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

Example 76 with Coverage

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

the class BeneficiaryTransformerTest method transformBeneficiaryWithIncludeAddressFieldsAllOptEmpty.

/**
 * Notes for reviewer: for header related coverage, do not test on the combination of headers
 * values if there is no correlation between the headers, hence removed includeAddressFields
 * header tests out of includeIdentifiers header tests to speed up tests and keep the same level
 * of coverage at the same time.
 */
/**
 * Verifies that {@link gov.cms.bfd.server.war.stu3.providers.BeneficiaryTransformer} works
 * correctly when passed a {@link Beneficiary} where all {@link Optional} fields are set to {@link
 * Optional#empty()} and includeAddressFields header take all possible values.
 */
@Test
public void transformBeneficiaryWithIncludeAddressFieldsAllOptEmpty() {
    List<Object> parsedRecords = ServerTestUtils.parseData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    Beneficiary beneficiary = parsedRecords.stream().filter(r -> r instanceof Beneficiary).map(r -> (Beneficiary) r).findFirst().get();
    TransformerTestUtils.setAllOptionalsToEmpty(beneficiary);
    RequestHeaders requestHeader = getRHwithIncldAddrFldHdr("true");
    Patient patient = BeneficiaryTransformer.transform(new MetricRegistry(), beneficiary, requestHeader);
    assertMatches(beneficiary, patient, requestHeader);
    requestHeader = getRHwithIncldAddrFldHdr("false");
    patient = BeneficiaryTransformer.transform(new MetricRegistry(), beneficiary, requestHeader);
    assertMatches(beneficiary, patient, requestHeader);
    requestHeader = getRHwithIncldAddrFldHdr("");
    patient = BeneficiaryTransformer.transform(new MetricRegistry(), beneficiary, requestHeader);
    assertMatches(beneficiary, patient, requestHeader);
    requestHeader = RequestHeaders.getHeaderWrapper();
    patient = BeneficiaryTransformer.transform(new MetricRegistry(), beneficiary, requestHeader);
    assertMatches(beneficiary, patient, requestHeader);
}

Example 77 with Coverage

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

the class SNFClaimTransformerV2Test method shouldReferenceCoverageInInsurance.

/**
 * Insurance
 */
@Test
public void shouldReferenceCoverageInInsurance() {
    // Only one insurance object
    assertEquals(1, eob.getInsurance().size());
    InsuranceComponent insurance = eob.getInsuranceFirstRep();
    InsuranceComponent compare = new InsuranceComponent().setCoverage(new Reference().setReference("Coverage/part-a-567834"));
    assertTrue(compare.equalsDeep(insurance));
}

Example 78 with Coverage

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

the class TransformerUtilsV2 method mapEobCommonClaimHeaderData.

/**
 * Transforms the common group level header fields between all claim types
 *
 * @param eob the {@link ExplanationOfBenefit} to modify
 * @param claimId CLM_ID
 * @param beneficiaryId BENE_ID
 * @param claimType {@link ClaimTypeV2} to process
 * @param claimGroupId CLM_GRP_ID
 * @param coverageType {@link MedicareSegment}
 * @param dateFrom CLM_FROM_DT || SRVC_DT (For Part D Events)
 * @param dateThrough CLM_THRU_DT || SRVC_DT (For Part D Events)
 * @param paymentAmount CLM_PMT_AMT
 * @param finalAction FINAL_ACTION
 */
static void mapEobCommonClaimHeaderData(ExplanationOfBenefit eob, String claimId, String beneficiaryId, ClaimTypeV2 claimType, String claimGroupId, MedicareSegment coverageType, Optional<LocalDate> dateFrom, Optional<LocalDate> dateThrough, Optional<BigDecimal> paymentAmount, char finalAction) {
    // Claim Type + Claim ID => ExplanationOfBenefit.id
    eob.setId(buildEobId(claimType, claimId));
    // Current timestamp => Created
    eob.setCreated(new Date());
    // "claim" => ExplanationOfBenefit.use
    eob.setUse(Use.CLAIM);
    if (claimType.equals(ClaimTypeV2.PDE)) {
        // PDE_ID => ExplanationOfBenefit.identifier
        eob.addIdentifier(createClaimIdentifier(CcwCodebookVariable.PDE_ID, claimId));
    } else {
        // CLM_ID => ExplanationOfBenefit.identifier
        eob.addIdentifier(createClaimIdentifier(CcwCodebookVariable.CLM_ID, claimId));
    }
    // CLM_GRP_ID => ExplanationOfBenefit.identifier
    eob.addIdentifier().setSystem(TransformerConstants.IDENTIFIER_SYSTEM_BBAPI_CLAIM_GROUP_ID).setValue(claimGroupId).setType(createC4BBClaimCodeableConcept());
    // BENE_ID + Coverage Type => ExplanationOfBenefit.insurance.coverage (ref)
    eob.addInsurance().setCoverage(referenceCoverage(beneficiaryId, coverageType));
    // BENE_ID => ExplanationOfBenefit.patient (reference)
    eob.setPatient(referencePatient(beneficiaryId));
    // "insurer" => ExplanationOfBenefit.insurer
    eob.setInsurer(new Reference().setIdentifier(new Identifier().setValue("CMS")));
    // "outcome" => ExplanationOfBenefit.outcome
    eob.setOutcome(RemittanceOutcome.COMPLETE);
    // FINAL_ACTION => ExplanationOfBenefit.status
    switch(finalAction) {
        case 'F':
            eob.setStatus(ExplanationOfBenefitStatus.ACTIVE);
            break;
        case 'N':
            eob.setStatus(ExplanationOfBenefitStatus.CANCELLED);
            break;
        default:
            // unknown final action value
            throw new BadCodeMonkeyException();
    }
    // CLM_THRU_DT || SRVC_DT (For Part D Events) => ExplanationOfBenefit.billablePeriod.end
    if (dateFrom.isPresent()) {
        validatePeriodDates(dateFrom, dateThrough);
        setPeriodStart(eob.getBillablePeriod(), dateFrom.get());
        setPeriodEnd(eob.getBillablePeriod(), dateThrough.get());
    }
    // CLM_PMT_AMT => ExplanationOfBenefit.payment.amount
    if (paymentAmount.isPresent()) {
        eob.getPayment().setAmount(createMoney(paymentAmount));
    }
}

Example 79 with Coverage

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

the class TransformerUtilsV2 method createBundle.

/**
 * Create a bundle from the entire search result
 *
 * @param paging contains the {@link OffsetLinkBuilder} information
 * @param resources a list of {@link ExplanationOfBenefit}s, {@link Coverage}s, or {@link
 *     Patient}s, of which a portion or all will be added to the bundle based on the paging values
 * @param transactionTime date for the bundle
 * @return Returns a {@link Bundle} of either {@link ExplanationOfBenefit}s, {@link Coverage}s, or
 *     {@link Patient}s, which may contain multiple matching resources, or may also be empty.
 */
public static Bundle createBundle(OffsetLinkBuilder paging, List<IBaseResource> resources, Instant transactionTime) {
    Bundle bundle = new Bundle();
    if (paging.isPagingRequested()) {
        /*
       * FIXME: Due to a bug in HAPI-FHIR described here
       * https://github.com/jamesagnew/hapi-fhir/issues/1074 paging for count=0 is not working
       * correctly.
       */
        int endIndex = Math.min(paging.getStartIndex() + paging.getPageSize(), resources.size());
        List<IBaseResource> resourcesSubList = resources.subList(paging.getStartIndex(), endIndex);
        bundle = TransformerUtilsV2.addResourcesToBundle(bundle, resourcesSubList);
        paging.setTotal(resources.size()).addLinks(bundle);
    } else {
        bundle = TransformerUtilsV2.addResourcesToBundle(bundle, resources);
    }
    /*
     * Dev Note: the Bundle's lastUpdated timestamp is the known last update time for the whole
     * database. Because the filterManager's tracking of this timestamp is lazily updated for
     * performance reason, the resources of the bundle may be after the filter manager's version of
     * the timestamp.
     */
    Instant maxBundleDate = resources.stream().map(r -> r.getMeta().getLastUpdated().toInstant()).filter(Objects::nonNull).max(Instant::compareTo).orElse(transactionTime);
    bundle.getMeta().setLastUpdated(transactionTime.isAfter(maxBundleDate) ? Date.from(transactionTime) : Date.from(maxBundleDate));
    bundle.setTotal(resources.size());
    return bundle;
}

Example 80 with Coverage

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

the class TransformerUtilsV2 method createBundle.

/**
 * Create a bundle from the entire search result
 *
 * @param resources a list of {@link ExplanationOfBenefit}s, {@link Coverage}s, or {@link
 *     Patient}s, all of which will be added to the bundle
 * @param paging contains the {@link LinkBuilder} information to add to the bundle
 * @param transactionTime date for the bundle
 * @return Returns a {@link Bundle} of either {@link ExplanationOfBenefit}s, {@link Coverage}s, or
 *     {@link Patient}s, which may contain multiple matching resources, or may also be empty.
 */
public static Bundle createBundle(List<IBaseResource> resources, LinkBuilder paging, Instant transactionTime) {
    Bundle bundle = new Bundle();
    TransformerUtilsV2.addResourcesToBundle(bundle, resources);
    paging.addLinks(bundle);
    bundle.setTotalElement(paging.isPagingRequested() ? new UnsignedIntType() : new UnsignedIntType(resources.size()));
    /*
     * Dev Note: the Bundle's lastUpdated timestamp is the known last update time for the whole
     * database. Because the filterManager's tracking of this timestamp is lazily updated for
     * performance reason, the resources of the bundle may be after the filter manager's version of
     * the timestamp.
     */
    Instant maxBundleDate = resources.stream().map(r -> r.getMeta().getLastUpdated().toInstant()).filter(Objects::nonNull).max(Instant::compareTo).orElse(transactionTime);
    bundle.getMeta().setLastUpdated(transactionTime.isAfter(maxBundleDate) ? Date.from(transactionTime) : Date.from(maxBundleDate));
    return bundle;
}