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

Example 16 with Reference

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

the class TransformerUtils method mapEobCommonGroupCarrierDME.

/**
 * Transforms the common group level data elements between the {@link CarrierClaim} and {@link
 * DMEClaim} claim types to FHIR. The method parameter fields from {@link CarrierClaim} and {@link
 * DMEClaim} are listed below and their corresponding RIF CCW fields (denoted in all CAPS below
 * from {@link CarrierClaimColumn} and {@link DMEClaimColumn}).
 *
 * @param eob the {@link ExplanationOfBenefit} to modify
 * @param benficiaryId BEME_ID, *
 * @param carrierNumber CARR_NUM,
 * @param clinicalTrialNumber CLM_CLNCL_TRIL_NUM,
 * @param beneficiaryPartBDeductAmount CARR_CLM_CASH_DDCTBL_APLD_AMT,
 * @param paymentDenialCode CARR_CLM_PMT_DNL_CD,
 * @param referringPhysicianNpi RFR_PHYSN_NPI
 * @param providerAssignmentIndicator CARR_CLM_PRVDR_ASGNMT_IND_SW,
 * @param providerPaymentAmount NCH_CLM_PRVDR_PMT_AMT,
 * @param beneficiaryPaymentAmount NCH_CLM_BENE_PMT_AMT,
 * @param submittedChargeAmount NCH_CARR_CLM_SBMTD_CHRG_AMT,
 * @param allowedChargeAmount NCH_CARR_CLM_ALOWD_AMT,
 */
static void mapEobCommonGroupCarrierDME(ExplanationOfBenefit eob, String beneficiaryId, String carrierNumber, Optional<String> clinicalTrialNumber, BigDecimal beneficiaryPartBDeductAmount, String paymentDenialCode, Optional<String> referringPhysicianNpi, Optional<Character> providerAssignmentIndicator, BigDecimal providerPaymentAmount, BigDecimal beneficiaryPaymentAmount, BigDecimal submittedChargeAmount, BigDecimal allowedChargeAmount, String claimDispositionCode, Optional<String> claimCarrierControlNumber) {
    eob.addExtension(createExtensionIdentifier(CcwCodebookVariable.CARR_NUM, carrierNumber));
    // Carrier Claim Control Number
    if (claimCarrierControlNumber.isPresent()) {
        eob.addExtension(createExtensionIdentifier(CcwCodebookMissingVariable.CARR_CLM_CNTL_NUM, claimCarrierControlNumber.get()));
    }
    eob.addExtension(createExtensionCoding(eob, CcwCodebookVariable.CARR_CLM_PMT_DNL_CD, paymentDenialCode));
    // Claim Disposition Code
    eob.setDisposition(claimDispositionCode);
    /*
     * Referrals are represented as contained resources, since they share the lifecycle and identity
     * of their containing EOB.
     */
    if (referringPhysicianNpi.isPresent()) {
        ReferralRequest referral = new ReferralRequest();
        referral.setStatus(ReferralRequestStatus.COMPLETED);
        referral.setSubject(referencePatient(beneficiaryId));
        referral.setRequester(new ReferralRequestRequesterComponent(referencePractitioner(referringPhysicianNpi.get())));
        referral.addRecipient(referencePractitioner(referringPhysicianNpi.get()));
        // Set the ReferralRequest as a contained resource in the EOB:
        eob.setReferral(new Reference(referral));
    }
    if (providerAssignmentIndicator.isPresent()) {
        eob.addExtension(createExtensionCoding(eob, CcwCodebookVariable.ASGMNTCD, providerAssignmentIndicator));
    }
    if (clinicalTrialNumber.isPresent()) {
        eob.addExtension(createExtensionIdentifier(CcwCodebookVariable.CLM_CLNCL_TRIL_NUM, clinicalTrialNumber));
    }
    addAdjudicationTotal(eob, CcwCodebookVariable.CARR_CLM_CASH_DDCTBL_APLD_AMT, beneficiaryPartBDeductAmount);
    addAdjudicationTotal(eob, CcwCodebookVariable.NCH_CLM_PRVDR_PMT_AMT, providerPaymentAmount);
    addAdjudicationTotal(eob, CcwCodebookVariable.NCH_CLM_BENE_PMT_AMT, beneficiaryPaymentAmount);
    addAdjudicationTotal(eob, CcwCodebookVariable.NCH_CARR_CLM_SBMTD_CHRG_AMT, submittedChargeAmount);
    addAdjudicationTotal(eob, CcwCodebookVariable.NCH_CARR_CLM_ALOWD_AMT, allowedChargeAmount);
}

Example 17 with Reference

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

the class TransformerUtils method addCareTeamPractitioner.

/**
 * Ensures that the specified {@link ExplanationOfBenefit} has the specified {@link
 * CareTeamComponent}, and links the specified {@link ItemComponent} to that {@link
 * CareTeamComponent} (via {@link ItemComponent#addCareTeamLinkId(int)}).
 *
 * @param eob the {@link ExplanationOfBenefit} that the {@link CareTeamComponent} should be part
 *     of
 * @param eobItem the {@link ItemComponent} that should be linked to the {@link CareTeamComponent}
 * @param practitionerIdSystem the {@link Identifier#getSystem()} of the practitioner to reference
 *     in {@link CareTeamComponent#getProvider()}
 * @param practitionerIdValue the {@link Identifier#getValue()} of the practitioner to reference
 *     in {@link CareTeamComponent#getProvider()}
 * @param careTeamRole the {@link ClaimCareteamrole} to use for the {@link
 *     CareTeamComponent#getRole()}
 * @return the {@link CareTeamComponent} that was created/linked
 */
static CareTeamComponent addCareTeamPractitioner(ExplanationOfBenefit eob, ItemComponent eobItem, String practitionerIdSystem, String practitionerIdValue, ClaimCareteamrole careTeamRole) {
    // Try to find a matching pre-existing entry.
    CareTeamComponent careTeamEntry = eob.getCareTeam().stream().filter(ctc -> ctc.getProvider().hasIdentifier()).filter(ctc -> practitionerIdSystem.equals(ctc.getProvider().getIdentifier().getSystem()) && practitionerIdValue.equals(ctc.getProvider().getIdentifier().getValue())).filter(ctc -> ctc.hasRole()).filter(ctc -> careTeamRole.toCode().equals(ctc.getRole().getCodingFirstRep().getCode()) && careTeamRole.getSystem().equals(ctc.getRole().getCodingFirstRep().getSystem())).findAny().orElse(null);
    // If no match was found, add one to the EOB.
    if (careTeamEntry == null) {
        careTeamEntry = eob.addCareTeam();
        careTeamEntry.setSequence(eob.getCareTeam().size() + 1);
        careTeamEntry.setProvider(createIdentifierReference(practitionerIdSystem, practitionerIdValue));
        CodeableConcept careTeamRoleConcept = createCodeableConcept(ClaimCareteamrole.OTHER.getSystem(), careTeamRole.toCode());
        careTeamRoleConcept.getCodingFirstRep().setDisplay(careTeamRole.getDisplay());
        careTeamEntry.setRole(careTeamRoleConcept);
    }
    // care team entry is at eob level so no need to create item link id
    if (eobItem == null) {
        return careTeamEntry;
    }
    // Link the EOB.item to the care team entry (if it isn't already).
    final int careTeamEntrySequence = careTeamEntry.getSequence();
    if (eobItem.getCareTeamLinkId().stream().noneMatch(id -> id.getValue() == careTeamEntrySequence)) {
        eobItem.addCareTeamLinkId(careTeamEntrySequence);
    }
    return careTeamEntry;
}

Example 18 with Reference

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

the class TransformerUtils method createExtensionDate.

/**
 * @param ccwVariable the {@link CcwCodebookInterface} being mapped
 * @param dateYear 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 createExtensionDate(CcwCodebookInterface ccwVariable, Optional<BigDecimal> dateYear) {
    Extension extension = null;
    if (!dateYear.isPresent()) {
        throw new NoSuchElementException();
    }
    try {
        String stringDate = String.format("%04d", dateYear.get().intValue());
        DateType dateYearValue = new DateType(stringDate);
        String extensionUrl = CCWUtils.calculateVariableReferenceUrl(ccwVariable);
        extension = new Extension(extensionUrl, dateYearValue);
    } catch (DataFormatException e) {
        throw new InvalidRifValueException(String.format("Unable to create DateType with reference year: '%s'.", dateYear.get()), e);
    }
    return extension;
}

Example 19 with Reference

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

the class TransformerUtils method createAdjudicationCategory.

/**
 * @param ccwVariable the {@link CcwCodebookInterface} being mapped
 * @return the {@link AdjudicationComponent#getCategory()} {@link CodeableConcept} to use for the
 *     specified {@link CcwCodebookInterface}
 */
static CodeableConcept createAdjudicationCategory(CcwCodebookInterface ccwVariable) {
    /*
     * Adjudication.category is mapped a bit differently than other Codings/CodeableConcepts: they
     * all share the same Coding.system and use the CcwCodebookVariable reference URL as their
     * Coding.code. This looks weird, but makes it easy for API developers to find more information
     * about what the specific adjudication they're looking at means.
     */
    String conceptCode = CCWUtils.calculateVariableReferenceUrl(ccwVariable);
    CodeableConcept categoryConcept = createCodeableConcept(TransformerConstants.CODING_CCW_ADJUDICATION_CATEGORY, conceptCode);
    categoryConcept.getCodingFirstRep().setDisplay(ccwVariable.getVariable().getLabel());
    return categoryConcept;
}

Example 20 with Reference

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

the class TransformerUtils method addResourcesToBundle.

/**
 * @param bundle a {@link Bundle} to add the list of {@link ExplanationOfBenefit} resources to.
 * @param resources a list of either {@link ExplanationOfBenefit}s, {@link Coverage}s, or {@link
 *     Patient}s, of which a portion will be added to the bundle based on the paging values
 * @return Returns a {@link Bundle} of {@link ExplanationOfBenefit}s, {@link Coverage}s, or {@link
 *     Patient}s, which may contain multiple matching resources, or may also be empty.
 */
public static Bundle addResourcesToBundle(Bundle bundle, List<IBaseResource> resources) {
    Set<String> beneIds = new HashSet<String>();
    for (IBaseResource res : resources) {
        BundleEntryComponent entry = bundle.addEntry();
        entry.setResource((Resource) res);
        if (entry.getResource().getResourceType() == ResourceType.ExplanationOfBenefit) {
            ExplanationOfBenefit eob = ((ExplanationOfBenefit) entry.getResource());
            if (eob != null && eob.getPatient() != null && !Strings.isNullOrEmpty(eob.getPatient().getReference())) {
                String reference = eob.getPatient().getReference().replace("Patient/", "");
                if (!Strings.isNullOrEmpty(reference)) {
                    beneIds.add(reference);
                }
            }
        } else if (entry.getResource().getResourceType() == ResourceType.Patient) {
            Patient patient = ((Patient) entry.getResource());
            if (patient != null && !Strings.isNullOrEmpty(patient.getId())) {
                beneIds.add(patient.getId());
            }
        } else if (entry.getResource().getResourceType() == ResourceType.Coverage) {
            Coverage coverage = ((Coverage) entry.getResource());
            if (coverage != null && coverage.getBeneficiary() != null && !Strings.isNullOrEmpty(coverage.getBeneficiary().getReference())) {
                String reference = coverage.getBeneficiary().getReference().replace("Patient/", "");
                if (!Strings.isNullOrEmpty(reference)) {
                    beneIds.add(reference);
                }
            }
        }
    }
    logBeneIdToMdc(beneIds);
    return bundle;
}