Examples with org.hl7.fhir.r5.model org.hl7.fhir.r5.model used on opensource projects

Example 21 with org.hl7.fhir.r5.model

use of org.hl7.fhir.r5.model in project beneficiary-fhir-data by CMSgov.

the class EndpointJsonResponseComparatorV2IT method eobReadCarrier.

/**
 * @return the results of the {@link
 *     ExplanationOfBenefitResourceProvider#read(org.hl7.fhir.dstu3.model.IdType)} operation for
 *     Carrier claims
 */
public static String eobReadCarrier() {
    List<Object> loadedRecords = ServerTestUtils.get().loadData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    IGenericClient fhirClient = createFhirClientAndSetEncoding();
    JsonInterceptor jsonInterceptor = createAndRegisterJsonInterceptor(fhirClient);
    CarrierClaim carrClaim = loadedRecords.stream().filter(r -> r instanceof CarrierClaim).map(r -> (CarrierClaim) r).findFirst().get();
    fhirClient.read().resource(ExplanationOfBenefit.class).withId(TransformerUtilsV2.buildEobId(ClaimTypeV2.CARRIER, carrClaim.getClaimId())).execute();
    return jsonInterceptor.getResponse();
}

Example 22 with org.hl7.fhir.r5.model

use of org.hl7.fhir.r5.model in project beneficiary-fhir-data by CMSgov.

the class EndpointJsonResponseComparatorV2IT method eobReadOutpatient.

/**
 * @return the results of the {@link
 *     ExplanationOfBenefitResourceProvider#read(org.hl7.fhir.dstu3.model.IdType)} operation for
 *     Outpatient claims
 */
public static String eobReadOutpatient() {
    List<Object> loadedRecords = ServerTestUtils.get().loadData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    IGenericClient fhirClient = createFhirClientAndSetEncoding();
    JsonInterceptor jsonInterceptor = createAndRegisterJsonInterceptor(fhirClient);
    OutpatientClaim outClaim = loadedRecords.stream().filter(r -> r instanceof OutpatientClaim).map(r -> (OutpatientClaim) r).findFirst().get();
    fhirClient.read().resource(ExplanationOfBenefit.class).withId(TransformerUtilsV2.buildEobId(ClaimTypeV2.OUTPATIENT, outClaim.getClaimId())).execute();
    return jsonInterceptor.getResponse();
}

Example 23 with org.hl7.fhir.r5.model

use of org.hl7.fhir.r5.model in project beneficiary-fhir-data by CMSgov.

the class EndpointJsonResponseComparatorV2IT method eobReadCarrierWithTaxNumbers.

/**
 * @return the results of the {@link
 *     ExplanationOfBenefitResourceProvider#read(org.hl7.fhir.dstu3.model.IdType)} operation for
 *     Carrier claims, with the {@link
 *     ExplanationOfBenefitResourceProvider#HEADER_NAME_INCLUDE_TAX_NUMBERS} set to <code>true
 *     </code>
 */
public static String eobReadCarrierWithTaxNumbers() {
    List<Object> loadedRecords = ServerTestUtils.get().loadData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    IGenericClient fhirClient = createFhirClientAndSetEncoding();
    RequestHeaders requestHeader = RequestHeaders.getHeaderWrapper(CommonHeaders.HEADER_NAME_INCLUDE_TAX_NUMBERS, "true");
    ExtraParamsInterceptor extraParamsInterceptor = new ExtraParamsInterceptor();
    extraParamsInterceptor.setHeaders(requestHeader);
    fhirClient.registerInterceptor(extraParamsInterceptor);
    JsonInterceptor jsonInterceptor = createAndRegisterJsonInterceptor(fhirClient);
    CarrierClaim carrClaim = loadedRecords.stream().filter(r -> r instanceof CarrierClaim).map(r -> (CarrierClaim) r).findFirst().get();
    fhirClient.read().resource(ExplanationOfBenefit.class).withId(TransformerUtilsV2.buildEobId(ClaimTypeV2.CARRIER, carrClaim.getClaimId())).execute();
    return jsonInterceptor.getResponse();
}

Example 24 with org.hl7.fhir.r5.model

use of org.hl7.fhir.r5.model in project beneficiary-fhir-data by CMSgov.

the class CarrierClaimTransformerTest method assertMatches.

/**
 * Verifies that the {@link ExplanationOfBenefit} "looks like" it should, if it were produced from
 * the specified {@link CarrierClaim}.
 *
 * @param claim the {@link CarrierClaim} that the {@link ExplanationOfBenefit} was generated from
 * @param eob the {@link ExplanationOfBenefit} that was generated from the specified {@link
 *     CarrierClaim}
 * @param includedTaxNumbers whether or not to include tax numbers are expected to be included in
 *     the result (see {@link
 *     ExplanationOfBenefitResourceProvider#HEADER_NAME_INCLUDE_TAX_NUMBERS}, defaults to <code>
 *     false</code>)
 * @throws FHIRException (indicates test failure)
 */
static void assertMatches(CarrierClaim claim, ExplanationOfBenefit eob, Optional<Boolean> includedTaxNumbers) throws FHIRException {
    // Test to ensure group level fields between all claim types match
    TransformerTestUtils.assertEobCommonClaimHeaderData(eob, claim.getClaimId(), claim.getBeneficiaryId(), ClaimType.CARRIER, claim.getClaimGroupId().toPlainString(), MedicareSegment.PART_B, Optional.of(claim.getDateFrom()), Optional.of(claim.getDateThrough()), Optional.of(claim.getPaymentAmount()), claim.getFinalAction());
    // Test to ensure common group fields between Carrier and DME match
    TransformerTestUtils.assertEobCommonGroupCarrierDMEEquals(eob, claim.getBeneficiaryId(), claim.getCarrierNumber(), claim.getClinicalTrialNumber(), claim.getBeneficiaryPartBDeductAmount(), claim.getPaymentDenialCode(), claim.getReferringPhysicianNpi(), claim.getProviderAssignmentIndicator(), claim.getProviderPaymentAmount(), claim.getBeneficiaryPaymentAmount(), claim.getSubmittedChargeAmount(), claim.getAllowedChargeAmount());
    assertEquals(5, eob.getDiagnosis().size());
    assertEquals(1, eob.getItem().size());
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.PRPAYAMT, claim.getPrimaryPayerPaidAmount(), eob);
    CarrierClaimLine claimLine1 = claim.getLines().get(0);
    ItemComponent eobItem0 = eob.getItem().get(0);
    assertEquals(claimLine1.getLineNumber(), new BigDecimal(eobItem0.getSequence()));
    TransformerTestUtils.assertCareTeamEquals(claimLine1.getPerformingPhysicianNpi().get(), ClaimCareteamrole.PRIMARY, eob);
    CareTeamComponent performingCareTeamEntry = TransformerTestUtils.findCareTeamEntryForProviderNpi(claimLine1.getPerformingPhysicianNpi().get(), eob.getCareTeam());
    TransformerTestUtils.assertHasCoding(CcwCodebookVariable.PRVDR_SPCLTY, claimLine1.getProviderSpecialityCode(), performingCareTeamEntry.getQualification());
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.CARR_LINE_PRVDR_TYPE_CD, claimLine1.getProviderTypeCode(), performingCareTeamEntry);
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.PRTCPTNG_IND_CD, claimLine1.getProviderParticipatingIndCode(), performingCareTeamEntry);
    TransformerTestUtils.assertExtensionCodingEquals(performingCareTeamEntry, TransformerConstants.CODING_NPI_US, TransformerConstants.CODING_NPI_US, "" + claimLine1.getOrganizationNpi().get());
    CareTeamComponent taxNumberCareTeamEntry = TransformerTestUtils.findCareTeamEntryForProviderTaxNumber(claimLine1.getProviderTaxNumber(), eob.getCareTeam());
    if (includedTaxNumbers.orElse(false)) {
        assertNotNull(taxNumberCareTeamEntry);
    } else {
        assertNull(taxNumberCareTeamEntry);
    }
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.PRVDR_STATE_CD, claimLine1.getProviderStateCode(), eobItem0.getLocation());
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.PRVDR_STATE_CD, claimLine1.getProviderStateCode(), eobItem0.getLocation());
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.CARR_LINE_PRCNG_LCLTY_CD, claimLine1.getLinePricingLocalityCode(), eobItem0.getLocation());
    TransformerTestUtils.assertHasCoding(TransformerConstants.CODING_SYSTEM_HCPCS, "" + claim.getHcpcsYearCode().get(), null, claimLine1.getHcpcsCode().get(), eobItem0.getService().getCoding());
    assertEquals(1, eobItem0.getModifier().size());
    TransformerTestUtils.assertHcpcsCodes(eobItem0, claimLine1.getHcpcsCode(), claimLine1.getHcpcsInitialModifierCode(), claimLine1.getHcpcsSecondModifierCode(), claim.getHcpcsYearCode(), 0);
    if (claimLine1.getAnesthesiaUnitCount().compareTo(BigDecimal.ZERO) > 0) {
        TransformerTestUtils.assertExtensionQuantityEquals(CcwCodebookVariable.CARR_LINE_ANSTHSA_UNIT_CNT, claimLine1.getAnesthesiaUnitCount(), eobItem0.getService());
    }
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.CARR_LINE_MTUS_CD, claimLine1.getMtusCode(), eobItem0);
    TransformerTestUtils.assertExtensionQuantityEquals(CcwCodebookVariable.CARR_LINE_MTUS_CNT, claimLine1.getMtusCount(), eobItem0);
    TransformerTestUtils.assertAdjudicationReasonEquals(CcwCodebookVariable.CARR_LINE_RDCD_PMT_PHYS_ASTN_C, claimLine1.getReducedPaymentPhysicianAsstCode(), eobItem0.getAdjudication());
    TransformerTestUtils.assertExtensionIdentifierEquals(CcwCodebookVariable.CARR_LINE_CLIA_LAB_NUM, claimLine1.getCliaLabNumber(), eobItem0.getLocation());
    // verify {@link
    // TransformerUtils#mapEobType(CodeableConcept,ClaimType,Optional,Optional)}
    // method worked as expected for this claim type
    TransformerTestUtils.assertMapEobType(eob.getType(), ClaimType.CARRIER, Optional.of(org.hl7.fhir.dstu3.model.codesystems.ClaimType.PROFESSIONAL), Optional.of(claim.getNearLineRecordIdCode()), Optional.of(claim.getClaimTypeCode()));
    // Test to ensure common item fields between Carrier and DME match
    TransformerTestUtils.assertEobCommonItemCarrierDMEEquals(eobItem0, eob, claimLine1.getServiceCount(), claimLine1.getPlaceOfServiceCode(), claimLine1.getFirstExpenseDate(), claimLine1.getLastExpenseDate(), claimLine1.getBeneficiaryPaymentAmount(), claimLine1.getProviderPaymentAmount(), claimLine1.getBeneficiaryPartBDeductAmount(), claimLine1.getPrimaryPayerCode(), claimLine1.getPrimaryPayerPaidAmount(), claimLine1.getBetosCode(), claimLine1.getPaymentAmount(), claimLine1.getPaymentCode(), claimLine1.getCoinsuranceAmount(), claimLine1.getSubmittedChargeAmount(), claimLine1.getAllowedChargeAmount(), claimLine1.getProcessingIndicatorCode(), claimLine1.getServiceDeductibleCode(), claimLine1.getDiagnosisCode(), claimLine1.getDiagnosisCodeVersion(), claimLine1.getHctHgbTestTypeCode(), claimLine1.getHctHgbTestResult(), claimLine1.getCmsServiceTypeCode(), claimLine1.getNationalDrugCode());
    // Test lastUpdated
    TransformerTestUtils.assertLastUpdatedEquals(claim.getLastUpdated(), eob);
}

Example 25 with org.hl7.fhir.r5.model

use of org.hl7.fhir.r5.model in project beneficiary-fhir-data by CMSgov.

the class R4PatientResourceProviderIT method assertExistingPatientIncludeIdentifiersExpected.

/**
 * Asserts that {@link
 * gov.cms.bfd.server.war.r4.providers.R4PatientResourceProvider#read(org.hl7.fhir.r4.model.IdType)}
 * contains expected/present identifiers for a {@link Patient}.
 *
 * @param includeIdentifiersValue header value
 * @param expectingMbi true if expecting a MBI
 * @param includeAddressValues header value
 */
public void assertExistingPatientIncludeIdentifiersExpected(boolean expectingMbi, RequestHeaders requestHeader) {
    List<Object> loadedRecords = ServerTestUtils.get().loadData(Arrays.asList(StaticRifResourceGroup.SAMPLE_A.getResources()));
    Beneficiary beneficiary = loadedRecords.stream().filter(r -> r instanceof Beneficiary).map(r -> (Beneficiary) r).findFirst().get();
    Patient expected = BeneficiaryTransformerV2.transform(PipelineTestUtils.get().getPipelineApplicationState().getMetrics(), beneficiary, requestHeader);
    IGenericClient fhirClient = createFhirClient(requestHeader);
    Patient patient = fhirClient.read().resource(Patient.class).withId(beneficiary.getBeneficiaryId()).execute();
    // Because of how transform doesn't go through R4PatientResourceProvider, `expected` won't have
    // the historical MBI data.
    // Also, SAMPLE_A does not have mbi history (it used to); however, what used to be denoted as
    // historical
    // is not provided as the 'current' MBI identifier (no historical).
    comparePatient(expected, patient);
    /*
     * Ensure the unhashed values for MBI are present.
     */
    Boolean mbiUnhashedPresent = false;
    Iterator<Identifier> identifiers = patient.getIdentifier().iterator();
    while (identifiers.hasNext()) {
        Identifier identifier = identifiers.next();
        if (identifier.getSystem().equals(TransformerConstants.CODING_BBAPI_BENE_ID)) {
            mbiUnhashedPresent = true;
        }
    }
    // Unhashed MBI should always be present in V2
    assertTrue(mbiUnhashedPresent);
}