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

Example 11 with Claim

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

the class CarrierClaimTransformer method transform.

/**
 * @param metricRegistry the {@link MetricRegistry} to use
 * @param claim the CCW {@link CarrierClaim} 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
 *     CarrierClaim}
 */
@Trace
static ExplanationOfBenefit transform(MetricRegistry metricRegistry, Object claim, Optional<Boolean> includeTaxNumbers) {
    Timer.Context timer = metricRegistry.timer(MetricRegistry.name(CarrierClaimTransformer.class.getSimpleName(), "transform")).time();
    if (!(claim instanceof CarrierClaim))
        throw new BadCodeMonkeyException();
    ExplanationOfBenefit eob = transformClaim((CarrierClaim) claim, includeTaxNumbers);
    timer.stop();
    return eob;
}

Example 12 with Claim

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

the class FissClaimResponseTransformerV2 method transformClaim.

/**
 * @param claimGroup the {@link PreAdjFissClaim} to transform
 * @return a FHIR {@link ClaimResponse} resource that represents the specified {@link
 *     PreAdjFissClaim}
 */
private static ClaimResponse transformClaim(PreAdjFissClaim claimGroup) {
    ClaimResponse claim = new ClaimResponse();
    claim.setId("f-" + claimGroup.getDcn());
    claim.setContained(List.of(getContainedPatient(claimGroup)));
    claim.setExtension(getExtension(claimGroup));
    claim.setIdentifier(getIdentifier(claimGroup));
    claim.setStatus(ClaimResponse.ClaimResponseStatus.ACTIVE);
    claim.setOutcome(STATUS_TO_OUTCOME.get(Character.toLowerCase(claimGroup.getCurrStatus())));
    claim.setType(getType());
    claim.setUse(ClaimResponse.Use.CLAIM);
    claim.setInsurer(new Reference().setIdentifier(new Identifier().setValue("CMS")));
    claim.setPatient(new Reference("#patient"));
    claim.setRequest(new Reference(String.format("Claim/f-%s", claimGroup.getDcn())));
    claim.setMeta(new Meta().setLastUpdated(Date.from(claimGroup.getLastUpdated())));
    claim.setCreated(new Date());
    return claim;
}

Example 13 with Claim

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

the class FissClaimTransformerV2 method transformClaim.

/**
 * @param claimGroup the {@link PreAdjFissClaim} to transform
 * @return a FHIR {@link Claim} resource that represents the specified {@link PreAdjFissClaim}
 */
private static Claim transformClaim(PreAdjFissClaim claimGroup) {
    Claim claim = new Claim();
    boolean isIcd9 = claimGroup.getStmtCovToDate() != null && claimGroup.getStmtCovToDate().isBefore(ICD_9_CUTOFF_DATE);
    claim.setId("f-" + claimGroup.getDcn());
    claim.setContained(List.of(getContainedPatient(claimGroup), getContainedProvider(claimGroup)));
    claim.setIdentifier(getIdentifier(claimGroup));
    claim.setExtension(getExtension(claimGroup));
    claim.setStatus(Claim.ClaimStatus.ACTIVE);
    claim.setType(getType(claimGroup));
    claim.setSupportingInfo(getSupportingInfo(claimGroup));
    claim.setBillablePeriod(getBillablePeriod(claimGroup));
    claim.setUse(Claim.Use.CLAIM);
    claim.setPriority(getPriority());
    claim.setTotal(getTotal(claimGroup));
    claim.setProvider(new Reference("#provider-org"));
    claim.setPatient(new Reference("#patient"));
    claim.setFacility(getFacility(claimGroup));
    claim.setDiagnosis(getDiagnosis(claimGroup, isIcd9));
    claim.setProcedure(getProcedure(claimGroup, isIcd9));
    claim.setInsurance(getInsurance(claimGroup));
    claim.setMeta(new Meta().setLastUpdated(Date.from(claimGroup.getLastUpdated())));
    claim.setCreated(new Date());
    return claim;
}

Example 14 with Claim

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

the class OutpatientClaimTransformerV2Test method shouldHaveRevenueStatusCode.

/**
 * Ensure that when the revenue status code exists in the claim, it should be mapped to an
 * extension.
 *
 * <p>The specific code value of the extension is tested in {@link
 * TransformerUtilsV2Test#mapEobCommonItemRevenueStatusCodeWhenStatusCodeExistsExpectExtensionOnItem()}
 */
@Test
public void shouldHaveRevenueStatusCode() {
    String expectedExtensionUrl = "https://bluebutton.cms.gov/resources/variables/rev_cntr_stus_ind_cd";
    assertNotNull(eob.getItem());
    assertTrue(eob.getItem().size() > 0);
    ExplanationOfBenefit.ItemComponent item = eob.getItem().get(0);
    assertNotNull(item);
    assertNotNull(item.getRevenue());
    assertNotNull(item.getRevenue().getExtension());
    assertEquals(1, item.getRevenue().getExtension().size());
    Extension ext = item.getRevenue().getExtensionByUrl(expectedExtensionUrl);
    assertNotNull(ext);
    assertEquals(expectedExtensionUrl, ext.getUrl());
    assertTrue(ext.getValue() instanceof Coding);
    assertNotNull(((Coding) ext.getValue()).getCode());
}

Example 15 with Claim

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

the class OutpatientClaimTransformerV2Test method generateClaim.

/**
 * Generates the Claim object to be used in multiple tests
 *
 * @return
 * @throws FHIRException
 */
public OutpatientClaim generateClaim() throws FHIRException {
    List<Object> parsedRecords = ServerTestUtils.parseData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    OutpatientClaim claim = parsedRecords.stream().filter(r -> r instanceof OutpatientClaim).map(r -> (OutpatientClaim) r).findFirst().get();
    claim.setLastUpdated(Instant.now());
    return claim;
}