Examples with AdjudicationComponent org.hl7.fhir.dstu3.model.ExplanationOfBenefit.AdjudicationComponent used on opensource projects

Example 6 with AdjudicationComponent

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

the class OutpatientClaimTransformerV2Test method shouldHaveLineItemAdjudicationRevCntr1stAnsiCd.

@Test
public void shouldHaveLineItemAdjudicationRevCntr1stAnsiCd() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByReason("CO120", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator", "denialreason", "Denial Reason")))).setReason(new CodeableConcept().setCoding(Arrays.asList(new Coding("https://bluebutton.cms.gov/resources/variables/rev_cntr_1st_ansi_cd", "CO120", null))));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 7 with AdjudicationComponent

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

the class OutpatientClaimTransformerV2Test method shouldHaveLineItemAdjudicationRevCntr2ndMspPdAmt.

@Test
public void shouldHaveLineItemAdjudicationRevCntr2ndMspPdAmt() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("https://bluebutton.cms.gov/resources/variables/rev_cntr_2nd_msp_pd_amt", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication", "priorpayerpaid", "Prior payer paid"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/rev_cntr_2nd_msp_pd_amt", "Revenue Center 2nd Medicare Secondary Payer (MSP) Paid Amount")))).setAmount(new Money().setValue(0).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 8 with AdjudicationComponent

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

the class OutpatientClaimTransformerV2Test method shouldHaveLineItemAdjudicationRevCntrRdcdCoinsrncAmt.

@Test
public void shouldHaveLineItemAdjudicationRevCntrRdcdCoinsrncAmt() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("https://bluebutton.cms.gov/resources/variables/rev_cntr_rdcd_coinsrnc_amt", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication", "coinsurance", "Co-insurance"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/rev_cntr_rdcd_coinsrnc_amt", "Revenue Center Reduced Coinsurance Amount")))).setAmount(// .0 and fail
    new Money().setValueElement(new DecimalType("11.00")).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 9 with AdjudicationComponent

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

the class OutpatientClaimTransformerV2Test method shouldHaveLineItemAdjudicationRevCntr2ndAnsiCd.

@Test
public void shouldHaveLineItemAdjudicationRevCntr2ndAnsiCd() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByReason("CR121", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator", "denialreason", "Denial Reason")))).setReason(new CodeableConcept().setCoding(Arrays.asList(new Coding("https://bluebutton.cms.gov/resources/variables/rev_cntr_2nd_ansi_cd", "CR121", null))));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 10 with AdjudicationComponent

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

the class OutpatientClaimTransformerV2Test method shouldHaveLineItemAdjudicationRevCntrPmtAmtAmt.

@Test
public void shouldHaveLineItemAdjudicationRevCntrPmtAmtAmt() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("https://bluebutton.cms.gov/resources/variables/rev_cntr_pmt_amt_amt", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://terminology.hl7.org/CodeSystem/adjudication", "submitted", "Submitted Amount"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/rev_cntr_pmt_amt_amt", "Revenue Center (Medicare) Payment Amount")))).setAmount(new Money().setValue(5000).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}