void searchForEobsByExistingPatientWithPageSizeZero() throws FHIRException {
    List<Object> loadedRecords = ServerTestUtils.get().loadData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    IGenericClient fhirClient = ServerTestUtils.get().createFhirClient();
    Beneficiary beneficiary = loadedRecords.stream().filter(r -> r instanceof Beneficiary).map(r -> (Beneficiary) r).findFirst().get();
    /*
     * FIXME: According the the FHIR spec, paging for _count=0 should not return any
     * claim entries in the bundle, but instead just a total for the number of
     * entries that match the search criteria. This functionality does no work
     * currently (see https://github.com/jamesagnew/hapi-fhir/issues/1074) and so
     * for now paging with _count=0 should behave as though paging was not
     * requested.
     */
    Bundle searchResults = fhirClient.search().forResource(ExplanationOfBenefit.class).where(ExplanationOfBenefit.PATIENT.hasId(TransformerUtils.buildPatientId(beneficiary))).count(0).returnBundle(Bundle.class).execute();
    assertNotNull(searchResults);
    /*
     * Verify the bundle contains a key for total and that the value matches the
     * number of entries in the bundle
     */
    assertEquals(loadedRecords.stream().filter(r -> !(r instanceof Beneficiary)).filter(r -> !(r instanceof BeneficiaryHistory)).filter(r -> !(r instanceof MedicareBeneficiaryIdHistory)).count(), searchResults.getTotal());
    /*
     * Verify that no paging links exist in the bundle.
     */
    assertNull(searchResults.getLink(Constants.LINK_NEXT));
    assertNull(searchResults.getLink(Constants.LINK_PREVIOUS));
    assertNull(searchResults.getLink(Constants.LINK_FIRST));
    assertNull(searchResults.getLink(Constants.LINK_LAST));
    /*
     * Verify that each of the expected claims (one for every claim type) is present
     * and looks correct.
     */
    CarrierClaim carrierClaim = loadedRecords.stream().filter(r -> r instanceof CarrierClaim).map(r -> (CarrierClaim) r).findFirst().get();
    assertEquals(1, filterToClaimType(searchResults, ClaimType.CARRIER).size());
    CarrierClaimTransformerTest.assertMatches(carrierClaim, filterToClaimType(searchResults, ClaimType.CARRIER).get(0), Optional.empty());
    DMEClaim dmeClaim = loadedRecords.stream().filter(r -> r instanceof DMEClaim).map(r -> (DMEClaim) r).findFirst().get();
    DMEClaimTransformerTest.assertMatches(dmeClaim, filterToClaimType(searchResults, ClaimType.DME).get(0), Optional.empty());
    HHAClaim hhaClaim = loadedRecords.stream().filter(r -> r instanceof HHAClaim).map(r -> (HHAClaim) r).findFirst().get();
    HHAClaimTransformerTest.assertMatches(hhaClaim, filterToClaimType(searchResults, ClaimType.HHA).get(0));
    HospiceClaim hospiceClaim = loadedRecords.stream().filter(r -> r instanceof HospiceClaim).map(r -> (HospiceClaim) r).findFirst().get();
    HospiceClaimTransformerTest.assertMatches(hospiceClaim, filterToClaimType(searchResults, ClaimType.HOSPICE).get(0));
    InpatientClaim inpatientClaim = loadedRecords.stream().filter(r -> r instanceof InpatientClaim).map(r -> (InpatientClaim) r).findFirst().get();
    InpatientClaimTransformerTest.assertMatches(inpatientClaim, filterToClaimType(searchResults, ClaimType.INPATIENT).get(0));
    OutpatientClaim outpatientClaim = loadedRecords.stream().filter(r -> r instanceof OutpatientClaim).map(r -> (OutpatientClaim) r).findFirst().get();
    OutpatientClaimTransformerTest.assertMatches(outpatientClaim, filterToClaimType(searchResults, ClaimType.OUTPATIENT).get(0));
    PartDEvent partDEvent = loadedRecords.stream().filter(r -> r instanceof PartDEvent).map(r -> (PartDEvent) r).findFirst().get();
    PartDEventTransformerTest.assertMatches(partDEvent, filterToClaimType(searchResults, ClaimType.PDE).get(0));
    SNFClaim snfClaim = loadedRecords.stream().filter(r -> r instanceof SNFClaim).map(r -> (SNFClaim) r).findFirst().get();
    SNFClaimTransformerTest.assertMatches(snfClaim, filterToClaimType(searchResults, ClaimType.SNF).get(0));
}

Example 7 with HospiceClaim

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

the class EndpointJsonResponseComparatorIT method eobReadHospice.

/**
 * @return the results of the {@link
 *     ExplanationOfBenefitResourceProvider#read(org.hl7.fhir.dstu3.model.IdType)} operation for
 *     Hospice claims
 */
public static String eobReadHospice() {
    List<Object> loadedRecords = ServerTestUtils.get().loadData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    IGenericClient fhirClient = createFhirClientAndSetEncoding();
    JsonInterceptor jsonInterceptor = createAndRegisterJsonInterceptor(fhirClient);
    HospiceClaim hosClaim = loadedRecords.stream().filter(r -> r instanceof HospiceClaim).map(r -> (HospiceClaim) r).findFirst().get();
    fhirClient.read().resource(ExplanationOfBenefit.class).withId(TransformerUtils.buildEobId(ClaimType.HOSPICE, hosClaim.getClaimId())).execute();
    return jsonInterceptor.getResponse();
}

Example 8 with HospiceClaim

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

the class ExplanationOfBenefitResourceProviderIT method adjustHospiceRecordForSamhsaDiagnosis.

/**
 * Adjusts the first Hospice record to support samhsa.
 *
 * @param loadedRecords the loaded records
 * @param entityManager the entity manager
 */
private void adjustHospiceRecordForSamhsaDiagnosis(List<Object> loadedRecords, EntityManager entityManager) {
    HospiceClaim hospiceRifRecord = loadedRecords.stream().filter(r -> r instanceof HospiceClaim).map(r -> (HospiceClaim) r).findFirst().get();
    entityManager.getTransaction().begin();
    hospiceRifRecord = entityManager.find(HospiceClaim.class, hospiceRifRecord.getClaimId());
    hospiceRifRecord.setDiagnosis2Code(Optional.of(Stu3EobSamhsaMatcherTest.SAMPLE_SAMHSA_ICD_9_DIAGNOSIS_CODE));
    hospiceRifRecord.setDiagnosis2CodeVersion(Optional.of('9'));
    entityManager.merge(hospiceRifRecord);
    entityManager.getTransaction().commit();
}

Example 9 with HospiceClaim

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

the class RifFilesProcessorTest method process1HospiceClaimRecord.

/**
 * Ensures that {@link RifFilesProcessor} can correctly handle {@link
 * StaticRifResource#SAMPLE_A_HOSPICE}.
 */
@Test
public void process1HospiceClaimRecord() {
    RifFilesEvent filesEvent = new RifFilesEvent(Instant.now(), StaticRifResource.SAMPLE_A_HOSPICE.toRifFile());
    RifFilesProcessor processor = new RifFilesProcessor();
    RifFileRecords rifFileRecords = processor.produceRecords(filesEvent.getFileEvents().get(0));
    List<RifRecordEvent<?>> rifEventsList = rifFileRecords.getRecords().collect(Collectors.toList());
    assertEquals(StaticRifResource.SAMPLE_A_HOSPICE.getRecordCount(), rifEventsList.size());
    RifRecordEvent<?> rifRecordEvent = rifEventsList.get(0);
    assertEquals(StaticRifResource.SAMPLE_A_HOSPICE.getRifFileType(), rifRecordEvent.getFileEvent().getFile().getFileType());
    assertNotNull(rifRecordEvent.getRecord());
    assertTrue(rifRecordEvent.getRecord() instanceof HospiceClaim);
    // Verify the claim header.
    HospiceClaim claimGroup = (HospiceClaim) rifRecordEvent.getRecord();
    assertEquals(RecordAction.INSERT, rifRecordEvent.getRecordAction());
    assertEquals(claimGroup.getBeneficiaryId(), rifRecordEvent.getBeneficiaryId());
    assertEquals("567834", claimGroup.getBeneficiaryId());
    assertEquals("9992223422", claimGroup.getClaimId());
    assertEquals(new BigDecimal(900), claimGroup.getClaimGroupId());
    assertEquals('V', claimGroup.getNearLineRecordIdCode());
    assertEquals("50", claimGroup.getClaimTypeCode());
    assertEquals(LocalDate.of(2014, 1, 01), claimGroup.getDateFrom());
    assertEquals(LocalDate.of(2014, 1, 30), claimGroup.getDateThrough());
    assertEquals("12345", claimGroup.getProviderNumber());
    assertEquals("P", claimGroup.getClaimNonPaymentReasonCode().get());
    assertEquals('1', claimGroup.getClaimServiceClassificationTypeCode());
    assertEquals(new BigDecimal("130.32"), claimGroup.getPaymentAmount());
    assertEquals(new BigDecimal("0"), claimGroup.getPrimaryPayerPaidAmount());
    assertEquals("AZ", claimGroup.getProviderStateCode());
    assertEquals("999999999", claimGroup.getOrganizationNpi().get());
    assertEquals("8888888888", claimGroup.getAttendingPhysicianNpi().get());
    assertEquals("30", claimGroup.getPatientDischargeStatusCode());
    assertEquals(new BigDecimal("199.99"), claimGroup.getTotalChargeAmount());
    assertEquals(new Character('C'), claimGroup.getPatientStatusCd().get());
    assertEquals(new BigDecimal(30), claimGroup.getUtilizationDayCount());
    assertEquals(LocalDate.of(2015, 6, 29), claimGroup.getBeneficiaryDischargeDate().get());
    assertEquals("R5555", claimGroup.getDiagnosisPrincipalCode().get());
    assertEquals('9', claimGroup.getDiagnosisPrincipalCodeVersion().get().charValue());
    assertEquals(LocalDate.of(2014, 7, 06), claimGroup.getClaimHospiceStartDate().get());
    assertEquals("38875439343923937", claimGroup.getFiOriginalClaimControlNumber().get());
    assertEquals("2718813985998", claimGroup.getFiDocumentClaimControlNumber().get());
    assertEquals(1, claimGroup.getLines().size());
    // Verify one of the claim lines.
    HospiceClaimLine claimLine = claimGroup.getLines().get(0);
    assertEquals(new BigDecimal(1), claimLine.getLineNumber());
    assertEquals("651", claimLine.getRevenueCenterCode());
    assertEquals(new BigDecimal("26.00"), claimGroup.getLines().get(0).getPaymentAmount());
    assertEquals(new BigDecimal("300.00"), claimGroup.getLines().get(0).getNonCoveredChargeAmount().get());
    assertEquals("Q9999", claimGroup.getLines().get(0).getHcpcsInitialModifierCode().get());
    assertEquals("345345345", claimLine.getRevenueCenterRenderingPhysicianNPI().get());
}

Example 10 with HospiceClaim

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

the class ExplanationOfBenefitResourceProviderIT method searchForEobsWithLargePageSizesOnFewerResults.

/**
 * Verifies that {@link ExplanationOfBenefitResourceProvider#findByPatient} works as expected for
 * a {@link Patient} that does exist in the DB, with a page size of 50 with fewer (8) results.
 *
 * @throws FHIRException (indicates test failure)
 */
@Test
public void searchForEobsWithLargePageSizesOnFewerResults() throws FHIRException {
    List<Object> loadedRecords = ServerTestUtils.get().loadData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    IGenericClient fhirClient = ServerTestUtils.get().createFhirClient();
    Beneficiary beneficiary = loadedRecords.stream().filter(r -> r instanceof Beneficiary).map(r -> (Beneficiary) r).findFirst().get();
    Bundle searchResults = fhirClient.search().forResource(ExplanationOfBenefit.class).where(ExplanationOfBenefit.PATIENT.hasId(TransformerUtils.buildPatientId(beneficiary))).count(50).returnBundle(Bundle.class).execute();
    assertNotNull(searchResults);
    /*
     * Verify the bundle contains a key for total and that the value matches the
     * number of entries in the bundle
     */
    assertEquals(loadedRecords.stream().filter(r -> !(r instanceof Beneficiary)).filter(r -> !(r instanceof BeneficiaryHistory)).filter(r -> !(r instanceof MedicareBeneficiaryIdHistory)).count(), searchResults.getTotal());
    /*
     * Verify that only the first and last links exist as there are no previous or
     * next pages.
     */
    assertNotNull(searchResults.getLink(Constants.LINK_FIRST));
    assertNotNull(searchResults.getLink(Constants.LINK_LAST));
    assertNull(searchResults.getLink(Constants.LINK_NEXT));
    assertNull(searchResults.getLink(Constants.LINK_PREVIOUS));
    /*
     * Verify that each of the expected claims (one for every claim type) is present
     * and looks correct.
     */
    CarrierClaim carrierClaim = loadedRecords.stream().filter(r -> r instanceof CarrierClaim).map(r -> (CarrierClaim) r).findFirst().get();
    assertEquals(1, filterToClaimType(searchResults, ClaimType.CARRIER).size());
    CarrierClaimTransformerTest.assertMatches(carrierClaim, filterToClaimType(searchResults, ClaimType.CARRIER).get(0), Optional.empty());
    DMEClaim dmeClaim = loadedRecords.stream().filter(r -> r instanceof DMEClaim).map(r -> (DMEClaim) r).findFirst().get();
    DMEClaimTransformerTest.assertMatches(dmeClaim, filterToClaimType(searchResults, ClaimType.DME).get(0), Optional.empty());
    HHAClaim hhaClaim = loadedRecords.stream().filter(r -> r instanceof HHAClaim).map(r -> (HHAClaim) r).findFirst().get();
    HHAClaimTransformerTest.assertMatches(hhaClaim, filterToClaimType(searchResults, ClaimType.HHA).get(0));
    HospiceClaim hospiceClaim = loadedRecords.stream().filter(r -> r instanceof HospiceClaim).map(r -> (HospiceClaim) r).findFirst().get();
    HospiceClaimTransformerTest.assertMatches(hospiceClaim, filterToClaimType(searchResults, ClaimType.HOSPICE).get(0));
    InpatientClaim inpatientClaim = loadedRecords.stream().filter(r -> r instanceof InpatientClaim).map(r -> (InpatientClaim) r).findFirst().get();
    InpatientClaimTransformerTest.assertMatches(inpatientClaim, filterToClaimType(searchResults, ClaimType.INPATIENT).get(0));
    OutpatientClaim outpatientClaim = loadedRecords.stream().filter(r -> r instanceof OutpatientClaim).map(r -> (OutpatientClaim) r).findFirst().get();
    OutpatientClaimTransformerTest.assertMatches(outpatientClaim, filterToClaimType(searchResults, ClaimType.OUTPATIENT).get(0));
    PartDEvent partDEvent = loadedRecords.stream().filter(r -> r instanceof PartDEvent).map(r -> (PartDEvent) r).findFirst().get();
    PartDEventTransformerTest.assertMatches(partDEvent, filterToClaimType(searchResults, ClaimType.PDE).get(0));
    SNFClaim snfClaim = loadedRecords.stream().filter(r -> r instanceof SNFClaim).map(r -> (SNFClaim) r).findFirst().get();
    SNFClaimTransformerTest.assertMatches(snfClaim, filterToClaimType(searchResults, ClaimType.SNF).get(0));
}