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

Example 11 with AdjudicationComponent

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

the class OutpatientClaimTransformerV2Test method shouldHaveLineItemAdjudicationRevCntrNcvrdChrgAmt.

@Test
public void shouldHaveLineItemAdjudicationRevCntrNcvrdChrgAmt() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("https://bluebutton.cms.gov/resources/variables/rev_cntr_ncvrd_chrg_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", "noncovered", "Noncovered"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/rev_cntr_ncvrd_chrg_amt", "Revenue Center Non-Covered Charge Amount")))).setAmount(new Money().setValue(134).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 12 with AdjudicationComponent

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

the class DMEClaimTransformerV2Test method shouldHaveLineItemAdjudicationLineCoinsrncAmt.

@Test
public void shouldHaveLineItemAdjudicationLineCoinsrncAmt() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", eob.getItemFirstRep().getAdjudication());
    // Need to maintain trailing 0s in USD amount
    BigDecimal amt = new BigDecimal(20.20);
    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", "coinsurance", "Co-insurance"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt", "Line Beneficiary Coinsurance Amount")))).setAmount(new Money().setValue(amt).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 13 with AdjudicationComponent

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

the class DMEClaimTransformerV2Test method shouldHaveLineItemAdjudicationLineSubmtdChrgAmt.

@Test
public void shouldHaveLineItemAdjudicationLineSubmtdChrgAmt() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://terminology.hl7.org/CodeSystem/adjudication", "submitted", "Submitted Amount"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt", "Line Submitted Charge Amount")))).setAmount(new Money().setValue(130.45).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 14 with AdjudicationComponent

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

the class DMEClaimTransformerV2Test method shouldHaveLineItemAdjudicationLineNchPmtAmt.

@Test
public void shouldHaveLineItemAdjudicationLineNchPmtAmt() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("https://bluebutton.cms.gov/resources/variables/line_nch_pmt_amt", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://terminology.hl7.org/CodeSystem/adjudication", "benefit", "Benefit Amount"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/line_nch_pmt_amt", "Line NCH Medicare Payment Amount"))));
    compare.setExtension(Arrays.asList(new Extension("https://bluebutton.cms.gov/resources/variables/line_pmt_80_100_cd", new Coding("https://bluebutton.cms.gov/resources/variables/line_pmt_80_100_cd", "0", "80%"))));
    compare.setAmount(new Money().setValue(123.45).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 15 with AdjudicationComponent

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

the class CarrierClaimTransformerV2Test method shouldHaveLineItemPriorPayerPaidAdjudication.

@Test
public void shouldHaveLineItemPriorPayerPaidAdjudication() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("priorpayerpaid", eob.getItemFirstRep().getAdjudication());
    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(0).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}