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

Example 11 with Use

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

the class ExplanationOfBenefitResourceProvider method findByPatient.

/**
 * Adds support for the FHIR "search" operation for {@link ExplanationOfBenefit}s, allowing users
 * to search by {@link ExplanationOfBenefit#getPatient()}.
 *
 * <p>The {@link Search} annotation indicates that this method supports the search operation.
 * There may be many different methods annotated with this {@link Search} annotation, to support
 * many different search criteria.
 *
 * @param patient a {@link ReferenceParam} for the {@link ExplanationOfBenefit#getPatient()} to
 *     try and find matches for {@link ExplanationOfBenefit}s
 * @param type a list of {@link ClaimType} to include in the result. Defaults to all types.
 * @param startIndex an {@link OptionalParam} for the startIndex (or offset) used to determine
 *     pagination
 * @param excludeSamhsa an {@link OptionalParam} that, if <code>"true"</code>, will use {@link
 *     Stu3EobSamhsaMatcher} to filter out all SAMHSA-related claims from the results
 * @param lastUpdated an {@link OptionalParam} that specifies a date range for the lastUpdated
 *     field.
 * @param serviceDate an {@link OptionalParam} that specifies a date range for {@link
 *     ExplanationOfBenefit}s that completed
 * @param requestDetails a {@link RequestDetails} containing the details of the request URL, used
 *     to parse out pagination values
 * @return Returns a {@link Bundle} of {@link ExplanationOfBenefit}s, which may contain multiple
 *     matching resources, or may also be empty.
 */
@Search
@Trace
public Bundle findByPatient(@RequiredParam(name = ExplanationOfBenefit.SP_PATIENT) @Description(shortDefinition = "The patient identifier to search for") ReferenceParam patient, @OptionalParam(name = "type") @Description(shortDefinition = "A list of claim types to include") TokenAndListParam type, @OptionalParam(name = "startIndex") @Description(shortDefinition = "The offset used for result pagination") String startIndex, @OptionalParam(name = "excludeSAMHSA") @Description(shortDefinition = "If true, exclude all SAMHSA-related resources") String excludeSamhsa, @OptionalParam(name = "_lastUpdated") @Description(shortDefinition = "Include resources last updated in the given range") DateRangeParam lastUpdated, @OptionalParam(name = "service-date") @Description(shortDefinition = "Include resources that completed in the given range") DateRangeParam serviceDate, RequestDetails requestDetails) {
    /*
     * startIndex is an optional parameter here because it must be declared in the
     * event it is passed in. However, it is not being used here because it is also
     * contained within requestDetails and parsed out along with other parameters
     * later.
     */
    String beneficiaryId = patient.getIdPart();
    Set<ClaimType> claimTypes = parseTypeParam(type);
    Boolean includeTaxNumbers = returnIncludeTaxNumbers(requestDetails);
    OffsetLinkBuilder paging = new OffsetLinkBuilder(requestDetails, "/ExplanationOfBenefit?");
    Operation operation = new Operation(Operation.Endpoint.V1_EOB);
    operation.setOption("by", "patient");
    operation.setOption("types", (claimTypes.size() == ClaimType.values().length) ? "*" : claimTypes.stream().sorted(Comparator.comparing(ClaimType::name)).collect(Collectors.toList()).toString());
    operation.setOption("IncludeTaxNumbers", "" + includeTaxNumbers);
    operation.setOption("pageSize", paging.isPagingRequested() ? "" + paging.getPageSize() : "*");
    operation.setOption("_lastUpdated", Boolean.toString(lastUpdated != null && !lastUpdated.isEmpty()));
    operation.setOption("service-date", Boolean.toString(serviceDate != null && !serviceDate.isEmpty()));
    operation.publishOperationName();
    List<IBaseResource> eobs = new ArrayList<IBaseResource>();
    // Optimize when the lastUpdated parameter is specified and result set is empty
    if (loadedFilterManager.isResultSetEmpty(beneficiaryId, lastUpdated)) {
        return TransformerUtils.createBundle(paging, eobs, loadedFilterManager.getTransactionTime());
    }
    /*
     * The way our JPA/SQL schema is setup, we have to run a separate search for
     * each claim type, then combine the results. It's not super efficient, but it's
     * also not so inefficient that it's worth fixing.
     */
    if (claimTypes.contains(ClaimType.CARRIER))
        eobs.addAll(transformToEobs(ClaimType.CARRIER, findClaimTypeByPatient(ClaimType.CARRIER, beneficiaryId, lastUpdated, serviceDate), Optional.of(includeTaxNumbers)));
    if (claimTypes.contains(ClaimType.DME))
        eobs.addAll(transformToEobs(ClaimType.DME, findClaimTypeByPatient(ClaimType.DME, beneficiaryId, lastUpdated, serviceDate), Optional.of(includeTaxNumbers)));
    if (claimTypes.contains(ClaimType.HHA))
        eobs.addAll(transformToEobs(ClaimType.HHA, findClaimTypeByPatient(ClaimType.HHA, beneficiaryId, lastUpdated, serviceDate), Optional.of(includeTaxNumbers)));
    if (claimTypes.contains(ClaimType.HOSPICE))
        eobs.addAll(transformToEobs(ClaimType.HOSPICE, findClaimTypeByPatient(ClaimType.HOSPICE, beneficiaryId, lastUpdated, serviceDate), Optional.of(includeTaxNumbers)));
    if (claimTypes.contains(ClaimType.INPATIENT))
        eobs.addAll(transformToEobs(ClaimType.INPATIENT, findClaimTypeByPatient(ClaimType.INPATIENT, beneficiaryId, lastUpdated, serviceDate), Optional.of(includeTaxNumbers)));
    if (claimTypes.contains(ClaimType.OUTPATIENT))
        eobs.addAll(transformToEobs(ClaimType.OUTPATIENT, findClaimTypeByPatient(ClaimType.OUTPATIENT, beneficiaryId, lastUpdated, serviceDate), Optional.of(includeTaxNumbers)));
    if (claimTypes.contains(ClaimType.PDE))
        eobs.addAll(transformToEobs(ClaimType.PDE, findClaimTypeByPatient(ClaimType.PDE, beneficiaryId, lastUpdated, serviceDate), Optional.of(includeTaxNumbers)));
    if (claimTypes.contains(ClaimType.SNF))
        eobs.addAll(transformToEobs(ClaimType.SNF, findClaimTypeByPatient(ClaimType.SNF, beneficiaryId, lastUpdated, serviceDate), Optional.of(includeTaxNumbers)));
    if (Boolean.parseBoolean(excludeSamhsa))
        filterSamhsa(eobs);
    eobs.sort(ExplanationOfBenefitResourceProvider::compareByClaimIdThenClaimType);
    // Add bene_id to MDC logs
    TransformerUtils.logBeneIdToMdc(Arrays.asList(beneficiaryId));
    return TransformerUtils.createBundle(paging, eobs, loadedFilterManager.getTransactionTime());
}

Example 12 with Use

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

the class ExplanationOfBenefitResourceProvider method findClaimTypeByPatient.

/**
 * @param claimType the {@link ClaimType} to find
 * @param patientId the {@link Beneficiary#getBeneficiaryId()} to filter by
 * @param lastUpdated the update time to filter by
 * @return the matching claim/event entities
 */
@SuppressWarnings({ "rawtypes", "unchecked" })
@Trace
private <T> List<T> findClaimTypeByPatient(ClaimType claimType, String patientId, DateRangeParam lastUpdated, DateRangeParam serviceDate) {
    CriteriaBuilder builder = entityManager.getCriteriaBuilder();
    CriteriaQuery criteria = builder.createQuery((Class) claimType.getEntityClass());
    Root root = criteria.from(claimType.getEntityClass());
    claimType.getEntityLazyAttributes().stream().forEach(a -> root.fetch(a));
    criteria.select(root).distinct(true);
    // Search for a beneficiary's records. Use lastUpdated if present
    Predicate wherePredicate = builder.equal(root.get(claimType.getEntityBeneficiaryIdAttribute()), patientId);
    if (lastUpdated != null && !lastUpdated.isEmpty()) {
        Predicate predicate = QueryUtils.createLastUpdatedPredicate(builder, root, lastUpdated);
        wherePredicate = builder.and(wherePredicate, predicate);
    }
    criteria.where(wherePredicate);
    List<T> claimEntities = null;
    Long eobsByBeneIdQueryNanoSeconds = null;
    Timer.Context timerEobQuery = metricRegistry.timer(MetricRegistry.name(metricRegistry.getClass().getSimpleName(), "query", "eobs_by_bene_id", claimType.name().toLowerCase())).time();
    try {
        claimEntities = entityManager.createQuery(criteria).getResultList();
    } finally {
        eobsByBeneIdQueryNanoSeconds = timerEobQuery.stop();
        TransformerUtils.recordQueryInMdc(String.format("eobs_by_bene_id.%s", claimType.name().toLowerCase()), eobsByBeneIdQueryNanoSeconds, claimEntities == null ? 0 : claimEntities.size());
    }
    if (claimEntities != null && serviceDate != null && !serviceDate.isEmpty()) {
        final Instant lowerBound = serviceDate.getLowerBoundAsInstant() != null ? serviceDate.getLowerBoundAsInstant().toInstant() : null;
        final Instant upperBound = serviceDate.getUpperBoundAsInstant() != null ? serviceDate.getUpperBoundAsInstant().toInstant() : null;
        final java.util.function.Predicate<LocalDate> lowerBoundCheck = lowerBound == null ? (date) -> true : (date) -> compareLocalDate(date, lowerBound.atZone(ZoneId.systemDefault()).toLocalDate(), serviceDate.getLowerBound().getPrefix());
        final java.util.function.Predicate<LocalDate> upperBoundCheck = upperBound == null ? (date) -> true : (date) -> compareLocalDate(date, upperBound.atZone(ZoneId.systemDefault()).toLocalDate(), serviceDate.getUpperBound().getPrefix());
        return claimEntities.stream().filter(entity -> lowerBoundCheck.test(claimType.getServiceEndAttributeFunction().apply(entity)) && upperBoundCheck.test(claimType.getServiceEndAttributeFunction().apply(entity))).collect(Collectors.toList());
    }
    return claimEntities;
}

Example 13 with Use

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

the class HospiceClaimTransformer method transform.

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

Example 14 with Use

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

the class InpatientClaimTransformer method transform.

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

Example 15 with Use

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

the class TransformerUtilsV2 method createExtensionQuantity.

/**
 * @param ccwVariable the {@link CcwCodebookInterface} being mapped
 * @param quantityValue the value to use for {@link Coding#getCode()} for the resulting {@link
 *     Coding}
 * @return the output {@link Extension}, with {@link Extension#getValue()} set to represent the
 *     specified input values
 */
static Extension createExtensionQuantity(CcwCodebookInterface ccwVariable, Optional<? extends Number> quantityValue) {
    if (!quantityValue.isPresent()) {
        throw new IllegalArgumentException();
    }
    Quantity quantity;
    if (quantityValue.get() instanceof BigDecimal) {
        quantity = new Quantity().setValue((BigDecimal) quantityValue.get());
    } else {
        throw new BadCodeMonkeyException();
    }
    String extensionUrl = CCWUtils.calculateVariableReferenceUrl(ccwVariable);
    Extension extension = new Extension(extensionUrl, quantity);
    return extension;
}