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

Example 26 with Coverage

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

the class R4CoverageResourceProviderIT method searchByExistingBeneficiary.

/**
 * Verifies that {@link
 * gov.cms.bfd.server.war.r4.providers.R4CoverageResourceProvider#searchByBeneficiary(ca.uhn.fhir.rest.param.ReferenceParam)}
 * works as expected for a {@link Beneficiary} that does exist in the DB.
 *
 * @throws FHIRException (indicates test failure)
 */
@Test
public void searchByExistingBeneficiary() throws FHIRException {
    List<Object> loadedRecords = ServerTestUtils.get().loadData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    IGenericClient fhirClient = ServerTestUtils.get().createFhirClientV2();
    Beneficiary beneficiary = loadedRecords.stream().filter(r -> r instanceof Beneficiary).map(r -> (Beneficiary) r).findFirst().get();
    Bundle searchResults = fhirClient.search().forResource(Coverage.class).where(Coverage.BENEFICIARY.hasId(TransformerUtilsV2.buildPatientId(beneficiary))).returnBundle(Bundle.class).execute();
    assertNotNull(searchResults);
    assertEquals(MedicareSegment.values().length, searchResults.getTotal());
    /*
     * Verify that no paging links exist within the bundle.
     */
    assertNull(searchResults.getLink(Constants.LINK_FIRST));
    assertNull(searchResults.getLink(Constants.LINK_NEXT));
    assertNull(searchResults.getLink(Constants.LINK_PREVIOUS));
    assertNull(searchResults.getLink(Constants.LINK_LAST));
    /*
     * Verify that each of the expected Coverages (one for every
     * MedicareSegment) is present and looks correct.
     */
    Coverage partACoverageFromSearchResult = searchResults.getEntry().stream().filter(e -> e.getResource() instanceof Coverage).map(e -> (Coverage) e.getResource()).filter(c -> c.getClass_().stream().filter(cl -> TransformerConstants.COVERAGE_PLAN_PART_A.equals(cl.getValue())).findAny().isPresent()).findFirst().get();
    CoverageTransformerV2Test.assertPartAMatches(beneficiary, partACoverageFromSearchResult);
    Coverage partBCoverageFromSearchResult = searchResults.getEntry().stream().filter(e -> e.getResource() instanceof Coverage).map(e -> (Coverage) e.getResource()).filter(c -> c.getClass_().stream().filter(cl -> TransformerConstants.COVERAGE_PLAN_PART_B.equals(cl.getValue())).findAny().isPresent()).findFirst().get();
    CoverageTransformerV2Test.assertPartBMatches(beneficiary, partBCoverageFromSearchResult);
    Coverage partDCoverageFromSearchResult = searchResults.getEntry().stream().filter(e -> e.getResource() instanceof Coverage).map(e -> (Coverage) e.getResource()).filter(c -> c.getClass_().stream().filter(cl -> TransformerConstants.COVERAGE_PLAN_PART_D.equals(cl.getValue())).findAny().isPresent()).findFirst().get();
    CoverageTransformerV2Test.assertPartDMatches(beneficiary, partDCoverageFromSearchResult);
}

Example 27 with Coverage

use of org.hl7.fhir.r4.model.Coverage in project hl7v2-fhir-converter by LinuxForHealth.

the class Hl7FinancialInsuranceTest method testFailingOrganizationTelecom.

@Test
// This test is to see the problem does not return.  It fails without PR #405, and is successful with it.
void testFailingOrganizationTelecom() throws IOException {
    String hl7message = "MSH|^~\\&|||||20211214105741||DFT^P03|1760487765|P|2.6|||||||||\n" + "EVN|P03|20211214105741\n" + "PID|||MR1^^^XYZ^MR||DOE^JANE^|||F||||||||||||||||||||||\n" + "PV1||I||||||||||||||||||||||||||||||||||||||||||\n" + // FT1.7 is required transaction code (currently not used)
    "FT1||||20201231145045||CG|FAKE|||||||||||||||||||||||||||||||||||||\n" + // IN1.8 to 15 NOT REFERENCED (Tested in testBasicInsuranceCoverageFields)
    "IN1|1|PLAN001|210012|GOLD CHOICE PLUS|||^^^^^800^3334444||||||||||||\n";
    List<BundleEntryComponent> e = ResourceUtils.createFHIRBundleFromHL7MessageReturnEntryList(ftv, hl7message);
    List<Resource> encounters = ResourceUtils.getResourceList(e, ResourceType.Encounter);
    // From PV1
    assertThat(encounters).hasSize(1);
    List<Resource> patients = ResourceUtils.getResourceList(e, ResourceType.Patient);
    // From PID
    assertThat(patients).hasSize(1);
    List<Resource> organizations = ResourceUtils.getResourceList(e, ResourceType.Organization);
    // From Payor created by IN1
    assertThat(organizations).hasSize(1);
    Organization org = (Organization) organizations.get(0);
    // Check organization Id's
    // IN1.4
    assertThat(org.getName()).isEqualTo("GOLD CHOICE PLUS");
    assertThat(org.getIdentifier()).hasSize(1);
    Identifier orgIdentifier1 = org.getIdentifierFirstRep();
    // IN1.3.1
    assertThat(orgIdentifier1.getValue()).isEqualTo("210012");
    // IN1.3.4 empty
    assertThat(orgIdentifier1.hasSystem()).isFalse();
    // IN1.3.7 & IN1.3.7 empty
    assertThat(orgIdentifier1.hasPeriod()).isFalse();
    // IN1.3.5 empty
    assertThat(orgIdentifier1.hasType()).isFalse();
    // Check Organization contact telecom.  IN1.7 is standard XTN, tested exhaustively in other tests.
    assertThat(org.getContact().get(0).getTelecom()).hasSize(1);
    // telecom is type ContactPoint
    ContactPoint contactPoint = org.getContact().get(0).getTelecomFirstRep();
    // default type hardcoded.
    assertThat(contactPoint.getSystemElement().getCode()).hasToString("phone");
    // IN1.7.2 is not mapped
    assertThat(contactPoint.hasUseElement()).isFalse();
    // IN1.7.6, IN1.7.7 via getFormattedTelecomNumberValue
    assertThat(contactPoint.getValue()).hasToString("(800) 333 4444");
    List<Resource> coverages = ResourceUtils.getResourceList(e, ResourceType.Coverage);
    // From IN1 segment
    assertThat(coverages).hasSize(1);
    // Confirm there are no unaccounted for resources
    // Expected: Coverage, Organization, Patient, Encounter
    assertThat(e).hasSize(4);
}

Example 28 with Coverage

use of org.hl7.fhir.r4.model.Coverage in project hl7v2-fhir-converter by LinuxForHealth.

the class Hl7FinancialInsuranceTest method testBasicInsuranceCoverageFields.

// Suppress warnings about too many assertions in a test. Justification: creating a FHIR message is very costly; we need to check many asserts per creation for efficiency.
@java.lang.SuppressWarnings("squid:S5961")
@Test
void testBasicInsuranceCoverageFields() throws IOException {
    // Tests fields listed below.
    String hl7message = "MSH|^~\\&|||||20151008111200||DFT^P03^DFT_P03|MSGID000001|T|2.6|||||||||\n" + "EVN||20210407191342||||||\n" + "PID|||MR1^^^XYZ^MR||DOE^JANE^|||F||||||||||||||||||||||\n" + "PV1||I||||||||||||||||||||||||||||||||||||||||||\n" + // FT1.7 is required transaction code (currently not used)
    "FT1||||20201231145045||CG|FAKE|||||||||||||||||||||||||||||||||||||\n" + // IN1.2.4, IN1.2.6 to second XV Coverage.identifier
    "IN1|1|Value1^^System3^Value4^^System6" + // IN1.3.8 to Organization Identifier.period.end
    "|IdValue1^^^IdSystem4^IdType5^^20201231145045^20211231145045" + // IN1.4 to Organization Name
    "|Large Blue Organization" + // IN1.5 to Organization Address (All XAD standard fields)
    "|456 Ultramarine Lane^^Faketown^CA^ZIP5" + // IN1.6.13 to Organization Contact Name .period.end
    "|LastFake^FirstFake^MiddleFake^III^Dr.^^L^^^^^20201231145045^20211231145045" + // IN1.7.18 to Organization Contact telecom .rank
    "|^WPN^^^^333^4444444^^^^^^20201231145045^20211231145045^^^^1" + // IN1.9.1 (2) to list element Coverage.class.name and value (because IN1.9.10 (2) does not exist)
    "|UA34567|NameBlue^^^^^^^^^IDBlue~NameGreen||" + // IN1.35 to Organization.identifier
    "|20201231145045|20211231145045|||||||||5|||||||||||||COMPANYPLANCODE35" + // IN1.49 has value to show that it is not used for Patient.identifier because NO relationship (IN1.17/IN2.72 empty)
    "|MEMBER36||||||||||Value46|||PatientId49.1||||\n" + // IN2.61 is purposely empty (primary to IN1.36) so IN1.36 will be used as the MB Coverage.identifier
    "IN2|||||||||||||||||||||||||IdValue25.1^^^IdSystem25.4^IdType25.5^^20201231145045^20211231145045|||||||||||||||||||||||||||||||||||||||||||" + // IN2.72 is purposely empty (backup to IN1.17) so no RelatedPerson is created.
    "|Name69.1^^^^^IdSystem69.6^UNK^^^IdValue69.10||\n";
    List<BundleEntryComponent> e = ResourceUtils.createFHIRBundleFromHL7MessageReturnEntryList(ftv, hl7message);
    List<Resource> encounters = ResourceUtils.getResourceList(e, ResourceType.Encounter);
    // From PV1
    assertThat(encounters).hasSize(1);
    List<Resource> patients = ResourceUtils.getResourceList(e, ResourceType.Patient);
    // From PID
    assertThat(patients).hasSize(1);
    Patient patient = (Patient) patients.get(0);
    String patientId = patient.getId();
    // From PID.3
    assertThat(patient.getIdentifier()).hasSize(1);
    Identifier patientIdentifier = patient.getIdentifier().get(0);
    // PID.3.1
    assertThat(patientIdentifier.getValue()).isEqualTo("MR1");
    // PID.3.4
    assertThat(patientIdentifier.getSystem()).isEqualTo("urn:id:XYZ");
    DatatypeUtils.checkCommonCodeableConceptAssertions(patientIdentifier.getType(), "MR", "Medical record number", "http://terminology.hl7.org/CodeSystem/v2-0203", // PID.3.5
    null);
    // IN1.49 not used
    List<Resource> organizations = ResourceUtils.getResourceList(e, ResourceType.Organization);
    // From IN1.3 creates Payor, IN2.25 to new PayorId Organization, IN2.69 creates new PolicyHolder Organization Name
    assertThat(organizations).hasSize(3);
    Organization org = (Organization) organizations.get(0);
    // Check Payor Organization Id's
    String payorOrgId = org.getId();
    // IN1.17.1 (no TENANT)  (Id's lowercased)
    assertThat(payorOrgId).isEqualTo("Organization/idvalue1");
    // IN1.4
    assertThat(org.getName()).isEqualTo("Large Blue Organization");
    assertThat(org.getIdentifier()).hasSize(2);
    Identifier orgIdentifier = org.getIdentifier().get(0);
    // IN1.3.1
    assertThat(orgIdentifier.getValue()).isEqualTo("IdValue1");
    // IN1.3.4
    assertThat(orgIdentifier.getSystem()).isEqualTo("urn:id:IdSystem4");
    // IN1.3.7
    assertThat(orgIdentifier.getPeriod().getStartElement().toString()).containsPattern("2020-12-31T14:50:45");
    // IN1.3.8
    assertThat(orgIdentifier.getPeriod().getEndElement().toString()).containsPattern("2021-12-31T14:50:45");
    // IN1.3.5
    DatatypeUtils.checkCommonCodeableConceptAssertions(orgIdentifier.getType(), "IdType5", null, null, null);
    Identifier orgIdentifier1 = org.getIdentifier().get(1);
    // IN1.35
    assertThat(orgIdentifier1.getValue()).isEqualTo("COMPANYPLANCODE35");
    // Check Payor Organization address. IN1.4 is a standard XAD address, which is tested exhaustively in other tests.
    assertThat(org.getAddress()).hasSize(1);
    assertThat(org.getAddress().get(0).getLine().get(0).getValueAsString()).isEqualTo(// IN1.4.1
    "456 Ultramarine Lane");
    // IN1.4.3
    assertThat(org.getAddress().get(0).getCity()).isEqualTo("Faketown");
    // IN1.4.4
    assertThat(org.getAddress().get(0).getState()).isEqualTo("CA");
    // IN1.4.5
    assertThat(org.getAddress().get(0).getPostalCode()).isEqualTo("ZIP5");
    // Check Payor Organization contact name.  IN1.6 name is standard XPN, tested exhaustively in other tests.
    HumanName contactName = org.getContact().get(0).getName();
    assertThat(org.getContact()).hasSize(1);
    // IN1.6.1
    assertThat(contactName.getFamily()).isEqualTo("LastFake");
    // IN1.6.2
    assertThat(contactName.getGiven().get(0).getValueAsString()).isEqualTo("FirstFake");
    // IN1.6.3
    assertThat(contactName.getGiven().get(1).getValueAsString()).isEqualTo("MiddleFake");
    // IN1.6.6
    assertThat(contactName.getPrefixAsSingleString()).hasToString("Dr.");
    // IN1.6.5
    assertThat(contactName.getSuffixAsSingleString()).hasToString("III");
    // from IN1.6 aggregate
    assertThat(contactName.getText()).isEqualTo("Dr. FirstFake MiddleFake LastFake III");
    // IN1.6.7
    assertThat(contactName.getUseElement().getCode()).hasToString("official");
    // IN1.6.12
    assertThat(contactName.getPeriod().getStartElement().toString()).containsPattern("2020-12-31T14:50:45");
    // IN1.6.13
    assertThat(contactName.getPeriod().getEndElement().toString()).containsPattern("2021-12-31T14:50:45");
    // Check there is no purpose. Don't need one, here.
    assertThat(org.getContact().get(0).hasPurpose()).isFalse();
    // Check Payor Organization contact telecom.  IN1.7 is standard XTN, tested exhaustively in other tests.
    assertThat(org.getContact().get(0).getTelecom()).hasSize(1);
    // telecom is type ContactPoint
    ContactPoint contactPoint = org.getContact().get(0).getTelecomFirstRep();
    // default type hardcoded.
    assertThat(contactPoint.getSystemElement().getCode()).hasToString("phone");
    // IN1.7.2 is not mapped (ignored)
    assertThat(contactPoint.hasUseElement()).isFalse();
    // IN1.7.6, IN1.7.7 via getFormattedTelecomNumberValue
    assertThat(contactPoint.getValue()).hasToString("(333) 444 4444");
    // IN1.7.13
    assertThat(contactPoint.getPeriod().getStartElement().toString()).containsPattern("2020-12-31T14:50:45");
    // IN1.7.14
    assertThat(contactPoint.getPeriod().getEndElement().toString()).containsPattern("2021-12-31T14:50:45");
    // IN1.7.18
    assertThat(contactPoint.getRank()).isEqualTo(1);
    // Check PayorId Organization from IN2.25
    org = (Organization) organizations.get(1);
    String payorOrgIdIn25 = org.getId();
    // IN1.25.1 (no TENANT) (Id's lowercased)
    assertThat(payorOrgIdIn25).isEqualTo("Organization/idvalue25.1");
    // IN2.25.1
    assertThat(org.getName()).isEqualTo("IdValue25.1");
    assertThat(org.getIdentifier()).hasSize(1);
    orgIdentifier = org.getIdentifier().get(0);
    // IN2.25.1
    assertThat(orgIdentifier.getValue()).isEqualTo("IdValue25.1");
    // IN2.25.4
    assertThat(orgIdentifier.getSystem()).isEqualTo("urn:id:IdSystem25.4");
    // IN2.25.7
    assertThat(orgIdentifier.getPeriod().getStartElement().toString()).containsPattern("2020-12-31T14:50:45");
    // IN2.25.8
    assertThat(orgIdentifier.getPeriod().getEndElement().toString()).containsPattern("2021-12-31T14:50:45");
    // IN2.25.5
    DatatypeUtils.checkCommonCodeableConceptAssertions(orgIdentifier.getType(), "IdType25.5", null, null, null);
    // Check PolicyHolder Organization Name and ID Organization from IN2.69
    org = (Organization) organizations.get(2);
    String policyHolderOrgId = org.getId();
    // IN2.69.1 (no TENANT) (Id's lowercased)
    assertThat(policyHolderOrgId).isEqualTo("Organization/idvalue69.10");
    // IN2.69.1
    assertThat(org.getName()).isEqualTo("Name69.1");
    assertThat(org.getIdentifier()).hasSize(1);
    orgIdentifier = org.getIdentifier().get(0);
    // IN2.69.10
    assertThat(orgIdentifier.getValue()).isEqualTo("IdValue69.10");
    // IN2.69.6
    assertThat(orgIdentifier.getSystem()).isEqualTo("urn:id:IdSystem69.6");
    // Becuase the code is unknown, the 0203 table lookup fails, and the coding has just the code, no system
    // IN2.69.7
    DatatypeUtils.checkCommonCodeableConceptAssertions(orgIdentifier.getType(), "UNK", null, null, null);
    List<Resource> coverages = ResourceUtils.getResourceList(e, ResourceType.Coverage);
    // From IN1 segment
    assertThat(coverages).hasSize(1);
    Coverage coverage = (Coverage) coverages.get(0);
    // Confirm Coverage Identifiers - Order matches order of identifier_X in Coverage.yml
    // XV, XV, XV, MB, SN; but not MA (IN2.8) nor MC (IN2.6)
    assertThat(coverage.getIdentifier()).hasSize(5);
    // IN1.2.1
    assertThat(coverage.getIdentifier().get(0).getValue()).isEqualTo("Value1");
    // IN1.2.3
    assertThat(coverage.getIdentifier().get(0).getSystem()).isEqualTo("urn:id:System3");
    // No use, here
    assertThat(coverage.getIdentifier().get(0).getUse()).isNull();
    DatatypeUtils.checkCommonCodeableConceptAssertions(coverage.getIdentifier().get(0).getType(), "XV", "Health Plan Identifier", "http://terminology.hl7.org/CodeSystem/v2-0203", null);
    // IN1.2.4
    assertThat(coverage.getIdentifier().get(1).getValue()).isEqualTo("Value4");
    // IN1.2.6
    assertThat(coverage.getIdentifier().get(1).getSystem()).isEqualTo("urn:id:System6");
    // No use, here
    assertThat(coverage.getIdentifier().get(1).getUse()).isNull();
    DatatypeUtils.checkCommonCodeableConceptAssertions(coverage.getIdentifier().get(1).getType(), "XV", "Health Plan Identifier", "http://terminology.hl7.org/CodeSystem/v2-0203", null);
    // IN1.46
    assertThat(coverage.getIdentifier().get(2).getValue()).isEqualTo("Value46");
    // No system, here
    assertThat(coverage.getIdentifier().get(2).getSystem()).isNull();
    // Use is enumeration "old"
    assertThat(coverage.getIdentifier().get(2).getUseElement().getCode()).hasToString("old");
    DatatypeUtils.checkCommonCodeableConceptAssertions(coverage.getIdentifier().get(2).getType(), "XV", "Health Plan Identifier", "http://terminology.hl7.org/CodeSystem/v2-0203", null);
    // IN1.36
    assertThat(coverage.getIdentifier().get(3).getValue()).isEqualTo("MEMBER36");
    // No system, here
    assertThat(coverage.getIdentifier().get(3).getSystem()).isNull();
    // No use, here
    assertThat(coverage.getIdentifier().get(3).getUse()).isNull();
    DatatypeUtils.checkCommonCodeableConceptAssertions(coverage.getIdentifier().get(3).getType(), "MB", "Member Number", "http://terminology.hl7.org/CodeSystem/v2-0203", null);
    // IN1.36
    assertThat(coverage.getIdentifier().get(4).getValue()).isEqualTo("MEMBER36");
    // No system, here
    assertThat(coverage.getIdentifier().get(4).getSystem()).isNull();
    // No use, here
    assertThat(coverage.getIdentifier().get(4).getUse()).isNull();
    DatatypeUtils.checkCommonCodeableConceptAssertions(coverage.getIdentifier().get(4).getType(), "SN", "Subscriber Number", "http://terminology.hl7.org/CodeSystem/v2-0203", null);
    // Confirm SubscriberId
    // IN1.36
    assertThat(coverage.getSubscriberId()).isEqualTo("MEMBER36");
    // Confirm coverage.Order
    // IN1.22 takes priority over IN1.1
    assertThat(coverage.getOrder()).isEqualTo(5);
    // Confirm Coverage Beneficiary references to Patient, and Payor references correct Organizations
    assertThat(coverage.getBeneficiary().getReference()).isEqualTo(patientId);
    // One for each payorOrganization
    assertThat(coverage.getPayor()).hasSize(2);
    assertThat(coverage.getPayor().get(0).getReference()).isEqualTo(payorOrgId);
    assertThat(coverage.getPayor().get(1).getReference()).isEqualTo(payorOrgIdIn25);
    // Confirm policyHolder references correct organization
    assertThat(coverage.getPolicyHolder().getReference()).isEqualTo(policyHolderOrgId);
    // Only one Coverage Class expected.  (getClass_ is correct name for method)
    assertThat(coverage.getClass_()).hasSize(3);
    // IN1.8  Only has value
    checkCoverageClassExistsWithCorrectValueAndName(coverage.getClass_(), "UA34567", null);
    // IN1.9 (1)
    checkCoverageClassExistsWithCorrectValueAndName(coverage.getClass_(), "IDBlue", "NameBlue");
    // IN1.9 (2) Name is also used for value
    checkCoverageClassExistsWithCorrectValueAndName(coverage.getClass_(), "NameGreen", "NameGreen");
    // Confirm Coverage period
    // IN1.12
    assertThat(coverage.getPeriod().getStartElement().toString()).containsPattern("2020-12-31T14:50:45");
    // IN1.13
    assertThat(coverage.getPeriod().getEndElement().toString()).containsPattern("2021-12-31T14:50:45");
    // Expect no RelatedPerson because IN1.17 was empty
    List<Resource> relatedPersons = ResourceUtils.getResourceList(e, ResourceType.RelatedPerson);
    // IN1.17 empty
    assertThat(relatedPersons).isEmpty();
    // Confirm there are no unaccounted for resources
    // Expected: Coverage, Organization (3x), Patient, Encounter
    assertThat(e).hasSize(6);
}

Example 29 with Coverage

use of org.hl7.fhir.r4.model.Coverage in project hl7v2-fhir-converter by LinuxForHealth.

the class Hl7FinancialInsuranceTest method testForDataBleedFromPatientToOrganization.

@Test
// Ensure that Patient data does not bleed into Organizations created for the Patient's insurance
void testForDataBleedFromPatientToOrganization() throws IOException {
    String hl7message = "MSH|^~\\&|TEST|TEST|||20220101120000||ADT^A01^ADT_A01|1234|P|2.6\n" + // PID.12 Used for district calculation
    "PID|1|103456|MR12345678^^^^MR||DOE^JANE^|||F|||19 Raymond St^Route3^Albany^NY^56321^USA^P|12||||||||||||||||||||||||||\n" + // PD1.4 Used for org creation to check for bleed of districts
    "PD1|||Mayo|123456^Walt^^^^Dr||||||||||||||||||\n" + // IN1 Broadly populated to create organization
    "IN1|1|GLOBAL|7776664|Blue Cross Blue Shield|456 Blue Cross Lane||||Blue|987123|IBM||||||NON||||||||||||20210322145350|Dr Disney|S|GOOD|200|12|B6543|H789456|||17|||1|M|123 IBM way|True|NONE|B|NO|J321456|M|20210322145605|London|YES\n" + // IN2 Broadly populated to create organizations
    "IN2|A23456|222001111|IBM 1345|EMPLOYEED|E|N23497234|R3294809|S234234|Army|U439823|SGT SCHULTZ|Army|Fort Wayne|USA|E1... E9|ACT|20300402145954|N|N|N|Yes|Grey Duck|Goose|T34941341232|D123123123|C435435345|2|SPR|2ANC|1234.00|O|A0|USA|EN|F|F|Y|N|COG|Stanley|DUTCH|N|M|20170322150208||Software Engineer|8|P|Mr Blue|1-555-333-4444|SURGERY|Jim Stanley|1-555-222-3333|FIRST|20170202150409|20210322150400|3|1-222-333-4444|GLOBAL|GROUP|B14456789|OTH|1-444-777-8888|1-444-555-3333|NONE|N|Y|N|GVH 123456|CDP 98765|2106-3|9\n";
    List<BundleEntryComponent> e = ResourceUtils.createFHIRBundleFromHL7MessageReturnEntryList(ftv, hl7message);
    List<Resource> patients = ResourceUtils.getResourceList(e, ResourceType.Patient);
    // From PID
    assertThat(patients).hasSize(1);
    Patient patient = (Patient) patients.get(0);
    assertThat(patient.getAddressFirstRep().getDistrict()).hasToString("12");
    List<Resource> organizations = ResourceUtils.getResourceList(e, ResourceType.Organization);
    // From Payor created by IN1
    assertThat(organizations).hasSize(3);
    Organization org = (Organization) organizations.get(0);
    assertThat(org.getAddressFirstRep().hasDistrict()).isFalse();
    org = (Organization) organizations.get(1);
    assertThat(org.hasAddress()).isFalse();
    org = (Organization) organizations.get(2);
    assertThat(org.hasAddress()).isFalse();
    List<Resource> coverages = ResourceUtils.getResourceList(e, ResourceType.Coverage);
    // From IN1 segment
    assertThat(coverages).hasSize(1);
    Coverage coverage = (Coverage) coverages.get(0);
    // Confirm Coverage Identifiers
    assertThat(coverage.getIdentifier()).hasSize(6);
    // Coverage Identifiers deep check in testBasicInsuranceCoverageFields
    // Because the relationship is NON, no subscriber is created
    assertThat(coverage.hasSubscriber()).isFalse();
    // Expect no RelatedPerson because IN1.17 is NON
    List<Resource> relatedPersons = ResourceUtils.getResourceList(e, ResourceType.RelatedPerson);
    // No related person should be created because IN1.17 was an unknown code
    assertThat(relatedPersons).isEmpty();
    // Confirm there are no unaccounted for resources
    // Expected: Coverage, Organization (3), Patient, Practitioner
    assertThat(e).hasSize(6);
}

Example 30 with Coverage

use of org.hl7.fhir.r4.model.Coverage in project hl7v2-fhir-converter by LinuxForHealth.

the class Hl7FinancialInsuranceTest method testInsuranceCoverageOfSelfAndTenant.

// Suppress warnings about too many assertions in a test.  Justification: creating a FHIR message is very costly; we need to check many asserts per creation for efficiency.
@java.lang.SuppressWarnings("squid:S5961")
@Test
// Tests multiple Organization Id's created with a TENANT prepend.
void testInsuranceCoverageOfSelfAndTenant() throws IOException {
    String hl7message = "MSH|^~\\&|||||20151008111200||DFT^P03^DFT_P03|MSGID000001|T|2.6|||||||||\n" + "EVN||20210407191342||||||\n" + // PID.19 purposely empty so IN2.2 used as SSN PatientIdentifier
    "PID|||MR1^^^XYZ^MR||DOE^JANE^|||F||||||||||||||||||||||\n" + "PV1||I||||||||||||||||||||||||||||||||||||||||||\n" + // FT1.7 is required transaction code (currently not used)
    "FT1||||20201231145045||CG|FAKE|||||||||||||||||||||||||||||||||||||\n" + // IN1.2.4, IN1.2.6 to second XV Coverage.identifier
    "IN1|1|Value1^^System3^Value4^^System6" + // IN1.5 to 15 NOT REFERENCED (Tested in testBasicInsuranceCoverageFields)
    "|IdValue1^^^IdSystem4^^^^|Large Blue Organization|||||||||||" + // IN1.18 through IN1.35 NOT REFERENCED
    "||SEL||||||||||||||||||" + // IN1.47 through IN1.53 NOT REFERENCED
    "|MEMBER36||||||||||Value46|||||||\n" + // Only used for MB Patient.Identifier because subscriber is SELF
    "IN2||SSN123456|||||||||||||||||||||||IdValue25.1^^^IdSystem25.4^IdType25.5^^20201231145045^20211231145045|||||||||||||||||||||||||||||||||||||||||||" + // IN2.72 is purposely empty (backup to IN1.17) so no RelatedPerson is created.
    "|Name69.1^^^^^IdSystem69.6^XX^^^IdValue69.10||\n";
    // TENANT prepend is passed through the options.
    ConverterOptions customOptionsWithTenant = new Builder().withValidateResource().withPrettyPrint().withProperty("TENANT", "TenantId").build();
    List<BundleEntryComponent> e = ResourceUtils.createFHIRBundleFromHL7MessageReturnEntryList(ftv, hl7message, customOptionsWithTenant);
    List<Resource> encounters = ResourceUtils.getResourceList(e, ResourceType.Encounter);
    // From PV1
    assertThat(encounters).hasSize(1);
    List<Resource> patients = ResourceUtils.getResourceList(e, ResourceType.Patient);
    // From PID
    assertThat(patients).hasSize(1);
    Patient patient = (Patient) patients.get(0);
    String patientId = patient.getId();
    // Check Patient.identifiers
    // From PID.3, IN2.2 and IN1.36
    assertThat(patient.getIdentifier()).hasSize(3);
    Identifier patientIdentifier = patient.getIdentifier().get(0);
    // PID.3.1
    assertThat(patientIdentifier.getValue()).isEqualTo("MR1");
    // PID.3.4
    assertThat(patientIdentifier.getSystem()).isEqualTo("urn:id:XYZ");
    DatatypeUtils.checkCommonCodeableConceptAssertions(patientIdentifier.getType(), "MR", "Medical record number", "http://terminology.hl7.org/CodeSystem/v2-0203", // PID.3.5
    null);
    patientIdentifier = patient.getIdentifier().get(1);
    // IN1.36 backup to IN2.61, active because subscriber is SELF
    assertThat(patientIdentifier.getValue()).isEqualTo("MEMBER36");
    // No system for MB
    assertThat(patientIdentifier.hasSystem()).isFalse();
    DatatypeUtils.checkCommonCodeableConceptAssertions(patientIdentifier.getType(), "MB", "Member Number", "http://terminology.hl7.org/CodeSystem/v2-0203", null);
    patientIdentifier = patient.getIdentifier().get(2);
    // IN2.2
    assertThat(patientIdentifier.getValue()).isEqualTo("SSN123456");
    // No system for SSN
    assertThat(patientIdentifier.hasSystem()).isFalse();
    DatatypeUtils.checkCommonCodeableConceptAssertions(patientIdentifier.getType(), "SS", "Social Security number", "http://terminology.hl7.org/CodeSystem/v2-0203", null);
    List<Resource> organizations = ResourceUtils.getResourceList(e, ResourceType.Organization);
    // From Payor created by IN1, PayorId Organization (IN2.25), and PolcyHolder Organization Name (IN2.69)
    assertThat(organizations).hasSize(3);
    Organization org = (Organization) organizations.get(0);
    String payorOrgId = org.getId();
    // IN1.17.1 w/TENANT prepend (Id's lowercased)
    assertThat(payorOrgId).isEqualTo("Organization/tenantid.idvalue1");
    // Check organization Identifier's
    // IN1.4
    assertThat(org.getName()).isEqualTo("Large Blue Organization");
    assertThat(org.getIdentifier()).hasSize(1);
    Identifier orgIdentifier = org.getIdentifierFirstRep();
    // IN1.3.1
    assertThat(orgIdentifier.getValue()).isEqualTo("IdValue1");
    // IN1.3.4
    assertThat(orgIdentifier.getSystem()).isEqualTo("urn:id:IdSystem4");
    // IN1.3.7 & IN1.3.7 empty
    assertThat(orgIdentifier.hasPeriod()).isFalse();
    // IN1.3.5 empty
    assertThat(orgIdentifier.hasType()).isFalse();
    // Check PayorId Organization from IN2.25
    org = (Organization) organizations.get(1);
    String payorOrgIdIn25 = org.getId();
    // IN1.25.1 w/TENANT prepend (Id's lowercased)
    assertThat(payorOrgIdIn25).isEqualTo("Organization/tenantid.idvalue25.1");
    // IN2.25.1
    assertThat(org.getName()).isEqualTo("IdValue25.1");
    assertThat(org.getIdentifier()).hasSize(1);
    orgIdentifier = org.getIdentifier().get(0);
    // IN2.25.1
    assertThat(orgIdentifier.getValue()).isEqualTo("IdValue25.1");
    // IN2.25.4
    assertThat(orgIdentifier.getSystem()).isEqualTo("urn:id:IdSystem25.4");
    // IN2.25.7
    assertThat(orgIdentifier.getPeriod().getStartElement().toString()).containsPattern("2020-12-31T14:50:45");
    // IN2.25.8
    assertThat(orgIdentifier.getPeriod().getEndElement().toString()).containsPattern("2021-12-31T14:50:45");
    // IN2.25.5
    DatatypeUtils.checkCommonCodeableConceptAssertions(orgIdentifier.getType(), "IdType25.5", null, null, null);
    // Check PolicyHolder Organization Name and ID Organization from IN2.69
    org = (Organization) organizations.get(2);
    String policyHolderOrgId = org.getId();
    // IN2.69.1 w/TENANT prepend (Id's lowercased)
    assertThat(policyHolderOrgId).isEqualTo("Organization/tenantid.idvalue69.10");
    // IN2.69.1
    assertThat(org.getName()).isEqualTo("Name69.1");
    assertThat(org.getIdentifier()).hasSize(1);
    orgIdentifier = org.getIdentifier().get(0);
    // IN2.69.10
    assertThat(orgIdentifier.getValue()).isEqualTo("IdValue69.10");
    // IN2.69.6
    assertThat(orgIdentifier.getSystem()).isEqualTo("urn:id:IdSystem69.6");
    // Becuase the code is known, the 0203 table lookup is successful and returns code, display, and system
    DatatypeUtils.checkCommonCodeableConceptAssertions(orgIdentifier.getType(), "XX", "Organization identifier", "http://terminology.hl7.org/CodeSystem/v2-0203", // IN2.69.7 with lookup
    null);
    List<Resource> coverages = ResourceUtils.getResourceList(e, ResourceType.Coverage);
    // From IN1 segment
    assertThat(coverages).hasSize(1);
    Coverage coverage = (Coverage) coverages.get(0);
    // Confirm Coverage Identifiers
    // XV, XV, XV, MB, SN
    assertThat(coverage.getIdentifier()).hasSize(5);
    // Coverage Identifiers deep check in testBasicInsuranceCoverageFields
    // Confirm Coverage Subscriber references to Patient
    assertThat(coverage.getSubscriber().getReference()).isEqualTo(patientId);
    // Confirm Coverage Beneficiary references to Patient, and Payors references correct Organizations
    assertThat(coverage.getBeneficiary().getReference()).isEqualTo(patientId);
    // One for each payorOrganization
    assertThat(coverage.getPayor()).hasSize(2);
    assertThat(coverage.getPayor().get(0).getReference()).isEqualTo(payorOrgId);
    assertThat(coverage.getPayor().get(1).getReference()).isEqualTo(payorOrgIdIn25);
    // Confirm policyHolder references correct organization
    assertThat(coverage.getPolicyHolder().getReference()).isEqualTo(policyHolderOrgId);
    // Expect no RelatedPerson because IN1.17 was self
    List<Resource> relatedPersons = ResourceUtils.getResourceList(e, ResourceType.RelatedPerson);
    // No related person should be created because IN1.17 was SEL
    assertThat(relatedPersons).isEmpty();
    // Check coverage.relationship (from SubscriberRelationship mapping)
    DatatypeUtils.checkCommonCodeableConceptAssertions(coverage.getRelationship(), "self", "Self", "http://terminology.hl7.org/CodeSystem/subscriber-relationship", // IN1.17
    null);
    // Confirm there are no unaccounted for resources
    // Expected: Coverage, Organization (3x), Patient, Encounter
    assertThat(e).hasSize(6);
}