Examples with Resource org.hl7.fhir.r4b.model.Resource used on opensource projects

Example 16 with Resource

use of org.hl7.fhir.r4b.model.Resource in project beneficiary-fhir-data by CMSgov.

the class FissClaimResponseTransformerV2 method transformClaim.

/**
 * @param claimGroup the {@link PreAdjFissClaim} to transform
 * @return a FHIR {@link ClaimResponse} resource that represents the specified {@link
 *     PreAdjFissClaim}
 */
private static ClaimResponse transformClaim(PreAdjFissClaim claimGroup) {
    ClaimResponse claim = new ClaimResponse();
    claim.setId("f-" + claimGroup.getDcn());
    claim.setContained(List.of(getContainedPatient(claimGroup)));
    claim.setExtension(getExtension(claimGroup));
    claim.setIdentifier(getIdentifier(claimGroup));
    claim.setStatus(ClaimResponse.ClaimResponseStatus.ACTIVE);
    claim.setOutcome(STATUS_TO_OUTCOME.get(Character.toLowerCase(claimGroup.getCurrStatus())));
    claim.setType(getType());
    claim.setUse(ClaimResponse.Use.CLAIM);
    claim.setInsurer(new Reference().setIdentifier(new Identifier().setValue("CMS")));
    claim.setPatient(new Reference("#patient"));
    claim.setRequest(new Reference(String.format("Claim/f-%s", claimGroup.getDcn())));
    claim.setMeta(new Meta().setLastUpdated(Date.from(claimGroup.getLastUpdated())));
    claim.setCreated(new Date());
    return claim;
}

Example 17 with Resource

use of org.hl7.fhir.r4b.model.Resource in project beneficiary-fhir-data by CMSgov.

the class FissClaimTransformerV2 method getContainedProvider.

private static Resource getContainedProvider(PreAdjFissClaim claimGroup) {
    Organization organization = new Organization();
    if (claimGroup.getMedaProv_6() != null) {
        organization.getIdentifier().add(new Identifier().setType(new CodeableConcept(new Coding(C4BBOrganizationIdentifierType.PRN.getSystem(), C4BBOrganizationIdentifierType.PRN.toCode(), C4BBOrganizationIdentifierType.PRN.getDisplay()))).setSystem(BBCodingSystems.PROVIDER_NUM).setValue(claimGroup.getMedaProv_6()));
    }
    if (claimGroup.getFedTaxNumber() != null) {
        organization.getIdentifier().add(new Identifier().setType(new CodeableConcept(new Coding(C4BBOrganizationIdentifierType.TAX.getSystem(), C4BBOrganizationIdentifierType.TAX.toCode(), C4BBOrganizationIdentifierType.TAX.getDisplay()))).setSystem(BBCodingSystems.FISS.TAX_NUM).setValue(claimGroup.getFedTaxNumber()));
    }
    if (claimGroup.getNpiNumber() != null) {
        organization.getIdentifier().add(new Identifier().setType(new CodeableConcept(new Coding(C4BBIdentifierType.NPI.getSystem(), C4BBIdentifierType.NPI.toCode(), C4BBIdentifierType.NPI.getDisplay()))).setSystem(TransformerConstants.CODING_NPI_US).setValue(claimGroup.getNpiNumber()));
    }
    organization.setId("provider-org");
    return organization;
}

Example 18 with Resource

use of org.hl7.fhir.r4b.model.Resource in project beneficiary-fhir-data by CMSgov.

the class FissClaimTransformerV2 method transformClaim.

/**
 * @param claimGroup the {@link PreAdjFissClaim} to transform
 * @return a FHIR {@link Claim} resource that represents the specified {@link PreAdjFissClaim}
 */
private static Claim transformClaim(PreAdjFissClaim claimGroup) {
    Claim claim = new Claim();
    boolean isIcd9 = claimGroup.getStmtCovToDate() != null && claimGroup.getStmtCovToDate().isBefore(ICD_9_CUTOFF_DATE);
    claim.setId("f-" + claimGroup.getDcn());
    claim.setContained(List.of(getContainedPatient(claimGroup), getContainedProvider(claimGroup)));
    claim.setIdentifier(getIdentifier(claimGroup));
    claim.setExtension(getExtension(claimGroup));
    claim.setStatus(Claim.ClaimStatus.ACTIVE);
    claim.setType(getType(claimGroup));
    claim.setSupportingInfo(getSupportingInfo(claimGroup));
    claim.setBillablePeriod(getBillablePeriod(claimGroup));
    claim.setUse(Claim.Use.CLAIM);
    claim.setPriority(getPriority());
    claim.setTotal(getTotal(claimGroup));
    claim.setProvider(new Reference("#provider-org"));
    claim.setPatient(new Reference("#patient"));
    claim.setFacility(getFacility(claimGroup));
    claim.setDiagnosis(getDiagnosis(claimGroup, isIcd9));
    claim.setProcedure(getProcedure(claimGroup, isIcd9));
    claim.setInsurance(getInsurance(claimGroup));
    claim.setMeta(new Meta().setLastUpdated(Date.from(claimGroup.getLastUpdated())));
    claim.setCreated(new Date());
    return claim;
}

Example 19 with Resource

use of org.hl7.fhir.r4b.model.Resource in project beneficiary-fhir-data by CMSgov.

the class McsClaimTransformerV2 method getContainedProvider.

private static Resource getContainedProvider(PreAdjMcsClaim claimGroup) {
    Organization organization = new Organization();
    if (claimGroup.getIdrBillProvType() != null) {
        organization.getExtension().add(new Extension(BBCodingSystems.MCS.BILL_PROV_TYPE).setValue(new Coding(BBCodingSystems.MCS.BILL_PROV_TYPE, claimGroup.getIdrBillProvType(), null)));
    }
    if (claimGroup.getIdrBillProvSpec() != null) {
        organization.getExtension().add(new Extension(BBCodingSystems.MCS.BILL_PROV_SPEC).setValue(new Coding(BBCodingSystems.MCS.BILL_PROV_SPEC, claimGroup.getIdrBillProvSpec(), null)));
    }
    if (claimGroup.getIdrBillProvEin() != null) {
        organization.getIdentifier().add(new Identifier().setType(new CodeableConcept(new Coding(C4BBOrganizationIdentifierType.TAX.getSystem(), C4BBOrganizationIdentifierType.TAX.toCode(), C4BBOrganizationIdentifierType.TAX.getDisplay()))).setSystem(BBCodingSystems.MCS.BILL_PROV_EIN).setValue(claimGroup.getIdrBillProvEin()));
    }
    if (claimGroup.getIdrBillProvNum() != null) {
        organization.getIdentifier().add(new Identifier().setType(new CodeableConcept(new Coding(C4BBIdentifierType.NPI.getSystem(), C4BBIdentifierType.NPI.toCode(), C4BBIdentifierType.NPI.getDisplay()))).setSystem(TransformerConstants.CODING_NPI_US).setValue(claimGroup.getIdrBillProvNpi()));
    }
    organization.setId("provider-org");
    return organization;
}

Example 20 with Resource

use of org.hl7.fhir.r4b.model.Resource in project beneficiary-fhir-data by CMSgov.

the class HHAClaimTransformerV2Test method shouldHaveLineItemRevenue.

@Test
public void shouldHaveLineItemRevenue() {
    CodeableConcept revenue = eob.getItemFirstRep().getRevenue();
    Coding code1 = revenue.getCoding().stream().filter(coding -> coding.getSystem().equals("https://bluebutton.cms.gov/resources/variables/rev_cntr")).findFirst().orElse(null);
    Coding code2 = revenue.getCoding().stream().filter(coding -> coding.getSystem().equals("https://www.nubc.org/CodeSystem/RevenueCodes")).findFirst().orElse(null);
    Coding code3 = revenue.getCoding().stream().filter(coding -> coding.getSystem().equals("https://bluebutton.cms.gov/resources/variables/rev_cntr_ddctbl_coinsrnc_cd")).findFirst().orElse(null);
    assertNotNull(code1, "Missing expected rev_cntr coding");
    assertEquals("0023", code1.getCode());
    assertEquals("Home Health services paid under PPS submitted as TOB 32X and 33X, effective 10/00. This code may appear multiple times on a claim to identify different HIPPS/Home Health Resource Groups (HRG).", code1.getDisplay());
    assertNotNull(code2, "Missing expected RevenueCodes coding");
    assertEquals("4", code2.getCode());
    assertNull(code2.getDisplay());
    assertNotNull(code3, "Missing expected rev_cntr_ddctbl_coinsrnc_cd coding");
    assertEquals("4", code3.getCode());
    assertEquals("No charge or units associated with this revenue center code. (For multiple HCPCS per single revenue center code) For revenue center code 0001, the following MSP override values may be present:", code3.getDisplay());
}