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

Example 46 with AdjudicationComponent

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

the class CarrierClaimTransformerV2Test method shouldHaveLineItemDenialReasonAdjudication.

@Test
public void shouldHaveLineItemDenialReasonAdjudication() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("denialreason", 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/carr_line_rdcd_pmt_phys_astn_c", "0", "N/A"))));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 47 with AdjudicationComponent

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

the class CarrierClaimTransformerV2Test method shouldHaveLineItemPaidToPatientAdjudication.

@Test
public void shouldHaveLineItemPaidToPatientAdjudication() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("paidtopatient", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication", "paidtopatient", "Paid to patient"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/line_bene_pmt_amt", "Line Payment Amount to Beneficiary")))).setAmount(new Money().setValue(0).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 48 with AdjudicationComponent

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

the class CarrierClaimTransformerV2Test method shouldHaveLineItemDeductibleAdjudication.

@Test
public void shouldHaveLineItemDeductibleAdjudication() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("deductible", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://terminology.hl7.org/CodeSystem/adjudication", "deductible", "Deductible"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt", "Line Beneficiary Part B Deductible Amount")))).setAmount(new Money().setValue(0).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 49 with AdjudicationComponent

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

the class DMEClaimTransformerV2Test method shouldHaveLineItemAdjudicationLineBenePmtAmt2.

@Test
public void shouldHaveLineItemAdjudicationLineBenePmtAmt2() {
    BigDecimal amt = new BigDecimal(82.29);
    amt = amt.setScale(2, RoundingMode.HALF_DOWN);
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategoryAndAmount("https://bluebutton.cms.gov/resources/variables/line_bene_pmt_amt", 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", "paidtoprovider", "Paid to provider"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/line_bene_pmt_amt", "Line Payment Amount to Beneficiary")))).setAmount(new Money().setValue(amt).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 50 with AdjudicationComponent

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

the class DMEClaimTransformerV2Test method shouldHaveLineItemAdjudicationLineBenePrmryPyrPdAmt.

@Test
public void shouldHaveLineItemAdjudicationLineBenePrmryPyrPdAmt() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("https://bluebutton.cms.gov/resources/variables/line_bene_prmry_pyr_pd_amt", eob.getItemFirstRep().getAdjudication());
    // Need to maintain trailing 0s in USD amount
    BigDecimal amt = new BigDecimal(11.00);
    amt = amt.setScale(2, RoundingMode.HALF_DOWN);
    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/line_bene_prmry_pyr_pd_amt", "Line Primary Payer (if not Medicare) Paid Amount")))).setAmount(new Money().setValue(amt).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}