use of org.hl7.fhir.r5.model.Money in project org.hl7.fhir.core by hapifhir.
the class RdfParser method composeMoney.
protected void composeMoney(Complex parent, String parentType, String name, Money element, int index) {
if (element == null)
return;
Complex t;
if (Utilities.noString(parentType))
t = parent;
else {
t = parent.predicate("fhir:" + parentType + '.' + name);
}
composeElement(t, "Money", name, element, index);
if (element.hasValueElement())
composeDecimal(t, "Money", "value", element.getValueElement(), -1);
if (element.hasCurrencyElement())
composeCode(t, "Money", "currency", element.getCurrencyElement(), -1);
}
use of org.hl7.fhir.r5.model.Money in project org.hl7.fhir.core by hapifhir.
the class ProfileDrivenRenderer method renderLeaf.
private void renderLeaf(ResourceWrapper res, BaseWrapper ew, ElementDefinition defn, XhtmlNode parent, XhtmlNode x, boolean title, boolean showCodeDetails, Map<String, String> displayHints, String path, int indent) throws FHIRException, UnsupportedEncodingException, IOException, EOperationOutcome {
if (ew == null)
return;
Base e = ew.getBase();
if (e instanceof StringType)
x.addText(((StringType) e).getValue());
else if (e instanceof CodeType)
x.addText(((CodeType) e).getValue());
else if (e instanceof IdType)
x.addText(((IdType) e).getValue());
else if (e instanceof Extension)
return;
else if (e instanceof InstantType)
x.addText(((InstantType) e).toHumanDisplay());
else if (e instanceof DateTimeType) {
renderDateTime(x, e);
} else if (e instanceof Base64BinaryType)
x.addText(new Base64().encodeAsString(((Base64BinaryType) e).getValue()));
else if (e instanceof org.hl7.fhir.r4b.model.DateType) {
org.hl7.fhir.r4b.model.DateType dt = ((org.hl7.fhir.r4b.model.DateType) e);
if (((org.hl7.fhir.r4b.model.DateType) e).hasValue()) {
x.addText(((org.hl7.fhir.r4b.model.DateType) e).toHumanDisplay());
}
} else if (e instanceof Enumeration) {
Object ev = ((Enumeration<?>) e).getValue();
// todo: look up a display name if there is one
x.addText(ev == null ? "" : ev.toString());
} else if (e instanceof BooleanType) {
x.addText(((BooleanType) e).getValue().toString());
} else if (e instanceof CodeableConcept) {
renderCodeableConcept(x, (CodeableConcept) e, showCodeDetails);
} else if (e instanceof Coding) {
renderCoding(x, (Coding) e, showCodeDetails);
} else if (e instanceof CodeableReference) {
renderCodeableReference(x, (CodeableReference) e, showCodeDetails);
} else if (e instanceof Annotation) {
renderAnnotation(x, (Annotation) e);
} else if (e instanceof Identifier) {
renderIdentifier(x, (Identifier) e);
} else if (e instanceof org.hl7.fhir.r4b.model.IntegerType) {
if (((org.hl7.fhir.r4b.model.IntegerType) e).hasValue()) {
x.addText(Integer.toString(((org.hl7.fhir.r4b.model.IntegerType) e).getValue()));
} else {
x.addText("??");
}
} else if (e instanceof org.hl7.fhir.r4b.model.Integer64Type) {
if (((org.hl7.fhir.r4b.model.Integer64Type) e).hasValue()) {
x.addText(Long.toString(((org.hl7.fhir.r4b.model.Integer64Type) e).getValue()));
} else {
x.addText("??");
}
} else if (e instanceof org.hl7.fhir.r4b.model.DecimalType) {
x.addText(((org.hl7.fhir.r4b.model.DecimalType) e).getValue().toString());
} else if (e instanceof HumanName) {
renderHumanName(x, (HumanName) e);
} else if (e instanceof SampledData) {
renderSampledData(x, (SampledData) e);
} else if (e instanceof Address) {
renderAddress(x, (Address) e);
} else if (e instanceof ContactPoint) {
renderContactPoint(x, (ContactPoint) e);
} else if (e instanceof Expression) {
renderExpression(x, (Expression) e);
} else if (e instanceof Money) {
renderMoney(x, (Money) e);
} else if (e instanceof ContactDetail) {
ContactDetail cd = (ContactDetail) e;
if (cd.hasName()) {
x.tx(cd.getName() + ": ");
}
boolean first = true;
for (ContactPoint c : cd.getTelecom()) {
if (first)
first = false;
else
x.tx(",");
renderContactPoint(x, c);
}
} else if (e instanceof UriType) {
renderUri(x, (UriType) e, defn.getPath(), rcontext != null && rcontext.getResourceResource() != null ? rcontext.getResourceResource().getId() : null);
} else if (e instanceof Timing) {
renderTiming(x, (Timing) e);
} else if (e instanceof Range) {
renderRange(x, (Range) e);
} else if (e instanceof Quantity) {
renderQuantity(x, (Quantity) e, showCodeDetails);
} else if (e instanceof Ratio) {
renderQuantity(x, ((Ratio) e).getNumerator(), showCodeDetails);
x.tx("/");
renderQuantity(x, ((Ratio) e).getDenominator(), showCodeDetails);
} else if (e instanceof Period) {
Period p = (Period) e;
renderPeriod(x, p);
} else if (e instanceof Reference) {
Reference r = (Reference) e;
if (r.getReference() != null && r.getReference().contains("#")) {
if (containedIds.contains(r.getReference().substring(1))) {
x.ah(r.getReference()).tx("See " + r.getReference());
} else {
// in this case, we render the resource in line
ResourceWrapper rw = null;
for (ResourceWrapper t : res.getContained()) {
if (r.getReference().substring(1).equals(t.getId())) {
rw = t;
}
}
if (rw == null) {
renderReference(res, x, r);
} else {
x.an(rw.getId());
ResourceRenderer rr = RendererFactory.factory(rw, context.copy().setAddGeneratedNarrativeHeader(false));
rr.render(parent.blockquote(), rw);
}
}
} else {
renderReference(res, x, r);
}
} else if (e instanceof Resource) {
return;
} else if (e instanceof DataRequirement) {
DataRequirement p = (DataRequirement) e;
renderDataRequirement(x, p);
} else if (e instanceof PrimitiveType) {
x.tx(((PrimitiveType) e).primitiveValue());
} else if (e instanceof ElementDefinition) {
x.tx("todo-bundle");
} else if (e != null && !(e instanceof Attachment) && !(e instanceof Narrative) && !(e instanceof Meta)) {
throw new NotImplementedException("type " + e.getClass().getName() + " not handled - should not be here");
}
}
use of org.hl7.fhir.r5.model.Money in project org.hl7.fhir.core by hapifhir.
the class QuestionnaireBuilder method processDataType.
private void processDataType(StructureDefinition profile, QuestionnaireItemComponent group, ElementDefinition element, String path, TypeRefComponent t, List<QuestionnaireResponse.QuestionnaireResponseItemComponent> answerGroups, List<ElementDefinition> parents) throws FHIRException {
String tc = t.getWorkingCode();
if (tc.equals("code"))
addCodeQuestions(group, element, path, answerGroups);
else if (Utilities.existsInList(tc, "string", "id", "oid", "uuid", "markdown"))
addStringQuestions(group, element, path, answerGroups);
else if (Utilities.existsInList(tc, "uri", "url", "canonical"))
addUriQuestions(group, element, path, answerGroups);
else if (tc.equals("boolean"))
addBooleanQuestions(group, element, path, answerGroups);
else if (tc.equals("decimal"))
addDecimalQuestions(group, element, path, answerGroups);
else if (tc.equals("dateTime") || tc.equals("date"))
addDateTimeQuestions(group, element, path, answerGroups);
else if (tc.equals("instant"))
addInstantQuestions(group, element, path, answerGroups);
else if (tc.equals("time"))
addTimeQuestions(group, element, path, answerGroups);
else if (tc.equals("CodeableConcept"))
addCodeableConceptQuestions(group, element, path, answerGroups);
else if (tc.equals("Period"))
addPeriodQuestions(group, element, path, answerGroups);
else if (tc.equals("Ratio"))
addRatioQuestions(group, element, path, answerGroups);
else if (tc.equals("HumanName"))
addHumanNameQuestions(group, element, path, answerGroups);
else if (tc.equals("Address"))
addAddressQuestions(group, element, path, answerGroups);
else if (tc.equals("ContactPoint"))
addContactPointQuestions(group, element, path, answerGroups);
else if (tc.equals("Identifier"))
addIdentifierQuestions(group, element, path, answerGroups);
else if (tc.equals("integer") || tc.equals("positiveInt") || tc.equals("unsignedInt"))
addIntegerQuestions(group, element, path, answerGroups);
else if (tc.equals("Coding"))
addCodingQuestions(group, element, path, answerGroups);
else if (Utilities.existsInList(tc, "Quantity", "Count", "Age", "Duration", "Distance", "Money"))
addQuantityQuestions(group, element, path, answerGroups);
else if (tc.equals("Money"))
addMoneyQuestions(group, element, path, answerGroups);
else if (tc.equals("Reference"))
addReferenceQuestions(group, element, path, t.getTargetProfile(), answerGroups);
else if (tc.equals("Duration"))
addDurationQuestions(group, element, path, answerGroups);
else if (tc.equals("base64Binary"))
addBinaryQuestions(group, element, path, answerGroups);
else if (tc.equals("Attachment"))
addAttachmentQuestions(group, element, path, answerGroups);
else if (tc.equals("Age"))
addAgeQuestions(group, element, path, answerGroups);
else if (tc.equals("Range"))
addRangeQuestions(group, element, path, answerGroups);
else if (tc.equals("Timing"))
addTimingQuestions(group, element, path, answerGroups);
else if (tc.equals("Annotation"))
addAnnotationQuestions(group, element, path, answerGroups);
else if (tc.equals("SampledData"))
addSampledDataQuestions(group, element, path, answerGroups);
else if (tc.equals("Extension")) {
if (t.hasProfile())
addExtensionQuestions(profile, group, element, path, t.getProfile().get(0).getValue(), answerGroups, parents);
} else if (tc.equals("SampledData"))
addSampledDataQuestions(group, element, path, answerGroups);
else if (!tc.equals("Narrative") && !tc.equals("Resource") && !tc.equals("Meta") && !tc.equals("Signature")) {
StructureDefinition sd = context.fetchTypeDefinition(tc);
if (sd == null)
throw new NotImplementedException("Unhandled Data Type: " + tc + " on element " + element.getPath());
buildGroup(group, sd, sd.getSnapshot().getElementFirstRep(), parents, answerGroups);
}
}
use of org.hl7.fhir.r5.model.Money in project org.hl7.fhir.core by hapifhir.
the class ProfileDrivenRenderer method renderLeaf.
private void renderLeaf(ResourceWrapper res, BaseWrapper ew, ElementDefinition defn, XhtmlNode parent, XhtmlNode x, boolean title, boolean showCodeDetails, Map<String, String> displayHints, String path, int indent) throws FHIRException, UnsupportedEncodingException, IOException, EOperationOutcome {
if (ew == null)
return;
Base e = ew.getBase();
if (e instanceof StringType)
x.addText(((StringType) e).getValue());
else if (e instanceof CodeType)
x.addText(((CodeType) e).getValue());
else if (e instanceof IdType)
x.addText(((IdType) e).getValue());
else if (e instanceof Extension)
return;
else if (e instanceof InstantType)
x.addText(((InstantType) e).toHumanDisplay());
else if (e instanceof DateTimeType) {
renderDateTime(x, e);
} else if (e instanceof Base64BinaryType)
x.addText(new Base64().encodeAsString(((Base64BinaryType) e).getValue()));
else if (e instanceof org.hl7.fhir.r5.model.DateType) {
org.hl7.fhir.r5.model.DateType dt = ((org.hl7.fhir.r5.model.DateType) e);
renderDate(x, dt);
} else if (e instanceof Enumeration) {
Object ev = ((Enumeration<?>) e).getValue();
// todo: look up a display name if there is one
x.addText(ev == null ? "" : ev.toString());
} else if (e instanceof BooleanType) {
x.addText(((BooleanType) e).getValue().toString());
} else if (e instanceof CodeableConcept) {
renderCodeableConcept(x, (CodeableConcept) e, showCodeDetails);
} else if (e instanceof Coding) {
renderCoding(x, (Coding) e, showCodeDetails);
} else if (e instanceof CodeableReference) {
renderCodeableReference(x, (CodeableReference) e, showCodeDetails);
} else if (e instanceof Annotation) {
renderAnnotation(x, (Annotation) e);
} else if (e instanceof Identifier) {
renderIdentifier(x, (Identifier) e);
} else if (e instanceof org.hl7.fhir.r5.model.IntegerType) {
if (((org.hl7.fhir.r5.model.IntegerType) e).hasValue()) {
x.addText(Integer.toString(((org.hl7.fhir.r5.model.IntegerType) e).getValue()));
} else {
x.addText("??");
}
} else if (e instanceof org.hl7.fhir.r5.model.Integer64Type) {
if (((org.hl7.fhir.r5.model.Integer64Type) e).hasValue()) {
x.addText(Long.toString(((org.hl7.fhir.r5.model.Integer64Type) e).getValue()));
} else {
x.addText("??");
}
} else if (e instanceof org.hl7.fhir.r5.model.DecimalType) {
x.addText(((org.hl7.fhir.r5.model.DecimalType) e).getValue().toString());
} else if (e instanceof HumanName) {
renderHumanName(x, (HumanName) e);
} else if (e instanceof SampledData) {
renderSampledData(x, (SampledData) e);
} else if (e instanceof Address) {
renderAddress(x, (Address) e);
} else if (e instanceof ContactPoint) {
renderContactPoint(x, (ContactPoint) e);
} else if (e instanceof Expression) {
renderExpression(x, (Expression) e);
} else if (e instanceof Money) {
renderMoney(x, (Money) e);
} else if (e instanceof ContactDetail) {
ContactDetail cd = (ContactDetail) e;
if (cd.hasName()) {
x.tx(cd.getName() + ": ");
}
boolean first = true;
for (ContactPoint c : cd.getTelecom()) {
if (first)
first = false;
else
x.tx(",");
renderContactPoint(x, c);
}
} else if (e instanceof UriType) {
renderUri(x, (UriType) e, defn.getPath(), rcontext != null && rcontext.getResourceResource() != null ? rcontext.getResourceResource().getId() : null);
} else if (e instanceof Timing) {
renderTiming(x, (Timing) e);
} else if (e instanceof Range) {
renderRange(x, (Range) e);
} else if (e instanceof Quantity) {
renderQuantity(x, (Quantity) e, showCodeDetails);
} else if (e instanceof Ratio) {
renderQuantity(x, ((Ratio) e).getNumerator(), showCodeDetails);
x.tx("/");
renderQuantity(x, ((Ratio) e).getDenominator(), showCodeDetails);
} else if (e instanceof Period) {
Period p = (Period) e;
renderPeriod(x, p);
} else if (e instanceof Reference) {
Reference r = (Reference) e;
if (r.getReference() != null && r.getReference().contains("#")) {
if (containedIds.contains(r.getReference().substring(1))) {
x.ah(r.getReference()).tx("See " + r.getReference());
} else {
// in this case, we render the resource in line
ResourceWrapper rw = null;
for (ResourceWrapper t : res.getContained()) {
if (r.getReference().substring(1).equals(t.getId())) {
rw = t;
}
}
if (rw == null) {
renderReference(res, x, r);
} else {
x.an(rw.getId());
ResourceRenderer rr = RendererFactory.factory(rw, context.copy().setAddGeneratedNarrativeHeader(false));
rr.render(parent.blockquote(), rw);
}
}
} else {
renderReference(res, x, r);
}
} else if (e instanceof Resource) {
return;
} else if (e instanceof DataRequirement) {
DataRequirement p = (DataRequirement) e;
renderDataRequirement(x, p);
} else if (e instanceof PrimitiveType) {
x.tx(((PrimitiveType) e).primitiveValue());
} else if (e instanceof ElementDefinition) {
x.tx("todo-bundle");
} else if (e != null && !(e instanceof Attachment) && !(e instanceof Narrative) && !(e instanceof Meta)) {
throw new NotImplementedException("type " + e.getClass().getName() + " not handled - should not be here");
}
}
use of org.hl7.fhir.r5.model.Money in project synthea by synthetichealth.
the class FhirStu3 method explanationOfBenefit.
/**
* Create an explanation of benefit resource for each claim, detailing insurance
* information.
*
* @param personEntry Entry for the person
* @param bundle The Bundle to add to
* @param encounterEntry The current Encounter
* @param claimEntry the Claim object
* @param person the person the health record belongs to
* @param encounter the current Encounter as an object
* @return the added entry
*/
private static BundleEntryComponent explanationOfBenefit(BundleEntryComponent personEntry, Bundle bundle, BundleEntryComponent encounterEntry, Person person, BundleEntryComponent claimEntry, Encounter encounter) {
boolean inpatient = false;
boolean outpatient = false;
EncounterType type = EncounterType.fromString(encounter.type);
if (type == EncounterType.INPATIENT) {
inpatient = true;
// Provider enum doesn't include outpatient, but it can still be
// an encounter type.
} else if (type == EncounterType.AMBULATORY || type == EncounterType.WELLNESS) {
outpatient = true;
}
ExplanationOfBenefit eob = new ExplanationOfBenefit();
org.hl7.fhir.dstu3.model.Encounter encounterResource = (org.hl7.fhir.dstu3.model.Encounter) encounterEntry.getResource();
// will have to deal with different claim types (e.g. inpatient vs outpatient)
if (inpatient) {
// https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Indirect-Medical-Education-IME
// Extra cost for educational hospitals
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-ime-op-clm-val-amt-extension", 400));
// DSH payment-- Massachusetts does not make DSH payments at all, so set to 0 for now
// https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/dsh
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-dsh-op-clm-val-amt-extension", 0));
// The pass through per diem rate
// not really defined by CMS
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pass-thru-per-diem-amt-extension", 0));
// Professional charge
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-profnl-cmpnt-chrg-amt-extension", 0));
// total claim PPS charge
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-tot-pps-cptl-amt-extension", 0));
// Deductible Amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-bene-ip-ddctbl-amt-extension", 0));
// Coinsurance Liability
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-bene-pta-coinsrnc-lblty-amt-extension", 0));
// Non-covered Charge Amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-ip-ncvrd-chrg-amt-extension", 0));
// Total Deductible/Coinsurance Amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-ip-tot-ddctn-amt-extension", 0));
// PPS Capital DSH Amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-dsprprtnt-shr-amt-extension", 0));
// PPS Capital Exception Amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-excptn-amt-extension", 0));
// PPS FSP
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-fsp-amt-extension", 0));
// PPS IME
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-ime-amt-extension", 400));
// PPS Capital Outlier Amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-outlier-amt-extension", 0));
// Old capital hold harmless amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-old-cptl-hld-hrmls-amt-extension", 0));
// NCH DRG Outlier Approved Payment Amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-drg-outlier-aprvd-pmt-amt-extension", 0));
// NCH Beneficiary Blood Deductible Liability Amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-bene-blood-ddctbl-lblty-am-extension", 0));
// Non-payment reason
eob.addExtension().setUrl("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-mdcr-non-pmt-rsn-cd-extension").setValue(new Coding().setSystem("https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd").setDisplay("All other reasons for non-payment").setCode("N"));
// Prepayment
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-prpayamt-extension", 0));
// FI or MAC number
eob.addExtension().setUrl("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-fi-num-extension").setValue(new Identifier().setValue("002000").setSystem("https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num"));
} else if (outpatient) {
// Professional component charge amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension", 0));
// Deductible amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension", 0));
// Coinsurance amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension", 0));
// Provider Payment
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension", 0));
// Beneficiary payment
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension", 0));
// Beneficiary Blood Deductible Liability Amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension", 0));
// Claim Medicare Non Payment Reason Code
eob.addExtension().setUrl("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension").setValue(new Coding().setDisplay("All other reasons for non-payment").setSystem("https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd").setCode("N"));
// NCH Primary Payer Claim Paid Amount
eob.addExtension(createMoneyExtension("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension", 0));
// FI or MAC number
eob.addExtension().setUrl("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension").setValue(new Identifier().setValue("002000").setSystem("https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num"));
}
// according to CMS guidelines claims have 12 months to be
// billed, so we set the billable period to 1 year after
// services have ended (the encounter ends).
Calendar cal = Calendar.getInstance();
cal.setTime(encounterResource.getPeriod().getEnd());
cal.add(Calendar.YEAR, 1);
Period billablePeriod = new Period().setStart(encounterResource.getPeriod().getEnd()).setEnd(cal.getTime());
if (inpatient) {
billablePeriod.addExtension(new Extension().setUrl("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-claim-query-cd-extension").setValue(new Coding().setCode("3").setSystem("https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd").setDisplay("Final Bill")));
} else if (outpatient) {
billablePeriod.addExtension(new Extension().setUrl("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension").setValue(new Coding().setCode("3").setSystem("https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd").setDisplay("Final Bill")));
}
eob.setBillablePeriod(billablePeriod);
// cost is hardcoded to be USD in claim so this should be fine as well
Money totalCost = new Money();
totalCost.setSystem("urn:iso:std:iso:4217");
totalCost.setCode("USD");
totalCost.setValue(encounter.claim.getTotalClaimCost());
eob.setTotalCost(totalCost);
// Set References
eob.setPatient(new Reference(personEntry.getFullUrl()));
if (encounter.provider != null) {
// This is what should happen if BlueButton 2.0 wasn't needlessly restrictive
// String providerUrl = findProviderUrl(encounter.provider, bundle);
// eob.setOrganization(new Reference().setReference(providerUrl));
// Instead, we'll create the BlueButton 2.0 reference via identifier...
Identifier identifier = new Identifier();
identifier.setValue(encounter.provider.getResourceID());
eob.setOrganization(new Reference().setIdentifier(identifier));
}
String npi = "9999999999";
if (encounter.clinician != null) {
npi = encounter.clinician.npi;
} else if (encounter.provider != null) {
npi = encounter.provider.npi;
}
// Get the insurance info at the time that the encounter happened.
Payer payer = encounter.claim.payer;
Coverage coverage = new Coverage();
coverage.setId("coverage");
coverage.setType(new CodeableConcept().setText(payer.getName()));
eob.addContained(coverage);
ExplanationOfBenefit.InsuranceComponent insuranceComponent = new ExplanationOfBenefit.InsuranceComponent();
insuranceComponent.setCoverage(new Reference("#coverage"));
eob.setInsurance(insuranceComponent);
org.hl7.fhir.dstu3.model.Claim claim = (org.hl7.fhir.dstu3.model.Claim) claimEntry.getResource();
eob.addIdentifier().setSystem("https://bluebutton.cms.gov/resources/variables/clm_id").setValue(claim.getId());
// Hardcoded group id
eob.addIdentifier().setSystem("https://bluebutton.cms.gov/resources/identifier/claim-group").setValue("99999999999");
eob.setStatus(org.hl7.fhir.dstu3.model.ExplanationOfBenefit.ExplanationOfBenefitStatus.ACTIVE);
if (!inpatient && !outpatient) {
eob.setClaim(new Reference().setReference(claimEntry.getFullUrl()));
List<Reference> recipientList = new ArrayList<>();
recipientList.add(new Reference().setIdentifier(new Identifier().setSystem("http://hl7.org/fhir/sid/us-npi").setValue(npi)));
eob.addContained(new ReferralRequest().setStatus(ReferralRequest.ReferralRequestStatus.COMPLETED).setIntent(ReferralRequest.ReferralCategory.ORDER).setSubject(new Reference(personEntry.getFullUrl())).setRequester(new ReferralRequest.ReferralRequestRequesterComponent().setAgent(new Reference().setIdentifier(new Identifier().setSystem("http://hl7.org/fhir/sid/us-npi").setValue(npi)))).setRecipient(recipientList).setId("referral"));
eob.setReferral(new Reference("#referral"));
eob.setCreated(encounterResource.getPeriod().getEnd());
}
eob.setType(claim.getType());
List<ExplanationOfBenefit.DiagnosisComponent> eobDiag = new ArrayList<>();
for (org.hl7.fhir.dstu3.model.Claim.DiagnosisComponent claimDiagnosis : claim.getDiagnosis()) {
ExplanationOfBenefit.DiagnosisComponent diagnosisComponent = new ExplanationOfBenefit.DiagnosisComponent();
diagnosisComponent.setDiagnosis(claimDiagnosis.getDiagnosis());
diagnosisComponent.getType().add(new CodeableConcept().addCoding(new Coding().setCode("principal").setSystem("https://bluebutton.cms.gov/resources/codesystem/diagnosis-type")));
diagnosisComponent.setSequence(claimDiagnosis.getSequence());
diagnosisComponent.setPackageCode(claimDiagnosis.getPackageCode());
diagnosisComponent.addExtension().setUrl("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension").setValue(new Coding().setCode("Y").setSystem("https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1").setDisplay("Diagnosis present at time of admission"));
eobDiag.add(diagnosisComponent);
}
eob.setDiagnosis(eobDiag);
List<ExplanationOfBenefit.ProcedureComponent> eobProc = new ArrayList<>();
for (ProcedureComponent proc : claim.getProcedure()) {
ExplanationOfBenefit.ProcedureComponent p = new ExplanationOfBenefit.ProcedureComponent();
p.setDate(proc.getDate());
p.setSequence(proc.getSequence());
p.setProcedure(proc.getProcedure());
}
eob.setProcedure(eobProc);
List<ExplanationOfBenefit.ItemComponent> eobItem = new ArrayList<>();
double totalPayment = 0;
for (ItemComponent item : claim.getItem()) {
ExplanationOfBenefit.ItemComponent itemComponent = new ExplanationOfBenefit.ItemComponent();
itemComponent.setSequence(item.getSequence());
itemComponent.setQuantity(item.getQuantity());
itemComponent.setUnitPrice(item.getUnitPrice());
itemComponent.setCareTeamLinkId(item.getCareTeamLinkId());
if (item.hasService()) {
itemComponent.setService(item.getService());
}
if (!inpatient && !outpatient) {
itemComponent.setDiagnosisLinkId(item.getDiagnosisLinkId());
itemComponent.setInformationLinkId(item.getInformationLinkId());
itemComponent.setNet(item.getNet());
itemComponent.setEncounter(item.getEncounter());
itemComponent.setServiced(encounterResource.getPeriod());
itemComponent.setCategory(new CodeableConcept().addCoding(new Coding().setSystem("https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd").setCode("1").setDisplay("Medical care")));
}
if (inpatient) {
itemComponent.addExtension(new Extension().setUrl("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-rev-cntr-ndc-qty-extension").setValue(new Quantity().setValue(0)));
} else if (outpatient) {
itemComponent.addExtension(new Extension().setUrl("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension").setValue(new Quantity().setValue(0)));
if (itemComponent.hasService()) {
itemComponent.getService().addExtension(new Extension().setUrl("https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension").setValue(new Coding().setSystem("https://www.accessdata.fda.gov/scripts/cder/ndc").setDisplay("Dummy").setCode("0624")));
}
}
// Location of service, can use switch statement based on
// encounter type
String code;
String display;
CodeableConcept location = new CodeableConcept();
EncounterType encounterType = EncounterType.fromString(encounter.type);
switch(encounterType) {
case AMBULATORY:
code = "21";
display = "Inpatient Hospital";
break;
case EMERGENCY:
code = "23";
display = "Emergency Room";
break;
case INPATIENT:
code = "21";
display = "Inpatient Hospital";
break;
case URGENTCARE:
code = "20";
display = "Urgent Care Facility";
break;
case WELLNESS:
code = "22";
display = "Outpatient Hospital";
break;
default:
code = "21";
display = "Inpatient Hospital";
}
location.addCoding().setCode(code).setSystem("https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd").setDisplay(display);
itemComponent.setLocation(location);
// Adjudication
if (item.hasNet()) {
// Assume that the patient has already paid deductible and
// has 20/80 coinsurance
ExplanationOfBenefit.AdjudicationComponent coinsuranceAmount = new ExplanationOfBenefit.AdjudicationComponent();
coinsuranceAmount.getCategory().getCoding().add(new Coding().setCode("https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt").setSystem("https://bluebutton.cms.gov/resources/codesystem/adjudication").setDisplay("Line Beneficiary Coinsurance Amount"));
coinsuranceAmount.getAmount().setValue(// 20% coinsurance
0.2 * item.getNet().getValue().doubleValue()).setSystem(// USD
"urn:iso:std:iso:4217").setCode("USD");
ExplanationOfBenefit.AdjudicationComponent lineProviderAmount = new ExplanationOfBenefit.AdjudicationComponent();
lineProviderAmount.getCategory().getCoding().add(new Coding().setCode("https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt").setSystem("https://bluebutton.cms.gov/resources/codesystem/adjudication").setDisplay("Line Provider Payment Amount"));
lineProviderAmount.getAmount().setValue(0.8 * item.getNet().getValue().doubleValue()).setSystem("urn:iso:std:iso:4217").setCode("USD");
// assume the allowed and submitted amounts are the same for now
ExplanationOfBenefit.AdjudicationComponent submittedAmount = new ExplanationOfBenefit.AdjudicationComponent();
submittedAmount.getCategory().getCoding().add(new Coding().setCode("https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt").setSystem("https://bluebutton.cms.gov/resources/codesystem/adjudication").setDisplay("Line Submitted Charge Amount"));
submittedAmount.getAmount().setValue(item.getNet().getValue()).setSystem("urn:iso:std:iso:4217").setCode("USD");
ExplanationOfBenefit.AdjudicationComponent allowedAmount = new ExplanationOfBenefit.AdjudicationComponent();
allowedAmount.getCategory().getCoding().add(new Coding().setCode("https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt").setSystem("https://bluebutton.cms.gov/resources/codesystem/adjudication").setDisplay("Line Allowed Charge Amount"));
allowedAmount.getAmount().setValue(item.getNet().getValue()).setSystem("urn:iso:std:iso:4217").setCode("USD");
ExplanationOfBenefit.AdjudicationComponent indicatorCode = new ExplanationOfBenefit.AdjudicationComponent();
indicatorCode.getCategory().getCoding().add(new Coding().setCode("https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd").setSystem("https://bluebutton.cms.gov/resources/codesystem/adjudication").setDisplay("Line Processing Indicator Code"));
if (!inpatient && !outpatient) {
indicatorCode.getReason().addCoding().setCode("A").setSystem("https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd");
indicatorCode.getReason().getCodingFirstRep().setDisplay("Allowed");
}
// assume deductible is 0
ExplanationOfBenefit.AdjudicationComponent deductibleAmount = new ExplanationOfBenefit.AdjudicationComponent();
deductibleAmount.getCategory().getCoding().add(new Coding().setCode("https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt").setSystem("https://bluebutton.cms.gov/resources/codesystem/adjudication").setDisplay("Line Beneficiary Part B Deductible Amount"));
deductibleAmount.getAmount().setValue(0).setSystem("urn:iso:std:iso:4217").setCode("USD");
List<ExplanationOfBenefit.AdjudicationComponent> adjudicationComponents = new ArrayList<>();
adjudicationComponents.add(coinsuranceAmount);
adjudicationComponents.add(lineProviderAmount);
adjudicationComponents.add(submittedAmount);
adjudicationComponents.add(allowedAmount);
adjudicationComponents.add(deductibleAmount);
adjudicationComponents.add(indicatorCode);
itemComponent.setAdjudication(adjudicationComponents);
// the total payment is what the insurance ends up paying
totalPayment += 0.8 * item.getNet().getValue().doubleValue();
}
eobItem.add(itemComponent);
}
eob.setItem(eobItem);
// This will throw a validation error no matter what. The
// payment section is required, and it requires a value.
// The validator will complain that if there is a value, the payment
// needs a code, but it will also complain if there is a code.
// There is no way to resolve this error.
Money payment = new Money();
payment.setValue(totalPayment).setSystem("urn:iso:std:iso:4217").setCode("USD");
eob.setPayment(new ExplanationOfBenefit.PaymentComponent().setAmount(payment));
if (encounter.clinician != null) {
// This is what should happen if BlueButton 2.0 wasn't needlessly restrictive
// String practitionerFullUrl = findPractitioner(encounter.clinician, bundle);
// eob.setProvider(new Reference().setReference(practitionerFullUrl));
// Instead, we'll create the BlueButton 2.0 reference via identifier...
Identifier identifier = new Identifier();
identifier.setValue(encounter.clinician.getResourceID());
eob.setProvider(new Reference().setIdentifier(identifier));
} else {
Identifier identifier = new Identifier();
identifier.setValue("Unknown");
eob.setProvider(new Reference().setIdentifier(identifier));
}
eob.addCareTeam(new ExplanationOfBenefit.CareTeamComponent().setSequence(1).setProvider(new Reference().setIdentifier(new Identifier().setSystem("http://hl7.org/fhir/sid/us-npi").setValue(npi))).setRole(new CodeableConcept().addCoding(new Coding().setCode("primary").setSystem("http://hl7.org/fhir/claimcareteamrole").setDisplay("Primary Care Practitioner"))));
eob.setType(new CodeableConcept().addCoding(new Coding().setSystem("https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd").setCode("71").setDisplay("Local carrier non-durable medical equipment, prosthetics, orthotics, " + "and supplies (DMEPOS) claim")).addCoding(new Coding().setSystem("https://bluebutton.cms.gov/resources/codesystem/eob-type").setCode("CARRIER").setDisplay("EOB Type")).addCoding(new Coding().setSystem("http://hl7.org/fhir/ex-claimtype").setCode("professional").setDisplay("Claim Type")).addCoding(new Coding().setSystem("https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd").setCode("O").setDisplay("Part B physician/supplier claim record (processed by local " + "carriers; can include DMEPOS services)")));
return newEntry(person, bundle, eob);
}
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