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Example 21 with Coverage

use of org.hl7.fhir.dstu3.model.Coverage in project beneficiary-fhir-data by CMSgov.

the class CarrierClaimTransformerV2 method transformClaim.

/**
 * @param claimGroup the CCW {@link CarrierClaim} to transform
 * @return a FHIR {@link ExplanationOfBenefit} resource that represents the specified {@link
 *     CarrierClaim}
 */
private static ExplanationOfBenefit transformClaim(CarrierClaim claimGroup, Optional<Boolean> includeTaxNumbers) {
    ExplanationOfBenefit eob = new ExplanationOfBenefit();
    // Required values not directly mapped
    eob.getMeta().addProfile(ProfileConstants.C4BB_EOB_NONCLINICIAN_PROFILE_URL);
    // TODO: ExplanationOfBenefit.outcome is a required field. Needs to be mapped.
    // eob.setOutcome(?)
    // Common group level fields between all claim types
    // Claim Type + Claim ID => ExplanationOfBenefit.id
    // CLM_ID => ExplanationOfBenefit.identifier
    // CLM_GRP_ID => ExplanationOfBenefit.identifier
    // BENE_ID + Coverage Type => ExplanationOfBenefit.insurance.coverage
    // (reference)
    // BENE_ID => ExplanationOfBenefit.patient (reference)
    // FINAL_ACTION => ExplanationOfBenefit.status
    // CLM_FROM_DT => ExplanationOfBenefit.billablePeriod.start
    // CLM_THRU_DT => ExplanationOfBenefit.billablePeriod.end
    // CLM_PMT_AMT => ExplanationOfBenefit.payment.amount
    TransformerUtilsV2.mapEobCommonClaimHeaderData(eob, claimGroup.getClaimId(), claimGroup.getBeneficiaryId(), ClaimTypeV2.CARRIER, claimGroup.getClaimGroupId().toPlainString(), MedicareSegment.PART_B, Optional.of(claimGroup.getDateFrom()), Optional.of(claimGroup.getDateThrough()), Optional.of(claimGroup.getPaymentAmount()), claimGroup.getFinalAction());
    // NCH_WKLY_PROC_DT => ExplanationOfBenefit.supportinginfo.timingDate
    TransformerUtilsV2.addInformation(eob, TransformerUtilsV2.createInformationRecievedDateSlice(eob, CcwCodebookVariable.NCH_WKLY_PROC_DT, Optional.of(claimGroup.getWeeklyProcessDate())));
    // map eob type codes into FHIR
    // NCH_CLM_TYPE_CD            => ExplanationOfBenefit.type.coding
    // EOB Type                   => ExplanationOfBenefit.type.coding
    // Claim Type (Professional)  => ExplanationOfBenefit.type.coding
    // NCH_NEAR_LINE_REC_IDENT_CD => ExplanationOfBenefit.extension
    TransformerUtilsV2.mapEobType(eob, ClaimTypeV2.CARRIER, Optional.of(claimGroup.getNearLineRecordIdCode()), Optional.of(claimGroup.getClaimTypeCode()));
    // CARR_CLM_PRMRY_PYR_PD_AMT => ExplanationOfBenefit.total.amount
    TransformerUtilsV2.addTotal(eob, TransformerUtilsV2.createTotalAdjudicationAmountSlice(eob, CcwCodebookVariable.CLM_TOT_CHRG_AMT, C4BBAdjudication.PRIOR_PAYER_PAID, claimGroup.getPrimaryPayerPaidAmount()));
    // Common group level fields between Carrier and DME
    // BENE_ID =>
    // CARR_NUM                       => ExplanationOfBenefit.extension
    // CLM_CLNCL_TRIL_NUM             => ExplanationOfBenefit.extension
    // CARR_CLM_CASH_DDCTBL_APLD_AMT  => ExplanationOfBenefit.benefitBalance.financial
    // CARR_CLM_PMT_DNL_CD            => ExplanationOfBenefit.extension
    // RFR_PHYSN_NPI                  => ExplanationOfBenefit.referral.identifier
    // => ExplanationOfBenefit.careteam.provider
    // RFR_PHYSN_UPIN                 => ExplanationOfBenefit.referral.identifier
    // => ExplanationOfBenefit.careteam.provider
    // CARR_CLM_PRVDR_ASGNMT_IND_SW   => ExplanationOfBenefit.extension
    // NCH_CLM_PRVDR_PMT_AMT          => ExplanationOfBenefit.benefitBalance.financial
    // NCH_CLM_BENE_PMT_AMT           => ExplanationOfBenefit.benefitBalance.financial
    // NCH_CARR_CLM_SBMTD_CHRG_AMT    => ExplanationOfBenefit.benefitBalance.financial
    // NCH_CARR_CLM_ALOWD_AMT         => ExplanationOfBenefit.benefitBalance.financial
    // CLM_DISP_CD                    => ExplanationOfBenefit.disposition
    // CARR_CLM_CNTL_NUM              => ExplanationOfBenefit.extension
    TransformerUtilsV2.mapEobCommonGroupCarrierDME(eob, claimGroup.getBeneficiaryId(), claimGroup.getCarrierNumber(), claimGroup.getClinicalTrialNumber(), claimGroup.getBeneficiaryPartBDeductAmount(), claimGroup.getPaymentDenialCode(), claimGroup.getReferringPhysicianNpi(), claimGroup.getReferringPhysicianUpin(), claimGroup.getProviderAssignmentIndicator(), claimGroup.getProviderPaymentAmount(), claimGroup.getBeneficiaryPaymentAmount(), claimGroup.getSubmittedChargeAmount(), claimGroup.getAllowedChargeAmount(), claimGroup.getClaimDispositionCode(), claimGroup.getClaimCarrierControlNumber());
    // ICD_DGNS_VRSN_CD(1-12) => diagnosis.diagnosisCodeableConcept
    for (Diagnosis diagnosis : DiagnosisUtilV2.extractDiagnoses(claimGroup)) {
        DiagnosisUtilV2.addDiagnosisCode(eob, diagnosis, ClaimTypeV2.CARRIER);
    }
    // CARR_CLM_RFRNG_PIN_NUM => ExplanationOfBenefit.careteam.provider
    TransformerUtilsV2.addCareTeamMember(eob, C4BBPractitionerIdentifierType.NPI, C4BBClaimProfessionalAndNonClinicianCareTeamRole.REFERRING, Optional.ofNullable(claimGroup.getReferringProviderIdNumber()));
    // CARR_CLM_ENTRY_CD => ExplanationOfBenefit.extension
    eob.addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.CARR_CLM_ENTRY_CD, claimGroup.getClaimEntryCode()));
    // Process line items
    for (CarrierClaimLine line : claimGroup.getLines()) {
        ItemComponent item = eob.addItem();
        // LINE_NUM => ExplanationOfBenefit.item.sequence
        item.setSequence(line.getLineNumber().intValue());
        // PRF_PHYSN_NPI => ExplanationOfBenefit.careTeam.provider
        Optional<CareTeamComponent> performing = TransformerUtilsV2.addCareTeamMember(eob, item, C4BBPractitionerIdentifierType.NPI, C4BBClaimProfessionalAndNonClinicianCareTeamRole.PERFORMING, line.getPerformingPhysicianNpi());
        // Fall back to UPIN if NPI not present
        if (!line.getPerformingPhysicianNpi().isPresent()) {
            performing = TransformerUtilsV2.addCareTeamMember(eob, item, C4BBPractitionerIdentifierType.UPIN, C4BBClaimProfessionalAndNonClinicianCareTeamRole.PERFORMING, line.getPerformingPhysicianUpin());
        }
        // Update the responsible flag
        performing.ifPresent(p -> {
            p.setResponsible(true);
            // PRVDR_SPCLTY => ExplanationOfBenefit.careTeam.qualification
            p.setQualification(TransformerUtilsV2.createCodeableConcept(eob, CcwCodebookVariable.PRVDR_SPCLTY, line.getProviderSpecialityCode()));
            // CARR_LINE_PRVDR_TYPE_CD => ExplanationOfBenefit.careTeam.extension
            p.addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.CARR_LINE_PRVDR_TYPE_CD, line.getProviderTypeCode()));
            // PRTCPTNG_IND_CD => ExplanationOfBenefit.careTeam.extension
            p.addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.PRTCPTNG_IND_CD, line.getProviderParticipatingIndCode()));
        });
        // ORG_NPI_NUM => ExplanationOfBenefit.careTeam.provider
        TransformerUtilsV2.addCareTeamMember(eob, item, C4BBPractitionerIdentifierType.NPI, C4BBClaimProfessionalAndNonClinicianCareTeamRole.PRIMARY, line.getOrganizationNpi());
        // CARR_LINE_RDCD_PMT_PHYS_ASTN_C => ExplanationOfBenefit.item.adjudication
        TransformerUtilsV2.addAdjudication(item, TransformerUtilsV2.createAdjudicationDenialReasonSlice(eob, CcwCodebookVariable.CARR_LINE_RDCD_PMT_PHYS_ASTN_C, String.valueOf(line.getReducedPaymentPhysicianAsstCode())));
        // HCPCS_CD               => ExplanationOfBenefit.item.productOrService
        // HCPCS_1ST_MDFR_CD      => ExplanationOfBenefit.item.modifier
        // HCPCS_2ND_MDFR_CD      => ExplanationOfBenefit.item.modifier
        // CARR_CLM_HCPCS_YR_CD   => ExplanationOfBenefit.item.modifier.version
        TransformerUtilsV2.mapHcpcs(eob, item, line.getHcpcsCode(), claimGroup.getHcpcsYearCode(), Arrays.asList(line.getHcpcsInitialModifierCode(), line.getHcpcsSecondModifierCode()));
        // tax num should be as a extension
        if (includeTaxNumbers.orElse(false)) {
            item.addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.TAX_NUM, line.getProviderTaxNumber()));
        }
        // CARR_LINE_ANSTHSA_UNIT_CNT => ExplanationOfBenefit.item.extension
        if (line.getAnesthesiaUnitCount().compareTo(BigDecimal.ZERO) > 0) {
            item.addExtension(TransformerUtilsV2.createExtensionQuantity(CcwCodebookVariable.CARR_LINE_ANSTHSA_UNIT_CNT, line.getAnesthesiaUnitCount()));
        }
        // CARR_LINE_MTUS_CNT => ExplanationOfBenefit.item.extension
        if (!line.getMtusCount().equals(BigDecimal.ZERO)) {
            item.addExtension(TransformerUtilsV2.createExtensionQuantity(CcwCodebookVariable.CARR_LINE_MTUS_CNT, line.getMtusCount()));
        }
        // CARR_LINE_MTUS_CD => ExplanationOfBenefit.item.extension
        line.getMtusCode().ifPresent(code -> item.addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.CARR_LINE_MTUS_CNT, code)));
        // Common item level fields between Carrier and DME
        // LINE_SRVC_CNT            => ExplanationOfBenefit.item.quantity
        // LINE_CMS_TYPE_SRVC_CD    => ExplanationOfBenefit.item.category
        // LINE_PLACE_OF_SRVC_CD    => ExplanationOfBenefit.item.location
        // BETOS_CD                 => ExplanationOfBenefit.item.extension
        // LINE_1ST_EXPNS_DT        => ExplanationOfBenefit.item.servicedPeriod
        // LINE_LAST_EXPNS_DT       => ExplanationOfBenefit.item.servicedPeriod
        // LINE_NCH_PMT_AMT         => ExplanationOfBenefit.item.adjudication
        // LINE_PMT_80_100_CD       => ExplanationOfBenefit.item.adjudication.extension
        // PAID_TO_PATIENT          => ExplanationOfBenefit.item.adjudication
        // LINE_PRVDR_PMT_AMT       => ExplanationOfBenefit.item.adjudication
        // LINE_BENE_PTB_DDCTBL_AMT => ExplanationOfBenefit.item.adjudication
        // LINE_BENE_PRMRY_PYR_CD   => ExplanationOfBenefit.item.extension
        // LINE_BENE_PRMRY_PYR_PD_AMT => ExplanationOfBenefit.item.adjudication
        // LINE_COINSRNC_AMT        => ExplanationOfBenefit.item.adjudication
        // LINE_SBMTD_CHRG_AMT      => ExplanationOfBenefit.item.adjudication
        // LINE_ALOWD_CHRG_AMT      => ExplanationOfBenefit.item.adjudication
        // LINE_BENE_PRMRY_PYR_CD   => ExplanationOfBenefit.item.extension
        // LINE_SERVICE_DEDUCTIBLE  => ExplanationOfBenefit.item.extension
        // LINE_HCT_HGB_TYPE_CD     => Observation.code
        // LINE_HCT_HGB_RSLT_NUM    => Observation.value
        // LINE_NDC_CD              => ExplanationOfBenefit.item.productOrService
        TransformerUtilsV2.mapEobCommonItemCarrierDME(item, eob, claimGroup.getClaimId(), item.getSequence(), line.getServiceCount(), line.getPlaceOfServiceCode(), line.getFirstExpenseDate(), line.getLastExpenseDate(), line.getBeneficiaryPaymentAmount(), line.getProviderPaymentAmount(), line.getBeneficiaryPartBDeductAmount(), line.getPrimaryPayerCode(), line.getPrimaryPayerPaidAmount(), line.getBetosCode(), line.getPaymentAmount(), line.getPaymentCode(), line.getCoinsuranceAmount(), line.getSubmittedChargeAmount(), line.getAllowedChargeAmount(), line.getProcessingIndicatorCode(), line.getServiceDeductibleCode(), line.getHctHgbTestTypeCode(), line.getHctHgbTestResult(), line.getCmsServiceTypeCode(), line.getNationalDrugCode());
        // LINE_ICD_DGNS_CD      => ExplanationOfBenefit.item.diagnosisSequence
        // LINE_ICD_DGNS_VRSN_CD => ExplanationOfBenefit.item.diagnosisSequence
        DiagnosisUtilV2.addDiagnosisLink(eob, item, Diagnosis.from(line.getDiagnosisCode(), line.getDiagnosisCodeVersion(), DiagnosisLabel.OTHER), ClaimTypeV2.CARRIER);
        // PRVDR_STATE_CD => ExplanationOfBenefit.item.location.extension
        line.getProviderStateCode().ifPresent(code -> item.getLocation().addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.PRVDR_STATE_CD, code)));
        // PRVDR_ZIP => ExplanationOfBenefit.item.location.extension
        line.getProviderZipCode().ifPresent(code -> item.getLocation().addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.PRVDR_ZIP, code)));
        // CARR_LINE_PRCNG_LCLTY_CD => ExplanationOfBenefit.item.location.extension
        item.getLocation().addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.CARR_LINE_PRCNG_LCLTY_CD, line.getLinePricingLocalityCode()));
        // CARR_LINE_CLIA_LAB_NUM => ExplanationOfBenefit.item.location.extension
        line.getCliaLabNumber().ifPresent(num -> item.getLocation().addExtension(TransformerUtilsV2.createExtensionIdentifier(CcwCodebookVariable.CARR_LINE_CLIA_LAB_NUM, num)));
    }
    TransformerUtilsV2.setLastUpdated(eob, claimGroup.getLastUpdated());
    return eob;
}
Also used : CarrierClaimLine(gov.cms.bfd.model.rif.CarrierClaimLine) ItemComponent(org.hl7.fhir.r4.model.ExplanationOfBenefit.ItemComponent) Diagnosis(gov.cms.bfd.server.war.commons.Diagnosis) ExplanationOfBenefit(org.hl7.fhir.r4.model.ExplanationOfBenefit) CareTeamComponent(org.hl7.fhir.r4.model.ExplanationOfBenefit.CareTeamComponent)

Example 22 with Coverage

use of org.hl7.fhir.dstu3.model.Coverage in project beneficiary-fhir-data by CMSgov.

the class CoverageResourceProviderIT method readCoveragesForExistingBeneficiary.

/**
 * Verifies that {@link
 * gov.cms.bfd.server.war.stu3.providers.CoverageResourceProvider#read(org.hl7.fhir.dstu3.model.IdType)}
 * works as expected for {@link Beneficiary}-derived {@link Coverage}s that do exist in the DB.
 *
 * @throws FHIRException (indicates test failure)
 */
@Test
public void readCoveragesForExistingBeneficiary() 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();
    Coverage partACoverage = fhirClient.read().resource(Coverage.class).withId(TransformerUtils.buildCoverageId(MedicareSegment.PART_A, beneficiary)).execute();
    CoverageTransformerTest.assertPartAMatches(beneficiary, partACoverage);
    Coverage partBCoverage = fhirClient.read().resource(Coverage.class).withId(TransformerUtils.buildCoverageId(MedicareSegment.PART_B, beneficiary)).execute();
    CoverageTransformerTest.assertPartBMatches(beneficiary, partBCoverage);
    Coverage partDCoverage = fhirClient.read().resource(Coverage.class).withId(TransformerUtils.buildCoverageId(MedicareSegment.PART_D, beneficiary)).execute();
    CoverageTransformerTest.assertPartDMatches(beneficiary, partDCoverage);
}
Also used : Assertions.assertNotNull(org.junit.jupiter.api.Assertions.assertNotNull) Arrays(java.util.Arrays) Bundle(org.hl7.fhir.dstu3.model.Bundle) Date(java.util.Date) Assertions.assertNull(org.junit.jupiter.api.Assertions.assertNull) Constants(ca.uhn.fhir.rest.api.Constants) LoggerFactory(org.slf4j.LoggerFactory) PipelineTestUtils(gov.cms.bfd.pipeline.sharedutils.PipelineTestUtils) DateRangeParam(ca.uhn.fhir.rest.param.DateRangeParam) BeforeAll(org.junit.jupiter.api.BeforeAll) Assertions.assertEquals(org.junit.jupiter.api.Assertions.assertEquals) IGenericClient(ca.uhn.fhir.rest.client.api.IGenericClient) ResourceNotFoundException(ca.uhn.fhir.rest.server.exceptions.ResourceNotFoundException) StaticRifResourceGroup(gov.cms.bfd.model.rif.samples.StaticRifResourceGroup) ServerTestUtils(gov.cms.bfd.server.war.ServerTestUtils) Coverage(org.hl7.fhir.dstu3.model.Coverage) Logger(org.slf4j.Logger) MedicareSegment(gov.cms.bfd.server.war.commons.MedicareSegment) InvalidRequestException(ca.uhn.fhir.rest.server.exceptions.InvalidRequestException) Instant(java.time.Instant) Test(org.junit.jupiter.api.Test) Beneficiary(gov.cms.bfd.model.rif.Beneficiary) List(java.util.List) AfterEach(org.junit.jupiter.api.AfterEach) TransformerConstants(gov.cms.bfd.server.war.commons.TransformerConstants) FHIRException(org.hl7.fhir.exceptions.FHIRException) IGenericClient(ca.uhn.fhir.rest.client.api.IGenericClient) Coverage(org.hl7.fhir.dstu3.model.Coverage) Beneficiary(gov.cms.bfd.model.rif.Beneficiary) Test(org.junit.jupiter.api.Test)

Example 23 with Coverage

use of org.hl7.fhir.dstu3.model.Coverage in project beneficiary-fhir-data by CMSgov.

the class CoverageResourceProviderIT method searchByExistingBeneficiaryWithPaging.

/**
 * Verifies that {@link
 * gov.cms.bfd.server.war.stu3.providers.CoverageResourceProvider#searchByBeneficiary(ca.uhn.fhir.rest.param.ReferenceParam)}
 * works as expected for a {@link Beneficiary} that does exist in the DB, with paging.
 *
 * @throws FHIRException (indicates test failure)
 */
@Test
public void searchByExistingBeneficiaryWithPaging() 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(Coverage.class).where(Coverage.BENEFICIARY.hasId(TransformerUtils.buildPatientId(beneficiary))).count(4).returnBundle(Bundle.class).execute();
    assertNotNull(searchResults);
    assertEquals(MedicareSegment.values().length, searchResults.getTotal());
    /*
     * Verify that only the first and last paging links exist, since there should
     * only be one page.
     */
    assertNotNull(searchResults.getLink(Constants.LINK_FIRST));
    assertNull(searchResults.getLink(Constants.LINK_NEXT));
    assertNull(searchResults.getLink(Constants.LINK_PREVIOUS));
    assertNotNull(searchResults.getLink(Constants.LINK_LAST));
    /*
     * Verify that each of the expected Coverages (one for every MedicareSegment) is
     * present and looks correct.
     */
    Coverage partACoverageFromSearchResult = searchResults.getEntry().stream().filter(e -> e.getResource() instanceof Coverage).map(e -> (Coverage) e.getResource()).filter(c -> TransformerConstants.COVERAGE_PLAN_PART_A.equals(c.getGrouping().getSubPlan())).findFirst().get();
    CoverageTransformerTest.assertPartAMatches(beneficiary, partACoverageFromSearchResult);
    Coverage partBCoverageFromSearchResult = searchResults.getEntry().stream().filter(e -> e.getResource() instanceof Coverage).map(e -> (Coverage) e.getResource()).filter(c -> TransformerConstants.COVERAGE_PLAN_PART_B.equals(c.getGrouping().getSubPlan())).findFirst().get();
    CoverageTransformerTest.assertPartBMatches(beneficiary, partBCoverageFromSearchResult);
    Coverage partDCoverageFromSearchResult = searchResults.getEntry().stream().filter(e -> e.getResource() instanceof Coverage).map(e -> (Coverage) e.getResource()).filter(c -> TransformerConstants.COVERAGE_PLAN_PART_D.equals(c.getGrouping().getSubPlan())).findFirst().get();
    CoverageTransformerTest.assertPartDMatches(beneficiary, partDCoverageFromSearchResult);
}
Also used : Assertions.assertNotNull(org.junit.jupiter.api.Assertions.assertNotNull) Arrays(java.util.Arrays) Bundle(org.hl7.fhir.dstu3.model.Bundle) Date(java.util.Date) Assertions.assertNull(org.junit.jupiter.api.Assertions.assertNull) Constants(ca.uhn.fhir.rest.api.Constants) LoggerFactory(org.slf4j.LoggerFactory) PipelineTestUtils(gov.cms.bfd.pipeline.sharedutils.PipelineTestUtils) DateRangeParam(ca.uhn.fhir.rest.param.DateRangeParam) BeforeAll(org.junit.jupiter.api.BeforeAll) Assertions.assertEquals(org.junit.jupiter.api.Assertions.assertEquals) IGenericClient(ca.uhn.fhir.rest.client.api.IGenericClient) ResourceNotFoundException(ca.uhn.fhir.rest.server.exceptions.ResourceNotFoundException) StaticRifResourceGroup(gov.cms.bfd.model.rif.samples.StaticRifResourceGroup) ServerTestUtils(gov.cms.bfd.server.war.ServerTestUtils) Coverage(org.hl7.fhir.dstu3.model.Coverage) Logger(org.slf4j.Logger) MedicareSegment(gov.cms.bfd.server.war.commons.MedicareSegment) InvalidRequestException(ca.uhn.fhir.rest.server.exceptions.InvalidRequestException) Instant(java.time.Instant) Test(org.junit.jupiter.api.Test) Beneficiary(gov.cms.bfd.model.rif.Beneficiary) List(java.util.List) AfterEach(org.junit.jupiter.api.AfterEach) TransformerConstants(gov.cms.bfd.server.war.commons.TransformerConstants) FHIRException(org.hl7.fhir.exceptions.FHIRException) IGenericClient(ca.uhn.fhir.rest.client.api.IGenericClient) Bundle(org.hl7.fhir.dstu3.model.Bundle) Coverage(org.hl7.fhir.dstu3.model.Coverage) Beneficiary(gov.cms.bfd.model.rif.Beneficiary) Test(org.junit.jupiter.api.Test)

Example 24 with Coverage

use of org.hl7.fhir.dstu3.model.Coverage in project beneficiary-fhir-data by CMSgov.

the class PartDEventTransformerV2Test method shouldHaveDrugCvrgStusCdSupInfo.

@Test
public void shouldHaveDrugCvrgStusCdSupInfo() {
    SupportingInformationComponent sic = TransformerTestUtilsV2.findSupportingInfoByCode("https://bluebutton.cms.gov/resources/variables/drug_cvrg_stus_cd", eob.getSupportingInfo());
    SupportingInformationComponent compare = TransformerTestUtilsV2.createSupportingInfo(// We don't care what the sequence number is here
    sic.getSequence(), // Category
    Arrays.asList(new Coding("http://terminology.hl7.org/CodeSystem/claiminformationcategory", "info", "Information"), new Coding("https://bluebutton.cms.gov/resources/codesystem/information", "https://bluebutton.cms.gov/resources/variables/drug_cvrg_stus_cd", "Drug Coverage Status Code")), // Code
    new Coding("https://bluebutton.cms.gov/resources/variables/drug_cvrg_stus_cd", "C", "Covered"));
    assertTrue(compare.equalsDeep(sic));
}
Also used : SupportingInformationComponent(org.hl7.fhir.r4.model.ExplanationOfBenefit.SupportingInformationComponent) Coding(org.hl7.fhir.r4.model.Coding) Test(org.junit.jupiter.api.Test)

Example 25 with Coverage

use of org.hl7.fhir.dstu3.model.Coverage in project beneficiary-fhir-data by CMSgov.

the class R4CoverageResourceProviderIT method searchByExistingBeneficiaryWithPaging.

/**
 * Verifies that {@link
 * gov.cms.bfd.server.war.stu3.providers.CoverageResourceProvider#searchByBeneficiary(ca.uhn.fhir.rest.param.ReferenceParam)}
 * works as expected for a {@link Beneficiary} that does exist in the DB, with paging.
 *
 * @throws FHIRException (indicates test failure)
 */
@Test
public void searchByExistingBeneficiaryWithPaging() throws FHIRException {
    List<Object> loadedRecords = ServerTestUtils.get().loadData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    IGenericClient fhirClient = ServerTestUtils.get().createFhirClientV2();
    Beneficiary beneficiary = loadedRecords.stream().filter(r -> r instanceof Beneficiary).map(r -> (Beneficiary) r).findFirst().get();
    Bundle searchResults = fhirClient.search().forResource(Coverage.class).where(Coverage.BENEFICIARY.hasId(TransformerUtilsV2.buildPatientId(beneficiary))).count(4).returnBundle(Bundle.class).execute();
    assertNotNull(searchResults);
    assertEquals(MedicareSegment.values().length, searchResults.getTotal());
    /*
     * Verify that only the first and last paging links exist, since there should
     * only be one page.
     */
    assertNotNull(searchResults.getLink(Constants.LINK_FIRST));
    assertNull(searchResults.getLink(Constants.LINK_NEXT));
    assertNull(searchResults.getLink(Constants.LINK_PREVIOUS));
    assertNotNull(searchResults.getLink(Constants.LINK_LAST));
    /*
     * Verify that each of the expected Coverages (one for every MedicareSegment) is
     * present and looks correct.
     */
    Coverage partACoverageFromSearchResult = searchResults.getEntry().stream().filter(e -> e.getResource() instanceof Coverage).map(e -> (Coverage) e.getResource()).filter(c -> c.getClass_().stream().filter(cl -> TransformerConstants.COVERAGE_PLAN_PART_A.equals(cl.getValue())).findAny().isPresent()).findFirst().get();
    CoverageTransformerV2Test.assertPartAMatches(beneficiary, partACoverageFromSearchResult);
    Coverage partBCoverageFromSearchResult = searchResults.getEntry().stream().filter(e -> e.getResource() instanceof Coverage).map(e -> (Coverage) e.getResource()).filter(c -> c.getClass_().stream().filter(cl -> TransformerConstants.COVERAGE_PLAN_PART_B.equals(cl.getValue())).findAny().isPresent()).findFirst().get();
    CoverageTransformerV2Test.assertPartBMatches(beneficiary, partBCoverageFromSearchResult);
    Coverage partDCoverageFromSearchResult = searchResults.getEntry().stream().filter(e -> e.getResource() instanceof Coverage).map(e -> (Coverage) e.getResource()).filter(c -> c.getClass_().stream().filter(cl -> TransformerConstants.COVERAGE_PLAN_PART_D.equals(cl.getValue())).findAny().isPresent()).findFirst().get();
    CoverageTransformerV2Test.assertPartDMatches(beneficiary, partDCoverageFromSearchResult);
}
Also used : Assertions.assertNotNull(org.junit.jupiter.api.Assertions.assertNotNull) Arrays(java.util.Arrays) Date(java.util.Date) Assertions.assertNull(org.junit.jupiter.api.Assertions.assertNull) Constants(ca.uhn.fhir.rest.api.Constants) LoggerFactory(org.slf4j.LoggerFactory) PipelineTestUtils(gov.cms.bfd.pipeline.sharedutils.PipelineTestUtils) DateRangeParam(ca.uhn.fhir.rest.param.DateRangeParam) BeforeAll(org.junit.jupiter.api.BeforeAll) Assertions.assertEquals(org.junit.jupiter.api.Assertions.assertEquals) IGenericClient(ca.uhn.fhir.rest.client.api.IGenericClient) ResourceNotFoundException(ca.uhn.fhir.rest.server.exceptions.ResourceNotFoundException) StaticRifResourceGroup(gov.cms.bfd.model.rif.samples.StaticRifResourceGroup) ServerTestUtils(gov.cms.bfd.server.war.ServerTestUtils) Coverage(org.hl7.fhir.r4.model.Coverage) Logger(org.slf4j.Logger) MedicareSegment(gov.cms.bfd.server.war.commons.MedicareSegment) InvalidRequestException(ca.uhn.fhir.rest.server.exceptions.InvalidRequestException) Instant(java.time.Instant) Test(org.junit.jupiter.api.Test) Beneficiary(gov.cms.bfd.model.rif.Beneficiary) List(java.util.List) AfterEach(org.junit.jupiter.api.AfterEach) TransformerConstants(gov.cms.bfd.server.war.commons.TransformerConstants) FHIRException(org.hl7.fhir.exceptions.FHIRException) Bundle(org.hl7.fhir.r4.model.Bundle) IGenericClient(ca.uhn.fhir.rest.client.api.IGenericClient) Bundle(org.hl7.fhir.r4.model.Bundle) Coverage(org.hl7.fhir.r4.model.Coverage) Beneficiary(gov.cms.bfd.model.rif.Beneficiary) Test(org.junit.jupiter.api.Test)

Aggregations

Test (org.junit.jupiter.api.Test)31 Coverage (org.hl7.fhir.r4.model.Coverage)28 Beneficiary (gov.cms.bfd.model.rif.Beneficiary)16 BundleEntryComponent (org.hl7.fhir.r4.model.Bundle.BundleEntryComponent)16 MedicareSegment (gov.cms.bfd.server.war.commons.MedicareSegment)15 Coverage (org.hl7.fhir.dstu3.model.Coverage)15 Reference (org.hl7.fhir.r4.model.Reference)14 TransformerConstants (gov.cms.bfd.server.war.commons.TransformerConstants)13 Arrays (java.util.Arrays)13 Instant (java.time.Instant)12 List (java.util.List)12 Date (java.util.Date)11 Complex (org.hl7.fhir.dstu2016may.formats.RdfGenerator.Complex)11 Constants (ca.uhn.fhir.rest.api.Constants)10 Timer (com.codahale.metrics.Timer)10 Bundle (org.hl7.fhir.r4.model.Bundle)10 Complex (org.hl7.fhir.r4.utils.formats.Turtle.Complex)10 CcwCodebookVariable (gov.cms.bfd.model.codebook.data.CcwCodebookVariable)9 Patient (org.hl7.fhir.r4.model.Patient)9 Assertions.assertEquals (org.junit.jupiter.api.Assertions.assertEquals)9