Examples with Claim org.hl7.fhir.r4.model.Claim used on opensource projects

Example 76 with Claim

use of org.hl7.fhir.r4.model.Claim in project beneficiary-fhir-data by CMSgov.

the class R4ExplanationOfBenefitResourceProviderIT method readEobForExistingHospiceClaim.

/**
 * Verifies that {@link
 * gov.cms.bfd.server.war.r4.providers.ExplanationOfBenefitResourceProvider#read(org.hl7.fhir.r4.model.IdType)}
 * works as expected for a {@link HospiceClaim}-derived {@link ExplanationOfBenefit} that does
 * exist in the DB.
 *
 * @throws FHIRException (indicates test failure)
 */
@Test
public void readEobForExistingHospiceClaim() throws FHIRException {
    List<Object> loadedRecords = ServerTestUtils.get().loadData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    IGenericClient fhirClient = ServerTestUtils.get().createFhirClientV2();
    HospiceClaim claim = loadedRecords.stream().filter(r -> r instanceof HospiceClaim).map(r -> (HospiceClaim) r).findFirst().get();
    ExplanationOfBenefit eob = fhirClient.read().resource(ExplanationOfBenefit.class).withId(TransformerUtilsV2.buildEobId(ClaimTypeV2.HOSPICE, claim.getClaimId())).execute();
    assertNotNull(eob);
    // Compare result to transformed EOB
    compareEob(ClaimTypeV2.HOSPICE, eob, loadedRecords);
}

Example 77 with Claim

use of org.hl7.fhir.r4.model.Claim in project beneficiary-fhir-data by CMSgov.

the class R4ClaimResourceProviderIT method shouldGetCorrectMcsClaimResourceById.

@Test
public void shouldGetCorrectMcsClaimResourceById() {
    IGenericClient fhirClient = ServerTestUtils.get().createFhirClientV2();
    Claim claimResult = fhirClient.read().resource(Claim.class).withId("m-654321").execute();
    String expected = testUtils.expectedResponseFor("claimMcsRead");
    String actual = FhirContext.forR4().newJsonParser().encodeResourceToString(claimResult);
    AssertUtils.assertJsonEquals(expected, actual, IGNORE_PATTERNS);
}

Example 78 with Claim

use of org.hl7.fhir.r4.model.Claim in project beneficiary-fhir-data by CMSgov.

the class ExplanationOfBenefitResourceProviderIT method searchForSamhsaEobsWithExcludeSamhsaFalse.

/**
 * Verifies that {@link ExplanationOfBenefitResourceProvider#findByPatient} with <code>
 * excludeSAMHSA=false</code> does not filter out SAMHSA-related claims.
 *
 * @throws FHIRException (indicates test failure)
 */
@Test
public void searchForSamhsaEobsWithExcludeSamhsaFalse() throws FHIRException {
    Beneficiary beneficiary = loadSampleAWithSamhsa();
    IGenericClient fhirClient = ServerTestUtils.get().createFhirClient();
    Bundle searchResults = fhirClient.search().forResource(ExplanationOfBenefit.class).where(ExplanationOfBenefit.PATIENT.hasId(TransformerUtils.buildPatientId(beneficiary.getBeneficiaryId()))).and(new StringClientParam("excludeSAMHSA").matches().value("false")).returnBundle(Bundle.class).execute();
    assertNotNull(searchResults);
    for (ClaimType claimType : ClaimType.values()) {
        // Without filtering we expect one claim for each claim type.
        assertEquals(1, filterToClaimType(searchResults, claimType).size());
    }
}

Example 79 with Claim

use of org.hl7.fhir.r4.model.Claim in project beneficiary-fhir-data by CMSgov.

the class ExplanationOfBenefitResourceProviderIT method searchForNonSamhsaEobsWithExcludeSamhsaTrue.

/**
 * Verifies that {@link ExplanationOfBenefitResourceProvider#findByPatient} with <code>
 * excludeSAMHSA=true</code> properly returns claims that are not SAMHSA-related.
 *
 * @throws FHIRException (indicates test failure)
 */
@Test
public void searchForNonSamhsaEobsWithExcludeSamhsaTrue() throws FHIRException {
    // Load the SAMPLE_A resources normally.
    Beneficiary beneficiary = loadSampleA();
    IGenericClient fhirClient = ServerTestUtils.get().createFhirClient();
    Bundle searchResults = fhirClient.search().forResource(ExplanationOfBenefit.class).where(ExplanationOfBenefit.PATIENT.hasId(TransformerUtils.buildPatientId(beneficiary.getBeneficiaryId()))).and(new StringClientParam("excludeSAMHSA").matches().value("true")).returnBundle(Bundle.class).execute();
    assertNotNull(searchResults);
    for (ClaimType claimType : ClaimType.values()) {
        // None of the claims are SAMHSA so we expect one record per claim type in the results.
        assertEquals(1, filterToClaimType(searchResults, claimType).size(), String.format("Verify claims of type '%s' are present", claimType));
    }
}

Example 80 with Claim

use of org.hl7.fhir.r4.model.Claim 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));
}