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

Example 1 with SNFClaim

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

the class SNFClaimTransformer method transform.

/**
 * @param metricRegistry the {@link MetricRegistry} to use
 * @param claim the CCW {@link SNFClaim} to transform
 * @param includeTaxNumbers whether or not to include tax numbers in the result (see {@link
 *     ExplanationOfBenefitResourceProvider#HEADER_NAME_INCLUDE_TAX_NUMBERS}, defaults to <code>
 *     false</code>)
 * @return a FHIR {@link ExplanationOfBenefit} resource that represents the specified {@link
 *     SNFClaim}
 */
@Trace
static ExplanationOfBenefit transform(MetricRegistry metricRegistry, Object claim, Optional<Boolean> includeTaxNumbers) {
    Timer.Context timer = metricRegistry.timer(MetricRegistry.name(SNFClaimTransformer.class.getSimpleName(), "transform")).time();
    if (!(claim instanceof SNFClaim))
        throw new BadCodeMonkeyException();
    timer.stop();
    return transformClaim((SNFClaim) claim);
}

Example 2 with SNFClaim

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

the class ClaimTypeV2Test method verifyServiceEndAttributeFunc.

/**
 * Verifies that our service end date function is working as expected. Since we are type casting
 * our claim object, we need to verify that every ClaimType is tested.
 */
@Test
public void verifyServiceEndAttributeFunc() {
    LocalDate start = LocalDate.now();
    LocalDate end = start.plusDays(10);
    CarrierClaim carrierClaim = new CarrierClaim();
    carrierClaim.setDateFrom(start);
    carrierClaim.setDateThrough(end);
    DMEClaim dmeClaim = new DMEClaim();
    dmeClaim.setDateFrom(start);
    dmeClaim.setDateThrough(end);
    HospiceClaim hospiceClaim = new HospiceClaim();
    hospiceClaim.setDateFrom(start);
    hospiceClaim.setDateThrough(end);
    PartDEvent partDEvent = new PartDEvent();
    partDEvent.setPrescriptionFillDate(end);
    InpatientClaim inpatientClaim = new InpatientClaim();
    inpatientClaim.setDateFrom(start);
    inpatientClaim.setDateThrough(end);
    OutpatientClaim outpatientClaim = new OutpatientClaim();
    outpatientClaim.setDateFrom(start);
    outpatientClaim.setDateThrough(end);
    SNFClaim snfClaim = new SNFClaim();
    snfClaim.setDateFrom(start);
    snfClaim.setDateThrough(end);
    HHAClaim hhaClaim = new HHAClaim();
    hhaClaim.setDateFrom(start);
    hhaClaim.setDateThrough(end);
    ImmutableMap.Builder<ClaimTypeV2, Object> builder = ImmutableMap.builder();
    builder.put(ClaimTypeV2.CARRIER, carrierClaim);
    builder.put(ClaimTypeV2.DME, dmeClaim);
    builder.put(ClaimTypeV2.PDE, partDEvent);
    builder.put(ClaimTypeV2.INPATIENT, inpatientClaim);
    builder.put(ClaimTypeV2.OUTPATIENT, outpatientClaim);
    builder.put(ClaimTypeV2.HOSPICE, hospiceClaim);
    builder.put(ClaimTypeV2.SNF, snfClaim);
    builder.put(ClaimTypeV2.HHA, hhaClaim);
    Map<ClaimTypeV2, Object> claimTypeToClaim = builder.build();
    // Verify that we're testing all of the ClaimTypes that are defined
    EnumSet.allOf(ClaimTypeV2.class).stream().forEach(claimType -> assertTrue(claimTypeToClaim.containsKey(claimType), String.format("ClaimType %s not tested", claimType.name())));
    claimTypeToClaim.entrySet().forEach(entry -> assertEquals(end, entry.getKey().getServiceEndAttributeFunction().apply(entry.getValue()), String.format("Claim type %s does not match expectations", entry.getKey().name())));
}

Example 3 with SNFClaim

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

the class RifFilesProcessor method buildSNFClaimEvent.

/**
 * @param fileEvent the {@link RifFileEvent} being processed
 * @param csvRecords the {@link CSVRecord}s to be mapped, which must be from a {@link
 *     RifFileType#SNF} {@link RifFile}
 * @return a {@link RifRecordEvent} built from the specified {@link CSVRecord}s
 */
private static RifRecordEvent<SNFClaim> buildSNFClaimEvent(RifFileEvent fileEvent, List<CSVRecord> csvRecords) {
    if (LOGGER.isTraceEnabled())
        LOGGER.trace(csvRecords.toString());
    CSVRecord firstCsvRecord = csvRecords.get(0);
    RecordAction recordAction = RecordAction.match(firstCsvRecord.get("DML_IND"));
    SNFClaim claim = SNFClaimParser.parseRif(csvRecords);
    return new RifRecordEvent<SNFClaim>(fileEvent, csvRecords, recordAction, claim.getBeneficiaryId(), claim);
}

Example 4 with SNFClaim

use of gov.cms.bfd.model.rif.SNFClaim 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 5 with SNFClaim

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

the class ExplanationOfBenefitResourceProviderIT method adjustSnfRecordForSamhsaDiagnosis.

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