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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));
}
Also used : Coding(org.hl7.fhir.r4.model.Coding) AdjudicationComponent(org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent) CodeableConcept(org.hl7.fhir.r4.model.CodeableConcept) Test(org.junit.jupiter.api.Test)

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));
}
Also used : Money(org.hl7.fhir.r4.model.Money) Coding(org.hl7.fhir.r4.model.Coding) AdjudicationComponent(org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent) CodeableConcept(org.hl7.fhir.r4.model.CodeableConcept) Test(org.junit.jupiter.api.Test)

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));
}
Also used : Money(org.hl7.fhir.r4.model.Money) Coding(org.hl7.fhir.r4.model.Coding) AdjudicationComponent(org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent) DecimalType(org.hl7.fhir.r4.model.DecimalType) CodeableConcept(org.hl7.fhir.r4.model.CodeableConcept) Test(org.junit.jupiter.api.Test)

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));
}
Also used : Coding(org.hl7.fhir.r4.model.Coding) AdjudicationComponent(org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent) CodeableConcept(org.hl7.fhir.r4.model.CodeableConcept) Test(org.junit.jupiter.api.Test)

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));
}
Also used : Money(org.hl7.fhir.r4.model.Money) Coding(org.hl7.fhir.r4.model.Coding) AdjudicationComponent(org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent) CodeableConcept(org.hl7.fhir.r4.model.CodeableConcept) Test(org.junit.jupiter.api.Test)

Aggregations

CodeableConcept (org.hl7.fhir.r4.model.CodeableConcept)67 AdjudicationComponent (org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent)67 Coding (org.hl7.fhir.r4.model.Coding)65 Test (org.junit.jupiter.api.Test)64 Money (org.hl7.fhir.r4.model.Money)62 BigDecimal (java.math.BigDecimal)18 DecimalType (org.hl7.fhir.r4.model.DecimalType)8 AdjudicationComponent (org.hl7.fhir.dstu3.model.ExplanationOfBenefit.AdjudicationComponent)5 IBaseExtension (org.hl7.fhir.instance.model.api.IBaseExtension)5 CodeableConcept (org.hl7.fhir.dstu3.model.CodeableConcept)4 Extension (org.hl7.fhir.dstu3.model.Extension)4 Observation (org.hl7.fhir.dstu3.model.Observation)4 Reference (org.hl7.fhir.dstu3.model.Reference)4 FhirContext (ca.uhn.fhir.context.FhirContext)3 TemporalPrecisionEnum (ca.uhn.fhir.model.api.TemporalPrecisionEnum)3 CcwCodebookVariable (gov.cms.bfd.model.codebook.data.CcwCodebookVariable)3 CcwCodebookInterface (gov.cms.bfd.model.codebook.model.CcwCodebookInterface)3 Diagnosis (gov.cms.bfd.server.war.commons.Diagnosis)3 Period (org.hl7.fhir.dstu3.model.Period)3 Quantity (org.hl7.fhir.dstu3.model.Quantity)3